Effects of Antidepressant Medications: How Do You Know if it is Working?

How will antidepressants make me feel? How do I know if it is working? Before starting antidepressant medications it’s important to know what to expect; both with potential side effects but also what to look for when assessing if there is a benefit. Antidepressant medication is slow to take effect so the benefits can creep up on the person. You will not suddenly be a different person from the effects of antidepressants (and if you are then you are likely having a side effect your physician needs to know about). Antidepressants are not “happy pills”…but will hopefully treat depression so that you can get back to your normal self.



How do antidepressants make you feel when they are working?

This is a frequent question I get when initiating antidepressant treatment. Although one could dismiss this question with a simple answer “You will feel better!” it is a great question and worthy of a more detailed explanation.

 

Antidepressants gradually take effect over 3-5 weeks (on average) from when a therapeutic dose is reached (this dose varies between different people). The benefits will creep in slowly so that sometimes it isn’t until reflecting back on a moment that a person realizes they are starting to feel back to their baseline.

Effects of antidepressants: When an antidepressant works

 

 

When getting better, often people begin to respond to situations in different ways than they would have while depressed. They may catch themselves laughing, realize they went a day without crying, or they find themselves resuming activities they used to enjoy.



It is not uncommon for family members to be the first to notice a difference in a person. Because change is gradual it is sometimes harder for the person to recognize the difference in themselves.

 

Before a follow-up appointment with your doctor, I recommend asking people close to you if they have noticed any differences. You might be surprised by the feedback!

What antidepressant medication won’t do:

Don’t expect the antidepressant to:

 

  • Change your personality,
  • Make you not sad about sad things (unless you get a side effect that causes emotional flattening. You may still feel sad but have a harder time crying. Discuss this with your doctor if you get it!),
  • Immune to stress.



As you feel better it may be easier to let stress roll off you and not feel as overwhelmed. This still requires adequate self-care to improve resiliency, however, will be easier to do when feeling less depressed. Also, if you aren’t viewing everything in life thru the lens of depression, more options and subsequent hope will continue to present.

Taking antidepressant medications:

It can be intimidating to take antidepressant medication and people worry they will be changed in uncomfortable ways or it will change their personality. Antidepressants don’t change the fundamental parts of what makes you “you” but hopefully will help you get back to your non-depressed baseline so you can live the life you are meant to.

What do you remember noticing when an antidepressant medication started to work in yourself or someone close to you?



Because depression is so common, and not everyone is able to see a psychiatrist for their treatment, I have written much about depression. Here are my most popular articles:

 

11 Effective Interventions for Depression

30 Healing Mantras For Depression

Treating Depression with Exercise

Seasonal Affective Disorder? Light therapy can help!

Journal Prompts For Depression and Anxiety

Suicide Prevention Plan: 5 Tips to Deal With Thoughts of Suicide

A Psychiatrist’s Take on Suicidal Thoughts and Suicide Prevention

Will You Have Antidepressant Withdrawal Symptoms?

2 Reasons Your Antidepressant Medication Doesn’t Work

6 Questions You Must Ask Before Choosing an Antidepressant

 

26 Symptoms of Adult ADHD: Can You Relate?

Although each person is unique, there are many common signs of adult Attention Deficit Hyperactivity Disorder (ADHD). The symptoms of adult ADHD listed below aren’t only experienced by those with the diagnosis. The difference between having ADHD or not relates to the extent of the struggles and the ways it interferes with functioning. ADHD can cause significant challenges in relationships, employment, and self-esteem for people who are not adequately treated. ADHD symptoms in adults don’t cause occasional trouble concentrating or careless mistakes…that’s normal life. Attention and focus exist on a spectrum and anyone can experience problems to some degree. Read these 26 signs of adult ADHD to learn more and see if you can relate.



26 Symptoms of Adult ADHD:There are many common signs of adult ADHD (Adult Attention Deficit Hyperactivity Disorder). Check out this list of 26 symptoms of adult ADHD. Can you relate? ADHD symptoms in adults may need treatment.

 

1.Struggles with organization. This can be for a project that is being worked on, desk surface and papers, dresser drawers, keeping track of bills…the list is often endless in adult Attention Deficit Hyperactivity Disorder.

 

2.Frequent but unsuccessful multitasking: creating a huge to-do list but most projects only get 80% finished before starting the next item. This adds to a constant feeling of stress since the list of things needing to be done never gets shorter.

 

3.Careless mistakes and missed deadlines. Because of a lack of focus and rushing, the quality of work produced is below what is capable. In addition to work-related issues, life management skills (like paying bills on time) are challenging.

 

4.The desire to avoid long, drawn-out tasks or projects. When they are required, a person with ADHD may struggle with follow through. The preference is for quick-fix projects that have an end in sight.There are many common signs of adult ADHD (Adult Attention Deficit Hyperactivity Disorder). Check out this list of 26 symptoms of adult ADHD. Can you relate? ADHD symptoms in adults may need treatment.

5.Getting distracted from doing work by social media or email instead of focusing on the task at hand. This is a great example of one of the signs of adult ADHD that many people without any diagnosis struggle with. There are so many temptations we have at our fingertips these days. Information and entertainment are readily available to us. Although we all can get distracted by these same items, someone with adult ADHD may be more prone to this and really struggle to bring themselves and what they need to be doing back into focus.

 

6.Struggles with the ability to relax. Constantly trying to remember things that have been forgotten and stressed by the many responsibilities that haven’t been completed.

 

7.The ability to “hyperfocus” on areas of interest where it becomes difficult to stop doing that activity and focus elsewhere. This task is sometimes done to the detriment of other responsibilities.

 

8.Drifting off (thinking of other things and not listening) when in longer conversations, lectures or meetings.There are many common signs of adult ADHD (Adult Attention Deficit Hyperactivity Disorder). Check out this list of 26 symptoms of adult ADHD. Can you relate? ADHD symptoms in adults may need treatment.

9.Easily distracted or bored and need to frequently bring oneself back into focus to remember what needs to be done.

 

10.Chronic underachievement. Getting work or school evaluations that comment on underperformance or “not performing to the level of ability”.

 

11.Increased physical activity such as pencil tapping, leg shaking, or general fidgety behaviors that can distract others.



