Thinking that causes relapses.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Inebriated people.

Alcoholism.
Photo courtesy of Pixabay.

Your automatic thoughts may be unhelpful.

Practice doesn’t make perfect it makes things permanent. I forget where I read that, but I’ve learned there’s a lot of truth in that statement. When you tell yourself something over and over, you start to believe it. Many people practice their unhelpful thoughts so frequently that they have convinced themselves they have no other choice. Let’s take some common automatic thoughts which may be making your problems worse and setting you up for relapse. I’ll illustrate this with statements about alcohol, but it could equally be true of drugs, behaviors, or mental health problems such as anxiety and depression.

I need a drink.

This unhelpful thought is baked into our society. You will hear it repeatedly on television, in the movies, or in statements made by those around you. The premise here is that the only way to cope with difficult life circumstances, problems, or unpleasant feelings, is to reach for a substance which will temporarily make you forget those problems. When you use a drug or alcohol to avoid feeling that avoidance is only temporary. Once the brief diversion wears off, you will have to face the problem, and it’s likely the problem has gotten worse while you were avoiding it.

If I stop drinking or using, I won’t have any friends.

People who are trying to get clean and sober may discover that all their current friends are drinkers and users. That doesn’t mean you can’t have friends. More than half of the adults in the U.S. have not had a drink in the last 30 days. You’ll probably make lots of friends in sobriety, and you’ll also find it’s an opportunity to reconnect with some of those clean and sober friends you haven’t talked to in a long time.

If I give up drugs and alcohol, I won’t have any more fun.

For a large segment of society fun for adults equates to drinking, using drugs, or having sex. It comes as a shock to many people how much fun you can have clean and sober when your senses are not dulled by substances. There are many enjoyable activities which do not include drugs or alcohol. Learning to have fun without substances can be a challenge if you’ve never done it. Make an effort to connect with people and to attend events that are clean and sober, and you will be surprised how much fun you can have.

Without alcohol, I’ll be miserable all the time.

One of the things we hear people in recovery say is that they were sick and tired of being sick and tired. Chemicals may temporarily change the way you feel, mainly by keeping you from feeling what you’re feeling, but once the chemicals wear off, you will find you feel better than when you had those drugs in your system.

Alcohol helps me get more done.

This used to be a common belief among news reporters and writers. The result of this belief was a lot of alcoholism, physical illnesses, and early deaths. Alcohol may temporarily disinhibit you, allowing you to do things that your brain is telling you not to do, but alcohol is a depressant, not a stimulant. Alcohol damages muscles in virtually every other part of the body. Using alcohol to get more done can result in an alcohol use disorder. Once alcohol has moved from being your solution to being your problem, you will get very little done.

How can you celebrate without alcohol?

Far too many alcohol-fueled celebrations end unhappily. Give sobriety a try. You will find plenty of ways to celebrate that don’t require alcohol or drugs. Using chemicals to celebrate impairs your ability to accomplish anything in the future.

Everybody else drinks, why can’t I?

This is one of those grand lie’s drinkers tell themselves. Everybody does not drink. Not even all the adults drink. One-third of the adult U.S. population doesn’t drink at all. Half of the people in America have not had a drink in the last 30 days. Having even one drink per day moves you into the top 20% heaviest drinkers. Heavy drinkers, particularly alcoholics, deceive themselves with the excuse that everybody else drinks the way I do. The truth is if you drink regularly, you drink way more than most other Americans.

You need a beer on a hot day.

For many people, this is a conditioned response, like Pavlov’s dogs. What you need on a hot day is plenty of water to prevent dehydration. The other thing you need is to get out of the heat whenever possible. Drinking alcohol on a hot day can result in you getting nothing done that day except drinking. Recovering from alcohol consumption can interfere with your functioning for several days after each episode of drinking.

Alcohol just goes with watching sports.

