Continued guilt, shame, and internalised stigma correlated to alcohol and other drug use

1. Alcohol (ethanol) enters the body through the oral cavity (i.e., the mouth). The inner surface of the oral cavity is mucosal tissue to keep the cavity lubricated and it is capable of absorbing alcohol into the bloodstream. This absorption is considered “insignificant”.

2. Alcohol flows down the oesophagus to the stomach where 10-20% of ethanol will be absorbed into the bloodstream. Alcohol enters the bloodstream via the mucosal tissue of the stomach wall, and travels straight to the liver. Alcohol can take 5-10 minutes to reach the brain because of the ethanol absorbed via the stomach. If you drink alcohol on an empty stomach, the pyloric sphincter [gateway between the stomach and the small intestine] is going to be more open, and the alcohol is going to immediately enter the small intestine after reaching the stomach. If food is also present in the stomach, the sphincter will open and close at a rate that allows food to enter the small intestine gradually, therefore if alcohol is also in the stomach, it will gradually enter the small intestine.

3. Alcohol flows through the pyloric sphincter into the small intestines where most alcohol absorption occurs. Human intestines are attached the to the posterior abdominal wall by a fold of membrane called the mesentery. Alcohol is absorbed into the mesentery via veins and then travels to the liver.

4. One function of the liver is that it detoxifies toxic elements into non-toxic elements before passing it to the heart and then the rest of the body. The liver sustains considerable “abuse” from a variety of toxic elements and chemicals, and therefore it needs to be capable of full regeneration. NOTE: Many diseases and exposures can harm it beyond the point of repair. These include cancer, hepatitis, certain medication overdoses, and fatty liver disease.

In the liver, ethanol is met with an enzyme called alcohol dehydrogenase and converts ethanol into acetaldehyde [ass-eh-tal-de-hide]. This chemical is more toxic than ethanol, so the liver uses another enzyme to convert acetaldehyde into acetate, which is non-toxic to the human body. NOTE: the amount of alcohol consumed + the timeframe it is consumed [and a variety of other factors] will influence the ability of the liver to effectively convert acetaldehyde all the way into acetate. The liver can’t handle the entire workload effectively therefore ethanol (before being metabolised) will go straight from the liver to the bloodstream and make its way directly to the heart.

NOTE: Genetics will play a role! Certain people do not produce the liver enzymes in enough quantity to properly breakdown ethanol.

5. Blood leaves the liver through the hepatic veins. The hepatic veins carry blood to the inferior vena cava—the largest vein in the body—to the right side of the heart. The heart will beat and send the incoming blood to the lungs to oxygenate and expel carbon dioxide as we breath out. This is how ethanol can be on your breath. Inside the lungs, at the very end of the bronchioles, are hollow air sacs called alveoli where there is a gas exchange. Ethanol evaporates through capillaries into the air sacs and exhaled out of the body. Breathalysers can detect the quantity of ethanol in a person’s system based on the quantity of ethanol in our breath.

6. Not all the ethanol will expel from the body via the breath. The rest will flow back to the heart, with newly oxygenated blood, and then get pumped all the way up to the brain and around the body. NOTE: Ethanol is water soluble. It will be distributed to every cell in the body except bone and fatty tissue [some will enter fat cells but not easily]. Ethanol will interact with every other cell i.e., every organ, gland, nerve, muscle etc.

7. Ethanol will affect and compromise protein synthesis inside muscle tissue. Therefore, if you have been training at the gym, running, swimming etc., your muscles will not effectively be able to repair.

8. Once ethanol has reached the brain, it will cross the blood-brain barrier and begin to affect chemical messengers [neurotransmitters] in the grey matter of the brain. It affects serotonin, dopamine, gamma-amino-butyric-acid (aka GABA), glutamate, endorphins etc. The person will experience pleasure, euphoria, lowered inhibitions [related to dopamine], lowered cognitive ability (e.g., decision making/problem solving, emotion regulation) and lowered coordination and reflexes.

The more ethanol ingested, the more dopamine is secreted and communicated between neurons (i.e., nerve cells). One of dopamine’s functions is to make you feel pleasure or ‘rewarded’ for doing things that are good for humans, hence, from an evolutionary perspective, we are likely to do them again to help us thrive in our environment and social world. Dopamine is secreted when we:

• eat healthy foods (but also recently developed processed foods that are high in sugar and salt)
• exercise
• achieve goals
• be productive (e.g., finish a task like cleaning, cooking, work-related tasks)
• master new skills (e.g., learning an instrument or a new talent), and
• have positive and stimulating social interactions

Ethanol influences so much dopamine secretion and communication that the brain becomes unable to make responsible decisions cognitively. The simultaneous experience of euphoria and lowered cognitive ability means we are more likely to be “happy” about making irresponsible decisions.

