Treatment

Individualized treatment has become more widespread than ever before, as researchers have found that each person’s unique history, experiences, and background contribute to their needs in recovery. Whether you’re attending treatment for a mental illness or addiction, your family dynamic can provide a lot of information to your healthcare team. When a therapist asks you questions regarding your family, this gives them insight into how you were raised and what problems you may have endured when you were younger. Most of us carry the weight of these issues far into adulthood, affecting our mental health and potentially factoring in as a cause of our substance abuse. Family systems theory was coined by American psychiatrist Dr. Murray Bowen and is based on the idea that a person is always connected to their relationships; they cannot be looked at individually without exploring the dynamic of their relationships and how they fit into a larger, complex system that serves as an emotional unit. According to Dr. Bowen, changes of behavior in one family member are likely to have an influence on everyone else in the family. The theory further suggests that as boundaries of a family system tend to change, roles within the family must change to maintain the family’s stability. If a family refuses to change their pattern of behavior, dysfunction may occur. Family doesn’t always mean “mother” or “father” – family is often made up of traditional families such as couples, single parents, adoptive families, foster relationships, grandparents raising children and stepfamilies, extended families such as grandparents, uncles, cousins, etc., and elected families such as godparents, friends, etc. The way in which you relate and communicate with these various systems says a lot about you and how you experience life. From this, a treatment center can explore what your needs are and what type of treatment would be best for you. Family systems are a major informant of what you need for treatment, but this is not the only factor. Your mental health and substance use history, genetics, biology, abuse history, personality, behavioral patterns and more can provide a lot of information as well.

Borderline personality disorder (BPD) is a mental illness categorized as having difficulty regulating emotions, difficulty controlling behaviors, and holding an unstable sense of self. People with BPD often experience emotions intensely and for extended periods of time, making it rather difficult for them to return to a foundational baseline after a particularly upsetting event. If you have BPD, you may experience symptoms of insecurity, impulsivity, feelings of worthlessness, and more, which can greatly affect your daily life. Unfortunately, there is much stigma associated with BPD, and between these and the symptoms experienced with the disorder, individuals with BPD are prone to self-injury and suicidal behaviors. Dialectical behavior therapy (DBT) is a form of cognitive behavioral therapy (CBT) which has been used to help treat those with BPD. The primary goal of DBT is to transform negative thinking and destructive thought patterns into more positive outcomes, such as building skills to better regulate emotions, reduce stress and anxiety, build self-management skills, control destructive habits, and more. Despite all of these wonderful outcomes, how does DBT address suicidal thoughts and behaviors specifically? One study sought to explore this very question. A 2015 study published in the journal JAMA Psychiatry analyzed the results of 99 women who were diagnosed with BPD and had previously had 2 suicide attempts and/or acts of self-injury within the past 5 years, attempts within the past 8 weeks before the study was conducted, and a suicide attempt within the past year. Participants were placed in either a standard DBT treatment program, a DBT skills training program, or a DBT individual therapy program. Results from the study indicated that while DBT is an effective form of support for those with BPD who are struggling with self-injury and/or suicidal behaviors, DBT skills training may lend itself the most to outcomes related to this area of concern. What skills are taught in DBT skills training? The following are just a few:

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) have been clinically shown to have four major overlapping symptoms: restlessness, loss of energy or feeling fatigued much of the day, difficulty concentrating, and sleep disturbances of insomnia. Rumination can be another experience associated with either disorder and has been defined in previous studies as “a negative, repetitive style of thinking about present and past symptoms, loss, and failure.” When we ruminate, we tend to dwell not only on events that we can’t change, but also on the “negative” aspects of our lives. While rumination is dangerous for anyone, it can be especially dangerous for those with MDD and/or GAD due to the other symptoms experienced. A 2015 study published in the Journal of Abnormal Psychology sought to the effects of rumination on those with either or both disorders. The research study involved 145 participants, 38 of whom were diagnosed with MDD but not GAD, 36 of whom were diagnosed with GAD but not MDD, a dual-diagnosis group which consists of 38 individuals whom were diagnosed with both MDD and GAD, and 33 individuals with no diagnosis to serve as a controlled group. Participants completed interviews and also wore an electronic device that would produce signals throughout the day; individuals were asked to record their thoughts and whether they were “positive” or “negative” each time the device signaled them to. Results from the study showed the greater rumination predicted more symptoms of those experienced with MDD or GAD; it also predicted greater levels of social withdrawal, inactivity, and behavioral avoidance. This makes sense, because during those times that we engage in rumination, we’re so hyper-focused on what our lives our lacking – why would we want to participate in life more? Participants with either MDD or GAD experienced difficulty in engaging in motivated activity when they were ruminating. Overall, the study’s results show that rumination can cause a lot of damage. Why? Because it can take us away from the present moment, it can exacerbate the symptoms of a mental illness, and it can cause us to hold back on what is supposed to make life more enjoyable. Speak with your therapist about ruminating if it’s something that you struggle with. Identify tools to overcome it. It is possible to change your thinking patterns – cognitive behavioral therapy (CBT) is a common therapy tool for this.

