Author: Kayla Gill

With 9 years in the rehab space, Kayla has overseen the creation of comprehensive addiction treatment content for online audiences worldwide. Her experience managing content for a luxury destination rehab, and her personal path to healing via residential rehab and various therapeutic modalities, inform her first-hand understanding of recovery. She takes inclusion seriously and is especially interested in how trauma and minority experiences shape readers’ journeys.
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When Drinking Doesn’t Help: The Connection Between Alcohol and Social Anxiety

Alcohol and anxiety are closely related. Many people with social anxiety disorder (SAD) feel like drinking alleviates their symptoms. In the short term, that might even be true. But over time, any alcohol consumption can make matters worse. Heavy drinking not only increases anxiety; it can also turn into addiction.

If you have either of these conditions, treatment can help. You can attend inpatient rehab to treat a drinking problem, social anxiety, or both at the same time. During recovery, you’ll learn better ways to cope with your symptoms. And with those skills in hand, you won’t have to self-medicate with alcohol.

“Getting to the Root of My Anxiety”

If you’re using alcohol to cope with social anxiety, ((Efilnikufecin. (2021, October 18). I became an alcoholic due to Social Anxiety [Reddit Post]. R/Socialanxiety. www.reddit.com/r/socialanxiety/comments/qau9cf/i_became_an_alcoholic_due_to_social_anxiety/)) you might feel stuck in a cycle. But according to one anonymous Reddit user, there’s always a way out:

Alcohol “was like a miracle cure,” they write in a post. “Super confident, I’d walk up and talk to anyone. And embarrass myself obviously. I’d blackout drunk every single time because I never wanted the feeling to end. I didn’t want to go back to being scared.”

Over time, this person’s symptoms got worse, but “the increasing anxiety made me drink more.” They would experience withdrawal whenever they were sober. It turned into a vicious cycle. When drinking got in the way of their parenting, they knew something had to change.

“Getting to the root of my anxiety and feelings of self hatred was the important thing,” they explain on the Social Anxiety subreddit. “It’s been 4 years now and I haven’t had a drop.” It may feel like you need alcohol in order to function—but in reality, drinking just compounds the problem.

When Social Drinking Becomes a Problem

Many people feel like they need alcohol to be social. And it can be hard to spend time around drinkers without joining in. But anxiety disorders and alcohol addiction go hand in hand. ((Book, S. W., & Randall, C. L. (2002). Social anxiety disorder and alcohol use. Alcohol Research & Health, 26(2), 130–135. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683821/)) If you have SAD, you may be at a higher risk of developing a drinking problem.

Defining Alcohol Abuse

The official criteria for alcohol abuse ((Drinking levels defined | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved July 5, 2022, from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking)) might surprise you. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinking as follows:

  • For men: Over 4 drinks in 1 day, or 14 drinks in 1 week
  • For women: Over 3 drinks in 1 day, or 7 drinks in 1 week

(These definitions are based on biological differences between cis male and female drinkers. They may not be accurate for people of all genders.)

These numbers might help you identify an addiction. But any quantity of drinking can cause anxiety. ((Social anxiety disorder and alcohol abuse | anxiety and depression association of america, adaa. (n.d.). Retrieved July 5, 2022, from https://adaa.org/understanding-anxiety/social-anxiety-disorder/social-anxiety-and-alcohol-abuse)) According to the Anxiety and Depression Association of America, “Even moderate amounts of alcohol can affect one’s mood and anxiety level.”

Alcohol use is so socially acceptable that it can take time to even realize you have a problem. But this addiction is all too common in people with anxiety. A study found that “about ⅕ of patients with social anxiety disorder also suffer from an alcohol use disorder.” ((Book, S. W., & Randall, C. L. (2002). Social anxiety disorder and alcohol use. Alcohol Research & Health, 26(2), 130–135. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683821/))

How Alcohol Impacts Anxiety

Drinking has a complex effect on mental health. On one hand, alcohol is an anxiolytic ((Gilman, J. M., Ramchandani, V. A., Davis, M. B., Bjork, J. M., & Hommer, D. W. (2008). Why we like to drink: A functional magnetic resonance imaging study of the rewarding and anxiolytic effects of alcohol. Journal of Neuroscience, 28(18), 4583–4591. https://doi.org/10.1523/JNEUROSCI.0086-08.2008)) —meaning that it reduces anxiety. However, data shows that alcohol abuse “can also lead to increased anxiety.” ((Lingford-Hughes, A., Potokar, J., & Nutt, D. (2002). Treating anxiety complicated by substance misuse. Advances in Psychiatric Treatment, 8(2), 107–116. https://doi.org/10.1192/apt.8.2.107)) And when the same behavior makes your symptoms both better and worse, it can be hard to imagine recovery. But with expert support, you can absolutely break out of this cycle.

Treatment for Co-Occurring Social Anxiety and Alcohol Addiction

It may feel like drinking is the best way to manage your symptoms—but in rehab, you’ll find healthy alternatives. If you’ve been drinking to self-medicate your anxiety, ((Turner, S., Mota, N., Bolton, J., & Sareen, J. (2018). Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety, 35(9), 851–860. https://doi.org/10.1002/da.22771)) you can recover from both. Experts say that treating these issues at the same time is “the current ‘gold standard’ model of care.” There are several ways you can approach treatment.

Detox

When you first quit drinking, medical detox is almost always necessary. This process can have serious side effects, and some people need 24-hour care. Your specific needs will depend on the amount you’ve been drinking and your physical health.

Anxiety is a common symptom of quitting alcohol. ((Saitz, R. (1998). Introduction to alcohol withdrawal. Alcohol Health and Research World, 22(1), 5–12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/)) If you have SAD, your symptoms may get worse during detox. In an inpatient program, you might get a prescription to help with this side effect.

Medications for Social Anxiety Disorder

A wealth of data supports treating social anxiety disorder ((Rose, G. M., & Tadi, P. (2022). Social anxiety disorder. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK555890/)) with medications. You might take SNRIs (ex. Cymbalta, Effexor) or SSRIs (ex. Prozac, Zoloft). A doctor or psychiatrist can determine whether any of these are the right fit for you.

Your physical and mental health should stabilize during your time in rehab. As that happens, your needs will change, too. Some people keep taking meds long after they start recovery, while others stop after a short time. No matter how long you spend taking meds, you should stay in close contact with your doctor the whole time. This is an important way to guard against relapse.

Cognitive Behavioral Therapy (CBT)

Research shows that CBT is a highly effective therapy for social anxiety disorder. ((Evren C. An overlooked combination in treatment: addiction and social anxiety disorder comorbidity. Dusunen Adam The Journal of Psychiatry and Neurological Sciences 2020;33:331-333. https://dusunenadamdergisi.org/storage/upload/pdfs/1614849083-en.pdf)) It is also a well-regarded treatment for alcohol addiction. ((Kiluk, B. D., Ray, L. A., Walthers, J., Bernstein, M., Tonigan, J. S., & Magill, M. (2019). Technology‐delivered cognitive‐behavioral interventions for alcohol use: A meta‐analysis. Alcoholism: Clinical and Experimental Research, 43(11), 2285–2295. https://doi.org/10.1111/acer.14189)) If you’re healing from both these conditions, it could be very helpful.

During CBT, you’ll meet with a therapist in 1:1 sessions. They’ll teach you practical skills that help you live with your anxiety. You’ll learn to reframe your thoughts and respond to triggers in a healthy way.

CBT is no substitute for traditional talk therapy. As a behavioral treatment, it’s designed to help you change your daily habits. However, you won’t spend much time talking about your past. And in order to move forward, it’s important to look back on where you’ve been. If you do CBT in rehab, it will likely be combined with other types of therapy.

Exposure Therapy

In exposure therapy, patients face stimuli that would normally trigger them. This involves creating a hierarchy of situations that cause anxiety and includes telling the story of a time you were triggered in real life. You’ll speak in the present tense, describing the event in great detail. Then, you and your therapist will talk through your emotional response. Preliminary research also shows that virtual reality exposure therapy can reduce social anxiety. ((Chesham, R. K., Malouff, J. M., & Schutte, N. S. (2018). Meta-analysis of the efficacy of virtual reality exposure therapy for social anxiety. Behaviour Change, 35(3), 152–166. https://doi.org/10.1017/bec.2018.15))

Some data suggests that a version of this treatment called cue exposure therapy (CET) can treat alcohol addiction. ((Mellentin, A. I., Nielsen, B., Nielsen, A. S., Yu, F., & Stenager, E. (2016). A randomized controlled study of exposure therapy as aftercare for alcohol use disorder: Study protocol. BMC Psychiatry, 16(1), 112. https://doi.org/10.1186/s12888-016-0795-8)) However, much more research is needed on the subject.

Mindfulness

Mindfulness strategies can treat many mental health issues, including anxiety and addiction. One study looked at mindfulness-based interventions (MBIs) as a treatment for social anxiety. ((Liu, X., Yi, P., Ma, L., Liu, W., Deng, W., Yang, X., Liang, M., Luo, J., Li, N., & Li, X. (2021). Mindfulness-based interventions for social anxiety disorder: A systematic review and meta-analysis. Psychiatry Research, 300, 113935. https://doi.org/10.1016/j.psychres.2021.113935)) Researchers found a “a dose-response relationship between MBIs duration and effect size.” In other words, the longer you spend practicing mindfulness, the more effective it can be in reducing anxiety.

For people recovering from an alcohol addiction, mindfulness can help prevent relapse. ((Zgierska, A., Rabago, D., Zuelsdorff, M., Coe, C., Miller, M., & Fleming, M. (2008). Mindfulness meditation for alcohol relapse prevention: A feasibility pilot study. Journal of Addiction Medicine, 2(3), 165–173. https://doi.org/10.1097/ADM.0b013e31816f8546)) Learning mindfulness techniques early in recovery may set you up for future success.

Support Groups

For people with social anxiety, the very idea of going to a meeting can be a trigger. But for people with alcohol addiction, support groups can improve treatment outcomes. ((Tracy, K., & Wallace, S. P. (2016). Benefits of peer support groups in the treatment of addiction. Substance Abuse and Rehabilitation, 7, 143–154. https://doi.org/10.2147/SAR.S81535)) Talk to your primary therapist about whether attending a support group is a good idea for you.

If you decide to try it out, there are many options available. Most peer-led support groups host free meetings all over the world. You can even connect with your peers online, from anywhere. In these groups, you can connect with people who share some part of your experience. If you feel anxious to be around them, that’s okay. They might feel that way, too. Talking about it can help you build meaningful relationships. And that’s an essential part of healing.

Specialized Care, in a Protected Space

And it can be hard to treat just one of these issues at a time. Instead, experts recommend integrated treatment for addiction and social anxiety. ((Nguyen, A., Mirbaba, M., Khaleghi, F., & Tsuang, J. (n.d.). Current treatment options for co-morbid anxiety and alcohol use disorders: A review. Journal of Addictive Behaviors and Therapy, 1(1), 0–0. Retrieved from https://www.primescholars.com/abstract/current-treatment-options-for-comorbid-anxiety-and-alcohol-use-disorders-a-review-106758.html)) In layman’s terms, that means starting recovery for both diagnoses at once.

Many rehabs offer this kind of specialized care. A team of providers can design a treatment plan to meet your needs. And in the privacy of an inpatient program, you can focus on what’s most important: your own recovery process.

In the right program, you’ll get the coordinated care you need. Connect with a rehab that specializes in treating co-occurring anxiety and alcohol addiction here.

Reviewed by Rajnandini Rathod

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Traumatic Brain Injuries and Your Mental Health

Traumatic brain injuries (TBIs) can be extremely serious. Unlike most injuries, they can directly alter brain function, and have a severe impact on your mental health. Some patients even develop addictions following TBI, whether or not they have a history of substance abuse.

Even a relatively mild concussion can cause long-term symptoms. And because those symptoms won’t necessarily appear right away, it can be hard to see the connection between TBI and subsequent mental health issues. After sustaining any type of head trauma, it’s important to see a doctor and learn about your options for recovery. Depending on your exact experience, you may benefit from getting treatment at a residential rehab.

Mental Health Symptoms of a Physical Injury

Although they’re caused by physical trauma, TBIs are strongly related to mental health and addiction issues. Because these injuries can affect brain function, mood and behavioral changes are common symptoms of traumatic brain injury.1

In some clients, head trauma can lead to serious mental health conditions,2 like depression or anxiety. This is even true for people with mild TBIs, like concussions. According to one study, “both moderate to severe and mild TBI are associated with an increased risk of subsequent psychiatric illness.3 Whereas moderate to severe TBI is associated with a higher initial risk, mild TBI may be associated with persistent psychiatric illness.”

The connection between TBIs and mental health conditions goes both ways. Many TBI patients experience emotional changes, regardless of their prior health history. People with a preexisting mental health diagnosis may also be at a higher risk for traumatic brain injury.4 No matter what your mental health history looks like, you may be especially vulnerable to certain issues after a TBI.

Depression

TBIs are correlated with major depressive disorder.6 One study found that this condition “occurs with sufficient frequency to be considered a significant consequence after TBI.” And unfortunately, these symptoms may get in the way of your recovery. Many people with depression have trouble finding the motivation to get the help they need.

