Ask 10 different people what substance abuse or addiction is and you are likely to get 10 different answers. Some insist it is a weakness of those who won’t take responsibility for their behavior.  They choose to abuse.  Other answers will range from heredity to the ‘disease’ model which views addiction as progressive and irreversible.

Most experts view addiction from a bio-psycho-social model which incorporates variables from one’s biology, psychology, environment, cognitive and social patterns. A common definition is the compulsive and continued use of a substance or participation in a behavior, exhibiting little of any control over the behavior in light of negative consequences.  Key characteristics that move abuse in into the category of addiction are the presence of tolerance and withdrawal.  Tolerance occurs when increasing amounts of the substance or behavior are required to achieve the same ‘high’.  Withdrawal symptoms occur when the substance or behavior is stopped.  Addiction is usually thought of as involving alcohol, drugs, smoking or caffeine but people can also be addicted to gambling, eating, sex, even exercise.

The most common treatments include outpatient therapy, medications and 12-step groups.   No single treatment is appropriate for all individuals and effective treatment addresses the multiple needs of the individual, not just the addiction.  Recovery can be a long-term process and may require multiple ‘episodes’ of treatment.  Yet, it is possible for people to manage their lives in a healthy way and resume a high level of functioning.

Symptoms of addiction:

• Impaired control of behavior or substance, compulsive use.
• Preoccupation with behavior or substance, narrowing of other interests
• Continued use of behavior or substance despite adverse or negative consequences
• Distorted thinking, most notably denial
• The dreaded tolerance and withdrawal

Treatment:

A variety of outpatient treatments or hospitalization is available for abuse and dependence, depending upon the severity of the problem. Our certified addiction counselors customize treatment methods and styles to meet individual needs, specializing in  and offering 8 evidence-based programs which have been proven to be some of the most effective available, including:

ENHANCED OUTPATIENT (EOP)   Based on the Matrix treatment model, it was originally developed for cocaine and methamphetamine abusers.  Typically, a participant engages in 2-5 hours of treatment per week, some it individual work but mostly in a group.

INTENSIVE OUTPATIENT (IOP) Regularly 10-12 hours of treatment per week, allowing individuals to participate in daily affairs (i.e. work, home), receiving treatment before or after their day.

MATRIX MODEL Combines several different therapeutic approaches targeted towards the individual’s struggle with alcohol or drug addiction.

STRATEGIES FOR SELF-IMPROVEMENT AND CHANGE (SSIC) Designed for individuals with past criminal history together with substance abuse issues.   Built on a cognitive behavioral approach, it is a 3-phase treatment program nearly spanning a year.

THINKING FOR A CHANGE   An integrated, cognitive behavior change program for criminal offenders that includes cognitive restructuring with social and problem-solving skill development.

DRIVING WITH CARE A scientific program designed to prevent future involvement in driving while under the influence of alcohol or other drugs.

Recovery from any addiction is a difficult, ongoing process.   Support from family and friends are important, and often group therapy is a good addition to treatment.  Sometimes the addicted person finds that certain people or situations are triggers for their addiction, resulting in the need to distance themselves from them.   Don’t give up!!  Relapse is considered a normal part of the recovery process and many, many people do eventually succeed in staying clean and/or sober permanently.

Stress is a fact of life for all of us these days, we can’t avoid it and anxiety is its nasty offshoot.  You are not alone.  Adjustment Disorder is a rather generic diagnosis applied to maladaptive reactions to identifiable circumstances or life events like a change in family (i.e. birth, death, divorce) or a change in circumstance (a move, job loss, financial difficulties). Anxiety disorders develop from a complex set of risk factors including genetics, brain chemistry, personality and life events, like the death of a loved one.   It is the most common psychological complaint in our country, affecting over 40 million American adults. Stress & Anxiety disorders are highly treatable yet only about a third of those suffering receive treatment and many of those seek relief for symptoms that mimic physical illness like that nagging headache or frequent insomnia.

