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You’ve probably heard the AA aphorism, “One day at a time.” The idea is that thinking about staying sober for the rest of your life is too much to think about. It’s too overwhelming. You get caught up in thinking “What if this or that happens?” “How am I going to stay sober for the rest of my life?” and so on. “One day at a time” is a mantra that has helped many people through hard days. 

Sometimes “One day at a time” becomes “one hour at a time” or even “one minute at a time.” That’s fine. In fact, the more you narrow that time horizon, the closer you come to that classic dictum of happiness, “Live in the present moment.” This is good advice for anyone, but especially anyone with a substance use issue. Ruminating about past mistakes or worrying about possible problems are typical features of major depression and anxiety disorders, respectively. Living in the present spares you from having to carry the weight of the past and future but it can be hard to do. The following tips can make living in the present easier.

Focus on the Process

For many people, the biggest obstacle to living in the present is that we feel the need to plan for possible problems. This is especially true of people who tend to be anxious. Prying your attention from your worries feels a bit like taking your eyes off the road when you’re driving. 

To overcome this resistance, focus on the process rather than the end result. Living in the present doesn’t mean you give up on the idea of progress but rather understanding that progress can only happen if you act on the present. So, for example, you can be engaged in writing down some recovery goals and some steps to get there. You’re planning for the future, but you’re actively engaged in that particular activity. 

Write Things Down

One reason we often don’t live in the present is that we have something we feel is important that we have to remember. Maybe you have a meeting after lunch or you’re supposed to call your mom, or you have a great idea for your friend’s birthday present, and so on. If you have to devote mental energy to remembering those things, they will take away your focus.

Instead, just write them down. If it’s an appointment, writing it down on a calendar or planner is always a good idea, but just writing a reminder on a sticky note is usually enough to get it off your mind.

Practice Mindfulness Meditation

Mindfulness meditation simply means setting aside a certain amount of time every day to deliberately practice being in the present moment. It could be as little as five minutes or it could be as long as you want. The exercise is about accepting whatever you experience in the moment without judgment and without your mind wandering off to the past or future.

Your mind will inevitably wander off, especially at first. When this happens, just notice that it happened. Just noticing brings you back to the present because you become aware of what your mind is doing. 

Use a Grounding Technique

A grounding technique is when you deliberately notice sensations in order to ground yourself in the present. You can do this as part of mindfulness meditation or just any time during the day when you find yourself preoccupied with worries or otherwise unable to concentrate. A common grounding technique is the 5-4-3-2-1 technique. You notice five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.

This engages all of your senses and the mild complexity of the task keeps you cognitively engaged. However, you don’t have to go through this whole exercise to ground yourself. You can engage with any sensation. For example, you might notice the sensations in just your feet or you might notice the sensations of your breathing. 

Forget About the Clock

Anyone who has ever had a job knows that the last 10 or 15 minutes of the workday are the longest. When you’re busy, you forget about time and focus on what you’re doing. When you start looking at the clock, you get restless. Time creeps by. You wish it were 20 minutes in the future and you were on your way home.

The same thing happens any time you’re too focused on the time. Part of your brain is always pulling you away from your task at hand to check the time. Try forgetting about the clock. If you have to do something at a certain time and you’re afraid you’ll get carried away and miss it, set an alarm. 

Accept Your Emotions

Another major challenge to staying present is when the present feels pretty bad. Either you’re in physical pain or discomfort or you are experiencing challenging emotions. It’s normal to want to escape that situation, even if you’re just imagining how nice it would be if you didn’t feel so miserable. 

Ironically, pushing away negative feelings only makes them stronger. The purpose of pain is to let you know that something is wrong. If you try to ignore it, it keeps tapping you on the shoulder. However, if you accept your discomfort and can be present with it without judgment, it typically becomes more tolerable.

This is especially important for anyone recovering from a substance use disorder because drugs and alcohol often serve as an avoidance mechanism. If you can look challenging emotions straight in the face and accept them for what they are, they have less control over you.

Living in the moment improves the quality of your recovery and your life in many ways. You’re more engaged in what you’re doing and you’re less bothered by rumination and worry when you live in the present. However, it does take practice. Focusing on the process rather than the outcome you want, practicing mindfulness, and periodically grounding yourself through your senses are great ways to spend more time living in the present.

At The Foundry, we know that recovery from addiction is about treating the whole person. That’s why we incorporate mindfulness meditation and trauma-informed yoga into our treatment program, along with evidence-based therapeutic methods and positive lifestyle changes. For more information, call us at 844-955-1066. 

If you look at any quality addiction treatment program, you’ll notice several things many of them have in common and one of those things is exercise. It’s becoming much more common for regular exercise to be an integral part of addiction treatment. Experts also frequently recommend that your post-treatment recovery plan includes regular exercise.

However, this can be challenging for many people, especially those who are busy or don’t really think of themselves as athletic. The following is a look at why exercise is one of the most important lifestyle changes for recovery and how to more easily make exercise part of your daily life.

Why Exercise Is Important

First, if you want to motivate yourself to exercise more, it helps to understand why you’re doing it. Otherwise, it just feels like a chore. There is now quite a bit of research supporting the role of exercise in recovery, both in terms of physical and mental health.

Physical Health

Heavy substance use is hard on your body. Its exact effects depend largely on which substances you use the most, but overall, you may suffer from malnutrition, increased cardiovascular risks, and more frequent illnesses due to poor immune function. If you want to recover your health as quickly as possible, it’s important to eat a healthy diet and get regular exercise. 

Exercise--especially aerobic exercise like walking, running, swimming, and biking--improves your cardiovascular health pretty quickly. It also helps you maintain a healthy weight and reduces your risk of type two diabetes, as well as reducing your risk of infections and cancer. Exercise may not totally offset the physical damage of substance use, but it gets you going in the right direction.

Mental Health

Perhaps more importantly, exercise boosts your mental health. It improves your mood by increasing levels of endorphins, serotonin, and BDNF, a neurotransmitter that grows neurons. It also causes structural changes that help you react better to stress. It’s thought to be this change, along with improved sleep, that is most responsible, for the health benefits of exercise.