Anxiety

Anxiety disorders are quite common after traumatic brain injuries.7 TBI is associated with a number of anxiety disorders, including (but not limited to) the following:

  • Social anxiety disorder
  • Phobias
  • Panic disorder
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)

In some cases, these conditions are simply emotional responses to the event that caused traumatic brain injury. For example, you might develop PTSD after being in a serious car accident. However, they may also result from changes to the brain itself. Experts have found that anxiety is “a strong predictor of social, personal, and work dysfunction” in people with TBIs.

Post-Traumatic Stress Disorder (PTSD)

PTSD commonly co-occurs with traumatic brain injuries. This might be true because of the prevalence of TBI among military veterans,8 who are at risk of PTSD for additional reasons. However, research has found that civilians with a history of head trauma are also at risk for developing PTSD.9 If you’re experiencing the symptoms of PTSD, whether or not you have a history of TBI, consider attending a program that offers trauma-informed care.

Choosing the Right Therapy for TBI Recovery

Treatment for TBI depends on your exact symptoms, and on their severity. Because these injuries may affect any area of the brain, different clients have vastly different needs during recovery. Most people benefit from a combination of physical and psychotherapeutic interventions for traumatic brain injuries.10

If you’re experiencing mood or behavioral changes, or other mental health symptoms, the following types of therapy can be especially helpful:

Cognitive Behavioral Therapy (CBT)

CBT is the most widely used mental health intervention for people with TBI.10 In this type of treatment, you’ll regularly meet with a therapist to discuss your emotional experience. During each session, you’ll identify challenging thought patterns and emotional responses, and learn practical tactics to help you navigate them. These skills empower you to approach difficult emotions and situations with equanimity.

Mindfulness Practices

Mindfulness techniques may be helpful for TBI,11 especially for people with both cognitive and psychological symptoms. Preliminary research shows that therapies like meditation, yoga, and mindfulness-based cognitive therapy (MBCT) are highly effective in treating a wide variety of symptoms. These techniques can help you come into the present moment, accept your emotions as they are, and find a sense of peace. More research is needed into this form of treatment in the context of TBIs. If you do engage in meditation as part of recovery, it’s important to combine it with other healing methods.

Pharmaceutical Treatment

Depending on your symptoms, you may be a candidate for pharmaceutical treatment for mental health issues following a TBI.12 If you decide to try taking medication after a brain injury, it’s important to stay in close communication with your prescribing doctor. Any prescription can have side effects, and you could be at risk for developing serious cognitive or even physical symptoms due to your health history. Some medications, including tricyclic antidepressants, may not be safe for people with a history of TBI.

all points north lodge indoor pool
All Points North Lodge offers specialized programming and facilities for both active and former professional athletes.

TBI and Addiction

There is a high rate of substance use disorders among people with a history of TBI.13 Although more research is needed into the exact link between these two conditions, data supports the idea that addiction can make people more vulnerable to brain injuries, and vice versa.

Drug and Alcohol Use Can Cause TBI

Like other mental health conditions, substance abuse can increase your risk of traumatic brain injury.12 One study suggests that problem drinking is an especially common risk factor for these injuries, because it interferes with physical coordination. Drinking post-TBI can lead to severe mental health symptoms.

Any history of addiction can have an impact on your recovery from these injuries. One study found that people who had already entered recovery for substance misuse, and then sustained a traumatic brain injury, were at an increased risk of addiction relapse after their TBI.13 And since new symptoms can appear long after the original injury, it’s important to make a long-term plan for your recovery.

Neurological Changes Following TBI

Evidence suggests that people who sustain early-life TBIs are at a greater risk for developing substance use disorders.14 Head trauma can impact brain development, and it sometimes changes the way you respond to certain stimuli. In particular, research shows that the “regions of the brain associated with the perception of reward” may be directly affected by brain injuries.

If these areas of your brain are changed or damaged, you’ll be more vulnerable to addiction. A wealth of neuroscientific research confirms that drug use hijacks the brain’s reward system.15 According to neuropharmacologists Wilkie A. Wilson, Ph.D., and Cynthia M. Kuhn, Ph.D., “when addictive drugs enter the brain they artificially simulate a highly rewarding environment.” This modifies brain chemistry, provoking behavioral changes. Habitual drug use causes “the reward system to modify the brain to crave the drug and take action to get it.”

Professional athletes may also be more vulnerable to developing addictions16 following TBI. According to one study, athletes are “more susceptible to the intoxicating effects of substances and may get in trouble more easily due to the disinhibiting effects of the brain injury.” Because addiction often starts as an attempt to self-medicate mental health symptoms, early treatment may help you avoid more serious consequences.

If you have a history of either drug abuse or brain injury, be sure to inform your doctor when you seek treatment for either condition. Healing is absolutely possible, but you may need specialized care during recovery.

Rehab for Professional Athletes

Traumatic brain injuries are common among athletes.17 Experts estimate that 10% of all TBIs “are due to sports and recreational activities.” And if you’re a professional athlete, this type of injury can directly interfere with your ability to do your job.

Fortunately, several luxury rehab programs are designed to meet your unique needs. Orenda at Futures offers the Orenda Athletes Track, in which clients can continue physical training during residential treatment. This empowers you to recover without sacrificing your long-term career goals in the process. At this facility, “a team that has provided training and physical therapy to MLB, PGA, and more helps athletes heal and train while receiving comprehensive care for mental health and substance use disorders.”

You may be eligible for one of these specialized programs even if you’ve already retired from professional sports. All Points North Lodge treats both active and former professional athletes. Their experts continue offering support even after clients complete inpatient treatment. With their guidance, clients can start planning for long-term recovery from the moment they enter rehab. For some, that recovery plan may need to include medical care alongside mental health treatment.

orenda at futures athletes track
Orenda at Futures’ Athletes Track allows clients to continue physical training during residential treatment.

Other Symptoms of Traumatic Brain Injuries

If you develop mental health symptoms after a TBI,18 you may be at greater risk for additional symptoms. Specifically, mental health issues could be a warning sign for functional limitations, like memory loss and difficulty performing regular activities. Your healthcare team may be able to recognize those signs in advance, and help you prepare for challenges.

TBIs may be classified as mild, moderate, or severe. According to the CDC, symptoms may last as little as a few hours, or they may linger for the rest of a person’s life. These injuries are especially dangerous for children and older adults. For children, TBI symptoms can affect brain development and result in long-term cognitive issues. Older adults are often misdiagnosed, and fail to receive the care they need as a result.

In mild cases, common symptoms of a traumatic brain injury5 include, but are not limited to:

  • Headache
  • Confusion
  • Dizziness
  • Blurred vision
  • Fatigue
  • Mood or behavioral changes

Moderate or severe TBIs present with the same symptoms, and may also cause the following issues:

  • Seizures
  • Nausea
  • Pupil dilation
  • Loss of coordination
  • Agitation

If you exhibit any of these symptoms after a head injury, no matter how minor, it’s very important that you consult a doctor.

Long-Term Recovery for Body and Mind

Traumatic brain injuries can have long-term health impacts. And if your brain functions differently than it did before, it can be difficult to imagine what healing will look like. Recovery might not mean returning to life as it used to be. Instead, this is your opportunity to get to know yourself again, and decide how you’d like to move forward.

It’s extremely important to get comprehensive care after a TBI. Physical and mental health are always connected, especially if you’re healing from a brain injury. By working with a skilled team of doctors and therapists, you can decide on a plan of care that feels right for you.

If you’re concerned about the impact of an injury on your mental health, talking to a treatment facility can be a good place to start.

Frequently Asked Questions About Traumatic Brain Injuries and Mental Health

What are the mental health symptoms associated with traumatic brain injuries?

Traumatic brain injuries (TBIs) can lead to various mental health symptoms, including mood and behavioral changes, depression, anxiety disorders (such as social anxiety, phobias, panic disorder, OCD, and PTSD), and post-traumatic stress disorder (PTSD). These symptoms can occur regardless of your prior mental health history.

Can traumatic brain injuries lead to addiction?

Yes, traumatic brain injuries (TBIs) are associated with a higher risk of developing substance use disorders and addiction. Addiction makes people more susceptible to brain injuries, and vice versa. Substance abuse, including problem drinking, can increase the risk of TBIs and worsen mental health symptoms. Early treatment and specialized care are important for individuals with a history of addiction or brain injury.

What types of therapy are effective for TBI recovery and mental health symptoms?

Cognitive behavioral therapy (CBT) is widely used for people with traumatic brain injuries (TBIs) and mental health issues. It helps identify challenging thought patterns and emotions and provides practical tactics to navigate them. CBT is only one kind of available talk therapy; your treatment provider can help you decide which therapies are best for you.
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Demystifying Transcranial Magnetic Stimulation (TMS)

Traditional therapy and medications aren’t always effective for treating mental health disorders. If this is the case for you, transcranial magnetic stimulation (TMS) could be a viable alternative. This non-invasive treatment works by stimulating different parts of your brain to alleviate symptoms of mental health conditions like depression and PTSD.

Your primary care physician, mental health treatment provider, or rehab treatment team can help you determine if TMS is right for you.

Health Conditions TMS Can Treat

TMS can be used to treat1 several conditions:

About 20-30% of patients with MDD continue to experience depressive symptoms2 despite therapy and medication. For those patients, looking for alternatives to traditional treatment approaches is often a logical next step. TMS shows significant potential to improve depressive symptoms among people with treatment-resistant depression and PTSD. It may take several weeks to see results, so it’s imperative for patients to consistently attend the number of sessions prescribed by their doctor.

Repetitive TMS, or rTMS, has also been shown to be successful for anxiety and bipolar disorders,3 although it’s more effective in treating depression than manic episodes. It may also speed up recovery after a stroke, and help alleviate symptoms that arise after the event. In addition, low-frequency rTMS can help control the symptoms of Tourette syndrome and OCD. High-frequency rTMS helps people quit smoking by reducing cravings. rTMS can even reduce cocaine use and cravings4 in people struggling with addiction.

What Exactly Is TMS?

TMS is a non-invasive procedure that stimulates brain tissue5 by producing a high- or low-intensity magnetic field through a copper wire. There are 3 main methods of TMS used today:

  • Single-pulse TMS (spTMS) stimulates the motor cortex while a machine measures and records electrical activity.
  • Paired-pulse TMS (ppTMS) delivers 2 pulses through the same coil, with long or short intervals in between.
  • Repetitive TMS (rTMS) is a popular variation of TMS that applies repeating pulses to a specific area of the brain. This method treats the symptoms that come from mental health disorders. Deep TMS (dTMS)6 is a newer type of rTMS that stimulates deep brain areas because their larger helmet allows for more surface area. All Points North Lodge is one rehab center that offers dTMS treatment.

Typically, spTMS and ppTMS evaluate brain functioning, while rTMS actually creates changes in the brain. If you’re treated for a mental health condition, you’ll most likely undergo rTMS. There are several different coils available for use in TMS treatment. The specialists who deliver your treatment will determine the best one for your needs.

You can either complete TMS sessions at an inpatient rehab center (Inspire Malibu, for example, offers this in partnership with a physician’s office) or at a private clinic as an outpatient. In the latter option, you’d stay at home and commute to your sessions each day.

What Happens During a TMS Session?

Before you undergo any TMS procedures,7 you’ll take a physical and mental health screening to confirm your candidacy. This includes discussions of symptoms, conditions, and any medications you take with your treatment team, who will then guide you through the process.

During your session, you’ll sit in a reclining chair with earplugs (or some sort of hearing protection) with an electromagnetic coil attached to your head. The Dawn Rehab in Thailand even lets you listen to music so you feel as comfortable as possible. During rTMS (the most common type of TMS procedure), the operating physician will turn the coil on and off repeatedly to deliver pulses to your brain. During this process, you’ll feel a tapping sensation, called “mapping.” The professional administering rTMS will slowly increase the dose of magnetic energy to determine the right amount for you.

Most people don’t find TMS painful,8 but some people may feel slight discomfort. The Dawn Rehab describes their TMS sessions:

“A TMS-trained nurse will place an electromagnetic coil against your head which will painlessly deliver brief magnetic pulses – the same as those used in MRI (Magnetic Resonance Imaging) machines – to the region of the brain involved in mood control and depression.”

After your session, you can continue your regular daily routine as usual.

How Long Are TMS Sessions?

Duration can vary from person to person, and will also depend on your diagnosis. Standard rTMS treatment for major depressive disorder,9 for example, averages around 20-30 daily sessions for around 4-6 weeks. However, research recommends a minimum of 6 weeks. One study found that 38.4% of MDD patients responded well to just 4 weeks of treatment, but then surveyed patients who didn’t respond well to the initial 4 weeks after an additional 12 weeks of biweekly sessions. 61% of those patients responded well to the longer treatment phase.

Some studies have explored another, faster form of rTMS called “accelerated rTMS” or arTMS. During rTMS, people undergo multiple sessions in one day. Some studies suggest promising outcomes from this procedure, but more research will determine if this is actually a more viable option. Theta burst stimulation (TBS) is another, newer form of rTMS that can produce quicker results.10 Some studies found that, after only 5 days, patients enrolled in TBS arTMS trials reported success rates of 90%.

Some people may continue to attend “maintenance sessions” after their first set of TMS sessions. This involves slowly reducing the number of sessions per week from 3 to 1, which is eventually reduced to 1 session every 2 weeks. However, some people stop rTMS altogether, and go back to therapy and medications after completing their sessions. Unfortunately, rTMS maintenance isn’t well studied, and needs more research before making any determinations.

