White River Manor

What you need to know about ecstasy

They call ecstasy the ‘love drug’ because it amps up your sensations and people using it feel things at a heightened level; colours, sound and touch. It’s great if you’re clubbing or at a manic music concert because you lose all your inhibitions and can dance and rave all night long. And sex on ecstasy is mind-blowing.

But what they don’t tell you is ecstasy also causes deep depression, confusion, severe anxiety, paranoia and other very scary psychotic episodes. It’s a synthetic drug and the short burst of exhilaration on ecstasy doesn’t last anywhere as long as the depressed slump you go into after your crazy night out.


What is ecstasy?


Methylenedioxymethamphetamine (MDMA) goes by a few names; ecstasy, Molly, Adam, beans, clarity, E, hug, love drug, roll, Scooby snacks or snowball. It’s a synthetic drug that acts as a powerful stimulant and a hallucinogen.

People mainly use it for parties, clubbing or music festivals because within an hour of taking Ecstasy your inhibitions or anxiety disappears and you experience an overload of mental and sensory stimulation. That’s if you’re lucky.

It’s a chemical street drug with hectic side effects, the worse being vivid and often frightening hallucination. You see and feel things that aren’t there and if they’re bad things, they’re amplified to a terrifying level.

The problem with ecstasy is it can cause severe emotional damage; either over the long term or even after one-time use. This ranges from chronic depression and confusion to severe anxiety, paranoia and psychotic behaviour.


“Did you know?

MDMA is highly addictive; not so much the chemical dependence but the psychological dependence. They say when you start liking ecstasy, it’s too late; you’re sunk!”


Where does ecstasy come from?


Merck, a German pharmaceutical company, first developed MDMA in 1912 as a pharmaceutical compound that could be used to develop other medications to control bleeding. They soon realised that it had hallucinogenic properties and patented it in 1914, although the drug wasn’t developed further for a few decades.

MDMA was used in the 1950s and 1960s during the Cold War for use in psychological warfare. In the 1960s and 1970s, a few psychiatrists prescribed MDMA to patients to lower their inhibitions during psychotherapy, despite the fact that the drug was not FDA-approved.

By the 1980s, MDMA was on the street being used by the party people at music festivals, raves, concerts and clubs. It’s listed as a Schedule III drug meaning it has a high potential for abuse. More recently, studies have been conducted to see if it’s effective for treating anxiety in people with a terminal illness as well as post-traumatic stress disorder (PTSD).


“Did you know?

92% of those who begin using ecstasy when they’re underage move onto harder drugs including amphetamines, cocaine and heroin.”


How does ecstasy work?


Ecstasy works by boosting the activity of three ‘feel-good’ chemicals in the brain; dopamine, serotonin and norepinephrine. These chemicals control a variety of functions including your mood, energy levels, appetite, trust, sexual desire, emotions and sleep.

Positive effects of ecstasy include:

  • mental stimulation
  • increased sense of physical and emotional well-being
  • increased empathy
  • loss of inhibitions
  • decreased anxiety
  • increased energy
  • enhanced sensory perception


Negative effects of ecstasy include:

  • nausea
  • chills or hot flashes
  • sweating
  • teeth clenching
  • muscle cramping or stiffness
  • loss of appetite
  • cluttered thinking
  • dehydration
  • restless legs
  • agitation


The problem with ecstasy is the feeling of complete freedom and heightened sensations you get when you take Ecstasy is soon replaced by very unpleasant feelings. These range from feeling tired and irritable to having panic attacks and nightmares. These side-effects can last up to 3-4 days which is a lot longer than the amount of time you feel good on the drug.

People with an ecstasy addiction may lose weight and start feeling weak. They become moody and aggressive and in serious cases, develop long-lasting psychotic issues such as schizophrenia and bi-polar disorder.


How harmful is ecstasy?


Ecstasy is not a harmless party drug. It’s a potentially fatal drug if you have a bad reaction on it and with regular use, can cause serious brain and heart problems. At the very least, you risk hyperthermia, a heart attack, impaired mental clarity, risky and dangerous behaviour and an overdose.

The big risk is that the majority of MDMA produced today is laced with extremely dangerous compounds found in bath salts, cocaine, LSD and PCP aswell as steroids and pain killers. In fact, what you take probably includes almost no MDMA. It may also be cut with soap or detergents.

This is dangerous because you don’t know what you’re ingesting and how your body will react. Whatever is in that ecstasy pill might also react with other substances in your system such as alcohol, caffeine and other medication.


How does ecstasy cause hyperthermia?


Hyperthermia is one of the most dangerous side-effects of taking ecstasy at clubs and raves. How it works is MDMA limits your body’s ability to regulate your temperature so you can overheat when your temperature becomes sky-high.

Hyperthermia needs to be treated immediately because it very quickly leads to muscle breakdown which causes kidney, liver or heart failure.


Other dangerous side-effects of ecstasy


Ecstasy is dangerous for people who suffer with irregular heartbeats, asthma, epilepsy, kidney disease, diabetes, chronic fatigue or any psychological disorders.

Heart problems

People who regularly use ecstasy are at risk of developing cardiovascular problems because the drug causes your heart to stop working efficiently. This is big problem if you participate in strenuous activity, which includes wild dancing at clubs and music concerts.

Poor memory and concentration

Within an hour of taking ecstasy, you can suffer from memory loss, impaired concentration and your capacity to judge motion. This is very dangerous if you’re driving but worse, you could make a bad decision because you’re not thinking clearly which could cost you your life.


It’s important to drink water and/or non-alcoholic liquid if you have taken ecstasy because of the risk of dehydration. MDMA raises your body temperature and if you’re dancing at a club or music concert, you need to keep hydrated and replace lost minerals from sweating.