The improvements in mood reduce your risk of depression and anxiety symptoms, which in turn reduces your risk of relapse. Given that most people with substance use disorders also have co-occurring mental health issues, it’s hard to overstate this particular benefit of exercise for anyone trying to stay sober.

How to Build an Exercise Habit

It’s one thing to know that exercise is good for you and it’s another thing entirely to actually do it. The following are some tips for going from “not an exercise person” to someone who exercises daily without really thinking about it.

Find Something You Like

First, find something you actually enjoy. According to research, the best exercise for mental health is a moderate-intensity aerobic exercise that lasts for at least 20 minutes, at least three times a week. However, that doesn’t matter at all if you aren’t willing to do it. It’s crucial not to let the perfect be the enemy of the good. You will get some benefit from staying active, even if it’s not the scientifically validated “best” exercise. Walking is great. So are gardening, boxing, yoga, dancing, and fencing. 

There are two divergent strategies that work pretty well: Either pick something you don’t mind doing and can just participate in mechanically or perhaps even socially, like walking; or pick something that really fires your interest and is complex enough to keep you engaged, like high-skilled sports or martial arts. 

Pick a Regular Time

The next thing is to pick a regular time and stick to it. Instead of picking a regular clock time, though, attach your exercise to an activity you already do every day or almost every day. So, for example, you get out of bed every day--ideally--so you can connect your exercise habit to that. The goal is to have one daily activity lead directly into the next so that you don’t have to exert any willpower to do it. Be patient though, it will probably take a month or two for the new behavior to become automatic.

Start Small

One of the most common mistakes people make when they decide to start exercising is that they go hard right away like they’re in a training montage. You actually want to do the opposite. You want to start out easy so you don’t resist building the habit. In the beginning, building a habit is the most important thing. At first, you may just want to put on your exercise clothes and leave it at that.

Or you may walk for five minutes. You want to have the feeling that exercise is just something you have to cross off your list, not something you have to brace yourself for and grind your way through. You can build the intensity later.

Build Gradually

When the habit is pretty well established, then you can begin to increase the volume or intensity. You may start to do this automatically just out of boredom. Five minutes may feel too easy so you start walking for 10 minutes. Building gradually accomplishes two things: You are less likely to get exhausted and burned out and quit after a few weeks or a month, the way 90 percent of people give up on new year’s resolutions.

Second, it keeps you from getting injured, which interrupts both your fitness progress and your habit formation. Also, being injured is painful. There’s no rush and, over the course of months and years, consistency beats intensity every time.

Reward Yourself

Finally, set up some kind of reward for doing your exercise, even if it's just patting yourself on the back. This is especially important to remember on bad days. So, for example, you intended to run a mile but you felt terrible and ended up walking most of it. That’s fine. We all have bad days. The important thing is to congratulate yourself for showing up and doing the work rather than chastising yourself for not doing it as well as you would have liked.

It may also help to schedule some rewarding activities after your exercise. For example, you might tell yourself, “Ok, after I exercise, I can have dinner, or watch TV, or go hang out with my friends.” This gives you something to look forward to and immediately associates something positive with exercise.

At The Foundry, we know that lifestyle changes like social support, a healthy diet, and regular exercise are the foundation of a long recovery and a healthy life. That’s why these are incorporated into our holistic treatment plan along with meditation, yoga, and outdoor activities. To learn more about our approach to addiction treatment, call us at (844) 955-1066.

Recovery from addiction isn’t a steady progression. There are times when you are super focused on it and make a lot of progress and there are times when you are distracted, indifferent, or depressed and can’t be bothered. Motivation is never constant. Many people find they are motivated and engaged early on when they still remember vividly how bad life was when they were actively addicted, when they are most hopeful that life can change, and when they are making a lot of progress quickly.

However, as recovery gets easier, it can also get boring. You forget what the big deal is and it’s harder to see progress from day-to-day. When you get complacent, you are in danger of backsliding. The following tips can help you escape your recovery rut and start making progress again.

Review Your Recovery Plan

The first thing you should do is have a look at your recovery plan and see to what extent you are still following it. Instead of just looking down the list and mentally checking boxes, spend about a week actually keeping track, in writing, of how you spend your time. You may be surprised by the disparity between how you think you spend your time and how you actually spend it. When you find some way that you’ve deviated from your recovery plan, try to correct it. 

For example, you may discover that it’s actually been a while since you’ve been to a meeting or that your daily exercise has become weekly exercise. The whole purpose of a recovery plan is to help you stay physically and mentally healthy, maintain some accountability, and stay focused on recovery. It’s easy to start cutting corners when recovery gets less challenging and that can lead to trouble.

Pay Special Attention to Self-Care

Self-care is an especially important part of any recovery plan and it’s something many people find easy to neglect. It includes things like eating healthy and exercising, but it also includes things like taking time each day to relax, spending time with supportive friends, doing fun things, and getting enough sleep. We often sacrifice these things when we’re busy or stressed, but that’s when we need them the most.

Relapse is a process that typically starts with emotional relapse, and emotional relapse is typically caused by poor self-care. Fortunately, at this stage, it’s pretty easy to turn things around if you focus on self-care. Make sure you’re following your recovery plan, that you’re eating healthy and exercising, sleeping, taking time to relax, socialize, and have fun, and so on.

Talk to a Therapist

If you’re following your recovery plan and you still feel stuck, it may be time to talk to a therapist. Ideally, you’ll already be seeing a therapist regularly for at least the first year of recovery, but that’s often not the case. If you get to a point where you feel stuck, like you’re not seeing progress, or maybe you are seeing progress but you still feel awful, it could be that you have some co-occurring mental health issues that need to be addressed. At least half of the people with substance use disorders have co-occurring mental health challenges including anxiety disorders, major depression, PTSD, bipolar disorder, borderline personality disorder, and others.

These issues tend to drive addictive behavior and it’s very hard to stay sober with an untreated mental health issue. Even if you did have therapy as part of treatment, it’s possible that the issue persists or that something new has come up. If your mental health issue is well-controlled, your therapist may be able to help you figure out why you feel stuck.

Change Something

Having a regular routine in addiction recovery is a two-edged sword. On the positive side, a regular routine reduces uncertainty and stress, it helps you automate healthy decisions, and it helps ensure you’re giving adequate attention to your recovery priorities. On the downside, it can get boring. You feel like you’re just living the same day over and over without much challenge or engagement.