Should You Try TMS Therapy? Consider the Cons

While TMS has relatively few drawbacks, they do exist. Side effects are possible, but are usually minimal. And, TMS can be expensive and time-consuming. However, it may still be worth it for you, since lifting your depression to any degree can greatly impact your quality of life. Here are some factors to consider before trying TMS:

Possible Side Effects

Although TMS is non-invasive and seldom produces side effects,11 it can cause seizures in rare cases, and doctors do not recommend it for patients with epilepsy. While the risk of a seizure is small (less than 0.01% if you don’t have epilepsy, and less than 3% if you do), it’s still a possibility. If any of the following apply to you, you may be more likely to experience seizures:

  • Pre-existing neurological conditions
  • Adolescent
  • Changes in medication
  • Active substance use

You should talk to your doctor if you have any metal or electronic implants that will be near the TMS coil. This includes cochlear implants. These may cause problems with the therapy, and can be dangerous.

You may feel some slight discomfort in your scalp or neck during the procedure or pain afterward. You might also become more sensitive to sounds or experience ringing in your ears—which is why treatment providers should always provide ear protection. Some people report feeling fatigued afterward. However, it’s unlikely that you’ll encounter any of these side effects, and if you do, they will most likely be mild and short-lived.

Cost

rTMS is expensive,12 ranging from $200-300 USD per visit in a private clinic. If you complete the full course recommended by your doctor, you may end up paying $5,000-10,000 USD. Of course, this can differ depending on the duration and number of sessions you attend. Check with rehabs you’re considering to see if TMS is included in the cost of your program, or how much additional costs are.

Could TMS Provide the Relief You’ve Been Looking For?

Being unresponsive to treatment is incredibly frustrating when you’re living with depression or other mental health issues. But the good news is, you still have options. Alternative treatments like TMS just might do the trick for you, and the simple act of being open to trying something new can empower you to move forward in your recovery journey.

To learn more about residential treatment programs that offer this and other alternative therapies, browse our collection of rehabs and connect with centers directly.

Frequently Asked Questions About Transcranial Magnetic Stimulation for Addiction Treatment

How does Transcranial Magnetic Stimulation (TMS) work for addiction treatment?

Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate specific areas of the brain. It works by delivering targeted magnetic pulses to activate or inhibit brain cells, which can help regulate mood and alleviate symptoms of mental health conditions.

Is Transcranial Magnetic Stimulation safe for treating depression and anxiety?

Yes, Transcranial Magnetic Stimulation is considered a safe procedure for treating conditions like depression and anxiety. It has been extensively studied and approved by regulatory authorities. Common side effects may include mild headache or scalp discomfort during or after the session, but these are generally well-tolerated.

What are the potential benefits and risks of Transcranial Magnetic Stimulation?

Transcranial Magnetic Stimulation offers several potential benefits, including its non-invasiveness, minimal side effects, and efficacy in treating certain mental health conditions. However, it may not be suitable for everyone, and some individuals may experience rare side effects such as seizures. It’s essential to consult with a qualified healthcare provider to determine if TMS is a suitable treatment option.

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Equine Therapy for Addiction Recovery: 4 Science-Backed Benefits Explained

Equine therapy (ET), also known as equine-assisted therapy (EAT), is an increasingly popular method of addiction treatment. In this therapy, your interactions with a horse will help you achieve therapeutic goals. Specifically, you might work on social skills, sensory processing, and physical wellness. You may also gain insight into how your behavior affects those around you.

Because ET doesn’t require much conversation, you may feel more at ease working through issues that you don’t feel comfortable addressing in traditional talk therapy. While you may already have an affinity for horses, this therapy can still be beneficial even if you’ve never interacted with these animals before–many people report that horses seem like nonjudgmental creatures that make them feel safe. If this sounds appealing to you, you may choose to explore rehab programs that offer equine therapy.

What Is Equine Therapy?

During equine therapy, your therapist will guide you through a series of tasks with the horse. This can include anything from riding to ground activities like grooming or walking, depending on the type of ET your treatment center offers. Session lengths vary, but you can usually expect them to last around 30-90 minutes.

One study determined the following common factors in equine-assisted therapies:1

  • The goal of the interaction is a positive outcome for the participant.
  • Treatment occurs through the interactions between the horse and human, which are purposeful and regulated.
  • A trained facilitator, such as a therapist, is present with the horse, in addition to the human receiving the therapy.

Throughout the session, your therapist will be able to learn about you through your interactions with the horse. This process can help you work through whatever comes up—sometimes it’s not at all what you expect.

Equine-assisted therapies are becoming more popular2 in Europe and the U.S. since their inception in the ‘90s. But what, exactly, takes place during one of these sessions?

What are the Different Types of Equine-Assisted Therapies and Activities (EAAT)?

There are several different kinds of equine-assisted therapies and activities (EAAT) that you may encounter at rehab centers. While there are some discrepancies about the terms used for various types of equine therapy, we’ll look at some of the more popular options below.

Note that offerings vary from rehab to rehab depending on their facilities, staff, and treatment approach. You can contact the admissions team at a center you’re considering for more details about their specific program.

Equine-Assisted Psychotherapy (EAP)

One that you’ll encounter often at many different rehab centers is equine-assisted psychotherapy (EAP). Contrary to popular belief, EAP doesn’t involve riding the horse. During this experiential therapy, the therapist leads the client and horse through a series of activities on the ground. The whole process is slow and gentle, and helps encourage personal growth, responsibility, and healing.

Don Lavender, program director at Camino Recovery in Spain, has worked with horses for over 40 years, and even helped bring the treatment to the U.S. in the early 2000s. According to Don, “It’s become a really effective therapy. It’s therapeutic for the person because they get to learn connection with others.” Don also says that this connection can replace their substance use, and be an integral part of the healing process.

Therapeutic Horseback Riding (THR)

THR includes horseback riding,3 and may include activities like leading the horse around or through obstacles, or simply walking or trotting, depending on the rider’s experience level. This may also include grooming and caring for the horse.

Therapeutic Carriage Driving

In therapeutic carriage driving,3 clients drive the horse while riding in a carriage. This can give the person driving feelings of empowerment and responsibility, especially if other people are present in the carriage. In addition, people who may be unable to ride a horse due to physical difficulties can still experience benefits from THR through this activity.

Interactive Vaulting

Interactive vaulting sessions3 can include gymnastics while riding the horse and group problem solving tasks.

What Happens During an Equine-Assisted Psychotherapy Session?

It may depend on the center, but at Soberman’s Estate, clients are eased into this type of therapy. Equine & Meditation Coach Janice Story doesn’t have the client participate in any particular activities on the first day. Instead, she simply lets the person bond with the horse. “I’ll have them just sit and pet the horse, and see what comes up for them,” she says.

Later, they might go on walks, practice leading the horse, and eventually work their way up to various trust-building and communication practices. During some of these sessions, the client has a blindfold on. Story, or another client, then leads the blindfolded client to the horse and through a series of trust-building tasks, such as picking up their feet. “It teaches clients that they can do something without really knowing how,” she says. “We give them tools and relate it to how they can take it with them when they leave, when they try to navigate their journey back into life.”

At Camino Recovery, Lavender has the client start by grooming the horse, and allows both parties to get to know each other. Eventually, they move towards “lunging.” This involves getting the horse to move around the pen with their personal energy rather than with a rope. To do this requires the client to understand, read and tend to the horse’s emotions.

These are just a few examples of what you might expect during equine-assisted psychotherapy. While it may seem intimidating, Story is confident that the experience will be a positive one. “When our clients first show up, some of them say, ‘I don’t know what this equine therapy is going to do for me,’” she says. “By the end of an hour they’re asking me when we come back.”

How EAT Can Improve Mental Health

Equine-assisted therapy can improve mental health3 in several ways. Research shows that it can increase self-esteem. It can also inspire feelings of freedom, independence, and competency.

Our own beliefs about these creatures play a role in this process. According to researchers, interacting with horses creates “visual imagery of power and beauty,” which can empower recipients of this therapy. What’s more, horses have been human companions for thousands of years.4 We’re used to seeing them as pets, working animals, transportation, and entertainment. This familiarity can help clients establish trust.

1. Horses Provide Connection and Comfort

Equine therapy can also facilitate connection.5 According to one study, “many people find that human-horse bonding results in a comforting and affectionate relationship.”

Horses are pack animals, and they need a connection with their herd. And that doesn’t just mean connecting with other animals—they can also bond with people. Experts believe horses may actually “perceive humans as herd members.” This allows them to form close bonds with ET clients during treatment.

In another study, scientists observed that equine therapy was an effective treatment for combat veterans.6 “When you’re with a horse they give you kindness and compassion and love and they don’t expect anything,” one participant explained. “They don’t want to give you advice and they don’t want to make things seem less than they are. They’re just there for you.”

These relationships can be extremely grounding for people in addiction recovery. Many people report that it feels comforting to connect with such a large, powerful animal. By slowly building a rewarding bond based on mutual trust and respect, as ET clients gain the horse’s trust, they learn to trust themselves.

2. Sharing Your Emotions Becomes Easier

Equine-assisted therapy provides a nonjudgmental place7 for people to express themselves. By interacting with a non-verbal animal, you may feel safe to share thoughts you normally wouldn’t mention to another person.

After over 30 years of working with horses, Janice Story understands the animals, and how much they can truly help her clients, very well. “The horses are really amazing at creating a safe space for our clients. When clients first come in, oftentimes they haven’t felt any emotions for a long time. Horses will bring that up for them.”

3. EAT Can Boost Your Confidence

Equine-assisted activities can improve your self-esteem.8 Horses are large animals, and some people may find this intimidating, especially if they haven’t interacted with them before. But when they overcome these challenges successfully, they feel empowered, which boosts their sense of self-confidence.

Because horses are pack animals, they naturally look for a leader. If the person doesn’t become the leader, the horse will. Therefore, the person must establish themself as the leader, and work on becoming assertive and confident in order to gain the horse’s respect. This process can teach you valuable leadership skills.

4. You Build Self-Awareness

Horses have evolved to be on the lookout for predators. Because of this, they’re highly attuned to their environment. And in equine therapy, that awareness includes empathy.

Horses easily understand and react to human emotions.9 And they’re not afraid to give you feedback. If you make a horse feel uncomfortable, you can trust it to let you know. This dynamic is intended to help you improve your self-awareness. Instead of acting on impulse, you’ll learn to control your emotional reactions to help the horse stay calm.

According to Story, horses act as mirrors, reflecting the client’s emotions back to them. “If the client needs to work on holding some boundaries, they might not know it, but the horse will show that to them,” she says. “And then at the same time, they’ll help them work through it. So it actually teaches them how to hold their boundaries.”

In that way, equine therapy differs from talk therapy. Janice points out that, in traditional therapy, “the issues might arise but sometimes the solution is not instant. Where with the horses, they’ll teach them at the same time.” This real-time feedback can help the client work through the issues that they’re dealing with right then and there.

Equine Therapy for Specific Mental Health Concerns

Equine therapy is used to treat various mental health concerns such as anxiety, depression, and post-traumatic stress disorder (PTSD). Many of these conditions occur alongside substance use disorders. And thus, equine therapy can be helpful in treating mental health concerns that arise because of, or separately from, drug misuse.

Post-Traumatic Stress Disorder (PTSD)

One study found that equine-assisted therapy can help alleviate PTSD symptoms.10 After just 6 weekly, 2-hour EAP sessions, participants reported feeling significantly less intense responses to trauma, and minimized PTSD symptoms. Additionally, they experienced less anxiety and reduced depressive symptoms.

Equine therapy may work especially well for symptoms of PTSD11 in part because horses are prey animals. This makes them hypervigilant, and unlike dogs, humans need to gain their trust over time. People with PTSD often experience the same hypervigilance, which can help them relate better to the horse. And because horses communicate primarily through body language, people can work to improve other PTSD symptoms, such as emotional numbness and bodily dissociation.

Anxiety

Numerous studies show that equine therapy helps reduce anxiety. A participant in one study said that therapeutic horseback riding helped her minimize her anxiety12 through the “teamwork” experienced between her and the horse. In this process, clients move “in sync with the horse’s body,” and the horse intuitively responds to the rider.

Aggression

One study found that equine-assisted psychotherapy can also treat aggression.13 This may be due to the horse’s larger size, which can make them seem more intimidating. People may realize that, if they can’t control their anger impulses, there is a possibility that the horse can cause them harm. This helps them to learn to react calmly and carefully. And because the horse gives instant feedback, patients can learn quickly exactly which behaviors are hurtful and work to correct them.

Autism Spectrum Disorder (ASD)

Another study looked at children with autism spectrum disorder (ASD) who did 10 weeks of therapeutic horseback riding.14 Children with ASD are sometimes rough with pets, but participants in this study were reportedly more caring towards them after the study ended. The control group, which learned about horses but did not interact with them, did not show as much of a change in their behavior.

A similar study discovered that adolescents with ASD showed significant improvements in social behaviors and communication.15 The researchers theorized that the reason for these positive changes was due to the “shared attention experience” that came from working with the horse. Horses mirror and respond to humans’ body language, which can help those with ASD better understand social cues and behaviors. The children also showed decreased irritability and hyperactivity, which may be due to the relaxing effect of horse riding.

A Program for Veterans

The Professional Association of Therapeutic Horsemanship (PATH) International Equine Services for Heroes® program is an equine-assisted therapy program that specifically works with veterans.16 Because veterans are more likely to experience PTSD after returning home from service, PATH developed this unique program just for them. Each veteran receives a horse intended to help them heal both physically and mentally. In this particular study, 13 veterans completed 24 weeks of both riding and ground activities (grooming and walking).