Common effects on body, mood & behavior

• Disturbed emotions or conduct

• Headaches, stomach aches, muscle tension or pain, including chest pain
• Numbness, tingling & other skin sensations
• General malaise, feeling like coming down with the flu
• Fatigue, or an excess of energy & inability to relax
• Change in sex drive
• Sleep problems, nightmares & bad dreams
• Restlessness, irritability, sadness or depression
• Lack of focus or motivation
• Over or under eating
• Substance abuse, caffeine & tobacco use
• Social withdrawal
• Heightened fears
• Concentration difficulty, short-term memory loss
• Frequent feeling of being overwhelmed or continually under pressure

Types of Anxiety Disorders

–Agoraphobia: fear of being outside the home, being in a crowd or being in any situation or place from which escape might be difficult and/or embarrassing.

–Panic Disorder: Repeated episodes of intense fear that strike often and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal distress, feelings of unreality and fear of dying.

–Obsessive-Compulsive Disorder: Repeated, unwanted thoughts or compulsive behaviors that seem impossible to stop or control and are experienced as intrusive and inappropriate. The most common obsessions are repeated thoughts about contamination (e.g. hyper fear of germs), repeated doubts (did I really lock the door?), a need to have things in a particular order & intense distress when they are disorganized or asymmetrical), thoughts of aggressive or horrific behavior (an impulse to hurt one’s loved one or shout obscenities in church) and sexual imagery (recurrent pornographic images). Compulsions are repetitive behaviors (e.g. hand washing, ordering, triple & quadruple checking) or mental acts (praying, counting, repeating words silently), the goal of which is to prevent or reduce anxiety or stress.

–Phobias: Two major types are social and specific. People with social phobias have an overwhelming and disabling fear of scrutiny, embarrassment or humiliation in social situations. People with specific phobias experience extreme, disabling and irrational fear of something that poses little to no actual danger. Both phobia types lead to avoidance of many potentially pleasurable and meaningful activities.

–Generalized Anxiety Disorder: Constant, exaggerated worrisome thoughts and tensions about everyday routine life events and activities, lasting at least six months. Almost always anticipating the worst even though there is little reason to expect it, accompanied by physical symptoms such as fatigue, trembling, muscle tension, headache or nausea.

TREATMENT

Knowledge is power when it comes to stress and anxiety-related issues.  Treatment can focus on symptom reduction and/or addressing core causes. Stress and adjustment disorders usually are not treated with medication but it may be helpful in certain circumstances. However, a number of medications that were originally approved for treating depression have been found to be effective for anxiety disorders as well. Two clinically-proven effective forms of psychotherapy used to treat anxiety are behavioral therapy and cognitive-behavioral therapy. Behavioral therapy focuses on changing specific actions and uses several techniques to stop unwanted behaviors. In addition, cognitive-behavioral therapy teaches people to understand and change their thinking patterns so they can react differently to situations that cause them anxiety.

According to the National Alliance on Mental Illness, Attention-Deficit Hyperactivity Disorder (better known by its acronym ADHD) is the most commonly diagnosed behavior disorder in young people, characterized by inattention, hyperactivity and impulsivity.  But ADHD is not limited to children, it often persists into adolescence and adulthood and is frequently not diagnosed until later years.

About 9% of kids and 4% of adults live with ADHD.  It impacts school performance, work and relationships.  More than half of all individuals with ADHD also have co-occurring conditions like anxiety, depression and substance use disorders.  While many behaviors associated with ADHD are normal, someone with ADHD will have trouble controlling these behaviors and will show them much more frequently, and for longer than 6 months.
Signs of inattention include:

• Becoming easily distracted and jumping from activity to activity
• Becoming bored with tasks quickly
• Difficulty in focusing and concentrating,
• Inability to complete tasks or activities, like homework
• Losing things, like toys or school supplies
• Not listening or paying attention when spoken to
• Daydreaming or wandering with lack of motivation
• Difficulty processing information quickly
• Struggling to follow directions

Signs of hyperactivity include:

• Fidgeting and squirming, have trouble sitting still
• Non-stop talking
• Touching or playing with everything
• Difficulty doing quiet tasks or activities

Signs of impulsivity include:

• Impatience
• Acting without regard for consequences, blurting things out
• Difficulty taking turns, waiting or sharing
• Interrupting others

If you suspect that you or your child may have ADHD, here are some suggestions:

• Talk with your primary care physician or mental health professional about your concerns.  Write them down before the appointment so that you are prepared to address each one.  Arrive at the appointment ready to discuss what is happening in school, at work and/or in relationships that have you concerned.
• Ask for a comprehensive assessment to determine whether you or your child may have ADHD.  This is important to help rule out other psychological or medical conditions that may be causing the symptoms and to help ensure an accurate diagnosis.
• If you or your child is diagnosed with ADHD, be prepared to be an active partner in developing and adhering to the treatment plan.  Ask questions, no question is off-limits when it comes to understanding treatment options.