If it’s the monotony of your daily routine that’s dragging you down, change something, anything. It doesn’t have to be something big. In fact, too big of a change can be stressful and distract from the productive parts of your routine. But there is plenty of room for tinkering. You might decide to take a different route to work or text a friend you haven’t seen in a while. Maybe you can go on a media diet or read a book that’s outside of your usual tastes. A change in perspective can make a big difference.

Take On a New Challenge

Along similar lines to making a change, it may be time to take on a new challenge. The point of recovery is not that it’s supposed to be challenging for the rest of your life. It’s supposed to get easier with practice, allowing you to do more in other areas of your life. If you’re sticking to your recovery plan and managing your mental health challenges, maybe you’re just bored and need something to do.

Maybe it’s time to get a job or take on more responsibility at work. Maybe it’s time to pursue another goal, like going back to school or learning a second language. Striving toward meaningful goals may be the next step in your recovery and feeling bored or restless may indicate it’s time to take that step.

Volunteer

Finally, it may be time to change the way you engage with recovery. When you’re first starting out, you need a lot of help and support. Later on, you don’t need so much help but it’s still important to stay engaged with your recovery community. That might mean taking on a more active role, like volunteering.

There are plenty of opportunities to help out at 12-Step meetings. Even if you don’t volunteer in any official capacity, you can get to know new people and help them feel welcome. This strengthens the group and it strengthens your own recovery.

Recovery from addiction doesn’t stay the same all the way through and you can run into problems if you try to resist these changes. On the one hand, you have to keep paying attention to the basics, the things that work. On the other hand, you have to be responsive to changing circumstances and your own growth. 

At The Foundry, we know that recovery doesn’t end after 30 days of inpatient treatment. That’s why we include three to six months of partial care following treatment, to help clients transition back to normal life and deal with new recovery challenges. To learn more, call us today at (844) 955-1066.

One stereotype commonly associated with people recovering from substance use disorders is that they are constantly drinking coffee and smoking cigarettes. At least one study suggests there may be some truth to this particular stereotype. The study of nearly 300 AA members in the Nashville area found that nearly 57 percent smoked cigarettes, compared to only about 14 percent of Americans overall.

By now, we’re all aware of the negative health effects of smoking but many in recovery tend to regard it as the lesser evil--it’s clearly bad, but if it helps keep you sober, maybe it’s worth the health risks down the road. However, it’s not clear that smoking does help you stay sober, and there may also be other reasons to consider giving up smoking at the same time you give up drugs and alcohol.

Smoking and Relapse

As noted above, smoking in recovery is a bit of a gambit: You’re accepting possible risks down the road to hedge against a present threat. The assumption that smoking can help prevent relapse is largely based on the idea that it can help manage negative affect--more on that below--but research suggests there may be more important factors in play. 

One study of more than 34,000 adults found that smoking was correlated with a much higher risk of relapse. Researchers from Columbia University examined three years’ worth of data from the National Epidemiologic Survey on Alcohol and Related Conditions, or NESARC, and found that among people who had struggled with substance use issues in the past, those who smoked were nearly twice as likely to relapse as those who didn’t--about 11 percent and 6.5 percent, respectively. Those who started recovery as smokers but later quit had a relapse rate somewhere in the middle, about 8 percent.

With so much data and such a large disparity between smokers and non-smokers, this is one of the more compelling studies related to addiction. However, it does leave some questions unanswered. Although the study controlled for a number of factors, including demographics, mood, anxiety, alcohol use disorders, and nicotine dependence, it may be that smoking correlates with more serious substance use issues. And this was a population study, not an intervention. Despite these limitations, there may still be reasons to think smoking increases relapse risk, including those below.

Smoking Can Trigger Cravings

Perhaps the biggest reason to think smoking may increase risk of relapse is that it is often a powerful trigger. For example, people quite often drink and smoke at the same time. Smoking is a perfect trigger because it has a distinctive taste, smell, and motor pattern associated with it.

So, for example, if you had been in the habit of coming home from work, lighting a cigarette and pouring your first drink of the evening, you may find yourself craving a drink after you light a cigarette. Identifying and avoiding triggers is especially important early in recovery and smoking may be a potent one.

Smoking Kills More People

Since the rationale for smoking involves a risk calculation, it’s a good idea to look at the actual numbers. In 2018, more than 67,000 people died of a drug overdose, and each year, about 88,000 people die from alcohol-related causes. That’s about 155,000 deaths a year combined. By comparison, more than 480,000 people die from smoking-related causes each year. These include lung cancer, heart disease, stroke, diabetes, respiratory infections, and COPD. 

For many people, a serious health scare--perhaps an overdose, a heart problem, or a diagnosis of liver disease--is what finally convinces them to get sober. It makes little sense to trade one serious medical issue for another.

Even if the trade buys you an extra 10 or 15 years, diminished quality of life is almost certain. Other people decide to get sober because of the way their substance use affects their families. Similarly, it’s worth considering how a protracted struggle with cancer, heart disease, or emphysema would affect your family.

Smoking and Unresolved Issues

In the study of Nashville-area AA members, smokers typically reported that the reason they smoked was to reduce negative effects, such as depression, anxiety, and irritability. While these are all common problems early in recovery, they may also be symptoms of untreated mental health issues, such as major depression or an anxiety disorder.

‍Mental health issues affect at least half of people with substance use disorders and they must be treated simultaneously for recovery to succeed long term. One shortcoming of mutual aid groups such as AA is that they can’t offer mental health treatment. So, if you are smoking more specifically to ward off depression or anxiety, it’s possible that you need to talk to a doctor or therapist about getting to the underlying cause.

Quitting and Willpower

Finally, quitting smoking might give you a slight boost in willpower. While it’s not a good idea to rely on willpower alone to recover from a substance use issue, it does play a supporting role and it can be handy in a pinch. One line of psychological research suggests that willpower is a faculty that can be strengthened with use.

A study on--of all things--smoking cessation found that participants who were asked to avoid sweets or squeeze a hand gripper for two weeks were more successful at quitting smoking than participants who were given a task that required no willpower. It’s possible you get a similar boost in willpower from quitting smoking, which can transfer to greater adherence to your recovery plan and longer abstinence from drugs and alcohol. 