12.The tendency toward excessive shopping, drinking, drug use, or working too much. There are many reasons this happens but may relate to impulse control challenges where decisions aren’t thought through or a lack of healthy coping mechanisms to help manage stress and anxieties. For someone who tends to be a “work-a-holic” this may be the natural result of poor self-esteem left-over from childhood underperformance mixed with executive functioning deficits and being inefficient at getting work done in a timely manner.

 

13.Struggles in relationships because of the lack of follow-through, not listening, disorganization, and emotional reactivity (ie react quickly instead of thinking through one’s feelings and what you want to say). The partner of someone with adult Attention Deficit Hyperactivity Disorder often interprets this lack of attention to the demands of running a household as “laziness” or lack of caring and resentments can build and drive apart a relationship. Each person in the relationship ends up feeling chronically stressed and unsupported.

 

14.Low self-esteem. Chronically feel less than or less capable than others around despite evidence to the contrary. Can look back and recognize a lifetime of feeling unable to somehow “measure up” or being told their performance was not what was expected and they were disappointing others.There are many common signs of adult ADHD (Adult Attention Deficit Hyperactivity Disorder). Check out this list of 26 symptoms of adult ADHD. Can you relate? ADHD symptoms in adults may need treatment.

15.Tasks or projects seem to take double the time they take others. Often need to study much longer than others or take projects home from work to complete them.

 

16.The tendency to make impulsive decisions. Some turn out well but some are regretted later when the consequences to the decision become apparent.

 

17.Dislike of planning and would rather just get started and figure it out as it goes.



18.Miss scheduled appointments or meetings. Sometimes this is due to forgetting to look at the calendar, not entering something correctly on the calendar, not setting a reminder alarm, or just getting distracted at the last minute and suddenly realizing the meeting started a half hour ago.

 

19.Frequently running late because of distraction or disorganization. Time management doesn’t come naturally.There are many common signs of adult ADHD (Adult Attention Deficit Hyperactivity Disorder). Check out this list of 26 symptoms of adult ADHD. Can you relate? ADHD symptoms in adults may need treatment.

20.Have relatives diagnosed with ADHD.

 

21.While reading, eyes may be moving yet none of the information is absorbed. Often need to go back and re-read the whole thing (sometimes multiple times). This can lead to an avoidance of reading. HELLO! This is #21 in the list of ADHD symptoms in adults. Congratulations for making it this far!

 

22.Procrastination of tasks that aren’t engaging. It can feel like it takes monumental effort to get started even when the task isn’t complicated.

 

23.The tendency to interrupt and talk over people in conversation. Often not a great listener.

 

24.Frequently Forgetful



25.Emotional volatility. This can be an appropriate passionate reaction to an event but because the communication of the emotion isn’t thought through people around them feeling attacked or put off by the delivery. Their message gets lost because of this.

 

26.While be given feedback, a person with ADHD can be quickly defensive without adequately listening to what the other person is saying. This defensiveness is a form of self-protection that happens after a lifetime of being criticized for one thing or another often due to being off-task or not performing to expectations. The defensive reaction helps protect against feelings of shame and frustration.

Do you relate to these 26 signs of adult ADHD?

There are many common signs of adult ADHD (Adult Attention Deficit Hyperactivity Disorder). Check out this list of 26 symptoms of adult ADHD. Can you relate? ADHD symptoms in adults may need treatment.

This list of symptoms of adult ADHD isn’t a set of diagnostic categories that need to be checked off but ways that ADHD often plays out in “real life”. Again, people with and without ADHD may identify with these symptoms but the extent to which it impairs functioning is the difference between having the diagnosis or not. How much do you relate to the list?

 

If you are curious if you or a loved one has ADHD take this ADHD symptom test. This is not diagnostic (the diagnosis needs to be made by a physician or psychologist) but can help you understand your own symptoms better.

 

Click HERE to take this quick symptom assessment.

 

Comments?

What symptoms of adult ADHD would you add to the list? I’m sure we could easily make this list longer.

 

All my articles about ADHD can be found at this link.

 

Here are my 3 most popular:

14 Benefits of ADHD

Top 10 books about ADHD

4 Myths About ADHD in Adults

 

 

Pulling weeds and psychotherapy: What do self-exploration, self-discovery, and gardening have in common?

As winter dredges on I find myself beginning to think about spring and the joys of planting a garden. Spring is one of my favorite times of the year, where life grows out of everything that appears dead. Buds pop from the clusters of sticks that are my hydrangea plants, and sprouts come out from the soil where bulbs have been waiting to give life. It’s a time full of hope, renewal, and opportunities for positive growth. Reflecting on the wonders of spring got me thinking about how psychotherapy works and the growth opportunities that emerge from both. The fresh start of spring parallels the opportunities for positive growth and self-exploration we have in our own lives: rejuvenation, inspiration, self-discovery, and beauty. The roots of psychotherapy are wrapped up in the basics of gardening.



How psychotherapy works: What’s under the surface?

The fresh start of spring and all it's beauty can explain how psychotherapy works: opportunities for positive growth, self-exploration, and self-discovery. Getting ahead of the weeds with gardening and growth opportunities.

Looking out into my back yard, my raised beds are lying in wait for spring; piles of dirt with the remains of a few dead plants and weeds that won’t give up. Under the surface, the beds are full of roots: some big or small, deep or superficial. They form the intricate network of the past and the future; the remains of a previous life and the foundation for what is to come.

 

Our life experiences lay down roots inside us: networks of patterns, habits, and automatic reactions. Sometimes the roots are more like weeds forming the basis of worry thoughts, PTSD, or ineffective coping skills. But other roots are what we can fall back on: the building blocks that make us who we are, our resiliency, drive, and passions.

Self-exploration and the roots of life: Some wanted, some not

The fresh start of spring and all it's beauty can explain how psychotherapy works: opportunities for positive growth, self-exploration, and self-discovery. Getting ahead of the weeds with gardening and growth opportunities.

Unwanted roots grow pesky weeds. Remove them as I may, they come back as soon as I stop being vigilant. The only way to eliminate these weeds is to work harder to dig down and get them at the root. Though it is impossible to create a permanently weed-free space, once the root is eliminated, the network can be minimized and dealing with them as they arise will prevent a major problem.