ADHD is most often treated with some combination of behavior therapy and medication.  Everyone is different and it is important to find the right combination that works best for you or your child.

Bipolar disorder is a recurrent illness that involves long-term, drastic changes in mood. A person experiences alternating highs (mania) and lows (depression). A manic period can be brief, lasting just a few days, or longer, lasting up to several weeks. The depressive periods may also last from days to weeks to even six or nine months. Periods of mania and depression range from person to person and many people experiencing very brief periods of these intense moods may not even be aware they have bipolar disorder. On average, someone with bipolar disorder has three years of normal mood between episodes of mania or depression.

The ‘high’s, or manic episodes, are characterized by extreme happiness, hyperactivity, little need for sleep and racing thoughts that may lead to rapid speech. People often become impulsive and act aggressively, resulting in high-risk behavior like repeated intoxication, extravagant spending and risky sexual behavior.   Symptoms of the ‘lows’ or depressive periods include extreme sadness, lack of energy or interest, an inability to enjoy normally pleasurable activities and feelings of helplessness or hopelessness. Sometimes a person with bipolar disorder may have symptoms that overwhelm their ability to deal with reality. This inability to distinguish reality from unreality results in psychotic symptoms such as hearing voices, paranoia, visual hallucinations and false beliefs of special powers or identity.

Those with the disorder often describe it as being ‘on an emotional rollercoaster’. The emotions, thoughts and behaviors of the person are beyond his control—family and friends must intervene to protect their interests. This makes the condition exhausting not only for the sufferer but for those in contact with them as well.

TREATE

Identifying the first episode of mania or depression and receiving early treatment is essential to managing bipolar disorder. Usually the first recognized episode of the disorder is manic. Those who first seek treatment as a result of a depressed episode may continue to be treated for depression and ironically, treatment of depressed bipolar individuals with antidepressants can trigger a manic episode in some. Another reason why a proper diagnosis is incredibly important.

Treatment for bipolar disorder most often consists of medication, particularly mood stabilizers such as lithium or divaproex sodium (Depakote). Sometimes antidepressants are used in conjunction with mood stabilizers and some antipsychotic medications have been found to have mood-stabilizing properties as well.

Therapy in conjunction with medication is recommended as people with bipolar disorder highly benefit from recognizing and dealing with their symptoms from a cognitive-behavioral perspective.

What makes depression different from ‘the blues’? Depression is a serious medical condition that involves the body, mood and thoughts. If affects how you eat and sleep. It alters your self-perception. It changes the way you think and feel. People with a depressive illness can’t just ‘snap out of it’ or ‘pull themselves together’ because depression isn’t the same as a passing mood. Left untreated, depression may last for weeks, months or years at a time.

Depressive illnesses can make routine tasks unbearably difficult. Pleasures that make life worth living can be drained of joy. Depression brings pain and disruption not only to the person who has it but also to their family and others who care about them.

Ask yourself are you feeling

Sad or ‘empty’?

Irritable or angry?

Guilty or worthless?

Pessimistic or hopeless?

Tired or ‘slowed down’?

Restless or agitated?

Like no one cares about you or life is not worth living?

Other signs may be sleeping and/or eating more or less than usual, having persistent headaches, stomach aches or chronic pain, trouble concentrating, remembering or making decisions and losing interest in work, hobbies, sex.

TRE

If these signs are familiar, it’s time to talk with your doctor. Depression is a real, medical illness that can be successfully treated and fortunately there are many effective options. Health professionals consider any biological, psychological and/or social factors causing depression in tailoring an effective treatment program for the individual. Treatment may include medication, exercise, counseling and physical therapies like bright light therapy. Help is all around you, you just have to ask.