Sexually-transmitted diseases

On ecstasy, you lose your inhibitions and your feelings of trust and emotional warmth increase. You’re likely to drop your guard and have unsafe sex with a stranger or someone you don’t know well. The result could be a sexually transmitted disease or worse, HIV.


Your body quickly absorbs MDMA but it battles to metabolise the chemical in your system. The risk is you take more ecstasy because you’re not feeling the desired effect. Coupled with alcohol and marijuana, this is a life-threatening scenario.

Symptoms of an overdose of ecstasy include:

  • high blood pressure
  • passing out
  • blackout
  • panic attacks
  • seizure


Long-term side-effects of ecstasy

You may feel anxious, restless, irritable and depressed for up to a week after taking ecstasy. You may experience gaps in your memory and have problems concentrating and your interest in sex might disappear for a while.

If you regularly take ecstasy, you might suffer from heart palpitations, insomnia, aggression and severe anxiety. MDMA can cause brain damage, which may only be noticeable several years after you first take ecstasy.

Studies show that ecstasy damages the neurotransmitters that secrete dopamine and serotonin. The neurotoxicity of MDMA is irreversible.


Did you know?

Ecstasy comes in tablet form in all shapes and colours, with designs stamped on them such as hearts, stars, butterflies and cloverleaves. This creates the impression they’re innocent and pure, but that’s a big fat scam!”


Can you get addicted to ecstasy?

Yes, you can! Well actually, it’s not so much addiction but a high tolerance for ecstasy that develops rapidly with repeated use. It becomes almost impossible to experience the same stuff you felt when you first took it so you take more ecstasy and that puts you at risk of overdosing.

You’re more likely to develop a psychological dependence on ecstasy rather than a chemical dependency. Like alcohol, you feel more confident and festive on ecstasy and you come to depend on this feeling of euphoria when you’re out at clubs or raves.

Ecstasy is what is known as a ‘designer drug’. The making of ecstasy has gone underground and who knows what they’re putting into it these days; definitely other drugs that are highly addictive. So the chances are it may not be ecstasy that you become addicted to but the other nasty stuff they put in the tablets.


Do I need help for my ecstasy habit?

Your brain releases a flood of ‘feel good’ hormones when you use ecstasy. This depletes your body of these hormones which is why you might feel extremely anxious, sad or restless afterwards. You’ll experience this slump in ‘feel good’ hormones as unpleasant withdrawal symptoms.

You might feel confused, dejected and extremely tired as well as battle to sleep, concentrate and think clearly. The temptation is to use more of the drug to deal with the negative symptoms or substitute it with other drugs such as marijuana or cocaine.

If you’ve got to this point, you need help to stop using ecstasy and treatment to restore your body’s natural physical and emotional well-being.


Where to get help for your ecstasy habit?

When the party or love pill starts destroying you or someone you love, it’s time to get help. You’re not on your own.

White River Manor works closely with medical practitioners such as psychologists and psychiatrists who have years of experience in dealing with alcohol and drug addiction as well as a team of highly experienced counsellors who understand the intervention process and are strong counsellors.

Is weed a gateway drug?

In other words, will using weed lead to harder drugs?

That’s a question many people are asking now that dagga is legal for private use in South Africa. There were a lot of funny memes doing the rounds on social media when the news broke in September 2018 but the bigger debate is, “is South Africa courting the devil”?

Marijuana, weed, cannabis, dope, dagga… whatever you call it, tends to be used as a social drug and it’s seen as a ‘soft drug’. Supposedly, it’s harmless and not addictive, and certainly less harmful than hardtack alcohol and less addictive than cigarettes.

Is it?

Or is it a gateway drug that leads to harder and more destructive drug addiction?


What is the gateway drug theory?

The Gateway drug theory claims that so-called ‘soft drugs’ like weed set naïve users on a path to experimenting with other drugs such as cocaine, meth, heroin and opiates. Most people who develop an addiction to these drugs say they started off smoking weed.

Weed provides a safe ‘high’ experience which lures users into a false sense of security when it comes to trying other drugs. If they hadn’t started with a soft drug like weed, the thinking is they may not have progressed onto harder drugs.

This is based on the notion people who use illegal substances progress along a linear path from “socially acceptable and legal substances” like alcohol and nicotine; to soft drugs like weed; and then onto harder illicit drugs like cocaine and heroin.

What’s the reason for this?

Firstly, experimenting with weed increases the taste and perceived pleasure for other drugs. And secondly, there’s an increased likelihood you’ll be exposed to harder drugs if you hang out with people that have a free association with drugs in general.


Gateway drug or not?

The science people say that weed isn’t any more or less of a gateway drug than alcohol and nicotine is when it comes to kickstarting a drug-taking habit. If you have a genetic predisposition (the addiction gene) to drug use, the springboard could be booze, cigarettes or dope. In fact, regular cigarettes are far more addictive than weed.

It’s impossible to say that someone who experiments with weed is likely to go on and experiment with harder drugs, mainly because the vast majority don’t get addicted. The latest research stats show that between 10 to 30% of regular users will develop a dependency on weed, while only 9% develop a serious addiction.

A study by The Center on Addiction and Substance Abuse at Columbia found that children who used marijuana, alcohol and tobacco were 266 times more likely to use cocaine than children who used none of the gateway drugs.

The same was true for adults. Adults who used marijuana, alcohol and tobacco were 323 times more likely to use cocaine than adults who used none of the gateway drugs. Adults who used all three were 104 times more likely to use cocaine than adults who used only one gateway drug.


The problem with weed

The fact is marijuana has been around since ancient times. The earliest recorded use as a drug was 2 737 BC in China. It made its entry to the New World in 1545 when the Spanish brought it and produced it as a commercial crop to make hemp fibers.

Marijuana is not necessarily the problem; the habit is. In other words, smoking weed can lead to a drug-taking habit. This is where a person enjoys the experience, feels withdrawal symptoms when not taking the drug and seeks out the drug to relieve the cravings; repeat!

