6 Mistakes to Avoid in Your Recovery from Depression and Anxiety

Psych Central Article Here

By Therese J. Borchard
Associate Editor Last updated: 10 Apr 2019
~ 3 MIN READ
Recovering from depression and anxiety call for the same kind of shrewdness and amount of perspiration as does running a 4,000-person company. I say that having never done the latter. But hear out my logic: great leaders must master impeccable governing skills, develop the discipline of a triathlete, and build enough stamina to manage multiple personalities. And so does anyone wanting to get outside of her head and live a little.

So I think it’s fitting to translate the insight of a book about business success, The Wisdom of Failure: How to Learn the Tough Leadership Lessons Without Paying the Price by Laurence Weinzimmer and Jim McConoughey, to victory over a mood disorder, or even mild but annoying anxiety and depression.

Weinzimmer and McConoughey describe their “taxonomy of leadership mistakes,” or nine common ways an executive falls flat on his face and is made fun of by his peers. The business world is replete with calculated risks. It’s a chess game, and a few too many wrong moves will have you packing up your stuff from the corner office.

As I read through them, I kept thinking about my main job — managing my depression as best I can — and the pitfalls that I so often run into. Many are the same listed in this book. Here are six mistakes business leaders make that are appropriate for our purposes:

Mistake one: Trying to be all things to all people.
The “just say no” problem that I have all the time. If you think of requests from friends, families, bosses, co-workers, and golden retrievers as customers asking you for all kinds of products that you can’t simultaneously produce, then you see the logic in your having to draw the line at some point. You must hang on to your resources to stay well.

Mistake two: Roaming outside the box.
Clarification: thinking outside the box is good. Hanging out there, strolling around in pursuit of some meaning that you keep finding in everything that passes by — that’s dangerous. When it comes to recovery, this is very important to remember. I like to try new things: yoga, new fish oil supplements, a new light lamp, different support groups.

What gets me in trouble is when I start to think that I don’t have bipolar disorder and can go off all meds, healing myself through meditation alone. I tried that once and landed in the hospital twice. Now I double check to make sure the box is still in my peripheral vision.

Mistake three: Efficiencies before effectiveness.
This has to do with seeing the forest behind the trees, and subscribing to a policy of making decisions based on the view of the forest, not the trees that are blocking everything from your sight. The authors cite the example of Circuit City’s CEO who cut 3,400 sales people to decrease costs despite the fact that their research said that customers want knowledgeable sales people to help them make decisions when buying electronics. His approach was efficient, but not all that effective.

When you are desperate to feel better, it’s so easy to reach for the Band-Aid — booze, cigarettes, toxic relationships — that might do an efficient job of killing the pain. Effective in the longterm? Not so much.

Mistake four: Dysfunctional harmony.
Like me! Like me! Please like me! Dysfunctional harmony involves abandoning your needs to please others, which jeopardizes your recovery efforts.

“Being an effective leader [or person in charge of one’s health] means that sometimes you will not make the most popular decisions,” the authors explain. “By doing what is necessary, you will sometimes make some people angry. That’s okay. It’s part of the job. If you are in a leadership role and you try to be liked by everyone all of the time, you will inevitably create drama and undercut your own authority and effectiveness.”

So think of yourself as the CEO of you and start making some authoritative decisions that are in the best interest of You, Inc.

Mistake five: Hoarding
I’m not talking about your sister’s stash of peanuts and Q-Tips. This is about hoarding responsibility. For those of us trying like hell to live a good and happy life, this means giving over the reins now and then to other people, persons, and things that can help us: doctors, husbands, sisters, even pets. It means relying on the people in your life who say they love you and letting them do the small things so that you can try your best to be the best boss of yourself again.

Mistake six: Disengagement
Burnout. It happens in all recovery. I have yet to meet someone who can continue a regiment of daily meditation, boot camp, and spinach and cucumber smoothies for more than three months without calling uncle and reaching for the pepperoni pizza. That’s why it is so critical to pace yourself in your recovery. What’s a realistic number of times to exercise during the week? Are you really going to do that at 4:30 am? Why not allow yourself one day of hotdogs and ice-cream in order to not throw out the whole healthy living initiative at once?

Imagine yourself a great leader of your mind, body, and spirit — managing a staff of personalities inside yourself that need direction. Take it from these two corporate leaders, and don’t make the same mistakes.

Positive Psychology Exercises Increase Happiness In People Recovering From Substance Use

Author Article

Positive psychology,Positive psychology exercises,Substance abuse
The study, published in the Journal of Substance Abuse Treatment, examined whether positive psychology exercises increase happiness in people recovering from substance use.(Shutterstock)

Self-administered exercises can significantly boost in-the-moment happiness for adults recovering from substance use disorders, suggests a recent study.

The study, published in the Journal of Substance Abuse Treatment, examined whether positive psychology exercises increase happiness in people recovering from substance use.

“Addiction scientists are increasingly moving beyond the traditional focus on reducing or eliminating substance use by advocating treatment protocols that encompass quality of life. Yet orchestrated positive experiences are rarely incorporated into treatment for those with substance use disorders,” said Bettina B. Hoeppner, lead author of the study.