Quitting smoking isn’t easy, but then, neither is overcoming any addiction. People with multiple addictions are expected to quit them all at the same time--with the exception of cigarettes. Although most addiction treatment programs don’t currently offer help quitting smoking, you can always decide to do it yourself. Given the other challenges of recovering from addiction, early recovery may be the least difficult time to quit smoking and it may improve your chances of a long recovery. 

At The Foundry, we know that recovery from addiction isn’t only about abstaining from drugs and alcohol, but rather about making changes that help you live a healthier, more fulfilling life. We provide a supportive recovery environment and use a variety of evidence-based methods to help our clients succeed long term. To learn more, call us at (844) 955-1066.

Hypnosis has been around for hundreds of years, and during that time, its reputation has periodically risen, fallen, and risen again. It has been used for everything from entertainment to battlefield surgery and some attribute to it near-magical abilities while others believe it’s pure nonsense. Using hypnosis to treat anything is generally based on the idea that if you can directly affect your subconscious mind in some way, you can dramatically change your experience of reality, whether you’re on stage believing you’re a chicken or undergoing surgery without pain. 

The idea that you could use this power to overcome addiction is tantalizing. Wouldn’t it be great, for example, if someone set a glass of beer in front of you and instead of feeling a powerful desire to chug it, you only felt bland indifference? This is the dream that has been sold to many people trying to overcome various substance use issues. As with many treatment methods, hypnosis appears to be a bit of a mixed bag. Here are some of the things hypnosis can and can’t do.

What Hypnosis Isn’t

First of all, hypnosis isn’t some kind of magic power. There’s no animal magnetism, as Franz Anton Mesmer--where the word “mesmerize” comes from--believed. There may not even be anything physically identifiable as a hypnotic state. No one can hypnotize you to do anything you don’t want to do, contrary to many Hollywood storylines.

Although the relaxed state you typically achieve in hypnosis may make it easier for you to recall certain memories, it’s not like opening a file on your computer. In fact, hypnotically retrieved memories are no longer admissible in court, following a disastrous spate of false accusations in the 1990s. Most importantly for our purposes, it’s very unlikely that hypnosis is like flipping a switch for major behavioral change, such as overcoming addiction.

What Hypnosis Is

Experts actually disagree about what exactly hypnosis is. As noted above, various studies have failed to identify a specific hypnotic state in the brain. To the extent that hypnosis works, it is typically by a combination of deep relaxation and subtle reframing. So, for example, the hypnotist may ask you to relax and just notice the weight of your body against the couch, which, of course, you can feel.

And don’t you also notice a warm feeling in your chest? Sure you do. And now it’s expanding outward. And your arms and hands, which are feeling warm and also heavy, and so on. In the context of a medical procedure, the hypnotist may describe an incision as a feeling of slight pressure, drawing your attention to the feeling as it is, rather than the frightful thought of your skin being cut. Much of hypnosis is just allowing yourself to be led into a certain way of thinking.

Some Studies Show Promise in Treating Addiction

We’re currently on an upswing in scientific interest in hypnosis and a number of studies have found some promising results in using hypnosis to treat addiction. For example, one small study found that treatment that included hypnosis for alcohol use disorder led to an impressive 77 percent sobriety rate after one year.  Another small study of people with opioid use disorder found that hypnosis helped all participants remain abstinent from all drugs for six months and 56 percent remained abstinent from heroin for two years. These were small preliminary studies but they suggest hypnosis may be a useful tool for addiction treatment.

Hypnosis May Enhance the Effect of Other Treatment Methods

In addition to treating addiction directly, hypnosis may be useful in addressing some of the factors that contribute to addiction. These typically include mental health issues, such as major depression, anxiety, bipolar disorder, and others, trauma, and dysfunctional relationships--in addition to genetic factors, which, unfortunately, we’re stuck with for the moment. Insofar as hypnosis can help improve these issues, it can help your chances of long-term recovery success too.

Hypnosis Can Help With Mental Health Issues

At least half of people with substance use issues also have some kind of co-occurring mental health issue. Addiction and mental illness each make the other worse and they must be treated simultaneously. Hypnosis may be useful in conjunction with other therapeutic methods. As noted above, hypnosis is really a skillful way of managing your attention through subtle suggestion and reframing.

In a way, this is what your therapist is trying to accomplish anyway. For example, a therapist using CBT might help you reframe a situation by bringing to your attention your irrational beliefs about the situation. Hypnosis can be used as an extension of this process.

Hypnosis May Help You Manage Pain

Many people develop substance use issues because they are taking opioids for chronic pain. This puts them in a bind because they are afraid quitting opioids will leave them defenseless against the pain. However, there are other ways of treating chronic pain, and hypnosis may play a part. Pain feels real and undeniable, but it’s actually complex and somewhat ephemeral.

It depends to some extent on our expectations and how we think about pain. In this regard, hypnosis can be helpful. As noted above, hypnosis has been used in battlefield medicine and its use for surgery is pretty well established. If it can help you through surgery, it can help with chronic pain. Just relieving some of your distress about pain can make the pain less intense and make it easier to give up your reliance on pain medication.

Not Everyone Is Equally Susceptible to Hypnosis

Finally, it’s important to note that not everyone is equally susceptible to hypnosis. We all fall somewhere on a spectrum from highly-hypnotizable to not at all hypnotizable, and so far, researchers have no idea why some people can be hypnotized and others can’t. This clearly will affect whether hypnosis can play a part in your recovery.

While this seems like a clear strike against hypnosis as a treatment methodology, it’s important to understand that the same applies to pretty much every treatment method. SSRI medications, for example, only work for about 40 to 60 percent of people with depression, but they remain an effective tool in the kit, and perhaps something similar is true of hypnosis.

Hypnosis isn’t magic and it won’t cause major behavioral changes overnight, but it is an adjunct treatment method with some scientific backing. If you’re interested in trying hypnosis as part of therapy or addiction treatment, look for a therapist or addiction counselor with real training in hypnotherapy, ideally, one certified by the American Society of Clinical Hypnosis, or ASCH.

