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What Triggers Dissociation?

What Triggers Dissociation?

Johns Hopkins Medicine explains triggers as “external events or circumstances that may produce very uncomfortable emotional or psychiatric symptoms, such as anxiety, panic, discouragement, despair, or negative self-talk.” Triggers can vary from person to person and can cause different physiological responses, including dissociation. Dissociation is a psychological phenomenon that, according to the Australian Institute of Professional Counsellors, “describes a state in which the integrated functioning of a person’s identity, including consciousness, memory, and awareness of surroundings, is disrupted or eliminated.” Dissociation is specifically influenced by the disruption of four key areas (identity, memory, consciousness, and awareness of oneself and surroundings) of personal functioning that typically operate automatically and seamlessly. Medical News Today asserts that “the exact cause of dissociation is unclear, but it often affects people who have experienced a life-threatening or traumatic event, such as extreme violence, war, a kidnapping, or childhood abuse.” Dissociation is an overload response that serves as an ineffective coping mechanism. 

Common Triggers

Some types of triggers that are common with dissociation could include, but are not limited to the following examples, provided by Good Therapy and other sources:

  • Recreational drug abuse: certain substances (e.g., ketamine, hallucinogens, marijuana, benzodiazepines, alcohol, etc.) work by interacting with the chemicals in one’s brain which can trigger dissociation.
  • Another mental health condition can trigger dissociation, including the following:
    • Depression: is “a mood disorder that causes a persistent feeling of sadness and loss of interest.”
    • Epilepsy: is “a central nervous system disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness.”
    • Schizophrenia: is defined as “a serious mental illness that affects how a person thinks, feels, and behaves.”
    • Phobic disorder: is defined as “an anxiety disorder characterized by an extreme and irrational fear of simple things or social situations.”
    • Obsessive-compulsive disorder (OCD): is “a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions).”
    • Post-traumatic stress disorder (PTSD): is “a mental health condition that’s triggered by a terrifying event – either experiencing it or witnessing it.”
    • Borderline personality disorder (BPD): is “an illness marked by an ongoing pattern of varying moods, self-image, and behavior.”
  • Trauma can trigger dissociation

The general symptoms of dissociation, according to a study published in Access Advances in Psychiatric Treatment, include changes in bodily senses and a reduced ability to react emotionally. The American Psychiatric Association (APA) provides examples of more severe symptoms of dissociation including perceptual alterations, emotional or physical numbing, distorted sense of time and space, unreal, unstable, or absent self, etc. An episode of dissociation can also cause an individual to feel as though their heart is pounding and/ or experience symptoms of light-headedness. The symptoms of dissociation can range from mild to severe, and last varied durations.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

What Is A Certified Addiction Specialist?

What Is A Certified Addiction Specialist?

A certified addiction specialist is a mental health professional that provides supportive services to individuals recovering from substance use disorder. Most mental health providers are required to hold degrees in higher education, are required to pass certain certification tests, and many receive relevant mental health accreditations. Certifications are earned through programs or services that may be based within or associated with a healthcare organization. An individual must earn a passing score on the National Clinical Mental Health Counseling Examination (NCMHCE) to become certified in mental health. Accreditations can be earned by an entire health care organization (e.g., hospitals, nursing homes, etc.). Both certification and accreditation require an evaluation by The Joint Commission. Although certified addiction specialists are commonly referred to as addiction counselors, they do not necessarily need to complete the same mental health counseling requirements. The certified addiction specialist (CAS) credential, according to the American Academy of Health Care Providers in the Addictive Disorders is a “clinical certification based upon experience providing treatment under the direction of a qualified clinical supervisor, specialized training, and a written examination.” The National Certification Commission for Addiction Professionals (NAADAC) offers three different types of addiction counselor certifications:

Addiction counseling certifications must be renewed through the NAADAC every two years. There are also continuing education requirements (40 hours of continuing education every two years) that addiction counselors must complete as a component of the renewal process, as well as submitting one’s two-year work history. 