Increased dopamine is how drinking alcohol “blocks” unpleasant emotions like fear, stress, anxiety, and insecurity. When we don’t feel these unpleasant, yet necessary, emotions we will behave in ways that are dangerous, abnormal, potentially embarrassing, and generally problematic.

Another significant brain region affected by ethanol is the hypothalamus and the pituitary glad [together known as the hypothalamic-pituitary axis]. These structures control the entire hormonal system. The hypothalamus monitors the body, and it will send instructions to the pituitary gland based on information it receives from the hypothalamus. The hypothalamus is aware that ethanol is flooding the brain and it starts adjusting the secretion of hormones via the pituitary gland.

One of the instructions it gives the pituitary gland is to start modulating the adrenal glands to secrete cortisol (i.e., stress hormone) and epinephrine and norepinephrine (i.e., adrenaline).

Now, our cognitive capacity is diminished, inhibitions are lowered, and we will experience a rush of stress hormones and adrenaline coursing through the body. Cortisol and adrenaline will provide a boost of energy. It will increase the heart rate, blood pressure, body sweat, sugar levels in the bloodstream, and enhances the brain’s ability to use glucose. Glucose is a “fuel” source for brain functioning, including the generation of neurotransmitters. Behaviourally, we can see this in children when we say they are “hyperactive” because they’ve ingested too much sugar.

The pituitary gland will also slow the secretion of anti-diuretic hormone (aka. vasopressin). A diuretic is something that makes us urinate. If the anti-diuretic hormone (also called vasopressin) slows down, then we won’t be “holding on” to water as effectively, hence we begin to urinate more. People call this “breaking the seal”.

9. South of the body, blood is pumped into the kidneys via the renal artery which spreads through the renal cortex. The blood is then filtered into urine and expelled from the body. The lowered anti-diuretic hormone will dilate (become wider/bigger or more open) blood vessels in the kidneys which means more blood gets passed through and filtered, but it also means we lose a lot more body water which leads to dehydration. Vasopressin is essential in the control of osmotic balance, blood pressure regulations, and kidney function, therefore, when vasopressin is lowered, we are losing essential water and minerals/electrolytes. Electrolytes are involved in urination because the kidneys need them to make the process of filtering blood more efficient.

The loss of water and electrolytes will contribute to a hangover. Electrolytes play a role in cellular water absorption so if we are losing more water than we are bringing in, and we are losing the electrolytes that support the absorption of water, we become dehydrated very quickly.

10. The Hangover

Symptoms: nausea, fatigue, diarrhoea, vomiting, paranoia, anxiety, anorexia (i.e., loss of appetite), increased thirst, muscle weakness, irritability, sweating, increased blood pressure, and headache.

The exact cause of a “hangover” is not yet known however variables affecting the hangover are:

• individual differences such as sex, size, body fat, genetics etc
• lack of sleep
• general health
• drinking behaviour e.g., frequency, duration, quantity
• food intake before and during
• water intake before and after
• your body’s ability to metabolise alcohol i.e., excessive amounts of acetaldehyde due to fewer enzymes to metabolise alcohol in the liver before entering the bloodstream
• general behaviour while drinking e.g., poly-substance use, dancing, sexual activity, risk-taking behaviours etc.

Strategies for Controlled Drinking

• Setting personal drinking limits and sticking to it
• Alternating alcoholic drinks with soft drinks i.e., one alcoholic drink then a water, soft drink, or juice
• Have a meal before drinking
• Switching to low alcohol drinks
• Having regular alcohol-free days/weeks/months
• Identifying high risk situations for heavy drinking and creating a management plan

Engaging in alternative activities to drinking

Supporting someone who’s having thoughts of suicide is one of the most important, and at times most challenging, parts of a support persons role. People who experience suicidality can vary from passing ideas to serious planning and often come from a place of deep emotional pain. We all have a duty to respond with care, compassion, and an attempt to understand the experience in a way that keeps safety at the heart of every conversation.

Firstly, if you or someone you know is having thoughts of suicide, please know that you’re not broken or beyond help. These thoughts often come when emotional pain feels unbearable and we can’t see a way out. But things can shift, and help is available. We may spend much of our time alone, and we can feel alone even in a crowded room, but you are not alone in this. Suicidality is not uncommon.

