Author: Loren Lachapelle

This fact could not have been made clearer than in a conversation with Theresa Russell*, who agreed to talk about how heroin has touched her life.

Theresa began by handing over a list of six people’s names, their ages, and the dates of their overdoses and deaths.  She reports she is very angry right now, as the most recent death was one of her very best friends from high school.  He was 32 years old and overdosed on Nov. 1, 2015.

She explains that her anger and disbelief stem from the very first overdose in 2002.  This was the father of a high school friend.  Theresa, along with a close circle of friends, attended the funeral in 2002, and in her mind, this was the moment she knew she would never pick up opiates and heroin.  She believed her peers all felt the same.  Sadly, this was not the case.

Until society finds a way to manage the heroin issue, friends and family will continue to ask themselves, “What more could I have done?” or “Why didn’t I see that?”

The list of six people who died of drug overdoses are all connected, in some way.  Her very best female friend from high school “Jane”, has struggled with opiate addiction.  Jane’s husband was the third one on the list to die in the fall 2008.  Jane also attended the funeral in 2002.  Theresa is puzzled that after attending a funeral of someone who overdosed and died of drugs, why anyone would ever choose to use drugs?  She also wonders what makes a person walk into a room and decide that they will jab a needle into their body to get high.  What is going through their minds the first time they try heroin?  It is no secret that after the first time, people can get hooked.  

Theresa had another friend that died in the spring of 2008 from a drug overdose, who was also at the funeral in 2002…they were all there to support their friend whose father lied in the casket. 

Theresa is angry and sad about what this drug is doing to our society.  She is also angry that her dearest friend from middle school and high school years have succumbed to the lure of heavy drugs. Theresa tried to intervene early on in her friend’s addiction, but the family and her friend were in denial.  Eventually, the family saw that Theresa was correct, and that their daughter needed help. Yet this friend still struggles today with relapses. 

When we hear about people dying from drug overdoses, it is important to also remember the friends and family left suffering.  Trying to make sense of death by heroin and of the addiction itself, is often terribly difficult.  Until society finds a way to manage the heroin issue, friends and family will continue to ask themselves, “What more could I have done?” or “Why didn’t I see that?”

Like Theresa’s loved ones, addiction can take hold of anyone and everyone. Addiction does not discriminate; whether wealthy, successful, or have a family, it can disrupt the lives of anyone. If you have someone in your life who is suffering from addiction, overdose is a real possibility. Here are some steps for dealing with a loved one you believe has overdosed:

Action Plan  **

  1. Call for help. The sooner emergency medical help arrives, the sooner professional treatment for the overdose can begin.
  2. Provide first aid. Becoming familiar with first aid techniques, such as CPR, can be helpful should the situation arise.
  3. Collect important information from the scene. Are there empty pill bottles or drug paraphernalia lying around? Take them with you to the hospital or provide them to first responders so the medical staff will know exactly what they are dealing with. This will help them render the proper treatment more quickly – a process that can mean the difference between life and death in some cases.
  4. Don’t judge. An overdose crisis is not the time to make judgments or accusations concerning your loved one’s addiction. While you should attempt to gain information concerning what drugs were taken and in what quantity, save your emotional commentary until after the crisis has passed.
  5. Be cautious and aware. Some drugs, especially in larger doses that can cause an overdose, can cause violence and anger. Some drugs can increase the user’s strength and tolerance for pain so drastically that they become almost super-human. Do not place yourself in physical danger to treat an overdose.

Author:  Lorrie Roberts, LADC, CCS

* Names have been changed for confidentiality reasons.
**Action plan courtesy of Alta Mira Recovery Programs

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Depression has been called having “the blues”, “feeling down”, “sad” or “in the dumps” but that doesn’t begin to cover what depression is and does. Depression affects the body, mind and spirit.  It can be devastating and life changing. It affects not only the person’s life, but can impact significant others, family members, employment and even the community as well.  It can last for weeks, months or years without treatment and it can end in death by suicide.

Depression is a serious illness.

What causes depression?

Depression has its roots in chemical changes in the brain. There are many factors that can combine to cause depression.  The person’s temperament and personality, early grief and losses, trauma, stressful life events, the change in seasons or any time the body’s internal clock is out-of-sync. Medical problems such as a thyroid imbalance heart attack survivors, immune diseases, cancer, and nutritional deficiencies can also play a part. The presence of persistent pain, women associated with having their premenstrual cycles and some medications and their side effects are all contributing factors. Substance abuse issues and associated withdrawal symptoms can also result in depression.

Genetics plays a part. If someone on either side of the family was depressed there is a better chance that this would be passed on to the next generation.  Depression also affects the brain and is negatively affected by stress.  The more stress and longer the stress occurs, the more the brain and the body is affected.

Are there different types of depression? If so, what are they? 

There are a number of different types of depression. The most common is Major Depressive Disorder which can be mild, moderate, or severe, in partial or full remission.  Other types can include 

  • Persistent Depressive Disorder, known as Dsythymia which occurs for at least two years.
  • Disruptive Mood Dsyregulation Disorder includes temper outbursts with irritability or anger that occur daily and is seen in children between 6-18 years old.
  • Premenstrual Dsyphoric Disorder is associated with the menstrual cycle, starting a week before and ending in the week afterwards. This brings mood swings, crying, irritability and anger, depressive symptoms, tension and anxiety.
  • Substance or Medication Induced Depression associated with taking a substance or medication.
  • Depressive Disorder due to another medical condition. 
  • Specified Depressive Disorder, which is when full criteria cannot be met but most symptoms are present.
  • Unspecified Depressive Disorder. This diagnosis may be made when there is not sufficient information or time to make a specific diagnosis.

In addition, depression can be a symptom of other diagnoses such as Bipolar Disorder, anxiety disorders with depression, Attention Deficit Hyperactivity Disorder and sadness, which is not a diagnosis, but a natural part of our existence.

Can depression be prevented? 

Depression is complex. It can’t be prevented for everyone yet, but it can be treated. That is why one pill won’t work the same way for everyone, and why medication usually takes weeks before a change in symptoms is noticed.  For some people taking their medication as prescribed, being proactive when participating in therapy and actively making changes in their lifestyles can greatly reduce symptoms over long periods of time. Cognitive Behavioral Therapy has proven to be effective in changing thoughts and feelings that are associated with depression and in helping to identify, and make lifestyle changes that reduce depressive symptoms.

How can we help someone who may be struggling?

The first part is to become aware that there has been a change.  The change includes having a depressed mood, a loss of interest or pleasure and feelings of hopelessness or despair.  Remember, depression can be sneaky.  It can start by a person feeling “off”, more sad than usual, or having low energy, and may be perceived as the onset of a flu or cold when no other flu or cold symptoms appear.

Be aware of changes in routine, difficulty with starting tasks, staying in bed longer, or increased feelings of not caring about anyone or anything.  Family members or friends who notice these symptoms should talk to the person about it and suggest that they get help. 

Above all, don’t ignore the symptoms.  Be patient, encouraging, understanding and support the person who is depressed. Talk to them and, more importantly, listen to them. Encourage them to be more active, don’t push too hard, but continue trying.

Are there resources to seek help?

If there are ever any suicidal thoughts or feelings, the person should immediately call their therapist, doctor, or the crisis hotline 1-888-568-1112.  Above all, if the person is a danger to themselves or others, hospitalization may be necessary.

If the person is not suicidal, a doctor’s appointment can help to determine if there is any physical cause for the depression. Depending on the severity, a psychiatrist or doctor may prescribe antidepressants. This can help reduce depressive symptoms and may be given in combination or alone. If there are any side effects noted, encourage the person to call their doctor and go to their appointments. 

Seeing a therapist or clinician, whether on medications or not, has been proven to be effective in helping reduce symptoms of depression. There are a number of psychotherapies treatments that can help.

Research has shown that getting treatment sooner can relieve symptoms quicker and reduce the length of time of treatment. In other words, try to encourage the person to seek therapy.  For the person that cannot get out of the home there are also telehealth services, so getting therapy is easier than ever. The best thing to do to treat symptoms of depression is to get help as soon as possible.

 

Author: Cynthia Booker-Bingler, LCSW, 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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Daylight Savings Time began on November 1st this year. 

The first Sunday of the month. There are over 70 countries all over the world that use Daylight Savings Time. That means that over a billion people are affected by the changes in time twice a year! Not only that, but the dates that Daylight Savings Time starts have also changed over the years.

But what happens to our bodies?

Over a 24-hour cycle, our bodies release chemicals that translate to the time of day. The time change affects our bodies. Ever noticed how going to bed late on weekends affects getting back on schedule on Mondays? The same thing happens when getting on an airplane and changing time zones. Changing time zone means adjusting to a difference in time. This same thing happens during Daylight Savings Time. Daylight Savings Time can disrupt our internal Circadian Rhythm – or our internal biological clock – and interfere with the amount of melatonin which our bodies produce for sleep. Melatonin is made by the body when there is a decrease in light playing a role in whether we feel sleepy or wide awake. When it is darker our body continues to release melatonin causing us to feel sleepy.

For adults and children

The transition of getting up an hour earlier can be difficult to adjust to. While getting used to change in their sleep pattern, most people react by feeling sluggish, tired and fatigued. Reactions to being tired can show as an increase in being seen as “cranky”, irritable, easily frustrated, less alert, a decrease in concentration and mood changes. This can lead to difficulties performing tasks that normally would not be as difficult – like doing school work, a job, or driving. Some studies suggest that there are more heart attacks brought on by the stress accompanying the change. (If you are affected by Seasonal Affective Disorder, the change in seasons and decrease in light can have an added impact).

For teens

Teens require an average of nine hours of sleep and if they haven’t slept long enough by going to bed too late, they feel “perpetually drowsy”. This affects their performance at school with their ability to pay attention and to learn.

What can be done to help adjust to this change in time?

It is very helpful to be proactive and prepared. Discussing the change ahead of time whether with family members, friends or colleagues. If your child has a lot of difficulty with transitions, talk to them about it. Remember, losing one hour may not seem like much, but it still affects our bodies and our routines. You might want to:

  • Talk to the teacher at school, the school bus driver and with your spouse as appropriate to your situation. This helps everyone and the family get used to the idea that a change is coming.

  • For some, getting clothing ready the night before, organizing everything that is needed for school or work is helpful.

  • Going to bed earlier and giving some time for waking up completely in the morning increases alertness and mental acuity.

  • Be prepared to feel tired, sluggish or fatigued when getting into the car and take a few extra minutes to look both ways before driving.
    Even if you feel fine, others may not be as prepared as you are!

  • Be prepared for having less daytime so having some activities ready can be helpful.

  • Children still have a lot of physical energy that they may not use if they cannot stay out after dark.

Parents Try This

Making a list of some activities your child or children can do inside to get that energy out is helpful like:

  • Play tag
  • Make an indoor fort
  • Play hide n’ seek
  • Jump rope
  • Do yoga
  • Exercises

Or can you add going swimming after school, going to the basketball court, or ice rink in the winter? Your child or children can help with ideas then put them in a jar and have your child pick one every day.  Just give them time to be physically active then time to wind down.

For You

Adults need the same things, so looking into what is available in your community may be helpful. How about:

  • Walking/jogging trails
  • The YMCA
  • Are there local swimming pools? Many motels are now offering swimming pool service for a fee (some even include the exercise room)
  • Or look at adult education programs that involve exercise.  

Finally, if there are symptoms of depression or any serious mental health concerns please contact a mental health provider for assistance. For those who are still interested in learning more I have attached the following articles:

http://www.businessinsider.com/health-effects-of-daylight-saving-time-2014-10

http://wgno.com/2015/10/27/falling-back-why-do-we-change-our-clocks-for-daylight-saving-time/

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

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