What Makes This Time Different? Keeping Faith After Relapse

Addiction does not just end. Everyone seems to know this, from addicts to their loved ones to people with only a passing association with addiction. When someone leaves rehab, there is a not insignificant chance they will return at some point.

The natural question after relapse is: what makes this time different?

This is one of the toughest questions recovering addicts grapple with. This time, I am determined to change. But I was determined to change last time, too. This time, I see no other option. But I saw no other option when I last left rehab. This time, I will work the program without fail. But I made the same commitment last time.

It is incredibly demoralizing to find yourself back in rehab, knowing that even if you succeed in getting and staying clean, there’s no guarantee it will last forever.

However, this reality points to one of the foundations of addiction treatment. In fact, recovery often hinges on this particular point.

Out of control

The term “out of control” is often used by non-addicts to describe the behavior of addicts during a bender. They have no control over their actions, which is why they are in a downward spiral. In recovery, however, our lack of control becomes healing.

Many of the 12 Steps revolve around the admission that, most of the time, we have no control. We are powerless over our addiction, which is why we are in rehab. We can’t fix this ourselves, which is why we submit to a higher power. And, crucially, we have no control over the future, which is why we focus on the present.

One of the most frightening realities of relapse is realizing that our days, months, or years of sobriety are back to zero. Sobriety was meant to last forever, but we’re so very far from forever. In recovery, we learn that forever is meaningless.

Giving up on forever

As long as we’re hoping to be sober “forever,” we are trying to force the future into our control. Recovering “forever” is impossible, and that ambition means that we can only be successful at the end of our lives. Do you really want to be living for that moment?

The key to recovery is coming to understand that the only moment we have is the one we are in. It is the only moment we have any power over. It is as important a moment as any. And it is the moment in which we can choose sobriety.

Finding yourself back in rehab is so demoralizing because you start seeing your time spent sober in the light of your relapse. But any time sober is not compromised by a relapse. What makes this time different is that this is now and that was then. This is the only time we have.

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How To Forgive Yourself In Rehab

Is it possible to forgive yourself in rehab when you’ve hurt the people you love most?

For my daughter’s sixteenth birthday weekend, my husband and I had planned a Friday night dinner, gifts on Saturday morning, and shopping on Sunday afternoon. Melissa was excited by the itinerary, but more so to spend time with her recently-sober mom. On that Thursday, my husband gave me cash to go buy Mel’s gifts. This was a display of trust I had worked hard to earn.

They didn’t see or hear from me until Tuesday morning.

When I’d left the house that Thursday, I’d had no intention of using. Almost unconsciously, I had found myself dialing my dealer’s number, which I remembered despite having deleted it from my phone. By the time I’d spent Mel’s birthday money, I was already spiraling down a path of shame and self-destruction. I ignored my husband’s calls and eventually turned my phone off.

Is it just me?

The fact that I didn’t know why I had done it only made things harder. Was I just a bad person? That was the question I grappled with during my second stint in drug rehab. I could blame the lies I’d told before my first stint in rehab on the drugs. But this time, I had been clear-headed when I’d left the house. And I’d still ended up hurting my family. Could I learn to forgive myself in rehab?

Ultimately, it was the Serenity Prayer which helped me forgive myself and move forward:

God, grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference.

Responsibility, not blame

The Serenity Prayer urges us to make a distinction between responsibility and blame. Blaming myself for my past actions was only leading me down a destructive cycle. I could call myself a bad person and feel justified for it, but that only justified my continued bad behavior. I cannot change what happened in the past – blaming myself only gave me an excuse not to change.

However, leaving blame behind does not absolve me of responsibility. Taking responsibility is about learning to change what can still be changed. I learned that I could behave differently in the future. I learned that I could still work towards making amends with my family. And I learned that I could begin to forgive myself.

Non-addicts tend to take a dim view of the lies and manipulations carried out by addicts. Understandably. But buying into that view does not make anything better. It does not exhibit righteousness or absolve you of what you’ve done. On the contrary, it makes it more difficult to get better.

Learning to forgive yourself in rehab requires an act of will. You need to keep the words of the Serenity Prayer in mind, remembering that the only way you can begin to make amends for the past is by working on yourself in the present moment.

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Mindfulness Practice for Opioid Addiction

According to a study published in Science Daily, “People suffering from opioid addiction and chronic pain may have fewer cravings and less pain if they use both mindfulness techniques and medication for opioid dependence.” Practicing mindfulness is said to increase self-awareness and self-control, therefore allowing those to curb their cravings as well as be less affected by emotional and physical pain.

Opioid Addiction

Opioids are commonly known as painkillers that are prescribed to treat mild to medium discomfort to severe and chronic pain.  Some of the most commonly prescribed opioids include oxycodone, fentanyl, buprenorphine, hydrocodone, codeine, and morphine. Opioids can change the brain’s chemistry and overtime a tolerance builds up. An opioid addiction occurs when the urge for the opioids occurs even after pain has diminished and they experience withdrawal symptoms when they stop taking the drug. Opioid abuse is rampant across the world and opioid addiction has reached epidemic proportions.

