Tag: Anxiety

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The Relationship Between Alcohol and Anxiety

Many people who struggle with anxiety turn to alcohol to cope with their stress. But what if that drink makes anxiety worse? We explore the self-perpetuating relationship between alcohol and anxiety, and provide insights and resources to help you manage both.

How Alcohol Affects Anxiety

People use the term “anxiety” so casually, we often forget what it means. One man in recovery, Leon, reminds us how profoundly it can impact your life:   

When I’m feeling extremely anxious I can’t talk to people; I can’t work; I can’t get out of my bedroom; I don’t even want to move; It’s horrible…It’s one of the hardest things that I’ve ever experienced. 

Those who use alcohol to cope with their anxiety often find that it bounces back even stronger when they stop drinking. “When I stopped drinking, I had a lot of experiences of up-and-down anxiety,”1 says Leon.

Short-Term Effects

Alcohol is a depressant, meaning it slows down the central nervous system. Initially, this makes people feel calm and relaxed—which is why so many people who live with anxiety turn to alcohol for symptom relief. In the short term, drinking makes it seem like social inhibitions are lowering and worries are fading away. But this calming effect is short-lived—and misleading—because alcohol makes anxiety worse down the line.

Kevin O’Hara, who is in alcohol recovery, recalls how he used to rely on alcohol to deal with social anxiety:2 

When I was younger and just I wasn’t able to speak to anyone—especially women—alcohol provided that lubricant that I needed at the time.

Long-Term Effects

Unfortunately, alcohol’s initial calming effects don’t last. Long-term alcohol use upsets the harmony of chemicals in your brain, such as GABA and serotonin, that regulate your mood. This worsens anxiety symptoms over time, creating a cycle that leads to dependence. As alcohol wears off and anxiety intensifies, you might start to drink even more. This cycle feeds anxiety and increases alcohol use. Before you know it, this can ramp up into a full-blown alcohol use disorder that further complicates your ability to manage your anxiety.

Leaning on alcohol in awkward moments also keeps us from learning the social skills we need to function without it. “You’re sort of priming yourself now for problems later on,” says O’Hara, “because you’re using an outside substance for a problem which is inside, and that is always going to cause problems.”

Alcohol-Induced Anxiety

Not only does heavy drinking disrupt brain chemistry in the long term, but it can also trigger immediate anxiety spikes. As your blood alcohol concentration (BAC) drops, your body goes into alcohol withdrawal. This results in a cascade of physical symptoms which might include sweating, tremors, and racing heart rate (which can be very anxiety-provoking). Heavy drinking also disrupts your sleep quality, and poor sleep is a major risk factor for anxiety. The physical effects of withdrawal combined with poor sleep quality can make your anxiety feel much worse both during and after heavy drinking episodes.

How Anxiety Influences Alcohol Use

Self-Medication

Anxiety symptoms can make life feel so much harder, and it’s common for people who struggle with this condition to self-medicate with alcohol. And understandably so—the initial calming effects of alcohol can feel like a welcome escape from the overwhelm of anxious spiraling. 

Danay, who founded Sober Girls Houston while in alcohol recovery, recalls how she started drinking to cope with academic pressures3 in high school: 

I went to a private school, and if I didn’t get an A there was a problem. So I always felt like I had the weight of the world on my shoulders. I was pretty hard on myself if I didn’t do everything exactly right every time. Drinking was like a way out of it. I mean, that’s all I saw, right? Everybody just got a drink when they were stressed out or when they had a lot going on. It was just what you did to survive, so I didn’t think anything different.

The relationship between alcohol and anxiety is so normalized that we often don’t even see it.

Cycle of Dependence

At first, you might drink to find temporary anxiety relief. But the problem with using substances to cope is that they ultimately don’t work—and you’re often left with an even bigger problem. Alcohol weakens your body’s natural ability to regulate anxiety. And as it wears off after a night of drinking, anxiety rebounds4 and intensifies. When that happens, it creates a strong urge to drink again to relieve your alcohol-induced anxiety. As tolerance builds over time, you have to drink more to get the same calming effect. This cycle eventually becomes deeply entrenched, making both problems worse.

Co-occurring disorders (also known as dual diagnoses)—mental health conditions that occur alongside substance use disorders—are notoriously complex and require specialized treatment to address both conditions at the same time. The best way to avoid this scenario is to find healthier alternatives to drinking, such as therapy, medication, and lifestyle changes, and talk therapy, as a way of managing anxiety.  

The Biochemical Connection

The connection between alcohol and anxiety goes deeper than the temporary stress relief you feel after a few drinks. 

Neurotransmitter Disruption

Alcohol disrupts the chemical balance in your brain. The neurotransmitter GABA, for example, has calming properties. Alcohol mimics the effects of GABA, which reduces anxiety in the moment. But over time, alcohol causes your brain to produce less GABA—and fewer GABA receptors.5 The same process happens with serotonin, dopamine, and other mood-regulating brain chemicals. This builds long-term anxiety by reducing your natural capacity to manage stress.

Impact on Sleep

While alcohol’s drowsiness-inducing effects might help you fall asleep, it negatively impacts your sleep quality throughout the night. Alcohol reduces the amount of time we spend in deep sleep, which in turn affects our mood and ability to regulate emotions. Poor sleep quality due to alcohol6 makes you feel sleepy throughout the day, affects your productivity, and worsens anxiety symptoms. Chronic sleep disturbances make anxiety far worse and create a feedback loop where poor sleep due to alcohol fuels anxiety, which then further disrupts sleep.

Psychological and Social Factors

Behavioral Patterns

Alcohol-related behaviors can also fuel anxiety. For someone with social anxiety, for example, drinking might seem like a welcome icebreaker. But those relaxed inhibitions can be a double-edged sword, as poor decision-making and awkward interactions only reinforce social anxieties once the fog clears. Depending on alcohol to be social can make you afraid to socialize without it, which limits your scope of connections as your social circle narrows to focus on party friends. 

Social Consequences

We don’t often think our behaviors pose risks to those around us, but problematic drinking will eventually affect our friends. 

The behavioral patterns that stem from heavy drinking are notorious for ruining relationships. Drinking destabilizes our mood, making us more irritable and less likely to show up to our relationships as our best selves. You might be more short-tempered or cynical for days following a heavy drinking session—which, if you drink several times a week, means your mood is affected virtually all the time. The effects of this get worse as alcohol dependence sets in: “Evidence suggests that alcoholics experience increasing dysphoria7 as a consequence of alcohol consumption,” say researchers. 

Drinking causes us to act impulsively, without regard for consequences, or without even realizing what we’re doing, leaving us with an embarrassing emotional hangover as we try to remember our actions the night before. 

All of this strains relationships and makes us feel isolated and more socially anxious. This erodes the very support systems that are so important when we’re changing our drinking behaviors and learning to manage anxiety.

Identifying the Signs of Co-Occurring Alcohol Use and Anxiety Disorders

Behavioral Signs

Spotting a co-occurring problem with alcohol and anxiety can be tricky. Here are some signs to watch for: 

  • You only feel comfortable socializing after drinking. 
  • You avoid social situations where alcohol isn’t available.
  • You drink more during periods of heightened anxiety.
  • You’re becoming more socially isolated.
  • Your sleep patterns are changing. 

If you notice any of these signs, it might be time to reevaluate your relationship with alcohol. 

Physical and Emotional Symptoms

Physical symptoms can also signal co-occurring alcohol use and anxiety disorders. These might include tremors, sweating, or difficulty sleeping, which can be caused by both anxiety and alcohol withdrawal. 

Emotional signs include chronic worry, irritability, and difficulty concentrating. Panic attacks8 (a hallmark of anxiety disorders) might also become more frequent. If these symptoms worsen with alcohol use or persist even when you’re sober, it may be time to seek professional help.

Treatment and Management Strategies

Professional Help

Breaking the cycle of anxiety and alcohol dependence is a complex process and is best taken on with professional support. 

If you require alcohol detox, it’s important to do so in a medically supervised environment. Alcohol withdrawals can be highly dangerous and should not be attempted alone. You can contact a detox center for an over-the-phone assessment to determine your level of need.

In a reputable addiction and mental health treatment program therapists provide a safe space to explore the underlying causes of both conditions, teach coping skills to manage anxiety without the use of alcohol, and help you implement lifestyle changes that sustainably support your well-being. Rehabs offer programs at different levels of intensiveness and use a variety of treatment approaches (which may include medication management, talk therapy, and complementary therapies) according to your needs. Your treatment team can help you determine the most effective path toward getting—and staying—well.

