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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.

Learning to set and maintain healthy boundaries is an important part of addiction recovery. Maintaining healthy boundaries means that you respect other people’s values and autonomy and you expect them to do the same for you. Unhealthy boundaries are typical in dysfunctional relationships and these are often one of the factors driving addictive behavior. 

For example, a physically abusive relationship is a situation where one person uses violence to control the other. This violates their right to personal safety and their right to make their own decisions. What’s more, physical abuse often leads to depression and substance use. If you are in an abusive relationship, the best thing to do is usually just to leave and get as far away from your abuser as possible. This is a very clear boundary, using physical distance. However, other relationships may be more complicated, and learning to maintain boundaries is a healthy behavior to learn in general. Here are some tips.

Know Your Values and Priorities

First of all, if you are going to set boundaries, it helps to know why. Start by identifying your core values, whether they’re family, integrity, honesty, learning, kindness, or whatever else. It might help to take some online tests to help you clarify your values or you may spend some time writing about it. Perhaps look back through the major decisions you’ve made in your life and see what your guiding principles have been.

For example, maybe you turned down a job that paid well because you felt you were being asked to do something dishonest. That indicates that you value honesty above money. That’s good to know and it indicates honesty is a value you are willing to protect. Knowing what’s really important to you can help you figure out where to draw the line and give you a boost in courage when you need it most. 

Listen to Your Gut

Another way to identify your values and to recognize when someone might be violating your boundaries is to listen to your gut. We often react emotionally before we fully understand a situation rationally. That doesn’t mean your gut is always right, just that if you feel weird about something, pay attention to the feeling and don’t dismiss it without consideration.

For example, if you feel confused by what someone is telling you, it could be they are trying to manipulate you--a clear violation of your boundaries. Take a step back and don’t make any decisions until you are seeing things more clearly. Or perhaps you just have a bad feeling about a situation. That might indicate that you should move away from that situation. Our instincts have evolved to keep us safe so give them some credit.

Communicate Clearly

No relationship is perfect and there will be plenty of times when you just disagree. Boundary issues don’t always imply sinister intent; often people just go along with things and the other person has no idea they don’t want to do them. This happens every day in big and small ways. It’s your responsibility to be clear about what you want and don’t want.

That means learning to communicate clearly. No matter how well the other person knows you, they aren’t psychic and they may not know what you want unless you tell them. The key is to do it politely. Not every disagreement has to lead to an argument. In fact, most disagreements can be worked out pretty easily if both parties are willing to listen.

Keep in mind that this goes both ways. It’s important to communicate clearly about what you want and it’s also important to listen to the other person and respect their values and autonomy. 

Learn to Say No

In many situations, especially when you’re recovering from addiction, learning to say no is a skill in itself and it’s one of the first skills you should learn. When you leave treatment, people may offer you all sorts of things. Since drinking is so common in American culture, there’s virtually no chance you won’t be offered a drink from time to time, usually by people with good intentions. That’s why a polite but firm no is a crucial skill to master quickly. 

Work With a Therapist

So far, we’ve discussed some important considerations in setting boundaries, but there may be deep-seated psychological reasons why setting boundaries is difficult for you. If you grew up in an abusive household, for example, or if you’re currently in a codependent relationship. Sometimes people lose touch with their own needs and desires entirely and sometimes they feel like setting boundaries is just impossible for them. If that’s how you feel, you need to talk to a therapist. They can help you figure out what you want and need and help you develop the skills to assert yourself. 

Family therapy is also great for this since it focuses specifically on family dynamics, clear communication, and healthy boundaries. Getting the relevant people to work through their relationship issues can make a huge difference. However, not everyone has to participate in order for family therapy to be effective. Just changing the behavior of one or two family members can change the whole family dynamic.

Get Reassurance from Your Support System

Finally, it’s always harder to set and maintain boundaries when you feel isolated. This is especially true when you’re first trying out a new behavior that you’re not really sure about. It feels like a big risk. However, if you have a strong support system behind you, you don’t feel quite so alone, even if your support system doesn’t happen to be with you at the moment.

This is one reason going to 12-Step meetings is helpful, even after you’ve completed a professional treatment program. You may also want to consider attending Al-Anon or Nar-Anon meetings, for family members of people with substance use disorders, since you may fall into that category too. If you do have a family member or close friend with substance use issues, these meetings can give you a different perspective on setting boundaries with them.

Boundaries are crucial not only for recovery but for being your own person and directing your own life according to your core values. Setting and maintaining boundaries means knowing what your values are, listening to your gut, and learning to communicate clearly and respectfully. It’s also important to keep in mind that maintaining values requires practice. You’ll get better the longer you keep at it.

At The Foundry, we know that much of recovery from addiction is about learning practical skills to improve your relationships and manage your behavior. Great relationships are especially important for a strong recovery. We use a variety of evidence-based practices, including CBT, DBT, and family therapy to help you improve your communication and relationship skills. For more information, call us at (844) 955-1066.