The Numbers Today

According to the latest figures (ABS, 2023):

Suicide is the leading cause of death for Australians aged 15 to 44.

In 2022, over 3,100 people died by suicide—about 8.6 deaths each day.

Men account for 75% of those deaths, though women attempt suicide more often (but less often fatally).

According to the Black Dog Institute, roughly 65,000 Australians attempt suicide each year, while around 3,200 die by suicide annually.

Rates among Aboriginal and Torres Strait Islander peoples are more than double the national average.

People living in rural and remote areas face higher suicide risks due to isolation, limited services, and other pressures.

Why Does the Mind Think About Suicide?

From a humanistic psychology point of view, suicidal thoughts are not signs of illness or failure, they are a deep emotional signal that something in your life or environment needs care, change, or healing.

Each person and living creature on the planet are inherently worthy, with an innate drive to survive, grow, connect, and for humans, find meaning. When life feels full of suffering, such as grief, isolation, trauma, shame, or hopelessness, the mind may start to believe that death is the only way to stop the pain.

In this view, suicidal thoughts are often not about wanting to die—but about wanting the pain to stop.

They arise when:

You feel disconnected from others or from yourself.

You feel stuck in circumstances that seem unchangeable.

You believe your worth or purpose has been lost.

You’re exhausted from holding on or pretending you’re okay.

But the humanistic perspective also holds this powerful truth: you are more than your pain, and within you is a capacity for healing, choice, and change, even if it doesn’t feel like it right now.

Treat Yourself with Compassion, Not Criticism

It’s easy to get caught in a spiral of self-blame. But you are not weak or selfish. You are a human being who is hurting—and just like you wouldn’t shame someone for being in physical pain, you deserve the same care when your pain is emotional.

Ask yourself:

If someone I loved felt this way, what would I want them to know?

Then try to offer yourself the same kindness.

Reach Out – Connection Saves Lives

Talking to someone can ease the intensity of what you’re feeling. You don’t have to explain everything. Just saying, “I’m not okay right now,” is enough to start.

Lifeline 13 11 14

Beyond Blue 1300 22 4636

Suicide Call Back Service: 1300 659 467

Beyond Blue: 1300 22 4636

13YARN (Support for Aboriginal and Torres Strait Islander Peoples): 13 92 76

QLife – National LGBTQIA+ Peer Support and Referral Service: 1800 184 527

Hours: 3pm – Midnight (local time), every day

What they offer: Confidential, non-judgemental, and inclusive support from trained LGBTQIA+ peer workers. They are not a crisis line like Lifeline, but they can support people in distress and connect you with further help if you’re at risk.

How Counselling Can Help: Evidence-Based Approaches

Counsellors and Psychologists don’t rely on guesswork when helping someone who’s feeling suicidal. They use researched strategies to support recovery. Here are a few key approaches:

Collaborative Assessment and Management of Suicidality (CAMS): This method focuses on working together with the person in distress, rather than telling them what to do. It aims reduce suicidal thoughts more effectively than traditional therapy.

Cognitive Behavioural Therapy for Suicide Prevention (CBT-SP): This version of CBT focuses specifically on managing suicidal thoughts by teaching problem-solving and positive thinking strategies.

Dialectical Behaviour Therapy (DBT): Originally designed for people with intense emotions or borderline personality disorder, DBT is now widely used to reduce suicide risk by teaching emotional regulation, mindfulness, and better relationship skills.

Safety Planning: This involves creating a personalised plan for what someone can do when they feel at risk, including who to call, calming strategies, and safe places to go.

Means Restriction Counselling: This involves helping someone reduce their access to anything they might use to harm themselves, like certain medications or weapons, done through sensitive, respectful conversations.

Barriers to Speaking Up

Even with growing public awareness, there’s still a strong stigma around suicide. Many people worry they’ll be judged, locked up, or shamed if they admit they’re struggling. These fears can stop people from reaching out for help, which is why creating a safe, non-judgmental space is so important in counselling.

Rural and Remote Communities

People in regional and remote parts of Australia often find it harder to access mental health support. Telehealth (online or phone sessions) has helped bridge that gap, but it’s not always easy to pick up on non-verbal cues or respond to crises from a distance.

