Recovery

Imagine this: You’ve been in recovery for about a month, and you’re feeling great. You’ve been working hard in individual and group therapy, and you finally feel as though your life is back on track. You think to yourself, “Finally, everything is just as it should be. I’m on TOP of the world!” Recovery consists of highs and lows – much like life – and when things are going well, it can be an amazing feeling. While you should embrace and appreciate these moments, you don’t want to allow yourself to feel invincible. Over-confidence can be just as much as predictor of relapse as feelings of helplessness can; just because everything seems to be going right, doesn’t mean your work in recovery is over. A 2016 study published in Substance Abuse Prevention, Treatment, and Policy, involved interviews of 36 participants regarding their history of drug use and rehabilitation, their self-evaluation of addiction, their motivations to abstain, their plans for the future and their attitudes towards rehabilitation. The researchers found that over-confident participants under-estimated their levels of addiction, over-estimated their self-control, and held external motivations and attributions. What does this mean for you? See if you can recognize these statements:

Narcissistic personality disorder (NPD) is a mental disorder in which the person has an inflated sense of self-importance and a deep need for admiration. Narcissism has been misconstrued as being the disorder as well, but narcissism is a spectrum that ranges from healthy to unhealthy. Those with healthy narcissism are confident in themselves and their capabilities, care about their appearance and health, and actively engage in self-love. Unhealthy forms of narcissism, such as constantly outdoing others in a negative way, believing one is superior to others, and using people to achieve fame, status, recognition, etc., are signs of NPD. Beyond these healthy and unhealthy forms, there are 2 sub-types of NPD: grandiose and vulnerable NPD.

In 2015, poet Sue Wallingford wrote a poem titled, “Life Goes On”. She wrote it as a form of art therapy, in remembrance of her addiction, as she was in recovery. Here is a small excerpt from her poem: “Your power to make me feel stronger slipped away gradually, almost Without notice. But in your wake you left your mark of betrayal and heartache. You tried to take everything away. But life goes on you see, New generations are on the horizon, And we’ll be ok.” Recovery means leaving behind destructive patterns of the past. It means growing, changing, and transforming into a better version of yourself; a version that places health, self-care, vitality and life fulfillment at the top of the priority list. Of course, necessary changes take lots of time and dedication. As humans, we’re not always excited about these steps because, well, it’s change – and change can be quite devastating. If you’re at a moment in your journey to recovery where you’re really missing aspects of your addiction, it’s okay to mourn this loss. Doing so can help you move on and embrace this journey that’s for the better. A 2017 study published by The American Academy of Psychoanalysis and Dynamic Psychiatry emphasized that addiction has many overlapping qualities to falling in love; both entail arousal, euphoria, and increasing preoccupation with the person or drug. When these have progressed into more serious stages, “leaving” the person or drug can lead to a sense of loss, dysphoria, changes in sleep and eating patterns, and more. Additionally, as with falling in love, addiction can involve social attachment, as many people who abuse substances due so around others. Recovery essentially involves not only quitting the object of your addiction but cutting out those in your life whom you have used with as well. Allow yourself to genuinely feel the pain of letting your past go. Utilize your tools from therapy and acknowledge the pain it’s caused you in life. Once you’ve allowed yourself to grieve you can begin focusing on building a social support network in your treatment program; over time, you will develop a new social circle, new ways of living – and you will be much happier and healthier.

Willie Nelson once said, “Once you replace negative thoughts with positive ones, you’ll start having positive results.” There’s no question that mental health recovery can be a scary journey – after all, it involves change, growth, and transformation – all of which most of us are nearly terrified of. However, our perception is what guides us through life, and having a positive perception of your recovery can give you the motivation that you need to succeed. When it comes to mental health, a reputable treatment program can provide you with essential tools to help you better manage your symptoms. While you’re working hard in your program by attending individual and group therapy sessions and activities, you want to ensure you’re taking major strides on your own as well. Positive psychology is a great foundation to motivate, inspire, and uplift your spirits during this time of change. As explained by a 2014 study published in the Eastern Asian Archives of Psychiatry, positive psychology is an umbrella term used to describe positive emotions and aspects of being such as creativity, optimism, resiliency, empathy, compassion, humor, life satisfaction, and more. How can you incorporate positive psychology into your recovery? The following are a few excellent exercises:

No matter if you’ve been working towards your recovery for a month, a year, or 10 years, there’s no doubt there will be challenging times. Recovery – like life – is comprised of many ups and downs, achievements and downfalls, moments of glory and moments of disappointment. Perhaps you’ve just received devastating news, or maybe you’re having an “off” day and feel anxious or depressed. No matter the case, it’s completely normal to worry about your progress. This is a sign that you genuinely care – if you didn’t, you wouldn’t be working towards your recovery at all, and you would have already given up. If you’re reading this, clearly you haven’t – which shows that you are getting better, you can keep going, and you will succeed. Perspective is one of the most important aspects of recovery. We all have different perspectives of what recovery means to us – but what we choose sets a precedence for how we carry ourselves through the ups and downs. Take, for example, a 2014 study published in the Journal of Studies on Alcohol and Drugs. An internet-based survey was completed by 9,341 individuals who self-identified as being “in recovery, recovered, in medication-assisted recovery, or as having had a problem with alcohol or drugs (but no longer do).” Results from the survey indicated 4 domain themes of perspective on recovery, with 35 elements total. The four themes are described below: Abstinence in recovery – no use of alcohol, no misuse of prescribed medications, no use of non-prescribed drugs Essentials of recovery – being honest with oneself, handling negative feelings without using drugs, being able to enjoy life without drinking or using drugs like one used to Enriched recovery – a process of growth and development, reacting to life’s ups and downs in a more balanced way than one used to, taking responsibility for the things one can change Spirituality of recovery – gratitude, giving back, helping others Ninety-seven percent of participants agreed that recovery is “a continuous process that never ends.” You’re not alone – there are so many other people out there who are struggling, but keep trying. Just as these individuals have, you can form your own perception of what recovery means to you. Once you’ve done this, you can choose to live by the values you’ve set for yourself. You may not recognize progress immediately, but it’s there. Just as a person may not recognize subtle changes in their appearance from seeing their reflection in the mirror each day, you may not notice slight changes on a day-to-day basis, but that doesn’t mean progress hasn’t occurred. Don’t give up.

Whether it’s you or a loved one who has recently began a treatment program for an addiction or mental illness, anxiety and overwhelming feelings may be at the forefront of your heart and mind. It’s normal to feel apprehensive – after all, it’s a completely new experience, one that you may not be sure you’re ready for. However, completing treatment is essential to your success in recovery, and identifying some of the risk factors for wanting to leave treatment early could help you overcome these thoughts and/or feelings. A 2018 study published in Qualitative Social Work interviewed 15 males and females aged 19 to 29 years old to explore patients’ own understanding of their drop out from residential substance use disorder treatment. The following were the themes found:

There’s no doubt that many people with mental illness experienced discrimination or stereotyping on a daily basis. Nearly one in five Americans experience a mental health disorder each year, yet only 25% of people with a psychological condition feel that others are understanding or compassionate about their mental illness, according the U.S. Centers of Disease Control and Prevention. Many people look at mental illness as a character deficiency – as if someone could simply “get over” their mental illness if they wanted to. Unfortunately, this has caused many people to internalize these damaging perceptions.OK Self-stigma, or internalization, refers to a time when a person cognitively or emotionally absorbs stigmatizing assumptions or stereotypes about their mental illness and comes to apply those beliefs to who they are as a person. According to a study published in Psychiatric Services, self-stigma can lead to a number of damaging outcomes, including: avoidant coping, social avoidance, decreased hope and self-esteem, worsening of symptoms of one’s mental illness, and decrease use of mental health services and other support groups. Self-stigma is marked by shame – a feeling that one isn’t “good enough” or that one cannot receive what they need because they are “inadequate”. A 2015 study conducted by researchers from the University of Connecticut interviewed 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Some participants ranked high on the following beliefs associated with internalization:

Imagine that everything has been going very well for you in recovery lately. You’ve met all of your goals that you’ve had set for yourself, and your therapist has commended you on your diligence in meeting those goals. You’ve been feeling great…but suddenly it all stops. You become a whirlwind of emotions one evening, and you feel all of this negative energy creeping in. Before you know it, you’ve relapsed, and you feel like it’s all gone terribly wrong. “How did this happen?” you may ask yourself. “Everything was going so well – where did it all go wrong, and where do I go from here?” Recovery is a lot like life. There are ups and downs and, at times, we may act in ways that contradict our values. This doesn’t mean that we have failed – it simply means that more reinforcement is needed, and/or we need a minor adjustment to our treatment regime. Perhaps something you’ve been working on in treatment hasn’t truly “sunk in” for you or you just don’t connect with it – that’s okay, as there are many treatment modalities for this very reason. If you’ve relapsed, you will want to work with your therapist to identify what led to this event. There are a number of triggers that could have affected you without you realizing it, such as:

According to the National Survey on Drug Use and Health, 948,000 people reported using heroin in 2016. Heroin addiction has shown to be very destructive to people’s health, social, home, and financial life; long-term use changes the physical structure and physiology of the brain, with several studies showing that heroin can deteriorate some of the brain’s white matter. If you’re seeking treatment for heroin addiction, you’ve made the best choice you possibly can. Seeking help, whether early on or later in addiction, may prevent further damage from being done and could potentially help your body to reverse some of the damages it has undergone. You’ve made a great decision. If you’ve attempted to recover several times but have not been successful, you are not alone. A study published in the Journal of Addictive Diseases found that after following an analysis of 242 heroin users (2 groups of people: one group who recovered and one group who didn’t) after 30 years, non-recovered individuals were more likely to utilize substances to cope with stressful situations, to have spouses that abused drugs, to lack proper social support, and to have a lack of self-efficacy. Without the right treatment program, heroin addiction can be challenging to overcome. Previous research has shown that addiction recovery must include community support, a structured program, and negative consequences of substance use; perhaps in previous programs you were not provided with these crucial components to success, or you attempted to recover at home. There are many successful interventions that can be used for heroin addiction, including both behavioral and pharmacological options; integrating both treatment options have been shown to be the most effective. Medications may be used to aid in withdrawal symptoms of heroin addiction, including: 1) agonists (activates opioid receptors), 2) partial agonists (activates receptors but produces a smaller response), or 3) antagonists (blocks opioid receptors, interfering with reward responses). Methadone, buprenorphine, and naltrexone are the most common medications currently used to treat this addiction. Behavioral therapy such as cognitive behavioral therapy (CBT) and contingency management are most likely to be used in a treatment program. These programs will help you to release negative, unproductive patterns of thought and replace them more positive, productive ways of thinking. Contingency management is based on providing vouchers and other healthy rewards for actively working towards your recovery. Reach out to a representative at a reputable treatment center today to begin your journey towards recovery.

In the beginning of your recovery, stabilization is incredibly important. Many people with addiction experience depression, anxiety, and more as they generally feel a physical and psychological imbalance. The right treatment program is meant to help you regain that balance first through detox, and then through a structured program. Detoxification is the first step and involves the natural cleansing process of your body getting rid of the toxins of addiction. Treatment programs are great for this step because you will have a healthcare team who can closely monitor you and provide you with medication if you are experiencing a lot of discomfort from your withdrawal. Change can be difficult, but treatment is supposed to help you make the changes necessary to benefit your life. Once you’re in a treatment program, the first step towards stabilization is attending all of your scheduled meetings, therapy sessions, and activities. Even on days that you don’t feel like going – those are likely the days you need to attend the most. In a publication titled, “Treatment Improvement Protocol” by the National Center for Biotechnology Information (NCBI), several factors were emphasized as ways to promote stabilization in recovery:

Addiction disrupts the body’s functions, including the body’s ability to produce chemicals such as dopamine, the “feel good” chemical. When this happens, many people who stop using experience withdrawal symptoms both physical and psychological; physical symptoms may include weakness, clammy skin, sweating, coldness, shaking, nausea and more, while psychological symptoms may include depression, hallucination, paranoia, severe anxiety, and more. Amino acids have been shown to give a person more stability while they are detoxing from substances, primarily by assisting the body in reproducing the neurotransmitters needed to feel relaxed and happy again. This, in turn, helps a person to curb the cravings associated with drug use.

Finding the right treatment program for you can be a daunting experience. With so many options and so much to consider, it may feel easy to simply select a program that’s the most convenient, affordable, or straight-forward. While all of these options provide some benefit, a key component of your decision-making should be focused on whether or not the treatment center works with you to develop a customized treatment program that will best suit your needs. As a 2015 study published in the Yale Journal of Biology and Medicine emphasizes, personalized programs are an emerging paradigm since many people have experienced misdiagnoses, late and inadequate treatment that has required them to re-enter programs, and unsuccessful attempts to recover due to a lack of support in other areas of life such as employment and finance management. Perhaps you have been on the receiving end of one of those unfortunate cases. If you have, you’ve likely found that there was a component of your initial program that was missing – something that didn’t quite speak to what you needed. For a customized treatment program, the following must be taken into account: