Leslie Glass's Blog, page 321

Can Stimulating The Brain Treat Chronic Pain?

From Science Daily:

For the first time, researchers at the UNC School of Medicine showed they could target one brain region with a weak alternating current of electricity, enhance the naturally occurring brain rhythms of that region, and significantly decrease symptoms associated with chronic lower back pain.

The results, published in the Journal of Pain and presented at the Society for Neuroscience conference in San Diego this week, suggest that doctors could one day target parts of the brain with new noninvasive treatment strategies, such as transcranial alternating current stimulation, or tACS, which researchers used in this study to boost the naturally occurring brain waves they theorized were important for the treatment of chronic pain.

“We’ve published numerous brain stimulation papers over several years, and we always learn something important,” said senior author Flavio Frohlich, PhD, director of the Carolina Center for Neurostimulation and associate professor of psychiatry. “But this is the first time we’ve studied chronic pain, and this is the only time all three elements of a study lined up perfectly. We successfully targeted a specific brain region, we enhanced or restored that region’s activity, and we correlated that enhancement with a significant decrease in symptoms.”

Co-first author Julianna Prim, a graduate student mentored by Karen McCulloch, PT, PhD, in the Department of Allied Health Sciences at the UNC School of Medicine, who works closely with Frohlich’s lab, said, “If brain stimulation can help people with chronic pain, it would be a cheap, non-invasive therapy that could reduce the burden of opioids, which we all know can have severe side effects.”

Chronic pain is the leading cause of disability in the world, but there is not consensus among scientists that brain activity plays a causal role in the condition. Frohlich says the pain research field has focused largely on peripheral causes of chronic pain. For example, if you have chronic lower back pain, then the cause and solution lie in the lower back and related parts of the nervous system in the spine. But some researchers and clinicians believe chronic pain runs deeper, that the condition can reorganize how cells in the nervous system communicate with each other, including networks of neurons in the brain. Over time, the theory goes, these networks get stuck in a kind of neural rut, essentially becoming a cause of chronic pain.

Previous studies showed that people with chronic pain experience abnormal neural oscillations, or brain waves. There are several kinds of brain waves related to different brain regions and various kinds of brain activities — processing visual stimuli, memorization, creative thinking, etc. When we speak, think, eat, play sports, watch television, daydream, or sleep, our brain activity creates electrical patterns researchers can measure using electroencephalograms, or EEGs. These patterns fluctuate or oscillate, which is why they appear as waves that rise and fall on an EEG printout.

One type of brain activity is called alpha oscillations, which occur when we are not taking in stimuli. When we meditate in silence, daydream in the shower, or even when we’re “in the zone” during athletic activity, alpha oscillations dominate the brain. Frohlich’s lab wanted to know if these alpha oscillations were deficient in the somatosensory cortex, located in the middle portion of the brain and likely involved in chronic pain. If so, then could Frohlich’s team enhance the alpha waves there? And if that were possible, would there be any pain relief?

Prim and colleagues recruited 20 patients with lower chronic back pain. Each of them reported back pain as “four” or greater for at least six months on the subjective scale of one to 10. Each participant volunteered for two 40-minute sessions that took place one to three weeks apart.

During all sessions, researchers attached an array of electrodes to the scalps of patients. During one session, researchers targeted the somatosensory cortex using tACS to enhance the naturally occurring alpha waves. During another session for all participants, researchers used a similar weak electrical current that was not targeted — this was a sham or placebo stimulation session. During all sessions, participants felt tingling on their scalp. They could not tell the difference between the sham and tACS sessions. Also, the researchers in charge of analyzing the data did not know when each participant underwent the sham or tACS sessions, making this study double-blinded.

Co-first author Sangtae Ahn, PhD, a postdoc in Frohlich’s lab, analyzed the data, which showed that Frohlich’s team could indeed successfully target and enhance alpha oscillations in the somatosensory cortex of people with chronic lower back pain. When Prim and colleagues surveyed the participants, all of them reported a significant reduction in pain immediately following the tACS sessions, according to the subjective 0-10 pain scale. Remarkably, some participants reported feeling no pain after the tACS sessions. Participants did not report the same pain reduction after the sham stimulation sessions.

“The exciting thing is that these results occurred after just one session,” Prim said. “We hope to conduct a larger study to discover the effects of multiple tACS sessions over a longer time period.”

Frohlich said his lab also hopes to conduct studies on people with various kinds of chronic pain.

“This study is a perfect example of what’s possible when scientists and clinicians collaborate,” he said. “Ultimately, if we want to develop better treatments, cures, and prevention strategies, then these sorts of new approaches that bring researchers together are of fundamental importance.”

