Author: Hannah Friedman

Hannah is a writer with a focus on holistic wellness. Her work explores post-traumatic growth and mental health as an intersectional issue. In addition to writing for Recovery.com, she’s composed meditations for the NatureSpace app, articles for the Cardea app, and essays on the connection between physical and mental health. In her private practice as a massage therapist, she works primarily with LGBTQIA+ clients and survivors of assault.
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Residential Addiction Treatment: What to Expect During Your Recovery in Rehab

There are a lot of stereotypes about rehab—and a lot of misinformation. You can’t always trust what you read about celebrities or see on TV. So what actually happens during inpatient treatment?

The specifics depend on your exact rehab program. But in most centers, treatment includes several different types of therapy, group activities, and long-term recovery planning.

The Goals of Inpatient Rehab

Rehab isn’t just about getting sober. It’s also an opportunity to reflect on your life and plan for a better future. In most residential programs, you’ll work toward a few key objectives during your stay.

Detox From Drug Use

Some people may have to medically detox before starting rehab. You might do this in a hospital setting, medical detox center, or sometimes at the rehab itself. Talk to your treatment team about which option is best for you.

Whether or not you have physical symptoms, detox can be difficult. But some withdrawal symptoms can be life-threatening. Medical detox is especially important if you’re in recovery from opioid, alcohol, or benzodiazepine addiction. During this process you’ll stop taking the substance and let it exit your system, which usually causes withdrawal symptoms.

Detox usually lasts a few days. ((Alison M Diaper, Fergus D Law, and Jan K Melichar, “Pharmacological strategies for detoxification.” National Library of Medicine. 2014 Jan 22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014033/)) But some drugs, like opioids, can take up to 14 days to completely leave your system. And even then, you might still experience withdrawal symptoms and cravings.

Manage Cravings

Cravings are a common part of recovery. ((Stephen T. Tiffany and Jennifer M. Wray. “The clinical significance of drug craving.” National Library of Medicine. 2011 Dec 16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4041083/)) And in early recovery, your cravings may be especially severe. An important part of rehab is learning how to manage these cravings to prevent relapse ((The Neurobiology of Substance Use, Misuse, and Addiction | Surgeon General’s Report on Alcohol, Drugs, and Health. https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-use-misuse-and-addiction. Accessed 28 Feb. 2023.)) in the future.

Some rehabs may prescribe medications to reduce cravings, like methadone for opioids or naltrexone for alcohol. This can help you focus on recovery, with fewer intrusive thoughts. Many therapists will also teach you ways to manage your cravings, like breathing or meditation techniques. ((Bahr-Robertson, Mary. Treatment of Cocaine Addiction With Integrative Meditation. Clinical trial registration, NCT01211418, clinicaltrials.gov, 24 Feb. 2022. clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT01211418.))

Address Underlying Issues

In most cases, addiction is a result of a larger issue ((“Substance Use and Co-Occurring Mental Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health. Accessed 28 Feb. 2023.)) in your life. Maybe you’ve been taking club drugs to release stress or reduce social anxiety. Or maybe drinking helps you ignore traumatic childhood memories. But in the long term, drug use makes these problems worse. Your addiction can even mask serious mental health issues. ((Substance Abuse and Mental Health Services Administration (US), and Office of the Surgeon General (US). EARLY INTERVENTION, TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS. US Department of Health and Human Services, 2016. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK424859/.)) Residential treatment encourages you to address the root cause of your own behavior.

Learn New Coping Strategies

Life is never perfect, and addiction recovery won’t solve all your problems. But it can give you the tools you need to cope with stress effectively. You may find that a daily yoga practice keeps you calm, or that keeping a journal helps you work through triggers. In residential rehab, you’ll have time and space to find the strategies that work best for you.

Build a New Daily Routine

When you’re in rehab, recovery is your only responsibility. Depending on the program, you may spend time in one-on-one therapy, group sessions, and reflecting on your own. You can also take advantage of complementary treatments, like music therapy or exploring the great outdoors. If you find value in these activities, you can keep doing them even after rehab.

Most rehab programs last between 30-90 days. ((Center for Substance Abuse Treatment. Chapter 5—Specialized Substance Abuse Treatment Programs. Substance Abuse and Mental Health Services Administration (US), 1997. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK64815/.))
That gives you enough time to learn, practice, and internalize a routine that supports your health. And when you leave rehab, these helpful habits can support your ongoing recovery.

How Does Treatment Work in Residential Rehab?

To accomplish those goals, many rehabs have a core program that guides your recovery journey.

Assessment

When you first arrive at rehab, you’ll likely meet with a few different staff members. In these meetings, you’ll talk about your reasons for starting treatment. You can also ask them questions about the healing process. Each member of your care team will evaluate your health from a slightly different perspective:

  • A therapist will perform a psychological assessment. They may ask about your drug use, trauma, and mental health symptoms.
  • A doctor or nurse will give you a physical exam, so they can address any health issues during treatment. This exam normally includes a drug test.
  • Other specialists may evaluate you using their expertise. For example, a nutritionist might perform a review of your dietary habits.

Planning Your Recovery

Using the information from your assessment, your team will design a plan of care. The details of your treatment plan depend on your exact symptoms and goals.

In some rehabs, every patient follows a similar program. This clearly defined structure can help you get your life back on track. Other clients benefit from a more personalized approach. In that case, you might choose a center that offers individualized care.

Follow the Treatment Program

In most rehabs, each patient follows the same treatment program. But your team will also account for your unique needs. For example, if you have a history of sexual trauma, you may meet with a sex therapist in addition to other therapy sessions.

While there are countless approaches to treatment, a few philosophies are especially common:

  • 12-Step rehabs broadly follow the 12 Steps of Alcoholics Anonymous and usually have a more standardized daily routine.
  • Hybrid rehab programs follow a core, evidence-based program and add complementary therapies to round out your treatment experience. Programming may be personalized to varying degrees.
  • Faith-based centers use spiritual pillars to guide your recovery, through religious readings or group prayers.
  • Holistic rehabs use alternative therapies to help you heal physically, mentally, and spiritually.

Finding a program that aligns with your values, life experiences, and goals can make the day-to-day life of inpatient treatment easier.

An Average Day in Rehab

Your days in rehab will probably be full. Boredom can trigger relapse, ((VA.Gov | Veterans Affairs. https://www.va.gov/WHOLEHEALTHLIBRARY/tools/reducing-relapse-risk.asp. Accessed 28 Feb. 2023.)) so many programs keep patients busy with a wide range of therapies and other activities. But most treatment plans also incorporate breaks in between these sessions. You may have time to meditate, or reflect on your own. Or you might choose to join a group recreational activity, like a hike or jam session.

Your exact daily schedule depends on the center. For example, at Serenity Knolls, a 12-Step rehab in California, each day of the week has its own specific schedule. But most of them follow a similar format:

  • Breakfast
  • Meditation
  • 12-Step meeting, sponsor meeting, or group activity
  • Lunch
  • Group therapy, complementary therapy, family therapy, or medical care
  • Free time or journaling
  • Dinner
  • Lecture, discussion group, or gender-specific programming
  • Lights out

This type of structure can serve as a scaffold for your healing process. But some patients prefer more flexibility during treatment. Looking at a rehab’s sample schedule can help you choose the program that’s best for you.

Sources of Support in Residential Treatment

Strong relationships are a crucial part of addiction treatment, ((Stevens, Ed, et al. “Investigating Social Support and Network Relationships in Substance Use Disorder Recovery.” Substance Abuse, vol. 36, no. 4, 2015, pp. 396–99. PubMed Central, https://doi.org/10.1080/08897077.2014.965870.)) especially during early recovery. And even in rehab, you’ll have several sources of support to lean on.

Qualified Staff Members

In residential treatment, a team of trained professionals will guide you through recovery. Each of these experts offers a unique perspective.

  • Your primary therapist will likely act as your main point of contact. They may also take the lead on designing your plan of care.
  • Psychotherapists lead individual and group therapy sessions.
  • Doctors, nurses, and other medical professionals address physical health issues and manage any medications you’re taking.
  • Support staff accompany you on group outings and provide emotional support throughout your recovery.

Fellow Patients

In most rehabs, you’ll go through treatment alongside a group of other patients. And your peers can provide a unique kind of emotional support. They may be in rehab for similar reasons, or they might share some of your recovery goals. But unlike your therapist, these people can connect with you on equal footing. Hearing someone else’s story can be hugely inspiring. These relationships also invite you to work on your interpersonal skills. So even before you leave rehab, you can see what it’s like to socialize without substance use.

Loved Ones

Depending on the tech usage policy at your rehab, you may be able to keep in touch with loved ones throughout treatment. And if your loved ones want to be more directly involved in your recovery, look for a program with family or couples therapy. Some rehabs even invite family members to visit for in-person sessions.

What Happens After Rehab?

Recovery doesn’t end when you finish treatment. But you won’t be starting your life over from scratch. By the time you leave rehab, you’ll already have a clear aftercare plan. Your provider may help you find a sober living environment, outside therapist, or 12-Step meetings in your area. With these systems in place, you’ll be well prepared for the next phase of healing.

Many Roads Lead to Addiction Recovery

There are countless ways to approach healing. The important thing is to choose one that works for you and your personal recovery goals. Inpatient rehab can be a powerful place to start. These programs let you take a step back from the hustle and bustle of daily life, to reconsider what you really want and need.

Learn more about life at residential treatment centers, including their locations, pricing, and types of therapy.

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What Happens in Residential Rehab?

There are a lot of stereotypes about rehab—and a lot of misinformation. You can’t always trust what you read about celebrities or see on TV. So what actually happens during inpatient treatment?

The specifics depend on your exact rehab program. But in most centers, treatment includes several different types of therapy, group activities, and long-term recovery planning.

The Goals of Inpatient Rehab

Rehab isn’t just about getting sober. It’s also an opportunity to reflect on your life and plan for a better future. In most residential programs, you’ll work toward a few key objectives during your stay.

Detox From Drug Use

Some people may have to medically detox before starting rehab. You might do this in a hospital setting, medical detox center, or sometimes at the rehab itself. Talk to your treatment team about which option is best for you.

Whether or not you have physical symptoms, detox can be difficult. But some withdrawal symptoms can be life-threatening. Medical detox is especially important if you’re in recovery from opioid, alcohol, or benzodiazepine addiction. During this process you’ll stop taking the substance and let it exit your system, which usually causes withdrawal symptoms.

Detox usually lasts a few days. ((Diaper, Alison M., et al. “Pharmacological Strategies for Detoxification.” British Journal of Clinical Pharmacology, vol. 77, no. 2, Feb. 2014, pp. 302–14. PubMed Central, https://doi.org/10.1111/bcp.12245.)) But some drugs, like opioids, can take up to 14 days to completely leave your system. And even then, you might still experience withdrawal symptoms and cravings.

Manage Cravings

Cravings are a common part of recovery. ((Tiffany, Stephen T., and Jennifer M. Wray. “The Clinical Significance of Drug Craving.” Annals of the New York Academy of Sciences, vol. 1248, Feb. 2012, pp. 1–17. PubMed Central, https://doi.org/10.1111/j.1749-6632.2011.06298.x.
)) And in early recovery, your cravings may be especially severe. An important part of rehab is learning how to manage these cravings to prevent relapse ((The Neurobiology of Substance Use, Misuse, and Addiction | Surgeon General’s Report on Alcohol, Drugs, and Health. https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-use-misuse-and-addiction. Accessed 3 Feb. 2023.)) in the future.

Some rehabs may prescribe medications to reduce cravings, like methadone for opioids or naltrexone for alcohol. This can help you focus on recovery, with fewer intrusive thoughts. Many therapists will also teach you ways to manage your cravings, like breathing or meditation techniques. ((Bahr-Robertson, Mary. Treatment of Cocaine Addiction With Integrative Meditation. Clinical trial registration, NCT01211418, clinicaltrials.gov, 24 Feb. 2022. clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT01211418.))

Address Underlying Issues

In most cases, addiction is a result of a larger issue ((“Substance Use and Co-Occurring Mental Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health. Accessed 3 Feb. 2023.)) in your life. Maybe you’ve been taking club drugs to release stress or reduce social anxiety. Or maybe drinking helps you ignore traumatic childhood memories. But in the long term, drug use makes these problems worse. Your addiction can even mask serious mental health issues. ((Administration (US), Substance Abuse and Mental Health Services, and Office of the Surgeon General (US). EARLY INTERVENTION, TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS. US Department of Health and Human Services, 2016. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK424859/.)) Residential treatment encourages you to address the root cause of your own behavior.

Learn New Coping Strategies

Life is never perfect, and addiction recovery won’t solve all your problems. But it can give you the tools you need to cope with stress effectively. You may find that a daily yoga practice keeps you calm, or that keeping a journal helps you work through triggers. In residential rehab, you’ll have time and space to find the strategies that work best for you.

Build a New Daily Routine

When you’re in rehab, recovery is your only responsibility. Depending on the program, you may spend time in 1:1 therapy, group sessions, and reflecting on your own. You can also take advantage of complementary treatments, like music therapy or exploring the great outdoors. If you find value in these activities, you can keep doing them even after rehab.

Most rehab programs last between 30-90 days. ((Treatment, Center for Substance Abuse. Chapter 5—Specialized Substance Abuse Treatment Programs. Substance Abuse and Mental Health Services Administration (US), 1997. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK64815/.)) That gives you enough time to learn, practice, and internalize a routine that supports your health. And when you leave rehab, these helpful habits can support your ongoing recovery.