At The Foundry, we understand that addiction is a complex problem that requires individualized solutions. We bring a number of evidence-based practices to the table to help our clients. These include CBT, DBT, EMDR, family therapy, lifestyle changes, and more. For more information about our approach to addiction treatment, call us at (844) 955-1066. 

Most people who struggle with substance use issues also struggle with at least one other mental health challenge. The National Institute on Drug Abuse estimates that at least half of people with substance use disorders have a co-occurring mental health issue. Typically, the mental health issue comes first and substance use is often a means of self-medicating.

However, drugs and alcohol only make symptoms worse in the long run. A strong recovery requires that you get integrated treatment for substance use and any mental health issues. The following are the most common mental health issues that occur with addiction.

Anxiety Disorders

Anxiety disorders include several specific conditions, such as generalized anxiety disorder, social anxiety disorder, phobias, panic disorder, obsessive-compulsive disorder, or OCD, and post-traumatic stress disorder, or PTSD. Anxiety disorders affect more people than any other mental health issue. The National Institute of Mental Health estimates that more than 30 percent of Americans will experience an anxiety disorder at some point in their lives.

Anxiety is also a significant factor in developing a substance use disorder. According to the National Epidemiological Survey on Alcohol and Related Conditions--a survey of more than 43,000 adults revealed nearly 18 percent of respondents with a substance use disorder also met the criteria for an anxiety disorder not related to withdrawal.

Perhaps not surprisingly, marijuana was the most commonly used substance among people with anxiety disorders. Perhaps more surprisingly, cocaine and amphetamine use was also common, while the association with alcohol was weaker. It’s important to note, though, that this survey didn’t include PTSD, which is a major risk factor in itself.

PTSD

Post-traumatic stress disorder, or PTSD, may be one of the single biggest risk factors for developing a substance use issue. PTSD is far less common than anxiety disorders generally, affecting less than eight percent of Americans, but its effect on addiction risk is huge.

Some studies estimate that as many as half of people with substance use disorders also have symptoms of PTSD. PTSD itself has a complicated relationship with other mental health issues such as depression and anxiety. For this reason, addressing trauma is often a crucial element of addiction treatment.

Major Depression

Just over seven percent of Americans will have a depressive episode in a given year and the World Health Organization estimates that depression is the world’s leading cause of disability. Depression also significantly contributes to addiction risk. One study found that among people with major depression, 16.5 percent had an alcohol use disorder and 18 percent had a drug use disorder.

In other words, depression roughly doubles your risk of developing a substance use issue. This is especially true of men, who are less likely to seek therapy and more likely to self-medicate with drugs and alcohol. 

Bipolar Disorder

Bipolar disorder is technically considered a depressive disorder, but it’s a much different challenge than unipolar depression and a much greater risk factor for addiction. The study cited above also found that among people with bipolar disorder, 56 percent developed a substance use disorder at some point in their lives.

Bipolar disorder also complicates addiction treatment since it often requires some trial and error with medications and people experiencing manic episodes sometimes believe they’re cured and no longer need treatment. Bipolar is also frequently misdiagnosed as unipolar major depression, which slows treatment and recovery.

ADHD

Attention deficit hyperactivity disorder, or ADHD, is a bigger risk factor than many people realize. It’s typically characterized by racing thoughts or jumping from one line of thought to another. In adolescence, this can lead to poor performance in school, social ostracism, and impulsive behavior--all risk factors for substance use.

One study found that more than 15 percent of adults with ADHD met the criteria for a substance use disorder, which is at least twice the rate in the general population. The good news is that that number appears to drop when ADHD is controlled with therapy and medication.

Borderline Personality Disorder

Borderline personality disorder, or PBD, is a condition characterized by volatile moods, unstable self-image, and turbulent relationships. While BPD only affects about 2.7 percent of adults, about 78 percent of people with BPD will develop a substance use disorder at some point in their lives. One reason that number is so high is that BPD also increases your risk of anxiety and affective disorders, including PTSD.

BPD also presents special challenges to addiction recovery, since people with BPD are more likely to drop out of treatment and remain sober for shorter periods. BPD requires special treatment methods and currently, dialectical behavior therapy, or DBT, is the best available treatment.

Schizophrenia

Schizophrenia affects just over one percent of Americans, but of those, around 50 percent have a co-occurring alcohol or drug use issue. The relationship between schizophrenia and substance use remains a bit more mysterious than that of other mental health challenges. For example, we aren’t quite sure why 70 percent of people with schizophrenia are nicotine-dependent, why they appear to use marijuana more heavily and at an earlier age, or why marijuana appears to precipitate symptoms in adolescents. As with bipolar and BPD, schizophrenia presents special challenges to addiction treatment since it often involves antipsychotic medication and difficulty sticking to a treatment regimen. 

Mental health issues significantly increase your risk of developing substance use issues, and they also increase your risk of developing other mental health issues. For example, major depression and anxiety disorders often go together. For this reason, it’s often hard to pin down the relationships between substance use and mental health issues and it’s often hard to pin down exactly what mental health issue is causing your problems. However, this is crucial to figure out if you want to sustain recovery from addiction and feel better in general.

At The Foundry, we understand the huge role mental health plays in addiction recovery. That’s why we employ a variety of proven methods to help our clients manage their mental health challenges. These methods include DBT, CBT, EMDR, and others. To learn more about our addiction treatment program, call us today at (844) 955-1066.

For most people, whether they’re entering an inpatient treatment program or slipping into their first 12-Step meeting, beginning recovery from addiction is an uncertain time. You aren’t sure whether you are doing the right things or if you have any chance of success in the long-term. When we aren’t sure what to do, we instinctively look around to see what other people are doing.

While this might get you through your first few meetings without making too many faux pas, comparing what you’re doing to what others are doing is not a great approach to recovery. Here’s why.

Comparison Makes You Unhappy

First of all, comparing yourself to others is perhaps the fastest way to wreck your mood. There have been quite a few studies on the psychology of social comparisons and they all agree that it’s bad for your mental health. One study found that people who made more frequent social comparisons were more likely to experience guilt, envy, regret, and defensiveness.

They were also more likely to lie, blame others, and have unmet cravings. All of these are counterproductive for anyone trying to stay sober. Lying, guilt, envy, resentment, and cravings are all typical elements of addictive behavior and you want to move away from those as much as possible. 