What Is Mindfulness?

Mindfulness is a psychological practice that focuses one’s awareness on the present moment, and letting thoughts pass through consciousness without judgement. Many people equate mindfulness with meditation and use the terms interchangeably, but mindfulness can be practiced on a daily basis, on your drive to work, while exercising or even while washing dishes.

Mindfulness is all about being aware of your thoughts, feelings, behavior and sensations at any given moment. As explained by Thrive Global, “Mindfulness is the awareness of “some-thing,” while meditation is the awareness of “no-thing.” People can set aside a designated amount of time to meditate, where they can be still and focus on attaining a state of consciousness.

Mindfulness and Methadone

Methadone, which is a medication used to treat opioid addiction, along with mindfulness is said to be the most effective because although patients are more aware of their cravings, they are more apt to be in control of cravings, stress and pain. Being aware of their cravings without self-imposing judgment decreases the severity of the craving. Mindfulness also helps change negative thought patterns and to observe and enjoy pleasant moments.

Holistic Therapy For Pain Management

Other alternative therapies that treat opioid dependence include acupuncture, aromatherapy, massage therapy, chiropractic therapy yoga, and other therapies. Although mindfulness may not solely cure opioid use disorder, the practice along with other forms of therapy are effective.

It’s important for those with opioid abuse disorder seek treatment at a professional facility immediately. Once a patient has medically assisted detoxed and entered treatment, they can then work mindfulness into their recovery journey.

 

References:

https://www.latimes.com/science/story/2019-10-17/addiction-to-opioids-can-be-overcome-with-mindfulness

https://www.sciencedaily.com/releases/2019/10/191015103358.htm

https://medium.com/thrive-global/mindfulness-meditation-whats-the-difference-852f5ef7ec1a

https://www.eurekalert.org/pub_releases/2019-10/uou-cjt101519.php

 

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Antidepressant Dependency Debate

According to the American Psychological Association, antidepressant usage is on the rise. There has been a 64 percent increase in the number of people using antidepressants between 1999 and 2014.  The Centers for Disease Control and Prevention (CDC) report that approximately 1 in 10 people aged 12 years and older take an antidepressant. The Independent reports seventy million prescriptions were issued last year for the 7 million adults using them.

Antidepressants are used in managing depression and alleviating their symptoms. Antidepressants help treat symptoms that include fatigue, loss of interest, trouble sleeping and thoughts of suicide. Antidepressant can also help with anxiety disorders, seasonal affective disorder , mood disorders and other conditions.

 

What Are Anti-Depressants

Although there are different types of anti-depressants, currently the most common are Selective Serotonin Reuptake Inhibitors (SSRIs), which relieve depression by boosting low levels of serotonin in the brain. They prevent ​the reuptake of serotonin, making more of the chemical available.

 

Types of Anti-depressants

 

Types of  anti-depressants include:

Serotonin and noradrenaline reuptake inhibitors (SNRIs)

Selective serotonin reuptake inhibitors (SSRIs)

Tricyclic antidepressants (TCAs)

Monoamine oxidase inhibitors (MAOIs)

Noradrenaline and specific serotoninergic antidepressants (NASSAs)

Atypical Antidepressants

 

The most commonly prescribed medications include:

Sertraline hydrochloride (Zoloft)

Citalopram hydrobromide (Celexa)

Fluoxetine hydrochloride (Prozac)

Trazodone hydrochloride (Desyrel)

Escitalopram oxalate (Lexapro)

Duloxetine hydrochloride (Cymbalta)

These medications all have their own set of side effects and usage should be consulted with your doctor. The most effective antidepressant medications is dependent on the person’s brain chemistry. When stopping the usage of antidepressants, it is important to gradually decrease the dosage of medication instead of abruptly stopping.

 

Dependency Debate

Although, this topic is debated, the question of the addictive nature of anti-depressants is often posed. While there is evidence of withdrawal symptoms from these types of drugs, there evidence of dependency is not yet clear. A dependency would be characterized by a person wanting more of the drug, which many find is not the case, and the prescription is sufficient.

Even for those who do in fact believe antidepressants form a dependency, dependency is not necessarily the same thing as an addiction. The World Health Organization describes the difference as “Dependence is the body’s adjustment to the presence of a foreign substance. If the substance is abruptly discontinued, withdrawal phenomena occur. Addiction is loss of control over the use of a substance despite adverse consequences.”

However, some users believe differently. Although initially create for short term usage, many people on ant-depressants have been doing so for many years even decades with many believing they don’t ever see the need to get stop taking the drug. According to New York Times “Many who try to quit say they cannot because of withdrawal symptoms they were never warned about.”

Some people’s symptoms were so severe that they could not bear to stop taking the drug and other say they “feel” addicted to their medication.

