I am in my twenties, with a decent job, a loving boyfriend and great family and friends, but I feel an overwhelming inadequacy and a constant void I can't seem to fill. Believe me, I've tried, with food, alcohol and shopping (to the point of having debts I can barely manage), but nothing seems to work. I'm verging on a serious eating disorder and have little control over alcohol. My doctor prescribed Prozac, which helps a bit, but it doesn't stop the uncontrollable urges to shop, eat to excess or drink to the point where I have no recollection of the night before. I have become needy and paranoid about my boyfriend's past relationships, despite his constant reassurance and love. He is moving abroad soon for work (he has no choice) and I am beside myself, wondering how I will cope. All I want is to feel normal, enjoy my relationship and be happy enough to be able to go out with friends without needing to drink to feel secure and relaxed. I am exhausted by the constant struggle and don't know where to turn. I have never actively considered suicide, but I feel so out of control that I am worried I may actually act on it.
That feeling of being out of control is called addiction. What you describe as a constant void you can't fill is what addicts call the "hole in the soul". Eating to excess is a good example. We literally stuff ourselves with food to try and fill the emptiness, but it's an impossible task because the hole we are trying to fill is emotional, not physical.
Addiction is a complex disorder, but at its heart are feelings of inadequacy and low self-worth. It's not simply about drinking or eating too much, it's a desperate attempt to change the way we feel. In others words, addictions are the messages, not the messenger. The messenger is a tangle of emotions that seems so impossible to sort out that we feel the only way to deal with them is to club them into submission, whether it's by using alcohol, food or shopping. It might make us feel better temporarily, but that sense of relief is so fleeting, we eat or drink or shop more and more.
You are not only trying to deal with feelings of inadequacy and powerlessness, you are also facing a paralysing sense of guilt and shame - about the empty bottles, the wrappers of family-sized packets of biscuits, the wardrobe full of clothes you'll probably never wear, the mounting debt you can't control. You feel too ashamed to tell anybody, so on top of emptiness and shame comes a crippling sense of loneliness and isolation.
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Prozac and other prescription drugs don't work (despite what many doctors seem to think) because they address an imbalance of chemicals in your head rather than a mess of emotions in your heart. You are also suffering from what is known as cross-addiction. This means that you try using one thing to make yourself feel better, and when that doesn't work, you try another, and then another. Eventually, you become so desperate that you use everything and anything to try and fill that void.
Addicts often feel suicidal because they feel so out of control and don't know where to turn for help. However much they crave a happy, peaceful life, they can't seem to reach it. When it gets really bad, suicide seems the only way out. I promise you're not the only one who feels that way. I understand how lonely and overwhelmed you feel, but there are thousands of people struggling in just the way you are. Every day, in every city around the world, people are sitting in 12 Step meetings, describing every emotion you've ever felt. For many people, hearing others talk openly and honestly about their feelings is like a thunderbolt. "How does she know?" they say, or, "He's talking about me."
Those meetings are known as fellowships because that's exactly what they provide: fellowship, mutual support, empathy and understanding. They help lift that terrible sense of loneliness and shame. It's hard to know from your letter what your primary addiction is (it's chicken and egg), so I would love to suggest you start by going into a rehab centre for four weeks to get you on the road to recovery. Twenty-eight days of expert help would give you the chance to sort things out - not only your addictions, but the emotions that trigger them. Sadly, rehab centres are incredibly expensive, and with your debts that's obviously not an option.
There is, however, another way, and it costs nothing. If you're dealing with a serious eating disorder and have no control over alcohol, there are two fellowships you might try. One is Alcoholics Anonymous (AA) and the other is Overeaters Anonymous (OA). Many women suffer with both food and alcohol addictions, so they attend both, and that's what I suggest you do. I know that walking into a room full of strangers seems terrifying, but there will be people there to welcome you. Even if you take nothing else away from my answer, please remember this: you are not alone.
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alcoholics-anonymous.org.uk; oagb.org.uk. Healing the Shame That Binds You by John Bradshaw (£10.99 Health Communications)
If you have a relationship question for Sally, e-mail sally.brampton@sunday-times.co.uk. In case of publication, names will be withheld. We're sorry, but Sally cannot answer letters personally