Substance Use Disorder Can Complicate Grief

In the past eighteen months, more than four million people around the globe have died from COVID-19. This massive loss has shined a spotlight on a normal, but painful, part of daily life — grief. Grief can occur for a variety of reasons: you can grieve the loss of a relationship, or the end of a career. However, the most acute and deep grief often comes around death.Although there’s no prescriptive way to move through grief, there are healthy ways to process loss. If grief begins interfering with your daily functioning and keeps you from healing, you may be experiencing complicated grief. This condition can have a big impact on your life, and often requires medical treatment.Here’s what you should know about grief, especially if there is a history of substance use disorder in your family.Substance Use Disorder and Grief: Risk for ComplicationsGrieving can be incredibly painful. That often leads people to look for coping mechanisms to get through. This can be problematic for people who have a history of substance use disorder. Research has shown that people who have a history of addiction are more likely to experience complicated grief, the type that keeps you from moving on and healing. In addition, when people with a history of substance use disorder experience complicated grief, they’re more likely to turn toward maladaptive coping strategies, like using drugs or alcohol.If you experience a loss, you should try to be proactive about maintaining your sobriety while you are grieving. Talk to trusted loved ones and medical professionals about how to cope with the pain of grieving if you are struggling. Have an emergency plan so that you know what to do if you’re very close to relapse, or if you have used.The Stages of GriefMost people have heard of the five stages of grief. Although people don’t move through the stages in a predictable manner, the stages can help normalize how you feel when you’re grieving. This alone can be helpful, reminding you that many other people have been through what you’re experiencing.The five stages of grief, as explained by researcher Elisabeth Kübler-Ross, are:Denial: When you first experience a shocking loss, you might not be able to comprehend it. The denial phase is characterized by feeling numb, and focusing on just getting through each day.Anger: As you begin to understand the depth of your loss, you may become angry about it. You might feel abandoned by God or the universe, or that the loss is unfair. Although anger might feel like a surprising emotion while grieving, it’s important to feel your anger and move through it.Bargaining: During the bargaining phase, you try to exert control and change the outcome of the loss. You might find yourself saying things like, “I’ll stay sober, as long as I get my mom back.”Depression: At this stage, the reality of loss has settled in. You’ve realized that you can’t bargain a solution or rail against the injustice of the loss. You settle into depression, which may put you at increased risk for relapse.Acceptance: Finally, after moving through the pain of grief, you might find yourself coming out the other side. You may notice that you’re remembering your loved one with joy and gratitude, rather than just focusing on the pain of losing them.The New, Sixth Stage of GriefRecently, David Kessler, a grief expert who worked with Kübler-Ross, introduced a sixth stage of grief: finding meaning. To truly heal from a loss, you must find a way to create a meaningful life, living in a way that honors the person you loved and the meaning of their life.This sixth stage is especially important for people who have a history of substance use disorder. In healing from addiction, it’s important to create a meaningful life. This can give you the impetus that you need to stay sober. Focusing on the components of a meaningful life — self-awareness, positive relationships, and intrinsic motivations — can support you in overcoming grief in a healthy way.A Hand to Hold: When to Get HelpGrief can become overwhelming. Communicating with your healthcare providers and your recovery community can help you navigate the grieving process. However, if you experience any of the following, you should reach out for more immediate help:An inability to recall good, happy memories about your loved one.Being unable to acknowledge or accept a lossHaving thoughts of self-harm or suicideThinking frequently about drug or alcohol use or relapse.Grief never goes away entirely. However, you can learn to incorporate grief and memories into your life in an emotionally healthy way, remembering what was, while continuing to live your life in the present and future.Sunshine Coast Health Centre is a non 12-step drug and alcohol rehabilitation center in British Columbia. Learn more here.

