Category: Blog

Posted on

The Complex Relationship Between Addiction and Depression

Depression can be either a cause or symptom of addiction. Some people try to self-medicate their symptoms, which leads to addiction. Others get depressed because of their substance use. But there’s a reason these 2 conditions appear together so often. If you have signs of both, you might need specialized treatment at a rehab for depression and addiction.

Common Causes of Depression and Addiction

Depression and addiction often occur at the same time. And in fact, having depression doubles your chance of developing addiction. But the link goes both ways. Taking drugs can also cause depressive symptoms.

What’s more, these 2 diagnoses have overlapping causes. The same factors that put you at risk for depression can also make you vulnerable to drug abuse:

Addiction and depression cause similar brain activity. And acute symptoms activate the same neural pathways over and over again. If you have depression, that happens during a depressive episode. With addiction, it happens when you take drugs. Both conditions make those pathways more and more sensitive over time. So without proper treatment, either one will continue getting worse. And, you’ll become even more vulnerable to the other.

Getting the Right Diagnosis

To get the right type of treatment, you first need an accurate diagnosis. And that can be more complex than it sounds. For example, if your depression is the result of drug use, your recovery will need to include addiction treatment.

Depression can co-occur with a wide variety of health issues. These can include mental health conditions, like anxiety, and even physical ones. For example, diabetes is linked to depression. And sometimes it’s just a symptom of a more complex diagnosis.

Depression as a Symptom of Bipolar Disorder

Bipolar disorder is a mood disorder that occurs in over 50% of people with addiction. People with this condition experience periods of depression interspersed with mania. And because it’s a primary symptom, bipolar is often misdiagnosed as major depression.

If you get the wrong diagnosis, it can interfere with your recovery. And it doesn’t just delay your progress—it can also make your symptoms worse.  For a person with bipolar, antidepressants can trigger manic episodes. They can also cause intense swings between mania and depression, called rapid cycling.

Addiction can exacerbate your mood disorder symptoms. That’s true whether you have bipolar disorder, major depression, or something else. If you’re healing from both addiction and any other mental health issue, you might consider going to rehab for co-occurring disorders.

Treatments for Depression and Addiction

Depression and addiction are receptive to similar types of treatment. That means you can heal from both simultaneously. You might even find that focusing on one condition helps you heal from the other. For example, data shows that most depressive symptoms resolve during addiction treatment. But that’s not true for everyone.

When you enter recovery, you might not know which condition came first. But you can work with your care team to answer that question. If your depressive symptoms fade after detox, you might just focus on healing from addiction. But if you do have clinical depression, there are several ways to approach treatment.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) teaches patients to cope with difficult thoughts. You’ll learn practical skills that help you live with and regulate even the most intense emotions.

CBT treats depression and addiction by helping people build self-confidence. And data shows that it has lasting effects, supporting your long-term recovery. You can also combine this therapy with other types of treatment, like medication.

Medication for Depression

Depending on your physical health, your care team may recommend prescribed medication. For example, it’s common to treat depression with selective serotonin reuptake inhibitors (SSRIs), like Prozac or Zoloft. Preliminary data shows that SSRIs may also support addiction recovery. Specifically, they might help people quit smoking or heal from sex addiction.

SSRIs typically take full effect after 6 weeks. And while they’re a common treatment for depression, they aren’t right for everyone. You may need to try a few medications before you find the right fit. Or, if you have treatment-resistant depression, you might need to take a different approach.

Alternative Treatments

If traditional therapy and medication aren’t working for you, there are many other ways to treat depression. Some of these methods are experimental, while others are highly researched but less well known.

These alternative treatments aren’t replacements for traditional medical care. But you can combine them with other therapies, or even attend a holistic rehab program. There’s no right or wrong way to plan your recovery—just the way that works best for you.

Clearing the Clouds

Depression and addiction have so much in common, it can be hard to tell which one has the greater impact on your life. But there’s a silver lining to their overlapping symptoms. With the right treatment, recovery can be straightforward. In the long term, you can use the same coping skills to manage any ongoing symptoms. But most importantly, healing means learning about the complex relationship between these conditions. And doing that will teach you more and more about yourself.

Browse rehab centers that treat depression to learn about their amenities, photos, and reviews.

Reviewed by Rajnandini Rathod

Posted on

Breaking the Cycle: How to Heal From Addiction and Anxiety

Anxiety can be more than a feeling. It also affects your behavior. And if it’s getting in the way of your daily life, it makes sense that you’d look for ways to cope. But not all coping strategies are healthy. Some—like drug use—can even make your anxiety worse. In rehab for anxiety, you can learn safer, more sustainable skills.

Recognizing Anxiety

Anxiety disorders ((What are the five major types of anxiety disorders? [Text]. 2013, February 9. HHS.Gov. https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html)) look different for different people. They can even be invisible to others. But even for high achievers, anxiety can get in the way of important goals. If anxiety is interfering with your daily life, you may have one of these diagnoses:

Everyone feels stressed from time to time. But if your anxiety interferes with the rest of your life, you might have one of these diagnoses. And while it’s normal to search for ways to manage these feelings, not all coping mechanisms are healthy.

The Connection Between Anxiety and Drug Addiction

Anxiety and addiction ((Smith, J. P., & Book, S. W. (2008). Anxiety and substance use disorders: A review. The Psychiatric Times, 25(10), 19–23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/)) are 2 of the most common diagnoses in the U.S. And they often occur together. Some people develop addiction in an attempt to self-medicate anxiety. Others feel anxiety about their addiction. Whichever comes first, one thing is clear: anxiety and addiction are a volatile combination. ((Nguyen, A., Mirbaba, M., Khaleghi, F., & Tsuang, J. (2017). Current treatment options for co-morbid anxiety and alcohol use disorders: A review. Journal of Addictive Behaviors and Therapy, 1(1), 0–0. https://www.primescholars.com/abstract/current-treatment-options-for-comorbid-anxiety-and-alcohol-use-disorders-a-review-106758.html))

What’s more, each of these conditions can make the other one worse. And that’s true even if a drug helps with your short-term symptoms. For example, benzodiazepines are commonly prescribed for anxiety. But some benzos, like Xanax, have a rebound effect. ((Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A review of alprazolam use, misuse, and withdrawal. Journal of Addiction Medicine, 12(1), 4–10. https://doi.org/10.1097/ADM.0000000000000350)) They’re hugely effective at relieving the symptoms of panic attacks. But, if you reduce your dosage, your anxiety might spike. This can easily lead to relapse.

The complex relationship between addiction and anxiety has an impact on treatment. ((Brady, K. T., Haynes, L. F., Hartwell, K. J., & Killeen, T. K. (2013). Substance use disorders and anxiety: A treatment challenge for social workers. Social Work in Public Health, 28(0), 407–423. https://doi.org/10.1080/19371918.2013.774675)) Specifically, it can be hard to treat underlying anxiety while you’re actively taking drugs. When you’re ready to heal from either of these conditions, you might benefit from treatment for co-occurring disorders.

Treating Both Addiction and Anxiety

There’s a silver lining here. Because these issues are so common, experts have sought out many effective therapies. In residential rehab, you might try one of these, or combine them as part of a comprehensive care plan.

Cognitive Behavioral Therapy

Data shows that cognitive behavioral therapy (CBT) can effectively treat anxiety and co-occurring addiction. ((Alamdarloo, G. H., Khorasani, S. M., Najafi, M., et al. (2019). The effect of cognitive-behavioral therapy on depression, anxiety, and stress levels in iranian males with addiction. SAGE Open, 9(1), 215824401882446. https://doi.org/10.1177/2158244018824466)) This type of talk therapy helps you recognize unhealthy thought patterns. When you understand the reason behind your own behaviors, you can learn to respond in a healthier way.