Addiction Medicine Specialists

Addiction medicine was formally recognized in 1990, and defined as “the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction, of those with substance-related health conditions, and of people who show unhealthy use of substances, including nicotine, alcohol, prescription medications, and other licit and illicit drugs.” Addiction specialists are addiction medicine physicians and addiction psychiatrists who hold either subspecialty board certification in: 

With the additional training and education, addiction medicine specialists focus on addictive diseases and the treatment of such diseases. They are qualified to recognize and treat the psychiatric and physical complications of addiction. Physicians in this subspecialty can also treat family members who have been adversely affected by a loved one’s substance use or addiction. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

What Does Dissociation Feel Like?

What Does Dissociation Feel Like?

Dissociation is a psychological phenomenon that, according to the Australian Institute of Professional Counsellors, “describes a state in which the integrated functioning of a person’s identity, including consciousness, memory, and awareness of surroundings, is disrupted or eliminated.” While not all people that experience dissociation will have a diagnosable disorder, there are three distinct types of dissociative disorders, listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which are dissociative amnesia, dissociative identity disorder (DID), and depersonalization-derealization disorder. Experts attribute the cause of dissociation symptoms to develop due to a break in the cohesive functioning of one’s inner world. Dissociation is specifically influenced by the disruption of four key areas (identity, memory, consciousness, and awareness of oneself and surroundings) of personal functioning that typically operate automatically and seamlessly. 

Symptoms

It is impossible to explain exactly what dissociation feels like, as everyone is different and each experiencing an episode of dissociation will be unique to each person. For those diagnosed with a dissociative disorder, the symptoms that develop will directly correlate with that disorder. A study published in Access Advances in Psychiatric Treatment asserts that general symptoms of dissociation can include changes in bodily senses and a reduced ability to react emotionally. The symptoms of dissociation are often broken into five overarching categories, which include:

  1. Depersonalization: feeling detached from one’s thoughts, feelings, and body
    • Becoming fully engrossed in something (e.g., a movie, a book, etc.) to the point of becoming unaware of what is going on in one’s surroundings
    • Having an out-of-body experience (e.g., an individual feeling as though he or she is floating away or watching themselves from a distance)
  2. Derealization: feeling disconnected from one’s environment
    • Daydreaming
    • Zoning out (e.g., scrolling through social media and suddenly noticing hours have passed)
  3. Dissociative amnesia: experiencing retrospective memory gaps 
    • Unable to remember important information about one’s life, history, and/ or identity
  4. Identity confusion: feeling unsure of one’s sense of self or place in the world
    • Obsessive behaviors (e.g., an individual repeatedly looking in the mirror to check and make sure that they are real)
  5. Identity alteration: the sense of being markedly different from another part of oneself

The symptoms of dissociation can range from mild to severe, and last varied durations. The American Psychiatric Association (APA) provides examples of more severe symptoms of dissociation including perceptual alterations, emotional or physical numbing, distorted sense of time and space, unreal, unstable, or absent self, etc. An episode of dissociation can also cause an individual to feel as though their heart is pounding and/ or experience symptoms of light-headedness. Anxiety can be a cause or a result of dissociation.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

 

What Does An Addiction Medicine Specialist Do?

What does an addiction medicine specialist do?

Addiction medicine was formally recognized in 1990, and defined as “the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction, of those with substance-related health conditions, and of people who show unhealthy use of substances, including nicotine, alcohol, prescription medications, and other licit and illicit drugs.” It was not until 2016 that the American Board of Medical Specialties (ABMS) recognized addiction medicine as a medical subspecialty under the American Board of Preventive Medicine (ABPM). Addiction specialists are addiction medicine physicians and addiction psychiatrists who hold either subspecialty board certification in addiction medicine from the American Board of Preventive Medicine, subspecialty board certification in addiction psychiatry from the American Board of Psychiatry and Neurology (ABPN), board certification in addiction medicine from the American Board of Addiction Medicine (ABAM), or a Certificate of Added Qualification in Addiction Medicine conferred by the American Osteopathic Association (AOA).