This is another excuse, not a reason. If you enjoy watching sports, you will pay more attention without the depressant drug alcohol in your system. You train your brain to connect these two items you can train your brain to disconnect them. When you do two things together, you condition your mind to expect to do both at the same time. Whatever you have learned, you can unlearn. Learn to pair your recreation with nonalcoholic pleasures.

Staying connected with David Joel Miller

Four David Joel Miller Books are available now! More are on the way.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive?

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon.

Want the latest blog posts as they publish? Subscribe to this blog.

For videos see: Counselorssoapbox YouTube Video Channel

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking, and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter.

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Urge Surfing Prevents Relapses.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Urge Surfing Prevents Relapses.

Urge Surfing Prevents Relapses.
Photo courtesy of Pixabay.com

Don’t let urges knock you down.

Urge surfing is an idea that comes from substance use disorder treatment. Learning to cope with urges can help prevent relapses into depression, anxiety, substance use disorders, and many other mental, emotional, and behavioral disorders.

A coworker and I discussed the similarities between surfing on the ocean and surfing urges. He is an avid surfer and tells me that not having a good relationship with the waves can leave scars. Ignoring urges and what is causing them can leave mental and emotional scars.

What is an urge?

Urges are sudden, intense impulses to do something. People with urges often feel compelled to act. When the idea enters the mind, it can become a compulsion. Urges can be intense, unpleasant sensations. Once the urge arises, it is hard to avoid acting on it. Wrestling with urges results in a lot of relapses into unhelpful thinking, and unhealthy behaviors.

Urges rise and fall.

Urges, in the early stages, can come on slowly and gradually, other times they rise rapidly, like a heavy ocean swell. You could easily be swept away before you realize the danger of the urge. The challenge with urges is to maintain your position without being carried away by the urge. Typically urges last 20 to 30 minutes.

Concentrating too much on ocean waves leaves you unprepared when they arrive. You should prepare for the rising and falling urges ahead of time also.

Wrestling urges, wears you out.

The typical response to urges is to try to avoid thinking about them and resist acting. The more you struggle, the more tired you become. Trying to not think about something makes the thought grow. To defeat urges you need to do two things. First, do not give in. Sometimes giving in and sometimes not amounts to intermittent reinforcement, one of the hardest things to overcome. Second, don’t exhaust yourself swimming directly into the urge. Practice floating above the surface, riding out the comings and goings of urges.

Urges can affect your thinking, your feelings, and your behavior.

Surfers who develop a negative attitude don’t last long. If you engage in self-criticism, telling yourself you should have caught the last wave, you need to wait for the next one; you don’t surf, you get washed ashore. Having cravings and urges is a natural part of recovery. Don’t beat yourself up for having urges. Having urges can make you feel like you’re not doing recovery correctly. Don’t let your urges take you places you should not go. Stick to the behaviors that will further your recovery.

Make peace with your urges.

Surfing the urges allows you to reach a place of neutrality where you neither wrestle the urge nor give in to it. What you need to do is to step back from the urge and begin to watch it as an outside observer. From this vantage point, you will see that your urges rise and fall. If you can stay in this relaxed state for a time, the urge recedes.

Accept that it is okay to feel however you are feeling.

You do not have to take action to change your feelings. Your life is a real life. There are things you like about it, and there are things that you will not like. Sometimes you will feel happy, and sometimes sad. Sometimes you will be calm, and sometimes you will be anxious. The key to making peace with your feelings, and not being swept away by urges, is to learn to recognize what you are feeling without rushing to change that feeling.

What feeling is coming up for you?

As you feel the urges rising, work on identifying what that feeling is. Are you feeling anxious, depressed, or frustrated? When urges rise, you may be thinking about others. Are you telling yourself it’s not fair that you must quit drinking or drugging, while others are continuing to do these things?

Learn the signs of oncoming cravings.

A water surfer notices the wave coming. Begins to paddle before the wave reaches them. They are up to speed when the wave reaches them. Notice the onset of uncomfortable feelings when urges are on the rise. Pay attention to increases in unhelpful thoughts. Watch your body for signs of negative emotions, that pain in the neck, the queasy stomach.