 

Think, for example, what happens when the roots of addiction are present. Ongoing attention to self-care and recovery are required or addiction can pop up to the surface and produce its ugly fruit again. Without digging down and eliminating as many of the roots as possible, addiction will grow under the surface and pop through once it is strong enough.

Growth opportunities: Self-care isn’t a one time job

 

There are outside influences that invade my weed-free garden space. Seeds and grass clippings blow into the garden and the process of weeds choking out the good starts over. Weeds are hearty and some will find a way to survive.



If we can’t eliminate the negative roots, we can have a maintenance plan to keep them in check.

 

As much as we take care of ourselves, there will always be bumps and bruises that come with life. If we can accept this, it makes the process of recovery easier. Instead of putting our energy into thinking about the unfairness of it all we could more quickly and effectively address the fact that “weeds happen” and move forward. This is a growth opportunity for us. Life evolves so we need regular maintenance to nourish the parts that are positive and quickly deal with what holds us back.

Self-discovery: The beauty of rootsThe fresh start of spring and all it's beauty can explain how psychotherapy works: opportunities for positive growth, self-exploration, and self-discovery. Getting ahead of the weeds with gardening and growth opportunities.

The roots under the surface don’t only bring unwanted chores and negativity, they are also the lifelines to the plants that bring beauty and fulfillment. These roots give life to perennial strawberries and flowers, and they also form the basis of who we are. They drive our interests, passions, depth of experiences, resiliency, humor, and the ability to explore and trust.

 

If we steadily maintain and minimize the weeds in our lives we allow what fulfills us to spend more time in the sun not being crowded out or shaded by negatives.

Opportunities for positive growth: Building blocks of life

The fresh start of spring and all it's beauty can explain how psychotherapy works: opportunities for positive growth, self-exploration, and self-discovery. Getting ahead of the weeds with gardening and growth opportunities.

Inside the soil are key nutrients that prepare the land so it can continue to give hearty life. These building blocks come from the plants that were there before; the imprint of the past that gets brought into the future.



As we incorporate our life experiences (both positives and negatives) into the entirety of ourselves we can feel whole and not defined by any particular experience. We are the sum of all that came before this moment and one piece cannot define the whole of our being. It’s important not to forget this.

Self-discovery: Identifying what is missingThe fresh start of spring and all it's beauty can explain how psychotherapy works: opportunities for positive growth, self-exploration, and self-discovery. Getting ahead of the weeds with gardening and growth opportunities.

If the soil is missing a key nutrient it needs supplementation or we will grow vulnerable plants. These plants may be thin and easily blow over with wind or lack the energy needed to produce flowers and fruit because their efforts are going into staying alive.

 

Some of us need to supplement our lives to increase our resiliency and improve our foundation by filling in the cracks.

 

This could mean:

 

  • Going to psychotherapy,
  • Learning additional coping strategies,
  • Education about and commitment to self-care,
  • Medication to treat an illness,

Self-exploration: The benefits of ongoing maintenance

The fresh start of spring and all it's beauty can explain how psychotherapy works: opportunities for positive growth, self-exploration, and self-discovery. Getting ahead of the weeds with gardening and growth opportunities.

 

A garden that has been cared for and nurtured takes less intense effort to maintain. It’s easier to enjoy these gardens when we have soil that will support healthy growth.



People doing work in therapy mimic gardens full of roots: self-exploration and self-discovery create opportunities for positive growth. Some roots support weeds and some grow flowers and fruit. If a rock is discovered buried deep in the soil a plan can be made to excavate or plant around it. Tasks are manageable with ongoing effort and the payoff is great.

 

Enjoy the fruit of your life and pull the weeds when they get in the way.

 

Here are more articles you will like to help you in your process of self-exploration and self-discovery:

 

Feeling stuck in life? Instructions from a psychiatrist on how to live the life you love

Achieve Your Dreams! A Series on the Importance of Setting Goals

“Embrace the Suck” How the Power of Positive Thinking Can Turn Your Day Around

Side Effects of ADHD Medication in Adults: Watch For the Crash!

The goal of ADHD treatment with stimulant medications is to find a medication that is both effective and has no (or minimal) side effects. Sometimes it takes a couple of different medication trials before finding the best treatment. Most ADHD medication side effects in adults are minor but one side effect, “crashing”, can be so disruptive the person will have to switch medications or stop altogether.

Wondering if you or a loved one have ADHD? Take this free ADHD symptom test to help you recognize the signs and symptoms of Adult ADHD: Click here

Side effects of ADHD medication in adults:



There are several frequent side effects of ADHD medication in adults including appetite suppression, nervousness, headache, and insomnia. For most people, these are mild or transient (most often happening at the start of treatment and then disappearing). The side effect we are reviewing today happens as the medication is coming out of your body and is often referred to as “crashing”.

What is “the crash”?ADHD medication side effects in adults are usually minor but crashing can be so disruptive it requires adjusting or changing stimulant medications. Read what to watch out for.

The significance of the crash varies with different people. For some, it will be mild and brief (they can feel their energy dip but then they are ok quickly). For others, they have a more significant crash that lasts hours and disrupts their ability to function.

 

They may feel:

 

  • down/depressed/sad
  • irritable/cranky
  • exhausted and unable to function without a nap
  • anxious



The timing of the crash varies by medication and person. Stimulant medications work for a certain amount of time determined by which medication is being taken (the “length of action” varies between different stimulant medications) and individual variability as to how fast a person clears the medication out of their body.

 

2 Ways to INCREASE the chance of crashing on stimulant medications:

Skipping meals during the dayADHD medication side effects in adults are usually minor but crashing can be so disruptive it requires adjusting or changing stimulant medications. Read what to watch out for.

People who have trouble remembering to eat because of the appetite suppression side effects will increase their potential for a “crash”. As the medication is coming out of the system a person who has forgotten to eat all day will suddenly feel starving and cranky.

 

If you struggle with remembering to eat during the day, set an alarm for yourself and bring easy foods to grab. Good options are a handful of almonds or a protein smoothie. These only take a minute to eat/drink but have enough calories to allow you to sustain your energy better.



