Category: Mental Health

Mental Health Mondays: A different kind of recovery

(c) NPGCsoho/Wikimedia Commons/CC-BY-SA-3.0/GFDL

(c) NPGCsoho/Wikimedia Commons/CC-BY-SA-3.0/GFDL

In these last few days of September, which is National Recovery Month, learn about a recovery program you may not have heard of—SMART Recovery.

SMART stands for Self Management And Recovery Training. It’s been around since1994. It has a “4-Point Program,” not Twelve Steps. It’s based in part on the principles of cognitive behavioral therapy. And you don’t start the program by admitting powerlessness.

“That’s been a resonating point for a lot of people,” said Ted C., who attends both SMART Recovery and AA meetings to maintain his long-term sobriety. “People who have tried the Twelve Steps and said, ‘You know, I just can’t handle that telling me I’m powerless.’”

Mark T., who facilitates the SMART Recovery meeting in Chapel Hill, said that was one of the things that struck him about his first SMART Recovery meeting, facilitated by John B., an area psychologist who doesn’t have addictive issues but who does think SMART Recovery makes sense.

“I still remember the first thing [John] said was, ‘You are not powerless,’” Mark T. recalled.  “Which I’ve always felt I could do whatever I decided to do, so it resonated with me. So I kept coming back, and it worked.”

“The principles of SMART Recovery are in keeping with my understanding of what helps people,” said John, who still comes to the Chapel Hill meeting in a supportive role. “They’ve been found to be useful in empirical studies.”

SMART Recovery’s 4 points are:

1 – Building and Maintaining Motivation

2 – Coping with Urges

3 – Managing Thoughts, Feelings, and Behaviors

4 – Living a Balanced Life

Faith is not a requirement for SMART Recovery.

“A lot of people believe, and a lot of people don’t,” Mark T. said.

SMART “is for anyone who has behavior they want to change, basically,” Mark T. said.  “Everyone exhibits addictive traits. It’s just when it crosses the line and starts interfering with your life, you at least need to think about making changes.”

In addition to alcohol addiction, the Chapel Hill SMART Recovery meeting has hosted people with gambling, sex and computer gaming addictions, as well as eating disorders.

“[The SMART program] avoids terms like ‘alcoholic’ and ‘addict,’ because it holds that everyone exhibits addictive behavior,” Mark T. said. “And they also think the connotations of the alcoholic as a drunk sitting on the curb with a paper bag… A lot of people with addictive problems are very successful.”

“At first,” Ted said.

Meetings

Mark T. said he runs the weekly Chapel Hill meetings, which run 60 to 90 minutes, according to the same basic pattern each week. People take 30 seconds to introduce themselves, then he lists the ground rules, which are: confidentiality; be open and honest, and don’t criticize when you’re giving feedback.

“Criticism makes most people defensive,” Mark T. points out.

Then generally there’s a handout focusing on one of the four points, and then the weekly check-in, where everybody takes turns saying what’s been going on in their life in the past week or two regarding recovery.

“We try to stress that we don’t care what happened 20 years ago, unless it’s impacting something that’s going on in your life today,” Mark T. said. “We’re about the present and going into the future.”

And then they pass the hat and adjourn.

Membership

While the SMART handbook says that attendees, “aren’t making a lifetime commitment to the program,” Mark T. and Ted both doubt that it will be possible for them to graduate—that is, stop attending meetings and become moderate drinkers.

“Of the people who’ve come to the SMART Recovery meetings, I only know one who successfully moderates,” Mark T. said. “But I will be open-minded on that subject,” he says of other people’s potential to graduate.

“We’re an abstinence-based program,” said Mark W., who facilitates the Carrboro program. “We welcome people whose goal is moderation
or ‘harm reduction,’ but our meetings focus on the techniques and challenges specific to abstinence.”

“I’m an evidence-based guy,” said Ted, who has three years sobriety now after a relapse. “And the evidence is pretty strong. I want to be very clear that I don’t have anything bad to say about AA,” he cautions. But, he concludes, SMART Recovery “works for me.”

“Meetings are open to anybody,” John said. “There’s no need to ask permission. We don’t pay dues, we don’t ask names. We’ll shake your hand.”

Mark W. clarified that meetings are open to anyone working on his or her own behavior.

“This restriction helps protect confidentiality,” Mark W. said, “and leaves attendees feeling they can be very open because everyone in attendance ‘has skin in the game.'”

“It really is welcoming,” Ted said.

For more information on the Chapel Hill meeting, go to http://trianglesmartrecovery.org/schedule/chapel-hill-meeting/. For more information on SMART Recovery, go to www.smartrecovery.org.

 

Recovery: doing the next right thing

CRP_Logo_6_25_15This blog post is part 2 of the story of Alex S., a 19-year-old student in recovery at the University of North Carolina at Chapel Hill.

“Somebody asked me, Alex, why do you smoke so much? And literally the response I gave was, You don’t need friends if you’re high. You don’t have to rely on other people to help you have a good day when you can just get f*-ed up. It was just so much insanity. This isn’t a joke—this was my thought process. This was my logic. And I liked it. It made sense.

“There’d be times we’d be at a party or something and my friends would be like, getting in trouble and having to deal with their parents or whatever. One time my friend was like, Alex, I’m so sorry this is happening, I know this ruined your night. And I was just like, ‘Let me stop you right there. I’m getting f*-ed up tonight. I don’t care what happens to anybody else here. My night’s going to be excellent.’ The social interaction of it all had nothing to do with why I was there. That was a nice bonus. But I could have been at home in my room just as easily doing the same thing, and been just as happy.

“For me, [recovery] means that I am able to live a life where I don’t have to use mind-altering substances like I used to. It gives me the tools to maintain the life that I have as well as to repair some of the wrongs of my past. So it’s not necessarily something that I think just affects me. It chiefly makes it so that I am working on myself, bettering myself, but by doing that it allows me to, like I just said, right the wrongs of the past, you know, towards my family and other people. That’s what it means for me, personally.

“I know when I first went to rehab,… my perception going into it… was like, Oh, I’m going to do this for a month, and then I’m going to come out and be like everyone else. That’s not how it works. This is something that affects me constantly. It’s a chronic thing, it’s not something that will occasionally affect me. It’s something that I work with in my daily life.

Wow. So now—you’ve been sober how long?

“About 14 months.

Fourteen months?

“Yeah.

Did you—

“Actually, is today the ninth? Yesterday was 14 months.

Congratulations.

“Thank you.

Tell a little bit, if you can, about the recovery program at UNC. What’s it like, what do you do, how does it work?

“We’re still in our infancy, but Dean Blackburn, the Dean of Student Wellness, he’s the one…. He sort of oversees—he’s the one who sort of started the recovery program. And he’s still very much involved with it, but like, it’s grown. We have people on campus who’ve been hired to help out with that. There’s a student-led group called the Carolina Recovery Group—it’s not completely student-led yet, but we’re trying to make it student-led—this year’s the first year the Carolina Recovery Program is being outwardly active. …We’re trying to do a lot more outreach, because a lot of people just don’t know that we exist. A lot of people—when we ran a table at FallFest and a lot of people came up and were just like, Oh, I’m in recovery—cool, I didn’t know you were here. So we’re just trying to get our name out there to help other people who might be in need, but specifically, what we do, the CRG meets every week, and it’s just like a support system. We’re trying to show that people aren’t alone. When I started coming, when I got here, there were people there who didn’t have very much time [sober], like a couple months, whatever, and some of them didn’t stick around. But some of them are my best friends now. There’s a lot of camaraderie. …

“We basically just try and support each other, and reach out to people in need, and guide everyone. And that helps us. That helps me—the guys who are more senior members. That’s the thing about AA and NA—helping others, helping other people like us is the best way to help us be sober. They say, ‘You can’t keep it unless you give it away.’ It’s like, the best way to learn is to teach. It’s the same kind of thing. It might sound weird, but in reaching out to help other people, we’re helping ourselves.

“I try to do the next right thing, is really what it comes down to for me. Try to be honest. About why I’m doing what I’m doing. Honest to myself and others.

What’s the one thing that people really need to know about recovery at Carolina?

“This might sound—this isn’t even that specific to recovery. But I’m going to make it specific to recovery: Just because you haven’t experienced something, doesn’t mean that others have not. And what I mean by that is, just because you can drink, or smoke, or whatever, once a month in your free time, does not mean that everyone else can. So don’t try to convince people that they don’t have a problem, when they’re telling you that they do. I’d say that’s probably the thing I want people to understand. Because, like, one, everything I just said. But two, even if for some reason they didn’t have a problem, it’s just not a big deal. People don’t have to drink and use, even if someone isn’t in recovery. There’s just this perception that at college, this is what we have to do. And even if we’re not in recovery, [we don’t]. I’d say that is it. Don’t assume that other people don’t face certain issues just because you don’t face them.”

September is National Recovery Month.

Celebrate with and for Alex and the 23 million Americans like him.

Mental Health Mondays: Recovery from what?

Joint_and_smoke

From commons.wikimedia.org.

September is National Recovery Month.

You might be wondering why we celebrate recovery.

There are an estimated 23 million Americans in long-term recovery from addictive behavior. Alex S., a 19-year-old student at the University of North Carolina at Chapel Hill, is one of them. Below, in his own words, read about what he was in recovery from.

“The substance I used the most was marijuana. I did other stuff too, shrooms, Adderall, I drank a fair amount, I tried ether one time….

“A lot of people just don’t think that marijuana’s addictive, because they have this idea that it’s not physically addictive, and therefore people can’t have problems with it… That’s just not true….

“If someone wakes up every morning and smokes, like, from the moment they wake up till the moment they sleep—if you live your whole life doing that for a year or even a few months and then suddenly you can’t do that? You’re going to feel something from that. But there’s this perception that that’s not the way it is….

“The lengths I was going to to steal money, just to smoke some weed, were ridiculous. It’s not something that a normal person does. A normal person doesn’t go around stealing things so that they can smoke weed—they just don’t smoke weed….

“I would smoke all my weed one night and be like, I’m done, I’m gonna quit. I’m just not going to have any more tomorrow. And the moment I opened my eyes, I felt there was literally a weight on my chest. It would be like, 5 in the morning, and I would be like, I have to find a way to smoke. And for the next three hours, it was all about trying to find money, and then trying to wake up my dealer so I could go buy from him. And that’s ‘just marijuana.’  Imagine if it wasn’t ‘just marijuana’; imagine if it was prescription drugs, or cocaine, or anything like that, which do have harder comedowns. I thought when I was doing this that I was just addicted to marijuana. But that’s not really how addiction works. People have this idea that you can be addicted to selective substances: Oh, I smoke weed, but I don’t have a problem drinking. But that doesn’t make any sense: ‘I smoke crack, so that means I can shoot heroin recreationally.’  It doesn’t make any sense. When you think about it, you’re not doing a specific substance. A true addict may have a substance that they like the most, but I myself know that I smoked a lot of weed and I used to hate drinking. But at the end of my use? I used to hate drinking but I drank when I didn’t have weed. And then I started to love [drinking]. And then smoking and drinking at the same time was becoming the new ‘best feeling ever.’ It just progresses; it doesn’t stay at one thing. …

Alex’s addictive behavior manifested at 15:

“I had this double life, I kept this perception up that I was this star student and all this other stuff, and I used that to get away with the other stuff that I was doing. I had this perception that I was like a f*in’ Batman or something. … I enjoyed that… When I was in high school, for a while, I could just breeze by everything. I was pretty into extracurriculars and all that stuff…. Eventually, however, all that started to deteriorate. Like everyone realized what I was doing, I wasn’t able to keep up this perception anymore, because I just didn’t care. My grades were suffering, I wasn’t doing as well in extracurriculars. It was just painfully obvious. I was really anti-social. I just didn’t talk to people much my last few months of high school. It was just pretty obvious that I wasn’t holding it together. And I absolutely dreaded the idea of going to college. I knew that that was going to be a f*in’ failure, if I went to college in the state that I was in. I was so incredibly scared. I remember in like May [of senior year in high school], I was like, I have to go to college in three months. There. Is. No. Way. That is going to work. None.”

What were you most afraid of? Like, what was the worst thing that could happen?

“I was going to show up, smoke weed all day, skip class and fail out. That was what was going to happen. There was no question in my mind. Either that, or things were going to get worse, like I was going to get caught by the police doing something, or I was going to start drinking a lot more, or doing other drugs. I just knew that there was no equation in that—there was no way to slice that. It was going to be bad.”

So you had the fear, but that wasn’t enough to keep you from doing the drugs.

“No, not at all. Every day for the last six months of using I didn’t want to do it. It was just like, God, this sucks, but I’m going to do it anyway. It’s literally a Jekyll/Hyde sort of thing, where like, I would just be having a day where I was not going to use. And then all of a sudden a cool show would come on TV, and I would be like, Hey, this would be really fun to do high, and then I would go through that process, get the money, go to my dealer, do whatever, make something to smoke it out of, smoke, and then three hours later it’s like, Wow, didn’t you say you weren’t going to smoke today? And it was like, Wow, I didn’t even think about that. The moment the thought crossed my mind that I was going to use one day? It was going to happen. And there was nothing that was going to stop that.”

So know you know a little about what addiction looks like. Recovery is the anti-addiction, and that’s why we celebrate it. Next Monday we’ll read about Alex’s recovery.

Mental Health Mondays: Recovering one’s life

MoviePoster_Final_300dpi_vA_croppedre-cov-er-y, n.: a regaining of something lost or stolen… a return to health, consciousness, etc.

It’s not just a word. For the millions of Americans living in long-term recovery, it’s a goal and a journey, a return to full life.

September is National Recovery Month, a time for the entire nation to recognize and support the struggles of people who are reclaiming their best selves from substance abuse and mental illness. If you think this doesn’t affect you, you’re wrong. There are an estimated 23.5 million Americans living in long-term recovery from alcohol and other drugs, and another 10 million living with serious mental illness. Together, that works out to about 10 percent of the population. If you know 10 people, it’s a good bet that at least one of them is in recovery.

Some of their stories are told in The Anonymous People, a documentary film that peels away the myths and stigma that surround recovery. It shines a light on the faces of community leaders, volunteers, corporate executives and celebrities, telling the story of the public recovery movement in the voices of those who are living it.

The Carolina Recovery Program—the recovery program at the University of North Carolina at Chapel Hill— is screening The Anonymous People on Thursday, Sept. 10 at 6 p.m., and again on Wednesday, Sept. 16, at 5 p.m. Both showings will take place in the Frank Porter Graham Student Union Auditorium, and both will be followed by a question and answer panel, with snacks. The Sept. 10 showing is aimed at students, the Sept. 16 at faculty and staff, but all are welcome at both. For more information, go to recovery.unc.edu.

Volunteering to improve health

A volunteer has the power to improve the community, while volunteering has the ability to improve the volunteer. A recent article in Gazette Review highlights four common health benefits of volunteering: (1) decreases depression, (2) helps you stay active, (3) makes you feel internally satisfied, and (4) decreases anxiety.

Just like exercising regularly and eating a balanced diet, it is never too late to start volunteering to enhance your health. In fact, September is a great time to volunteer–September 11th, next Friday, is a National Day of Service and Remembrance. Organizations, companies, and individuals all over the nation will be participating in various activities to honor those who were directly affected by the attacks, but also thank the many emergency responders and volunteers who emerged as examples of exemplary citizens.

9605580633_95c23a2ffeSome reasons people may have for not volunteering are: not knowing where to volunteer, not thinking they have any valuable skills to contribute, or not having time. However, online resources and websites make finding and signing up for volunteering easy. Locally, ActivateGood.org provides a search tool for residents of the Greater Triangle Area to filter volunteer opportunities by location, date, cause, and skills. AllForGood.org is a national example of a similar website. Both provide potential volunteers with the resources they need to get involved and the ability to sign up from the website. These web-based platforms allow users to easily connect with non-profits, schools, and other community organizations in need, thus reducing some of the barriers listed above: people now know who needs volunteers and where to go, people understand that their skills or abilities are needed, and people can specify times they are willing or able to volunteer.

So, if you haven’t already made plans to volunteer this Friday, consider using ActivateGood.org or AllForGood.org to do your part, and simultaneously improve your personal health.

Wellness Wednesdays: What is ‘Wellness’?

Exploring the Idea

‘Wellness’ – the word itself conjures positive feelings of energy and youth, self-efficacy and joy.  But wellness is more than simply the ‘absence of illness’ – to me, it revolves around the pursuit of a balanced physical, mental, emotional, and spiritual life. Beyond that, however, I believe everyone has their own definition of wellness, their own concept of what it looks like when applied to their lives.

 

Today’s Reality

The healthcare system in the United States was designed to diagnose and treat disease – in the early 20th century people were largely healthy, and relied on the healthcare system to cure them when they fell sick. Today, however, the needs of our population have shifted. A significant proportion of Americans are burdened with at least one medical condition, and our struggle is now focused more on how to maintain and improve our collective health.

 

More than Willpower

I think many of us try very hard to live ‘well’ – but as the saying goes, ‘the best laid plans of mice and men often go awry’. It is incredibly challenging to follow the lifestyle advice that we know is associated with good health, like ‘eating a plant-based diet’ or ‘getting two and a half hours of moderate physical activity every week’. Do we all just lack the willpower necessary to accomplish these deceptively simple goals? I don’t think so.

 

How ‘Free’ Are We?

Our environment constrains our individual behaviors – it can make these behaviors either easier or harder to achieve, depending on how the environment is structured. However, America was built on the values of ‘freedom’ and ‘personal responsibility’, which can often seem at odds with this idea that ‘context’ can have so much influence on our choices.

 

What does wellness mean to you? Where do you fall on the continuum of health? Do you feel you are closer to ‘healthy’ or ‘sick’? How ‘free’ do you consider yourself to be? Please help us continue this important conversation by sharing your responses to some of these questions in the comments section below.

September is Recovery Month

2015-recovery-month-square-web-bannerTomorrow, Sept. 1, begins National Recovery Month 2015.

That’s a simple statement that cloaks a huge happening. People all over the country will be learning, acknowledging or celebrating the fact that substance use treatment and mental health services can enable folks with a mental and/or substance use disorder to live healthy, rewarding lives.

This year’s theme is: “Join the Voices for Recovery: Visible, Vocal, Valuable!,” reflecting this year’s emphasis on peer support. Many of the most well-known recovery programs, such as Alcoholics Anonymous, have peer relationships at the heart of their success. And anyone who has dealt with any kind of health diagnosis (but especially a mental health diagnosis) will acknowledge that support systems are critical to achieving and maintaining good health.

According to the Substance Abuse and Mental Health Services Administration (a division of the U.S. Department of Health and Human Services), nearly 1 in 5 American adults—43.8 million– have a diagnosable mental, behavioral or emotional disorder. In 2013, 22.7 million people aged 12 or older needed treatment for a substance abuse problem—but only a tenth of them got it at a specialty facility.

Recovery is community. It’s the people around you. It’s you.

For more information on Recovery Month, go to recoverymonth.gov.

Depression doesn’t denote violence

Mohammed Abdulazeez, the Chattanooga shooter, battled depression-- but that didn't cause those deaths. Image courtesy of telegram.com.uk.

Mohammed Youssef Abdulazeez, the Chattanooga shooter, battled depression– but that doesn’t explain those deaths. Image courtesy of telegram.co.uk.

The family of Mohammad Youssef Abdulazeez, the young man who shot the military recruiters in Chattanooga on July 16, has issued a statement which says in part, “For many years, our son suffered from depression. It grieves us beyond belief to know that his pain found its expression in this heinous act of violence.” A July 20 story about Mr. Abdulazeez in the Chattanooga Times Free Press is headlined “Depression dogged Chattanooga gunman.”

The Abdulazeez family knew their son better than anyone else, most likely, and I accept at face value their statement that their son suffered from depression. That he experienced pain I have no doubt. But it is important for the public to understand that depression does not generally manifest itself in outward violence. Violence against the self, yes, but not other people.

The National Institute of Mental Health’s list of signs and symptoms of depression lists nothing more aggressive than “irritability.” Depressed people hurt themselves. They may seek relief in ideologies and activities that lead to violence, as it is theorized that Mr. Abdulazeez did— but the violence should not be attributed to the depression.

It’s hard enough to face each day when you have clinical depression. Shame and stigma make it harder. Let’s not make it harder still by inaccurately correlating depression with violence against others.

Future of mental health care?

David Ebersman, former CFO of Genentech and Facebook, is tackling mental health. Photo courtesy of LyraHealth.com.

David Ebersman, former CFO of Genentech and Facebook, is tackling mental health. Photo courtesy of LyraHealth.com.

The former chief financial officer of Facebook and Genentech is betting that big data can have a transformative effect on behavioral health care. David Ebersman launched Lyra Health in early June with an unspecified amount of venture capital funding.

“Through a combination of innovative technology and a human touch,” their press release stated, “Lyra Health will identify, engage and coordinate care for people with behavioral health issues; guide and match patients with the right providers and treatments; and rigorously assess treatment outcomes to better understand what works so that patients get the best care.”

In an interview with MobiHealthNews.com, Ebersman was a little more specific: “What we want to develop is technology that enables us to identify people who are at risk of behavioral health problems and in need of behavioral health treatments. We want to develop technology that enables us to most effectively match people with care that’s available, meets their needs, and is likely to help them,” he said, indicating that the platform would “likely include options like video visits and computerized therapy.”

Later in June Lyra received a $3.1 million investment from Castlight Health, a coordinator of corporate health benefits, reflecting the new company’s concentration on employee health.

“We view this as a really interesting and complicated technology problem,” Ebersman told MobiHealthNews, “and we are planning to build the company as one that taps into the best minds in terms of software engineering and data science that we can find in the fertile environment of Silicon Valley.”

 

June is Alzheimer’s Awareness Month

A conceptual look at Alzheimers disease, and some of the problems it brings. Courtesy of caring4youragingseniorcitizen.com

A conceptual look at Alzheimers disease, and some of the problems it brings. Courtesy of caring4youragingseniorcitizen.com

June is Alzheimer’s and Brain Awareness Month.

The reason for this is that June contains the summer solstice, the longest day of the year. If you’ve ever been responsible for the care of a person with a dementia, like Alzheimer’s, you know the significance of the longest day.

It’s never over. Nothing can be taken for granted or left to chance. Every single daily function—eating, bathing, dressing, toileting—needs supervision. You can’t leave the person with dementia alone for more than a moment, because you just can’t tell what she or he might do. Things you take in stride may upset that person; things that ought to upset the person can pass unremarked.

Not only is it physically exhausting; it’s emotionally exhausting. You know, you know, that the person you knew and loved is in that body somewhere. But you can’t reach him or her.

Music helps. Patience helps. Love helps.

And help helps. If you have a family member who’s caregiving someone with dementia, consider providing them with a respite, either by sitting with that person or by sourcing professional respite care through your local Department of Social Services or from a nursing or CNA service. If that’s too much for you, be a driver for a short outing. Do a grocery run. Drop off a meal, or flowers or a movie. Or just ask the caregiver what she or he could use.

For more information, go to http://www.alz.org/.