What Do They Do?

With the additional training and education, addiction medicine specialists focus on addictive diseases and the treatment of such diseases. The National Institute on Drug Abuse explains that addiction medicine specialists “provide prevention, evaluation, diagnosis, and treatment services for patients with unhealthy substance use or substance-related health conditions.” The various types of addictions that can be treated with addiction medicine include, but are not limited to the following examples provided by the New York Society of Addiction Medicine:

  • Tobacco Use Disorder: an addiction medicine specialist will conduct a thorough evaluation, provide an accurate diagnosis, assess the severity, and offer treatment options. Typical treatment plans for tobacco use disorder may include a combination of:
  • Alcohol Use Disorder: an addiction medicine specialist will conduct a thorough evaluation, provide an accurate diagnosis, assess the severity, and offer treatment options. If the individual requires detox (acute medical stabilization and withdrawal services) the addiction medicine specialist can help to arrange those services. The subsequent treatment plan for those struggling with alcohol use disorder may include:
  • Opioid Use Disorder: an addiction medicine specialist will conduct a thorough evaluation, provide an accurate diagnosis, assess the severity, and offer treatment options. It is not uncommon for those struggling with opioid use disorder to require detox, which the addiction medicine specialist can help to arrange. After the successful completion of the detox process, the treatment plan may include a combination of:

Physicians in the subspecialty can also treat family members who have been adversely affected by a loved one’s substance use or addiction. They serve as clinical experts, teachers, faculty, and researchers. Addiction medicine specialists are qualified to recognize and treat the psychiatric and physical complications of addiction. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

What Is Radical Acceptance?

What Is Radical Acceptance?

Radical acceptance is tool used in dialectical behavior therapy (DBT), that is designed to keep pain from turning into suffering. Psychologist Marsha M. Linehan developed dialectical behavior therapy in the late 1980s as a means to help better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is an evidence-based psychotherapy that is founded on principles of cognitive behavioral therapy (CBT), but places greater emphasis on the psychosocial aspect of treatment. It combines standard CBT techniques for emotional regulation and reality testing with concepts derived from Buddhist meditative practice such as awareness, mindfulness, and attentiveness to current situations and emotional experiences to encourage acceptance. DBT specifically focuses on providing therapeutic skills in the following four key areas, as provided by the Linehan Institute:

  1. Core Mindfulness: skills focused on improving an individual’s ability to accept and be present in any given moment.
  2. Distress tolerance: skills focused on increasing an individual’s tolerance of negative emotions instead of attempting to avoid or escape them.
  3. Interpersonal effectiveness: skills focused on increasing an individual’s communication strategies.
  4. Emotion regulation: skills focused on helping an individual identify, name, and understand the function of emotions, and increasing one’s ability to regulate emotions. 

Radical acceptance, specifically, is a skill that is addressed in the distress tolerance module. According to VeryWell Mind, “Radical acceptance can be defined as the ability to accept situations that are outside of your own control without judging them, which in turn reduces the suffering that is caused by them.” Much like every component of DBT, radical acceptance is a skill that requires practice, as it involves letting go of the need to control a situation.

How to Practice Radical Acceptance

Marsha M. Linehan provides the following ten steps for practicing Radical Acceptance using DBT:

  • Watch for thoughts that you are fighting against reality. 
  • Remind yourself that reality cannot be changed. 
  • Acknowledge that something led to this moment and think about the cause of events that you are unable to accept. 
  • When you are in a situation that causes extreme emotions, try focusing on breathing deeply and examining the thoughts you are having (and let them pass).
  • List what your behavior would look like if you did accept the facts then act accordingly.
  • Create a plan of action for events that seem unacceptable, think about what you will do, and how to appropriately cope.
  • Practice a feeling of total and complete acceptance through positive self-talk and relaxation strategies.
  • Remain mindful of physical sensations throughout your body such as tension or stress.
  • Embrace feelings such as disappointment, sadness, or grief.
  • Accept that life is worth living even when experiencing pain. 

