Category: Assisting Loved Ones

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How Do You Help Someone With an Addiction? 8 Actionable Steps to Support Recovery

Recognizing when a loved one is struggling with substance use can be confusing, heartbreaking, and overwhelming. You may feel desperate to help, but unsure of how to do so without enabling their behavior or pushing them away. 

Fortunately, with patience, compassion, information, and evidence-based strategies, it’s possible to support someone through the recovery process.

1. Recognize the Signs of Addiction in Others

Addiction isn’t always obvious. While some people display clear warning signs, others—especially people with high-functioning addiction—may mask their struggles with problematic drug use or addiction behind a facade of normalcy.

Common signs of addiction1 include:

  • Behavioral red flags: Secrecy, denial, impulsivity, lying, or missing obligations
  • Emotional signs: Mood swings, irritability, anxiety, or depression
  • Physical indicators: Weight changes, bloodshot eyes, slurred speech, or poor hygiene

In people with high-functioning addiction,2 drug or alcohol use may remain hidden due to career success or social engagement. However, you might still notice subtle patterns related to behavioral health like isolation, frequent “bad days,” or noticeable shifts in demeanor. Many also exhibit a cycle of justification, denial, or defensiveness.

For children or young adults,3 these common signs can also include changes in friend groups, a decrease in participation in school functions or extracurriculars, or changes in grades and academic performance.

Two people walking together with one holding a flashlight that creates a beam of light on the path ahead, illustrating supportive companionship in addiction recovery

2. Understand There Is a Why Behind Substance Use

People don’t usually turn to drugs or alcohol just because they’re bored, they use substances to cope with pain, trauma, or emotional overwhelm. Addiction often starts as a form of control of a seemingly uncontrollable situation. 

Substances may offer short-term relief from anxiety, depression, loneliness, or past wounds. In the beginning, the ability to change how you feel with a drink or a pill can seem empowering. But over time, that temporary sense of control, however, can turn into dependency and eventually, loss of control.

Understanding this doesn’t mean you’re excusing the behavior, but it does help you meet your loved one with greater compassion. It shifts the conversation from:

  • “Why don’t you just stop?” to “What are you trying to escape or manage?” 
  • “What’s wrong with you?” to “What happened?”

Most people with substance use disorder are carrying deep emotional burdens. Recognizing the underlying why behind their substance use can guide more effective, empathetic support and help you focus not just on the behavior or coping mechanism,4 but the pain beneath it.

3. Educate Yourself About the Science of Addiction

Addiction may not have a one-size-fits-all cure, but with the right knowledge and support, you can be better prepared to support a loved one. One of the most empowering steps you can take is to understand what addiction really is.

Addiction is a chronic brain disease,5 not a moral failing or a lack of willpower. Long-term substance use changes how the brain communicates, especially in areas related to reward, decision-making, and impulse control. This disruption often stems from changes in neurotransmitters like dopamine, which plays a major role in pleasure and motivation.

At first, for your loved one, using substances may feel like a choice, but over time, the brain rewires itself, increasing tolerance and craving while decreasing natural dopamine production. That’s when people often feel “trapped”—not weak, but physically and mentally hooked.

Understanding these biological realities6 helps reduce blame and increases compassion. It also reminds us that support, grace, and education are crucial parts of the healing process.

Infographic showing 5 steps to support a loved one through addiction: 1) Educate yourself, 2) Choose the right moment, 3) Express concern, 4) Offer options not ultimatums, 5) Take care of yourself too. Includes illustration of two people embracing in support.

4. Learn the Dos and Don’ts of Supporting Someone in Addiction

Loving someone with an addiction requires empathy, education, and strong boundaries. You might be feeling helpless, but there are things you can do. Here are some practical ways to offer support:

Do:

  • Listen with compassion. Let them talk openly and acknowledge what they’re feeling without judgment.
  • Set healthy boundaries. Set clear limits around what you’re able to offer and follow through.
  • Learn about addiction and recovery. Understanding substance use, withdrawal, and treatment options can help you support them better.
  • Celebrate progress. Encourage small steps forward and remind them that change takes time.

Don’t

  • Don’t enable or protect them from consequences. Covering up, making excuses, or giving money can unintentionally prolong the problem.
  • Don’t give ultimatums before they’re ready. Lasting change usually starts with internal motivation, not outside pressure.
  • Don’t blame yourself. Their choices are not your fault, even when it’s hard to watch.
  • Don’t expect them to quit cold turkey. Sudden withdrawal from substances like alcohol or benzodiazepines can cause death without medical support.

Supporting someone who’s struggling with addiction7 can be emotionally draining. It’s important to keep in mind that you matter, too. It’s important to care for your own heart and well-being as you walk alongside your loved one.

You won’t be able to fix everything and that’s okay. Healing is a long road, and it’s not your job to carry it all.

Set boundaries that protect your peace. If a conversation becomes too intense, give yourself permission to step away. A simple pause can make space for clarity, calm, and compassion. Come back when you’re ready with a clearer mind and a softer heart.

And remember: you don’t have to be involved in every part of their journey. Showing up consistently in small, healthy ways often speaks louder than trying to do it all.

Infographic comparing enabling vs. supporting someone with addiction. Enabling behaviors include giving money, ignoring warning signs, taking on their obligations, and making excuses. Supporting behaviors include encouraging treatment, listening with empathy, setting healthy boundaries, and celebrating recovery wins.

5. Understand How to Talk to Someone About Their Addiction

Confronting someone about their substance use is difficult, but it can also be a turning point. To have the best outcome, choose a calm, private setting and use non-threatening language.

Pam Lanhart, Founder and Director of Thrive Family Recovery Services shares:

First, we need to listen to our loved ones well and listen for language that might indicate that they are getting tired of the way things are. Then we validate that and ask them what it might look like to do something different. ‘What step do you think you might be able to take to move forward?’

We need to be patient and let them feel like they have agency in these decisions.  Walking with them while they figure things out is critical. And of course, we can’t do that if we don’t have boundaries. I love language such as ‘say more about that,’ or ‘Can you tell me more?’ or ‘I’m trying to understand. Can you explain?’ Just listen and be curious because they know what they need and will often come to the conclusion themselves.

Here are a few brief conversation tips that can help you as you communicate with your loved one who may be struggling with an addiction.

Conversation Tips

  • Start with an “I” statement: “I’ve noticed you seem stressed lately, and I’m worried about you.”
  • Express concern, not control: “I care about your well-being and want to help.”
  • Avoid labels like “addict” or “junkie,” which can cause shame or defensiveness.

Timing matters. Choose a moment when they’re sober and not in a state of crisis or withdrawal.

6. Decide When and How to Encourage Treatment

Suggesting treatment should be a compassionate invitation, not a demand. If the person is open to help, present options like:

  • Speaking with a mental health professional or healthcare provider
  • Considering inpatient or outpatient addiction treatment programs
  • Exploring evidence-based options such as behavioral therapy, medication-assisted treatment, detox, or other types of medical treatment
  • Encouraging holistic wellness and recovery support services

It’s normal for people to resist the idea at first. Ambivalence doesn’t mean they’re not willing—it often means they’re afraid or unsure of what recovery entails.

How do people change? Over time. With stops and starts, along a crooked line. With practice. With ambivalence. More often than not, without formal help. When the trade-offs seem worth it. With a little help—sometimes a lot of help—from friends and family. With anguish. With effort. With joy.

― Jeffrey Foote, PhD., Beyond Addiction: How Science and Kindness Help People Change8

7. Know What to Do if They Refuse Help

Refusal doesn’t mean you should give up. Harm reduction strategies9 can keep your loved one safer, sometimes easing cravings, while leaving the door open for change:

  • Encourage safer practices (like not mixing substances and using clean supplies)
  • Stay emotionally available without enabling
  • Know your limits and take care of yourself

You might need to seek your own mental health support or attend family therapy to cope with feelings of guilt, anger, or helplessness. That’s okay. Recognizing that addiction impacts the entire family and not just the person struggling is key to a healthy recovery journey for everyone.

8. Get Familiar With Resources for Families and Friends

Support services exist for those affected by a loved one’s addiction.10 You are not alone.

  • Al-Anon and Nar-Anon: Peer-led groups for family and friends
  • SMART Recovery Family & Friends: Offers tools based on cognitive behavioral therapy
  • SAMHSA resources that define and discuss recovery principles and supports
  • Books and podcasts that explore addiction and family dynamics
  • Helplines that provide 24/7 support
  • Therapy with a mental health professional familiar with substance use disorders

Helping someone with drug use, drug addiction, or alcohol use isn’t about fixing them—it’s about walking beside them, with compassion and hope. Whether they’re seeking professional help or resisting treatment options, your role matters. Take steps to protect your own well-being, stay informed, and know that recovery is possible for your family member—even when the road is long.

Connect With Professional Support

Ready to connect your loved one with professional help? Find qualified addiction treatment programs in your area that offer personalized care and proven recovery methods.

FAQs

Q: What should you not say to someone who has an addiction?

A: Avoid blaming, shaming, or using stigmatizing terms like “junkie” or “addict” when talking to or about your family member.  Phrases like “just stop” or “you’re ruining everything” often shut down communication. Focus instead on expressing care and concern while encouraging effective treatment options.

Q: How can I help without enabling?

A: Helping without enabling means supporting their recovery, not their addiction. Avoid giving money, covering up consequences, or making excuses. Instead, offer emotional support, resources, and healthy boundaries.

Q: What are some ways to help people who are suffering from addiction?

A: You can help by listening without judgment, offering treatment options, and encouraging small steps toward change. Support groups, harm reduction strategies, and family therapy can also make a difference.

Q: What is substance use disorder (SUD)?

A: A substance use disorder is a medical condition characterized by an uncontrollable urge to use drugs or alcohol despite negative consequences. It affects brain function and behavior and often requires comprehensive treatment.

Q: How do I get a loved one to admit they have a problem?

A: Use “I” statements to express concern, avoid confrontational language, and choose a calm moment to talk. Understand that denial is common and change takes time.

Q: How do I know if someone needs help for their drug or alcohol use?

A: Warning signs of alcohol addiction or other drug abuse include neglecting responsibilities, changes in mood or behavior, secrecy, physical deterioration, and an inability to stop despite consequences. A professional assessment can clarify their needs.

Q: Is there a good way to convey addiction concerns to a family member or friend?

A: Yes. Speak from a place of compassion using statements like, “I’ve noticed some changes and I’m worried.” Choose a quiet time, avoid judgment, and be prepared for resistance.

Q: Are you covered for addiction treatment?

A: Many insurance plans cover addiction treatment, including inpatient, outpatient, and therapy options. Check with your insurance provider or rehab admission team for guidance on available coverage.

Q: What are effective ways to support someone in recovery from addiction?

A: Offer encouragement, celebrate milestones, be patient during setbacks, and avoid substances around them. Attending support groups together and staying informed can strengthen your role in their recovery. Encouraging effective treatment plans that address not only substance use, but also co-occurring mental health conditions, is important.

Q: What steps can I take to support someone seeking addiction recovery?

A: Help research treatment options, provide transportation or childcare if needed, and support attendance in therapy or peer groups. Remind them that recovery is a journey, not a destination.

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Effects of Substance Use During Pregnancy

Substances like alcohol, marijuana, and illicit drugs can greatly affect the mother and child during pregnancy and cause complications during and after birth. Sometimes, the mother isn’t aware of her pregnancy and may use substances as if she weren’t carrying. In any case, using substances while pregnant can alter the health of the mother, the fetus, and the baby as it grows in and out of the womb.

Knowing the effects of substance use beforehand can help those who know they’re pregnant or think they may become pregnant carefully assess the risks to plan ahead for a healthier birth and pregnancy.

