Stress is a state of mental and emotional tension that comes when we are facing or in a challenging situation. To a certain extent, it can be useful to help motivate and focus us.
But all too frequently it becomes a debilitating condition. This is because it is not meant to be a state of being that is with us for too long.
For some people, stress becomes their normal condition every day. This is unsustainable and not a good way to be.
The word itself is very revealing. “Stress” is from Middle English stresse and it’s a shortening of “distress” and partly as well from Old French estresse meaning “narrowness, oppression”. That’s based on Latin strictus meaning “drawn tight”.
“Distress” means “extreme anxiety, sorrow, or pain” and is based on Latin distringere that means “stretch apart”. Isn’t that so often the cause of stress and how it feels: there’s just too much to do or even think about and so we feel completely stretched apart?
What are the signs of stress?
It’s not that you will necessarily have all these signs, but certainly, if you have a few of them, it could indicate you are stressed.
From a physical perspective alone, that’s not healthy for anyone.
But it also means we will underperform and not be able to make the best decisions. Thankfully, there are many ways of coping with stress and anxiety.
These are a range of physical and mental/emotional practices. Those who have the greatest success with them have found they work best if devoted to on a daily basis. That means to keep doing them even when things are going well, and life doesn’t feel stressed.
Although some planning and preparation have to be done in life and at work, it’s beneficial to try being more conscious of the task in hand.
Worrying about the future doesn’t change anything. The only thing it guarantees is to ruin the moment.
There’s plenty that can be done to deal with stress. The sooner it is recognized and dealt with, the better.
Leaving it too long and not dealing with it will often lead to mental health problems as well as physical issues.
The longer stress is left untreated, the progressively worse it will get.
The executive burnout recovery program at White River Manor is tailored to a client’s specific needs.
We practice a holistic, person-orientated method which focuses on burnout symptoms within the individual.
At White River Manor, our dedicated professional specialist team has great experience helping people to reduce and beat stress. Get in touch to see how we can help you or someone you care about move towards a stress-free and more peaceful life.Giles Fourie
Children smile around 400 times per day, but as adults, we only smile about 20 times a day. That’s not healthy for adults as it’s been proven that smiling is good for us.
Not only that, it’s good for the world around us.
“Smile and the world smiles with you.” (The often unheard part of that is: “Cry, and you cry alone.”)
So we can learn a lot from children.
Basically, as adults, we stop living in the moment. Also, we demand more from life – so setting ourselves up for being dissatisfied.
Then, many of us carry resentments like a heavy boulder that means achieving our goals is even more difficult. It’s why so many relate to the Greek myth about Sisyphus who had to roll a boulder up a hill only for it to roll down every time it neared the summit, and he repeated this forever.
Children live in the now, have more acceptance, and if they do get a resentment, they are swiftly forgiving.
So many adults live in their head and are all about drive: what they need to do to get somewhere – but never enjoying the journey.
As John Lennon said:
“Life is what happens while you are busy making other plans.”
Of course, children are generally unaware of what stress is.
This is because they don’t have anywhere near as much responsibility as we do when we are grown-up.
So they smile about 25 times every waking hour compared to an adult who on average smiles just a fraction more than once an hour over the day. Yet if we knew the benefits of smiling we’d surely do it more…
When we smile, our immune system is more effective because we’re more relaxed. That means the body knows we’re not in fight or flight mode when it redirects our blood to our brain, arms and legs – and that diminishes our immune system’s effectiveness.
It has also been discovered that smiling is a natural pain reliever as it releases chemicals called endorphins and serotonin.
As well as boosting immune defences, smiling lowers heart rate and blood pressure.
Wayne State University researchers in the US studied 230 photos of baseball players from the 1952 season. It was found that those who didn’t smile had a 50 per cent chance of surviving to 80, whereas those with big smiles had a 70 per cent chance of reaching this age.
Smiling reduces stress – amazingly, this is even if we force a smile. This is because the physical act of smiling activates neural messaging in the brain. The endorphins and serotonin that are released are known to be “feel-good” chemicals.
Studies show that people who regularly smile seem more confident and trustworthy. It is thought this is because we are naturally drawn to smiles.
This is why someone smiling will usually look more attractive. Muscles used to smile lift the face, which makes someone look younger too.
Uppsala University researchers in Sweden carried out a study in which people looked at photos of smiling or frowning faces.
They were asked to frown at a picture of someone smiling and vice versa. Electronic devices measured their facial movement, and it revealed it was much harder for them to frown at a photo of someone smiling than it was the other way round. So it’s true – smiling is infectious!
But since there is little we can do to avoid responsibility as adults – not least because many have children who need caring for every day – what can we do?
Many people have grown up in families that primarily focus on negative things, worst-case scenarios and what they don’t have in life. This sort of thinking doesn’t give much to smile about.
But it can be turned around with gratitude. That is, focus on all the positive aspects of life and what can go right with any ideas or plans. There is always something for which we can be grateful.
According to research published in the scientific journal Cerebral Cortex in 2008, gratitude stimulates the hypothalamus.
This is the part of our brain that regulates stress and is connected to our rewards pathways.
The more times a certain neural pathway is used, the clearer that way becomes. This is why anything we focus on grows bigger – our magnifying minds.
We have a choice over which we focus on of the estimated 70,000 thoughts a day we have (according to the University of Southern California’s Laboratory Of NeuroImaging).
Focusing on gratitude means we are choosing positive over negative.
One of the most beneficial ways is to write down before bedtime ten things for which you’re grateful. Include “big” things such as health, friends, food, nature, being alive; and it can be “small” things too – but that are also all too often taken for granted – such as the internet or your favourite TV show.
In the morning, soon after waking up, read through your gratitude list. Then start the day in stillness and quiet rather than scrolling through social media or packing your mind with busy thoughts. If during the day you find yourself drifting away from positivity, reread the gratitude list. Or, any time, write a new one.
This seems tricky, but people who do it say they feel much more positive in life. This works when, for instance, you are stuck behind a slow driver. Instead of negative thoughts, think positively by giving gratitude for such as having the chance to practice your patience and tolerance.
Think too of such as there’s a valuable lesson for you to leave more time for journeys. We can most nearly always learn and grow from things like this in life.
Many people – especially if they’ve grown up in a similar family – will focus on the negative in their partner and family. Focus on their positives instead.