How Does Treatment Work in Residential Rehab?

To accomplish those goals, many rehabs have a core program that guides your recovery journey.

Assessment

When you first arrive at rehab, you’ll likely meet with a few different staff members. In these meetings, you’ll talk about your reasons for starting treatment. You can also ask them questions about the healing process. Each member of your care team will evaluate your health from a slightly different perspective:

  • A therapist will perform a psychological assessment. They may ask about your drug use, trauma, and mental health symptoms.
  • A doctor or nurse will give you a physical exam, so they can address any health issues during treatment. This exam normally includes a drug test.
  • Other specialists may evaluate you using their expertise. For example, a nutritionist might perform a review of your dietary habits.

Planning Your Recovery

Using the information from your assessment, your team will design a plan of care. The details of your treatment plan depend on your exact symptoms and goals.

In some rehabs, every patient follows a similar program. This clearly defined structure can help you get your life back on track. Other clients benefit from a more personalized approach. In that case, you might choose a center that offers individualized care.

Follow the Treatment Program

In most rehabs, each patient follows the same treatment program. But your team will also account for your unique needs. For example, if you have a history of sexual trauma, you may meet with a sex therapist in addition to other therapy sessions.

While there are countless approaches to treatment, a few philosophies are especially common:

  • 12-Step rehabs broadly follow the 12 Steps of Alcoholics Anonymous and usually have a more standardized daily routine.
  • Hybrid rehab programs follow a core, evidence-based program and add complementary therapies to round out your treatment experience. Programming may be personalized to varying degrees.
  • Faith-based centers use spiritual pillars to guide your recovery, through religious readings or group prayers.
  • Holistic rehabs use alternative therapies to help you heal physically, mentally, and spiritually.

Finding a program that aligns with your values, life experiences, and goals can make the day-to-day life of inpatient treatment easier.

An Average Day in Rehab

Your days in rehab will probably be full. Boredom can trigger relapse, so many programs keep patients busy with a wide range of therapies and other activities. But most treatment plans also incorporate breaks in between these sessions. You may have time to meditate, or reflect on your own. Or you might choose to join a group recreational activity, like a hike or jam session.

Your exact daily schedule depends on the center. For example, at a rehab like Serenity Vista in Panama, your day is divided into morning, afternoon, and evening programming:

  • Early morning: You’ll start most days with a neighborhood group walk.
  • Breakfast
  • Morning therapy: After breakfast, you’ll have a 2-hour individual therapy session, followed by a 12-Step meeting.
  • Lunch
  • Afternoon group: This could be a 2-hour therapy session or recreational activity.
  • Family-style dinner

Weekends work a little differently. On those days, you may go on a group outing and even eat dinner off-site.

At Serenity Knolls, a 12-Step rehab in California, each day of the week has its own specific schedule. But most of them follow a similar format:

  • Breakfast
  • Meditation
  • 12-Step meeting, sponsor meeting, or group activity
  • Lunch
  • Group therapy, complementary therapy, family therapy, or medical care
  • Free time or journaling
  • Dinner
  • Lecture, discussion group, or gender-specific programming
  • Lights out

This type of structure can serve as a scaffold for your healing process. But some patients prefer more flexibility during treatment. Looking at a rehab’s sample schedule can help you choose the program that’s best for you.

Sources of Support in Residential Treatment

Strong relationships are a crucial part of addiction treatment, especially during early recovery. And even in rehab, you’ll have several sources of support to lean on.

Qualified Staff Members

In residential treatment, a team of trained professionals will guide you through recovery. Each of these experts offers a unique perspective.

  • Your primary therapist will likely act as your main point of contact. They may also take the lead on designing your plan of care.
  • Psychotherapists lead individual and group therapy sessions.
  • Doctors, nurses, and other medical professionals address physical health issues and manage any medications you’re taking.
  • Support staff accompany you on group outings and provide emotional support throughout your recovery.

Fellow Patients

In most rehabs, you’ll go through treatment alongside a group of other patients. And your peers can provide a unique kind of emotional support. They may be in rehab for similar reasons, or they might share some of your recovery goals. But unlike your therapist, these people can connect with you on equal footing. Hearing someone else’s story can be hugely inspiring. These relationships also invite you to work on your interpersonal skills. So even before you leave rehab, you can see what it’s like to socialize without substance use.

Loved Ones

Depending on the tech usage policy at your rehab, you may be able to keep in touch with loved ones throughout treatment. And if your loved ones want to be more directly involved in your recovery, look for a program with family or couples therapy. Some rehabs even invite family members to visit for in-person sessions.

What Happens After Rehab?

Recovery doesn’t end when you finish treatment. But you won’t be starting your life over from scratch. By the time you leave rehab, you’ll already have a clear aftercare plan. Your provider may help you find a sober living environment, outside therapist, or 12-Step meetings in your area. With these systems in place, you’ll be well prepared for the next phase of healing.

Many Roads Lead to Addiction Recovery

There are countless ways to approach healing. The important thing is to choose one that works for you and your personal recovery goals. Inpatient rehab can be a powerful place to start. These programs let you take a step back from the hustle and bustle of daily life, to reconsider what you really want and need.

Learn more about life at residential treatment centers, including their locations, pricing, and types of therapy.

Reviewed by Rajnandini Rathod

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Find Joy in Healing From Ecstasy Addiction

You might call it molly, ecstasy, E, X, or MDMA. By any name, this drug is extremely popular and easy to find. But that doesn’t make it safe. And because it’s often cut with other drugs, you might not even know what you’re taking.

Misinformation about ecstasy runs rampant. And that puts you at risk of addiction. When you’re ready to heal, a rehab that treats MDMA addiction might help you start recovery.

The Unpredictable Effects of Ecstasy

Experts disagree about whether you can physically depend on ecstasy. ((Abuse, National Institute on Drug. “Is MDMA Addictive?” National Institute on Drug Abuse, –, https://nida.nih.gov/publications/research-reports/mdma-ecstasy-abuse/mdma-addictive.)) During recovery, some people have withdrawal symptoms or even need medical detox. But other patients only have psychological symptoms.

Whether it’s physical or purely psychological, addiction develops over time. But, more than many other drugs, molly can have serious short-term impacts.

Is Molly Really MDMA?

MDMA is an acronym. ((Abuse, National Institute on Drug. “MDMA (Ecstasy/Molly) DrugFacts.” National Institute on Drug Abuse, 15 June 2020, https://nida.nih.gov/publications/drugfacts/mdma-ecstasymolly.)) It stands for 3,4-methylenedioxy-methamphetamine. But when you take ecstasy, it almost always includes other substances. And because these additives are rarely disclosed, it’s hard to predict the effect.

This is an issue for every form of molly. You might expect ecstasy pills to contain substances ((Department of Justice/Drug Enforcement Administration. “Drug Fact Sheet: Ecstasy/MDMA.” April 2020. https://www.dea.gov/sites/default/files/2020-06/Ecstasy-MDMA-2020_0.pdf)) like amphetamines, meth, or other stimulants. But MDMA isn’t any safer in crystal form. ((Stone, Zara. “Tastes Like Tesla: How Tesla Ecstasy Pills Became The Hot Way To Get High.” Forbes, https://www.forbes.com/sites/zarastone/2017/08/08/tastes-like-tesla-how-tesla-ecstasy-pills-became-the-hot-way-to-get-high/. Accessed 3 Feb. 2023.)) Joseph J. Palamar, assistant professor New York University Langone Medical Center, explains:

“In the 2000’s [Americans] thought pills had become so adulterated with other drugs that [Molly] was marketed as a purer form. But anyone can adulterate powder.”

And anyone can lie. It’s common for sellers to claim that their molly is pure, even if it doesn’t actually contain any MDMA. ((Dolan, Sean B., and Matthew W. Johnson. “The Drug Purity Discounting Task: Ecstasy Use Likelihood Is Reduced by Probabilistic Impurity According to Harmfulness of Adulterants.” Drug and Alcohol Dependence, vol. 208, Mar. 2020, p. 107772. PubMed Central, https://doi.org/10.1016/j.drugalcdep.2019.107772.))

If you’re concerned about what’s in molly crystals, pills, or powder, you can test a drug’s purity ((Nasir, Ace. Drug Checking Kit Instructions | DanceSafe. https://dancesafe.org/testing-kit-instructions/. Accessed 3 Feb. 2023.)) with a drug checking kit. When you dissolve the drug in a certain chemical, the liquid will change color. Then, you can compare it to a key to see what it contains. Some community organizations, like DanceSafe, give these kits out for free.

Mixing Ecstasy With Other Drugs

The Drug Enforcement Administration calls MDMA a “party drug.” ((Department of Justice/Drug Enforcement Administration. “Drug Fact Sheet: Ecstasy/MDMA.” April 2020. https://www.dea.gov/sites/default/files/2020-06/Ecstasy-MDMA-2020_0.pdf)) In other words, most people take it in social contexts like clubs, bars, concerts, and house parties. These situations encourage drinking and taking multiple drugs at a time. That practice is so common, there are even special names for various combinations. ((Chary, Michael, et al. “Candyflipping and Other Combinations: Identifying Drug–Drug Combinations from an Online Forum.” Frontiers in Psychiatry, vol. 9, 2018. Frontiers, https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00135.))

When you combine MDMA with other substances, you can’t predict how your body will respond. And if you have a bad reaction, you might not be able to get the help you need. For example, there are legal drugs that can reverse an opioid overdose. ((Abuse, National Institute on Drug. “Naloxone DrugFacts.” National Institute on Drug Abuse, 11 Jan. 2022, https://nida.nih.gov/publications/drugfacts/naloxone.
)) But time is of the essence. And if no one knows you took molly laced with fentanyl, they won’t know how to treat your symptoms.

Physical Effects

Even on its own, molly’s physical effects ((Department of Justice/Drug Enforcement Administration. “Drug Fact Sheet: Ecstasy/MDMA.” April 2020. https://www.dea.gov/sites/default/files/2020-06/Ecstasy-MDMA-2020_0.pdf)) can make it dangerous to be in a crowd. For one thing, the drug makes it hard to regulate your body temperature, so it’s easy to overheat. And you might get dehydrated, because MDMA interferes with the way you process water. ((Baggott, Matthew J. et. Al. “MDMA impairs response to water intake in healthy volunteers.” June 18, 2015. https://www.biorxiv.org/content/10.1101/021113v1.full.pdf)) This can lead to cause kidney damage.

Like other stimulants, ecstasy puts a strain on your heart. ((Perrine, Shane A., et al. “Cardiac Effects of MDMA on the Metabolic Profile Determined with 1H-Magnetic Resonance Spectroscopy in the Rat.” NMR in Biomedicine, vol. 22, no. 4, May 2009, pp. 419–25. PubMed Central, https://doi.org/10.1002/nbm.1352.)) And the effect is immediate—even if it’s your first time taking the drug. It raises your blood pressure, and can also increase your heart rate. For some people, this may be life-threatening.

Neurological Effects

Molly works by flooding your brain with serotonin ((Abuse, National Institute on Drug. “MDMA (Ecstasy/Molly) DrugFacts.” National Institute on Drug Abuse, 15 June 2020, https://nida.nih.gov/publications/drugfacts/mdma-ecstasymolly.
)) and dopamine. These naturally occurring neurotransmitters make you feel happy. Serotonin also regulates your mood, ((Serotonin: Functions, Normal Range, Side Effects, and More. 29 Sept. 2022, https://www.medicalnewstoday.com/articles/232248.)) appetite, and sleep cycles. Dopamine is responsible for pleasure ((Watson, Stephanie. “Dopamine: The Pathway to Pleasure.” Harvard Health, 20 July 2021, https://www.health.harvard.edu/mind-and-mood/dopamine-the-pathway-to-pleasure.)) and a sense of reward.

Artificially boosting your serotonin and dopamine levels can feel good—briefly. But these chemicals aren’t infinite. Coming down from MDMA leaves you with a neurochemical deficit. ((Kim, Jueun, et al. “Ecstasy Use and Suicidal Behavior Among Adolescents: Findings from a National Survey.” Suicide & Life-Threatening Behavior, vol. 41, no. 4, Aug. 2011, pp. 435–44. PubMed Central, https://doi.org/10.1111/j.1943-278X.2011.00043.x.)) For some people, that leads to severe symptoms like depression, fatigue, and even suicidality.

If you’re thinking about suicide or self-harm, contact the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255). Trained counselors are available to help 24 hours a day.

Long-term molly use can have an effect on your brain. ((Kelly, Paul A. T. “Does Recreational Ecstasy Use Cause Long-Term Cognitive Problems?” Western Journal of Medicine, vol. 173, no. 2, Aug. 2000, pp. 129–30. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071023/.)) Experts believe that it might increase your risk of mental health problems, especially mood disorders. However, researchers are still gathering data about this issue.

Serotonin Syndrome

For some people, ecstasy causes serotonin syndrome—a potentially life-threatening medical condition. ((Tao, Rui, et al. “Environment Influencing Serotonin Syndrome Induced by Ecstasy Abuse.” Annals of Forensic Research and Analysis, vol. 4, no. 1, 2017, p. 1039. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931730/.)) This is most likely for people who combine MDMA with prescribed selective serotonin reuptake inhibitors ((Dobry, Yuriy, et al. “Ecstasy Use and Serotonin Syndrome: A Neglected Danger to Adolescents and Young Adults Prescribed Selective Serotonin Reuptake Inhibitors.” International Journal of Adolescent Medicine and Health, vol. 25, no. 3, 2013, pp. 193–99. PubMed, https://doi.org/10.1515/ijamh-2013-0052.)) (SSRIs) like Zoloft, Prozac, or Lexapro. But anyone can develop serotonin syndrome while on molly, even if it’s the only drug you’re taking.