Radical acceptance is achieved when one lets go of the urges to fight reality, does not succumb to the need to respond with impulsive or destructive behaviors, and releases the bitterness that may be trapping an individual in a cycle of suffering. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

Is Addiction A Disease?

Is Addiction A Disease?

Yes, addiction, also referred to as substance use disorder, is a mental health disorder listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is characterized by compulsively engaging in rewarding stimuli (often, dangerous, risky, and/ or unhealthy) regardless of the ensuing negative consequences. Engaging in habitual substance abuse is a slippery slope that can quickly lead to addiction. The type of substance abused, the duration of one’s substance abuse, the potency of the drug abused, one’s personal health history, as well as one’s family health history will all contribute to the length of time it may take for an individual to develop an addiction. An individual that struggles with addiction will put his or her need for satisfying a drug craving above all else in his or her life. Therefore, addiction has the propensity to affect every aspect of an individual’s life. It is important to note that addiction does not develop overnight, nor should an individual expect his or her recovery from addiction to occur instantaneously. The treatment process for recovering from an addiction will require steadfast dedication and will be a lifelong commitment.

Habitual use of any substance can lead to increased tolerance, meaning an individual will require more of the substance (e.g., higher dosage, frequency of use, etc.) to achieve the same feeling. When an individual constantly abuses drugs and/ or alcohol, his or her body must make accommodations to properly function with the substance present. When a substance that one’s body has become accustomed to functioning with is absent or has less of the substance in his or her system, it will react accordingly. Adverse withdrawal symptoms will ensue, and the individual will be unable to function optimally. When an individual is unable to stop using a substance without experiencing withdrawal symptoms, he or she has reached some level of dependence. An individual that struggles with drug and/ or alcohol dependence and continues to abuse drugs and/ or alcohol increases his or her susceptibility to developing a full-blown addiction

Risk Factors

The precise reason behind why an individual develops an addiction remains unknown. There are, however, several risk factors that have been reported to increase one’s propensity for developing an addiction. According to the National Institute on Drug Abuse (NIH) these include environmental risk factors, genetics, drug of choice, method of use, and the age an individual started abusing drugs and/ or alcohol. Every individual is different and will have or lack various predispositions that can contribute to developing an addiction. Nevertheless, it is important to note that anyone can develop an addiction, regardless of social status, beliefs, or background. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

Borderline Personality Disorder’s Effects on Relationships

Borderline Personality Disorder

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic mental health disorder. It characterized by a pervasive pattern of instability in interpersonal relationships, self-image issues, and difficulty managing emotions and behaviors, which interfere with one’s ability to function in everyday life. The symptoms of BPD will often result in reckless and hasty actions, negatively affecting one’s relationships. The cause for borderline personality disorder remains unknown. However, the National Institute of Mental Health (NIH) alludes to research that “suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder.” Though these factors can contribute to one’s susceptibility for developing BPD, exposure to one or more risk factors does not indicate an individual will inevitably to go on to develop borderline personality disorder. Most commonly, BPD develops in early adulthood, often with more severe symptoms occurring in the early stages of onset. 