If you haven’t got a partner or children, focus on the positives of being single and without the ties of having a family.
Write such as: “I am worthy of good things”, “I can” or “I love myself and others unconditionally”. As with a gratitude list, it’s most beneficial to start the day with this. But also at any time, especially if not feeling positive.
At White River Manor, we offer a tailor-made program for you or someone you care about in 5 Star luxury nestled in stunning surroundings. Our positive experienced team here can help restore purpose, direction and self-worth.Giles Fourie
There’s a big difference between feeling a little sad and having depression. In fact, we are made to have all sorts of emotions ranging from joy to sadness.
They are a completely natural part of life. But they should not be our “normal” state.
So if someone feels down for more than a few days, it could be because they have depression. According to the World Health Organization (WHO), depression is a mental disorder affecting more than 264 million people worldwide.
Depression is a real illness with debilitating symptoms. Anyone suffering from this condition needs professional help to overcome it.
The causes of depression are not completely understood.
But it’s believed there are several factors, including that someone may be more vulnerable to depression due to certain personality traits.
These are such as low self-esteem or being excessively self-critical. This could be because of genes and/or family habits they’ve been taught – for instance, how to react to certain things in life. Many families will habitually focus on the negative, what they lack and worst-case scenarios. This runs from generation to generation.
A traumatic experience in early life is considered to be another major factor in causing depression. This is such as abuse or the death of a parent.
For others, it’s something unwelcome in their present-day life that seems to be behind their depression. This includes redundancy, a relationship breakdown, serious illness or bereavement. It could be a combination of these.
Some studies have discovered people are also more likely to get depression as they get older. Other research points to a poor diet playing its part.
Some women are vulnerable to depression after pregnancy. Other factors include being isolated, using drugs, hypothyroidism, some head injuries and drinking excessively.
Many people ask what a clinical diagnosis of depression is based on?
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is the handbook published by the American Psychiatric Association that’s used by healthcare professionals around the world as the definitive guide to the diagnosis of mental disorders.
According to the DSM-5 someone must be experiencing five or more of the following symptoms during the same two-week period.
At least one of the symptoms has to be either depressed mood or loss of interest or pleasure.
To receive a diagnosis of depression, these symptoms have to cause the person clinically significant distress or impairment in occupational, social or other important areas of functioning.
However, these symptoms cannot be due to another medical condition or substance abuse.
If it is determined that someone has severe long-term symptoms that are badly impacting on the quality of life, it’s referred to as clinical depression. This is sometimes also known as major depression or major depressive disorder.
Depression can take on many forms.
This includes such as premenstrual dysphoric disorder (PMDD); seasonal affective disorder (SAD); dysthymia (or persistent depressive disorder); situational depression; and bipolar disorder depression. More details on the types of depression can be found here.
It’s important that the type of depression is identified as this helps to find the most effective treatment. It’s also vital to identify if someone with depression has any other mental health conditions.
Common co-occurring conditions in people with clinical depression include:
Treatment for depression frequently involves a combination of talking therapies, medicines and self-help. It depends on the type and severity of the depression.
There are several talking therapies that can help with depression, such as cognitive behavioural therapy (CBT).
CBT recognizes that events in the past may have had big influences, but it concentrates mostly on how to change the way we think, feel and behave in the present – for example, how to challenge feelings of hopelessness.
Antidepressants are medicines that treat symptoms of depression. There are different types of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), one of the most commonly prescribed.
It is often asked: are antidepressants bad for you? They are generally considered safe, but as with all medical treatment, there can be some risk. They need to be prescribed by a doctor who can discuss this with a patient. More information on antidepressants can be found here.
There’s plenty of evidence that exercise can also help alleviate depression. This could include simply taking a daily walk, and exercising at the gym can help with feelings of loneliness.
Talking through feelings with a group can be useful to some people. There are self-help groups for people with depression. Also, there are many self-help books that deal with depression.
Eating a balanced healthy diet can be very beneficial as well. This means plenty of fresh fruits, vegetables, nuts, whole grains and fish.
The professionals at White River fully understand depression and will help you or someone you care about to be able to live a meaningful and fulfilling life.Giles Fourie
If this headline has piqued your interest, it’s probably because you’re questioning whether you do indeed have an addiction to technology.
Are you dependent on your devices? Do you feel the need to be in constant contact with others? Do you find yourself obsessively checking for emails, messages, missed calls? Are you continually engaged on social media – mindlessly scrolling for satisfaction?
Like millions of us, we are attached to our devices most of the time, with some of us even “wearing” smartphones as a brand accessory.
A study carried out by software company RescueTime showed that an average user spends around 3 hours and 15 minutes per day on their phone and a top smartphone user will spend 4 hours and 30 minutes per day on devices.
As many of us struggle to go a day without technology, the threat of tech addiction is a growing problem.
Technology addiction is often described as the inability to control the use of technological devices such as smartphones, tablets, computers, and gaming systems. And in particular as a result of the use of various types of technology involving the internet, video gaming, shopping and numerous social media sites.
Although technology is inevitable in our everyday lives, it’s important to differentiate from the regular use and the problematic, addictive use.
The effects of over-dependence can manifest itself in both physical and emotional symptoms.
Common symptoms include mood imbalance, insomnia, agitation, poor diet, denial, lack of control, loss of interest in important daily activities and neglect in relationships, work or school life.
Some individuals become so obsessed with online activities and social media that they have difficulties engaging with the present world.
Excessive use of technology, especially social media may have a negative impact on mental health and development, particularly among children and young adults.
Research suggests that young people who spend more than three hours a day on social media are more likely to report poor mental health and internalising behaviours – including anxiety and depression.
While we are manipulated by the most powerful digital marketing channels that have a vested interest in keeping our eyeballs glued to their screens, we are also driven by the top tech forces the world has ever seen.
Tech giants like Google, Apple, Microsoft, Facebook and Amazon who have a far-reaching influence on millions of consumers worldwide.
As these multi-billion companies fight for first place, a record-breaking number of active users are influenced by compelling technology. These sophisticated technologies rely on persuasive and motivational techniques to lure us in and keep us hooked.
Techniques which encourage specific human behaviour, for example, video gamers are driven by a developmental desire to gain skills and accomplishments.