Cultural Awareness Matters

For Aboriginal and Torres Strait Islander peoples, suicide cannot be separated from the impacts of colonisation, loss of culture, and ongoing trauma. Culturally safe, community-led solutions are essential and more effective in these contexts.

Remember That Feelings Change—Even the Darkest Ones

It may not feel like it right now, but these feelings will pass. Emotions are like waves—sometimes crashing, sometimes calm—but never permanent.

What you feel today is not a life sentence. With support and time, things can change. You deserve the chance to see what healing and hope feel like.

Safe Haven NSW Services (for suicidal distress, NOT EDs)

Please check official websites for update information re contact information, hours of operation, and status of operation i.e., still operating. The information on this website has been collected June 2025.

Safe Havens are calm, non-clinical spaces where you can talk with peer workers and mental health clinicians if you’re in emotional crisis — no appointment needed.

No police or emergency involvement unless requested or necessary.

Warm, trauma-informed and recovery-focused.

🔗Find your local Safe Haven: nsw.gov.au/mental-health-initiatives/safe-haven

Examples:

Safe Haven locations across NSW — these are welcoming, non-clinical places where anyone feeling suicidal or in deep distress can drop in and speak to peer workers or mental health clinicians. No appointment, referral, or Medicare card needed. Visit the following for operating hours and locations across NSW: Safe Haven

Regional & Metro Locations

Campbelltown / Ambarvale (SWSLHD)

Address: 80 Woodhouse Drive, Ambarvale (Campbelltown area)

Open Mon, Fri, Sat, Sun 2 – 9 pm

Phone: 0457 093 109 during hours swslhd.health.nsw.gov.au

North Ryde (Macquarie Hospital)

For youth aged 12–17 (sometimes to 18 if still at school)

Open daily 4 – 8 pm and public holidays nslhd.health.nsw.gov.au

Parramatta / Westmead

Drop-in at 26 Grand Ave, Westmead

Open Sun–Wed 3:30 – 9:30 pm

Phone: 0436 377 113

Bega Safe Haven, Bega, NSW, Australia, Supports 14 + in a calm, welcoming space.

Broken Hill Safe Haven, Broken Hill, NSW, Australia, Supports 17 + with peer and clinician support 

Brookvale Safe Haven, Brookvale, NSW, Australia, High‑school aged young people support

Darlinghurst Safe Haven,

Darlinghurst, NSW, Australia, 16 + LGBTQIA+ inclusive spot at St Vincent’s

St Vincent’s O’Brien Centre, 390 Victoria Street, Darlinghurst NSW 2010

Hours: Monday: closed, Tuesday: closed, Wednesday: 5:00pm – 8:30pm​, Thursday: 5:00pm – 8:30pm, Friday: 5:00pm – 8:30pm, Saturday: 12:00pm – 4:00pm, Sunday: 12:00pm – 4:00pm​.

Gosford Safe Haven, General adult Safe Haven

Corner of Ambulance Road and Holden Street, Gosford NSW 2250

Hours: Monday: 9:00am – 4:30pm, Tuesday: 9:00am – 4:30pm, Wednesday: 9:00am – 4:30pm, Thursday: 9:00am – 4:30pm, Friday: 9:00am – 4:30pm, Saturday: closed, Sunday: closed, Closed on public holidays​

Phone: (02) 4394 1597​​

Kogarah Safe Haven, Kogarah, NSW, Australia,16 + adults,

U2/15 Kensington St, Kogarah NSW 2217

Phone: (02) 9113 2981

The function of anger is to protect vulnerability and neutralize threat.

The threat humans cognitively perceive is almost always to the ego i.e., how we want to think of ourselves and have others think of us. Anger neutralizes ego-threat by devaluing, demeaning, or undermining the “power” of the person perceived to be threatening. Humans get angry when they don’t get what they want, when they’re disrespected, or when they perceive something is unjust/unfair. Anger, the emotion, is a chemical messenger. It communicates to us, to others, and motivates us to act, speak, do something. Healthy responses to anger include being assertive, feeling empowered, protecting ourselves and love ones from ACTUAL threat, setting boundaries with others, and making social change for justice (for example). It becomes unhealthy when we become passive-aggressive, violent, vengeful, spiteful, aggressive, resentful, sarcastic, “moody”, rude etc.

Receive the message and respond from a wise, calm place after the intensity of the emotion has past. Sometimes we have to act in the moment. Our ancestors may have required this for fight/flight survival. These days, we can generally PAUSE and calm the self before responding from a mindful and compassionate heart and mind. Remember: Hurt people, hurt people.