Leslie Glass's Blog, page 338

How Deeply Addiction And Abuse Affect Foster Kids

From Jenny Rough @ The Washington Post: “Raise your hand if you think every child deserves a loving home,” the social worker said.

She held up a photo of five brothers and sisters, all teenagers.

I glanced around the room and tried to read the eyes of other potential foster-care parents at the information session. A dozen couples and a handful of singles ranging in age from late 20s to mid-50s sat in the conference room of a private nonprofit agency in Maryland that handles foster placements. Did they feel as uncertain as I did?

People often say they can’t be a foster parent because it would be too painful to grow close to a child only to say goodbye. But with more than 430,000 kids in foster care in the United States and a decline in the number of available beds in licensed foster homes, according to the Chronicle of Social Change, I wondered whether the real reason for the shortage of foster parents stems from the unspoken fear I harbored: concern about the health and behavioral challenges of kids who had experienced trauma.

Not only do kids suffer trauma from the circumstances that led to foster care in the first place, but they also experience the grief of being separated from their primary attachment, says Chrissy Levine, a social worker with the Department of Community and Human Services in Alexandria, Va.

“Even when the abuse and neglect is bad, that’s what their normal looks like, so when you take them away from their primary attachment, that to them is the most traumatic thing,” she says.

The back-and-forth system of reuniting families, separating them again or moving among foster homes further traumatizes the children, adds Anne Moody. In her book “The Children Money Can Buy,” she chronicles her observations of the foster and adoption system based on her career as a social worker and adoption counselor.

Neither the abuse nor the number of different placements is the child’s fault. Kids often flourish when placed “in a committed, nurturing home that keeps them connected to their birth families,” Levine says. But it doesn’t change the fact that caring for a child who has been through severe trauma can be intimidating.

Foster kids are six times as likely as other children to have behavioral problems, according to a study published in the journal Pediatrics.

The types of issues will “range all over the place, depending on the kid and what happened to them previously,” says Nathan Fox, director of the Child Development Laboratory at the University of Maryland. Some kids show anxiety and depression. Others might be openly uncooperative or physically aggressive. Many struggle with impulse control.

“Kids who experience abuse or neglect have behavioral problems which are ultimately associated with the development of psychiatric problems,” Fox says.

“They will be continually worried not only about themselves but about their parents and siblings. And they will be exhausted from all this emotion,” Moody adds.

Research conducted by Harvard Medical School, the University of Michigan and Casey Family Programs found that former foster kids developed ­post-traumatic stress disorder at almost twice the rate of combat veterans. And research by Bruce Perry, a senior fellow of the ChildTrauma Academy in Houston, has shown that a chaotic childhood or abusive caregiving can disrupt brain development in multiple and complex ways.

“These abnormalities in brain development may result in a persisting or abnormally over-reactive flight-or-flight response that can include attention problems, and oppositional and defiant behaviors,” he says. Or the child may develop a dissociative response that can contribute to detachment and withdrawal.

Physical health problems, including cardiovascular disease and diabetes, have also been linked to children who experience early abuse, says Fox, “but it takes longer for the physical health consequences to emerge.”

The information meeting I attended in Maryland occurred nine years ago. I was 35 and had assumed I’d be a mom. But I developed endometriosis. Treatment didn’t help, so when my husband and I saw an announcement about foster care on a fertility association’s website, we decided to check it out. If motherhood wasn’t in my future, I wanted to at least explore mothering-type roles.

“Teens and sibling groups,” the social worker holding the photo of five said. “That’s our biggest need.”

I gave my husband big eyes to see if he thought this whole idea was crazy. He didn’t. Nothing scared him — not even unruly teenagers.

“Fostering teenagers can be challenging,” the social worker continued. “They’ll test boundaries. For example, they might steal your car in the middle of the night.”

I felt uneasy — until I remembered I’d done the same thing to my parents as a teenager.

“Younger kids will act out, too,” she said. “Recently, a couple took in a 7-year-old. She set the bathroom rug on fire.”

Fire? As in combustion, smoke and flames? That sounded bad. Then again, my brother set the backyard trees on fire when he was 8.

“It’s not unheard of for a foster child to falsely accuse a foster parent of sexual abuse,” the social worker continued. “Child Protective Services may be required by law to open a case against you if that happens. Try not to let it rattle you.”

By the end of the meeting, I sprinted to the parking lot.

The social worker hadn’t minced words. She wanted prospective foster parents to understand the challenges of living with a traumatized child. “The last thing [child welfare] workers want is to place children with families who didn’t understand what they were taking on,” Moody says. Many people will self-select out of the process.

On the one hand, misbehavior by a foster child might simply be a kid being a kid, or normal teenage rebellion. When biological children act out, it’s handled within the family. But when it happens with foster kids, it’s a different story.

“Because of the stigma, these kids make a bad decision and the foster parent says, ‘I can’t handle this; they need to leave my home,’ ” Levine says.

On the other hand, behavioral problems with foster kids often aren’t the same as with those who were raised in nurturing environments. “It’s not behavior that happens once or twice. It’s chronic behavior that puts themselves and other people in danger,” Fox says.

One key in addressing the health and behavioral issues, in addition to providing a stable, nurturing environment for as long as possible, is to understand the root cause of the behavior, Levine says.