How the media may be making the COVID-19 mental health epidemic worse

Since the pandemic began, anxiety rates in the U.S. have tripled; the rate of depression has quadrupled. Now research is suggesting the media is part of the problem. Constantly watching and reading news about COVID-19 may be hazardous for your mental health.We are professors who study the psychological effects on people caught up in crisis, violence and natural disasters. COVID-19 surely qualifies as a crisis, and our survey of more than 1,500 U.S. adults clearly showed that those experiencing the most media exposure about the pandemic had more stress and depression.It’s understandable. The intimations of death and suffering, and the images of overwhelmed hospitals and intubated patients can be terrifying. COVID-19 has created an infodemic; members of the public are overwhelmed with more information than they can manage. And much of that information, especially online, includes disturbing rumors, conspiracy theories and unsubstantiated statements that confuse, mislead and frighten.Stress worse for some than othersA June 2020 study of 5,412 U.S. adults says 40% of respondents reported struggling with mental health or substance use issues. This finding did not address whether respondents had COVID-19. Since then, some people who had COVID-19 are now reporting mental health issues that appeared within 90 days after their illness subsided.Taking care of a relative or friend with the virus might result in mental health problems, and even just knowing someone with COVID-19 can be stressful. And if a family member or friend dies from it, anxiety and depression often follow the grief. This is even more likely if the individual dies alone – or if a memorial isn’t possible because of the pandemic.Essential workers, from hospitals to grocery stores, have a higher risk for COVID-related mental health problems. This is particularly true for health care workers caring for patients who ultimately died from the virus.[Get facts about coronavirus and the latest research. Sign up for The Conversation’s newsletter.]Black and Hispanic adults also report more mental health issues, including substance abuse and thoughts of suicide. Having access to fewer resources and experiencing the systemic racism running through much of U.S. health care may be two of the factors. The COVID-19 pandemic also intersected with episodes of police violence toward Black Americans. This alone may have exacerbated mental health problems.Children, young adults and college students also show comparatively worse mental health reactions. This could be due to the disconnect they feel, brought on by the isolation from peers, the loss of support from teachers and the disappearance of daily structure.Setting limits essentialStaying informed is critical, of course. But monitor how much media you’re consuming, and assess how it affects you. If you are constantly worrying, feeling overwhelmed, or having difficulty sleeping, you may be taking in too much COVID media. If this is happening to you, take a break from the news and do other things to help calm your mind.Parents should frequently check in with children to see how they are affected. Listening to and validating their concerns – and then providing honest responses to their questions – can be enormously helpful. If a child is having difficulty talking about it, the adult can start with open-ended questions (“How do you feel about what is happening?”). Reassure children that everything is being done to protect them and discuss ways to stay safe: Wear a mask, socially distance, wash hands.Finally, you can model and encourage good coping skills for your children. Remind young people that good things are still happening in the world. Work together to list healthy ways to cope with COVID-19 stress. Then do them. These activities will help your children cope – and it will be good for you too.J. Brian Houston, Associate Professor of Communication and Public Health, University of Missouri-Columbia and Jennifer M. First, University of Tennessee, College of Social Work, University of TennesseeThis article is republished from The Conversation under a Creative Commons license. Read the original article.

Incorrigible

Tara had the body of a runway model with thick blond hair that cascaded down her shoulders to the middle of her back. We had become good friends, pulled together like magnets by our mutual brokenness.It was the late sixties, I was sixteen when Tara and I were sitting on the bleachers together at school. I was etching my initials into the soft, splintery wooden bench with a paperclip. I knew better than to leave my entire name amongst the other scattered names, initials and drawings of hearts or it could be used against me later on.“Look at those stupid girls,” Tara said, glaring off into the distance.“Which ones?” I followed her gaze.“All of them. Those snobby bitches make me want to puke.”She was referring to the loud, happy teenagers sitting on the grass eating their lunches. Some had their hair piled up in beehives, held together by copious amounts of hairspray, while others had short bobs that flipped at the ends. I didn’t think any of the girls were intentionally trying to arouse our envy, but that’s exactly what they did.“Fucking clueless bitches,” I said.I was trying my best to stay out of trouble when Tara made this announcement: “I’m going to run away.”“Really? Why?” “I hate my step dad.” I knew Tara’s mother had recently remarried and the new hubby was strict.“That bad, huh?”“He’s trying to tell me what I can, and can’t do, and he’s not even my dad.”Silence. Then I said, “I’ll go with you if you run away.”