Afterwards, the veterans involved in the study reported feeling more confident, less isolated, and more trusting of others. Their depressive symptoms decreased over the course of treatment. “You’re forced to bring [problems] up and deal with them to the horse,” said one participant. “It’s pretty interesting. It’s amazing.”

Another participant stated that “I learned that even though I have issues in my life, I can come here to this program and get past my issues by working with the horse.”

Reconnect With Yourself Through Equine Therapy

Horses can teach you communication, confidence, and even interpersonal skills. Don Lavender may summarize it best: “Equine therapy is about connection, learning to connect to self by first learning to connect to another.”

Through your connection with a horse, you can learn how to reconnect with yourself.

To learn more about this powerful approach and see photos, reviews, insurance information, and more, visit our searchable directory of equine therapy rehab centers.

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Finding Treatment for Cocaine Addiction

Cocaine addiction can wreak havoc on a person’s life. And once you’re caught in the cycle of substance misuse, healing may seem out of reach. That’s a misperception. Recovery is always possible. For some people, rehab for cocaine addiction is the best place to start.

“Cocaine is the most commonly reported illicit stimulant used in the U.S.”1 Because its abuse is so common, this drug has been the subject of widespread research. As a result, many treatment programs are well-equipped to help patients recover from cocaine misuse.

The Prevalence of Cocaine Addiction

Cocaine is a stimulant2 derived from the coca plant native to South America. It can briefly increase a person’s energy, self-confidence, sociability, and mood. Because the effects of cocaine3 are so short-lived, it can quickly become habit-forming. Long-term use may cause less desirable effects, such as cause paranoia, hypersensitivity, and irritability.

The history of cocaine4 is strongly connected to mental health. In fact, its popularity can be traced back more than a century. “In 1884, Sigmund Freud detailed his experiments with cocaine, recommending it for treatment of opiate addiction and melancholia.” However, he did not account for its negative effects, and reportedly struggled with addiction for much of his life. Unfortunately, his endorsement of the drug helped make it socially acceptable for some time, for both medical and recreational purposes.

Reported drug abuse statistics5 paint a clear and distressing picture of cocaine use today. According to the National Center for Drug Abuse Statistics, 2% of people in the U.S., or 5.5 million people, reported taking cocaine in 2018. As of 2022, more recent data is not yet available. Researchers also caution against comparing current data about drug use and health6 with surveys taken before 2020, since the COVID-19 pandemic has changed the way surveys are conducted.

Cocaine use can have serious ill effects on both physical and mental health. Deaths caused by cocaine overdose in the U.S.7 have skyrocketed in recent years, increasing from nearly 4,000 in 1999 to nearly 16,000 in 2019. Because cocaine increases blood pressure8 and heart rate, it may cause strokes or respiratory failure. “Even first time users may experience seizures or heart attacks, which can be fatal.”

Because of these potential outcomes, cocaine misuse is extremely dangerous. However, patients don’t develop substance use disorders by choice. You may be highly susceptible to addiction despite your own better judgment, or desire to remain healthy. And some patients may be at a higher risk for developing a psychological dependence on cocaine.

Risk Factors for Cocaine Addiction

Certain demographics are especially vulnerable to cocaine misuse. Patients who exhibit one or more of the following risk factors may be at higher risk for this condition, or may require specialized care.

Adolescence

Teenagers may be more susceptible to developing cocaine addictions.9 Relative to adults, “adolescents show greater intake of cocaine, acquire cocaine self-administration more rapidly, work harder for the drug and are less sensitive to increases in price.” In layman’s terms, young people do more of this drug than adults, and are willing to work harder to obtain it.

Adolescents also face social pressures that may not impact adult behavior. Specifically, many teenagers develop substance use disorders10 while trying to fit in with their peer groups. Parents of adolescents should take note of any drastic behavioral changes, as these may indicate the onset of addiction. Teens with substance use disorders may show less interest in activities they used to enjoy, pay less attention in school, or start spending time with new friends who encourage these behaviors. By itself, any one of these signs may be a normal part of adolescence; however, sudden and extreme behavioral changes can be a cause for concern.

Novelty-Seeking Personality Traits

According to one study, “cocaine addiction has been associated with several distinct behavioral/personality traits.” For example, novelty-seeking behavior is associated with cocaine abuse.11 And in particular, people with sensation-seeking tendencies may be more vulnerable to cocaine use. However, people with high impulsivity are more vulnerable to cocaine addiction.

These traits may be genetic, learned, or influenced by a person’s environment and life circumstances. More research is needed to understand the link between personality, behavior, and substance use disorders.

Neurochemical Effects of Cocaine Use

Cocaine has a direct effect on the way the brain processes dopamine, which regulates the reward system.12

During normal brain activity, this neurotransmitter is released, binds to dopamine receptors, and is then recycled by a protein called the dopamine transporter. “If cocaine is present,” however, “it attaches to the dopamine transporter and blocks the normal recycling process, resulting in a buildup of dopamine in the synapse, which contributes to the pleasurable effects of cocaine.”13

In the short term, this can be enjoyable. In the long term, however, cocaine use can change brain function.14 The drug causes neurochemical imbalances, which make it difficult for the patient to feel a sense of pleasure or achievement without substance misuse. Over time, “the brain will gain a tolerance to feelings of pleasure and it will take more and more of the drug to achieve the same level of euphoria.”

What’s more, the act of abusing any substance affects dopamine levels.15 This is because the experience of ingesting a drug can trigger the release of the chemical, whether or not that drug has an effect on dopamine levels. This feeds into the cycle of addiction, in which the patient continues using illicit substances in order to feel any sense of reward. This effect is amplified with substances that have a direct effect on dopamine to begin with.

Treatment for Cocaine Addiction

Substance use disorders are treatable. No matter how long you’ve been using cocaine, or what impact it’s had on your life, change is always possible. And because its misuse is so prevalent, experts have been perfecting cocaine addiction treatment options16 for decades.

At present, “there are no medications approved by the U.S. Food and Drug Administration to treat cocaine addiction,17 though researchers are exploring a variety of neurobiological targets.” However, there are a number of effective therapeutic and behavioral interventions. And the first step toward healing is to learn about the options available.

Detox

Cocaine withdrawal18 may or may not have any physical symptoms. Unlike alcohol and opiates, detox from this substance is rarely life-threatening. That being said, it can be extremely uncomfortable and psychologically distressing.

If at all possible, it’s best to go through this process under medical care. If you attend a detox program, you’ll be closely monitored by a team of doctors, nurses, and therapists, possibly including a psychiatrist. Patients may receive non-addictive prescriptions to help them manage the symptoms of withdrawal. This experience can also help you transition into a longer-term rehab program.

Learn More: What You Need to Know About Detox

Rehab

Studies have shown that long-term rehab for cocaine dependence can be extremely effective.19 By attending a residential program, patients can take time away from triggers and difficult life circumstances, which may have been caused or exacerbated by their substance use. During that time, they can begin talk therapy, attend support groups, and make plans to live a healthier, more sustainable life after treatment.

Psychotherapy

Several therapeutic modalities can be effective in treating cocaine misuse. Researchers are most optimistic about contingency management (CM), a behavioral therapy that activates the patient’s reward system.

According to one study, contingency management is “perhaps the most effective psychosocial treatment” for cocaine use disorder.”20 In this treatment, patients receive vouchers redeemable for goods and services in the community, contingent upon achieving a predetermined therapeutic goal. CM treatment has been found to be especially effective in promoting initial abstinence from cocaine.”

Cognitive behavioral therapy (CBT) has also been shown to help these patients, although it may not be as productive as CM. This might be because CM has a more direct impact on brain chemistry, whereas CBT is skills-based.

Long-Term Recovery From Cocaine Addiction

Patients with a history of cocaine abuse can improve dramatically. In fact, detox and recovery from cocaine misuse can help you recover brain function.21 One 2017 study provided “early evidence that individuals with cocaine use disorder have the potential to at least partially reverse prefrontal cortex damage accompanying cocaine misuse, and regain associated cognitive abilities important for executive functions when cocaine use is stopped or significantly decreased.” In other words, you may be able to physically heal your brain during recovery.

But healing isn’t just about physical improvement. It’s also the process of building a better life. And in order to achieve that, patients must stay focused on recovery even after completing inpatient treatment. This ongoing commitment to healing may include regular talk therapy, attending support groups, or other modalities. For example, some studies have found that “greater participation in self-help programs” is an important factor in sustained recovery from cocaine dependence.22 ((McKay, J. R., Van Horn, D., Rennert, L., Drapkin, M., Ivey, M., & Koppenhaver, J. (2013). Factors in sustained recovery from cocaine dependence. Journal of Substance Abuse Treatment, 45(2), 163–172. https://doi.org/10.1016/j.jsat.2013.02.007))

Building a Better Life

When you have a history of substance misuse, recovery is often a lifelong process. That being said, it is absolutely possible to live a fulfilling life without cocaine use. Healing can even be fun! As you recalibrate your internal system of rewards, it’s important to do things you find enjoyable and exciting.

As you learn to make healthier choices, you can also begin building a new kind of confidence. And, best of all, you won’t be held back by the destabilizing pattern of substance abuse. Over time, you may find that joy is both more accessible and more sustainable.

If you’re ready to begin recovery, you can find a rehab center that treats cocaine addiction here.

Frequently Asked Questions About Cocaine Addiction Treatment

What are the treatment options for cocaine addiction?

Treatment options for cocaine addiction often include a combination of behavioral therapies, counseling, support groups, and medication in some cases. Individualized treatment plans are designed to address the specific needs of each person seeking recovery.

How long does treatment for cocaine addiction typically last?

The duration of treatment for cocaine addiction varies depending on factors such as personal progress, treatment goals, and circumstances. Treatment usually ranges from 2 weeks to 60 days. Some people benefit from longer treatment and ongoing aftercare support.

What should I look for in a luxury rehab for cocaine addiction?

When searching for a luxury rehab for cocaine addiction, it’s important to consider factors like clinical expertise, the level of personalized care, comfort, staff credentials, and confidentiality. It’s also important to verify accreditation and success rates. Most centers list accreditations directly on their site; CARF and the Joint Commission are the most common accreditation bodies.

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Could Sunny Malibu Be the Perfect Place for Your Recovery?

If you love the sun, beautiful beaches, and holistic healing in a laid-back atmosphere, then attending a rehabilitation facility in Malibu could be a great choice for you. Malibu is known for its year-round warm weather and beautiful scenery, as it’s located between the Pacific Ocean and the Santa Monica Mountains. It’s hard to believe that Los Angeles is only a 30-minute drive away.

Many Malibu treatment centers take advantage of their location and temperate climate, offering programs like surf therapy in addition to outdoor excursions like beach walks or hikes. Holistic therapy is also a popular method of treatment throughout California, and several centers in Malibu embrace this approach.

You may want to start your journey to mental health and addiction recovery in Malibu if you enjoy ocean views, a warmer climate, and unique therapy techniques focused on the outdoors and alternative medicine.

Malibu’s Inviting Climate and Landscapes

Malibu is in close proximity to nature, with stunning views in every direction. Malibu’s 11 public beaches are located along 21 miles of coastline on the famous Pacific Coast Highway, and include some of the best beaches in California, including Zuma Beach and El Matador State Beach.

Several recovery centers, such as Oceanside Malibu, are located right on the coast. You’ll be able to hear the sounds of the waves from Malibu Beach as you work on healing, take long walks by the water, or participate in beach fitness activities.

Mountains rise up behind the city, providing an abundance of hiking opportunities with beautiful views. Malibu has plenty of parks, including the Santa Monica Mountains National Recreation Area, which has over 5,000 miles of hiking trails on 156,000 acres of land. Solstice Canyon Park and Malibu Creek State Park are 2 other popular outdoor recreation areas that people enjoy exploring.

Some centers, like Cliffside Malibu, are located in the mountains themselves. This scenic landscape offers plenty of space for peaceful reflection. You can either explore the trails nearby or relax on the sun deck to take in the stunning views of the Pacific Ocean.

Malibu’s Mediterranean climate means you can comfortably enjoy outdoor activities like swimming, hiking, and biking in any month of the year.

Unique, Recovery-Focused Activities

Many centers offer activities that are best experienced in the California sunshine. Between the ocean and the mountains, there are endless opportunities to explore the outdoors. And because California is such a multicultural hub, some centers offer opportunities to visit nearby museums and attractions.

Surf Therapy

Several rehabs, including Oceanside Malibu and Cliffside Malibu, offer surf therapy for their clients. Surf therapy is a healing modality1 that “combines surf instruction, surfing, and structured individual and/or group activities to promote physical, psychosocial, and psychological well-being.” One study found that surfing improved overall well-being for combat veterans with post-traumatic stress disorder (PTSD),2 and offered both a respite from the symptoms of this condition, and increased positive feelings gained from connecting with peers.

cliffside malibu slide 8
Perched in the mountains of Santa Monica, Cliffside Malibu offers therapies ranging from reiki to surf therapy.

Surf therapy is also a promising method of treatment for adolescents. Research shows that surf therapy has a positive impact on mental health,3 improving emotion regulation, social competencies, and social connections, while decreasing behavioral problems and depressive symptoms in youth experiencing psychological difficulties. Another study found surf therapy improved adolescents’ self-confidence4 through the feelings of accomplishment that come from mastering a new skill, a sense of escape, and strengthened social connections. Paradigm Teen & Young Adults Treatment understands the positive effects that surf therapy can have, and offers this activity to its adolescent and young adult clients.

