Tag Archive: co-occurring disorders

  1. Redefining the Concept of Normal

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    new normalOne of the most popular questions posed by young people to their therapists is this: “Am I normal?” They posit that a baseline for normal exists, and there are gradations of deviating from it. Worrying that they do not fit the bill for what normal thoughts, emotions, and behaviors should be can cause a great deal of concern.

    A fundamental way to move forward when being treated by a therapist is to learn to retire the concept of “normal.” Some therapists remind their clients that normal is a setting on a dishwasher or dryer. Using it as a barometer against which clients must measure all thoughts and actions proves unrealistic and unproductive.

    Living During the Pandemic Altered the Concept of “Normal”

    A world gripped by the coronavirus caused everyone to throw out the old, familiar ways. For the past year, the phrase “the new normal” has been a mantra of sorts. Society experienced adapting to concepts like social distancing and staying home most of the time as the new normal.

    For young people who are already struggling with substance use disorder, adjusting to change often proves difficult. Now that medical staff are administering vaccines to so many, society has begun a reopening process. The expectation that everything goes back to “normal” can be challenging to grasp. This concept may be tough if the person never felt normal, to begin with.

    They may become nervous about how to assimilate from a pandemic world to the next version of it. People excitedly anticipate the reopening of their world. They may also struggle with anxiety over not being sure what that world will look and feel like.

    Trying to Be “Normal” Stresses Adolescents Out

    Children often feel free to express themselves in a variety of ways. They haven’t yet reached the stage of life when peer pressure begins to shape their behavior. Around the time the teenage years start, many young people worry excessively about being perceived as normal. Trying to fit that mold can cause anxiety in their worlds. A skilled clinician can help their young clients let go of the concept of normal.

    Many people who suffer from an addiction to alcohol or drugs also experience co-occurring disorders. Pressure to appear and feel normal proves tough enough. A young person often deems it necessary to hide or quickly conquer mental health issues like anxiety, depression, or bipolar disorder. The pandemic may have exacerbated those underlying conditions. They might feel mired in an inability to conceal their truth.

    Ways Adolescents Can Express Their Individuality

    A certain amount of concern about being similar to others can be beneficial. When it becomes the sole goal a young person shoots for, it becomes problematic. Try opening a dialogue with your clients about how to honor their individuality. Doing so without concern about if others will perceive a client’s individuality as normal can be liberating.

    Many adolescents want to wear the latest style of clothing. Point out to your clients that taking fashion risks can pay off, too. Letting their personalities shine through via their clothing choices can help them feel true to themselves. They may even start a trend among their peers.

    Expressing themselves through artistic arenas can help them feel more centered. Pouring their feelings of abnormality into artwork, the written word, and other creative outlets can feel empowering. Many books, songs, and works of art showcase negative emotions for which the creators needed an outlet. Challenge your clients to vent fears and feelings of inadequacy via the visual, written, and performance art worlds.

    Social Media Can Promote False Images About Normalcy

    A Pew Research Study found a correlation between teen usage of social media and stress related to self-concept. When engaging in social media, many teenagers develop a concern about:

    • Pressure to post lots of content that showcases them in a positive and attractive light
    • Appearing to have an active social life and romantic interactions
    • Seeing posts and pictures about peer events to which others did not invite them
    • Feeling unpopular if they do not receive a lot of comments and likes on their posts
    • Viewing content others have posted about them without permission or that showcases them negatively

    Struggling With Addiction Is a Commonality for Many Young People

    Some of your clients may feel like an outsider due to their substance use disorder. Remind them that they are not alone. A report from the Journal of Adolescent Health concludes that substance use by young people was concerning during the pandemic. Before COVID-19, an estimated 28.6% of teenagers used alcohol. Since the pandemic, the number rose to 30.4% and the use of cannabis also increased.

    According to the National Center for Drug Abuse Statistics, ten million young people aged 12-29 need treatment for substance abuse disorder. Sadly, only about 10% of them will receive professional treatment. This means young people share their disorder with more peers than they may realize. While no one wants to “normalize” addiction, it can prove helpful for young clients to know they do not suffer alone.

    Young people expend a great deal of energy worrying if they are “normal.” Peer pressure provides the impetus to want to fit in, but the concept of normal is fluid. Trying to be and feel normal can cause many adolescents to feel they can never live up to unrealistic expectations. The pandemic itself forced people to redefine normal, challenging people to revisit their views on their lives. Sustain Recovery provides long-term treatment plans that help young people understand themselves and remove the pressure to be perfect or so-called “normal.” We recognize that drugs and alcohol are not the problems but rather the unhealthy solutions our young clients tried to apply to their issues. Our Southern California campus offers individual and family therapy, as well as treatment for co-occurring disorders. We provide schooling to keep your child from losing out on their education. Call us now at (949) 407-9052 to find out how we can help.

  2. Recovery is Evolving

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    doctor and female patient talk about mental health

    In the 1970s, treatment professionals became aware of a real correlation between mental illnesses and substance abuse. Initially, the terms ‘dual diagnosis’ or ‘dual disorder’ were used to describe this but were confusing in that they implied there were only two diagnoses in place when there could be multiples ones. The term ‘co-occurring disorders’ has since replaced those terms and is defined as having one or more alcohol or drug abuse disorders and mental health challenges.

    The mental illnesses that can co-occur with substance abuse include:

    • Anxiety Disorders
    • Depression
    • Bipolar Disorder
    • Eating Disorders
    • Schizophrenia
    • Borderline Personality Disorder
    • ADHD (Attention Deficit-Hyperactivity Disorder)
    • OCD (Obsessive-Compulsive Disorder)

    Public Awareness Allows For More Acceptance

    Increased awareness of mental health issues has gone a long way in helping people seek treatment. For generations, people were taught to hide their symptoms and, if they sought treatment, to keep it quiet. “Therapy is for crazy people” was a jaded and common way to view those seeking help for their mental health conditions. Nowadays, the general public has become much more aware of the reality of living with a condition such as bipolar disorder or depression, taking away some of the stigmas. Today’s younger generation is much more accepting of mental health issues and more likely to speak openly about their own experiences with it. 

    The same is true for alcoholism and addiction. While in the past, it was relegated to something people with no self-control experienced. It is widely understood today that people suffer from the disease of addiction and alcoholism, and with the proper diagnosis and treatment, they can achieve sobriety. Similarly to mental illness, those who struggled with substance abuse were encouraged to keep it a secret. Currently, there is a much more open climate in which people can talk about their experiences. 

    One Size Does Not Fit All

    Society has come a long way in how they treat and view co-occurring mental illnesses. For a long time, many people who needed individualized care, instead suffered in facilities reminiscent of the one featured in the 1975 film One Flew Over the Cuckoo’s Nest. These asylums were a last resort that didn’t so much focus on providing what each patient needed but kept them out of society and from harming themselves or others. Many patients were pronounced hopeless either due to mismanagement or a lack of understanding of how to help them.

    Today there are many more options, such as PHP (partial hospitalization program), IOP (intensive outpatient program), and residential programs in which each person is fully evaluated for co-occurring illnesses, and a treatment plan is created specifically for them. Patients are not expected to fit a pre-formed mold; they are given the respect of discovering who they are and what they need to manage their illnesses and live a productive life. Often families are offered the opportunity to participate via family therapy appointments, which gives them a better understanding of what their loved one is experiencing and arms them with ways to assist them.

    Legislation Has Helped Treatment Evolve

    In 1990, the Americans with Disabilities Act was passed, which was a game-changer for millions. While offering newfound protection to those with physical disabilities, it also reclassified several mental illnesses as disabilities, opening the door for many to experience assistance with obtaining and understanding the rights to employment, schooling, public service and accommodation, and home life situations. President George H.W. Bush signed the Act into law, and it is considered by many to be more than just protection, but a piece of civil rights legislation. 

    When the Affordable Care Act was passed under the Obama Administration, it offered protection from insurance companies that typically refuse to cover pre-existing conditions. For someone suffering from mental health challenges that often require long-term care, allowing coverage for pre-existing conditions can mean the difference between having access to treatment options, and not being able to afford any treatment at all. For example, someone suffering from an eating disorder may benefit from seeking individual counseling, a nutritionist, going to an IOP or residential program, and after-care treatment. If all of these become something they can only fund out-of-pocket, many sufferers or their families have no options to provide for professional help. 

    Treatment Options for Your Clients

    Clients who need help dealing with co-occurring diagnoses are fortunate to live in a time where there are many treatment options available. Studies on genetic predisposition and the environment in which a person lives or grew up, continue to shed light on what causes co-occurring disorders and how best to treat them. The continued revising of the DSM (Diagnostic and Statistical Manual of Mental Disorders) creates an ongoing conversation about what treatment professionals know and what modalities and definitions can be updated. All of this provides myriad options for designing a treatment plan for those who need help with their co-occurring disorders. 

    Once upon a time, there were few options for treating either addiction or mental illnesses for people of all ages. Nowadays, incredible strides have been made in understanding both conditions, as well as the commonly co-occurring disorders that afflict so many people. Sustain Recovery provides Outpatient Services, Intensive Outpatient Programs, Partial Hospitalization Programs, and Residential or Inpatient Services. We understand the unique challenges that face adolescents who struggle with co-occurring disorders, and our professional staff can help design a treatment plan that addresses all of them. Our California programs provide the specialized treatment that adolescents in trouble require. If you need assistance finding help for a child who deals with both the disease of addiction and mental illness, call us today to discuss how we can help them heal and become whole again.

    Get your child on the road to wellness today! (949) 407-9052


  3. Getting Help for a Loved One with a Gambling Problem

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    Getting Help for a Loved One with a Gambling ProblemCompulsive gamblers often justify their conduct by arguing that it is a solitary activity. They claim that they gamble by themselves and that they are not hurting anyone when they do gamble. Their families and friends, however, know that the truth is exactly the opposite. Compulsive gamblers will be increasingly disassociated from their families, careers, and friends; they will use money for gambling and leave their families short of funds for food and shelter. Their gambling takes a larger psychological toll on their relationships as they turn increasingly inward to satisfy their compulsions. Families and friends who are faced with the challenge of dealing with a compulsive gambler will have no idea where to begin. Fortunately, they have access to a growing pool of resources that can offer assistance with their need and desire to help a loved one who has a gambling problem.

    Getting Help for a Loved One with a Gambling Problem

    Before taking any rash action, a person should make an effort to understand gambling addiction and to confirm that their loved one has fallen prey to it. Compulsive gamblers are unable to control their actions when faced with an opportunity to gamble. Over time, they seek out more and more opportunities to gamble. They spend larger sums of money to support their compulsion, they ignore work and family commitments to participate in gambling activities, they attempt to hide or downplay the amount of time and money they dedicated to gambling, and they might borrow or steal money to support their habits. No black-and-white rule exists to conclusively define a problem gambler, but if you have a loved one who exhibits a few of these symptoms, he may well be on a path toward developing a gambling addiction.

    You can use the same tactics with a problem gambler as you might use with a person who has a substance abuse problem. If you confront a problem gambler about his or her actions, stay as objective and non-judgmental as is possible. Do not blame yourself for the problem, and avoid heated arguments. Focus on how your loved one’s gambling is affecting you and your family. If you concentrate only on your negative impressions of the gambler, you may trigger his defensiveness and the conversation will rebound onto you.

    Treatment for Gambling Addiction

    Take pains to avoid any enabling activities of your own. Do not give or lend money to a gambler. Do not make excuses for him, for example, by agreeing to call his employer to excuse an absence or to explain why he might be missing a family event. Beware of any manipulative conduct on the part of the problem gambler. Addicts, including gambling addicts, develop an almost uncanny ability to cover their tracks and to have other people cover for them. When you have determined that your loved one is a problem gambler, you may need to put some distance between him and yourself to protect you from that manipulation.

