Depression

How The Addiction to Dopamine Hijacks the Brain. (Part 3) -Stepping Stone Community Services

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Author: Lynda Benigno

The goals of treatment for addiction should comprise of stopping the use of the substance, helping the addict remain substance-free and become productive in all areas in life including family, work and society. No single treatment will work for everyone, and as with other diseases, some trial and error to see what is effective for the patient is needed. One of the most effective methods of treatment is counseling and behavioral therapy. Treatment should also include addressing traumas and any existing psychological disorders. Patients should have a complete physical exam that includes testing for STD'S, infectious diseases and other health problems that the substance use may have caused. Detoxing while under a medical professionals care is preferred and a good first step. Long term follow up care that also includes support from family, friends or a sponsor will help prevent relapse. Restructuring the family unit through family therapy can create a loving and supportive environment that increases the chance of sobriety and aid in the healing process for all who are involved.

Detoxing and the role of medication

As previously mentioned, detoxing under a medical professionals care is preferred. An addict with severe dependence may experience dangerous withdrawal symptoms that can last from days to weeks. While not all withdrawal symptoms are life-threatening, they can be alarming to the addict and those around them. These acute symptoms may include, hyperactivity, sweating, nausea, increased blood pressure or heart rate, body pains or headaches, disorientation, insomnia, night sweats, fatigue, fever or chills, and hallucinations. A medical professional can prescribe medications that can ease withdrawal symptoms and aid in sobriety. These include:

*Naltrexone: Reduces relapse for narcotic and alcohol dependence by blocking opioid receptors that are involved with the pre-frontal cortex of the brain where reward is triggered.

*Suboxone, Probuphine, Sublocade: Reduces cravings and withdraw symptoms for those with opioid dependence

Behavioral and Cognitive Therapy

The goal with behavioral and cognitive therapies is to modify the patient's attitude and behavior related to substance abuse as well as create healthy lifestyle goals that will promote sobriety. This process works to keep the patient engaged in the treatment process and provides incentives to stay sober. Patients learn how to cope with everyday stressors as well as the thoughts and emotions that lead to substance use. They also learn how to how to remove themselves from situations that trigger substance use. By rewarding healthy behavior and consciously seeing thoughts in a realistic way, the patient will learn not to attach a negative emotion or response to their experience. Behavioral and cognitive therapies can be tailored to meet the patients individual needs making treatment effective.

Family Therapy

Family therapy has been shown to be more effective than standard support counseling. Family therapy is used to resolve family conflict, repair relationships and improve the function of the unit as a whole in a way that promotes sobriety. Family therapy will address the impact of addiction, mental health concerns and any trauma that is the result of addiction. Family therapy also helps to validate the experiences of each family member while developing new communication skills and healthy behavioral dynamics. Family therapy provides healing and sobriety for all parties involved.

12 Step Program

12 step facilitation therapy helps promote long term sobriety through engagement with peers. The three basic tenants behind this approach are acceptance, surrender and active involvement. Although the 12 step program was initially developed for alcoholics, the program is useful for various addictions including narcotics and debtors. The program is based heavily on religion, but those with non-religious beliefs have found the program helpful. The focus does not have to be on any particular religion or deity but rather something bigger than yourself such as the universe. The 12 steps are as followed:

*Admit that you are powerless over your addiction and your life has become unmanageable.

*Believe a power higher than yourself can restore you to sanity

* Decide to turn over your will and life to God; however, you understand God to be.

*Take moral inventory of yourself in a fearless manner

*Admit to God, yourself and others the true nature of your wrongs

*Be entirely ready to have God remove all of your defects of character

*Humbly ask God to remove your shortcomings

*Make a list of all persons you have wronged and be willing to make amends

*Make amends to those on your list except when doing so will cause more harm to the other person

*Continue to take a moral inventory of yourself and when you are wrong promptly admit so

*Through prayer and meditation, seek to improve contact with God, pray for knowledge of his will for you and the strength to carry it out

*Having experienced a spiritual awakening, try to carry this message to other addicts and continue to practice these principals in all of your affairs.

Role of a Sponsor in Recovery

Having a sponsor as well as regular meetings offers social support that is a critical component of AA. A sponsor provides one on one support and has usually had experience in the program for an extended period. Majority of sponsors make themselves available 24/7 so that there is someone available whenever the need arises. Since your sponsor is also in recovery, they can detect the early warning signs that you may relapse and provide the extra support needed to help you stay sober. Your sponsor is also responsible for giving honest feedback on behavior and thought patterns as well as helping you through your 12 steps.

