Teens in early recovery are extremely vulnerable to relapse. It can be hard to understand why a teenager would work so hard to achieve sobriety only to fall back into drug use−but that’s the power of addiction.

Studies suggest that between 50 percent and 90 percent of addicts relapse at least once in the first four years of sobriety, and most relapse many times. Triggers for relapse can be as mundane as hearing a certain song on the radio or as significant as hanging out with friends from the old drug crowd.

Although relapse is considered normal and predictable, knowing the common triggers for relapse and having an action plan can help teens and their families guard against any slip-ups. Here are a few common relapse triggers to watch out for:

1. Being in social situations or places where drugs are available

Unless teens remain on guard, their thoughts will likely turn back to old behavior patterns when they are around the people or places associated with their past drug use. Old friends who still use drugs will use peer pressure, teasing and subtle manipulation to get a teen in early recovery to return to their “fun” old self. These friends may not be ready to confront their own drug use and will not respond positively to someone who questions their habit or forces them to take a look at their own behavior.

Each adolescent has their own set of high-risk friends, places and situations that they must sacrifice for the sake of their sobriety. In drug rehab, teens can practice ways to cope with those triggers, make new friends who don’t use drugs and find sober activities they can enjoy.

After maintaining their sobriety for a time, many teens want to “test” their willpower by going back to certain places or social situations. This can be risky and seldom makes teens feel more secure in their recovery.

2. Being socially isolated

While it’s risky to stay in touch with old friends who use drugs, it’s equally risky to be socially isolated. Teens in early recovery need to closely follow the relapse prevention plan they created during drug rehab. This plan likely includes attending 12-Step meetings and therapy sessions to get support from other people in recovery and to have someone they can go to when the urge to use arises. Without this support system, teens start to feel alone in their struggles, which may make them want to start using again.

3. Being around drugs or using any mood-altering substance

Being around drugs of any kind can trigger a craving to use.  Even the sight, smell or sounds associated with a drug can bring back memories of the way drugs made the teen feel, as well as an overwhelming desire to use again. Most teens in early recovery will need to get rid of all paraphernalia, photos or any other item related to drugs or alcohol in order to avoid temptation.

A common pitfall for teens is thinking they can use drugs, as long as they avoid what used to be their drug of choice. So if they were hooked on painkillers, they figure it’s safe to drink alcohol. The reality is that addiction to one drug easily transfers to another drug (and even other compulsive behaviors like video game addiction, gambling and spending). If a teen has abused drugs before, they will likely need to abstain from all mood-altering substances for the rest of their life.

4. Stress

Many teens first start using drugs to cope with stress brought on by school, relationships or home life. Although adolescents learn new coping skills in drug rehab, it is common to revert back to old methods when life gets tough.

Before drug rehab, when conflicts arose, drugs or alcohol would allow the teen to escape the situation. Now, the teen must practice new ways of coping, such as taking a walk, calling a friend, journaling or some other form of healthy expression.

Establishing a daily routine, including getting up at a certain time or joining a club that meets regularly, may help teens maintain a sense of control in their lives. While predictability can help, teens will eventually have to learn to accept that they cannot control everything.

5. Over-confidence

Self-confidence and an optimistic outlook are protective factors against relapse, but over-confidence is one of the most common reasons for relapse. The 12-Step principles remind teens that humility and an admission of powerlessness over addiction are essential for lasting recovery. But after staying sober for a period of time, some teens are so proud of their accomplishments that they don’t think they need to follow their relapse prevention plan anymore. They stop attending meetings and become less vigilant in monitoring their emotions and cravings.

6. Complacency

A close cousin to over-confidence is complacency. Some teens in early recovery start to take their sobriety for granted. They become complacent, assuming if they’ve been able to maintain their sobriety for a certain amount of time, they no longer need to monitor their mental state, attend meetings or follow their relapse prevention plan with the commitment they started with.

In many cases, teens begin to wonder if they can use only occasionally or have just one drink without returning to their addiction. They want to prove to family and friends that they no longer have a problem. Unfortunately, complacency often leads to relapse.

7. Mental or physical illness or pain

Addiction frequently goes hand in hand with mental illnesses such as depression and anxiety. Something that aggravates an underlying mental illness can also trigger the desire to use drugs or alcohol. Teens with co-occurring disorders require dual diagnosis treatment that addresses both their substance abuse and psychiatric illness. After formal treatment ends, they also need to carefully monitor their state of mind through journaling, therapy and other forms of self-reflection.

Physical illness is also problematic, particularly if a doctor prescribes painkillers or other drugs as a form of pain management. Teens who self-medicate a mental or physical illness may find themselves becoming dependent on drugs of relief. For this reason, self-care is essential. A healthy diet, exercise and adequate sleep will help guard against exhaustion and physical illness.

Though it may seem counter-intuitive, positive life events and emotions can also trigger relapse.  For example, getting straight A’s, falling in love or getting into a good college could be cause for celebration and reignite the desire to use drugs.

8. Reminiscing about drug use or telling “war stories”

If an adolescent spends time thinking obsessively about how it felt to be high or telling “war stories” to friends about past drug use, this is an indication that relapse is imminent.

9. Boredom

Without drugs, many teens in recovery don’t know what to do with their free time. A bored teen is a teen who is asking for trouble. Drugs are exciting; there are other activities and hobbies that are equally thrilling without the high level of risk. Teens can get involved in rock climbing, white water rafting, or some other adventure sport. They can also keep busy with school activities, clubs, sports, exercise or hanging out with sober friends.

10. Self-pity

We all want life to go out way, but even the most fortunate among us won’t always get what we want.  Many teens fall into the trap of self-pity; feeling impatient that recovery isn’t happening fast enough, wondering why they have to deal with addiction and rehab, and questioning why other people can go out for a drink with friends and they can’t. They begin to feel entitled to have a drink or use drugs because they’ve been sober and worked so hard.

Though it isn’t fair, this is the reality of addiction. It’s better to accept the good and bad life deals rather than feeling like a victim.

Preventing Relapse

Relapse doesn’t mean drug rehab was a waste of time or money, or that a teenager is a failure. Rather, experts now view relapse as a valuable learning experience that brings an adolescent one step closer to lasting recovery.