“Really? You would do that?”I wanted to show her what real friendship looked like, but I also wanted to get away from the constant drama and craziness going on at home. “Of course,” I said, like it was a no brainer.“Where would we go?”Staring off in the distance I spotted a girl with two long braids, dressed in a bright orange tie-dyed, t-shirt. “We can see where the open road takes us.”Tara and I met by the flagpole in front of school the next day. I was dressed in bell-bottom jeans and a sweatshirt. I’d also brought a back pack stuffed with a toothbrush, a change of clothing and a dozen Twinkies in case we got hungry. Tara was wearing a cool brown rawhide jacket with fringe that hung from the back of her arms like wings. “You sure you want to do this?” Tara’s forehead was crinkled up.“Totally.”That was it. An hour later we were standing on the Pacific Coast Highway with our thumbs out. It took less than five minutes before a green and white Volkswagen van with flowers and a peace sign pulled over. Tara climbed in the back and I got in the front. Instantly I was hit with the smell of stale cigarette smoke and Patchouli oil. Strands of beads hung from the rear-view mirror. The driver was a guy with long brown hair, a straggly beard, and a rawhide vest worn over a linen shirt.“Where you girls headed?” he asked.“That way.” I pointed in front of me.“Well, what a coincidence. I’m going that way too,” he smiled.“Groovy.”“My name is Jeff by the way.”We told him our names.“We just ran away from home,” Tara blurted out.Jeff tilted his head sideways. “Oh really? Runaways?”“Our parents suck,” I said, as if no other explanation was needed.“I dig it man. I left home when I was seventeen.”“Wow. That’s really cool,” Tara said.As we drove up the coast, I watched the waves reaching up like fingers on the shore. I loved everything about the ocean. The mere sight of it could put me at ease. When we came to a red-light Jeff hit the brakes causing empty bottles and beer cans to roll forward from underneath the seat.“Looks like you had a party,” I said.“Oh yeah, sorry about that.”“No problem.”The salty wind was whipping my hair in my face.“What do you do Jeff?” Tara said, leaning forward.“I’m a singer-songwriter.”I liked the sound of that. He seemed like a free spirit.“Right now I happen to be living in the caves.”“What caves?” Tara asked.“In the canyon.”“I’ve never met a cave man before,” I smiled.“You chicks are welcome to come check it out.”Looking around Tara gave an enthusiastic nod.“Yeah. Okay,” I said.A few minutes later the bottles and cans crashed again as we were made a sharp right turn. Topanga Canyon Boulevard was a narrow, windy road, curling through the burnt orange Santa Monica Mountains. As we drove deeper into the canyon, I stuck my head out the window, causing my hair to windmill in my face. The chaparral-covered hills with steep rock out-cropping’s were breathtaking. I gazed down at the creek that rushed over massive boulders and rocks below. The raw beauty and energy of it all caused my blood pressure to drop a good ten points.Pulling my head in, I asked Jeff. “Are we still in L.A?”“Yup.”“I never even knew this place existed.”“Topanga is a well-kept secret,” Jeff smiled.“Well, I’ve had plenty of practice keeping secrets in my life,” I said.“Haven’t we all,” Jeff said, in a matter of fact tone.The van pulled onto a sliver of dirt by the side of the road. “Here we go ladies.” Jeff reached over and picked up his bag.Tara and I grabbed our backpacks and crawled out of the van.“So, where are the caves?” I asked.Jeff pointed. “Down there.”“Looks sort of dangerous.” Tara’s face was all scrunched up.“I climb it every day.” Jeff swung his long leg over the guardrail.Tara and I followed, dropping down onto a narrow clearing that was being strangled off by a thick layer of prickly underbrush and plants. Beyond the ledge was a dramatic drop into what seemed like a dark abyss.“Oh shit,” I said.“I know. I know,” Tara said.“If you start to lose your balance grab onto something,” Jeff said.“Have you ever fallen before?” I cupped my hands over my mouth.“Just once….” he said, without stopping.As we made our way down the loose dirt started to slip beneath us.“Watch out for poison ivy,” Jeff yelled.“What’s it looks like?”“Red and orange with almond shaped leaves.”All of a sudden I lost my balance and fell. I grabbed a handful of shrubbery to keep myself from going further down the hill. I pushed myself up and dusted the dirt off my butt. We see-sawed down the embankment. In some places it was so steep I had to sit down and scoot along on my butt.Out of breath we finally made it to the bottom. I noticed how everything was super quiet except for the water gushing in the nearby creek. The smell of sage and pine hung in the air. “Wow. It’s so quiet here,” I said to no one in particular.“This way, girls.” Jeff wanted us to keep moving.Dry leaves and twigs crunched beneath our feet. I turned to Tara and said, “How the hell are we going to get back up?”“Can’t go up when it’s dark that’s for sure,” she said.As we followed the creek downstream, Jeff abruptly stopped in front of a huge gray boulder. “Camp is on the other side of this,” he said, patting the rock with his hand. My neck craned as I gazed upward. The boulder was the size of a small house.“But how do we get over?” Tara asked.