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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.

Author Martin Kantor explains a common, painful truth of avoidant personality disorder (APD) in his book titled “Distancing: Avoidant Personality Disorder” by stating, “Some [people with avoidant personality disorder] are isolated individuals, who, unmindful of the pathological nature of their avoidance, cite, and live by, its presumed advantages, and eventually come to believe that their isolation from family, friends, and potential intimates is a good thing.” If you struggle with APD, perhaps you can relate to the deep, internal fear of being criticized, judged, or ridiculed; many people with APD feel inadequate or socially inept, causing them to withdraw from others. Personality disorders affect the way a person thinks and behaves, as well as how they connect with themselves and relate to others. People with APD may have difficulty forming and maintaining relationships of any kind because they fear of doing something wrong. APD is said to affect 1.8% to 6.4% of the U.S. population, split fairly equally between men and women. If you have APD, you likely can relate to the following:

After a night of drinking, you wake up, and feel a massive headache coming on. Your muscles ache, you feel groggy, and you didn’t get much sleep. These are all signs of a hangover; although typically harmless, hangovers can make it difficult to function the next day at work, and may cause you a lot of discomfort. An estimated 75% of people who drink alcohol to intoxication will experience a hangover the next morning as a result. Other symptoms, such as dry mouth, dizziness, rapid heartbeat and change in blood pressure may occur. What happens to your body when you drink alcohol that causes you to have a hangover the next day? Let’s look at what science has to say. First, it all depends on what you have been drinking. Research says the darker in color your alcoholic beverage is, the more congener it contains – leading to more severe hangovers. When the body processes alcohol in its system, chemicals called congeners form, which increase the frequency and severity of hangover symptoms. Many people also become low in blood levels of various hormones, which effect the hangover as well – for example, alcohol inhibits the antidiuretic hormone, leading a person to urinate more frequently and become easily dehydrated. Secondly, it depends on how much you had to drink and how you drank it. For example, a person who drinks quickly and has had little food to eat is more likely to experience a more severe hangover than someone who drinks moderately and has been eating throughout the night. A 2018 study published in the journal, “Addictive Behaviors” found that greater hangover severity predicted more future drinks per drinking day and alcohol problems. This makes sense, as many people who experience severe hangovers are likely heavy drinkers or drink dark liquors. Lastly, the environment in which a person drinks can affect the quality of and their ability to sleep. Loud music, smoke, flashing lights, and more can all impact your experience the next morning. Based on the physical effects of drinking, how can you prevent a hangover? There are many ways:

Stress can negatively affect many areas of our lives – our relationships may suffer, our work performance and productivity may decrease, and our lives may spin out of control; there’s no doubt that sleep can also be negatively affected, but how? If you’ve been tossing and turning all night or experiencing insomnia due to stress of any sort – getting to the bottom of this could help you ease your mind – and body – a little more. When you become stressed, your body muscles tense. As emphasized by the American Psychological Association (APA), muscle tension is nearly a reflex to stress – it’s the body’s way of guarding itself against pain or injury. Chronic stress often causes the body’s muscles to be more or less tense in a constant state, which can lead to further distressing physical issues such as migraines. Your respiratory system is also affected, as you may experience shortness of breath or even anxiety attacks. The body’s cardiovascular system is affected, as stress hormones such as adrenaline, noradrenaline, and cortisol amp up. The endocrine system is affected as when your body is in “fight or flight” mode, the liver produces more glucose, a blood sugar that gives you the energy to react in response to an emergency. Furthermore, energy will come from the additional cortisol and epinephrine that your adrenal cortex has produced in your adrenal glands. Your gastrointestinal system is affected, as your stomach, esophagus, and bowels experience heightened activity. All of these symptoms together affect the central nervous system, which plays a part in your sleeping patterns. A study published in Experimental Neurobiology found that stress can cause an activation in the body’s hypothalamic-pituitary-adrenal (HPA) axis, one of the main neuroendocrine stress systems during sleep. When stress hormones are activated, the sympathetic nervous system results in wakefulness, attention, and arousal. The study further denoted that stress-related insomnia can easily become a vicious cycle of as the hypothalamus is known as a key center for sleep regulation; in order to sleep better at night, you need to take part in activities such as mindfulness, breathing exercises, and other self-care exercises to protect your mind and body from the considerable damage that stress can cause.

