Anxiety and Alcoholism: The Complicated Relationship

Like depression and alcoholism , anxiety and alcoholism  are undoubtedly linked.   Studies have shown that one-third of the people who have anxiety disorders struggle with substance abuse, and that one-third of substance abusers  also have an anxiety disorder. The most common mental illness in the U.S., anxiety disorders afflict 40 million adults—twice as many women as men—and take a toll on the economy of more than $40 billion each year due to health-care costs and lost productivity.  A recent New York Times article reports that,  “the anti-anxiety drug alprazolam, — better known by its brand name, Xanax — was the top psychiatric drug on the list, clocking in at 46.3 million prescriptions in 2010.”

The tragic side of alprazalom and many other anti-anxiety drugs is that they are highly addicting, and contribute to a large percentage of people recovering from substance use disorder who want to quit or  relapse back to alcohol or drug use after many years of recovery.  A relapse can be devastating to a person’s mental and physical health. Some people lose their families and their jobs. Some even lose their lives.  Benzodiazepines detoxification  is dangerous, and can lead to a seizure and death, so do not try to do it alone.  You need the help of a qualified doctor or detoxification center of a hospital or outpatient detoxification center to help you with the withdrawal side effects.

Anxiety is normal.   Anxiety disorders  are not normal. The challenge of diagnosing anxiety disorders is that everydiv has some degree of anxiety.  Anxiety becomes a disorder when it interferes with life or causes a lot of distress.

Everyone has a different threshold level or limit as to how much of stress or stimulus coming to us from the world, that we can handle. As soon as that threshold is exceeded – we deal with that by engaging in a variety of coping mechanisms. Most ‘dysfunctional’ behavior stems from our ability to withstand this ‘stress.’  

Anxiety sometimes drives people to do things to get rid of the discomfort.  Many people who experience chronic feelings of anxiety about social situations, work and relationships, or other aspects of everyday life often reach for a beer or a glass of wine to quell their unease.

Alcohol may help anxious people cope in the short term, but over time this strategy can backfire. Self-medicating with alcohol or drugs can increase the risk of alcoholism and other substance-abuse problems , without addressing the underlying anxiety. And anxiety becomes the trigger for continued alcohol use and dependence.

People probably believe that self-medication works. What people do not realize is that this quick-fix method actually makes things worse in the long term.

On the flip side of the alcohol/anxiety relationship, alcohol consumption and hangovers can make many people anxious. It is a scientifically based understanding fact that alcohol can cause anxiety.

Scientists believe that alcohol causes or at least increases anxiety in 6 basic ways:

1. Mood

Alcohol can affect our mood because it can affect the level of serotonin in the brain. Serotonin is a feel good brain chemical that when in short supply can cause feelings of anxiety and depression.

2. Drop in blood sugar

A drop in blood sugar can cause dizziness, confusion, weakness, nervousness, shaking and numbness. These symptoms can most certainly trigger a bout of anxiety.

3. Dehydration

This has been known to cause nausea, dizziness, fatigue, light-headedness and muscle weakness. These symptoms wouldn’t cause anxiety per say but they add to a sense of illness which fosters anxiety.

4. Nervous System

The nervous system is affected because in order for the div to fight off the sedative effects of alcohol it puts the div into a state of hyperactivity in order to counteract this effect. This hyperactivity can lead to shaking, light/sound sensitivity and sleep deprivation.

5. Heart Rate

Your heart rate can become elevated as a result of consuming alcohol which can cause a palpitation false alarm and put you into a state of anxious anticipation. Is it a heart attack or isn’t it you might ask. This “what if” questioning can increase your general state of anxiety.

6. Concentration

A hard night of drinking can also make you hazy, bring on headaches and create a sense of disorientation.

Treatment for many anxiety disorders most often includes a combination of non addicting medication and cognitive-behavioral therapy.  Research suggests that a combination of cognitive-behavioral therapy and medication can help control symptoms and lead to complete remission in some people.

For those people who have suffered an  alcohol and drug relapse, or who have not been able to maintain sobriety due to anxiety, Lasting Recovery offers a cognitive behavioral program.  We support people  to people make changes in their thinking and in their lives and to understand the causes of anxiety and basic fears. We offer the Fearless Change Process that helps you to see that a lot of anxiety comes from unmet needs or fear that one’s needs  will not be met in the future.

If you are suffering from dependence on anti-anxiety medications, alcohol or drugs, call us at (858) 453-4315. We can help you to reduce your anxiety and get back the quality of life you deserve.

Judy Saalinger, Ph.D., MFT, CAS

Co-Founder and Executive Director

Labels: A-Z of Addiction Recovery , Addiction , Alcoholism , Anxiety , Outpatient Treatment of Alcohol use , Recovery

Signs of Prescription Drug Abuse in Carmel Valley, Del Mar, Encinitas and Carlsbad

Prescription drug addiction continues to be a growing problem that many people don't take as seriously as they should. After years of focusing primarily on marijuana use, there was news from CBS News that the more urgent growing problem is prescription-drug misuse. Antidrug campaigns from both the private and public sector have turned their attention to what's seen as a more urgent problem: prescription-drug misuse. Authorities say marijuana by comparison to prescription drug use, is 'benign.'

Prescription drugs that create physical dependency and addiction belong in two classes of pills; opiates and benzodiazepines. opiates include drug such as codeine, vicodin, norco, oxycodone and benzodiazepines/tranquillizer drugs including xanax, valium, ambian and others.

The Signs of Addiction to Prescription Drugs:

• A preoccupation with symptoms of pain or sleeplessness in order to justify the request for more medication. 
• Lack of interest in doing other activities unrelated to the drug using experience. 
• Good, drug induced feelings preoccupy the mind. 
• Mood swings
• Borrowing from friends and/or purchasing from drug dealers. 
• Purchasing drugs on the internet or from pharmacies in Mexico. 
• Past history of drug addiction. 
• On and off relief from anxiety. 
• Using more than the recommended amount of the medication. 
• Taking medications from family, friends or strangers medicine cabinets. 
• Hiding medications or lying about taking them. 

Medication changes the brain chemistry,making it less effective at producing chemicals like dopamine or endorphin. Since the brain has stopped producing these chemicals itself, they must be introduced through another source. At this point, the prescription drug addict has become physically dependent on the medication.

Effects of Excessive Use of Prescription Pills:

A person who is addicted to prescription drugs may experience the following:

• Anxiety 
• Depression 
• Difficulty sleeping or sleeping too much 
• Loss of interest in relationships with friends or family members 
• Withdrawal symptoms when they try to stop using the medications on their own 

Important: Consumption with or without alcohol can effect the central nervous system causing respiratory distress, failure or even death.

Lasting Recovery provides Detoxification Services and Intensive Outpatient Treatment for Prescription medication addiction. Recovery is possible --- we can help.

Judy Saalinger, Ph.D., MFT, CAS

Co-Founder and Clinical Director

Women At Risk of Developing Alcohol Problems in San Diego County?

Are women who drink wine with their friends in Del Mar, Encinitas, Carmel Valley and La Jolla, alcoholics?

Women who have a few social drinks now and then are probably not alcoholics. Some, however, may be on their way to developing an addiction to alcohol. I get calls every day from women who think they might have an alcohol problem, and women who know they have a drinking problem and are asking for help.

When I was struggling to understand my drinking behavior over 25 years ago , I felt guilty and confused. I thought I should be able to control the effects of my drinking. Betty Ford and Elizabeth Taylor, two very famous women in our country, could not control the amount they drank either. These women identified a pattern of drinking behavior that was predictable, and distinguished them from light social drinkers. Knowing that they could face their problem with alcohol gave me courage to face mine. Read over the following list of predictable behaviors for alcohol dependency and see if you can identify with any of the following. If so, you are not alone.

___Buying liquor at more than one location to keep the quantity secret.

___Hiding bottles or cans of alcohol or secretly disposing of them.

___Advance planning to reward yourself with heavy drinking.

___Memory loss after drinking too much.

___Feeling sick and hung over after drinking.

___Feeling afraid you made a fool of yourself the night before.

___Drinking alcohol before leaving the house for party or event

___Drinking to feel wittier, more relaxed, or less anxious.

___Uncertain about going to events where there will not be alcohol.

___Entertaining or creating situations so you can drink alcohol.

___Avoiding discussions, literature or TV programs on alcoholism.

___Carrying liquor in your purse, car or at the office.

___Becoming defensive when someone questions you about drinking.

___Are angry that other people are trying to control you and your drinking.

___Drinking while angry, upset, depressed, or under stress.

___Driving after you have been drinking alcohol, feeling certain you can drive.

___Switching types of alcohol to prevent becoming too intoxicated.

___Drinking at work or at your activities with your children.

___Other people show concern about how much you drink.

___Breaking promises to others because of drinking.

___Feeling crazy or overwhelmed but knowing why.

___Feeling guilt and remorse for behavior while drinking.

___Being unable to predict how many drinks will be consumed in one sitting.

___Drinking more than planned or faster than other people do.

___Feeling like it is impossible or difficult to stop drinking without help.

If you can relate to some of the above questions, talk to someone who understands what you are going through and get the help you need. You do not need to suffer any longer. Call Lasting Recovery toll free: 800-808-6373, or in San Diego County, 858-453-4315.

Judy Saalinger, Ph.D., MFT, CAS

How Alcoholism Develops - Part 3

Late Stage 

Throughout San Diego County, in areas of La Jolla, Mission Valley, Pacific Beach, and Coronado, people are struggling with trying to stop drinking, and others have given up, thinking to themselves that they are hopeless and why bother, they are unable to stop and stay stopped. Other men, women and young people continue drinking by telling themselves that their problems with alcohol are not that bad.

In denial, these folks may minimize the consequences of using and blame the family or friends for complaining. Denial of addiction is based on the mistaken belief that the person does not have a problem because they still have a job, a family and do not drink every morning.

Some are still working, others have quit or lost their jobs. Some are homeless, but most are at home through San Diego county, being cared for or enabled (actually leading to more severe progression of the disease), by family or friends who wish the person would stop drinking, and yet do not know how to get them to stop.

Living in Late Stage alcoholism is the image of what most people think of when the words alcoholism is mentioned - drinking from early morning, lost job, abandoned by family, multiple legal offenses and treatment programs without gaining substantial periods of recovery.

There are hundreds of people getting sober each day in San Diego. In the Middle and Late Stages of alcoholism and addictions, they call treatment centers and ask for help. They ask for Outpatient or Inpatient detoxification; ask their doctors for help, or go online and check out the alcohol treatment programs or alcohol rehabs in their area. They show up at AA meetings.

These folks even tell us they are relieved when they get a DUI, knowing that this will be a chance for them to get help to stop drinking.

Identification of the Late Stage of Alcoholism :

• the person drinking thinks that responsibilities interfere with drinking. 
• loss of job 
• radical deterioration of family relationships 
• unreasonable resentments 
• loss of will power 
• onset of lenthy drunks 
• moral deterioration 
• urgent need for morning drink 
• geographic escape attempted (I won't drink in this new town) 
• urgent need for morning drink 
• impaired thinking 
• loss of family 
• successive and lengthy drunks 
• unable to initiate action 
• obsession with drinking 
• all alibis exhausted 

If you are reaching out for help give us a call here at Lasting Recovery. If we are unable to help yo and your family with our outpatient detoxification , intensive outpatient alcohol and drug program we will refer you to a program that will work for you. If you are a family member and are unable to encourage your family or friend into treatment, we can recommend an Interventionist that will be of help to your family.

Call us at 858-453-4315. Do not wait any longer. The stakes are too high.

Judy Saalinger, Ph.D., MFT, CAS 

How Alcoholism Develops - Part 2

Middle Stage 

In addressing this Middle Stage of the disease of addiction here in San Diego County, you may be asking the question: Given the already negative effect of drinking alcohol, as outlined in the Early Stage, why do I keep on drinking?

The answer:

There is a growing illusion in this disease, that alcohol is continuing to have the same effects as it once had. We refer to this as Euphoric Recall.

People keep using alcohol for the effect they remember - the drug's action is pleasant or useful, including social or medical uses, and it allows people to temporarily feel more pleasure, less pain or discomfort or both. People recall how alcohol used to help them feel more at ease in social situations. Only now, in the Middle Stage of the addiction, the effects of the drugs have changed.

This Middle Stage is often called the Loss of Control Phase. During this phase drinking has different effects. Occasionally we can drink socially and do not crave the alcohol once we have been exposed to it. Other times we are confused as to why, drinking the same amount, it seemed to take us over. As rationalization begins to dominate the individual, i.e., we make up excuses to ourselves and others as to why we drank more, or ended up in an embarrassing situation. Rationalization are the lies we tell ourselves and how we learn to avoid others because we are thoroughly confused at our behavior. For many of us, we are able to control a lot of things in our life and think that if we just tried a bit harder, we could consistently control our alcohol use as well. So we firmly tell ourselves that we will not drink more than two drinks at the next party, or that we will not drink at all.

We this stage progresses without help, we are unable to keep our commitments to not drink, so we begin making excuses or lying about drinking. We may drink in bars or restaurants to hide the evidence of bottles if we drink at home. Many of us then decide that going out socially to drink alcohol becomes such a disaster that we would rather stay at home and drink.

Our anxiety is actually increasing as the alcohol does progressively more damage to the brain and div. Nutrition is negatively affected, and important vitamins and minerals are depleted. At the same time, we ironically keep remembering that alcohol once reduced fear, anxiety and even anger. It used to help us feel more confident, helped us sleep and reduced physical discomfort.

Instead, what alcohol actually does is cause drowsiness, disorientation and blackouts. Alcohol may impair our motor coordination and cause impaired judgment. Some people will receive a DUI, have an extra marital affair, or make poor financial decisions while under the influence. We may experience nausea or vomiting after drinking - a minor overdose. In this Middle Stage there are increased memory blackouts and the beginning of early morning tremors. Toward the end of this stage, many people begin to break their rules about not drinking before 5, or noon and start earlier and earlier in the day and eventually drink alcohol in the morning. The compulsion to drink overrides commitments we have make to ourselves, to our families, friends and employers.

We then avoid family and friends, and experience a loss of other interests. The efforts to control the drinking fail repeatedly. We are unable to discuss problems as the alcohol has taken over our days and nights. At the end of this stage, we find ourselves drinking alone. If this sounds like a portrait of your life right now, reach out and ask for help.

If we reach out for help now, we will avoid the Late Stage of alcoholism. Our Staff at Lasting Recovery can answer any questions for you or your family member about getting help with detoxification or intensive outpatient treatment. If we are unable to meet your needs for detoxification and outpatient care, we will refer you to a program that can. Give us a call at 858-453-4315.

Judy Saalinger, Ph.D., MFT, CAS

How Alcoholism Develops - Part 1

Early Stage 

Every day in San Diego people are feeling confused and asking themselves why they drank an entire bottle, or 2, of wine. Some people have told their wife, husband, friend or child that they were not going to drink more than 2 small glasses. Or that they were going to quit drinking. Some people begin to justify this drinking episode with the thoughts that they changed their mind, or it wasn't that bad, or they could not have an alcohol problem because they do not drink in the morning, or before 5pm, or drink and drive.

How do we know if our drinking is a problem?

Many millions of people are social drinkers and many millions more are just crossing over the line from social drinking into the early stages of alcoholism, or the addiction to alcohol.

The American Society of Addiction Medicine defines addiction as a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. They define this disease to be often progressive and fatal. It is characterized by continuous or periodic impaired control over alcohol or drugs, preoccupation with drugs or alcohol, use of addictive substances despite adverse consequences, and distortions in thinking, most notably denial.

The time it takes from the early stage of the disease, to the last stage of addiction, where there are severe medical, family or legal consequences ,varies between men and women. Research has shown that men process the alcohol more quickly in their bodies, and the severe effects take an average of 15 years to show up. Women, who process the alcohol more slowly, thereby staying in the div longer before it is discarded, the damage occurs within an average of 8 years.

SYMPTOMS OF THE EARLY STAGE

• An increase in alcohol tolerance. It takes more than 2 standard drinks to obtain a change in mood.
• Drinking to calm nerves. Alcohol or drugs become the favored way to reduce stress, quiet generalized anxiety and fears of the unknown in relation to work, family, finances, or health issues.
• Desire to continue when others stop. The loss of control or impaired control begins to take over most drinking experiences. The 2 standard drinks is many times not enough to feed the developing compulsion to drink larger amounts.
• Occasional memory lapses after heavy drinking. Research has shown that after only a few drinks, the alcohol can produce impairments in memory that is detectable. The degree of impairment is directly related to the amount of alcohol consumed. When large amounts of alcohol are consumed quickly, as in a binge, the brain and div are overloaded and unable to metabolize the substance. This is the beginning of the brain deficits that occur. Most notably the effects are seen in the lack of ability to transfer new information from short term to long term storage, as in a blackout.
• Secret irritation when your drinking is discussed. Many people begin to feel some confusion and guilt about their drinking, and start to rationalize to themselves and others as to why they continue drinking. 

Rationalizing, a thought distortion, is the beginning of the development of the psychological defense system of denial. If there is no help requested by the person, or an intervention by the family, workplace or legal system to point out the beginning of the problem of early stage alcoholism , the disease will progress.

Next - Part 2 of 3 - How Alcoholism Develops - Middle Stage

Thanks for reading and passing along this information.

Judy Saalinger, Ph.D. MFT, CAS 

Don’t Let It Become A DUI

Seeking help for alcohol dependence in San Diego County

Seek help before it's too late. Before the next crisis. If you or some you love is having a problem drinking too much and recognize you have a problem, it is almost a sure thing that there will be even more problems in the future related to your chemical use. Medical problems, family problems and possibly legal problems.

It's a fact: In San Diego Count, on average 2 of our neighbors are killed in alcohol related traffic accidents each week, according to Mothers against Drunk Driving, MADD. San Diego County has the second highest DUI arrests and convictions according to the DUI Arrest Management Systems. If you have had one or more DUI arrests, getting effective treatment will be the answer for you.

New and improved research based treatment improves the outcomes of those seeking help. Research shows:

• women stay sober longer if they receive treatment in women only groups 
• medications given for alcohol craving significantly reduce relapses 
• motivational and caring treatment approaches with the therapist increases recovery rates 
• 12 step recovery and an intensive outpatient treatment program doubles the chance of recovery 
• cognitive behavioral therapy increases the management of anxiety and depression 
• family education is essential to the long term recovery of the entire family 
• complete detoxification is essential to effective treatment 

Lasting Recovery's intensive outpatient treatment is one of many programs in the country that provide these types of services, and one of only a few in San Diego County. If you or your family is seeking treatment, ask about these research based treatment methods. If you are in San Diego county, call us at 858-453-4315. We are here to help you.

Judy Saalinger, Ph.D., MFT, CAS