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A Dozen Addiction Zappers and Depression Busters

By Therese J. Borchard

Lest the readers think that I’m contracted by the Dark Side (sorry, watching too much “Star Wars” lately) to encourage addictive behavior and rationalize all weakness, here are a dozen addiction zappers and depression busters I use in deficient moments (23 hours of any given 24-hour day):

1. Get Some Buddies

It works for Girl Scouts and for addicts of all kinds. I remember having to wake up my buddy to go pee in the middle of the night at Girl Scout camp (actually I was a Brownie–I never graduated to the Girl Scouts). That was right before she rolled off her cot, out of the tent and down the hill, almost into the creek. Had the roller’s buddy not been such a deep sleeper–dreaming of beatific visions–the Girl Scout wouldn’t have woken up in the woods.

The same method works for addicts–to help each other not roll out of the tent and into the stream, and to keep each other safe during midnight bathroom runs. My buddies are the six numbers programmed into my cell phone, the voices that remind me sometimes as many as five times a day: “It will get better.”

2. Read Away the Craving

Books can be buddies too! And when you are afraid of imposing like I am so often, they serve as wonderful reminders to stay on course. When I’m in a weak spot, and my addiction has the power–dangling me upside down like Rosie O’Donnell in her inversion therapy swing–I place a book next to my addiction object: the Big Book goes next to the liquor cabinet (Eric’s very modest stash); some 12-step pamphlet gets clipped to the freezer (where I store the frozen Kit Kats, Twix, and dark chocolate Hershey bars); William Styron’s “Darkness Visible” or Kay Redfield Jamison’s “An Unquiet Mind” rest on my bedside table; and I’ll get out Melody Beattie before e-mailing an apology to someone who just screwed me over. And there are my spiritual staples: books by Henri Nouwen, Thomas Merton, Anne Lamott, and Kathleen Norris.

3. Be Accountable to Someone

In the professional world, what is the strongest motivator for peak performance? The annual review (or notification of the pink slip). Especially if you’re a stage-four people pleaser like me. You want nothing more than to impress the guy or gal who signs your checks. Twelve-step groups use this method–called accountability–to keep people sober and on the recovery wagon. Everyone has a sponsor, a mentor to teach them the program, to guide them toward physical, mental, and spiritual health.

In my early days of sobriety, I didn’t drink because I was scared to tell my sponsor that I had relapsed (she was kind of intimidating, which is why I chose her). Today several people serve as my “sponsor,” keeping me accountable for my actions: Mike (my writing mentor), my therapist, my doctor, Fr. Dave, Deacon Moore, Eric, and my mom. Having these folks around to divulge my misdeeds to is like confession–which I’ve never enjoyed–it keeps the list of sins from getting too long.

4. Predict Your Weak Spots

When I quit smoking, it was helpful to identify the danger zones–those times I most enjoying firing up the lung rockets: in the morning with my java, in the afternoon with my java, in the car (if you’ve been my passenger you know why), and in the evening with my java and a Twix bar.

I jotted these times down in my “dysfunction journal” with suggestions of activities to replace the smokes: In the morning I began eating eggs and grapefruit, which don’t blend well with cigs. I bought a tape to listen to in the car (which distracts me and gets me lost in D.C. and Baltimore). An afternoon walk replaced the 3:00 smoke break. And I tried to read at night, which didn’t happen (eating chocolate is more soothing after tucking in a three-year-old girl who tells you after bedtime prayers that she knows how to kiss like Princess Leia of “Star Wars,” and she likes it a lot).

Especially difficult were the times Eric and I went out socially–when my cigarette was a substitute for drinking. I think I devoured sweets on those evenings–which wasn’t optimal, but, again, chocolate is a less-threatening addiction to my health than nicotine, so it wasn’t the worst thing to do.

5. Distract Yourself

Any addict would benefit from a long list of “distractions,” any activity than can take her mind off of a cig, a glass of merlot, or a suicidal plot (during severe depression). Some good ones: crossword puzzles, novels, Sudoku, e-mails, reading Beyond Blue (a must!); walking the dog (pets are wonderful “buddies” and can improve mental health), card games, movies, “American Idol” (as long as you don’t make fun of the contestants…bad for your depression, as it attracts bad karma); sports, de-cluttering the house (cleaning out a drawer, a file, or the garage…or just stuffing it with more stuff); crafts (I failed occupational therapy, but it works for many a depressive) like sewing, scrap-booking (it pains me to write that word), framing pictures; gardening (even pulling weeds, which you can visualize as the marketing director that you hate working with); exercise (of course), nature (just sitting by the water), and music (even Yanni works, but I’d go classical).

