Category: Symptoms

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Porn Addiction: 9 Signs and How It Impacts Your Well-Being

Porn addiction, like other behavioral addictions, can negatively impact mental health, relationships, and daily life. But how do you know if you have a problem? Are there signs that can help you determine if you or a loved one has a porn addiction?

If this issue impacts you, a loved one, or friend, you are not alone. Recognizing the signs of porn addiction is the first step in seeking professional help and treatment options.

What are the top 10 signs of pornography addiction and how they affect overall well-being?

1. You Can’t Stop

One of the most evident signs of porn addiction is the inability to stop viewing pornography despite repeated attempts. This compulsive behavior can interfere with daily life, relationships, and responsibilities. Individuals may experience withdrawal symptoms,1 such as mood swings and cravings, when trying to cut back.

Research suggests that behavioral addictions like pornography addiction2 activate the same reward pathways in the brain as substance addictions, making compulsive use a serious concern.

Recognizing the signs of porn addiction is the first step toward recovery.

Infographic titled Key Statistics That Reveal Dark Truths About Porn Addiction. Highlights include 1 in 10 men say their porn use feels out of control, problematic porn users are 2.4 times more likely to experience depression, and 68 percent of men and 18 percent of women report porn use hurting their relationships. Other stats show a 300 percent increase in searches for porn addiction help over the past decade, and the average age of first exposure is 11 to 13 years old.

How can I tell if I have a porn addiction?

“Like other forms of addiction, porn addiction is primarily marked by a loss of control. Here, an individual’s thoughts, behaviors, and emotions ultimately become consumed by pornography to the point where they begin neglecting other priorities and even people. It often leads to a state of distress whereby even when one wants to take pause and distance themselves, they cannot. Interpersonal relationships, especially romantic or sexual ones, become compromised too, as the obsession with pornography takes priority over real-life interactions and can develop to the point where true physical connection is no longer desirable.”

Matt Glowiak, PhD, LCPC, CAADC, ACS, NCC | Hazelden Betty Ford Graduate School

2. You Want More

Pornography consumption can lead to tolerance, similar to substance addiction. Over time, an individual may seek out more explicit or extreme pornographic content to achieve the same level of excitement. This escalation can reinforce dependency and increase the risk of sexual dysfunction.

Social media can also promote unrealistic standards of physical attractiveness and sex, making the lure from these sites to pornographic ones a quick one.

Pornography can create a vicious cycle in the brain, largely due to its impact on dopamine,3 the neurotransmitter responsible for pleasure and motivation.

  • When someone watches porn, their brain releases a surge of dopamine, leading to intense feelings of reward. However, overstimulation can cause the brain to downregulate dopamine receptors4—essentially, reducing their sensitivity to dopamine over time.
  • As a result, the person may start feeling depleted or less satisfied with the same content, leading them to seek out more stimulating material or spend longer periods watching porn to achieve the same high. This is similar to what happens in substance addiction, where repeated exposure leads to tolerance and an increased need for stronger stimuli.5
Illustration of a sad man sitting on a smartphone screen, with a glowing silhouette behind him symbolizing emotional connection. Text emphasizes the contrast between porn and real relationships, stating that one leads to loneliness while the other offers true connection.

3. You’ve Lost Time

Pornography use is on the rise due to a number of factors including “accessibility, affordability, and anonymity.”6 Many individuals report losing track of time, which affects productivity, work performance, and personal relationships. Excessive time spent on porn use can lead to neglecting important daily responsibilities.

  • Over time, a pattern of pornography use can make it harder to enjoy everyday pleasures, as the brain becomes wired to seek its dopamine fix through pornography rather than real-life experiences.
  • Some studies suggest that excessive porn use may even contribute to issues like desensitization, difficulty in forming relationships, and sexual dysfunction.
  • In short, by constantly chasing the dopamine high, some people find themselves caught in an escalating loop—needing more extreme content or longer sessions just to feel the same level of excitement, all while their brain becomes less responsive to natural rewards.

4. You’ve Lost Interest in Sex

Frequent viewing of pornographic material can lead to a decline in real-life sexual relationships. Unrealistic expectations created by pornography consumption may result in reduced attraction to a loved one, leading to intimacy issues and relationship problems.

  • The Journal of Sex Research notes that porn websites are more frequently visited7 than any other type of website on the internet and for a longer duration of time.
  • The current market value of the porn industry8 is expected to surpass one billion dollars annually and has experienced a 58% growth in the market since 2018. These are overwhelming statistics that highlight the prevalence and availability of porn that competes with real-life sexual relationships.

5. You’re More Demanding

As porn addiction progresses, individuals may develop unrealistic expectations of sexual activities. They may pressure their partner into engaging in behaviors seen in pornographic content, leading to dissatisfaction and strain in romantic relationships.

  • Porn use becomes a coping mechanism that creates mental health issues and disrupts and replaces natural sexual behavior. While porn addiction is not officially recognized as a diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), it does not mean that it does not significantly impact relationships and cause mental health conditions.
  • While the DSM-5 doesn’t classify it as an addiction, the World Health Organization’s ICD-11 (International Classification of Diseases)9 does recognize Compulsive Sexual Behavior Disorder (CSBD), which can include problematic porn use.

So, while there’s still debate over whether “porn addiction” is the right term, research suggests that compulsive porn use can have real effects on mental health and behavior.

Infographic titled Top 6 Signs of Porn Addiction, listing loss of control, seeking increasingly graphic content, neglecting responsibilities, relationship strain, emotional distress, and withdrawal symptoms. Each sign is shown in a web browser-style box. A graphic on the right shows hands tied to a laptop, symbolizing compulsive use.

What is the difference between sex addiction and pornography addiction?

“Sex and porn addiction both involve compulsive sexual behaviors that manifest differently. Sex addiction typically includes a pattern of seeking out sexual experiences (such as multiple partners, risky encounters, or excessive masturbation) despite negative consequences. Porn addiction, which is a subset of sex addiction, is characterized by compulsive pornography use that interferes with relationships, work, or emotional well-being. Both can stem from deeper emotional or psychological struggles, and addressing them often requires exploring underlying issues, developing healthier coping strategies, and developing meaningful connections.”

Andrew J. Schreier, ICS, CSAC, LPC, ICGC-II, BACC

6. You’ve Lost Attraction

Another warning sign of porn addiction is a loss of attraction to a romantic partner. The overstimulation of the brain’s reward system due to frequent viewing of pornography7 can alter real-life perceptions of beauty and desirability, affecting the ability to maintain healthy relationships.

  • Sexual health is impacted in a way that influences romantic relationships in real life. Social media can also play a role in disrupting healthy, human relationships. Struggling with porn addiction can also lessen the amount of time spent with partners in romantic relationships.
  • Young adults are also impacted by symptoms of porn addiction like mental health disorders and low self-esteem.

7. You’re Losing Money

Some individuals struggling with pornography addiction may spend significant amounts of money on subscriptions, premium content, or even engaging in online sexual activities.

This financial strain can impact daily life, leading to stress and potential conflicts with a family member or loved one. Use of pornography can also have a heavy financial burden, with some sites requiring increasing fees for use.

8. You’re Distracted

In today’s digital age, pornography is more accessible than ever, making it easy to develop compulsive behaviors without realizing the impact on mental health, relationships, self-esteem, and daily life.

While many people consume porn casually, for some, it becomes a habit that feels impossible to break. If you’ve ever found yourself struggling to stop, needing increasingly explicit content, or noticing a decline in real-life intimacy or continual distraction, you’re not alone.

Porn addiction can make it difficult to focus on tasks, leading to decreased productivity and performance at work or school. Individuals may frequently think about viewing porn, leading to an inability to concentrate on important responsibilities.

How can pornography addiction get in the way of my everyday life?

“Pornography addiction goes beyond casual viewing—it consumes your time and energy affecting your work, relationships, and mental well-being. The constant need for stimulation rewires your brain creating unrealistic expectations and making real-life intimacy feel unfulfilling. Over time, isolation, secrecy, and shame take over, leading to withdrawal from loved ones and neglect of personal growth. True wellness comes from balance, and breaking free from addiction means reclaiming control over your time, relationships, and sense of self.”

Rebecca E. Tenzer MAT, LCSW, CCTP, CGCS, CCATP, CCFP, CIMPH | Astute Counseling & Wellness Services

9. You’re Angry

Feelings of guilt, shame, and frustration can contribute to increased irritability and anger in individuals struggling with pornography addiction. Withdrawal symptoms from excessive porn use may lead to mood swings, emotional instability, and relationship problems.

Research suggests that when people become deeply engrossed in internet pornography, their brains react in a way similar to substance addiction8—certain neural pathways light up, triggering a direct and intense response to the content.

  • Just like in drug addiction, watching porn releases a surge of dopamine, the brain’s pleasure and reward chemical, reinforcing the habit and making it harder to stop.
  • However, over time, dopamine receptors become less responsive, meaning the same content no longer provides the same thrill. This can lead to frustration, irritability, and even anger issues, especially when a person tries to cut back or when real-life experiences don’t match the high of pornography.

Some studies even link compulsive porn use to emotional dysregulation, making individuals more prone to mood swings and impulsivity.

In extreme cases, this cycle of addiction and emotional instability can increase aggression, particularly when someone experiences withdrawal-like symptoms from trying to quit or faces obstacles to accessing porn. This makes it even harder to break free from the cycle, as stress and negative emotions can push them back toward their habitual coping mechanism—watching more porn.

Talking About Porn Addiction

Discussing pornography addiction can be challenging, especially for individuals who experience feelings of guilt or shame. Support groups9 such as addiction treatment options can provide a safe space for individuals to share their struggles and receive guidance from others who have faced similar challenges.

Porn addiction is often linked with other behavioral addictions and substance use disorders, such as alcohol addiction and drug dependency.

Research suggests that behavioral addiction, like pornography addiction, affects the same brain regions10 as substance addiction, reinforcing compulsive behavior.

Seeking Treatment and Recovery

Overcoming pornography addiction requires a combination of self-awareness, support, and professional intervention. Treatment options such as CBT, psychotherapy, and addiction treatment programs can help individuals break free from compulsive pornography use and improve their quality of life.

Recognizing the signs of porn addiction is the first step toward recovery. By seeking help and implementing positive changes, individuals can restore their well-being, maintain healthy relationships, and regain control over their lives.

Porn addiction can feel isolating, but recovery is possible with the right support and strategies. Recognizing the signs of problematic use is the first step toward making meaningful changes. Help and treatment are available.

Overcoming compulsive pornography use isn’t just about quitting—it’s about regaining control, rebuilding healthy relationships, and improving overall well-being.

If you or someone you know is struggling, seeking help is a courageous step toward a healthier and more fulfilling life. You are not alone in this journey, and with the right tools and support, healing is within reach.

Frequently Asked Questions

Q: What Is Porn Addiction?

A: Pornography addiction, also known as problematic pornography use (PPU), is characterized by an individual’s inability to control their consumption of pornographic material, leading to significant distress or impairment in personal, social, or occupational areas of life. This compulsive behavior persists despite negative consequences.

Q: What Are 5 Warning Signs of Addiction?

A: Identifying addiction involves recognizing certain behavioral patterns. Five warning signs include:

  1. Preoccupation: Constantly thinking about engaging in the addictive behavior.
  2. Loss of Control: Unsuccessful attempts to reduce or stop the behavior.
  3. Tolerance: Needing increasing amounts of the behavior to achieve the desired effect.
  4. Withdrawal: Experiencing negative emotions or physical symptoms when unable to engage in the behavior.
  5. Neglecting Responsibilities: Prioritizing the behavior over important personal or professional obligations.

Q: What Does Porn Addiction Do to Your Brain?

A: Chronic consumption of pornography can lead to neurobiological changes similar to those observed in substance addictions. These changes may include altered brain structure and function, affecting areas related to reward, motivation, and decision-making. Such alterations can reinforce compulsive viewing behaviors and diminish sensitivity to natural rewards.

Q: How to Treat Pornography Addiction?

A: Effective treatment approaches for pornography addiction often involve:

  • Psychotherapy: Cognitive Behavioral Therapy (CBT) has been shown to reduce the severity of PPU and associated symptoms like anxiety and depression.
  • Support Groups: Participating in peer support groups provides community support and shared coping strategies.
  • Medication: In some cases, pharmacotherapy may be considered as part of a comprehensive treatment plan.

A combination of these approaches is often recommended for optimal outcomes.

Q: What Causes Problematic Pornography Use?

A: The development of problematic pornography use can be influenced by various factors, including:

  • Psychological Factors: Stress, anxiety, and depression are strongly related to increased pornography consumption.
  • Behavioral Factors: Habitual use as a coping mechanism for negative emotions or boredom.
  • Social Factors: Exposure to environments where pornography use is normalized or encouraged.

Understanding these underlying causes is crucial for effective intervention and treatment.

Q: What Is the Difference Between Sex Addiction and Pornography Addiction?

A: While both involve compulsive sexual behaviors, they differ in focus:

  • Sex Addiction: Encompasses a broad range of compulsive sexual activities, including promiscuity, excessive masturbation, and risky sexual behaviors.
  • Pornography Addiction: Specifically relates to the compulsive consumption of pornographic material, often leading to isolation and neglect of real-life relationships.

Both conditions can co-occur and may require similar therapeutic approaches.

Q: How Can Pornography Addiction Affect Your Mental Health?

A: Problematic pornography use is associated with various mental health challenges, including:

  • Increased Anxiety and Depression: Excessive use can exacerbate feelings of anxiety and depression.
  • Cognitive Distortions: Developing unrealistic expectations about sex and relationships.
  • Emotional Distress: Feelings of guilt, shame, or hopelessness related to one’s behavior.

Addressing these mental health issues is a critical component of comprehensive treatment.

Q: How Can I Tell If I Have a Pornography Addiction?

A: Self-assessment questions to consider:

  • Frequency: Do you spend a significant portion of your time engaging with pornography?
  • Control: Have you tried to cut back without success?
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Does Alcohol Really Help You Relax? Understanding the Effects

Alcohol can make you feel relaxed, but it’s fleeting, dangerous, and not a true state of relaxation. Reaching for alcohol to cope with stress can start a self-feeding cycle marked by anxiety and eventual dependence.

Let’s explore the true effects of alcohol and how short- and long-term consequences can hide behind the guise of relaxation.

How Alcohol Affects the Brain and Body

Does alcohol help you relax if you’re stressed? It can, but that’s because alcohol is a central nervous system depressant. So it can lower your ability to feel stress—not make it go away.

Alcohol as a Central Nervous System Depressant

Your central nervous system (CNS) controls1 your movement, thinking, speech, senses, and general awareness of what’s happening within and around you. When it’s depressed from alcohol, you may slur your speech, lose your balance and coordination, feel less pain, and lose your ability to think clearly. 

You’ll also feel an initial calming sensation as your CNS slows down. But operating without your central nervous system in full gear can have disastrous effects, including

  • Accidental self-injury due to falls
  • Criminal behaviours
  • Drunk driving
  • Memory blackouts
  • Vomiting
  • Slowed (or stopped) breathing and heart rate

Impact on Neurotransmitters

Alcohol increases ‘inhibitory’ neurotransmitters2, meaning brain activity slows down. This is what causes that initial wave of calmness. Alcohol also acts on the GABA (gamma-aminobutyric acid) receptor, causing a sense of sedation and lowered anxiety. It affects serotonin levels3, too, and over time, these skewed levels contribute to alcohol addiction.

To balance the inhibitory effects of alcohol, your brain produces excitatory neurotransmitters2. If you stop drinking alcohol and the extra excitatory neurotransmitters have nothing to balance, you can develop symptoms of alcohol withdrawal. 

Disruptions to Sleep and Rest

Alcohol lowers the quality of your sleep4. It negatively affects the same neurotransmitters involved with sleep, meaning it can alter your body’s natural cycles and rhythms. You may fall asleep due to the initial sedative effects of alcohol, but it disrupts your sleep later on in the night. 

Sleeping with alcohol in your system leads to frequent wakings during the night5 and poor-quality sleep as the alcohol slowly makes its way out of your body. This means you’ll wake up feeling unrested, groggy, and generally not your best.

Heavy, continuous drinking can lead to insomnia. People with sleep challenges like sleep apnea or snoring are likely to experience more negative effects5 if they drink before bed, even if just one drink. 

The Short-Term vs. Long-Term Effects of Alcohol on Relaxation

The initial slowing of activity in your CNS causes a feeling of relaxation, but it doesn’t last. 

The Initial Relaxing Effect

Drinking alcohol can produce a sense of calm6, and for some, even a sense of euphoria. This can make it seem like a quick solution to stress, but since it doesn’t take away the problem, only distracts from it, alcohol isn’t a true solution.

Alcohol also activates the brain’s reward system6, which can make the act of drinking feel pleasurable or exciting. This excitatory state combined with reduced inhibitions can cause the sense of euphoria some feel.

And, alcohol slows down the parts of your brain that process negative emotions7, which is why it can seem like sadness, guilt, or grief vanish after drinking.

Increased Anxiety and Stress Over Time

Drinking regularly can build a dependence and increase your tolerance7, meaning you’ll need to drink more and more to mitigate the negative effects (like cravings) and feel intoxicated. As dependence and tolerance grow, drinking changes from pleasurable to monotonous—satiating a need for alcohol rather than enjoying its effects.

Feeling more dependent on alcohol can increase your overall anxiety and stress, especially for those balancing other responsibilities and demands.

The “Alcohol Hangover” and Rebound Anxiety

A study reports that “alcohol may reduce anxiety by inhibiting responding to anxiety-provoking stimuli.8” Once those effects wear off, rebound anxiety can occur as the dampened systems in the brain start functioning normally. Rebound anxiety can feel like a wave of symptoms crashing all at once.

Rebound anxiety can lead to a cycle of consumption in hopes of keeping the wave from crashing—but it’s not sustainable. People can inadvertently develop alcohol use disorder trying to stay afloat.

Alcohol and Stress: Myths vs. Reality

Think of how many “person-unwinding-after-a-hard-day-with-alcohol” scenes crop up in movies, TV shows, and books. It would seem to be a perfectly normal stress response.

In reality, the stress-relieving idea and the normalcy of this ritual both prove to be myths.

The Myth of Alcohol as a Stress Reliever

Alcohol only changes your ability to notice your stress—it doesn’t take any bit of it away. It may dampen the sensations of stress, which some people experience more pronouncedly than others9, but doesn’t solve the underlying issue. Momentary distractions like this may feel like an adequate solution, but they can cause much more harm than the initial stressor itself.

The Reality: Alcohol’s Impact on Stress and Mental Health

Over time, alcohol can actually raise levels of stress and worsen (or cause) mental health conditions10 like depression and anxiety. It can also make you more irritable and emotionally volatile. 

Its negative effects on sleep can also worsen mental health conditions and cause additional stress11. Fleeting relief from negative emotions comes with a high price, but it doesn’t have to.

Healthier Alternatives to Alcohol for Relaxation

For a comprehensive list of ways to relax without alcohol, check out our article here.

Meditation and Deep Breathing Techniques

Your mind and lungs can be powerful tools in inducing relaxation. 

Next time stress overwhelms, try sitting down and playing a guided meditation session. Search the app store on your phone to find dozens of meditation apps to choose from.

Either separately or alongside your meditation, try a paced breathing technique. Deep, slow breathing tells your brain you aren’t under threat. Examples of breathing techniques include

  • Box breathing: Breathe in for 4 seconds, hold for 4, exhale for 4, hold for 4, and start the cycle again.
  • Belly breathing: Focus on expanding your stomach as you breathe. When you breathe out, decompress your stomach as much as you can. This is also called diaphragmatic breathing—try putting your hand on your stomach to feel it rise and fall.

Physical Exercise

Exercise lowers levels of stress hormones12, helping you feel more relaxed. You don’t have to do certain exercises to get these benefits, just find a way of moving that works for you. You could try

  • Walking
  • Weightlifting
  • Jumproping
  • Running
  • Climbing the stairs in your house/apartment
  • Swimming

Developing an exercise routine can help you stick to your goals, like working out before you head into work. And, you can use exercise as-needed to manage acute stress—like doing jumping jacks before or after a stressful situation.

Music and Creative Outlets

Creative expression can also relieve stress13 by engaging the mind and body in a pleasurable, open-minded way. Art and music can alter your perception of the stressful event by helping you take a step back from it. Keeping your hands busy can also help you process stressful events without feeling overwhelmed.

Examples of creative outlets include

  • Doodling
  • Painting
  • Singing
  • Listening to music
  • Creative writing
  • Poetry

Building Sustainable Relaxation Habits

Identifying Triggers for Alcohol Use

Identifying what triggers an urge to drink can help you proactively avoid and prepare for these scenarios, including stress. For example, maybe certain days of the week feel more stressful, like Mondays. Planning a relaxing activity on these days can help manage that stress, and give you peace of mind knowing you have a plan and won’t need to resort to alcohol.

Other situations could include social settings, like a party or event. You might feel stressed and want to use alcohol to numb the nerves and help you be more social—plan ahead by practicing breathing techniques (or other coping skills) before the event and opt for non-alcoholic drinks to limit your alcohol intake.

Creating a Relaxation Routine

Block off time to relax and write down your favorite relaxation techniques. Do one or more relaxation techniques during the time you block off, like a meditation before bed or spending time outside after work. Incorporating relaxation into your daily routines can help it become habitual. 

Seeking Support for Alcohol Dependence

Sometimes you need more than stress relief—developing a physical and emotional dependence on alcohol takes medical care to safely reverse. Set up an appointment with your primary care provider to voice your concerns and learn your next steps. Helpful conversation points include

  • “Should I be concerned about my symptoms?”
  • “What can I do to stop being dependent on alcohol?”
  • “Will I need a medical detox to start my treatment?”
  • “Would you recommend alcohol rehab?”
  • “What strategies or treatments can I start using right away?”

Your doctor may refer you to therapy, outpatient alcohol addiction treatment, or residential rehab for alcohol addiction. Detoxing at a rehab or hospital may be a necessary first step; make sure you ask your doctor for their medical opinion. You can use Recovery.com to find rehabs and outpatient programs that treat alcohol addiction.

The Reality of Alcohol and Relaxation

Alcohol isn’t a healthy or sustainable relaxation tool, but relaxation techniques relevant to your preferences and needs are. Fill your toolbox with techniques like breathing exercises, meditation, exercise, creative expression, and more to cope with stress without alcohol. Planning ahead for stressful situations can help you feel more prepared and empowered.

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Bipolar 1 vs. Bipolar 2: Crucial Differences You Need to Know

Not everyone with bipolar will have the same symptoms. The differences are drastic enough for bipolar to have two distinct clinical categories: types 1 and 2. 

Both versions of bipolar include ‘polar’ opposite moods—noticeable highs and lows. Just how noticeable depends on what type of bipolar you have. Shorter periods of low-level mania (called hypomania) are unique to bipolar 2, while bipolar 1 has pronounced episodes of mania that may require hospitalization. 

With such distinct differences between symptoms, treatment and management for these sister conditions requires a personalized touch.

Characteristics of Bipolar Disorders

Bipolar disorder is a biological mental illness1, meaning parts of your brain aren’t working exactly how they should. Unlike depression, which can be the product of an unpleasant situation, bipolar exists independently of what you’re experiencing. Life events can certainly trigger a mood swing, but they aren’t what causes bipolar to exist in the first place. 

A combination of genetics, your brain’s ability to send and receive signals, your natural temperament2, and more produces bipolar disorders. Malfunctioning connection points in the brain mean you can get skewed amounts of neurotransmitters like dopamine and serotonin, leading to extreme mood swings, irritability, depression, and mania2. 

Mood Stabilizers vs. Antidepressants

Mood stabilizers, the go-to medication for bipolar, work by improving and stabilizing2 those ineffective connection points in your brain. This means neurotransmitters can flow as designed, leveling out mood swings and reducing mania. Highs won’t feel as high, and lows not so low—basically, the healthy baseline between depression and mania. 

Antidepressants produce more of certain mood-boosting neurotransmitters or help your brain receive more of them. While mood stabilizers help neurotransmitters flow correctly, antidepressants affect the amount of neurotransmitters created and/or received. 

Often, both a mood stabilizer and an antidepressant are used to treat bipolar disorders.

Signs and Symptoms of Bipolar I

Bipolar 1 mania often has a strong presentation, including out-of-character behavior that patients typically fear or regret. Manic episodes last at least 7 days1, including symptoms like

  • Extreme irritability
  • Extreme elation; high mood
  • Fun-seeking behaviors, including sexual promiscuity
  • Lacking sound judgment when it comes to purchases, activities, and priorities
  • Talking quickly and bouncing between ideas, sometimes so fast others can’t keep up or understand
  • Needing less sleep
  • Highly productive
  • Feeling especially important or special

And, sometimes,

  • Psychosis
  • Delusions
  • Hallucinations

The symptoms of mania may require hospitalization to manage the person’s safety and well-being, and to prescribe the correct mood stabilizers and bring them out of acute mania. Mood stabilizers like lithium can address acute mania and manage symptoms long-term, though prescription trends show more doctors leaning away from lithium3 and into other medications. These can have fewer side effects and easier tolerability. Atypical antipsychotics have proved helpful for bipolar 1 and 2.

Along with high moods and mania, people with bipolar 1 also experience extreme periods of depression. Episodes of depression typically last 1-2 weeks with bipolar 11, but can last longer. With this depression can come symptoms like

  • Thoughts or plans of suicide
  • Self-harm
  • Decreased energy and motivation
  • Loss of interest or pleasure in once-enjoyable activities
  • Feeling hopeless
  • Low mood and fatigue

Mood stabilizers and atypical antipsychotics can help manage depression, too. Interestingly, for bipolar depression, clinicians don’t recommend antidepressants as a sole medication. They can actually trigger a manic episode if not combined with a mood stabilizer1 or atypical antipsychotic.

It’s not a choice, it’s a condition. I have bipolar disorder, but it doesn’t define me.

Carrie Fisher

Research suggests that there are complex links between diabetes and mental health conditions, such as depression, bipolar disorder or schizophrenia — connections that are not fully understood.

National Alliance on Mental Illness

Signs and Symptoms of Bipolar 2

Bipolar 2 mimics bipolar 1, but with a crucial difference in manic symptoms. Someone with bipolar 2 experiences hypomania4, which means their periods of mania are much less intense and less debilitating, often not affecting their safety, relationships, and work responsibilities nearly as much as mania. You can remember “hypo” means low or less, so low-mania.

Sometimes, people with bipolar 2 actually enjoy their hypomanic states. They often feel more energized, but not out of control, and happier, but not over energized. Perceiving hypomania as a “good mood”, especially following a depressive episode, can keep those with bipolar 2 from seeking treatment or realizing something’s amiss. 

Hypomania occurs more frequently than mania5 and can have negative consequences even if people perceive them as positive. Many people with bipolar 2 don’t feel comfortable with their actions and behaviors during a hypomanic episode, either. Symptoms of hypomania5 include

  • Increased energy
  • Less need for sleep
  • Urge to socialize and talk about anything and everything
  • Risky and promiscuous sexual behaviors
  • Extreme irritability
  • Intense anxiety

Notably, hypomania doesn’t cause psychosis, delusions, or hallucinations. People in a hypomanic state may not even notice it’s happened, whereas mania has much more pronounced signs and effects. Loved ones may notice hypomania, and they will certainly notice mania.

Bipolar 2 also includes periods of depression, often more so than bipolar 16. Periods of depression can last months or years, while hypomania often lasts several days. 

Those with bipolar 2 face the highest likelihood of an incorrect diagnosis6. Since symptoms of mania are much less pronounced than bipolar 1, providers may misdiagnose patients with major depression, dysthymia (constant low-level depression), or borderline personality disorder (BPD). Hypomania can even present as extreme anxiety and irritability, which could be misdiagnosed as general anxiety disorder. Though these conditions can co-occur with bipolar 2, mistaking them for the primary diagnosis delays proper treatment.

Recognizing the cyclic nature of low/high moods can help patients and their providers arrive at an accurate diagnosis. Getting the right diagnosis means getting the most effective medications and therapy, which can be especially vital in treating bipolar disorders.

Key Differences

Key, overarching differences between bipolar 1 and 2 include

  1. Mania vs. hypomania
  2. Less vs. more frequent depressive episodes

Other differences vary person-to-person. Everyone will experience bipolar 1 or 2 differently. Doctors will often take a deep-dive to determine if you have bipolar 1 or 2, or an entirely different diagnosis.

Treatments for Bipolar 1 and 2

Medications

It’s true mood stabilizers like lithium can be life-changing medications for those with bipolar, especially bipolar 1. Mood stabilizers can manage mania (acute and long-term) and prevent mood cycling. 

Certain mood stabilizers and atypical antipsychotics center on reducing depression and suicidality, not mania. Those with bipolar 2 often benefit from these types of mood stabilizers, plus an antidepressant. 

Therapy

Therapy can help people manage and understand their symptoms. Cognitive behavioral therapy (CBT) focuses on changing thoughts and behaviors to positively alter mood, which can help in a depressive episode. Dialectical behavioral therapy (DBT) teaches practical strategies for managing distress, surviving crisis urges (like suicidal ideation), and interpersonal communication.

Those with bipolar often remain in therapy throughout their lifetime, as regular sessions can help manage stressors and other life events that could trigger a mood swing. Patients can learn personalized strategies for managing their symptoms and receive ongoing emotional support by working with a therapist.

Mood Tracking

Tracking mood serves as a vital tool for people with bipolar disorders. You can download apps designed exactly for this, or track it in a notebook. Keeping track of your mood and what’s happening in your life can clue you into the unique aspects of your mood cycles, helping you proactively manage highs and lows. This can help you feel more in control, not like your moods are happening to you.

Finding Your Cornerstone: Bipolar Maintenance

Figuring out your unique symptoms and expression of bipolar 1 or 2 can take time, but with accurate diagnoses, medications, therapy, and acceptance, you can learn to manage your bipolar as confidently as you might manage your diet or sleep. 

Regular appointments with therapists and psychiatrists can be key to long-term recovery. Let your loved ones know of your condition too, so they can offer their support when needed. And keep an open, non-judgemental mind as you navigate your symptoms—you’ve got this, and you’re in good company on the journey.
Use Recovery.com to find recovery centers offering bipolar treatment, with pictures, insurance information, reviews, and much more to help you find the best fit for you.

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Opioid Misuse and Addiction

Opioids have many forms and uses, from essential painkillers to illicit pseudo-prescriptions with hidden risks and dangers. In any form, prescribed or illicit, they’re highly addictive.

In this article, opioid “misuse” will describe the act of taking opioids, prescribed or not, for purposes beyond their intent. This type of use can quickly spiral into addiction, but many treatment programs offer pathways to recovery.

What Are Opioids?

Opioids are a type of drug derived from the opium poppy plant1, but can also be lab-created without the opium base. When opioids bind to opioid receptors in the brain, they block pain signals1 and produce a sense of euphoria. This aspect in particular can spur misuse and, eventually, addiction.

Opioid Types and Their Uses

Opioids come in many forms, carefully modified for medicinal uses or haphazardly assembled in clandestine labs for illicit purposes. Here are some of the most common types and their uses.

Pain Relievers

Pain-relieving opioids have been developed specifically for intense pain. Doctors often prescribe them after surgeries or for painful, chronic conditions like cancer. When used as prescribed (usually a small amount over a specific time frame), prescription opioids are less likely to lead to addiction. 

Prescription opioids2 include:

  • Oxycodone
  • Hydrocodone
  • Morphine
  • Oxymorphone
  • Fentanyl
  • Codeine

Illegal Types

Some opioids are never prescribed due to their potency and potential for addiction. These opioids might be naturally derived or synthetic (man-made). They’re classified as illegal, and having them can result in jail time. Examples include

  • Heroin, which comes directly from the opium poppy
  • Fentanyl and carfentanil (when procured and taken without a prescription)

Risk Factors for Opioid Misuse

Although opioids can be highly addictive, not everyone who takes an opioid, prescribed or otherwise, will develop an addiction. Certain risk factors can make addiction more likely, like your genetics, environmental influences, and mental health conditions.

Genetics

Your genes can increase the chance of opioid addiction3. They don’t cause addiction, but slight variations and epigenetics (changes in how your body reads gene sequences) can make you more prone to opioid addiction. For example, variations in your mu-opioid receptors can alter how your reward system works—an integral part of developing an addiction.

Environmental Influences

Growing up in an environment that normalizes substance use can make addiction more likely. Stressful environments can, too, as substances can serve as a coping mechanism. People may also use substances to connect and fit in with peers4.

For example, a child who grows up with family members who drink heavily may get introduced to alcohol early on and view drinking as a way to connect with their loved ones. Someone who grows up in high-stress environments, like poverty or often witnessing domestic violence, may also turn to substance use as a way to cope with the ongoing strain. These types of environments can lead to the initiation of use, which can snowball into addiction.

Mental Health Conditions

Having a mental health condition like depression, anxiety, or post-traumatic stress disorder (PTSD) can make you more susceptible to addiction5. Someone may use substances to self-medicate6 the symptoms of their condition. For example, someone with anxiety may notice their prescription opioids gave them a sense of calm and well-being that made social interactions easier. Or, a stressed executive may find they can get through the day easier if they take heroin before work. 

Regular use for these reasons can bloom into an addiction. 

Signs of Opioid Use

If you suspect a friend or a loved one has started using opioids not as prescribed or procuring illicit opioids, you can look for key signs of opioid use7 and voice your concerns to them. This can start the process of getting treatment if and when they’re willing.

Physical Signs

  • Seeming tired often, “out of it”
  • Small pupils
  • Disheveled appearance
  • Track marks on their arms or legs and/or unseasonal clothes to hide them
  • Sudden, unexplained loss of pain that previously impaired their functioning

Behavioral Signs

  • Avoiding family and friends without adequate explanation
  • Acting secretive about their belongings and activities
  • A marked change in their attitude or personality
  • They may lose their job or academic standing due to poor performance

Symptoms of Opioid Addiction

The symptoms of an opioid addiction may look similar to the signs of initial use. Their key differentiator is how greatly they affect someone’s day-to-day life. An addiction will rewrite someone’s priorities and motives, while regular use often doesn’t.

Job Loss and/or Financial Struggles

Fixating on using opioids can lead to neglecting work responsibilities, which may cause job loss and ensuing financial struggles. They may lose their home or need to sell personal belongings, like their car and jewelry, to keep paying for opioids. They might even resort to theft.

Health Complications

An opioid addiction can cause various health complications8, including weight loss, infection, and blood-borne diseases from unclean needles. You may notice they seem haggard and generally unwell.

People who regularly take opioids are also more likely to fall, get sick more often, and actually become more sensitive to pain.

Relationship Struggles

Someone with an opioid addiction may neglect personal relationships and friendships to either hide their use or spend more time on getting, taking, and coming down from opioids. Their relationships may fade and crumble as a result. 

Treatments for Opioid Use

Opioid addiction has many paths to recovery. 

Detox

Opioid treatment often starts with detox, which safely removes opioids from the body and allows it to return to homeostasis. Medications like buprenorphine9 and methadone10 can help people detox from opioids more comfortably and lessen cravings. Some people stay on these medications to enhance their recovery since they reduce the effects opioids have and make them pointless to take.

Rehab

Many residential rehabs offer detox and therapeutic care over the course of 28+ days. Rehabs aim to treat both the medical and emotional effects of opioid addiction, helping people address root issues and build practical relapse prevention skills.

A typical day in rehab includes 1:1 and group therapies, plus group activities and likely a peer step meeting or two. Depending on its location, some rehabs may offer daily activities or weekly outings, like hiking.

Outpatient

Outpatient programs offer intensive care with greater flexibility. You’ll attend therapy during the day but go home at night and have time for personal responsibilities. Many clinics also offer medication-assisted treatment for opioid addiction recovery.

For example, you may go to outpatient treatment after work from 5-7 p.m. You’ll likely attend multiple group therapy sessions and focus on building and strengthening relapse prevention skills. A more intensive outpatient program is day treatment, which typically runs for 5-8 hours a day, 5-7 days a week. Intensive outpatient programs (IOPs) often include 3-5 days of weekly treatment for 2-3 hours daily. 

Continuing Support

Treatment for opioid addiction doesn’t end once your programs do—it can continue for years in aftercare and peer support programs. For example, you could attend regular 12-Step meetings like Narcotics Anonymous (NA) or secular SMART Recovery meetings. These keep you connected to others in recovery and provide accountability.

Ongoing therapy can support your healing, too. You can meet with a therapist on a regular cadence to discuss current events and keep working through issues identified in addiction treatment.

Find Opioid Rehabs

Opioid rehabs exist worldwide. They offer various approaches and levels of care, meaning you can find a rehab best suited to your needs and preferences. 
On Recovery.com, you can search for opioid rehabs by location, insurance type, level of care, and more. You can also see reviews, photos, pricing information, and read detailed descriptions of each center.

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Effects of Substance Use During Pregnancy

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

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

Understanding Substance Use During Pregnancy

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

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

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

Effects of Alcohol Use During Pregnancy

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

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

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

Effects of Tobacco Use During Pregnancy

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

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

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

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

Effects of Illicit Drug Use During Pregnancy

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

Neonatal Abstinence Syndrome: Symptoms and Recovery

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

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

Effects of Prescription Medication Use During Pregnancy

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

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

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

Combined Substance Use and Its Effects

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

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

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

Psychological and Emotional Impact on Pregnant Women

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

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

Preventative Measures and Treatment Options

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

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

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

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

Support Systems and Resources

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

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Sleeping Pills Misuse and Addiction

Sleeping pills help people get a good night’s sleep. But on the other side of the pillow is a potential for dependence and addiction.

Following prescription guidelines and staying in communication with your prescribing doctor can mitigate the risks of addiction, as can tapering off sleep medications as soon as you can. If you or someone you love develop an addiction to them, you have resources for healing.

Types of Sleeping Medications

Some sleeping medications you can buy over-the-corner, like melatonin and sleep aids with doxylamine or diphenhydramine (the active ingredient in Benadryl). These medications aren’t likely to cause addiction, though you can get used to your starting dose and need more and more to feel tired—signifying you’ve built a tolerance.

Prescribed sleeping pills are used to treat insomnia1, which is a sleep disorder that makes it difficult to fall asleep, stay asleep, or both. Behavioral treatments (therapy) can also treat insomnia by addressing what’s keeping you up, like stress, trauma, or racing thoughts related to a condition like attention-deficit hyperactivity disorder (ADHD).

Here are some common prescription sleeping pills:

  • Ambien
  • Lunesta
  • Sonata
  • Belsomra
  • Dayvigo

Sleeping pills broadly fall into these categories: sedative-hypnotics, benzodiazepines, and antidepressants, since some antidepressants have sedative effects. 

Statistics of Sleeping Pill Misuse and Addiction

Many people struggle with sleep, either in response to a stressor or chronically. A study by the Center for Disease Control (CDC)2 found these statistics in 2020:

  1. 8.4% of American adults took sleeping pills every day or most days over the past month.
    1. 6.3% took sleeping pills every day.
  2. Taking sleeping pills becomes more likely with age, from 5.6% in young adults to 11.9% in those 65 and older.
  3. While the percentage of people who become addicted to sleeping pills isn’t known yet, scientists have estimated an addiction percentage of nearly 20% for benzodiazepines3, which are often used as short-term sleeping pills.

Dangers of Sleeping Pill Misuse and Addiction

Using any medication outside its prescription guidelines can come with dangers, but they can be especially prevalent for sleeping medications due to their sedative effects.

Physical Dangers

Since sleeping pills sedate people, taking too many at once can dangerously enhance those effects. You may sleep much longer than intended, find it extremely difficult to wake up, or in extreme cases, die from your central nervous system slowing too much. Overdosing can lead to a coma and heart failure or stopped breathing.

If you think you or someone else has taken too many sleeping pills, call 911 for emergency medical care or contact Poison Control.

Emotional Dangers

Becoming reliant on anything, sleeping pills included, can lead to anxiety and an overall worsening of mental health conditions. If you can’t take the pills, you may become too anxious to sleep, leading to a cycle of use even if you want to stop. Tapering can help with this.

Depending on which kind of sleeping pill you take, like an antidepressant versus a hypnotic, you could also experience new or worsening mental health conditions as a side effect of the medication.

Harm to Relationships

Addiction can alter priorities, making substance use more important than spending time with loved ones and maintaining relationships, personal and professional. This can damage those relationships over time.

Can You Overdose on Sleeping Pills?

Yes, you can overdose on sleeping pills. You can take too many of almost any pill, but the effects of a sleeping pill overdose can be especially pronounced due to their sedative nature. The more potent they are, the more easy an overdose becomes—which is why following prescription guidelines is so important.

Sleeping pills can react to other substances, like alcohol, and have a much stronger effect. For example, alcohol is also a central nervous system depressant, so having alcohol and sleeping pills can create a dangerous double-strength effect4 even at your usual dose. Be sure to read the warnings on your prescription bottle and ask your doctor about potential drug interactions.

If you think you or someone else has overdosed on sleeping pills, call 911 or your local emergency number. 

Signs of Sleeping Pill Addiction

Someone who’s developed an addiction to sleeping pills typically will show a few key signs that you and other loved ones can look out for—or you might recognize these signs in yourself. In any scenario, identifying the need for help is the first big step in getting it.

Taking More Than The Prescribed Dose

For example, someone may have a prescribed dose of 10mg but take 50mg daily. Or, they might take 10mg throughout the day, multiple times daily. 

For a stronger effect some people may crush up their sleeping pills and snort the powder, dilute it in water and inject it, or dissolve it into a drink for a quicker impact.

Negative Consequences, But an Inability to Stop

Someone who’s unable to stop taking sleeping pills despite clear negative consequences has likely developed an addiction. These consequences could include job loss, damage to relationships, negative health effects, and stress.

Frequently Under The Influence

Overusing sleeping pills can mean someone often seems under their influence—sleeping or sleepy, disoriented, woozy, and disconnected from reality. They may go about daily life in this state or isolate themselves to hide symptoms.

New Habits and Friend Groups

As procuring and taking sleeping pills becomes more imperative due to an addiction, people’s habits and friend groups can change in turn. For example, they may adopt new habits to hide or excuse their drug use, like taking walks at night that could actually be private time to take substances unseen or meet dealers. 

New friend groups might include others in active addiction who can supply substances or connect people to more. At the least, these new friends may not discourage substance use, which can make them appealing substitutes for concerned friends and family.

Treatment Options for Misuse and Addiction

An addiction or dependence on sleeping pills can be treated, often with a tailored combination of behavioral therapies and medical care.

Behavioral Therapies

Therapy aims to reach the root of an addiction and pluck it. You’ll learn the purpose addiction serves in your life and how to address the issues and emotions that led to it, all in a safe and therapeutic space.

Common therapies for addiction include

Therapy occurs 1:1 with a therapist or in group settings. Many rehabs and outpatient addiction programs offer a structured daily routine of therapy and skill-building to address core issues and build relapse prevention skills.

Medical Interventions

Medical care can help people detox from substances like sleeping pills, safely removing them from their body. Detoxing without medical care can be dangerous and even fatal, so be sure to get your doctor’s advice on the level of care you need for your symptoms. You can ask questions like

  • “What treatments will make my recovery as safe and comfortable as possible?”
  • “How can I improve my sleep without sleeping pills?”
  • “Do I need medical detox? If so, what are my next steps for that?”
  • “What lifestyle changes can I make to improve my physical and mental health as I recover?”

Support Groups

“Connection is the opposite of addiction”5 has been touted and found true in many instances. One of the best ways to find connection is through peer support groups like Pills Anonymous (12-Step-based) or SMART Recovery groups (non-12-Step). These groups occur worldwide, in-person or virtually. You can also find connection and support through religious organizations, your workplace, and other community settings (like sports and craft communities). 

Find Help for Sleeping Pills Misuse and Addiction

With medical, therapeutic, and emotional support you can stop using sleeping pills, or cut down to a dose you and your doctor feel comfortable with. Your doctor can be your first point of care, guiding you to your various options and offering treatment.
You can also go to a rehab that treats sleeping pill addiction. Use Recovery.com to find sleeping pill rehabs by what insurance you have, your location, desired amenities and more.

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What Is Gaslighting? A Guide to Recognizing and Healing from Emotional Manipulation: Matthew Glowiak

My name is Matt Glowiak, and I am a mental health and addictions counselor, professor, author, presenter, and advocate of positive social change. Though my pathway toward becoming a mental health professional was not necessarily linear, it was one that continually called to me throughout life, and here I find myself following my callings. Beyond working with clients in a clinical setting and teaching graduate level students, I find immense value in educating the public on mental health and addiction in a relatable manner that makes sense. The more the general population knows on these topics, the more quickly and effectively we may destigmatize mental health and addictive disorders. 

There is this common misconception that people only see a counselor when they are struggling with significant mental health or addiction issues. The truth, however, is that not everyone who comes to counseling has a true diagnosable condition. Given that all of us face challenges at one point or another, counseling can prove fruitful toward helping one understand oneself and others better, work through a temporary challenge, and so much more. One frequently occurring topic of discussion that is sometimes connected to a diagnosable condition and other times not is gaslighting. 