Recovery can be challenging, because it involves building a new lifestyle for a better future. If you’ve recently begun a treatment program, you may feel apprehensive about your capabilities; many people who begin recovery have identified with a label – “addict”, for example – that holds them back from their true potential. Motivational enhancement therapy (MET), may help you discover the self-confidence that you need to push through the barriers that addiction tries to enforce on you. MET is designed to help people find new labels of their lives – ones that incorporate happiness, health, recovery, and much more. In the first session, your therapist will conduct an initial assessment to learn more about your history with substance abuse and your thoughts on recovery. Your therapist may work with you to come up with an action plan, as well as discuss with you some useful coping strategies that could help you in times of need. MET therapists are trained to listen to you rather than tell you what to do – this places the decision-making process in your hands. Your therapist won’t argue with you regarding any thoughts or decisions you plan to make about recovery; rather, they will explore with you all of the possibilities that you could take and help you make an informed decision. Ambivalence is completely normal when considering a major change. Often a key method for deciding if treatment would be best is to conduct a cost/benefit analysis; talk to your therapist about the benefits of attending treatment and what it could do for your life, as well as some potential challenges you may run into and some hesitancies you are having. On some occasions, addressing these issues may allow you to reconsider if the risks are all that bad – or more, what you may do in situations where these risks arise. If you’re unsure of whether treatment is the best option with you, schedule an appointment with a professional at a reputable treatment center. Get more information and speak with a therapist regarding your thoughts. Sometimes all it takes is talking to another person out loud so that you can process everything in front of someone who truly cares about your happiness and health.

If you have anxiety, you’ve probably noticed at one point or another your heartbeat escalating, your thoughts racing, and feelings of nausea, fatigue, dizziness, etc. Anxiety is caused by worry, nervousness, or unease typically surrounding an event or something with an unpredictable outcome. Thankfully, cognitive behavioral therapy (CBT) has been shown to help many people with anxiety; in fact, it’s one of the most effective, widely-used therapies for this issue. If you’re ready to incorporate CBT into your daily life, begin taking control over your anxiety by following these steps: Step 1: Begin taking note of your thoughts, feelings, and sensations in a log. Get a journal and write down every instance that you feel anxiety. What are your thoughts at the time? What situation is this regarding? Did someone say or do something to make you feel this way? How would you describe your feelings? What physical sensations are you feeling (ex. sweaty palms, heart racing, etc.)? Lastly, how did your anxiety influence the situation/interaction? For example – did it cause you to leave an event early? Not go at all? Taking inventory of these can help you become an investigator of your own reactions. Step 2: Recognize patterns that are coming from these notes. Is there a certain time of day you experience anxiety the most? What about a specific person or place that tends to lead you to a lot of anxiety? Highlight commonalities between your experiences – with assorted colors if that makes it easier for you. Step 3: Do a cost-benefit analysis. As you review the notes you’ve taken so far, write another list that weights out the benefits and the consequences to having this anxiety. For example, how has having anxiety helped you? In what situations has it caused more pain or discomfort, when it didn’t really need to? This is your change to get an understanding for how anxiety is affecting your life. Step 4: Create alternative ways to react. What can you think to yourself that will make you more at ease, more confident, and less worried? For example, if you’re nervous about going to a work gathering, write the following thought: “The gathering will go well, and I’m excited to get to know other people.” Even if you don’t necessarily feel that way, stick with these positive thoughts. Step 5: Practice daily, no matter how you’re feeling. This is a great start to CBT – towards changing your thought processes towards something more positive and productive. Practice this every day, no matter how you’re feeling.

There are times when we see changes in our loved ones – changes they may not directly be able to see. When it comes to mental illness, stigma often causes people to either fear having one or to fear others who have one. If your loved one does not believe they have a mental illness, but you are certain there are obvious signs of this, they may be in denial. This can be particularly challenging, especially if you want your loved one to seek help. A 2015 study titled “Assessing and Improving Clinical Insight Among Patients in ‘Denial’”, emphasized the difference between denial and lack of insight – does your loved one reject the notion that they have a mental illness or have symptoms of one, or have they simply not recognized the connection between their thoughts, feelings, and experiences and how they relate to mental illness? Denial is often considered a psychological defense mechanism, while lack of insight could be due to symptoms being perceived as a sign of something else, having neurocognitive deficits that make it challenging to form connections between instances such as these, or having a unique way of thinking about symptoms, mental illness, etc. If your loved one has been open to talking about mental illness with you, you may want to consider having them speak to a therapist. Motivational interviewing is a technique that helps those with apprehension come to their own realizations about their mental health and recovery options. Rather than push the client towards choosing recovery, the therapist may gently probe them with questions and will remain supportive and neutral during the entire process. Some people with a lack of insight to their mental illness don’t seek treatment because they don’t know they need to – this could be a wonderful time to help them gain insight into their experiences. If your loved one doesn’t believe they show signs of a mental illness, but you can see it’s potential for significantly reducing their quality of life, you may want to speak with a professional about staging a family mental health intervention. Untreated mental illnesses often get worse over time and could lead to the development of either another mental illness or an addiction, as a person tries to self-medicate to cope with their symptoms. Getting several friends or family members together with clear examples could help your loved one understanding the truth.