It’s known as ‘marijuana use disorder’ and it becomes addiction if you cannot stop using weed even when it starts having a negative effect on your life. Marijuana dependence occurs when your brain adapts to large amounts of the drug.

Marijuana often makes you irritable and moody, affects your sleep pattern and decreases your appetite. About 1 in 10 frequent marijuana users experience anxiety, hostility, insomnia and depression after the intoxicating effects of weed wear off.

If and when you try to quit, you’ll battle with mild to strong cravings, restlessness and different forms of physical discomfort. This is proof weed is not completely harmless and is addictive in the same way people become addicted to the habit of smoking cigarettes as well as the actual nicotine.

The big problem with weed today is its potency. It’s been steadily increasing over the past few decades. In other words, the weed you smoke in 2019 is a lot stronger than the weed your folks smoked 20 years ago. And the scariest problem with smoking weed in South Africa is it’s not always pure and clean. In other words, there’s a good chance it’s laced with something like Tic or Mandrax.


The verdict

The verdict is still out whether weed is a gateway drug or not. One side says it’s a scare tactic and the other side says it is a gateway drug.

What we know for sure is; if you have a genetic predisposition to drug use, the springboard could be booze, cigarettes or dagga. If you develop an addiction, you can’t say for sure whether weed was the main culprit or whether there were other factors at play. If you have the addiction gene, something will ignite it.



If you or a family member need help with drug or alcohol addiction, all you need to do is call us. You’re not on your own.

White River Manor works closely with medical practitioners such as psychologists and psychiatrists who have years of experience in dealing with alcohol and drug addiction as well as a team of highly experienced counsellors who understand the intervention process and are strong counsellors.

Am I an addict?

This is a question only you can answer and it’s not the easiest thing to do.

Unless you’ve got to a really bad place in your life and risk losing everything; you can go a long time thinking, “I can handle this”. But in the end, the drugs you’re using will end up controlling you.

Here’s a list of questions that were drawn up by recovering addicts as part of their recovery programme. They’re blunt questions with no sugar coating. All you need to do is answer them honestly.




Do you ever use drugs alone?

Yes ǀ No

Have you ever substituted one drug for another because you think the other one is a problem?

Yes ǀ No

Have you ever deceived or lied to a doctor to obtain prescription drugs?

Yes ǀ No

Have you ever stolen drugs or stolen to obtain drugs?

Yes ǀ No 

Are you hiding your drug use from family and friends because you feel ashamed?

Yes ǀ No

Do you friends and family try to talk to you about your drug use and you avoid the conversations?

Yes ǀ No

Do you regularly use a drug when you wake up or before you go to sleep?

Yes ǀ No

Have you ever taken one drug to overcome the effects of another?

Yes ǀ No

Have you stopped seeing friends and family and spend more time on your own using drugs?

Yes ǀ No

Have you ever used a drug without knowing what it was or what it would do to you?

Yes ǀ No

Is your job or school performance suffering from the effects of your drug use?

Yes ǀ No

Have you ever been arrested for using drugs?

Yes ǀ No

Do you lie to the people close to you about how much you use?

Yes ǀ No

Do you ever buy drugs before you pay your bills?

Yes ǀ No

Have you stopped and started using drugs a few times?

Yes ǀ No

Do you feel it’s impossible to live without drugs?

Yes ǀ No

Do you feel you don’t want to live without drugs?

Yes ǀ No

Do you sometimes feel you’re going crazy?

Yes ǀ No

Is your drug use making life at home unhappy?

Yes ǀ No

Do you battle to fit in or have a good time without using drugs?

Yes ǀ No

Do you get defensive when someone talks about how much you’re using?

Yes ǀ No

Do you think a lot about drugs?

Yes ǀ No

Do you have irrational or obscure fears?

Yes ǀ No

Does your drug use make you feel uncomfortable and guilty around others?

Yes ǀ No

Are you spending less time with loved ones because of drugs?

Yes ǀ No

Are you afraid to stop using drugs?

Yes ǀ No

Has using affected your sexual relationship with your partner?

Yes ǀ No

Do you ever take drugs that you would prefer not to use?

Yes ǀ No

Have you ever overdosed on any drugs?

Yes ǀ No

Do you continue to use despite how bad drugs make you feel and affect your family?

Yes ǀ No

Do you think that you have a drug problem?

Yes ǀ No




The number of times you answered ‘YES’ doesn’t matter. It’s how you feel about yourself when answering these questions. Does talking about using drugs bring up feelings of guilt or self-loathing? Do these questions make you feel uncomfortable?

Addiction is a devious and sinister disease.

It sneaks up on you and takes over your whole life. You might think you’ve got a handle on your drug use; it’s just to get through a tough patch and you’ll be able to stop when you want to stop. But eventually drugs strip you of your pride, self-esteem and the love and support of your family and friends.

When you get to this point, you’ll realise 3 things:

  • You’re powerless over your addiction and you can no longer “handle it”
  • You can no longer blame people, places or your past for your addiction; it’s time to face up to your problem and take responsibility for your recover
  • Only you can do it; you can be pushed to get help but your recovery is entirely up to you




The first step in your recovery is asking for help for addiction. Pick up the phone and speak to someone at White River Manor for professional advice and guidance.

White River Manor works closely with professionals with years of experience in dual diagnosis. Our multidisciplinary team includes a psychiatrists, cognitive behaviour specialist, counsellors, nursing sisters and a nutritionist. The aim is to ensure you receive a tailor-made recovery programme that’s holistic and comprehensive.

Do interventions actually work?

An intervention is often a last-gasp attempt to convince a loved one struggling with addiction to get help. They’ve become more and more popular over the last 20 years and given rise to reality TV shows where families are filmed confronting a son or daughter in the grip of a drug or alcohol addiction.