“Sensory issues can look like defiance, but it’s not. A kid might act out because they’re missing their mom or dad. A phone call with Mom or Dad can help a kid cope with regulating their big feelings,” Levine says. “Foster parents can educate themselves on positive discipline techniques that address the behavior and the root cause.”

The social worker assured us we would develop a real relationship with a child and that the size of a problem on paper can look more challenging than it actually is. Still, I was wary about taking on foster kids and didn’t feel equipped to handle it.

Over time, my life didn’t feel empty from a lack of children or child-care responsibilities. It felt full with meaningful relationships and work I loved. Yet my thoughts occasionally returned to foster parenting, especially when I heard news stories about babies being born hooked on heroin or of children who were taken from parents who abandoned or neglected them. The reports kept bringing my attention to the crisis in our country.

A lawyer friend of mine once said that when he learned of the plight of incarcerated youth, he thought: “Somebody needs to do something about this problem. It’s not going to be me.” Until one day he realized, yes, it was. Today, his work focuses on improving the criminal justice system for young people.

Serita Cox, founder of iFoster, a nationwide online community of 45,000 members that provides resources to children in foster care, dedicates her life to helping foster families. Cox says she has witnessed tremendous improvements in the behavior of foster kids when they receive opportunities that other kids normally have, such as the chance to take guitar lessons or attend summer camp. iFoster partners with Microsoft to provide foster kids with laptops, works with a nonprofit group called Smiles Change Lives so kids can get braces for their teeth, and arranges scholarships for after-school activities such as gymnastics and equine therapy.

“Kids need to feel loved, they need to feel safe and supported, and they need the stuff that other kids get the opportunity to do, like get glasses or go to the movies,” Cox says.

There is a big debate about how to best handle kids who have been cared for inappropriately. Ideally, “we would pour resources into helping families who are in danger of separation due to factors such as homelessness, substance abuse, mental-health concerns or poverty before the children are removed from the home instead of after,” Moody says. Yet ultimately, as she concludes in her book, “the real world is full of children who need to be safe and loved right now, and they should not be asked to put their lives on hold while we wait for a perfect world.”

Moody’s book turned out to be the game-changer for me. It opened my eyes to the hard truths of foster care without making me despair. After I read it, I walked away with an important understanding: Being a foster parent is hard, but being a foster child is much harder.

This past spring, my husband and I signed up for foster-care training. In class, we learned about all sorts of difficult situations we might face: how to handle a repeat runaway; what to do if an 11-year-old girl acts out by having sex with boys from school; what to do if a child, removed from a home because of a hoarding situation, brings in bed bugs.

I don’t yet have all the answers, but I do have some: If you can’t talk the child out of leaving, let the runaway go, then call 911; address the safety and ­self-esteem issues of early sex with the child’s social worker and therapist; bug control is a phone call away. I’m gaining confidence I’ll learn what I need to learn. Receiving proper training helps, foster parent support groups exist, and iFoster has a hotline. Still, there are times in class when I hear about behavioral issues and the fear creeps back.

“Lock up your prized possessions,” the social worker once warned.

Those are the moments I glance at the door. My running shoes are on my feet. And I wonder whether the most difficult decision isn’t going to be anything like how to handle a teenager who wets the bed or a 9-year-old who slashes furniture with a knife. The most difficult decision is the one I face right then: the decision to stay.

Did you know coloring can help you find peace and serenity? Check out Reach Out Recovery’s latest book, Find Your True Colors In 12-Steps.

The post How Deeply Addiction And Abuse Affect Foster Kids appeared first on Reach Out Recovery.

Overcoming 3 Fears That Keep Us Isolated

From John Amodeo Ph.D., MFT @ Psychology Today: Many of us feel lonely, but we never get to the roots of why—and how we might feel more connected. Here are some common fears that may be keeping us isolated.

Fear Of Taking Risks

If we cling to the belief that we should be perfect, we may not risk doing things that might expose our imperfections. We might think “I should get out of the house more often or join a dating site,” but we don’t want to risk of being disappointed. Our fear of failing keeps us isolated.

We may ruminate about asking someone on a date, but we can’t bear the prospect of hearing “no,” which may reinforce the belief that we’re flawed. Being consumed by self-doubt, we may not consider a more benign interpretation, such as they’re not seeking new friends at this time.

Rather than take an intelligent risk to reach out, we may find a curious comfort in what is familiar, even though it keeps us painfully isolated and disconnected.

The Fear Of Shame And Embarrassment

Another factor that may fuel our aversion to risk-taking is a fear of facing shame or embarrassment. We don’t want to be seen as defective—or see ourselves as flawed. The belief that we’re flawed or a failure can create one of the most painful human emotions.

Toxic shame is so agonizing that we’ll do almost anything to avoid it. And there are many things we won’t do in order to sidestep the prospect of shame. We won’t reach out to people, share our thoughts, or allow our natural humor to come out. We won’t begin a new hobby or enterprise. We won’t place ourselves in situations where we might not excel. Without a guarantee of success, we succumb to our default mode of not exposing ourselves to possible embarrassment or humiliation.

Of course, life offers no guarantees. Without a willingness to take intelligent risks and face possible criticism or rejection, we remain paralyzed, which perpetuates our loneliness.