The latest generation of video games are designed with triggers to increase the time spent playing on them – the more time spent, the more rewards you get or add-ons you’ll purchase.
Similarly, with social media companies, the motivation is the craving for social connection and popularity. A breeding ground for comparison, young adults, in particular, spend hours perfecting profile images and making comparisons with one another.
Social media influencers, notorious for creating that perfect “Insta” pic, have a direct impact on the behaviour of followers – leading to the development of a self-absorbed culture of young people with potentially harmful outcomes.
As advancements in technology continue to develop, the problem with addiction to smartphones becomes great. Dependency leads to feelings of distress and anxiety if we are out of mobile contact or without our phones. Often fuelled by the overuse of internet addiction, these feelings of fear and separation anxiety are known as “nomophobia” aka no-mobile-phone-phobia, a term coined by researchers 12 years ago and added to the online Cambridge dictionary in 2018.
Even the most influential tech figures in the world: Steve Jobs and Bill Gates, are known to have limited their kid’s tech time at home.
After years ensuring dependency is at the core of their designs – how have tech companies responded to consumer criticism on the overuse of technology?
Tech giants Google and Apple offer screen time features that monitor and restrict phone use. Apple has also implemented a communications limit so that parents can set limitations on kids Contacts lists for incoming and outgoing phone calls, messages and FaceTime – whether during the permitted screen time or otherwise.
With family time often compromised by continuous screen time, adults should also set a good example. Yet many parents find it challenging to limit screen time and are often just as guilty of digital distraction. To ensure children develop healthy habits parents need to first be aware of their own habits and introduce real boundaries and balance. Curbing screen time by banning phones or iPads at mealtimes and spending quality time together as a family doing fun activities is a good start.
Technologies like social media can offer a range of global benefits and opportunities. One of the most powerful benefits is the ability to raise global awareness of an important issue. Every day, more people, such as mental health and body-positive advocates, promote change and make positive interactions to a mass audience.
Social media is also a great platform for like-minded people with similar interests to share their views. It provides them with the opportunity to stay in touch and nurture relationships around the world.
Like it or not, technology has also become essential in today’s schools. It is an integral part of modern-day learning with students and teachers constantly engaging inside and outside of the classroom.
Technology in the classroom can help students learn useful life skills needed to be successful in the education and careers of the future.
While technology can add a wealth of value to our lives it’s important to use it mindfully and find a healthy balance with other aspects of “real” daily life.
If you’d like to discuss your tech use with one of our clinicians, contact us today for a free and no obligations chat.Giles Fourie
It seems like a riddle: those who have experienced past trauma often put themselves in situations to experience similar trauma.
It’s not a conscious decision either. They don’t think to themselves: I will put myself through more pain on purpose.
These people may continuously find themselves in toxic, abusive relationships. They may become violent, chronically depressed, or deep into financial problems. They may seem to go in a positive direction for a while and then seemingly choose to do something to sabotage themselves.
Maybe you know someone like this, or maybe this describes you. Perhaps you feel that you cannot find a healthy relationship.
You are drawn toward those who are toxic for you, but you cannot seem to stop landing yourself into these situations. When you think about it logically, it may make no sense.
However, if you understand the reenactment of trauma, you will see why this happens.
Those who suffer from trauma reenactment often cannot differentiate between what is happening now and the past emotional pain that still envelopes them.
This means that past emotional pain keeps accumulating through reenactment, new experiences, new circumstances, which leaves the sufferer unable to tell the difference between what is truly happening now and what is not.
It is important to understand that trauma reenactment is usually unconscious.
Trauma victims were used to living in chaos and toxicity. They saw the world through a dysfunctional lens, and chaos became their “normal.”
Sometimes these victims may become addicted to the feelings that the trauma ensued. Similarly, some trauma survivors become intensely attached to those who resemble former abusers.
Many theories exist on why those with past trauma reenact their trauma. Sigmund Freud, in his essay “Beyond the Pleasure Principle,” 1920) called certain repetitive behaviours in his clients “repetition compulsion,” and that the reason people repeated traumatic events was to attempt mastery and control.
Since Freud, many researchers have observed that trauma reenactment is an underlying theme for a person’s inability to mentally and emotionally escape from the traumatic experience.
Dr. Sandra Bloom, author of Creating Sanctuary: Toward the Evolution of Sane Societies, states that
“The memories of the traumatic experience are dissociated, nonverbal, and unintegrated. Over and over, people find themselves in situations that recapitulate earlier trauma and lack any awareness of how it happened much less how to prevent it from happening the next time. The lack of awareness is due to the dissociative blockade that places the behaviour out of the context of verbal and conscious control.”
Others suggest that childhood trauma survivors have poor coping strategies and low self-esteem, which makes them easy targets for predators.
We do know that trauma survivors are “burdened by major impairments in self-care, in cognition and memory, in identity, and in the capacity to form stable relationships,” according to Judith Herman’s book, Trauma and Recovery.
When trauma survivors reenact their past trauma, they may take on the role of either the victim or perpetrator. Dr. Dorothy Lewis’s research has focused on some of the world’s most violent criminals.
She states that while the most damaged people do not turn into killers, almost every killer is a damaged person, and the pain and damage began in their childhoods.
Trauma survivors may also reenact trauma by causing harm to themselves. Some common examples of self-harm are eating disorders, self-mutilation, avoiding medical care, addiction, putting oneself in danger, and unrealistic, self-attacking beliefs.
While the trauma reenactment is a serious effect of unresolved trauma, there is hope.
For those wanting to help a trauma victim, it is helpful to know that someone who seems to be repeating destructive patterns may be incapable of reversing this behavior because of the unresolved trauma they have locked in their minds.
They need professional help that allows them to come to grips with the original trauma and process it in a healthy way. In addition, because of the core beliefs they have adopted about themselves, they will need therapy in order to correct these beliefs and thoughts.
If this sounds like you, seek help. Many times, those who suffer from trauma reenactment are too ashamed to seek help.
The professionals at White River understand trauma and will help you uncover your past pain and process it healthily so that you can live a productive, free life.Giles Fourie
There are so many stresses in life between work, personal relationships and social commitments. Sometimes we forget that contact with another being can seriously affect our stress levels – in a positive way!
Believe it or not, science research has established that daily cuddles with your pet are good for both of you. Just 30 minutes with a puppy positively affects your brain chemistry and changes the bodies stress response.
Pet cuddles can also play an important role in improving your physical health and helping relieve anxiety and depression. They can help to reduce our blood pressure in stressful situations, lower cholesterol and increase physical activity.
What are the other benefits of spending times with pets or animals?
When you are battling with substance addiction, the support you receive from your loved ones is vital. Having people around to love and care for us goes a long way to aid our rehabilitation. But what about love and cuddles from a pet? Can that also help?
The answer is yes, pet therapy, or animal-assisted therapy can have far-reaching benefits in addiction therapy and rehabilitation.
Animal-assisted therapy uses animals to support clients with mental health disorders or addiction problems. Research shows that it improves our physical, mental and emotional wellbeing.
A study carried out in 2015 with 231 people taking part demonstrated that mental health rehabilitation which involved animal-assisted therapy strengthened the therapeutic alliance between patient and therapist.
In fact, animal-assisted intervention is widely recognised as being beneficial to addiction therapy and has been used in hospitals, rehabilitation centres, prisons, and nursing homes.
Undertaken alone, pet therapy isn’t the answer. To be effective, it should be included as a goal assisted intervention, directly linked to the client’s overall treatment plan.
If you are seeking an addiction rehabilitation program which includes animal-assisted therapy, make sure you choose a centre that has practitioners with experience working with animals in a mental health environment.
In most countries, there are no specific qualifications or occupational standards for practitioners working in the AAT field. The therapy is generally carried out in a controlled environment with a multi-disciplinary team of certified therapists, where some have taken AAT as an extended module to their overall qualification or taken part in a stand-alone certification course for animal professionals.
Dogs (canine-assisted therapy) are the most commonly used animals in pet therapy. But what animal you work with, will depend on your specific needs and the chosen centre. Horses (equine therapy) are also commonly used in the treatment of substance abuse.
A centre that uses animal-assisted therapy will carefully select and train the animals, which are typically mature dogs or horses. When trained and used correctly, they can become your loving and supportive companions during your rehabilitation time.
Other animals that are used in animal-assisted therapy include:
No research has been done on whether some animals are more successful than others in addiction and mental health disorder treatment.
There are many benefits to using animals as part of a holistic program for addiction treatment. The most important recognised benefit is the strengthened alliance between client and therapist.
Animal-assisted therapy creates a better bond between the two, and when there is a strong relationship, it supports the success of the treatment.
In turn, this decreases the problem of the client pulling out of rehabilitation treatment before they have recovered, which can often happen. The stronger the bond between client and therapist, the more likely the client is to continue treatment and improve their chances of success.
The other important benefit to animal-assisted intervention during addiction treatment is in improving the client’s range of emotional responses.
Client’s suffering from substance abuse or trauma disorder often experience a reduced range of emotional responses and have difficulty experiencing and processing their emotions. When their treatment incorporates animal-assisted therapy, it can help to regulate their emotional responses to situations.
In these cases, pet therapy acts as a model for mindfulness. Teaching clients how to experience emotions in real-time and how to navigate the world of emotions.
Other ways that AAT can help in addiction treatment
Animal-assisted therapy isn’t a stand-alone therapy for substance abuse disorders. The intervention should be used to complement traditional and holistic therapy methods where it can improve the bond between patient and therapist, help to strengthen our emotional processes and motivate patients to stay in treatment.
At White River Manor in South Africa, we take a whole-person approach to addiction therapy, using a range of treatments and activities. Our professional team has decades of experience in addiction treatment.
Our holistic programs are individually tailored to the client and incorporate the required level of intensive therapy, medical management, psychiatric evaluation, invigorating exercise options, healthy eating, and incredible experiences exploring this beautiful part of the world.Giles Fourie
Buzzwords such as ‘stay home’ and (even more recently) ‘stay alert’ have sparked off their very own movements in recent months.
This aside, how are people coping psychologically amid the pandemic and crucially, how can they manage their mental health during this unprecedented time?
The Spanish flu that erupted in 1918 killed 50 million people worldwide with similar parallels to the Coronavirus. At its peak, 1,200 people died each day from the Spanish Flu and populations were also a lot smaller a century ago.
Interestingly, how people ‘coped’ back then is similar to how many of us are coping now. Self-isolation booths in 1918 may not have been as high-tech as they are today, however, quarantine rules were strictly imposed on a global level as was social distancing, rationing and panic buying.
The difference between history and what’s happening today largely boils down to two things: technology and mental health awareness (and in the case of the Spanish flu lack thereof).
If we were to draw any positives from the Coronavirus, it would probably be the advancement of technology and scientific research methods.
Essentially, technology has the power to create awareness and as we’ve been taught many times before: awareness saves lives. Unfortunately, since science and medicine were vastly underdeveloped in the 1918’s, medical professionals simply didn’t have the tools to develop a vaccine to treat the virus.
Not forgetting the lessons that can be learned from history. And although most of us had never heard of the terms ‘social distancing’ and ‘self -isolation’ pre-Covid19, it doesn’t mean that they didn’t exist. Equally, being privy to past knowledge puts us in a stronger position as we have something to draw on.
Another important factor when it comes to pandemic survival is the role it plays in mental health.
Decades ago the stigma attached to mental health was much stronger than it is today. And research into the Spanish Flu pandemic shows just how deprived mental health initiatives were back then.
Historical demographer, Svenn -Erik Mamelund, PhD, conducted research into asylum hospitalizations in Norway from 1872- 1929. The study found that the number of first-time hospitalized patients experiencing mental disorders attributed to influenza increased by an average yearly factor of 7.2 in the 6 years after the pandemic.
Mamelund reported that Spanish flu survivors experienced sleep disturbance, mental distraction, dizziness and an inability to concentrate at work. Many also reported feelings of depression and anxiety, and in the years between 1918-1920, the US suicide rates were positively and significantly related to the Spanish flu pandemic.
Fortunately, support and awareness surrounding mental health issues have drastically improved with the emergence of rehabilitation treatment centres and movements such as Mind and Alcoholics Anonymous (AA).
If history teaches us anything at all, it is the lessons we can learn from the past, including what to do (and crucially what not to do) amid a global pandemic.
With the world currently experiencing varying levels of grief, it’s important that mental health professionals continue to spread the message surrounding grief and the many ways it manifests.