“Just watch me, and do the same thing.” Jeff started to climb with a surprising agility for a man who had to be over thirty. He used the tips of his fingers and toes to shimmy up the side. He made it look so easy, and seconds later he was at the top, cupping his hands over his mouth, he yelled, “Okay, girls, come on up. One at a time.”Tara went first. I bit my lip as she snaked her way up the side. I was afraid she would fall and break a bone. Then what? But Tara didn’t fall and when she made it to the top, I let out a long sigh of relief.“It’s not as hard as it looks,” Tara said, cheering me on.My heart was pounding as I inserted the tips of my fingers into the same dusty crevices that they had both used. I felt the hard, unrelenting rock beneath the front of my body. The toes of my sneakers found a small ledge as I reached my right arm overhead, searching for the next crack. When I found something to hold onto, my thigh and calf muscles tightened as I pushed myself up a few more feet. Reaching with my left arm to a crevice, I pulled myself up again. Twenty pounds over my ideal weight, and a half-pack-a day-smoker, I quickly became out of breath. When I made it the top, I felt a great sense of satisfaction.Standing next to Tara and Jeff, I gazed down at a waterfall with dark water gushing out from between two rocks. I was surprised to see a bunch of naked hippies standing waist high in a swimming hole with a crescent slice of sand encircling a private beach. It was the first time I had seen so much exposed flesh in one place. Embarrassment rippled up my spine. I had to look away.A guy with his dick dangling between his thighs yelled, “Who are your friends, Jeff?”“They’re runaways,” he said.“Well, come on in girls,” Dick man said. “The water is refreshing.”“Ah… No. I’m good, but thanks,” I replied, holding up my hand.We kept descending the boulder, but getting down was much easier than going up. Toward the bottom, I pushed off and landed with a thud on the crunchy gravel. I noticed the shallow caves Jeff was talking about at the base of the jagged mountain. Each opening was stuffed with a sleeping bag and scattered articles of clothing. I could see why all the hippies would want to stay there. It was the ideal place to live off the grid.A big-breasted girl with hair the color of chocolate fondue was stirring a pot over an open fire as smoke drifted toward the sky.“Do you girls want some of my special brewed cowboy coffee?” she asked.“Sure.” I shrugged.Tara and I sat on a log in front of the fire.“How did you guys meet Jeff?” she asked.“We were thumbing it on PCH.”“Groovy.” She stirred the simmering liquid in the pot. “They call me Sunshine around here.”“Do you have parents Sunshine?” Tara asked. “I mean, how do you live down here?”“My parents were always up my ass, so I ran away.”“Yeah, my parents were up my ass too,” Tara said, nodding.A few minutes later Dick man came and sat on a rock, his flaccid penis nearly touching the ground. I averted my eyes as Tara dug her elbow deep into my ribs.“Hello ladies.” He smiled.Making sure to avoid the penis I gazed just over his head.“Welcome to our casa,” he said, smiling directly at Tara.Minutes later Sunshine pulled out a fat joint. It was getting late and the sky had an orange, pinkish glow. By then all the other hippies were joining us. When the pot came around to me I took a hit. The smoke was harsh and burned the back of my throat. Coughing, I passed it on to Tara.As we got buzzed, we listened to stories while the sound of water fell over rocks a few feet away. Smiles emerged in the blurry orange light from the flames. A half-gallon of Red Mountain wine got passed around and everyone took swigs directly from the bottle.I had a good buzz going on when one of the younger guys started playing his guitar and singing, Heart of Gold, by Neil Young. My shoulders swayed to the sound. The sweetness of his voice coaxed everyone else to join in. We all knew the song and it sounded like a chorus bouncing off the canyon walls and reverberating into the ethers.I want to live.I want to give.I’ve been a miner for a heart of gold. …The words never felt truer to me than they did in that moment.We stayed up until the fire started going out. Some of the people said goodnight before drifting off into the blackness. I watched in horror when Dick man took Tara by the hand and guided her to his cave.Suddenly, I was struck with fear. Where am I going to sleep? As if reading my mind Jeff said, “You’re welcome to share my sleeping bag.”I put my palms closer to the fire and took a deep breath. “Okay. Cool,” was all I managed to say.Jeff stood up and I watched him walk away.A jittery feeling took over my entire body.I was trapped. While I had let plenty of guys feel me up or put their fingers inside me I hadn’t actually gone all the way with anyone yet. I was afraid Jeff might want to have sex. After all, weren’t the hippies all about having free love?A few minutes later I found myself fully clothed worming my way into Jeff’s sleeping bag. And while I might have had sex with him had he tried, Jeff only went as far as holding me in his arms. What I remember mostly was how the moon shone like a bleached oyster shell and the zillion silvery stars, flashing like sequins on a black velvet cocktail dress in the sky.“Gorgeous right?” Jeff said.“It’s, it’s so beautiful.” Jeff may not have noticed, but tears had welled up in my eyes. With a mind like a finely-tuned torture-device, it was rare for me to notice such beauty. As I drifted off to sleep, I wondered if my Dad was looking for me, but eventually my entire body merged with the blackness of the night. Excerpted from Incorrigible: A Coming-of-Age Memoir of Loss, Addiction & Incarceration by Wendy Adamson, available now at Amazon and elsewhere.

Did You Fail Treatment, or Did Treatment Fail You?