It takes wisdom to realize that even if we’re rejected, it doesn’t mean we are a reject. Our inner work is to hold ourselves with dignity and respect, whatever outside events befall us. We have no control over how others view us, but we have some control over how we view ourselves.

The Fear Of Being Vulnerable

Taking risks that might move us toward satisfying connections and a more fulfilling life means being willing to embrace our vulnerability, which means realizing and accepting that we don’t always get what we want. This takes a courageous willingness to feel sad or disappointed sometimes, or even a mild sense of shame, which might help us learn and grow. This is simply the human condition. The good news is that we can learn to have a more friendly relationship with all of our feelings, perhaps through the help of a psychotherapist.

Moving toward a less lonely, more engaging life means cultivating resilience. Resilience means finding the strength to say “yes” to ourselves when others say “no” to us. It requires realizing that how others respond to us says something about them; it is not a statement about our worth and value.

This is the deeper meaning of self-love: honoring ourselves and learning to rest comfortably in our body and being as we venture out into an uncertain world. We come to affirm that we’re ok just as we are. As psychologist Carl Rogers put it,

“The curious paradox is that when I can accept myself just as I am, then I can change.”

Being Friendly With Ourselves

We experience the universe as a friendlier place as we become friendly with our inner experience of life. Trusting ourselves to deal with the full range of feelings that life brings up in us, we can take more risks to be vulnerable. We can extend our hand to others with courageous vulnerability, knowing that if we’re not met with a positive response, we can feel good knowing we tried… and move toward people who might be more responsive.

Most of us feel a little lonely sometimes. There’s nothing wrong with that. If we can hold ourselves with gentleness as we experience our loneliness, it may begin to shift. Asking ourselves “What does this loneliness need?” we might discover a new gentleness toward ourselves or some small act that may help us feel more inner peace and connection.

Did you know coloring can help you find peace and serenity? Check out Reach Out Recovery’s latest book, Find Your True Colors In 12-Steps.

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Video Games And Emotional States

From Psychology Today:

“Oh no!!!” My son screams from his room at midnight. My wife and I don’t panic. Actually, we hardly blink or notice. You see, our son, like millions of teens all around the world, is addicted to a video game called Fortnite. Aside from the fact that one of the goals of the game is to shoot as many other players with an automatic weapon as possible, it is (strangely) not really a violent game – and, I have to say, it seems very fun. While there are several variants of the game out there, the main point is that you are one of 100 individuals dropped on some random island and the last one standing at the end is the winner.

My wife and I are pretty adept at being able to tell when Andrew gets shot by a sniper versus when he has just won the entire game. His emotional expressions are pretty clear and sound travels quickly in our house.

A loud, “Oh no!!! Aaaahhh!!! Aaaaaahhhh!!! No! No! No!” usually means he got sniped.

On other hand, “Yes!!!! Yes! I can’t believe it. Yes!!!” – accompanied by a big smile and sometimes a little dance – typically means that he won the round.

And so it goes. Life as a parent in 2018.

Video Games and Emotional States

One of the reasons that games like Fortnite are so addicting is that they play on the human emotional system, comprised of a long-standing set of psychological adaptations that has features going back millions of generations and across thousands of kinds of species of animals. Darwin (1872) himself was the first person to really make a strong case for the evolved function and motivational nature of the human emotion system.

In more recent history, Randy Nesse and Phoebe Ellsworth (2009), discuss the evolved nature of emotions and psychological attributes designed to motivate people to engage in certain adaptive behaviors. From their evolutionist perspective, for instance, they see some emotions as evolved responses to success regarding social opportunities (we feel happy when we are provided with success in obtaining social opportunities) and some emotions as evolved responses to failure regarding social opportunities (we feel sad and anxious when we are threatened with rejection in efforts to obtain social opportunities).

Recently, members of our research team, the New Paltz Evolutionary Psychology Lab, published a paper that examined Nesse and Ellsworth’s (2009) evolutionary model of emotions. Relevant to the discussion of Fortnite here, our study manipulated emotions in a video game context (see Guitar, Glass, Geher, & Suvak, 2018).

Using Second Life software, we designed a study that provided 50 individually run adult participants with situations that included the following:

Physical opportunities (finding a large amount of food (or not))
Physical threats (successfully walking across a balance beam suspended high above the ground (or falling to one’s death))
Social opportunities (being liked by others in a virtual meeting room and obtaining VIP status (or failing to make VIP status))
Social threats (making a lot of friends on the island (or failing to do so, leading to exile from the island))

For each of these four conceptual experiences, we manipulated things so that, based on random assignment to conditions, participants either succeeded or failed (unbeknownst to them, they actually had no control whatsoever as to the outcome!).

We asked participants to complete a brief measure of basic emotional/affective states after each outcome. These states including happiness, sadness, anxiety, anger, embarrassment, and several other items.

Well it turns out that manipulating these kinds of situations using an avatar-based video game paradigm is very powerful at manipulating emotions. Succeeding at a physical-opportunity-based task (by finding a lot of food on the island) led to confidence. Failing to find a lot of food led to embarrassment. Making it into the VIP room led to happiness. Failing to make the VIP room led to frustration. Falling off the balance beam led to a feeling of shame. And getting kicked off the island led to overall negative mood, frustration, and a major dip in confidence.