In recent decades, more people have become aware of the importance of emotional intelligence, and it is especially important for recovering from addiction. While cognitive intelligence can help you get good grades in school and excel in certain jobs, it won’t protect you from developing a substance use disorder. In fact, some studies suggest that IQ correlates with a greater risk of substance use issues.

The problem is that cognitive intelligence has little influence over emotions. And once you develop a substance use issue, you mainly use your intelligence to get more drugs and alcohol. That’s why they often say in AA that “your best thinking is what got you here.” In a way, recovery from addiction is all about strengthening your emotional intelligence. The following are the five standard components of emotional intelligence and how they contribute to sobriety.

Self-Awareness

Self-awareness is the foundation of all emotional intelligence. It means being aware of your own strengths, weaknesses, blind spots, biases, and triggers. It means knowing what your core values are, what you enjoy, and what you don’t. Having relatively good self-awareness is like having a good map of your own mind. It helps you accomplish the things you want to do.

Unfortunately, self-awareness is not easy. As noted above, well all have biases and blind spots and these are usually most extreme regarding ourselves. This is compounded by the illusion that we know ourselves very well. Luckily, you can improve your self-awareness. The best tools for doing that are group and individual therapy.

These provide the rare opportunity to get objective feedback about your personal history, your beliefs, and your thinking habits. Another way to improve self-awareness is just to ask for feedback from people who know you well--friends, family members, coworkers, and so on. However, these people may be reluctant to be too honest, so you have to make it clear that you’re trying to better understand yourself, including your weaknesses.

Self-Regulation

Self-regulation is when you put your self-knowledge to good use. It’s the ability to keep yourself from lashing out in anger or from pouring a drink when you feel stressed. It’s the ability to cope with feeling overwhelmed or comfort yourself when you’re feeling anxious.

When you know yourself, you know what kinds of situations are likely to trigger cravings and which people you have trouble saying no to. Self-regulation is the main area where the rubber meets the road in addiction recovery, where the self-discovery you did in therapy is put to practical use improving your real-life behavior.

Self-regulation, like self-awareness, is a never-ending process and each depends on the other. Again, therapy is the single most powerful way to improve self-regulation. You learn many cognitive and behavioral strategies to help you cope with challenging emotions and make better decisions.

Some therapeutic methods, like dialectical behavioral therapy, or DBT, specifically use group sessions as a safe space to practice new skills before you have to use them in the wild. For example, it’s a good place to practice hearing constructive feedback without becoming angry or defensive. 

Motivation

Motivation is being able to motivate yourself and others to do what needs to be done. In addiction recovery, self-motivation is most important, but it can also be a way to support fellow group members and possibly even mentor others later on. People often start out in recovery feeling motivated because they are desperate for change. However, motivation often wanes as people encounter unexpected challenges or start to feel complacent about recovery. Knowing how to motivate yourself can make the difference between sticking to your recovery plan and gradually sliding toward relapse. 

Motivation is mainly about three factors: remembering why sobriety matters to you, remembering how bad things were when you were actively addicted, and overcoming your doubts about whether you can succeed. There are various ways to address each of these but a good place to start is by connecting sobriety to your highest values. Having a why can keep you going through tough times.

Empathy 

Empathy is the ability to put yourself in someone else’s place, to be able to have some idea of what they’re feeling and thinking. It’s the basis of compassion, which is empathy plus the desire to relieve someone’s suffering. In the context of addiction recovery, empathy is most important for its role in strengthening relationships--both with friends and family and with your sober network. The more connected you feel to others, the easier it is to stay sober. Socially connected people feel less stressed, less lonely, more accepted, and more accountable. 

Increasing your empathy is mainly a matter of making a consistent effort to understand other people’s perspectives. This is especially important for people you don’t especially like or get along with. It helps to start by identifying the things you have in common. For example, you both want to be happy, you don’t want to be in pain, you want to feel like you matter, and so on. Recognizing these universal needs can help you understand what other people are going through.

Social Skills

Social skills are built on empathy and they are important for many of the same reasons as empathy is important. However, just as self-awareness is the foundation of self-regulation, empathy is the foundation of social skills. Much of our stress in life comes from interpersonal conflict, and much of that comes from poor communication. By improving your communication and conflict resolution skills, you can eliminate a lot of stress and irritation. 

Improving your social skills is a huge subject, but it all starts with being a good listener. Give the person you’re talking to your undivided attention--which means put down your phone for a minute. Use reflection to show you’re listening and figure out whether you’ve understood correctly. Reflection usually involves phrases like, “So, what you’re saying is--” Validate what the person is saying and try to understand points of confusion or ambivalence. 

Although some people are born with more emotional intelligence than others, we can all improve our emotional intelligence. What’s more, some people are stronger in some areas than others. You might have loads of empathy but poor self-awareness or vice versa. Correcting your weaknesses can help you have a better, longer recovery and be happier overall.

At The Foundry, we believe that overcoming a substance use disorder is really part of the larger project of living a better life. We use methods like DBT, group therapy, and mindfulness meditation to help our clients live fully realized lives, free from drugs and alcohol. For more information about our treatment options, call us at (844) 955-1066.