Understanding Substance Use During Pregnancy

Substance use during pregnancy can look like taking drugs that aren’t approved for pregnant people, like alcohol. These drugs have been identified as dangerous for the mother and fetus or potentially harmful. 

Common substances used during pregnancy, whether done intentionally or not, include alcohol, nicotine, some prescription medications (like prescribed opioids), and illicit drugs like cocaine or heroin. Studies found roughly 5% of pregnant women use substances while pregnant1.

Much of what mothers consume while pregnant reaches their infant because the placenta is easily permeable—including addictive and non-addictive substances.

Effects of Alcohol Use During Pregnancy

Alcohol can have damaging effects on a developing fetus throughout each stage of pregnancy1, even before mothers realize they’re pregnant. Drinking while pregnant can cause Fetal Alcohol Syndrome Disorders (FASD), which includes Fetal Alcohol Syndrome and other birth defects caused by alcohol.

FASDs cause cognitive, physical, and behavioral damage2 that may show right after birth or later on in childhood. Alcohol can disrupt the development of vital organs, like the brain, heart, and how the body functions as a whole. Heavy drinking can cause the most damage, especially when it occurs throughout the entire pregnancy. But no amount of alcohol is safe during pregnancy2. And with many pregnancies not being planned, doctors recommend women not to drink even while they’re trying to get pregnant or think they might be2.

Children born with a FASD may have defining facial features, cognitive impairments, and related behavioral problems. 

Effects of Tobacco Use During Pregnancy

Smoking while pregnant can harm the mother and baby3 in several ways. It can lead to:

  • Premature births
  • Low birth-weight even if the baby is to term
  • Damage to the baby’s lungs and brain
  • Birth defects
  • Higher risk of sudden infant death syndrome (SIDS)
  • A doubled risk for excessive bleeding at birth and during pregnancy

Smoking can also create issues with fertility3 for both the mother and father. Nicotine can affect the fetus throughout the whole pregnancy—some mothers give birth to healthy babies, but that doesn’t guarantee they can smoke through a second pregnancy and get the same results. Smoking while pregnant can even result in a stillbirth (a deceased baby born after 20 weeks). Quitting at any point during the pregnancy can reduce the likelihood of all negative effects.

Second-hand smoke can also cause damage. Pregnant mothers can reduce their risks by quitting smoking and limiting their exposure to second-hand smoke. 

Effects of Illicit Drug Use During Pregnancy

Using illicit drugs when pregnant can double or even triple the chances of a stillbirth1. These types of drugs include heroin, cocaine, methamphetamine, and psychedelics like psilocybin. Since drugs pass easily through the placenta and into the developing fetus, babies can be born reliant, and addicted, to the substance their mother used. This is called neonatal abstinence syndrome (NAS).

Neonatal Abstinence Syndrome: Symptoms and Recovery

NAS correlates to illicit or prescribed opioids used during pregnancy4. Babies born with NAS greet the world in a state of withdrawal, experiencing irritability, stomach issues, seizures, and trembling. Babies with NAS also cry excessively and with a higher pitch than normal.

Medical care can help babies detox4 from substances safely and with greater comfort. Some babies require benzodiazepines, morphine, or methadone to relieve symptoms. They can recover to full health.

Effects of Prescription Medication Use During Pregnancy

Some prescribed medications aren’t fit to use during pregnancy—doctors should make women well-aware of this if they’re trying to conceive or are already pregnant. When pregnant women take prescribed medications against doctor’s advice, or procure them from non-medicinal places, it can harm them and their baby. 

These medications include benzodiazepines, opioids, and stimulants like Adderall. Most medications, prescribed or over the counter, haven’t been well-studied in regards to how they affect pregnant women and babies. A study found 9 out of 10 pregnant women took medications1—many of whom don’t know how it might affect their developing fetus, which is why providing a list of all medications taken can help doctors identify any risks.

Some medications can cause NAS, like oxycodone. Other medications may cause no harm, but it’s best to let doctors make the final call.

Combined Substance Use and Its Effects

Using more than one substance, or polysubstance use, can create more pronounced health effects for the mom and baby. For example, a pregnant woman who smokes and drinks alcohol imposes greater health risks to herself and the baby than someone only smoking or only drinking. 

The more substances passing through the placenta to the baby, the more likely they’ll have a negative effect on their development and future health. The National Institute on Drug Abuse says1,

Children born to mothers who both drank and smoked beyond the first trimester of pregnancy have a twelvefold increased risk for sudden infant death syndrome (SIDS) compared to those unexposed or only exposed in the first trimester of pregnancy.

Psychological and Emotional Impact on Pregnant Women

Taking drugs during pregnancy can have a host of emotional and psychological effects on women. They may feel low or depressed as a result of their substance use, especially when that combines with hormone fluctuations. Regular substance use can cause a cyclical effect, where highs are followed by extreme lows and cause someone to continue their use to mitigate the lows.

Impaired mothers may also struggle to bond with their baby once they’re born. Drug use can affect the parts of the brain that help mothers bond with their baby5, making it difficult for them to form a secure parental relationship. This can impact their connection and parenting style throughout the baby’s life.

Preventative Measures and Treatment Options

One of the first steps in preventing substance use during pregnancy is testing regularly (or as needed) for pregnancy if using substances—or don’t use substances at all if you’re hoping to conceive. 

Educating men and women on the dangers of substance use during pregnancy can help mothers and partners understand and evaluate risks, and then adjust their behaviors accordingly. Knowing these risks before pregnancy can help mothers adequately prepare and create a substance-free environment for their baby to form and grow.

If you’re struggling with an active addiction and become pregnant, you can attend recovery programs and rehabs specifically for pregnant women (there’s a lot!). These programs account for you and your baby, addressing your needs with appropriate medical care, therapies, and prenatal care to support a healthy, full-term pregnancy.

If babies are born with substance-related complications, hospital staff can initiate a detox for the baby with medications to ease their withdrawals. Some birth defects caused by substances can’t be treated or reversed, but medical care can treat some symptoms throughout the person’s life.

Support Systems and Resources

Friends, loved ones, and medical staff can offer key support for pregnant women, helping them navigate addiction treatment if needed, and the journey of pregnancy. Women can join various support groups too, like 12-Step peer meetings or non-12-Step groups like SMART Recovery meetings. Prenatal clinics may also offer support groups to educate women on child-raising, best practices for their health, and to connect women to resources for housing, mental health care, and other personal needs. 
If pregnant women need to detox and/or get addiction treatment, they can go to one of the many rehabs with specialized care for pregnant women. Some rehabs will also offer services and help for other children, helping pregnant mothers attend treatment when childcare needs may otherwise prevent them.

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Navigating the Tempest: Understanding Binge Drinking in College

As dusk settles on college campuses, a familiar scene unfolds. Throngs of students escape the confines of lecture halls, swapping textbooks for what might seem like harmless revelry. Yet, beneath the veneer of college nightlife lurks a more troubling ritual: binge drinking. This practice, often glamorized as a rite of passage, carries profound implications for health, safety, and academic success.

Binge Drinking in College: Understanding the Risks and Promoting Safer Choices

Binge drinking in college is a pervasive issue that threatens student health, academic performance, and safety. Understanding the risks associated with this behavior is crucial for developing strategies that promote safer choices. Defined as consuming an excessive amount of alcohol in a short period, binge drinking is alarmingly common among college students, often due to social pressures, a desire for acceptance, or as a misguided method for managing stress. 

The consequences can be severe, ranging from immediate risks like accidents and alcohol poisoning to long-term effects such as liver damage and psychological disorders. Addressing this issue requires a multi-faceted approach that includes education on responsible drinking, enhancing campus mental health resources, and fostering an environment where students feel supported in making healthier decisions. By raising awareness and providing practical interventions, colleges can help mitigate the dangers of binge drinking and guide students toward safer, more informed choices.

The High Tide of Binge Drinking

Binge drinking is defined as consuming five or more drinks for men or four or more for women1 in about two hours. However, these numbers are just a starting point for many college students. The National Institute on Alcohol Abuse and Alcoholism reports alarming statistics: roughly 2 out of 5 college students admit to binge drinking within the past month.

Why do so many students find themselves caught in the current of excessive drinking? The reasons are as complex as the individuals themselves. Social pressure acts as a powerful undertow, pulling even the most steadfast into its depths. For others, alcohol serves as an anchor, steadying the tumult of stress and anxiety that often accompanies university life.

The Impact: A Ripple Effect

The consequences of binge drinking extend beyond individual health risks, such as injuries, alcohol poisoning, and long-term effects on brain function. Academically, it’s a storm surge that washes away potential. Studies link heavy episodic drinking to lower GPAs, missed classes, and delayed graduations. Socially, it can erode trust, fueling incidents of assault and impaired relationships.

Yet, it’s the hidden ripcurrents of mental health issues that are particularly concerning. Many students who binge drink may be attempting to navigate the murky waters of depression or anxiety, not realizing that alcohol, in reality, may pull them further from shore.

Changing Tides: Strategies for Navigating Safer Waters

Addressing binge drinking in college requires a multifaceted approach beyond mere policy changes and tapping into the heart of campus culture. Here are some strategies that can be implemented:

  1. Education and Awareness: Knowledge is the lighthouse guiding students away from dangerous waters. Comprehensive education about the effects of alcohol, tailored to college students’ realities, can demystify myths and highlight risks.
  1. Building Community: Creating strong, inclusive communities on campus can provide the social fulfillment many seek from alcohol. Clubs, sports, and other group activities can offer social connections without the need for binge drinking.
  1. Mental Health Support: Enhancing access to mental health resources can help address underlying issues that may contribute to binge drinking. Counseling, support groups, and wellness programs can provide lifelines to those struggling.
  2. Peer Intervention Programs: Training students to recognize the signs of alcohol abuse among their peers—and to intervene effectively—can act as a first line of defense against binge drinking behaviors.
  1. Parental Involvement: Engaging parents in discussions about alcohol providing them with strategies to open dialogues with their children, can reinforce healthy behaviors from a trusted source.

A Call to Action

As we chart the course for healthier collegiate environments, it’s crucial that all stakeholders—students, faculty, administrators, and parents—work collaboratively to alter the tide of binge drinking. No matter how small, each step taken is a step towards calmer, safer seas.

While the waters of college life are often turbulent, navigating them does not necessitate succumbing to the undertow of binge drinking. We can guide our students to survive and thrive in these formative years with concerted efforts and communal support.

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Nurturing Resilience: Guiding Your Child Through the Storm of Parental Addiction

Dear Parent,

Navigating the tumultuous waters of addiction in your family is challenging, not just for you but profoundly so for your child. As someone standing on the frontline of your child’s world, you hold a lantern of hope that can light their way through this storm. Here’s a heartfelt strategy to help you secure your child’s emotional and psychological well-being during these trying times.

Create a Harbor of Safety

Imagine your home as a safe harbor against the world’s stormy seas. This is where your child can drop anchor and feel protected from outside turbulence. Offer a consistent, calm, and non-judgmental environment where they can freely share their thoughts and emotions. Establish a sense of normalcy and safety through clear boundaries and predictable consequences, ensuring they understand that home is a place of love and security.

Anchor in Routine

The sea might be unpredictable, but your ship must not be. A disciplined schedule brings stability—routine is like the compass that guides sailors through the fog. Regular meals, consistent bedtimes, and a structured daily schedule help impose a rhythm and order that can be incredibly reassuring to a child living in a chaotic environment. This predictability in their day-to-day life helps to foster a sense of control and normalcy.

Encourage the Voyage of Expression

Your child’s journey through their parent’s addiction is fraught with complex emotions. Encourage them to express their thoughts and feelings openly. Provide them with tools for expression like journals, art supplies, or music, which can be therapeutic outlets. Teach them that seeking help and expressing vulnerability are signs of strength, not weakness. Let them know their feelings are valid and they have a safe space to discuss anything without fear of judgment.

Chart the Waters of Understanding

Education is your child’s beacon in the night. Explain addiction in terms they can understand, emphasizing that it is a disease—a medical condition that needs treatment, just like diabetes or asthma. This understanding can demystify their parent’s behavior and relieve some of their fears and misconceptions. They must learn that their parent’s struggles do not define them and that they are not responsible for fixing the problem.

Build a Crew of Support

No ship braves the sea alone. Introduce your child to support groups like Alateen, where they can meet others navigating similar challenges. These peers can become part of their crew, sharing experiences and coping strategies to help them feel less isolated. This community can provide a critical support network, offering friendship and understanding to help them weather their storms.

Promote the Wellness of the Sea and Sky

Encourage your child to engage in physical and creative activities. Physical exercise, like sports or dancing, can significantly reduce stress and improve mood1, while creative outlets like drawing or writing provide a means for emotional release. Activities like these not only occupy their mind and body positively but also help develop confidence and a sense of accomplishment, which are vital during times of personal family crisis.

Seek the Guidance of Seasoned Captains

Sometimes, navigating through a storm requires the expertise of a seasoned captain. A professional therapist or counselor who specializes in addiction and family dynamics can provide your child with a safe space to discuss their feelings and learn healthy coping mechanisms. These professionals can offer guidance tailored to your child’s needs, helping them understand their emotions and develop resilience.

Guard Their Rights and Well-being

A guardian must sometimes stand up and fight the waves in tumultuous times. If your family’s situation puts your child’s well-being at risk, involving child protective services or seeking legal advocacy may be necessary. Ensuring that your child has a stable, safe living environment is paramount, and sometimes additional interventions are necessary to protect their mental and physical health.

In Closing

You are the captain of this ship, and your steadfast love and support are the guiding stars in your child’s sky. Remember, your efforts to provide stability, understanding, and compassion during this storm will shape their ability to navigate life’s challenges. With your guidance and the right support, your child can emerge stronger, more resilient from this storm and with a bright horizon ahead.

With warmth and support,

Dr. Mala

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Thoughtful Gift Giving: Balancing Awareness and Inclusivity: Andrew Schreier

As a licensed professional counselor and clinical substance abuse counselor, I have dedicated my career to helping individuals navigate challenges surrounding substance use, mental health, and behavioral struggles. Working in outpatient therapy, recovery support groups, and community education, I’ve witnessed the role of thoughtful communication and mindful actions in fostering recovery, healing, and deeper human connection.

The holiday season, in particular, allows us to show our care through gift-giving. Giving gifts is a tradition cherished across cultures and generations. The intention of gift-giving can be used to express love, gratitude, and loyalty, demonstrate power, seek prestige, or manipulate relationships. However, this seemingly simple act can carry added weight for many people. For those dealing with substance use recovery, grief, gambling, financial challenges, strained relationships, or separation from loved ones, holidays can intensify emotions that may otherwise remain manageable. 

Understanding these circumstances and approaching gift-giving with care, intention, and inclusivity is critical. This article provides insight into how we can create a culture of mindful gifting—one that celebrates generosity while respecting the needs and experiences of others.

Statistics Related to Gift-Giving

GiftAFeeling provides these statistics from their “103+ Gift Giving Statistics: A Comprehensive Study for 2024”1 to share key insights into understanding gift-giving trends:

  • 85% of People Believe Gifts Strengthen Personal Relationships
    • Giving a gift is a meaningful way to show someone you care. Studies reveal that 85% of people feel gifts help build closer personal connections. It’s not about the item itself but the sentiment behind it, which can make friends, family members, or loved ones feel appreciated and valued. A thoughtful gift can strengthen bonds, creating lasting memories that deepen personal relationships.
  • 67% of People Feel More Appreciated with Recognition Gifts from Loved Ones
    • Receiving a thoughtful gift can make anyone feel recognized and appreciated. In fact, 67% of people feel more valued when they receive a gift that acknowledges a special milestone, such as birthdays, anniversaries, or personal achievements. These gestures remind loved ones that they’re seen and valued, helping build stronger bonds in families and friendships alike.
  • 43% of People Remember Thoughtful Gifts Longer
    • People tend to remember meaningful gifts that show someone really thought about them. Research shows that 43% of people remember gifts longer when the gift is personal and thoughtful. Whether it’s a favorite book, a custom item, or something that aligns with their hobbies, a well-chosen gift can leave a lasting impression, making the gesture feel special and memorable.

Navigating Gift Giving: Recovery and Mental Health 

Gift-giving is one of the hallmarks of the holiday season. It’s a way to express love, appreciation, and gratitude. However, for some, receiving certain gifts or the very act of gift-giving itself can trigger emotional challenges, highlight financial insecurities, or exacerbate feelings of isolation.  The same gift can convey love, gratitude, or shared memories2, while for another might create stress or obligations for both giver and receiver.

Here are a few key challenges to consider:

  1. Substance Use and Mental Health Recovery
    For individuals in recovery, certain gifts can unintentionally undermine their progress. A bottle of wine given to someone abstaining from alcohol, gambling-related items like lottery tickets, or gifts that allude to harmful coping mechanisms can be deeply triggering. While the giver’s intention may be positive, the impact can result in emotional setbacks, shame, or even relapse.
  2. Grief and Loss
    Holidays often magnify the loss of loved ones. For someone spending their first season without a family member or friend—or even years after a passing—grief can resurface strongly. Well-meaning gifts might unintentionally stir up painful reminders. At the same time, overlooking someone’s grief entirely can make them feel unseen or isolated.
  3. Gambling-Related Issues
    Individuals struggling with gambling-related problems may find gift-giving during the holidays challenging due to financial strain, such as limited resources or gambling away money intended for gifts. Emotional factors like guilt, shame, or damaged relationships can further complicate their ability to participate in holiday traditions. The pressure to meet societal expectations or strained connections with loved ones may lead to avoidance of celebrations altogether. It is also common for gambling-related items (such as lottery tickets) to be given as gifts to children and youth who are at risk.
  4. Financial Barriers
    For individuals unable to afford gifts, societal and family expectations during the holidays can create shame, embarrassment, or stress. Gift exchanges often emphasize material items, unintentionally excluding those for whom spending money is simply not feasible.
  5. Separation from Loved Ones
    Whether someone is serving in the military, working away from home, incarcerated, or otherwise unable to be with family, holidays can feel especially lonely. Gift-giving traditions may serve as a reminder of their physical absence, exacerbating feelings of disconnection.
  6. Strained Relationships
    For individuals experiencing tension, estrangement, or conflict within their families, holidays can be emotionally complex. Traditional gatherings and gift-giving can add pressure to reconcile, making them feel conflicted about participating.

When these challenges go unacknowledged, gift-giving can shift from a thoughtful, meaningful practice into something that feels burdensome, exclusionary, or harmful. Instead, a mindful approach to gifting—one that centers on empathy and inclusivity—can transform the act into a powerful gesture of care and connection.

Does Stigma Impact Gift Giving?

The stigma surrounding substance use, mental health, and gambling can have a profound effect on gift-giving.  Assumptions or a lack of understanding about what may be helpful or harmful to individuals dealing with these challenges is a result of stigmas. For example, a well-intentioned gift of alcohol or lottery tickets may unintentionally trigger harmful behaviors or undermine someone’s recovery journey. Similarly, ignoring the unique needs of individuals facing mental health challenges may result in gifts that feel thoughtless or even alienating, reinforcing feelings of isolation or shame. There might also be beliefs that individuals in recovery from substance use, mental health, and recovery don’t deserve gifts because of the impact of their behavior on family members and loved ones.

One of the ways stigma manifests in gift-giving is through avoidance or discomfort. People may hesitate to address sensitive issues or ask what someone might truly need, fearing awkwardness or judgment. This reluctance can perpetuate harmful stereotypes, such as assuming that a person in recovery can “just avoid” triggers or that someone with mental health challenges doesn’t need additional support. By failing to consider the individual’s circumstances and experiences, the act of giving a gift can lose its intended purpose of fostering connection, care, and inclusion.

A Safe Space for Gift-Giving Insight

In my counseling practice, I’ve seen firsthand how thoughtful adjustments to holiday traditions foster healing and strengthen relationships. While our initial reaction to giving and receiving gifts may come with excitement, it’s often common to see how these traditions and culture around the holiday seasons have the opposite impact. I’ve worked with families, individuals, and communities to address some of the challenges outlined above.

For example:

  • Supporting Recovery: One family struggled to adjust their holiday traditions after their loved one entered treatment for alcohol use disorder. They initially felt frustrated at the idea of giving up their long-standing tradition of gifting alcohol as part of a larger family tradition when relatives were over. Through open conversation, they understood that maintaining this tradition was not worth jeopardizing their loved one’s progress and identifying their ultimate goal of giving gifts. They replaced alcohol-related gifts with shared experiences; and their first one was attending a holiday concert together. The family deepened their bonds and honored their loved one’s recovery.
  • Navigating Grief: In another case, a client expressed how painful it was to celebrate the holidays without their partner, who had passed away. Rather than ignoring the loss, their family honored their partner’s memory by sharing stories, cooking their favorite dish, and giving gifts that reflected their shared memories. This acknowledgment of grief brought comfort and inclusion during an otherwise difficult time.
  • Addressing Financial Barriers: During a community workshop, families expressed anxiety about not being able to afford gifts for their children. Together, we explored non-material alternatives—such as handmade crafts, letters of gratitude, or creating “experience coupons” for activities like family game nights or movie marathons. These small gestures carried deep meaning without placing financial strain on the family.
  • Campaign to Gift Responsibly: There are campaigns to commit to gifting responsibly.  The Gift Responsibly Campaign3 by the National Council on Problem Gambling (NCPG) raises awareness about the risks of gifting lottery tickets to minors. The campaign emphasizes that lottery tickets are not appropriate gifts for children, as they can contribute to unhealthy gambling behaviors later in life. By promoting thoughtful and responsible gift-giving, the initiative encourages individuals to consider the long-term impact of their choices during the holiday season. The campaign also highlights the importance of education and prevention in fostering healthy attitudes toward gambling. This example can lead others to consider thoughtful gift giving for areas like substance use, mental health, and grief.

These examples underscore an important point: mindful gift-giving doesn’t require perfection or grand gestures. It simply involves thoughtful consideration of someone’s circumstances, needs, and experiences.

General Tips for Gift-Giving Conversations

Having conversations around gift-giving can be challenging. We may be reluctant to over fear that we are dismissing someone’s excitement or enthusiasm; however, it is important that through conversation we can get to a better idea of what is best for the individuals in relation to gift giving. Start with empathy and intention when discussing gift-giving. Emphasize that the goal is not to criticize traditions but to create thoughtful, inclusive moments that support everyone. Frame the conversation as an opportunity for learning and growing together. Use language like, “This is an opportunity to make our gift-giving more meaningful for everyone.”

  • Share Personal Stories and Examples
    Real-life scenarios can make the message more relatable. Share how small changes in gift-giving have positively impacted others.
  • Encourage Open Conversations
    Normalize questions like:
    • “What kind of gifts do you find meaningful?”
    • “Are there gifts you’d prefer to avoid?”
      Promote curiosity and understanding rather than making assumptions.

The Solution: Strategies for Thoughtful, Inclusive Gift-Giving

Here are actionable strategies to make gift-giving more intentional, inclusive, and supportive for all individuals:

1. Avoid Triggering Gifts

  • For individuals in recovery, avoid gifts related to alcohol, gambling, or other substances. Instead, focus on hobbies, shared experiences, or wellness-related items.
  • Be mindful of individuals grieving a loss. Avoid gifts that unintentionally emphasize the absence of their loved one unless they are specifically chosen to honor their memory.

2. Consider Non-Material or Meaningful Alternatives

  • Shared Experiences: Give gifts that focus on spending time together, such as tickets to events, a home-cooked dinner, or a nature outing.
  • Personalized Gifts: Handwritten letters, photo albums, or handmade items show thoughtfulness and appreciation without relying on materialism.
  • Self-Care Gifts: Journals, books, cozy blankets, candles, or wellness kits can provide comfort and support.
  • Acts of Service: Offering your time—such as helping with chores, cooking meals, or offering childcare—can be an invaluable gift, especially for those under stress.

3. Acknowledge Unique Circumstances

  • For individuals with financial limitations, emphasize gifts that don’t require spending. Organize traditions centered on shared time, games, or storytelling.
  • For those grieving or away from family, consider thoughtful gestures like letters, care packages, or simple check-ins to let them know they are remembered and valued.
  • Respect the boundaries of individuals navigating strained relationships, and create spaces where they can still feel included without pressure.

4. Foster Open Communication

  • Normalize conversations about gift-giving preferences and sensitivities. Asking someone about their comfort level can prevent unintentional harm and help you choose a meaningful gift.
  • Share these practices within your family, workplace, and community to encourage a broader culture of inclusivity.

Beyond the Holidays

While the conversation around thoughtful gift-giving often surfaces during the holidays, it is a relevant and meaningful practice year-round. Gift-giving is not limited to presents under a tree during the winter month holidays. It is an ongoing part of how we show care, connection, and empathy in our daily lives. Whether it’s acknowledging someone’s grief, supporting their recovery, or respecting their personal circumstances, the intention behind a gift carries far more weight than the gift itself.

As we move forward, let us approach gift-giving with the awareness that our choices have the power to uplift or unintentionally harm. By fostering a culture of thoughtful, inclusive gifting, we can transform this tradition into one that brings joy, connection, and healing for all. This holiday season and beyond, let’s commit to gifts that reflect care, understanding, and respect. Whether big or small, material or experiential, a thoughtful gift can make a lasting impact on the lives of those we love.

Mindful gifting isn’t just a seasonal practice—it’s a lifelong commitment to inclusivity and compassion.

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How to Help a Veteran: Supporting Mental Health, PTSD, and Substance Use Recovery

The Importance of Supporting Veterans in Everyday Life

Veterans face unique challenges after leaving the military. Returning to civilian life often means confronting mental health issues such as PTSD, depression, and, for some, substance use. The transition from military service to civilian life can be difficult as veterans adjust to new routines and environments, which can feel isolating and overwhelming. Given these complex challenges, it is vital to provide veterans with continuous, accessible support.

Recognizing When a Veteran Needs Support

Understanding PTSD in Veterans

PTSD (Post-Traumatic Stress Disorder) is common among veterans, especially those who have experienced combat. It may manifest in symptoms such as flashbacks, avoidance of certain places or situations, and emotional numbness—for veterans with PTSD, this can look like avoiding situations that remind them of traumatic experiences, or they may seem detached or hypervigilant. Family and friends can help by learning these signs and observing changes in behavior to know when they might need additional help. 

Identifying Substance Use Issues

Veterans may turn to substance use as a coping mechanism to manage the lingering effects of trauma, stress, and other mental health challenges. Substances like alcohol and drugs may temporarily numb emotional pain or offer an escape from intense memories or anxiety that accompany these drastic changes. Still, they can quickly spiral into dependency, especially when used as a means to cope.

Behavioral Signs

Behavioral signs that might indicate a veteran is struggling with substance use can vary but often include social withdrawal, mood swings, and a noticeable increase in irritability or anger. Social withdrawal, for instance, can occur when veterans feel shame or discomfort around others due to their use. They may begin to distance themselves from family, friends, and hobbies, leading to increased isolation and loneliness, further exacerbating the issue. 

Excessive reliance on substances might be observed as regular drinking sessions, a growing tolerance that leads to higher consumption, or frequent use of drugs to “relax” or “escape.”

Physical Signs

Alongside noticeable behavioral shifts, veterans experiencing challenges may exhibit physical signs that signal underlying stress or mental health struggles. These can include significant changes in appetite, eating much more or less than usual, and a decline in personal hygiene routines, such as bathing, grooming, or wearing clean clothes. 

Veterans might also start neglecting daily responsibilities that once seemed manageable, such as attending work, handling household chores, or even taking care of personal health needs like regular exercise or sleep. 

Loved ones should pay close attention to these subtle but telling indicators. Often, veterans may attempt to mask their difficulties, either out of a desire to avoid burdening others or due to feelings of shame or vulnerability. Recognizing and acknowledging these signs can be an essential first step in providing the understanding and support they need.

Understanding Stress in the Transition from Military to Civilian Life

Military life often leaves veterans with deep-seated experiences from high-stress environments, where discipline, routine, and camaraderie are essential to daily operations and survival. When transitioning to civilian life, veterans may find themselves in an entirely different world, where the structure they once relied on and the support network of fellow service members are no longer present. 

The absence of these familiar frameworks can lead to feelings of isolation, disorientation, and even frustration as they navigate a less regimented environment. Without the same level of structured support, veterans may struggle with adjusting to a new pace and rhythm, managing stress, or finding a renewed sense of purpose. This transition period can be especially challenging, as it may bring unresolved trauma or mental health challenges to the surface, making it essential for communities and support systems to be mindful of the unique needs veterans face as they adapt to civilian life.

Early Intervention and Patience Are Key

By noticing these warning signs early on, family members, friends, or coworkers can step in with compassion and support, initiating conversations without judgment. Encouraging veterans to seek help before the issue becomes severe can prevent long-term health risks, improve their quality of life, and reconnect them with the support they need. 

Treatment options may include counseling, substance use programs, or group therapy sessions where they can share their experiences with others who understand their journey. With patience and support from loved ones, early intervention can make a significant difference in helping veterans reclaim their health and well-being.

General Mental Health Concerns in Veterans

Beyond PTSD and substance use, veterans may experience depression, anxiety, and feelings of isolation. These challenges can lead to mood swings, irritability, or a lack of interest in previously enjoyed activities. Friends and family should watch for these signs, as they may indicate that the veteran is struggling and could benefit from mental health support.

How to Help a Veteran Access Mental Health Services

VA Mental Health Services

The Department of Veterans Affairs (VA) offers various mental health services, including counseling, therapy, and specialized PTSD programs. These services are tailored to meet veterans’ needs, often covering therapies such as cognitive behavioral therapy (CBT) and trauma-focused approaches. Veterans can contact their local VA center to learn about available mental health programs.

Non-VA Mental Health Resources

Many local counseling centers, community clinics, and online therapy services, such as BetterHelp are available for veterans who prefer non-VA options. Nonprofits and community organizations often provide mental health support tailored to veterans, making mental health services accessible even for those not connected to the VA system.

Encouraging Veterans to Seek Professional Help

Encouraging a veteran to seek professional help necessitates approaching the topic with understanding, without pressuring them, and emphasizing that seeking support is a positive step toward well-being. Let them know you’re there for them every step of the way, respecting their pace and comfort level.

When encouraging veterans to seek professional help, it’s essential to convey empathy, patience, and respect for their experiences. Here are some supportive phrases that can help foster trust and make the suggestion feel gentle and encouraging:

  1. “I can’t imagine what you’ve been through, but I’m here to listen and support you in whatever feels right.”
  2. “It’s completely understandable to feel hesitant about seeking help, but know that professional support can make a difference, and I’ll be here for you every step of the way.”
  3. “You don’t have to go through this alone. Some people specialize in understanding these experiences, and I’m here to help you connect with them if you’re ready.”
  4. “I’m here for you, no matter what. When you feel comfortable, some people can help make things easier whenever you’re ready.”
  5. “Taking that first step can feel challenging, but I truly believe it’s a brave choice, and I’ll support you in any way you need as you decide what’s best for you.”
  6. “I’ve noticed some things seem to be weighing on you lately. If it ever feels helpful to talk to someone, just know you have options and people who can listen.”
  7. “I admire your strength in dealing with so much. Some people can offer more support if that’s something you might want to explore – only when you feel ready.”
  8. “I just want you to know, there’s no rush or pressure, but when and if the time is right, I’d be more than happy to help you find someone who understands.”
  9. “Seeking help doesn’t mean facing everything alone. Sometimes it can be comforting to have someone guide you through the process, and I’ll be here as you consider that.”
  10. “Your well-being means a lot to me, and whatever path feels right for you, I’ll support it. If talking to someone professionally might help, just know I’m here with you in that decision.”

Supporting Veterans with PTSD

Therapy Options for PTSD

There are several effective therapy options for veterans with PTSD, including Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and group therapy. These therapies focus on navigating and reducing PTSD symptoms, helping veterans gain control over their thoughts, emotions, and responses to triggers.

Everyday Strategies for PTSD Support

Supporting a veteran with PTSD goes beyond formal therapy. Simple daily practices, such as maintaining a predictable routine, practicing patience, and encouraging grounding exercises or mindfulness techniques, can be beneficial. By creating a calm, stable environment, friends and family can help veterans feel more secure.

Alternative PTSD Treatments

Many veterans find additional relief through alternative treatments like equine therapy, yoga, meditation, or art therapy. These non-traditional approaches offer emotional expression and self-care, which can be empowering and restorative.

Addressing Substance Use Challenges in Veterans

Understanding Why Veterans May Struggle with Substance Use

Veterans may turn to alcohol or drugs to manage stress, trauma, or mental health symptoms, especially if they lack a robust support system. Substance use may start as a coping mechanism, but it can quickly develop into a dependency. Understanding these underlying issues can help friends and family approach the subject compassionately.

Treatment Options for Substance Use Disorders

For veterans facing substance use challenges, treatment options include inpatient and outpatient rehab, detox programs, and sober living environments. These programs provide structured support and are often tailored to address the unique needs of veterans.

How to Encourage Veterans to Seek Addiction Treatment

When discussing addiction treatment, approach the conversation with empathy. Express your concern non-judgmentally, making it clear that you are there to support them through every step of the recovery process. Emphasize that addiction treatment is a pathway to a healthier, fulfilling life.

Long-Term Support for Veterans’ Mental Health

Building a Strong Support System

A strong support network is essential for veterans’ mental health. Family, friends, and peer groups can provide a valuable emotional foundation, helping veterans feel less isolated. Encourage participation in social gatherings, veteran support groups, or recreational activities that foster connection and community.

Encouraging Healthy Coping Mechanisms

Healthy coping strategies, such as regular physical exercise, creative outlets, and relaxation techniques, can help veterans manage stress and enhance their well-being. Simple routines, like daily walks or art activities, offer positive ways to release tension and stay grounded.

Fostering Open Conversations About Mental Health

Encourage ongoing, open conversations about mental health to normalize these discussions and reduce stigma. By checking in regularly and offering a listening ear, you can create an environment where veterans feel safe discussing their mental health concerns.

Resources to Help a Veteran

VA and Non-VA Resources for Veterans

Veterans have access to a variety of resources, including VA mental health services, local veteran centers, and nonprofit organizations focused on mental health, PTSD, and substance use. These resources are tailored to address the specific needs of veterans and provide a range of support options.

Veteran Support Groups

Peer-to-peer support is invaluable for veterans. Groups like the Veterans of Foreign Wars (VFW) offer opportunities to connect with other veterans who share similar experiences. This camaraderie can be instrumental in the healing process and foster a sense of belonging.

Online and Telehealth Services for Veterans

Online and telehealth services make mental health support more accessible, especially for veterans in remote areas or those who prefer privacy. Many organizations and apps offer virtual counseling tailored to veterans’ unique needs, providing them with flexible and convenient support options.

Conclusion: Helping Veterans Achieve Better Mental Health

Veterans face unique challenges upon returning to civilian life, and support from friends, family, and the community can make a profound difference. Recognizing when they need help, guiding them toward mental health resources, and supporting their journey through PTSD and substance use recovery are crucial steps in their journey. Providing ongoing support and fostering open conversations about mental health, we help veterans live healthier, more fulfilling lives. In assisting them to thrive, we honor their service and contribute to a stronger, more compassionate society.

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How to Stop Shopping Addiction

What may start as harmless shopping can turn dangerous when it becomes compulsive spending. If your shopping feels out of control and you’re spending excessive amounts on clothes, gadgets, makeup, or other items, shopping addiction can be just as damaging as drug addiction.

By understanding shopping addiction and its treatment you can learn how to manage your purchasing decisions and well-being.

Understanding Shopping Addiction

Shopping addiction, also called compulsive buying disorder, involves excessive buying behavior that leads to distress or impairment1. An individual with compulsive buying disorder is unable to control their thoughts and actions around spending, and feels relieved after a purchase. 

Shopping addiction often co-occurs with other behavioral health conditions involving impulse control, particularly mood and anxiety disorders, substance use disorders, and eating disorders. Compulsive shopping tends to run in families, especially those with mood and substance use disorders.

When spending becomes compulsive, other life facets suffer because of the energy spent on purchasing. Pre-spending anxiety can govern a person’s entire life, only to be relieved by a purchase. The individual can neglect their personal relationships, health, and employment to shop, and they can also be in serious financial trouble. 

Signs and Symptoms of Shopping Addiction

Shopping addiction usually has 4 phases: 1) Anticipation; 2) Preparation; 3) Shopping; and 4) Spending1. Phase 1 includes thoughts and urges with a specific item or spending. In the second phase, the person prepares for shopping and spending, including decisions on when and where to go, on how to dress, and which form of payment to use. Phase 3 involves the actual shopping experience, which is intensely exciting and can even lead to sexual arousal2. Finally, the item is purchased, often followed by disappointment with oneself.

As this cycle repeats, loved ones may notice shifts in behavior and mood that make the shopping addiction apparent. Spotting these signs within oneself or another can help prevent further damage.

Behavioral Signs

You may notice a change in someone’s behaviors as compulsive buying disorder takes hold. Signs include

  • Frequent shopping sprees
  • Impulse buying 
  • Financial struggles due to excessive spending
  • Hiding purchases
  • Chasing sales and deals
  • Accumulating unused items
  • Often returning items (due to buyers remorse)

Emotional Symptoms

A person with compulsive buying disorder will cycle through different emotions1 as they move through the 4 phases.

  • Anticipatory signs of compulsive purchases include
    • Depression 
    • Anxiety  
    • Boredom  
    • Self-critical thoughts 
    • Anger 
  • Immediate consequential emotions after spending include
    • Euphoria 
    • Relief from negative feelings
  • Emotions following the purchase after the initial euphoria fades include
    • Guilt
    • Shame
    • Low self-esteem
    • Emotional numbness

Financial Consequences

A shopping addiction can cause severe financial consequences that impact both the individual and their loved ones. The person often collects debt from maxed-out credit cards and personal loans, which is accompanied by additional fees, higher interest rates, and a damaged credit score. 

As the addiction progresses, they may be unable to pay essential bills, such as rent, utilities, groceries, or medical expenses, leading to unpaid invoices and the potential loss of services or even housing. In extreme cases, compulsive buying disorder can result in personal bankruptcy, as the person is unable to repay their debts and meet financial obligations.

Causes of Shopping Addiction

Compulsive buying disorder is a multi-pronged condition caused by various factors. Understanding the developmental, neurobiological, and cultural influences of shopping addiction can guide treatment efforts.

Psychological Factors

The Diamond Rehab in Thailand details the prevalence of co-occurring conditions that can precede and worsen compulsive spending behaviors3, forming a complex and chaotic concoction. These conditions often involve impulse control and emotional regulation, specifically obsessive compulsive disorder, borderline personality disorder, and other avoidant personality disorders. 

Impulsive spending acts as a coping mechanism to manage negative emotions such as stress, anxiety, depression, loneliness, and low self-esteem, using shopping to solve the negative feelings temporarily. Shopping addiction can be both a product of and the cause for mental health concerns, necessitating personalized treatment when unraveling these conditions.

Environmental Influences

In a world consumed and fueled by media, people are taught that material possessions equate to happiness, success, and social status. Advertisements are designed to create desire, often exploiting emotional triggers to encourage impulsive purchases. This is especially true nowadays, with social platforms using targeted ads based on internet history.

For example, if you search for winter jackets on Google, you may encounter ads for trench coats on your social media platforms.

Consumerism is deeply ingrained in many cultures, with immense pressure to keep up with fashion, technology, and lifestyle societal norms. Social media amplifies this pressure by showcasing small, curated portions of people’s lives, often filled with luxury items and experiences, leading to anxiety and a desire to conform to these perceived standards4.

The internet also provides easy access to spending with online shopping. The convenience of being able to shop anytime, anywhere, has removed many of the barriers that previously limited impulsive purchases. Individuals may feel less inhibited and guilty for spending money as they have fewer in-person interactions, like handing money to a cashier, creating a false illusion of security behind a screen.

Biological Factors

Neurobiological theories credit compulsive buying disorder to abnormal neurotransmission1, particularly in the serotonergic, dopaminergic, or opioid systems. Dopamine, a neurotransmitter associated with pleasure, reward, and reinforcement5, is a key player in “reward dependence.” Dopamine is released when spending, creating a sense of euphoria. This reinforcement can lead to repeated behaviors in an attempt to experience that pleasurable feeling again, contributing to the cycle of addiction.

Irregular serotonin levels, a neurotransmitter responsible for emotional regulation and impulse control, are connected with various impulse control disorders, including compulsive shopping. Low levels of serotonin disrupt the ability to manage urges, leading to compulsive shopping behaviors as a way to temporarily alleviate negative emotions.

There is also evidence that individuals with a family history of addictive behaviors, such as substance use or gambling addiction, may be more genetically predisposed to developing other types of compulsive behaviors, including shopping addiction6.

Strategies to Overcome Shopping Addiction: Professional Treatment Options

Navigating compulsive buying disorder recovery requires a comprehensive approach that often demands outside professional help. Building an extensive toolkit of skills to manage negative feelings and impulses tied to shopping behaviors can empower you to save and spend your money confidently. 

Therapy and Counseling

Individual, group, and family therapy each offer a unique approach to help manage compulsive behaviors. Individual counseling, often through cognitive behavioral therapy (CBT), creates a personalized setting where you and your therapist collaborate to identify the specific emotional and psychological issues driving the addiction. You can learn tailored coping mechanisms and practice using them when in stressful or triggering situations. 

Group therapy provides a supportive environment to share experiences and challenges with others facing similar issues. A group setting can help you feel less isolated and gain insight from peers’ experiences. You’ll practice accountability, build connections, and develop healthier social interactions, which can be a crucial part of the recovery process.

Family therapy is another important option, especially when shopping addiction negatively affects relationships and family dynamics. Your family unit can improve communication, address underlying family conflicts, and learn more on how to support you in recovery. Loved ones can learn how to set healthy boundaries and avoid enabling compulsive shopping behaviors.

Cognitive Behavioral Therapy for Shopping Addiction

Cognitive behavioral therapy (CBT) is one of the most effective forms of therapy to navigate compulsive buying disorder7. CBT helps individuals identify and address the underlying thoughts, beliefs, and emotions that trigger compulsive shopping. By recognizing these patterns, you can learn healthier thought processes, coping mechanisms, and strategies to manage impulses. 

CBT helps individuals recognize the triggers and irrational thoughts that lead to their compulsive shopping behavior, such as stress or low self-esteem, as well as external factors like social pressure. You can learn to critically examine these thoughts and replace them with more rational, balanced perspectives. For example, you might learn to question whether buying an item will improve your mood or help you gain social approval, leading to a more realistic assessment of your needs. 

Medication

Sometimes, medication is necessary to manage the impulsive urges as well as the co-occurring mental health conditions like OCD and anxiety. Selective serotonin reuptake inhibitors (SSRIs) like Fluoxetine, Fluvoxamine, and Sertraline can treat compulsive buying disorder1 due to the similarities in neurotransmission and behaviors with other compulsive disorders. 

A comprehensive evaluation can guide medication usage for shopping addiction. Your professional care team can help you navigate your needs to find the appropriate medication and dosage. 

Financial Counseling

In many cases, financial counseling helps individuals regain control over their monetary struggles, especially if the person is in debt or battling legal issues. The proper counselor or mentor can help you manage finances, develop better money management skills, and repair the financial damage caused by compulsive spending. You may benefit from creating a debt repayment plan, learning budgeting skills, and developing a healthier relationship with money. 

Financial counseling skills can serve as a strong foundation for lifelong budgeting methods. You and your counselor may set savings goals for major life events, such as buying a home, funding education, or preparing for retirement. Developing realistic savings plans and making investment decisions can help you align your long-term financial goals.

Support Groups 

Joining support groups like Spenders Anonymous provides a sense of community, understanding, and accountability in your recovery. They offer a safe space to share experiences, learn from others, and receive ongoing support.

Developing Healthy Shopping Habits

Overcoming shopping addiction requires a combination of self-awareness, discipline, and practical strategies. Recovery stories are built on everyday habits that support a sustainable, healthy mindset.

Creating a Budget

Adopt a strict budget that you and your financial counselor create for discretionary spending, limiting the amount of money available for shopping. By tracking your spending and sticking to this budget, you can prevent impulsive purchases and stay within your means. Apps and websites like YNAB and Goodbudget keep users on track with time-tested budgeting methods, as well.

You may motivate yourself to adhere to your budget by giving yourself a small reward, such as going for ice cream if you do not overspend each week. A day of recovery is a day worth being celebrated! The effort to choose your health and well-being every day is a great feat, so continue to reflect and pride yourself on your hard work.

Mindful Shopping

When shopping for necessities, ask yourself whether you truly need the item, how it aligns with your values, and what the long-term consequences of the purchase will be. Mindfulness can help you stay grounded and make more intentional decisions.

Consider using cash instead of credit cards to make purchases, as this can help you directly feel the impact of spending. You could remove saved payment information from online shopping accounts, making it less convenient to make impulsive purchases, too.

You can also practice delayed gratification. By implementing a “cooling-off” period—waiting 24+ hours before making a purchase—you give yourself time to evaluate whether the item is truly necessary, which can help reduce impulsive buying.

Lifestyle Changes

Occasionally deleting social media apps can offer solace from advertisements and convincing influencers who tell you to try the newest product. You can also try unsubscribing from marketing emails or limiting time spent on shopping sites with website controls to reduce the urge to shop.

Real dopamine from healthy activities is the best kind of dopamine. Rediscover and reignite your passions by reading, painting, taking walks, and volunteering to keep you occupied and fulfilled.

Preventing Relapse

Relapse prevention planning aims to recognize and address warning signals before they escalate to the physical stage—compulsive spending. It takes a cognitive behavioral approach to preventing relapse and provides appropriate skills for what to do if a relapse does occur. It blends education, coping strategy development, trigger identification, building support networks, and lifestyle changes.

Identifying Triggers

You and your care team can begin to build your relapse prevention plan by reflecting on 3 key recovery components: 

  1. Reflect on your recovery history. In treatment, what worked and what didn’t work? If you’ve relapsed before, what led to it? What were your triggers before you got treatment? Learn from mistakes of the past to make a realistic relapse prevention plan.
  2. Write down personal, relationship, and employment goals to highlight situations you want to be in and people you want to be around. 
  3. Identify your triggers—all the people, places, and things that could cause stress. Developing coping strategies for each trigger can empower you to live life without fear.

One of the most essential parts of a relapse prevention plan is building skills to navigate uncomfortable feelings and situations. You may practice coping techniques such as breathing exercises, regulating emotions through journaling, and saying “no” to situations that do not serve your recovery. This can help you walk into any situation with confidence. 

Ongoing Support

Attending outpatient care or talk therapy sessions can help you navigate foreign situations and continue skill-building. During individual therapy sessions, you’ll likely engage in various therapeutic methods like dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT). 

What Real People are Doing

A user on Reddit shares their practical and realistic lifestyle changes that helped them overcome shopping addiction8, serving as an inspiring example for others facing similar struggles. They walk through the importance of decluttering, adopting mindful shopping practices, and creating a monthly budget to track their spending. 

By focusing on delayed gratification and shifting their mindset from impulsive buying to intentional purchasing, they successfully broke free from compulsive shopping. Their experience highlights how small, sustainable changes in daily habits and financial awareness can make a significant impact on their physical, mental, and financial well-being.

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The Signs a Young Adult May Have an Eating Disorder

Adolescence and early adulthood are pivotal periods for navigating life’s challenges and developing a sense of identity, particularly when it comes to mental health. During this time, external pressures can contribute to the rise of eating disorders, which have become a silent epidemic among young adults. Disorders like anorexia, bulimia, and binge eating not only impact physical health—leading to malnutrition, heart complications, and other severe conditions—but also take a profound toll on mental well-being.

Recognizing the signs early during these formative years can make the difference between a lifelong struggle and a successful recovery. Early intervention allows young adults to regain their health, rebuild self-esteem, and restore a healthy relationship with food and body image.

Listen to our podcast episode with Dana Sedlak (LCSW, CEDS-C) to learn more about eating disorders and adolescent treatment options. 

Common Types of Eating Disorders in Young Adults

Eating disorders can affect anyone, but especially young people. The average onset begins between ages 18-211, a time when individuals are particularly vulnerable to societal pressures and body image concerns. Each eating disorder is a complicated and multifaceted condition that requires specialized care.

Anorexia Nervosa

Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image, leading to severe restriction of food intake1. People with anorexia often have an obsession with being thin and extreme dieting, excessive exercise, or other behaviors to avoid weight gain.

A person with anorexia nervosa can drastically lose weight, refuse to maintain a healthy weight, and fixate on calorie counting or food-related rituals. Despite the risks such as malnutrition, fatigue, and weakened immune function, the fear of gaining weight drives the person’s cycle of restrictive behaviors.

Bulimia Nervosa

Bulimia nervosa involves cycles of binge eating followed by compensatory behaviors, or “purging,” to prevent weight gain2. During a binge, the individual can feel “out of control” while eating and consume a large amount of food in a short period of time, followed by intense guilt, shame, or distress. To counteract the binge and these negative feelings, the person purges by self-induced vomiting, excessive laxative use, or extreme exercise. 

Unlike anorexia, people with bulimia may maintain a normal or above-average weight, making the disorder less immediately visible. However, bulimia can lead to serious health complications, including electrolyte imbalances, gastrointestinal problems, dental erosion, and heart issues, making it a dangerous and harmful disorder if left untreated.

Binge Eating Disorder

Binge eating disorder (BED) has recurrent binge episodes, and, unlike bulimia nervosa, individuals do not purge3. During a binge, the person may eat rapidly, eat until uncomfortably full, eat large quantities even when not hungry, and isolate themselves, then feel ashamed or guilty afterward. These intense emotions can lead to a cycle of emotional eating. 

Someone with BED does not take immediate action to counteract the calories consumed, leading to weight gain and health risks like obesity, diabetes, and cardiovascular issues. 

Other Specified Feeding or Eating Disorders (OSFED)

Some eating disorders may not neatly fit into the traditional categories but still have severe health implications. Avoidant/restrictive food intake disorder (ARFID), for example, is when individuals limit food intake due to a lack of interest in eating4 or an aversion to certain textures or tastes, rather than concerns about body image. Orthorexia nervosa, though not officially recognized as an eating disorder, involves an unhealthy obsession with eating foods deemed “pure” or “healthy,”5 which can lead to severe dietary restrictions and malnutrition.

Other specified feeding or eating disorders (OSFED) can also be a diagnostic category for individuals who exhibit significant eating disorder behaviors but do not meet the full criteria6 for anorexia, bulimia, or BED. OSFED can include a wide range of disordered eating patterns that still pose serious health risks, such as night eating syndrome or purging disorder. 

Physical Signs of an Eating Disorder

While weight fluctuation is perfectly normal, staying vigilant to your child’s physical and mental well-being can help you discern if the changes are healthy or warning signs of an eating disorder. 

Noticeable Weight Changes

Restrictive eating behaviors can result in weight loss, as seen in anorexia nervosa and bulimia nervosa, where food intake is drastically reduced or purging prevents weight gain. This weight loss often comes with other red flags, including fatigue and dizziness as the body becomes deprived of essential nutrients.

Conversely, rapid weight gain can indicate BED with frequent episodes of overeating. 

When talking to your child about weight loss or gain, remember that this topic is sensitive and accompanied by a host of negative feelings. Instead of focusing on their weight, you can discuss your concern about their eating habits and its impact on their health.

Physical Health Issues

Outside of weight, unhealthy eating behaviors impact all parts of the body via inadequate nutrition or harmful behaviors like vomiting. Carbohydrates serve as the brain’s main energy source7, so severely restricting food intake causes low energy levels, dizziness, and fatigue8 as well as cognitive impairment and decline.  

Symptoms such as bloating, constipation, or abdominal pain can manifest from irregular eating patterns9, starvation, or the misuse of laxatives.

For women, hormonal imbalances due to extreme weight loss or nutritional deficiency can cause amenorrhea10, or disruptions or complete cessation of their menstrual cycle. In these cases, the body prioritizes essential survival functions over the reproductive system, which has the potential for long-term harm.

Changes in Appearance

Due to a lack of essential nutrients, particularly protein and vitamins, hair and nails become brittle and dry11. Malnutrition and dehydration can also cause the skin to lose its elasticity and moisture, leading to a dry and flaky appearance.

Purging behaviors, such as vomiting, create dental problems as stomach acid erodes tooth enamel12. This can lead to tooth decay, sensitivity, discoloration, and even gum disease. Chronic vomiting can also damage the throat and mouth lining.

Behavioral Signs of an Eating Disorder

Often, someone with an eating disorder will try to hide their unhealthy eating habits. If you suspect that your child has an eating disorder, try to pick up on the subtle behavioral indicators that they may need help.

Obsession with Food and Weight

In an attempt to maintain control over their weight and emotions, they may constantly track every calorie consumed, often to an extreme degree, indicating an unhealthy relationship with food. Chronic dieting or switching between restrictive eating plans disrupt normal eating patterns, contributing to a cycle of weight loss and gain, damaging both physical health and mental stability.

By fixating on their body image, they may have a distorted view of their own size, even when underweight. You may notice frequent body checking (e.g., excessively looking in mirrors, pinching skin). 

Secretive Behavior

Rooted in deep emotional struggles related to body image and self-worth, someone with an eating disorder may isolate themselves and exhibit sneaky behavior around meals. They may stash or hide food in their room, bags, or other secret locations and consume large quantities of food privately. 

The person can lie about their eating habits, claiming to have eaten when they haven’t or significantly downplaying how much they ate. Or they may immediately leave the table after eating to purge. 

Emotional and Psychological Signs

While the most obvious signs of an eating disorder appear physically, the emotional distress behind the changes can sometimes have the most negative impact. 

Mood Swings and Irritability

When the body is fighting to function without proper fuel (food), cognition declines. Malnutrition and restrictive behaviors can affect brain chemistry13, leading to a lower tolerance for life’s ups and downs and causing sadness, frustration, or mood swings. 

Eating disorders like anorexia can lead to structural changes in the brain14 such as loss of gray matter and decreased thickness of the cerebral cortex and the outer layer of the brain. These mutations influence emotional regulation, lending to an overall negative affect.

Anxiety and Depression

It’s no coincidence the rise of anxiety and depression among young adults correlates with the onset of eating disorders15. These conditions provoke more severe disordered eating symptoms and create a complex web of co-occurring conditions necessitating specialized treatment. 

Much like anxiety and depression, someone with an eating disorder tends to have low self-esteem and withdraw from social activities, either due to fear of eating with others or from fatigue. A constant preoccupation with food, weight, and body image also creates emotional exhaustion, exacerbating the symptoms.  

Perfectionism and Control Issues

For some, controlling their eating is a way to process and cope with situations that are out of their control—usually spiraling into unhealthy and restrictive habits. Perfectionism can manifest as strict dietary rules and an extreme exercise regimen to feed the obsession of an ideal body type. And when they fall short of these unattainable standards, the person can experience intense self-criticism and guilt, perpetuating disordered eating patterns.

Eating disorders often coincide with conditions like obsessive compulsive disorder (OCD) and other compulsive disorders as both are driven by intrusive, distressing thoughts16. Someone with these co-occurring conditions may severely restrict their food among other behavioral rituals in an attempt to control their anxieties and thoughts. Each disorder has a unique impact on the brain and body, requiring individualized care.

Impact on Daily Life

Physical, behavioral, and emotional disruptions can blend into a symphony of destructive daily habits, worsening the eating disorder. Over time, this degrades the person’s overall well-being.

Academic Performance

Depriving the brain of proper nutrition leads to poor attention, concentration, and problem solving skills13, therefore decreasing academic performance. Students can then feel overwhelmed and frustrated by their poor performance, contributing to a cycle of restrictive behaviors and underperformance.

Beyond the physical impact of malnutrition, obsessive thoughts and anxieties can further disrupt concentration as they fixate on counting calories, planning meals, or their weight. Mood swings may also make it hard to stay present in academic settings.

Social Withdrawal

People with eating disorders tend to distance themselves from loved ones, avoiding social interactions and family gatherings to hide their food habits. They may feel ashamed of their eating disorder and concerned about judgements from worried friends and family. 

Isolation can only worsen the negative thought patterns involved in an eating disorder as a cycle of rumination grows. If you’re concerned about your child, you can try to do low stress, fun activities with them without mentioning their weight or eating habits to break this habit.

Daily Routine Disruptions

Eating disorders often interfere with healthy sleep17 due to energy and hormonal imbalances, leading to issues such as insomnia and irregular sleep patterns. This lack of sleep and food can contribute to poor concentration, irritability, and more.

Many individuals, particularly those with anorexia nervosa, orthorexia, or bulimia nervosa, compulsively or excessively exercise as a way to control weight or “burn off” calories. This overexercising can become a rigid part of their routine, often prioritized over other aspects of life, including social activities, rest, or work. 

Whether through lost hours of sleep, a preoccupation with exercise, or difficulty completing daily tasks due to fatigue, an eating disorder can take over much of their mental and physical energy.

When to Seek Professional Help

There is no such thing as a “bad” time to ask for help—whether you’re noticing the onset of eating disorder warning signs or the person needs serious medical care, professional treatment and family support can help your young adult not feel alone in their struggles.

Consulting Healthcare Providers

A healthcare professional can offer tailored insights for eating disorders and collaborate with you to create an achievable care plan. 

A pediatrician or general practitioner can be a good first point of contact. They can perform an initial physical assessment to evaluate the individual’s overall health, checking for signs of malnutrition, weight loss, or other physical symptoms associated with eating disorders (heart irregularities, electrolyte imbalances, or gastrointestinal issues). After these initial meetings, the practitioner can refer you to a specialist.

You may employ a diverse range of professionals to treat the eating disorder and any co-occurring conditions. Eating disorders are often linked to deep-seated emotional and psychological issues such as anxiety, so a psychologist can help address the mental and emotional aspects of each disorder through therapy. A registered dietitian specializing in eating disorders plays a crucial role in nutritional rehabilitation, as well. They can help restore a healthy relationship with food by creating personalized meal plans that support both physical and emotional recovery.