Therapeutic Communities

Rehabilitation at a therapeutic community provides a highly structured program where patients reside. The time frame is dependent on the severity of the addiction and can range anywhere from 6-12 months. Staff members, as well as peers, play a role in influencing change. It is a group based approach that also includes medically trained professionals and other specialists such as a psychiatrist. The focus is placed on the overall health and well being of the patient. These include making lifestyle changes such as developing a routine as well as learning life skills that promote sobriety. The patients attend group therapy, individual or family therapy, education classes as well as participating in work-related responsibilities. The running of the community is based on everyone's participation and is highly structured. This tactic promotes healthy socialization skills and helps each person participate constructively in society.

Access to Care

Insurance does not always cover addiction treatment and when it does it may not include treatment for as long as the patient requires. When looking for a treatment center, many are surprised to find that immediate access is not possible. Restrictions placed on clinicians that include how many patients can be treated at a time limits the number of beds available at rehab centers. Without immediate access, an addict may discard the notion of treatment and continue using.

Addressing our response to addiction is critical. Accepting that addiction is a disease also means accepting it should be treated as a disease. Although penalties should be imposed for criminal offenses, addressing the underlying condition with the primary focus on rehabilitation would be much more effective.

If you or someone you know has a substance abuse problem, please contact the Substance Abuse and Mental Health Services Administration at 1-800-662-4357

The opinions expressed in this article are of the author and not intended to diagnose, treat or cure any physical or mental condition. If you are struggling, please contact your healthcare provider, the National Suicide Hotline at 1-800-273-8255 or the Stepping Stone Community Services at 330-577-6656.

What doesn't kill you makes you stronger, or maybe just slightly depressed? -Stepping Stone Community Services

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Author: Lynda Benigno

Imagine you are, by all outward appearances, put together and active. You go to work every day, attend social events with family and friends, and engage in hobbies. People who know you would say you have got everything in your life under control, you are a high achiever, and everything appears fine all of the time. However, underneath something festers. You push through your thoughts and feel little to no joy during your day. When you get home, you are exhausted. Sadness, anger, guilt or self-doubt slowly returns. You went through the motions of another day, decide to watch some tv and go to bed. You may be getting through each day, but that doesn't mean you don't need help.

The term" high functioning depression" is not an official diagnosis. It is a buzzword coined mainly on social media and blogs as a description for what it feels like to have PDD, Persistent Depressive Disorder or Dysthymia. Many people have said the buzzword used to describe PDD has helped them talk about their condition more openly or got them back into therapy to work on their coping skills. PDD is a less severe but more chronic form of major depressive disorder. There are nine different forms of depression currently recognized by the Diagnostic and Statistical Manual of Mental Disorders. Your level of functioning is used for diagnostic purposes. The low end is crippling depression. Basic hygiene, getting out of bed, difficulty maintaining relationships or holding down a job are characteristic of crippling depression. Goals set in talk therapy for crippling depression are more clearly defined because the impact on daily life and functionality is more apparent, taking a shower or going to the grocery store would be actionable goals. With PDD, identifying actionable goals during treatment can be more difficult because the patient is performing daily functions and the patients desired outcome is often vague, he or she just wants to be happy. Symptoms of PDD mirror that of other depressive disorders and may vary from person to person.

Symptoms of PDD can include :

*Lost interest in daily activities

*Hopelessness

*Low self-esteem

*Feelings of inadequacy

*Sadness, emptiness

*Trouble concentrating or making decisions

*Irritability or excessive anger

*Feeling of guilt or excessive worry

*Poor appetite or overeating

*Excessive sleeping or insomnia

*Patients with PDD are often high achievers who seek perfection and may have trouble slowing down or resting.

Recognizing symptoms and seeking help is an important step to take to start feeling better. Identifying myths is just as crucial because they can keep you from seeking treatment.

These include:

*Depression always involves episodes of crying or irritability

*Depression always contains thoughts of suicide

*There must be an identifiable reason for your feelings ( often there is no explanation other than " I just feel this way")

*Functionality is always tied to your emotional well being

*Everyone who has depression has the same symptoms and experience

Medication, when used in conjunction with talk therapy has been proven to be the most effective for patients with PDD. Your treatment can vary depending on a number of factors, including, willingness to get better, your ability to tolerate medication, and severity of symptoms. Acceptance of your condition, giving yourself permission to slow down and lifestyle changes are also beneficial.