Serotonin syndrome can include elevated temperature and blood pressure, confusion, and seizures. These symptoms range from mild to severe. Mild cases can resolve without intervention, but severe serotonin syndrome is often fatal. If you experience these symptoms while on ecstasy, it’s important to get immediate medical care.

Recognizing Addictive Behaviors

There’s a reason people are drawn to molly. MDMA is a common way of self-medicating, ((Moonzwe, Lwendo S., et al. “The Role of MDMA (Ecstasy) in Coping with Negative Life Situations Among Urban Young Adults.” Journal of Psychoactive Drugs, vol. 43, no. 3, 2011, pp. 199–210. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235684/.)) especially for people living through trauma like abuse or racism. Scientists are even researching ecstasy as a possible therapy for PTSD. ((Smith, Kimberly W., et al. “MDMA-Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta-Analysis.” Journal of Clinical Pharmacology, vol. 62, no. 4, Apr. 2022, pp. 463–71. PubMed, https://doi.org/10.1002/jcph.1995.)) But that treatment is still highly experimental.

When you take it recreationally, molly can mask painful emotions and temporarily distract you from problems in the rest of your life. But there’s a big difference between feeling good and actually healing. And in the long term, it’s dangerous to take any drug without medical supervision.

Certain people are particularly vulnerable to ecstasy addiction. According to the U.S. Department of Justice, “most MDMA users are teenagers or young adults” ((National Drug Intelligence Center. “MDMA Fast Facts.” https://www.justice.gov/archive/ndic/pubs3/3494/3494p.pdf
)) between the ages of 18-25. LGBTQ+ people are also at a higher risk. And because peer pressure can normalize drug use, it might be hard to know when you need treatment. If you’re concerned about addiction, talk to your doctor or therapist about next steps.

Treating Ecstasy Addiction

Because of the cultural norms around molly use, treatment can be complex. For example, you might be in recovery from more than 1 addiction at a time. And since most people do molly in social settings, ((Wardle, Margaret C., et al. “‘Ecstasy’ as a Social Drug: MDMA Preferentially Affects Responses to Emotional Stimuli with Social Content.” Social Cognitive and Affective Neuroscience, vol. 9, no. 8, Aug. 2014, pp. 1076–81. PubMed Central, https://doi.org/10.1093/scan/nsu035.)) healing may change the way you think of community.

1:1 Therapy

Individual therapy is a vital part of addiction recovery. And depending on your rehab center, you may have access to a few different types of treatment. In particular, experts recommend cognitive behavioral therapy (CBT) as a treatment for MDMA addiction. ((Abuse, National Institute on Drug. “How Are MDMA Use Disorders Treated?” National Institute on Drug Abuse, –, https://nida.nih.gov/publications/research-reports/mdma-ecstasy-abuse/how-are-mdma-use-disorders-treated.)) CBT equips you with practical skills to navigate both psychological and external triggers. In treatment, your therapist will help you identify difficult thought patterns. Then, you’ll practice responding to them with new coping strategies.

Social Support

When you’re high, ecstasy makes you feel closer to other people. ((Baggott, Matthew J., et al. “Intimate Insight: MDMA Changes How People Talk about Significant Others.” Journal of Psychopharmacology (Oxford, England), vol. 29, no. 6, June 2015, pp. 669–77. PubMed Central, https://doi.org/10.1177/0269881115581962.)) And in the short term, that can feel very good. But it can also be hollow. Relationships that center around drug use don’t always last. And social problems make you more vulnerable to molly addiction. ((García-Pardo, M. P., et al. “Role of Acute Social Stress in the Rewarding Effects of MDMA in Adolescent Mice.” Behavioural Brain Research, vol. 410, July 2021, p. 113348. ScienceDirect, https://doi.org/10.1016/j.bbr.2021.113348.))

In recovery, you might want to focus on building stronger relationships. Many types of treatment support this goal. For example, some rehabs offer family therapy or couples counseling. You can also attend group therapy with other patients in your program. And it doesn’t have to end when you leave rehab. Support groups—including 12-Step groups like Alcoholics Anonymous and non-12-Step groups like SMART Recovery—offer community support in every stage of recovery.

Alternative Treatments

During rehab for ecstasy addiction, your brain chemistry will rebalance. Specifically, your serotonin and dopamine levels may start to normalize. Certain holistic therapies can support this process:

  • Massage therapy improves both mental and physical health. It also has a direct impact on neurotransmitters. Specifically, getting a massage increases your serotonin levels. ((Field, Tiffany, et al. “Cortisol Decreases and Serotonin and Dopamine Increase Following Massage Therapy.” The International Journal of Neuroscience, vol. 115, no. 10, Oct. 2005, pp. 1397–413. PubMed, https://doi.org/10.1080/00207450590956459.))
  • Acupuncture is an ancient treatment that supports every aspect of recovery. It even has a spiritual component. Data shows that acupuncture helps regulate serotonin. ((S Surijadi et al 2018 J. Phys.: Conf. Ser. 1073 062041. https://iopscience.iop.org/article/10.1088/1742-6596/1073/6/062041/pdf#:~:text=Acupuncture%20induces%20therapeutic%20effects%20by,the%20process%20of%20serotonin%20degradation )) This therapy also reduces anxiety.
  • Physical exercise has well-documented mental health benefits. Fitness improves your mood ((Basso, Julia C., and Wendy A. Suzuki. “The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, And Neurochemical Pathways: A Review.” Brain Plasticity, vol. 2, no. 2, Jan. 2017, pp. 127–52. content.iospress.com, https://doi.org/10.3233/BPL-160040.)) by balancing neurochemicals. There are countless ways to incorporate exercise into your rehab experience. You can do yoga, go hiking, or even take a boxing class.

Learning to Love Yourself in Recovery

MDMA simulates happiness, pleasure, and even love. But as soon as the drug wears off, so do those feelings. In rehab, you’ll learn to find joy in more sustainable ways. Recovery can help you connect on an even deeper level. Over time, your relationships will get better and better—including your relationship with yourself.

Browse a list of rehabs that treat ecstasy addiction to learn about their types of therapy, housing, and locations.

Reviewed by Rajnandini Rathod

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Choosing the Right Rehab as a Celebrity

We hear it all the time: “celebrities are just like everyone else.” And in many ways, that’s true. But you might have some unique concerns when it comes to rehab. For example, privacy, flexibility, and maintaining your lifestyle might be especially high priorities. In a luxury rehab center, you can start addiction and mental health recovery without sacrificing your other needs. 

Why Is Addiction So Common in Celebrities?

Addiction doesn’t discriminate. Whether or not you’re famous, you might develop an addiction for a variety of reasons. But certain aspects of fame contribute to higher rates of addiction among affluent people:1

  • Easier access to drugs and alcohol
  • Isolation from trustworthy support systems
  • Trauma from abuse and neglect, especially during childhood fame
  • Pressure from demanding professions

Like anyone else, some celebrities may also have a genetic predisposition to addiction.2 This risk is further increased when combined with a stressful lifestyle. 

Unique Challenges of Recovery for Celebrities

If fame plays a role in developing addiction, it also affects how you access treatment. Many celebrities have ongoing contractual obligations like games, tours, or interviews. So if you take time off work for treatment, you might face career and financial penalties. And those commitments don’t end after rehab. Many of them even come with an expectation to drink or use drugs with your colleagues and fans.

High achievers also face significant financial pressures. You might be supporting a large staff, artistic collaborators, and loved ones. So if you stop working, they could feel immediate effects. And fame doesn’t always bring financial success. High-profile activists, politicians, and artists can’t always afford rehab centers with the strict privacy they need. 

For this demographic, public opinion has a major impact on the recovery process. And unwanted media attention can interfere with healing. Because of this, confidentiality is a major concern for high-profile clients—as it should be. You have the right to recover on your own terms. That’s why most rehabs have privacy policies that keep celebrities safe from prying eyes. 

What Do Celebrity Rehabs Offer?

Celebrity rehabs understand the unique ways that fame affects addiction and recovery. There are a few key ways rehabs approach treatment for high-profile patients. 

Confidentiality

For most celebrities, privacy is essential for recovery. That way, you can focus on yourself and the changes you want to make, without distractions. With this in mind, celebrity rehabs have strict privacy policies. 

For the utmost confidentiality, some rehabs treat only one client at a time, and some centers cater specifically to celebrities. They take a personalized approach to recovery, tailoring treatment to meet your unique needs. 

Location can also play a role in keeping your recovery private. Swiss rehabs, for example, take anonymity to the next level. Jan Gerber, CEO of Paracelsus Recovery in Zurich, explains: 

“In terms of confidentiality, that’s basically the second name of Switzerland. It’s the banking secrecy, the whole discretion. The Swiss mindset is, in a way, non-sensational. We get clients who are celebrity, A-list Hollywood actors, who go to the local Starbucks. Of course they’re recognized, but it’s not in the news, the local tabloids don’t write about it, and they’re not harassed for autographs either.”

Flexibility

With success comes responsibility. If a team of employees depend on you, you might not be able to take time off work for recovery. Or you might need to attend social functions, or stay in touch with your family. At many elite rehabs, you can keep these commitments during your stay. 

Some centers have more relaxed device use policies, so you can stay connected throughout treatment. Others even allow you to work remotely. As long as these activities don’t interfere with your progress, you can continue taking care of business while you heal.   

Gerber describes how the clinicians at Paracelsus Recovery accommodate each patient’s individual needs:

“We’ve had people with regular scheduled TV appearances, such as entertainers who have had to be in front of the camera once a week in a different country. We could accommodate that. We have people who run companies, or family business empires. They have to have work calls every day. We have to accommodate that.”

tikvah lake recovery pool
Tikvah Lake Recovery provides clients with a sober companion to join them at special events.

Joyful Recreation

If you’re successful in your chosen field, you may be accustomed to a certain lifestyle. Rehab doesn’t have to interrupt that. In fact, learning to enjoy yourself without drug use is an important part of recovery.3 

At White River Manor in South Africa, for instance, patients can go bungee jumping, whitewater rafting, or even on safari. Director Co-Owner Giles Fourie describes the therapeutic value of these activities:  

“There’s great therapy in that. It’s also just about having fun. There’s great value in our clients experiencing what it is to have fun outside of addiction, outside of the substances that they believed they needed in order to experience joy in their lives.” 

And these experiences don’t just bring joy to your time in treatment. They can also set you up for long-term success. 

Comprehensive Aftercare

When you leave inpatient treatment, you’ll probably return to the same world you left behind. Even if you’re sober, you might need to keep attending high-profile events where drugs and alcohol play a role. And you’ll still face the same pressures you did before entering treatment. 

That’s why many celebrity rehabs offer comprehensive aftercare. You can return to the center for a follow-up stay, or meet with your therapist remotely. Some rehabs, like Tikvah Lake Recovery, even offer sober companions to join you at special events. Their presence can help you work through triggers and avoid relapse. 

What Rehabs Do Celebrities Go To?

Recovery is unique for everyone—even high-profile clients. While many celebrity rehabs are lavish retreats, that’s not universally true. 

As extravagant as this sounds, not all celebrity rehabs are expensive. And most of them accept insurance since the adoption of the Affordable Care Act. Treatment in some parts of the world, like Thailand, is particularly accessible. Whatever your budget is, you can likely find a luxury rehab that fits your lifestyle.

the hills rehab chiang mai property
The Hills Rehab Chiang Mai and other rehabs in Thailand offer luxury amenities at an affordable price point.

Bespoke Luxury Rehabs

When you’re used to a high standard of living, leaving it behind can interfere with healing. But if luxury amenities are a priority for you, many rehabs can meet your needs. You might have a private chef, personal trainer, and house staff assigned to you during your stay. And you can stay in a 5-star room, private suite, or even an entire villa. Many luxury rehabs also offer a 24/7 concierge service. You’ll have somebody there to act as a liaison between you, the staff, and your loved ones throughout treatment. And they can also be an important source of emotional support outside of your treatment team. 

In rehabs like Orenda at Futures, this approach is central to recovery. Their team believes “freeing patients to concentrate fully on therapy produces better outcomes.” To that end, their team is dedicated to meeting each client’s unique needs. They’re always available to answer your questions and make your stay as comfortable as possible. 

Holistic Rehabs

Holistic rehabs treat addiction using a variety of evidence-based and alternative therapies:

These types of rehabs treat the whole person, addressing your physical, mental, and spiritual wellness. At Alta Mira Recovery in California, expert staff “address neurobiological, psychological, social, physical and spiritual aspects of addiction” with therapies ranging from cognitive behavioral therapy (CBT) to equine therapy.4

Celebrity Rehabs: Joyful and Private Places to Heal

When you find fame, it’s all too easy to lose yourself in the process. In treatment, you can get to know yourself again without the pressure of public opinion. And you won’t have to choose between career success and recovery. Celebrity rehabs show you how to keep the best parts of your lifestyle, and let go of the behaviors that aren’t serving you.

Search our collection of luxury rehabs to learn more about their locations, approaches, and special considerations.

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The Real Value of Recovery From Shopping Addiction

Has your shopping gone from casual to compulsive? Shopping is such a common way to cope, some people call it “retail therapy.” But it can get out of hand. Shopping can even become an addiction. And when that happens, you may start to rack up debts—and not just financial ones.