When necessary, eating disorder treatment centers offer intensive, multidisciplinary care based on the client’s needs. Some people with eating disorders may need a more intensive level of care to help monitor and manage their symptoms. When talking to your doctor, you can figure out which level of care best fits your needs:

  • Outpatient (OP): You’ll meet 1-2x per week with your provider and others in treatment.
  • Intensive outpatient (IOP): You’ll meet 3-5x per week for several hours at a time for more intensive care.
  • Partial hospitalization (PHP): You’ll meet 5-7 times a week for a full day.
  • Residential: You’ll live in a rehab for 28+ days and engage in treatment with a comprehensive staff and a community of peers.
  • Inpatient: You’ll live in a treatment center or hospital-like setting and have 24/7 monitoring.

Supporting a Young Adult with an Eating Disorder

Your child might be going through a confusing and complex time, and your support can set them on the path to a healthy relationship with their mind and body.

Open Communication

When talking to your young adult, it’s important that they feel safe in their space and in the conversation to be honest and vulnerable. Try to approach them with a non-judgemental tone, and calmly voice your concerns. You can say phrases like “I’ve noticed that you seem to be struggling with eating lately, and I’m concerned about your health.” This approach focuses on your feelings and observations rather than making the person feel judged or blamed.

Avoid talking about their physical appearance. Comments about their size, even if intended to be positive or neutral, can reinforce the focus on body image and exacerbate shame and guilt. 

Change takes time, and they may not be ready to acknowledge their problem immediately. Be patient and try to avoid threatening language, as this may push them away or increase their resistance to seeking help.

Let them know that you are there for them, regardless of their response to your concerns. Make it clear that your support is unwavering, and they can talk to you whenever they feel ready.

Creating a Supportive Environment

Your home can be a safe space where your young adult feels encouraged, understood, and supported in their journey toward health and well-being. In addition to having filling, nutrient dense foods, you can create a comfortable environment that encourages discussing emotions, struggles, and progress without fear of judgment.

You can be a positive role model for your child. Try to avoid dieting and weight talk, as this can reinforce disordered thinking. Shift the focus from appearance and weight to overall health and well-being, as this helps reduce the pressure they may feel to meet certain body image standards.

Recovery from an eating disorder is often a long and complex process, with setbacks and challenges along the way. Be patient and compassionate as they navigate their journey.

Resources for Further Help

These resources provide various levels of support, from immediate crisis intervention to long-term recovery assistance, and are available to individuals, families, and caregivers.

Hotlines:

  1. National Eating Disorders Association (NEDA) Helpline

Phone: 1-800-931-2237

Text: Text “NEDA” to 741741 for 24/7 crisis support

  1. Crisis Text Line

Text: Text “HELLO” to 741741

  1. The Trevor Project (for LGBTQ+ youth)

Phone: 1-866-488-7386

Text: Text “START” to 678678

Websites:

  1. National Eating Disorders Association (NEDA): Offers comprehensive resources, including a screening tool, information on treatment options, and support forums.
  2. National Association of Anorexia Nervosa and Associated Disorders (ANAD): Offers free, peer-led support groups, mentoring programs, and educational resources for individuals and families affected by eating disorders.
  3. Eating Disorder Hope: Provides resources on eating disorder treatment, recovery tools, and educational information for individuals and families.
  4. BEAT (United Kingdom): Offers support, resources, and a helpline for individuals with eating disorders in the UK.

Support Groups:

  1. ANAD (National Association of Anorexia Nervosa and Associated Disorders)
  2. Eating Disorders Anonymous (EDA)
  3. Overeaters Anonymous (OA)
  4. The Body Positive
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What Happens in Family Therapy?

Family therapy for addiction or mental health conditions may come as an unexpected aspect of treatment. If you’re not the one getting treatment, why are you getting involved? Many families initially wonder the same thing.

Many family members also want to, and would, do anything to help their loved one get better. If that means going to family therapy, they’ll do it in a heartbeat, even if it’s unexpected. Others may feel more skeptical and resistant, depending on the nature of their family dynamics and their mental health literacy. 

However, each group will likely have the same question: what’s family therapy like? What happens? 

We’ll help you learn more about it and what to expect in this article. You can also explore more about family therapy and group work by listening to our recent podcast episode with Dr. Claudia Black.

What Is Family Therapy?

Some family members first assume family therapy means hearing everything they did wrong and getting blamed for their loved ones predicament. That’s false. If behaviors from family did contribute to the patient’s condition, that will likely come up, but in a respectful, compassionate way. Family therapy isn’t a trick for the patient and their therapist to gang up on family members—it’s meant to restore loving relationships and heal their family dynamics.

The therapist, psychologist, or counselor who leads family therapy strives to help both the patient and their loved one verbalize and work through problems with respect and love, not judgment or blame. Through open communication, patients and their families can resolve issues, forgive, and learn how to modify potentially harmful behaviors. 

Many treatment centers strongly suggest and offer family therapy as part of their core treatment. That’s because family therapy has the power to heal relationships, improve the support system of the person in treatment, and give the whole family unit hope in recovery. You can also attend family therapy as a stand-alone service, without your loved one being in a residential or outpatient program.

Goals and Reasons for Family Therapy

The ultimate goal of family therapy is to help the person in treatment get better. Since family is often an extension of ourselves, their involvement in this healing is often crucial. 

And, after patients leave treatment, the closest and most impactful support system they return to is often their family. Discussing concerns, past issues, and resolving conflict in family therapy can create a stronger support system for when they get back. 

Another crucial reason for family therapy is to give loved ones the chance to heal. They often have their own recovery journeys to walk, even if they weren’t the one struggling with an addiction or a mental health concern. For example, some family members fall into codependency as a way to have some grasp at control over their loved one’s condition. Family therapy can help you recognize your own recovery needs and process the experience of your loved one’s condition without guilt, anger, or self-responsibility.

What Family Therapy Looks Like: First and Continuing Sessions

Family therapy typically begins once your loved one has stabilized, expressed approval for family therapy, and has shown initial progress in their treatment. This means your sessions could start anywhere from a couple weeks to 1+ months after they admit into treatment. It’ll depend on their preferences and progress. Once they’re ready and their treatment team determines it beneficial, you’ll come in for your first session.

Before that, you’ll likely meet with the family therapist to go over expectations, ask questions, and become more comfortable in the space. This might happen as soon as your loved one admits into treatment or just before your first official session.  

First Session

Your very first family therapy session will likely include these key parts:

  1. Setting expectations together.
  2. Agreeing (and even signing a written contract) on how you will conduct yourself and treat others in your session. For example, you may all sign a contract promising to listen without interrupting or to not raise your voices.
  3. Outlining what your goals are for family therapy and how the therapist will know if they’re being met.
  4. Defining a direction and plan for your future sessions.
  5. If time allows, diving into how everyone’s feeling and any conversations they’d like to have now, or something they’d like to understand about their loved one in treatment.

You’ll likely sit in a small, private room—probably the therapist’s office, or the designated family therapy room if the treatment center has one. Your sessions will stay confidential and what’s shared won’t leave the room. Before you leave, your therapist may check in with how you’re all feeling and how you think the session went.

Continuing Sessions

Treatment centers vary in how often they provide family therapy. Some will schedule it once a week or once every couple weeks; others will designate 3-5 consecutive days for loved ones to engage in education and family therapy. This format is called a family week, or family program. Family programs often split their focus between 1) education and multi-family support groups and 2) family therapy with the patient and their loved ones. 

If your loved one isn’t participating in a residential or outpatient treatment program and instead attending family therapy as a stand-alone treatment, your sessions may be more regular and adaptable to your schedules. For example, you could request weekly or bi-weekly appointments. 

In continuing sessions, you’ll build off the goals and outlines set in your first session. They may also flow more organically, addressing issues as they arise or as they come to mind. For example, you may talk about something that happened recently or, during your session, your discussions may remind you of a past event you want to go over.

You’ll check in continuously with others and the therapist to ensure you’re meeting the goals set in the beginning, and that you’re finding the therapy beneficial. If you have changes or suggestions in mind, you may discuss these at the very beginning or end of the session.

Who Can Go to Family Therapy?

You don’t need to share DNA to go to family therapy. Chosen family can come too—anyone who supports the patient and that they trust. When asking the patient about family therapy, the therapist will see who they’d like included or excluded. Here are just some of the people that can come to family therapy:

  • Parents
  • Siblings
  • Friends
  • Cousins
  • Step-siblings
  • Step-parents
  • Coworkers
  • Children
  • Foster parents
  • Foster children
  • Grandparents
  • Grandchildren
  • Honorary and/or chosen family members

Is Family Therapy Required?

No. The patient may not want to engage in family therapy, or family members may not want to participate. No one is forced to, though family therapy is often strongly recommended.

For example, patients who were abused and traumatized by their families would not find it appropriate to bring their family members into treatment. Their treatment providers would agree. In these cases, and any other time the patient doesn’t want their family involved, family therapy will not be required or pursued.

Family Therapy vs. Family Education

Therapy and education for families aren’t the same things. They may overlap in some ways, but they have different goals and purposes. 

Family Therapy

Family therapy aims to heal relationships and reconnect loved ones, strengthening their bond and support system. They learn how to communicate better and process disagreements with respect and love. 

Family Education

Family education focuses on teaching loved ones about addiction and mental health conditions. It covers how conditions develop, contributing factors, and the recovery process. Families learn the biological background of addiction and mental health conditions, helping them see behavioral health conditions don’t arise from a lack of willpower. 

If a treatment center offers a family program, they may include workshops and presentations from a variety of professionals or those with lived experience. These sessions are often more interactive between the educator and other family members. 

Family therapy will likely touch on these aspects as questions arise or to explain behaviors of the patient. But the main focus of family therapy isn’t education.

Resources for Family Healing and Education

Family members have many resources and support available, whether their loved one is in treatment or not. 

Online Resources and Groups

Here’s a few online resources to access support:

Call Lines

And here are some numbers you can call for support or crisis care:

Books

These books offer education and support for family members of someone with behavioral health concerns:

  • Undaunted Hope by Dr. Claudia Black, “Stories of Healing from Trauma, Depression, and Addictions”
  • Unspoken Legacy by Dr. Claudia Black, “A far-ranging examination of how the effects of addiction and trauma in the family can reverberate for generations”
  • Codependent No More by Melody Beattie, “How To Stop Controlling Others And Start Caring For Yourself”
  • Addict in The Family by Beverly Conyers, “Rather than providing simple solutions or definitive answers to every question, Conyers’ careful research and warm writing offer education and support from those who “have been where you are” and the healing, isolation-breaking power of shared experiences.”

Family members can also attend individual therapy to discuss their experiences, process trauma, and develop coping skills in a 1-1 setting. These private sessions offer greater personalization and may be helpful for family members who don’t feel comfortable sharing in a family setting.

Ultimately, family therapy in rehab benefits both the person in treatment and the ones who love them. It’s often a critical aspect of recovery, and one you can support simply by attending and participating in sessions. 
To learn more about family therapy and its importance in recovery, you can listen to our recent podcast episode with expert Dr. Claudia Black!

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What Is Self-Harm and Why Is It Done?

*Trigger warning: This article includes details and discussions of self-harm.*

Self-harm is self-inflicted and harmful behavior done without the intent of death. Examples include cutting, burning, and bruising the skin. Picking at wounds and pulling hair may also be self-harm. 

Self-harm is often used to manage strong emotional pain, express intense emotions, and escape numbness. It’s not typically done to initiate suicide, but someone who self-harms is more likely to die by suicide1.

Understanding Self-Harm

Self-harm can be confusing and difficult to understand, whether you or a loved one do it. It can seem illogical—causing pain to escape the pain. Knowing the reasons behind it can help you support a loved one or learn more about how treatment can help you. 