They both sound similar – codependency and dependent personality disorder (DPD) – but are they the same? What level of dependency constitutes as having a mental disorder versus an unhealthy view of relationships? Whether you’ve recently been diagnosed or are concerned about a loved one, there are some distinct differences between the two. Both can be very distressing and there are ways to treat each – but DPD is classified as a mental disorder whereas codependency is not. The following is a brief breakdown of what each means:

Individualized treatment has become more widespread than ever before, as researchers have found that each person’s unique history, experiences, and background contribute to their needs in recovery. Whether you’re attending treatment for a mental illness or addiction, your family dynamic can provide a lot of information to your healthcare team. When a therapist asks you questions regarding your family, this gives them insight into how you were raised and what problems you may have endured when you were younger. Most of us carry the weight of these issues far into adulthood, affecting our mental health and potentially factoring in as a cause of our substance abuse. Family systems theory was coined by American psychiatrist Dr. Murray Bowen and is based on the idea that a person is always connected to their relationships; they cannot be looked at individually without exploring the dynamic of their relationships and how they fit into a larger, complex system that serves as an emotional unit. According to Dr. Bowen, changes of behavior in one family member are likely to have an influence on everyone else in the family. The theory further suggests that as boundaries of a family system tend to change, roles within the family must change to maintain the family’s stability. If a family refuses to change their pattern of behavior, dysfunction may occur. Family doesn’t always mean “mother” or “father” – family is often made up of traditional families such as couples, single parents, adoptive families, foster relationships, grandparents raising children and stepfamilies, extended families such as grandparents, uncles, cousins, etc., and elected families such as godparents, friends, etc. The way in which you relate and communicate with these various systems says a lot about you and how you experience life. From this, a treatment center can explore what your needs are and what type of treatment would be best for you. Family systems are a major informant of what you need for treatment, but this is not the only factor. Your mental health and substance use history, genetics, biology, abuse history, personality, behavioral patterns and more can provide a lot of information as well.

John Forsyth and George Eifert described in the book titled, “The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy” the true essence of fear experienced with phobias and anxiety alike. They stated, “More deeply you may know, with absolute certainty, that anxiety has brought ruin to you and your life. You may feel frustrated and exhausted. You may feel broken, damaged, and at your wit’s end. You may think something is wrong with you. And you are looking for a way out.” Perhaps this is how you’re feeling right now. If you have a phobia, you likely know that you have an irrational fear towards something – whether it be social situations, trains, spiders, or something else, but you can’t help but to make each decision in effort to avoid facing whatever it is you’re fearing. This impending fear takes over your thoughts, decisions, interactions, and at times, your physiological responses – feeling as though your mind and body have quite literally been “hi-jacked”. You’re not alone; an estimated 19.2 million Americans have a specific phobia, with many having several phobias. A 2015 study titled, “Spider or No Spider? Neural Correlates of Sustained and Phasic Fear in Spider Phobia” confirmed that in phobic patients, significantly higher amygdala activation was present when presented with an image of their phobic fear; the amygdala is an almond-shaped structure in the middle of the brain’s temporal lobes that controls automatic responses to fear, arousal, and emotional stimulation. While exposure therapy has proven successful for many people, those that do not find success may be using mental safety precautions – such as dissociation - to protect themselves, not allowing the exposure to disconfirm any pre-existing negative beliefs they had. If you experience this, speak with your treatment center to make subtle changes to your treatment regime. Most often, treatment involves a variety of techniques to determine what works best for you – medication, psychotherapy, group therapy, and other complementary forms of treatment may be used to help you overcome the fears that have been holding you back. Your phobia does not define you, and it does not have to take control over your life. Make the decision to seek the help you need today.

Obsessive-compulsive disorder (OCD) is a mental health disorder that involves excessive thoughts (obsessions) and repetitive behaviors (compulsions). OCD affects nearly 3.3 million people in the United States; if untreated, it can cause much distress in various aspects of life. If you’ve been diagnosed with OCD, you may have obsessions related to contamination, loss of control, religious or moral concerns, fear of losing things you may need, order and symmetry, and more. Many people seek treatment for OCD and find that while there is no cure, treatment can drastically reduce distressing symptoms and may help a person better manage their life, living happier and healthier.

You may be feeling as though your friends and family have been making a lot of comments related to your drinking habits lately. You might be thinking to yourself, “It’s just a few drinks and I’ve been taking care of all my responsibilities – what’s the problem?” While it might seem that your drinking is under control, hearing concerns from loved ones is a sign that you need to re-evaluate your drinking patterns to make sure that you aren’t developing dependence or alcoholism. Preventative measures are important to ensure you’re on the right track to leading a happy, healthy, long-lived life. The following are some reasons why your loved ones may be concerned about you, and these are reasons to believe that you may have a drinking problem:

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.