How to Beat the Holiday Blues

http://img2-2.timeinc.net/toh/i/g/10/holidays/xmas/12-diy-disasters/04-homeowner-mishaps.jpg

Thanksgiving is the first of the triple threat (Christmas and New Year's complete the trifecta) that can make you sing the holiday blues... If you are like me making "happy happy" during this time can actually be a real downer. If there are family conflicts (who doesn't?) the obligatory joy and gladness can seem like one big fat cruel joke. In addition, if you are struggling with relationships, work, money or going through a significant life-changing event (breakup, divorce, death of a loved one) you feel you want to skip the festivities. However, non-participation may not be an option. And for others the possibility of spending any of these holiday without family and friends can them into a dark and lonely place.

Here are some tips for avoiding emotional fallout this holiday season. 

1. Recognize physical symptoms of depression and anxiety. Emotional distress begins in the body. If you feel exhausted and tired look inward to see if it's psychological or physical. Anxiety can manifest as stomach upset, insomnia, irritability or jumpiness. Again, take an inventory. Identifying and understanding physical symptoms is the first step in addressing them. Whether the source is emotional or physical, you can do something about them.

2. Ask yourself what the symptoms mean. If they are physical, slow down, rest, change your diet etc... If they are psychological in origin ask yourself what are these feelings and what do they mean? Are you trying to suppress or ignore feelings of guilt, obligation, resentment and anger, or any other negative emotion?

3. Be kind to yourself and others. If you don't feel well and cranky maybe going to a holiday party isn't the best idea as it may make you feel worse. Sitting out a party or a gathering can be the kinder thing for yourself and for others; you are sparing negative energy from people you love and like. Listen to your inner voice even if it's saying something out of the ordinary.

4. Talk it out with your therapist, friends and family (not at the party or the dinner). Engage, reach out and share your feelings. If other people aren't available, talk to yourself by writing it out in a journal.

5. Go easy with food and drink. Alcohol will certainly amplify whatever you are feeling and overindulging will actually worsen symptoms of anxiety and depression and decrease the quality of sleep. As for food, gaining extra weight is much easier and more fun than losing it, so practice moderation.

6. Get your sleep and exercise. Enough said.

7. Be proactive. If you know you are going to be alone research and plan ahead activities. Do you have books, movies and activities to keep you occupied? Reach out to others who may be also be in the same boat.

8. Lower your expectations, or at least make realistic your expectations of the holiday season. Norman Rockwell's version of American holiday experience is aspirational at best. 

9. Create your own rituals even if it's just for this year. Maybe Santa Claus will no longer be welcomed in your home. Rather than receiving maybe Christmas is just about giving nonmaterial things. Go ahead and create your own activities based on YOUR values.

10. Be mindful. Holidays come around once a year and for some it is a season of fun and celebration. Acknowledge their right as your own. Also, be mindful that, thank god, they come around just once a year and this too shall pass. 

Iguala, Mexico and the Casual American Drug User

Wikipedia

Iguala is a city of about 100,000 people southwest of Mexico City, a city at the center of national and international attention after 43 students went missing. Students were from a rural Mexican teacher's college, and they are are presumed dead — murdered — their remains burned and buried.

In Mexico thousands have marched in protest to express their anger and outrage. Some protesters went far as even torching the national palace in Mexico City to bring attention to government officials who are ineffectual at best and at their worst who collude with the narco traffickers, who are certainly behind this massacre. Mexicans are fed up. After years of drug war and brutal murders of thousands, this case sparked a national outrage, and rightfully so.

Narco traffickers is the general term to assigned to large, powerful drug cartels who fight among themselves for territory and control of drugs flowing from South America and Mexico to the United States. Without our staggering demand for illegal drugs these gangs would not be in existence, or they would not be as powerful. Profits are so vast they can buy politicians and the police, locally and nationally to protect their interests and operate without impunity.

How and why does this relate to my work? Americans spend about 500 billion dollars annually on cocaine, heroin, marijuana and meth. It is a staggering amount of money and most of the product travels through Mexico. Cocaine is produced further south Colombia, Peru and Bolivia. Heroin poppies are cultivated in Mexico as is marijuana. Mexico by its location serves as the funnel for drugs entering the country. Obviously we have a great appetite for drugs in America. And I've always made it clear that I advocate for personal choice when it comes to drug use.

Unlike other consumer goods the street drug buyers do nots have choice when it comes to the source of the supply. It is strictly a supplier's game. Cocaine and heroin are not labeled with their countries of origin or provenance. There is no Community Supported Agriculture (CSA) for drugs, or ethical cocaine and heroin, unlike, say, diamonds or chocolates.

I think one of the reasons why marijuana is being legalized in the US at a quickened pace is to decrease the amount trafficked from Mexico.

Am I saying casual drug users are somehow implicated in this? Maybe.

What I am saying is we cannot take street drugs from the larger global context. The money we spend on it may be supporting crime and even terrorist organizations. If you are going to boycott Walmart, GMO foods and blood diamonds, shouldn't you do the same with your weekend supply of recreational drugs?

16 Danger Signs of Relapse

Flickr Commons

This list is from an excellent Facebook post. Even though the list seems it's from AA (Alcoholics Anonymous) for AA members, I think we can all benefit from this list even if we are not struggling with a severe addiction. I feel addicted can also mean we compulsively repeat certain patterns of behavior based on a set of beliefs, which can hold us back from growth.

For those of you who say you are "allergic" to the AA model,  go ahead and read the list and replace AA, sponsor, meetings with family, friend, get together, etc...

Relapse can mean returning to an old behavior which you attempted to change or correct. Or it can mean actual addiction to alcohol and drugs.

Basically, be present and be mindful of what's going on in yourself.

DANGER SIGNS OF RELAPSE

1. Exhaustion — Allowing oneself to become overly tired; usually associated with work addiction as an excuse for not facing personal frustrations.

2. Dishonesty — Begins with pattern of little lies; escalated to self-delusion and making excuses for not doing what's called for.

3. Impatience — I want what I want NOW. Others aren't doing what I think they should or living the way I know is right. Instant gratification is a monster that needs to be tamed.

4. Argumentativeness — No point is too small or insignificant not to be debated to the point of anger and submission.

5. Depression  — All unreasonable, unaccountable despair should be exposed and discussed, not repressed: what is the "exact nature" of those feelings?

6. Frustration  — Controlled anger/resentment when things don't go according to our plans. Lack of acceptance. See #3. Being a baby.

7. Self-pity — Feeling victimized, put-upon, used, unappreciated, disrespected: convinced we are being singled out for bad luck.

8. Cockiness — Got it made. Know all there is to know. Can go anywhere, including frequent visits just to hang-out at bars, boozy parties or an other potentially complicated setting where the addiction monster may get tempted.

9. Complacency - Like #8, no longer sees value of daily program, meetings, contact with other(s) alcoholics, (especially sponsor!), feels healthy, on top of the world, things are going well. Heck may even be cured!

10. Expecting too much of others — Why can't they read my mind? I've changed, what's holding them up? If they just do what I know is best for them? Leads to feeling misunderstood, unappreciated. See #6.

11. Letting up on disciplines — Allowing established habits of recovery - meditations, prayer, spiritual reading, emotional support system or AA contact, daily inventory, meetings or getting together with a pal — to slip out of our routines; allowing recovery to get boring and no longer stimulating for growth. Why bother?!

12. Using mood-altering chemicals — May have a valid medical reason, but misused to help avoid the real problems of impending alcoholic, drug or a behavioral addiction relapse.

13. Wanting too much — Setting unrealistic goals: not providing for short-term successes; placing too much value on material success, not enough on value of spiritual growth.

14. Forgetting gratitude — Because of several listed above, may lose sight of the abundant blessings in our everyday lives: too focused on # 13.

15. "It can't happen to me." — Feeling immune; forgetting what we know about the disease of addiction, including alcoholism and its progressive nature.

16. Omnipotence — A combination of several attitudes listed above; leads to ignoring danger signs, disregarding warnings and advice from fellow members or emotional support network.

Swedish Therapy Cabs: Therapy on the Go

http://www.ngvglobal.com/images/stories/vehicles/Volvo_tri-fuel_Stockholm_Taxi_(2009).jpg

Sweden has the highest number of one-person households in the EU — 47% of Swedish households are comprised of persons living alone. Living alone can increase loneliness and other symptoms of depression especially during long Swedish winters where there is very little daylight.

In an attempt to introduce therapy to riders who may be experiencing depression and/or other issues, Taxi Stockholm, a private taxi service, has hired three therapists to provide counseling in the back seat of its taxis to passengers. The idea is to normalize therapy and even help passenger/client with a pressing issue. No matter how short the ride, bringing therapy to the rider can expose and normalize the idea of therapy so they are more likely to seek it out themselves after they leave the taxi.

What a great idea! I am all for it — especially in large cities where personal connections are difficult to make and maintain and time is short. This could be one very clever idea to destigmatize therapy for the general public.

Watch Now! Russell Brand: From Addiction to Recovery

Russell Brand is one celebrity who is pretty cool. This isn't the first time I've written about him. I can respect him because he uses his fame to bring attention to the problem of addiction and benefits of meditation and yoga.

So I was happy to discover that after Amy Winehouse’s death from alcohol withdrawal, Brand made a short documentary with BBC about addiction and recovery. And The Guardian published a moving eulogy he wrote for her.

Discovering this short doc (about an hour long) several years late does not diminish its significance. Brand discusses with experts about opiate replacement therapy. At times, he can be overbearing and appears fixated on his recovery process. However, Brand’s narcissism is tolerable, because he argues that for addicts like himself it's abstinence or death.

He argues against methadone saying it’s an opiate replacing heroin, which means that the addict is not drug free, and an addict wiI am certain he would criticize Suboxone since it too is a synthetic opiate prescribed to curb cravings and withdrawal symptoms, just like methadone. The difference is that Suboxone is prescribed by a psychiatrist, as opposed to daily pick ups at a methadone clinic, so it no longer carries the stigma of having to drop in every morning at your local MMTP (Methadone Maintenance Treatment Program).

An addict, Brand stresses, must be free of all drugs, although whether he includes psychotropic medications, it’s unclear. Both AA and NA agree with Brand; and they consider prescription medications as drugs. Therefore, an AA member who is prescribed medication, for say depression and anxiety, is not drug free or abstinent. I find problem with this, because so many people struggling with substance abuse suffer from underlying mental illness. 

What are your thoughts?

Newest Eating Disorder: Orthorexia

http://www.choosingraw.com/neda-week-2014-considering-orthorexia/

Do you or do you know someone who adheres to a self-imposed dietary restriction that make going out for a simple meal a major headache? Do they sometimes go to the extreme of not eating because the food doesn't pass the "clean" test? Does a simple trip to the supermarket turn into a time consuming and stressful event during which every label must be carefully studied?

We all know vegetarians, rawfood enthusiasts, glutenphobics, pescartarians, freegans or just picky eaters. When does health consciousness become pathological? When does it become an eating disorder?

Eating disorders is primarily a problem of the West though it might be more accurate to say it's a problem in wealthier countries. In no way do I want to minimize the seriousness of eating disorders, a serious medical and mental health issue. But the fact that one in nine people in the world do not consume enough food to sustain a healthy life makes this disease especially poignant. Having an abundance of choices sometimes can be problematic.

Eating disorders (anorexia nervosa and bulimia) can cause amenorrhea, damage to the teeth, and in extreme cases it can even cause death. 

So what exactly is orthorexia? Ortho (straight, rectangular, upright, as in orthodontics and orthopedics) + orexia (desire, appetite). Anorexia = loss of appetite or lack of desire for food. Orthorexia: rigid appetite.

Orthorexia has not been recognized by the DSM, so it is not an official diagnosis, yet. Professionals in the field define orthorexia pathological desire to eat healthily, so much that it interferes with a "normal" life and jeopardizes physical health.

Experts say orthorexia becomes life-threatening when people's food restrictions make it impossible for them to take in enough calories and nutrients to maintain good health. Bell recently treated a 14-year-old girl who ate only raw fruits and vegetables. She dropped to 80 pounds and had to be hospitalized for an irregular heartbeat.

Orthorexia is one example of a healthy enthusiasm that becomes an addictive behavior creating harm and decreasing one's quality of life.

Economics of Drinking

Pareto Law is a little known principle applicable to multiple disciplines. It is better known as the 80-20 rule: 80% of the effects comes from 20% of causes, or 20% of workers in an organization perform 80% of the work. 

What does this have to do with alcohol consumption? Everything, of course. 20% of Americans consume 80% of alcohol sold in the U.S. 

Check out this graphic.

Shockingly, 10% of Americans (24 million people over the age of 18) drink over 50% of all alcohol consumed in America. That averages out to 10 drinks per day or nearly 74 drinks a week (2 bottles of wine a day, or 18 bottles of wine or three 24-cases of beer per week).

These statistics are from Paying the Tab: The Costs and Benefits of Alcohol Control by Philip Cook, a professor of Public Policy at Duke. And, I have not read the book yet.

Here are some more fascinating bits from the book which used data from a national survey that took place between 2001 and 2005: 

• 30% of Americans don't drink at all. 
• 30% of Americans drink at least one drink a day 
• 20% drink at least two a day. (BTW, low-risk or moderate drinking falls somewhere between the two.) 

And according to the CDC excessive drinking costs us $223.5 billion in 2006, or about $1.90
per drink.

Definitely more to come on this fascinating topic...

All About Alcohol

Contrary to what we are led to believe, alcohol is the worst when it comes to harmful consequences. Globally it kills 2.5 million people and nationally 75,000 people die prematurely because of alcoholism and alcohol-related illnesses. It is the third leading killer globally.

An infographic from the team at Addiction Blog
Alcohol and the modern world (INFOGRAPHIC)

Here are some sobering facts about alcohol you may not have considered:

What is heavy drinking or risky drinking?
For men 14 or more units of alcohol per week.
For women, the number drops to 7.

What is a unit of alcohol?
.6 fluid ounce or 12 grams of pure alcohol, that is a 12 oz. bottle of beer, a shot of booze or a glass of wine (1/5th of a bottle).

Prolonged alcohol abuse or heavy drinking is linked to serious health risks:

• alcoholic cardiomyopathy 
• alcoholic liver disease 
• decrease in bone density 
• decrease in bone mass (leading to osteoporosis) 
• heart arrythmias 
• increased blood pressure 
• increased risk of bone fracture 
• loss of immune response 
• stroke

But, just being drunk can be bad in the short term.

• impaired, drunk or intoxicated driving
• fighting and violence, including domestic violence
• child neglect: 7.5 million children or 1 in 10 children live in homes with alcohol use disorder
• accidents

Lest we forget: alcohol costs money, it has calories, and it speeds up the ageing process.

Russell Brand on Spiritual Practice

I don't know about you but Russell Brand is difficult to ignore. He has certainly made most intimate aspects of his life public: short lived marriage to a pop star; addiction to drugs and alcohol followed by recovery. He has made a name for himself as a passionate advocate of yoga and meditation. I respect him for making statements on subjects that make people and corporations very uncomfortable. But let's not forget he is a comedian and it's their job to make us feel hot under the collar, but he does a particularly great job at it.

I am featuring the short video above, actually a compilation of clips, which showcase his view on spirituality, addiction, culture, etc... And I have to say I like what he says and how he says it. The intensity of the delivery reveals the zeal with which he once consumed alcohol, drugs and sex. It is to our benefit that he has found another outlet to sublimate or redirect his energy. And so is he. In fact, as any addict in recovery will tell you, he probably wouldn't be alive to tell it how it really is.

One more thing, addiction takes time, energy, money and effort. Which begs the question, what are you going to do instead of abusing alcohol and drugs? How are you going to fill the time which was once devoted to getting high and drunk? For many, as is the case for Mr. Brand, a spiritual practice fills that void.

Anxiety in Choosing

Whether you are looking to purchase your first home, choosing an outfit for that first date or job interview, or deciding to marry or move-in together with your boyfriend or girlfriend, making decisions can be a harrowing process.

If the decision involves a lot of money it will raise all sorts of associated worries. Do I have enough money? Will I have to cut back on something else to cover the investment? If something goes wrong what will happen to my future? Will I become homeless or need to work two jobs?

If you need to decide the fate of a romantic relationship, anxieties in the form of ambivalence may rise. You can love and feel affection for someone while secretly harboring concerns about them: Will they become financially and emotionally dependent on me? Will their quirks become full-blown craziness down the road? What sort of parents are they going to become? Will they become their parents?

Ambivalence is the experience of feeling two opposing emotions simultaneously. The ambivalent partner may feel weighed down by guilt and confusion: If I really loved this person I shouldn't be feeling this way... so the thought goes. But is there anything in life that is wholly black and white?

The fact is we are constantly choosing. We make decisions each and every moment. We don't notice because for the most part these decisions are miniscule and inconsequential: a poorly thought-out outfit probably isn't going to affect your future too much. Also, when we make the same decision repeatedly (mindlessly, without thinking) we forget we are choosing.

One aspect of being a mature human being is that inevitably we have to make a big decision that will affect the rest of our lives. The option to not choose is really not an option (remember Bartleby the Scrivener?).  The other option is to live off the grid and live independently, freed from social conventions and modern amenities.

Here is a very good piece of marketing — profound and entertaining at the same time!



More on decisions and decision-making process later.

P.S. I condone moderate drinking, as does Jim Beam and Willem Dafoe, I am sure.

Peaches Update: Death from Heroin OD

This is a follow up post to an earlier post on the tragic death of Peaches Geldof at age 25 with her young child next to her. I had played celebrity death sleuth but was incorrect in my assessment.

Legacy of addiction gets handed down like family estates and jewelry. Her mother overdosed at age 41 with a child at her side, and our Peaches recreates the scene 14 years later, except she was only 25.

Do we all become our parents? I think not.
Are we helpless to go on repeating the past, whether it is an addiction or a pattern of thinking and behaving?

This is why therapy needs to be part of every recovery process. Addiction isn't just the physical and psychological dependence. There exists a core conflict, our defining wound which originates in childhood. The resulting pain, whether psychological or spiritual or both, is what we attempt to dull with our substance(s) of choice.

Through therapy and/or spiritual reflection, we can become more aware, more in tune with our subconscious, so that we are less likely to act out, or behave unconsciously, and repeat what we know or become the parents whom we feel let us down.

http://www.thefix.com/content/peaches-geldof-reportedly-died-heroin-overdose

David Foster Wallace on Meaning of Life or How to Think

Waking up on this beautiful spring morning I wanted to share this with my readers (and my clients). Listen for his emphasis on "the default settings" of the self, which "make us automatically think that we are the center of the world." Becoming aware, or tending to our awareness is the escape key from this default setting. Sounds like mindfulness practice to me.

I also love how he defines true freedom: ". . . attention, and awareness, and discipline and being able truly to care about other people and sacrifice for them over and over, in myriad, heady little unsexy ways. That is real freedom."

This is just one part of the talk, for the other half please follow the link.


Here is a meaty quote to ponder from the commencement speech delivered at Kenyon college in 2005.

"If you worship money and things — if they are where you tap real meaning in life — then you will never have enough. Never feel you have enough. It’s the truth. Worship your own body and beauty and sexual allure and you will always feel ugly, and when time and age start showing, you will die a million deaths before they finally plant you. On one level, we all know this stuff already — it’s been codified as myths, proverbs, clichés, bromides, epigrams, parables: the skeleton of every great story. The trick is keeping the truth up-front in daily consciousness. Worship power — you will feel weak and afraid, and you will need ever more power over others to keep the fear at bay. Worship your intellect, being seen as smart — you will end up feeling stupid, a fraud, always on the verge of being found out. And so on."

I can't close a piece on DFW without mentioning his suicide. I don't have much to say at present other than again raise the connection between creative people and mental illness. BTW, one piece of fact I do know is that he hung himself as he was trying to wean off psychiatric medications he had been taking for many years for depression.

FYI: April Is the Cruelst Month and Child Abuse Prevention Month

I. THE BURIAL OF THE DEAD

APRIL is the cruellest month, breeding
Lilacs out of the dead land, mixing
Memory and desire, stirring
Dull roots with spring rain.

excerpt from T.S. Eliot's The Waste Land

Yes, in case you didn't hear, April is child abuse prevention month. The connection between the poem and government-sponsored, PSA-worthy month which goes unnoticed is beyond tenuous. But child abuse is cruel as it makes lasting negative impact for the rest of that child's life, I make no apologies for quoting T.S. Eliot.

As a social worker I am a mandated reporter, which means by state law I have to report to ACS (Administration for Children's Services) suspected cases of child physical, neglect or sexual abuse. Teachers, doctors, psychologists, nurses, police, EMS are also mandated reporters. I am sure I am forgetting a few professions.

Physical and sexual abuse is easy to define and comprehensible by non-professionals. Neglect, however, is a bit more difficult to define. It can mean abandonment — leaving children under the age of 12 unattended, using drugs around minors (cannabis excluded), not having food in the home, children missing school and providing inadequate medical care. Since I am listing them from memory I am sure it's incomplete. Child neglect/emotional abuse is difficult to assess, but it can damage just as much as other forms of abuse.

Working with children can be one of the most rewarding/heart-breaking experiences. Most children end up in therapy due to "benign neglect; their parents (in my case single mothers) simply lack the energy (depression, poverty) or their attention have been compromised by their own needs (boyfriend, job) to be fully emotionally present with their kids (or to provide good-enough parenting). But children are amazingly resilient, and like the way plants forgotten in the corner become revitalized with regular watering and sunlight, children respond to undivided attention and adult presence.

On a couple of occasions, children who were actively being abused were put under my watch. And making that report was heart wrenching knowing what I know about the overburdened system. It felt like I was handing a child over to a barely functioning bureaucracy with my fingers crossed, hoping their welfare didn't deteriorate.

For a brief overview on the lasting impact of childhood trauma, go here.

NCA PSA 2013 "Stand Up, Step Forward" from Ian Buchanan on Vimeo.

Importance of Sleep

http://www.animal-ethics.org/sentience-section/

Whenever I see a new client, I always review their sleep pattern. Quality and length of sleep is indicative of general mental health. Inability to have a good night's rest indicates anxiety, which tends to be a close companion of depression. Depression can make one sleep too much or too little; and it can make one eat too little or too much. (Here is a very moving talk on depression.)

Below is a small set of questions I ask my clients at the start of therapy and periodically thereafter to monitor their overall mental health.

• Are you able to fall asleep within a reasonable amount of time?
• Are you able sleep through the night or do you wake up in the middle of the night and find yourself unable to fall back to sleep?
• Do you require alcohol or other depressants like marijuana to become "sleepy"?
• Do you wake up early morning but not able fall back asleep right away, only to fall asleep after a period and then wake up later than planned?
• Do disturbing dreams or nightmares regularly wake you up?
• Do you regularly get less than 6 hours of sleep a night?
• Do you "catch up" on the weekends?
• Do you experience sleep apnea?

Most adults require at minimum 6 hours and at optimum 8 hours of sleep a night. Younger adults require more sleep than older people. It's a myth that you can catch up on sleep. What's actually happening is that your body is resting for a longer period than normal, but sleep itself cannot be made up.

Here are some suggestions to help you re-regulate your sleep to a more healthier routine to help you feel recharged.

• Make the room as dark as possible. An eye mask can do the trick, as well as ear plugs.
• A cooler room is better for sleeping. We all know how it's hard it is to sleep in the middle of a heat wave.
• Remove or cover your clock, or smartphone. Being conscious of time can worsen insomnia. Being a clock watcher during the night can increase anxiety. Even a small amount of light from an alarm clock can affect the production of melatonin, an enzyme released by the pineal gland in the brain that regulates your circadian rhythm, or your natural sleep cycle.
• Keep the bedroom for sleeping, or for sex: Don’t work, use your computer or watch TV in bed, at least not right before going to sleep. (Personally, reading in bed during an off day is one of the greatest luxuries.)
• Stay away from all electronic devices before sleep. We all know why. 
• Stick to a routine: Human bodies work better on a schedule, so try and unwind an hour or two before bed and go to sleep at around the same time each night. We get our best sleep between 10 p.m. and 1 a.m., so don’t stay up late.
• Have a spoonful of honey before bedtime. 
• From Tim Ferris: Eat a small snack of celery with almond or peanut butter. He will give you scientific reasons why it works, along with other super high-tech, downright odd hints about getting optimum sleep.
• Take a hot bath or shower. (Tim Ferris suggests a cold bath before bed.) Lavender oil in the water and on your temples will help you relax.
• Journaling before sleep will help you clear your mind and set the agenda for the next day. My suggestions to clients: What 3 things went right today? Or, you can write in a gratitude journal. 
• Make a list for the morning, important things that need your attention right away. If you are anxious about something you have to wake up for, make a check off list and check off everything on that list, so your mind can shut off.

Before reaching for Tylenol PM, or asking your doctor for Ambien or another prescription sleeping pill, try chamomile tea with honey, valerian tea with lots of honey (valerian stinks but is a mild sedative), or melatonin (essential for business travelers). Melatonin is available at drug stores and is a nutritional supplement.

One of the greatest sleep aid is strenuous exercise like running. In addition to promoting good sleep, great skin turns out to be another benefit from running.

Mortality

Whenever I feel indignation, this brings me back to reality.

Hitchens wrote this just days before dying from cancer.

Peaches Geldof: Eating Disorders and Body Dysmorphic Disorder

Peaches Honeyblossom Geldof March 13, 1989-April 7, 2014

Peaches Geldof died the other day. Autopsy results are still pending, but given her family history, many, including myself, are guessing that it's related to drugs and/or eating disorder. She was just 25. Horrifyingly, next to her body was her 11-month old son. When PG's mother died, her half sister, a baby at the time, was also found next to their mother who had overdosed from heroin.

PG had gone off radar, at least for me, for a few years, during which she seemed to have grown up —she had gotten married and became a young mother two young boys. Before this she was primarily known for being an English party girl famous for her druggy antics and her father.

I couldn't help knowing who she was just as I know Paris, Lindsay and Brittney. I've given up being resentful about celebrity culture and accepted that this is the pop culture we deserve; we celebrate the famous for just being famous.

In PG's case she was the daughter of Sir. Geldof. For anyone who came of age in the 80's, his name is difficult not to remember. Her mother, Paula Yates, died from a heroin overdose three years after the "suicide" of Michael Hutchence, the INXS singer, another difficult name to ignore from the same era. And as mentioned earlier, Yates' body was found in bed with her youngest daughter.

I am not interested in focusing on celebrities, but these occasional tragedies provide access points to discuss finer points about the nature of addiction and different forms it can take. Her mother was also diagnosed with an eating disorder (anorexia, bulimia, or dependence on stimulants to lower appetite or misuse of laxatives?), so the issue of "heritability" of addiction can be discussed, not just addiction to alcohol and drugs, but behavioral addictions. And is there a positive correlation between early trauma and addiction later on? (My answer? Duh.) Here is an ominous last interview she gave to The Independent, an English newspaper.

In my work, mostly I deal with addictions to drugs and alcohol. But over the years, I've encountered a few clients with eating disorders and body dysmorphic disorder (BDD). Always, these food-related, self-image centered issues were just one part of a larger cluster of addictive behaviors to drugs, alcohol, sex and self-defeating relationships (both romantic and social), in addition to poor self-esteem and a history of early loss of a parent, divorce, parental neglect, emotional abuse, and sometimes sexual abuse. Working with these clients (I am not an expert in eating disorders, btw) it felt as if one's body was the easiest, most readily controllable target onto which to transfer unprocessed negative feelings and memories, all of which take time and lots difficult work. Rather than looking inward to dig at the source of pain, eating disorders and BDD forces the body, and ultimately the self, to take all the blame.

History of substance addiction in the Geldof clan is well known, and the experience of losing one's mother at a young age to addiction without the privacy that is afforded to ordinary people, would have made any young woman susceptible and fragile to becoming self-conscious.

Ultimately, I feel PG's addiction to drugs and alcohol was replaced with pathological obsession/addiction to her weight and appearance, and partly at fault is the celebrity industrial complex, whatever that is exactly.

My heart goes out to the two young children who've just lost their mother, as well as rest of Peaches' family and friends.

What Not to Say to Someone Who Is Depressed

Depression is the common cold of mental illnesses. Statistics of Americans with diagnosable symptoms of major depression is staggering. Nearly 20% of Americans experience major depression during their lifetime. As someone who have struggled with it myself I know personally how it feels like to live with it.

During our lowest point, our inclination is to reach out to people close to us, to remind ourselves that we are not alone. Sadly, many people, even those who love us who haven't experienced the darkness of depression misunderstand the illness of depression and believe it is a personal choice the depressed person makes.

So here is a helpful guide to what not to say when someone reaches out to you (those of you who haven't experienced the psychic pain of depression). And for those of you who are struggling with depression, I hope that it can help you educate/inform those around you to become more sensitive.

What Not to Say to Someone Who Is Depressed:

1. “Get busy, and distract yourself.”
2. “Do you want to get better?”
3. “Change your attitude.”
4. “Stop focusing on the bad stuff, and just start living.”
5. “You have everything you need to get better.” 
6. “You can snap out of it. Everyone feels this way sometimes.”
7. “Just pray about it.” 
8. “Why can’t you work?”
9. “You have the same illness as my ______.”

These are bullet points from a longer piece by Margarita Tartakovsky, M.S.

Again, I am reposting this illuminating talk by Andrew Solomon on depression. 

When Life Kicks You in the Ass

The Importance of Addiction Counseling in Staying Sober

flickr commons

One of my favorite bloggers writing on the subject of sobriety, the Drunky Drunk Girl, recently posted a piece about why counseling should be part of living sober. She does not downplay the importance of AA and other types of mutual support groups to maintaining sobriety.

But, she says, professionals are needed to help "unravel the core issues" hidden under the addiction.

I've been doing this work for a few years, and I glimpsed some of these core issues. I mean glimpses because even the those in therapy are not completely invested in the process. It could take years of work and courage to digging, and for many this is too daunting.

Whether a client has had the most horrific childhood, suffered abuse and neglect, witnessed addiction and violence, and subjected to immeasurable harms caused by poverty; or the client comes from old money and had access to all the educational and vocational opportunities afforded by money, the underlying issues are very much similar — unresolved, unprocessed emotional pain originating in childhood. It can be parental neglect, enmeshment, a traumatic event, or even a habit (modeling) — if your parents drank fine wines with every meal, it wouldn't seem abnormal that you consume over 5 or 6 drinks during an evening out, which becomes the norm.

My job is to ask question, then listen, ask more questions and listen some more. And what comes to the surface is magical thinking, habitual (mindless) behavior, projection, distorted negative self-image, lack of a support network, anxiety and depression, etc. And they all intersect at one point or another.

It's possible to work through all this. However, you have to be willing to work at it and learn to be okay with the discomfort. There is just no other way.

https://drunkydrunkgirl.wordpress.com/2014/03/30/the-importance-of-professional-counseling/

Nymph()maniac Volume 1: Love Is Lust with Jealousy

I really enjoyed this film and looking forward to volume 2. It’s definitely a film, not a movie. There is depiction of sex (simulated and real) with lots of frontal nudity. Sex doubles were used for penetrative sex, as stated in the end credits, to distinguish it from pornography. I think maybe it's because for many people images of naked bodies engaged in sex, independent of director's intentions, will get aroused. Pornography is intended to arouse, but films are not. But, we all know how men love to "read" Victoria’s Secret catalog.

I am not sure what Volume 2 has in store, but I think Lars Von Trier, who is Danish, is looking at sex from a philosophical point of view, as in what it can represent to different people and its many functions, and how it relates to pleasure and pain.

SPOILER ALERT!

Joe, the nymphomaniac, shares/confesses her sexual history to Seligman, an innocent, asexual (so far), rescuer/listener. His passion is fly-fishing and at first likens her compulsive sexual behavior to fishing: studying the environment, learning the behavior of the fish, baiting, hooking and finally catching the prize.

However, as her exploits become more compulsive, he becomes concerned about her her lack of ethics. Joe either ignores or doesn’t care that her sexual compulsions are hurting others, and she constantly lies. Not surprisingly, Joe’s alienation grows in proportion to the frequency of sexual encounters. Like addicts addicted to drugs and alcohol, Joe engages in addictive behaviors to not feel (to stuff her feelings), but over time she needs more and more to maintain feeling "normal."

Joe's best friend/partner in fishing for sex leaves her after falling in love and tells Joe that the secret ingredient to sex is love. In response, Joe says love is just lust with jealousy. But when she does fall in love and finds that love indeed improves sex, she is horrified to discover that she can’t FEEL anything, including love or sexual pleasure.

An aside which I find really interesting: The word nymphomaniac came about in the 18th century and is specific to women. Its counterpart for men is satyriasis, and both words mean abnormal or deviant craving for sex.

The word nymphomania has two roots. Seligman connected nymphomania to the nymph (immature insect) used in fishing. This meaning originates from Greek mythology — nymph is a beautiful young female wood sprite. But the Latinate nymphae refers to the the inner labia of the vagina, and the definition of mania is obvious. Clearly, Joe sees herself as a nymphomaniac in the Latin sense.

Interestingly, Von Trier alludes to electra complex by portraying the mother as emotionally cold and distant. Her father at death’s throes calls for her mother even though it was Joe who had been at his side. The mother appears only after the death and leaves the corpse of her husband without so much a word to Joe. The conflict is too neat; mothers have been blamed for all kinds of neurosis since the invention of psychology. I think a more realistic or nuanced way to explain development of mental illness (including addiction) is inadequate attachment and lack of love. And it's not necessarily just about the parents, it's about the environment as a whole. But I do agree that it is always about the childhood. 

Celebrity Drug Death Memorial Wall

This feels cheap to me but it is fascinating and hopefully educational.


via DrugAbuse.com

Running as Therapy

One of the first things I explore with my new clients is how they spend their day. The intended goal is to see what sort of structure or routine their days rest on.

Difficult and inevitable life changes (break-ups, unemployment, loss) activate situational or reactive depression or grief. It could be pass as sadness or become a full-on depressive episode. See Andrew Solomon's talk on depression.

For clients struggling with substance abuse instituting a new routine can help manage habitual mindless patterns of behaviors or rituals (after work drinks, weekend brunch drinks) that led to out-of-control use and consequent abuse and dependence.

I stress the importance of structure to one's day, and I stress exercise, journaling, and some sort of a mindfulness practice (yoga included).

Regular physical exercise should be a part of every one's life. Physical exercise a win/win proposition, just as smoking is a lose/lose.



https://www.flickr.com/photos/sinkat0864/

This post is about running, and it is my primary form of exercise. Like so many things in life, it has its own set of challenges and pleasures: It's time consuming and commitment; you sweat more and that means breakouts; it hurts; it's hard to run when it's cold, windy, hot, rainy, or when you don't feel like it; and laundry that require immediate attention.

However, after a few miles when you get your bearings (doesn't happen all the time), your breathing and legs sync up, and you realize you are mere physical matter cutting through space. You get in that headspace one strives for in meditation. Your thoughts recede behind a veil that alternate between euphoria and pain. You are just your body. For this reason, running is referred as meditation in motion.

After running a substantial distance, after the chocolate milk and mandatory stretching and shower, you feel clear headed, calm, energized. Your sleep improves, you easily fall into a deep, satisfying sleep. In addition, as your body grows stronger, leaner and gains stamina, so does your sense of confidence in knowing that you can endure temporary pain and meet goals which at one point in time unimaginable.

Just don't take my word for it. The Times runs many pieces on benefits of running (and many tedious pieces about it too). And there was this: a personal essay on long distance running and how it helped the writer deal with life's harshest emotional challenges. 

And she mentions Haruki Murakami's book What I Talk About When I Talk About Running, which helped me transition from a fitness runner to a more "serious" runner.

I will end this rather long-winded blog with my favorite quote from the book (as does the author of the Times piece):

“Pain is inevitable. Suffering is optional.” ― Haruki Murakami, What I Talk About When I Talk About Running

Visualizing Success

John Wooden was a basketball coach at UCLA and other teams. He is famous for this equation for success which he used with his players, among them Kareeem Abudul Jabbar, a professional athlete I actually respect.

I think this has excellent applications for the rest of us non-athletes. 

Russell Brand on the Seduction of Addiction

Russell Brand speaks with Oprah about why HE CAN'T EVER DRINK OR USE DRUGS AGAIN.

Coming Out from the Closet of Anonymity: New Recovery Advocacy Movement

I have written before about many of my clients' disfavor towards AA/NA approach to recovery. Complaints range from discomfort about its "religious" or "spiritual" take, emphasis on handing your life to "higher power": the necessity of admitting of "powerlessness": the depressive atmosphere of the meetings "AA/NA meetings are for older addicts who've run out of options.

I have addressed some of these criticisms and offered alternative communities where people can come together to provide mutual support and commiserate about their personal daily struggles.

New Recovery Advocacy Movement is gaining momentum by challenging the anonymity of recovery and declaring that it contributes to stigmatization of addiction and recovery. I very much agree about the problem of stigmatization (societal/personal). If the addict is alone with it it only contributes to the cycle of shame, guilt and isolation.

People behind movement have produced a documentary "Anonymous People."

This is the trailer, to view the full documentary you need to purchase it on Vimeo on Demand.
And here is the link to the longer piece from the Fix.

Passion vs. addiction

“Passion creates; addiction consumes—first the self and then the others within its orbit.”

“Any passion can become an addiction; but then how to distinguish between the two? The central question is: who’s in charge, the individual or their behaviour? It’s possible to rule a passion, but an obsessive passion that a person is unable to rule is an addiction. And the addiction is the repeated behaviour that a person keeps engaging in, even though he knows it harms himself or others. How it looks externally is irrelevant. The key issue is a person’s internal relationship to the passion and its related behaviours”

Excerpt From: Gabor Maté, M.D. “In the Realm of Hungry Ghosts.” 

What are your passions? 

Self portrait by Vivian Maier, a photographer whose passion for her art verged on addiction. But then again she suffered numerous emotional traumas which made her vulnerable to mental illness - hence obsession/addiction to her art. Fascinating woman and fantastic work: http://en.wikipedia.org/wiki/Vivian_Maier

An Affair

An Affair is a piece of video work I found online, and I felt it deserved to be viewed by my readers. To me it's a poem set to moving images. Whatever it is called, I happened to really like it.

Here is a still:

It is artful, cool and fashion-y, but it also distills the pain, hopelessness and the ambivalence of someone trapped by their alcohol abuse.

For professionals working in fashion, arts, and even advertising, how do you balance the romanticism of urbanity, nightlife, alcohol, creativity and fashion with the sometimes brutal and painful reality of alcohol abuse?

I think that the creator of An Affair knows she has an issue with alcohol. She uses images and video segments from alcohol ads designed to make it glamourous. But... reality is far from it.

Enjoy this very personal work.

For some reason I can't directly link it on the page.

Soon, my site will be relocating to a more sophisticated platform...

Sound Advice

Normally I don't do this but I think this is worth sharing.
I know I could benefit from this advice. It's easy to get swayed by strong emotions, good and bad.

from Brilliant Quotes

Does Cannabis Harm?

This morning like any other day began with NPR and a strong cup of coffee. I knew I had to share the piece on marijuana they aired earlier. 

Since Washington state this summer is to become the second state to legalize recreational use, (Colorado was the first, in case you haven't heard), we need to look at it more closely.

Wikimedia Commons

These are some of the interesting facts I gathered. I am sharing them here because it is something many of my clients struggle with. And it pertains not just to cannabis but to drugs and alcohol in general.

• A typical pot smoker uses it moderately: 16 million Americans smoke a joint once a week.
  
• The risk of pot smoking, according to researchers, is "getting hooked," or become dependent on it. The risk you take by smoking pot is that you might learn that you want to smoke it every day.

• One in 9 is a habitual (daily) user of cannabis (2 million Americans):

"About 11 percent of marijuana users fits the definition of dependence – that is, their habit interferes with their life and they've been unable to cut back. That's lower than dependence number for heroin and other opioids (23 percent), cocaine (17 percent), cigarettes or alcohol (15 percent) or nicotine (32 percent)."

More research needs to be done to answer the following questions:

Once you get hooked, how do you get off it? How do we help the dependent user free themselves from the habit?

What are the long term effects on the lungs? Tobacco and cannabis share some of the toxic properties. Is pot hazardous as tobacco to pulmonary health?

What is the link between cannabis and schizophrenia? Those who have had a schizophrenic episode or come from a family with a history of schizophrenia are cautioned from use. Use alone is not going to cause schizophrenia, but it can be a trigger for people with genetic vulnerability. 

BTW, I have worked with cases in which just a single use of marijuana brought on a frightening and mysterious psychotic episode. In one particular case, thereafter, the user was afflicted with debilitating anxiety which seemed to have come from nowhere. 

*****

I want to part with these ideas:

• Substance use alone isn't the problem. 

• The issue is that we have no way of knowing how it's going to affect us. 

• If you choose to use, become an educated user.

• Know the risks. 

• Develop self-awareness to recognize when it becomes a problem.

Enter Zohyrdo

Just heard on the radio this morning that in a few weeks a new painkiller called Zohydro is about to hit the market. A single 50 mg capsule contains 10 times the hydrocodone than a regular Vicodin. An adult with no tolerance could potentially overdose on two capsules and a child on a single capsule. And the capsules are easily crushable.

Zohydro "was first developed in 2002 by Elan, which merged with Alkermes, and Zogenix acquired the U.S. rights in November 2007."* Elan's parent company Perrigo is based out of Dublin. 

Given the recent surge in painkiller-related overdose deaths and increase in heroin abuse and overdose deaths — experts in the field, even doctors specializing in pain management are puzzled if not extremely concerned. I am quoting from Huffingtonpost below (see the link below):

"Concerned about FDA approval of Zohydro? You are in good company. This morning a letter signed by more than 40 organizations was sent to FDA Commissioner Hamburg, urging her to keep Zohydro off the market. The organizations include some of the most prominent addiction-treatment agencies in the country, including Hazelden, Caron, and Phoenix House. Other co-signers include CASA Columbia, the American Society of Addiction Medicine, Blue Cross Blue Shield, the consumer advocacy group Public Citizen, and dozens of community-based addiction-prevention organizations."

http://www.huffingtonpost.com/andrew-kolodny-md/zohydro-the-fdaapproved-p_b_4855964.html

BTW, Elan plans to introduce a non-crushable form in three years, which I believe has something to do with limiting generic versions being produced by other manufacturers.

Here is another block quote from Huffingtonpost:

"Second, please make your way to Washington, D.C., for the FED UP! rally on Sept. 28, 2014, where you will be joined by thousands of people who are equally fed up by the FDA's long track record of putting opioid manufacturers' interests ahead of public health."

*Read more from Journal Sentinel: http://www.jsonline.com/watchdog/watchdogreports/zohydros-maker-not-required-by-fda-to-take-abuse-deterrent-steps-b99129543z1-229528381.html#ixzz2uR0NfR1S 

What Kind of Love Do You Desire?

Love is our true destiny. We do not find the meaning of life by ourselves alone - we find it with another.  –Thomas Merton

Today being Valentine's Day I thought to write about love.
Oh, how very original.

John Lee, a Canadian psychologist who wrote The Six Colours of Love (it's out of print). It's somewhat like Erich Fromm's The Art of Loving, a book which I read. Fromm's book is a classic, but for cynical New Yorkers it's a bit out there. It's aspirational at best. We all want to cultivate a loving, supportive, mutually dependent relationship. Something would be wrong if we didn't want this.

There is no single ideal way of loving another. At some point we have to decide whether we can be okay with what we don't get from a relationship. We have to deal with the ambivalence — what it is that frustrates us. More on that another time.

In the meantime, here are the six types of LUV.

• Eros: a passionate physical and emotional love based on aesthetic enjoyment; stereotype of romantic love. What is aesthetic enjoyment? Aesthetics is the philosophic study of beauty. You love each other so much you can just enjoy how good looking you are together. This type of love is the mainstay of "date movies," and selling point of everything from cars to perfume.
• Ludus: love as a numbers game, a game of winning hearts. The aim of this sport or past-time is the conquest and so more the merrier. This type of lover is able to love multiple lovers at one time. Perhaps an indication of a narcissistic person trying to fill a big old hole in the heart, or a spiritual void, or sex addiction?
• Storge: an affectionate love based on mutual commitment, which slowly develops from friendship, based on similarity. What an unromantic sounding word. It's Greek and means natural affection, like the affection of a parent toward their child. Probably the type of love that will endure and the basis for our notion of "marriage." Passion becomes familiarity and bears true friendship. Probably what keeps couples together for 50 years plus.
• Pragma: Head over heart. Love that is akin to a coalition or corporation. You agree on your core values and assign duties and responsibilities and march towards the end. And, the end justifies the means. The end is beneficial to both partners, whether it is mutual gain of power and prestige or 2.5 children, new Lexus every year and a summer home in the Hamptons. The Clintons, and Anthony Weiner and Huma Abedin come to mind.
• Mania: The stuff of novels, poetry and opera from a few centuries ago. It was common lovers out of jealous passion committed suicide and even killed their rivals (it still happens.) Men would have duels with firearms or blades. Now, it's considered more of a female problem and deemed unhealthy and pathological. Even at the height of Romanticism passion slid into the darker ideé fixe.  What we term codependency is at the lighter end of manic love. Jealousy and possessiveness are its markers. To paraphrase Andrew Solomon, a little mental illness can be a good thing. A bit of jealousy and possessiveness is okay, as long as it doesn't become violent and stalky.
• Agape: I think this is the most idealistic form of love. It's all about being selfless, sacrificing, accepting, giving without expectations. It's unconditional love. It sounds unrealistic and dated. In fact, it is very dated. It is the basic principle of Christian love, embodied in the historical/mythical figure of Jesus. And he was martyr numero uno. 

French Youth Turn to Smoking Hydrangea Flowers for a High

http://www.albion-prints.com/

Hydrangeas, perennial flowering shrub found in many private and public gardens, are being stolen by recreational drug users in France. Personally they don't hold much appeal for me horticulturally; I find them old fashioned and uninteresting. But little did I know about their hallucinogenic properties. 

It's been reported that gangs of kids are indiscriminately lobbing off flowers from gardens private and public with the intention of drying the petals which then are mixed with tobacco for a flowery blunt. 

Botanists and pharmacists confirm that the smoking the flowers induce a similar high from that of THC, but (this is a big BUT) the resulting smoke also contains hydrogen cyanide. 

I am quoting the Guardian here:

"'The secondary effects of it are very bad for the health,' Hostettmann told Le Matin newspaper last year. He said the flowers could provoke stomach and respiratory problems, speed up the heart, cause dizzy spells and, if consumed in large quantities, produce hydrogen cyanide (also known as prussic acid), the base of Zyklon B, the poison gas used in the Nazi death chambers, causing a slow and painful death."

Yikes! 

Economic troubles are forcing people to turn to cheaper alternatives for intoxication. And my position is that the desire for intoxicants or mind-altering experiences is human, it has been and it always will be"; it is neither criminal (although stealing is) or pathological. 

Here is the link again:

http://www.theguardian.com/world/2014/feb/06/high-danger-hydrangea-french-police-hunt-gang

What If Money Were No Object? Asks Alan Watts

"Better to have a short life that is full of doing what you like doing than have a long life spent in a miserable way."

Alan Watts