Your therapist will act as a guide, teaching you practical coping strategies. As you incorporate those skills into your daily life, you’ll learn to regulate your emotions. This healthy behavior can make it easier to work through anxiety without taking drugs.

Yoga

There’s more to yoga than physical exercise. It also teaches mindfulness, breathwork, and emotional endurance. It can even give you a sense of community. For these reasons and more, research shows that yoga reduces anxiety. ((Kuppili, P. P., Parmar, A., Gupta, A., & Balhara, Y. P. S. (2018). Role of yoga in management of substance-use disorders: A narrative review. Journal of Neurosciences in Rural Practice, 9(1), 117–122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/))

This is part of why yoga is often used in addiction treatment. Specifically, this mind-body practice can reduce drug cravings, helping you kick-start recovery. And over time, it can help you reconnect with yourself in an even deeper way.

Biofeedback

Biofeedback uses sensors to track your physical responses ((Banerjee, S., & Argáez, C. (2017). Neurofeedback and biofeedback for mood and anxiety disorders: A review of clinical effectiveness and guidelines. Canadian Agency for Drugs and Technologies in Health. https://www.ncbi.nlm.nih.gov/books/NBK531603/)) to certain stimuli. For example, you might wear a heart rate monitor during a therapy session. Then, with a clinician’s help, you’ll review the data it collected. This helps patients understand their own reactions to stress.

This treatment gives you valuable information about how your body reacts to certain emotions. You can then use that data to change your physiological response using different relaxation techniques. The goal is to empower you to make different choices—ones that will support your long-term health. As a result, biofeedback reduces both anxiety and drug cravings. ((Khatami, M., Woody, G., O’Brien, C., & Mintz, J. (1982). Biofeedback treatment of narcotic addiction: A double-blind study. Drug and Alcohol Dependence, 9(2), 111–117. https://doi.org/10.1016/0376-8716(82)90056-4))

Moving Forward, on Your Own Terms

Often, anxiety is the fear of things you can’t control. Some of those things—like the weather—will always be out of reach. That’s okay. In recovery, you can learn to accept your emotions just as they are. And by doing that, you can take back control of the best parts of your life.

Browse a list of anxiety treatment centers to learn about their housing, treatment options, insurance, and more.

Reviewed by Rajnandini Rathod

Posted on

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

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

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

Immediate Help

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

Recognizing Abuse

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

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

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

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

Violence Against Men

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

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

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

Abuse in LGBTQ+ Relationships

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

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

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

Abuse and Addiction

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

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

Trauma Bonding

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

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

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

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

Long-Term Recovery From Abuse

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

Trauma-Informed Care

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

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

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

Cognitive Behavioral Therapy

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

Eye Movement Desensitization and Reprocessing

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

Cognitive Processing Therapy

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

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

Find Yourself Through Recovery

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

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

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

Posted on

Exploring the Link Between ADHD and Addiction

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

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

The Brain Chemistry of Addiction and ADHD

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

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

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

The Biology of ADHD

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

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

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

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

Drug use falls neatly into this category.

Dopamine and Addiction

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

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

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

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

Treatment for ADHD and Addiction

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

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

Cognitive Behavioral Therapy

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

Integrated Cognitive Behavioral Therapy

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

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

Medication for ADHD

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

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

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

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

Getting an Accurate Diagnosis

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

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

ADHD in Teens

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

Women With ADHD

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

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

Differentiating Between ADHD and Anxiety

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

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

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

ADHD May Be a Risk Factor for Depression

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

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

Post-traumatic Stress Disorder

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

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

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

Many Roads to Recovery

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

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

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

Find Balance in Treatment for ADHD and Addiction

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

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

Posted on

Holistic Recovery From Eating Disorders

Eating disorders can be isolating. And that’s hard enough on a social level, if you’re skipping group activities that include shared meals. But it’s more than social. These conditions can also make you feel disconnected from yourself.

If that’s your experience, holistic treatment for eating disorders might be a good fit. This approach invites you to reconnect your mind and body. Some therapies take it a step further, teaching you healthy ways of relating to the world. Over time, you can learn to ground yourself in your own needs and values. And from that foundation, you can make empowered decisions about your recovery process.

What Is Holistic Treatment?

Holistic treatment doesn’t just treat your symptoms. Instead, it focuses on you as a whole person, with complex recovery goals. This approach is rooted in Eastern philosophies. And while it’s not a replacement for evidence-based therapies, holistic care has many unique advantages.

By definition, this type of treatment is not one-size-fits-all. However, many holistic rehab programs share certain ideals. For example, they may encourage mindfulness as a treatment for eating disorders.1

Why Mindfulness Matters

Here’s the secret about mindfulness: anyone can do it. You can practice mindful meditation, or you can be mindful while you’re washing the dishes. And with enough practice, it can become a way of life.

When you act mindfully,2 you pay attention to your own experience, and to the world around you. You might notice tension in your shoulders, or the sound of the washing machine, or your sense of anxiety about catching the train. By cultivating this greater awareness, you can learn to regulate your feelings. And emotion regulation is a big part of healing from an eating disorder.

Mindful Recovery From Eating Disorders

Eating disorders can make it feel like your body and mind are out of sync. You might find yourself ruminating about your eating habits,3 so focused on what you think of your body that you forget how you feel. Those thoughts can manifest as unhealthy eating behaviors, regardless of your physical needs. In fact, eating disorders can make it hard to recognize natural cues like hunger and fullness.4

Mindfulness increases body awareness,5 addressing this disconnect. When you act mindfully you bring your body and mind back together, meeting yourself in the present moment. Many people find this practice grounding, comforting, and even empowering. There are several specific treatments that promote mindful, holistic healing.

Types of Holistic Recovery

Holistic rehab honors the fact that you’re a unique person, with a unique definition of wellness. While mindfulness is a big part of many holistic treatments, it’s not always central to recovery. Depending on your exact needs, your provider may recommend a combination of several types of therapy.

Yoga

Doing yoga in rehab helps patients build both physical and emotional strength. Certain poses may be hard at first, and it takes willpower to practice them. Over time, as you get better at it, you might also develop more confidence. And because yoga asks you to be present in the moment, you’ll also practice self-acceptance. This empowers you to observe and care for your body just as it is, instead of passing judgment.

Data shows that yoga can improve your body image6 and overall sense of well-being. Unlike some forms of exercise, the goal isn’t to look or even feel a certain way. Instead, it invites you to exist safely in your own body. For people with eating disorders, that can be transformative.

If you’re new to yoga, it’s important to learn from an expert. But once you understand the basics, you can practice almost anywhere, at any point during recovery. While you’re in treatment, some providers combine yoga and eating disorder education.7 And when you leave rehab, you can easily incorporate it into your plan for aftercare. This healthy coping skill can help you bridge the gap between different stages of healing.

Nutrition

Good nutrition is a vital part of eating disorder recovery. When you first enter treatment, you might need to replenish certain vitamins and minerals. In that case, your care team may personalize your meal plan, or even provide medical treatment. But there’s more to nutrition than receiving this type of care.

In some rehabs, you’ll also work directly with a nutritionist or dietitian. These experts can teach you to plan healthy menus based on your nutritional requirements. They might even help you shop for groceries or learn to cook. It’s important to practice these skills during treatment, so you’re set up for success when you return home. Over time, you’ll develop these healthier habits—and even more importantly, you’ll develop intuition about your own needs. By rebuilding trust within yourself, you can improve your relationship with food.

Acupuncture

Acupuncture is a form of traditional Chinese medicine8 in which thin needles are inserted into pressure points around the body. The goal of this is to unblock the flow of qi, or life force energy, promoting physical and mental health.

Because it treats both physical and emotional issues, acupuncture supports eating disorder recovery.9 This technique doesn’t just treat your symptoms. It also helps patients heal from the underlying causes of their diagnosis. For example, acupuncture can simultaneously reduce anxiety and improve digestion. By treating these issues together, it teaches patients how connected their minds and bodies really are.

Mindfulness-Based Eating Awareness Training

Mindfulness-based eating awareness training (MB-EAT)10 uses guided meditations to support recovery. Treatment targets the negative thoughts associated with eating disorders. Patients also practice mindfulness and emotion regulation skills. For example, MB-EAT teaches you to notice how hunger and fullness actually feel in your body.

MB-EAT can be especially helpful if you have a binge eating disorder. By riding the waves of your urges, you can stay in touch with your body, but avoid unhealthy behavior. These skills help you accept your feelings just as they are, without always acting on them.

Find Wholeness in Rehab for Eating Disorders

You are more than the sum of your parts. Those parts include the way you look, the way your body feels, your mental health, and your healing journey. But that’s an incomplete list. Holistic treatment honors the complexity of each person’s identity. And it invites you to learn who you already are, and decide who you want to become.

Connect with a rehab that treats eating disorders to find out which holistic therapies they offer.

Posted on

Can You Go to Rehab for Multiple Addictions?

Addiction takes many forms. For some people, it means relying on a particular drug. But it’s not always that simple. If you’re consistently taking more than one drug at a time, or switching between drugs, you might have polysubstance use disorder.

This condition looks a little different for everyone. You might feel like it’s safer to take more types of drugs, so you don’t start depending on any of them. Or, you might be mixing substances to get a certain result. But this behavior doesn’t protect you from addiction.

If you’re ready to make a change, there are several ways to approach recovery and rehab. And in treatment, your care team can help you understand the nuances of this complex issue.

Can You Have More Than One Addiction?

The CCD defines polysubstance use as “the use of more than one drug,” adding that “this includes when two or more are taken together or within a short time period, either intentionally or unintentionally.” Often, this behavior is socially acceptable. Have you ever smoked a cigarette while drinking a beer? If so, you’ve engaged in polysubstance use.

Addiction is, among other things, a behavioral issue. In other words, you can have addiction even in the absence of physical symptoms like cravings or withdrawal. And at first, you might not even notice. It’s all too easy to use multiple drugs at the same time, especially if you’re taking illicit substances. Street drugs like heroin and cocaine aren’t regulated, and might be mixed with other things.

Addiction Can Sneak Up On You

Stigma plays a complex role in many types of addiction. Because drinking is so socially acceptable, it can be hard to know when you have alcohol addiction. On the other hand, meth addiction is so stigmatized that it’s easier to recognize the problem—even if it’s still hard to get help.

When you’re switching between substances, this metric can work against you. For instance, you might not be doing enough of any single drug to be worried about addiction. But are you taking drugs every day? This behavior can quickly become a slippery slope.

Legality makes some substances seem safer, but mixing any drugs has unpredictable results. Think of alcohol, marijuana, and nicotine. In many U.S. states, all 3 are both legal and socially acceptable. It makes sense that people mix these substances without thinking twice. But taking substances together can have unintended, even dangerous, effects.

The Effects of Combining Drugs

Combining drugs can be unpredictable. That’s especially true when you’re taking illegal, untested drugs, but it can even be an issue with prescriptions. For example, taking MDMA along with certain antidepressants can lead to serotonin syndrome. This condition is rare, but extremely dangerous. And it’s just one of several drug combinations to watch out for.

The following combinations can also put you at risk of serious side effects:

  • Drinking with benzodiazepines, like Xanax, makes it easier for your body to process the benzos. This can exponentially raise the concentration of drugs in your bloodstream. And because you can’t control or measure that increase, you might increase your risk of overdose.
  • Cocaine and alcohol heighten the risk of cardiotoxicity, or heart damage.
  • Mixing opioids and stimulants—or “speedballing”—is dangerous and unpredictable. If the 2 drugs effectively cancel each other out, you might even feel sober. And if you respond by taking more, then you risk overdosing. Speedballing can also cause serious heart problems.
  • Mixing multiple opioids is easy to do by mistake. Many sources mix drugs like heroin with fentanyl, a cheaper synthetic opioid. Because fentanyl is stronger than other similar drugs, this makes it difficult to dose properly—especially if you don’t know you’re taking it. And even accidental use of fentanyl can increase your risk of addiction.
  • Mixing alcohol with any drug can have a direct impact on your mental health. This can cause anxiety and increase drug cravings, making it harder to begin recovery.

Numerous Ways to Treat Multiple Addictions

Recovering from even one addiction can be a complex process. And if you’ve been taking several different substances, you may need highly specialized treatment. Your care team can help you decide which types of therapy are most appropriate. A comprehensive treatment program might include therapies like the following:

Prescribed Medications

When taken under a doctor’s supervision, certain medications can support your recovery from multiple addictions. However, this may not be appropriate for all patients. For instance, if you have a history of misusing prescription drugs, talk therapy may be a safer treatment.

Even if you find meds helpful, they’re just one part of recovery. It’s important to combine this approach with other therapies, and with healthy lifestyle choices.

Exercise and Movement

Physical fitness has a huge impact on mental health. That makes it important for everyone. But data suggests it matters even more if you’re healing from addiction.

For people with multiple addictions, exercise decreases cravings and improves your mood. Experts say physical fitness might even guard against relapse. And best of all, you can put this data to work for you in any stage of recovery. During treatment, you might benefit from a form of movement that gets your blood pumping. And after you return home, you can take up yoga, go swimming, or just jog around the block.

Fitness can also aid in recovery by helping you build a healthy routine. Doing things you genuinely enjoy is an important part of long-term healing. Sustainable habits, like exercise, can give you the strength you need to stay on track.

Contingency Management

Contingency management (CM) activates your internal reward system. In treatment, patients get material rewards for achieving specific goals. For example, you might get free movie tickets after your 5th negative drug test in a row.

Data shows that CM can effectively treat patients with multiple addictions. This therapy can protect against relapse both during and after inpatient rehab. It even works as a virtual treatment.

Finding the Right Tools for Recovery

Multiple addictions are a complex issue. So when you start recovery, you’ll need a treatment approach that covers all your bases.

Talk to your care team about which combination of therapies will work best for you. The act of designing your treatment plan is the first step toward a healthier future. And that future can be as multifaceted and exciting as your past, even if the details are different.

Browse our list of rehab centers to learn about their locations, treatments offered, and insurance options, and to start planning your recovery.

Reviewed by Lisa Misquith

Posted on

Unplug From Gaming Addiction and Reconnect With Real Life

In moderation, video games can be a great way to unwind. But gaming can take over your life. If it goes from a casual hobby to an all-consuming part of your routine, you might need support to get back on track. And there are many ways to approach recovery. You can even go to rehab for gaming addiction.

Treatment Options for Gaming Addiction

Addiction doesn’t always include taking drugs—it can also be behavioral. In fact, some of the best therapies for gaming addiction can also treat other types of addiction.1

Adventure Therapy Gives You Other Outlets

Adventure therapy can be exciting. During treatment, you’ll explore the great outdoors and learn new skills. This popular therapy for gaming addiction2 also invites you to connect with other people. By solving problems together, you can learn to support each other in person—not just through a screen. Wilderness therapy, in particular, offers important benefits during recovery from gaming addiction:

  • Treatment includes an extended period of time (usually 30 days) away from the game.
  • Outdoor activities reinforce different strengths than video gaming.
  • Spending time outside can become a healthier hobby.

This approach invites you to heal and have fun at the same time. As you rock climb, kayak, or hike, you’ll also develop greater self-awareness and confidence.

Change How You Think About Gaming With Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a common method for treating gaming addiction.3 It can also treat people with internet addiction.4 During each session, you and your therapist will talk through your most frequent thought patterns. Then, they’ll teach you practical ways to cope with those thoughts. For example, you might practice these skills:

  • Identifying negative impacts gaming has on your life
  • Exercising self-restraint
  • Communicating with other people and building relationships

The skills you learn in therapy will help you manage your symptoms. But that’s not the only reason CBT is effective for treating gaming addiction.6 This therapy also treats the underlying causes of gaming addiction, like impulse control.

Reconnect With Loved Ones in Family Therapy

Gaming addiction can damage your relationships. But the reverse is also true: an unhealthy family environment is a risk factor for gaming addiction.7 If that’s your experience, family therapy might be an important part of recovery.

Data shows that family therapy can improve gaming addiction symptoms.8 Specifically, this treatment lowers the time patients spend gaming or just being online. It also helps family members understand why their loved one has a gaming addiction. That makes it easier for them to support the person through recovery.

Access Motivational Interviewing Online or in Person

Motivational interviewing (MI) helps patients define their own reasons for wanting to recover. When the desire to heal comes from within, committing to treatment gets easier. MI is a common treatment for gaming addiction.9

You can access MI in a variety of ways, such as in therapy, from another clinician, or even remotely. In fact, some forms of online MI are specifically designed to treat gaming addiction.10 Data shows this type of treatment can be hugely effective.

Find Offline Community in Support Groups

Gaming might give you a sense of community. But that community won’t necessarily protect you from addiction. On the contrary, it might even make your symptoms worse. Addiction support groups offer a healthy alternative.

If the 12 Steps resonate with you, Gaming Addicts Anonymous might be a good place to start. However, faith-based recovery isn’t a good fit for everyone. In that case, you can consider non-12-Step groups that welcome people with any type of addiction, like SMART Recovery. But even if you don’t join a support group, it’s important to start building relationships with people who understand what you’re going through.

What Is Gaming Addiction?

When compared to other addictions, gaming is relatively new. Perhaps because of this, there are some common misconceptions about gaming addiction.11 But if you’re showing the symptoms of addiction, it’s important to take them seriously.

Gaming addiction is a preoccupation with gaming that interferes with all other parts of your life.12 People with this condition may lie about how much they play, lose interest in other activities, and develop sleep issues. You can even experience withdrawal symptoms, like cravings, when you try to take a break.

Who Is at Risk for Gaming Addiction?

Addiction doesn’t happen in a vacuum. That’s true for drug use, gambling, and any other unhealthy behavior. And there are certain factors that increase your risk of gaming addiction:13

  • Genetic predisposition, including a family history of addiction
  • Psychological issues, like low self-esteem
  • Environmental factors, like family conflict
  • Stress, including grief or major life changes

Additionally, some demographics are more likely to develop video game addiction.14 Specifically, young people and boys may be at a greater risk.

Gaming Addiction and Other Mental Health Issues

Many people with video game addiction have co-occurring disorders,15 like anxiety or depression. Some of the most common co-occurring mental health issues16 include the following:

  • Anxiety, especially social anxiety
  • ADHD
  • Depression
  • Certain personality disorders
  • Autism

If you have more than one diagnosis, it’s important to give each one the attention it deserves. Often that means getting treatment for co-occurring disorders. This approach may give you more insight into your complex emotional experience.

What Leads to Gaming Addiction?

No matter who you are, or what risk factors you face, 2 types of games make addiction more likely:17

  1. Massively multiplayer online role-playing games (MMORPGs), like World of Warcraft, and
  2. First-person shooters, like Overwatch.

Different games also correlate with different addiction symptoms. For example, people who play first-person shooters tend to be more impulsive. But people with addiction to MMORPGs are often more extroverted, even if gaming gets in the way of in-person relationships. It’s also worth noting that not everyone who plays MMORPGs or first-person shooters is at risk of gaming addiction. Why you’re playing matters just as much as what you’re playing.

The Need for Escape

Some people use games to avoid real-life issues.18 This is most common with MMORPGs,19 in which players take on an in-game persona. And most of the time, your character faces less complicated issues than you do. Fighting a dragon is easy once you’re good at the game. And it has a straightforward outcome: win or lose. Either way, you’re still the main character. Most of the time, real life is much messier than that.

20Many escapist gamers have low emotional and impulse control. As a result, it can be hard to manage the stress of daily life. Instead, people turn to fictional worlds that reward impulsive behavior. But this just compounds the issue. If this is your experience, you might practice emotion regulation skills during recovery.

Relying on Video Games for Community

Gaming can fulfill players’ need for connection,21 especially if you don’t have many strong relationships in real life. It might even feel easier for you to talk to people when you’re behind a screen. Studies show that people with gaming addiction feel closer to other people during online interactions than they do in person.

Over time, this can become a vicious cycle. First, you reach out online by gaming. But as your addiction develops, you may lose interest in your real-world relationships. And as you let go of those friendships, it can feel like gaming is your primary source of connection. In treatments like wilderness therapy, patients relearn how to build sustainable relationships.

Instant Gratification

Video games are meant to be engaging.22 Game developers want you to continue playing. That’s one reason they offer so many rewards. Leveling up gives you instant access to new skills, with no studying required. This pattern appeals to people who feel unsuccessful outside of gameplay. Research shows a relationship between gaming addiction and low self-esteem.23

Doing well in a game can give you a sense of accomplishment. It may also earn you the respect of fellow gamers, which can boost your self-image. However, these achievements don’t prepare you for the hard work of building a meaningful life. There’s no loot drop after you deal with a breakup, or retake a failed exam. But often, those experiences are necessary in order for you to grow as a person.

A Sense of Purpose

Unlike most areas of life, video games have clear storylines. Even when you’re exploring an open world, you usually have a specific quest in mind. If you feel lost and driftless when you’re offline, gaming addiction can satisfy your need for a personal mission.24

This can be true for people without clear goals, and also for those with lofty ambitions. Most of the time, the stakes are lower in a boss fight than they would be if you applied to law school. And you might feel more confident about winning the game than you do about achieving your dreams. But if you let gaming take up too much of your time, it becomes an obstacle in its own right.

Level up Into the Real World

Gaming might feel like a great adventure. To be good at it, you need dedication and creativity. But as you build on those skills, you may find that you need a more complex challenge. With the right support, you can find what you’re looking for in real life.

Browse our list of rehabs for gaming addictions to learn about their pricing, treatment options, and more.

Posted on

Sadness vs. Depression: How to Tell the Difference

Feeling sad is normal—even healthy. It’s a natural part of the human experience. But persistent sadness can cross a line. When this emotion becomes a mental health condition, you might need professional support. The problem is, it can be hard to distinguish between sadness and depression.

There are some key differences between these 2 experiences. But either way, knowing what’s wrong is the first step toward healing. If you need to, you can seek treatment for depression. And if not, you can still take active steps to move past feeling sad.

Working Through Sadness

We all feel sad from time to time; it’s a normal part of being human. Usually, that feeling has a clear external cause. For instance, sadness is often associated with grief ((Lokko, Hermioni N., and Theodore A. Stern. “Sadness: Diagnosis, Evaluation, and Treatment.” The Primary Care Companion for CNS Disorders, vol. 16, no. 6, Nov. 2014, p. 10.4088/PCC.14f01709. PubMed Central, https://doi.org/10.4088/PCC.14f01709.)) or loss. There’s nothing wrong with this important emotion, and it doesn’t need to be pushed away. But—if it’s really sadness, and not depression—there’s a lot you can do to support yourself as you ride out the experience.

Make a Change

Most of the time, you can point to a specific reason you’re feeling sad. Maybe you failed an exam or lost a job. Upsetting as these issues are, they can inspire you. You might recommit to studying, so you’ll get better grades on future tests. Or, you might look for a new job where your skills can really shine. Taking action is empowering. And as you work to improve your life, your feelings might improve too.