The medical community is at odds as to whether they work or not and there’s little data to support both sides of the argument. An intervention may work to get an addict into an alcohol and drug recovery programme but all too often the attempt fails if the person doesn’t go in committed to his or her recovery.

The idea behind an intervention is to gently coerce the person in a non-threatening way to accept help but too often they feel bullied and hijacked, particularly if it’s a surprise intervention. It can often do more harm than good and further break down what are already strained relationships.

Done in the proper manner, an invention should be a carefully planned meeting with an intervention specialist in charge to manage fraught emotions and outbursts. It’s often set up as a surprise because telling the addict in advance might send the person running and he or she won’t show up.

Whether an intervention is the best way to go or not depends on a number of factors and there’s no way to tell in advance what will unfold and how effective it will be. It may be crushingly disappointing for the family and make matters worse or it could be the beginning of the end of the addiction cycle.


What is an intervention?

An intervention is when family and friends come together and make a non-threatening appeal for an addict to agree to attend an inpatient or outpatient alcohol and drug recovery programme. It’s a form of peer pressure but it comes from a place of love.

Each person in the group has a chance to say how the addict and the addiction makes them feel and how it’s harming their relationship. Most importantly, each person must list the consequences for not seeking treatment. This might be no longer financially supporting the person or kicking him or her out the home and cutting all ties until they commitment to recovery treatment.

Interventions can be very tense and a whole range of emotions can potentially be unleashed in a very negative way; from crying and shouting to accusations, resentment and laying blame. This is why you need a neutral professional person to manage an intervention. It shouldn’t be attempted without one.

The addict may or may not accept the help offered. If they do, you need to have a plan in place for where they can immediately go for help. You can’t get their buy-in and then wait a few weeks for a drug and alcohol recovery centre to take them.

If they resist the help offered and refuse to go to a recovery centre, what happens? You have to follow through with the consequences you gave. If you don’t, you lose control again and make the problem worse. Before an intervention, you as a family member or friend need to have got to the point where you are willing and able to follow through with your “threat”.


Why is professional help important for an intervention?

s you well know, an addict is manipulative and knows which buttons to push. Likewise, an enabling family member knows which buttons to press with the addict. A person with professional experience in handling interventions is the one in control and won’t allow either side to manipulate the conversation.

The professional mediator can also help the individual family members and friends follow through with the consequences given to the addict if he or she refuses to attend a recovery programme for their alcohol or drug addiction.


Why do interventions not work?

An intervention will not lead to a successful or happy ending if the addict is not willing to enter a treatment programme. If they go to an alcohol and drug rehabilitation centre only out of guilt or because they’ve been forced into it by the “threats” made; the chance of them relapsing once they get out is highly likely.

What the experts say is addicts are more likely to seek treatment when they undergo an intervention but interventions don’t affect the outcome of the treatment itself. If an addict is not fully committed to a life of sobriety, it’s very likely he or she will relapse.

Intervention needed for the whole family

Another reason interventions aren’t successful is they’re often one-tracked and only focus on the addict. There’s a lot of finger pointing and the addict bears the brunt of the shaming. The professionals will tell you that in the majority of cases there is an enabler in the family group that’s fueling the addiction in one way or the another.

If they’re allowed to get away with it, they’ll be there and carry on when the person comes out of the alcohol and drug treatment programme. A professional intervention specialist will focus on the entire group and weed out the people who enable the addiction and ensure they too confront their own issues.


Intervention plus dual diagnosis

Dual diagnosis is so common that most alcohol and drug recovery centres expect to find it in a patient. It’s where a patient is diagnosed with a mental illness and a co-occurring addiction. This ranges from alcohol and drug addiction to an addiction to sex, gaming and stealing.

Studies show that at least 50% of people living with a mental illness have a substance abuse problem. Similarly, more than half of the people battling with alcohol and drug addiction have a common mental health disorder.

Substance abuse and a mental health disorder needs to be treated simultaneously. If the addict goes to a recovery treatment centre that doesn’t offer an integrated approach, the chances of him or her relapsing is high.

Dual diagnosis should ideally be made by a multi-disciplinary team at an alcohol and drug recovery centre and needs to be treated using an integrated dual disorder treatment programme.

White River Manor works closely with professionals with years of experience in dual diagnosis. Our multidisciplinary team includes a psychiatrists, cognitive behaviour specialist, counsellors, nursing sisters and a nutritionist. The aim is to ensure you or your loved one receive a tailor-made recovery programme that’s holistic and comprehensive.


Professional tips for a successful intervention

Come from a place of love; express your feelings without being confrontational.

An intervention is not supposed to put pressure on the addict to get sober and deepen any sense of shame and guilt they are already living with. You want the willingness to get better to come from within the addict and all you’re offering is a helping hand to get them into the right alcohol and drug treatment centre.

Addiction often co-occurs with one or more mental health disorder; including depression, anxiety, bipolar disorder or schizophrenia. Dual diagnosis should ideally be made by a multi-disciplinary team at an alcohol and drug recovery centre and needs to be treated using an integrated dual disorder treatment programme.

Be prepared for the worse. If the addict refuses help, you have to follow through with the consequences you listed. This could lead to a complete breakdown in the relationship and traumatic action such as a divorce, kicking them out your home or calling the police. Ask yourself if you’re ready for that before the intervention takes place.

Don’t isolate the addict in the intervention and only point fingers at him or her. Every member of the family and friend in the intervention group needs to look in the mirror at what might be enabling behaviour and hold themselves accountable.

Use a professional intervention specialist who is a neutral party. Don’t DIY because there’s a very high chance the intervention will fail.

Have an alcohol and drug recovery centre lined up that the addict can go to immediately as soon as they accept the help offered. Don’t let much time lapse between getting them to admit they need help and getting them the help they need for alcohol and drug addiction.

