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Is there an alcoholic in your life? We don’t often talk about the people whose lives have been affected by someone else’s drinking – but the impact on loved ones, family and partners can be immense. For Alcohol Change UK – the charity behind Alcohol Awareness Week (July 3-9) – it is important that loved ones of alcoholics know they are not alone. According to a new survey commissioned by the charity – which is not anti-alcohol but working towards ‘alcohol change’ and to reduce the harm it causes – some 19% of drinkers consider alcohol to be an “essential” in their shopping basket, with 15% of people worried about the amount of alcohol someone in their household has been drinking. “Far too many lives are tragically cut short each year due to alcohol, with the latest figures on the number of alcohol-specific deaths at a record high. At the moment, 600,000 people in the UK could benefit from alcohol treatment but the vast majority are not receiving it,” said Andrew Misell, Director for Wales at Alcohol Change UK. “It can be heart-breaking to see someone close to you struggle with alcohol problems. But it is not only the drinker who is affected – their loved ones can feel the effects too. The pressures of caring for someone who is drinking heavily can be overwhelming,” Misell adds. “But by encouraging them to seek support, you can really improve their health and yours.” Is somebody close to you an alcoholic? Here are some key pieces of advice that may be helpful… Visit your GP Seeing your GP could help you address any anxiety you may be grappling with. They can offer professional and nuanced advice that will help you communicate how you really feel to a loved one who needs to stop drinking, and steer you towards your own mental health support if necessary. “Living with someone who is struggling with an alcohol problem can be exhausting. You will want to do the best you can for your loved one, but your relationship with them is bound to be strained. You may no longer feel able to trust them,” Misell said. “They may well be neglecting family duties, and their moods may swing erratically. It’s important you find some time and space for yourself and for your own concerns and interests.” Also, anyone is allowed to contact the GP or safeguarding anonymously if, for instance, there is a parent with alcoholism looking after young children. Reach out to family support services Whatever your relationship with the person with an alcohol problem, other people will have had, or be having, similar experiences. Connecting with them at one of the many family support services across the country can be really helpful. “It may be worth you seeking out support from a families’ organisation like Adfam or Al-Anon, where you’ll be able to connect with others who are in the same boat as you,” Misell said. Bottled Up, meanwhile, offers information and advice for family members living with someone who is alcohol-dependent. The founders of the organisation are a therapist and a psychologist who have direct experience with alcoholism. Al-Anon provides free meetings where the family and friends of alcoholics can listen to the shared experiences of those in a similar positions. Al-Anon also has a separate arm for children aged between 12-17 called Alateen, where teenagers can share their experiences and find support, while also learning about the nature of the illness. Think about the four aspects of their health Before sitting down to talk about what is going on with a family member who is drinking too much, it might be a good idea to be prepared about what you need to say. This could be a helpful step in deciding what actions to take in order to seek help, too. Dr Niall Campbell, Priory consultant psychiatrist and addictions expert, based at Priory Hospital in Roehampton, southwest London, suggests thinking about these four aspects of their health first: physical health, mental health, relationship health and their work health. “Are they falling over? Have they injured themselves? Have they been drinking to the point of amnesia? Blackouts? Are they hungover and sick in the morning? Have they gone to see their GP? Some results, such as high blood pressure, could be a good indicator,” Campbell said. “And then mentally, is it making them depressed? Are they irritable? Do they seem ashamed or guilty? Is their drinking adversely affecting relationships between a husband and wives, siblings, children, and parents? “When it comes to their work, are they missing it? Are they late going into the office and saying they can’t do their job properly because they’re drinking at home? This is a big problem since the lockdown.” He suggests doing this with a third party that’s already aware of the situation, so you can pull together more concrete examples. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live The history of royal fashion at Wimbledon How to be waterwise in your garden this summer Every Barbie-inspired outfit Margot Robbie has worn so far