The unfortunate death toll that has emerged because of Covid-19 is devastating and has triggered it’s very own grief pandemic. Grief has always been somewhat of a taboo subject. Although when one experiences the death of a loved one, it is expected for them to go through the grieving process. But what about grief that is spurred on by a pandemic?
There are many levels to grief and how one copes is subjective to the individual. Some might turn to substance addiction as a way of coping, while others perhaps turn to other forms of self- destructive behaviour. Grief recovery experts define grief as being:
‘’The normal and natural emotional reaction to loss or change of any kind.’’
If the above statement has any truth to it, the dramatic changes the pandemic has brought to our lives means that we are all grieving to some degree. Ever since the Coronavirus, rehabilitation centres have reported concerns particularly for patients in recovery from addiction.
Recovery from addiction largely involves a connection with others and sharing challenges with people who understand. Experts have become increasingly concerned about the impact that isolation will have on patients and their recovery.
The World Health Organisation (WHO) recently reported an increase in alcohol use as a coping mechanism during the Coronavirus lockdown, and have labelled it an ‘unhelpful coping strategy’. Relying on alcohol to curb anxiety and cabin fever ‘’can only make things worse’’.
There are several ways in which people can effectively manage stress and anxiety during lockdown which include:
Routine is essential to our daily lives. It provides us with structure and purpose and helps us to keep things in order.
For those working from home, it can be tempting to opt for a more relaxed routine, such as getting up late or lounging around in your pyjamas for half the day, but this can quickly turn into a vicious cycle.
The best advice is to follow a similar routine from the pre-quarantine days: get up early, shower, eat breakfast and do some exercise (if possible).
Since Covid-19, peoples’ lives have been thrown into disarray and sticking to a routine provides a bit of structure, it also helps to minimise a ‘fear of the unknown’. The more predictable your daily schedule is, the less likely you are to feel anxious.
This is especially true for those in addiction recovery too, as they can continue (as much as possible) to practise the principles learned from the 12 – step recovery program.
The language people use and their inner dialogue is an important aspect of mental health.
When it comes to lockdown if we consciously affirm: ‘’I’m enjoying being at home and doing all the things I couldn’t do before’’ instead of ‘’I am isolated indoors’’ it’s likely that over time, your brain will start to respond to the positive narrative it’s being fed.
Almost like ‘rewiring’ the brain, the use of positive language is a very powerful tool in the management of anxiety and stress.
Those that suffer from anxiety attacks are often advised to use positive affirmations in order to control their breathing during an attack and this approach usually works on both a physiological and emotional level.
Lately, the outside world has served us with enough chaos to last a lifetime, it’s important then, that we keep our home environment as chaos-free as possible.
This might prove more challenging to those who have children, but maintaining a calm environment when everything else seems out of control, allows us to put specific techniques into practice such as taking up home yoga or meditation.
Essentially, being able to shut the front door and step into a calm, tranquil environment will work wonders in the minimisation of stress – meaning that people are less likely to turn to unhealthy coping mechanisms such as alcohol and other substances.
While it’s important to know what is going on in the world, excessive news coverage, especially at the current time, will only add to peoples’ stress and anxiety levels.
The advice would be to stay informed about any changes in rules and the pandemic in general, but not to the point where you are excessively news watching or reading about the pandemic on social media.
Too much negative exposure can create nervous tension within the body and what happens when people become overly nervous? They turn to ‘something’ like alcohol to get rid of the anxiety. A good rule of thumb would be for people to minimise any news exposure to once a day.
Those who happen to be isolating alone are more at risk of anxiety and feelings of loneliness mental health experts advise.
Long-term disconnectedness from others can often lead to self-destructive behaviour such as excessive drinking, smoking and other forms of addiction. That’s why staying connected to family and friends is important during this time.
Fortunately, with social platforms like Zoom, Webex and other messaging apps it’s a whole lot easier for people to stay connected compared to a century ago.
Interestingly, recent research has shown that those who are isolated with family members and partners are also at risk of loneliness regardless of sharing a household with others. For those people, checking in with themselves regularly and staying connected to people outside the house-hold can be extremely cathartic, especially when cabin fever starts to kick in.
The benefits of physical exercise are endless. Mainly because exercise helps to:
Regular exercise can have a positive profound effect on anxiety, depression and other mental health disorders such as ADHD and the reasons for this are limitless:
Feeling overwhelmed at times is part and parcel of being human. But when things seem unmanageable or you feel as though you can no longer cope, then it might be time to seek help from a professional.
There are plenty of mental health organisations out there and whichever one you decide on, will depend largely on where you live and your symptoms. An individual might be offered tailored therapy or something more intense.
If someone is living with high-functioning anxiety, for example, they might demonstrate a range of symptoms such as: controlling or strict behaviour, perfectionism and the need to over-achieve all of which mask underlying anxiety.
Often people tend to ‘accept’ anxiety as a way of life, but fortunately, it doesn’t have to be this way.
Rehabilitation centres offer a variety of treatments designed to help people manage stress and anxiety through specific therapy packages and wellness programs.Giles Fourie
You may have noticed that what you eat and drink can lift or lower your spirits. It affects how we feel, think and even how we behave.
Some foods are known to lift your mood, concentration and energy levels, while others can have the opposite effect.
For example, eating a diet rich in fresh fruits, vegetables, nuts, and whole grains can help reduce your risk of some mental health conditions.
Whereas a diet high in sugars and saturated fats are considered detrimental to cognitive function.
Nutrition is one of the most obvious yet under-recognised factors in the development of mental health.
To stay healthy, the brain requires varying quantities of complex carbohydrates, essential fatty acids, amino acids, and even water.
Our brain is made up of mostly water (about 75%) and so drinking the recommended daily consumption helps with brain function and connectivity in a number of ways.
Water helps balance your mood and emotion, improves cognition and concentration, increases blood flow and oxygen to the brain and also helps reduce stress.
A fully hydrated brain will help the exchange of nutrients and toxins to become more efficient, thus ensuring better concentration and mental performance.
Our brain works hard around the clock, even when we are asleep, and requires a constant supply of fuel – primarily obtained from a balanced diet rich in nutrients.
Those of us who chronically under-eat or regularly skip meals can experience blood sugar decreases, causing our brain to become sluggish and foggy.