Sometimes drinking calories is easier than eating food when a person doesn’t feel hungry but needs to eat. Figure out what works for you!

Skimping on sleepADHD medication side effects in adults are usually minor but crashing can be so disruptive it requires adjusting or changing stimulant medications. Read what to watch out for.

Another thing to evaluate is how well you are sleeping. Most people feel lousy if they don’t sleep enough. If you are sleep deprived it increases the chance of crashing as the medication comes out of your body.

 

Sometimes people who take stimulant medications in the morning don’t appreciate their exhaustion until later in the afternoon when the medication is out of their system. Treating this may be as simple as getting better quality sleep.

 

Fix what isn’t working. What to do if the crashing continues:

ADHD medication side effects in adults are usually minor but crashing can be so disruptive it requires adjusting or changing stimulant medications. Read what to watch out for.

 

If someone is sleeping and eating well, yet consistently crashes each day, a new medication (or a different form of the same medication) can be tried. Even though other stimulant medications have the same chance for this to happen, often times, people do not have the crashing side effects when they switch.



Crashing can be disruptive and needs to be dealt with. Some people without depression will feel significant dysphoria each afternoon when the medicine leaves their system. Or some feel irritable and exhausted and struggle to function for the rest of the evening.

 

It is rare that we can’t find a medication routine that eliminates the crash. If this is happening to you, discuss this side effect with your doctor and come up with a plan to minimize this uncomfortable and unnecessary side effect.

 

Read more about ADHD here:

14 Benefits of ADHD

4 Myths About ADHD in Adults

Top 10 books about ADHD

The Ultimate Guide: 15 Tips to Improve Executive Function Disorder

 

 

 

Need help quitting Juul? Learn more about treating Juul addiction.

The quit-smoking techniques available for traditional cigarettes also work for people treating Juul addiction. A Juul e-cig is unique, but not so special that it needs separate therapies to treat Juul addiction. Nicotine addiction is the same, regardless of the delivery mechanism. Quitting Juul is hard but not impossible.



Read the first post in this series to learn all about Juul e-cig and what makes it different from other e-cigarettes.

First, make a quit plan

Come up with a plan that makes sense for you and pick a date to quit your Juul e-cig. It is more effective to choose a specific date rather than a general goal of quitting in the future. Once you pick a date let other people know your plans. This will help you stay accountable.

 

Part of the preparation involves getting rid of your Juul device and pods. You don’t want it to be effortless to restart Juul in a moment of significant craving.

 

The CDC has great resources on quitting nicotine. Here is a link to their page on building a quit plan.

Nicotine addiction and withdrawal:

The physical withdrawal from nicotine lasts for approximately 1 week but breaking the psychological addiction can take longer.

 

Nicotine withdrawal symptoms include:

 

  • feeling irritable, angry, anxious, restless
  • trouble thinking clearly
  • increased hunger
  • cravings for nicotine

Managing nicotine cravings to treat Juul addiction:

 

Nicotine cravings generally last 5-10 minutes and then pass. The key to management is what you do when the craving is happening. As part of your plan to quit smoking, I recommend having a pre-planned list of options to choose from instead of trying to think of how to manage it during a craving.



Create your list! Here are a few options:

  • Chew gum, suck on hard candy, drink water
  • Distract yourself by doing something other than what you were doing when the craving started. Walk away from the area you were in.
  • Get up and move. Do a short burst of physical exercise to give yourself an energy boost and reduce the anxiety that accompanies cravings. Do some jumping jacks, go for a quick vigorous walk or jog around the block, walk up and down stairs.
  • Call a friend and talk to them about what they are up to. Try to take the focus off yourself and the way you currently feel.
  • Deep breathing and relaxation techniques can help, especially if you are unable to step away from the task at hand.
  • Keep a card in your pocket with the reasons you want to quit nicotine written on it. Pull this out and read it during a craving.

Options for treating Juul addiction:

 

Some people can successfully treat Juul or nicotine addiction on their own without support but many people benefit from help. There are several different options people use when trying to stop Juul.

 

  • Get advice, support, and/or counseling including information on withdrawal, coping strategies to deal with nicotine withdrawal, and a personalized plan for quitting
  • Use over the counter nicotine replacement products such as the nicotine patch, gum, and lozenges
  • Start prescription medication like bupropion SR (Zyban) and varenicline tartrate (Chantix). Ask your doctor if this is appropriate for you.



Counseling and medication are both effective for treating nicotine dependence, but using them together is more effective than using either alone.

 

Free resources to help with quitting Juul:

The CDC includes many free resources to help people stop using nicotine. Keep in mind, the language the CDC uses in many of their resources refers to “stop smoking” but you can substitute this language with “stop using nicotine”. Remember, the underlying addiction is the same.

 

  • Each state has a quit-line that can be accessed by calling 1 (800) QUIT-NOW. This resource provides all types of information and services to help people stop using nicotine.
  • There is an app called QuitGuide that helps you track cravings and build skills to needed to remain nicotine free. It even sends inspirational messages to you each time you log a craving.
  • Sign up for SmokeFreeTxt a free resource that will send messages to you each day to help support quitting nicotine. If you text a keyword such as “Crave” a text response will be sent to you with messages to help you get through the urge. There are specific texting apps for adults, vets, teens, women, and age 60+ so the messages sent are targeted to the population using it.



If you are struggling to stop using Juul and are wondering what treatment is right for you, reach out to your physician for advice and support.

 

To learn more about addiction read these posts:

We Can Help Prevent Prescription Medication Abuse and Drug Diversion

7 Alternatives to AA in Recovery from Addiction

There is a drug in school called Lean. Have you heard of it?

Dr. Deborah Burton and Dr. Kristen Stuppy are both physicians dedicated to educating the public about health issues. They each wrote educational pieces about the dangers of using Juul, especially for children. Find these posts here and here.

Share your additional pointers for quitting nicotine. What helped you or others you know?

 

7 Alternatives to AA in Recovery from Addiction

Alcoholics Anonymous (AA) has helped countless people in their recovery from addiction but one size does not fit all with healing. The messages of AA don’t resonate with everyone and it’s important to know alternatives to AA exist. Healing and recovery are lost on some that become distracted by what they interpret as religious aspects of AA. This post is about the other options for a self-help addiction recovery program.

 

The more alternatives to choose from, the greater the chance that people will find a program they identify with. Recovery will still be hard but may be easier to start when it’s the right fit.



Keep in mind, AA is the most prolific addiction recovery program with multiple meetings every day all around the world. It is by far the easiest to attend if you are looking for daily, free, in-person support. However, it is not the only game in town.

 

This post does not cover medication-assisted recovery. This is an important option for many people on their path to recovery and will get covered in a separate post.

SMART Recovery:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

SMART Recovery (stands for Self-Managment And Recovery Training) describes itself as a “science-based secular alternative” and is not specific to alcohol, but for any type of addiction (including gambling and other non-substance related dependencies).  It has face-to-face and daily online meetings in addition to a 24/7 chat room and online message board.

 

SMART recovery views addiction as a bad habit and not a disease.

 

The purpose of SMART Recovery according to their website:

 

To support individuals who have chosen to abstain, or are considering abstinence from any type of addictive behaviors (substances or activities), by teaching how to change self-defeating thinking, emotions, and actions; and to work towards long-term satisfactions and quality of life.

SMART Recovery works as a 4-point recovery program based on cognitive-behavioral techniques that teach how to change self-defeating thinking, emotions, and actions. The 4-point program covers building and maintaining motivation, coping with urges, managing thoughts, feelings, and behaviors, and living a balanced life.

 

The SMART Recovery Toolbox provides a variety of methods, worksheets, and exercises to help support you through addiction recovery. Find them here.



Alternative to Alanon:

In addition, Smart Recovery has a friends-and-family section so they can get support and be better prepared to help their loved one.

Refuge Recovery:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

Refuge Recovery is a mindfulness-based recovery method founded in Buddhism and focused on compassion. Some of the steps in Refuge Recovery are similar to AA’s like taking an inventory and mentorship.

 

We do not use Buddhism as a religion, but as a liberating approach to a more wholesome life, while remaining thoroughly engaged with the world and cultures in which we live.

 

From their website:

 

Refuge Recovery is a non-profit organization grounded in the belief that Buddhist principles and practices create a strong foundation for the addiction recovery process. Wisdom and compassion enable those struggling with any form of addiction to become more mindful of their mental processes while also developing a deep understanding of the suffering that addiction has created and compassion for their own pain. The mission of Refuge Recovery is to support those on this path of recovery by building an extensive and comprehensive network of Refuge Recovery groups, meetings and communities that practice, educate and provide Buddhist-inspired guidance and meditations for anyone seeking recovery from addiction. We hope to serve you, and meet you on the path.

Refuge recovery has a separate women’s recovery program!

Refuge Recovery has a women’s recovery section called Women’s Recovery and Refuge Online (WRRO) which offers support services for all women (including those that self-identify as women) to ease the suffering caused by addiction.

Women for Sobriety (WFS):Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

An abstinence-based program encouraging spiritual and emotional growth as a way to help women discover a happy new life as they recover from substance use disorders. This program aims to address the emotional needs of women and uses positive reinforcement and thinking, relaxation techniques, meditation, diet, and exercise.

 

WFS has in-person support meetings, a message board, chat room, phone support, and even a yearly conference to go to.

 

WFS believes that having a life-threatening problem with alcohol and/or drug use is not a moral weakness, it is the symptom of a serious disorder which demands rigorous attention to healing. Founded by a sociologist who related over-reliance on substances to the loss of identity many women feel with competing roles in society, WFS believes that guilt, depression, and low (or no) self-esteem are common problems women experience for which substances have become the primary coping mechanism.



Here are the 13 acceptance statements from the Women for Sobriety website:

 

1. I have a life-threatening problem that once had me. I now take charge of my life and my well-being. I accept the responsibility.
2. Negative thoughts destroy only myself.
My first conscious sober act is to reduce negativity in my life.
3. Happiness is a habit I am developing.
Happiness is created, not waited for.
4. Problems bother me only to the degree I permit.
I now better understand my problems. I do not permit problems to overwhelm me.
5. I am what I think.
I am a capable, competent, caring, compassionate woman.
6. Life can be ordinary or it can be great.
Greatness is mine by a conscious effort.
7. Love can change the course of my world.
Caring is all-important.
8. The fundamental object of life is emotional and spiritual growth.
Daily I put my life into a proper order, knowing which are the priorities.
9. The past is gone forever.
No longer am I victimized by the past. I am a new woman.
10. All love given returns.
I am learning to know that I am loved.
11. Enthusiasm is my daily exercise.
I treasure the moments of my New Life.
12. I am a competent woman, and I have much to give life.
This is what I am, and I shall know it always.
13. I am responsible for myself and for my actions.
I am in charge of my mind, my 
thoughts, and my life.

WFS suggests to spend 15 minutes each morning reading and thinking about the acceptance statements and recommends to choose one to “use it consciously all day”.  Close out the day by reviewing and reflecting on your chosen acceptance statement, how you applied it, and how it affected your day.

The Hip Sobriety ProjectRecovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

The Hip Sobriety Project is an 8-week coaching course that includes readings, worksheets, and weekly small-group conference calls. It is an individualized program designed to meet you where you are at in your addiction recovery process. This program is not free but there is a scholarship program for highly-motivated individuals from a disadvantaged background.

 

From the website:

 

Over the course of 8 weeks, you’ll be exposed to a wide-range of tools, teachings, and practices, pulled from all schools of thought and the most recent scientific findings in addiction recovery. The information is delivered in a thoughtful, easy-to-digest manner, and is accessible to you forever.

Through weekly lectures, accompanying workbooks and worksheets, daily emails, daily and weekly exercises, and a vast resource library, this course delivers participants the quintessential field guide on recovery that is not available anywhere else. You’ll walk away empowered with knowledge, and a personalized Hip Sobriety recovery map so that you can put what you learn to work for you and know what step to take, when.

Rational Recovery:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

Rational Recovery is an abstinence-based addiction recovery program founded by Jack Trimpey, a recovered alcoholic and social worker. It is based on the Addictive Voice Recognition Technique (AVRT), which teaches recognition of the “addictive voice” that tells you to seek drugs or alcohol.