Bottom Line

Why are video games so addicting, to the point that they are wreaking havoc on humans across the globe? One reason is this: Well-designed video games have the capacity to manipulate the human motivation and emotion systems – systems that are the result of millions of years of vertebrate evolution. Is your kid playing Fortnite, or something similar, into the wee hours? Does your household include regular conversations with your child about the fact that he or she is becoming something of a video game zombie? Well guess what? Video games represent just another technological “advance” that hijacks our evolved psychology in an evolutionarily mismatched way. We allow our technologies to advance while ignoring our evolved nature to our own peril.

This said, good luck with your next round of Fortnite, kids. I hope you win a battle royale!

Reach Out Recovery.

The Importance Of The Sober Sister

I just spent HALF the day discussing my issue du jour with one sober sister then another. It began with a situation that made me uncomfortable… Wow, something made me uncomfortable. What a shocker. I immediately called my sober sister to tell her about it while also trying to get out of going to the meeting she was on her way to pick me up for. Needless to say, I was picked up for the meeting, and we talked about what happened on the ride to the meeting, while getting coffee, then on the way home from the meeting.

All in all, my sober sister spent three hours “unpacking” this problem with me. Then I got home and I called another sober sister to do the same thing because apparently I had not had enough of talking about myself and my feelings. By the end of many hours, I felt much better. Want to know why?

I felt heard. I felt respected. I felt loved. That’s what our sober sisters do for us.

I love my family, but they don’t always know what to say to me, and I don’t always know what to say to them and that’s okay. I care deeply for many of the people in my life, but it’s the same thing. I am okay to admit that communicating with people is something I’m always working on getting better at because…most people can’t read minds.

However, sober sisters CAN read minds!

I need people in my life who can read my mind because I like to suffer in silence. The great martyr inside me wants to feel pain and not tell anyone. I want to keep it a secret and let it fester until I’m being eaten from the inside out. That’s the place where I get to be self-destructive and ultimately go out. This is why it’s vital to have sober sisters who can take one look at me and say, “What’s wrong?” Or, “What kind of trouble are you getting into?” We just operate on a different plane. We get that we wake up in the morning with broken thinking and we need each other to help fix it. We talk to each other for hours about our problems, work, whatever’s taking up room in our heads and hearts.

Having friends like this in recovery is absolutely critical for survival.

Now, this is nothing against our loved ones and boyfriends and girlfriends and siblings. I’m just shining a light on this particular part of the recovery family because it is so damn important. Part of a healthy recovery is having people you can tell anything and everything to—it doesn’t all have to be to the same person. In fact, it probably shouldn’t be. But, having women who act as a sisterhood of support and can laugh at the horrors with you and cry at the heartbreak is literally everything.

I’ve learned the hard way that there’s no point in discussing every weird thought that comes into my head with certain people. They won’t get it, and it will upset them. You must know your audience when you go into recovery. The beauty of sober sisters is you can give them anything, and they can handle it. There’s also this weird miraculous phenomenon that we NEVER lose our shit at the same time. It’s the craziest thing. Someone is always stable!

Anyway, we made the sober sisters pin because we literally love our sober sisters and wanted to do something that would show pride in this significant relationship.

So, Happy Recovery Month! Stay sober, love your sisters and let’s get through this crazy ride together.

xx,

Lindsey

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Happy 14th Sober Birthday To Dax Shepard

From Emily Zaumer @ People: Dax Shepard has a lot to celebrate — and wife Kristen Bell could not be prouder!

As Shepard, 43, rang in his 14th year of sobriety, the Veronica Mars alum, 38, wrote a sweet tribute to her husband on Instagram Saturday that just might have fans reaching for the tissues.

“To the man mocked me when in our wedding photos because I cried too many tears of joy, who wore a baby Bjorn for 2 straight years to show his girls how to be as adventurous as possible, who held our dear little shakey man pup for 8 hrs straight on the day we had to put him down, I know how much you loved using. I know how much it got in your way. And I know, because I saw, how hard you worked to live without it,” Bell said.

The actress, who shares 5-year-old daughter Lincoln and 3-year-old daughter Delta with Shepard, continued, “I will forever be in awe of your dedication, and the level of fierce moral inventory you perform on yourself, like an emotional surgery, every single night. You never fail to make amends, or say sorry when it’s needed. You are always available to guide me, and all of our friends, with open ears and tough love when its needed most.”

Calling her husband “the fertilizer in the garden of our life,” Bell praised Shepard for sharing his story. She concluded, “I love you more than I ever thought I could love anyone, and I want you to know, I see you. I see how hard you work. You set an excellent example of being human. Happy 14th year sobriety birthday, @daxshepard.”

The mother of two also shared a fun family album that included pictures of the couple’s laid-back wedding and children (whose faces were covered by cartoon hearts and apples).

Bell’s Instagram post particularly spoke to one fan, who commented, “This hit home for me. I’m trying to get sober…again and I hope to continue to have the same kind of support from my partner for just as many years. Thank you.”

Bell replied, “It’s hard and worth it. One day at a time xoxo.”

Meanwhile, Shepard shared that his wife surprised him a unique present for the anniversary — a tour of the King’s Hawaiian factory!