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Six Tips For Addiction Treatment Success

Addiction treatment success can be tricky. While going away to rehab is the first step in the recovery journey for millions of people, it is not the only path to recovery. In patient treatment is just one option. In addition, 30, 60, and even 90-day stays are not adequate to heal the brain, learn new habits, and insure long term recovery success. Medically assisted treatment, counseling over a period of years, intensive out patient treatment, being under the care of psychologists, addiction professionals, and psychiatrists  may also be required. Each recovery journey is different. What remains constant are the following 6 tips that apply to all forms of treatment. Here are some addiction facts you should know that reinforce how crucial it is to follow through and get help as quickly as possible.

Statistics show that 23.5 million Americans have a drug or alcohol problem.
Every day more that 5,000 emergency room visits are attributed to substance use.
144 people perish every day from drug overdoses.
Only 11.2% or 2.1 million people receive help, or 1 in 9 people

The statistics for getting help should be a lot higher. Everybody deserves to be treated. Here are six tips to insure your treatment is effective no matter what treatment option you choose.

1. Follow All Of The Rules

Make sure that you follow all the rules whatever your program is. Your goal is to get better, and you’re not there to see what you can get away with. Focus your energies on getting better, and don’t do anything that could get you kicked out.

2. Listen To The Professionals

A person who goes into treatment must follow the advice of their counselors. The counselors treating you are professionals and they have dealt with many people in your situation. These counselors are experts and following their advice will help speed up your recovery.

3. Ask Questions If You Are Not Sure What To Do

Going into any kind of treatment can be a new and stressful experience. Always ask questions on anything that you are not familiar with to help make your experience more pleasant. The people treating you are there to answer your questions. There is no such thing as a dumb question so don’t feel hesitant to get the answers to your questions related to your recovery experience.

4. Don’t Assume Anything

Many people think they know what to expect when they go into treatment or to a rehab from what they have heard from others. It is very important not to assume anything. Each situation is a new experience, and don’t assume that your previous recovery experiences will be repeated. Things change all of the time so if in doubt about what’s happening, ask!

5. Write Down The Advice Given To You

When talking to the addiction counselors, it is impossible to remember every detail of the advice given to you. Most people forget what counselors say after a day or so. Talking to these experts can provide valuable advice on how to deal with your fears and anxieties, and you don’t want to forget what you were told. Always write down the advice given to you by the doctors and staff.

6. Follow The Program

Many rehab and sober living facilities offer addiction programs in the mornings, afternoons, and at night. Make sure you attend most of these daily programs. The purpose of the programs is to educate you in finding the right way of overcoming your fears and changing your habits. If you decide to sleep in or decide to just skip the programs all together you could miss valuable information and delay the recovery process.

6 Tips provided by Guest Blogger Stan Popovich

Stan is the author of a popular managing fear book, “A Layman’s Guide To Managing Fear.” Stan’s book has received over 400 book reviews and offers a lot of free mental health advice on his website. For more information and some more helpful advice, visit Stan’s website at www.managingfear.com

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Honoring Our Veterans Who Have PTSD

From Diana Raab Ph.D. @ Psychology Today: It’s now a well-known fact that more U.S. veterans die from suicide than in combat. Post-traumatic stress disorder (PTSD) is prevalent in many sectors of the population, but we most often hear it talked about when it comes to veterans.

After being exposed to traumatic events such as war, there are two typical responses to save oneself from the situation—fight or flight and immobilization. In fight or flight, typically the central nervous system becomes vamped up, and heart rate and blood pressure increase. It’s a temporary situation. When the danger passes, the central nervous system returns to normal. The second response, immobilization, is longer lasting—the body becomes stuck as a result of long-lasting stressors and is unable to return to normal functioning. The latter incidence is what happens during PTSD episodes.

Not all vets succumb to PTSD, but those who do are left with lifelong challenges. Whether you believe in war or not, the issue of PTSD among vets is a real one. The degree of PTSD among veterans varies and often depends on where the person was stationed. While the Department of Veterans Affairs claims that only 31 percent of vets suffer from PTSD, this seems rather low. There might be many other cases that remain undocumented, so the percentage could be much higher.

PTSD is an anxiety disorder that can occur after any traumatic event. For the most part, those with the condition have been involved in situations where they felt as if their lives were in danger. After the experience, they may be fearful, angry, and/or confused because they’ve witnessed or endured horrible things. Subsequently, they may feel a loss of control regarding their situations. It’s common that future events can result in a retriggering or a reliving of their lived traumas. This retriggering can be brought on by sounds, smells, or sights that remind them of the initial occurrences.

When in direct contact with vets suffering from PTSD, one might notice that they seem hyperaroused, are subject to intrusive thoughts, experience flashbacks, have nightmares, and are overwhelmed with negativity. Someone with PTSD might have difficulty with decision-making, communication, and the ability to trust others, which can present challenges when it comes to forming and maintaining interpersonal relationships.

As a baby boomer, I’ve known a few friends who suffered from PTSD and who were easily triggered by events in their lives. Sometimes just the thought of Veterans Day can be a triggering event, or even the whirring sounds of helicopters and/or hearing about conflicts in the news.