As part of the study, the authors noted that effectiveness of positive psychology exercises may be promising tools for bolstering happiness during treatment and may help support long-term recovery.

According to lead researchers, the study underlines the importance of offsetting the challenges of recovery with positive experiences. Recovery is hard, and for the effort to be sustainable, positive experiences need to be attainable along the way.

The “Addiction Spectrum” Challenges You To Think About Substance Abuse Differently

Author Article

In our culture, we don’t tend to talk about being “a little bit” addicted to something. It’s not like there are AA meetings for people who are “kind of” alcohol dependent, or a treatment plan for someone who is “a little” obsessed with working out.

But a new book, titled The Addiction Spectrum, is rethinking the idea that addiction is so cut and dry. Author Paul Thomas, MD, an addiction medicine specialist and integrative practitioner, argues that addiction is more of a sliding scale that factors in the severity of the addiction as well as life events, genetic predispositions, and other contributing factors. And, he says, this addiction spectrum is just as applicable to things like food or social media as it is to drugs or alcohol.

This is a little different from the other way experts commonly define addiction: as a disease. The Center of Addiction (CoA), the American Psychiatric Association, the American Medical Association, and the American Society of Addiction Medicine (ASAM) all ascribe to this particular view, which has been mainstream in the medical community for decades. “Addiction is a primary, chronic disease of brain reward, motivation, memory, and related circuitry,” stipulates the ASAM. The CoA compares addiction to diabetes, heart disease, and cancer because “it’s caused by a combination of behavioral, environmental, and biological factors.”

Experts have been thinking about addiction as a disease for a long time. But in his book, Dr. Thomas argues that by classifying addiction as a disease, you’re not getting the full picture of how addiction works—and thus you’re missing out on opportunities to turn around a problematic habit before it gets out of control.

But if addiction is more of a spectrum than a you-are-or-you-aren’t kind of thing, how do you know if you actually have a problem? And what does all this gray area mean for treating substance use disorders? Here, leading addiction experts give all the intel, explaining what you really need to know about addiction—and why you don’t have to hit rock bottom to turn a potentially destructive habit around.

addictionPIN IT
Photo: Stocksy/Ivan Gener

Understanding the spectrum

Sometimes addiction is obvious—like when it starts affecting your relationships and career—and sometimes it’s more hidden, making it harder to identify. “I use [noise] volume as a metaphor to explain it to people,” says Neeraj Gandotra, MD, the chief medical officer at Delphi Behavioral Health, a national addiction treatment network. “Sometimes it’s a disorder that’s very loud and disruptive, and sometimes it’s more quiet.”

That’s where the addiction spectrum comes in. “The way someone can figure out where they fall on the spectrum is based on the number of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria you meet,” says Samantha Arsenault, the director of national treatment quality initiatives for Shatterproof, a non-profit dedicated to ending the destruction addiction causes. There are 11 different factors that specialists use to determine someone’s place on the addiction spectrum, including how much of the substance a person is taking and how long they’ve been taking it, whether they feel cravings for that substance, and whether it’s causing problems in their relationships.

“Technically, a mild substance abuse disorder means they have two or three different factors,” Arsenault says. Someone in the middle of the spectrum would have four of five of these factors, she says, while a person with a much more severe addiction would have six or more of symptoms. While the DSM-5 is currently used for substances like alcohol, stimulants, cannabis, and opioids, Dr. Thomas says the concept of the addiction spectrum could apply to anything that could potentially turn problematic (like exercise and sugarconsumption).

“The reason why it’s so important to view addiction as a spectrum is because it means you don’t have to hit rock bottom to turn it around.” —Samantha Arsenault, Shatterproof

Interestingly, this fits in well with the ASAM’s viewpoint on unhealthy substance use. While they do define addiction as a disease, the group also says that there is a whole range of behaviors, from low-risk use (where you’re consuming alcohol or drugs below harmful levels) to hazardous use (where you’re consuming these substances in a way that increases the risk of health consequences) and ultimately addiction. Addiction is less about how much of a substance a person uses or how often they use it, and rather the way in which they respond to those substances, the ASAM says.

To put this thinking in context: “I had a client who was a high-powered executive and he would drink a bottle-and-a-half of wine every night after work to de-stress,” says clinical psychologist Kevin Gilliland, PsyD. “But even though he drank a lot, he would always make it to a 6 a.m. workout. Was he on the severe end of the spectrum? Well, not fully, because he’s holding down a good job and to the outside world he’s not destroying his life in any obvious ways. But he was still putting his health at risk and it actually was greatly harming his relationship with his wife, so it was problematic in those ways.”

A generally non-problematic habit, like a daily glass of wine, can potentially get pushed into more dicey territory. “There are factors that could cause someone to creep up on the addiction spectrum, such as genetic predisposition,” Dr. Thomas says—meaning that if someone in your family is an addict, it could make you more likely to develop an addiction, too. “Or if stressful events in your life occur and you’re turning to that glass to relax, it could increase to two, three, or more a night.” He also adds that it’s pretty common for tolerance to increase, so if you’re drinking a glass of wine to get a little buzz, it could morph into needing more to have the same feeling.