In rehab for shopping addiction you can reevaluate why you feel like you need to shop. You’ll learn new coping strategies, change your spending habits and get your life back on track.

Treating Shopping Addiction

In the short term, buying new things can boost your mood. But if your life revolves around shopping, it can get in the way of your other goals. While there’s no standard treatment program for shopping addiction, ((BLACK, DONALD W. “A Review of Compulsive Buying Disorder.” World Psychiatry, vol. 6, no. 1, Feb. 2007, pp. 14–18. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/.)) rehabs use a variety of methods to help you manage your symptoms.

Cognitive Behavioral Therapy (CBT)

One of the most popular shopping addiction treatments is CBT—especially group CBT. In treatment, you’ll start by identifying why you shop. Then, you’ll learn new financial planning strategies. Patients also practice tolerating difficult feelings. For example, your therapist might help you accept the desire to shop without acting on it. Studies show that CBT is the most effective treatment for shopping addiction. ((Hague, Ben, et al. “Treatments for Compulsive Buying: A Systematic Review of the Quality, Effectiveness and Progression of the Outcome Evidence.” Journal of Behavioral Addictions, vol. 5, no. 3, pp. 379–94. PubMed Central, https://doi.org/10.1556/2006.5.2016.064. Accessed 31 Jan. 2023.))

Pharmacological Treatments

Some medications can help you manage compulsive buying. ((BLACK, DONALD W. “A Review of Compulsive Buying Disorder.” World Psychiatry, vol. 6, no. 1, Feb. 2007, pp. 14–18. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/.)) For example, studies show that antidepressants can support your recovery. Typically, this treatment works best as a long-term solution, instead of a stopgap during rehab. And no medication is right for everyone. Talk to your treatment team about your physical health and your recovery goals to learn more about various options.

12-Step Groups

Groups like Debtors Anonymous and Spenders Anonymous take a 12-Step approach to shopping addiction recovery. Modeled after Alcoholics Anonymous, these groups connect you with a community of people on a similar journey. Peers gather to support each other, discuss spending habits, and share coping strategies. These free meetings take place worldwide, and even remotely.

Family and Couples Therapy

Because compulsive buying can cause relationship issues, some shopping addiction programs involve family in your treatment. ((BLACK, DONALD W. “A Review of Compulsive Buying Disorder.” World Psychiatry, vol. 6, no. 1, Feb. 2007, pp. 14–18. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/.)) Family and couples therapy provides a space for everyone involved to share their feelings about compulsive shopping. This can improve your relationships in a number of ways. For one thing, it can help your loved ones understand what you’re going through. That makes it easier for them to support your continued recovery. Family therapy can also facilitate communication, helping you repair mutual trust.

Understanding Shopping Addiction

Shopping addiction, also called compulsive buying disorder, is a behavioral addiction that includes impulsive and excessive purchasing. ((Granero, Roser, et al. “Compulsive Buying Behavior: Clinical Comparison with Other Behavioral Addictions.” Frontiers in Psychology, vol. 7, June 2016, p. 914. PubMed Central, https://doi.org/10.3389/fpsyg.2016.00914.)) And, like any addiction, you keep buying things despite negative social, financial, and legal consequences. Shopping becomes more than a way to acquire products you need. You might also use it to boost your self-esteem, cope with stress, and get social approval. Over time, it can become your primary coping mechanism.

Symptoms of Shopping Addiction

Shopping addiction is more than just enjoying buying new things.There are a few ways compulsive buying ((BLACK, DONALD W. “A Review of Compulsive Buying Disorder.” World Psychiatry, vol. 6, no. 1, Feb. 2007, pp. 14–18. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/.)) stands out from other types of shopping:

  • Preoccupation with shopping
  • Boredom or depression before shopping
  • Guilt or shame after purchasing something
  • Pre-purchase tension that’s only relieved by buying the item you’re fixated on
  • Devoting an excessive amount of time, energy, and money to shopping
  • Shopping in private to avoid being questioned about your behavior
  • Prioritizing the quantity of items you purchase rather than their quality or usefulness

If you have this addiction, you can actually build up a tolerance to shopping. ((Barrett, Claer. ‘The Dopamine Is so High’: The Psychology of Shopping Addiction. 29 Nov. 2022, https://www.ft.com/content/5b4d2fd6-5510-4b0c-aeba-402211d97510.)) Over time, you might have to shop more often or spend more money to feel satisfied. In severe cases, going without shopping can even cause withdrawal symptoms. ((BLACK, DONALD W. “A Review of Compulsive Buying Disorder.” World Psychiatry, vol. 6, no. 1, Feb. 2007, pp. 14–18. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/.))

The Impact of Compulsive Shopping

People with shopping addiction keep making new purchases, no matter the consequences. If you notice these effects of compulsive buying, ((ROSE, SUSAN, and ARUN DHANDAYUDHAM. “Towards an Understanding of Internet-Based Problem Shopping Behaviour: The Concept of Online Shopping Addiction and Its Proposed Predictors.” Journal of Behavioral Addictions, vol. 3, no. 2, June 2014, pp. 83–89. PubMed Central, https://doi.org/10.1556/JBA.3.2014.003.)) you might consider getting treatment:

  • Excessive credit card debt
  • Hoarding
  • Relationship problems due to financial stress or keeping secrets about your spending
  • Legal problems if you start to fund your shopping in illegal ways
  • Inefficiency at work as you spend more time shopping and preparing to shop

Who Does Shopping Addiction Affect?

The most common time people begin compulsively buying is in early adulthood. ((BLACK, DONALD W. “A Review of Compulsive Buying Disorder.” World Psychiatry, vol. 6, no. 1, Feb. 2007, pp. 14–18. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/.)) This could be because it’s the first time young people have financial freedom and uncontrolled access to credit cards. And women are more likely to develop shopping addiction.

Up to 1 in 20 people are addicted to shopping. ((“Are you addicted to shopping? If you can’t stop, you are.” Optum Life Balance. April 2014. https://www.hrm.oa.pa.gov/workplace-support/seap/Documents/Life%20Balance%20Newsletter/2014-shopping-addiction.pdf)) And compulsive buying is becoming more prevalent, ((Wilczaki, Andrew Richard, “Understanding compulsive buying: The dimensions and management of addictive shopping” (2006).
Master’s Theses and Doctoral Dissertations. 186.
http://commons.emich.edu/theses/186)) for several reasons. First, credit cards are very easy to access, even for people who already have debt. Also, some cultures consider material wealth to be a sign of a person’s value. And because so much shopping takes place online, it’s easier than ever to buy things impulsively.

The Psychology of Shopping Addiction

Shopping addiction is an impulse control spectrum disorder. ((Granero, Roser, et al. “Compulsive Buying Behavior: Clinical Comparison with Other Behavioral Addictions.” Frontiers in Psychology, vol. 7, June 2016, p. 914. PubMed Central, https://doi.org/10.3389/fpsyg.2016.00914.)) People who compulsively buy typically share some personality traits, like reward-seeking. And it’s common to experience both shopping addiction and other impulse control disorders.

Shopping Addiction and Co-occurring Disorders

Studies show that many people who compulsively shop also have at least one other mental health condition. ((BLACK, DONALD W. “A Review of Compulsive Buying Disorder.” World Psychiatry, vol. 6, no. 1, Feb. 2007, pp. 14–18. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/.)) If that’s true for you, you can look for a rehab that treats co-occurring disorders. A few conditions are especially likely to co-occur with shopping addiction: ((Black, Donald W., et al. “Pathological Gambling and Compulsive Buying: Do They Fall within an Obsessive-Compulsive Spectrum?” Dialogues in Clinical Neuroscience, vol. 12, no. 2, June 2010, pp. 175–85. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181956/.))

Experts are still researching the relationship between these conditions. Shopping addiction may be a symptom, or it may stem from the same root cause as another diagnosis.

What Causes Shopping Addiction?

Compulsive shopping is not a moral failing. In fact, biological, psychological, and social factors can all lead to shopping addiction.

Genetic Factors

Studies indicate that there’s a genetic component to shopping addiction. (( It often appears in multiple members of the same family. If you have this condition, your relatives are also more likely to experience depression, alcohol addiction, and other mental health issues.

Social Norms

Most of the time, shopping addiction appears in Western countries. This hints at a cultural source of compulsive buying. ((BLACK, DONALD W. “A Review of Compulsive Buying Disorder.” World Psychiatry, vol. 6, no. 1, Feb. 2007, pp. 14–18. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805733/.)) In these areas, data shows 2 primary factors that motivate people to shop compulsively.

First, capitalist society makes shopping easily accessible. A huge variety of different goods are readily available. People may also have more disposable income and more leisure time to use the items they buy.

Second, much of Western culture places high value on material wealth. People judge each other—sometimes harshly—for what and how much they own. As a result, there’s a great deal of pressure to prove your worth by purchasing new things.

A History of Trauma

Surviving childhood trauma can also lead to compulsive shopping. ((Sansone, Randy A., et al. “Childhood Trauma and Compulsive Buying.” International Journal of Psychiatry in Clinical Practice, vol. 17, no. 1, Feb. 2013, pp. 73–76. PubMed, https://doi.org/10.3109/13651501.2011.653379.)) Any type of trauma, like physical abuse or neglect, can make shopping addiction more likely. But certain childhood experiences—like emotional abuse and witnessing violence—are especially common among people with shopping addiction.

For some people, shopping is a way to cope ((Wilczaki, Andrew Richard, “Understanding compulsive buying: The dimensions and management of addictive shopping” (2006).
Master’s Theses and Doctoral Dissertations. 186.
http://commons.emich.edu/theses/186)) with the symptoms of their trauma. Focusing on a new purchase can briefly distract you from painful memories by making you feel better in the moment. And making financial decisions—even unsustainable ones—can give you a sense of control.

Shopping as a Coping Mechanism

Even for people without childhood trauma, compulsive buying isn’t really about money. ((“Are you addicted to shopping? If you can’t stop, you are.” Optum Life Balance. April 2014. https://www.hrm.oa.pa.gov/workplace-support/seap/Documents/Life%20Balance%20Newsletter/2014-shopping-addiction.pdf)) Instead, it’s a way to control or cope with stress. That’s why people with shopping addiction are more likely to buy something after experiencing a difficult emotion, like sadness or anger. Instead of accepting that feeling, you might seek the short-term gratification of a purchase in order to avoid emotional pain.

Take Ownership of Your Recovery Journey

Shopping—even sustainable shopping—relates to the idea of value. It might seem like buying things increases your self-worth. But the math isn’t that simple.

There’s so much more to you than what you own.

To learn more about treatment methods and contact centers directly, see our searchable list of rehabs for shopping addiction.

Reviewed by Rajnandini Rathod

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The Hidden Risks of Club Drugs

Synthetic drugs can be misleading. It’s easy to take them by mistake, because they’re often mislabeled or poorly described. Maybe a friend offered you “pure” molly at a festival. Or you saw packages of “legal weed gummies” in your local convenience store. But many synthetic drugs contain other harmful substances. And they’re often unregulated, or even unlabeled. And when you don’t know what you’re taking, you can’t predict the risks.

These drugs carry high risks of bad interactions and overdose. As with all drugs, there’s also a risk of addiction. And when you’re gambling with substances and dosages, it can sneak up on you. When you’re ready to recover, you might consider attending a rehab program for synthetic drug use.

What Are Synthetic Drugs?

Synthetic drugs—sometimes called club drugs or designer drugs—are drugs manufactured in labs.1 They’re supposed to mimic the effects of “natural” drugs like marijuana or cocaine that are derived from organic substances like the cannabis plant or coca plant.

You can sometimes find synthetic drugs in convenience stores2 or smoke shops with labels like “not for human consumption” or “for cleaning purposes.” These labels help sellers avoid detection by law enforcement. But that plausible deniability creates misinformation. As a result, synthetic drugs aren’t always easy to spot. In order to stay safe, it’s important to know how to recognize them.

Synthetic Marijuana

Some stores sell synthetic marijuana as an alternative to weed.3 They might also call it an “herbal supplement,” “K2,” or “Spice.” But it’s usually a combination of plant materials and synthetic chemicals, despite labels claiming to contain only natural substances. These drugs can cause severe agitation and even hallucinations.

Because synthetic marijuana is unregulated, you likely won’t know what you’re buying. It’s also much stronger than regular marijuana, and can include heavy metals or other dangerous chemicals. If you regularly smoke weed, taking synthetic marijuana may seem like a safe alternative. But despite its similar name, it’s a completely different drug.

Bath Salts

Bath salts are a synthetic stimulant.4 They normally come in a crystal powder form packaged as plant food or phone screen cleaner. Bath salts may produce paranoia, hallucinations, increased sex drive, or panic attacks. In some cases, taking bath salts leads to violent behavior. The term “bath salts” can refer to a variety of specific drugs. Among these, a drug called flakka is increasingly popular.5

Because bath salts are typically cheaper and stronger than other stimulants, they’re especially addictive. According to the National Institute on Drug Abuse, many people report “intense, uncontrollable urges” to use bath salts6 repeatedly.

Ecstasy

Also known as molly or MDMA, ecstasy acts as both a stimulant and hallucinogen.7 It can alter your perception of time and space, and increase pleasure and energy. However, it can also cause sleep problems, anxiety, and memory issues. Molly comedowns are notoriously depressing—that’s because it depletes your brain of its natural pleasure chemicals.8 A study published in Neurology found that,

Striatal levels of serotonin and those of its metabolite 5-hydroxyindoleacetic acid were severely depleted by 50 to 80% in the brain of a chronic user of methylenedioxymethamphetamine (MDMA)… Our data suggest that MDMA exposure in the human can cause decreased tissue stores of serotonin and therefore some of the behavioral effects of this drug of abuse could be caused by massive release and depletion of brain serotonin.