The length of time an individual experiences PTSD varies from person to person and is dependent on personality, genetics, and the particular trauma involved. As with most mental illnesses, there’s no cure for PTSD, but it can be managed with psychotherapy and medications. Some studies say that it doesn’t last forever, while others claim that it’s a lifelong condition. If the person has had multiple traumas, there’s less of a chance that it will go away. It also depends on someone’s individual coping skills.

If you or someone you know is experiencing post-combat PTSD, here are some important things to consider:

Try to avoid emotional triggers that can set off an episode.
Engage in daily exercise. This is important because it burns off the adrenaline that accompanies PTSD symptoms and also helps to increase endorphins.
Mindfulness/breathing exercises are especially useful—that is, where someone slows down and focuses on every breath and movement. Also, sometimes tapping someone’s arms brings the person back into the present moment.
Refrain from social isolation. Form connections with positive, trusted individuals.
Remember that taking care of both the body and mind is essential, especially through techniques such as meditation, yoga, and massage.
Eat a healthy diet that includes Omega-3s, which help foster emotional health.
Get adequate sleep—aim for seven to eight hours each night.

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What It’s Like To Have PTSD: A Vietnam Vet’s Struggle

What does PTSD in veterans really look like? Here’s one man’s story. John served as a combat officer in Vietnam.  John was a friendly, interesting individual, but he was unable to work because of his  extreme PTSD symptoms. He also lost all of his family’s support. John has alcohol use disorder as well.

John directly experienced destruction, death, and horror in combat. But he refused to talk about those experiences. He boiled them down to one simple phrase: they were horrible. In tears, he told me, “Carol, I like you too much to tell you about the things I saw, and worse, the things I did during battle. I did horrible things to people.”

No matter how often I reassured him I could handle anything he would tell me, he was unable to discuss these atrocities. John lived with these ongoing flashbacks throughout the day and was terrorized nightmares. He was always “on guard,” waiting for the next battle. John also suffered from day-mares, where these flashbacks took on the intensity of nightmares, although he was wide awake. He felt he was actually in combat and was not in the here-and-now reality of being safe back in his hometown. Other times he would dissociate by leaving his body and being a viewer of the horrors.

John’s PTSD symptoms fall into these four categories:

1. Denial

Although he was coming for counseling, he refused to examine the trauma. Avoidance is often a part of PTSD.  It allows the person to try to stop any reminders or situations that bring back the distressing events. Unfortunately, by not addressing the PTSD, John continued to have severe trauma responses. Sadly, his responses may have been lessened through therapy. This led to psychic numbing where he struggled to feel attachment to others or to life in general.

2. Anger

John had intense anger outbursts and hyper-vigilance regarding everyone and everything surrounding him. By being constantly on guard, he was never able to relax.  Everything was a threat. He also had an intense startle response. On day, I ran across John and his inpatient psychiatric social worker taking a wake outside. For some reason, when I came up behind them, I called his name and touched him on the shoulder. He whirled around and was ready to hit me until he saw who I was. I apologized profusely and he was upset that he nearly struck me. I tried consoling him with the fact that it was my fault, but he couldn’t be consoled.

3. Noise

Like many others, John struggled with loud noises. Unfortunately in his home town, the Blue Angels participate an annual, four-day long festival. Every year during the festival, John “hits the deck” and re-enacts being back in combat while these exceptionally loud military planes flew overhead. For John and other vets, this demonstration of military prowess brings back some of the worst symptoms of the PTSD. Every year, he is terrorized by reliving Vietnam for four days.

4. Addiction

Another common aspect of PTSD is self-destructive behavior. John’s PTSD is so intense that he uses alcohol to try to cope. John is an alcoholic and was never able to stay sober although he tried. Tragically, like many veterans, John died from a combination of his mental health issues, not complying with taking his psychiatric meds (so he could drink), and his alcoholism. John drank himself to death in a slow suicide. What a tremendous loss. Here was someone who fought for his country but was terminally affected by this duty.

John Isn’t Alone – Thousands Have PTSD

For thousands of other veterans, this story is all too familiar for PTSD is a horrible, difficult mental illness to overcome and alcohol and drug abuse often go along with the PTSD. Learn about ways to help our vets to not only survive from PTSD, but to thrive by finding ways to heal through various medical and psychological treatments, find housing and employment, and recover with their loved ones.

PTSD may develop when someone is exposed to horrors or traumatic events outside the norm of typical crisis events, such as combat veterans, who have some of the highest rates.

In exploring a number of studies, the risk for PTSD varies between 7 – 20%, while on average, 22 veterans commit suicide daily, and a high percentage of vets are homeless, addicts and alcoholics.

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3 Tips For Falling In Love With Fitness

Substance abuse, degenerative disc disease, and occasionally my job prevented me from being physically fit, sometimes for months or years at a time. In some cases, I gained weight, in others, I lost weight. (Having to gain weight is indeed easier.) However, through my physical trials and tribulations, I learned how enjoy the pursuit of fitness. Here are my three biggest takeaways:

1. Patience

Set realistic goals for yourself. I was in a job for a while that required long hours in the office, and I found myself soothing with food in a way I hadn’t in years. 15 pounds later, I felt so bad about myself I was willing to start a boot camp. One just happened to open up down the street from me. It was impossible to ignore.

I’m a petite woman so trying to lose 15 pounds wasn’t going to happen in a couple of months, and I knew that from experience. I started three times a week, and I was so weak at the beginning. The gorgeous instructors clapped and smiled along with me just to make sure I didn’t get discouraged. I love them for that. Love goes further than yelling in my book.

It took a full nine months for me to lose all the weight, but I never got disappointed in myself because I knew I was doing everything I could.

I gave myself a full year to get it done. Much better to exceed your expectations then constantly be pushing that date back because everything takes longer than you expect.

2. Food Matters

It doesn’t matter how much I work out if I put really bad food in my body. That doesn’t mean I don’t eat sweets and carbs and every other delicious thing, but I try not to eat processed foods. That makes a big difference. I also had to learn to love vegetables and cuisines that favor healthier ingredients, like a Mediterranean diet. The big surprise here was a healthy diet also made me feel better in every way. My digestion improved, my mood improved, and my self-care improved. This took years for me to sort out, but this is one of my major takeaways regarding being healthy and maintaining a healthy weight.

3. Get Professional Guidance

I’m not saying hire an expensive trainer, but talk to someone who is educated on fitness. Make sure to discuss:

Your physical issues
Your goals
Which exercises are best for you based on those parameters

For years, I was doing one kind of exercise religiously, almost compulsively, only to find out it was hurting my back and not strengthening the correct parts of my body. All of that exercise was making me worse, not better!!! After my spinal surgery four years ago, I worked with several trainers and PT specialists who helped me devise an exercise program.  Finally I knew what was safe, what was unsafe, and what to look out for in terms of improvement or red flags. That guidance built a foundation for me to feel good about working out again.

Whether you’re considering exercise for mood stability, want to get back into shape as part of a recovery, or you just enjoy it, take the time to set goals. Get informed on how to reach those goals, and figure out a diet that will help as well. It’s so worth it.

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Vets Suffer From Many Sources Of Trauma

My two oldest sons, Max and Mitch, are proud veterans. Their stories of service are as different as they are. One joined the 82nd Airborne, went to Afghanistan, and was seriously injured on a jump. One went to NJ, and served at an Air Force Base. He wasn’t physically injured, but he came home with hidden emotional scars from trauma. This Veterans Day we salute Veterans in all of our United States branches:

Coast Guard
Army
Air Force
Marine Corp
Navy

Trauma Before Military Life

While my sons each still suffer from different types of injuries from their service time, they also have deep wounds from their time in another type of  war zone. They each grew up in a household affected by Alcohol Use Disorder (AUD). Many veterans lived lives similar to my sons, and many were traumatized before they ever went off to defend our country. My sons today struggle with AUD, and recovery reminds me to show compassion to them.

Many go to battle with a healthy mind and body, but how many more go with a spirit that has been harmed previously by a family caught up in addiction? Add into this mix a co-occuring problem of SUD, and the vet has a real struggle to overcome:

More than 2 of 10 Veterans with PTSD also have SUD
War Veterans with PTSD and alcohol problems tend to be binge drinkers. Binges may be in response to bad memories of combat trauma
Almost 1 out of every 3 Veterans seeking treatment for SUD also has PTSD
The number of Veterans who smoke (nicotine) is almost double for those with PTSD (about 6 of 10) versus those without a PTSD diagnosis (3 of 10)
In the wars in Iraq and Afghanistan, about 1 in 10 returning soldiers seen in VA have a problem with alcohol or other drugs. *United States Department of Veterans

The recovery community teaches me to “Do the next right thing.” Today, I’m going to thanking a vet for serving.

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How Crossing Boundaries Affects Our Veterans

Boundaries keep us safe and help us feel peaceful. When we have to defend ourselves, it can actually make us physically sick. Soldiers defend our borders and are deployed overseas to cross enemy lines. Let’s look at how this affects our veterans physical and mental health.

Crossing And Defending Boundaries Hurts Our Health

When civilians are constantly defending their personal boundaries, we get physically sick. Drs. Cloud and Townsend explain in their book Boundaries: When to Say Yes, How to Say No, to Take Control of Your Life:

Many clinical psychological symptoms, such as: depression, anxiety disorders, eating disorders, addictions, impulsive disorders, guilt problems, sharing issues, panic disorders, marital and relational struggles find their root in conflicts with boundaries.