“Best sober birthday present ever. @kristenanniebell got me a tour of the @kingshawaiian factory and I ate 8 STRAIGHT oughta the oven. 2 more upstairs, and 3 at home. 13 all-in for one day is an accomplishment I will not soon forget,” he wrote on Instagram.

“Also, the fact that Kristen looks like a scientist and @mlpadman looks like she’s on a kindergarten field trip just makes my heart swell to dangerous levels. Thanks Ladies!” Shepard added.

The couple has opened up about Shepard’s substance abuse in the past. Two years ago, Shepard tweeted, “12 years ago today I came out of my last toxic, life-threatening stupor. I now have a wife & babies & some self-esteem.”

In 2016, Bell told E! News that her husband changed how she views the world.

“Seeing the world through his eyes has really opened mine to knowing that it is a disease and nobody is choosing to drink more than others,” she explained.

“They are doing it because of a variety of reasons and they deserve the attention of a mental health professional, and not the county jail or however else we’re choosing to pretend we’re fixing the problem.”

Did you know coloring can help you find peace and serenity? Check out Reach Out Recovery’s latest book, Find Your True Colors In 12-Steps.

The post Happy 14th Sober Birthday To Dax Shepard appeared first on Reach Out Recovery.

Overdose Is A Cry For Help

From SAMHSA:

Earlier this month there was news that over 90 people overdosed on synthetic marijuana laced with the powerful opioid fentanyl at a park in New Haven, Conn. Thankfully, no one died of an overdose that day due to the quick response from emergency personnel. Such stories remind us that people across the country are struggling with addiction to illicit substances and opioid-based pain medications. In 2017, the lives of over 72,000 Americans ended prematurely due to overdose, which is now the leading cause of death for people under 50 years old.

International Overdose Awareness Day, which is August 31, brings into focus the importance of seeking help for addiction. As a doctor specializing in addiction medicine for over 10 years, I have seen firsthand how people develop physical and psychological dependence on drugs and alcohol and how that can take over their lives. For some, it starts with curiosity and experimentation. For others, it starts with a need for something to help them cope with physical or emotional pain. No matter how illicit drug use begins, the dangers are serious—an overdose can happen instantly and before help can arrive. We should all learn to recognize the signs of overdose and learn how to safely reverse an overdose. For example, signs of an opioid overdose include:

Unconsciousness or not being able to wake up;
Slow, shallow breathing or breathing difficulty such as choking sounds or a gurgling/snoring noise from the person who cannot be woken up; and
Fingernails or lips turning blue/purple.

We should also be aware that addiction can affect anyone. Addictive substances hijack the brain into releasing chemicals that give a feeling of pleasure and reward. These substances trick the brain into seeking more gratification after each use. When left untreated, addiction often leads to other chronic illnesses, including physical illness and mental health disorders that, over time, become more debilitating and life-threatening. The good news is that people can and do recover with the right treatment. SAMHSA’s guide to Finding Quality Treatment for Substance Use Disorders is a good resource for those seeking treatment.

Starting treatment is a step toward recovery, but it’s only the first step. Even for those in treatment or recovery, a substance use disorder is a chronic disease. As with other diseases, relapse can happen. Recovering from an addiction is like starting physical therapy after experiencing a debilitating physical injury. It takes time to heal and to learn new ways to function. Although there may be setbacks, with the right kind of help and continued perseverance, people with a substance use disorder can enjoy a healthy life in long-term recovery.

If you or someone you know is in need of help for a substance use disorder, you are not alone. Call 1-800-662-HELP for a treatment referral or visit https://findtreatment.samhsa.gov to find a treatment provider near you. For immediate help for a potential drug overdose, call 911 or go to the nearest emergency room.

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Sex, Drugs, And Death: Why Two Recent Government Statistics Should Sober Us Up

By CLIFTON LEAF for Fortune:

Americans contracted a record number of sexually transmitted diseases in 2017, beating the 2016 tally—which was then an all-time high—by more than 200,000 cases, according to preliminary data revealed yesterday by the CDC. An estimated 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the U.S. last year, capping a multiyear period of “steep and sustained increases in STDs,” said the U.S. health agency. Gonorrhea cases alone jumped a shocking 67 percent from the number in 2013, according to the analysis presented at the CDC’s 2018 STD Prevention Conference in Washington.

The news follows a report earlier this month that an estimated 72,000 Americans had died from drug overdoses in 2017, according to a provisional count by the CDC’s National Center for Health Statistics—a figure that would mark not only a dismal milestone, but also a nearly 7% increase from the year before.

To put it bluntly, as Jonathan Mermin, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, did in a CDC press release: “We are sliding backward.”

This double-barreled data shot from our friends in the U.S. government is yet one more reminder of how critical social determinants are in human health. Yes, “social determinants” is one of those academic terms that makes the eyes of all but academics gloss over. But such factors—drug and alcohol use, sexual and reproductive health, smoking status, nutrition and weight, oral health, our homes and environment, violence, wealth, social exclusion, zip code—have more of a collective impact on our wellbeing, population-wide, than every pharmaceutical drug and medical device put together. It’s not even close.

And yet we all but ignore these critical health components when we talk about, plan for, and pay for health.

Luckily, I think that conversation is just beginning to change—as Fortune’s conversation with Kaiser Permanente CEO Bernard Tyson two weeks ago reflects. (See Sy’s wonderful write-up here.) Aetna CEO Mark Bertolini, likewise, emphasized the importance of social determinants in his discussion with me at this year’s Fortune Brainstorm Health conference.