This is not at all to say that everyone who drinks a glass of wine a day will always develop an addiction. But something that seems harmless could potentially transform into a destructive pattern, depending on other factors in your life and your genetic makeup.

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Photo: Getty Images/ Petri Oeschger

The varying degrees of addiction

This might seem overwhelming. But changing how we think about addiction—not as an “on-off” switch, but more as a gradient with levels of seriousness—could be helpful when it comes to prevention, at least according to the experts who tout this way of thinking. “The reason why it’s so important to view addiction as a spectrum is because it means you don’t have to hit rock bottom to turn it around,” Arsenault says. “If you’re on the low or medium end of the spectrum, you can look at that and think about the lifestyle changes you can make before it gets worse.”

Since addiction comes in varying degrees, treatment can vary, too. When Dr. Gandotra is working to treat a patient with an addiction, his first thoughts are on their most basic, primary needs. Do they have a place to live? Are they going to be going through withdrawal? Do they need to be enrolled in a rehab program? “Rehab isn’t always the best answer,” he says. “It really does depend on where they are on the spectrum and factors like if they’re able to hold down a job and have familial support.”

He adds that the substance in question matters, too. “There’s a hierarchy in terms of the consequences. Someone using an illicit substance is at risk of being arrested, or using cocaine puts you at risk for sudden death.” Definitely not the same as being addicted to your phone.

For a person on the lower end of the spectrum, the experts say treatment starts with meeting someone where they are, and what they’re willing to change. “Maybe someone isn’t ready to stop drinking alcohol completely, but they can make the step to limit it to every other night [rather than] every night,” Dr. Gandotra says. “It also allows for the chance to tweak the script a little bit and ask them, ‘Is there any aspect of your drinking you would like to change?’ That can help someone figure out where to start.”

However, in the case of someone with a severe addiction (or a person who is addicted to a life-threatening substance), quitting cold turkey is necessary. “If someone is on the severe end of the spectrum, the physical symptoms need to be addressed first. Then, the lifestyle changes can be addressed,” says Dr. Thomas.

“What I’m really hoping to get across by talking about addiction as a spectrum is, again, you don’t have to hit rock bottom to change,” adds Dr. Thomas. “Maybe your relationship with alcohol, food, screen-time—whatever it is—isn’t as healthy as you would want it to be. You don’t have to reach a tipping point to change it.”

Here’s what you need to know about exercise addiction. And if you’re recovering from an eating disorder, approaching wellness can be tricky. Here’s how to do it.

Your Genes and Addiction

Author Article
Over the last decade, the prevalence of opioid addiction has increased to epidemic levels, but unfortunately therapeutic interventions for the treatment of addiction remain limited. We need to better understand the triggers for the development of addiction in order to develop more targeted prevention and treatments. One of the key questions that researchers in the field of neuropsychiatry are trying to answer is why some people are more vulnerable to addiction. As in most cases of psychiatric disorders, genetic and environmental factors interact to determine how vulnerable, or likely, you are to developing a substance use disorder.

Drugs of abuse, including opioids, act on the brain’s reward system, a system that transfers signals primarily via a molecule (neurotransmitter) called dopamine. The function of this system is affected by genetic and environmental factors. For example, a recent study published in the scientific journal PNAS revealed one of those genetic factors. Researchers demonstrated that a type of small infectious agent (a type of RNA virus called human endogenous retrovirus-K HML-2, or HK2) integrates within a gene that regulates activity of dopamine. This integration is more frequently found in people with substance use disorders, and is associated with drug addiction.

How does stress induce epigenetic changes?

Accumulating evidence suggests that environmental factors, such as stress, induce epigenetic changes that can trigger the development of psychiatric disorders and drug addiction. Epigenetic changes refer to regulations of gene expression that do not involve alterations in the sequence of the genetic material (DNA) itself. Practically, epigenetic changes are information that is added on to already existing genetic material, but can affect the expression of genes.

A stressful situation, such as the death of a significant other or the loss of a job, triggers the release of steroid hormones called glucocorticoids. Those stress hormones trigger alterations in many systems throughout the body, induce epigenetic changes, and regulate the expression of other genes in the brain. One of the systems that is affected by stress hormones is the brain’s reward circuitry. The interaction between stress hormones and the reward system can trigger the development of addiction, as well as a stress-induced relapse in drug or alcohol recovery.

Stress reduction can help reduce the risk of developing an addiction and prevent relapse

Fortunately, the negative effects of stress can be alleviated by other factors, such as physical activity or social support. These behaviors produce epigenetic changes that prevent the development of addiction and can have a beneficial role in treatment when used in combination with other interventions, such as cognitive behavioral therapy and, for some people, medications. One of the ways that physical activity could be effective is by reducing negative feelings, including stress and the accompanied stress-induced epigenetic changes. In the example of a stressful situation such as the death of a significant other or loss of a job, if a person engages in physical activity this can reduce their stress-induced epigenetic changes, which will decrease the risk of developing addiction or stress-induced relapse.