Defending America’s Boundaries Hurts Vets’ Health

Veterans pay a high price for protecting these boundaries. From RAND, of the 2.7 million Iraq and Afghanistan veterans:

20% suffer from PTSD and/or depression
50% of the veterans who suffer from PTSD seek treatment, and then only half of them get “minimally adequate” treatment
14% suffer from post-traumatic stress disorder; 39% from alcohol abuse; 3% from drug abuse
5,000 to 8,000 veterans commit suicide each year, equaling 22 veteran suicides every day
Almost 50,000 veterans are homeless per the National Alliance to End Homelessness

Let’s take just a few minutes not just on Veteran’s Day, but every day to thank the brave men and women in our military, who happen also to be our family, members. Thank you for your love of country and family and service to the great United States of America, God Bless you all.

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From ‘A Star Is Born’ to ‘Ben Is Back’: When the Oscars Join My Recovery Group

From The Hollywood Reporter:

Bradley Cooper, Timothee Chalamet and Lucas Hedges all star in addiction dramas, a genre with a long history of Academy love, though today’s films are rightly held to a higher standard of accuracy, writes a Hollywood Reporter 12-stepper.

I am not typically up and out of the house before 7 a.m., but a few days ago I happened to be at a break-of-dawn meeting — you know, the kind of meeting where alcoholics and addicts gather to focus on recovery and the 12 steps. And as we all were finding our way to our seats, one woman announced quite passionately to the rest of us early birds, “I saw our movie last night!” This is L.A., so “our movie” could mean ownership in many forms: Was she a director or producer? Maybe an actress? A publicist perhaps? Nope. Anonymous lady was not at all involved in the film she watched the previous evening — Beautiful Boy, starring Steve Carell and Timothee Chalamet. But as a person in recovery, she claimed it on our behalf because its plot is basically the reason we were all seated in brown folding chairs on a Thursday just after sunrise.

In fact, Amazon’s Beautiful Boy — with Chalamet as a charming kid teetering on the edge and Carell as his I-love-you-so-much-it-hurts father — is just one of the high-profile films vying for Oscar gold this season that traffic in substance-abuse-related plots and performances.

There’s also Warner Bros.’ A Star Is Born, a worldwide hit that has collected $295.5 million, with Bradley Cooper as an alcoholic rock star; Lucas Hedges as an opioid addict who ditches sober living to surprise his family on Christmas Eve in Roadside Attractions’ Ben Is Back, opening Dec. 7, with a never-better Julia Roberts as Ben’s I-love-you-so-much-it-hurts mother; and Melissa McCarthy and Richard E. Grant as alcoholic delinquents with a big secret in Can You Ever Forgive Me?

Certainly, addicts and alcoholics often make for compelling and idiosyncratic characters because they can be both villain and hero in the same story — dependent upon where they stand in the one-day-at-a-time of it all. And that hasn’t been lost on Hollywood. Films have trained a spotlight on self-destructive alcoholics since before even the original 1937 A Star Is Born, with a boozy Fredric March. And the Academy has frequently rewarded performers who wrestle with the bottle — Ray Milland in 1945’s The Lost Weekend, Nicolas Cage in 1995’s Leaving Las Vegas (on my personal favorites list alongside Leonardo DiCaprio in 1995’s The Basketball Diaries and Naomie Harris in 2017’s best picture Oscar winner Moonlight).

This year’s films, though, could be held to an even higher standard than those of the past. In addition to how well they work as drama, they’ll be judged on how accurately they portray addiction and recovery. Alcoholics Anonymous, founded in 1936, was a fairly new concept when The Lost Weekend was released — alcoholism was not freely discussed and no recovery industry existed. Today, as the Beautiful Boy end credits powerfully state, more than 72,000 lives were lost to overdoses in 2017, and there were another 82,000 alcohol-related deaths that year. On this subject, authenticity now matters more than ever.

So, as someone who has been gratefully sober since Jan. 12, 2010, I am relieved these films live up to the challenge. I want to see A Star Is Born a second time, not for its concert sequences or Lady Gaga (though both are worth repeat viewing) but for Cooper’s pained expression and glassy eyes as he stumbles toward another blackout. I’ve been there — and so has he. Cooper, who’s been open about his recovery, once said sobriety was the best thing that ever happened to him. “I wouldn’t have been able to have access to myself or other people, or even been able to take in other people, if I hadn’t changed my life.” Same.

I also cheered Chalamet’s committed and convincing performance in Beautiful Boy as Nic Sheff, on whose memoir (and that of his father, David Sheff) the film is based. For me, director Felix van Groeningen’s decision to tell a nonlinear story robbed the film of the full emotional wallop I experienced when I read the two memoirs. But Chalamet is just as convincing and electric as a strung-out IV drug user as he is in a reflective moment on a beach with his kid brother. And when Carell, in a finely tuned performance, refuses to help his son anymore because that’s often the best thing one can do for an addict — “I love you, and I hope you get your life together,” he says as he hangs up — I recognized the moment because I know how badly dial tones can sting.

Peter Hedges’ Ben Is Back — so great I have seen it twice — while also offering a gripping and emotional tug-of-war, takes the broadest view of its subject through intricately woven scenes that address many issues surrounding addiction. It’s about family, forgiveness, skeptical relatives and where to place the blame for America’s urgent opioid crisis. There are much-deserved digs about insurance coverage and the government’s troubling and complicated treatment of addicts. And the 12-step meeting featured in the film is the most authentic one you’ll see. It manages all of this without ever feeling preachy. Quite a filmmaking feat.

The elder Hedges said that he’d been thinking about this film for years and it shows. In Toronto, he explained that he lost “his favorite actor,” Philip Seymour Hoffman, to an overdose; his mother got sober when he was 15 years old and he estimates that he joined her for hundreds of AA meetings over 22 years as he watched her “save so many lives,”; and his niece, who survived a near-death experience, appears (with blue hair) in the film’s 12-step meeting.

I spent years asking myself the same questions Lucas Hedges’ Ben contemplates onscreen, like this one, “With the things I’ve done to myself and others, I don’t know why I’m still here,” he says. In another scene, he stares at his perfect sister (an impeccable Kathryn Newton) singing in church and sobs. I know why — as an addict normalcy can sometimes seem too far a reach. It hurt my heart when wunderkind Lucas Hedges declares not once but twice, “I’m not worth it.” I believed that I wasn’t either until a surrender changed everything.

While those who’ve been through recovery undoubtedly will measure these films by their own personal experiences, like I have, that’s not to suggest that a wider audience won’t also be able to relate. As Roberts explained of her film when I talked to her about why these dramas seem so topical and universal right now, “Our movie is just this one family on this one day, and it reminds us all, ‘Oh wait, it’s not this big monster. It’s this quiet, insidious monster, and it’s next door, and it’s across the street, and it’s in the next town.'” Also, it’s right here.

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4 Environmental Addiction Factors Crucial In Recovery

From Psychology Today:

In the last few decades, there has been much debate about which aspect of our lives has the most significant influence on our behavior. In the area of addiction, I have separated the four primary camps (as I refer to them in The Abstinence Myth) to include spiritualists, traumatists, biologists and environmentalists—all theoretical frameworks that put forward excellent reasons why someone struggles with addiction.

However, the best explanation for addiction draws on all four of these camps. Understanding and accepting the factors that contribute to our thoughts, feelings, and actions can not only be useful, but very empowering when you’re on the road to recovery.

Today I want to focus on the environmental domain, which not only contributes to addiction, but also maintains it. Environmentalists and social scientists believe that external factors and forces dictate our behavior. Addiction, according to supporters of this camp, is primarily a result of external, and not internal, factors. For example, we know that alcohol and drug use increases during adolescence (ages eighteen to twenty-four), because this is a time when young people socialize with each other and are susceptible to “peer-pressure.”1

Once you are familiar with the environmental factors that are relevant to YOUR life, then you can take action to create change and improve the odds that you’re the one with the control—not the addiction. You’ll also find helpful tips for partners and family members who want to support a loved one in addiction recovery—since they make up a substantial portion of the environmental influence.

Four Environmental Domains that contribute to addiction

As mentioned, members of the “environmental camp” believe that social systems and external factors drive human behavior. The way I see it, this camp is made up of four environmental sub-domains that play a role in the development of addiction.

The Family Domain

There’s no denying that our early life experiences and familial interactions play an important role in the development of our mental health. You may not realize, however, just how critical those interactions and parenting styles can be and how they can contribute to later addiction.

Identify the factors

Parents who have favorable attitudes toward drug use or use drugs themselves often have children who are more likely to use and drugs, and with the increased probability of use comes an increase in the probability of problems.

Additionally, parenting styles identified as authoritarian (highly demanding, little positive feedback, harsh punishments) or avoidant (difficulties responding to emotional needs of child and child learns to hide their emotions) also lead to increased substance use problems when compared to an authoritative (high responsiveness and high demand) parenting style. Better work on those boundaries early!

A NIDA funded study also found that addiction was more likely in individuals who had a sibling or spouse who had an alcohol or substance addiction. The closer the siblings were in age, the greater the relationship.2 While some may want to attribute the sibling connection primarily to biology, there is a substantial environmental influence for shared childhood households and it is obvious that the spousal relationship is largely environmental. Although, as we’ll discuss later, these factors are not truly independent at all.

If you can relate to these experiences, then you may begin to form a picture of the critical influence of family and why you have an addiction.

Opportunities for Change

I’ve mentioned the risk factors in the family domain which contribute to addictions, but family can also play a protective role. Research suggests that family support (and psychoeducation provided to family members) during the recovery process leads to higher recovery success in people with addictions.

If you have a family member with an alcohol or substance use disorder, then your support (both practically and emotionally) can go a long way in aiding the recovery of your loved one’s addiction.