But for us to have a real and lasting hope of a healthier America, we have to rethink our entire health system to align with such improvements in social health indicators. The CDC just gave us two scary reminders of the cost of business as usual.

 

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When Anxiety Leads To Addiction And What You Can Do Instead

From Adi Jaffe Ph.D. @ Psychology Today: Anxiety is an uncomfortable, sometimes terrifying emotion and it’s no wonder people try to find ways to minimize, avoid or shut out those feelings. While alcohol and drugs may lessen anxious feelings in the short-term, do they actually make the anxiety worse in the long run?

I actually started drinking exactly because of that anxiety… At a sleep-away camp, when some guys pulled out vodka and passed it around, I drank because I didn’t want to stick out, but the near-immediate effect I had when the alcohol started taking its effect was a substantial reduction in my level of nervousness. This was especially true around girls. All of the sudden, I didn’t care so much about making a food of myself. It felt good to relax for the first time in years that way.

Do you currently drink or use to overcome social anxiety or to fit in? Do you use alcohol or drugs to cope with stress? Have you tried to quit drinking or drugs and felt so anxious you’ve started using again? If you answered yes to any of these questions, you might be self-medicating to manage your anxiety.

What Are The Symptoms Of Anxiety?

These are some of the most common symptoms of anxiety generally, and are incredibly common among individuals who struggle with pathological anxiety, or an anxiety disorder:

Sweating
Trembling
Shortness of breath
Tightness in the chest
Accelerated heart rate
Dizziness or nausea
Muscle tension
Sleeping difficulties
Irritability
Feeling like something bad will happen
Problems concentrating
Ruminating about the same thought over and over

Often times, if you experience these feelings, you may also behave in unhealthy ways to escape, avoid or reduce the anxiety such as:

Avoiding situations that make you feel anxious (including work, family gatherings, and other outings)
Withdrawing from others (could include close friends and family)
Using alcohol or drugs to cope

Unfortunately, it’s only short-term relief from stress.

Why is this a problem? Because relying on substances to cope with anxiety does not resolve the underlying problem and the ongoing reliance on a substance essentially assures that it will eventually become less effective at solving it.

Some people develop an alcohol or drug addiction because they need to drink or use greater amounts of drugs more frequently to cope with their anxiety. This creates tolerance and physiological dependence. The reason for the anxiety is ignored, and it perpetuates a cycle of anxiety and addiction. Not only that, but long-term alcohol and drug abuse can actually make the anxiety worse. People often feel anxious when they are experiencing cravings or are withdrawing from alcohol or drugs.

I know this from personal experience, using alcohol and meth to cope with ADHD and social anxiety. In spite of—or perhaps because of—all the drugs and using, I walked around with a constant stream of self-doubt and anxiety that would fill my head at any quiet moment … So I made sure to have as little quiet as possible. At 25, I was going nowhere fast. Then I got arrested, and things got really bad.

That’s when I knew something had to change. I wanted to understand why I turned to drugs, what impact it had on my brain, but more importantly how I could treat those underlying issues without turning to drugs?

5 Ways To Cope With Anxiety Without Relying On Drugs

We know that anxiety has an effect on our brain and that drugs can target GABA and minimize anxiety. But alcohol and drugs aren’t the only options. There are many self-help measures that you can try that target the same mechanisms in the brain, only without the negative impact that alcohol and drugs bring to your life.

1. Mindfulness & Meditation

Mindfulness is a focusing technique that helps you become more in tune with your thoughts, emotions, and body. There are many ways to introduce mindfulness into your life (we focus on this quite a bit with clients and IGNTD Recovery Course members), but here’s one simple way to get started: Sit or stand in a relaxed posture, and breathe deeply. Take a slow in-breath, holding for four seconds, and then release it gradually over 5 seconds. Bring your attention to your breath, and when you notice your mind wander, acknowledge the thought without judgment and then release it. Returning your focus to your breath.

When you first start out, you may find your mind wanders every few seconds, and that’s okay. Mindfulness is a skill to be learned, one that requires patience and practice. The benefits of mindfulness are twofold: Firstly, it relaxes your body and mind. Secondly, it helps your mind focus on what’s happening right now. When we feel anxious, we’re often ruminating about the past, or worrying about the future. Mindfulness helps you stay in the present. It has also been shown to increase inhibitory control in the brain, which is exactly the antidote to anxiety!

2. Biofeedback

Biofeedback (and its brain-centric version known as neurofeedback) is a very effective research-based treatment for anxiety that teaches you how to respond to your anxious thoughts and feelings appropriately. It uses an electronic instrument to display involuntary physiological processes so you can learn to influence those processes by changing your thought processes voluntarily. Biofeedback is a very visual and experimental process where you are an active participant in the treatment. It gives you the opportunity to view your physiological responses to stress and learn how to manage and control it without the use of medications, or drugs. I love using biofeedback with clients to help them learn how to control their anxiety and train their brain to produce less of it.

