Blog & Announcements

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.

Daily writing is one common element of addiction recovery plans. To some people, the reasons for this will be obvious. Others may be skeptical, especially if they don’t think of themselves as writers or they are skeptical of self-expression in general. However, daily writing can be a potent and versatile element of your recovery plan. Here are some different writing exercises and how they can help you stay sober.

Journaling

The writing exercise most people are familiar with is keeping a simple journal or diary. This is just sitting down for a few minutes every day and writing whatever you feel like. You might just write down what you did that day or what happened that was notable. Or you might go into depth about something you’re thinking about or challenging emotions. This simple practice can help you in several ways.

Most notably, it helps you relieve stress. Instead of stewing over a problem, you get it down on paper where you can think it through. You will probably find that after you write about something that’s been bothering you, you will feel better about it, even if you didn’t come up with a specific solution. Just writing about your day, your thoughts, your emotions, your challenges, and so on will help you spot patterns in your life. And, of course, you can also incorporate any of the following exercises into your daily journaling session.

ABCs

ABC stands for activating events, beliefs, and consequences. It’s a framework developed by psychologist Albert Ellis, one of the pioneers of cognitive therapy. The central idea is that events only bother us because we have certain beliefs or assumptions about those events. For example, if someone cuts you off in traffic, there’s no reason to be angry about it for the rest of the day.

That only happens if you have an irrational belief about it. You may think that guy shouldn’t have done that or that it was a deliberate insult to you. In reality, it was probably just a mistake; it happens all the time. 

The ABC exercise is a way to practice identifying the beliefs that disturb us. Whenever you feel angry, anxious, depressed, and so on, write down exactly what you’re feeling. This is C, the consequence. Next, identify the activating event, A--the guy cutting you off in traffic or the remark by a coworker, or whatever. Finally, identify the belief, “He shouldn’t do that,” “Everyone at work is against me,” and so on.

This is the trickiest part since we are often unaware of our own assumptions. You may need a therapist to help you identify your irrational beliefs at first. In fact, his exercise is often given as a homework exercise in therapy. You can use it that way or you can try it on your own. Either way, it’s a good way to get in the habit of identifying and challenging irrational thoughts.

Gratitude

In recent years, research in positive psychology has identified a range of benefits of gratitude. It improves relationships, lowers stress, improves sleep, makes people feel more optimistic, increases your sense of wellbeing, and it might even help you live longer. The problem is that when you’re starting out in recovery, you might not feel very grateful. Your life is likely at a low point and you have a lot of work ahead of you. The good news is that there are two easy writing exercises that studies have shown, can boost your gratitude. 

The first one is to keep a gratitude journal. This is simple and only takes a couple of minutes. Just write down about three things you were grateful for that day. It’s fine if they’re small--you slept unusually well, the weather was nice, you got a text from a friend you hadn’t talked to in a while. Not life-changing stuff but they make your day a little better.

Since we’re hardwired to notice pain and threats, training yourself to notice more of the good things makes you happier and more optimistic. You might want to do this exercise daily for about two weeks, then switch to doing it weekly so you don’t get overly accustomed to it.

The second exercise is to write a gratitude letter. This one takes a bit longer but research shows the effects last longer too. Think of something someone did for you that you never really thanked them for. Again, it doesn’t have to be huge, just something you truly appreciated. Describe in a letter what they did and what it meant to you. You can deliver the letter or not. Research suggests you get a happiness boost either way.

Anxiety

Writing is an excellent way to relieve anxiety. It takes those amorphous fears that are haunting your mind and gives them some definite form on the page. This is true whether your anxiety is caused by a past or future event. A number of studies have found benefits from expressive writing. This is where you choose a stressful event, one that’s at least six months in the past, and write about it on four consecutive days.

Set a timer for 20 minutes and write the whole time without censoring yourself or worrying about spelling or grammar. No one will read it but you. This exercise has been shown to reduce anxiety and even improve physical health over the following months. 

What’s more, an abbreviated version of this exercise can help relieve anxiety about an upcoming challenge. Research has shown that having students spend a few minutes writing about their worries just before a test reduced test anxiety and improved test scores. A similar strategy can help with other tasks, such as going to your first 12-Step meeting or going to a job interview.

Writing alone won’t replace therapy and solve all your problems but it can be a helpful tool to manage your mood, analyze your patterns, and generally understand yourself better. A regular writing practice can be a powerful element in your recovery plan.

At The Foundry, we believe that a strong recovery is built on mental health and self-knowledge. We use a variety of evidence-based methods, including CBT, DBT, family therapy, mindfulness meditation, and others to help our clients understand themselves better, regulate their emotions, and manage their behavior. For more information about our approach to treatment, call us at (844) 955-1066. 