    Look for resources that can help you as a friend or family member of a loved one who has a gambling problem. Support groups can give you more tools and techniques that can increase your likelihood of succeeding in getting help for the problem gambler. Lastly, understand that your efforts to help a problem gambler will take time. Do not expect an immediate resolution of a problem that might have taken months or years to develop. Convincing a compulsive gambler to get help may require persistence and patience on your part.


    For additional suggestions on how you can help a compulsive gambler whose actions are affecting your life, please call Sustain Recovery Services at (949) 407-9052. We can provide confidential counseling to help both you and your family member to address and stop a compulsive gambling problem.

  4. How to Stop Binge Eating

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    How to Stop Binge EatingThe advertising tag line “ I bet you can’t eat just one” foreshadowed the growing obesity epidemic that is being fueled by binge eating. Binge eaters will numbly go through an entire bag of potato chips or a box of cookies without stopping to think about what they are doing and with no sense of hunger or fulfillment. Eating comforts them, distracts them from the stresses in their lives, and fills an emotional hole that might otherwise leave them feeling depressed, angry, or anxious about negative events in their lives.

    The Dynamics of Binge Eating

    If binge eating is not controlled, it can lead to severe health problems that are associated with obesity, including diabetes, heart disease, high blood pressure, and stomach and renal disorders. A person might be biologically predisposed to binge eating as, for example, if he has a disorder that blocks messages from his brain telling him to stop eating because he is full. In modern society, social, cultural and psychological factors are more likely to lead to binge eating disorders. A young person who is bullied at school or abused at home will turn to binge eating to ease the pain of those events. People use food as a reward for surviving on-the-job stress or difficult conditions in their home lives or relationships. Binge eaters will consume salty or sugary snacks to alleviate symptoms of depression. Any situation that leads a person to consume large quantities of food with no consideration of any accompanying hunger can signal the start of a binge eating disorder.

    Treating a Binge Eating Disorder

    Binge eating is characterized by a complete lack of control over food consumption. Binge eaters will obsess about food. They will eat in secret and try to hide their proclivities from friends and family members. They might feel guilty or disgusted with themselves at the end of an eating binge, or even eat until they are sick, but no amount of guilt, disgust, or illness will convince them to take control, of their food consumption.

    The first step in ending a binge eating problem is for a binge eater to gain a sense of awareness of how much food he or she is consuming. This can be accomplished with the maintenance of a food journal. That journal will become a record of the stresses and events that lead to eating binges, which will allow the binge eater to develop different strategies to handle those stresses and events. Binge eaters can also remove temptations to overeat by keeping foods out of their houses that they have used to satisfy food cravings, and instead to focus on eating no more than three regular meals or five smaller meals every day.

    Binge eaters should also focus on starting an exercise program and incorporating activities into their lives that they can turn to as alternatives to binge eating. Getting a sufficient amount of sleep will also be critical to manage a binge eating problem, as a lack of sleep has been shown to increase cravings for carbohydrate-laden foods. Binge eaters should also strive to focus on feelings other than the urge to eat, and to develop alternative responses to negative feelings. If a binge eater cannot manage these tasks alone, he or she should seek professional help to counteract the urge to binge eat.

    Modern society may have created the conditions that gave rise to binge eating problems, as well as the ready and available products that can satisfy the binge eater’s cravings. Fortunately, binge eaters have countless resources to fall back on that can help them break a binge eating problem.

    If you are concerned over your own binge eating, please call Sustain Recovery Services at (949) 407-9052. We can assess your relationship with food and give you suggestions on how to make that relationship healthier and more fulfilling.

I first met Sayeh in November of 2013 just after my 15 year old daughter had been admitted to a residential treatment program. As part of the program I was required to attend 2-3 AlAnon meetings a week. Sayeh attended the same AlAnon meetings as well as Alumni events as I. It soon became apparent to me that Sayeh had a heart for recovery, program, and God. When I was encouraged to get a sponsor I didn’t hesitate. Dependable, respectful, kind and generous of spirit, she exudes an inner peace that I hope to achieve with her loving guidance, as I work my own program. She is patient, & full of wisdom that she is always happy to share with her sponsees and fellow parents. I am so grateful our journeys brought us together.

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