6. Sweat

Working out is technically an addiction for me (according to some lame article I read), and I guess I do have to be careful with it since I have a history of an eating disorder (who doesn’t?). But there is no addiction zapper or depression buster as effective for me than exercise. An aerobic workout not only provides an antidepressant effect, but you look pretty stupid lighting up after a run (trust me, I used to do it all the time and the stares weren’t friendly) or pounding a few beers before the gym. I don’t know if it’s the endorphins or what, but I just think much better and feel better with sweat dripping down my face.

7. Start a Project

Here’s a valuable tip I learned in the psych ward–the fastest way to get out of your head is to put it in a new project–compiling a family album, knitting a blanket, coaching Little League, heading a civic association, planning an Earth Day festival, auditioning for the local theatre, taking a course at the community college.

“Try something new!” the nurses advised us as we chewed our rubber turkey. “Get out of your comfort zone.”

I knew that Eric would love it if I became more domesticated–actually notice the dying plants and do something like watering them or pulling off the dead leaves. So, partly to please him, I went to Michael’s (the arts and crafts store) and bought 20 different kinds of candles to place around the house, five picture boxes for all the loose photos I have bagged underneath the piano, and two dozen frames. Two years later, all of it is still there, bagged and stored in the garage.

However, I also signed up for a tennis class, because I’m thinking ahead and when the kids go off to college, Eric and I will need another pastime in addition to reading about our kids on Facebook. I met a wonderful friend with whom I’m training for a triathlon (which distracts and burns calories simultaneously), and I enrolled in a writing class, which gave me enough confidence to launch Beyond Blue. (If I weren’t training for a triathlon and writing Beyond Blue, I might be smoking (and doing a few other less-than-healthy activities) as I try to organize our pictures.

8. Keep a Record

One definition of suffering is doing the same thing over and over again, each time expecting different results. It’s so easy to see this pattern in others: “Katherine, for God’s sake, Barbie doesn’t fit down in the drain (it’s not a water slide)” or the alcoholic who swears she will be able to control her drinking once she finds the right job. But I can be so blind to my own attempts at disguising self-destructive behavior in a web of lies and rationalizations. That’s why, when I’m in enough pain, I write everything down–so I can read for myself exactly how I felt after I had lunch with the person who likes to beat me up as a hobby, or after eight weeks of a Marlboro binge, or after two weeks on a Hershey-Starbucks diet. Maybe it’s the journalist in me, but the case for breaking a certain addiction, or stopping a behavior contributing to depression, is much stronger once you can read the evidence provided from the past.

9. Be the Expert

The quickest way you learn material is by being forced to teach it. That lesson is fresh on my brain this morning after an hour of tutoring a student on a paper about the history of the Supreme Court. Sometimes that’s how I feel about Beyond Blue–in cranking out spiritual reflections and mental health secrets, I have to pretend to know something about sanity (even if I feel like one crazy and warped chick). I adamantly believe that you have to fake it ’til you make it. And I always feel less depressed after I have helped someone who is struggling with sadness. It’s the twelfth step of the twelve-step program, and a cornerstone of recovery. Give and you shall receive. The best thing I can do for my brain is to find a person in greater pain than myself and to offer her my hand. If she takes it, I’m inspired to stand strong, so I can pull her out of her funk. And in that process, I am often pulled out of mine.

10. Grab Your Security Item

Everyone needs a “blankie”. Okay, not everyone. Mentally ill addicts like myself need a “blankie” (and a pacifier to suck on when trying to quit smoking), a security object to hold when they get scared or turned around. Mine used to be my sobriety chip. Today it’s a medal of St. Therese that I carry in my purse or in my pocket. I’m a bit of a scrupulous, superstitious Catholic (the religious OCD profile), but my medal (and St. Therese herself) give me such consolation, so she’s staying in my pocket or purse. She reminds me that the most important things are sometimes invisible to the eye: like faith, hope, and love. When I doubt all goodness in the world–and accuse God of a bad creation job–I simply close my eyes and squeeze the medal.

11. Get On Your Knees (Of Course)

This would be the addiction-virgin’s first point, not the eleventh, and it would be followed by instructions on how to pray the rosary or say the Stations of the Cross. But I think that the true addict and depressive need only utter a variation of these two simple prayers: “Help!” and “Take the bloody thing from me, now!”

12. Do Nothing

Which means you’re on the third level of recovery that I talked about above–not a bad place to be.

Therese J. Borchard is the editor (with Michael Leach) of the best-selling “I Like Being Catholic,” “I Like Being Married,” and “I Love Being a Mom.” After her Prozac pooped out, she didn’t like much of anything, so she compiled “The Imperfect Mom: Candid Confessions of Mothers Living in the Real World.” She lives with her husband, Eric, and their two “spirited” preschoolers in Annapolis, Maryland, where she runs, meditates, and sleeps eight hours a night to stay sane.

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Problem, Pathological Gambling Rates High Among Veterans

By: DAMIAN MCNAMARA, Internal Medicine News Digital Network

05/20/11

|HONOLULU – About 8% of U.S. veterans are problem gamblers who report between one and four gambling-related problems, and an additional 2% are pathological gamblers with five or more such problems, a study of 2,185 veterans in Department of Veterans Affairs care reveals.

Age, education level, and ethnicity were not big predictors of pathological gambling risk. “The one that does show a lot of difference is unemployment [odds ratio, 1.85], which is not necessarily what you expect. People need money to gamble, and they need a lot of money,” Dr. Joseph J. Westermeyer IV said at the annual meeting of the American Psychiatric Association. The unemployed in the study, however, included part-time and seasonal workers who had some access to money, he said, and others were “homebodies” (typically unemployed men who were married to women with jobs).

Marital status emerged as an important variable in a binary analysis, with unemployment remaining significant (OR, 1.41). “The folks who were divorced, separated, widowed, or single were underrepresented [OR, 0.69], so folks who were married were more likely to be in the problem and pathological gambling group. Again, this is not necessarily what you would expect,” said Dr. Westermeyer, who is director of the mental health service at the Minneapolis VA Medical Center and professor of psychiatry at the University of Minnesota.

“Interestingly, male veterans and female veterans had almost identical rates of both problem gambling and pathological gambling, which is not – so far – what you see in the general population.” Men usually outnumber women by a factor of two to three or more, Dr. Westermeyer said. It might be that the military exposes more women to gambling. “Some of the women we talked to say, ‘We hang around with the guys when we have time off. We don’t go to different places. We go to the same bars, and if they go gambling, we go gambling with them.’ ”

The study included only veterans who were treated at least once in the previous 2 years at a VA facility. This design was intentional, so that any demographic or other risk factor that was identified would be relevant when incorporated into a future screening instrument.

Another aim was to identify co-morbid symptoms “so primary care, as well as psychiatry, can begin to be alert to what might be associated with pathological gambling,” Dr. Westermeyer said.

The veterans completed the SCL-90 (the 90-item Symptom Checklist instrument) and the PCL (PTSD [Posttraumatic Stress Disorder] Checklist). Their responses were directly and highly correlated with DSM-IV criteria and the South Oaks Gambling Screen. “In other words, people who have more posttraumatic symptoms, anxiety, and depression tend to have more gambling problems,” Dr. Westermeyer said.

Participants also completed the AUDIT (Alcohol Use Disorders Identification Test) and the MAST (Michigan Alcohol Screening Test). The AUDIT addresses recent alcohol use and the MAST is a lifetime alcohol use measure, which was adapted to include drug use. Again, correlations were high. But in this study, people with more alcohol and drug problems tended to have fewer gambling problems, according to Dr. Westermeyer, which is contrary to other research that shows more substance problems associated with more gambling problems.

“All these findings tend to be a tad atypical,” Dr. Westermeyer said.

The data were assessed in two different ways to reflect the current prevalence and to predict the future prevalence of problem and pathological gambling. For example, data were weighted to reflect the typical older male population that is seen at most VA centers today. Raw data included an oversampling of women (to bring the 7% in weighted data up to 35%) as well as younger veterans from the Iraq and Afghanistan conflicts (to reflect the way the VA population is likely to appear in a decade or two).

The weighted data show that veterans have about twice the rate of problem gambling as does the general population. The raw data suggest a greater disparity in the future, with a rate 2.7 times that of the general population.

The other worrisome thing about the future is the ratio of problem gamblers to pathological gamblers, Dr. Westermeyer said. General population surveys show a 1:1 ratio of problem gambling to pathological gambling among people who are exposed to gambling for a decade or more, and up to 2:1 with more recent exposure. “It’s worrisome with the veterans. The ratio is … like four or five problem gamblers to one pathological gambler. The problem gamblers are the people at risk to become pathological gamblers … which does not bode well for the future.”

“Veterans in VA care have a high rate” of pathological gambling, he added.

All 10 DSM-IV gambling symptoms were assessed in the study. The sixth criteria (characterized in the DSM-IV as “chasing one’s losses”) were the most common symptom, endorsed by 6.3% of participants with problem or pathological gambling. Tolerance was next at 5.1%, followed by escape gambling at 5.1%. The eighth criteria, which refers to committing illegal acts such as writing bad checks and committing property crimes, was the least commonly reported symptom, at just over 1%.

Another unexpected finding was a propensity for younger veterans to have higher scores on the South Oaks Gambling Screen for pathological gambling. “Most surveys that include people in their 20s rarely find a high prevalence [of pathological gambling], so ours was not a typical finding,” said Dr. Westermeyer. Those who show up on the survey data tend to be people aged 35 years and older, he noted.

Participants were paid $20 to complete 2 hours of computer-based data collection; a research assistant was on hand to answer any questions. Participants were recruited at two VA medical centers and 14 rural community-based outpatient clinics.

This was a clinical epidemiologic study and not community-based research, a potential limitation.

Unanswered questions remain, Dr. Westermeyer said. Do these high rates among veterans in VA care reflect rates among all veterans? Also, would it be possible to identify earlier cases through screening?

The study was funded by VA Health Services Research & Development. Dr. Westermeyer said he had no relevant disclosures.


Copyright © 2011 International Medical News Group, LLC. All rights reserved.
This page was printed from www.InternalMedicineNews.com . For reprint inquires, call 877-652-5295, ext. 102.

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12 Stupid Things That Mess Up Recovery by Allen Berger, Ph.D.

There are as many ways to mess up recovery as there are alcoholics and addicts, but Allen Berger, Ph.D., presents twelve common misguided beliefs and attitudes that can lead to relapse, and he provides a useful guide for working through these problems.

This passage is excerpted from 12 Stupid Things That Mess Up Recovery by Allen Berger, Ph.D. Berger is a nationally recognized expert on the science of recovery. For more than thirty years, he has been on his own journey in recovery while helping thousands of others discover a way of life free from addiction. He is also the author of 12 Smart Things to Do When the Booze and Drugs Are Gone.

I believe that if we are truly to recover from the disease of addiction, we must grow up—emotionally. True recovery is the product of humility that emerges from living and practicing a conscious and spiritual life. In order to attain humility, we must be honest with ourselves. This necessarily includes looking at the stupid things we do, today, in our recovery. I use the term stupid to indicate the things we do that are self-destructive and not in our best interest.

Before we move on to a discussion about how to identify the underlying causes of self-destructive behavior, I want to share how I selected the twelve issues that I discuss in this book. There must be at least a million stupid things that we can do to mess up recovery—all of them self-destructive. A book cataloging all of these would be unwieldy. I wanted to narrow down the list to a more manageable size so I used the following criteria for my selection. I chose what I considered to be the most commonly confronted and critical issues during the early stages of recovery. I define early recovery as the first two years of recovery. The main issues that we confront during this time include breaking the bonds of addiction, establishing a spiritual foundation for our recovery, learning effective tools to deal with ourselves and our relationships, and dealing with the wreckage of our past.

Few of us will relate to all of these issues, but the general themes should be familiar. So without further ado, here are my top twelve nominations for stupid things we do to mess up our recovery:

1. Believing addiction to one substance is the only problem
2. Believing sobriety will fix everything
3. Pursuing recovery with less energy than pursuing addiction
4. Being selectively honest
5. Feeling special and unique
6. Not making amends
7. Using the program to try to become perfect
8. Confusing self-concern with selfishness
9. Playing futile self-improvement games
10. Not getting help for relationship troubles
11. Believing that life should be easy
12. Using the program to handle everything

These twelve things are tried-and-true ways of messing up recovery. In the following chapters, I will elaborate on each of them. Please try and keep an open mind as you read this book. It has been my experience that those who do best in recovery are those who are honest with themselves, open to new ideas and experiences, and willing to take direction.

There’s one more thing I want to talk about before we move ahead to the task at hand. As you read about each of these twelve stupid things, please ask yourself, What would cause me to think in this particular way or behave in this particular manner? The rest of this introduction presents a series of questions to help you become aware of the causes of self-destructive behaviors. The more we become aware of the underlying cause of a particular belief or behavior, the less it controls our life: awareness of what we are doing to ourselves—awareness of how we sabotage ourselves—starts the process of change.

Identifying the Causes of Self-Destructive Behaviors
Psychologists and philosophers throughout modern history have tried to understand why we human beings are so self-destructive. Their discussions have ranged from speculating that a death instinct exists deep within our psyches to believing that personality type, childhood trauma, low self-esteem, or an undercurrent of self-hatred are the culprits behind self-destructive acts.
I believe there are four possibilities to consider when assessing the causes of self-destructive behavior. They are numbered because it is important to consider them in order. I recommend starting with number one and working down the list, until the best fit is discovered:

1. our addiction, or our disease
2. ignorance
3. unreasonable expectations and emotional dependency
4. self-erasure and self-hate

Remember to consider each possibility in sequence. When we identify what motivates or causes our stupid behavior, we begin the process of change. Awareness starts the process of change.

Read Alan’s book:
12 Stupid Things That Mess Up Recovery
Softcover, 136 pages
Hazelden Press
List Price: $14.95
Online Price: $13.45

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