Unfortunately there is a lack of long-term data and even if healthcare professionals acknowledge that some people will develop dependency on antidepressants, they are unable to predict who is specifically at risk. Antidepressants have indeed helped so many people live happier fulfilling lives and it is important for these drugs to be further studied and the risks discussed with your doctor.

 

https://www.apa.org/monitor/2017/11/numbers

https://www.verywellmind.com/most-common-antidepressants-1066939

https://www.independent.co.uk/voices/antidepressants-drugs-pills-opioids-addiction-mental-health-a9131901.html

https://www.latimes.com/opinion/story/2019-09-11/antidepressants-cause-dependence-not-addiction

https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html

 

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5 Healing Activities for Recovery

Everyone needs to spend some time trying to process their emotions and heal themselves from the difficult things that they go through. For people in recovery from an addiction or a mental illness, they will need to find multiple ways to heal themselves in their mind, body and spirit. These are some of the best and most effective healing activities for recovery.

1. Meditation
One of the best places to start when getting involved in healing activities is meditation which naturally helps calm anxiety and stress. Meditation is a beneficial way to quiet our thoughts and allow emotions to run their course as we stay present in the moment.

2. Expressive Art or Music
Self-expression can be crucial for coping with addiction or mental illness as the two can lead to complex emotions. Art and music therapy can be a great way to use creativity in order to express feelings that are hard to talk about.

3. Spending Time in Nature
Living in an urban environment can be stressful so it is important for people in recovery to reconnect with nature. Being in a natural place can relax our minds and help us feel connected to our inner spirituality.

4. Diet and Exercise
Many people don’t realize the amount of stress they put on their bodies by consuming toxic and unhealthy foods. Taking a break from sugar, caffeine, alcohol and processed foods can help heal the body and the mind.

5. Journaling and Writing
The act of writing can be another great way to process complicated feelings that are hard to discuss out loud. Writing in a journal can release emotions and also put them in a different perspective so that you can start to make sense of them.

There are many other activities that can help people heal, but these are some of the most immediately beneficial to use in recovery.

References

https://nccih.nih.gov/health/integrative-health

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Signs and Symptoms of a Panic Attack

People with anxiety issues sometimes suffer from panic attacks when they experience intense and overwhelming fear. A panic attack can lead to physical and emotional reactions to a trigger and can make people feel as though they are losing control. Panic attacks can be debilitating because they involve a number of frightening and uncomfortable symptoms.

Symptoms of a panic attack can include:
-Sense of danger or doom
-Fear of death or harm
-Rapidly beating heart
-Trembling or shaking
-Difficulty breathing and tightness in throat
-Sweating or chills
-Nausea
-Chest pain
-Sudden headache
-Dizziness or faintness
-Numbness or tingling sensation
-Feeling of detachment or unreality

When someone experiences a panic attack it can happen suddenly and without warning, causing them to feel unstable and afraid for their safety. What can make panic attacks difficult is that even after they subside the individual may have an intense fear that an attack will happen again at any moment. They may start to avoid certain situations that they feel could potentially trigger an attack.

People that suffer from panic attacks can develop them for a variety of reasons. They may have specific phobias that trigger them such as a fear of driving or leaving the house. They can also have social phobias that cause them to avoid people or public places.

Panic attacks can also sometimes be triggered by stress when it becomes overwhelming and affects the mind and body. In order to treat panic attacks it can be helpful for patients to be gradually exposed to situations that trigger them and learn strategies to cope with their stress. Medications can also be very useful in helping people manage panic attacks when they occur.

Treatment for panic attacks usually combines anxiety medication and cognitive behavioral therapy to help relieve more severe symptoms.

https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml

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5 Things to Know about Addiction and Bipolar Disorder

Substance abuse often is closely connected to mental health issues and bipolar disorder can be one of the most vulnerable to dual diagnosis. Because bipolar disorder and substance abuse frequently occur together, it is helpful to know certain facts about the disorder and how it relates to drug use.

1. Bipolar disorder is often misdiagnosed during substance abuse – People that are struggling with bipolar disorder may not know that they have this mental illness, especially if their alcohol or drug use triggers symptoms and can seem like effects of the substances. Even people going through detox may be misdiagnosed because their symptoms may seem to be related to withdrawal effects.

2. There is no single cause for bipolar disorder or addiction – The reason people develop bipolar disorder or abuse substances can be related to a number of different issues including genetics, environment, biology and many other factors.

3. Co-occuring abuse with bipolar disorder is extremely common- Mood disorders like bipolar disorder very common in the US and the disorder is often accompanied by substance abuse issues. Many people with bipolar disorder use drugs as a way to cope with their symptoms.

4. Drug use can trigger bipolar symptoms – While many people already have bipolar disorder when they start using drugs, others can start to develop symptoms as a result of their drug use. It can intensify mood swings and worsen their state of mind, leading to manic and depressive episodes.

5. Treating bipolar disorder can reduce addiction issues and vice versa – It is important for people with co-occurring disorders to treat both problems simultaneously and ease the symptoms of each problem in connection with each other. When both issues are treated they can help relieve the other and bring about better mental health and behavior overall.

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