Hope for targeted addiction treatments

We now know that the function and dysfunction of the brain’s reward system is complicated, plastic (undergoes changes based on negative and positive factors), and involves complex interactions of genetic and environmental factors. Alterations in gene expression can lead to changes in the function of the brain’s reward system, so a person is more or less likely to self-administer drugs. Together this knowledge can ultimately lead to the development of multilevel and more efficient prevention and therapeutic approaches to address the ongoing opioid epidemic.

Resources

Human Endogenous Retrovirus-K HML-2 integration within RASGRF2 is associated with intravenous drug abuse and modulates transcription in a cell-line modelProceedings of the National Academy of Sciences, September 24, 2018.

11 Warning Signs of Emotional Abuse in Relationships

Psych Central Article
By Jessica Cline

You never really know someone until you’ve tried to leave them.

Many women who witnessed various forms of physical abuse and domestic violence in their parents’ marriages swear they will never settle for the same kind of treatment in their own relationships.

However, many are so focused on physical forms of abuse that they too often miss the warning signs of emotional abuse, at least, until they find themselves caught in the trap of an emotionally abusive relationship or marriage themselves.

Having set the bar at physical abuse, which is where our society still keeps that bar to a large extent as well, women in these situations often feel that if they aren’t being hit, they aren’t being abused, and they therefore have no right to complain, let along initiate a divorce or breakup.

If you were raised in an environment of abuse, you may feel more comfortable living within a cycle of violence, which includes emotional forms of violence such as threats to your privacy and control of resources, than you realize.

And even if you do realize this and feel certain that you want to get divorced or leave the toxic relationship, abusers have plenty of tricks up their sleeves for making you believe that doing so impossible.

Signs You’re Being Quietly Abused (and Don’t Even Know It)

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You can leave, and you should and you will, but before you do, you should know what to look out for so you can be as prepared to deal with it all as well as possible.

Here are 11 signs of emotional abuse in relationships and marriages, and how each may affect you in a divorce or breakup.

1. Withholding Affection.

Withholding affection from a partner is a way to punish the partner and to exercise power and control. This is done intentionally and is sometimes stated to the partner by saying something like, “No kisses until you can be nice again.”

Some partners withhold affection after a disagreement because they don’t feel connected or they don’t feel like offering loving gestures in the moment, but in such cases, the behavior happens only occasionally, rather than on a frequent basis.

2. Threats.

An abuser might threaten to expose you in a way you find embarrassing, or they may threaten to take something important away from you, such as money, your home, or even your own kids.

Some might threaten to leave you if they don’t get their way, or they may say they will tell your friends and/or family something personal about you, which is doubly damaging, as not only are they threatening you, but they are implicitly stating that there is something so wrong with you that you should feel ashamed.

3. Ultimatums.

Ultimatums are really a covert threat, with the abuser placing the blame for “having” to make you decide about something back on you.

The way they see it, the fact that they are giving you a choice through which you can rectify the situation (by doing what they want you to do) is a way in which they are actually being “generous” to you, and that, therefore, all blame for the situation and any possible consequences are entirely your fault.

4. Lack of Respect for Your Privacy.

This is often a subtle sign of emotional abuse. Your partner may check your private messages or voicemails, either by hacking into them or directly insisting you give them the passwords for all of email and social media accounts.

They might even go so far as to insist your share email and social media accounts, so they can analyze everything you do and say.

5. Property Damage.

This skirts the line between physical and emotional abuse. An abusive partner may break or “lose” something they know is meaningful to you as a way to punish you and remind me you of the power they hold over you.

8 Critical Things Loving an Emotional Abuser Teaches You

6. “Magic Tricks.”

Many emotionally abusive behaviors are “magic tricks”, meant to distract you from the reality of the ways in which you are being mistreated, i.e., “Look at this here (so you don’t notice what my other hand is doing there)!”

This might take the form of redirecting blame for their bad acts back to you, starting fights, and firing accusations at you immediately before or after being especially nice and loving, but the sole purpose of all these things is to distract from the abuse that they are subjecting you to repeatedly.

7. Playing the Blame Game.

Partners using power and control in a relationship often aren’t insightful enough to notice the profound effects of their own behavior, nor are likely to ever be willing to taking responsibility for any of it.

Instead, they prefer to blame you, saying things like, “If you just hadn’t done that, I wouldn’t have had to act that way in response.”

8. Alienation.

Abusive partners often want to control who you are allowed to have meaningful connections with, and how deep those connections should be allow to run. This means that, over time, you may feel as though you have lost some of your most supportive relationships with friends and family, because your partner didn’t approve.

9. Excessive Gift-Giving.

Some abusers give gifts following a fight as an indication of how much they care about you — or, as a threat reminding you of all their generosity you might lose as a consequence should you choose to leave.

In such cases, you may hear them say things like:

  • “Of course I love you. I bought you this ______.”
  • “I buy you so many nice things, even though you don’t appreciate anything I do.”
  • “Everyone else sees what you have and wishes their spouse was as giving as I am.”
  • “If you leave me, you will never have this ______.”