Other Outdoor Activities and Experiential Therapies

Because Malibu is so close to the beach, many centers invite their residents to go on beach walks, or engage in related activities like swimming and hiking. The region’s warm weather gives clients plenty of opportunities to relax in the fresh air throughout every season. Milestones Ranch even holds therapy sessions while walking on the beach.

According to research, exercise can help clients navigate addiction recovery,5 and participating in new activities can build confidence through the mastery of a new skill. Oceanside Malibu encourages clients to participate in surf therapy, rock climbing, horseback riding, fishing, and other adventure outings. These exciting experiences can help clients find new hobbies and improve the mind-body connection, all while working through difficult emotions that may not easily come up during talk therapy.

Events and Cultural Outings

Milestones Ranch offers exposure therapy activities both on and off their 160-acre private property. This center’s take on exposure therapy, which they term “supervised sober recreation,”6 lets clients participate in activities while sober that they may have only previously done with drugs or alcohol. Clients can attend musical performances and dance parties at the ranch, in addition to weekly outings at comedy clubs, museums, concerts, movie theaters, and more off the property. According to this treatment team, participating in exposure therapy helps “build the client up through social and sober activities, providing the practical skills and confidence needed to socialize without the use of drugs.”

After some time in treatment, Milestones Ranch even gives clients opportunities to plan outings themselves with other friends from nearby sober living houses. This can help clients get accustomed to being in social settings while sober.

Specialized Treatment for Teens and Young Adults

Building community is important in recovery, as studies show that people with more close friends are more likely to recover from addiction.7 And oftentimes, people may find it easier to make friends with peers that they can relate to. Because of this, it may be beneficial for adolescents and young adults to attend teen-specific treatment centers surrounded by others of their own age.

According to Visions Adolescent Treatment, “Adolescents need to be approached differently than adults because they are still developing their emotional and environmental understanding.” With this in mind, the center only treats adolescents between the ages of 13-18. They provide daily activities and hold events at their rural rehab center, set in the Malibu hills to minimize distractions and keep the focus on recovery.

visions adolescent treatment slide 4
Visions Adolescent Treatment is tucked away on 25 acres of tranquil grounds in Malibu.

“When I came to Visions, I was extremely depressed and emotionally volatile. I was anxiety-ridden and I really didn’t see the point in life,” says JuliAnn Crommelin, a Visions Adolescent Treatment alum. “Visions not only got me sober, but they gave me the life that I never knew I always wanted.”

“It’s About a Non-Judgmental, Supportive Environment”

Paradigm Teens & Young Adults Treatment caters to clients aged 12-26, although teens and young adults are treated separately. Paradigm Treatment conducted a study that followed up with 195 of their clients a year after completing treatment and found that their depression, anxiety, and stress levels significantly decreased during rehab,8 compared to reported levels at their intake.

Paradigm focuses on creating a community-based environment that fosters healing and space for reflection. Dustin Wagner, Paradigm’s COO, explains:

“We know right off the bat it’s about building a relationship. It’s about a non-judgmental, supportive environment…Where other clients are also supporting each other. This program is transforming lives and providing hope to these families.”

Both Beachside Teen Treatment Center and Pacific Teen Treatment also focus exclusively on treatment for teens and their families. Pacific Teen Treatment even offers academic activities so that teens don’t fall behind in school during their recovery process.

As their parent, you may need to make treatment decisions for your teen. As JuliAnn from Visions Adolescent Treatment says,

“I’m grateful that my mom knew what to do with me, because at that point in my life I didn’t know what I needed, and looking back on it, I needed a parent who knew to call the professionals.”

Malibu’s Top-Notch Care

Malibu’s treatment facilities are highly regarded nationwide. Cliffside Malibu and Seasons in Malibu rank among the best rehab centers in California,9 according to Newsweek. The survey reviewed addiction recovery programs throughout the U.S. based on their quality of service and overall reputation.

Some centers focus on smaller group sizes in order to offer more personalized treatment. For example, Oceanside Malibu only accepts 6 people at a time. This allows them to offer each client a highly individualized experience. They also focus on building community within this small number of clients.

Director Dave Johnson describes Oceanside Malibu’s welcoming atmosphere:

“When people come to Oceanside, we try to create a family-like environment where people are allowed to heal and feel safe enough, and in doing that we try and break down that shame and guilt and get rid of it because it doesn’t serve any purpose.”

A Holistic Approach to Healing From Addiction

Mindfulness is a powerful way to approach recovery.10 According to experts at UC Berkeley’s Greater Good Magazine, mindfulness is defined as “maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens.” This practice encourages you to focus on the present moment, which helps alleviate anxiety about past painful or stressful situations and potential future ones. Studies have shown that meditation can aid in addiction recovery11 by decreasing cravings and improving control over one’s emotions.

Many centers incorporate mindfulness practices into their treatment programs, taking a holistic approach to treatment. Summit Malibu, for example, blends Eastern and Western mindfulness practices to help clients with the physical, mental, and spiritual symptoms of addiction. Clients can participate in yoga, art therapy, meditation, relaxation therapy, somatic experiencing, and more. William Oswald, the center’s CEO and Founder, says:

“To treat substance abuse and mental disorders12 we must go deeper than the physical being. As a recovering addict, I know that healing comes from within. That’s our mission at Summit Malibu.”

Avalon Malibu incorporates experiential therapies like traditional Chinese medicine (TCM), herbs, and neurofeedback into their programs, along with mindful practices like meditation, yoga, and qi gong. TCM includes natural products and acupuncture, which are especially helpful in treating opiate addiction. Acupuncture may help alleviate withdrawal symptoms13 and possibly even help clients avoid a relapse. This modality can also improve the immune system, have a positive effect on memory, and decrease the likelihood of neurological disorders.

Cliffside Malibu offers many different forms of holistic therapies and treatments, like Reiki, acupuncture, hypnotherapy, and more. These practices can help bring clients peace and promote healing, especially when combined with Malibu’s beautiful natural setting.

Ease of Travel to Malibu

Malibu is easily reachable by plane, and is just a short drive from Los Angeles International Airport (LAX), one of the largest airports in California and busiest in the U.S. It’s hard to believe that this coastal haven is so close to such a busy metro area, but that certainly makes travel much more convenient.

Since Malibu is located right along Highway 1, which has some of the best views in California, it’s also easily accessible by car.

Peaceful Addiction and Mental Health Recovery on the Coast

It’s up to you to determine the best place to start recovery. Traveling to Malibu for rehab might make sense if you’d like a more peaceful, quiet setting surrounded by mountains and beaches, and would like to try beachside experiential therapies.

Malibu’s tranquil surroundings may offer you clarity and a sense of calm, so you can focus all your energy on healing. However, this setting may be too quiet for some clients. Even with Los Angeles so nearby, treatment in Malibu may not be a good fit if you feel more comfortable in a big city.

See our collection of rehabs in Malibu for an inside glimpse into treatment, including virtual tours, pricing, and reviews.

Frequently Asked Questions About Malibu Rehabs

What rehab programs are available in Malibu?

Malibu treatment centers take advantage of their ideal location and climate, offering activities like surf therapy, beach walks, and hikes. Holistic therapy is popular in California, and several centers in Malibu embrace this approach.

Why go to rehab in Malibu?

You may want to start your journey to mental health and addiction recovery in Malibu if you enjoy ocean views, a warmer climate, and unique therapies focused on nature and alternative medicine.

What city in California has the best rehab?

Malibu’s treatment facilities are highly regarded nationwide. Cliffside Malibu and Seasons in Malibu rank among the best rehab centers in California, according to Newsweek (based on quality of service and overall reputation).

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Healing From Post-Traumatic Stress Disorder

Everyone deals with trauma differently. At times, experiencing traumatic events can develop into post-traumatic stress disorder (PTSD). Although this disorder may feel isolating, remember that many people are diagnosed with PTSD—probably more than you realize. And because of this, there are so many different resources available that can help you along your recovery process.

Rehab is one of those resources. Attending a treatment center can help you process your emotions and feelings related to the trauma you’ve experienced, and to learn to cope with them in a healthy way.

Finding a rehab that treats PTSD can be an effective and supportive place to begin your recovery journey.

What is PTSD?

PTSD is a disorder that develops in response to a traumatic event. ((Ptsd basics – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/understand/what/ptsd_basics.asp)) Symptoms from PTSD may develop soon after the trauma occurred, but can also arise months or even years later. You may have PTSD if you have any of the symptoms below and notice that they last longer than 4 weeks, are extremely stressful, and significantly affect your life.

The symptoms of PTSD include (but aren’t limited to) the following:

  • Reliving the event: This may involve nightmares or flashbacks, especially when a trigger is present. A trigger is something that reminds you of the event, such as a loud noise or seeing an accident similar to the one you experienced, that elicits a strong emotional reaction.
  • Avoiding anything or anyone that reminds you of the event.
  • Experiencing intrusive thoughts and emotions on a consistent basis after the event: For example, you may feel guilt or shame, lose interest in things you once enjoyed, or feel numb.
  • Feeling on edge: You may feel you have to be “ready for anything” and find it difficult to sleep, concentrate, or may be easily startled.

It may feel daunting to realize that you might have PTSD. However, know that it’s not just you—according to the National Center for PTSD, PTSD in adults is not rare. ((How common is ptsd in adults? – Ptsd: national center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/understand/common/common_adults.asp)) They estimate that 6 of every 100 people will be diagnosed with PTSD during their life.

The Many Treatment Options for PTSD

Trauma-informed care approaches treatment with a focus on trauma. This may look different from patient to patient, but the idea is that providers understand the nature of trauma and take that into account during treatment.

Trauma-specialized rehabs also offer trauma-specific therapies, which are very effective for PTSD. ((Ptsd treatment basics – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/understand_tx/tx_basics.asp)) These therapies center the patient’s attention on the memory or meaning of the traumatic event, and may use visualization, talking, or thinking to help you work through the experience.

Exposure therapy, eye-movement desensitization and reprocessing (EMDR), and cognitive processing therapy are the most popular treatment options for PTSD. However, there are several other options, and your treatment provider can help you choose which will work the best for you.

Prolonged Exposure (PE)

During PE, patients learn to face uncomfortable feelings in order to gain control over their experience. Patients will discuss any traumatic experiences with a counselor, as well as participate in events they’ve avoided related to the event. This treatment is highly effective for PTSD ((Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating ptsd: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258)) according to research—one meta analysis found that 41-95% of people who participated in PE no longer had PTSD symptoms by the end of treatment. Another study discovered that PTSD symptoms significantly lessened in people who had PE during treatment, as compared to supportive counseling, relaxation training, medication, and “treatment as usual.” Because PE can provoke feelings of anxiety, you should only do it with a trained professional.

Eye-Movement Desensitization and Reprocessing (EMDR) Therapy

EDMR has the patient think about the traumatic experience while performing lateral eye movements, ((van den Hout, M. A., & Engelhard, I. M. (2012). How does EMDR work? Journal of Experimental Psychopathology, 3(5), 724–738. https://doi.org/10.5127/jep.028212)) usually by following a light or the therapist’s finger. This helps move traumatic memories into long-term storage, so that when they’re brought up, patients are less activated. The goal of EMDR is to minimize the vividness and emotion that results from these thoughts.

Cognitive Processing Therapy (CPT)

CPT teaches patients to challenge and change their negative thoughts surrounding the traumatic event through talk therapy and writing assignments. CPT treatment shows a significant reduction in PTSD symptoms ((Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating ptsd: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258)) in several different samples of veterans, sexual assault survivors, and others with PTSD. These statistics remained similar during 5 and 10-year follow ups.

Cognitive Behavioral Therapy (CBT)

In CBT, patients reframe their thoughts and feelings from negative to more positive, and learn healthy coping skills and strategies to manage them in the future. One study determined that PTSD patients using CBT in their treatment plan ((Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating ptsd: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258)) worked better than supportive therapy or self-help booklets.

Written Narrative Exposure (WNE)

Patients write about the trauma they’ve experienced and discuss it with a therapist afterwards.

Brief Eclectic Psychotherapy (BEP)

This approach helps the patient adjust negative emotions to help relieve them of shame and guilt. In addition to talk therapy, patients may learn relaxation skills, write about their traumatic experience, and even work through a ritual to help them leave the traumatic event in the past and start over.

Narrative Exposure Therapy (NET)

Patients craft a story consisting of stressful events that occurred in their lives. This therapy is often used with people who experienced war, conflict, or violence.

Medications

Antidepressant medications known as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) help patients experiencing PTSD. There are 4 prescribed medications commonly used for PTSD:

  • Sertraline (Zoloft)
  • Paroxetine (Paxil)
  • Fluoxetine (Prozac)
  • Venlafaxine (Effexor)

Potential Causes of PTSD

Not everyone is affected by trauma in the same way. For example, 2 people can have the same experience, but one may develop PTSD while the other doesn’t.

People can develop PTSD from many different stressful situations or events. Combat veterans and survivors of sexual trauma and intimate partner violence may be more likely to develop PTSD. People that have witnessed or been in a serious accident or catastrophic event may find themselves feeling differently afterwards, and be unable to process what happened to them.