Because ecstasy is unregulated, it’s frequently mixed with other drugs. Even when it appears in crystal form, it’s almost certainly combined with additives like methamphetamine, bath salts, ketamine, and fentanyl. And because many people use ecstasy at clubs or festivals, it’s common to mix it with alcohol and other drugs. This creates a dangerous situation that can potentially lead to overdose.

Synthetic Opioids

Synthetic opioids, like fentanyl, replicate the effects of natural opioids, like morphine. But synthetic opioids produce stronger narcotic effects9 than natural opioids, increasing the risk of overdose. Synthetic opioid addiction often resembles addiction to natural opiates like heroin and morphine, though it may be compounded by the effects of other ingredients. Most rehabs treat these opioid addictions in the same way.

Designer drugs have some unique risks. And that’s not only because of their chemical makeup. Their legal and cultural statuses also play a role.

Lack of Regulation

One of the main dangers of club drugs10 is their lack of regulation. FDA-approved drugs like benzodiazepines can also lead to addiction. But if you choose to, you can track your dosage. And that information might make it easier to know when you need help.

Designer drugs are different. Because they’re made in labs without oversight, chemists don’t have to follow a precise formula. They might even switch between different chemicals because of changing supply chains. Then, distributors can add other substances to bulk up the quantity and increase their profit margins.

When you mix these substances with alcohol or other drugs, they can be a deadly combination. And you may not recognize the warning signs of overdose. In order to reduce overdoses from laced drugs, some nonprofits and governments have started to offer drug testing kits.11

Increased Availability of Designer Drugs

Synthetic drugs are also dangerous12 because of how accessible they are. To buy them, you don’t need to learn a secret code, or meet up with anyone covertly. Instead, you can just walk into a store and buy them with a credit card. And many people only take club drugs at events,13 which can feel like special occasions. So even if you go clubbing every weekend, it might feel like your drug use is under control. And that can make it harder to notice a growing addiction.

Designer drugs are typically cheaper than other drugs, so some people may prefer them for practical reasons. This also means that synthetic drugs are more accessible to young people.14 And people who start using drugs during adolescence are more likely to develop addiction.

Misunderstood Risks

There’s a misconception that some synthetic drugs are natural—especially synthetic marijuana. While some brands do contain plant material, they also include other chemicals. Some types of synthetic marijuana may even contain synthetic opioids15 like fentanyl.

Experts are still researching the best treatment methods for synthetic drug addiction. As of now, there’s no standard treatment program for synthetic drug abuse.16 But certain behavioral therapies appear to be helpful.

Cognitive Behavioral Therapy (CBT)

CBT is a popular treatment method for addiction and other mental health issues. Studies have proven CBT effective for treating psychoactive drug addiction,17 which includes synthetic drugs.

In CBT, you’ll learn new coping skills for handling emotional stress. Treatment also helps you work through and change unhealthy thought patterns. Your therapist might ask you how you feel before, during, and after taking synthetic drugs, to help you identify triggers. For example, maybe you take molly when you go out with friends because you have social anxiety. Once you recognize this, you can practice new ways to manage difficult emotions.

CBT can also include motivational interviewing (MI). With MI, your therapist will help you identify what changes you want to make in life and why. By reminding yourself why you want to change, you can commit more fully to recovery.

Behavioral Therapy for Teens

Synthetic drug addiction is especially common among teens,18 and young people have unique needs during treatment. For example, teens benefit greatly from group therapy with peers. This helps them connect with others who share their experiences, offering them invaluable camaraderie and social support for their recovery.

Experts also recommend family therapy for adolescents recovering from synthetic drug addiction. This empowers teens in recovery, their parents, and other family members to support each other’s healing.

Get Expert Help

Rehabs have been treating synthetic drug use for decades. So while it may seem like there are a lot of unknowns, your chance for a successful recovery doesn’t have to be one of them.

Search for rehabs that treat synthetic drug addiction to learn about their pricing, treatment approaches, and more.

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What Happens in Residential Rehab for Trauma?

Rehab isn’t just for addiction recovery. That’s a common reason to start treatment, but it’s not the only one. You can also go to rehab to heal from trauma.

Defining Trauma

Traumatic events don’t always cause trauma symptoms.1 The same event that leaves you with post-traumatic stress disorder (PTSD)2 could be annoying but forgettable for someone else. Certain qualities can make you more vulnerable to developing symptoms. Specifically, people who have a history of childhood trauma, mental health issues, or addiction may be at higher risk.  

Trauma Symptoms

Everyone reacts to trauma differently. But there are a few common effects you might experience after a traumatic event:3

  • Fatigue
  • Confusion
  • Anxiety
  • Emotional numbness
  • Loss of hope
  • Fear

These are often short-term reactions in the immediate aftermath of the event. But for some people, they become ongoing symptoms. If that’s the case, you can ask your doctor to evaluate you for PTSD.  

Post-traumatic Stress Disorder

PTSD is a prolonged reaction4 to a finite traumatic experience. This could be a single event, like a car accident, or a period of time, like a tour of duty in the military. Symptoms of PTSD include the following:

  • Flashbacks 
  • Sleep problems like nightmares
  • Avoidance, where you stay away from reminders of your trauma
  • Feeling tense
  • Angry outbursts
  • Loss of interest in your passions

To fit the criteria for PTSD, these symptoms need to last for more than a month and interfere with your quality of life. 

Complex Post-Traumatic Stress Disorder

Chronic trauma can lead to complex PTSD5 (c-PTSD), instead of PTSD. The 2 conditions are similar, but with a few key differences. Unlike PTSD, c-PTSD is the response to long-term circumstances. For example, teens or adults who survived child abuse might show signs of c-PTSD. 

In addition to the symptoms of classic PTSD, people with c-PTSD may also experience the following: 

  • Dysregulated emotions
  • A negative self-image
  • Difficulty forming and maintain healthy relationships

While treatment for these diagnoses is similar, c-PTSD can cause additional challenges. 

Co-occurring Trauma and Addiction

Studies indicate a strong link between addiction and traumatic experiences.6 There are several reasons for this. Drugs and alcohol can offer a temporary distraction from the pain of trauma. Or, you might decide to self-medicate in order to manage your symptoms. 

It’s all too easy to get caught in a cycle of trauma and addiction. That’s true for a few reasons. First, drug and alcohol use can make your mental health worse. And second, addiction itself can be traumatic. You might find yourself in dangerous situations because of the way you obtain or take drugs. Those experiences can compound your trauma. But without support, drug use might be the only way you know how to manage your symptoms.

What Happens in Rehab for Trauma?

If you’re having a hard time healing on your own, you might benefit from residential treatment. There, you’ll have the time and space to focus on healing, instead of just surviving. 

What is Trauma-Informed Care?

Trauma-informed rehab programs provide treatment in a safe and empowering way. Clinicians are sensitive to your concerns, and may have special training in trauma recovery.

Trauma symptoms can put you on high alert,7 even if there isn’t any danger. The tranquility of a trauma-informed treatment center can help you stay centered. For example, you might attend therapy in a soundproof room, so there’s a lower chance of loud noises. Or, your massage therapist might ask for consent before starting every session.

This type of care accommodates your needs, but it won’t insulate you from all your triggers. Instead, you’ll learn how to navigate them while keeping yourself safe. Rehab gives you the chance to practice new coping skills before you reenter a less curated environment. 

A Framework for Recovery

While you can heal from your trauma in an outpatient setting, going to residential treatment offers unique benefits. For example, keeping a consistent schedule helps people with PTSD feel safe.8 And when you attend inpatient treatment, your days will have a set routine. It’s common for people to feel overwhelmed after trauma,9 so taking a break from making certain decisions can be a relief. That way, you can focus on your recovery, instead of what you’re going to have for dinner.

A Calming Environment

It’s much harder to heal in the same place where you got hurt. If your trauma happened close to home, a change of scenery might be necessary for recovery. Studies even show that changing your environment can improve your mood.10 

If you travel for rehab, you can choose your ideal location. And some environments make healing even easier. Specifically, living in the midst of nature can help you process your thoughts11 and cope with stress. 

Social Support During Treatment

Trauma can be isolating.12 And when your symptoms interfere with relationships, it’s hard to ask for the help you need. Many residential rehabs offer a built-in community13 of patients with a similar experience of trauma. Some programs even cater to people with shared identities, like LGBTQ+ patients. And studies show that having robust social support can help your recovery14 from trauma. 

Specific Therapies for Trauma 

Everyone’s healing process is different. That’s why so many rehabs offer personalized care. During inpatient treatment for trauma, you can access several different types of therapy in the same program. This empowers patients to take control of the healing process, under the expert guidance of their care team.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a popular treatment for trauma symptoms.15 In session, patients learn to recognize and work through thought patterns that no longer serve them. This is easiest to understand with triggers. For example, after an accident, you might feel intense fear about getting into a car. CBT can help you put that feeling in context. Instead of avoiding cars altogether, you could learn how to calmly assess whether it’s safe to drive. And then, additional CBT skills can help you stay centered while you’re on the road.

Prolonged Exposure Therapy 

Prolonged exposure therapy (PE)16 is a type of CBT. In PE, you’ll confront your trauma head-on. Patients do this by recounting their most painful memories in great detail. As you tell the story of what happened, your therapist may encourage you to engage your 5 senses. What did the room smell like? What noises did you hear? How did your body feel?

PE isn’t easy. The goal is to trigger yourself, purposely causing an intense emotional response. But as you return to the same memory over and over again, you’ll become desensitized to it. Eventually, you’ll be able to think about what happened without feeling triggered at all. 

If you’re healing from complex trauma, you may need to repeat this process with a few different memories. Over time, PE helps patients regulate their feelings in and outside of sessions. 

Cognitive Processing Therapy

Cognitive processing therapy (CPT)17 helps you address the emotional fallout of trauma. With a therapist’s guidance, you’ll explore the way you feel about what happened. Early in treatment, you’ll write a trauma impact statement.18 There, you’ll describe why you think your trauma happened, and list its lasting effects on your life. Then, you’ll recount a traumatic experience and talk through the way it makes you feel. 

While this process is a lot like PE, the goal is a little different. Instead of desensitizing yourself, you’ll work to understand why you feel the way you do. For example, self-blame is a common response to trauma.19 If you feel guilty about what happened, you might practice self-compassion during CPT. You’ll also learn how to cope with the triggers you encounter in daily life. 

Eye Movement Desensitization and Reprocessing

Eye movement desensitization and reprocessing (EMDR)20 uses visual or audio cues to help you process your trauma. First, you’ll learn more about trauma and coping skills. Then, you’ll identify a “target” traumatic event. For about 30 seconds, you’ll focus on that target as you pay attention to an external cue. 

Studies indicate that EMDR helps patients reduce anxiety and other PTSD symptoms. But it can also be emotionally taxing to concentrate on your trauma. You might feel triggered or vulnerable after a session. But in residential treatment, you won’t have to jump right back into other tasks after EMDR.  

Holistic Therapies for Survivors

Trauma affects more than just your mental health. For example, trauma can cause physical pain,21 or interrupt your spiritual practice. Holistic therapies address all parts of your life,22 and help you heal in an integrated way. There are several different types of holistic treatment: 

These methods aren’t replacements for talk therapy, but they can work well as complementary therapies. In rehab, you can combine holistic treatments with more traditional techniques. 

What Are the Stages of Trauma Recovery?

No matter what therapy you use, it still takes time to heal from trauma. And healing is nonlinear. As you grow and change, your feelings about what happened might change, too. For example, some people have trauma from romantic relationships. They might feel completely healed—while they’re single. But then new triggers might come up when they start dating again. 

While everyone’s process is different, experts describe 5 distinct stages of trauma recovery.23 You might progress through these in order, or all at once. You might even revisit some stages more than once. But as you heal, it’s likely that you’ll touch on these different perspectives.

Trauma Processing and Reexamination

Processing your trauma is an important part of recovery. Therapies like CBT and PE help you understand the effects of what happened to you. By working through your past triggers, you can focus on the present, and start to build a meaningful future. Living on-site in a rehab program helps you focus on healing, without the distractions of daily life.

Managing Negative States

During rehab, you’ll learn more sustainable coping strategies. And when you encounter triggers, your care team will likely be on hand to help you practice them. As you develop those skills, you can let go of any behavior—like addiction—that doesn’t support your growth.

Rebuilding the Self After Trauma

Trauma can make you feel disconnected24 from yourself. During rehab, you can rebuild your confidence and self-esteem. There are several ways to work toward that goal. Holistic therapies, for instance, can help you reintegrate different parts of your identity. 

Connecting With Others

Trauma affects the way you relate to other people.25 And no one exists in a vacuum. On the contrary, healthy relationships are vital to recovery. There are countless ways to approach this part of healing. You might connect with other patients, or join a support group. But those options don’t work for everyone. Some high-profile clients, for instance, may need confidentiality during rehab. If privacy is a priority, you might consider family therapy with your closest loved ones.

Regaining Hope and Power

After you survive trauma, serious danger stops being theoretical. You know from personal experience that getting hurt is a real possibility. It’s happened before, and it might happen again. Recovery means learning to live a rich, beautiful life in the face of that uncertainty. Treatment can help you regain your power and hope for the future. 