Parents can support their teen in early recovery by taking the following steps:

• Don’t keep alcohol, tobacco or other drugs in your home.  Safeguard your prescription drugs and over-the-counter medications by locking them in a medicine cabinet and disposing of them properly when you no longer need them.
• Offer praise and encouragement when your teen attends 12-Step meetings or therapy sessions, follows their relapse prevention plan or get through a difficult situation without using.
• Support your teen if they relapse and get them back into treatment rather than blaming, nagging, or judging them. At the same time, avoid enabling their addiction by refusing to make excuses or cover for your child.
• Encourage your teen to befriend teens who don’t use drugs and to get involved with hobbies, activities or work that appeal to them.
• Talk openly with your teen about how they are feeling, and if either of you senses the threat of relapse, get help right away.
• Make sure your teen isn’t overbooked or dealing with excessive stress.
• Take care of yourself by speaking with a therapist, attending Al-Anon meetings, joining a support group or taking time for the things you enjoy.

Although teens in early recovery may relapse, substance abuse treatment helps them get back on track before they make a full return to their old drug-abusing lifestyle.

The majority of American women are dissatisfied with their bodies. One study found that 86 percent of women want to lose weight, and in another study, 63 percent of female participants identified weight as the key factor in determining how they felt about themselves — even more important than family, school, or career.

For some, the result of this dissatisfaction is the development of an eating disorder. One cause of eating disorders, experts argue, is the negative messages women in particular receive from the media. According to studies, higher rates of body dissatisfaction and drive for thinness have been associated with the rates of exposure to soap operas, movies, and music videos. As young people spend more time watching television and movies and thumbing through magazines, eating disorders such as anorexia and bulimia are being diagnosed at younger ages (some as young as 8 or 9), and with greater frequency.

Because eating disorders are the most fatal of all mental illnesses, professional treatment is often an absolute necessity. At Center for Hope of the Sierras, a renowned eating disorder treatment program for women ages 16 and up, patients receive residential treatment and a step-down transitional program for the treatment of anorexia nervosa, bulimia nervosa, and related disorders. Each client’s comprehensive treatment plan includes individual, group, and family counseling designed to promote healing through equine programs, art therapy, meditation, yoga, body image groups, and more.

Anna Treacy, MPH, NCHES, leads weekly body image groups and individual educational sessions with Center for Hope’s eating disorder patients. As a 10-year veteran health educator who has worked at Center for Hope since its inception, Treacy has an arsenal of tools and approaches to helping women work through their body image issues. Having fully recovered from an eating disorder herself, she knows all too well the devastation a woman’s mind can inflict on her body.

Connecting the Mind and Body
According to Treacy, effective eating disorder treatment rebuilds the damaged connection between the mind and body. Women with eating disorders often suffer from a distorted body image, in which they misperceive the size, shape, or attractiveness of their body. In treatment, patients learn how to transform their distorted self-perception, identify and respond to internal cues, and begin to develop personal boundaries and a sense of self.

“Almost every woman who has come to Center for Hope has had issues with body image,” notes Treacy. “Some are completely disassociated from their bodies and won’t even look in the mirror, while others tear down their bodies to the point of self-harm. In either case, the connection between mind and body has been severely damaged and must be repaired by developing new coping mechanisms and an improved self-image.”

One body image exercise Treacy uses in group sessions at Center for Hope is for each participant to write a letter from her mind to her body, and from her body to her mind. Once she’s comfortable, the patient will share her work with a group of supportive and understanding peers “Group sessions create an enriching peer environment where women can see that they’re not alone in the world,” explains Treacy. “When they see that others have been feeling the same way, they feel more comfortable addressing their deep-seated issues.”

The patients at Center for Hope are also asked to complete an individual self-assessment, working through a list of body parts and indicating which parts they’re comfortable with, and which they are not. The women also describe any body image rituals, such as pinching fat, visually dissecting themselves in the mirror, measuring their wrist with their fingers, and seeing how much bone they can feel on their bodies.

Through this process, staff discovers what influences have impacted each woman negatively or positively, including media images and feedback from meaningful people in their lives, and how her eating disordered patterns manifest in daily life. Each patient is then asked to fill out a “body image statement of intent” to put in writing her goals during treatment and concretely describe how she wants to feel about herself and her body.
Acceptance and Self-Love

“Much of the work we do at Center for Hope centers on helping women get to know, accept, and love who they are. By the time they complete formal treatment, we want them to stand on firm ground regarding their own self-worth, in spite of negative messages from the media or the numbers on the scale, clothing labels, or tape measurer.”

Using cognitive-behavioral therapy, positive affirmations, and mirror work, Treacy helps clients restructure their rituals and self-image. In one exercise, the women take pictures of themselves and label the photos with positive body affirmations. In this way, patients begin to associate their own image with positive characteristics.

In another exercise, Treacy provides patients with diet and beauty magazines that are likely to trigger eating disordered thinking and asks them to make collages of images, words, or advertisements that lead to rituals, self-harm, or eating disorder behaviors. As a group, the participants discuss how those images affected them and what they feel ready to let go of in each collage. Together, they go outside and burn those images as a symbol of release, which leads to a discussion of actions they will take to avoid being affected by those messages in the future. For some women, this means limiting their exposure to negative media messages in television and magazines; for others, it means using positive affirmations or learning to identify and challenge negative thought patterns.

Part of the process of learning acceptance and self-love is making fewer comparisons to other people. At Center for Hope, Treacy takes the residents to a popular summer swimming spot and asks them to write down their judgments about others and themselves, as well as the way it feels to make those judgments. The women then discuss ways to avoid or limit making judgments, treat themselves and others with compassion, and align their thoughts and behaviors with their core values.

Eating disorders don’t have to be a life sentence. With intensive treatment at the appropriate level of care, women can and do go on to lead healthy, productive, and fulfilling lives. The staff of licensed clinicians, registered nurses, a dietician, chef, psychiatrist, and physician at Center for Hope of the Sierras has helped hundreds of women with anorexia, bulimia, and related disorders recover with compassion and dignity. For more information about eating disorder treatment at Center for Hope, or call (866) 690-7242.

Author: Lori Enomoto
Date: 12/7/2009

The holidays are here. It’s the happiest time of the year, right? For some, the answer is a resounding “yes.” For others, the holidays bring into sharp focus how desperately unhappy they feel.