In the rush and pressure of modern life, busy schedules mean stressful times and often leave us eating in a frazzled state with little to no time to sit down to a healthy meal – or drink the recommended intake of water for a hydrated body and mind.
Lack of time has a direct impact on our food choices and we are often found compromising a well-intended diet for quick-fix snacks and stimulants – leaving you zapped of energy both physically and mentally.
Corporate leaders and high flying executives working long hours in a competitive environment accept stress as a normal part of life.
For some, it’s not uncommon to self-medicate in order to cope with the stress brought on by running a fast-paced company and the pressures of leading at the top.
But behind closed doors, challenges and vulnerabilities are faced and often they believe the actions they are participating in are helping, not harming them.
There’s a high expectation to perform at peak levels and much rides on their success and behaviour. But how aware are high-powered individuals of their mental health?
Lifestyle factors such as demanding work roles, unhealthy diet, drugs and alcohol, and lack of sleep can all affect your mental health.
Ongoing stress can start to affect our mental health and turn into more serious problems – such as anxiety and Depression.
We have all almost certainly experienced anxiety at some point; it is perfectly normal. The right amount of anxiety can help us do our best in situations that involve performance.
However, the ugly side of anxiety can cause emotional distress and at worse develop anxiety disorders and depression – impacting on our lives as well as our physical and mental health.
Eating is one of life’s pleasures. So why are so many of us rushing through it?
Our diet and the foods we eat can make a difference when it comes to brain health and function.
Many of us rush through meals or even skip them. You may think it’s not a problem to skip a critical meal, eating fewer calories -what’s the harm-right?
Missing a meal, particularly breakfast, or not eating for long spells can lead to blood sugar decreases, which cause interruption in your ability to think straight – this leaves you feeling irritable, confused and fatigued. In turn, your body starts to increase the production of Cortisol, leaving you even more stressed.
The same can be said about skimping on carbohydrate foods. The term “carbs” may have become a taboo word, and its reputation put into question, but our bodies need carbs to produce serotonin, a feel-good brain chemical that lifts your moods and has a calming effect.
Your brain needs glucose for energy, and this is obtained from carbs when broken down.
Avoiding carbohydrates can actually have negative effects on your brain, and a diet low in carbs can be detrimental to your memory and your ability to learn and think.
Think ‘good’ complex carbs and not ‘bad’ simple carbs.
The good: vegetables, fruits, beans, whole grains
The bad: cookies, cakes, candy bars and all high sugar options are very easy to breakdown but cause a spike in blood sugar resulting in a crash and low mood.
In order to remain healthy, the brain needs other nutrients such as omega-3s, antioxidants, vitamins and minerals.
Specific fats are a key component in the structure of cell membranes and play an important role in neuron development and function.
For example, omega-3 fatty acids help build and regenerate brain cells, and antioxidants minimise cellular stress and inflammation, which are associated with brain ageing and neurodegenerative disorders.
Omega-3 fatty acids EPA and DHA are vital for normal brain function and development throughout all stages of life. Found in fatty fish (salmon, tuna, sardines, mackerel) they improve memory and mood. They can also be found in soybeans, flaxseed, nuts and other seeds. Low levels of omega-3s may accelerate brain ageing and brain function deficits.
For those who fall short of their recommended fish intake, fish oil supplements may be a convenient alternative.
Antioxidants are particularly important for brain health since the brain is highly susceptible to oxidative stress, a condition of imbalance between the production of free radicals and antioxidants, that is thought to contribute to age-related illnesses such as Alzheimer’s and Parkinson’s.
Antioxidants are found in most fruit and vegetables but in general, the brighter the colour, the higher level of antioxidants. Berries – whether strawberries blackberries, blueberries are the ideal antioxidant fix and can help improve concentration and memory.
In particular, blueberries are considered to contain the highest antioxidant levels of all common fruits and vegetables. Make sure to have a place on your plate for brightly coloured fruits and vegetables with every meal.
Catch up on those zzz’s. Sleep and health are strongly related; getting a good night’s sleep helps to repair and restore body and mind whereas poor sleep can have a negative effect on our health.
Sleep is vital for maintaining good physical and mental health. Simple lifestyle adjustments can benefit the quality of our sleep. A lack of sleep or poor quality of sleep can affect our energy, mood and concentration levels.
Taking time out to relax and let go of any worries or concerns is vital for mental wellbeing.
Relaxing gives your body and mind the time to recover from everyday stresses. Stop, breath and take time out for yourself to de-stress and rejuvenate, book yourself that well-deserved getaway without hesitation, take up a yoga class and learn to breathe again.
Breathing exercises can genuinely help, its one of the best ways to reduce tension and lower stress. A perfect tranquil environment will benefit your mind, body and soul.
Sleep well, eat well, exercise and make time for you – Healthy life, Healthy mind!Giles Fourie
You’ve missed the train and will be late for an important meeting. Your deadlines are getting tighter, your hours longer, and you’re always under pressure to perform at peak level.
All of these scenarios can cause us to feel stressed out. Most of the time, that’s okay, as stress is a natural reaction to events that happen during the course of our lives.
It can even be beneficial to health, helping us to cope with difficult or dangerous situations. This is called the ‘fight or flight response’ or the acute stress response. In a stressful situation, our bodies react by activating our sympathetic nervous system, which releases hormones which prepare the body to deal with the threat or run for the hills!
When we are in fight or flight mode, our bodies emit signals, such as a rapid heart rate and breathing, dilated pupils, trembling and we either go pale or get flushed.
These signals are a response to help protect our bodies in an emergency. When the emergency passes, we revert back to normal levels within 15-20 minutes.
There are many situations that can cause high levels of stress, such as high-pressure executive careers, financial problems or difficult relationships. Often one may lead to another leading to a cumulative effect, with each stressor building on top of the other.
When we feel constantly stressed, our bodies remain in a hyper state of tension. This prolonged period of stress is known as Chronic Stress and can lead to serious psychological problems.
In turn, we may find ourselves in a state of progressive depression, coping with substance abuse or having suicidal thoughts.
Psychological and emotional signs that you’re stressed out:
Whilst some people only experience psychological effects, many of us also feel the physical toll of stress on the body.