Understanding Gaslighting: Recognizing the Signs

Seemingly, there is a lot more literature available on gaslighting these days than in the past. Why is this? Well, I think the definition of the term provides a lot of insight into the why. Gaslighting is a form of psychological manipulation that seeks to make a person doubt their own perceptions, memories, or reality. What makes this form of manipulation especially challenging to identify is that victims often feel as though they are the ones with the issue while potentially never discovering the true reality of what’s happening. It’s important to note that gaslighting does not necessarily indicate a diagnosable mental health disorder, though it can be a symptom of some diagnoses. 

Gaslighting often involves a manipulator denying facts, lying, or presenting false information to confuse or destabilize the victim. A common example in the workplace might entail an employee being reprimanded by upper-level management for poor performance in the workplace associated with a specific task. When the employee speaks to the directives provided by their direct supervisor, the supervisor might continually deny having made a decision or giving specific instructions, leading the employee to question their memory or competence. Ultimately, the employee takes the blame and truly feels remorseful.

Gaslighting is also a common feature in many toxic relationships. Consider an abusive relationship where one individual makes every attempt to control another out of their own insecurities. They might call names, behave erratically, threaten safety, and otherwise to continue getting what they want. When called out, however, the perpetrator will frequently belittle their partner’s feelings, suggesting they are overreacting or being too sensitive, which can diminish the victim’s self-esteem. Again, the victim blames themself. 

Two mental health disorders most associated with gaslighting include narcissistic personality disorder (NPD) and borderline personality disorder (BPD). Individuals with NPD may engage in gaslighting to maintain control over their environment and to avoid responsibility. For example, a person with NPD might manipulate a partner into believing they are responsible for the narcissist’s unhappiness, creating a sense of guilt and confusion. In the case of BPD, symptoms associated with emotional instability might lead them to distort reality or project their feelings onto others, causing those around them to doubt their own perceptions.

Healing From Gaslighting

Whether gaslighting stems from a diagnosable mental health condition or not, the consequences for the victim are similar. This behavior can lead to significant emotional distress and can be a form of emotional abuse. When addressing gaslighting, it’s important to utilize approaches most appropriate for victims as well as perpetrators. In my experience, I have worked with both. 

For victims of gaslighting, Cognitive Behavioral Therapy (CBT) helps victims understand and reframe distorted thoughts and beliefs, empowering them to reclaim their sense of reality. Support groups provide the opportunity to connect with others who have experienced similar situations and can provide validation and support. Assertiveness training can help victims to express their feelings and needs more effectively, reinforcing their sense of worth and reality.

For perpetrators of gaslighting, engaging in individual therapy, particularly with a focus on understanding the underlying reasons for their behavior, can be crucial. Therapies such as Dialectical Behavior Therapy (DBT) may be beneficial, especially for those with personality disorders (i.e., NPD & BDP). With communication skills training, learning healthy communication strategies can help perpetrators understand the impact of their words and behaviors on others. Working to develop empathy can also assist individuals in recognizing and addressing their harmful behaviors.

In both cases, fostering a safe, supportive environment is key to healing and change. This is especially poignant while working with couples and families. Here, the counselor serves as a facilitator who guides the conversation, ensuring that the dialogue is respectful and that each party has their voice heard without disruption. In more severe cases, potentially where safety is threatened, it is most appropriate to begin with each party individually to help them arrive at a better place personally before beginning their work collectively. 

Helping Clients Overcome The Effects of Gaslighting

Admittedly, working with victims or perpetrators of gaslighting is challenging. For the victim, sometimes the effect of gaslighting is so glaringly obvious that it can be frustrating when your client does not connect the dots despite all the evidence pointing in that direction. On the end of the perpetrator, especially when they are aware of what they are doing and express no empathy, you sometimes feel as though there is no end in sight. Hence, patience can be a virtue while remaining objective is a must. 

In either case, it’s important to stick to the facts. As a counselor, I always meet my clients where they are, regardless of where that place might be. It is important to remain empathic, as on either end, there is a reason why some continually accept or commit such behavior. Being accusatory often leads to denial, frustration, or otherwise negative feelings that compromise treatment. Accordingly, I listen, guide, educate, reflect what the client says, and grasp onto key insights revealed while helping clients make further sense of them. The further we journey down this pathway, the more we find that ties it all together, and when we arrive at the origins of the behavior, we can truly get to meaningful work where progress occurs. 

As one who practices a lot of CBT, I like to help clients arrive at ample awareness of their thoughts, behaviors, emotions, and how they all connect. Physiological sensations are also appropriate for assessment here. What I love about CBT is that it ultimately teaches clients a new way. Some of the benefits include but are not limited to identifying distorted thoughts, reframing negative beliefs, building self-esteem, developing coping strategies, improving emotional regulation, and enhancing problem-solving skills (among others). Ultimately, this form of therapy is empowering. When aware, one may recognize what is happening in any given moment, take a step back, acknowledge it for what it is, and respond in a more appropriate manner.

Though I more commonly use DBT with individuals diagnosed with NPD or BPD, many of its interventions are helpful with so much more, including gaslighting. Mindfulness is a key feature of DBT. Mindfulness skills in DBT encourage individuals to stay present and aware of their thoughts and feelings without judgment. This can help those affected by gaslighting to recognize when their perception is being challenged and to validate their experiences, reducing self-doubt. Given that DBT is a modified version of CBT, they do share similar qualities in how they help clients. With DBT, clients may come to benefit from heightened emotional regulation, interpersonal effectiveness, distress tolerance, validation, and building self-compassion.

Perhaps one of the more interesting challenges as a counselor working with gaslighting is when perpetrators try gaslighting you. Every time this happens, I call it out. Though I may receive some pushback, I remain firm. Here, the client quickly learns their manipulation will not work on everyone. The clinical setting and interactions had with clients are meant to represent the real world. If I give into the gaslighting and the client feels successful, the cycle continues. Accordingly, with everything I do—serving the perpetrator or victim—the intent is to break the cycle. 

Closing Thoughts and Future Initiatives

Although the term “gaslighting” did not become more popular until the mid-2010s, it became such a hot topic that Merriam-Webster named it its word of the year in 2022. This is telling. After learning about gaslighting and what it is, so many people felt impacted by it that they began researching it further. I mean, here I am even writing about it right now. That said, this behavior is more common than one might think.

As I continue saying, everything begins with awareness. Now that the general population has become more familiar with the term, and likely will continue becoming more familiar moving forward. On the other end, for those who commit this behavior seemingly outside of their control but want to have healthier relationships, they might be more inclined to seek their own help. With both victims and perpetrators seeking help, the condition may continue to improve over time. 

We would be remiss, however, not to consider gaslighting on a larger societal—or even global—scale. There are numerous individuals in leadership and other high-ranking positions who use gaslighting as a strategy to gain power. This is why it is imperative that people do their research. Misinformation, disinformation, and otherwise all contribute to this phenomenon. When something doesn’t feel right, trust your gut. Most often, you are likely right. Do your research, seek support if needed, and never forget that everything begins with awareness.

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Adderall Addiction Treatment

Many see adderall as a “safe” drug because it can be medically prescribed and appears to lack negative side effects; however, adderall is one of the most addictive drugs on the market today1, especially for teens. Emerging adults, a population with developing, vulnerable brains, are more likely to take adderall to navigate school work, their social lives, and other stressors. 

Understanding the potential for addiction, health risks, and early intervention techniques can prevent long-term complications with this drug.

Understanding Adderall Addiction

Adderall is a prescribed stimulant drug that boosts nervous system activity2 by increasing dopamine, norepinephrine, and serotonin in the brain3. Individuals diagnosed with attention-deficit hyperactivity disorder (ADHD) can take adderall to help enhance attention, memory, self-regulation, and executive function4. Those with narcolepsy can use it to improve wakefulness.

While adderall benefits those with a diagnosed condition, it does not substantially improve cognitive function in other individuals4. So for the students using adderall in hopes of better academic performance, or just using it recreationally, they are simply taking a stimulant drug. 

A stimulant use disorder alters the brain5 by: 1.) affecting cognitive processes such as memory, learning, and other functions, and 2.) acting on the brain’s reward system. The repeated use of the drug boosts dopamine, creating a craving to ingest it. With time, adderall use can destroy dopaminergic terminals3 and disrupt the natural production of dopamine—meaning, without consistent drug consumption, mood and cognition decline.

A dependence forms when individuals need adderall to feel happy or “normal,” since, without it, they may experience withdrawal symptoms like cravings, sleep disturbances, and stress. These negative consequences can also enforce the addiction. 

Despite common stereotypes, adderall is a serious drug that can cause addiction. Spotting the signs early can help prevent dependence. 

Signs of Adderall Addiction

The Hazelden Betty Ford Foundation, a renowned treatment provider, lists signs of adderall misuse6:

  • Trouble falling asleep or staying asleep 
  • Often “spacing out” 
  • Decreased appetite 
  • Restlessness 
  • Hair loss (often coming out in clumps) 
  • Headaches 
  • Dizziness 
  • Nausea 
  • Excessive fatigue 
  • Constipation or diarrhea 
  • Changes in libido 

If you are concerned for a loved one, a change in their behaviors can indicate an addiction. They may lie about their adderall consumption, isolate themselves, have mood swings, and lose interest and motivation in important activities so they can use. If their dependence continues, more severe health complications can follow.