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Despite increasing public awareness of endometriosis, with celebrity figureheads including Lena Dunham and Molly Mae, the condition’s ‘evil twin sister’, adenomyosis, remains neglected. While the NHS has an entire webpage which explains what endometriosis is, there is currently no equivalent for its sister condition. Read on for five things you should know. It’s not the same as endometriosis Both endometriosis and adenomyosis occur when the lining of the uterus (known as the endometrium) grows out of place, but there are major differences between the two. In endometriosis, the rogue tissue invades areas outside of the uterus. While the extent of the growth varies from patient to patient, it can affect areas such as the bladder, bowel, ovaries, and even the lungs. Adenomyosis, on the other hand, causes the rogue tissue to bury inside the muscular wall of the uterus. It’s possible to suffer from both conditions at the same time. Symptoms include bloating, heavy periods, and pelvic pain Thanks to the invasive endometrial growth, adenomyosis is characterised by an enlarged uterus. During menstruation, the embedded tissue swells and bleeds, typically causing a variety of symptoms (although some women are asymptomatic). According to a patient leaflet published by University College Hospital, sufferers commonly have painful and irregular periods, with more than half experiencing heavy bleeding. Chronic pre-menstrual pain, and feelings of heaviness and discomfort in the pelvis are among other possible symptoms. Less frequently, adenomyosis can cause bloating, pain during intercourse, and pain related to bowel movements. All symptoms should stop after the menopause. It affects 1 in 10 women The condition is believed to affect 10 per cent of women in the UK. That makes it just as prevalent as endometriosis, although it’s more common in women between the ages of 40-50, and those who have been pregnant before. While the cause of the condition is not known, UCH says that “genetics and some hormones may play a role”. In terms of long-term effects, the North Bristol NHS trust says that adenomyosis does not appear to decrease the chance of pregnancy, however it has been linked to an increased risk of miscarriage and premature birth. Treatment options are limited For women with mild symptoms, trying to get pregnant, or nearing menopause, the North Bristol trust says that treatment may not be necessary, but for those seeking relief from symptoms, it recommends medication to reduce pain and bleeding, and hormonal interventions such as the contraceptive pill. The only “cure” is a surgical procedure involving the removal of the womb (hysterectomy), although this is a last resort intervention. The Bristol-based trust also offers an alternative surgery which involves blocking the blood supply to the endometrial growth, forcing it to shrink, but neither procedure is advisable for women who want to get pregnant in the future. It can take years to diagnose The condition is typically diagnosed using MRI and ultrasound scans, but the NHS says that adenomyosis can take “a long time, even years, to diagnose” because “symptoms and severity can vary between women”. The frequent dismissal of women’s gynaecological symptoms means that signs of adenomyosis may be conflated with ‘normal’ menstruation, or even other conditions such as endometriosis. Anecdotal reports of sufferers suggest that misdiagnosis is common. Gabrielle Union, one of the only celebrities to have publicly identified as having the condition, suspects her condition went undiagnosed for years. Speaking at a conference in 2019, Union explained: “The gag is I had [adenomyosis] in my early twenties, and instead of someone diagnosing me they were like ‘Oh you have periods that last nine or 10 days and you’re bleeding through overnight pads? Not a mere inconvenience... perhaps there’s something more there.’” Earlier this year, the charity Tommy’s reported that the condition might be “underdiagnosed” after a review of existing studies found that “mild” cases could be missed by clinicians using current diagnostic methods. “There should be training for clinicians and sonographers to diagnose adenomyosis using a standardised criteria,” said Dr Ishita Mishra, leader of the review. “Being able to identify this condition using a uniform set of criteria would then help give us a true picture of the numbers affected, and better understanding of the impact of this condition,” Mishra explained. If you have any health concerns, you should always contact your GP in the first instance. There is also information available via NHS Scotland or Endometriosis UK. Read More Lena Dunham marks five years of sobriety: ‘Happiest of my time on earth’ ‘Some days things just do not work’: What happens when your smear test doesn’t go smoothly? Woman’s warning after terminal cancer mistaken for heavy periods 5 things you need to know about adenomyosis, the ‘evil twin sister’ of endometriosis Woman’s warning after lip filler left her unable to close mouth ‘Suddenly, I saw Dad again’: The radical tech helping those living with dementia

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