Depression isn’t just about feeling sad. It’s a clinical disorder that warrants medical attention and can affect physical health. Without help, it’s like a car getting stuck in the mud, spinning its wheels to get out, and instead, only getting in deeper. What’s more, once someone suffers a bout of depression and has managed to get past it, the depression may return, making it even more difficult to find a way to move past the new set of challenges.

The holidays are a prime time for depression. We all can imagine the perfect holiday gathering with the perfect holiday meal, and the perfect family on perfect behavior. We see images of it in the media: the traditional, happy family gathered around the holiday table, or the tree surrounded by loads of wrapped gifts.

The problem with these idyllic images that we see repeated in movies, on TV shows and in retail ads is simply that reality doesn’t measure up. Instead, depression shows up, an unwanted and uninvited holiday guest that thrives on a certain confluence of factors that typically comes together over the holidays:

• Stress from unrealistically high expectations
• Comparison to how it used to be
• Distance from family and friends
• Overemphasis on one day instead of the season
• Financial pressure of buying gifts
• Overcommercialization of the holiday
• A lack of meaning

When holiday expectations collide with reality, it can be particularly depressing. A frenzy of shopping, cooking, houseguests, familial conflicts, credit card debt and separation from loved ones can all contribute to exhaustion and depression. What may seem fun to one person is overwhelming for another. Sometimes it’s just too much to deal with, so we don’t. We get depressed and shut down.

Warning Signs of Depression

Depression affects the body and mind. Here are some warning signs:

• Insomnia
• Excessive sleep
• Fatigue/lack of energy
• Indecisiveness
• Lack of direction or purpose
• Difficulty concentrating
• Inability to cope with challenges
• Self-inflicted injury
• Talking about suicide or feelings of worthlessness
• Suicide attempts

Depression, Drugs and Alcohol

Depression increases the risk of alcohol or drug abuse. It’s very common, especially among teens and males in particular, to find clinical depression co-occurring with alcohol and drug abuse.

Alcohol is a depressant. It depresses the brain and nervous system, leaving the drinker feeling worse, despite the fact that it temporarily lowers levels of stress hormones. Someone who is depressed shouldn’t drink, as drinking can intensify negative feelings, making a person feel morose.

Regardless of our better judgment to stay away from alcohol when we’re depressed, time and time again, when people are upset or feeling down, they get drunk. “I just want to get wasted” is a common escapist response to a stressful situation, especially for a teen or young adult. A drinking binge is almost excused for someone who is facing life difficulties. Particularly as parents of teens, we should be challenging this dangerous coping mechanism.

Alcohol use in males generally happens before the onset of depression, whereas with females, depression generally comes before alcohol use. Alcohol use can be a means of self-medication to blunt feelings, or it can be a cry for help. Drinking often goes hand-in-hand with unintentional injury due to poor judgment, and with intentional injury due to feelings of worthlessness.

It’s important to be aware that alcohol is within easy reach of your teen, and even more so during the holidays. The holidays are a great excuse for alcohol consumption. It’s an acceptable form of “holiday cheer” and a way to try to escape feeling sad. As parents of teens, this is the time to be extra vigilant about alcohol use, not only due to the increased pressures of the season, but also alcohol’s availability. Parties with free-flowing alcohol, older teens who purchase alcohol and parents’ stock of alcohol offer easy access.

The holidays are also a good time to talk to your teen about drinking at parties and ask them how they cope with friends who are drunk. Ask your teen if he ever feels compelled to take a drink due to stress or anxiety. These discussions can help open the door to figuring out what’s really going on with your teen. If you sense that there’s a deep, underlying problem, look for signs of depression. Today’s teens face a minefield of challenges in coping with the pressures of life.

Self-Injury

Cutting is a way to inflict harm in the form of tissue damage. Cutting and other forms of self-injury can be a sign of depression. Self-injury often starts in the teen years and is more common among girls. A typical cutter isn’t the “goth” on the corner. It’s actually an educated female who wants to please people and can’t live up to expectations.

Cutting, other forms of self-injury and putting oneself in danger are signs that should not be ignored. These behaviors may signal:

• An attempt to alter one’s mood
• A desperate plea for help or attention
• A way to express feelings of worthlessness
• A way to express or stop emotional pain
• A way to cope with pressure to be perfect
• A way to express the pain from past physical abuse
• A way to feel something when a person otherwise feels emotionally numb
• A way to equalize emotional pain with physical pain
• A sign of suicidal thoughts

Cutting is psychologically addictive behavior. It makes the person feel better while she’s hurting herself. Painful stimulation also releases endorphins, so there’s some degree of physical relief that results from cutting.

How to Help

A common myth is that talking about your problems will make you feel worse. Talking with supportive, caring friends and knowledgeable professionals is often a positive step, preferable to keeping the negative feelings bottled up. The negative feelings don’t go away by themselves. It’s important to encourage people who are suffering to get evaluated for depression.

The National Institute of Mental Health estimates that depression affects 17 million Americans a year. It’s also estimated that one in four women and one in eight men will experience depression in their lifetime. Clinical depression isn’t something to just sleep off or snap out of.

About 25 million people a year seek treatment for depression in the U.S. That’s about double what it used to be 15 years ago. The numbers are staggering, yet oftentimes, depression is missed as a diagnosis. When it is diagnosed, treatment for depression may include antidepressants and psychotherapy.

If your depression persists after the holidays, you may need to get help at a residential treatment facility that specializes in depression, such as Sierra Tucson in Arizona. A residential treatment center like Sierra Tucson has expertise in treating all types of depression, as well as any co-occurring disorders, such as substance abuse or anxiety. In addition to any necessary anti-depressants, Sierra Tucson provides individual therapy, group therapy, family therapy, and integrative therapies such as yoga and acupuncture.

If you suspect that someone you care about is suffering from depression, do something about it. Get that person to a medical professional with a strong track record for treating patients with depression. You may be saving their life.

Author: Lori Enomoto
Date: 12/29/2009

Traditionally a celebration of the past year and the year to come, New Year’s Eve is the perfect time to reflect upon the changes we’d like to see in our lives. If you think you could improve your life (and who doesn’t?), it’s an opportunity to start fresh and break the patterns that have held you back in the past year. To start off right, it’s a good idea to give some thought to how you’re going to ring in the new year.