It’s important to keep in mind that comparisons don’t just make you feel bad when you come up short. One study of participants' tendencies to make comparisons on Facebook found that participants who made more comparisons experienced more depressive symptoms, even when they felt like they were better than the other person. Something about the comparison itself makes us unhappy.

Perhaps it promotes self-consciousness or self-criticism, even when the scale tips in our favor. This is an important point, given that the early weeks and months of recovery are already emotionally challenging and many people who struggle with substance use issues have mental health issues such as depression, anxiety, and personality disorders as well.

Comparisons Are Always Misleading

If the primary purpose of comparing yourself to others is to orient yourself or measure your progress, then comparisons aren’t very useful anyway. First of all, your needs in treatment and recovery will be different from everyone else’s. You have different strengths, weaknesses, personal history, addiction history, values, and goals. You have different medical and psychological needs. Some people will have a lot of family support and others won’t. In the end, you’re never really comparing apples to apples. 

Second, you only know what others want you to know. It’s entirely possible to seem like you have everything together but still be struggling on the inside. If you doubt it, just consider how long you were able to keep your substance use issues secret. Someone who seems to be doing great may or may not actually be doing great. You just have to be comfortable with the fact that you can never really know where you rank among your sober peers and that such a rank would be so qualified as to be useless anyway. You just have to accept some degree of ambiguity.

Everyone Has Different Needs and Goals in Recovery

Since everyone’s situation in recovery is different, everyone will have different needs and therefore different goals. Your recovery plan should reflect your individual goals and values. One person may be invested more in repairing family relationships while another may be more focused on dealing with a mental health issue.

Your goals and therefore your recovery plan will, therefore, look different from anyone else’s. You’re going to get off track if you start feeling the need to start competing in areas that aren’t central to your own recovery. It’s much better to keep your eyes on your own particular prize.

Comparisons Create a Competitive Environment

Finally, you don’t want to feel like you’re competing against your peers in recovery. There may be some limited space for friendly competition in recovery--for example, if you and a friend are challenging each other to stick to a healthy diet or exercise regimen--but overall, you want to encourage feelings of mutual support. Making constant comparisons creates a mindset of competition.

You feel like when someone else succeeds, then you lose. In reality, the opposite is true: When one person succeeds, you’re all a little better off. Instead of comparing yourself to your peers in recovery, try to be happy for them when they do well, and support them when they struggle.

How Can You Break the Habit?

Comparison can be a tough habit to break. The first step is to just accept that comparison won’t do you any good. You’re all sort of on separate journeys together. Second, be conscious of when you’re actually making comparisons. Notice what it feels like to need that kind of reassurance and notice how that feeling of grasping makes you feel worse.

It may be a good idea to limit your social media use since social media use tends to promote social comparison and defensiveness. In fact, comparison is what most studies have focused on as the reason social media use exacerbates feelings of depression and loneliness. 

Finally, instead of comparing your progress to others’, figure out more relevant ways to track your own progress. This might be by setting goals and subgoals related to recovery, such as attending 90 meetings in 90 days or it might be tracking your progress according to goalposts you came up with along with your therapist for measuring your progress. What matters is that you set your own goals and stay engaged in the process. 

At The Foundry, we know that recovery from a substance use disorder is always an individual journey. No two clients are the same and we work with you individually to create a recovery plan that will promote your long-term success. That’s why we use a variety of proven methods to help you overcome the diversity of challenges you’re likely to face along the way. To learn more about our approach to treatment, call us at (844) 955-1066. 

We’re living in the age of bingeable TV. Not only are there a lot of great shows available to stream in their entirety, Netflix and other platforms automatically play the next episode before you even have time to go to the bathroom. Therefore, we have a lot of little incentives encouraging us to sit on the couch watching one show for hours at a time. While we all have days--especially when we’re sick--when sitting on the couch and binging a TV show is all we can manage, we have to wonder: Is binge-watching good for you?

This question is especially pressing for anyone recovering from a substance use disorder, a mental health issue, or both. In fact, most people who struggle with a substance use disorder will also have a co-occurring mental health issue and a strong recovery entails looking after your mental health. While there are specific ways you should be doing this, such as seeing a therapist and possibly taking medication, lifestyle factors--including how much time you spend binge-watching TV--also play a major role. Let’s look at some ways binge-watching might affect your mental health.

Binge-Watching May Increase Anxiety, Depression, and Loneliness

Since binge-watching is a relatively new phenomenon, ballooning over the past five years or so, there hasn’t been a lot of research into how it affects mental health. However, what research there is should give you pause. One study by researchers from the University of Texas at Austin found a high correlation between binge-watching, depression, and loneliness.

‍Other studies have found negative effects including increased fatigue, mood disturbances, and insomnia. Many of these studies show correlation, rather than causation and it’s easy to imagine that someone who is already depressed or anxious might spend more time binge-watching TV. However, there are also a number of reasons to believe that binge-watching may negatively affect your mental health.

Binge-watching Can Disturb Your Sleep

At least one study has found that people who binge-watch more have more insomnia and poorer quality sleep. While this may also be a matter of correlation to some extent, “pre-sleep arousal” also appears to play a significant role. Pre-sleep arousal includes both biological and psychological factors. Biologically, a number of studies have found that the bright light from screens, especially in the blue spectrum, mimics daylight.

If you are exposed to this kind of light before bed, it may disrupt your circadian rhythm, making it harder to sleep. Psychologically, a show may get you wound up, perhaps for hours, when you should be winding down for sleep. We enjoy the drama, tension, suspense, and action of good TV shows, but these also increase your heart rate, blood pressure, and adrenaline. When you finally go to bed, you may feel like you’ve just been through a stressful or even mildly traumatic experience, which is not conducive to sleep. 

This sleep disruption can take a toll on your mental health. A number of studies have found that a chronic sleep deficit can quickly impair mental faculties such as attention, working memory, and emotional regulation. In the long run, insomnia has been linked to a higher risk of major depression and anxiety disorders.

Binge Watching Makes You Less Physically Active

Perhaps the biggest single problem with binge-watching is that it has a high opportunity cost. That is, every hour you spend watching TV is an hour you’re not spending doing something else--not even moving. This affects both your mental and physical health. Too much sitting--and snacking--increases your risk of obesity and related conditions such as diabetes and heart disease.  Recent research has found that obesity significantly increases your risk of depression and vice versa. 