You may have noticed that your significant other, friend, or family member tends to act a bit differently when they’ve been drinking. For example, they may typically be shy and reserved sober, but after they’ve been drinking, they become the “life of the party”. Some people become very irritable and angry when they’re drunk – what accounts for these differences between people? Many studies have delved into this area to find out the exact cause. A study published in Clinical Psychological Science involved the recruitment of 156 participants who were split into several groups and assessed on five of the major personality traits after consuming either Sprite or vodka and Sprite cocktails to induce a blood alcohol content of about .09. After a 15-minute absorption period, participants who drank alcohol reported lower levels of conscientiousness (being careful or vigilant), openness to experience (attentiveness to inner feelings, active imagination, etc.), and agreeableness (warm, friendly, tactful), with higher levels of extraversion (outgoing, talkative, energetic) and emotional stability (stable and balanced). Overall, this study could show that our perception of what a “drunk person” or a “sober person” looks like doesn’t pan out to mean the same for everyone. As each person is different, it likely depends on the individual’s personality to begin with. For example, a 2016 study conducted by researchers from Finland found that individuals high on agreeableness and low on openness to experience are more likely to reduce alcohol consumption and lean more towards abstinence; where do you fit in? Many people who drink excessively are high sensation seekers – they tend to be more impulsive and use less perseverance because of their alcohol consumption. In addition, the way we handle our emotions can impact the way we think and act when we’re drunk. As alcohol tends to suppress our decision-making and emotion regulation strategies, people who suppress their anger are more likely to become more hostile when drinking. If you’ve been struggling with alcoholism, make the decision to seek help today. Excessive drinking can have negative repercussions on your health, relationships, career aspirations, and more. Don’t wait any longer to reach out to a reputable treatment center.

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:

More than 4 million people in the United States have borderline personality disorder (BPD), a disorder characterized by intense emotions experienced for extended periods of time. BPD makes it difficult for a person to achieve stability after an emotionally triggering event; this difficulty can lead to impulsivity, poor self-image, rocky relationships and dangerous self-harming behaviors. According to the National Alliance on Mental Illness (NAMI), 75% of those with BPD are women. In whole, BPD is associated with difficulties in regulating emotion. What is emotion regulation? Emotion regulation is a complex combination of ways in which a person relates to and acts upon their emotional experiences. This may involve one’s ability to understand and accept their emotions, one’s ability to cope with uncomfortable emotions, and one’s ability to engage in appropriate behaviors when they’re distressed. Individuals who do not have difficulty with emotion regulation are able to – for example – remain calm even in a distressing situation, whereas someone with BPD may self-harm or engage in reckless behavior when upset. A 2015 study conducted by researchers from the University of Missouri identified 4 main components to emotion dysregulation that those with BPD experience:

Traumatic events such as rape, domestic violence, natural disasters, severe illness or injury, the death of a loved one, witnessing an act of violence and more can have a lasting impact on one’s physical, mental, and/or emotional stability. Many people who experience trauma also struggle with guilt, denial, anger, sadness, and emotional outbursts. Physical effects of trauma may include paleness, lethargy, fatigue, poor concentration, racing heartbeat, hypertension and more, making compassion such a critical component of recovery. A 2017 study published in Behavior Therapy assessed the effectiveness of compassion-based interventions for individuals who experienced symptoms of post-traumatic stress disorder (PTSD). At a 2 and 4-week follow up after the intervention, researchers found that the participants showed improvements in self-compassion and self-blame. Shame is often a major component of trauma, and having compassion-based therapy helped these individuals push past these damaging beliefs. What does a compassion-based intervention consist of? Compassion-based therapy aims to promote mental and emotional healing by encouraging individuals to be compassionate towards themselves and others. This form of therapy often integrates components of cognitive behavioral therapy (CBT), a type of therapy that helps people overcome negative, unproductive thought patterns and develop newer, more positive and productive ones. Much of the way a person recovers from trauma is grounded in their perspective of the event, themselves, and others. A reputable treatment program that is grounded in customized treatment, compassion, and CBT can have a major positive influence on those who are struggling with the distressing symptoms of PTSD. How can I be more compassionate to myself in recovery?

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:

Much research has shown that mental and physical health are linked; this is why your muscles may tense or you may experience a prolonged headache because you’re feeling stressed. A 2018 review of the literature published in Psychiatric Services denoted that mental illness, general medical comorbidity, and premature mortality are greatly affected by risk factors such as tobacco use, substance use, poor diet, and lack of physical activity. Thus, reputable treatment programs offer several effective components to addressing these concerns: medical and psychological interventions, nutrition assessment and management, and physical fitness exercises.

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: