Mental Health week is every week

It’s Mental Health Week, but every week is Mental Health Week here at Sarah Warry Counselling and Addiction Recovery Services. Mental health care is an often-overlooked aspect of our overall well-being, yet it's essential for living a happy, healthy, and fulfilling life. In this blog post, we'll explore the importance of mental health care, the consequences of neglecting it, and ways to prioritize our mental well-being.

The Consequences of Neglecting Mental Health Care

Mental health issues, such as depression, anxiety, and trauma, can have a profound impact on our daily lives. If left untreated, they can lead to:

- Strained relationships

- Decreased productivity

- Poor physical health

- Social isolation

- Suicidal thoughts and behaviors

-Addiction

Breaking the Stigma

Unfortunately, mental health care is often stigmatized, and many people hesitate to seek help due to fear of judgment or shame. It's crucial to recognize that mental health issues are not a personal failing, but rather a sign that we need support and care.

The Importance of Mental Health Care

Prioritizing mental health care is vital for:

- Developing coping mechanisms and resilience

- Improving relationships and communication skills

- Enhancing problem-solving and decision-making abilities

- Boosting self-esteem and confidence

- Increasing overall quality of life

Ways to Prioritize Mental Health Care

1. Seek Professional Help: Consult with a therapist, counselor, or psychiatrist for guidance and support.

2. Practice Self-Care: Engage in activities that bring joy and relaxation, such as exercise, meditation, or hobbies.

3. Build a Support Network: Surround yourself with understanding friends, family, and support groups.

4. Take Breaks and Prioritize Rest: Allow yourself time to rest and recharge.

5. Educate Yourself: Learn about mental health, its importance, and available resources.

Conclusion

Mental health care is not a luxury, but a necessity. By acknowledging its importance, breaking down stigmas, and prioritizing our mental well-being, we can lead happier, healthier lives. Remember, seeking help is a sign of strength, not weakness. Let's work together to create a society that values mental health care and supports those who need it.

If you're struggling with your mental health, please reach out to a trusted adult, mental health professional, or call a helpline such as the Suicide Prevention Lifeline 9-8-8.

There is help available, and you are not alone. <3

you’ve prepared for the expected, but what about the unexpected?

Often times, people in recovery may be working on how to cope with and minimize day to day stress. This is excellent work, however, may times, even in residential treatment, we forget to expect the unexpected and that life often comes with issues we aren’t prepared to deal with.

I work with my clients on how to deal with stress management, stress mitigation, and the removal of the things we don’t need or want in our life. Also, dealing with grief and loss. Not as a grief counsellor, but how to identify grief and complex grief, and the stages of grief and loss. As humans, we should expect that we will encounter losses. Losses of friends, family, and others- through death or the ending of relationships. Also, the loss of material things, jobs, children leaving the home, or even parts of ourself.

These losses can bring us through the same grief cycle as death, so being prepared and understanding of the process is more than helpful. If we understand addiction can be created when we have a desire to escape, and the desire to escape negative or uncomfortable feelings being very common, we understand the importance of this work. WHen you are working on your recovery, ensure you are working on being realistic with your life and the events and happenings that have and may or will happen. It’s better to have things and not need them, than need them and not have them. Talking about death and loss can be hard, but being proactive and getting the skills and tools ahead of time can make your recovery much more successful.

“It is not death or pain that is to be dreaded, but the fear of pain or death.” – Epictetus

Helping others by understanding their story

Part of assisting those struggling with mental health and/or addiction, is understanding their life and story.

When we understand a person's story, we get a better understanding of why and how they make the choices they do, and think the way they think.

Whether it's stemming from negative schemas and core beliefs that come from childhood abuse and trauma, symptoms of an underlaying mental health diagnosis that's not treated or undertreated, or a learned behaviour they've been conditioned to do or not do.

We can have greater success when we use compassion and understanding with the individuals we see. By understanding others and not judging or trying to consequence them into changing, we can allow for the opportunity for them to also understand their story and connection to their current situation. If the goal through counselling is self development and change, the idea and promotion of self awareness should come first.

For counsellors, you must understand, your client will only go as far as you allow them through your own understanding and emotional intelligence. When we look at what is meant by E.I, this is the ability to manage both your own emotions and understand the emotions of people around you. The 5 parts that make up EI are: self-awareness, self-regulation, motivation, empathy, and social skills.

By understanding the story of others and having a strong understanding of your own story and your E.I level, you can assist your clients in understanding and building theirs.

“First off, don’t let the force of the impression carry you away. Say to it, ‘hold up a bit and let me see who you are and where you are from—let me put you to the test’ . . .” — Epictetus, Discourses, 2.18.24

#addiction #addictionrecovery #recovery #mentalhealth #mentalhealthawareness #trauma #traumarecovery #recoveryjourney #stoicism #life #emotionalintelligence #buildingabetterme #hamont

Enabling within the family system

***Trigger warning- this post may be harmful to some.***

More often than not, Addiction floods into the family system. When one or more family members are struggling with addiction, it can change the dynamics of the family and the roles of those in it.

There may be one parent who is in active addiction, while the other parent or another member of the home plays the role of " The Enabler". The enabler often makes excuses for the addictive family member and tries to cover up for them by hiding the problems the addictive family member is having, and protecting them from the consequences their addiction causes.

This can be seen when the enabler makes excuses for why the addictive family member can't make it to work or pay bills, they may call into the addictive family member's employer or school stating they are unwell and can't come in, they may hide and deny abuse in the home and property damage, or they may pretend the addiction doesn't exist at all.

Kids in the home may be told to lie to people outside of the family about what happens, and they may take on roles that create further dysfunction for them that often lasts into adulthood and causes generational cycles of trauma and addiction issues.

The longer the family stays in this cycle of denial, the further the addictive family member snowballs into their addiction, and the more problems it causes for everyone in the family. Because the addictive individual isn't confronted, or the enabler doesn't set boundaries, nothing changes and the family deteriorates.

Children have a higher risk of developing trauma, mental health, and addiction issues, and their chances of building healthy relationships with others as adults will be fragmented due to the modelling they see in the home. Children in this environment will also be at high risk of having emotional dysregulation and other behavioural issues due to the unhealthy environment around them. Children may have to take on the role of the addictive parent or family member to help the family function, and sometimes child services and other outside agencies may become involved.

It's hard to be firm with those we love and care for sometimes, but it's harder to undo a lot of things once they are done. By setting boundaries and learning how to help someone you love who is struggling with an addiction, you can ensure you are maintaining the health and safety of yourself and the family, and the person you love.

If you are finding you are struggling to have boundaries and may be enabling a loved one, please reach out to a professional. Families can and do recover.

Your Window Of Tolerance

Most people understand the basics of both addiction and trauma, but what do the two have in common? Many individuals who struggle with addiction have had 1 or more traumatic experiences in their life. Childhood Trauma and what is known as Complex PTSD (C-PTSD) can often be discovered when working with clients and present in ways such as having difficulties with emotional regulation, problems coping with day-to-day life, trouble dealing with stressful situations, or having frequent reminders of abuse and traumatic events.

 Unfortunately for some, this pattern began in childhood when they were vulnerable and unable to properly regulate themselves due to their childhood developmental stage. Without proper guidance or role models to teach and display healthy ways to cope and deal with stress, individuals can often go on to develop unhealthy patterns that become a part of them and turn into addiction and addictive behavioural patterns. The inability to regulate oneself and not having a strong social system or attachment figure leaves a vacuum that can easily be filled with substances and process addictions. This can be seen in some youth who begin experiencing substance and alcohol abuse as a means to cope with life and go on to continue throughout adulthood. Sometimes, it emerges in adulthood and may result after events that occurred in an individual's adult life. Another situation that happens is when an individual was not having their needs met as a child, and then experiencing the same as an adult, addiction begins because it becomes a safety blanket so to speak and gets reinforced after substance use creates a sense of ease or calm in the individual. 

When working with clients on coping and self-regulation skills, it is important for counsellors to be mindful that for many people, their substance use was/is a way to escape their trauma, and what may have kept some people alive.

Dr Dan Seigel's "Window Of Tolerance" is an amazing graphic that depicts where an individual feels safe and secure, and can easily manage day-to- day life. Once triggering stimuli enter the picture, individuals can go up or down, and this is where things can begin to create issues for the individual and create a desire to use. Trauma and Abuse can often alter a person's brain and create a constant state of panic, or make it easy for stimuli to distress them and put them into unhealthy states. Stimuli in everyday life can trigger an overactive amygdala and create emotional, mental, and physical reactions in the individual. Memories, smells, sights, feels, and tastes can take a person out of calm within seconds and bring mental and physical discomfort and illness. By using substances, the individual hopes to successfully block these reactions and "numb" themselves. At times, however, the opposite effect can take place and worsen the reactions to stimuli and amplify trauma and panic. This can be seen in some individuals who become anxious, scared, or aggressive and violent when using. 

By working on the individual's Window Of Tolerance, we can help them learn about where they are at and identify what triggers and events put them into Hypo or Hyper Arousal. By doing so, we can further help them identify problem areas and begin working on coping mechanisms to help bring them back into their Window Of Tolerance and find ways to make their Window of Tolerance larger while decreasing the Hyper and Hypo Arousal triggers and reactions brought on by inside and outside stimuli.  

Hyperarousal can be seen as the "Upper" part of the window where stimuli and events create fight, flight, or freeze responses. 

Hyperarousal Symptoms:

• Angry outbursts

• Fear

• Anxiety

• Emotional overwhelm

• Panic

• Hypervigilance

• Tight muscles

• Deer in the headlights- freezing

People often feel like they are losing control and unable to stop these feelings, and they may feel as if they are going crazy. Helping individuals learn skills in mindfulness, breathwork, guided imagery, and other techniques to help ground them when entering this stage can be a strong starting point and help them learn to regain control over their physical body and mind. 

Hypoarousal is on the lower side of the Window Of Tolerance and when a person has become too activated for too long and their parasympathetic nervous system gets tired and doesn't react. This can be seen in individuals who look numb, dissociated, and empty. They may face stimuli and have no reaction and completely shut down. In this state, some individuals may sleep for prolonged periods, overeat or not eat at all, and have no desire to participate in day-to-day life. 

Hypoarousal Symptoms:

• Depression

• Numbness

• Emptiness

• Flaccid body

• Blank stare

• Inability to speak

• Dissociation

Some activities to help individuals come out from Hypoarousal can be guided breath work, physical activity, and engaging in activities that excite or entertain the individual and create a sense of well-being. 

By working on emotional regulation and coping skills, individuals can begin learning how to move back into their Window Of Tolerance. By replacing their use with healthy coping mechanisms they can begin to cope better and not turn to substances to block out the thoughts, feelings, and physical sensations that being outside of their Window Of Tolerance brings. Ongoing monitoring of triggers and reactions will help individuals learn what works, what doesn’t, and where they can keep learning. Using journals, tracking charts, and other documentation, clients and their counsellors can mark progress and help the individual widen their self awareness and master their skills.

“Remember, no human condition is ever permanent. Then you will not be overjoyed in good fortune nor too scornful in misfortune.” – Socrates

How to f@#k up your chance at change and screw up everything.

“Is any man afraid of change? What can take place without change? What then is more pleasing or more suitable to the universal nature? And can you take a hot bath unless the wood for the fire undergoes a change? And can you be nourished unless the food undergoes a change? And can anything else that is useful be accomplished without change? Do you not see then that for yourself also to change is just the same, and equally necessary for the universal nature?” – Marcus Aurelius

Change is hard, but not changing may be worse, and change may be one of the scariest words in the English language. When most people even think of the idea of changing something, you can expect anxiety, discomfort, and even anger. But why is this? If a person is experiencing something that is perhaps ruining their health, relationships, and/or life, why would they not change? For this post, I'm going to talk about the idea of any kind of change for any given person, and not in the context of someone struggling with an addiction. That will be a later post, but this will be a starting point which may open some eyes to the subject. Today we are going to discuss how to make change impossible and how to completely destroy your chances at success.

Most people are comfortable, even when they aren't. What.............?

As humans, when we get into routines and habits, our brains wire themselves to know and expect to do things in a certain way, at a certain time, and for a certain period and it becomes a part of us. Social Learning Theory and Operant and Classical Conditioning add a few more layers to the complexity of this but let's look at why people don't like change. Let's explore what they do to themselves to ruin their chances.

So change is hard. If you go back to the part about being comfortable and having routines and habits, you can understand this. First off, change means having to consciously (and with effort) do things differently. Because of this, the idea of change can destroy your attempts before even getting ready. Mind traps often become one of the largest obstacles we face when attempting to change. Cognitive Distortions can play a part in why many people struggle to make changes, even in minor aspects. Some people minimize their problems and behaviours, so the need to change doesn't seem important to them. They could generalize that "everyone does this" and reinforce the idea that change isn't needed. Perhaps they carry some rigidity in their overall personality and that plays a part. The more negative we swing ourselves into, the harder it will be to make a change. Negativity seems to be the hardest obstacle, but making things negative seems to be the easiest part.

Often, we don't want to hear something is "wrong" with us or feel we aren't doing something "right". We may become rigid and closed off. Our ego can often get in the way of becoming a better version of ourselves. If we tell ourselves that we need to change, we may feel that means we aren't happy with ourselves or aren't good enough. For those struggling with low self-esteem or mental health issues, this could create a crisis in itself.

If we don't know how the change will affect us in the short or/and long term, it also creates issues. The comfort in knowing what we are doing now, even if it brings negativity, still means being in the know- and that is more comforting than surprises and not being in control. Because we don't know what the outcome will be, only what we want, we can doubt ourselves and fear failing, or fear wasting our time, or fear looking stupid if we don't get the results we or someone else wants us to get. When we don't see results as quickly as we want, this also detours us from continuing. We live in an age of instant gratification, if we can't do or get something quickly, it loses its glamour and our ambition to carry on with it. If we don't have the ambition to start with, this brings more problems. If we are changing because someone else wants us to and/or we don't think it's needed, we start to slack and find excuses or blame others for our failure to work towards getting and maintaining the change. There goes our motivation.

The less motivation we have, the less likely we are to attempt and/or continue working on change. Working on something also means time and effort, and "What is the price we are paying to make this change" becomes a question we start to ask ourselves. We can begin to manipulate the need to change into a negative situation. Sometimes we don't want to take responsibility for that failure that's possible to occur, and if we set ourselves up for failure from the start, we can grow more and more resentful and unwilling to carry out tasks to change knowing failure is looking more and more possible.

On the flip side. others may be up and running and ready to do something. There are times when someone may spend too much time planning their action plan for change. The planning phase overtakes the actual attempt and work towards change. Maybe they have great intentions, but then they started focusing on making too many changes, they have too many plans, and then their focus gets completely side-railed. They may have all these ideas and pictures in their mind about the actions to take, but they don't seem to ever find the right time or place to do so, or gain the resources needed to make the change. They can become a perfectionist in the way they want to carry out the change and it becomes a hinder or even an excuse to not move forward. They may start to even doubt the process of change from overthinking it. Eventually, if you struggle with the above, you could likely give up.

Many people will consciously and/or unconsciously spend more time and energy working against themselves and self-sabotaging their effort to change than actually attempting and carrying out the tasks to change. Some people try and don't get it at first, then they give up. Sometimes it becomes exhausting or annoying and they get to a certain point and think "good enough" is good enough.

No matter what negative trap you find yourself in, the best solution is to start by getting out. Begin telling yourself that change is a natural part of life and growth, and that winners don't win unless they try and then finish. You start by being good, and with continuation and dedication, you become great.

The stoics and other great minds taught some great things about change. Bringing a little of their wisdom into your life and efforts will go a long way.

"As long as you live, keep learning how to live." – Seneca

“There is nothing permanent except change.” – Heraclitus

“When it is obvious that the goals cannot be reached, don't adjust the goals, adjust the action steps.” – Confucius

“Everything changes, nothing remains without change.” – Buddha

“When you let go of who you are, you become who you might be.” – Rumi

Boundaries For a Healthy recovery.

In life, but especially recovery, we need to sit back and take an inventory of the people around us. In order to be healthy, we need to have healthy people around us. This isn't to judge others or try and isolate them, it's to ensure that we aren't taking on more issues than we need ourselves, especially when we are at a turning point and trying to grow. And this doesn't mean that we need to cut off everyone we know who may be having issues. It means we need to see what and who may impede on our growth.

Sometimes we may have people around us who don't like that we are progressing. This may be because they benefit from us being unwell, and while it may not even be conscious to that person, sometimes it is. Some individuals may have co-dependency issues and like when we are not well because it allows them to be in a caretaker role. Others may use our illness or misfortunes as a way to feel better about themselves and the issues they have. Some people unfortunately enjoy seeing other people having misfortunes for no reason but their own entertainment.

There are also people who are your friends and do care, but they are also using or partaking in activities you are trying to recover from and now see your recovery as something taking you away from them. Other times, friends and family may be going through issues and don't have the coping skills or self awareness to see how their actions or inactions may create issues for your recovery.

These people may not be trying to be malicious, and it may just be their coping if they start to lash out or treat you differently. You do however need to decide whether this is a potential road block or could initiate a possible relapse. It all comes down to deciding if there is room for them in your life at this moment, and maybe only with set boundaries.

In any event, the healthier and more supportive the people are around you, the more likely your recovery efforts will be smooth and long lasting.

As Epictetus says “The key is to keep company only with people who uplift you, whose presence calls forth your best.”

What is Addiction and what are some things done in counselling?

I made a short slide show that discusses addiction and a brief intro to what addiction counselling entails.

People often ask what benefits counselling and recovery brings.

91% of recovering addicts have a very positive quality of life, with:

96% having stable housing;

94% being able to pay bills on time; and

90% actively participating in family activities

-(www.ccsa.ca Stats Document)

This is important because "1 in 3 people will experience mental illness in their lifetime" and "An estimated 21 percent of Canadians will experience addiction issues in their lifetime." - CAMH

Together we can stop the stigma and help our friends, family members, neighbours, and others get access to services and improve their quality and quantity of life.

I made a short slide show that discusses addiction and a brief intro to what addiction counselling entails.

Why isn’t “Just stopping” enough in recovery?

People often ask why counselling is beneficial to those who are looking to start recovery or have already taken the first step. They ask why "just stopping" isn't effective enough. Why can't my loved one just quit and be healthy? Why do I need to see a counsellor if I feel I can just stop drinking?

While "just stopping" and no longer using drugs, alcohol, or behavioural addictions, seems like what recovery is all about, that's just scratching the surface. No longer using is both the short and long-term goal, but to get to the long-term goal of lasting sobriety, we often have to explore many other areas and do other work to stay on track to not returning to using. During addiction recovery (or many other behavioural change/modification processes) we recognize relapse is a possible occurrence. We’ve learned a behaviour that may have gotten us through rough periods in life, and even though it may have also caused us problems in various areas of our lives, it has become imprinted into us. Just like we know to eat when we feel hungry, we have also learned to use when we feel stress or discomfort or a variety of other reasons.

To learn how to be sober means to UNLEARN using. Relapse often occurs after a series of events or stressors begin to create a sense of discomfort in the individual in recovery. There are signs and events that usually precede relapse, and if the individual and/or their support network understand and see these signs and have a "plan" and tools to deal with them, their chance to mitigate relapse is heightened. The first stage of relapse is usually referred to as EMOTIONAL RELAPSE. It is at this time that old maladaptive thoughts and moods start to reoccur. Individuals may begin experiencing depression, mood swings, anxiety, and other red flags. Their sleeping may become disturbed, they may begin isolating themselves from others and not attending meetings or appointments, and they may begin ignoring their recovery plan and ignoring others' offers to help.

To see how this looks, let's use smoking for example because cigarettes are one of the most commonly used drugs in our society which people attempt to quit daily.

Many people who smoke have placed an attachment to their cigarettes. By this, I mean that they have placed an emotional or other personal connection to them. They identify that cigarettes help them during stressful times. So aside from the difficulty they may experience quitting due to the physiological addiction cigarettes cause, they now also have the mental aspect of the addiction to work through. When experiencing stress, anxiety, or even positive emotions, an individual may be conditioned to reach for a cigarette. They know this cigarette is going to relax them. Indeed they do. The chemicals in cigarettes affect your body in such a way that within seconds of inhaling nicotine, dopamine is released and causes a sense of relaxation. The double edged sword, however, is that once the levels of nicotine in your body start to disappear, you begin to have withdrawal symptoms which now may be more problematic than the original stress or anxiety you were having which led to the urge to smoke. This is the case with most substances and alcohol after physical dependence has been established. Often, the original issue may not even be resolved, and now you are left with an ongoing concern or worry regarding issue X, plus you have nicotine (or alcohol or drug) withdrawal symptoms which can cause symptoms such as anxiety and anger, illness, and so forth. By working with a counsellor, you can start learning new ways to deal with life and how to implement healthy coping mechanisms and replace addictive behaviours and substances with healthy outlets and positive coping skills. You can also learn about cross- addiction and learn to look for signs you may be replacing your primary addiction with another during your recovery process.

When a person has not explored new coping mechanisms, discovered how to practice self-awareness, or changed their environment or things which may be creating the desire to use drugs and alcohol to escape or "deal with" people and situations, they can easily fall back into addiction via relapse. Learning about “lapses” and relapses, and having relapse prevention plans will help individuals and their families feel empowered and motivated in the recovery process.

So, why isn’t “just quitting” enough? Participating in addiction counselling helps individuals and their families learn about addiction and gives them the tools to start recovery and relapse prevention planning. By exploring what creates the urge to use and learning the skills to help them with these day-to-day issues, individuals can reduce their risk of relapse and start living happier, healthier lives. Working with a counsellor and discussing maladaptive coping skills, faulty thinking patterns, undiagnosed or untreated mental health concerns, past or ongoing trauma, and other things in life that have and may continue attributing to the addiction can help an individual ensure their road to recovery includes education, skills, and plans and goals to name a few.

A trained and certified addiction counsellor will have the skills and background to help clients work towards challenging their urge to use and identify the thoughts and feelings that cause these, as well as teaching the skills and tools to promote lasting success in recovery.

What the stoics Taught us about control

"Some things are in our control and others not. Things in our control are opinion, pursuit, desire, aversion, and, in a word, whatever are our own actions. Things not in our control are body, property, reputation, command, and, in one word, whatever are not our actions.''
-Epictetus, Enchiridion and Selections from the Discourses

It is a well-known fact that stress is a major contributor to whether someone is at high risk to develop an addiction, and experience relapse while in recovery. While many people may believe that stress is not within their control, by learning about control itself, one can actually reduce the amount of stress they experience.

The Dichotomy of Control is a philosophical practice developed by the Stoics to help identify the things in life that are within our control, and not within our control. By learning to identify and respond depending on which category a situation falls under, we can reduce our stress and worry, and ultimately begin living happier, less stressful lives. While some may say "this sounds difficult", or " no way", let's look at the way this works.

There are two choices to categorize your situation into: within your control and not within your control. Ultimately the only things within your control to the Stoics are your beliefs, your values, your perspective, and your actions. Everything else is outside of your control whether you like it or not.

Fast forward to modern times and we see the implementation of a third option. In his book " A guide to the good life", William B. Irvine adds a third and somewhat controversial third category. Enter now option three" “things over which we have some, but not complete control”. So what exactly does that mean? Well, let's use the example of rain. While you cannot control the rain, you do control whether you choose to yell and curse and ruin your day by being in a bad mood. Now, by using the third category, you can exercise some control over the negative effects of the situation and mitigate some of the negative emotions the rain brings to your day. For instance, you can use an umbrella, you can leave early for work to avoid being late due to slow traffic ( traffic is also not in your control, total rager, I know), and you can choose to use breathing exercises and mindfulness if you feel yourself becoming upset. You can also choose to find the positives, like telling yourself why rain is needed and things you enjoy (ex flowers need rain to grow). This alone can change your perspective and overall mood.

The reason I mentioned this third category is controversial is that in some stoic circles, it's seen as putting the focus on a wanted outcome and not necessarily the situation itself. In any event, if it works, go with it. We can choose to be happy or not, that's in your control, do with it what you shall.

By learning to use this daily, you can hopefully start seeing some of the stress in your life go down, and lessen the urge to use substances or behaviours (shopping, excessive internet use) to help relieve the negative feelings and desire to escape life. This also helps you free up your time and mental efforts so they can be put towards things you enjoy and that are in your control. So, will you choose to let go of control and lessen stress so you can bring more enjoyment to your life?

Words of wisdom from our friend Epictetus- "There is only one way to happiness and that is to cease worrying about things which are beyond the power or our will."

Learning to give up control to reduce stress in early recovery

One of the hardest parts of early recovery is dealing with stress and one's own emotions. For many people, drug and alcohol use was a way to escape negative thoughts and feelings, and dealing with one's own emotions became foreign to them. This is especially true for those who may be dealing with untreated PTSD or trauma caused by childhood abuse or neglect. Often, one may not even understand the thoughts or feelings they are experiencing if they become common and frequent. Some may know very well the issue that caused them to reach for something to numb their feelings.

For those in an inpatient setting, they may find they are coping well and cravings are minimal while in a treatment centre. Upon discharge when they are entering back into the world, they may begin to struggle with life stresses and the people in their life, and they find the cravings return. Not having the tools to help work through stress and find healthy coping mechanisms can set you up for relapse. Emotional relapse is often the first sign that an individual is about to start using again. Learning to deal with stress isn't particularly easy. One also doesn't have to be going through recovery to know this. The amount of stress the average person faces becomes enough for even the most mildly tempered individual to break at some point. The goal is to find an outlet and ways to help you deal and cope with the stress you face.

When dealing with stress, there are several tools you can use to help you get started and make a plan of action. We are going to focus on learning to identify What's in your Control and how to respond. When you start identifying what's in your control and what's not, and not trying to control everything and everyone, it can relieve a lot of unneeded stress in your life. When dealing with situations and people, it's easy to want to try and take control, especially if things aren't going our way or are causing distress. This often blows up in our faces and only causes added stress when we realize we cannot change and control all the things we want.

By categorizing things into In My Control, Not In My Control, and Some Parts are or this May Be In My Control, you can learn to choose your battles and save yourself from added stress that serves no purpose and triggers you to want to use.

Not In My Control: A great example is it's raining. You cannot control the rain. This is a hard no in the control factor. What You can control, however, is your response to it. While you have 0 control over the rain, you can make adjustments to avoid some of its negative effects. You can grab an umbrella, you can leave early to avoid slowed traffic, and you can tell yourself the rain is natural and needed. Also, examine any cognitive distortions you have and tell yourself they aren't true (ex " Of course, it's raining, my life is hell, and everything bad happens to me. Why do I bother.")

As you know, getting upset and yelling won't bring you peace or fix anything. Nor will ruminating or lashing out at others while upset. On top of this, if you let this bug you bad enough, odds are you will find other negative things happening throughout the day because you will be in a bad mindset, and other things will seem worse than they are. “Bad luck” will literally follow you. So, don't let the rain get you bent out of shape and add further issues that aren't needed to your day -unless lightning strikes your house and it lights on fire. Rain is not the end of the world.

Things that are Somewhat/Maybe In My Control: Maybe you ordered a sandwich for lunch. Your order arrives and you notice mustard pouring out of the sides. You hate mustard. You were looking forward to getting this sandwich all morning and now it's covered in mustard and you want to throw it. Fortunately, you have some possible control over this. You can politely return your sandwich, point out the issue, and ask for a new one. The best-case scenario is you get a new one and it's only been a minor inconvenience in your day. Perhaps they won't change your order, but at least you tried, and then you tell yourself you won't let mustard drive you to drink. Note: If you have difficulties with situations like this, it would beneficial to learn some extra communication/assertiveness skills. The other options you have are to yell, throw your sandwich, or eat it and be miserable and ruminate all day about mustard ruining lunch and your life. The choice is yours.

In My Control: You're sitting at home enjoying your favourite movie and you don’t want to listen to your phone keep ringing. You know that you can't control the other people contacting you. You could ask them all to stop, but they may not though. You know that you can turn the sound off your phone for the duration of your movie though. This is in your control, so you simply control the situation by stopping your device from making sounds and bugging you.

While these are simple situations and the issues we face may be much larger and more pressing, the idea is by practicing this daily, and journaling about situations that occurred and how you handled them or could have done better, you will equip yourself with one tool to help you mitigate some of the stressors in your life in the stressful world we live in.

Why being sober doesn’t always mean you are Doing well.

Recovery is difficult. It takes time, patience, and dedication, but all too often people have the idea that being sober and in recovery is interchangeable with being “well” and better. While sobriety and recovery are huge steps that need to be celebrated, we can sometimes be sober but not healthy. According to CAMH, “ people with mental illness are twice as likely to have a substance use disorder compared to the general population”. What this means is that for those who have a mental health diagnosis, it is likely that if both the alcohol/ substance use disorder and mental health diagnosis aren’t treated together, the rate of relapse will be higher or other issues can arise. The reason for this is that many people begin using heavily and get addicted due to self-medicating and changing their brain's reward system. For those who haven’t received an official diagnosis or aren’t aware that their symptoms are a mental health issue, this could cause further issues and ongoing relapse as they attempt to soothe themselves and self-medicate to feel better. Stats also show that those with more serious mental health issues tend to use more than those with some or no mental health issues. 

While most people understand what a relapse looks like, there are other complications that can go unnoticed by family, friends, and others who aren’t trained in the area of addiction. Relapse in itself is basically described as “when a person returns to using drugs or alcohol after a period of sobriety” and a slip is ““where a person may drink or use, but then immediately stop again”.

But what if someone doesn’t go into relapse and begin using drugs or alcohol, what other behaviours can indicate that someone is recovering well from their primary AUD/SUD but aren’t doing “well” in other areas? Cross addictions can sometimes pop up when individuals have learned to successfully discontinue their primary drug and alcohol addiction, but not cope well with life or treat underlying mental health issues. Some cross-addictions may take the shape and form of addictions to other drugs and alcohol, but I am going to focus on process/ behavioural addictions. A behavioural addiction looks like a compulsive behaviour that affects a person the same as an alcohol or drug addiction would. An individual is compelled to partake in the behaviour beyond “normal” amounts and continues despite the negative consequences it caused to their physical and mental health, relationships with those close to them, and so on.

For a more detailed understanding, let’s look at Jim. Jim is a 45 year old man with a history of alcohol use disorder and mental health issues. Jim has successfully conquered his AUD and has been sober for 10 years, however, Jim is easy to anger, he is restless, and he often works 12 hours or more a day. When Jim isn’t working, he finds other activities to partake in to “kill time”. Jim also spends a large quantity of his time on social media scrolling through Facebook and often picks his phone up when with family and friends. Jim compulsively checks his emails and even describes them as “overwhelming” and causing uncomfortable feelings of anxiety and distress at times. Jim however sees this as being a hard worker and dedicated to his business. Jim’s wife however continues to feel disconnected and second to all his “activities” and relationship issues have started to creep into their marriage because of it. Jim feels uncomfortable when not working and can become upset and argumentative when his wife nags at him to reduce his workload or that she feels it’s problematic.  

 Or Sammy. Sammy is a 20 year old female. She finished high school but spends her days and nights playing video games and shopping. She often can’t visit the store to buy groceries without venturing into the gaming aisle or toy section without buying something. She plays video games late into the night and can’t wake in the morning. Sammy has recovered from an eating disorder she had early in high school and experimented with alcohol use and drank alone for a year before quitting. Her parents are worried that her behaviours are problematic because they are causing her to spend money she doesn’t have and interfere with her ability to find and keep a job. 

So, what is the connection between AUD/SUD and behavioural addiction? Dopamine. When individuals use drugs and alcohol, dopamine in the brain increases, and the reward system becomes activated. The more and more it becomes activated, the more it needs to be stimulated to have the same effect. Over time, the more and more dopamine that is used, the more the system becomes “burnt out” as the number of dopamine receptors decrease due to the heavy load of dopamine in the brain. When dopamine receptors decrease, the need to stimulate yourself or use substances increases. So once a person stops using, they may still have depleted dopamine receptors and begin acting impulsively and acquire process/behavioural addictions in order to increase the amount of dopamine in their brain subconsciously, or knowingly. When a person isn’t acting on increasing their dopamine they may begin to suffer from depression or anhedonia, which is a state of loss of pleasure. The loss of pleasure and need to supplement dopamine through behavioural addiction now creates a new problem for those in recovery as low self- control can become problematic and create cascading events.