Get Social Support

There’s a link between sadness and loneliness. ((Yanguas, Javier, et al. “The Complexity of Loneliness.” Acta Bio Medica : Atenei Parmensis, vol. 89, no. 2, 2018, pp. 302–14. PubMed Central, https://doi.org/10.23750/abm.v89i2.7404.)) So when you’re feeling sad, spending time with people you trust can make you feel better. Your loved ones are allies for your happiness. Their support can give you a new perspective on your own feelings, or just a welcome distraction. Either way, shifting your focus away from sadness can help you move forward. ((“Probing the Depression-Rumination Cycle.” Https://Www.Apa.Org, https://www.apa.org/monitor/nov05/cycle. Accessed 12 Dec. 2022.))

Defining Clinical Depression

Life doesn’t stop when you’re sad. You can go about your day, taking care of responsibilities at home, work, and school. Depression takes a greater toll. ((Duggal, Harpreet S. “Self-Management of Depression: Beyond the Medical Model.” The Permanente Journal, vol. 23, May 2019, pp. 18–295. PubMed Central, https://doi.org/10.7812/TPP/18-295.)) You might feel like everything is a chore—even hobbies and plans with friends. This condition can even have physical symptoms.

Symptoms of Depression

Depression can change your brain chemistry. ((Syvälahti, E. K. “Biological Aspects of Depression.” Acta Psychiatrica Scandinavica. Supplementum, vol. 377, 1994, pp. 11–15. PubMed, https://doi.org/10.1111/j.1600-0447.1994.tb05795.x.)) And while intense, persistent sadness is a common symptom, it’s not the only one. Depression can also manifest in your body, ((“Depression.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/depression. Accessed 12 Dec. 2022.)) with effects like insomnia, weight changes, or physical pain. This is one reason that treatment usually includes medication. ((Depression: How Effective Are Antidepressants? Institute for Quality and Efficiency in Health Care (IQWiG), 2020. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK361016/.))

Unlike sadness, depression rarely goes away with simple activities. It also lasts longer than a run-of-the-mill emotion. If you’ve had the symptoms of depression for longer than 2 weeks, ((“Depression.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/topics/depression. Accessed 12 Dec. 2022.)) it might be time to get professional support.

Root Causes of Depression

It’s usually easy to figure out why you’re sad. Depression is a more complex issue. It often occurs with no apparent cause. According to experts, there may be a genetic component to depression. ((“What Causes Depression?” Harvard Health, 9 June 2009, https://www.health.harvard.edu/mind-and-mood/what-causes-depression.
)) But it can also be intensified by external events.

For example, trauma can cause depression. ((VA.Gov | Veterans Affairs. https://www.ptsd.va.gov/understand/related/depression_trauma.asp. Accessed 12 Dec. 2022.)) But trauma isn’t something you just “get over.” If you’re recovering from depression in response to traumatic events, you might benefit from trauma-informed care for both conditions. When you’re ready to seek treatment, it’s best to get professional advice about where to start.

When Should You Get Help?

If you think you might have depression, talk to your doctor or therapist about your symptoms. Depending on your experience, they might recommend a combination of therapy, medication, inpatient rehab, or other types of treatment. To prepare for this conversation, you can answer a few questions, and share your responses with your care team.

  • How long have you had symptoms? By definition, depression lasts for at least 2 weeks. ((Lokko, Hermioni N., and Theodore A. Stern. “Sadness: Diagnosis, Evaluation, and Treatment.” The Primary Care Companion for CNS Disorders, vol. 16, no. 6, Nov. 2014, p. 10.4088/PCC.14f01709. PubMed Central, https://doi.org/10.4088/PCC.14f01709.)) Sadness usually resolves more quickly.
  • Is it hard for you to keep up with your responsibilities? When your emotions get in the way of daily activities, it’s often a sign of mental health issues.
  • Can you point to a cause? Sadness usually happens for a reason. If you feel sad even when things go well, you might need treatment for depression.
  • Are you considering self-harm? This is a very serious symptom, and requires immediate care.

If you or someone you love is contemplating self-harm, call the 988 Suicide & Crisis Lifeline at 1-800-273-8255 to get immediate support.

No matter how you answer these questions, you can always talk to a therapist about what you’re going through. A professional can offer specific advice, tailored to meet your unique needs.

Finding Your Path Toward Wellness

You and your care team can work together to find the best way forward. And it’s okay to ask for help even before you have serious symptoms. If it turns out that you’re sad, but not depressed, you can still get meaningful support. Or, if you do have depression, your doctor can connect you to the resources you need for recovery.

Browse our list of rehab programs for depression to read reviews, see photos, and learn about pricing options.

Reviewed by Rajnandini Rathod

Posted on

Beyond the Stigma: Recovery From Personality Disorders

Yes, you can find treatment for a personality disorder. These are serious conditions, but they’re not monsters under the bed. Your personality is not broken.

Data shows that there are many effective ways to treat these mental health issues. In a rehab program for personality disorders, you’ll have access to a variety of therapies. Prepare for recovery by learning about your options.

Overcoming the Stigma Around Personality Disorders

As a group, personality disorders are generally misunderstood. ((Sheehan, Lindsay, et al. “The Stigma of Personality Disorders.” Current Psychiatry Reports, vol. 18, no. 1, Jan. 2016, p. 11. PubMed, https://doi.org/10.1007/s11920-015-0654-1.)) And unfortunately, it’s not just the public who carry ignorant views of these diagnoses. Some healthcare providers also have harmful ideas about personality disorders. As a result, stigma is often a barrier to treatment. ((Sheehan, Lindsay. “The Stigma of Personality Disorders.” Curr Psychiatry Rep (2016) 18: 11. BPD Community. https://www.bpdcommunity.com.au/static/uploads/files/2016-sheehan-the-stigma-of-pds-wfcdbbajayss.pdf))

For Amanda Wang, living with borderline personality disorder (BPD) was overwhelming: ((BPD Profile: Struggles, Breakdown & Breakthrough. www.youtube.com, https://www.youtube.com/watch?v=B3t8s2JvVHg. Accessed 11 Dec. 2022.))

“I felt like something was wrong with me. It would start out with something small and it would escalate to thinking that I was probably the worst person in the world and that I wasn’t good enough.”

And without unbiased professional advice, it can be hard to plan your recovery.

So it’s understandable if you’re hesitant to seek help. But facing your condition head-on can empower you to heal. In fact, long-term studies show that remission is common for people with personality disorders, ((Pickersgill, Martyn. “How Personality Became Treatable: The Mutual Constitution of Clinical and Mental Health Law.” Social Studies of Science, vol. 43, no. 1, Feb. 2013, pp. 30–53. PubMed Central, https://doi.org/10.1177/0306312712457722.)) even in the most severe cases. Specialized therapies reduce your symptoms, improve your quality of life, and make it easier to navigate the world.

Not all therapists are qualified to support your healing journey. And it might take a while to find the right provider. Set yourself up for success by researching ahead of time, so you know what to look for in a therapist.

Effective Treatments for Personality Disorders

People with personality disorders rarely start treatment ((Lawton, Erin M., and Thomas F. Oltmanns. “Personality Pathology and Mental Health Treatment Seeking in a Community Sample of Older Adults.” Personality and Mental Health, vol. 7, no. 3, Aug. 2013, p. 10.1002/pmh.1198. PubMed Central, https://doi.org/10.1002/pmh.1198.)) because of those issues alone. More often, patients first enter recovery for addiction or another mental health issue. In that case, you might get diagnosed with a personality disorder once you’re already in rehab.

Once you begin healing, consistency is the key to treatment. ((Pickersgill, Martyn. “How Personality Became Treatable: The Mutual Constitution of Clinical and Mental Health Law.” Social Studies of Science, vol. 43, no. 1, Feb. 2013, pp. 30–53. PubMed Central, https://doi.org/10.1177/0306312712457722.)) With talk therapy and medication, many people make slow, steady progress. Then, for some people, personality disorder symptoms simply vanish in middle age. ((Oltmanns, Thomas F., and Steve Balsis. “Personality Disorders in Later Life: Questions about the Measurement, Course, and Impact of Disorders.” Annual Review of Clinical Psychology, vol. 7, Apr. 2011, pp. 321–49. PubMed Central, https://doi.org/10.1146/annurev-clinpsy-090310-120435.))

To find the right type of therapy, you first need a formal evaluation from a therapist. They’ll assess the intensity of your emotions and your relationships, and ask about other symptoms. Then, with a diagnosis in hand, you and your care team can consider a range of treatment options.

Transference-Focused Psychotherapy Helps You Build Relationships

Transference-focused psychotherapy (TFP) helps you improve your relationships. ((Transference-Focused Psychotherapy Program | Columbia University Center for Psychoanalytic Training and Research. https://www.psychoanalysis.columbia.edu/train/psychotherapy-programs/transference-focused-psychotherapy-program. Accessed 11 Dec. 2022.)) Patients do this by practicing interpersonal skills with a therapist. In that dynamic, you can learn to relate to others’ emotions more easily. This empowers you to build stronger, more sustainable relationships. TFP can treat BPD ((Kernberg, Otto F., et al. “Transference Focused Psychotherapy: Overview and Update.” The International Journal of Psychoanalysis, vol. 89, no. 3, 2008, p. 601. www.academia.edu, https://www.academia.edu/330551/Transference_Focused_Psychotherapy_Overview_and_Update.)) and narcissistic personality disorder, among other conditions.

Most people attend about 2-3 sessions per week for 1-3 years, and get additional support outside of therapy. Your relationship with your therapist is central to this process. By observing the way you act toward them, they’ll learn how you approach other dynamics. Then, they can help you develop healthier behavioral patterns.

Schema-Focused Therapy Soothes Your Inner Child

In schema-focused therapy (ST), you learn how to comfort yourself. ((Tan, Yeow May, et al. “Schema Therapy for Borderline Personality Disorder: A Qualitative Study of Patients’ Perceptions.” PLoS ONE, vol. 13, no. 11, Nov. 2018, p. e0206039. PubMed Central, https://doi.org/10.1371/journal.pone.0206039.)) It’s based on the idea that personality disorders result from childhood trauma. Patients recover by soothing their inner child. ST is especially effective for people with BPD ((Dr. K. Thomaes, MD PhD. “Prediction and Outcome Study in PTSD and Personality disorder.” https://clinicaltrials.gov/ProvidedDocs/53/NCT03833453/Prot_SAP_000.pdf)) and anxious personality disorders, like avoidant personality disorder.

For example, many people with personality disorders were abandoned as children. ((Mahari, A. J. The Legacy of Abandonment In Borderline Personality Disorder. Phoenix Rising Publications, 2006.)) That trauma can cause an intense fear of abandonment in adulthood. ST teaches these patients how to manage that fear. You and your therapist might roleplay a conversation with a parent who abandoned you in the past. You’ll use specific coping skills to regulate your feelings, and still express yourself in a healthy way. This empowers patients to meet their own needs.

Dialectical Behavior Therapy Teaches Emotion Regulation

Dialectical behavior therapy (DBT) teaches you how to process intense emotions healthily. Research shows that DBT reduces symptoms of several personality disorders. ((May, Jennifer M., et al. “Dialectical Behavior Therapy as Treatment for Borderline Personality Disorder.” The Mental Health Clinician, vol. 6, no. 2, Mar. 2016, pp. 62–67. PubMed Central, https://doi.org/10.9740/mhc.2016.03.62.)) Specifically, it helps patients improve impulse control, mindfulness, and emotion regulation.

This is a very practical approach to personality disorder treatment. Treatment includes both individual and group sessions. You’ll go through assignments from a textbook, complete homework, and share what you learn. In some ways, DBT is more like a class than it is like group therapy.

DBT teaches you to accept yourself, ((Chapman, Alexander L. “Dialectical Behavior Therapy.” Psychiatry (Edgmont), vol. 3, no. 9, Sept. 2006, pp. 62–68. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/.)) intense emotions and all. You can’t hate yourself into recovery. Instead, patients cultivate the desire to heal because they deserve to be well.

Mentalization-Based Therapy Lets You Understand Others’ Feelings

Mentalization is related to empathy. ((Schnell, Knut. “Functional relations of empathy and mentalizing: An fMRI study on the neural basis of cognitive empathy.” Elsevier. https://www.researchgate.net/profile/Brigitte-Konradt/publication/45799025_Schnell_K_Bluschke_S_Konradt_B_Walter_H_Functional_relations_of_empathy_and_mentalizing_an_fMRI_study_on_the_neural_basis_of_cognitive_empathy_Neuroimage_54_1743-1754/links/5d63dbb3299bf1f70b0dfece/Schnell-K-Bluschke-S-Konradt-B-Walter-H-Functional-relations-of-empathy-and-mentalizing-an-fMRI-study-on-the-neural-basis-of-cognitive-empathy-Neuroimage-54-1743-1754.pdf)) According to the American Psychological Association, mentalizing ((APA Dictionary of Psychology. https://dictionary.apa.org/. Accessed 11 Dec. 2022.)) is “the ability to understand one’s own and others’ mental states.” This lets you understand why people do what they do, and what effect those actions will have.

Mentalization based therapy (MBT) ((BATEMAN, ANTHONY, and PETER FONAGY. “Mentalization Based Treatment for Borderline Personality Disorder.” World Psychiatry, vol. 9, no. 1, Feb. 2010, pp. 11–15. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816926/.)) teaches people how to mentalize in a balanced way. Studies prove MBT can reduce the symptoms of BPD ((Vogt, Katharina Sophie, and Paul Norman. “Is Mentalization‐based Therapy Effective in Treating the Symptoms of Borderline Personality Disorder? A Systematic Review.” Psychology and Psychotherapy, vol. 92, no. 4, Dec. 2019, pp. 441–64. PubMed Central, https://doi.org/10.1111/papt.12194.)) and other mental health conditions. Empathy is especially hard for people with narcissistic personality disorders, ((Gabbard, Glen O., and Holly Crisp‐Han. “The Many Faces of Narcissism.” World Psychiatry, vol. 15, no. 2, June 2016, pp. 115–16. PubMed Central, https://doi.org/10.1002/wps.20323.)) so mentalization is an important skill to learn in treatment.

In MBT, patients practice mentalization during both group and 1:1 sessions. You might use specific events from your real life as examples. You’ll describe a situation—say, a recent argument with a friend. And your therapist will help you imagine how your friend might have felt. They’ll also help you identify and regulate your own feelings. These skills can improve your relationships with other people, and with yourself.

Medication Can Manage Symptoms

Currently, there are no medications specifically designed to treat personality disorders. ((“What are Personality Disorders?” American Psychiatric Association (APA). https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders)) Despite this, your doctor might recommend a prescription to control your symptoms. Antidepressants and mood stabilizers are common treatments. But it’s important to note that personality disorders aren’t purely neurochemical. ((Ma, Guorong, et al. “Genetic and Neuroimaging Features of Personality Disorders: State of the Art.” Neuroscience Bulletin, vol. 32, no. 3, Apr. 2016, pp. 286–306. PubMed Central, https://doi.org/10.1007/s12264-016-0027-8.)) On the contrary, experts think some of them may have environmental causes. As a result, it’s unlikely that medication alone will “fix” your personality disorder. You might also need to make some major behavioral changes. These complex conditions can impact every aspect of your life.