The inability to complete treatment for addiction or remain sober after treatment can have a damaging impact on the individual seeking recovery. Failure, for whatever reason, in recovery can leave those struggling with addiction with a host of negative emotions and thoughts (also known as "stinking thinking" ): people might think that because they failed drug treatment, they are also incapable of succeeding in other areas of their life. They might also start believing that recovery programs are not a solution to addiction and there's no point in trying other treatment programs. Such thoughts can place an individual fresh from recovery in a precarious position that, in many cases, can lead to relapse and further danger to their physical, mental, and emotional wellbeing.One significant component of the unsuccessful result of those in treatment is the overinflated promises attached to it. When those struggling with addiction or their loved ones call treatment centers, they are often oversold by the treatment professional or facility. Patients may believe that treatment is a "golden ticket" to instant sobriety, mental health healing, social rehabilitation, and more, without further work on their end once they leave the facility. Usually, this inaccurate message is not delivered with malicious intent on the part of the treatment provider, but more often than not, due to a lack of complete information and a need to affect positive change in a manner that may not be immediately available to both provider and patient."I believe it's really important for us as treatment providers to be realistic about what we can and cannot offer," says Clare Waismann, RAS/SUDCC and founder of WAISMANN METHOD®, an opioid treatment program and rapid detox center, and Domus Retreat on a recent episode of the Waismann Method podcast. "When patients say, 'I failed treatment so many times,' more often [than not], the treatment failed them. They failed the treatment because they and their families were promised that their personalities would change, their lives and their realities would change, and their mental health issues would be solved. So I think it's really important [for] treatment providers to tell [patients] exactly what you will be provided, exactly what your ability is as a provider, and what their responsibility [will be] not only during treatment, but after treatment."What creates these inaccurate narratives between patient and treatment professional? The issue is often due to a lack of clarity regarding each individual's unique needs and the scope of what a recovery treatment can actually provide. Outlining the limits of a program and managing realistic expectations can be vital to connecting a patient with subsequent success. "My goal is to give people real, personal insight into some of the specific things that are causing [the] compulsivity," says David Livingston, LMFT and psychotherapist at Waismann Method, who joined Clare on the podcast. "And then we try to put together a plan that will address that. That often includes continued therapy, and we go through the positives and negatives­­­ of that. I'll even talk about the 12-step [programs]. I try to give them a realistic understanding of what treatments, the difficulties [that are inherent] in them, and what [they] need to look for in terms of finding and sustaining a successful treatment."Another stumbling block for treatment professionals is the "one-size-fits-all" theory regarding recovery. For Waismann, this idea that one single recovery track applies to all patients is a "red flag." As she notes, "You're not treating the condition, you are treating a patient. Not every treatment is effective for everybody. People tend to push patients to receive what they have to offer. That's a mistake. It's really important to hear the patient's history and needs, and make sure that they – and you – know that there are different options."Hand-in-hand with this peg-and-hole approach is the idea that treatment will completely "cure" the patient. "That's impossible," says Waismann, who notes that this particular perspective will always lead to unrealistic expectations that prove disastrous for patients and professionals. "Individuals often feel unseen, when professionals focus on a certain (addiction) diagnosis." she says.As patients and families search for a solution in the face of an often challenging and intense situation, they lack an understanding of their condition, which causes them to lose the ability to distinguish credible from unreliable sources. Additionally, vulnerable situations lead people to seek hope or the impossible-to-guarantee promise of a positive treatment outcome, however unlikely those outcomes may be. "If you're just getting pushed into things that don't make sense to you, that don't feel helpful to you, and that you're resenting, that will drive up your frustration," adds Livingston. "I don't see that as productive treatment."Livingston also suggests that the failure to provide a complete picture of recovery expectations – which sometimes involves challenges after treatment – can also lead to inflated expectations. "Compared to most [facilities], we have a shorter program, because we get people detoxed quicker, and they feel better faster," he says. "That is really the strength of our program. We do it to try and minimize the length of suffering involved – a suffering that I see as neurotic suffering because it does not help you grow. It's just suffering to get something done that needs to get done."After the detox, the next level of work begins, and it's here that Livingston notes that attention and flexibility can produce actual results. "We go a step at a time addressing the most relevant needs as they surface," he says. "If you understand what those needs are, and you're not loading them up on your own program, and you're talking about the limitations [of the program], it's a great comfort – it actually aids in the treatment. "What's therapeutic for them is that patients actually feel what it means to have their needs met and to have a handle on their lives. But [as a therapist], you have to do your part and delineate and specify what exactly [needs to be done], and then make sure it's getting done."

Oh No, Is He Talking About God Again?

One of the bigger issues in the recovery community is the idea of god. Is a belief in one necessary to getting clean and sober? If so, does that god have to be one spelled with a capital “G,” as it is in The Big Book, or a lower-case “g” that allows for a more open dialogue? The following is excerpted from Writing Your Way to Recovery: How Stories Can Save Our Lives.Chapter SixOh No, Is He Talking About God Again?My sponsor hates it when I talk about feeling like an agnostic, or an atheist, or just conflicted and confused. He definitely believes in God, capital “G” and all. But you know I’m not so sure about god. In truth I had, and sometimes still do have, a lot of trouble with the concept of a higher power.For a lot of us the god part of A.A. was a roadblock we had to navigate around if we wanted to remain in the fellowship and stay sober. Unfortunately quite a few of us had religion shoved down our throats as children, typically of the sort that damned you for being who you were. Then we showed up at our first meeting, and boom, it’s god all over again. Not so oddly the statistics say A.A. loses a large percentage of newcomers due to its thinly veiled Christianity.I grew up in a very conflicted household, especially when it came to religion. My mother was a quasi-Catholic-sometime-Protestant that would force us kids to go to church on a not so regular basis. My father was a