By Cheryl Steinberg
I admit it. I’m guilty of spreading the idea that mental illnesses are a result of a “chemical imbalance” in the brain. As a person with chronic depression, I had been given this very explanation for my depression by more than one mental health professional. And I swallowed it: hook, line, and sinker. After all, it seemed to make sense and, if I’m going to be honest, it was comforting to have some kind of explanation for why I feel the way that I feel and have felt for most of my life.
But, it turns out, that this kind of theory is outdated and basically incorrect. But why is it that we (read: the mental health industry) still bandy about this explanation of brain chemicals and their insufficient levels? Well, that’s a whole other can of worms.
The mental illness story in the United States is one of how pharmaceutical companies and psychiatrists led the public to believe that depression was the result of a simple chemical imbalance.
As cynical as that may sound, the upside is that this is also a story about how scientists, patients, and psychiatrists are working to better understand the more complicated truth to mental illnesses, such as depression.
“Chemical imbalance is sort of last-century thinking. It’s much more complicated than that,” Dr. Joseph Coyle, a professor of neuroscience at Harvard Medical School, told NPR in 2012. “It’s really an outmoded way of thinking.”
One in ten Americans takes an antidepressant like Zoloft or Prozac. Although these drugs have been shown to help some patients, the drugs were designed based on the so-called “chemical imbalance” theory of depression. A theory that is incomplete, at best, and just plain wrong, at worst.
Is the Chemical Imbalance Theory of Mental Illness Outdated?
It’s clear that the chemical imbalance theory is behind chemists’ inventions of new-and-improved antidepressants. Working on a theory that says depression is a direct result of irregular levels of the brain chemicals dopamine and serotonin has left scientists and researches blind to other possibilities. And, in fact, finding proof that low serotonin is to blame for depression – and that subsequently raising serotonin levels is the key to treating it – has eluded researchers.
First of all, it’s impossible to directly measure the brain’s serotonin levels in humans. That’s because human brain tissue cannot be sampled without also destroying it.
Furthermore, the chemical imbalance theory that says raising brain serotonin levels will alleviate depression, has also been hard to prove. Drugs that actually had the effect of lowering serotonin levels seemed to help some depression patients, while at the same time causing it in others.
McMaster University psychologist Paul Andrews led a group of researchers in a recent meta-analysis investigating the role of serotonin in depression. What they found was, in rodents, depression was actually more closely associated with elevated serotonin levels. Andrews argues that depression is therefore a disorder of too much serotonin, but the ambiguous truth is that different experiments have shown “activation or blockage of certain serotonin receptors [to improve] or worsen depression symptoms in an unpredictable manner.”
While not everyone with depression benefits from antidepressants, many do and it’s a trial-and-error process to find what works best. Often times, people with depression or another mood disorder or other type of psychological disorder turn to alcohol and other drugs as a way to self-medicate. Ironically, this only “works” temporarily and then only serves to make their condition and symptoms worse. If you’re looking for help for your depression and substance abuse, Palm Partners offers dual diagnosis treatment. Please call toll-free 1-800-951-6135 to speak with an Addiction Specialist today.
Cognitive behavioral therapy in drug treatment is the most common type of therapy in drug rehab; it can be used in group therapy and individual therapy.Cognitive behavioral therapy (CBT), when used in drug treatment, is based on the idea that feelings and behaviors are caused by a person’s thoughts, not on outside circumstances and events.
People are not always able to change their circumstances but, CBT says, they can change their thoughts thus changing how they feel and behave. As for drug addicts, this therapeutic approach brings awareness the way they behaved and felt when using drugs and alcohol. With cognitive behavioral therapy in drug treatment, they can change these destructive behaviors and develop new, healthy ones.
Cognitive Behavioral Therapy in Drug Treatment: What is CBT?
Cognitive behavioral therapy (CBT) refers to behavior therapy, cognitive therapy, and therapy based upon a combination of basic behavioral and cognitive principles. It is a “structured, short-term, present-oriented psychotherapy for depression, directed toward solving current problems and modifying dysfunctional (inaccurate and/or unhelpful) thinking and behavior.”
CBT has been shown to be effective in treating a variety of conditions, including mood, personality, eating, substance abuse, and psychotic disorders. Evidence-based treatment, where specific treatments for symptom-based diagnoses are recommended, has favored CBT over other approaches such as psychodynamic treatments.
Cognitive Behavioral Therapy in Drug Treatment: Mood Disorders
It’s quite common for people who struggle with substance use disorders, such as addiction, to also be suffering with mental illness, such as a mood disorder (i.e. depression, anxiety). Therefore, the most successful programs offer dual diagnosis treatment. Dual diagnosis treatment approaches treating the client for both of their conditions simultaneously for the best treatment outcomes.
Because CBT is useful in treating clients when it comes to addiction as well as those with mood disorder, cognitive behavioral therapy in drug treatment for those with a dual diagnosis is a valid, beneficial and therefore often-used approach.
Most therapists working with patients dealing with anxiety and depression use a blend of cognitive and behavioral therapy. This technique acknowledges that there may be behaviors that cannot be controlled through rational thought, but rather emerge based on prior conditioning from the environment and other external and/or internal stimuli.
Mainstream cognitive behavioral therapy assumes that changing maladaptive thinking leads to change in affect and behavior as well as emphasizes changes in the client’s relationship to maladaptive thinking rather than changes in thinking itself. Therapists use CBT techniques to help clients challenge their patterns and beliefs and replace what they call “errors in thinking such as overgeneralizing, magnifying negatives, minimizing positives and catastrophizing” with “more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behavior.”
Modern Cognitive Behavioral Therapy in Drug Treatment
Modern forms of CBT include a number of diverse but related techniques such as exposure therapy, stress inoculation training, cognitive processing therapy, cognitive therapy, relaxation training, dialectical behavior therapy, and acceptance and commitment therapy. Some practitioners promote a form of mindful cognitive therapy which includes a greater emphasis on self-awareness as part of the therapeutic process.
Cognitive behavioral therapy in drug treatment has six phases:
- Assessment or psychological assessment;
- Skills acquisition;
- Skills consolidation and application training;
- Generalization and maintenance;
- Post-treatment assessment follow-up.
CBT is “problem focused,” meaning that it is used to address specific problems as well as “action oriented” – the CBT therapist assists the client in creating specific strategies in order to address the identified problems.
If you are struggling with a psychological disorder and/or substance use disorder, CBT and dual diagnosis treatment can get you on the path to health and recovery. At Palm Partners, we employ CBT methods as well as several other approaches to treatment, including holistic methods, in order to help our clients reach successful outcomes of their cognitive behavioral therapy in drug treatment program. Please call toll-free 1-800-951-6135 to speak with one of our knowledgeable and compassionate Addiction Specialists; we are available 24/7.
Author: Justin Mckibben
For anyone who has experienced depression, there is a noticeable difference between that deep and sometimes manic emotion and a rational sadness. Depression is a mood disorder that most people know to be characterized by extreme fits of melancholy, grief or despair. Depression can range from moderate to severe, and can make a definite impact on the way a person thinks, feels and behaves. Typically people with severe depression find it almost impossible to go about their day to day activities, or to find any measure of joy. Many times people with depression will feel like life is not worth living, and thoughts of suicide may persist as well.
Recently studies have suggested there are new ways that depression can be indicated in a person’s blood. However these studies have yet to be completely proven. Today many people will go on living with depression without ever knowing they have it. Although I am no doctor and therefor have no authority or expertise, many people get it wrong and there are several types of depression with different details to them, here are at least 11 signs of depression that are commonly used to narrow it down today.
#1. Helplessness and Hopelessness
Having a more negative or miserable outlook is one common indicator of some kind of depression. The mind-state that nothing will ever get better and there is now way of improving your life or your situation is a familiar feeling for those experiencing depression.
#2. Loss of Interest
Taking no kind of interest things on a daily basis that you usually would can be a sign of depression. Someone who takes no pleasure in former hobbies, pastimes, social activities, or even sex can be showing signs of depression that are suppressing.
#3. Weight and Appetite
Someone’s eating habits and weight shifting drastically is another sign of depression, Significant weight loss or weight gain, specifically a change of more than 5% of body weight in a month, is a serious change that should be noted.
#4. Sleeping Habits
The nature of an individual’s sleeping habits is a sign of depression as well. Insomnia, especially waking in the early hours of the morning can be one indicator, the other being hypersomnia, which is basically oversleeping.
#5. Anger or Irritability
When a person is constantly feeling agitated, restless, or even violent and expressing that regularly to those around them, they may have some level of depression whether they are able to identify the emotion or not. When the tolerance level is low, or the temper short, and everything and everyone gets on your nerves, you may be in a state of depression you are not yet too familiar with or you find it harder to identify with your depression.
#6. Lack of Energy
This kind of goes along with the sleeping habits, and/or the loss of interest. But you may still have interests and may sleep just fine, but you still feel fatigued, sluggish, and physically drained sometimes. Your whole body may even feel heavy, and small tasks are exhausting or take longer to complete. The utter lacking of energy is a common symptom of depression.
People who are severely depressed can sometimes make a habit of beating themselves up about everything. Experiencing strong feelings of worthlessness or guilt, depression can make a person turn against themselves much more than the outside world. When someone harshly criticizes themselves for perceived faults and mistakes, a self-loathing attitude often leads to depression.
#8. Reckless behavior
So people with depression commonly resort to substance abuse and end up with some sort of addiction. This escapist behavior can also include compulsive gambling, reckless driving, or dangerous sports. Maybe they simply crave the adrenaline and stimulation to feel better, but either way obsessing over dangerous behavior can be a sign of depression.
#9. Trouble Concentrating
Depressed people quite often have some trouble focusing, making decisions, or remembering things. It can be that someone who is depressed finds it hard to listen and retain information in class, or they could find it too troubling to focus and decipher information to where they can make better choices.
#10. Unexplained aches and pains
An individual who is suffering from depression will probably experience a real increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain. Some forms of depression are accompanied and exaggerated by migraines.
#11. Thoughts of Suicide
Now not everyone who experiences depression may feel conflicted with thoughts of suicide. Many people who suffer from depression do however, and in many cases individuals with depression will make attempts to take their own lives. This is often a result of the hopelessness and despair they feel.
Hope for the Hopeless
Luckily the symptoms of depression are very treatable even in the most severe cases. The sooner a person can be treated for their depression the better off they will be. Studies show that the sooner treatment for depression is sought the less likely depression is to occur. Depression can be treated with a number of different therapies including medications and psychotherapy. Psychotherapy is also known as talk therapy, and is meant to increase the person’s sense of well-being and to reduce their discomfort. Depression does not have to control or ruin a person’s life.
These signs of depression again are not a completed diagnosis because this mood disorder is very difficult to reduce to a simple synopsis, especially considering the different kinds of depression. Although depression can feel overwhelming and relentless, there is always a solution to be found and the sooner treatment for depression is sought, the sooner further risks like risks of suicide can be avoided. If your loved one is struggling with depression and substance abuse or drug addiction please call toll-free 1- 800-951-6135. We want to help. You are not alone!
By Cheryl Steinberg
In light of the untimely, tragic death of comedian and actor Robin Williams, we thought it would be interesting to start a discussion about the 12 Steps and whether they can help or harm someone who struggles not only with addiction but depression or another mood disorder. And we thought it would be interesting to get some insight from people outside the rooms; that might lend some unbiased insight into 12 step fellowships.
So, here it is. Normies Weigh In: Are the 12 Steps Harmful for Some?
#1. Perpetuating Negative Stigma
Non-alcoholics who are aware of some of the vernacular common to us ‘in the program’ feel that, by calling others “normies” and “Earth People,” we are reinforcing the idea that we are somehow different – but not just different – abnormal. Because when we call others ‘normies’ – the abbreviation for “normal” we are by default saying that we are not normal. Also, by calling others “Earth people,” we are saying that we are somehow aliens on this planet. Now, in my personal experience, when I was in my active addiction, I wholeheartedly believed that I was an alien from another planet. But, now in recovery, it begs the question: Is using language that implies negative connotations only perpetuating the negative stigma that’s attached to addiction?
#2. Admitting Powerlessness
I wonder, is admitting that you’re powerless is always helpful, especially for those with depression? One normie said, “I think admitting to having a problem in general is the right first step, but to admit powerlessness is unhealthy… I think admitting powerlessness is more harmful because it doesn’t help. Admitting that you want and need help is more useful after admittance.” I think that this is such a powerful quote.
Some who have never read the 12 steps disagree that listing defects and shortcomings can motivate a person with depression. One non-alcoholic said, “I think listing positive qualities is better.” She also mentioned that some of her family members benefited from AA, and added that her belief was that, if you care for and love others, it is only natural to support their decisions to quit drinking. Regardless of whether they’re in AA or not.
#4. Prayer as a Solution to Mental Illness
Upon reading the 12 steps for the first time and then asked if she thought they could help someone with depression, one woman admitted, “I have never seen the steps [written] out before. Is it church? I do not think all [the] steps would help a depressed person. Seven to ten might be helpful to some people dealing with mental illness. Eight to ten would help the people around the mentally ill person and thus may bring closure and more support. But the rest I would personally find unnecessary, maybe even harmful for a person that is dealing with mental illness. Just believing in a higher power can’t always fix things. Meds can be needed. And therapy to help get to the root of the problem.”
In a past life, I worked as a social worker for a non-profit that served the homeless and low-income people of my city. I saw a lot of untreated substance abuse and mental illness on a daily basis. One of the other organizations in the town was a religious-based one that preached prayer as an answer to homelessness and mental illness. As someone who is dedicated to working for social change and a self-proclaimed realist, I don’t see prayer and meditation as the solution to these issues. And as someone with both depression and a history of addiction, I supplement my recovery program with outside help: talk therapy and medication. I believe that these issues need major interventions, on a community- and even federal-level.
#5. AA is the Only Way
Another woman, a non-alcoholic, who wasn’t particularly pro- or anti-AA said that, if AA didn’t help, it “would be pretty depressing to go get help and it not work. I think people should research and be able to decide what they think is best. What works for some does not necessarily work for others. And then there’s the whole religion aspect of it.” Perhaps this is the sort of thing that leads people who are considered to be dual diagnosis to feel like the program just isn’t working.
Mara Wilson, the child actress who worked alongside the late Robin Williams in Mrs. Doubtfire wrote: “To focus on someone’s pain instead of their accomplishments is an insult to them.” I think this is such a profound statement.
There are many different ways to recover from alcoholism and addiction. It’s important to find what way or ways fit you best on your journey of healing and recovery. Palm Partners Recovery Center is a holistic treatment approach that incorporates several different modalities of therapy and introduces clients to the many different avenues to recovery, including but not limited to 12 Step philosophy. If you or someone you know is struggling with substance abuse or addiction, please call an Addiction Specialist today at 1-800-951-6135.
By Cheryl Steinberg
I am a person in long term recovery from drug addiction. And I experience depression. It didn’t go away when I got clean. It got better but, it’s still there. For some of us, that’s the reality of our situation; we have a long-term mood disorder. In my case, my depression set in long before I ever picked up alcohol and drugs. When I finally did start using, substances were the perfect solution to my need to self-medicate.
Today, I see a therapist and take my prescribed antidepressant medications. These things support me in my recovery from both addiction and depression. The thing is, just as there are a lot of people out there who still don’t understand addiction, there are people who really just don’t get it when it comes to depression. And it can be really annoying. Here are 11 things everyone gets wrong about depression.
#1. You can just snap out of it
Having depression is not a choice. It is a chronic medical condition that results from genetic and environmental factors. People don’t decide one day to be depressed. People do choose, however, to cope and live with their depression.
#2. There’s a reason or circumstance for it
First of all, there are two kinds of depression, situational and chronic (dysthymia). Situational is short term and – yes – tends to be brought on by circumstance such as loss of a loved one or job.
With chronic depression, which is long term, there is no reason, other than an actual physiological chemical imbalance in the brain that is probably due to genetics. Someone with depression experiences peaks and valleys with their moods, which can happen for no external reason at all.
#3. Pointing out that others have it worse will help us cheer up
Don’t. Just don’t. Ever. Do. This. Don’t you think that we already feel guilty for being depressed when others have it so much worse than we do? Again, depression isn’t a choice. I don’t know how much more I can emphasize that. Therefore, trying to give us logical reasons to not be depressed not only is futile, it’s hurtful.
#4. People with depression “look” depressed all the time
What do you expect? That we walk around looking like Eeyore from Winnie the Pooh all the time? Just because we have depression doesn’t mean we don’t experience a full range of emotions. It’s just that our “default” is ‘depressed.’ Also, probably because we’ve been told for the better part of our lives to put on a happy face, make sure to hide how we’re truly feeling so as not to bring down the crowd or get unwanted pity-attention.
#5. We have phantom physical pain, that is, we’re hypochondriacs
Physical symptoms are common in depression, and, in fact, vague aches and pain are often the presenting symptoms of depression. These symptoms include chronic joint pain, limb pain, back pain, gastrointestinal problems, tiredness, sleep disturbances, and appetite changes.
But it’s not merely psychosomatic. Physical pain and depression have a deeper biological connection. The neurotransmitters that influence both pain and mood – serotonin and norepinephrine – are out of whack, we see both depression and pain. Many physicians consider patients to be in remission from their depression when their mood improves, but when the physical symptoms, such as pain, are still present, there is an increased likelihood for relapse of the mood disorder.
#6. You know how it feels ‘cause you’ve had a ‘bad day’ before
Empathizing is one thing but, remember, depression is much more than having a bad day or being in a bad mood. It is a pervasive mood disorder that underlies daily life for the person who suffers with depression.
#7. We’re just selfish people
Actually, people with depression are probably of the most thoughtful people around, to a fault. We often are preoccupied with others’ feelings because, as people with depression, we tend to be hypersensitive to the energy that others put off. And, on top of that, we are aware that our depression can affect those around us and thus we worry about bringing them down.
All of that combined with just how tough we are on ourselves, in general, and about having depression, specifically, really don’t make the case for selfishness. Plus, remember that depression isn’t a choice.
#8. People with depression are just weak
Having depression is like walking around with a lead suit on – at all times. It means pushing through the low energy, physical pain, mental anguish, and the constant inner voice telling us, “You can’t.” So, I’m pretty sure people with depression are actually pretty tough people. Also, again, I’d like to point out that depression isn’t a choice and, like addiction, it is a non-discriminating disease. Therefore, it doesn’t only target one type of person.
#9. People with depression are seriously pessimistic
On the contrary, studies show that depressed people have an unusually realistic worldview. This can be a real mind f*ck for us because our capacity for logic allows us to more easily rationalize our depressive thinking, such as “I’m a bad person,” as an indisputable fact.
#10. We can ‘fake it till we make it’
Although there is some science behind this – where you can turn around having a bad day by changing your mindset, again it’s important to remember that depression is a totally different beast when it comes to ‘bad days.’
#11. Depression causes mental fog
According to Buddhist thought, depression is actually an “extraordinarily interesting and a highly intelligent state of being.”
“Depression is an unsatisfied state of mind in which you feel that you have no outlet…Whatever is in it is extraordinarily powerful. It has all kinds of answers in it, but the answers are hidden. So, in fact…depression is one of the most powerful of all energies. It is extraordinarily awake energy, although you might feel sleepy.”
Another way to look at depression, especially from a spiritual standpoint is that it is a state of emptiness, a sort of doorway, to meditation. With depression there is the feeling that nothing is happening at all. And that can be most conducive to meditation, in which one sits in quiet, inner awareness.
Both depression and addiction are serious medical conditions that require medical interventions and treatment. Many people struggle with both. The good news is that you’re not alone and that help is available. Call us toll-free at 1-800-951-6135 to speak directly with an Addiction Specialist before it’s too late. We are here 24/7.