Compare rehabs that treat trauma and reach out to them directly to learn how you can get started on your healing journey.

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The Search for Solid Ground: How to Heal From Narcissistic Abuse

The term ‘narcissist’ gets thrown around a lot. And it’s often misused or used too casually. Narcissism is more than selfishness. And for survivors of narcissistic abuse, it’s anything but casual. If you’ve experienced the intensity of a relationship with a narcissist, you may need to heal from ongoing trauma symptoms. Some people find solace in self-help resources, while others use holistic therapies like yoga or acupuncture. You can even attend residential rehab to heal from narcissistic abuse.

If you or someone you know is being threatened or abused, call 800-799-SAFE or text “START” to 88788 to connect with the National Domestic Violence Support Hotline. Their support is free and confidential.

Understanding Narcissistic Personality Disorder

Narcissistic personality disorder (NPD) is a serious condition ((Mitra, Paroma, and Dimy Fluyau. “Narcissistic Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556001/.)) that can affect all parts of a person’s life. It falls under the cluster B umbrella of personality disorders, featuring unpredictable behavior and intense emotions. Researchers haven’t determined the exact cause of NPD. But childhood trauma, genetics, and receiving excessive praise can all be risk factors.

NPD can be hard to recognize, but these are some common traits:

  • A sense of superiority
  • Boldness
  • Aggression
  • High or unstable self-esteem
  • Defensiveness
  • Hypersensitivity
  • Constant need for praise and attention
  • Difficulty extending empathy to others
  • Manipulation of other

People with NPD can show arrogance, jealousy, and an unwillingness to relate to others. Because of this, many people with NPD have trouble forming and maintaining healthy relationships. This, combined with the high rates of aggression and manipulation, can easily result in narcissistic abuse. Domestic violence can take place in any relationship. But it’s often seen between parents and children, and romantic partners.

What Is Narcissistic Abuse?

Narcissistic abuse is any abuse from a person with NPD, ((Roberts, Michelle D., “Moth to a Flame: An Investigation of the Personality Traits and Early-Life Trauma
Histories of Women Who Have Survived Adult Relationships with Men with Pathological Narcissism”
(2021). Dissertations. 1043.
https://irl.umsl.edu/dissertation/1043)) or someone who exhibits narcissistic behaviors. It’s rooted in the aggressor’s inability to show empathy. The abuser tries to control the other person with intimidation, manipulation, and deception. This can happen in any type of relationship, but it’s often seen between parents and children, and in romantic partnerships.

Between 60-158 million people experience narcissistic abuse. ((Roberts, Michelle D., “Moth to a Flame: An Investigation of the Personality Traits and Early-Life Trauma
Histories of Women Who Have Survived Adult Relationships with Men with Pathological Narcissism”
(2021). Dissertations. 1043.
https://irl.umsl.edu/dissertation/1043)) Although so many people go through it, it can be hard to recognize—which is why it’s important to know the signs:

  • Isolation, in which the abuser cuts you off from supportive loved ones
  • Gaslighting, in which the abuser tries to convince you that they’re not abusive
  • Love bombing, where the abuser overwhelms you with excessive affection and attention, usually at the beginning of a relationship or after violence
  • Instability
  • Name-calling
  • The silent treatment
  • Stonewalling, where the abuser shuts down conversations they don’t like

It can be extremely difficult to recognize this behavior. It might start in small ways, and get worse over time. By the time it reaches full-on abuse, you’re so used to being treated poorly that you don’t see how bad things are. And if you love the other person, it’s easy to make excuses for them. You might even blame yourself, believing their behavior is justified.

Abusive relationships can even fool the experts. In fact, studies show that almost 60% of therapists miss the signs of narcissistic abuse. ((Roberts, Michelle D., “Moth to a Flame: An Investigation of the Personality Traits and Early-Life Trauma
Histories of Women Who Have Survived Adult Relationships with Men with Pathological Narcissism”
(2021). Dissertations. 1043.
https://irl.umsl.edu/dissertation/1043)) And because many people with NPD are charming and sociable, sometimes other people don’t take narcissistic abuse seriously. That’s especially true when the abuser is in a position of power.

Parental Abuse

People with NPD have a hard time considering other people’s needs—even their children’s. That can damage familial relationships, causing trauma on both sides.

When you’re a child, it’s natural to trust your parents. You rely on them for food, shelter, and emotional support. And, because you haven’t yet seen the world, you can’t easily compare their behavior to social norms. If gaslighting is your daily reality, you might not know there’s a better way to treat people.

Living through narcissistic abuse is one type of adverse childhood experience (ACE). ACEs affect your emotional development. And as an adult, ACEs can make you vulnerable to physical and mental health issues. For example, studies indicate having a narcissistic parent results in lower self-esteem ((Brittany N. Bach. “The impact of parental narcissistic traits on self-esteem in adulthood.” Smith College, 2014. https://scholarworks.smith.edu/cgi/viewcontent.cgi?article=1922&context=theses)) in adulthood.

Narcissistic parents project their inflated self-views ((Jabeen, Fakhra, et al. “Healing the next Generation: An Adaptive Agent Model for the Effects of Parental Narcissism.” Brain Informatics, vol. 8, no. 1, Mar. 2021, p. 4. PubMed Central, https://doi.org/10.1186/s40708-020-00115-z.)) onto their children, who then internalize them. You may believe your role in a relationship is to give affection but never receive it. If you get stuck in that dynamic, this pattern can damage your adult relationships.

Intimate Partner Violence

Narcissistic abuse is also common in romantic relationships. Intimate partner narcissistic abuse usually happens in 3 stages: ((Roberts, Michelle D., “Moth to a Flame: An Investigation of the Personality Traits and Early-Life Trauma
Histories of Women Who Have Survived Adult Relationships with Men with Pathological Narcissism”
(2021). Dissertations. 1043.
https://irl.umsl.edu/dissertation/1043))

  1. Idealization, where the abuser imitates their partner’s personality and values to create the illusion of a perfect relationship;
  2. Devaluation, when the abuser drops the act and pulls away from, criticizes, or humiliates their partner;
  3. Discard, in which the abuser suddenly leaves the relationship, usually in an extremely hurtful way like cheating.

Narcissistic or not, abusive relationships are extremely difficult to escape. ((Leaving an Abusive Relationship | Office on Women’s Health. https://www.womenshealth.gov/relationships-and-safety/domestic-violence/leaving-abusive-relationship. Accessed 27 Dec. 2022.)) People with NPD may even show remorse after they discard you, only to leave again as soon as you forgive them. The goal here is to maintain the power imbalance, not repair the relationship. And even after you get to safety, the end of an abusive relationship rarely leaves you with closure. ((Cunen, Mary-ann Borg. The Recovery Process after Being in a Relationship with a Narcissist. www.academia.edu, https://www.academia.edu/3640472/The_recovery_process_after_being_in_a_relationship_with_a_Narcissist. Accessed 27 Dec. 2022.))

When you’re connected to your abuser financially, legally, or through children, breaking up can be dangerous. If you’re experiencing domestic violence, you can get immediate help. And you can make a safety plan before you’re ready to leave.

If you or someone you know is being threatened or abused, call 800-799-SAFE or text “START” to 88788 to connect with the National Domestic Violence Support Hotline.

Their support is free and confidential.

What Are the Long-Term Effects of Abuse?

Abuse of any kind can do immediate damage. But even after you get to safety, you might feel the lasting effects of trauma.

Post-traumatic-stress disorder (PTSD) is a common result of narcissistic abuse. ((Arabi, Shahida. 2022. PTSD Symptoms: Romantic Relationships with Individuals Who Have
Narcissistic and Psychopathic Traits. Master’s thesis, Harvard University Division of Continuing
Education.)) With PTSD, you might experience flashbacks, nightmares, or feel guilty or on edge. And because narcissistic abusers manipulate their targets, it can be difficult to trust people again.

It’s hard to build a stable relationship without trust. That’s one reason why many people have trouble connecting with others in a healthy way after abuse. ((Rakovec-Felser, Zlatka. “Domestic Violence and Abuse in Intimate Relationship from Public Health Perspective.” Health Psychology Research, vol. 2, no. 3, Oct. 2014, p. 1821. PubMed Central, https://doi.org/10.4081/hpr.2014.1821.)) And if your parent was your abuser, you may have learned unhealthy behavioral patterns at a young age. These could include emotional outbursts, control issues, or high-risk behaviors. In fact, studies show that experiencing abuse increases your risk of addiction. ((Rich, S. Lynne, et al. “The Impact of Abuse Trauma on Alcohol and Drug Use: A Study of High-Risk Incarcerated Girls.” Journal of Child & Adolescent Substance Abuse, vol. 25, no. 3, 2016, pp. 194–205. PubMed Central, https://doi.org/10.1080/1067828X.2015.1007197.))

Narcissistic abuse also impacts your self-esteem. ((Cunen, Mary-ann Borg. The Recovery Process after Being in a Relationship with a Narcissist. www.academia.edu, https://www.academia.edu/3640472/The_recovery_process_after_being_in_a_relationship_with_a_Narcissist. Accessed 27 Dec. 2022.)) People with NPD have trouble showing empathy, so they often say cruel things to the people closest to them. This can cause anxiety or depression, which are common among people recovering from abuse of any kind. ((Radell, Milen L., et al. “The Impact of Different Types of Abuse on Depression.” Depression Research and Treatment, vol. 2021, Apr. 2021, p. 6654503. PubMed Central, https://doi.org/10.1155/2021/6654503.))

Approaching Recovery From Narcissistic Abuse

When you’re ready to heal from trauma, you might need specialized treatment. Trauma-informed care is often the right place to start. In a trauma-informed program, your provider will have experience working with survivors. As a result, they’ll understand the unique needs of people with a history of abuse.

This approach can include several different types of therapy:

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) ((Iverson, Katherine M., et al. “Cognitive-Behavioral Therapy for PTSD and Depression Symptoms Reduces Risk for Future Intimate Partner Violence among Interpersonal Trauma Survivors.” Journal of Consulting and Clinical Psychology, vol. 79, no. 2, Apr. 2011, pp. 193–202. PubMed Central, https://doi.org/10.1037/a0022512.)) is a popular method of treatment for survivors of narcissistic abuse.

In session, your therapist will help you break through unhelpful thought and behavioral patterns ((Cully, J.A., & Teten, A.L. 2008. A Therapist’s Guide to Brief Cognitive
Behavioral Therapy. Department of Veterans Affairs South Central MIRECC, Houston.)) that come from your trauma. For example, you might be hesitant to trust a new partner. In that case, your therapist could help you trace your fears back to their point of origin. Perhaps a parent broke your trust as a child, and you now expect betrayal in your closest relationships.

Once you identify the cause, you’ll learn practical ways to reframe your response. Your therapist might ask you to check the facts, comparing your partner to the person who abused you. Given their current behavior, do you expect them to betray you? And do they have the ability to harm you as much as your parent did? When a parent never arrives to pick you up from school, you could get stuck there. If an adult partner stands you up at a restaurant, your feelings might be hurt, but you’ll still get home safely.

You’ll practice these skills in session with your therapist, and also in your daily life. There are a few specialized types of CBT that can help you recover from narcissistic abuse:

  • trauma-focused CBT (TF-CBT), ((Vanderzee, Karin L., et al. “Treatments for Early Childhood Trauma: Decision Considerations for Clinicians.” Journal of Child & Adolescent Trauma, vol. 12, no. 4, Dec. 2018, pp. 515–28. PubMed Central, https://doi.org/10.1007/s40653-018-0244-6.)) a type of CBT for children and their non-abusive loved ones;
  • cognitive processing therapy (CPT), ((VA.Gov | Veterans Affairs. https://www.ptsd.va.gov/understand_tx/cognitive_processing.asp. Accessed 27 Dec. 2022.)) which teaches you healthier ways to think about your trauma;
  • prolonged exposure therapy (PE), ((VA.Gov | Veterans Affairs. https://www.ptsd.va.gov/understand_tx/prolonged_exposure.asp. Accessed 27 Dec. 2022.)) where you consciously confront your trauma in a safe environment to desensitize yourself to it.

Holistic Therapies

Because many people with trauma find it painful to talk about their past, talk therapies like CBT can be extremely difficult. And patients often drop out of these types of therapies (( E. Alpert, A. M. Hayes, J. B. Barnes, et al., Predictors of Dropout in Cognitive Processing Therapy for PTSD: An
Examination of Trauma Narrative Content, Behavior Therapy, https://doi.org/10.1016/j.beth.2019.11.003)) because they can be so triggering.

In those cases, alternative treatment can be a great place to start. Holistic trauma therapies ((Wahbeh, Helané, et al. “Complementary and Alternative Medicine for Post-Traumatic Stress Symptoms: A Systematic Review.” Journal of Evidence-Based Complementary & Alternative Medicine, vol. 19, no. 3, July 2014, pp. 161–75. PubMed Central, https://doi.org/10.1177/2156587214525403.)) aren’t a replacement for other methods, but they can still have a major impact on your recovery. These are some of the most well-known holistic treatments for trauma:

Holistic treatments invite you to start healing your mind, body, and spirit at the same time. Patients reflect on the past traumas while rebuilding their sense of self. This can empower you to recover in a gentler, more sustainable way.

Physical techniques like massage and acupuncture can help you release tension stored in the body. If you survived physical abuse, this can be an extremely important part of healing. These treatments are opportunities for you to practice receiving safe, supportive touch. And by doing that, you can learn to feel safe in your own body again.