10. Controls of Resources.

Partners may control financial or other resources as a form of punishment or as a way of maintaining control in the relationship, causing you to believe you won’t be able to care for yourself (and your children, if you have them) if you try to leave.

The resources in question aren’t necessarily limited to money. An abuser might limit your access to your car, your cell phone, health insurance, and more.

11. “Micro-Cheating.”

Micro-cheating is considered by some to be ways in which your partner connects with others and hides it from you.

This can take the form of secret messages, code names in their phone’s contact list, going out and refusing to tell you where he’s headed, or giving attention to someone else while withholding attention from you.

You never really know someone until you have divorced them.

Often, we see an even worse side of our partner when we try to leave the relationship. Sometimes divorces and breakups are amicable, however, if you’ve experienced emotional abuse during your marriage or relationship, you can expect these tactics to continue long after you leave.

Leaving partners who are emotionally abusive requires more planning and more support than typical, and it often requires the advice of professionals as well.

If you detect these signs in your relationship, reach out for help from friends, family, a therapist, or a counseling network.

This guest article originally appeared on YourTango.com: 11 Signs Of Emotional Abuse In Relationships — And How Abusers Try Using Them Against You If You Leave.

If You’re Often Angry Or Irritable, You May Be Depressed

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Registered nurse Ebony Monroe of Houston recently went through a period of being quick to anger about every little thing. She didn’t realize then what it might mean for her health.

“If you had told me in the beginning that my irritability was related to depression, I would probably be livid,” Monroe says with a laugh. “I did not think irritability aligned with depression.”

She’s not alone. Many people — including physicians — associate depression with feelings of hopelessness, sadness and a lack of motivation or concentration, but not anger. Some researchers say that’s a problem, given that there appears to be a strong link between irritability and depression.

If you pick up what is often called the “bible of psychiatry,” the Diagnostic and Statistical Manual of Mental Disorders, you’ll find that the list of core symptoms for major depression doesn’t include anger.

“It’s not included at all in the adult classification of depression,” says Dr. Maurizio Fava, a psychiatrist at Massachusetts General Hospital and a professor at Harvard Medical School.

But he points out that irritability — a reduced control over one’s temper that results in angry outbursts — is listed as a core symptom of depression for children and adolescents. It has never made sense to him that it’s not included for adults. “Why would someone who happens to be irritable and angry when depressed as an adolescent suddenly stop being angry at age 18?” he asks.

Anger is an emotional and physical feeling that makes people want to warn, intimidate or attack a person who is perceived as threatening. Fava says a depressed adult with lots of anger is often assumed to have bipolar disorder or a personality disorder.

“We see in our clinics patients who are labeled as having other diagnoses because people think, ‘Well, you shouldn’t be so angry if you are depressed,’ ” says Fava. The diagnosis matters because it affects the kind of treatment people get.

Back when he was trained decades ago, Fava says, he was taught that in depression, anger is projected inward — that depressed people would be angry at themselves but not at others. That didn’t match what he was seeing in a lot of his patients with depression.

“I would say 1 in 3 patients would report to me that they would lose their temper, they would get angry, they would throw things or yell and scream or slam the door,” says Fava. Afterward, these people would be filled with remorse.

Fava thinks these “anger attacks” may be a phenomenon that is similar to panic attacks. His research found that this kind of anger subsided in the majority of patients treated with antidepressants.

Psychiatry has carefully studied how anxiety and depressed mood are experienced by patients, notes Fava, but anger has been relatively neglected. “I don’t think that we have really examined all the variables and all the levels of anger dysregulation that people experience,” he says.

That view is shared by Dr. Mark Zimmerman, a professor of psychiatry at Brown University. “The field has not sufficiently attended to problems with anger,” says Zimmerman.

“The most frequently used scales to evaluate whether or not medications work for treating depression don’t have any anger-specific items,” he notes.

Yet Zimmerman says clinicians frequently see increased anger in people who come to doctors seeking help. “Irritability is not that much less frequent than sadness and anxiety in patients who are presenting for psychiatric treatment,” he says.

Zimmerman and some colleagues recently surveyed thousands of patients who were making their first visit to the Rhode Island Hospital’s outpatient psychiatric practice. All were asked about the level of anger they had felt or expressed in the preceding week.

“Two-thirds of individuals reported notable irritability and anger,” he says, “and approximately half reported it at a moderate or severe level.”

Another large study by a different research group looked at more than 500 people who had been diagnosed with major depression. It found that more than half showed “overt irritability/anger,” and that this anger and irritability appeared to be associated with more severe, chronic depression.

Monroe, the nurse, was lucky enough to have a concerned friend who gently suggested that maybe she should talk to someone. “The way that she approached me decreased that wall of anger and anxiety,” says Monroe, “and that’s when I decided to seek the help.”

Monroe came to realize that traumatic events from her childhood had left her depressed and full of unresolved anger. With nowhere for that anger to go, she was lashing out at loved ones like her sister and husband. “So they caught the back end of my irritability when, in fact, they had nothing to do with the source of it,” she says.