No one gets better overnight, be gentle with yourself. Seek support from friends and family who are capable of being equally gentle. It takes strength to seek treatment so take a moment to recognize that strength within yourself. Sometimes it takes some trial and error to figure out how to get to equal footing. Staying on a long term treatment program will help prevent relapse of symptoms. Genetics, trauma, and stress are contributing factors and can be addressed in psychotherapy. Depression, no matter which type you suffer from, is a lifelong companion, but it does not need to be so loud.

The opinions expressed in this article are of the author and not intended to diagnose, treat or cure any mental or physical condition. If you are struggling, please contact your healthcare provider, the Nation Suicide Prevention Hotline at 1-800-273-8255 or the Stepping Stone Community Services at 330-577-6656.

How to get through the holidays after a trauma. Stepping Stone Community Services Blog

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Author: Lynda Benigno

Exhausted, scared, numb, lonely, angry. Emotionally and maybe physically tapped out. Whatever feeling it is inside of you is okay. The holiday season can be especially difficult for anyone who has gone through a trauma or experienced a loss. The expectation is everyone should be joyful no matter what is going on inside. We don't want to make others uncomfortable, so we stuff our emotions down and put on a smile. This expectation extends beyond the holiday season. There is a general push in society to be optimistic at all times. While I will be the first to admit I believe in the importance of optimism in everyday life, I also think it has its time and place. Ignoring our emotions, attempting to cover them up seemingly for our own sake or the sake of others is at best, damaging. Being present isn't just about the joys in our life, it means giving full attention to the unpleasant as well. Acknowledgment can be a catalyst for change when you are ready, but you don't have to be ready now.

Whatever negative emotions you have, they are yours to have. It is your experience for as long as you need it to be. The experience does not define you as weak. Honoring those feelings- by recognizing its presence and allowing yourself to feel it fully, makes you pretty darn strong. Feel no guilt for the existence of those feelings or taking the time to honor them. Notice when you accept those emotions that you are still breathing, you are still standing, and you are strong.

Sometimes our emotions are not something that needs to be resolved quickly so we can go about our day. We can find compassion for ourselves by honoring our emotions as opposed to covering it up with positivity. People you are close to may be well-intentioned and want to help because they want you to feel well. Sometimes this has more to do with their discomfort; they see you are not happy, and they want to "fix" so that you feel happy, and so do they. If we recognize this tendency, we can respond with compassion. I recommend using a phrase such as: " Thank you for trying to help, I am processing right now and need some time.".

No one's life is free from discomfort, and our emotions can be challenging to get a handle on sometimes. I promise you are not alone. You may wake up one day and feel unhappy. You have no idea why, no clue as to what brought it on. That's okay! If you know why it's occurring that's okay too. There is zero need for you to justify it to anyone. Now that's not to say you can walk around and treat others terribly because of it and unfortunately that does occur. We have all heard the saying " Hurt people hurt others.", and if you are having difficulty processing your emotions or projecting your hurt onto others, I highly recommend you speak with a therapist.

I want you to know it's okay that you don't feel okay, take all the time you need.

The opinions expressed in this article are of the author and not intended to diagnose, treat or cure any mental or physical condition. If you are struggling, please contact your healthcare provider, the National Suicide Prevention Hotline at 1-800-273-8255 or the Stepping Stone Community Services at 330-577-6656.

Have You been affected by Trauma? -Stepping Stone Community Services Blog

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By: Bethany Latimer

Trauma is defined as a distressing or disturbing experience. An estimated 7 out of 10 people have been through a traumatic event. People are resilient, they make it through horrible events in life and continue to manage life, day by day. However, there is a difference in “managing” versus “thriving” in life. Although, we can cope with trauma with the help of friends and family, trauma often lingers in the form of depression, anxiety, quick mood changes and physical ailments like headaches, stomach aches and more. Trauma shows up in the form of nightmares, flashbacks and avoidance of situations that may remind us of the trauma. People may tell us “life goes on” or “life is for the living.” Though these people may mean well, it certainly doesn’t mean the event is forgotten or that we have healed. In some cases, we perceive the trauma as so shameful or humiliating that we keep it to ourselves. Often it takes a professional to help us navigate what the trauma means for our personal story and how we get past the strong emotions associated with it. Therapy is an excellent way to heal from a trauma and feel whole again.

The opinions expressed in this article are of the author and not intended to diagnose, treat or cure any mental or physical condition. If you are struggling, please contact your healthcare provider, the National Suicide Prevention Hotline at 1-800-273-8255 or the Stepping Stone Community Services at 330-577-6656.