Practice urge reduction skills before the urge waves wash over you. Learn grounding techniques, scanning your body for tension, and use other relaxation methods. Breathing is especially important when it comes to keeping your head above water. Positive self-talk, affirmations, and grounding techniques can keep you prepared for the next round of urges.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Do you have an acute or a chronic illness?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

medical

Acute or Chronic Illness?
Photo courtesy of Pixabay.com

Getting the right kind of treatment for your illness is important.

Whether it’s a physical, emotional or mental disorder, getting the right treatment makes all the difference.

One of the problems we have in the behavioral health field is a tendency to treat chronic illnesses as if they were acute illnesses.

What is an acute illness?

Acute illness is something like breaking your leg. It happened suddenly, you go to the hospital and the Doctor sets it in a cast.  Eventually, the broken leg heals and you walk normally. Another example of an acute illness would be a case of pneumonia.  This can be quite serious and may result in a hospital stay.  You may need emergency treatment.  When that pneumonia goes away and you can return home.  You may have some after effects, But at some point, you will be pronounced cured of your pneumonia.

How is a chronic illness different?

Chronic illnesses have to be managed not cured.  Things like diabetes and heart disease are managed.  With a chronic illness, the Doctor continues to provide care and monitoring to keep the disease from getting worse.  In the past, acute illnesses were the main things doctors treated, today more than 75% of what doctors’ treat are chronic illnesses.

Mental health and substance use disorders are chronic illnesses.

For years we’ve made a mistake by thinking that we can treat mental and emotional illnesses as if they were acute. Someone is under the influence of a substance and are sent to detox for 72 hours.  As if substance use disorders were the same sort of things as a broken leg or an overdose of poison.

The belief used to be that once the drugs were out of their system that person was cured.  If the substance use disorder was an acute disorder, like poisoning, that would have work.  It is common for people straight out of detox to pick up drugs again within a few days. Detoxification does not work to cure substance use disorders because they are chronic illnesses.

The person sent to the psychiatric hospital for a suicide attempt might be released after two or three days when they no longer were feeling suicidal.  Sometimes that person gets additional care after the hospitalization.  But not always.

This is often another case of treating a chronic illness as if it were an acute illness. Without further treatment, after the brief hospitalization, there is a good chance that the depression and thoughts of suicide will return.

Mental health problems and substance use disorders require long-term treatment.

Repeatedly we have found that people with mental health problems who get treatment over a longer period of time are less likely to have a return of symptoms. Those people who continue to stay in treatment for up to two years after an episode of depression are less likely to have a recurrence of that depression.

With substance use disorders we find that those people who continue to stay in some form of continuing care are less likely to have a relapse.  Staying connected to whatever program or treatment helped you to recover from your substance use disorder improves the chances that you will stay recovered. In drug and alcohol treatment this continuing care is often referred to as aftercare.

One thing that has been sorely missing in mental health treatment is some form of continuing care after the initial episode. Far too often mental health issues are treated as if they were acute illnesses rather than the chronic conditions they are. Providing some kind of continuing support, groups, or individual counseling, reduces the risk of relapse into an active state of mental illness.

One highly effective continuing care system is the development of a written wellness and recovery plan.

For more about aftercare see the post in the “What is.” series.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Suicide – Addiction Proclamations.

Proclamation, Proclamation so many Proclamations.

Town crier proclamation.
Photo courtesy of Pixabay.com

By David Joel Miller.

Two very special proclamations came across my desk on the very same day this week. The president has proclaimed September as National Alcohol and Drug Addiction Recovery Month.

Here in Fresno County, California, our Board of Supervisors has declared September 7 through September 13th as Suicide Prevention Week. I suspect that lots of other jurisdictions are issuing proclamations for Suicide Prevention Week what with The World Suicide Prevention Day coming up on September 10th.

Why does Suicide Prevention Day and Week share the attention with Addiction Month?

Turns out there are a lot of connections between addiction, alcoholism, and suicide. Addiction, suicide, and mental health issues all co-exist and these are challenges that many people are reluctant to talk about. As uncomfortable as having these conversations may be they are topics we all need to think about and be prepared to discuss with those we come in contact with.

Most people are uneasy with the topic of suicide. Professionals get special training in how to talk with clients about their urges to self-harm and their thoughts of suicide. Even with that training, there are counselors who feel uncomfortable asking the simple questions like “Are you thinking of killing yourself?”

No one should ever feel uncomfortable with this question. If you have concerns about someone ask away. Just make sure you ask in a caring non-judgmental way. I see no evidence that asking someone if they are thinking about a suicidal act will put the idea in that person’s head. Many people who have started to think of suicide as a solution to their problems are just waiting for someone to care enough to ask.

Learning about mental illness, suicide prevention and substance use disorders.

At some point in your life, you will encounter a person with a mental health challenge, an addiction or possible you will cross paths with a suicidal person. What should you do? One important thing to do is to prepare for those possibilities now. An excellent source of information on mental health issues is the Mental Health First Aid course.

Certified Mental Health First Aid instructors are available across the United States and most of the rest of the world. Consider taking the class or better yet get your group to sponsor trainings in your area. If you need more information please feel free to leave a comment or contact me.

There is also a special Mental Health First Aid training for those who work with youth which trains you how to respond to a youth who is having mental health issues.

One other handy resource for a potentially suicidal person is the

National Suicide Prevention Lifeline – 1 (800) 273-8255 which has services available 24-7 and in both English and Spanish languages. Website: www.suicidepreventionlifeline.org

Your local 911 or emergency number is also a good resource in a crisis.

Why the connection between suicide prevention and addiction?

We find that those who drink heavily, binge drinkers, are about fifty-five times more likely to attempt suicide. Intravenous drug users are about fourteen times more likely than the general population to try to suicide. Other drug users? Any drug use disorder raises the risk of a suicide attempt by at least tenfold.

If you know someone who has a substance use disorder encourage them to get help and learn all you can about the impact that substance use disorders are having on our country.

People with an addiction can recover.

This month during National Alcohol and Drug Addiction Recovery Month it is important to emphasize how very possible it is to recover from an addiction, a mental illness or other emotional challenges. People do change, recover and go on to live happy productive lives no matter what the challenge is they have faced.

Today, this week, and all this month think about the problems we all face whether we know it or not, every day with addiction, substance use disorders and the possibility that someone close to you may start thinking that suicide is an option for them.

Maybe together we can all do just a little to help those who are feeling hopeless and helpless today.

Photo by Marcus Jeffrey 

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Why people become addicted – deltaFosB

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Addiction.
Photo courtesy of Pixabay

Is there really something different in the brains of addicted people?

Yes, there really does seem to be a physical change in the brain that accounts for why some people become addicted to chemicals, drugs in particular, and behaviors also. These brain changes may explain why and how people move from just experimenting, trying new novel exciting things, to the point of being addicted. Once addicted, the brain begins to demand more of the chemical or the behavior it has become dependent on.

One possible explanation for this brain change is deltaFosB.

It was quite by accident that I came across a description of deltaFosB and how it was causing a behavioral addiction. That instance had nothing to do with drugs, alcohol or chemical dependency but came from the field of research on erectile dysfunction.

Erectile dysfunction was once considered purely a problem among older men and presumably their partners. Recently we have discovered there is a group of men who are developing erectile dysfunction at an amazingly young age.

The common denominator in this early onset of erectile dysfunction? Watching pornography. A few views appear to be no problem but those who watch a lot gradually develop a dependency on the watching of porn and become unable to be aroused by a real physical partner. The brain has rewired itself to become dependent on or addicted to porn to achieve sexual arousal.

For more on this see: Your Brain on Porn.

For those of you who like to watch – there is a YouTube TEDx Talks video on this research titled The Great Porn Experiment.

These brain changes do not happen suddenly but a little at a time.

Research on cocaine, morphine, nicotine, ethanol (drinkable alcohol) and Delta (9)-tetrahydrocannabinol (Delta (9)-THC, the active ingredient in marijuana, found they all produce specific changes in the brain. These changes do not happen suddenly from one dose but gradually over time the levels of deltaFosB increase and at some point, different for different people or different for different mice, and the brain begins to rewire itself to depend on the drug.  Interestingly enough each drug changes the brain in a different characteristic way.

Patterns of addiction for different drugs involve different changes in the brain. For more on this see: Distinct Patterns of ΔFosB Induction in Brain by Drugs of Abuse by Perrotti LI, Et. Al. Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas.

A full explanation of the chemistry involved is beyond my expertise or the scope of this blog but I have included a few links to some resources on the topic for those of you who are so inclined.

Wikipedia describes the role of deltaFosB this way.

“The ΔFosB splice variant has been identified as playing a central, crucial (necessary and sufficient) role in the development of many forms of behavioral plasticity and neuroplasticity involved in both behavioral addictions (associated with natural rewards) and drug addictions.”

How many doses does it take to become addicted – Gene Expression.

Genes are a lot more complicated than we used to think. When I went to school back in the post dark-ages era, we thought genes were yes or no things. You inherit your gene for eye color, hair color, height and so on from your parents in a predictable, dominant-recessive way. Right?

Not really.

There is a thing called gene expression.

My gene for hair color dictated dark black hair. At least in my teens, it did. Those of you who have seen my blog bio picture realize that most of my hair is now gray, Ok maybe we should call it white. How did the gene for my hair color change?

As we age, or under the influence of environment and substances our genes can “Flip.” That switch in our genes moves and now that gene for black hair becomes the gene for white. The same thing happens for behaviors and for drugs.

That chemical that used to be just an extra add-on for your pleasure becomes something you must have just to feel passable.

Here is a specific study on the process for those who take cocaine.

Expression of the transcription factor deltaFosB in the brain controls sensitivity to cocaine.

Now we have an explanation, of sorts, for how someone can use a substance or do a behavior for a while with no problem and then at some point the switch flips and they are now addicted to that drug or behavior. Presumably, this would also allow us to determine which behaviors fit the model as true behavioral addictions and which are just bad habits.

Can we flip that switch back? So far we have not found a way to turn an addict or an alcoholic back into a non-addicted person. You can dye your hair or you can let it go but once you turn gray you are stuck.

Be careful with the behaviors you practice and the chemical you use. They may be changing your brain.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

5 Reasons Mental Illness and drug use hangout together.

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

sign

No Drugs.
Photo courtesy of Pixabay.com

Why do so many people have both Substance Use Disorders and a Mental Illness?

Having multiple problems is so common today that we are surprised when someone shows up looking for help for one and only one problem. People who have a mental illness often abuse drugs or alcohol. People with a Substance abuse disorder frequently have one or more mental illnesses.

The overlap is so common we have come to expect that someone who has one life problem is at risk to develop another. When people have more than one problem it is hard to recover from one unless the other gets treated.

The old method was to ask the mentally ill to give up drugs and alcohol, stay clean 30 days and then they could get help for their mental illness. Substance abuse clients were told to go get their depression or anxiety treated and then come back for drug treatment. The result was people with multiple problems who were ping-ponged back and forth between providers and many never got the help they needed.

The newer approach is to treat multiple problems all at once and improvements in one life area help recovery in other areas. So why are mental health problems so very common among those with substance use disorders? Here are some of those reasons.

A prior Mental illness puts you at risk to abuse substances.

Having a mental health problem puts you at risk to use substances to cope with your issue. Someone with anxiety finds that alcohol or drugs help them get past the anxiety and be more outgoing. The more of a drug they do the better they feel. Before long this use is out of control and becomes first a habit and then an addiction.