 

Addiction is not seen as a disease and Rational Recovery rejects the idea of being “powerless” over addictive impulses. With AVRT, a person gains awareness of thoughts and triggers that can cause cravings (named “The Beast”) and through that can override addictive impulses in order to remain abstinent.



There are no meetings. Their website includes instruction on self-recovery from addiction using AVRT instructional videos, downloadable PDF’s, a book, and AVRT teleconferences.

 

The goal in AVRT-based recovery is to live comfortably with residual addictive desire, and not to silence or stave off your Addictive Voice. You should welcome the AV as a sign of health, and not as a threat, because your Beast is utterly powerless to act independently of your will.

Moderation Management:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

This program is not based on abstinence from alcohol but instead on learning how to moderate and control problem drinking behaviors. They use a 9-step program geared toward helping members find balance and moderation with alcohol and also with life.

 

The program provides education, guidelines, exercises, goal-setting, and self-management techniques through their in-person meetings or online support.



Their website explains what Moderation Management is:

 

Moderation Management (MM) is a behavioral change program and national support group network for people concerned about their drinking and who desire to make positive lifestyle changes. MM empowers individuals to accept personal responsibility for choosing and maintaining their own path, whether moderation or abstinence. MM promotes early self-recognition of risky drinking behavior, when moderate drinking is a more easily achievable goal. MM is run by lay members who came to the organization to resolve personal issues and stayed to help others.

Some people find it is more difficult to moderate drinking than it is to abstain completely. MM estimates that 30% of attendees will go on to an abstinence program.

LifeRing Secular Recovery:Recovery from addiction isn't one-size-fit-all and alternatives to AA exist. This post details 7 other options for a self-help addiction recovery program.

LifeRing provides a network (in-person and online) for people who want to be free of addiction. A requirement for membership is a desire to remain abstinent from alcohol and drugs.

 

Per the LifeRing website:

 

In LifeRing, we offer each other peer-to-peer support in ways that encourage personal growth and continued learning through personal empowerment. Our approach is based on developing, refining, and sharing our own personal strategies for continued abstinence and crafting a rewarding life in recovery. In short, we are sober, secular, and self-directed.

The principles of LifeRing are sobriety, secularity, and self-help. LifeRing “supports recovery methods that rely on human efforts rather than on divine intervention.” They believe the key to recovery is the individual’s own motivation and effort.

Books to help with addiction recovery:

There are many great books about addiction and recovery and here are a few. For a full list of my recommended mental health books look here.

More posts about addiction:

Alcohol Use Disorder: Do you have a drinking problem?

Alcohol Dependence and Withdrawal: Are You at Risk?

Naloxone: The antidote for opiate overdose

Will a Prescription Monitoring Program Help Combat Addiction?

 



Find the program that works for you. There are many options for recovery with different philosophies and approaches, in-person meetings, online support, books, etc… AA meetings are practically everywhere but aren’t for everyone. Don’t let that hold up your healing.

 

Please share this list of resources and help spread the word about alternative programs so we can reach the people that may need this.

 

What have you, or a loved one, found to be helpful for addiction recovery? What programs, books, or resources am I missing? Let me know so I can add them to the list.

 

What is Telepsychiatry? How a Virtual Doctor Visit Can Help You

Telepsychiatry visits are just like any other medical appointments- the only difference is they are conducted from the comfort of your own home or office using live video-conferencing. There are different names used for the same thing: virtual doctor visit, telehealth, telemedicine, telepsychiatry. They all mean the same thing: delivering health care services at a distance.



What is telepsychiatry?

Telepsychiatry visits are carried out using a HIPAA-compliant connection to keep your protected health information safe. The technology is similar to using Skype or Facetime, however, the telepsychiatry technology is encrypted. The technology has to meet certain medical standards to use.

 

What is HIPAA? Read here for a summary of the privacy laws. This link can also be used if you are having trouble falling asleep….

Want to prepare for your first visit with a psychiatrist?

Read my 16 questions to answer before your appointment so you are ready.

 

3 Benefits of a virtual doctor visit:What is telepsychiatry? It is a virtual doctor visit. The virtual visit is just like regular medical appointments. Learn 3 benefits of virtual doctor visits.

1. Telepsychiatry eliminates geographic barriers.

Many communities are underserved by psychiatrists and wait times can be prohibitive. Previously unavailable services can now be accessible throughout the country. Telepsychiatry allows us to easily connect with one another irrespective of location.

 

There is an important caveat though. Even though we have the capabilities to see anyone in the world using this technology, doctors can only treat people in the states they are licensed!

 

For example, I am licensed only in Connecticut. If you are in any other state I cannot treat you. There are provisions allowed for short-term treatments (ie if you are my patient and leave for vacation out-of-state I am able to continue my treatment of you during your vacation.)



The psychiatrist doesn’t have to reside in the state where they are licensed. A psychiatrist can be licensed in multiple states and treat people all over the country. It is a time consuming and expensive process to get and maintain different licenses hence why many doctors just stick to one.

2. A virtual visit saves time!

Telepsychiatry visits can be a welcome solution for challenges that make it hard to come to appointments. This includes time pressures at work, transportation issues, or childcare difficulties.

 

Reduce the need to travel to appointments and take time off work by scheduling a virtual appointment. No more sitting in traffic or wasting time in a waiting room. Reduce the stress that surrounds the logistics of scheduling and getting to an appointment.

3. Virtual doctor visits improve access to specialists.

There are not enough psychiatrists and certain areas have severe shortages. This especially rings true for subspecialists such as Geriatric, Child and Adolescent, and Addiction Psychiatrists.



There is a national opiate crisis yet there are many areas of the country where there are no licensed psychiatrists to treat patients needing help with opiate dependence. In order to prescribe buprenorphine (Suboxone), psychiatrists need extra training in order to get the special DEA license. Without that license, a doctor is unable to prescribe “medication-assisted treatment”. Telepsychiatry can expand access to licensed psychiatrists in areas of shortages.

Ask your doctor if they do virtual visitsWhat is telepsychiatry? It is a virtual doctor visit. The virtual visit is just like regular medical appointments. Learn 3 benefits of virtual doctor visits.