3. Cognitive-Behavioral Therapy (CBT)

Trained psychologists and health professionals often use cognitive-behavior therapy to identify, challenge and alter thought processes to reduce anxiety symptoms and avoidant behavior. CBT generally involves a structured treatment plan within a specified timeframe. It is goal-oriented and often requires the participant to engage in homework activities to practice outside of therapy. As mentioned earlier, part of feeling anxious has to do with the interpretation of the biological and chemical changes (is it anxiety or excitement?), and so CBT works a lot on reframing negative beliefs and thinking patterns to help people reduce their subjective experience of anxiety. There is a long history of research into CBT and its positive effects on anxiety and depression.

4. Yoga

Like mindfulness and meditation, yoga is another practice that reduces a state of alertness through breathing and focused attention on the body. Yoga requires deep breathing through uncomfortable positions and teaches you to breathe through stress using only your body and mind. How does it help anxiety, exactly? It taps into the GABA I mentioned earlier. Yoga increases GABA levels which enables you to relax. Interestingly, yoga has been found to be more relaxing (higher GABA) than other forms of exercise such as walking.

5. Healthy Lifestyle Choices

There are many ways you can look after yourself to reduce anxiety and increase your emotional wellbeing. Try the following:

Eat healthily and get regular exercise. Good nutrition is good for mental health while exercising releases pent-up stress and energy in the body.
Have a sleep routine. Sleep deprivation can make anxiety worse, so try to go to bed and wake at the same time every day. Good quality sleep will help you deal with everyday stress far better than a tired mind.
Make time to rest. There are many ways to relax such as mindfulness, walking, listening to music, or reading a book. These techniques can also help you manage cravings for alcohol or drugs.
Reduce your caffeine intake. Did you know that coffee, tea, and energy drinks can exacerbate anxiety? Caffeine is a stimulant drug that can make you feel on edge, jittery and even cause heart palpitations. In other words, it makes you feel anxious! Try to cut down by avoiding high doses, particularly in the afternoons (as this will affect your sleep).
Take your medication as prescribed. Avoid mixing medication with alcohol or other drugs as this can be a dangerous combination not only for your mental health but your physical health too.
Seek support. Talk to friends, family or a professional about your anxiety and addiction. Sometimes we just need someone on our side before we can believe in ourselves and make positive changes in our lives.

Commit To YOUR Recovery

You will find that most of these strategies involve relaxation, increased self-awareness and being better informed about your anxiety to find ways to cope with it. When we know how our brain works, and how anxiety develops, then it can help us handle it, by feeling more in control of our mind and body.

By learning how to manage your anxiety better, you can learn to manage your alcohol and substance abuse better. I feel strongly about dealing with the underlying emotional difficulties before the addiction and have made that the central tenant of all the work I do nowadays.

So, don’t wait until tomorrow to try out one of these strategies. Choose something that you can do today. What will it be?

Did you know coloring can help you find peace and serenity? Check out Reach Out Recovery’s latest book, Find Your True Colors In 12-Steps.

The post When Anxiety Leads To Addiction And What You Can Do Instead appeared first on Reach Out Recovery.

Treating A Case Of Toxic Anger

Have you ever had poison ivy? It’s a miserable rash that seethes, oozes, and blisters. It spreads quickly and can even scar. A recent brush with toxic anger affected me in a similar way. Here’s how I’m handling it.

A Toxic Plant

A few years ago, my friend Heather and I went to pick some cherries. The cherry tree was surrounded by a mote of poison ivy. I saw the dangers, knew the risks, and charged ahead. The sweet red cherries were too tempting. This time, I foolishly promised myself, would be different.

It wasn’t it. Heather and I both ended up with an epic case of poison ivy. I spent weeks soaking the blisters in Epsom salt and coating them with over-the-counter creams. Nothing cooled the burning itch, which was a relentless reminder of my choice.

Poison ivy is incredibly contagious. One small patch on your skin can easily spread to your whole body, and one innocent soothing scratch puts your entire body at risk. Whatever area you touch is the next victim and no body part is safe. My left eye once swelled shut from the oozing rash.

A Toxic Person

Recently, I had a run-in with a woman named Susan. Our sons are a part of the same after-school club, and Susan leads the group. Earlier this summer, I signed up to be in charge of our annual fundraiser and it was a huge success.  We more than doubled the amount of donations we normally receive. Last week, Susan asked me to meet for coffee to talk about the fundraiser.

I thought we were going to talk about how successful the fundraiser was, and I was expecting a hearty “Thank You!” or “Way to go!” Instead, Susan yelled at me for changing the fundraiser’s location and told me that my son and I were no longer welcome to attend the club.

I left the coffee shop devastated. The other Moms in this club were some of the first women I met in Florida. They are like family to me, and Susan just cut me off from my support group.

A Contagious Toxin

Susan’s behavior towards me is also extremely contagious because I want to treat her exactly the same way she treated me. I want to humiliate her in public and cut her off from the group. I haven’t, and I won’t, but I want to. I’ve wasted precious time planning out my tirade, knowing I’ll never confront her. I selfishly want to complain to the other moms about how Susan mistreated me. I want sympathy and vindication.

Susan’s demand for me to leave isn’t the reason I left the group. I could have stayed and fought for my position, but honestly, this after school group hasn’t been working for my son or me. I’ve ignored some glaring problems for the last six months because:

Staying in a toxic relationship is easier than finding a new one.

My son and I are now in the market for a new after school program, yet I am still mourning this loss.