After about a year of counseling, her life has improved a lot, Monroe says. She now works with a group called Families for Depression Awareness to help others recognize the signs of depression. Its list of symptoms that families should watch for includes “picking fights, being irritable, critical, or mean.”

Still, people with depression can have a hard time recognizing this in their own lives.

When I called up the Depression and Bipolar Support Alliance to ask about anger, I reached its communications person, Kevin Einbinder. He initially thought to himself, “I’m sure somebody else certainly deals with anger, but I don’t have anger issues associated with depression.”

Then he started reflecting on his life with depression over the past three decades. “I thought of all the people in my life who have interacted with me — my family, the counselors, psychiatrists, even employers, significant others,” he says, “and I realized that anger was an underlying factor in all those relationships.”

For example, he used to use caustic, sarcastic humor to put people down. “This really drove people away,” says Einbinder. He also recalls sending angry emails late at night after lying awake and ruminating about things that had happened during the day. A counselor helped him see why this wasn’t such a good way to handle problems.

Overall, though, he and his caregivers never focused on anger.

In hindsight, he says, he really wishes they had.

“I think that would have provided a tremendous amount of context for what’s adding to my depression and in helping me, early on in my life, with more effective coping mechanisms,” Einbinder says.

With medication and therapy, he is doing much better now. Einbinder hopes that sharing his experiences will help people understand that if they’re dealing with depression and anger, “they’re not alone and there’s loads of resources out there.”

Life Sucks When You Are Too Anxious To Socialize

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By Holly Riordan

When you are too anxious to socialize, you sit around waiting for a text message to come through your screen because you are too nervous to send the first text yourself. When no one reaches out to you, you feel isolated. Alone. Abandoned. While staring at a blank screen, the little voice in the back of your head mocks you. It convinces you no one likes you, no one cares, no one notices when you are not around. The longer you spend on the own, the more you convince yourself you are always going to be alone.

Of course, if someone does happen to text you, you are going to be smacked with stress. You are going to waste time trying to come up with the perfect reply, trying to find the right emoji, trying to figure out how to strike a balance between being friendly and clingy. Since you only have a scattering of social interactions throughout the week, each one seems like a big deal. If one goes wrong, you won’t be able to stop thinking about it. You won’t be able to handle the embarrassment.

When you are too anxious to socialize, the idea of being invited to a party is as horrifying as the idea of being the only one not invited. You are never satisfied. You are either alone in your bedroom, wishing you were out with friends. Or you are surrounded by people, wishing you could crawl back underneath your covers.

You are a living contradiction. You cannot stand the boredom of being alone — but you cannot stand the stress of being around other people either. You do not want to spend the weekend all by yourself — but you do not want to spend it at a crowded bar or a noisy party either.

When you are too anxious to socialize, you become your own best friend. You spend most of your time finding new ways to keep yourself occupied. You distract yourself with books and movies. You try to ignore your growing loneliness. You tell yourself you are better off on your own as a way to protect yourself, as a way to stop feeling so miserable about having no one to invite over on weekends or text after work hours.

When you’re too anxious to socialize, it’s easy to start thinking less of yourself. It’s easy to start wondering whether you are worthy of love or friendship. It’s easy to allow your insecurities to get the best of you. However, you have to remember no one is judging you as harshly as you have been judging yourself. No one is going to examine the words you type in a text or the facial expressions you make in a conversation as deeply as you have been. No one is going to care about your ‘mistakes’ as much as you think. Most people will not even notice them.

When you’re too anxious to socialize, you need to break out of your comfort zone in order to achieve happiness — otherwise you are going to stay stuck in your routine forever, wishing you had the courage to make a change.

What is Narcissistic Supply?

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By Sharie Stines, Psy.D

(Note: I am using pronouns he, his, him, for simplicity. Narcissism applies to both genders.)

Secure attachment in infancy creates a solid foundation for a person’s entire life.  It creates a feeling of “confidence and trust in the goodness of me, you, us” (Divecha, 2017). This secure attachment is created by the comingling of reflection, attunement, empathy, and love between mother (or other primary caregiver) and infant. It is created when the mother is present, consistent, kind, reassuring, and soothing. With secure attachment, a person learns to trust others and love others for the rest of his life.

Narcissists do not know how to “trust the goodness of me, you, and us.” Narcissists are all about protecting the self – at the expense of the other. Because of the narcissist’s inability to connect in a healthy way with another person, he uses a system of relating that is created in order for the narcissist to take care of himself. Instead of healthy connection, a narcissist seeks for “narcissistic supply.”

People with narcissism usually suffer with a form of early childhood attachment trauma (interpersonal abuse.) At some point in early childhood the narcissist was not properly attached to, or was insufficiently loved. Because of this, he learned how to survive in relationships using a sort of barter system, rather than relying on “normal” human connection skills (because these were not properly internalized in his psyche.)