Some of the most prevalent and known behaviour addictions seen in cross addiction are Gambling, Sex Addiction, Shopping Addiction, Exercise Addiction, Internet Addiction, Food Addiction, and Work Addiction. So how does one distinguish between a habit, routine, “work ethic” and addiction? Generally speaking, a habit is something that people do that becomes second nature. You wake up and make a coffee, then get dressed and brush your teeth before work. It’s a routine that you have settled into and doesn’t cause any negative consequences in your life. It often creates ease and predictability and leads to a more fulfilling life. Things become addictive however when there becomes an intense, increased focus on the behaviour, and it may start taking over other parts of their life and other obligations.

Some questions you can ask yourself to distinguish a habit vs addiction are:

Am I unable to stop the activity or behaviour once started or am I doing this activity more than I want to or planned to ?

Is this activity or behaviour interfering with other areas of my life or taking time away from other things?

Are people in my life concerned or voicing complaints about the activity or behaviour?

Do I get anxious when I can't engage in the behaviour or activity or do I get withdrawl symptoms when I am not engaging in it?

Am I getting most of the pleasure in my life from this behaviour or activity?

So what can be done if you are noticing that you’re excelling at sobriety from your primary addiction but you’ve slipped into a new one or someone in your life believes you are experiencing a process/behaviour addiction?

*Seeking a mental health assessment. Research shows that half of adults with ADHD have had or will have a SUD in their life.  Knowing this information is helpful because many people with undiagnosed or untreated ADHD share similar symptoms to those above. Hallmark ADHD symptoms include impulsive behaviour, low self-control, trouble coping with boredom, and restlessness. Visiting a dr to get a referral for a proper ADHD evaluation and treatment if the diagnostic criteria is met can be very helpful for those who may be suffering from undiagnosed or untreated ADHD. Caution must be taken by doctors and patients though due to the addictive nature of the ADHD meds however so individuals must be prepared to be honest with the diagnosing and prescribing doctor about their addiction and recovery process. Sammy may be dealing with untreated anxiety and depression and be using video games and shopping to distract her and keep her active so she doesn’t have to deal with intrusive thoughts or bad feelings. An assessment and mediations if decided by a dr and patient, may help ease some of the negative behaviours associated with process addictions and make it easier to start scaling back shopping and video games to a healthier level.

*Seeking addiction counselling for the process/behavioural addiction. If you have already established a good rapport with an addiction counsellor for your pre-existing addiction, this may be a good time to give them a call. Addiction counsellors can help us pinpoint problem areas in our life and why we may be venturing back into addictive behaviour, or why we have never truly exited from it and have simply replaced it. Learning how to cope with stressors in our life and examining what may be driving us to act compulsively on certain activities or behaviours can be the starting point to cutting them down to healthy levels and repairing relationships in our life that may be becoming strained because of them. Having family sessions with the addictions counsellor as well may help you and your partner discuss the behaviours and learn how to support each other as you begin your recovery work to cut back the behaviour.

*Being honest with yourself and listening to those around you. Yes, this seems very simple, but it is very hard when we feel like we don’t have an issue. It’s not easy to hear someone thinks we have something “wrong” with us, or that we are doing something “bad”. Guilt and shame often precede addiction and only grow as the addiction grows. Learning that those who love us are looking out for us and themselves can help us become more self-compassionate. It sounds contradictory to think “someone pointing out a flaw is helping and not trying to hurt me?” YES. Being honest with yourself as well and recognizing when something is interfering in your quality of life and that of those you share your life with is a big challenge, but the more you become self-aware and able to see things and be honest, the easier it becomes to tackle problems and keep them from returning.

*Finding the areas of your life you are trying to avoid. Sometimes we begin doing activities to distract us from other things we aren’t necessarily thrilled with doing or don’t even want to be bothered with. Perhaps Jim no longer wants to be married to his wife and feels uncomfortable about the topic. Jim instead works endlessly and tries to avoid her until bedtime. Maybe he is worried about retirement, but it is at an unhealthy level where it’s become an obsession. His compulsion to work to obtain money and feel safe has become an addiction. Finding the things that are bothering us and working on adopting healthier coping skills that can help replace the maladaptive behaviours we are currently using is necessary for recovery. Aside from an addiction counsellor, perhaps if Jim no longer feels happy in his marriage, he should speak to his wife and visit a marriage counsellor. If he’s having a fear of retiring, a few sessions with a psychotherapist to discuss his fears will help him learn emotional regulation skills, map out whether they are rational or not, and learn how to delegate a better work to life ratio for him and his wife so she isn’t feeling left out.

Most people are just trying to get by with what they have available. There is no shame in this as long as you aren’t hurting others, but once you become aware of the issue, you- and only you have the power to change it. As the ancient philosopher Zeno said, “Man conquers the world by conquering himself.”