A Toxic Anger

I worked through this incident with my sponsor, cried, wrote about my feelings, and read a lot on the subject. I have processed the pain, yet regular reminders resurface, and a toxic anger erupts. My stomach fills with acid and my blood boils. At this point, I have to decide how much time I want to spend fighting off toxic anger and how I want to behave.

I am reminded of the poison ivy. When Heather and I went to pick the cherries, I knew the risks. When I broke out in painful blisters, I didn’t take the quick fix of scratching the rash.

Gossiping about Susan or retaliating in kind would be self-harming, just like scratching poison ivy. To heal from this, I have to set a boundary with myself. I can control what I chose to remember and how often I think about it. I can also re-frame how I look back at the incident:

Susan hurt my feelings and how she leads the group does not work for my son or me.
I empowered myself to find a group that works better for us.

Just because something itches doesn’t mean I have to scratch it.

Did you know coloring can help you find peace and serenity? Check out Reach Out Recovery’s latest book, Find Your True Colors In 12-Steps.

The post Treating A Case Of Toxic Anger appeared first on Reach Out Recovery.

It’s Time To Measure Addiction Recovery Rates, Not Just Addiction Rates

Lost among the headlines of opioid addiction and overdose deaths are the many quiet stories of recovery. An estimated 22 million Americans— that includes the three of us — are in recovery from opioid and other addictions. We say “estimated” because states and the federal government don’t track recovery like they track addiction rates or overdoses.

Oregon, recently ranked last in providing mental health and addiction treatment services by Mental Health America, and almost last in terms of adults needing but not receiving treatment for substance use disorders, is about to change that. We urge other states to follow.

In the midst of a serious addiction crisis, in which 72,000 people died from overdoses in 2017, it can be easy to forget that recovery is not only possible but is the reality for nearly 10 percent of U.S. adults. Losing sight of that can skew public policy and funding priorities to narrowly focus on preventing deaths instead of aiming more broadly to both reduce unnecessary deaths and promote long-term wellness among the 20 million Americans who have a substance use disorder — barely 4 million of whom receive treatment.

Since 1971, the Substance Abuse and Mental Health Services Administration (SAMHSA) has tracked the rates of substance use disorder in all 50 states and the District of Columbia. The tool it uses, the National Survey on Drug Use and Health, is invaluable for measuring tobacco, alcohol, and drug use, as well as mental health and other health-related issues. But it has never included questions related to the most positive outcome of having a substance use disorder — recovery from it.

Filling this gap has been left to researchers like Harvard University’s John F. Kelly, who directs the Recovery Research Institute, with work like the National Recovery Study. Kelly’s study has one critical limitation though: It provides recovery rates only at the national level and leaves out regional and local estimates.

That’s what makes state reporting so important. More accurate numbers about recovery could provide information on the success of expanding treatment for opioid use disorder and help state policymakers decide where to direct increasing federal aid for addressing the opioid epidemic. These state-specific rates could also be used to help monitor the success of new policies like Good Samaritan and naloxone access laws. Regularly collecting statistics on recovery could also give us a sense of accomplishment compared to the ever-increasing overdose rates since 2000.

Thanks to advocacy by Oregon Recovers and an executive order recently signed by Kate Brown, Oregon’s governor, that declared addiction to be a public health crisis in Oregon, a new effort aims to lower the state’s addiction rate and increase its recovery rate. The first goal of this strategic initiative is easily measurable, since the annual National Survey on Drug Use and Health provides state-by-state data on addiction rates. But measuring progress on improving recovery wasn’t possible — until now.

The state’s Public Health Division, in partnership with Oregon Recovers, plans to pilot a biannual measurement of recovery rates through the Adult Behavioral Risk Survey, to be done in collaboration with the Centers for Disease Control and Prevention.

The pilot will add three questions to the digital version of the survey, which is performed once in the fall and once in the spring. It will ask a sample of Oregonians 1) if they once had a drug or alcohol problem but no longer do; 2) if they identify as a person in recovery; and 3) what supports or resources they use to assist their recovery.

This kind of information will help state authorities, policymakers, treatment providers, and recovery community organizations better understand what is working (including large-scale investments in statewide addiction treatment systems via funds from the Comprehensive Addiction and Recovery Act and 21st Century Cures Act), what is not working, and how individuals with addictions and those in recovery can better be served.

States such as Pennsylvania, South Carolina, Florida, Nevada, and Wisconsin are beginning to explore similar initiatives, but many more states need to follow Oregon’s lead.

Given the logistics of trying to develop state-by-state initiatives to measure recovery rates, a more efficient approach would be for SAMHSA to modify the National Survey on Drug Use and Health so it can measure recovery nationally and deliver this information to states. That means the same things would be measured in the same ways in all states, ensuring that results about addiction and recovery are comparable across states.

As individuals in long-term recovery, we believe it is essential that federal, state, and local authorities begin shifting their focus from the problem of addiction to the solution of recovery by tracking recovery rates among individuals with substance use disorders. By following Oregon’s example and collecting this valuable information, communities hit hard by this crisis will have a more complete and nuanced picture of the effects local programs are having. That will help them achieve higher rates of success in treating substance use disorders and promoting long-term recovery — which should be held up as the norm and expected outcome for the millions of Americans living with active addictions.

From StatNews:

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