Marxist. On Sunday, he’d say, “you can go to church if you want, but I’m going out to hike in the woods and then eat doughnuts and drink hot chocolate. You want to go, too?”I’m laying odds you could easily guess what a six-year-old wanted to do more than go to Sunday school. So every time I read “God” in the Big Book I’d think of my dad. Which brought up all those old conflicting feelings of wanting to please an authority figure as opposed to rebelling.In the beginning I had a sponsor I would later learn was what they called a “Big Book Thumper,” and he didn’t really care or understand my issues with religion and god. Anytime I expressed doubt and a lack of faith he would tell me to read, “We the Agnostics” because he said, “A.A. is a spiritual, not a religious program.” But then two seconds later he was telling me I had to pray.As a newcomer it seemed impossible to separate religion and spirituality.So what does all this talk of a higher power and spirituality have to do with writing your way to recovery? Well if you read a lot of addiction memoirs, or just memoirs in general, you’ll notice there’s a connecting tissue that most of them have. Memoir often embraces seemingly un-embraceable subjects such as death, loss, illnesses, catastrophes, squandered opportunities, horrific events, addiction, broken dreams, and then chronicle the protagonist’s ability to overcome adversity and persevere.But the memoirs that really resonate are when the authors reflect on their “journey” and use their story as an opportunity to look inside themselves. It’s not just everything that they have experienced, but how everything has helped change them into who they are today — the person that is writing the memoir. That “internal change” is by definition spirituality, “the quality of being concerned with the human spirit or soul.”Whew, that took a long way to get here, right? Okay so again, you may be wondering, what the hell is he talking about now? And if I haven’t lost you yet, here it is. Spirituality is not just what we need in a memoir; it’s also what we need for our program of recovery.Yet for me the concept of spirituality was a bit too ambiguous. Okay, so it’s not god. It’s not religion. It’s... oh shit, I don’t know what the hell it is.Then one sunny afternoon I was driving on the freeway in Los Angeles and I passed a broken down and very overloaded station wagon on the side of the road. The hood was up, gray smoke billowing out, and a family huddled together on the shoulder. For a nanosecond I locked eyes with the mother as she hugged her child and I swear I could feel her sadness and absolute despair.I was hemmed in between two lanes of speeding traffic and I couldn’t stop to help. Yet the fear in that woman’s eyes haunted me and I remember thinking, let those people be all right. Let that woman get her kids home safely.Now that might not seem like a big deal to you, and I understand. But for someone that used to drive by similar situations and think, better you than me, sucker, it was a huge departure. And in that moment I came that much closer to understanding spirituality. It wasn’t that I had to attain nirvana, or make some magnanimous gesture, or even perform a miracle. I just had to give a shit about someone other than myself.Chapter SevenGod? Not God?Like Patrick, I had trouble with God. Since the ripe old age of seven, when my mother was arrested and thrown in jail, I sat on the lawn outside our apartment complex, looked up at the sky, and cursed Him. Or Her. Or It. I think I actually said “fuck you,” fully expecting to be struck dead by lightening. It didn’t happen. And in the mind of a child this was only further proof that He didn’t exist. And if He did, as my older sister firmly believed and tried her best to make me believe, then what sort of God was He to allow our mother to be taken from us?So began my life as an atheist, or, at best, an agnostic.Believing or not believing in God didn’t seem to present any problems for me until my forties. I got by just fine on my own, or so I thought, because by then I was a total mess. Nevertheless, when I first walked into the rooms of Alcoholics Anonymous, the “God thing” almost sent me running. By now I’d come to accept that I was “powerless over alcohol,” and when push came to shove, though I resisted it for as long as I could, I also eventually had to admit that my life had “become unmanageable.” Of course this is the First Step in A.A. and there’s no point in attempting the next if you honestly don’t think that you’ve fucked up just about everything in your life because you couldn’t stop drinking and drugging.But that Second Step?It says that we have to believe in a “Power greater than ourselves,” and it capitalizes the P in power, which is a dead giveaway that it’s referring to God, thereby assuming that God exists. And that, as I said earlier, was a problem for me. Actually it’s a problem for a lot of people, and I’m not just talking about A.A.Patrick wrestles with this same issue, empathizing with those who had “religion shoved down [their] throats as children,” predisposing them to later reject god. Especially the one spelled with a capital G. Even today, with 20 years of sobriety, his definition of spirituality continues to evolve.I understand that. I respect that.In time, however, I changed, but this doesn’t mean that I don’t or can’t still identify with those who either downright don’t believe in a God or are struggling to embrace one. For me the change occurred slowly, over a period of a couple years, when my sponsor kept after me to pray, to whom or what didn’t matter, just pray, even if I only saw it as a one-sided conversation with myself.“Open your mind to the possibility of a God,” he said. “That’s all I’m asking. And when you pray, keep it simple. At night, if you got through the day sober, hit your knees and say ‘thank you.’ And in the morning, when you wake up, hit your knees and ask for ‘the strength’ to do it again. What’s that take out of your day? Thirty seconds? A minute? Don’t tell me you can’t do that.”Allowing for the possibility of a God involves an openness toward faith, and as the sober days began to accumulate, the simple act of prayer combined with a little faith eventually turned into a belief in God. Once that happened, the conversation was no longer one-sided. Obviously it’s more complicated than this, requiring much soul-searching and willingness, confronting looming questions and doubt, but it’s how the process began for me.But that’s just me.What about you?Is there a God, and, if so, who is He or She or It?***In two-to-three pages, describe the God of your own understanding. Do you picture Him as Christians picture Jesus? Is He or She or It different than the God of traditional world religions? Do you see this Power in terms of Mother Nature? The Great Spirit? The Collective Consciousness of Human- kind? Does It defy personification? What strengths, virtues and qualities does your God possess? Kind- ness? Love? Is He forgiving or punishing or both?For the non-believers, for the sake of argument, if you were to have a God, what would you like Him or Her or It to be? Again, you don’t have to believe in a God, but you do have to pretend that if by some chance there was one, what might He or She or It mean to you? What would be Its strengths, virtues and qualities?What we’re after with this exercise is nothing more than a better grasp of a God of our own understanding. And we do it by articulating and describing who and what He or She or It means to each of us. Writing Your Way To Recovery: How Stories Can Change Our Lives, by James Brown and Patrick O’Neil, is now available on Amazon and elsewhere.