Narcissistic supply is a form of payment given by others in order to be in a relationship with a narcissist. In essence, when a young child is not sufficiently attuned to or attached with, emotionally soothed and protected, he develops self-protective survival skills. These survival skills come in the form of emotional manipulation and alternate-personality development.

Realize that in essence, people with early attachment trauma, are developmentally delayed – particularly with respect to interpersonal relationships.

Have you ever noticed how your loved one demonstrates behaviors akin to a three year old having a temper tantrum?  This is probably because he was triggered by not getting his way somehow and then he emotionally regressed to an earlier stage of development (one which he has not completed the development phase of maturing through.)

In essence, a narcissist has not properly matured through each stage of early childhood development resulting in stunted emotional growth.

Narcissists are never satisfied.  Once they receive the narcissistic supply for the moment, they soon become empty again; it isn’t lasting. A narcissist’s emotional or “narcissistic supply” tank is always running low or on empty. It’s as if there are holes in the bottom of the narcissistic supply tank. No matter how much you try to love your narcissist well, it is never going to be enough.

What are some common forms of narcissistic supply?

  • Attention
  • Compliments/Praise
  • Accomplishments, such as winning
  • Feeling powerful (having power over you)
  • Feeling in control (being able to control you, and thus, his environment)
  • An addictive substance or activity
  • Sex
  • Emotional energy (can be positive or negative)

The list is not exhaustive and narcissistic supply can be as unique as the individuals involved.

What are some things the supplier of this narcissistic “food” can do to feed the narcissist?

  • Do whatever he wants
  • Lose your autonomy; yourself
  • Praise him/compliment him
  • Be a good “object”
  • Be compliant
  • Be controllable
  • Give up your power

How do narcissist’s obtain this supply from their “victims?” They use some primary tools; these are seduction, manipulation, anger and bullying behaviors.

Realize this truth:

“In a narcissistic encounter, there is, psychologically, only one person present. The co-narcissist disappears for both people, and only the narcissistic person’s experience is important” (Rappaport, 2005).

You can see how this quote applies to this concept of narcissistic supply. The entire purpose of the relationship is that everyone in it has one goal – to feed the narcissist. This form of psychological manipulation works, because when the narcissist is “fed” everyone involved is lulled in to a false, albeit brief, sense of security.

Narcissistic supply is any substitute form of temporary supplier of “satisfaction.”  Most likely, this “food” is in the real form of the neurotransmitter dopamine – the “feel good” brain chemical.

What the narcissist really needs and has needed all along is true human connection. But, since the want of that is a serious threat to the narcissist’s psyche, he has learned to accept narcissistic supply as his source of sustenance.

 

(If you would like to receive a free copy each month of my newsletter, the psychology of abuse, please send me your email address and I will add you to my subscription list:  therecoveryexpert@gmail.com)

References:

Childress, C. A. (2016.) The Narcissistic Parent: A Guidebook for Legal Professionals Working with Families in High-Conflict Divorce. Claremont, CA: Oaksong Press.

Divecha, D. (2017). How to Cultivate a Secure Attachment with Your Child. Greater Good Magazine. Retrieved from: https://greatergood.berkeley.edu/article/item/how_to_cultivate_a_secure_attachment_with_your_child

Rappoport, A. (2005). Co-narcissism: How we accommodate to narcissist parents. The Therapist. 16(2).36-38.

That’s right. Stop wasting time arguing because they will drive you to the point of insanity. They can’t lose. They can’t be wrong and if you fuck with their facade they will try and destroy you. Trust your gut and walk the very first time you catch them in a lie or when you have […]

via Stop wasting time arguing with narcissistic people — Share our story to end the violence…

How To Cope With Addiction When We Also Have Depression

See Author Article Here

When we think of addiction, our thoughts tend to turn to drug and alcohol addiction but addiction can relate to numerous different things; drugs, alcohol, food, exercise, pornography, gaming, social media, tattoos, self-harm, gambling, shopping – anything that we feel as though we’re not in control of, and has an impact on our mood and behaviours. Addiction can be incredibly difficult to cope with, particularly when the things we’re addicted to are often readily available. Depression and addiction can go hand in hand. Addiction can help us to cope with depression, but equally, depression can be caused or worsened by the things we’re addicted to.

Depression: Coping With Addiction
IDENTIFY TRIGGERS
In terms of addiction, triggers are any emotional or environmental factors that cause us to feel as though we need to use our addiction. It could be related to people, places, things, times of the year, or something else. Working out what our triggers are can take time, but once we know what they are, we can avoid them or learn ways to manage them.

HIGH-RISK SITUATIONS
High-risk situations are similar to triggers, but rather than being a specific ‘thing’, such as ‘seeing a person walking a dog’, they’re specific situations. This could be something like Christmas, seeing family, or getting a piece of negative feedback at work. Sometimes these situations can be difficult to spot until we’re in them, so it can be helpful to make a note when a situation causes us to feel like we need our addiction.

Once we identify these situations, we can make a plan for how to cope with them without turning to our addiction.