The Impact of Adderall Addiction

Adderall addiction, like any addiction, affects all areas of a person’s life, making this even more volatile for the young adult population using it.

Health Risks

As a central nervous system stimulant, adderall alters blood and oxygen flow, contributing to irregular or erratic heartbeat, cardiomyopathy (an enlarged heart), and high blood pressure. Over time, these alterations can cause a slew of negative health effects, including cardiac arrest and stroke7. Chronic adderall use can also lead to skin disorders, seizures, brain damage, and kidney damage6.

Additionally, adderall addiction is closely linked with depression, aggression, suicidal thoughts, panic attacks, and psychosis-like symptoms.

Social and Emotional Consequences

The impact of addiction goes beyond physical and mental health—it affects all facets of life. Adderall addiction often leads to secretive behavior and isolation, such as lying about drug use or hiding the extent of the problem, eroding trust with loved ones and straining relationships. And as addiction takes hold, the person may neglect their relationships to prioritize using adderall. They may withdraw from social activities, fail to fulfill commitments, and become emotionally unavailable to those who care about them.

While adderall is sometimes used to enhance focus, addiction can lead to decreased overall productivity. For example, someone may become less effective at their job due to the need for higher doses to achieve the same level of focus. They may also frequently skip work due to the physical and mental toll of addiction.

Students may initially use adderall in an attempt to enhance focus and academic performance; however, over time, addiction can lead to a dependency, impairing cognitive function and reducing overall academic performance.

First Steps in Seeking Help

You can ask yourself questions like 

  1. Would you be able to quit using adderall right now?
  2. Has your adderall use caused tension or conflict with friends, family, or colleagues?
  3. Do you miss important events or obligations because you are high?
  4. Do you use adderall to cope with stress, sadness, loneliness, or boredom?
  5. Have friends, family, or co-workers expressed concern about your adderall consumption?
  6. Have you given up hobbies or activities you used to enjoy because you prefer to take adderall?
  7. Are you concerned where your health and happiness might lead to if you keep using adderall at your current rate?

The answers will likely be straightforward and telling if you need medical treatment. Telling a trusted loved one can help get you on the right path to recovery. They can listen to what you’re going through, help make doctors appointments with you, and offer comfort throughout the journey.

Your primary care physician can provide an initial evaluation and refer you to a specialist for a more comprehensive assessment, like a mental health professional or addiction specialist. During this appointment, you can ask questions such as:

  1. How is my current adderall consumption affecting my overall health?
  2. What are the signs and symptoms of adderall dependence I am exhibiting?
  3. Based on my evaluation, do you believe I have a mild, moderate, or severe adderall use disorder?
  4. What kind of treatment do you think I need?
  5. How can I safely reduce or quit my adderall use, and what steps should I take to do so?
  6. Can you refer me to any support groups or resources that might help me?

Treatment Options for Adderall Addiction

As you embark on your recovery journey, you and your care team can explore treatment options to determine the best fit for your needs.

Detoxification

Many people begin their journey by going through the detox process, so you can safely rid your body of adderall. You’ll have medical professionals there to ensure you’re as comfortable as possible. This can help you feel more focused and prepared to take on therapy. It is crucial to detox under medical supervision, as withdrawal symptoms can be life threatening. 

Medication-Assisted Treatment (MAT)

In some cases, FDA-approved medications, such as Bupropion and Modafinil, can be prescribed8 to assist the tapering process. These medications help keep you safe during detox, ease withdrawal symptoms, and alleviate mental health concerns. Medication-assisted treatment can last for a few weeks or for years to maintain recovery. Your clinical team can help you decide what treatments and procedures are right for you.

Inpatient vs. Outpatient Programs

Residential Programs

Residential rehab provides an intensive, distraction-free environment to focus on psychotherapies and learning healthy coping skills. Individuals in this stage of care live in the center and have 24/7 support. Ideally, the clinical team creates a personalized treatment plan to address the unique needs of each individual in recovery. 

You might participate in evidence-based therapies like cognitive behavioral therapy (CBT), as well as holistic and alternative healing methods like yoga and massage therapy. The center may provide a blend of individual and group therapy sessions. Your loved ones can engage in family therapy, so you can find common ground, improve communication skills, and work towards healthier relationships. 

Outpatient Programs

Your care team may recommend an outpatient program if your recovery does not require 24/7 support. Outpatient treatment has varying levels of care, with partial hospitalization (PHP) providing a more intensive level of care and outpatient (OP) providing the least intensive. You’ll participate in the program for a few hours a day on certain days of the week, allowing you to go to work or attend school simultaneously. You’ll likely participate in therapies similar to a residential program and build your support network as you heal with others in therapy.

Support Systems and Recovery

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

Family and Community Support

Creating a support network with strong relationships is a foundational aspect of long-lasting recovery. Social support in recovery can reduce stress, increase self-efficacy, and motivate lasting sobriety9. Your relapse prevention plan can detail how you will connect with loved ones who supported you through the treatment process. You may make new friends through sober activities and groups. Try your best to plan regular get-togethers with friends and family, as avoiding isolation and bolstering these relationships can make recovery easier. 

Setting and communicating boundaries in recovery is a practice of self-love and can enhance your relationships. Without boundaries, you may say “yes” to things you don’t want to, avoid necessary conversations, and be consumed by others’ negative feelings. Prioritizing your boundaries ensures that you’re aligned with what’s best for your well-being.

Managing Relapse

Not everyone in recovery will relapse, but it can be a part of the recovery process10—and that’s okay. Relapse prevention can help you address these obstacles and keep you on the right track.

Relapse prevention planning focuses on identifying and addressing early warning signs before they lead to a physical relapse, such as using adderall after a period of sobriety. This approach utilizes cognitive behavioral techniques to prevent relapse while equipping individuals with practical skills to manage relapse if it occurs. It combines education, coping strategies, trigger identification, support network development, and lifestyle adjustments to create a comprehensive prevention plan.

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

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

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

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

Creating a daily routine that promotes physical and mental health, including regular exercise, balanced nutrition, and sufficient sleep, can bolster sustainable recovery11. A scheduling system, such as time blocking in a calendar, can help you avoid idle time that might lead to thoughts or behaviors associated with relapse.

A day of sobriety is a day worth being celebrated! The effort to choose your health and well-being every day is a great feat, so continue to reflect and pride yourself on your hard work.

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Attention Deficit Hyperactivity Disorder (ADHD) and Substance Use Disorders: Dr. Sarah Anderson

There is a strong relationship between Attention Deficit Hyperactivity Disorder (ADHD) and substance use disorders. Research indicates that up to 50% of individuals with a substance use disorder also have an ADHD diagnosis, and those with ADHD are estimated to be six times more likely to struggle with substance abuse compared to those without the diagnosis (Davis et al., 2015). So, what accounts for this connection? 

Some evidence points to personality traits associated with ADHD that may predispose individuals to substance use. Other research has examined differences in the dopamine reward pathway between those with and without ADHD. The impulsivity and self-regulation challenges linked to ADHD, along with difficulties in executive functioning, is another factor that potentially increases the risk of substance use. 

Although we may not be able to alter inherent personality traits or easily address the complexities of the dopamine system, therapy can play a vital role in supporting and enhancing executive functioning skills.

Executive Functioning and Its Role in Recovery 

Executive functioning encompasses the cognitive processes necessary for planning, organizing tasks, following through, and achieving long-term goals. Additionally, executive functioning skills are needed to maintain a job, live independently, and successfully engage in one’s daily life. Executive dysfunction can pose barriers to recovery. Individuals with executive dysfunction experience challenges in organizing their environment, accurately remembering facts/dates/appointments, and completing tasks (Barkley, 2015). 

Additionally, the inability to manage impulses, initiate tasks, and self-regulate can result in significant stress and hinder one’s ability to manage life independently, which may lead to relapse (Mannuzza et al., 2008).  Therefore, when it comes to designing a path for sustainable recovery, individuals struggling with both ADHD and substance use disorders must engage in therapy that focuses on building executive functioning skills.

Occupational Therapy, Executive Functioning & Substance Use Recovery 

As an occupational therapist specializing in mental health and substance use recovery, my role differs from that of other mental health therapists. My primary focus is on supporting the development of independent living skills, which includes a range of activities such as household management, job responsibilities, driving, grocery shopping, cooking, and budgeting. Executive functioning plays a crucial role in a person’s ability to live independently; I believe it is one of the most important skills necessary for successful independent living. Currently, I work at a mental health and substance use recovery center. Many of the clients I work with have difficulties maintaining employment, keeping their environment organized and clean, consistently taking their medications, engaging in basic self-care activities, managing their emotions, handling their finances, and structuring their time. I can confidently say, based on client reports, that the vast majority of clients I’ve worked with experienced challenges with executive functioning prior to their substance use. Furthermore, many clients who sought treatment before arriving at the center have mentioned that issues related to executive dysfunction, such as boredom—which is closely associated with difficulties in task initiation and time management—function as triggers for relapse.

Therefore, to ensure they can maintain their recovery, it is essential that we focus on fostering the development of their executive functioning skills.