What Is a Personality Disorder?

Personality disorders affect more than your thoughts and feelings ((Personality Disorders: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/000939.htm. Accessed 11 Dec. 2022.))—they also impact relationships. Even though they’re highly stigmatized, almost 10% of adults in the U.S. have a personality disorder. ((“Personality Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/statistics/personality-disorders. Accessed 11 Dec. 2022.))

People with personality disorders have intense emotions, ((Fariba, Kamron A., et al. “Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556058/.)) which can lead to unhealthy behaviors. Your mental health may interfere with your relationships, schoolwork, career, and more. And because people with personality disorders are so sensitive to stress ((“Personality Disorder.” Mental Health America, https://www.mhanational.org/conditions/personality-disorder. Accessed 11 Dec. 2022.)) that adversity can make your symptoms worse.

There’s some debate about when these conditions develop. Some experts say that personality disorders appear in adolescence. ((Adshead, Gwen, et al. “Personality Disorder in Adolescence.” Advances in Psychiatric Treatment, vol. 18, no. 2, Mar. 2012, pp. 109–18. Cambridge University Press, https://doi.org/10.1192/apt.bp.110.008623.)) Others describe symptoms during childhood. And some caution against diagnosis before patients reach adulthood. At any age, these are serious conditions.

Scientists categorize personality disorders into 3 different clusters:

Cluster A Personality Disorders

People with cluster A personality disorders ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) share a few traits. Most people with these conditions are socially withdrawn. You might actively mistrust the people around you, or you might just prefer solitude. You may also have a hard time expressing how you feel. Cluster A includes 3 diagnoses:

  • Schizoid personality disorder (ScPD): People with ScPD have a hard time showing emotion, and prefer to be alone most of the time. They rarely have relationships outside of family.
  • Paranoid personality disorder (PPD): The main characteristic of PPD is a distrust of others. This condition makes it hard to build or maintain relationships.
  • Schizotypal personality disorder (STPD): People with STPD may have strong superstitions, or think they have supernatural abilities. This often undermines relationships.

Cluster B Personality Disorders

People with cluster B personality disorders have intense emotions and low impulse control. This can make it hard for anyone—including them—to predict their behavior. As a result, they often have a pattern of unstable relationships. There are a few different Cluster B personality disorders:

  • Antisocial personality disorder (ASPD) describes people who don’t conform to social norms. In particular, they may disregard other people’s safety. People with ASPD often engage in risky activities, like high-risk sexual behavior or drug abuse. They generally lack remorse for this behavior.
  • Borderline personality disorder (BPD) involves a pattern of instability in relationships, self-image, and identity. People with BPD are highly emotionally sensitive.
  • Narcissistic personality disorder (NPD) ((Mitra, Paroma, and Dimy Fluyau. “Narcissistic Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556001/.)) occurs in 2 types. Grandiose NPD includes an inflated sense of self, boldness, and sometimes aggression. Vulnerable NPD appears as hypersensitivity and defensiveness.
  • Histrionic personality disorder (HPD) includes attention-seeking behavior and emotional sensitivity. People with HPD place a lot of value on their reputation and physical appearance.

Much of the stigma around personality disorders comes from a misunderstanding of cluster B diagnoses. As a result, finding treatment for cluster B disorders might be the most difficult. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) But at the same time, a great deal of research on personality disorders focuses on cluster B types. ((Mitra, Paroma, and Dimy Fluyau. “Narcissistic Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556001/.)) That research proves recovery is common, even in the most severe cases.

Cluster C Personality Disorders

On the other hand, cluster C personality disorders have the most treatment options. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) For these patients, the healing process resembles recovery from anxiety or depression. That’s because cluster C usually includes anxious thought patterns. There are 3 cluster C personality disorders:

  • Avoidant personality disorder (AvPD) features strong feelings of inadequacy. People with AvPD are sensitive to criticism. They usually fear intimacy and connection with other people.
  • Dependent personality disorder (DPD) involves being highly submissive in relationships. DPD undermines confidence, making it hard to make decisions for yourself.
  • Obsessive-compulsive personality disorder (OCPD), centers on perfectionism and the need for control. People with OCPD are hyperaware of rules and social norms, but reluctant to ask for help. This condition is notably different from obsessive-compulsive disorder (OCD).

Experts continue to research new treatments for all 3 clusters of personality disorders. Despite that growing body of work, the cause of these conditions is largely unknown.

What Causes Personality Disorders?

Scientists have several theories about what causes personality disorders. ((Fariba, Kamron A., et al. “Personality Disorder.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK556058/.)) But they still need more data. Some experts theorize that biology might play a role in these conditions. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) For instance, ScPD has a similar biological cause as schizophrenia, which hints at a genetic link.

Meanwhile, other studies show that ASPD and BPD have a similar impact on brain chemistry. That could explain why both conditions interfere with impulse control.

Other experts believe that childhood trauma can cause personality disorders. For example, people with BPD are more than 3 times more likely to report childhood adversity. ((Porter, C., et al. “Childhood Adversity and Borderline Personality Disorder: A Meta-Analysis.” Acta Psychiatrica Scandinavica, vol. 141, no. 1, Jan. 2020, pp. 6–20. PubMed, https://doi.org/10.1111/acps.13118.)) And it’s not just BPD. Other personality disorders are linked to childhood traumas, ((“What Causes Personality Disorders?” Https://Www.Apa.Org, https://www.apa.org/topics/personality-disorders/causes. Accessed 11 Dec. 2022.
)) like physical and emotional abuse.

Not all the data supports this theory. According to some, childhood trauma “does not appear to be a key factor” in the development of personality disorders. ((Berenz, Erin C., et al. “Childhood Trauma and Personality Disorder Criterion Counts: A Co-Twin Control Analysis.” Journal of Abnormal Psychology, vol. 122, no. 4, Nov. 2013, pp. 1070–76. PubMed Central, https://doi.org/10.1037/a0034238.)) But they’re certainly linked to other diagnoses. For example, many people with personality disorders also experience addiction. ((“Personality Disorders.” National Institute of Mental Health (NIMH), https://www.nimh.nih.gov/health/statistics/personality-disorders. Accessed 11 Dec. 2022.))

The Link Between Personality Disorders and Addiction

Researchers have identified a link between personality disorders and substance abuse. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) Specifically, addiction is more common in people with ASPD, BPD, and STPD than others.

Studies show that over 50% of people with BPD have a history of addiction. ((“An Introduction to Co-Occurring Borderline Personality Disorder and Substance Use Disorders.” In Brief: Fall 2014, Volume 8, Issue 3. Substance Abuse and Mental Health Services Administration, Department of Health and Human Services. https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4879.pdf)) And people with schizotypal personality disorder often have addictions ((Hasin, Deborah, et al. “Personality Disorders and the 3-Year Course of Alcohol, Drug, and Nicotine Use Disorders.” Archives of General Psychiatry, vol. 68, no. 11, Nov. 2011, pp. 1158–67. PubMed Central, https://doi.org/10.1001/archgenpsychiatry.2011.136.)) to cannabis and alcohol.

There’s also a complex relationship between antisocial personality disorder and addiction. ((Robins, L. N. “The Intimate Connection between Antisocial Personality and Substance Abuse.” Social Psychiatry and Psychiatric Epidemiology, vol. 33, no. 8, Aug. 1998, pp. 393–99. PubMed, https://doi.org/10.1007/s001270050071.)) Some experts believe one condition can cause the other. Others think that both ASPD and addiction develop in response to underlying issues, like unresolved trauma. From that viewpoint, both conditions are ineffective coping strategies for untreated symptoms. And working through those symptoms might help you recover.