While your experience is unique, remember that other people have gone through similar situations. You may find support by surrounding yourself with others who share your experience, and finding a rehab with a specialized PTSD program can help you connect with them in treatment.

The Link Between PTSD and Addiction

Trauma is strongly correlated with drug and alcohol addiction. ((International Society for Traumatic Stress Studies. Traumatic Stress and Substance Abuse Problems. [Pamphlet]. https://istss.org/ISTSS_Main/media/Documents/ISTSS_TraumaStressandSubstanceAbuseProb_English_FNL.pdf)) People who experienced traumatic events in their lifetimes are more likely to use drugs and alcohol as a way to deal with the negative thoughts and feelings that arise from the experience. And unfortunately, substance abuse only worsens the problem.

Some studies found that the relationship between substance use and PTSD ((Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and Anxiety, 27(12), 1077–1086. https://doi.org/10.1002/da.20751)) was significantly high in adolescents. Additionally, experiencing trauma in adolescence can heighten your stress response. This trauma can elevate plasma cortisol levels, making it more likely that they may develop PTSD and other conditions.

However, substance use can actually make the effects of PTSD much worse. It can increase emotional numbing, depression, anxiety, and more. If you have both a substance use disorder and PTSD, you may want to find a rehab that specializes in co-occurring disorders.

How PTSD Can Affect Your Life and Relationships

Some people with PTSD struggle with family and friendships, ((Relationships – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/family/effect_relationships.asp)) even if they had trusting relationships in the past. People may avoid closeness with others to avoid negative feelings, or being reminded of the event by someone who was present at the time. Close relationships may feel downright dangerous, as many trauma survivors feel a need to be on guard. On the contrary, people may also go in the opposite direction and lean heavily on their loved ones.

If you’re going through this, don’t worry—most people are able to restore their relationships to where they were before the trauma occurred. And whether you’re avoiding closeness or depending on others too much, the right treatment can help you learn to mitigate these situations in a healthy way so you can feel more at ease with your loved ones. It may even be helpful to attend therapy with one of these people, and to consider marital or family counseling.

The Differences Between PTSD and CPTSD

Complex post-traumatic stress disorder (CPTSD) ((Complex ptsd – ptsd: National center for ptsd. (n.d.). [General Information]. Retrieved from https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp#subone)) is similar to PTSD, with some slight differences. CPTSD might arise from exposure to repeated traumatic events over a longer duration of time, such as survivors of childhood or sexual abuse, or veterans that were deployed on active duty for longer periods of time.

According to Dr. Judith Herman of Harvard University, CPTSD symptoms include the following:

  • Behavioral issues
  • Emotional suffering
  • Cognitive difficulties
  • Interpersonal problems
  • Somatization (physical reactions to stress)

While CPTSD isn’t yet officially recognized, many clinicians treat it as a serious condition. Other disorders also often occur alongside CPTSD, such as addiction, dissociation, borderline personality disorder, and sleep problems. Fortunately, the treatments for CPTSD also help treat these issues.

Empower Yourself to Move Past Your Trauma

Although PTSD can feel debilitating at times, you can move forward with your recovery. Be gentle with yourself as you focus on healing. This isn’t the time to push yourself too hard—instead, try to remember how far you’ve come.

Dealing with past trauma isn’t easy. You’ll have good days and bad days, and that’s completely normal. The right treatment can help you develop the skills and coping strategies to manage the bad ones in a healthy, positive way.

Don’t be afraid to reach out for help–it’ll be there when you need it.

To learn more about treatment options and see information on pricing, insurance, special programs, and more, see our directory of centers offering PTSD treatment near you.

Reviewed by Rajnandini Rathod

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Resilience in Recovery From Childhood Trauma

Childhood trauma doesn’t just go away. You may continue to feel its effects throughout your adult life. Some people—although certainly not all—develop mental health conditions, like post-traumatic stress disorder (PTSD), as a result of these painful experiences. And because the past can’t be undone, it can be hard to imagine moving forward.

No matter how much you’ve been through, you can learn to carry your memories in a less painful way. There are rehab programs specifically for those struggling with trauma that can help you cope with your symptoms and learn how to move forward. The first step in taking back your personal power is choosing which type of treatment feels right to you.

Choosing Trauma-Informed Care

Whether or not trauma is your primary reason for seeking treatment, you may benefit from choosing a treatment program that offers trauma-informed care. This approach centers each person’s unique experience, creating a safe and respectful environment for healing. With guidance and support, you can become empowered to live a life you love.

Trauma-informed care is an approach, not a therapy. However, many trauma-informed facilities offer therapies with proven success in treating trauma:

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a form of talk therapy1 that helps people manage difficult feelings, urges, and behaviors. In conversation with a therapist, you’ll discuss and analyze various aspects of your internal emotional landscape. Your provider will teach you practical strategies you can use to navigate challenging situations.

For example, the American Psychological Association (APA) recommends that therapists “encourage patients to re-evaluate their thinking patterns and assumptions in order to identify unhelpful patterns (often termed ‘distortions’).” By stepping back and assessing your thoughts objectively, you may be able to regulate your emotional response.

Data shows that CBT is a highly effective treatment for PTSD.2 In one study, “92% of participants no longer met criteria for PTSD” after a series of CBT interventions. However, it’s not the only available form of therapy. Also, some clients may benefit from specialized types of CBT, such as prolonged exposure therapy (PE).

Prolonged Exposure Therapy (PE)

Experts strongly encourage the use of prolonged exposure therapy as a treatment for trauma.3 During a PE session, you’ll recount the details of a traumatic event, speaking in the first person and the present tense. For example, instead of just saying “I was in a car accident when I was a kid,” you might begin the story with “I’m 5 years old. I’m in the back seat of my mom’s car. It’s raining, and I can see the drops of water on the window to my right.” Patients describe their memories in as much detail as possible, and reexperience painful emotions within the safe context of a therapy session.

Over time, and with repetition, the goal is for you to move past your most intense reactions to the initial trauma. You may also be assigned homework between sessions, in which you seek out triggering stimuli in order to confront your own responses. To overcome trauma associated with a car accident, for example, you might practice driving or riding in a car on the highway. These exercises ramp up slowly over time, and you’ll process each one in your next therapy session.

Although this form of treatment can be extremely difficult, it’s also highly effective. Multiple studies have demonstrated that PE is an appropriate therapy for adults with a history of trauma.4 Some experts also suggest that combining PE with eye movement desensitization and reprocessing (EMDR)5 may improve patients’ commitment to ongoing treatment.

Eye Movement Desensitization and Reprocessing (EMDR)

Somewhat like PE, EMDR invites people to revisit traumatic memories safely,6 with the support of a therapist. During each session, you’ll relate a present-day emotional state to a challenging past experience. For example, you might start by talking about an argument you’re currently having with a friend, and then go on to compare it to a fight you had with a parent during your childhood. Your therapist will instruct you to engage in certain activities, such as repetitive eye movements or tapping on your arms with your hands, while you revisit the memory of a difficult emotion.

EMDR helps you work through unprocessed adverse experiences,7 so you can release the emotions associated with them. Evidence suggests that this therapy might actually change the way traumatic memories are stored in the brain. Specifically, experts posit that EMDR might move those memories “from implicit and episodic memory to explicit and semantic memory systems.” In other words, patients become conscious and aware of thoughts they may never have considered before. “Consequently, the disturbing life experience becomes a source of strength and resilience.”

Yes, You Can Go to Rehab for Trauma

Contrary to popular belief, inpatient rehab isn’t just for addiction recovery. You can also attend residential treatment for a variety of diagnoses, including trauma-based disorders like PTSD, complex PTSD, and others. By taking time away from your daily life to focus on treatment, you may be able to kickstart the healing process.

Rehabs may employ a variety of therapeutic techniques, including CBT, PE, and EMDR. Some centers also teach life skills, empowering patients to practice self-reliance. Depending on your program, you may also be encouraged to connect with your recovery peers, which lets you practice valuable interpersonal skills. Research shows that community is extremely important during the process of healing from trauma,8 and the act of sharing mutual support may give you insight into your personal history.

The Impact of Adverse Childhood Experiences

Developmental trauma results from adverse childhood experiences, or ACEs. It can sometimes be hard to recognize these events as traumatic until years later. When you’re young, you simply haven’t had the time to encounter diverse ways of living. As a result, it’s difficult to compare your own life to “the norm.” You might take highly distressing circumstances for granted, and not fully understand the harm you experienced until after you reach adulthood.

Whether or not you can identify childhood trauma at the time, it has a lasting impact. You may develop coping mechanisms that help you survive in the short term, but get in the way of living a healthy and meaningful life as an adult. For example, many trauma survivors learn to dissociate9 as a way of protecting themselves from emotional pain. That strategy might help you endure parental abuse, but interfere with later romantic partnerships. The first steps toward healing are understanding what caused your symptoms, and validating your own experience.

Understanding Adversity

Childhood trauma can take many different forms. The American Psychiatric Association (APA) defines ACEs as “disruptions to the promotion of safe, stable, and nurturing family relationships and are characterized by stressful or traumatic events that occur during an individual’s first 18 years of life.”10

The more different types of adversity you experienced as a child, the higher your ACE score. If you have a history of trauma in only one of the defined areas, you could be said to have a low ACE score—even if that type of trauma happened repeatedly. People with higher ACE scores are at a greater risk of ongoing health and behavioral concerns. For example, research shows that people with high scores are more vulnerable to addiction, depression, and heart disease. However, that risk is just one part of the story.

Experts caution against thinking of ACE scores as the only predictors of wellness. Jack Shonkoff, Director of the Center on the Developing Child at Harvard University, explains that “there are people with high ACE scores11 who do remarkably well.” Certain protective factors, like trauma-informed therapy, may mitigate the health risks associated with trauma. And not every type of trauma has the same effect.

The Lasting Effects of Emotional Abuse

Every person grows up with a unique set of risk and protective factors for the development of mental health issues. Based on your unique combination of experiences, a traumatic event may or may not cause you to have trauma-related symptoms.12 And it can be extremely difficult to predict exactly which experiences will have long-term effects.

Mental health professionals distinguish between traumatic experiences in a number of ways. For example, some experts categorize these events as either “big T” or “small t” traumas. Examples of big-T traumas are listed as the “exposure to actual or threatened death, serious injury, or sexual violence,” while small-t traumas may include parental neglect or humiliation.

However, these terms can be misleading. At first glance, it might sound like big-T traumas are more serious, while small-t traumas can be easily dismissed. For some patients, the exact opposite is true. Research shows that survivors of interpersonal trauma usually exhibit more severe PTSD symptoms than survivors of non-interpersonal trauma. And many types of small-t trauma are interpersonal.

“It Could Have Been Worse”

Unfortunately, it’s quite common for trauma survivors to feel guilt and shame about what happened to them. This can make it difficult to accept the magnitude of an event’s impact. And as a result, you may delay getting the help you need.

Preliminary research has found that many people minimize the effects of their trauma.13 More data is needed to understand why and how this happens, and how it can interfere with the recovery process. But even without that data, this tendency is widely recognized within established support systems for trauma survivors.

Sexual Assault Survivors Anonymous (SASA), for example, has published resources that describe the phases of processing trauma after sexual assault.14 In what they term the “Outward Adjustment Phase,” the survivor goes about their apparently “normal” life despite emotional dysregulation. SASA lists 5 primary coping mechanisms to watch out for during this time. The first of these is minimization, in which you might pretend “‘that ‘everything is fine’ or that ‘it could have been worse.’”

And yes, of course it could have been worse. Here you are, reading this article, with the emotional resources to think about healing. Not everyone gets this far. That doesn’t mean what happened to you was okay. Your feelings are valid, and you deserve to get support while you heal. That’s true for everyone who lived through developmental trauma—even if you blame yourself, even if you feel ashamed, and even if you can’t clearly remember what happened.

The Minefield of Memories

Traumatic events can directly affect brain function15 and structure. One study found that people with PTSD may present with changes to the amygdala, hippocampus, and prefrontal cortex. Researchers say that “these brain areas play an important role in the stress response. They also play a critical role in memory, highlighting the important interplay between memory and the traumatic stress response.”

As a result, trauma survivors may struggle to trust their own memories.16 According to experts at the International Society for Traumatic Stress Studies (ISTSS), multiple scientific studies have “demonstrated a connection between childhood trauma and amnesia.” Some survivors repress their memories as a defense mechanism, even if it is “​​established fact that the traumatic events occurred.”

Over time, you may or may not remember the details of what happened to you. In some cases, rediscovering those memories can inspire people to begin recovery in earnest, finally seeking out the support they need. Others may never remember the specifics of their trauma, even if they’re actively engaged in therapy. Healing is always possible, whether or not you remember exactly what happened in your childhood.

Healing From Trauma You Don’t Remember

Kati Morton, LMFT, explains how it’s possible to heal from trauma even if you don’t clearly remember it.17 Even people who have repressed their worst memories are likely to have a noticeable response when confronted with triggers. Morton puts the most likely responses into 2 categories:

  • With body memories, the body responds to triggering thoughts, conversations, or events with a noticeable sensation. For example, you might feel tightness in your jaw whenever you talk about your childhood.
  • Emotional flashbacks can be triggered just like body memories, but may be harder to define. Instead of physically sensing pain or discomfort, you might feel an overwhelming sense of fear, sadness, anger, or any other emotion. It can be hard to tell whether these feelings are a proportionate response to your current circumstances, or a learned response to a painful repressed memory.

