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In Maine, over the last 10-15 years, the rising tide of prescription painkillers abuse and other opiates based drugs (legal and illegal) has reached epidemic proportions. The abuse of alcohol and other addictive drugs like marijuana/synthetic cannabinoids, cocaine/crack, benzodiazepines, and methamphetamine also remain widespread.

As our families come together over the holiday season and we transition into the new year, it is important for us to all be aware that the devasting disease of addiction can impact all areas of an individual’s life, causing problems with family, friendships, work, school, finances, legal issues, along with physical and psychological health.

Addiction and its ripples effect cause destruction not only in the individual who abuses substances but in the lives of loved ones as well. These loved ones often experience unhealthy stress, anxiety, depression, physical sickness, and an overall diminished ability to do their best work or enjoy activities.

Warning Signs of Drug Abuse/Addiction:

  • Intense cravings or urges for the drug (mental and physical)
  • Compulsion to use the drug frequently (several times a day to several times a week)
  • Increased tolerance to the drug
  • Irresponsible spending of money
  • Failing to meet obligations and responsibilities, and/or cutting back on social/recreational activities
  • Violating historic morals and values to hide use or by doing things to get the drug that you normally wouldn’t do (stealing, cheating, manipulating)
  • Increased risk taking behaviors
  • Continuing to use despite wanting and trying to stop
  • Experiencing psychological and/or physical withdrawal symptoms when you attempt to stop taking the drug

Recognizing drug Abuse/Addiction in family members, friends, and co-workers:

  • Problems at work or home – frequently missing work, increased isolation, increased irritability
  • Physical health issues – lack of energy and motivation
  • Neglected appearance – lack of interest in clothing, grooming
  • Changes in behavior – exaggerated/argumentative efforts to hide or minimize use from family members, being secretive, distancing from family and friends
  • Changes in relationship with money – irresponsible spending of money, requests for money without a reasonable explanation, stealing money and valuables from others.

Help is Available:

If you or someone you know, needs assistance with addiction:

 

Author: Brian Dineen, LCPC, LADC, CCS, Outpatient Therapy Program Supervisor, Health Affiliates Maine

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For some people, the shorter days of the fall and winter months bring with it an increase in depressive symptoms.  This type of depression has been called Seasonal Affective Disorder (SAD). It usually impacts people during the change of seasons when there is a decrease in light, and it lessens or stops when the seasons change again, bringing additional light. 

Studies showing the numbers of people with SAD vary from about half a million people (4-6% of the population) up to 10-20% of the population in the U.S.  

Symptoms of SAD include:

  • being sluggish/low energy/ fatigue; reduced sex drive
  • losing interest in activities that once were pleasurable
  • decrease in social interactions
  • experiencing difficulty concentrating
  • sleep problems
  • gaining or losing weight
  • feeling depressed most or all of the day, almost every day
  • feeling worthless or hopeless
  • having frequent thoughts of suicide
  • The symptoms occur for more than two weeks and recur during the same time of year

What Causes SAD?

The exact cause of SAD is still to be determined, however most theories attribute the disorder to the lessening of daylight hours.  This can disrupt circadian rhythms (the body’s internal clock), increases the production of melatonin (causing sleepiness, the body’s way of telling us when it is time to go to bed), and decreases the production of serotonin (which helps to regulate mood).

It’s more prevalent in the northern than southern States.   Not everyone gets treatment for SAD as it is typically attributed to the “winter blues” or “cabin fever” and there is an expectation to just ignore it, endure it or “man up”. 

Now, the good news. SAD can be treated. 

First, if you feel you may have SAD, after looking at the symptoms listed above, it is recommended that you see your doctor to determine whether it is due to a medical cause (i.e.: hypothyroidism or another medical condition) and a therapist to assess if symptoms are due to SAD or another diagnosis (Depression, Bipolar disorder or trauma).  During the therapist’s assessment you might be asked to fill out the Seasonal Pattern Assessment Questionnaire or a depression questionnaire.  These will help determine the cause of your symptoms. 

Next, depending on the symptoms and their severity your doctor may prescribe medication, light therapy and CBT therapy. 

  • Medication: Selective Serotonin Reuptake Inhibitors (SSRIs) for depressive symptoms.
  • Light box therapy: A prescribed therapy using light to reset circadian/ biological rhythms. Work with your doctor due to changes in length of time, intensity and type of light used.
  • Cognitive Behavioral Therapy – To change the pattern/thoughts/ behaviors leading to the symptoms.

If you are diagnosed with SAD there are a number of things that you can do.

  • Educate yourself and your family about SAD and any treatments.
  • Increase the amount of light you get each day by: going outside, allowing natural light to shine inside, rearranging work areas, going without sunglasses, sitting in the sunshine or next to a window in classrooms, restaurants, and other places.
  • While it is light out, avoid dark areas. This increases the level of melatonin.
  • Exercise outside or facing a window to maximize the amount of sunlight.
  • Be aware of the temperature and dress warmly due to sensitivity to cold.
  • Putting a timer on lights so that the lights go on one half hour or more before awakening. This has made it easier for some people to wake up in the morning.
  • Keep a daily record of energy levels, moods, appetite/weight, sleep times and activities to track biological rhythms.
  • Stay on a regular wake/sleep cycle to increase alertness and decrease fatigue.
  • Postpone making major decisions in your life until the season is over and symptoms abate.
  • Share experiences/treatment with others who have SAD.

For those who are still interested in learning more about SAD please read the following articles:
http://www.helpguide.org/articles/depression/seasonal-affective-disorder-sad.htm

http://www.theatlantic.com/health/archive/2014/07/when-summer-is-depressing/375327/

 

Author: Cynthia Booker-Bingler, LCSW, Health Affiliates Maine

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For those in early recovery, it is probably not a good idea to go to a New Year’s party where there is going to be alcohol. Even those who are well established in their sobriety can find such events a challenge. Sometimes, though, it can be difficult to avoid such events, and there may be a situation where you might feel as though you cannot get out of going.

For example, it may be expected as part of a job commitment. If you feel that you are at high risk of relapse then you should avoid this party no matter what the consequences.

Here are a few ideas for creating a plan to survive a New Year’s party with your sobriety intact:

Practice saying NO.

It may sound a bit odd but it can actually help to practice saying no to alcoholic drinks before the party. This can be better done with the help of somebody else in the form of role play. Some partygoers can be particularly persistent when it comes to getting other people to drink, often because they have their own alcohol demons pulling the strings. It is best to be prepared for such doggedness. In most instances, a firm no will be enough to end such questioning. Giving a longwinded answer can just lead to further questioning.

Bring a friend.

One of the best ways to survive these gatherings is to bring along another friend who is not going to be drinking alcohol. If this individual is also in recovery, then it is vital that their sobriety is well-established. Otherwise, both of these attendees could be at risk of relapse.

Take along some additional support.

It can also be helpful to take along some addiction recovery material. These days this can be discreetly done using Smartphone such as the iPhone. There are many apps available that are designed for people recovering from addiction. These include written, audio and video material.

Check ahead for drink alternatives. 

It is crucial to check ahead to make sure that there will be suitable non-alcoholic drinks available. If they are not then you will want to bring along your own favorite soft drink.

Don’t leave your drink alone. 

It is not a good idea for people in recovery to ever leave their drink unattended. There are some individuals who enjoy spiking the drinks of other people by adding alcohol to them. The person who engages in such behavior may think that they are livening up the party, but it can be devastating for people in recovery to find out that their drink has been spiked.

It’s ok to leave.

If you feel overwhelmed by the occasion, you should leave right away. You should then seek assistance and support from a sober friend or recovery group. It is best to plan an escape route before you attend.

 

Content courtesy of alcoholrehab.com

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Each January, millions of people attempt to improve something in their lives by committing to a New Year’s Resolution – a promise to themselves that, this year, things will be different.  By February, many of those resolutions are forgotten or discarded. 

What happens to our resolve?

We set a goal that is too large.

Smaller steps toward a larger goal help you to experience success along the way and evaluate what to do next (or whether you want to continue).

We catch a bad case of the “shoulds.” 

We think we should lose weight, should be more organized, should stop smoking.  When we try to do something we think we “should” do, we can feel resentful and uninvested.

We try to go it alone. 

Change is hard.  When we try to do it all by ourselves, it can be easy to get exhausted and discouraged.

When we don’t follow through on our resolutions, we can feel like we’ve failed.

What can we do?

Focus on what you want, phrased in positive language. 

When we phrase our goals in positive language, in present tense, we train our minds to look for the positive.  So, instead of “I will stop smoking,” try “I breathe clean, fresh air,” or instead of “I will stop spending money,” try “I use my money to buy the necessities in life” or “I use my money for things that bring meaning and joy to my life.”

Evaluate why you want to make this resolution. 

Are you making this resolution to please others? Because you feel obligated?  Because you should?  Consider your investment in and motivation for the resolution.  Doing it for others rarely works.

Get support. 

Having others cheer you on (or doing it with you) can make the difference between sticking with it or not.  We feel accountable to those others. 

Remember, we can resolve to change any time we want.  Positive mental, physical, and spiritual health are lifelong resolutions – promises to ourselves that are worthy of keeping! 

 

Author: Mary Gagnon, LMFT, Training and Clinical Development Specialist & Outpatient Therapy Supervisor, Health Affiliates Maine

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Sometimes holidays hurt.  The holiday cards and promotions are full of pictures of beautiful families smiling around a fireplace or dinner table.   For some families, the reality doesn’t match that picture.  Family relationships come with history, “the good, the bad, and the ugly,” anything from an unintentional slight, to childhood trauma.  Hurts are the emotional leftovers of life, and when mixed with alcohol, they can turn into not-so-happy holidays.

Holiday celebrations and family gatherings are a good thing.  For many, they are the most important part of the year. Everyone wants “Peace on Earth,” not just for the world, but at home and in our hearts.  If there are emotional leftovers and hurtful words that have affected your family relationships, it is healthy to try to sort it out, and when possible, to make amends.

Everyone wants “Peace on Earth,” not just for the world, but at home and in our hearts. 

First

Own what is yours.   We all make mistakes.  Sometimes, we just hurt people.  It might be out of anger, or, we innocently step on a minefield with our words and actions, unaware of how someone else will interpret them.  

Next

Apologize.  Learning to apologize and take responsibility for our actions takes work and courage.  There are many sites online to help you learn this, using the search word “apology”.   The payoff can mean deeper more loving relationships. 

Here’s an example.  Let’s say you had a heart-wrenching misunderstanding with someone you care deeply about.  You may not have known how to apologize — unsure of what you had done.  In this case, you might to call them saying, “I really value our relationship and I want to fix it, but I don’t know how”.  They may hang up on you or they may allow a conversation to begin.  Just knowing you tried will bring you peace.

Sometimes it takes more than an apology. 

Some hurts run deep and can affect other relationships.  That is when reaching out to a counselor for help can really make a difference in your life.  It takes courage.  Feeling better is worth it.  The holidays come around every year — another chance to make them happy.

 

Author: Luanne Starr Rhoades, LCPC, LADC, CCS, Health Affiliates Maine

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That’s a good question isn’t it? Most of the time when people talk about mental health they are talking about mental health treatment or a person who was given a mental health diagnosis, (which is a fancy name for describing what symptoms a person has), but that isn’t what mental health is either.

Mental Health has a lot of different parts. It is our sense of well-being. How we think, how we act and how we feel about ourselves.  It is looking at the complete picture of who you are, what is happening around you and how it does or does not change your thoughts about who you are.  The most important part is that EVERYONE has mental health.  It is a part of who we are as human beings. 

How do we figure out what our mental health is?

Let’s look at the different parts…think of it like a circle with all of these things around it.

circle2Emotions:  Do you spend a lot of time being happy, smiling, laughing?

Your mind:  Are you satisfied, content, at peace with yourself and others? Do you like yourself and who you are?

Your thoughts: Do you think about how happy you are with yourself? Are you proud of yourself?  Do you say to yourself “way to go”, “I am wonderful”, “I am a great person”, “I really did well”, “I did the best that I could and that’s okay” or other thoughts that make you feel worthwhile?

Your Body:  Is your body physically fit? The correct weight?  Does your body feel calm and at ease?  Are you okay with your body?  Is it good enough, pretty/handsome enough? Does it do what you want it to do when you want it to?

Your immediate world:  Do you have family/friends that cheer you up and that you feel you can talk to about anything?  Is everything going well at school/work/your family/your neighborhood?  Do you have beliefs or a religion or go to a church, synagogue, mosque, prayer group or other where you are accepted for who you are?  Do you follow certain beliefs about your culture – learned from your family, by following certain holidays -Christmas, Hannukah, Ramadan,…or by celebrating 4th of July, having a birthday party to celebrate another year of life; being raised to know what foods to eat or not to eat, what clothes to wear, how to talk to others, etc.?

Your greater world:  Are you satisfied how your State or how the government is being run?  With the environment and climate change?   With how your country and other countries deal with each other?  Do you think about this at all? A little?  A lot????

In General:  Do you feel that life is okay or even great!  Do you feel okay with yourself and who you are?  When you do get upset – sad and cry, angry and throw a tantrum or yell or when you are frustrated raise your voice, throw things, hit something or not want anyone to be around you, is it only for short periods of time and then you feel better? As you grow older do you change how you react to others?  Do you feel in control of yourself and your actions?

In the circle, all of these things coming together to change how you feel about yourself, which changes how you behave, which affects your mental health.  The wonderful part is that your mental health changes daily and, if you are not satisfied, you can change. 

So, if you are doing well, can control yourself, talk to others and feel happy with yourself, then your mental health is fine.  If however, you are not and that ongoing worries, are sad or upset most of the time, don’t feel alright with yourself, you are not alone. There are many people that have difficulty with their mental health. A mental health specialist – therapist, counselor can help get you back on track and feeling better about yourself.

 

Author: Cynthia Booker-Bingler, LCSW, Health Affiliates Maine

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Have you ever felt as though you need a little help getting into the spirit of the holidays?  It can be true for many of us, because let’s face it; this time of year can be rather stressful. Often times though, it is the smallest and simplest of activities that provide us joy and happiness.  And it is no different during the holidays.

So we have pulled together a list of inexpensive activities that might help lift you into that festive mood.  Pick a few that bring a smile to your face and hopefully you will experience your own little slice of the holiday spirit.

  1. Watch your favorite old holiday movies at your house.
  2. Play in the snow or make your own.
  3. Drink hot cocoa in your pj’s.
  4. Write letters to out-of-town friends and relatives.
  5. Look at old family holiday photo albums (these make for great TBTs).
  6. Make homemade potpourri to make your place smell amazing.
  7. Go ice-skating.
  8. Light an evergreen-scented candle in your room.
  9. Do holiday-themed nail art.
  10. Make a holiday playlist.
  11. Create an Elf Yourself
  12. Host an “Ugly Sweater” party.
  13. Make a jar of good things — write down all the things you’re thankful for that happened in 2015. Read them again at this time next year.
  14. Have a bonfire with friends who are in town.
  15. Donate canned goods to a local food bank.
  16. Go on an outdoor adventure and take photos of the wintry scenery.
  17. Volunteer at a nursing home’s holiday party.
  18. Go see a local school’s holiday play.
  19. Do random acts of kindness; anonymously leave notes spreading holiday cheer on people’s cars.
  20. Hang Christmas lights along your bedroom walls.

*List courtesy of: www.popsugar.com

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Sometimes the news is just plain scary. 

For most everyone, events of terror shake our foundations and change the way we view our safety and well-being. That’s the point of terror.  Anxiety happens to everyone, some more than others.  I would be lying if I said I didn’t worry and let my mind move into the “what if’s”.  Any good worrier can move easily from scenario to scenario, each one worse than the other. 

Worry can be a gutter ball of a thought that always moves us to the negative, the scary and the catastrophic.  This “catastrophizing” can be no joke.  Here are some strategies to manage your anxiety about terrorism, if you find yourself in a dark and negative place over events in the world or just your own corner of it.

  1. Stay In The Day 
    First, stay in the day, the “what if’s are all about things you can’t control. Try to learn when you are doing this and listen for your voice saying “what if”.  That doesn’t mean don’t plan or strategize if you need to, but doing the “what if’s” is that same as spinning and going nowhere.  When you find it happening, remind yourself to only focus on the here and now…the things you can control.  The Serenity Prayer is great for calling you back to helpful thinking.
  1. Consider The Odds
    Another helpful strategy is to consider the odds.  With all the chaos in the world people are still living long, productive and reasonably happy lives, putting one foot in front of the other.  Odds are that things we do every day like driving, working, or even eating a sandwich can be dangerous, and more likely to affect us than an act of terror in our town.  
  1. Find Comfort in Connecting
    Lastly, in uncertain times people often find great comfort connection to those things that bring their lives meaning; faith, family and interests. Don’t worry alone.  Share your concerns and allow others to help.  Some people, both children, and adults, sometimes find that they can’t stop the spinning “What if’s… the Gutterball Thoughts… or the Catastrophizing.  That’s exactly when a counselor can help.  Everyone worries, but the worries don’t need to control your life.

Author: Luanne Starr Rhoades, LCPC, LADC, CCS, Health Affiliates Maine

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According to Maine’s Attorney General’s Office, the evident opiate epidemic in Maine has resulted in 50 more deaths in 2014 from just 4 years ago.

In response to WMTW’s series on Maine’s Heroin Epidemic this month, Outpatient Therapy Director Luanne Starr Rhoades of Health Affiliates Maine comments, “There are a lot of reasons Maine is struggling with this epidemic.  In the not too distant past, physicians felt freer to treat their patient’s pain with opiates. In many cases, it was too much, for too long; and some people became addicted.”

Rhoades elaborates, “Now, with increased scrutiny of prescribing practices, physicians are hesitant to prescribe opiates for pain.  Left to their own devices, some people in pain have turned to Heroin and opiate medications sold on the street.  Criminal activity of stealing and diverting prescribed medications also happens.  Street drugs, and especially heroin, are abundant and relatively inexpensive. The supply of opiates and other drugs come into Maine right up the 95 corridor from Boston and New York.   As a result, we are now seeing our neighbors, co-workers and friends impacted by these drugs like never before”.

According to the Maine Office of Substance Abuse and Mental Health Services, in 2014, nearly seven out of ten overdose deaths involved an opiate. And since 2012, the numbers of deaths involving heroin and or morphine have more than doubled.

Getting help.

These are very alarming statistics, and many are wondering what we can do to combat this.  For those families who want to know how to help their loved one overcome this, there are some options they can consider.  For instance, doing an online search of Intensive Outpatient Programs (IOP) is a likely first step towards getting clean.

There are also Medication Assisted Treatment options for opiate addiction which are available in Maine in the form of Methodone and Saboxone prescribed by a physician.  Nevertheless, even after moving beyond the physical dependency and the cravings the reasons behind the abuse often are still there.  Seeking therapy from a substance abuse counselor can help individuals work through all of the struggles that lead them to using.

What to watch for.

Some signs and signals we can all watch for, that might mean someone is struggling with an opiate addiction:

  • Social withdrawal from family & loved ones
  • Extreme alterations in mood
  • Weight loss, nausea, diarrhea & vomiting
  • Continued use of the opiate, even after pain has subsided

You can get a complete list of warning signs and other useful information on opiate addiction at:  http://www.addictionhope.com/opiates

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