Dysthymia:

Dysthymic Disorder, or Dysthymia, is a chronic, lower-grade depression that must persist for at least 2 years in adults, 1 year in children or adolescents. Symptoms are typically not as severe as Major depressive Disorder and many people do not even realize they are depressed. Dysthymia, as with the rest of the Depressive Disorders, is highly treatable and responds well to psychotherapy and medication. Once people feel the difference after treatment they can then realize how depressed they actually felt. A mental health or healthcare provider can determine whether Dysthymic Disorder or Major Depressive Disorder is the correct diagnosis for your symptoms.

Personality Disorders are mental disorders characterized by inflexible, deeply ingrained, maladaptive patterns of adjustment to life that cause either subjective distress or significant impairment in functioning. Generally recognizable by adolescence, these disorders cannot be formally diagnosed before age 18.

Types of Disorders:

• Paranoid
• Schizoid
• Schizotypal
• Histrionic
• Narcissistic
• Anti-Social
• Borderline
• Avoidance
• Dependent
• Obsessive-Compulsive

TREATMENT

People with personality disorders may be receptive to various kinds of therapies although some schools of thought classify personality disorders as untreatable. Yet, Dialectical Behavior Therapy (DBT) has been proven effective with Borderline Personality Disorder and can be modified to work for other disorders as well. The success of treatment depends upon many factors including the person’s level of insight, circumstances, motivation and severity of symptoms.

DBT is an evidence-based practice that helps identify the thoughts, beliefs and assumptions that make life harder and helps people learn different ways of thinking to make life more pleasant, leveraging the concepts of mindfulness, relationship effectiveness, distress tolerance and emotional regulation.

Schizophrenia is a mental illness characterized by disturbances in mood, behavior and thinking (psychosis). The thinking disturbance shows up as a distortion of reality, sometimes with delusions and hallucinations, and fragmented thinking that results in disturbances of speech. The mood disturbance includes ambivalence and inappropriate or constricted display of emotions. The behavior disturbance may show up as apathetic withdrawal or bizarre activity. Schizophrenia is NOT the same thing as ‘split or multiple personalities’ which is Dissociative Identity Disorder (DID).

Types of schizophrenia include

Disorganized: Characterized by wild or silly behavior or mannerisms, inappropriate display of emotions, frequent hypochondriacal complaints and delusions and hallucinations that are transient and unorganized.

Catatonic: Typically a state of stupor, usually characterized by muscular rigidity, resistance to move or opposite behavior to what is being asked. Occasionally catatonic excitement occurs which is excited, uncontrollable motor activity.

Paranoid: Characterized by unwarranted suspicion and thinking that others have evil motives, and/or an exaggerated sense of self-importance (delusions of grandeur).

Undifferentiated: Psychotic symptoms are prominent but do not fall into any other subtype.

Residual: No longer psychotic but still shows some symptoms of the disorder.

TREATMENT:

Typically, schizophrenia is treated with antipsychotic medications. When the older medications such as mellaril, prolizin, trilafon and thorazine are used for an extended period of time a sometimes-permanent condition called tardive dyskinesia can result. Symptoms may include involuntary movements of face, mouth, tongue or limbs. Stopping the medication may cause the symptoms to disappear in some but not all. Medications can treat the side effects but not the tardive dyskinesia.

There is a new generation of antipsychotic medications which have very little risk of tardive dyskinesia including Seroquel, Zyprexa, Risperdal and Clozaril.

Self-harm is a complex behavior that can be seen as a maladaptive response to acute and chronic stress, and often but not exclusively linked with thoughts of dying.  Parasuicide is an apparent attempt at suicide in which death is not the aim.  Both can be predictors of mental illness.

Young women are most at risk for self-harm, with 2/3 of those who self-harm females under the age of 35. However, the rate in young men aged 15-24 is rising more quickly than any other group.  20% of those who self-harm repeat several times in a given year, and 10% repeat at least five times. Rates of depression are substantial after self-harm and are particularly high in the elderly and other vulnerable groups.  Depression is one of the strongest risk factors for self-harm so treating depression is usually called for and treatment can alleviate thoughts of suicide.  Other risk factors include medical illness and social isolation.

Should you or someone you know be self-harming or parasuicidal, please seek professional help immediately, either by calling our 24/7/365 Crisis Hotline  1.888.207.4004 or visiting your local Mind Springs Health office.

Suicide and suicide attempts are a major health problem in our region.  Colorado Health Institute’s latest statistics from 2016 note a record  1,156 died by suicide state-wide, with Colorado having the 9th highest suicide rate in the country. 20.5 out of every 100,000 Coloradans take their lives and in Mesa County it’s a devastating 34.7 per 100,000 residents. Nearly twice as many people die by their own hands than in car accidents and almost 80% of suicides are men. Firearms were involved in more than half the suicides in 2016.

Know the Signs of Suicide and How to Handle Them

Listen. Give individuals any and every opportunity to unburden or vent. Offer patience, sympathy and acceptance, avoid arguments or advice-giving. You don’t need to say much, just let them know you are glad they turned to you.

Ask if They are Having Any Thoughts of Suicide. Asking is a good thing and shows that you care, you take the person seriously and are willing to share their pain. If they are having suicidal thoughts find out how far along their ideation has progressed.

Take it Seriously. Many suicides occur for reasons that do not seem serious enough to others. It is not how bad the problem is but how badly it’s hurting the person who has it. Do not judge, aid.

Give & Get Help Sooner than Later. Suicide prevention is not a last-minute activity. Do whatever you can to reduce their pain and constructively involving yourself on the side of life as early as possible can reduce the risk.

Consider Suicidal Behavior a Cry for Help. Suicidal persons can be ambivalent, part of them wants to live and part wants not so much to die as to have the pain end. If a suicidal person turns to you they probably believe you are caring and competent. Regardless of the negativity level of their talk, just having the talk is a positive thing.

Urge Professional Help. Persistence and patience may be needed to seek, engage and continue with as many options as possible.

Don’t keep Secrets. Respond to the part of the suicidal person that wants to stay alive. Do not go it alone, seek assistance for the person and yourself, you can do so without breaches of privacy. Distributing the responsibility of suicide prevention makes it easier and more effective.

If you or anyone you know is contemplating suicide, please seek immediate help by calling 1.888.207.4004 or texting TALK to 38255.

Post-traumatic stress disorder is a very common anxiety disorder that develops in some people following frightening, stressful or distressful life events.  Once thought of as a soldier’s disease, it affects more than 3,000,000 people of all ages in the US every year.  It is characterized by intense fear, helplessness and stress and affects life’s normal functioning.   It is natural to experience fear after a traumatic situation and nearly everyone will experience a rancge of reactions after trauma.  Most people recover from initial symptoms naturally, it’s when one continues to experience problems they may be diagnosed with PTSD. Not every traumatized person experiences PTSD and not everyone with PTSD has been through a dangerous event.  The National  Institue of Mental Health notes that some experiences, life the sudden, unexpected death of a loved one, can also cause PTSD.

Risk factors for PTSD include people who have been through a physical or sexual assault, abuse, accident, disaster or another serious event. According to the National Center for PTSD, about 7 or 8 of every 100 people will experience PTSD at some point in their lives.  Women are more likely than men and genetics may also play a factor.

Symptoms usually begin with 3 months of an experience but can sometimes begin years later.  To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:
– At least one re-experiencing symptom:  Flashbacks – reliving the trauma over and over, including physical symptoms like sweating or a racing heart
– At least one avoidance symptom:  Staying away from places, events or objects that are reminders of the traumatic experience
Avoiding thoughts or feelings related to the traumatic event.
– At least 2 arousal and reactivity symptoms: Being easily startled
Feeling tense or ‘on edge’
Difficulty sleeping
Angry outbursts
– At least 2 cognition and mood symptoms: Trouble remembering key aspects of traumatic event
Negative thoughts about oneself or the world
Distorted feelings like guilt or blame
Loss of interest in enjoyable activities

CHILDREN & ADOLESCENTS can have extreme reactions to trauma but their symptoms may not be the same as adults.  In very young children these symptoms can include wetting the bed after having learned to use the toilet, forgetting how to or being unable to talk, acting out the scary event during playtime or being unusually clingy with a parent or other adult.

Older children and teens are more likely to show symptoms similar to those seen in adults.  They may also develop disruptive, disrespectful or destructive behaviors, including thoughts of revenge

We treat a variety of beahvioral health issues not listed here. Please make your first appointment today.