Medication

Some therapists recommend using medication to decrease trauma symptoms. ((VA.Gov | Veterans Affairs. https://www.ptsd.va.gov/understand_tx/meds_for_ptsd.asp. Accessed 27 Dec. 2022.)) This is a common treatment for patients with conditions like PTSD, depression and anxiety. Doctors often prescribe antidepressants like Zoloft or Prozac to help people manage intense emotions. But everyone’s experience is different. Talk to your doctor about your recovery goals, so they can guide you toward the right type of treatment.

Taking medication can lighten the emotional load during recovery. But it’s just one aspect of healing. It’s important to combine any prescription meds with other approaches to your care.

Self-Help Resources

In addition to residential rehab, therapy, and medications, other resources can support your healing journey. You can start educating yourself about this complex topic, alongside your search for a provider. If you enjoy podcasts, you can start by listening to one of the following:

Or, to read about healing from narcissistic abuse, you can check out one of these books:

These resources can help you learn more about NPD, narcissistic abuse, and the healing process. For many people, they’re an important first step to recognizing realities. But they’re no replacement for therapy. Survivors also benefit from professional care.

Residential Treatment for Survivors of Narcissistic Abuse

Abuse is never the survivor’s fault. But healing from it is your responsibility. And there’s no shame in admitting you need help. If it feels like trauma symptoms are dominating your life, you might consider attending inpatient rehab for trauma. Living on-site can help you fully focus on healing, become part of a community, and get a new perspective on your recovery.

See our list of residential rehabs for information on therapies, pricing, and more.

Reviewed by Rajnandini Rathod

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You’re Still You: Resources for Recovery from Domestic Violence

Domestic violence is more complicated than it sounds. Until you’re in the thick of it, you might imagine the lines are clearly drawn. “If it ever gets physical, I’ll leave right away.” But then it happens on a holiday, or while you’re between jobs. It happens in private, and you can’t remember all the details. So you tell yourself it wasn’t as bad as it felt. Or, it could have been worse. Or, it didn’t really happen at all.

Here’s the thing: it doesn’t matter how bad it is. You don’t get a prize for withstanding more abuse. By the time you’re wondering if you need support, you probably do. That means different things for different people. Maybe it’s time to text a friend and ask them to have coffee. If things are more serious, you can call a hotline or find a shelter. And once you meet your basic needs for safety, you might consider rehab that treats domestic violence survivors.

Immediate Help

If you’re in a violent relationship, you can get immediate support. These hotlines and resources can help you make urgent decisions and get to safety.

Recognizing Abuse

You might not be sure if a relationship is abusive. Maybe the aggressor’s actions seem justified. And if you can empathize with someone, it’s hard to think of them as an abuser. But at the end of the day, even if you understand their motivations, violence is never acceptable. Look for these signs to recognize domestic abuse:

  • Physical violence against you, your pets, your home, or your belongings
  • The threat of physical violence, whether or not it’s carried out
  • Intimidating you physically, verbally, or with weapons
  • Verbal insults, humiliation, or threats
  • Controlling behavior, such as telling you what you can and can’t wear, or setting a curfew for an adult partner
  • Isolating you from family or friends, or discouraging you from getting social support
  • Taking control of your finances
  • Sexual assault, or pressuring you to perform sexual acts
  • Pressuring you to use drugs or alcohol

Cultural norms can make it hard to admit that abuse is happening at all. In the media, domestic violence usually takes place in heterosexual relationships, with a man as the aggressor. And it almost always includes a physical attack. But in reality, abuse can be much more complicated.

Domestic violence can happen within any close relationship: between partners, parents and children, or even platonic friends. And it can happen to anyone, including men, CEOs, and people with other types of privilege. Your identity doesn’t protect you from being abused—and it doesn’t have to stop you from getting help.

Violence Against Men

Approximately 25% of women and 14% of men experience domestic violence1 from a partner. While women are at a higher risk, men are still vulnerable to this dynamic. And the stereotype that men can’t be abused2 may prevent them from getting support.

One study interviewed staff members at an organization that supports male abuse survivors. A service manager for their hotline described a typical conversation with a new client. “I have guys that call me and say ‘I can’t be a victim of domestic abuse…I am a police officer, I’m a judge, I’m a solicitor, I work in the field, I can’t be a victim.’ Even though they know what is going on.”

This reluctance is so common, there’s a word for it. Denial, or minimization, is a common response to trauma.3 It may come from the abuser, who tries to convince you they did nothing wrong. Or it might feel like a way to protect yourself from your own feelings about their abuse. But denial can be invalidating. And no matter who you are, or how society views you, you deserve to be healthy and safe.

Abuse in LGBTQ+ Relationships

Stereotypes can also make it hard to acknowledge abuse between people of the same gender. The narrative that “men can’t be abused and women can’t be abusers” hurts everyone—even LGBTQ+ people. And the numbers make it clear that abuse goes beyond gender or sexuality. In fact, bisexual people are at greater risk for domestic violence4 than either gay or straight people.

Even in healthy LGBTQ+ relationships, stigma can prevent you from getting social support.5 And if your partnership gets violent, it gets even harder. LGBTQ+ abuse survivors face unique barriers6 to social services, treatment, and other resources.

There are several reasons for this. First, not all clinicians are experienced in LGBTQ+ issues. And when you’re in crisis, the last thing you want to do is spend time educating a therapist. Some clients might even be afraid to come out to their provider. If that’s your experience, you can connect with an LGBTQ+ affirming program to get effective support.

Abuse and Addiction

Drug and alcohol use complicate any relationship. That’s true whether it’s healthy, abusive, or somewhere in between. You might go out drinking with coworkers, and end up kissing your work crush for the first time. Or, you might stay in a violent relationship because it’s the only way you can access cocaine. These are extreme examples, but they’re both on the same spectrum.

Coercion is common in abusive relationships.7 In that dynamic, one person convinces the other to do things they don’t really want to do. This reinforces the imbalance of power. It can also make you feel ashamed of your own actions. And if they’re coercing you to take drugs or drink excessively, there’s a direct impact on your mental health. Drug use can stop you from thinking clearly, so it’s impossible to make an escape plan. It can also dull your emotions and interfere with your memory, so you have a harder time proving there was abuse in the first place.

Trauma Bonding

Drug abuse increases the risk of domestic violence.8 These two patterns also follow a similar rhythm. The high of being on drugs is often followed by the crash of a hangover. The same thing happens in abusive relationships—the good times are the very best, and the bad times are awful. In some relationships, there’s little in between.

This cycle can lead to traumatic bonding.9 Here’s how that works:

  1. You develop a close, trusting relationship with another person. You come to rely on them for emotional support.
  2. They commit an act of violence against you.
  3. You feel hurt, and instinctively seek comfort.
  4. Because you’re close to your abuser, you turn to them. If they’re also isolating you from friends and family, you may not have anyone else to talk to.
  5. They either provide or withhold emotional support. Either way, this reinforces the power dynamic, reminding you how much you need them.

The experts at All Points North Lodge say that trauma bonds feel a lot like addiction.10 So whether or not you’re actually taking drugs, residential rehab might be the right place to start healing.

Long-Term Recovery From Abuse

When it’s time to leave an abusive relationship, you’ll have some urgent priorities. And your long-term mental health might not be one of them. That’s okay. Start by securing a place to live, an income stream, and other basic necessities. You can plan your emotional recovery when you’re ready. At that point, you’ll have several options.

Trauma-Informed Care

Trauma-informed care is a general style of treatment, not a specific type of therapy. It’s often helpful for people with specific diagnoses, like post-traumatic stress disorder (PTSD) or complex PTSD (c-PTSD). It can also treat more general symptoms of trauma, as well as addiction and other mental health issues.

In this approach, providers use certain tactics to make recovery accessible. For example, if you get triggered during a therapy session, they’ll know how to respond. Trauma-informed care honors you as the authority on your own experience.

According to experts in domestic violence, a trauma-informed therapist “views individuals as survivors11 rather than victims, and recognizes symptoms as adaptive responses.” In other words, the symptoms of trauma serve a purpose. Or, they did while you were in a dangerous situation. Once you get to a safe place, those same behaviors might get in the way of your mental health. Treatment empowers you to recognize when those responses are and aren’t helpful. You’ll also learn more sustainable coping strategies.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) takes a practical approach to recovery. As a behavioral treatment, it puts you in the driver’s seat. Instead of focusing on how you feel, it teaches you new ways to respond to your feelings. And changing the way you act can improve your life and relationships. In time, you’ll feel better because of your ongoing behavior. CBT is a popular treatment for survivors of partner violence.12

Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing (EMDR) uses physical stimuli to help you work through traumatic memories. Usually, patients describe those memories in detail during a therapy session. By performing certain eye movements, they become desensitized to triggers. But EMDR for domestic violence survivors can look a little different.13 You won’t always recount past memories during a therapy session. Instead, you might focus on mindfulness techniques and free association.

Cognitive Processing Therapy

Cognitive processing therapy (CPT) was first developed to treat survivors of sexual assault.14 It can also help you heal from other types of intimate violence, like verbal and physical attacks. Unlike CBT, this approach delves into your deepest thoughts and feelings about your trauma.

After intimate violence, many survivors have a sense of cognitive dissonance. For instance, you might blame yourself for someone else’s actions. But at the same time, you may feel like you had no power in the situation. It’s often hard to reconcile your sense of self with the reality of abuse. CPT helps patients make peace with that paradox.

Find Yourself Through Recovery

Trauma changes you. Maybe you lost a period of time, or a relationship you cared about. It can even seem like you lost yourself.  And the process of recovery can feel a lot like grief.

There’s no simple solution here. But with the right support, there is a way forward. Over time, you can get to know yourself again, and build the beautiful life you deserve.

Connect with a trauma-specialized rehab to learn about their housing options, pricing, and treatments.

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Exploring the Link Between ADHD and Addiction

Attention-deficit/hyperactivity disorder (ADHD) is a serious mental health issue. From the name, it’s easy to think this condition is a set of behavioral problems. But those are just the symptoms. In reality, ADHD comes from a neurochemical imbalance—and it’s remarkably similar to the brain chemistry of addiction.

If you’re considering treatment for ADHD and addiction, you can start by learning how they relate to each other.

The Brain Chemistry of Addiction and ADHD

People with ADHD have much a higher risk of addiction. ((Davis, Caroline, et al. “Attention-Deficit/Hyperactivity Disorder in Relation to Addictive Behaviors: A Moderated-Mediation Analysis of Personality-Risk Factors and Sex.” Frontiers in Psychiatry, vol. 6, Apr. 2015, p. 47. PubMed Central, https://doi.org/10.3389/fpsyt.2015.00047.)) This is true across age groups, affecting both adults and teens with ADHD. ((Schellekens, Arnt F. A., et al. “Often Overlooked and Ignored, but Do Not Underestimate Its Relevance: ADHD in Addiction – Addiction in ADHD.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 169–72. www.karger.com, https://doi.org/10.1159/000509267.)) Experts agree that the 2 conditions have “a shared biological background.” Specifically, both addiction and ADHD have an impact on dopamine, which is a neurotransmitter.

Dopamine relates to the brain’s reward system. ((Watson, Stephanie. “Dopamine: The Pathway to Pleasure.” Harvard Health, 20 July 2021, https://www.health.harvard.edu/mind-and-mood/dopamine-the-pathway-to-pleasure.)) This naturally occurring chemical is released when you do something pleasurable. The brain defines “pleasure” broadly: your dopamine might increase when you buy a new pair of shoes, get a job, or eat a cookie. And when an activity feels good, you’re more likely to do it again.

That can be very healthy. For example, you can get dopamine from exercise. ((“Five Surprising Ways Exercise Changes Your Brain.” Greater Good, https://greatergood.berkeley.edu/article/item/five_surprising_ways_exercise_changes_your_brain. Accessed 14 Dec. 2022.)) Your brain is quite literally wired to make you want to work out. But there’s a downside to dopamine. Plenty of activities—like substance use—feel good while doing serious damage to your health. And for people with ADHD, dopamine might already be hard to come by.

The Biology of ADHD

If you have ADHD, it may take extra effort to concentrate, sit still, or complete important tasks. This often interferes with relationships, schoolwork and career. In severe cases, people with ADHD can qualify for disability benefits. ((Is ADHD A Disability? https://www.disability-benefits-help.org/disabling-conditions/adhd-and-social-security-disability. Accessed 14 Dec. 2022.)) But it also comes with some advantages. Like any other type of neurodivergence, this condition changes the way you see the world. And your unique insight can be a strength.

Biologically, people with ADHD can’t regulate dopamine levels. ((Blum, Kenneth, et al. “Attention-Deficit-Hyperactivity Disorder and Reward Deficiency Syndrome.” Neuropsychiatric Disease and Treatment, vol. 4, no. 5, Oct. 2008, pp. 893–918. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626918/.)) This condition affects at least one of the genes responsible for that process. And that, experts say, “makes it difficult for neurons to respond to dopamine.”

In other words, even if you have healthy dopamine levels, it may not feel that way. So things that “should” be pleasurable might not always feel as good as you want them to.

If nothing feels good enough, it makes sense to go looking for new types of stimulation. This may explain the link between ADHD and risk-taking. ((Shoham, Rachel, et al. “ADHD-Associated Risk Taking Is Linked to Exaggerated Views of the Benefits of Positive Outcomes.” Scientific Reports, vol. 6, no. 1, Oct. 2016, p. 34833. www.nature.com, https://doi.org/10.1038/srep34833.))

Drug use falls neatly into this category.