Avoid scheduling an intervention at a time when the addict is likely to be high, drunk and/or stressed. He or she will have trouble listening to what the group has to say if they’re distracted by problems at work, financial stress, a break up or trouble with the law.

Try to be specific when you tell the addict how his or her behaviour is affecting you. Saying, “your addiction makes be unhappy” is vague. Saying, “you’ve put us into financial ruin and we’re going to lose the house” is more specific.

Keep it short and to the point. Don’t ramble and rant. It’s better to write down a number of point notes and refer to them so you don’t go off topic and overwhelm the person with a litany of accusations.

Do careful research to find the right alcohol and drug rehabilitation centre that offers a holistic and comprehensive programme. There are many, many unscrupulous operators running recovery centres who are more interested in the money from the medical aid then they are in the patient. Get referrals and visit the alcohol and drug treatment centre beforehand to check it out.

You have to be emotionally prepared for a fundamental change in your relationship once the intervention is over. Regardless of the outcome, an intervention affects your relationship with the addict one way or another.

Use a professional intervention specialist. He or she has years of experience in the field of alcohol and drug addiction, and in many cases is a recovering addict themselves and can identify with the addict and the tricks they have up their sleeves.



White River Manor works closely with medical practitioners such as psychologists and psychiatrists who have years of experience in dealing with alcohol and drug addiction as well as a team of highly experienced counsellors who understand the intervention process and are strong counsellors.

Don’t try to do this on your own. You need expert advice and assistance or else you could make the problem a lot worse.

Addiction & mental illness… which one comes first?

Dual diagnosis is so common that most alcohol and drug recovery centres expect to find it in a patient. It’s where a patient is diagnosed with a mental illness and a co-occurring addiction. This ranges from alcohol and drug addiction to an addiction to sex, gaming and stealing.

Studies show that at least 50% of people living with a mental illness have a substance abuse problem. Similarly, more than half of the people battling with alcohol and drug addiction have a common mental health disorder.

The fact that there’s a link between addiction and mental illness is fairly obvious. If you’re feeling out of sorts emotionally, you’re likely to reach for alcohol and drugs to cope. Likewise, if you’re regularly abusing alcohol and drugs, you’ll likely develop symptoms of a mental disorder.

In the medical world, it’s called a co-occurring disorder or comorbidity when a person has more than one mental disorder.


A simple analogy to help you understand a dual diagnosis is comparing it to the science of fire. It takes more than one element to ignite a fire. Similarly, it takes more than one element to ignite an alcohol and drug addiction.

The Fire Triangle

For a fire to ignite, it needs fuel, heat and oxygen. They say that when all three elements are present and combine in the right mixture, a fire is actually an event rather than a thing.

You can prevent a fire or put it out by removing ANY ONE of the three elements in the fire triangle. For example, you can remove oxygen by throwing a wet blanket over the fire and remove heat by dousing it with water. And a fire will naturally die out when it runs out of fuel (wood, paper, grass etc.).


If you don’t COMPLETELY remove that element, the fire will reignite.

You think you’ve put the fire out but the woodpile is silently smoldering (heat). All it takes is for the wind (oxygen) to pick up and the fire reignites.

The Addiction Triangle

Let’s call a dual diagnosis the Addiction Triangle.

The three sides of your Addiction Triangle are alcohol and drugs, negative thought patterns and a mental disorder.

When all three elements are present and combine in the right mixture, a fire of pain and destruction will ignite. You can remove any one of the three elements to extinguish the fire of destruction but it’s only temporary if you don’t COMPLETELY remove it.

You can stop using alcohol and drugs and you can learn self-help tools to deal with feelings and situations that trigger a relapse. However, if you don’t deal with your mental illness; you’re highly likely to relapse if you turn to alcohol and drugs to cope with anxiety and depression.

This is why an integrated treatment plan is critical for a patient with a dual diagnosis. All three elements of the Addiction Triangle must be treated for successful recovery from alcohol and drugs.



Substance abuse and a mental health disorder needs to be treated simultaneously. If you’re staying at a recovery treatment centre that doesn’t offer an integrated approach, the chances of you relapsing are high.

Co-occurring mental disorders that go hand-in-hand with addictions include:

  • Anxiety
  • Attention Deficit Disorder (ADD)
  • Bipolar Disorder
  • Obsessive Compulsive Disorder (OCD)
  • Eating Disorders
  • Post-Traumatic Stress Disorder (PTSD)

The integrated approach usually involves:


Detox is the first stage in the recovery process and the most grueling. The detox process purges your body of harmful chemicals and restores it to a clean slate.

During detox, a patient stops using what they’re addicted to immediately. You experience painful and very uncomfortable withdrawal symptoms which include seizures, hallucinations and cravings.

Withdrawal symptoms such as seizures and a sudden drop in alcohol levels can lead to sudden death. It’s critical that you have proper medical supervision when you detox. This is very important for alcohol and opioid detoxification.

Your medical team will keep you safe and comfortable using the right medication and therapy to see you through the detox process.

Behaviour therapy (cognitive behavioral therapy and psychotherapy)

Behaviour therapy helps people uncover and address the negative thoughts, false beliefs and insecurities that lead to substance abuse. In the process, patients are provided with self-help tools to deal with situations that trigger cravings and self-destructive behaviour.

When an addict understands why they feel or act in a certain way and understand how these feelings or situations trigger substance abuse, they’re more likely to succeed in their recovery.


Depending on the diagnosis, this could include:

  • Lithium for bipolar disorder
  • Anti-convulsant to stabilise your mood
  • Selective serotonin reuptake inhibitors for anxiety and alcohol abuse
  • Buspirone for anxiety and alcohol abuse
  • Topiramate for cocaine addiction and anxiety



A person living with a mental illness is more likely to abuse alcohol and drugs mainly because they mask symptoms such as of depression, anxiety, self-loathing and low self-esteem. Using alcohol and drugs over a period of time will make a mental illness worse and the medical treatment less effective.