Not all doctors see patients via telemedicine but many are starting to. I use telepsychiatry in my practice and I love it. Sometimes my patients come to see me in the office and sometimes we schedule a follow-up virtual visit. If a patient is running late (or missing the appointment) we can quickly change to telepsychiatry. This allows care to continue without the need for rescheduling.



Have you had a virtual doctor visit? What was it like for you? I find that even patients that are hesitant, realize that it is actually quite comfortable and will request telepsychiatry follow-up once they try it.

How well do you know your medical history?

Do you know what the plan is to manage your medical diagnosis? What is your medication is for? What can you do to take charge of your health?

 

You need to be your #1 advocate and that requires you to have a good knowledge of your medical history. Download a form with the questions you need to know by entering your email here:

 

 

What is Self-Respect?

WHAT IS SELF-RESPECT? In my profession, I see lots of people who feel broken. Some have been struggling for years with depression, anxiety, bipolar, etc…. but others are broken because they are afraid to be themselves. I wish I had a magic wand or even a magic pill, anything to make it easier for people to push back the blinds, stop hiding, and live true to themselves. I see self-respect as just that. Not hiding. Imagine the freedom that can come with self-respect. Let me define self-respect better for you.



Aretha Franklin: R-E-S-P-E-C-T

Although this post is written for all of you out there to encourage you to stop and reassess; it is dedicated to Aretha Franklin who just recently died. Her song, Respect, became a battle cry for African Americans and the woman’s rights movement, for everyone who felt marginalized and wanted to be respected. This song reminded people that respect was OK to ask for and helped several generations feel brave.

What is self-respect?What is self-respect? It's the ability to live true to yourself. Let me define self respect and why it is an essential ingredient for mental health.

Let me define self-respect by using some similar words that come to mind: acceptance, love, openness, confidence, resiliency, truth, wellness, values, dignity, bravery, choice.

 

The dictionary defines self-respect as:

1 : a proper respect for oneself as a human being. 2 : regard for one’s own standing or position.

What words would you add?

 

Self-respect is not entitlement, self-serving, selfishness, or narcissism.

How do you define self-respect?

Is it the same as self-confidence? Self-esteem? I don’t think so. I think the terms are related like siblings but they aren’t identical twins.

 

Respect means valuing your own needs. Valuing yourself. Valuing your inner being and everything that you encompass. This doesn’t mean that you value yourself to the exclusion of others, but at least equal to others.



Self-respect doesn’t even mean loving everything about yourself. We all have things we wish we could change and ways we wish we were different. Self-respect means that we continue to try to do better, love ourselves despite the things we wish were different, and live true to ourselves.

How to live trueWhat is self-respect? It's the ability to live true to yourself. Let me define self respect and why it is an essential ingredient for mental health.

Self-respect requires being in touch with one’s feelings constantly where I don’t always think self-confidence requires the same. In order for self-respect to remain intact, one needs to recognize how a situation makes you feel and respond accordingly. I think there is a certain level of self-confidence running in the background of people using self-respect, but I also think that self- respect requires acting even when not self-confident.

Self-respect needs to be considered the bottom line that doesn’t get crossed over.

How can a person reflect on how they feel in a situation?



Ask yourself:

 

  • Are you uncomfortable?
  • Does the situation make you feel negative or sad inside?
  • Do you feel pressured to be a certain way to live up to the expectations of others?
  • As you “go with the flow” do you feel worse inside?
  • Are you hiding because you are afraid of the reactions of others?
  • What would you tell a friend if they were in a similar situation?

 

The more you are able to reflect on these questions the better you will get at deciding how to respond so you can live true.

 

What are the consequences of ignoring your own needs?What is self-respect? It's the ability to live true to yourself. Let me define self respect and why it is an essential ingredient for mental health.

 

The answer to this lies in each individual’s situation. Sometimes people hide minor things about themselves… and some hide major things.

Semi-lame example of hiding minor things:

I may eat Cilantro if someone makes homemade salsa and brings it over. I am grateful they have taken the time to make that salsa but I HATE CILANTRO! However, I knowingly make the choice to eat it and take pleasure in appreciating the other person’s efforts. The only consequence is my taste buds that suffer eating that green leafy disgusting soap…. but I don’t suffer internally, because I know I have made a choice that won’t have lasting consequences.

Hiding major things?

There are a million ways people can (and do) hide who they are. One obvious example is the challenges people face coming out as homosexual. What if a person decides to pretend they are heterosexual so they don’t have to face telling their friends and family? What do you think the internal consequences of that will be? We have seen it over and over so I think we have a good idea of the answer.

 

Let me take a minute to say I am NOT judging people who make choices to hide. Sometimes the choices are about emotional survival. A person may need to first work on extricating themselves from a situation or finding coping strategies to better take care of themselves before they can live in a way that is consistent with who they are.



But I AM recognizing the pain that comes with hiding. I see it every day in my practice. Can a person feel totally satisfied living a life that isn’t their own? When people are hiding their true selves they are often depressed. Some are even suicidal. The path to fulfillment is paved with self-respect.

 

Feeling depressed? Read this post on 11 Effective Interventions for Depression.

Live trueWhat is self-respect? It's the ability to live true to yourself. Let me define self respect and why it is an essential ingredient for mental health.

I wish we could come up with a vaccine for self-respect. Something we could inoculate our kids with, allowing everyone to have a universal base to work from in life. Yes, I recognize this is wishful magical thinking but love and self-respect are the elixirs that make life tolerable… and even fun… and breed contentment and peaceful feelings. I know this inoculation takes the form of parenting in real life but all parents aren’t able to give this to their kids. And the kids that don’t get it can really struggle.

 

Does self-respect translate to less angst in this world? It certainly doesn’t mean hearts wouldn’t still get broken. But maybe they wouldn’t be crushed. If a person can walk away knowing that they have their own back then it makes it a lot easier to heal.



Please ask yourself these questions to assess your self-respect:

  • Who are you inside?
  • What do you stand for?
  • What matters to you?
  • Do you live in a way consistent with what matters to you and what you stand for?
  • Are you living true to yourself?
  • Would you be different?
  • Are you fearful of other’s reactions to who you truly are?
  • Does that keep you from being who you are?