According to Morton, “identifying and understanding” these responses helps people “find better ways to manage them.” During treatment, your therapist can help you learn how to respond to triggers in a more effective way, without engaging in unhealthy behavior. This is especially important for people who have a history of both trauma and addiction.

Addiction and Developmental Trauma

A wealth of research links childhood trauma with addiction during adulthood.18 Multiple studies have found “extraordinarily high percentages of childhood trauma of various sorts, including physical, sexual and emotional abuse” among people with a history of substance abuse.

Perhaps because of this connection, some of the same techniques can be used to treat either or both of these diagnoses. In particular, prolonged exposure therapy can effectively treat both PTSD and addiction.19 If you’d like to address the 2 conditions at once, you might benefit from attending a rehab program for people with co-occurring disorders.

It’s also important to note that addiction itself can cause additional trauma.20 If you experienced trauma as a child, this can quickly become a vicious cycle: getting triggered can make you want to take drugs, and the situations that arise because of your drug use can be even more triggering. Many people need professional support in order to break free of this pattern.

You Can Learn to Thrive

Healing from trauma isn’t easy, simple, or fast. If you remember what happened to you, those memories probably won’t just disappear. And even after completing treatment, you may continue to face triggering situations. Recovery can’t undo the past—but it can help you imagine a better future.

Learn more about programs that can help, and see reviews, therapies offered, virtual tours, and more, in our searchable list of trauma rehabs.

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Stop Smoking, Start Living: Rehabs That Can Help You Quit

It’s notoriously difficult to quit smoking, especially since it’s such a habitual part of everyday life. However, the physical and emotional effects of nicotine dependence are less than desirable, and you may have decided it’s time to put a stop to them. If you’ve tried unsuccessfully to quit before, you may feel understandably frustrated.

Did you know that there are rehabs and retreats specifically designed to help you stop smoking? Some treatment regimens can even help alleviate the effects of withdrawal. When you’re ready to quit for good, you can get the support you need from experts.

Deciding to Stop Smoking

There are many reasons why people decide to stop smoking, and yours may be personal to you. These might include health concerns, high costs of tobacco products, smoking bans at work or at home, or maybe you’re a parent concerned about the well-being of your children. Understanding your motivations can help you stay focused.

The good news? You don’t have to do it alone. Plenty of addiction professionals help people stop smoking, and yes—you can even go to rehab for this.

Treatment Options for Nicotine Dependence

Fortunately, there are many effective treatments that can help you quit smoking, ((Abuse, N. I. on D. (–). What are treatments for tobacco dependence? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence)) including behavioral therapies and medications. Regardless of which treatment method you choose, it’s important to consider your own needs and reasons for smoking. Per the National Institute on Drug Abuse (NIDA)’s Tobacco, Nicotine, and E-Cigarettes Research Report, “some people smoke to avoid negative effects of withdrawal while others are more driven by the rewarding aspects of smoking.”

Determining why you smoke can help you choose a treatment approach designed to address that issue.

Residential Rehab

Smoking addictions can be very serious. You may be tempted to dismiss the severity of this condition, simply because cigarettes aren’t as taboo as some other substances. However, the accessibility of a drug doesn’t make it any less dangerous. And several rehab centers treat nicotine dependence.

During inpatient treatment, you can engage in a variety of therapies designed to help you quit smoking, permanently. Before you choose a specific program, know that many rehab centers permit residents to smoke. If being around cigarettes is a trigger for you, it’s important to find a rehab center that can accommodate your needs.

Cognitive Behavioral Therapy (CBT)

This form of therapy helps patients determine why they smoke, and teaches them skills and coping strategies they can use to avoid smoking, even when faced with difficult situations.

Motivational Interviewing (MI)

Motivational interviewing helps patients determine where their ambivalence about quitting smoking is coming from, and increases their motivation to create a healthier lifestyle.

Remote Help: Phone, Web, and Apps

There are various ways to get help for quitting smoking without attending an in-person treatment program. For example, every state in the U.S. has free “quitlines” that people can call and receive support from a counselor, such as 800-QUIT-NOW.

In addition to telephone calls, people can sign up for mobile text messages that provide motivation and advice for quitting smoking. ((ABROMS, L. C., AHUJA, M., KODL, Y., THAWEETHAI, L., SIMS, J., WINICKOFF, J., & WINDSOR, R. A. (2012). Text2quit: Results from a pilot test of a personalized, interactive mobile health smoking cessation program. Journal of Health Communication, 17(Suppl 1), 44–53. https://doi.org/10.1080/10810730.2011.649159)) Messages may include information related to smoking and relapse prevention, as well as motivational texts from other ex-smokers and medication reminders. You can also use interactive components, such as a cigarette tracking feature and a craving trivia game. One study found that the number of people who were still abstinent 6 months after quitting smoking almost doubled in the group using Text2Quit, ((Text2quit: Mobile-based intervention for smoking cessation. (2017, March 7). Recovery Research Institute. https://www.recoveryanswers.org/research-post/text2quit-mobile-based-intervention-for-smoking-cessation-2/)) as opposed to the group that didn’t receive any texts at all.

Another similar text messaging service, run by the National Cancer Institute, is called SmokefreeTXT, and lasts for 6-8 weeks. They even offer a program specifically for vets called SmokefreeVET, in which texts are tailored to veterans, in addition to ones personalized to moms and teens. An example of one of these texts, according to the Smokefree website, ((Frequently asked questions | smokefree. (n.d.). Retrieved from https://smokefree.gov/tools-tips/text-programs/faqs)) looks like this: “Cravings can be triggered by seeing other people smoking. Spend time in places where smoking isn’t allowed. Try malls, museums, or the movies.”

One app by Smokefree, called quitSTART, ((Quitstart | smokefree. (n.d.). Retrieved from https://smokefree.gov/tools-tips/apps/quitstart)) is a personalized program that sends tips, motivation, and challenges based on your smoking history. It teaches you to manage negative feelings, what to do if you relapse, how to deal with cravings, and more. This app is best used before you actually quit—it’ll send you information to help you stop smoking in anticipation of your quit date.

Medications

Several different medications are proven to be effective treatments for nicotine dependence. ((Abuse, N. I. on D. (–). What are treatments for tobacco dependence? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence))

    • Nicotine replacement therapy (NRT): NRTs reduce or eliminate uncomfortable nicotine withdrawal symptoms and cravings by triggering brain receptors normally affected by nicotine. NRTs come in different forms, such as the transdermal patch, gum, and lozenges, and are available over the counter. You can also purchase an inhaler or nasal spray with a prescription. They are all equally effective, and even more so when the transdermal patch is used with another NRT, especially when the treatment is taken beyond 12 weeks. NRT is estimated to boost quit rates by 50-70%.
    • Bupropion: This antidepressant stops the reuptake of 2 neurotransmitters, dopamine and norepinephrine, and also releases them. Studies show that it’s just as effective as NRT.
    • Varenicline: This medication triggers the same brain receptor affected by nicotine to minimize cravings. There is evidence that it works better than just 1 NRT alone, and studies also suggest that it’s more effective than bupropion.
    • Medication combinations: Research shows that combining medications may be the most effective approach for people who want to quit smoking. For example, one study gathered data from research literature and determined that using both varenicline and the NRT transdermal patch together worked better than varenicline alone.
    • Precision medicine: Pharmacogenetics aims to help health professionals tailor medications to the genetics of the individual, and may help you quit smoking. For example, some gene variations make people metabolize nicotine differently. ((Lerman, C., Schnoll, R. A., Hawk, L. W., Cinciripini, P., George, T. P., Wileyto, E. P., Swan, G. E., Benowitz, N. L., Heitjan, D. F., Tyndale, R. F., & PGRN-PNAT Research Group. (2015). Use of the nicotine metabolite ratio as a genetically informed biomarker of response to nicotine patch or varenicline for smoking cessation: A randomised, double-blind placebo-controlled trial. The Lancet. Respiratory Medicine, 3(2), 131–138. https://doi.org/10.1016/S2213-2600(14)70294-2)) People who metabolize nicotine at a faster rate smoke more, are more dependent, and find it more difficult to quit.

Mindfulness

In mindfulness-based sessions, ((Abuse, N. I. on D. (–). What are treatments for tobacco dependence? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence)) patients learn how to “increase awareness of and detachment from sensations, thoughts, and cravings that may lead to relapse.” They learn how to notice the thoughts that arise related to cravings and change them to be more tolerable. They’re also taught methods to help them deal with negative emotions in a healthy way, without the use of tobacco products.

Tobacco Use and Your Mental Health

Smoking often co-occurs with other psychiatric disorders, ((Aubin, H.-J., Rollema, H., Svensson, T. H., & Winterer, G. (2012). Smoking, quitting, and psychiatric disease: A review. Neuroscience and Biobehavioral Reviews, 36(1), 271–284. https://doi.org/10.1016/j.neubiorev.2011.06.007)) such as substance use disorder or depression. Depression and schizophrenia, in particular, are associated with higher tobacco use due to their sensitivity to its desired effects, such as better concentration and cognition, relief of stress and feelings of sadness, and pleasurable sensations. Data suggests that between 70-85% of people with schizophrenia also smoke tobacco. ((Abuse, N. I. on D. (–). Do people with mental illness and substance use disorders use tobacco more often? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often)) However, new research also indicates that stopping tobacco use may actually help alleviate negative mental health symptoms, ((Minichino, A., Bersani, F. S., Calò, W. K., Spagnoli, F., Francesconi, M., Vicinanza, R., Delle Chiaie, R., & Biondi, M. (2013). Smoking behaviour and mental health disorders—Mutual influences and implications for therapy. International Journal of Environmental Research and Public Health, 10(10), 4790–4811. https://doi.org/10.3390/ijerph10104790)) especially if it’s coupled with mental health care.

Nicotine dependence is more likely in people with anxiety, depression, and substance use disorders. ((Abuse, N. I. on D. (–). Do people with mental illness and substance use disorders use tobacco more often? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often)) In addition, they may be more prone to relapse when faced with stress or uncomfortable feelings. However, new research shows that tobacco use is correlated with poor behavioral and physical health in people with mental disorders, and that quitting smoking will lead to an overall better quality of life.

If you use tobacco regularly and also have a substance use disorder, you may be wondering whether you should try to quit both at once. Studies show that receiving treatment for both nicotine dependence and substance misuse does not negatively impact either case, ((Smoking interventions can help individuals in addiction treatment quit cigarettes, although questions remain about cessation effects on treatment outcomes. (2019, April 21). Recovery Research Institute. https://www.recoveryanswers.org/research-post/smoking-cessation-addiction/)) and another study found that they were actually both improved when patients were offered monetary rewards during addiction treatment. ((Quitting cigarettes in addiction treatment? (2017, March 8). Recovery Research Institute. https://www.recoveryanswers.org/research-post/quitting-cigarettes-in-addiction-treatment/))

Smart Strategies for Long-Term Abstinence From Smoking

Learn Your Triggers (And How to Deal With Them)

It’s easy to be triggered or socially pressured to smoke, even years after you’ve quit. In order to stay abstinent from smoking, ((How to stay smokefree | smokefree. (n.d.). Retrieved from https://smokefree.gov/stay-smokefree-good/stick-with-it/how-to-stay-smokefree)) it’s important to learn your triggers, or situations that entice you to smoke. For example, stress is a trigger for many people. In this instance, you’d want to devise a plan that consists of healthy behaviors that can alleviate stress, such as exercise. You can help learn more about these skills and coping mechanisms in CBT.

Have a Plan for When Cravings Hit

You should also come up with other activities you can do when cravings hit that prevent you from smoking. For example, you can go for a walk, engage in an enjoyable hobby, or call a friend. And remember—the longer you go without smoking, the fewer cravings you’ll experience.

Take Time to Reward Yourself

Don’t forget to reward yourself for not smoking. Quitting smoking is hard—there’s no doubt about that—so it’s important to celebrate and treat yourself to things you enjoy, like the movies or cooking classes. Take time to look at how far you’ve come.

Social Support is Important

Social support is crucial when quitting tobacco use. You may want to choose designated friends or family members that you can call when you feel like smoking again, and they can help you remember your reasons for abstaining from tobacco. A peer or mentor that has quit smoking in the past can be an invaluable source of support.

Technology Can Help Too

Sign up for an app or texting service like the ones described above, or see our article on finding online treatment for more resources.

Live a Healthier, Smoke-Free Life

Although it can be difficult to quit smoking, there are many different resources available that can help, making the process much easier. You can replace your smoking habit with activities that boost your mental and physical health, like exercise and therapy. In turn, these healthy hobbies can help you stay abstinent and help prevent relapse.

When you’ve decided it’s time to quit, know that there are many different programs that can help. See program highlights, pricing, insurance information, and more in our directory of smoking cessation rehabs.

Reviewed by Rajnandini Rathod

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How to Recognize High-Functioning Alcohol Addiction

If you’re keeping up the appearance of a healthy lifestyle, it can be hard to know whether you have a high-functioning alcohol addiction. However, this condition can have just as many negative effects as more recognizable alcohol misuse. If drinking is having any negative impact on your life at all, you don’t have to wait for the problem to get worse. By connecting with a rehab that treats high-functioning alcohol addiction, you can assess your own behaviors. And, if necessary, you can get the help you need to start recovery.