Perhaps more significantly, if you have a history of depression or anxiety, getting regular exercise is a critical part of a comprehensive treatment plan. Many studies have found that exercise improves mood by increasing levels of endorphins, serotonin, and BDNF, a neurotransmitter that grows neurons in certain parts of the brain. Exercise also causes structural changes in the brain that make you less vulnerable to stress and anxiety. If you have struggled with depression or anxiety, spending hours sitting on the couch is the last thing you should be doing.

We Tend to Binge-Watch Alone

Or alone together. Watching TV is an activity that mainly entails getting absorbed into the world of the show. No company is necessary or even desirable. If you are binge-watching with someone, it’s unlikely you are simultaneously having a stimulating discussion or otherwise connecting in any meaningful way. You’re both just watching the show.

Binge-watching may just be a symptom of loneliness, but it may also make you less likely to accept an invitation, reach out to friends, or even just leave the house, all of which perpetuates loneliness. However, it’s worth noting that many people cite social motivations for binge-watching. In other words, they want to be able to talk about a show with friends or colleagues. So in this limited way, binge-watching may have a prosocial silver lining. 

You May Feel Let Down When a Show Is Over

Finally, you may feel better while binge-watching a show, but it will inevitably end, at which point, you may feel a significant letdown. At some level, we respond to TV characters as if they are real friends and acquaintances and we miss them when they’re gone. We get invested in the meaning created by the storylines, the exciting events of the show, and the interesting worlds in which it all happens. When it’s all over, you’re left facing dull reality and it’s not great for your mood. 

The explosion of quality TV shows in recent years has been amazing, but like most things in life, moderation is key. Binging is bad for you, whether it’s alcohol, cake, or TV, even if it’s good TV. What’s more, binging has become a phenomenon largely through behavioral manipulation by media giants. It’s in your own interest to decide how to use your time and to use it in ways that maximize your health and happiness.

At The Foundry, we know that abstinence from drugs and alcohol is only one aspect of a strong recovery. Long-term success depends on making healthy lifestyle changes and generally taking control of your own life, rather than falling prey to destructive habits. To learn more about our approach to addiction treatment, call us today at (844) 955-1066.

One stereotype about addiction that may actually have some truth to it is that people in recovery smoke and drink a lot of coffee. A study of nearly 300 AA members in Nashville found that nearly 57 percent smoked cigarettes, compared to just 14 percent of Americans overall, and nearly 89 percent drank coffee, compared to about 64 percent of Americans overall.

Smoking is clearly bad for you and your recovery, as discussed in another post, but what about coffee? As you might expect, the picture with coffee, and caffeine in general, is more complicated.

The Source Is Important

First, it makes a huge difference whether you’re getting caffeine from coffee or tea or from energy drinks. Health experts are pretty much unanimous that energy drinks should be avoided. Part of the problem is that you never quite know what you’re getting. Some energy drinks have extravagant levels of caffeine. Others contain exotic ingredients, the effects of which are poorly understood, especially in combination with other ingredients.

Perhaps most importantly, energy drinks tend to have a lot of sugar. The average energy drink has about 23 grams of sugar. The American Heart Association recommends consuming no more than 36 grams of sugar per day total for men and no more than 25 grams of sugar per day for women. The energy drink with the most sugar is Rockstar Xdurance, with a stunning 69 grams.

Excess sugar consumption is bad for your health in general and has been linked to obesity, diabetes, heart disease, chronic inflammation, and fatty liver disease. For people recovering from substance use disorders, these outcomes are especially bad. Someone recovering from alcohol use disorder, for example, is already at greater risk for diabetes, heart disease, and liver disease. 

Sugar can take a toll on your mental health as well, putting you at greater risk for relapse. Several studies have found that high-sugar diets and obesity increase your risk of depression. Inflammation has also recently been implicated in some forms of depression. In short, if you’re recovering from addiction and drinking energy drinks, you would be far better off consuming an equal amount of caffeine in the form of coffee.

Pros

There Appear to Be Some Mild Health Benefits

As for whether you should drink coffee or tea, it’s a mixed bag and it largely depends on your situation. There do appear to be some mild health benefits associated with coffee and tea. The case for tea is pretty straightforward. It’s loaded with antioxidants and numerous studies have shown that heavy tea drinkers have a slightly lower risk of various cancers. The only real downside is burning your mouth when drinking it too hot. 

Coffee is a bit harder to pin down since contradictory studies emerge every few years. For example, some older studies found a slight increase in bladder and pancreatic cancer risk but those have been largely discredited. It does appear that coffee raises your blood pressure and that unfiltered coffee can raise your cholesterol. 

However, a number of studies have identified a number of health benefits from moderate--that is, about four cups a day or less--coffee consumption. These include a lower risk of cardiovascular disease and stroke, type 2 diabetes, liver cancer, liver cirrhosis, and gout--all risks that are heightened by excessive alcohol consumption. These positive effects aren’t huge, but if you’re already drinking a few cups of coffee a day, they’re a nice bonus.

Caffeine Can Improve Your Mood

Caffeine can also have some positive effects on your mental health. Coffee’s effects on mental health have been pretty well documented and they include increased alertness--obviously--more energy, better cognitive function, and better mood, as well as fewer depressive symptoms and lower risk of suicide. These effects can give you an edge in dealing with the sluggishness and irritability common early in recovery.

Drinking coffee might be considered a form of self-medicating, but for most people, the negative effects of moderate coffee consumption will be preferable to those of even well-tolerated SSRIs. The only caveat is that you shouldn’t use caffeine as a substitute for therapy for a mental health issue.

Cons

Caffeine Can Aggravate Anxiety

The biggest drawback for many people in recovery will be caffeine’s tendency to aggravate anxiety. Caffeine stimulates the sympathetic nervous system, which feels the same as anxiety or even panic. If you’re not prone to anxiety, moderate consumption is probably fine but if you have issues with anxiety, even a little caffeine may make them worse. According to one study, nearly 18 percent of people with a substance use disorder had problems with anxiety in the past year. That means there’s a decent chance you should be trying to manage your anxiety levels, which might include cutting down on caffeine.