A person with Post Traumatic Stress Disorder will find that chemicals, alcohol or drugs, numb the symptom. Some people drink to forget the depression. All of these uses of chemicals to cope with a mental health issue could fit under the idea of self-medication. Using drugs and alcohol can help the person cope for a while, but since this is an unsafe coping strategy eventually the person’s solution becomes a second problem.

Common stressors and environments increase risks for both.

Living in poor neighborhoods increase the risk that you will have life difficulties. More crime more mental health issues and more drug and alcohol abuse in your neighborhood. Poverty is depressing and substances are a way to cope, temporarily, with poverty and unemployment.

Substances change your brain and induce mental health disorders.

People try drugs for all sorts of reasons. Many people have had the experience of a hangover. After that experience, a common treatment for the hangover is the hair of the dog that bit you, more alcohol.

Substance use progresses from experimentation to habitual use. The more of a drug someone uses the more their brain chemistry changes. At some point, not a planned occurrence, this habit becomes a mental need, a psychological addiction to the substance. Eventually, this progresses to a psychical addiction, a chemical dependency.

Excessive substance abuse results in long-term changes in the functioning of the brain. Depression, anxiety or even psychosis may develop as a result of using, being under the influence and withdrawing from substances.

Life experiences from either increase the risk of the other problem.

People with serious mental illnesses are more likely to be the victim of crime than the perpetrator. Being mentally ill makes you vulnerable. Having a mental illness increases the risk that you will be unemployed, have a psychical illness and die at an earlier age. All of these are risk factors for substances abuse.

The life experiences that drug users have, poor neighborhoods, crime, and poverty are all risk factor for poor mental health. The drug using experience increases the risk for traumatic experiences. Rapes, robberies, assaults, and incarcerations all can accompany substance use disorders.

The experience of having a substance use disorder increases the risk for a mental illness. Trying to live with a mental illness increase the risk that you will abuse substances.

Giving up a drug of choice is painful.

For most substance abusers their drug of choice becomes their best friend. Women come and go but Sherry is always waiting in the bottle for you. A man may leave you but Jose and Jack will always be in the bottle when you need them.

Crystal is always ready for your next date with the pipe.

People become closer to their drug of choice than to their family or friends. Giving up drugs or alcohol means losing that best friend. This loss of a friend and support system can leave the substance user alone with no coping mechanism and at high risk to develop a mental health problem or return to active use.

Hope that these 5 ideas will help to explain why having both a substance use disorder and a mental illness at the same time is so very common. If you or someone you know has one or both of these issues help is available. If that person has both conditions, look for a treatment provider who is comfortable with working on both issues at the

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Is he Internet addicted?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Computer

Internet.
Photo courtesy of Pixabay.com

Is this just having fun or is it internet addiction?

How much internet usage is a problem?

When it comes to behaviors how can you tell when enough is too much?

We know that behaviors can become problems. Some like pathological gambling can destroy lives and families but when is a behavior an addiction?

Is internet addiction a real addiction?

It would appear so. Brain scan studies show that in both drug-addicted individuals and people with problematic internet usage the same areas of the brain light up when they think about their preferred activity. The brain has changed in response to their habit and has resulted in characteristic symptoms of addiction.

The hallmarks of addiction are; building up a tolerance, withdrawal symptoms, excessive involvement with the drug or activity and continued participation in the activity despite negative consequences. We should also mention here that cravings for the drug or activity are the factor that maintains the addiction.

Let’s look at how these characteristics will manifest in someone with an internet addiction. We think there is a difference between high levels of computer usage and a true internet addiction. Computers and the internet have become parts of modern life. They can have good and bad aspects. Many jobs now require the use of the computer, often for many hours per day. We use computers and the internet for business, person and social applications. Some usages have more risk of becoming a problem than others.

Internet addiction is one of these “behavioral addictions” or compulsions that are poorly understood and little researched.