Plan Ahead
A good way to start the new year is to plan ahead for a sober New Year’s Eve celebration and a sober new year. If you’re committed to making plans for a sober New Year’s Eve, you’re much more likely to avoid putting yourself in a situation where there’s too much alcohol and nowhere else to go.

Set an Example
Actions speak louder than words. Regardless of what teens say, they emulate their parents. If they see that you’ve had too much to drink, don’t be surprised to see them doing the same.

Rethink the Drink
If in the past you’ve had a problem with drinking at New Year’s Eve parties, make a resolution to do it differently this year. Go to a sober party. Yes, they exist, or you can even throw one yourself. Throw a theme party, so it takes the attention away from what guests are drinking and places the emphasis on the theme instead.

Make sure to state on the invitation that only non-alcoholic drinks will be served and are welcome. Or, you can put the focus on the drinks, but alcohol-free drinks; whip out your blender and some delicious alcohol-free recipes and make copies of the recipes for your guests.

More people than you might think would prefer to go to a sober party, as they struggle with the same issues related to alcohol. For those who don’t drink at all or those who don’t like to get drunk, it’s not much fun being around people who do, so an alcohol-free New Year’s Eve celebration is a welcome change.

Alcohol-Related Traffic Fatalities
U.S. National Highway Traffic Safety Administration statistics show that highway crashes during the holiday season, especially the time around New Year’s Eve, are much higher than during the rest of the year. From 2001 to 2005, 41 percent of traffic fatalities during the New Year’s holiday involved alcohol.

How Much Is Too Much
A lot of people are aware that blood alcohol content (BAC) of .08 or higher is illegal; however, here’s something to keep in mind that’s not as commonly understood: Impairment can begin with the first drink. Your judgment and coordination can be compromised even if your BAC is well below the legal limit.

It doesn’t take much to start showing the signs of impairment. You can go online to find Blood Alcohol Content calculators, which take into account weight, the alcohol content of your drink and how many hours you’ve been drinking. Because women generally have a lower body weight than men, they also generally have a lower tolerance for the amount of alcohol they can consume before becoming seriously impaired.

If you’re going to drink to celebrate New Year’s Eve, make sure to know your limits ahead of time. The more you drink, the more you may think you can handle. Since once you’re drinking, your judgment about how much is too much will be impaired, along with your coordination and reflexes.

Designated Drivers Can’t Change Their Minds
If you’re going to a New Year’s Eve party where there will be drinking, you can volunteer to be the stand-up person who’s the designated driver. However, if you know you’ll be tempted to drink, it’s best to decline to be the designated driver, rather than put yourself and others at risk if your resolve weakens.

Don’t Get Sucker Punched
Fruit juices in punch, eggnog and energy drinks can mask the taste of alcohol. Don’t get fooled! Bring a large water bottle with you on New Year’s Eve and keep it in your hand. That will help prevent you from impulsively or automatically picking up a drink with alcohol.

Stop Caring So Much About What Others Think
There’s some truth to the thinking that people drink or smoke “to be cool.” People want to be accepted. That means fitting in by doing what others are doing, whether they’re drinking or not drinking. If you can consciously free yourself from automatically doing what others are doing, you can start to be more determined in how you lead your life. Sounds simple, doesn’t it? It’s not. Study after study shows that our behavior is influenced by what others do.

Understand Your Own Reasons for Not Drinking
Think through why you want to have a sober New Year’s Eve. Is it to please others? It’s important to reason through why having an alcohol-free evening is a good idea, or why you’ve decided to put pre-determined limits on your drinking. Expect to be challenged by well-meaning partygoers; if you’ve decided not to drink, being clear about the reasons ahead of time will help you remember why when you’re in the midst of a party.

Talk to Your Teen
Teens are told by parents, teachers and counselors not to drink, but for teens to follow through, they need to decide for themselves that they want to stay sober. As a parent, it’s important to not just tell your teen not to drink, but also give them good reasons why they should stay away from alcohol, particularly on New Year’s Eve.

It’s also wise to have your teen check in with you during the evening, as even teens with the best of intentions can let them slide when their friends are indulging.

Spend New Year’s Eve at Home
When you were a kid, you probably spent New Year’s Eve at home; maybe it’s time to do it again. Make some cocoa or cider, put on some music, play a board game, watch a movie and maybe even fall asleep before the clock strikes twelve. Or watch the big ball drop in Times Square snuggled under a warm comforter. It can be a fun family evening. And it’s not a bad idea to stay off the roads, since there are drunk drivers out on New Year’s Eve, despite the police checkpoints and publicity about not drinking and driving.

Stick with Your Decision
Whether you’re planning on drinking a limited quantity or having an alcohol-free evening, decide ahead of time what, where and how much (if any). If you find yourself at a party where people are drinking too much, consider leaving or leaving by a certain time, as it will be difficult to follow through on your commitment to yourself.

The way you spend New Year’s Eve sets the tone for the new year. Do it right this year, and instead of waking up with a headache on New Year’s Day, you’ll wake up feeling good about yourself and the year to come.

Post-Traumatic Stress Disorder (PTSD) is most commonly associated with military combat veterans, but it can affect anyone who has gone through a life-threatening traumatic event. People with PTSD generally have a difficult time trying to return to a normal life after they have gone through something traumatic, and they also have a hard time connecting, or reconnecting, to other people.

Post-Traumatic Stress Disorder can occur not only in the people who actually experience a traumatic event, but also in people who witness the event or in those who are responsible for “cleaning up” after the fact, such as emergency medical personnel and law enforcement officers.

Why PTSD Occurs
When PTSD occurs in people, it is in response to a terrifying situation that simply overwhelms a person emotionally. As a general rule, the individual ways that people are able to cope with what they have gone through determines whether or not they will develop PTSD.

When people experience a traumatic event, it causes both the mind and body to go into a state of shock. People who are able to process their emotions and make some sense of what happened will eventually come out of this state of shock and be able to get on with their lives. People who are not able to process the traumatic events remain in psychological shock and may eventually develop PTSD.

There are a variety of traumatic events that can lead to the development of PTSD:

• Kidnapping
• Assault
• Rape
• War
• Physical or sexual abuse
• Plane or car crash
• Natural disasters
• Medical procedures (usually in children)

Symptoms of PTSD

After people have experienced some type of traumatic event, it is quite common for them to experience at least some of the symptoms that are most commonly associated with PTSD, even if they do not actually go on to develop this disorder.

Following such an event, most people have bad dreams or they find themselves feeling unusually afraid. In a normal situation, these symptoms will only last for a few days or weeks, and then they will disappear, allowing the person to get back to their normal way of life.

The unusual thing about PTSD is that it does not necessarily manifest in the days or weeks immediately following a traumatic event. In many cases, PTSD does not develop for several months or even years after the event has occurred.

In some people, the symptoms of this disorder appear quite suddenly, and with little or no warning. In others, symptoms may start to appear on a gradual, periodic basis before developing into a full-blown case of PTSD.

There are three primary classifications of symptoms that are indicative of PTSD: re-experiencing the traumatic event, increased arousal, and avoidance and emotional numbing.

Symptoms of re-experiencing the traumatic event:

• Nightmares
• Flashbacks
• Intense feelings of distress or anxiety
• Upsetting memories of the event
• Physical reactions to memories of the event that are usually intense in nature, and may include nausea, sweating, racing heart, muscle tension or rapid breathing

Symptoms of increased arousal:

• Irritability or irrational anger
• Easily startled or feeling jumpy
• Lack of concentration
• Insomnia

Symptoms of avoidance and emotional numbing:

• Feeling detached and/or emotionally numb
• Avoiding people, places or things that remind you of the traumatic event
• Lack of interest in life or social activities
• Unable to remember certain events from the traumatic episode

In addition to the symptoms listed above, there are other symptoms that are characteristic of PTSD:

• Substance abuse
• Headaches
• Stomach problems
• Chest pain
• Feelings of guilt or shame
• Depression
• Suicidal thoughts

Treatment of PTSD

A large part of the treatment process for PTSD is for people to start to relive the trauma they experienced in order to be able to really deal with it. Recalling the events and emotions that were experienced at the time helps people to process their emotions, which ultimately helps to promote the healing process.

There are four basic types of treatment that are recommended for people with PTSD:

1. Eye Movement Desensitization and Reprocessing (EMDR) incorporates different types of left-right stimulation along with traditional cognitive behavioral therapy. Medical professionals believe that eye movements can help to unfreeze the processing system in the brain. This process becomes interrupted whenever we go through an extremely upsetting or traumatic event, which leaves us with frozen emotional fragments rather than a complete, cohesive memory. EMDR helps to bring the emotional fragments together so that the complete memory, or memories, can be processed and dealt with.
2. Cognitive behavioral therapy is a type of talk therapy that focuses on gradually making people directly address and deal with their painful thoughts, memories and feelings. Over time, cognitive behavioral therapy helps to put the big picture into perspective, and allows people to process their emotions so that they can move past the painful events of the past.
3. While there are no medications that will help to alleviate the symptoms associated with PTSD, medications may be prescribed to those individuals who are also suffering from anxiety or depression.
4. For people who are going through the emotional ups and downs of PTSD, it is often quite helpful for their family members to also go through therapy. Family therapy sessions can help family members to gain a better understanding of what the PTSD sufferer is going through, which will provide them with the knowledge and ability to be more supportive throughout the treatment process.

For people with PTSD, it can also be helpful to find a support group to become actively involved in. The sharing of different traumatic experiences can help sufferers to deal with their own emotions in a more positive way, and it also helps them to feel less isolated.

Author: Staff Writer
Date: 5/2/2011

Learn more about wilderness therapy today. Click anywhere on the image above to download your free copy of this e-book!

CRC Health Group is proud to acknowledge a momentous accomplishment by one of our therapeutic wilderness programs for teens.

SUWS Wilderness Programs, which first opened in 1981, will be hosting a number of events to celebrate 30 consecutive years of superior service to young people in crisis and their families.

SUWS will be hosting gatherings in Philadelphia, Dallas and Los Angeles, and will also be holding a celebration for staff members and program alumni on the SUWS campus in Shoshone, Idaho.

A TRADITION OF EXCELLENCE

“We’ve had a lot of changes over the years,” said SUWS Executive Director Kathy Rex, “but our underlying philosophies and our dedication to helping children and families get their lives back on track has been a constant through the decades.”

Rex, who has been with SUWS for more than 17 years, said the program’s core values have provided the ideal foundation upon which to build a dynamic program that continues to evolve and improve.

“SUWS has definitely evolved,” she said. “For example, in our earlier days, we worked primarily with the child in crisis. Today, we identify the entire family’s struggle, not just the child’s struggle.”

SERVING TEENS & PARENTS

In addition to ongoing dialogue between parents and SUWS staff members throughout the student’s time at SUWS, the centerpiece of the SUWS family outreach effort is a weeklong Family Camp that parents attend near the halfway point of their child’s enrollment period.

“The Family Camp has been unbelievably successful,” Rex said. “The parents come out to Idaho & spend five days immersed in the program. It’s a life-changing experience for the families.”

In addition to providing services for parents as well as students, SUWS has also been a leader in the effort to promote licensure and regulation throughout the therapeutic wilderness industry.

PROMOTING HIGH STANDARDS

“In the mid-1990s, SUWS became the first youth wilderness program in Idaho to be licensed,” Rex said. “We have always emphasized the benefits of establishing standards and regulations for programs throughout the United States.”

Since receiving that initial license, SUWS has earned a number of additional accreditations, including CARF (Commission on Accreditation of Rehabilitation Facilities) and AdvancED (an academic accreditation organization that serves more than 27,000 schools in 69 countries).

FOCUSED ON FUTURE SUCCESSES

While the anniversary events will certainly involve some reflection the program’s past successes, the SUWS staff won’t spend much time resting on their laurels.

Rex said that she and her colleagues remain focused on ensuring that SUWS continues to evolve — both to meet the changing needs of students and families, and to remain one of the nation’s premier providers of therapeutic wilderness services.

“We’re all on a mission to help others,” she said. “We are always looking to the future and exploring how we can make SUWS an even better place for children and their families.”

ABOUT SUWS

SUWS offers therapeutic wilderness programs for boys and girls ages 11 to 17 with a focus on clinical intervention and assessment. Based in southern Idaho, the programs use the outdoors as an alternative to conventional treatment environments, while engaging students using traditional therapeutic methods.

Since 1981, SUWS programs have provided guidance and support to thousands of misdirected and at-risk teens experiencing low self-esteem, defiant behavior, attention deficit, depression, substance abuse, and other emotional and behavioral issues.

SUWS is a program of Aspen Education Group, the nation’s leading provider of therapeutic education programs for struggling or underachieving young people. Aspen’s services range from short-term intervention programs to residential treatment, and include a variety of therapeutic settings such as boarding schools, outdoor behavioral health programs and special needs summer camps, allowing professionals and families the opportunity to choose the best setting to meet a student’s unique academic and emotional needs.

Aspen Education Group is a member of CRC Health Group, the most comprehensive network of specialized behavioral care services in the nation. For over two decades, CRC Health has been achieving successful outcomes for individuals and families.

Post-Traumatic Stress Disorder (PTSD) is most commonly associated with military combat veterans, but it can affect anyone who has gone through a life-threatening traumatic event. People with PTSD generally have a difficult time trying to return to a normal life after they have gone through something traumatic, and they also have a hard time connecting, or reconnecting, to other people.

Post-Traumatic Stress Disorder can occur not only in the people who actually experience a traumatic event, but also in people who witness the event or in those who are responsible for “cleaning up” after the fact, such as emergency medical personnel and law enforcement officers.

Why PTSD Occurs
When PTSD occurs in people, it is in response to a terrifying situation that simply overwhelms a person emotionally. As a general rule, the individual ways that people are able to cope with what they have gone through determines whether or not they will develop PTSD.
When people experience a traumatic event, it causes both the mind and body to go into a state of shock. People who are able to process their emotions and make some sense of what happened will eventually come out of this state of shock and be able to get on with their lives. People who are not able to process the traumatic events remain in psychological shock and may eventually develop PTSD.

There are a variety of traumatic events that can lead to the development of PTSD:

Kidnapping
Assault
Rape
War
Physical or sexual abuse
Plane or car crash
Natural disasters
Medical procedures (usually in children)

Symptoms of PTSD
After people have experienced some type of traumatic event, it is quite common for them to experience at least some of the symptoms that are most commonly associated with PTSD, even if they do not actually go on to develop this disorder.

Following such an event, most people have bad dreams or they find themselves feeling unusually afraid. In a normal situation, these symptoms will only last for a few days or weeks, and then they will disappear, allowing the person to get back to their normal way of life.

The unusual thing about PTSD is that it does not necessarily manifest in the days or weeks immediately following a traumatic event. In many cases, PTSD does not develop for several months or even years after the event has occurred.

In some people, the symptoms of this disorder appear quite suddenly, and with little or no warning. In others, symptoms may start to appear on a gradual, periodic basis before developing into a full-blown case of PTSD.

There are three primary classifications of symptoms that are indicative of PTSD: re-experiencing the traumatic event, increased arousal, and avoidance and emotional numbing.

Symptoms of re-experiencing the traumatic event:

• Nightmares
• Flashbacks
• Intense feelings of distress or anxiety
• Upsetting memories of the event

Physical reactions to memories of the event that are usually intense in nature, and may include nausea, sweating, racing heart, muscle tension or rapid breathing

• Symptoms of increased arousal:
• Irritability or irrational anger
• Easily startled or feeling jumpy
• Lack of concentration
• Insomnia

Symptoms of avoidance and emotional numbing:

• Feeling detached and/or emotionally numb
• Avoiding people, places or things that remind you of the traumatic event
• Lack of interest in life or social activities
• Unable to remember certain events from the traumatic episode

In addition to the symptoms listed above, there are other symptoms that are characteristic of PTSD:

• Substance abuse
• Headaches
• Stomach problems
• Chest pain
• Feelings of guilt or shame
• Depression
• Suicidal thoughts
• Treatment of PTSD

A large part of the treatment process for PTSD is for people to start to relive the trauma they experienced in order to be able to really deal with it. Recalling the events and emotions that were experienced at the time helps people to process their emotions, which ultimately helps to promote the healing process.

There are four basic types of treatment that are recommended for people with PTSD:
Eye Movement Desensitization and Reprocessing (EMDR) incorporates different types of left-right stimulation along with traditional cognitive behavioral therapy. Medical professionals believe that eye movements can help to unfreeze the processing system in the brain. This process becomes interrupted whenever we go through an extremely upsetting or traumatic event, which leaves us with frozen emotional fragments rather than a complete, cohesive memory. EMDR helps to bring the emotional fragments together so that the complete memory, or memories, can be processed and dealt with.

Cognitive behavioral therapy is a type of talk therapy that focuses on gradually making people directly address and deal with their painful thoughts, memories and feelings. Over time, cognitive behavioral therapy helps to put the big picture into perspective, and allows people to process their emotions so that they can move past the painful events of the past.

While there are no medications that will help to alleviate the symptoms associated with PTSD, medications may be prescribed to those individuals who are also suffering from anxiety or depression.

For people who are going through the emotional ups and downs of PTSD, it is often quite helpful for their family members to also go through therapy. Family therapy sessions can help family members to gain a better understanding of what the PTSD sufferer is going through, which will provide them with the knowledge and ability to be more supportive throughout the treatment process.

For people with PTSD, it can also be helpful to find a support group to become actively involved in. The sharing of different traumatic experiences can help sufferers to deal with their own emotions in a more positive way, and it also helps them to feel less isolated.

Sure, electronic cigarettes are appealing. They are odorless, there is no butt to toss and they won’t stain your teeth. They also don’t contain all of the cancerous chemicals that regular cigarettes have, and using them doesn’t expose others to the risks of second-hand smoke.

But they are still addictive, and one puff of an electronic cigarette can cause you to inhale more than twice the mount of nicotine of a conventional cigarette.

About E-Cigarettes
Electronic cigarettes (or e-cigarettes) are battery-operated devices designed to simulate the look and feel of conventional cigarettes. The devices contain cartridges filled with nicotine, flavor and other chemicals. The electronic cigarette turns nicotine and other chemicals into a vapor that is inhaled by the user, resulting in the same addictive properties as those found in conventional cigarettes.

The level of nicotine found in an electronic cigarette varies depending on the type of device purchased, but can be as high as 24 milligrams. A conventional cigarette typically contains about 1 to 2 milligrams of nicotine.

Of course, for either type of cigarette, how much nicotine a person actually inhales depends on a number of factors, including how they smoke, how many puffs they take and how deeply they inhale. E-cigarettes purport to have a higher nicotine level because they are not supposed to be smoked completely in one sitting.

A Toxic Alternative
A recent study by the U.S. Food and Drug Administration (FDA) determined that electronic cigarettes do contain trace amounts of toxic substances and other carcinogens, despite claims by electronic cigarette manufacturers that their products are safer than everyday cigarettes.

The FDA analyzed the ingredients of two leading brands of electronic cigarettes and found nitrosamines (tobacco-specific compounds known to cause cancer) and diethylene glycol (a chemical used in antifreeze that is toxic to humans).

“We’re concerned about [electronic cigarettes] because of what we know is in them and what we don’t know about how they affect the human body,” said Joshua Sharfstein, the FDA’s principal commissioner, in a July 2009 article in The New York Times.

Because e-cigarettes aren’t required to be submitted to the FDA for evaluation or approval, the agency’s only knowledge of the amount of nicotine and chemicals in the devices is based on its 2009 study. As stated on its website, the FDA has expressed the following concerns:

• E-cigarettes can increase nicotine addiction among young people and may lead kids to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death.
• The products may contain ingredients that are known to be toxic to humans.
• Because clinical studies about the safety and efficacy of these products for their intended use have not been submitted to FDA, consumers currently have no way of knowing 1) whether e-cigarettes are safe for their intended use, or 2) what types or concentrations of potentially harmful chemicals, or what amount of nicotine, they are inhaling when they use these products.

Appeal to Youth
Most youth have been properly warned about the health risks of cigarette use, and many have been discouraged from taking up the habit. However, they may see e-cigarettes as a fun new technology that couldn’t possibly have the same effects as the cigarettes their parents warned them about.

The FDA raised concerns that electronic cigarettes may actually increase nicotine addiction and tobacco use in young people. That is because they are being marketed to a younger demographic, who may not be aware of the risks of the e-cigarette since they contain no health warnings such as those found on a package of conventional cigarettes or nicotine replacement products.

Electronic cigarettes are sold with no legal age restrictions, and are accessible to teens through the Internet and at shopping malls. They are available in flavors such as strawberry, bubblegum and chocolate, which may be appealing to younger consumers.

“The FDA is concerned about the safety of these products and how they are marketed to the public,” said Margaret A. Hamburg, M.D., the FDA’s commissioner of food and drugs.
At least in part because of these concerns, the FDA has banned the importation of e-cigarettes into the country. The FDA labeled the electronic cigarettes as drug delivery devices, which requires manufacturers to get federal approval before marketing them.

In several other countries ? including Australia, Hong Kong and Brazil ? electronic cigarettes are illegal.

Addictive Nature of Cigarettes
Though e-cigarettes do not contain tobacco, they still contain nicotine. And nicotine is an addictive drug. That means smokers of electronic cigarettes can fall victim to the same psychological and physical dependence to which smokers of conventional cigarettes are privy.

Of the nearly 20 percent of smokers in America, only 4 to 7 percent are able to quit smoking on their own, according to the American Cancer Society. Some of the remainder of the 40 percent of smokers who try and quit each year may seek treatment for their nicotine addiction through support groups, outpatient therapy or residential treatment programs.
Before you switch to electronic cigarettes thinking they will help you beat your nicotine addiction, do your research. Be sure to also educate your kids on the dangers of nicotine addiction in any form, be it electronic cigarettes or conventional. Not doing so may lead to a life-long addiction, as well as chronic health problems that can’t be kicked.

For many people, the holidays are something to “get through,” rather than enjoy. People backslide on their commitments to a healthy lifestyle by overindulging in eating, drinking and spending. New Year’s goes hand-in-glove with New Year’s resolutions, as people try to stop the downhill slide that happens over the holidays.

There are a few key factors that make holiday time a time for overindulgence:

People’s routines are disrupted
People are off work and relatives are in town. Your free time, when you would normally exercise and unwind, all but disappears, only to be replaced by shopping, group activities and parties. Your eating routine is disrupted as well, with more opportunities to eat unhealthy foods, especially desserts, in abundance.

Family gatherings can be stressful
Some people feel anxiety at the prospect of spending additional time with their family over the holidays. If you’ve experienced problems before at holiday gatherings, the negative memory of these times becomes as much of a tradition as the get-together itself.

Celebrations often involve alcohol
If you’re trying to stay away from alcohol, this becomes even more difficult due to holiday parties and gatherings. Walk in the door, and someone may put a drink in your hand, whether it’s wine, liquor, beer or even eggnog or punch spiked with alcohol. Resisting alcohol or knowing when to say “no” becomes a test of willpower, made even more difficult by the stresses triggered by the holidays. For those looking for an excuse to drink, holiday parties supply plentiful justification.

Overindulgence is expected
Stuffing yourself is in some ways a compliment to the chef — the food was too good to resist. If the chef spent hours laboring over the dinner, there is a certain expectation that the guests will eat the meal and imbibe in alcohol to celebrate with holiday cheer.

Gift giving can break your budget
Those after-Thanksgiving and pre-holiday sales are hard to resist. No surprise, since retailers are pushing sales even harder than usual during the holiday season. For many retailers, holiday sales represent 25% to 40% of their sales. The day after Thanksgiving, or Black Friday, considered the biggest shopping and sale day of the year, got its name because it’s when retailers go from being “in the red” to “in the black.” It’s also traditional for families to spend and overspend so that loved ones get everything on their wish lists, even if it means buying gifts on credit.

Coping With the Holidays
Here are some ideas for coping with the holidays, so they don’t become an excuse to overindulge:

Lower your expectations, lower your stress
How can you cope with holiday stresses? For one thing, lower your expectations. If you don’t expect your holiday dinner to be perfect, it will be less stressful. If you can laugh at whatever the family throws your way, you’ll be better off. If you haven’t had a stellar year, which is the case with many of us, and you’re dreading talking about it, don’t. Instead, think of something else to talk about that others can relate to (movies, for example) and run with that. Ask people about themselves, since it doesn’t have to be all about you. You may be pleasantly surprised to learn something new about family members once you treat them like acquaintances that you’d like to get to know better.

Maintain, don’t gain
Holiday weight gain can be exaggerated. According to a New England Journal of Medicine study, the average weight gain is only a pound from mid-November to mid-January. However, people who were already overweight tend to gain more. The real problem is that the weight is hard to take off. The gradual weight gain that we see over the years tends to be partially due to holiday weight gain. So that’s where that pound a year weight gain comes from! The holidays.

BYOB
Bring Your Own Bottle … of water! It’s much easier to circulate at a party without finding yourself automatically drinking whatever someone hands you if you already have a drink in your hand. So bring your quart-size water bottle with you. It will also help you stay hydrated and avoid empty calories.

Don’t feel obligated
Excuse yourself from gatherings where it’s going to be too hard to resist alcohol. You know which parties and people to avoid in order to stay sober. So “just say no” to the circumstances that will create a difficult atmosphere for you. Instead, spend the holidays with sober family and friends who can support you in your goal of not drinking.

Don’t go to a party starving and parched
Eat something sensible before you go, so you don’t overindulge in foods and drinks while you’re there.

Know thyself, and to thy own self be true
You know what your triggers are. Whether it’s stress or a weakness for auntie’s pie or being around heavy drinkers or watching a football game, you know what sets you off, so avoid it. You might try writing out how you’re going to cope to get it really clear as a commitment.

Set goals
If you don’t set goals, you have nothing to gauge your behavior by. Set reasonable goals so you have something to live up to. It’s too easy to forget unless you formalize it as a goal by writing it down and telling people, so they can support you in it. Being a designated driver is one way to set your goal ahead of time, but you must absolutely live up to it!

Set spending limits
To avoid overspending, draw names in your family for gift giving, so you don’t have to buy gifts for everyone, but everyone still gets a gift. Discuss with your family limiting the dollar amount per gift, so everyone’s in agreement ahead of time. Also, you can always make your gifts instead of buying them. It will be more meaningful.

Count
Count calories, cookies, chips and drinks and even the number of times you chew, so you’re conscious of how much is going in your mouth.

Don’t multi-task
Eating while reading or watching TV is a surefire way to overdo it. Enjoy what you’re eating or drinking more by being conscious of what you’re doing, one thing at a time. You’ll naturally slow down instead of wolfing down.

Bring the veggies
If you want to make sure there’s something at the party that won’t blow your diet, bring it. And while you’re out and about, don’t stop at the café and pick up a wonderful coffee specialty drink. It’s loaded with calories, sugar and fat.

Reset
If you do overdo it, figure out what triggered it, and make a commitment to not go there again, whether it’s partying with a certain crowd, baking desserts as an excuse to eat them or overdoing the holiday drinks. Skip it next time around and get back on track for the holidays.

Depression, obesity and alcohol abuse are often treated as discrete disorders.

But a new study shows that, for women under the age of 30, those three conditions may be interrelated — meaning treating all three may be key to overcoming any of them.

Researchers at the University of Washington (UW) found that almost half of the 776 adults they tracked during the study met the criteria for one of those conditions at each of the observed ages of 24, 27 and 30.

“The proportion of people with all three of these conditions at any one point is small,” said Carolyn McCarty, the study’s lead author and a UW research associate professor of pediatrics and psychology.

“For women, there is a great deal of overlap between these common emotional and health problems that span early adulthood,” McCarty said. “Men may develop one of these conditions, but they don’t tend to lead to another one later on.”

The UW study revealed the following about women, alcohol, obesity and depression:

• Women with an alcohol disorder at age 24 were more than three times as likely to be obese when they were 27.
• Women who were obese at 27 were more than twice as likely to be depressed when they were 30.
• Women who were depressed at 27 were at increased risk for alcohol disorders at 30.

The research did not point to any step-by-step progression from one disorder to another, but McCarty said clinicians treating women with one of the listed conditions should be aware that patients might develop another disorder.

“These conditions are major public health problems,” she said. “They take a toll on families and community, and are not subject to quick fixes. It requires a lot of time, money and energy to treat them.”

Alcoholism and Obesity
McCarty pointed to two reasons why women with an alcohol disorder at 24 years old were more likely to be obese at 27:
The caloric intake associated with drinking alcohol may increase metabolic processes leading to weight gain, or there may be an underlying connection to levels of dopamine in the reward pathway in the brain because the same pathways reward both food and alcohol intake.
Some people substitute alcohol for food, leading to obesity.

Obesity and Depression
The link between obesity at 27 years old and depression at 30 years old is body image, according to McCarty.
“Body image is particularly important for women. There seems to be a transfer that when women feel bad, they eat more,” she said. “That can have devastating effects emotionally and physically.”

The study found that the reverse is true for men: Obesity actually offers some men protection against developing depression later on.
“It’s the so-called ‘jolly fat man’ theory, which suggests that overweight people are actually happier,” McCarty said.

Depression and Alcoholism
When it comes to the link between depression and alcohol abuse, the two may be related to stress.

“People who feel more emotionally down may use alcohol for a quick lift or a short-term boost,” McCarty said. “The two conditions may be connected by an underlying stress mechanism. Stress is linked to depression, so women under stress potentially eat and drink more.
Obesity and Income

The study also found that people with higher incomes were at lower risk for obesity. That is often because many of the least nutritional items are inexpensive, and low income areas don’t have the same access to fresh fruit and vegetables that higher income areas have.
“It costs more to eat well,” McCarty said.

Treating All Three Disorders
The best way to keep these disorders at bay is through early prevention, including stress management and family support.
“Early prevention is important because the sooner we start, the more impact we can have,” McCarty said. “Interventions should include stress management so we can provide young people with tools to cope with situations and emotions. We also need to explore underlying factors that predispose people to these conditions, such as a family background that is not supportive or is toxic.”

People who do find themselves dealing with depression, obesity and alcohol abuse, together or in any combination, can get the help they need through residential treatment centers. Residential treatment centers have the resources and mental health professionals needed to help patients overcome each of those disorders at one time, while addressing any underlying emotional disorders.

Dealing with just one of those disorders is not easy. Dealing with all three can leave you feeling out of control. Get the help you need today by calling a residential treatment center that can help you overcome your disorders and get your life back.