Integrated Treatment Programs

For people who struggle with both alcohol use disorder and anxiety, the most effective treatment is a comprehensive program that specializes in dual diagnosis treatment. These programs address both conditions simultaneously and recognize the synergy between them. Therapists experienced in treating co-occurring disorders can tailor interventions to treat symptoms and address the root causes of anxiety and alcohol addiction. This might include therapies like CBT alongside medication management for anxiety, as well as relapse prevention strategies for staying sober long-term. Integrated programs can be highly effective, healing underlying problems and teaching the skills you need to manage your anxiety and live a fulfilling, alcohol-free life.

Medications

As part of your treatment plan, doctors might prescribe medications to target anxiety symptoms,9 such as selective serotonin reuptake inhibitors (SSRIs). These medications may also reduce cravings for alcohol. 

Your treatment team might also recommend medications like buspirone or hydroxyzine to address anxiety and potentially decrease alcohol use as a coping mechanism. 

Medications should only be prescribed by a qualified prescribing doctor after in-depth psychological testing to determine your specific needs and best course of action. 

Not everyone is open to medication, and that’s okay. But for those who are, it can be effective for managing both alcohol and anxiety. Medication is most effective when combined with psychotherapy,10 which helps you learn coping strategies and make lasting behavioral changes. Medication management can help you get symptoms under control so that talk therapy is more effective. 

Self-Help and Lifestyle Changes

Mindfulness and Stress Reduction

Mindfulness practices and stress reduction techniques can help you manage anxiety without relying on alcohol. Mindfulness meditation helps you cultivate self-awareness as you learn to observe your thoughts and feelings without judgment. This can also help you place some distance between feeling triggered and acting on it, meaning you’ll gain more control over your reactions as you learn to self-regulate your emotions.

Stress reduction techniques can include deep breathing exercises, which slow your heart rate and activate your body’s natural relaxation response. Spending time in nature, taking up a new hobby (or rediscovering an old one), and getting regular, good-quality sleep all support your emotional well-being. By making these practices a regular part of your life, you’ll build resilience and get better at managing your anxiety.

Healthy Habits

Long-term recovery from anxiety requires a strong foundation of healthy habits. These lifestyle changes include getting regular exercise, nourishing your body with a nutrient-dense, anti-inflammatory diet, and improving your sleep hygiene. Doing things that nourish your spirit and allow your mind and body to recharge increases your capacity for handling stress and sets you up for success in daily life. 

Support Systems

No one should fight anxiety or alcohol addiction alone—strong support systems are key to long-term success. As you make these life changes, surround yourself with friends and family who understand your struggles and offer nonjudgmental support. Consider joining a local or online support group specifically focused on anxiety. Sharing your experiences openly and hearing those of others reminds you that you’re not alone. 

Feeling Anxious and Doing It Anyway 

There are times when it’s okay to pull back from situations that make us uncomfortable, and times when it’s helpful to push through to achieve your goals. O’Hara says he finds it helpful to put himself in social situations without alcohol11 even if it feels uncomfortable at times: 

You have to put yourself into situations where, if there was no alcohol around, you might normally feel awkward about it. But every time you do that, you learn something. You gain a more confidence in yourself and your abilities.

Resources for Further Help

These hotlines, websites, and support groups are great starting points to learn more about co-occurring anxiety and alcohol use disorder and find the help you need: 

If you’re struggling with anxiety and alcohol addiction, a treatment center can help you uncover the cause of both conditions and make a plan to address them. Search co-occurring disorder treatment centers and reach out to their admissions teams directly to find the right program for you.

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Understanding the Physical Toll: How Anxiety Impacts the Body and Ways to Cope

Learning how anxiety affects the body can help you understand mysterious symptoms and the impact untreated mental health conditions can have. Although anxiety can manifest in many ways, not everyone will experience physical symptoms. On the other hand, some people may feel the physical symptoms most acutely. 

Anxiety’s physical symptoms could first seem purely like a physical health condition, especially if you’ve never been diagnosed with it. Set an appointment with your doctor if you’re wondering if your symptoms may be caused by or related to anxiety.

What Is Anxiety?

People with anxiety disorders experience frequent and persistent worry1 out of their control.  This can manifest as generalized anxiety disorder or as a specific phobia, such as social anxiety disorder or panic disorder. Even when temporary stressors resolve, people with anxiety disorders don’t experience relief. Anxiety can be thought of as a constant anticipation of future threats2.

For example, someone with anxiety may constantly worry about their job, their health, or the safety of their loved ones. They’ll perseverate on worries like, “What if I’m not performing well and get fired? What if my loved one gets into an accident or gets sick? What if I get sick or hurt?”  It may feel like a preventative measure to prepare for worst-case scenarios, but in reality, these festering worries just lead to stress and anxiety.

A lack of issues does not alleviate their anxiety. That often means they need to learn how to reduce their anxiety manually, since it won’t fade in times without stress. They can learn to counter recurrent and persistent worries, stopping the thoughts from lingering and causing symptoms of anxiety.

Physical Symptoms of Anxiety

Some of the most common physical symptoms of anxiety3 include:

  1. Headaches
  2. Shortness of breath
  3. Nausea
  4. Diarrhea
  5. Back pain
  6. Insomnia
  7. Racing heart (also called tachycardia)

Anxiety affecting your physical health is also called somatization4, where emotions and feelings express as physical pain or discomfort. This can happen with other mental health conditions too, but is especially common with anxiety. 

Cognitive Effects

Anxiety can affect how you process and take in information5. For example, if you’re in a near-constant state of hyperarousal, benign events could seem scary or exacerbate your anxiety. Feeling anxious can also make it harder to make educated decisions and react appropriately.

Anxiety may prevent you from concentrating and remembering dates, information, and tasks you need to get done. If your brain is stressed, it may not feel like those things are important enough to be remembered. Instead, you may perseverate on potential threats and prepare for fear.

Anxiety can also distort your perception5. It can cause stronger reactions to cues of threat, like fearful expressions, an edged tone, or an unwanted task you suddenly must do. The threat itself may not even be a threat or is a small one, but a distorted perception from anxiety makes it feel much scarier. You may experience friends and loved ones questioning your reactions or anxiety levels and telling you “it’s no big deal.” From your perspective, though, it does feel like a big deal. 

Immune System and Stress Response

A perceived threat triggers your body’s stress response2. Since anxiety can alter perceptions and make non-threats seem threatening, it can regularly activate the stress response. This sends floods of stress hormones and other stress responses throughout the body. 

The stress response is intended to help you survive2 and escape threats, so your heart rate increases, you get a spike in adrenaline, your muscles tense for action, and you breathe faster. While this works great in certain situations, it’s not always intended to happen and can feel distressing.

Excess stress hormones can affect the immune system6 similarly to an inflammatory disorder. Hormone-releasing glands may work ineffectively after continued activation and use. This can also make you more susceptible to autoimmune diseases and other health problems, especially if you have chronic stress or long-term untreated anxiety.

Gastrointestinal Effects

Anxiety can sometimes feel like a pit in your stomach. Your brain and gut share a strong connection7, which is why anxiety can cause nausea, pain, and diarrhea. The gut-brain axis is a complex communication network that involves the central nervous system and the enteric nervous system, linking emotional and cognitive areas of the brain to your gut. Anxiety can activate the autonomic nervous system8, which can impact your gut and lead to symptoms such as nausea and diarrhea. These painful and disruptive physical symptoms can also worsen your anxiety, creating a cycle.

Treating one or both parts of the cycle can help you find relief. Therapy and medications for anxiety can relieve gastrointestinal symptoms, and treatment for gastrointestinal symptoms can relieve anxiety. Treatment targeted at both may be most effective for you.

If you’re feeling nauseous before a presentation or other anxiety-inducing event, you can practice coping skills to soothe stress. Deep, mindful breathing can calm your nervous system. You can try box breathing, where you breathe in through your nose for 4 seconds, hold the breath for 4 seconds, and breathe out through your mouth for 4 seconds, then start again from the top. Physical activity and healthy distractions (like reading, cooking, or watching a show you enjoy) can help, too.

Sleep Disturbances

The hyperarousal state caused by anxiety can make it hard to fall asleep9 and stay asleep. Your brain may wake you up more often if it’s used to feeling under threat, especially if you’re having nightmares that trigger the stress response. Anxiety can also trigger nightmares; for example, a parent may have persistent nightmares of losing a child. 

You may compulsively worry about what happened during your day, replay interactions, or start mentally preparing for tomorrow’s threats as you try to fall asleep. Worrying about what happened and what could happen can trigger your stress response and bar your brain from the relaxed state it needs to sleep. 

Those diagnosed with sleep conditions like insomnia could find their anxiety improves once they get insomnia treatment9, and vice versa. Treatment for insomnia depends on which kind you have (trouble falling asleep, staying asleep, or both), but often includes therapy and medications. Short-term hypnotics, certain antidepressants, and benzodiazepines can calm the mind and allow sleep.

Muscular Tension and Pain

The stress response causes your muscles to tense2 and prepare to fight or flee. If your anxiety often activates this response, you can experience muscle pain from the prolonged tension. This could also lead to skeletal conditions like low back pain and make pre-existing osteoarthritis more painful. Anxiety can lower your ability to tolerate pain10 and make other musculoskeletal conditions more painful as well. 

Relaxation techniques can help relieve tension and pain. Try progressive muscle relaxation, where you’ll mindfully tense and untense your muscles (head to toes, toes to head, or another pattern.) You can also apply topical remedies to relieve pain.

Respiratory System

The stress responses speeds up breathing to ensure your cardiovascular system has enough oxygen to react to threats. You may experience shortness of breath when anxiety triggers this response11 without a threat to run from or fight. Feeling like you can’t breathe or aren’t getting enough air can intensify your anxiety and create a self-feeding cycle. 

Sometimes, this can worsen to a panic attack, which may cause you to hyperventilate or hold your breath. Both of these can cause someone to pass out (or feel close to it). 

Feeling constantly short of breath or like you’re just barely getting enough air could be a sign of anxiety. Practice deep breaths, filling and expanding your stomach, and bring your concerns to your doctor.

Hormonal Imbalance

Anxiety can interfere with hormone production and release12, which can lead to thyroid problems and menstrual irregularities. This can even extend to reproductive issues. Stress and anxiety can cause endocrine disorders when they go untreated. 

Anxiety treatment can alleviate the disruptions in your endocrine system and restore it to health. Treatment options for anxiety include therapy, medications, and a combination of the two.

Seeking Professional Help

If you notice physical or emotional symptoms of anxiety, you can start your treatment journey by scheduling an appointment with your doctor. They will help you determine the cause of your symptoms and rule out other potential conditions. They may also refer you to therapy and prescribe an anxiety medication. At your appointment, you can ask questions like these to better understand your condition and treatment:

  1. Do I meet diagnostic criteria for anxiety?
  2. Should I be on medications for my symptoms? If so, what are the potential side effects?
  3. What are my next steps in treatment?
  4. Can you refer me to therapy or a different level of care?

Behavioral therapies for anxiety aim to change unhelpful thought patterns and challenge the compulsion to worry. Cognitive behavioral therapy, for example, invites you to notice the thoughts and emotions behind your behaviors and question their validity. Dialectical behavioral therapy encourages you to notice and accept your emotions while also aiming to adjust how you respond. 

Exposure therapies can reduce anxiety around places or situations that trigger anxiety. You may imagine the exposure or go out and experience it. For example, you may take small drives to reduce anxiety around driving, especially if you’ve been in a car accident. Your therapist will be careful to not retraumatize you or suggest anything you don’t feel able to do, but you’ll likely venture outside your comfort zone with their support.

Lifestyle Changes for Anxiety Management

Lifestyle changes can have a huge impact on your overall wellness and anxiety levels, especially when combined with professional treatment. You can try any combination or number of changes to see what works best. 

Strengthen Your Sleep Hygiene 

Good sleep can help you feel more rested and capable of handling challenges. The amount you need varies by person, but you can shoot for 6-8 hours. Set up a nighttime and morning routine to align your circadian rhythm and ease anxiety about falling asleep and waking up. 

Set Boundaries at Home and at Work

Setting emotional boundaries can shield you from additional stress and anxiety. For example, if interactions with a family member cause you anxiety, set a boundary. You could do this by limiting the time you spend with them, how often you text them back, and by what information you share with them. You can verbalize your boundary or let your actions express it.

At work, you can clearly communicate your working hours and set an expectation to work within them closely. Creating a healthy work-life balance can lower anxiety and give you more time to pursue activities you enjoy. 

Eat Well

Healthy eating allows you to function at your full capacity, which can help you manage stress and anxiety. Prioritize whole foods with nutrients and vitamins. As much as you can, avoid processed foods, fast food, and sugar. Sugar rushes can feel like panic attacks13, so limit how much you have. Similarly, excess caffeine can cause a spike in adrenaline, heart rate, and make you feel panicky.  

Make sure you’re drinking enough water, too. Dehydration can sometimes cause or mimic anxiety symptoms13; sip on water throughout the day and shoot to drink an ounce for every 2 pounds of your body weight. Someone who weighs 150 lbs would drink 75 ounces of water following that suggestion.

Exercise

Exercise can help relieve stress and make you feel good (thanks to endorphins). Gentle and intense exercise offers these benefits. You could go on walks, try yoga, or weightlift. Exercise can lower stress levels and help you relax. Align your exercise with your lifestyle and ensure it’s something you enjoy.

Meditation

Meditation can reduce anxiety symptoms14. Many phone apps offer free guided meditation sessions you can attend anytime. You can also meditate with binaural beats, other music you like, or no music at all. 

Meditation can help align your mind and body in a state of calmness. It’s often described as a spiritual experience; you could also use prayer as a form of meditation.

Resources and Hope for Healing

Anxiety has multiple effects on the body and multiple avenues for recovery. Talk with your doctor or mental health provider today to assess your symptoms and seek treatment. 
You can also browse Recovery.com to find treatment centers for anxiety with photos, reviews, pricing information, and more.

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Understanding Psychodrama Therapy: Techniques and Benefits

Psychodrama is a therapeutic method that uses dramatic techniques, such as role-playing, to help people understand and resolve their emotional conflicts1. During sessions, patient groups enact scenes from their lives or dreams to gain insights and practice new ways of being in the world2. 

The goal of psychodrama is for patients to gain mental clarity so they can learn new ways of thinking and cope with their feelings surrounding the event. Through these exercises, patients may see improved social skills, a boost in self-esteem, or a positive attitude shift3. Psychodrama can teach adaptive coping strategies, leading to resilience4. 

Incorporating psychodrama into your recovery plan can offer a new perspective on healing and a deeper understanding of yourself.

Origins and Development

Jacob Levy Moreno, a Romanian psychiatrist and psychoanalyst, invented psychodrama in 19215. Moreno studied the power of relationships and group interactions, seeing a person become the healing agent for another. His creation was inspired by improvisation theater and the rise of the psychoanalytic movement led by Sigmund Freud. It became the first form of group psychotherapy.

Moreno quickly developed one of the fundamental concepts, role theory, which shows how social roles shape behavior6. People take on different roles in their lives, and exploring these roles in a therapeutic setting can lead to insights and personal growth.

In the 1940s-60s, interest grew in psychodrama, and it became a therapeutic practice. Psychodrama was applied not only in clinical settings but also in educational and community settings. Today, psychodrama can be applied to family therapy, trauma work, and addiction treatment. It’s even being discussed as an alternative method of education in schools. 

Core Principles of Psychodrama

Psychodrama therapy is guided by several core principles. Moreno defined these principles7 as:

  1. Warming up: A process that creates an appropriate environment for spontaneity. This may look like physically shaking your body to loosen up, clearing any doubts, and having silly conversation. 
  2. Spontaneity: By being in the present moment, you can react to things without any preconceived notions. This can benefit role play.
  3. Creativity: Spontaneity helps catalyze creativity—it is born by reacting the way you normally would, a true-to-self reaction. When you are rooted in the here and now, there’s more opportunity for play, creativity, and new ways of thinking.
  4. Encounter: Meeting another person where they are at and mentally viewing the event from their perspective.
  5. Tele: Sensing the feeling/bond between 2+ people. During the first encounter between a group, the tele should be neutral. Then, a positive or negative feeling forms over time and between interactions.
  6. Co-conscious vs co-unconscious: These are states shared between 2+ people. A co-conscious state is when a particular feeling in a group is voiced or acted out, so it is known. A co-unconscious state occurs when 2+ people who are closely existing develop a normal atmosphere amongst themselves. This is created through shared and unshared feelings, actions, and beliefs, but it is not outrightly stated.
  7. Role: An identity that someone takes on in the moment, depending on the context. For example, the eldest sibling may assume the role of parent if the younger sibling is in distress and the parent is not nearby.
  8. Role vs ego: The ego is a concept that helps us balance between societal norms and our true desires. In psychodrama, the ego actively explores roles, emotions, and conflicts. It aims to strengthen ego function.
  9. Role reversal: Changing from your current role to the other person’s. This can help you gain insight.

Looking at all these principles, we can form the inner workings of psychodrama. Focusing on spontaneity and creativity while role-playing allows you to develop a new perspective on past events, feelings, and behaviors. 

Key Roles in Psychodrama

There are 3 key characters in a psychodrama session: the protagonist, auxiliary egos, and the director.

The protagonist takes center stage during a psychodrama session. They are the main focus and typically present an issue or situation they want to explore and work through. The protagonist enacts personal situations, bringing them to life through role-playing.

Auxiliary egos are people in the group who play roles within the protagonist’s enacted scenario. They may portray significant people, objects, or aspects of the protagonist’s internal world. Auxiliary egos offer alternative perspectives for the protagonist.

The director is the therapist or facilitator guiding the session. They set the stage, facilitate interactions, and ensure a supportive environment. The director leads warm-up activities, and they may intervene or suggest things to facilitate exploration and resolution.

Techniques and Processes: How It Works

In a psychodrama session, you may participate in various techniques to find the best for your healing. At the core, you will be role-playing as the protagonist or acting out specific roles or situations to explore emotions, thoughts, and behaviors. 

From there, you could practice mirroring, where the auxiliary egos copy your behaviors, emotions, or body language—this can foster self-awareness.

Another group member may practice doubling, voicing your thoughts and opinions for you. Speaking your internal feelings aloud can help deepen your understanding of the event. 

You may role reverse with another person, allowing you to experience the situation from a new perspective. 

Sometimes, you, as the protagonist, talk through your inner thoughts, providing insight into your internal dialogue and expressed emotions. This is called soliloquy.

Practices such as these can strengthen your emotional awareness. The director (your therapist) will ensure that the sociometry of the group is healthy and balanced, meaning the auxiliary egos are well suited to support the protagonist. As group dynamics grow, these techniques will become easier and easier, making room for deeper exploration.

The Role of Action and Enactment

Physically acting out past experiences is what sets psychodrama apart from traditional talk therapy. This approach is immersive and engaging, and activating all the senses can help patients work through buried feelings. Psychodrama pulls patients out of their internal world and allows them to experience emotions, thoughts, and behaviors directly.

Psychodrama can be particularly effective for patients who feel limited by traditional talk therapy. Reenacting certain events can provide insights and much needed emotional release.

Applications of Psychodrama

Psychodrama is commonly done in group therapy, although it can be used in individual and family therapy, as well. In a group or family setting, other participants in the group would help set the scene, while individual therapy usually involves the counselor and the patient engaging in this practice.

Psychodrama can be beneficial for specific conditions, such as trauma. Trauma affects both the brain and the body8, and it can be hard to find words to describe trauma (because Broca’s area, the part of the brain responsible for language, is less active when remembering trauma9), making it difficult to process in traditional talk therapy. Psychodrama provides an alternative way to connect the mind and body to work through trauma.

As this approach aims to boost self-esteem and self-sufficiency, psychodrama can improve depression and anxiety symptoms10. It can also aid addiction recovery. Role playing a patient’s addictive behaviors helps them understand the roots of their substance use and develop healthier coping strategies.

Any patient can benefit from psychodrama—it’s not only for self-proclaiming “creative” people. With the right guidance, engaging in these practices can improve communication, self-awareness, and promote healing.

Integrating Psychodrama with Other Therapies

Psychodrama can be integrated with other therapeutic modalities to create a well-rounded treatment plan. 

Cognitive behavioral therapy (CBT), one of the most common and effective therapies for addiction11 and mental health disorders, can combine with elements of psychodrama. Your therapist may use role-play or family of origin imagery12 (exploring mental images, memories, and perceptions of your family and childhood) in addition to CBT techniques that replace unhealthy thought patterns with more positive ones.

Psychodrama can also work in conjunction with Gestalt therapy. This therapy takes a “whole person” approach to healing and looks at many aspects of someone’s life that may have contributed to their struggles instead of just one event or trauma. Gestalt therapists can use role reversal and the empty chair method13 (similar to role-playing with an auxiliary ego, but instead, you interact with an empty chair) in addition to Gestalt techniques such as “I” statements.

Dialectical behavioral therapy (DBT) compliments psychodrama, as well. DBT has similar processes to CBT; however, there is an emphasis on mindfulness and healing in the present moment. While engaging in role play and other psychodrama practices, focusing on mindful words and movements can increase spontaneity and creativity—thus facilitating exploration and recovery breakthroughs. 

Questions to Ask Your Provider About Psychodrama

Before beginning psychodrama sessions, you may consider asking your provider a few questions, such as 

  1. How do you act as the director of the group? Can you give examples of how you mediate sessions?
  2. How do you determine who would be a good auxiliary ego for my role-playing session?
  3. How would you evaluate my progress in the sessions?
  4. Are there follow-up sessions to break down what we’ve learned in the psychodrama sessions?

Training and Certification

As a therapist, proper psychodrama training can ensure that your patients get the most out of your sessions. You can receive training through many organizations; some are in person, while others are virtual. At the American Board of Psychodrama14, you can learn the theory, master the techniques, and understand group dynamics to facilitate your patients’ healing.

If you’re seeking out a psychodrama therapist, ensure that they have this certification and proper experience and education—this should be a Master’s degree or higher, and their credentials can look like Psy.D., M.S.W., and L.M.H.C. Ask them questions such as

  1. What does a typical psychodrama session look like?
  2. How do you integrate psychodrama practices into other therapies?
  3. How will you manage the group dynamics?

To find more resources to support your recovery journey, visit our Resources Hub.

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25 Recovery Quotes for the Christmas Season

Although addiction has no yearly time frame, the holidays can be a hard time for people with an addiction, those in recovery from substance use disorders, and their loved ones. Staying aware of recovery-related topics can help ensure that each family member or friend feels comfortable to celebrate. Discover recovery words of wisdom to inspire you this holiday season.

Recovery Quotes

Quote #1 

“Forgiving yourself, believing in yourself, and choosing to love yourself are the best gifts one could receive.” ― Brittany Burgunder

Quote #2 

“I am not defined by my relapses, but in my decision to remain in recovery despite them.” ― Anonymous 

Quote #3 

“Believe you can, and you’re halfway there.” ― Theodore Roosevelt

Quote #4

“Be stronger than your strongest excuse. Be greater than your most negative voice.”

― Alan Maiccon

Quote #5

“The best way to predict your future is to create it.” ― Abraham Lincoln

Quote #6

“It’s the days you have every right to break down and fall apart, yet choosing to show up anyway is what matters most. Don’t diminish the small steps that others can’t see.” ― Brittany Burgunder

Quote #7

“I am a great believer in luck, and I find that the harder I work the more luck I have.” ― Thomas Jefferson 

Quote #8

“Courage isn’t having the strength to go on―it is going on when you don’t have strength.” ― Napoléon Bonaparte

Quote #9

“It does not matter how slowly you go as long as you do not stop.” ― Confucius

Quote #10

“Rock bottom became the solid foundation on which I rebuilt my life.” ― J.K. Rowling

Quote #11

“The only person you are destined to become is the person you decide to be.” ― Ralph Waldo Emerson

Quote #12

“One of the hardest things was learning that I was worth recovery.” ― Demi Lovato

Quote #13

“Change your thoughts, change your life.” ― Lao Tzu

Quote #14

“Don’t judge each day by the harvest you reap but by the seeds that you plant.” ― Robert Louis Stevenson

Quote #15

”At the end of the day, you can either focus on what’s tearing you apart or what’s keeping you together. ” ― Anonymous

Quote #16

“Courage is resistance to fear, mastery of fear, not absence of fear.” ― Mark Twain

Quote #17

“Recovery is hard. Regret is harder.” ― Brittany Burgunder

Quote #18

“Every worthy act is difficult. Ascent is always difficult. Descent is easy and often slippery.” ― Mahatma Gandhi

Quote #19

“The most common way people give up their power is by thinking they don’t have any.” ― Alice Walker

Quote #20

“Don’t let the past steal your present.” ― Terri Guillemets

Quote #21

“Hardships often prepare ordinary people for an extraordinary destiny.” ― C.S. Lewis

Quote #22

“Turn your face to the sun and the shadows fall behind you.” ― Charlotte Whitton

Quote #23

“The journey of a thousand miles begins with a single step.” ― Lao Tzu

Quote #24

“We can’t solve problems by using the same kind of thinking we used when we created them.” ― Albert Einstein

Quote #25

“When everything seems to be going against you, remember that the airplane takes off against the wind, not with it.” ― Henry Ford

Recover in Love

Whether it’s the holiday season or not, you can always prioritize healing. Discover the best version of yourself by exploring and connecting with rehabs near you.

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What Is Binge Eating?

Binge eating involves recurring episodes of eating large amounts of food in a short amount of time. Recognizing the signs of binge eating is important because it has physical, mental, and societal effects. 

Your mental and physical health can deteriorate from binging episodes. Those who struggle with binge eating often experience intense guilt, shame, and distress, which can negatively impact self-esteem and well-being. Usually there’s a deeper root cause, like something emotionally-driven, behind your binging episodes. And eating large amounts of food can lead to significant weight gain and related health problems.

Caring about your health, and taking steps to improve it, is essential for your well-being. Prioritizing your health can empower you to lead a fulfilling life and positively impact your loved ones and communities.

Defining Binge Eating

The DSM-51 defines binge eating disorder (BED) as “eating, in a discrete amount of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.”

Often, those with BED feel a lack of control when they’re binging. And sometimes, they’ll eat alone because they’re embarrassed or disgusted by how much they eat.

BED occurs frequently. Overeating to the point of feeling uncomfortably full may be distinct from BED, as the episodes do not occur as often. If these episodes are followed by purging behaviors such as self-induced vomiting or excessive laxative use, you may be diagnosed with bulimia nervosa.

Symptoms and Signs of Binge Eating

Common behavioral indicators of BED include:

  • Eating faster than normal during an episode
  • Eating until uncomfortably full
  • Eating a large amount of food, even when you’re not hungry
  • Feeling ashamed of your binge eating, and often hiding it from others
  • Often choosing to eat high-calorie foods that are rich in fats and sugars
  • Hoarding food

Emotional signs of BED include:

  • Feeling a loss of control over your eating
  • Emotional distress
  • Emotional numbing
  • Obsession with weight/body image

Causes and Risk Factors

While no one thing leads to binge eating disorder, various influences can trigger its onset. That’s why looking at this disorder with a multifaceted approach is so important.

Biological Factors

While you may think these eating patterns are something you can easily stop on your own, BED mirrors the neurobiology of substance use disorder3. Palatable foods, along with drugs and alcohol, can change your brain. 

Eating sugary and fatty foods increases endogenous opioid activity in the brain, and over time this binging cycle can alter the opioid system, just like with substance addiction. Additionally, activating the dopamine system can temporarily relieve stress, and eating these foods can do just that. However, this can lead to food, or substance, addiction which can also change your brain chemistry.

The gut-brain axis is the bidirectional communication between the gastrointestinal system and the brain4. Emerging research suggests that gut microbiota composition and function may influence food cravings, mood, and eating behaviors, potentially contributing to binge eating tendencies.

Emotional Triggers

Emotional triggers can play a role in BED, too. Those with binge eating disorder often reach for food when they’re feeling uncomfortable emotions like stress, loneliness, and sadness. This happens because you think you’re craving food, when in reality you’re lacking something emotional, like security, control, warmth, excitement, or love. Unfortunately, food does not compensate for these non-negotiable emotional needs.

Socio-cultural Influences

Socio-cultural influences play a significant role in shaping body image ideals, dieting behaviors, and the development of binge eating tendencies. Some key socio-cultural factors that contribute to this include:

  • Media: Thin, idealized bodies we see in the media contribute to unrealistic beauty standards.
  • Peers: Peer pressure, comparisons, and social acceptance can contribute to body dissatisfaction and a desire to conform to certain appearance standards.
  • Diet culture: This culture claims thinness equals health and moral superiority. It emphasizes strict dieting, weight loss, and the pursuit of an “ideal” body shape.
  • Accessibility to food: Limited access to affordable, nutritious foods may lead to reliance on cheap, energy-dense foods, which can contribute to weight gain and disordered eating patterns.
  • Cultural and gender expectations: Cultural ideals and gender expectations can influence body image and eating behaviors differently across societies. For example, certain cultures may value larger body sizes as a symbol of beauty and fertility, while others may prioritize thinness.
socio cultural influences for binge eating disorder

Consequences of Binge Eating

Binge eating can have significant physical health implications, particularly when it leads to obesity and related medical conditions. It can result in:

  • Type 2 diabetes
  • Cardiovascular disease
  • Gastrointestinal problems
  • Sleep apnea
  • Joint problems
  • Respiratory issues

Aside from physical health, BED can take a toll on you emotionally. There is a relationship between binge eating and anxiety and depression because binging is often used as an escape from these complicated feelings. You may also experience low self-esteem and guilt because of your eating habits.

Binge eating can impact your overall quality of life. It can strain relationships because your embarrassment could lead you to isolate yourself or avoid social situations that involve food. It could also impact your work or hobbies because of the fatigue, reduced concentration, and emotional distress that comes with BED.

Addressing binge eating through treatment and support can help you improve your relationships, social life, and overall quality of life. Therapy, support groups, and developing positive coping mechanisms can promote a healthier relationship with food, enhance self-esteem, and facilitate meaningful connections with others.

Diagnosis and Treatment

According to the DSM-51, BED is diagnosed by  

  • According to the DSM-51, BED is diagnosed by 
  • Eating a larger than normal amount of food in a discrete period of time
  • A lack of control during these binging periods 
  • 3 or more of the following:
  • Eating more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not hungry
  • Eating alone because of embarrassment when binging around others
  • Feeling shame and depressed after binging
  • Marked distress about the binging
  • Episodes occurring 1+ times per week for 3+ months
  • The binge eating not being followed by purging behaviors

If you think that you or someone you know may have BED, it is important to seek help from a healthcare professional. A proper diagnosis can guide the creation of your treatment plan, and early intervention can significantly improve outcomes and quality of life.

Therapy for BED

Cognitive behavioral therapy (CBT) is an effective treatment for binge eating disorder (BED)4. It addresses the underlying thoughts, emotions, and behaviors associated with binge eating. CBT aims to challenge and modify unhelpful thoughts and beliefs, and it helps you develop alternative coping strategies. It’s also beneficial for co-occurring disorders like anxiety or depression because CBT is a widely recognized treatment for many mental health disorders5. 

Interpersonal therapy (IPT) is another evidence-based approach used for BED treatment. IPT focuses on addressing interpersonal issues and improving relationships to reduce binge eating behaviors. This could look like learning to cope with emotions like stress, sadness, or anger in healthier ways, in turn relying less on food as a way to deal with them.

Strategies for Coping with Binge Eating

While professional treatment is the most important component for recovery, building a healthy relationship with food and practicing mindful eating can help you along your journey.

This can look like paying attention to your body’s hunger and fullness cues, mindful eating where you slow down eating and pay attention to the food sensations, stocking your kitchen with nutritious foods, and striving for a flexible, non-restrictive approach to eating.

If your BED is triggered by stress, developing effective stress management techniques can help you navigate a trigger before the binge starts. This could be deep breathing exercises, getting adequate sleep, exercising, and positive self-talk. 

Finally, seek support from friends, family, or support groups. Sharing your feelings and experiences with trusted individuals can provide comfort and perspective. And engaging in social activities and maintaining healthy relationships can also help reduce stress levels and manage your BED.

Prevention and Long-Term Management

Building a healthy relationship with food and your body is the best way to prevent BED. You can adopt balanced eating patterns that include a variety of nutrient-rich foods. There are no “good” and “bad” foods, all food is fuel. So allow yourself to have those treats without feeling guilty. Being unrestrictive can help you sustain a healthy diet.

BED develops not just because of your eating habits but also from your emotional well-being and coping strategies. Keeping yourself mentally healthy is just as important as being physically healthy. Find positive ways to cope with stress, boredom, or difficult emotions that do not involve turning to food. You can exercise, practice mindfulness, engage in creative outlets, or spend time with loved ones.

Ongoing self-care and self-compassion will be key in your journey. Set boundaries, validate your emotions, and create goals. Growth and being the best version of yourself doesn’t come from being your harshest critic. It comes from being your biggest supporter and talking to yourself like a best friend.

You have the potential to be the happiest and healthiest version of yourself. See where professional help and positive lifestyle changes can take you by browsing our list of eating disorder treatment options. 

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How to Help Someone Who Has Relapsed on Drugs or Alcohol

Relapse involves drinking alcohol or using drugs again after abstinence or successful recovery. Like other chronic diseases, addiction relapse is always possible. Relapse can happen at any time in the recovery process, including early stages or even after long periods of sobriety.

When relapse does happen, your loved one will need all the support you can provide. If you know someone who has relapsed, there are ways you can help. Your help can make a big difference in their life. Browse rehabs specializing in chronic relapse to give you an idea of how to help your loved one continue their recovery journey.

Understanding Relapse

In addiction recovery, relapse can often be part of the overall process rather than a failure. Addiction is a chronic condition1, and relapse does not mean that your loved one’s recovery is impossible. Instead, relapse provides an opportunity for learning and growth. 

This journey can help them identify triggers and areas that need attention in their recovery. Be aware of these common things that trigger relapse:

  • Environmental cues: Specific locations, objects, smells, or even certain people associated with their previous substance use can be powerful triggers.
  • Co-occurring disorders: People with addiction often have underlying mental health conditions2 such as anxiety, depression, or trauma. If these co-occurring disorders are not properly addressed and treated, they can significantly increase the risk of relapse.
  • Stress: High levels of stress can weaken their ability to cope and make them more vulnerable to relapse.
  • Unhealthy coping mechanisms: If they haven’t developed healthy and effective coping mechanisms to deal with stress, manage emotions, or solve problems, your loved one might resort to their addictive behaviors as a way to cope with stressors.

Recognizing Signs of Relapse

Signs of addiction relapse can manifest in various ways, depending on the individual and their specific addiction. Here are some common signs to be aware of, so you can hopefully address this issue early on:

  • Behavior changes: They may become secretive, defensive, or dishonest. They may also isolate themselves, withdraw from social activities, or show a lack of interest in things they used to enjoy.
  • Mood swings: Emotional instability, mood swings, and irritability are common signs of relapse. They might also be anxious, depressed, or angry.
  • Justification: If they’re on the verge of relapse, they may begin to rationalize their drinking or drug use again. 
  • Reconnecting with old using friends: Reconnecting with old friends who are still drinking or doing drugs is a red flag.
  • Loss of interest in recovery: A noticeable loss of interest or commitment to recovery can be an indicator of relapse. They might stop attending therapy or support group meetings or disregard their relapse prevention plan.

Communicating with Your Loved One About Their Relapse

Sometimes, it just takes the right person to help someone kick start their recovery. So when you’re helping your loved one through their relapse, work on showing empathy. Active listening without judgment can help them feel supported. Having a reliable ally can make a huge impact.

When having these conversations, timing is everything. First, make sure the person you are talking to is not under the influence of any substances during these conversations. Next, have conversations with this person in a calm and safe atmosphere. This will allow them to feel more relaxed and comfortable discussing their thoughts and feelings.

Blaming or criticizing them for their relapse can create defensiveness and hinder open communication. Instead, emphasize your support and understanding. Let them know that relapse doesn’t define their worth or undo the progress they’ve made so far.

Providing Emotional Support

Relapse can bring feelings of shame and guilt. Emotional support provides a safe space for your loved one to express their emotions and experiences without judgment. Feeling understood can help them recognize that they are not alone in their struggles. Sometimes, people just need to be heard without receiving immediate advice or solutions.

Creating a supportive and non-enabling environment for someone in addiction recovery is crucial for their well-being. After educating yourself on addiction and the recovery process, you can create a caring home for your loved one to come back to. You can also support them by adopting a healthy lifestyle that complements their recovery. Encourage regular exercise, nutritious eating, and adequate sleep. Offer to participate in activities together that provide alternative outlets for stress and anxiety.

Be mindful of enabling behaviors that inadvertently support their addiction. This can include providing financial support for their unhealthy lifestyle, making excuses for their behavior, or covering up the consequences of their actions. Instead, focus on supporting their recovery and encouraging self-sufficiency. And celebrate milestones because recognizing their progress reinforces their commitment and boosts their self-esteem.

Assisting with Treatment and Recovery

While relapse can be common, it’s still a tricky situation that requires immediate attention. After you talk to your loved one, and they agree to get treatment, you can help them find the best treatment for their needs. 

Whether this is their first relapse or not, residential rehab may be in the cards for them. Here, your loved one can separate from triggers and distractions in their day-to-day life and focus on recovery. They’ll likely participate in a variety of evidence-based therapies, like cognitive behavioral therapy (CBT). This will help them change any unhealthy thought patterns or behaviors that might’ve contributed to their relapse. And many rehab centers will offer holistic therapies and activities, like yoga, to help them connect their mind and body. 

Ongoing care will be important for your loved one. Outpatient treatment can help them transition back home while still providing some structure. They’ll continue building vital coping skills for stress and negative feelings, without using substances. And outpatient programs allow them to go to school or work. This is a great option for those who cannot fully give up those commitments.

Reconnecting with support networks, such as support groups or 12-Step programs like AA or NA, can be a helpful piece of their journey, too. You can even offer to help them find these groups or attend them, too, if they feel comfortable with that. Being part of a supportive community can provide valuable insights, encouragement, and accountability during the recovery process. And they can lean on others for support who have been in similar circumstances.

Setting Boundaries

Boundaries can help maintain a healthy relationship dynamic and prevent enabling behaviors. For example, you can express that you won’t participate in activities or situations that enable their addiction, but you’ll support their recovery efforts. You can encourage their recovery efforts by helping them find appropriate treatment, celebrating milestones, and staying consistent with your support. Boundaries help create a healthy and balanced dynamic while providing a framework for sustainable progress.

Not only is setting boundaries during their recovery important for your loved one, but this is also essential for you. Supporting someone in addiction recovery can be emotionally demanding. Take care of yourself by setting healthy boundaries, seeking support from others, and practicing self-care. Your own well-being is crucial to being an effective support system.

Dealing with Relapse Triggers

Identifying addiction relapse triggers is an important step in relapse prevention. You can find these by:

  • Paying attention to your loved one’s emotional cues (like mood swings)
  • Recognizing high-risk situations (their stressors)
  • Reflecting on their past relapses (what triggered them in the past?)

Developing healthy coping strategies can ease the impact of their triggers. For a while, drinking alcohol or using drugs was your loved one’s coping strategy, even though it was an unhealthy one. Finding positive ways to deal with stress can prevent a trigger from greatly affecting them.

Prevention is much easier than dealing with the after effects of relapse. You can help your loved one create a relapse prevention plan to maintain long-term recovery. This might include being aware of triggers, developing healthy coping mechanisms, building a support network, and making lifestyle changes.

Encouraging Continued Recovery

Your loved one will deal with uncomfortable feelings and situations for the rest of their life, just like all of us do. Creating sustainable habits to manage discomfort is key during their journey.

Motivation to continue their recovery comes from not only within, but also from others around them. Sometimes, they’ll need a “pick me up” from you or someone else, and that’s okay. The support network your loved one will build requires effort and reciprocity. Nurturing these relationships involves active listening, offering encouragement, and celebrating each other’s successes.
Recovery is a journey, and with the right support and treatment, your loved one can continue moving forward toward sustainable sobriety. Recovery is, in fact, possible. Explore centers that specialize in treating chronic relapse to open up new doors for you and your loved one.

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Coming Out and Mental Health: Navigating the Emotional Journey

Coming out as a member of the LGBTQ+ community can feel daunting, liberating, scary, or all of the above. It can also have positive or negative impacts on your mental health, both of which you can navigate. 

Don’t feel like you need to follow a script, set of steps, or anything else to successfully come out. It’s up to you and what you’re comfortable with. You know your life and circumstances better than anyone else. 

But you do have resources for the journey and its emotional effects. 

Understanding Coming Out

The American Psychological Association defines coming out1 as, “self-awareness of same-sex attractions; the telling of one or a few people about these attractions; widespread disclosure of same-sex attractions; and identification with the lesbian, gay, and bisexual community.” 

For many, coming out shapes the rest of their lives. It can be one of the most significant journeys you ever face. For others, it’s not a big deal. It’s different for everyone, and that’s perfectly okay.

Challenges And Fears of Coming Out

A potent fear related to coming out is the possibility of rejection. Your loved ones could reject your core identity, and that would hurt. 

Social prejudices, misconceptions, and misguided views could also make coming out scary, both right away and in your future. Even if the reactions aren’t negative, they might not feel affirming, either. Both can hurt.

Picking the right time to come out can also feel like a challenge. When do you say it, and who do you tell? Should you tell one person, or a group of your friends and family? 

Only you can truly answer those questions. But the weight of wondering can affect your wellbeing. Drinking or using drugs could seem like a way to alleviate the stress. If you’re struggling with addiction, you can browse our list of LGBTQ+-affirming rehabs. 

Mental Health Considerations in Coming Out

Feeling unaccepted can lead to depression, anxiety, and even trauma. Society’s attitude towards the LGBTQ+ community can also cause minority stress2, which can exacerbate or cause mental health conditions. Some may experience chronic minority stress, which means they’re hypervigilant to possible discrimination, frequently worried about it, or carry internalized stigma of themselves. 

This stress, fear, grief, and trauma can create or worsen mental health conditions. It’s not hard to see why—but that’s not how the story has to go. 

The Impact of Attitudes And Acceptance on Mental Health

Coming out could relieve the emotional toll of hiding. When you come out, you won’t have to adjust your behaviors, actions, and words to hide who you really are. That can feel like a deep relief. 

But make sure you know how you feel about your identity. Take a deep and thoughtful search of your heart—what do you feel when you think about who you are? Internalized homophobia can add stress and shame to your coming out journey. As much as you’re able, try to find and challenge these feelings. 

Coming out can lead to self-acceptance, which can powerfully erase any internalized homophobia. And once you’ve accepted and embraced who you are, what others think might not matter so much. It’s okay and normal if it does. You have ways to navigate that, too. 

Mental Health Resources for the Coming Out Process

Many support groups, online chats, and other resources can help you through the coming-out process. Here’s a few:

  • PFLAG: A LGBTQ+ resource with 400 local chapters in America. Started in 1973, they were the first organization to offer help, education, and support to LGBTQ+ people and their families.
  • 988: They provide resources for LGBTQ+ people and a 24/7, nation-wide suicide crisis hotline. 
  • The Trevor Project: They’re the world’s largest crisis service for LGBTQ+ youth ages 25 and under. You can call, text, or chat the crisis interventionists here 24/7. 
  • Trans Lifeline: A crisis line for trans people that respects your rights and doesn’t use non-consensual interventions.
  • Pride Counseling: A specialized online counseling service for the LGBTQ+ community.
  • LGBT National Help Center: They provide a phone hotline for LGBTQ+ people of all ages to speak with an educated volunteer about identity struggles, coming out, and other concerns. 
comingout

Self-Care Strategies for Mental Well Being

Coming out likely won’t be completely stress-free, and that’s okay. Whether the stressor is big or small, you have ways to manage your emotions and improve your wellbeing. 

You can practice mindfulness and meditation when your emotions feel overwhelming. Try to identify the support you have in your life, too. The resources listed above definitely count as someone you can talk to when you feel overwhelmed.

Be sure to practice self-care, self-compassion, and self-acceptance as you plan and execute coming out. Don’t force yourself to follow what anyone else did, either. The way and time you come out is unique to you—try to take comfort in that. Here’s some other self-care steps you can take:

Your mentor could be someone who came out months or years ago. They can help you through the process and offer support from someone who’s really been there. 

To find one, you can connect to an openly queer person in your life. Even if they’re not able to help you throughout the whole process, it might help you to know that they know what you’re going through. If you don’t know any potential mentors, or don’t feel comfortable doing so, you can connect with others online. 

Building Resilience and Creating a Supportive Environment

A negative reaction to your identity will probably hurt. But you can manage that pain by building resilience and creating a supportive, safe environment for yourself.

The American Psychological Association suggests group environments build resilience3. Your group may be other LGTBQ+ people in your neighborhood, work, or school, or a more formalized LGBTQ+ gathering. All your group must do is offer support and bring you happiness to strengthen your recovery. 

A supportive environment will feel safe and accepting. For you, this might include your family, friends, or others in the LGBTQ+ community. It differs for everyone, and that’s okay. If your environment becomes unsupportive, consider leaving it, if you can. Mental health professionals can help you navigate this change. 

Resilience also ties into self-care. The healthier you are physically, the more prepared you’ll be to handle emotional challenges. Take care of your mind, too. That’s where meditation, journaling, and mindfulness come in.

Reach The Other Side of Your Rainbow

Coming out is your unique journey. It can come with stress, worry, and fear, even if you’re excited for the change. But you have help available along the way. 

Along the way, make sure to prioritize your mental health and well being. You can do so through therapy, engaging in support, and actively practicing self-care. 

And remember that your coming-out process is your own. If you think writing out a script will help, do it! If a video seems more helpful, or even baking a cake, do that! The path you take is up to you.

Good luck and be well.

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What is Hangover Anxiety?: Why Drinking Causes ‘Hangxiety’

Hangover anxiety, or hangxiety, isn’t a diagnosis, but rather how you feel after a night of drinking alcohol. A hangover has physical symptoms like nausea and a headache, but you can have mental effects as well.

Drinking responsibly likely won’t lead to these negative feelings; however, if you’re consistently drinking a lot and feeling hangover anxiety, then it may be time to look for help. Getting treatment for alcohol addiction can help you get a handle on your drinking, so you don’t have to wake up with worry the next morning. 

Hangover Anxiety or ‘Hangxiety’

75% of those who get a hangover have some impairment in their normal functioning1, like difficulty concentrating. On top of that, roughly 22% of drinkers also experience psychological effects like anxiety and depression after a night out. This is what we call hangxiety.

What Does Hangover Anxiety Feel Like?

When you start drinking, alcohol drives a surge of endorphins in the brain2, which feels good at first. Then, after this rush, there’s a decrease in blood alcohol concentration (BAC) which leads to a form of withdrawal. This is what we commonly refer to as a hangover.

This withdrawal affects you physically and mentally, including provoking anxiety and depression symptoms. Hangover anxiety can look different for everyone, but these are some common symptoms:

  • Restlessness
  • Anxiousness
  • Ruminating on yesterday’s events
  • Heart racing
  • Feeling guilt
  • Difficulty concentrating

What Causes Hangover Anxiety?

After your endorphins drop, your brain can quite literally feel exhausted the next day. Your body uses a lot of energy trying to maintain homeostasis after being affected by the alcohol. And cortisol, the stress hormone, releases after drinking3, making you feel even more anxious. 

These factors can also exacerbate hangnxiety symptoms:

1. Social Anxiety

You might use alcohol as a “social lubricant” if you experience social anxiety. This can cause you to drink more than you should. Though for those few intoxicated hours you may feel less anxious, these feelings return as the alcohol wears off. And if you have a hangover from excessive alcohol consumption, your anxiety can skyrocket. Alcohol will enhance whatever emotional state you’re in, so if you’re anxious, it’s going to come back in full swing.

2. Water intake

Alcohol is a diuretic, so drinking it makes you dehydrated. This can contribute to hangover anxiety because low water intake, which happens while drinking, is associated with detrimental effects on mood4. The more hydrated you are, the better chance you have of being in a good mood.

3. Sleep

Alcohol causes poor sleep quality5 because it messes with your rapid eye movement (REM) cycle. This, in turn, negatively affects your mood because getting proper sleep is vital for good mood and functioning. 

4. Emotional dysregulation

Emotional dysregulation is a common symptom in disorders like anxiety and depression. It’s also associated with intense cravings, higher alcohol consumption, and is commonly experienced during hangovers6. Lowered emotional competence during a hangover can lead to negative mood and thoughts, or, what you may feel during hangxiety. This can also contribute to regretful drinking behaviors.

5. Repetitive negative thinking (RNT)

Repetitive negative thinking (RNT) is negative thought patterns that are recurring, unproductive, and common in disorders like anxiety and depression. It’s also a part of emotional dysregulation. These patterns of thinking are associated with prolonged negative emotional states6, so this can exacerbate symptoms when you experience hangover anxiety. 

How to Cope with Hangxiety

The best way to avoid hangxiety is to avoid drinking, especially in excess. Doctors recommend drinking a minimal amount of alcohol because excessive alcohol consumption can lead to various health problems such as liver damage, heart disease, and certain types of cancer.

However, if you do decide to drink, there are a number of ways you can cope with your hangover anxiety and make this experience manageable:

However, drinking responsibly, or being abstinent, can help you avoid these feelings all together.  

How to Have Fun Without Alcohol

Life can be just as fun, if not better, without alcohol. You’ll feel healthier and more energized, which can help you do more outdoor activities like hiking or kayaking. You’ll also save a lot of money from not buying drinks, which you can spend on new experiences like travel or exploring the area you live in.

You can also talk with your therapist and dig into the real reasons why you’re drinking alcohol. Why are you having this drink? And why do you feel like you need to drink so much? This can reveal deeper issues that you can work through together. 

When to Seek Professional Help for Your Drinking and Anxiety

Taking a step back and assessing the role that alcohol plays in your life, especially if you have pre-existing anxiety or depression, is crucial. If you’re using alcohol as a crutch, and as a coping mechanism to suppress difficult feelings, then it may be time to reach out for help.

Mental Health Treatment Options

Alcohol is a depressant, so it can aggravate your existing conditions. If you drink to escape your anxiety or depression, treating the root cause of your disorder can help mediate this issue.

Attending an outpatient program can teach you skills to help you replace your drinking with healthy coping techniques. You’ll explore how drinking has been a way to hide from uncomfortable feelings, and then you’ll learn how to face those hard emotions. You’ll likely practice different talk therapies like cognitive behavioral therapy (CBT) to learn new positive ways of thinking. 

Virtual treatment for anxiety and depression can be a great way to learn these tools with more flexibility. You can prioritize healing and see how it fits into your life.

Alcohol Addiction Treatment Options

Detox with a licensed professional may be the first step in your sobriety journey. Safely ridding your body of alcohol can help you feel clear minded and ready to tackle treatment. Different levels of residential or outpatient care can help you replace your unhealthy coping mechanism, drinking, with positive habits.

A great option post-treatment is sober living homes. These programs are less structured than residential rehab, and provide a comfortable place for you to focus on your recovery. While living here, you’ll likely attend an outpatient program, go to work or school, and grow with other companions in recovery. 

Life Without Worry in the Morning

Drinking socially and safely is perfectly acceptable, but if heavy drinking and hangxiety is a normal thing that you’re getting addicted to as a coping mechanism, then it’s time to get help. Life can feel so much more fulfilling without hiding behind alcohol. Embrace your true self and find freedom through rehabs for alcohol addiction.

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Neurofeedback For Addiction Recovery: Letting Your Body Heal Your Mind

Neurofeedback can help those who need something different than a traditional way of healing during their recovery journey. With neurofeedback, you can see how your mind and body connect. And you’ll learn how you can shift your habits and ways of thinking to help you overcome addiction. You can start moving in the right direction to align your mind and body through neurofeedback treatment. 

How Addiction Affects the Brain

The human brain is made up of cells called neurons1 that interact with each other in different networks. One neuron releases a neurotransmitter, like a message, into the gap called a synapse, which then attaches to the next neuron telling it what to do. And different networks, or circuits, of neurons are responsible for different functions in the body.

neurotransmitter process

When you take drugs, they interrupt how this process occurs in the brain. Some drugs mimic the structure of natural neurotransmitters, and others cause neurons to release a lot of natural neurotransmitters. 

Addiction starts when your brain begins to produce less of its natural neurotransmitters due to high, constant drug use. It becomes harder to find the same happiness from things you used to enjoy. You then need to use drugs to find that pleasure again. And oftentimes, you need to use higher and higher amounts to get that same joy.

This becomes a dangerous cycle. Fortunately, there are treatments that can help you find your passion for life again without the use of a substance.

What Is Neurofeedback?

Neurofeedback, also known as EEG biofeedback, measures brain activity with a few different devices like an electroencephalogram (EEG), sweat sensors, and heart rate monitors. Then, a trained professional can see where damage is in the brain. Your neurofeedback practitioner can work with you to get these harmed parts of the brain back to healthy functioning. It essentially harmonizes your brain waves. This treatment is non-invasive and does not use medication.

The main goal is to give you strategies to interfere with unhealthy thought patterns and help you take charge of your mind. This facilitates positive changes in thinking and behavior.

How It Works

Professionals at Luna Recovery explain that an electroencephalogram (EEG) uses sensors placed on your skin to gather information about brainwave activity2. It also collects data about your blood pressure, heart rate, and skin temperature. Practitioners then locate where there’s damage in the brain due to drug use, or other conditions. Knowing this, they can help you correct these faulty neural pathways.

What Happens During Neurofeedback Therapy?

During a neurofeedback session, which typically lasts about an hour, you’ll likely wear a cap on your head with different electrodes placed on it. These electrodes connect to a machine to monitor your brain’s activity.

neurofeedback session

After this is all set up, your practitioner will do activities with you to stimulate different areas of your brain. This could include watching a movie or playing a video game; however, your brain activity directly affects what’s happening on the screen. 

For example, your screen may only be at full brightness when your brain waves are interacting in unison. If you lose focus and your brain activity scatters, the screen will dim. Simple exercises like this not only show you how your brain is working, but they also begin to teach you how you can control it.

Are There Risks Associated with Neurofeedback Treatment?

Neurofeedback is generally a safe form of treatment because it’s non-invasive. It is possible, but unlikely, to experience some side effects during sessions, like anxiety, fatigue, and headaches.

Neurofeedback for Addiction Treatment

Addiction typically creates irregular brain waves3, and each drug creates different types of damage in different areas. Luckily, we can correct these irregularities through neurofeedback. 

During sessions, you’ll pay close attention to your thoughts. Outside of sessions, you can practice what you’ve learned to help you manage your feelings or cravings in real life. You’ll learn skills to adapt to any new situation that life throws at you. Throughout treatment, you can train your brain to become as healthy as someone without addiction4.

Neurofeedback and Mental Health

Neurofeedback is extremely useful for not only addiction recovery, but also for mental health disorders5. It’s an effective treatment for common disorders like anxiety and depression6. But neurofeedback can also treat co-occurring disorders and other singular  diagnoses:

  • Attention deficit/hyperactivity disorder (ADHD)
  • Insomnia
  • Schizophrenia 
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)

By disrupting unhelpful thought patterns, you can manage the emotions that come with your mental health condition. And neurofeedback can offer a good alternative to medication, especially if medications or other treatment plans haven’t worked for you in the past.

A Different Way of Healing

You have resources available to heal from addiction or mental health issues. Neurofeedback can give you a whole new perspective on life. You can attune your mind and body to connect with yourself and the world around you. Discover how rehabs with neurofeedback can help you start living fully.

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Understanding Anxiety’s Effect on Eating Disorders

Eating disorders don’t develop in a vacuum. They often go hand in hand with other mental health conditions, like anxiety. And that can make it hard to get the treatment you need.

In rehab for eating disorders, providers know that mental and behavioral issues are connected. Eating disorders are unhealthy coping mechanisms, but they exist for a reason. And with help, you can learn better coping strategies. These skills empower people to recover from disordered eating and the anxiety that can trigger it.

Understanding Eating Disorders

These complex conditions are about more than just food. In fact, eating disorders affect 30 million Americans.1 There are a few different types of eating disorders,2 as defined by the American Psychiatric Association (APA):

  • Anorexia nervosa is the restriction of food intake. This “self-starvation” can result in weight loss and an unhealthily low weight.
  • Bulimia nervosa follows a cycle. People with this condition binge large amounts of food, then take extreme actions to avoid gaining weight. For example, a person might induce vomiting, restrict food intake, use laxatives, or exercise excessively.
  • Binge eating disorder follows a similar cycle, but does not include purging. It’s characterized by episodes of eating large amounts very quickly, followed by feelings of guilt, shame, and distress.
  • Avoidant/restrictive food intake disorder (ARFID) is an umbrella term. It describes any pattern of disordered eating that doesn’t fit the criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder.

Disordered eating can appear as a wide array of symptoms and behaviors, and it’s important to not try to fit yourself into a box. Like any other diagnosis, the impact of these conditions goes beyond the definitions that you read online. And it’s especially complex for people with co-occurring disorders, like anxiety.

Where Does Anxiety Come In?

Much like eating disorders, there are a wide variety of anxiety disorders. And these 2 categories are more similar than you might think. In fact, research suggests that eating disorders could be classified as anxiety disorders.3

Even if you don’t have anxiety, most people with eating disorders have at least 1 other diagnosis. One study found that 97% of people hospitalized for an eating disorder had a co-occurring disorder.4 When you’re ready to start recovery, it’s important to seek treatment for every aspect of your mental health. Fortunately, many rehabs are prepared to treat co-occurring anxiety and eating disorders.

How Anxiety Impacts Eating Disorders: A Cycle

According to the team at Rosewood Ranch,

“About half of individuals with eating disorders also have an anxiety disorder (and most of the time, the anxiety disorder began prior to the eating disorder.”5

These behaviors may form as coping mechanisms, albeit dysfunctional ones. Some people use eating as a distraction from anxious thoughts,6 or to feel a sense of control. But when you rely on harmful tactics to deal with your emotions, it gets harder to learn healthy ones. This creates a cycle that’s hard to break. And that cycle can be seen in people with any type of anxiety disorder.

Social Anxiety

The U.S. Department of Health and Human Services defines social anxiety7 as a “disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.” And that self-consciousness can turn into anxiety about your appearance. This opens the door to eating disorders. In fact, the fear of being negatively judged is linked to a desire for thinness.8

These social fears are valid—but restricting your diet won’t necessarily make them go away. Studies reveal that levels of social anxiety are similar across all eating disorder diagnoses.9

When you recognize how your anxiety impacts your eating habits, you can start developing healthier behaviors.

Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is characterized by anxiety and intrusive thoughts. Because of this, repetitive, self-destructive behaviors are a common symptom. Disordered eating can sometimes be one of those behaviors.

An article from Timberline Knolls says that for both OCD and eating disorders, the goal of the behavior10 “is to reduce levels of apprehension, anxiety and overall negative effect.” For example, you might binge a large amount of food in an attempt to self-soothe during a panic attack. These behaviors can snowball and worsen your anxiety, and keep you from learning how to handle it differently. You may need professional support to interrupt this behavioral loop.

Breaking the Cycle With Treatment

Research shows that it’s important to treat eating disorders and anxiety together.11 Because of the overlap between these issues, you might want to attend a rehab that treats co-occurring disorders.

The good news is, therapy for either of these conditions may help you recover from both. For instance, experts agree that anxiety lessens when people get treatment for anorexia.12 When you’re ready to heal, several types of therapy can help.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT)13 is a type of therapy that teaches you how to interrupt negative thoughts. It’s also the most recognized method for treating eating disorders.14 Most inpatient treatment programs offer some version of this therapy.

Holistic Therapies

Alternative therapies are an increasingly common way to treat mental health issues. These modalities encourage patients to heal their mind, body, spirit as one. In rehab, you might have access to a variety of holistic therapies. For instance, studies show that mindfulness is a powerful way to treat eating disorders.15

Medication

Evidence shows that medication can treat eating disorders.16 This treatment is normally combined with talk therapy. The combination can be hugely effective. But like any treatment, it’s not right for everyone. If you have any physical health issues due to an eating disorder, talk to your doctor (or treatment team in rehab) about your concerns.

Recovery From Eating Disorders and Anxiety

Whatever types of therapy you pursue, there’s good news: eating disorders and anxiety disorders are very treatable.17 With proper care, these conditions have high recovery success rates. And if you’re living with both diagnoses, many rehabs offer specialized care.

Connect with a rehab that treats eating disorders to learn more about the therapies they offer, housing options, and recovery from co-occurring disorders.