Dopamine and Addiction

Over time, addiction makes the brain less sensitive to dopamine. ((The Neurobiology of Substance Use, Misuse, and Addiction | Surgeon General’s Report on Alcohol, Drugs, and Health. https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-use-misuse-and-addiction. Accessed 14 Dec. 2022.)) At first, your brain starts associating drugs with a sense of reward. The act of taking drugs triggers a release of dopamine, whether or not the drug itself does.

As you get used to this repeated flood of dopamine, you’ll feel less satisfaction from taking drugs. This effectively increases your tolerance to the drug, so you need to take more of it to achieve the same result. At the same time, you start feeling less pleasure from other activities. So even if you no longer enjoy the sensation of being high, you might still feel driven to take drugs.

These behaviors quickly become a vicious cycle. Psychiatrist and dopamine expert Dr. Anna Lembke explains that for people in this state, joy is often out of reach. “Now, our drug of choice doesn’t even get us high,” she says. “It just makes us feel normal.” ((Hu, Elise, and Audrey Nguyen. “Too Much Pleasure Can Lead to Addiction. How to Break the Cycle and Find Balance.” NPR, 4 Apr. 2022. NPR, https://www.npr.org/2022/03/31/1090009509/addiction-how-to-break-the-cycle-and-find-balance.))

But if you have ADHD, addiction recovery might not be enough to break the cycle. You might stop taking drugs, but still feel unsatisfied with your life. In order to heal from these co-occurring disorders, it’s important to find treatment for both of them.

Treatment for ADHD and Addiction

ADHD is often diagnosed in children ((Braaten, Ellen. “5 Things Parents and Teachers Need to Know about ADHD.” Harvard Health, 27 Oct. 2017, https://www.health.harvard.edu/blog/5-things-parents-and-teachers-need-to-know-about-adhd-2017102712643. and teens, and some people grow out of their symptoms. But that’s not true for everyone. And recent data shows that you can develop ADHD as an adult, ((“‘Late-Onset’ ADHD May Emerge in Young Adults.” Psychiatric Times, https://www.psychiatrictimes.com/view/late-onset-adhd-may-emerge-young-adults. Accessed 14 Dec. 2022.)) even if you showed no signs of it in childhood.

Because of these complexities, you might need different types of treatment in different stages of recovery. And after you complete rehab, you may benefit from ongoing care for addiction, ADHD, or both. Certain therapies are especially helpful for people with these diagnoses.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a popular treatment for many mental health conditions. And a wealth of data supports CBT as a therapy for ADHD and addiction. ((Zulauf, Courtney A., et al. “The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders.” Current Psychiatry Reports, vol. 16, no. 3, Mar. 2014, p. 436. PubMed Central, https://doi.org/10.1007/s11920-013-0436-6.)) This framework focuses more on practical skills than it does on emotional processing. Your therapist will teach you coping strategies for dealing with difficult thoughts, urges, social situations, and more. In between sessions, you’ll try them out in your daily life.

Integrated Cognitive Behavioral Therapy

As the name implies, integrated cognitive behavioral therapy (ICBT) integrates components of CBT ((Capone, Christy, et al. “Integrated Cognitive Behavioral Therapy (ICBT) For PTSD and Substance Use in Iraq and Afghanistan Veterans: A Feasibility Study.” Journal of Traumatic Stress Disorders & Treatment, vol. 3, no. 4, 2014, p. 1000134. PubMed Central, https://doi.org/10.4172/2324-8947.1000134.)) and other treatment methods. Patients learn about their condition, practice mindfulness, and learn flexible thinking skills. You’ll use a workbook, and your therapist will give you homework assignments to complete between sessions. This format empowers clients to develop practical skills and put them to use in real-life situations.

ICBT is a highly effective treatment for co-occurring ADHD and addiction. ((van Emmerik-van Oortmerssen, Katelijne, et al. “Integrated Cognitive Behavioral Therapy for ADHD in Adult Substance Use Disorder Patients: Results of a Randomized Clinical Trial.” Drug and Alcohol Dependence, vol. 197, Apr. 2019, pp. 28–36. PubMed, https://doi.org/10.1016/j.drugalcdep.2018.12.023.)) One study even found it to be more effective than other forms of CBT. ICBT can also treat post-traumatic stress disorder (PTSD). ((McGovern, Mark. Integrated Cognitive Behavioral Therapy for Co-Occurring PTSD and Substance Use Disorders. Clinical trial registration, NCT01457404, clinicaltrials.gov, 23 Oct. 2015. clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT01457404.)) However, like most types of talk therapy, ICBT focuses on mental, emotional, and behavioral issues. Since ADHD is also a neurochemical issue, many people need medical treatment as well.

Medication for ADHD

Prescribing medication to treat co-occurring ADHD and addiction ((Mariani, John J., and Frances R. Levin. “Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders.” The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, vol. 16, no. Suppl 1, 2007, pp. 45–56. PubMed Central, https://doi.org/10.1080/10550490601082783.)) is a controversial issue. If a patient has ADHD without addiction, prescription stimulants are the standard treatment. But stimulants are highly addictive. Because of this, experts disagree about the best course of action.

This controversy even affects people with ADHD who have no history of drug abuse. Some sources caution against treating ADHD with stimulants ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) because of the risk of future addiction. Others say prescribed stimulants protect against addiction, ((APA PsycNet. https://psycnet.apa.org/record/2013-43688-006. Accessed 14 Dec. 2022.)) because they empower patients to manage symptoms in a healthy way.

During addiction recovery, taking medication of any kind can be complicated. Tell your doctor about your history before you start a new prescription. Together, you can make a plan to keep yourself safe. For example, they might only prescribe you a few pills at a time, and ask you to come back into their office before you can get more.

Whatever treatments you pursue, it’s essential for you to get an official diagnosis first. That can be surprisingly difficult, especially for people of certain demographics.

Getting an Accurate Diagnosis

Because of the overlapping symptoms of ADHD and addiction, ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) doctors can’t always distinguish between them. This means that if you already have an ADHD diagnosis, you might need to start addiction treatment before you can get one. Most rehabs start their program with thorough assessments, so it’s relatively easy to get assessed for ADHD while you’re in residential treatment. Some doctors even recommend screening everyone in addiction treatment for ADHD. ((Matthys, Frieda, et al. “[Summary of the practice guideline for the diagnosis and treatment of ADHD in adolescents and adults with addictions].” Nederlands tijdschrift voor geneeskunde, vol. 157, no. 24, Jan. 2013, p. A6025.))

In some populations, though, ADHD is harder to diagnose. There are several possible reasons for this. Many clinicians have a preconceived image of what ADHD patients look like. This makes it easy to miss the symptoms when they present in a different way. It can also be hard to differentiate between ADHD and other mental health issues.

ADHD in Teens

For children and teens with ADHD, ((“Severity of ADHD in Children Increases Risk of Drug Use in Adolescence, Says Longitudinal Study.” Https://Www.Apa.Org, https://www.apa.org/news/press/releases/2003/08/adhd-drugs. Accessed 14 Dec. 2022.)) early diagnosis is key. That’s because children with more severe ADHD symptoms are at a greater risk of developing addiction later on. However, ADHD symptoms may not appear before puberty. ((Ostojic, Dragana, and Carlin J. Miller. “Association Between Pubertal Onset and Symptoms of ADHD in Female University Students.” Journal of Attention Disorders, vol. 20, no. 9, Sept. 2016, pp. 782–91. DOI.org (Crossref), https://doi.org/10.1177/1087054714535249.)) And because even healthy teenagers go through behavioral changes, that timing can make it difficult for parents to notice a problem. While this can be an issue for teens of any gender, it’s most common among young women.

Women With ADHD

Data suggests that up to 75% of women with ADHD may be undiagnosed. ((Walters, Anne. “Girls with ADHD: Underdiagnosed and Untreated.” The Brown University Child and Adolescent Behavior Letter, vol. 34, no. 11, Nov. 2018, pp. 8–8. DOI.org (Crossref), https://doi.org/10.1002/cbl.30337.)) That might be because women with ADHD often show different symptoms ((Quinn, Patricia O., and Manisha Madhoo. “A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls: Uncovering This Hidden Diagnosis.” The Primary Care Companion for CNS Disorders, vol. 16, no. 3, 2014. www.ncbi.nlm.nih.gov, https://doi.org/10.4088/PCC.13r01596.)) than clinicians expect.

For example, one study found that women were more likely to be inattentive than hyperactive. Inattention primarily affects the person feeling it. Your inability to focus on your book won’t distract a stranger at a bus stop. But hyperactivity, which is common in men with ADHD, can be disruptive in a group setting. Both clinicians and patients’ loved ones commonly miss “internalizing” symptoms like inattentiveness. Instead, women with ADHD are often misdiagnosed with bipolar disorder, anxiety, or depression.

Differentiating Between ADHD and Anxiety

ADHD and anxiety ((Pliszka, Steven R. “ADHD and Anxiety: Clinical Implications.” Journal of Attention Disorders, vol. 23, no. 3, Feb. 2019, pp. 203–05. DOI.org (Crossref), https://doi.org/10.1177/1087054718817365.)) often go hand in hand. While ADHD is not an anxiety disorder, ((ADHD and Anxiety: What’s the Connection? 15 May 2017, https://www.medicalnewstoday.com/articles/315303.
)) they can present with similar symptoms. For instance, either condition might get in the way of finishing your homework. In people with ADHD, that’s probably because you just can’t focus. On the other hand, people with anxiety might be able to focus, but afraid of getting it wrong.

ADHD can also cause anxiety. That’s because its symptoms make it harder to achieve your goals. Some people get anxious about the impact ADHD has on their lives. Without proper treatment, it’s all too easy to get stuck in this loop.

If you have both of these conditions, it’s important to get the right diagnosis before taking medication. Otherwise, you’ll risk making your symptoms worse. ADHD patients commonly take stimulants, which can increase anxiety. ((Stimulants – Alcohol and Drug Foundation. https://adf.org.au/drug-facts/stimulants/. Accessed 14 Dec. 2022.)) Stimulants may still be a good fit for some people with anxiety disorders—it all depends on your specific health history. You can work closely with your doctor to design a care plan that meets your needs.

ADHD May Be a Risk Factor for Depression

There’s less of an overlap between the symptoms of ADHD and depression, but they have a strong correlation. People with ADHD often develop depression ((Riglin, Lucy, et al. “ADHD and Depression: Investigating a Causal Explanation.” Psychological Medicine, vol. 51, no. 11, Aug. 2021, pp. 1890–97. Cambridge University Press, https://doi.org/10.1017/S0033291720000665.)) later in life, even if they grow out of childhood ADHD symptoms.

There may be a genetic link between these conditions. And people with ADHD and depression often have other mental health issues, like addiction or trauma. Recovering from these co-occurring disorders is complex. You may require specialized care, and ongoing treatment even after rehab.

Post-traumatic Stress Disorder

Everyone experiences trauma differently. Something that feels like just a bad day to you might be deeply traumatizing for someone else. And your personal history can make you more or less likely to develop post-traumatic stress disorder (PTSD).

ADHD increases your risk of developing PTSD ((Biederman, Joseph, et al. “Is ADHD a Risk for Posttraumatic Stress Disorder (PTSD)? Results from a Large Longitudinal Study of Referred Children with and without ADHD.” The World Journal of Biological Psychiatry, vol. 15, no. 1, Jan. 2014, pp. 49–55. DOI.org (Crossref), https://doi.org/10.3109/15622975.2012.756585.
)) in response to trauma. That’s especially true for people with both ADHD and alcohol addiction. ((Luderer, Mathias, et al. “ADHD Is Associated with a Higher Risk for Traumatic Events, Self-Reported PTSD, and a Higher Severity of PTSD Symptoms in Alcohol-Dependent Patients.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 245–53. www.karger.com, https://doi.org/10.1159/000508918.)) And data shows that people with ADHD experience a higher number of traumatic events, whether or not they develop PTSD.

If you have trauma symptoms, you might benefit from trauma-informed care (TIC). TIC is a general approach to treatment, not a specific type of therapy. This means you can get trauma-informed care for ADHD, addiction, PTSD, and any other concerns you’re seeking help for.

Many Roads to Recovery

Everyone’s recovery is unique, and that’s doubly true for people with co-occurring disorders. Your provider will help you design a care plan that accounts for your various goals.

The act of healing can empower you to understand the depth of your emotional experience. That’s how it happened for Peach Perkins.

Peach is in recovery from ADHD, alcohol and drug addiction, ((ADHD and Substance Abuse: ADHD Aha! Podcast. https://www.understood.org/en/podcasts/adhd-aha/adhd-and-substance-abuse-peachs-story. Accessed 14 Dec. 2022.)) as they explained on the podcast ADHD Aha! But it took them almost a year of sobriety to understand how those conditions worked together. At first, they thought addiction was “the thing preventing me from doing a good job at work. Now I can really go all in. And I was still at work, just my eyes were crossed and I still couldn’t do what I needed to do. That wasn’t what was in my way.” After that realization, they were able to get an official ADHD diagnosis. With the right diagnosis, they finally got the treatment they needed—and you can too.

Find Balance in Treatment for ADHD and Addiction

ADHD is often, but not always, a life-long condition. Recovery usually doesn’t mean getting rid of your symptoms entirely. Instead, you’ll learn to manage them in a healthier way. And those coping skills can make it easier to heal from co-occurring diagnoses like addiction.

Learn more about rehab programs for ADHD, including their locations, pricing, insurance coverage, and more.