The Peer Domain

It will come as no surprise that the people we surround ourselves with do have an impact on the choices we make and the way we behave. While you may associate “peer-pressure” with adolescence, the same factors that underlie this phenomenon can persist well into the adult years (I mean, who doesn’t still get affected by friends when it comes to fashion style, car-choice, and so many more factors?)

Identify the factors

Stress in the workplace can lead to addiction. When under pressure, people draw on their default coping strategies—whether helpful or unhelpful—to help them manage how they are feeling. For those in the retail and food industries, the stress levels are incredibly high, and so too is the risk of alcohol and substance addiction.

According to a 2015 study by the Substance Abuse and Mental Health Services Administration, the food service and hospitality industry have the highest rates of substance use disorders and third-highest rates of heavy-alcohol use of all employment sectors.

In the school environment, a student’s performance, participation, and commitment to school can be a major risk factor in addiction. A lack of social structure can also contribute while some structures, like the Greek system, can exacerbate substance use struggles.5

Opportunities for Change

Research has shown programs addressing alcohol and other drug use in the workplace to be cost-effective, contributing to the health and well-being of the employee and organization.

When you study or work in an environment that actively promotes good mental health and a healthy lifestyle, then you are more likely to absorb these messages, feel safe to ask for help, and have the confidence to overcome an addiction. If you find that your work/school environments do not promote healthy habits, it is often possible to change these patterns through active engagement and discussion with decision makers. After all, this is your life!

The Community Domain

Your connection, or lack thereof, to the community in which you live plays a big part in the likelihood of developing an addiction. Additionally, social norms in a given context, culture and time define what is even identified as a problem.

Identify the factors

Research shows that if an individual’s community has favorable attitudes toward alcohol and drug use, then their risk of developing a problem is increased.

Still, drinking averages have changed dramatically over the years. As mentioned above, the average amount of alcohol consumption in the U.S. has dropped to only 1/5th of what it used to be in colonial times! Now, if everyone was drinking five times more alcohol 200 years ago (on average), it is safe to assume that the threshold for calling someone a problem drinker, or “alcoholic,” was also higher. We don’t have great records from this time, so documentation is difficult, but moderate drinking standards have changed, meaning what used to be normal drinking is now considered deviant or excessive. Society’s rules and standards define the way we measure “addiction” and also create the perception of those who struggle and what is or isn’t OK (this is where shame and stigma come from).

Opportunities for Change

Funded by the National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism (NIAAA), a new report concluded that individuals with substance abuse problems who are living in a collaborative housing setting would have their addiction treated more effectively than abusers not residing in a community-based facility.

This means that people who reside with other people in similar circumstances who are in treatment are less likely to feel stigmatized and shamed.

But it goes much deeper than that: if social norms play such a crucial role in what addiction is, then it has to be obvious that biology alone (or psychology alone) cannot be the primary culprits in its development. And if we can understand that the lens through which we see “addicts” can have an incredible influence on their success and quality of life then we have to adjust our way of talking about addiction wholesale.

Other factors to consider

We have looked at the four big environmental domains, but there are a couple more factors worth mentioning that can also increase drug use and addictive behavior. These include:

Media consumption:  Children and adolescents who are frequently exposed to media (advertisements, TV shows, and movies) containing alcohol and substance use can lead to addiction. The portrayal of alcohol and drugs in a favorable light can influence child and adolescent attitudes and behaviors around alcohol and drugs.

Proximity to drugs: Access to alcohol and drugs is one of the biggest contributors to first use (and ongoing use) of alcohol and drugs by children and young people.

Take home message

While environmental factors can contribute to a substance use problem, they can also help during the recovery process. If you’re seeking treatment for addiction, then you want to be aware of all the factors that contribute to your problem and not “box yourself in” by only focusing on the factors others believe to be important.

While we may think we have little control over biological factors (there is actually quite a bit we can do there too), and psychological factors can take time to resolve, the environmental domain is something you CAN make changes in with substantial payoff and relative ease. Whether it’s enlisting the help of your family, connecting with other people in your circumstances (who are motivated towards recovery), and ensuring the environments you work or study in are conducive to recovery, there is much you can do.

Here’s a little trick I recommend for everyone I work with that can help if there is a specific room or place that you tend to drink/use in more frequently. This room, or location, in your environment has become a trigger for your behavior. When you enter it or get near it, you likely begin craving or thinking about your drinking, using, or engaging in your addictive/compulsive behavior. But here is where biology and environment can meet. Since your brain recognizes specific aspects of this place in order to create the overall picture and therefore the connection with the behavior, there’s an opportunity to intervene! Change the look of the room as completely as possible—move furniture around, paint the walls or add wallpaper or art, change the scent and the lighting. If you do this, you’ll notice that much of the power of the trigger has dissipated because your brain now thinks of this location as different. It’s a quick and easy fix for the vexing problem of bedroom/living-room/kitchen drinking that, while not a silver bullet, should give you a little relief. Here’s what’s important though—if you simply continue using in that room moving forward you’ll create the exact same old relationship with the new environment… So beware.