Mild symptoms such as headache, muscle tension and heartburn, are common, but prolonged bouts of stress can put a lot of pressure on the major systems in our body and cause damage to organs and tissues, leading to serious health problems.
Physical signs that you’re stressed out:
When you feel completely overwhelmed with stress and anxiety for a prolonged period, it becomes difficult to cope with even the smallest daily tasks, let alone try to address the underlying feelings of stress and helplessness. However, it’s important to put some discipline into place and to make positive changes before things spiral out of control.
The first thing to do is to identify the root of the problem, which is causing you to feel stressed. Finding the connection between feeling stressed and the pressures you are facing will help you move towards a less stressful life.
What are you doing when symptoms of stress are triggered? Are you at work, home, or calculating your financial situation?
Start to recognise the symptoms and note down where you are and what you’re doing when they come on.
When you have an idea of what’s causing the problem, you need to decide whether the factors are self-manageable.
If there are practical solutions to your problems, it’s time to implement them.
Here are some examples:
Delegation: If you are taking on too much at work, speak to your team about delegating some of your tasks.
Prioritisation: Do you need to prioritise a relationship over your work or work over a relationship to get the situation under control? Decide on your priorities and put lesser tasks or issues aside for now.
A great example of this can be found in the Coronavirus lockdown situation:
We are working from home and homeschooling our children. Attempting to keep both ourselves and our families focused. But to maintain order in a chaotic world can be highly stressful.
This is a key time for prioritisation and perhaps putting aside the rules that we might have insisted upon at home during normal times.
Organisation: How can you re-organise areas of your life so that they are handled in a more relaxed fashion?
Scheduling time between tasks and free time, time off from emails and social media, and not allowing colleagues to jump into your space for improvised meetings will help you to become more organised and focused.
Often when we find ourselves in stressful times, we turn to unhealthy habits. Using short-term fixes to feel better is a typical way of dealing with stress. You’re not alone.
Some of these habits might be harmless in the short-term, such as drinking too much caffeine or switching to watching endless YouTube videos instead of focusing on work.
However, if our stress is prolonged, these quick-fixes turn into seriously bad habits.
It’s essential to be more aware of those moments when you reach for an unhealthy fix to your problem. When you feel like having one drink too many or starting an argument with your partner, why not try to connect with someone you can talk to instead.
It might not be easy at first, but as they say: a problem shared is a problem halved.
Aside from getting bad habits under control, there are lots of things we can do to move towards a healthier and more stress-free life.
Daily physical exercise, even if it’s only 20 minutes a day, is a positive habit to introduce and is scientifically proven to decrease tension and elevate our mood. Even light exercise and fresh air, such as a daily walk around the neighbourhood will do you the world of good.
Eat for health:
When we reach for sugary snacks or junk food, we are feeding our stress. Recent research suggests that certain foods affect our state of mind.
When we eat healthy foods, we get adequate amounts of nutrients, vitamins and minerals and have positive feels of wellbeing. When we eat unhealthy food, we feel negative about ourselves almost immediately after doing so, and we are increasing the risk of contracting a diet-related disease.
Mindfulness & Meditation:
You’ve probably heard something about mindfulness, but in your stressed state, you’ve dismissed it in favour of another glass of wine or a line of coke. However, mindfulness is an excellent method to help build inner strength and better manage stressful situations.
Both mindfulness and meditation teach us to become more aware of our thoughts and how to step back from them, so we don’t immediately react to certain situations. You also become more sensitive to the needs of your body, which helps reduce bad habits.
At White River Manor, we incorporate mindfulness therapy into our executive burnout and addiction programs.
The most stressful thing about being stressed is blaming yourself when things don’t go according to plan.
In times of stress and worry, it’s important to keep perspective and remember that you’re not the only person to have a bad day.
Instead of beating yourself up, be kind and supportive instead. Take some time each day to appreciate yourself and if you are going to critic yourself, don’t always look for your faults, instead look at the bigger picture.
You’ll be amazed out how much is actually out of your control in these situations – especially with work-related stress.
When stress is prolonged, and your symptoms list grows longer, it’s time to take a step away and focus on self-care. Taking time off from work and yourself out of the routine is the best way to put things into perspective and make positive decisions about your future.
“I don’t have time for a holiday” is so often the excuse we use for avoiding ‘me’ time, in which we should be making healthy decisions about our future.
However, regular breaks are essential if we want to strike a healthy work-life balance. And they will do the world of good for our mental health.
Whether you stay at home and practice self-care, take a well-earned holiday, or book yourself into a recovery centre like White River Manor, the sooner you take action the quicker you’ll be back to your optimum self.
We can’t avoid it altogether, but it’s important to accept that holding onto stress is a detriment to our health.
Avoiding bad habits and keeping a healthy balance between work and play, helps us to live longer and stronger, be more successful at work and enjoy more fulfilling relationships.Giles Fourie
Recovery is a long journey of self-discovery and you walk it by taking one step at a time. One approach is to follow the 12-step programme that has strong spiritual roots and offers guiding principles to uncover deep-seated behavioural issues that drive addiction.
There is much debate whether the world-acclaimed 12-steps programme is still relevant considering how neuroscience and addiction therapy have evolved in the 80 years since the programme was first introduced. It’s relevancy is constantly questioned, but at the end of the day if the programme resonates with you and you’ll benefit from it; then there’s no harm in including it in a holistic therapy plan.
Although the 12-step programme is not central to White River Manor’s therapy philosophy, it can always be incorporated into your individual therapy plan.
Since it was introduced in 1935, the renowned 12-step programme has dominated the primary approach to treating addiction. In fact, more than two-thirds of addiction treatment centres solely focus on the 12-step programme and they advocate recovering addicts attend AA-type meetings after they complete a stay at a rehabilitation centre.
The purpose of the 12-step model is to aid recovery from compulsive, out-of-control behaviours that are ultimately linked to substance abuse. It’s one of the tools often used to understand what the root cause is of a person’s addiction; where participants attend self-help group meetings which serve as a safe place to admit past mistakes, surrender to a higher power and learn to stay sober.
These AA-type meetings are readily available, easily accessible and most often free to join. Men and women from all walks of life attend who share experiences and gain strength and hope from one another.