A bigger problem is alcohol and drug abuse can trigger a mental illness. If you have a predisposition to a psychotic illness such as bipolar disorder or schizophrenia; alcohol and drugs may trigger your first episode which then becomes a lifelong illness.

The common mental health disorders linked to alcohol and drug addiction include:


Alcohol and drugs are a form of self-medication for people living with depression but it usually makes the problem worse. Feelings of self-loathing after alcohol and drug binges can drive a person deeper and deeper into depression.


People who suffer from generalised anxiety disorder (GAD) may use alcohol and drugs to cope with their anxiety. They’re more likely to abuse benzodiazepines which are prescribed for anxiety and highly addictive.

OCD (Obsessive Compulsive Disorder)

People living with OCD often suffer from high levels of anxiety and low self-esteem which leads to depression. They may use alcohol and drugs to cope with their feelings that arise from irrational obsessions and compulsions.

ADHD (Attention-deficit Hyperactive Disorder)

People, in particular school-going children, are prescribed a stimulant to treat their ADHD which can be habit-forming. When coupled with anxiety and low self-esteem, it can lead to destructive behaviour patterns and substance abuse.

Eating disorders

People struggling with anorexia or bulimia often use drugs to suppress their appetite. Cocaine is a common drug used by models forced to keep their weight down to the bare minimum as it takes your appetite away completely.

PTSD (Post-Traumatic Stress Disorder)

The brain of a person struggling with PTSD produces less endorphins which often leads to depression. Someone who’s experienced a traumatic or violent event and has not dealt with it in therapy may turn to alcohol and drugs to cope with their anxiety and stress.

Bipolar disorder

Alcohol and drugs provide temporary relief from the emotional, manic rollercoaster that people with bipolar travel in life. The statistics are that about half of people with bipolar disorder struggle with addiction.

BPD (Borderline Personality Disorder)

Research shows there’s a strong link between BPD and addiction. A person living with BPD is more likely to use alcohol and drugs to cope with their symptoms.


Schizophrenia is characterised by bouts of severe hallucinations and delusional thinking. A person with schizophrenia may use alcohol and drugs to cope with their symptoms and this can make things much worse.



The most difficult thing about a dual diagnosis is separating the addiction from the disorder. This is because many of the symptoms overlap. It all depends on the type of substance abused and the severity of the mental health disorder.

Overlapping symptoms include:

  • a sudden change in behaviour
  • poor hygiene and health
  • neglecting daily tasks and responsibilities
  • erratic and impulsive behaviour
  • delusional thoughts and irrational feelings
  • depression and anxiety
  • suicidal thoughts or attempts
  • avoiding social occasions and alienating family and friends
  • unsociable and disruptive behaviour
  • poor decision-making
  • poor financial management



Dual diagnosis is used to describe a person living with an addiction and a mental health disorder. More than half of people with a chronic mental illness will also have a substance use or abuse disorder.

Comorbidity is used when a person has two or more mental health disorders. They may occur at the same time or one comes after the other.

If an addiction and mental illness co-occurs in a patient, they need an integrated dual disorder treatment programme delivered by a multidisciplinary team.

The more severe the mental illness, the more likely the person will be to use and abuse alcohol and drugs. People living with a mental illness commonly use alcohol, marijuana and/or cocaine to cope with their symptoms.

Males aged 18 to 44 years old living with a mental illness are at greatest risk of developing an alcohol or drug addiction.

Teenagers and young adults with serious behavioural problems are 7 times more likely to eventually use and abuse substances.



Dual diagnosis should ideally be made by a multi-disciplinary team at an alcohol and drug recovery centre and needs to be treated using an integrated dual disorder treatment programme.

White River Manor works closely with professionals with years of experience in dual diagnosis. Our multidisciplinary team includes a psychiatrists, cognitive behaviour specialist, counsellors, nursing sisters and a nutritionist. The aim is to ensure you or your loved one receive a tailor-made recovery programme that’s holistic and comprehensive.

Do I have executive burnout?

Harry arrived at White River Manor seeking help for executive burnout. It had been a hard, exhausting year with excessive stress building up month after month. A short stint in a calm, tranquil environment was what he needed to escape the relentless pressures of work and get back on track physically, mentally and emotionally. Healthy meals and exercise would do the trick. So he thought.

In the first week, Harry acknowledged he was drinking more than usual to unwind and occasionally using cocaine when the going got really tough. Later he confronted the fact that what he’d glossed over as “occasional use” was in fact regular use and he was likely dealing with a serious drug addiction.

When it came close to leaving at the end of his 28-day stay, Harry opted to stay on longer and fully explore the dark underbelly of his drug addiction. Working closely with our professional team and peeling back the layers, Harry was finally diagnosed with bipolar disorder. This life-long affliction is not welcome news for anyone but we were all relieved that the real work needed for Harry’s recovery could begin.

It’s an example of how important dual diagnosis is at a recovery centre where co-occurring disorders are relatively common. It’s the difference between treating the symptoms versus getting to the bottom of what’s causing them.

Executive burnout or depression or both?

This is the burning question that’s regularly dealt with at a recovery centre like White River Manor. Is the general diagnosis of executive burnout masking something more serious?

If you’re feeling more and more burned out and you can’t tell if it’s executive burnout or if you’ve  slipped into depression, here is a description of executive burnout from Dr Michael Meyers that’ll throw some light on the subject.

Source: Dr Meyers is Professor of Clinical Psychiatry and the author of 7 books that deal with mental health issues. He also serves on the Advisory Board to the Committee for Physician Health of the Medical Society of the State of New York.