When Drinking Becomes a Problem

According to the CDC, drinking in moderation is defined as “limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed.” Note that these gender differences are based on scientific research, and not on evolving social norms. Also, keep in mind that a “standard” drink has only 14 grams of pure alcohol. These are examples of what counts as one drink, ((What is a standard drink? | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved May 24, 2022, from https://www.niaaa.nih.gov/alcohols-effects-health/overview-alcohol-consumption/what-standard-drink)) according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA):

  • 12 ounces of regular beer (usually about 5% alcohol)
  • 5 ounces of wine (12% alcohol)
  • 1.5 ounces of distilled spirits (40% alcohol)

These numbers are far lower than most people assume. And even in casual settings, friends may unintentionally enable you to drink more than you should. They may not recognize the signs of high-functioning alcoholism at first—and as a result, you may not immediately get the support you need.

Alcoholism Hides in Plain Sight

Drinking is a normalized activity in most cultures around the world, and some people can drink without developing an alcohol use disorder. ((Witkiewitz, K., Litten, R. Z., & Leggio, L. (2019). Advances in the science and treatment of alcohol use disorder. Science Advances, 5(9), eaax4043. https://doi.org/10.1126/sciadv.aax4043)) Because drinking is so socially acceptable, however, it can be difficult to realize or admit that you have this particular addiction. People with high-functioning alcohol use disorder are often said to be leading double lives, in which everything looks perfect to a casual observer. However, the underlying reality is much more dangerous than it appears.

Someone with a high-functioning alcohol addiction can still function in their daily lives, despite heavy alcohol use. People around them may not realize the amount of alcohol they’re drinking, although they may have suspicions. Someone with a high-functioning alcohol addiction may still perform well at work, spend time with family and friends, and participate in hobbies, all while consuming much more alcohol than what experts consider healthy.

“My Success was the Mask”

Sarah Allen Benton is a mental health counselor who once had a high-functioning alcohol addiction ((Brody, J. E. (2009, May 4). High functioning, but still alcoholics. The New York Times. https://www.nytimes.com/2009/05/05/health/05brod.html)) herself, although you might have never guessed—she has a Master’s degree from an esteemed university and a job as a mental health counselor at a prestigious college in Boston. She recounted her experience in an interview with the New York Times:

“Having outside accomplishments led me and others to excuse my drinking and avoid categorizing me as an alcoholic. My success was the mask that disguised the underlying demon and fed my denial.”

In the same interview, she went on to describe the following criteria, which may help you determine whether your drinking is, in fact, problematic:

  • You can’t seem to control how much you drink, even if you set intentions to limit your alcohol intake.
  • You think about alcohol obsessively, making plans around the next time you’ll be able to drink.
  • Your behavior when you’re sober is markedly different than it is when you’ve been drinking.
  • You sometimes drink so much that you black out.

“It’s not the number of drinks that defines [someone with an alcohol addiction],” said Ms. Benton. “It’s what happens to you when you’re drinking.”

Deciding to Get Sober

High-functioning alcohol addiction is a common condition—probably more common than most people realize. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that about 19.5% of alcohol addictions in the U.S. are considered high-functioning, ((Researchers identify alcoholism subtypes. (2015, September 29). National Institutes of Health (NIH). https://www.nih.gov/news-events/news-releases/researchers-identify-alcoholism-subtypes)) and most people are well-educated with secure careers and families. Even if your life appears to be sustainable, you might still benefit from receiving care.

If you recognize the signs of alcohol addiction in a loved one, you may be able to help them get treatment. Make sure you care for yourself by setting appropriate boundaries throughout this process. Remember that their condition is not your fault—and ultimately, it’s not your responsibility to “fix” the problem.

When people do decide to seek treatment for high-functioning alcohol addiction, it’s often because of concern from others. They may also experience a “wake-up call” that makes them fear for their own safety. For example, someone may realize the severity of their alcohol addiction after a DUI, an arrest, or a serious health problem that arises related to your drinking.

Starting Recovery from High-Functioning Alcohol Addiction

When you’re ready to get treatment for a high-functioning alcohol addiction, you can choose between a variety of healing modalities. For alcohol, even more than other substances, it’s important that you begin healing under proper medical supervision.

Medical Detox

You may need to undergo medically supervised detox, depending on the severity of your alcohol use. During this time, a team of medical professionals will supervise you throughout the process and help ease your withdrawal symptoms. This may involve the use of non-addictive medications to help make you feel more comfortable. Even people who can perform the functions of daily life may be drinking at a level that requires detox, and it’s extremely dangerous to attempt this process alone. It’s very important that you seek medical advice before you begin detoxing, as withdrawal can be fatal without proper care.

Remember that detox is not recovery, but a preliminary step to receiving treatment. To fully and sustainably overcome any addiction, you’ll need to work on the underlying issues that caused it. This may require residential addiction treatment, or some combination of the treatment methods listed below.

Inpatient Rehab

During inpatient treatment, patients stay at a rehab facility, usually for a minimum of 28 days. You’ll work with therapists and most likely attend both 1:1 sessions and group therapy, in addition to receiving medical attention when needed. Depending on your specific rehab program, you may also participate in therapeutic activities such as hiking or swimming.

Each treatment facility is different. Some rehabs have a special focus on treating alcohol addiction, while others would be a good fit for patients with co-occurring disorders. Whatever your diagnosis, your time in residence should help you plan for a future without alcohol. Remember that while inpatient rehab will allow you to begin the healing process, recovery continues after you return home.

Intensive Outpatient Programs

In some situations, you may choose to attend an intensive outpatient program (IOP) instead of staying at a residential rehab. This type of treatment is often appropriate for patients who would benefit from treatment, but can’t spend that much time away from home due to work, school, family, or other time commitments. Your insurance might also cover an IOP even if it won’t cover inpatient treatment.

During an IOP, you’ll live at home and attend therapy and other treatments during the day. You may be onsite for several hours a day, several days a week; the time commitment is similar to that of a job. This flexibility is very important for some patients, but it’s not sufficient for everyone. You may still be vulnerable to triggers at home that you wouldn’t encounter while attending an inpatient rehab.

Medications

The U.S. Food and Drug Administration (FDA) has authorized 3 medications for treating alcohol dependence: ((Treatment for alcohol problems: Finding and getting help | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#pub-toc1))

  • Naltrexone makes drinking less desirable by blocking the pleasurable effects of alcohol.
  • Acamprosate reduces alcohol cravings.
  • Disulfiram causes uncomfortable symptoms —such as nausea and flushing of the skin—if you drink, making alcohol less appealing.

A medical professional can prescribe these non-addictive medications for use alone or along with other forms of treatment. You may have to experiment to find which medications work best for you. You can also choose to combine these medications with talk therapy, or if using medication doesn’t work for you, focus on talk therapy alone.

Talk Therapy

According to the National Institute on Alcohol Abuse and Alcoholism, there are several different behavioral therapies that may successfully treat alcohol addiction. ((Treatment for alcohol problems: Finding and getting help | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/treatment-alcohol-problems-finding-and-getting-help#pub-toc1)) These may include 1 or more of the methods below.

  • Cognitive behavioral therapy (CBT) focuses on helping you change your own thoughts and behavioral patterns from negative to positive. This treatment helps you understand the feelings and situations that may trigger you to drink, and teaches strategies for managing that stress in a healthy way.
  • Motivational enhancement therapy helps you find the motivation to change your drinking habits. During these sessions, you’ll create a plan to stay sober, focus on building your confidence, and develop the skills you need to stay on track with your plan.
  • Family therapy works on healing the relationships between spouses and within families, since support from loved ones is crucial during the recovery process.

Support Groups

Social support is extremely beneficial when recovering from alcohol abuse. ((Groh, D. R., Jason, L. A., Davis, M. I., Olson, B. D., & Ferrari, J. R. (2007). Friends, family, and alcohol abuse: An examination of general and alcohol-specific social support. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 16(1), 49–55. https://doi.org/10.1080/10550490601080084)) Research has found that people with bigger social circles and stronger relationships have a greater likelihood of abstaining from alcohol. If you’re looking to build relationships with people who can support you during recovery, you may benefit from attending a support group.

Alcoholics Anonymous (A.A.) ((What is a. A.? | alcoholics anonymous. (n.d.). Retrieved from https://www.aa.org/what-is-aa)) is a free program that is “open to anyone who wants to do something about their drinking problem.” Members can attend peer-led meetings regularly or casually in order to share mutual support. This 12-Step program’s primary goal is to help people achieve sobriety through 12 spiritual principles.

Faith-based recovery is right for some, but not for everyone. Other free support groups, like SMART Recovery, ((Self-help addiction recovery program | addiction support groups. (n.d.). SMART Recovery. Retrieved from https://www.smartrecovery.org/)) are available for people who prefer a more scientific approach. In any group, you’ll have the opportunity to connect with people who share your experience.

Social support is a hugely important component of recovery. You can find that support in groups, and also by strengthening relationships with friends, family, and chosen family who want to see you heal. Some rehab programs have an especially strong focus on this issue, and will incorporate it into your process of planning for aftercare. Depending on your exact needs, your relapse prevention plan may include personal relationships, ongoing therapy, a rehab alumni network, and in-person or online support groups.

Sober Living Environments

After you’ve completed treatment, you may choose to stay in a sober living home (also known as a therapeutic community) before transitioning to life back home. This entails living with others in recovery, which will allow you to exchange mutual support and build relationships with people at a similar stage of their journey.

Sober living environments allow you to start reintegrating into the wider world, while still providing the structure and support of a substance-free environment and recovery-focused daily schedule. Not everyone needs sober living, but it can be a great fit for some while stepping down from residential care.

It’s important to note that each of these communities has their own set of rules. For example, you may be required to attend therapy, participate in group activities, or test negative for drug and alcohol use in order to maintain residence. This kind of structure is designed to support your continuing process of recovery.

Long-Term Effects of Alcohol Abuse

Long-term exposure to alcohol can impact on every aspect of your health. Alcohol addiction can even change your brain chemistry, ((Brochures and fact sheets | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://pubs.niaaa.nih.gov/publications/aa77.pdf)) affecting the function of neurotransmitters. As you progress in your recovery journey, you may need to make long-term plans not just for your mental health, but also for your physical recovery.

Physical Effects

High-functioning alcohol addiction can sneak up on you. As your alcohol tolerance slowly increases, you may find yourself drinking more and more just to achieve the same effect. Many people don’t even realize the sheer quantity of alcohol they’re consuming on a regular basis. And unfortunately, higher alcohol consumption is associated with more severe health risks, regardless of how intoxicated it makes you feel.

High-functioning alcohol addiction can cause a plethora of negative effects on the body. ((Alcohol’s effects on the body | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body)) Over time, alcohol misuse can cause problems with your heart, liver, pancreas, and brain. Research has found neurons in the brain may become smaller in size due to alcohol misuse, ((Alcohol and the brain: An overview | national institute on alcohol abuse and alcoholism(Niaaa). (n.d.). Retrieved from https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-and-brain-overview)) causing cognitive dysfunction. You may develop a compromised immune system, which can make you more vulnerable to disease and illness, and can even lead to cancer. Eventually, consistent alcohol abuse can be fatal.

Social and Emotional Problems

Alcohol misuse has a negative effect on mental health, ((Understanding alcohol use disorders and their treatment. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/topics/substance-use-abuse-addiction/alcohol-disorders)) and increases your risk for depression and anxiety. Excessive drinking also causes social challenges, ((Rehm, J. (2011). The risks associated with alcohol use and alcoholism. Alcohol Research & Health, 34(2), 135–143. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307043/)) and may damage the most important relationships in your life. When you stop drinking, you can expect your social circle to change significantly—and not always in the ways you might expect.

In the best case scenario, you’ll be able to repair relationships that were undermined by your addiction. However, you’ll probably also need to let go of relationships with people who once enabled your behavior. Research has found that it’s more likely for people to begin drinking again when they surrounded themselves with loved ones who still drank alcohol ((Groh, D. R., Jason, L. A., Davis, M. I., Olson, B. D., & Ferrari, J. R. (2007). Friends, family, and alcohol abuse: An examination of general and alcohol-specific social support. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 16(1), 49–55. https://doi.org/10.1080/10550490601080084)) and encouraged drinking. The opposite was true for people who spent more time around sober friends and family. Never underestimate the importance of strong, supportive relationships during your recovery. According to one study, positive support from friends was the most important predictor in abstinence from alcohol ((Groh, D. R., Jason, L. A., Davis, M. I., Olson, B. D., & Ferrari, J. R. (2007). Friends, family, and alcohol abuse: An examination of general and alcohol-specific social support. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 16(1), 49–55. https://doi.org/10.1080/10550490601080084)) for adults.

You can live a full, happy life that’s also a sober one. And in order to do that sustainably, you’ll learn how to enjoy yourself while sober. That could mean going on early morning hikes, taking up painting, or learning how to cook. The good news is, you can still do these things with the important people in your life. In fact, many people find they have more fun in recovery than they did while they were drinking – and that their relationships are more genuine.

Get Your Life Back in Recovery

Although it may seem difficult to imagine life without alcohol now, it’s entirely possible. Recovery isn’t just about abstaining from substances—it’s about creating a life that you love. And that has everything to do with discovering what fulfills you and finding a lifestyle that’s aligned with your values.

The most important thing to remember is that recovery is about what works best for you. Only you can determine what your life will look like moving forward, but know that support is available to help you get there.

If you’re concerned about your drinking, learn more about available programs and connect with admissions team members who can offer you an initial assessment via our directory of inpatient alcohol rehabs.

Reviewed by Rajnandini Rathod