For example, if one of our high-risk situations is ‘seeing my auntie’, we might choose to see them less often, only see them in the company of other friends/family, and invite a friend to stay over for the night whenever we do see them, so that we’re not having to cope alone. We could also note down any alternative coping mechanisms we could use, so that we don’t have to think about them ‘in the moment’, and can just refer to our notes. It’s often helpful to write down a couple of different ideas because sometimes our first or second ideas aren’t possible or don’t work.

Depression: Coping With Addiction
CLICK TO TWEET

WORKING OUR HOW OUR ADDICTION HELPS US
If our addiction didn’t help us on some level, we wouldn’t keep using it. Something that can be really key when coping with addiction is working out how it helps us and then finding a healthy coping mechanism to replace it. It can sometimes be helpful to use the acronym ‘Hungry Angry Lonely Tired (HALT)‘ when thinking about the need that we’re filling, as these are common emotions associated with addiction.

ALTERNATIVE COPING MECHANISMS
Having a list of coping mechanisms that we can use when we want to turn to our addiction is helpful. We’re all different, and we all turn to our addictions for different reasons, so we will find that different coping mechanisms work for different people. As an alternative to our addiction, we could try things like watching TV, reading, walking, talking to a friend, drawing, writing, painting, listening to music, listening to podcasts, doing some breathing exercises, ripping up sheets of paper, drawing on ourselves, running, cleaning, self-soothing, doing some puzzles, singing, hugging a pet, dancing, playing with play-doh or contacting a helpline. Sometimes we’ll have to try a coping mechanism a few times before we can get it to work for us – practice makes perfect!

REMINDERS
There are times when we don’t see the point in fighting our addiction. It feels too hard. We’re too tired. There’s no point because we can’t do it so why even bother trying?!

At times like these, we have no interest in reaching out for support, or in using healthy coping mechanisms.

These times are very ‘high risk’, in terms of falling back into our addiction. Having reminders of why we don’t want to go there can help us to keep going. This could be in the form of photos on our phone, on the wall, or in our purse or wallet. We might have lists of ‘reasons to keep going’, or ‘things we want to do once we’re up to it’. There might have been a time when we had a particularly amazing day, and we might have a momento from that day that we can hold. A specific smell or taste could take us back to happier times that we’re hoping to replicate at some point in the future. Keeping little reminders in our house, bag, or coat pocket, can help us to keep going at times when we want to return to our addiction.

REFLECT
There are times when things go really well, and we feel like we’re beating our addiction. At other times, things don’t go so well, and it can feel as though our addiction is beating us.

It’s important to remember that a lapse is not the same as a relapse. Recovery is not a straight line. Whether things go right, or wrong, it’s important to reflect and learn from them.

If we’ve managed a difficult situation without turning to our addiction, then that’s wonderful progress! How did we do it? What coping mechanisms did we use? Is there anything that could be helpful to note down so that we know to try it again in the future?

If we’ve struggled through a difficult situation and turned to out addiction, then we haven’t failed, we’ve just had a wobble. Recovery is a learning curve, and we can learn as much (if not more) from our mistakes as from our successes. What went wrong this time? Was there a trigger that we weren’t expecting, or a high-risk situation that we didn’t know would be high-risk? Did anything go right? Can we think of anything we could do differently in future? Sometimes we have to try a coping mechanism a few times before we can get it to work. At other times, we might have tried a coping mechanism that didn’t work for us at all, so it’s not one that we want to try again.

This reflection can be really important because it can help us to keep moving forward. Some of us might find it helpful to journal this sort of thing.

Depression: Coping With Addiction
HONESTY IS IMPORTANT
One of the most important things when it comes to addiction is honesty. Honesty to others, and honesty to ourselves. Lying to ourselves and others is likely to cause a lot of problems, so even when it’s really difficult, it’s important to try and tell the truth.

SUPPORT SYSTEM
We don’t have to cope with addiction alone. Addiction can be incredibly strong, so we need to try and build up a strong support system to fight it with. Our support system doesn’t need to be massive, but it can be helpful to have a couple of friends or family members or organisations we can turn to when we’re struggling. Sometimes, it can be dangerous to stop an addiction ‘cold turkey’, so it’s often a good idea to reach out for some professional support on top of the support we get from our loved ones. We might also find that some medication, therapy or counselling from professionals is something that we need.

There are times when we struggle to let people help us. We might feel as though we don’t deserve it or we’re being a burden – but we do deserve support, and in the same way that if one of our friends were struggling, we’d want to support them, our friends will probably want to support us. There are times when it can be hard to reach out for support because we don’t have any hope, but there’s nothing wrong with letting other people hold our hope for a little while until we’re able to hope again.

SUPPORT GROUPS
On top of support from our friends, family, and professionals, we might find that support groups with others who have experienced similar addictions to us can be comforting and can help us to cope. Sometimes being around others who’ve experienced similar things to us can help us to feel less alone, and can give us some hope of things improving. There are different support groups for different addictions including alcoholics anonymous, narcotics anonymous, national self-harm network, sex addicts anonymous, overeaters anonymous, Beat support groups, on-line gamers anonymous, and gamblers anonymous.

Please help us to help others and share this post, you never know who might need it.