“Executive burnout is a sense of emotional exhaustion and decreased personal achievement, among other things. It’s an occupational illness; a state of fatigue and frustration brought about by devotion to a cause or a way of life that is failing to produce the expected reward. It’s not just tiredness; it’s an erosion of the soul in people with ideals and commitment.

If this feeling of physical, mental and emotional burnout is unifocal and restricted to work commitments, it sounds like burnout. If your energy and mood picks up on weekends when surrounded with family and friends or when you’re on holiday, it sounds like burnout.

However, if you’re unable to shake the heavy feeling of ‘doom and gloom’ away from your work environment and the black cloud continues to hang over your head no matter how hard you try to reconfigure your work/life balance, you may have mild or clinical depression.”

In short, executive burnout usually occurs in people who display no other symptoms of depression, anxiety or other forms of mental illness. However, there are many overlapping symptoms of executive burnout and depression. It’s also hard to know which comes first; executive burnout that slides into depression or depression that results in executive burnout.

Some people adopt a “wait and see” approach to dealing with executive burnout, some opt for a short course of anti-depressants to see if it helps take the edge off their heavy feelings of despair and hopelessness.

If you chose anti-depressants or consciously adjust your work/life balance by cutting back on work commitments, taking an extended holiday or start exercising and eating better; your zest for work and home life should return. If it doesn’t, then you need to consult a physician for a more accurate diagnosis.


Executive burnout can be measured using specialised laboratory tests which measure your Cortisol levels. Cortisol is produced by the adrenal glands to protect the body against stress and it gets fatigued and literally “burnt out” when a person experiences relentless pressure and stress.

If you want to avoid subjecting yourself to clinical tests, there are obvious signs you can look out for which are a good indication you’re heading towards or are in the throes of full-blown executive burnout:

  • You feel hopeless and uninterested in work and your home life
  • You always feel tired and worn out
  • You feel overwhelmed by simple tasks
  • You feel dull, like a light in your life has been switched off
  • You feel unappreciated and feel nothing you do makes a difference
  • You no longer enjoy life
  • You lack self-esteem and feel worthless

How the above signs resonate in your day-to-day life includes feeling a deep sense of emptiness and a complete lack of interest or care in things that used to interest you. You’re indecisive, unmotivated and may have this overriding urge to “run away”.

When executive burnout starts to peak, you stay away from people you care about and lose interest in socialising, eating, sex and everything else that should bring joy to your life. Physically; executive burnout is experienced as body and muscle aches, heart palpitations or picking up any illness going around the office like colds and flu and stomach bugs.

As you can see, the majority of these signs are also symptomatic of clinical depression. With luck, it’s executive burnout and can easily be remedied by adjusting your priorities and work situation. On a much lighter note, you may just be thoroughly bored with your career and your lack of interest is genuine. You may be burning the candle at both ends socially and drinking too much or taking drugs purely to evade the fact that you’re stuck in a rut and miserably unhappy with your life’s choices.

A diagnosis of executive burnout carries less of a stigma than depression. Burnout is easier to remedy than major depression or worse, bipolar disorder. Finding out it’s more than executive burnout can be shocking and upsetting but it’s not the end of the world. It’s the beginning of your journey to recovery from alcohol and drug addiction if that’s what you’ve used to mask the symptoms of chronic depression or bipolar disorder.


Executives suffering from burnout all too often “self-medicate” with alcohol and drugs to relieve the symptoms. There’s nothing like a few beers or glasses of wine every night to take the edge off your irritability, anxiety or feeling of emptiness. Or a few lines of cocaine to anaesthetise yourself against life’s woes.

Cocaine enhances alertness and helps you maintain a high level of performance. It’s a quick fix but not the answer to your problems. The same applies to prescription medication used to cope with the physical symptoms of burnout such as insomnia, muscle or joint pain or racing heart.

Executive burnout has three components: loss of energy, loss of enthusiasm and loss of self-confidence and self-belief. Alcohol and drugs work wonders in the short-term to raise your flagging spirits and attention span. But what does executive burnout combined with alcohol and drugs cost you in the long run? Your career, your marriage and family and your health. Sadly, if you’re burnt out enough, you may not even care.

The slippery slope from executive burnout to alcohol and drug addiction is short and fairly rapid. Insomnia, racing thoughts and heart palpitations are just a few of its symptoms. It’s easy to see why people turn to alcohol because it acts as a sedative and drugs like cocaine act like jumper cables for your life’s dead battery.

You’re looking for something to keep you awake and alert or put you into a deep and restful sleep because you wake up anxious and overwhelmed and go to bed the same way. Coffee just doesn’t cut it with executive burnout.


This simple self-assessment is a good place to start if you suspect you’re suffering from executive burnout and need help to rebalance your physical, mental and emotional health.

I always feel tired and lethargic even when I get enough sleep


I feel detached from my colleagues and family and don’t care about their problems and needs


I have trouble falling asleep and staying asleep because my mind is racing


I used to love my work but I’ve lost interest and can’t get enthusiastic about anything anymore


I don’t feel I’m working hard enough or fast enough to cope with the demands of my job


I feel used and unappreciated by the people I work with and people close to me


Small things trigger my temper and I get easily frustrated and irritable


I’m not getting through my work load and I don’t really care if I do or don’t


I’m eating and/or drinking too much and making unhealthy life choices but I can’t do better


I take longer now to make decisions than I used to


I’m often sick; I pick up anything going around the office like colds and flu and stomach bugs


I don’t enjoy going out and usually make an excuse to avoid seeing friends and family


I take my frustrations out on the people close to me


I’m not a happy and likeable person to be around most of the time


I wish I could get away from it all and disappear for awhile




If you’ve answered YES to the majority of the questions above, it’s highly likely you’re suffering from executive burnout or may even have slipped into clinical depression.

