Women have also borne the brunt of many new pressures of pandemic life, from virtual school and increased responsibilities at home, even as ads and pop culture have continued to validate the idea of drinking to cope: Mommy Juice, Rosé All Day, Wine Down Wednesdays. On top of that, eating disorders and underlying trauma from physical or sexual violence often add fuel to the fire, fanned by social isolation.
"Whether this is early life sexual trauma or they are in a recent or ongoing abusive relationship, we see this link very, very closely," says psychiatrist Dr. Scott Winder, a clinical associate professor at the University of Michigan who treats patients with alcoholic liver disease. "Just the sheer amount of trauma is really, really tragic."
Alcoholic liver disease is complex because it isn't just one thing; it's the physical manifestation with roots in emotional and psychological distress. Successful treatment needs to address both, Winder says, but usually doesn't.
He calls that a "tragic gap" in care. A patient discharged from the hospital with alcoholic liver disease is often motivated to get psychological help but frequently can't find outpatient care until weeks or months later, he says.
"The cultures of hepatology and the cultures of psychology and psychiatry are very disparate; we see patients very differently," so physicians aren't coordinating care, even when they should, he says.