How to Change Your Life with 3 Daily Habits

“If you are someone who has struggled with addiction, you are excellent at forming habits.”The first time my friend Dr. Darlene Mayo said that sentence to me, I was a little taken aback, and very intrigued. She was right: addicts are great at forming habits, and that propensity, when applied for good, can be life-changing.During our conversation on The Recovered On Purpose Show, I shared with Dr. Mayo the story of my past as a homeless heroin addict, and my present as someone seeking to change other people’s lives through the power of the lessons I’ve learned on my journey to recovery.I wanted to know if building solid habits was one of the keys to unlocking the kind of life I had always dreamed –– the kind of life I built for myself, and wanted to help others build as well.And Dr. Mayo, neuroscientist and neurosurgeon who has spent decades studying the brain and how it’s wired, was absolutely right.Don’t get me wrong, this isn’t my way of glamorizing addiction. My addiction ruined my life, and it was only when I realized I had nothing left to give but my life that I resolved to turn my life around. However, if Dr. Mayo’s wise words, and the habits I’ve built on my path to recovery, can ring true for even one person, it will have made my journey worth it.My StoryWhen I was 26, I had it all: a 2,400-square-foot ranch home 10 minutes from the Central California beach, a girlfriend, a motorcycle, two cars, and a dog. My sales job working for DirecTV provided me with a comfortable living on about 25 hours a week, so I had plenty of time to do what I loved, like taking my girlfriend out on dates, swimming in the ocean, riding that motorcycle…And shooting up with heroin.At this point, my habit of shooting up before going to work and then shooting up when I got home hadn’t taken over my life. In fact, no one noticed anything was off. I was able to maintain my lifestyle, my home, and my relationships, and I thought I was truly capable of having it all.A year later, when I was 27, I had lost that job, my house, all my vehicles, my girlfriend, and the dog. I was living on the streets – I had been kicked out of homeless shelters – and was severely underweight. Three years ago, I realized I had nothing left to give my addiction and resolved to get clean.But, as I’m sure you know, that’s much easier said than done.I got clean and sober in November 2017, and stopped smoking cigarettes a month later. Since then, I’ve built an online following of over 40,000 people, run a mile in under six minutes, published a best-selling autobiography, and created a seven-figure company.But between 2017 and now, and between the lowest low of my addiction and the height of my success (so far), there was one key component that shaped my future:My habits.The Habits that Changed My LifeWhether you want to recover from an addiction, a breakup, a psychological or spiritual upset, or just want to re-set your life, cultivating new habits to replace the old, negative cycles you’re used to is a lifelong practice. These three habits changed my life – and they’ll change yours too.Prioritize LearningWhat are you interested in? What are you passionate about? Where in your life do you feel you’re lacking? Once you answer those questions, you’re well on your way to understanding what you should be learning about in your free time. Not only is lifelong learning a great practice for your mental health and agility, it also ensures you stay humble. No one can possibly know everything about everything, after all.If you don’t have time to read, or know you take in information better through other means, that’s okay. We all learn and grow differently; the important thing is that you intentionally set aside time – at least 10 minutes – every day to invest in your growth.Invest in Your MorningsThere’s a reason why morning routines are hailed by successful people all over the world as the key to unlocking your potential: you can spend your morning hours taking control of your day and investing in yourself before even starting to serve other people.There’s no right or wrong way to craft your perfect morning routine; it all depends on your priorities and what you know is healthy for your mind, body and spirit. These are a few of the things I’ve incorporated into my morning routine:Brushing my teethMaking my bedDrinking lemon-flavored salt waterTaking vitamins and supplementsReading my BibleJournalingGoing to the gymI also practice what I call the “list of six” every night. Before bed, I write down six things I want to do in the morning before my work day starts. My brain will work on them while I sleep and I’ll be ready to go the moment my eyes pop open the next morning.Invest in YourselfYou’re no good to anything or anyone if you don’t take care of yourself first. And, while mastering yourself through self-discipline, healthy eating, exercise and more are all important, taking an hour a day to have fun and unwind is equally so.I think we overestimate how much one hour will take away from our schedules, and underestimate what one hour can do for our lives. Setting aside time dedicated to enriching your spirit and bringing you joy is a great habit to establish, not only because it staves off burnout, but because everyone needs fun in their lives.