Located in the lush Mpumalanga Province of South Africa, White River Manor is a world-class treatment centre offering busy executives the time and space needed in a safe and tranquil environment to recover from whatever is dragging them down physically and emotionally.

Working with a team of highly qualified professionals with years of experience in the field of executive burnout, depression and alcohol and drug addiction; together we can get to the bottom of whether you’re dealing with simple executive burnout or something  more serious.

White River Manor : African Experience

White River Manor is proud to present the launch of our twelve week recovery programme. This is the newest venture that the experienced White River Manor team is introducing as part of the already successful group of recovery centres. This new programme has been developed with the same inspiration and vision to help those caught in addiction. At White River Manor we have a team of professionals who are passionate about people and seeing them get set free from the substances that have held them captive.

Keeping clients engaged with constructive and developmental activities is part of the every day programme that is designed to build and develop character and understanding. Our holistic approach looks at all aspects of a person and we believe that it is essential to restore a balance back to the life of an individual in recovery. Taking the time to truly get to know someone and what their needs are is important to us, it is fundamental that a relationship of trust be established between the client and the counsellor.

The Following Treatments Are Offered:

• ITP (Individual Treatment Plan)

• Individual Development Plan / Personal Goal setting

• Assessment by Multi-professional team

• Individual sessions with Psychiatrist / Psychologist / Social Worker / Addiction


• Family Therapy

• Daily Group Therapy

• Pastoral / Spiritual Counselling

• Assistance with 12 Step Programme (lectures & written work / individual


• Music Therapy facilitated by registered Music Therapist

• Art Therapy with a registered Art Therapist

• Wilderness therapy with qualified guides

• Sporting & Adventure Sports – as an effective stress outlet

• Outreach programmes to Mozambique as well as local outreach

• Aftercare Plan and ongoing counselling / therapeutic support

Centro de reabilitação de cinco estrelas para profissionais de língua portuguesa e

Uma instalação de reabilitação executiva na África do Sul está pronta para receber residentes moçambicanos e portugueses que procuram tratamento acessível para o vício.

Situado num antigo jardim dos arredores da cidade de White River, a porta de entrada para o Parque Nacional de Kruger, White River Manor oferece um programa de tratamento abrangente adaptado para atender as necessidades individuais dos clientes que querem ficar longe de tudo.

five star lodge rehab

Considerado um dos melhores centros de tratamento da dependência da África do Sul, oferece alojamento de cinco estrelas e tratamento de classe mundial num ambiente tranquilo, com ênfase em oferecer aos clientes uma experiência que muda a sua vida.


As sessões de terapia individual e em grupo usam uma abordagem avançada no tratamento da dependência, juntamente com atividades terapêuticas holísticas, com o objetivo de restaurar o equilíbrio para ajudar os clientes a fazer uma transição suave para uma nova vida.

O White River Manor foi fundado por Jerry Hartless, Giles Fourie e Jeanine Fourie, que compraram a propriedade de oito hectares para criar uma instalação que oferecesse comodidades melhores do que as que ele havia experimentado nos Estados Unidos. Quando foi inaugurado em 2015, o resultado foi um centro de tratamento de primeira classe que oferece alojamento de luxo e serviço exemplar por uma fração do custo das instalações de reabilitação internacionais.

luxury rehab white river manor

Ao seu comando estão Giles e Jeanine Fourie, que têm mais de 25 anos de experiência entre eles; trabalham num centro de tratamento da dependência de longa permanência muitíssimo bem-sucedido na África do Sul. O centro tem uma equipa dinâmica de profissionais formada por psicólogos clínicos e de aconselhamento, psiquiatras, especialistas em TCC, terapeutas EMDR, Terapeutas de Música e Arte, especialistas em dependência e comportamento, além de um pastor e conselheiro espiritual; todos trabalham em colaboração para o plano de recuperação de um cliente com uma abordagem altamente personalizada à terapia individual e de grupo.

Estar em forma e praticar exercício físico são vistos como componentes essenciais no processo de recuperação e os clientes são encorajados a participar em atividades destinadas a rejuvenescer a mente, o corpo e a alma. Os clientes têm liberdade e flexibilidade para se manterem conectados aos seus negócios e entes queridos; telemóveis e computadores portáteis são permitidos e há um centro de negócios na propriedade com wi-fi gratuito e uma instalação de videoconferência.

Dining Hall (4)

Defensores da reabilitação de destino – “destination rehab” – dizem que, além de ser uma opção mais acessível, oferece uma oportunidade de colocar alguma distância entre a pessoa e a sua situação de trabalho ou doméstica e abraçar novos lugares, novas culturas e novas experiências.

No White River Manor, há uma ênfase em atividades excitantes de lazer e aventura que podem ter um forte impacto na recuperação de um cliente, construindo um renovado senso de autoestima. As experiências incluem um passeio de safári ao longo de um dia inteiro no Parque Nacional Kruger e uma manhã de interação com os meigos gigantes do Elephant Whispers, caminhadas ou ciclismo pelas pitorescas áreas de montanha e floresta, sobrevoar o amplo Graskop Gorge, canoagem no selvagem Rio Sabie ou contemplar tranquilamente a vida enquanto pesca no deslumbrante Rio Komati.

A estadia mínima em White River Manor é de 28 dias, mas os clientes podem permanecer pelo tempo que necessitarem para a sua viagem de recuperação. O preço com tudo incluído começa em $USD6950 por 28 dias ($USD248 por dia).


Porque é perfeito para os moçambicanos?


  • Apenas a 150 km da cidade capital Maputo.
  • Excelente serviço profissional.
  • Classificado como um dos melhores centros de reabilitação da África.


Visite o website para mais informação ou, para uma opção mais acessível na instalação irmã White River Recovery Center, clique aqui.