Self-awareness is the degree to which you are aware of your own tendencies, your strengths and weaknesses, your values, your interests, and how you respond to various situations. Self-awareness is the foundation of addiction recovery and good mental health in general. It is a key skill of emotional intelligence and is the basis for the other skills of self-regulation, motivation, empathy, and social skills. 

However, self-awareness is also deceptively difficult. We all assume we know ourselves well because we have unique access to our own thoughts, emotions, and personal history. While that is true, we are also constrained by biases, blindspots, and cognitive distortions. What’s more, it’s hard to understand ourselves when we don’t really know what it’s like to be anyone else. Despite these challenges, we can all improve our self-awareness and reap the benefits in addiction recovery and in life. Here’s how.

Therapy

The most direct route to greater self-awareness is therapy, both group and individual. Both can help you become more aware of your blind spots and biases. Individual therapy can help you dive deep into your personal history and explore your cognitive distortions. For example, if you have a habit of focusing on the negative or discounting the positive things about yourself, you may have an unfairly negative view of yourself and your abilities. Or perhaps you have unfair expectations of other people or the world in general. You may never even consider these possibilities without expert guidance. 

Group therapy can be especially helpful for increasing self-awareness since you can get many different perspectives on your problems. Perhaps most importantly, in group therapy, you learn to give and receive feedback and generally improve your communication skills. These can help improve your self-awareness outside of the therapeutic setting as well.

Asking for Feedback

As noted above, getting feedback from different people is a great way to improve your self-awareness. In the context of therapy, this is relatively easy since much of your therapist’s job is to help you in this regard and create a healthy environment for sharing in group therapy. However, outside of a therapeutic environment, soliciting feedback becomes more challenging.

The people who know us well and spend a lot of time around us, whether they are friends, relatives, coworkers, or romantic partners are often reluctant to be completely honest. It’s uncomfortable to hurt someone’s feelings--even with the best of intentions--and then have to live or work together. 

To get around this obstacle, you have to find ways to give them permission to be honest. This might start with choosing the right medium. For example, people typically find it easier to be honest over text or email than face-to-face. Also, make it clear that you are seeking honest feedback and not just testing them. You might also give them an opportunity to say something nice about you to offset the constructive feedback, something like, “What would you say is my greatest strength?

What is my greatest weakness?” Or, in a work environment, you might ask something like, “What’s one thing I could work on to most improve my performance?” People tend to feel more comfortable answering specific questions rather than making a judgment on you as a person. Just be sure you aren’t deliberately shielding yourself from the feedback you don’t want to hear.

Mindfulness Meditation

One way to improve your self-awareness on your own is to practice mindfulness meditation. This is a simple practice; just set aside 20 or 30 minutes a day, and during that time, try to remain present. You typically do this by paying attention to your breath, listening to ambient sounds, or feeling for sensations in your body.

Inevitably, thoughts and emotions will arise on their own and you can use these opportunities to practice observing them without judgment. So, for example, an unpleasant memory may suddenly come to mind. Instead of trying to ignore it or think of something else, you might try tracing the chain of associations that led to that memory.

Or you might pay attention to the emotions the memory evokes and ask yourself why you respond that way. The more you learn to accept your own thoughts and emotions, the more you will be aware of what's going on in your own mind.

Journaling

Journaling is another great way to improve self-awareness on your own. Part of the reason is that writing about what happens and how you feel about it helps you make connections that you might not notice otherwise. Just the act of writing about your feelings can change your brain in ways that make you more aware of your emotions. However, journaling can go far beyond that.

For example, just keeping an accurate and relatively detailed record of what you do all day can yield surprising insights into your behavior. If you’re skeptical, try estimating how much time you’ve spent on your phone today and then check it against your actual screen time in your phone’s settings. Writing is a way of keeping ourselves honest about what we’ve actually done, thought, and said.

Writing about what happens and how you feel about it will reveal a lot of patterns. Even if you never go back and read what you’ve written, you’ll probably notice you spend a lot of time worrying about your work situation or complaining about your parents, or whatever else.

Self-awareness is an ongoing project. Not only is it a big challenge in itself, but we are always changing and growing. Knowing yourself better requires that you make a consistent effort, keep an open mind, and learn to accept constructive criticism with equanimity. 

At The Foundry, we know that overcoming addiction isn’t just a matter of abstaining from drugs and alcohol; it’s a journey of self-discovery. We use proven methods such as dialectical behavioral therapy, group therapy, and mindfulness meditation to help our clients better understand themselves and live a fuller life. For more information, call us at (844) 955-1066.

Living with depression is never easy and that’s especially true during times of stress. At the moment, we’re all coping with the coronavirus pandemic. Although the quarantine is beginning to be lifted in some areas, the virus remains a threat and the economic impact has been huge. However, it doesn’t take a global pandemic to cause a personal crisis.

We all go through stressful times and whether it’s buying a house, getting a divorce, or being quarantined at home, stress can trigger a depressive episode, especially if you have a history of depression. If you have struggled with depression in the past, or are struggling with it now, here are some tips for keeping it together during stressful times.