Key Areas of Executive Functioning

Understanding the relationship between ADHD, substance use disorders, and long-term recovery requires an exploration of the key components of executive functioning that are often affected in individuals facing these co-occurring diagnoses. Below, I break down each of these areas, highlighting their impact on recovery and strategies that can help enhance these skills for improved outcomes.

Planning and Prioritizing

Individuals with ADHD often face challenges with planning and prioritizing, which can lead to difficulties in breaking tasks into manageable steps and organizing their responsibilities. Clients I have worked with who struggle with these skills often have trouble paying bills on time, cooking, grocery shopping, and arriving at work punctually. Additionally, they may find it difficult to balance their time between work, family, friends, and other responsibilities. 

Challenges with planning and prioritizing can pose significant issues in early recovery, as many individuals who are newly discharged are tasked with managing new responsibilities, including completing step work, regularly attending meetings, and independently handling everyday life activities. Effective strategies to assist clients in these areas include the use of planners or digital calendar tools, which help establish a structured framework for daily activities (Cole et al., 2024). Other strategies such as time-blocking and creating actionable task lists can further enhance the ability to stay organized. 

The Eisenhower Matrix is an incredibly useful tool for prioritizing tasks, as it allows individuals to categorize their responsibilities based on urgency and importance (Jyothi & Parkavi, 2016). The matrix divides tasks into four quadrants: 

  1. Urgent and Important: Tasks that require immediate attention and are critical to achieving goals. These should be done right away. 
  2. Important but Not Urgent: Tasks that are essential for long-term goals but do not require immediate action. These should be scheduled for later. 
  3. Urgent but Not Important: Tasks that require immediate attention but are not necessarily tied to your personal objectives. These can often be delegated to others. 
  4. Neither Urgent nor Important: Tasks that have little significance; these should be minimized or eliminated from your to-do list. 

Using the Eisenhower Matrix can help individuals visualize their tasks and prioritize effectively, ensuring they focus their time and energy on what truly matters. 

Organization:

Organization directly impacts a person’s ability to manage various aspects of daily life. Effective organization helps individuals create a structured environment, prioritize tasks, and manage important responsibilities, including appointments, medication schedules, and personal commitments. For those recovering from substance use, the ability to stay organized can significantly reduce feelings of overwhelm and stress, which are often triggers for relapse (Kitzinger et al., 2023). 

When I work with clients, I help them create systems to declutter their living spaces, use visual reminders, and implement paper or digital organizers to keep track of their tasks. I also support them in developing personalized routines that foster consistency and accountability, which ultimately empowers them to manage their recovery journey more successfully.

Task Initiation

A common hurdle for clients with ADHD is difficulty in starting tasks, which often leads to procrastination and avoidance, further exacerbating feelings of anxiety and overwhelm. Two of my favorite methods to use with clients are the “5-minute rule” and the “Pomodoro Technique,” as they encourage them to work on tasks in smaller, more manageable time intervals. 

The Pomodoro Technique, in particular, involves breaking work into 25-minute focused intervals, known as “Pomodoros,” followed by a 5-minute break (Biwer et al., 2023). After completing four Pomodoros, clients take a longer break of 15 to 30 minutes. This method not only makes tasks feel more manageable but also helps sustain attention and reduce distractions. By creating a structured approach to work, the Pomodoro Technique allows clients to cultivate a rhythm that can enhance productivity and concentration. 

Additionally, this technique promotes a sense of accomplishment as clients complete each interval, reinforcing positive behavior and making it easier to tackle larger tasks over time. The regular breaks also provide opportunities for clients to engage in self-care or relaxation, further reducing feelings of stress and anxiety that can often hinder their progress (Gnanavel et al., 2019). Implementing the Pomodoro Technique can be a powerful tool for fostering time management skills and improving overall task initiation. 

Impulsivity Control

Enhancing impulse control, particularly when it comes to making unhealthy choices during times of distress or dysregulation, is essential for recovery. Interventions aimed at improving impulse control involve teaching clients mindfulness techniques to help them pause and reflect before acting on their impulses (Zylowska et al., 2008). Incorporating games and activities that promote impulse control, such as Jenga and Simon, can also significantly aid in fostering self-regulation. Lastly, cognitive-behavioral strategies can be utilized to help clients identify and challenge the thought patterns that contribute to impulsive decisions. 

Emotional Regulation

Improving emotional regulation is crucial for reducing ADHD symptoms and minimizing substance use behaviors. Difficulty in managing emotions effectively can result in increased stress, strained relationships, and other life challenges, all of which can potentially contribute to relapse. Teaching clients techniques like sensory modulation strategies, deep breathing exercises, and coping skills can empower them to manage their emotions more effectively. Incorporating expressive arts, such as drawing or painting, or physical activities, such as exercise, can also serve as healthy outlets for emotions (Hasegawa et al., 2017).

Working Memory 

Deficits in working memory significantly affect a person’s ability to engage in daily life. Difficulties in short-term memory can lead to issues such as forgetting important appointments, mismanaging medication schedules, or failing to recall coping strategies during stressful situations, all of which can increase the risk of relapse. To address this area, therapists implement memory aids, such as written reminders or digital apps, that assist in retaining important information and instructions. Training in mnemonic devices and visualization techniques can also enhance memory recall (Martin & Marsh, 2009). 

Additionally, engaging in mindfulness practices has been shown to enhance short-term memory. Research indicates that mindfulness can improve cognitive functions, including memory retention and recall abilities, by promoting focused attention and reducing distractions (Zeidan et al., 2010; Killingsworth & Gilbert, 2010).

Self-Monitoring 

Self-monitoring skills are important because they help individuals notice how they are doing and make changes to their behavior when needed. Clients often benefit from learning how to evaluate their performance on tasks and reflect on their emotions and thoughts throughout the process. Journaling or using mobile apps can facilitate self-reflection by allowing individuals to document their thoughts, feelings, and experiences regularly. 

For example, someone might use a journal to reflect on their daily challenges and successes, helping them identify patterns in their behavior over time. Similarly, mood tracking apps can encourage clients to log their emotions throughout the day, providing insights into triggers for anxiety or stress. This process of self-reflection can lead to more effective self-regulation, as they become more aware of their emotional responses and can devise strategies to manage them (Barkley, 2015).

Comprehensive Assessment and Goal Setting

To help clients enhance their executive functioning skills, the process begins with a thorough assessment aimed at identifying both strengths and weaknesses. This assessment is crucial, as it not only reveals specific executive functioning deficits but also ensures that the interventions used are relevant and effective. Without a comprehensive evaluation, important areas of need may go unrecognized, resulting in interventions that do not adequately address the client’s deficits. Standardized tools, interviews, and observations provide valuable insight into how these limitations impact daily life engagement. Once the assessment is complete, establishing goals collaboratively is essential. This process empowers clients to choose goals that are meaningful to them, fostering a sense of ownership in their recovery journey. 

By creating a collaborative environment, clients are more likely to make significant progress. This tailored approach not only addresses specific challenges associated with ADHD and substance use disorders but also promotes a greater sense of agency and self-efficacy. When clients feel that their needs are understood and prioritized from the start, they are better equipped to engage in the therapeutic process and achieve lasting change.

Key Points

The significant connection between ADHD and substance use disorders presents unique challenges that require a comprehensive approach to support sustainable recovery. Addressing executive functioning skills — such as organization, time management, impulse control, and emotional regulation — is essential for individuals with these dual diagnoses. By focusing on enhancing these skills, individuals in recovery can learn how to manage their daily lives more effectively and navigate the complexities associated with both ADHD and substance use.

Recognizing the specific needs of individuals with this dual diagnosis is crucial for developing effective treatment strategies. Tailored interventions that target executive functioning can lead to improved recovery outcomes and a better overall quality of life. A holistic focus on these skills not only helps individuals address the symptoms of ADHD but also empowers them to take control of their lives, establish meaningful goals, and create a sustainable path toward lasting recovery.

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The Signs a Young Adult May Have an Eating Disorder

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

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

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

Common Types of Eating Disorders in Young Adults

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

Anorexia Nervosa

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

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

Bulimia Nervosa

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

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

Binge Eating Disorder

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

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

Other Specified Feeding or Eating Disorders (OSFED)

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

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

Physical Signs of an Eating Disorder

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

Noticeable Weight Changes

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

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

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

Physical Health Issues

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

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

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

Changes in Appearance

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

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

Behavioral Signs of an Eating Disorder

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

Obsession with Food and Weight

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

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

Secretive Behavior

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

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

Emotional and Psychological Signs

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

Mood Swings and Irritability

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

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

Anxiety and Depression

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

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

Perfectionism and Control Issues

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

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

Impact on Daily Life

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

Academic Performance

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

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

Social Withdrawal

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

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

Daily Routine Disruptions

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

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

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

When to Seek Professional Help

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

Consulting Healthcare Providers

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

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

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

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

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

Supporting a Young Adult with an Eating Disorder

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

Open Communication

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

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

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

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

Creating a Supportive Environment

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

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

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

Resources for Further Help

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

Hotlines:

  1. National Eating Disorders Association (NEDA) Helpline

Phone: 1-800-931-2237

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

  1. Crisis Text Line

Text: Text “HELLO” to 741741

  1. The Trevor Project (for LGBTQ+ youth)

Phone: 1-866-488-7386

Text: Text “START” to 678678

Websites:

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

Support Groups:

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