High-risk behavior, including self-harm, is associated with several personality disorders. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) In other words, addiction can be a symptom. But that’s not always the case. Some people use drugs to cope with other symptoms of their personality disorders. For instance, many people with AvPD have intense social anxiety. ((Module 13: Personality Disorders – Fundamentals of Psychological Disorders. https://opentext.wsu.edu/abnormal-psych/chapter/module-13-personality-disorders/. Accessed 11 Dec. 2022.)) And, whether or not you have AvPD, there’s a clear link between social anxiety and alcohol abuse.

If you or a loved one is at risk of self-harm, you can get help right away. Call The National Alliance on Mental Illness HelpLine at 1-800-950-6264 or text “HelpLine” to 62640.

If you have these co-occurring disorders, it’s important to treat both at the same time. Your personality disorder might make recovery more complex. But with the right treatment, you can learn to manage your symptoms with healthier coping skills.

Recovery and Remission From Personality Disorders

Untreated personality disorders can impact every area of your life. Serious symptoms can interfere with your mental health, work, relationships, and dreams for the future. But it’s important to note that many of these symptoms are behavioral. And by learning better behaviors, you can heal both your symptoms and their underlying causes. With the right types of ongoing care, it’s even possible to go into complete remission.

To start recovery, browse our rehabs that treat personality disorders and learn more about their pricing, locations, and different types of therapy.

Reviewed by Rajnandini Rathod

Posted on

Return to Your Values in Tennessee’s Affirming Rehabs

From the majestic Appalachian Mountains to the melodic voices crooning down Nashville’s Music Row, there’s a lot of beauty in Tennessee. This pretty place can make addiction treatment relaxing and joyful. If you’re looking for a welcoming setting to start your recovery, a rehab in Tennessee could be a great fit. 

Heal According to Tennessee’s Strong Principles 

Tennessee’s rich history of working hard, and enjoying life’s simple pleasures spills over into modern life. And when you go to rehab there, those principles can also shape your treatment.

Recover in Tennessee’s Restorative Nature

All across Tennessee, you’ll find flowing rivers, sprawling forests, and ancient mountains. Many of the state’s rehabs boast large campuses with plenty of room for reflection. Some offer meandering walking trails and tranquil places to enjoy the view.

Smoky Mountain Lodge sits on the edge of Great Smoky Mountains National Park. Clients can take full advantage of their location by hiking to see the park’s gorgeous views. Recovering in peaceful nature can keep you grounded and centered throughout the healing process. 

cumberland heights tennessee
Cumberland Heights in Nashville

Stay Active With Experiential Therapies  

Many treatment centers in Tennessee offer experiential therapies, inspired by the area’s traditions and geography. For example, horses are an important part of Tennessee’s history and culture.1 Treatment centers like The Ranch Tennessee honor that heritage in their equine therapy program. On their expansive 2,000-acre ranch, equine-assisted therapy is a major component of treatment. By caring for the resident horses, clients learn more about themselves and practice building relationships.

Tennesseeans are also known for their taste for adventure. Rehabs like the ARCH Academy, which treats adolescent boys, tap into this mentality with adventure therapy. Clients can go canoeing, hiking, or fly-fishing to bond with their peers and learn new skills. These experiences invite teens to express their feelings in a new context.  

Get Into the Rhythm of Recovery in Music City

Home to country, rock ‘n’ roll, and the blues, Tennessee is famous for its music scene.2 And if music is important to you, professionally or personally, it can be a powerful tool during treatment.

This is especially true at rehabs like Recovery Unplugged Nashville. That’s why they designed their entire program around music. Their unique brand of music-assisted treatment can improve your depression, anxiety, mood, and chronic pain during recovery. They have a fully equipped jam room, group music therapy, and even songwriting sessions to help you express yourself through song. Plus, they frequently hold open mic nights and performances by other artists in recovery for sober fun. 

Relax in Family-Style Accommodations 

For many people, community is an important part of recovery. That’s why some programs have a strong focus on building relationships. In these rehabs, you can connect with like-minded people who want to support you in your journey toward wellness. 

In Tennessee, many rehabs offer family-style housing to support those connections. At centers like Morningstar, a women’s rehab outside of Nashville, clients live in a lodge with 5 other women. You and your housemates will cook dinner together, go on day trips, and attend the same group therapy sessions. Discovery Place offers treatment for men using a similar approach. Sober relationships are essential for long-term success in recovery,3 and family-style rehabs allow you to start forming them early on. 

the ranch tennessee
The Ranch Tennessee in Nunnelly

Find Identity-Affirming Treatment in Tennessee

Everyone’s recovery is as unique as they are. So finding a rehab that supports the most important parts of your identity is a crucial part of treatment. Many Tennessee rehabs offer specialized care for clients of different identities.

Gender-Specific Care

Attending rehab is a vulnerable experience. And for some people, it feels safer to be vulnerable around people of the same gender. What’s more, people of different genders face different obstacles to recovery. Going to a gender-specific rehab can help some clients access effective treatment.

In Tennessee, it’s easy to find a women-only or men-only rehab.  Morningstar, for example, has a women-only campus. Other programs, like Cumberland Heights, offer separate treatment for men and women on the same property. They even break down their men’s group into age-specific programming, recognizing how your stage of life can affect your recovery. 

Gender-specific treatment isn’t always a priority. And even if it is, these binary options might not meet your needs. In that case, you might consider a rehab that offers affirming treatment for LGBTQ+ people. These programs can be a good fit for people of many different genders and sexualities. Such supportive environments empower clients to live out their own highest values.  

Faith-Based Recovery

As you work to be your best self, spirituality can guide you forward. Many people find comfort and inspiration in faith-based treatment. In these rehabs, the tenets of a particular belief system inform every aspect of recovery.  

S2L Recovery, for instance, uses 7 Christian principles as the framework for their treatment program. They use lessons from the Bible to help you develop a deeper faith and sense of resilience. This can set you up for success after you complete treatment. If your faith is important to you, then it can be an excellent foundation for your ongoing recovery. 

Other faith-based treatment centers follow the 12 Steps, a well-known recovery philosophy. At The Next Door, in Nashville, treatment “integrates 12 step recovery, faith, and evidence-based practices to address the needs of the whole woman – mind, body, and spirit.” 

discovery place tennessee
Discovery Place in Burns

How to Travel to and Around Tennessee

More than half of the U.S. population lives within about a day’s drive of Nashville.4 But if you’re coming from farther away, you’ll most likely want to fly.

Flying Into Tennessee 

If you’re traveling from abroad, you’ll likely fly into Nashville International Airport (BNA), which serves 22 different airlines with over 585 nonstop flights daily. BNA is centrally located in Tennessee.

If you’re going to rehab in western Tennessee, flying into the Memphis International Airport might bring you closer to your treatment center. And for people attending eastern Tennessee rehabs, the Chattanooga Airport is closest.  

Getting Around Tennessee

Most of Tennessee’s public transit options are in metropolitan areas, so you’ll probably have to rely on private transportation to get to your treatment center. Because of this, many rehabs will pick you up from the airport directly, making the last leg of your journey that much simpler.

With any mode of transport, it’s a good idea to have a support person travel with you to rehab. This is an emotional time. When someone else is handling the logistics, you can stay focused on starting recovery.

Recover, Relax, and Reconnect in a Tennessee Rehab

If you’re thinking about addiction treatment, it might feel like life has gotten away from you. In Tennessee, rehab can be a safe place to gather your strength. Here, you’ll be healing among people who welcome you just as you are, and share many of your values. Even if you’ve never been to the state before, treatment here can feel like coming home to yourself.


Visit our list of rehabs in Tennessee for information on their amenities, pricing, experiential treatments, and more.