Stick to Your Treatment Regimen

First of all, if you are already on a treatment regimen for depression, keep it up. Keep taking your medication, if that applies to you, keep doing your writing exercises, keep meditating, and keep exercising. If you’re seeing a therapist, keep seeing them, even if you have to see them remotely. If you haven’t been seeing your therapist lately, now is probably a pretty good time to resume. Reach out either through the phone or email and see if they can fit you in.

Set a Strict Limit on Media

This especially applies to news and social media. While it’s understandable that you want to stay informed, it’s easy to get sucked into the vortex of divisiveness and negativity that is the 24-hour news cycle. Set a strict daily limit on how much time you spend consuming news. Try to remember that in a week, 90 percent of it won’t matter anyway. 

The same is true of social media. When you don’t have anything else to do, it may be especially tempting to endlessly scroll through Facebook, Twitter, Instagram, Reddit, and so on. A number of studies have found that excessive social media use is terrible for your mental health, mainly because it promotes comparisons and fragments your attention.

One study found that participants who limited their social media use to 30 minutes a day for three weeks reported significantly lower levels of depression and loneliness by the end of the three-week study.

Try to Follow a Routine

Sometimes, when you’re feeling depressed and overwhelmed, all you can do is put one foot in front of the other. Having something like a regular routine can help you get through the day in several ways. First, a regular routine reduces anxiety because you feel more in control and less uncertain about what’s ahead. Second, a routine breaks your day into manageable chunks.

The whole day might be too much to think about all at once but maybe you can think about just taking your shower, then just having breakfast, and so on. Your regular activities can serve as signposts throughout your day.

Get Some Exercise

Getting a bit of exercise is one of the most important things you can do if you feel depressed or if you want to avoid feeling depressed. Exercise helps improve your mood and it improves your stress tolerance. Many studies have found that exercise improves mental health outcomes overall. Of course, when you’re depressed, summoning the energy to do anything, much less exercise, is a big ask. Whatever you can do, even if it’s just a five-minute walk, will make you feel a little better.

Eat Healthy

There are now quite a few studies showing that diet has a significant effect on depression and depression risk. A number of studies have shown that dietary interventions can even improve depressive symptoms. The most beneficial diets typically include mostly whole foods, such as fruits, vegetables, whole grains, nuts, beans, legumes, and fish. They are also low in processed meats, refined flour, sugar, and fried foods. It may be that such a diet helps reduce inflammation, which recent research suggests may be a significant factor in some forms of depression. 

Look for Ways to Help Other

Part of the trouble with depression--especially during the current pandemic--is that it too often leads to isolation. You end up sitting alone feeling awful and even feeling awful about feeling awful. You may feel like you have very little control over the situation or anything else in your life. One way to fight both of these feelings is to look for ways to help other people.

For example, in the current crisis, just staying home helps, but you may also be able to do other things, like check on neighbors and relatives, donate to food banks, or sew masks. This helps take your mind off your own problems and allows you to contribute in some way, which boosts your sense of self-efficacy.

Try to Stay Present

As noted above, operating on a short time horizon can help you get through your day. The more you can stay in the present moment, the better you will feel in general. It’s too easy to get swept up in ruminations about past mistakes or worries about the future. The more you can stay present, the less you will fall into either of these traps. This is easier said than done.

It may help to practice mindfulness meditation, which is essentially just training yourself to be present for 20 or 30 minutes a day. In a pinch, you can also use grounding techniques, such as closing your eyes and paying attention to all the sounds around you or feeling sensations such as your breath or your weight in your chair. These things help you connect to the present moment and worry less about the past or future.

Avoid Drugs and Alcohol

If you’re recovering from a substance use disorder, this one is obvious, but if you feel depressed, trying to cope with it using drugs or alcohol is a huge red flag. Depression significantly increases your risk of developing a substance use disorder. One study found that among people with mood disorders such as major depression or bipolar disorder, 32 percent also had substance use disorders--nearly four times the risk than in the general population. 

Men are especially prone to self-medicating depression with drugs and alcohol. Even if you don’t have a substance use issue, drugs and alcohol are likely to worsen depression. If you quit drinking, for example, you’re likely to feel better pretty quickly. If you can’t quit drinking, reach out for help, whether it’s to a therapist, a 12-Step group, or an addiction treatment program. If you have substance use issues and depression, you will need a program that can treat both.

At The Foundry, we know that substance use disorders are usually accompanied by other mental health challenges, such as trauma, anxiety, and depression. We use a variety of proven methods, including dialectical behavioral therapy, or DBT, eye movement desensitization and reprocessing therapy, or EMDR, and mindfulness meditation to help our clients heal and sustain their recovery long term. To learn more, call us today at (844) 955-1066.