Definitions and Forms of Self-Harm

Self-harm is defined as inflicting physical harm to yourself on purpose1. It’s more common in teens and women. Some people will only do it a few times; others may struggle to stop once they start. Media representation (TV shows or movies) commonly portrays self-harm as cutting the skin, but it actually takes many forms. Here’s some examples:

  • Burning the skin with matches, a lighter, or another source of fire. Chemical substances can also cause burns.
  • Punching or hitting to cause bruising or broken bones.
  • Scratching, piercing or cutting the skin with razors and other sharp objects.
  • Pulling out hair. 
  • Ingesting toxic substances, like drugs, high doses of medications, and chemical cleaners to inflict harm.
  • Any self-inflicted behavior intended to cause physical harm. 

Though self-harm can cause injuries that need medical treatment (and even life-threatening injuries), it differs from suicide attempts in that the person does not intend to die. Suicide attempts are often intended to cause death, while self-harm is used as a coping tool. 

For example, someone may cut deeper than intended, requiring immediate medical care for a wound that could have killed them. This differs from a suicide attempt because they did not make that cut with the intention or hope to die.

The Psychology Behind Self-Harm

Self-harm commonly occurs as a way to cope with overwhelming emotions2, including anger, grief, and numbness. It’s also frequently used as a tool for self-punishment. Some people self-harm to gain attention and help from others (also called a cry for help). Others may self-harm for all 3 reasons. In any case, they need and deserve help.

Self-harm also serves as an emotional outlet2 and provides a sense of control. It can provide a more continuous distraction from intense emotional pain, as the inflictor often needs to bandage and care for their recurring wounds, which also offers a sense of control and can provide nurturing not otherwise received. 

Though it seems counterintuitive, self-harm can release endorphins3 as the body responds to pain. This can spike your adrenaline and improve your mood, which offers an escape from numbness and a break in intensely low mood. But it’s only temporary. 

Addressing The Stigma Around Self-Harm

The stigma surrounding self-harm claims it’s a sign of weakness and attention-seeking, which can cause people to feel ashamed and unwilling to ask for help. Cuts, scars, and bruises also don’t align with most beauty standards, which can cause further shame. 

Shame can cause a cycle of self-harming, as continuous harm reinstates shame, which can cause ongoing self-harm. Hiding injuries and crafting cover-up stories can also fuel shame and cause even greater stress, which can feed the cycle.

To break through the stigma, you can practice empathy and compassion—towards yourself and others. Educate yourself on self-harm to better understand its causes; this can help you approach conversations about getting help with greater confidence and compassion. You can also advocate for yourself or others by correcting common misconceptions about self-harm. Discuss it as a symptom of overwhelming pain, not an inability to cope with it. If people don’t understand and are not willing to try, you can leave them out of your journey.

Factors Contributing to Self-Harm

Self-harm isn’t usually the first way people try to manage strong emotions and cope with pain. People may even seek treatment but ultimately not get the relief they need. And since self-harm can offer momentary relief or distraction, stopping may sound pointless and daunting—why quit something that works? Fear can then contribute to repeated self-harm: fear of giving up potentially the only coping tool you have.

Treating underlying conditions, beginning treatment as soon as possible, and catching the signs early can prevent self-harm and the fear of letting it go. 

Emotional Distress and Mental Health Disorders

Conditions like depression, anxiety, trauma, and borderline personality disorder can contribute to and cause self-harm as a symptom. Here’s why:

Pre-existing mental health conditions can largely contribute to and cause self-harm, but so can your environment, the people around you, and the media you take in.

Environmental and Social Influences

Bullying, family dynamics, and peer pressure can lead to self-harm. Media may also create curiosity around self-harm, which could lead to experimentation, and then a habit that becomes hard to break. Some TV shows and movies geared toward teens vividly show (and often romanticize) self-harm. This can prompt teens to replicate the behavior or see it as the only way to deal with negative emotions. 

Similarly, and especially for teens in middle or high school, being in a peer environment where self-harm is normalized and romanticized can lead to experimentation. Teens may self-harm to fit in, to relate to their friends, or to gain sympathy from classmates (which is often a genuine cry for help). Bullying can cause self-harm as a way to cope with emotional pain and as a form of self-punishment.

Signs and Symptoms of Self-Harm

If you’re worried about a loved one or a friend self-harming, you can keep a few warning signs in mind as you note their physical and emotional changes. If you do notice any signs, try to keep your questions gentle and centered on concern. Make sure your emotional state invites vulnerability. Though distressing, self-harm and the causes behind it are treatable.

Warning Signs of Self-Harm

If you’re a parent, a teacher, a sibling, or a concerned friend, you can keep a lookout for the following signs of self-harm in someone you care about.

  1. Suddenly spending time alone, usually in a shut or locked room. This could be their bedroom, bathroom, or another area of your house. 
  2. Unexplained injuries, cuts, or burns.
  3. Taking or hoarding first-aid supplies. 
  4. Finding blood on their clothes, sheets, and used first-aid supplies (like gauze or bandages).
  5. Wearing full-coverage clothes and seeming particular about not revealing their arms, legs, stomach, or other areas they’re normally okay with showing. This may be especially noticeable in the summertime (like wearing a hoodie in hot weather). 
  6. Items like razor blades, knives, lighters, or other self-harm tools going missing in your home. You may find them tucked away into a hiding place in their room or bathroom. School lockers can also hide supplies.
  7. Behavioral changes like seeming down, tearful, and hopeless.
  8. Acting withdrawn and unfocused in social and family situations.
  9. Flinching or seeming in pain when certain parts of their body are bumped or touched. 

Starting The Conversation and Next Steps

Remember: noticing these signs may mean your loved one needs help, but with that help, they’ll learn to heal. Keep that in mind as you bring your concerns to light. You can start with gentle questions about their behaviors and items you may have noticed go missing, like self-harm tools and first-aid supplies. You may ask something like,

“I’ve noticed you seem very down and that you spend a lot of time in your room. I’ve also found band-aid wrappers hidden in the trash. You aren’t in trouble if you say yes, but I want to know if you are hurting yourself.”

If your loved one answers yes, they have been hurting themselves, you may need to see the wounds to make sure they don’t need medical attention. If they’re unwilling to show you but agree they need treatment, you can offer to take them to urgent care or the emergency room. 

If they don’t need immediate medical treatment, you can discuss getting help in other ways. Acknowledge and validate their pain, avoid judgment, and encourage them with the vast array of treatments available to people who self-harm (like therapy, peer support groups, virtual care, outpatient care, and even residential rehabs). When they’re ready, you can help them take the first steps into treatment.

Depending on your relationship, you may be able to control their environment in the meantime. If you’re the parent of a child who self-harms, for example, you may gather and hide all your knives, razors, lighters, and other self-harming tools as a preventive measure. You can also set rules about alone time (like limiting it to an hour a day, keeping their door open, or requiring frequent check-ins) to keep a closer eye on them and their behaviors. 

In some cases, alone time may not be safe in any sense. Consider going to the emergency room to get admitted to a psychiatric hospital, where your loved one receives continuous monitoring in a safe environment. 

Support and Treatment Options

Many forms of treatment and therapy can help you or your loved one heal from self-harm and its underlying causes. 

Professional Help and Therapies

Behavioral therapies address the unhealthy or inaccurate thoughts and emotions leading to behaviors like self-harm. Examples include:

  • Cognitive behavioral therapy (CBT), which addresses and challenges the emotions causing self-harm, like anger, shame, and grief. Using CBT, a therapist will help their patient determine the validity of their thoughts, prevent spiraling, and reshape their thought patterns. 
  • Dialectical behavioral therapy (DBT) helps manage intense emotions and teaches tools for coping and resilience. Rather than challenging or changing thoughts, DBT helps patients accept the thought and manage how they respond to it. For example, someone experiencing intense emotions may respond with a coping tool they learned in therapy, not with self-harm.
  • Problem-Solving Therapy8 uses skill and attitude training to see problems as solvable, promote rationalization, and reduce impulsivity. This therapy can be especially helpful for adolescents with depression, suicidality, and self-harming behaviors.

Self-Care Strategies and Coping Mechanisms

Alongside professional help, you can also practice self-care strategies and at-home coping mechanisms for self-harm. Here are a few of those strategies and practices you can try:

  • The ice-cube method: Hold an ice cube in your hand (or your mouth) when emotions become intense and overwhelming. The cold ice cube serves as a neurological distraction9 and can give you mental clarity. Relief and clearer thinking can then prevent self-harm.
  • Exercise: Fitness can serve as a distraction8 and an action. Let out emotions through weight-lifting, boxing, running, or taking a walk. 
  • Drawing/doodling: Making shapes, lines, or drawings can release emotions and give a sense of accomplishment. You can make angry slashes with your pen over the page, slowly color in shapes, or draw lines over and over. You can even add words and combine journaling with doodling.
  • Busy your hands: Whether you have to sit on them, play with a fidget toy, or simply run them over textured fabric, keeping your hands busy can help distract you until the urge to self-harm fades.
  • Tear something apart: Rip up paper, food, or something you’re okay with tearing. This serves as a distraction and an emotional outlet, which can prevent self-harm by satiating the need to do so.
  • Tell someone: Let a trusted friend or family member know when you feel the urge to self-harm. They can keep you company (even virtually) and keep you accountable by checking in. You don’t even have to specifically mention self-harm, just let them know you need support.
  • Remove yourself from your environment: Physically step away from your current environment and the potential self-harm tools within it. Ideally, you could go on a walk to get outside and separate from your home or other living environment. If you can’t, move to another room or seek company with a family member.
  • Make your environment as safe as you can: As you feel able, remove, destroy, or throw away self-harm tools. Give your stash to someone to get rid of. Tell a trusted family member to hide or lock up other self-harm tools in your home. These could include knives, shaving razors, and other sharp tools.
  • Be kind to yourself: The recovery journey for self-harm isn’t a straight line. You may go one, two, even 10+ days (or months) without self-harming, but end up doing it again. That’s okay. Don’t see it as failing, rather as a bump in your road to recovery—and you’re still on the road. Remind yourself of that often.

Self-care strategies can reduce your overall stress and promote wellness day-to-day. Here are a few techniques you can try:

  1. Set aside time to relax and do something you enjoy. Schedule yourself an hour each night (or however long you can) to read, meditate, craft, or call a friend.
  2. Stay hydrated and incorporate more whole foods into your diet to fuel and nourish your body.
  3. Get outside to soak in sunlight and Vitamin D—try walking through your neighborhood, taking your dog to a park, or sitting on your balcony.
  4. Prioritize good sleep. Follow a nighttime routine and try to wake up at the same time each morning to even out your sleep cycle.
  5. Move your body through exercise, yoga, playing with a pet, or taking walks. You could also take up new sports or hobbies like hiking, swimming, and rollerblading.

Prevention and Building Resilience

Changing the narrative around self-harm and offering education can prevent teens and adults from using it as a coping tool. To combat the glamorization of self-harm, schools, peers, and teachers can instead educate vulnerable teens on the realities of self-harm and what it means for their health. 

Knowing your treatment options can also serve as a prevention tool, as someone may not feel drawn to self-harm if other sources of relief are readily available (like therapy, support groups, or crisis services). The earlier schools and other organizations can make these resources available, the better.

Find Help and Hope

Understanding self-harm is the first step towards offering the necessary support and compassion to those in need. It’s about looking beyond the behavior and recognizing the underlying pain, offering a helping hand in their journey toward healing. Remember, with the right approach and resources, recovery is not just a possibility but a reality. 

If you or someone you know is struggling with self-harm, seek help from a professional to navigate the path to recovery together. You can also find rehabs with self-harm treatment by browsing Recovery.com.