First, the 4 characteristics of addiction applied to excessive internet usage. Then some information on possible psychiatric connections.

1. Tolerance.

People who become addicted to the internet need more and bigger computers, more software, and the time they spend on the computer continues to increase. They may spend excessive (for their income) amounts of money and time on their computer activates.

2. Withdrawal.

When unable to do their usual activities the internet addict will become angry, fearful, anxious or depressed. Should their connection fail they are unable to do other activities in the place of their internet routine.

3. Excessive usage.

What is excessive is a matter of perspective. Most addicts can’t see that their activity has become excessive until it has become too late. Neglect of other areas of the life is a good sign this activity is becoming excessive.

Does the internet user stay up too late and then are they tired all the next day. Does this time online interfere with their job, school work or family life? Is this person neglecting their role responsibilities?

All of these are signs that the use of the internet has become excessive.

4. Continued use despite negative consequences.

The internet addict will begin to lie to others around them about their usage and the nature of their online activities. We have talked elsewhere, or will soon about how this lying may be a sign that the person is using the internet in the service of another addiction, like an affair, gambling or a sexual addiction. The lying we are talking about here is not about covering up the why of their usage but this lie is about covering up the extent of their usage.

Poor school work or job performance are common results of excessive internet usage. Chronic fatigue with a loss of motivation and interest in other activities occurs. Social isolation, with few friends and few offline activities, also occur.

Psychiatric considerations and co-morbidity.

So why should we be concerned about an internet addiction? They could be addicted to books (an incurable condition for a writer.) As long as they do not lose their job or family, what’s the harm?

Internet addiction may be a symptom of other disorders rather than a primary disorder. Internet addiction coexists with several other serious mental health problems. Those with an internet addiction often have depression from mild all the way to serious. Anxiety is a common co-morbidity and may be of the generalized, over-anxious, variety or the social phobia type.

Among those with excessive internet usage, alcohol and marijuana abuse is common. Addictions travel in flocks and switching one addiction for another is commonly reported in recovery circles.

Internet addiction is not yet a recognized disorder in the DSM. One variation Internet Gaming Disorder has been proposed for further study. The mental health community is still not quite sure how to understand this internet addiction thing.

Some authors have proposed that this may be a variant of Obsessive Compulsive Disorder (OCD.) Use of the internet may be a way of reducing anxiety in those with OCD. Other authors have noted that the anxiety in Internet addiction is more like that in drug addiction, the addict becomes anxious when they are unable to get the thing that is the object of their addiction.

Internet addiction may be another of those catch-all groups that are really a set of similar symptoms that represent several distinct disorders. A cough can be a symptom of many illnesses and what if excessive internet usage is really a symptom of many differing mental health disorders?

Three variations of internet addiction appear likely

1. Internet Gaming.

This variant is the need for the repetitive playing of games and racking up points. They may be playing against others online or this may be a solitary activity. Research currently distinguishes this from internet gambling. Gambling Disorder (formerly called Pathological Gambling) seems the same online and offline and pathological gamblers move between various settings and games of chance.

2. Cyber Sex.

This appears to fit in with other sexual issues. It is distinguished from the use of the internet to facilitate affairs or other crimes. This can vary from sex chat and sexting all the way to a pornography addiction. In a cybersex addiction, the goal is to get sexual gratification online rather than the goal of meeting a real person offline.

3. Obsessive use of the internet for social contact.

This includes frequent usage of emails, text messages, and social media sites. The internet addict may become obsessed with how many friends they have on a particular site, what others are saying and so on. This reliance on the internet for human contact may lead to a lack of social skills and few friends when in offline situations.

One serious concern with excessive reliance on the internet for social contact is the risk of pain caused by online stalking and cyberbullying which can result in suicide or other emotional crises.

Hope this brief summary of the problem of internet addiction and the link to other behavioral disorders may be helpful to someone. As always appropriate comments are welcome.

Staying connected with David Joel Miller

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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.