Alcohol Anonymous pioneered the 12-step programme which was established in the 1930s by Bill Wilson and Dr Robert Holbrook Smith, known to AA members as “Bill W” and “Dr Bob”. Together, they wrote about the positive effects people with alcoholism experienced when they shared their stories with one another and wrote down their own ideas for tackling addiction (to alcohol initially) in what came to be known as the Big Book.
Wilson and Smith’s guide to shared recovery was deeply rooted in the Christian faith and still is today, although non-religious people tend to swop a higher “God” with a higher “spiritual being”.
In addition to the Alcoholics Anonymous (AA) franchise, many other similar programmes sprung up as an offshoot of the original 12-step programme. This included Narcotics Anonymous (NA), Heroin Anonymous (HA) and Gamblers Anonymous (GA).
For a long time, the 12-step programme dominated the world’s approach to treating substance abuse. However, over time, other therapy programmes have replaced the tradition 12-step programme and it’s no longer the preferred method for recovery.
This is largely because many people struggle with the strong religious element of the programme, where the basic premise is healing cannot come about unless you surrender to a higher power. This doesn’t sit comfortably in a multi-denominational and multi-cultural world, particularly as the 12-step programme has a strong Christian foundation.
The 12-step programme offers a set of guiding principles to help you on your journey to sobriety. More importantly, it provides continuity in the form of self-help group meetings once a person has left an addiction treatment centre and returned to daily life.
The programme gives recovering addicts a simple process they can follow which allows them to understand and manage their addiction, find a supportive and non-judgemental group outside of the rehab centre and mend broken relationships and/or end destructive relationships with enablers.
The focus of the 12-step programme is to enable cognitive restricting around substance abuse and similar behaviour. This entails understanding the root cause on the addiction and changing behavioural patterns.
The 12-step meeting is well-known. We’ve seen it in movies and television series where a group gathers and someone stands up and says, “Hello, I’m Mary and I am an alcoholic.”
One member of the group leads the meeting; it opens with a prayer or meditation and people introduce themselves and at the same time, acknowledge their substance abuse.
The rest of the meeting is spent either listening to an outside speaker or going over addiction literature, working through the 12 guiding principles and speaking out about experiences and challenges. You can choose to share or keep quiet and listen. It’s entirely up to you.
The meeting ends off in prayer or another meditation.
The 12-step approach to recovery from addiction follows a set of guidelines that act as steps in your journey of recovery. The idea is to visit these steps as often and whenever necessary.
The 12-steps in the 12-step program are:
1st principle: Surrender
We admitted we were powerless over our addiction – that our lives had become unmanageable.
2nd principle: Hope
Came to believe that a Power greater than ourselves could restore us to sanity.
3rd principle: Commitment
Made a decision to turn our will and our lives over to the care of God as we understood Him.
4th principle: Honesty
Made a searching and fearless moral inventory of ourselves.
5th principle: Truth
Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6th principle: Willingness
Were entirely ready to have God remove all these defects of character.
7th principle: Humility
Humbly asked Him to remove our shortcomings.
8th principle: Reflection
Made a list of all persons we had harmed and became willing to make amends to them all.
9th principle: Amendment
Made direct amends to such people wherever possible, except when to do so would injure them or others.
10th principle: Vigilance
Continued to take personal inventory and when we were wrong promptly admitted it.
11th principle: Atonement
Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12th principle: Service
Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics (addicts) and to practice these principles in all our affairs.
As they say; “it works if it works for you”. Basically, the 12-step programme works if you are motivated to recover and maintain sobriety. It doesn’t work if you don’t buy into it, aren’t committed to getting “clean” or are forced into it by, for example, a court mandate or family intervention.
The 12-step programme is not for everyone and if it’s the only approach offered by a rehabilitation centre, that would be limiting. Included in a holistic approach to addiction treatment, the 12-step programme has real value if it resonates with you.
Non-religious addicts or addicts who practise a different religion are as likely to benefit from the programme; particularly, as part of an after-care programme where the 12-step programme can help to reinforce what they’ve discovered about themselves in rehab. Like them or hate them, AA-type meetings have been around for decades and have been life-saving for countless people.
One would think that after so many years, the 12-step programme or modified versions of it would have evolved. It hasn’t; in fact, the 12-steps haven’t been touched since 1939… in other words, since the beginning of World War II.
In that time, 80 years to be exact; there have been incredible advances in the field of neuroscience, genetics and psychotherapy. This has led to the development of highly effective treatment approaches such as Cognitive Behavioural Therapy (CBT), Motivational Interviewing (MI), Mindful Meditation (MM) and Contingency Management.
These therapy approaches have added to the arsenal that therapists have on hand to understand and treat the underlying causes of addiction. Used in isolation, the 12-step programme is limited when you consider how much more can be done to help a person seeking treatment for addiction.
In short, many addiction specialists view the 12-step programme as being antiquated and no longer relevant. And there’s much debate in general over its credibility and just how successful it is. At the end of the day, it comes down to the person in recovery and how committed he or she is to the 12-step programme. If it doesn’t work, that may have more to do with the person than the programme.
The AA-type meetings that form a big part of the 12-step programme are inclusive and provide comfort and support in a non-judgemental environment. However, critics of the spiritual-based model say that confession and prayer are not enough if addiction is to be treated as a medical condition. In many cases, substance abuse is linked to a mental disorder and simply handing something that serious over to a “higher power” can do more harm than good.
When dealing with drug or alcohol addiction, we’ve come to understand how complex the condition can be. Any recovering addict knows that the recovery process is like peeling an onion layer by layer. Just when you think you’ve uncovered a deep emotional issue, something deeper surfaces; and the next layer begins to peel off and so the process continues.
The modern approach to treating addiction involves a multi-disciplinary specialist team that designs a treatment plan for you that meets your individual needs, and always with your buy in. This may include the 12-step programme if the guiding principles resonate with you. An integrated, holistic approach that considers the whole being – mind, body and soul – is proving to be the most effective approach to treating addiction.
White River Manor has had years of experience in dealing with alcohol and drug addiction and works closely with a dynamic team of specialists, therapists, highly experienced counsellors, medical practitioners, psychologists, and psychiatrists to create a holistic nurturing environment for clients.
If you need expert advice and assistance, then White River Manor is the right place to go to make those changes in your life. You don’t need to struggle on your own.Giles Fourie
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:
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:
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.
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.
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:
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.