ADHD in adults: what it’s like living with the condition – and why many still struggle to get diagnosed

Many of us think of ADHD (attention deficit hyperactivity disorder) as a childhood condition – which is typically when it’s diagnosed. But a growing number of people are sharing their experiences of being diagnosed with ADHD in adulthood. Social media has even played a role in this, with reports of people going to see their doctor after first learning about symptoms on TikTok. In fact, around 2.5% of adults are thought to live with ADHD – including us.Yet despite this growing awareness, many adults continue to struggle to get a diagnosis.ADHD is a genetic neurodevelopmental disorder, in which the brain grows differently, lacking action from specific chemicals involved in pleasure and reward. This means ADHD brains often search for ways to stimulate these chemicals, which is why people can experience inattentiveness, hyperactivity and impulsivity.Common traits of ADHD include:Not following through on longer tasks (or not starting them)Getting distracted by other tasks or thoughtsSeeking out risk or activities that provide immediate rewardRestlessness (either outwardly or internally)Interrupting other people (without wanting to)Symptoms are similar for both adults and children, although elements of them differ or change as we age. For example, inattention is the most persistent symptom in adults.ADHD can be debilitating and is associated with higher likelihood of lower quality of life, substance use issues, unemployment, accidental injuries, suicide and premature death. In addition, ADHD can cost adults around £18,000 per year because of things like medical care or paying for social support.It’s also commonly associated with a wide range of co-existing conditions in adults.For example, depression is almost three times more prevalent in adults with ADHD. And nearly half of all adults with ADHD also have bipolar spectrum disorder.Around 70% of adults with ADHD also experience emotional dysregulation, which can make it more difficult to control emotional responses. It’s also thought that almost all adults with ADHD have rejection sensitive dysphoria, a condition where perceived rejection or criticism can cause extreme emotional sensitivity or pain.On top of this, adults with ADHD may have poor working memory – such as being unable to remember a simple shopping list – and “time blindness” (the inability to perceive time). Some may also have oppositional defiant disorder, which means they often react poorly to perceived orders or rules.While none of these co-existing conditions are used to diagnose ADHD, they can make ADHD feel all the more difficult to live with.Being diagnosedGetting an ADHD diagnosis as an adult in the UK is notoriously difficult – with reports of some people waiting up to five years.This is because you can only be diagnosed by a specialist psychiatrist. But even with a referral to a specialist, a person has to show clear evidence of almost all ADHD traits, having had these traits since childhood, and that they’re having a serious affect on their life – such as causing issues with work, education, or maintaining relationships.For us, our experiences of being diagnosed with ADHD aren’t all that different from what other adults have gone through.Like many people I (Alex) was only diagnosed with ADHD “by accident” after being referred to an NHS psychiatrist to get help with (what I now know to be) alcohol self-medication. Because of my ADHD, my brain demands quite extreme inputs most of the time.Ironically, I’ve published scientificpapers on ADHD and – probably due to a classic ADHD lack of self-awareness – it didn’t cross my mind that I could have it. The “label” has since helped me move away from feeling broken toward an understanding of my behaviour.My main challenges remain prioritising tasks based on importance (instead of excitement) and quite extreme anti-authority behaviour (sometimes called oppositional defiance). I am also a terrible spectator, struggling to attend conference talks or sit still at the theatre – it can feel like physical pain.On the other hand, I (James) was diagnosed pretty quickly because I used a private clinic – though there was still a long wait for medication. Yet I’d known for five years before this that I probably had ADHD, but coped with it well until the pandemic. The added pressure of isolation and increased workload impacted my mental health, so I sought a diagnosis.Now diagnosed and medicated, life is getting easier to cope with – although there are still many challenges every day. I frequently get anxiety about the silliest things, like talking to a friend, but appearing on television is fine.On a daily basis I forget many simple things, such as where I left my keys, or that I am running a bath. I struggle immensely with controlling my emotions and with rejection especially. For example, when no one responded to a joke I made about my ADHD on a senior management messaging group I was tempted to quit my job. I am utterly unable to pay full attention in meetings or seminars and cannot control my impulse purchasing.While there’s a growing recognition of ADHD in adults, many people still live with it undiagnosed for any number of reasons – sometimes even because they’re unaware that what they experience is actually different from other people.Understanding the condition in adults, taking it more seriously as a disorder, raising awareness of it, and investing in services to improve diagnosis times are key. Diagnosis opens the door to treatment, which can have a marked impact on living with the disorder – such as improving self-esteem, productivity and quality of life.James Brown, Associate Professor in Biology and Biomedical Science, Aston University and Alex Conner, Associate Professor in Biomedical Sciences, University of BirminghamThis article is republished from The Conversation under a Creative Commons license. Read the original article.