 

Thanks Aretha!

 

Why You Need to Ask Your Doctor Questions!

Let me clear up a couple of myths regarding asking your doctor questions. Some people are too afraid and feel intimidated to ask a doctor a question. The truth is that we want you to ask questions! At least I do…But seriously, I think most doctors do too. Let’s talk about why you need to ask your doctor questions. The next blog will give you 4 tips to be more effective at getting your questions answered during the doctors appointment. You need to ask doctors questions so you can understand and take charge of your health!

 

Make sure to complete my important health challenge at the end of this post. Test your knowledge about your health and make sure you are informed!

You will also be able to download a health history form that has the key questions you need to know about medical diagnoses and medications.



Why ask doctors questions?

We are a team!

We are a team working together and you are a valuable and essential member of that team. You must understand your health to actively participate in the team! I need you to make informed decisions that are right FOR YOU!

 

If you ask your doctor questions, you have more of a chance to understand everything you can about your health and wellness. The more you comprehend, the more likely you are to follow through with treatment.

 

If you understand fully why I am giving you a particular medication and what I am trying to treat, there is a better chance you will take that medication and hopefully get better.

Ask a doctor a question: You want me to do WHAT?Why you need to ask your doctor questions during your doctors appointment. Ask a doctor a question so you can understand your health. Ask doctors questions so you can advocate for yourself.

If you don’t understand why I am making certain recommendations, and you don’t ask for clarification, how likely are you to follow all the directions?



Let me give you an example:

If I go to physical therapy and they tell me to do XYZ exercises 3 times each day but they don’t explain to me WHY I need to do these exercises and HOW they will help me (or they explain it but I don’t understand them) than I am not likely to be as dedicated to doing my rehab.

 

The truth is: I don’t want to do these exercises. They are boring and I don’t have the time. If I can’t visualize how they will help me then I might slack off after a few days (let’s be honest… it’s not might… I will definitely slack off).

“The doctor said to take them, so I take them.”

Sometimes people take medications because of blind trust in their doctor. They don’t understand why the medications are being given to them but they take them.

Why you need to ask your doctor questions during your doctors appointment. Ask a doctor a question so you can understand your health. Ask doctors questions so you can advocate for yourself.

But often, people don’t want to:

  • Take medication!
  • Or do mantras (see my post on mantras to treat depression to learn how they can help).
  • Or exercise when they are depressed (see this post for tips on how to get this done and WHY it’s important. Exercise works!!).
  • Or any number of the self-care things I recommend…

And if they don’t understand why they are doing it then how often will it get done?



Be informed. Ask your doctor questions!

How can you help yourself if you don’t know what’s going on?

In the ER, or at an initial appointment, I ask about medications. MANY people have no idea why their medications are being prescribed and how the medication is supposed to help.

 

How can you take charge of your health if you don’t ask your doctor questions and make sure you understand? Usually, there are things we can modify in our environment (diet, exercise, sleep, self-care, etc..) that will assist in our recovery. It’s important to make yourself informed so you can take charge of your self-care!

Who is your #1 advocate?

YOU need to be the #1 advocate for your own health and you need all the information to make informed decisions!

Is it disrespectful to ask your doctor questions?Why you need to ask your doctor questions during your doctors appointment. Ask a doctor a question so you can understand your health. Ask doctors questions so you can advocate for yourself.

Sometimes people feel intimidated to ask their doctor questions. They worry asking questions may seem disrespectful or that you are questioning the doctor’s judgment. No, you just want to understand what is going on!

 

I love when patients ask questions because that means that they want to be involved in their treatment! They care and desire to feel better. I want to partner with you in your care- not be a dictator telling you what you have to do.



I want you to:

  • understand as much as possible about your health,
  • why something may be happening,
  • what it means,
  • and what our plan is to make it better.

 

My appointment is too rushed to ask my doctor questions!Why you need to ask your doctor questions during your doctors appointment. Ask a doctor a question so you can understand your health. Ask doctors questions so you can advocate for yourself.

It can be intimidating when you want to ask questions but you know your doctor is rushed. Even though I am a physician myself, I feel pressure to be quick and not hold up the doctor with my questions. I know how stressful it is to run late and I don’t want to contribute to messing up their schedule.

Side point: 2 Reasons for the rush

  1. Doctors are often pressured to see too many patients in a day (this is another topic in itself. There are SO many reasons why doctor’s schedules get squeezed and overscheduled. It isn’t pleasant for the doctor or the patients!)
  2. Insurance companies will only pay for short visits. The time allotted is often inadequate to address a patient’s needs (Ok, this is another topic too. You may not want to get me started on this one!).

 

In the next post, I will discuss 4 tips on how to get your questions answered in the doctors appointment. These tips will help you deal better with an appointment that is rushed and increase the chance for you to get the information about your health that you need.

CHALLENGE TIME!Why you need to ask your doctor questions during your doctors appointment. Ask a doctor a question so you can understand your health. Ask doctors questions so you can advocate for yourself.

Here is my challenge to you:

  1. If you are on medication, go through each medicine and write down what it is for. What is it helping you with?
  2. If you have a medical diagnosis: Write down what it is, how it affects you, and what the plan is to treat it (or manage it).

 

After you complete this exercise you should have a good sense of how well you understand your health. If you identify areas that you are unclear about bring these questions to your next doctors appointment!

 

Let me know how well you did on the challenge! Did any of your answers (or lack of answers) surprise you? Did you identify questions you need to ask your doctor?

Part of being healthy is understanding your personal medical history.

Enter your email here to download a form that will keep track of all the important details you need to know (and questions you need to ask) regarding your medical history and medications.

 

Read 4 tips to help you get your medical questions answered before your next appointment to be better prepared!

Do you have a mental health question you have always wanted to ask?

Let me know your burning questions! What mental health topics do you want more information about? I cannot give direct medical advice to anyone who isn’t my patient but I am happy to answer general mental health questions! The more information you have, the more you can be in charge of your mental well-being.

 

If you are looking for self-help resources here are my BOOK RECOMMENDATIONS for mental health topics.