Caffeine Can Disturb Your Sleep

The other major concern about caffeine for people in recovery is its effect on sleep. Insomnia is a common withdrawal symptom and it may persist for weeks or months into recovery. If you’re guzzling coffee all day, that’s not likely to help you sleep any better. Caffeine has a half-life of about four to six hours, depending on your metabolism. That means that even if you quit drinking coffee at noon, there may still be quite a bit of caffeine in your system at bedtime. That may keep you up or it might just cause you to sleep less deeply. 

Insomnia and chronic sleep deficit have been linked to a number of mental health issues. In the short term, these include poor concentration, poor working memory, and poor emotional regulation. In the long term, it significantly increases your risk of anxiety disorders and major depression. Since both of these are common factors in developing substance use disorder and relapsing to substance use, it’s important to get enough quality sleep, which may entail reducing or eliminating your caffeine intake. 

Everyone’s situation in recovery is different. Some people are more sensitive to caffeine and some people metabolize it very quickly. Some people can’t sleep after drinking a cup of coffee in the afternoon, others can sleep fine if they have a cup right before bed. Some people have anxiety issues and some don’t. It’s important to be aware of your own vulnerabilities and act accordingly.

At The Foundry, we understand that recovery from addiction is highly individual, which is why we work with clients to come up with a treatment plan that best suits their specific needs. We also know that a strong recovery depends on making healthy lifestyle changes, including diet. We incorporate all of these things into our holistic addiction treatment. To learn more, call us at (844) 955-1066.

It’s often said that recovery from addiction is a marathon, not a sprint. As in a marathon, there are plenty of opportunities to give up in recovery and the people who do well aren’t necessarily the ones who come blasting off the start line, but the ones who can keep themselves going when they feel totally exhausted. There is no easy trick to staying motivated, but some of the following strategies might help.

Understand that Motivation Is Variable

First, understand that motivation is not some intrinsic quality and it’s not something you can do equally well every day. Motivation is a skill and sometimes you can do it well and other times you just have to be content to make it through the day. The good news is, that like any skill, the more you practice motivating yourself and creating the right conditions for motivation, the easier it gets. 

Identify Your Core Values

When you’re trying to keep yourself motivated, it helps to have a clear vision of why you’re doing what you’re doing. Otherwise, you don’t have much incentive to persist through tough times. While it may be hard to picture your perfect sober life, you can certainly identify some of your core values and how staying sober relates to those values. 

For example, many people decide to get sober when they realize what their drinking and drug use is doing to their family. For these people, it’s important to keep the value of family clearly in front of them. You can do this in various ways. You might keep pictures of your family around you, where you can see them easily. You might periodically write about why family is important to you. Studies have found that this practice--called self-affirmation--can help you make healthier decisions and improve your relationships.  

Create Good Habits 

As discussed above, motivation goes up and down. Therefore, it’s important to create structures in your life to hedge against the risk of relapse on low motivation days. Part of that structure is made of healthy habits and routines. It typically takes about two months for a new behavior to become automatic, but after that, the healthy behavior is on autopilot.

This may be one reason people new to recovery are often advised to attend 90 12-Step meetings in 90 days. If you commit to that, then going to your meeting should be automatic by the end of the 90 days. That’s a major piece of your recovery plan that you won’t have to put any thought or effort into--you just go. The more healthy habits you create, the more the odds are stacked in your favor.

Build a Great Sober Network

Another big part of creating a structure that will keep you on track is creating a great sober network. This includes sober friends, supportive family members and friends, and fellow 12-Step members as well as your therapist, your doctor, your sponsor, and anyone else that has a special interest in your recovery. A sober network helps you in many ways.

It helps reduce stress because there are people who will listen without judgment and who can offer advice and support. You have more resources to deal with any problems that arise and you feel a greater sense of accountability. The last thing you’ll want to do is go to your 12-Step meeting and admit that you slipped up. That can be a powerful incentive to stay sober even when you don’t feel like it.

Find Ways to Cope with Doubt

Learning to deal with doubt is crucial for staying motivated because nothing kills your motivation faster than listening to that little voice that asks you, “Why are you putting yourself through this? You’re just going to fail anyway.” In order to stay motivated, you have to have a reasonable expectation of success. The problem is that it’s hard to judge what’s reasonable, especially when you’re just starting out. 

The other strategies described here can help you cope with doubt. Having a strong sober network is especially helpful since you’ll meet people who have succeeded despite significant challenges. It’s also important to learn ways to push back against irrational thoughts. For example, if you think things like, “You’ll fail at this because you fail at everything,” you might recognize this as an overgeneralization and push back with a thought like, “Really? Everything?” and think of some evidence to contradict your overgeneralization. 

Take One Day at a Time

This may sound cliche, but it’s a cliche because it works. If you think that you have to motivate yourself to keep going forever, it will feel exhausting. However, if you only think that you have to make it through the day or even through the hour, that typically feels more manageable. You can only act in the present moment, so if you can motivate yourself to not drink, to go to your meeting, to call your therapist, or whatever else you need to do right now, that’s really all you have to worry about. If you can do it today, you can do it tomorrow too.

Play the Tape

Finally, in an emergency, you can always play the tape. This is where you think through the consequences of drinking or using again. Typically, when you have a craving, you’re only imagining the immediate gratification of drinking or using again. Unfortunately, that gratification only lasts a short time and then you have to deal with the consequences of relapse. Instead of focusing on the relapse itself, think through the entire thing--the next hour, the next day, the next week, and so on.

Imagine how you’ll feel about relapsing after so much hard work, how disappointed your family will be, how hard it will be to tell your 12-Step group, and so on. Think about how bad things were in active addiction when you finally decided to get help. Picturing all of this clearly can make the momentary gratification of relapse seem small by comparison.

Motivation is a single thing, but rather learning to select and use a range of skills appropriate to the situation. Identify your core values, create good habits and routines, create a good support system, and learn to play the mental game.

At The Foundry, we believe that recovery from addiction entails a set of skills that anyone can learn. We use a variety of methods, including dialectical behavioral therapy, mindfulness meditation, yoga, and lifestyle changes to help our clients learn recovery skills and build a sense of self-efficacy that will serve them long after they graduate from our program. To learn more, call us at (844) 955-1066.