If you have a family member with an addiction and you’ve begun to lose hope, then you’ll find that what you say and do will make an impact on your loved one. Learn about the multitude of factors relevant to your loved one and try to have inclusive and supportive conversations with them about what you learn. Your support and understanding could go a long way.

I find environmental factors the most helpful in leading clients to see how powerful their surroundings, community, relationships, and home can lead toward health or relapse. Our environment has an incredibly strong influence on our behavior and the way we see the world.

The post 4 Environmental Addiction Factors Crucial In Recovery appeared first on Reach Out Recovery.

Holiday Parties And Alcohol In Recovery

Holiday parties and alcohol can be a problem for 1o percent of the adult population. Did you know that 10 percent of Americans are in recovery from an alcohol or substance problem? That’s a lot of people we need to start thinking about. There are several points of view on drinking when family members are in recovery, not only during holidays, but also at family dinners every night. I am the mom of adult children in recovery, and I have chosen not to serve alcohol, and not to drink myself. Here’s why. First, there is the issue of isolation. People in early recovery are badly missing what they loved the most (whether it’s drinking, drugging, gambling or whatever).

Holidays isolate those who can’t join the fun. When people in early recovery are surrounded by family celebrating with alcohol, they feel left out, less than, ashamed, tempted, maybe even angry. Wouldn’t you?

Here’s an example of how it feels to be someone who can’t drink among heavy drinking family members. This is a true story that may resonate with you. Betty (not her real name)  hosted a birthday party reunion for me after I had been sober for about a year. It didn’t occur to her that the champagne and wines that were the centerpiece of the birthday party were beverages I couldn’t drink. Another important note is that women get drunk faster and stay drunk longer than men, and that alcohol biology fact isn’t widely understood. I watched as the family got loud talking about wines and wineries I would never see or taste, and I felt sadder and sadder, totally left out. My reaction was hurt not to have my needs recognized by people I didn’t see very often. And I haven’t been back, which should come as no surprise.

A Thoughtful Response To Sober Friends

I invited new neighbors to dinner, and they brought a bottle of wine not knowing we wouldn’t drink it.  When they invited us over soon after, they served sparkling cider and birch beer. The second party was more fun for everyone. The fact that Sarah and Bill cared about our needs was so thoughtful and inclusive. The conversation was lively, and we bonded.

Think Of Substance Use Disorder As Having An Allergy

For those with other physical diseases, we naturally adapt to their needs because we don’t want to make them sick. No shrimp, nuts, or gluten to allergy sufferers. No salt laden dishes for those with heart disease. No sugar laden meals and tempting desserts to diabetics. No meat to vegetarians. It’s very simple. As families we adjust lovingly to people’s needs because we don’t want to make those we care about worse. It should be no different with alcohol. Do we really need alcohol to bond and have fun?

Alcohol Free Dinners Bring A New Culture Of Fun

I don’t serve alcohol in the family, and I don’t drink myself. I didn’t intend to join the sobriety movement. My sea change began with not drinking in front of loved ones in recovery. That worked a little, but there was still a distance between us. Loved ones lived in a kind of alcohol-free jail, and I could get out of it any time I wanted by not seeing them. One day I wanted to have my martini more than I wanted to be with a “boring” loved one in recovery. It turned out that my culture of fun was the martini, after all, just like the relatives I don’t see anymore. Did I have to drink to have fun? No, I didn’t. I stopped drinking with that realization. Without alcohol, our family was  suddenly less loud, less dramatic, more fun and frankly happier. Our parties are now about the food, the sports events on TV, movies, each other. Sometimes we shoot pool.

I’m Not Against Alcohol

Our family oriented recovery lifestyle is a choice I made to support my loved ones. It isn’t fun at first to feel left out of society’s biggest addiction. For families who don’t have Alcohol Use Disorder, holiday drinking may well be an important part of the fun. And that’s great for them.  Our culture, after all, is all about the drink. We’re an alcoholic country, always have been. That isn’t going to change any time soon, but acknowledging the needs, caring for, and respecting people who don’t drink should also be part of our culture. We should never think of people who don’t drink as boring. People in long term recovery like me and my family know that we may have to skip the cocktail hour and arrive just at dinnertime. We may have to leave early when the party gets too loud. Or we may decide not to go to places where alcohol is the only entertainment. For me, making the choice to respect the sobriety of others helped their long term recovery succeed. Being sober myself made me a better person because I get it. I know how hard it is to be a non drinking person in a drinking world.

For our family, celebrating with zero proof brings holidays, and every day, all the peace and joy we prayed for. Cheers.

The post Holiday Parties And Alcohol In Recovery appeared first on Reach Out Recovery.