Effects on Relationships

Borderline personality disorder directly affects how one feels about him or herself, one’s behavior as well as how an individual can relate to others. According to the DSM-5 key signs and symptoms of BPD that will have a direct effect on one’s relationships may include:  

  • Unstable personal relationships that alternate between idealization and devaluation, sometimes referred to as splitting
  • Frantic efforts to avoid real or imagined abandonment by family and friends
  • Impulsive behaviors resulting in dangerous outcomes (e.g., engaging in unsafe sex, reckless driving, abuse of drugs, etc.)
  • Distorted and unstable self-image, affecting one’s moods, relationships, goals, values, and/ or opinions
  • Self-harming behavior (e.g., suicidal threats)
  • Chronic feelings of emptiness and/ or boredom
  • Periods of intense depressed mood, irritability and/ or anxiety lasting anywhere from a few hours to a few days long
  • Dissociative feelings
  • Intense, inappropriate, and/ or uncontrollable anger, typically followed by feelings of guilt and/ or shame

People with borderline personality disorder have a more difficult time returning to an emotional baseline, which can make sustaining relationships challenging. The quick changing nature of BPD symptoms (e.g., emotional peaks and valleys) can lead to conflict-filled, chaotic relationships. Hence, people with BPD typically have rocky relationships with others, both platonic and romantic.

Treatment

Although BPD is a chronic condition, there are a variety of treatment options available for a person diagnosed with borderline personality disorder. Treatment for BPD will help an individual learn strategies, techniques, and tools to effectively manage the symptoms associated with borderline personality disorder, reducing the severity of symptoms experienced and increase one’s quality of life. Every individual is different and will require a somewhat tailored treatment plan when it comes to BPD. Often treatment plans include a combination of medication and psychotherapy (e.g., dialectical behavior therapy, cognitive behavioral therapy, etc.). Some individuals that experience severe symptoms will require inpatient, intensive care, while others may never need emergency care or hospitalization. With proper treatment an individual can have healthy relationships despite BPD. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment. 

Treatment Options for Alcoholism

male alcoholic

Alcoholism, also referred to as alcohol use disorder, is a chronic disease that will affect all areas of one’s life. According to the Mayo Clinic, “it is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptom when you rapidly decrease or stop drinking.” An individual that is addicted to alcohol will prioritize satisfying his or her alcohol cravings above all else. This can invariably lead to physical complications, relationship fractures, financial strain, legal problems, and more. There are a variety of treatment options available for individuals struggling with alcohol use disorder.

Detox

Prior to attending a formal substance abuse and/ or addiction treatment program, an individual that has struggled with alcohol abuse must undergo detox. Detox is the process that rids one’s body of all abused substances. When an individual has habitually abused alcohol, his or her system will become accustomed to functioning with it present. When alcohol is removed from one’s system it will react accordingly and withdrawal symptoms will ensue. Though the withdrawal symptoms that accompany detoxing from alcohol are not inherently life threatening, many can cause severe discomfort, and support throughout the duration of the detox program via a medically supervised detox is recommended. Subsequent to the detox process, an individual that has struggled with alcohol abuse should seek formalized substance abuse and/ or addiction treatment. 

Treatment Options

Every person is different and will require a somewhat customized treatment plan when it comes to recovering from alcoholism. There are two main types of substance abuse and/ or addiction treatment programs, which are inpatient treatment programs and outpatient treatment programs. Inpatient treatment options require an individual to reside at the treatment facility for the duration of the program, whereas outpatient treatment options do not. Though the structure of the programs differs, both have the same primary goal: to help an individual become sober and healthy. Treatment programs can vary in length, typically ranging between twenty-one days long to three months long, in some cases longer. Each inpatient and outpatient substance abuse and/ or addiction treatment program is different. Substance abuse and/ or addiction treatment programs are often comprised of a variety of treatment methods (e.g. individual psychotherapy, group therapy, creative arts therapies, etc.). Both options, inpatient treatment and outpatient treatment, can yield successful results, depending on the needs of the individuals. 

Aftercare

Developing an aftercare plan is an integral component of any type of formalized substance and/ or addiction treatment. An aftercare plan provides general suggestions and personal recommendations for an individual to refer to after he or she has completed the substance abuse and/ or addiction treatment program. An aftercare plan can be an excellent resource as it often includes relapse prevention strategies as well as provides tailored guidance for an individual to maintain continued sobriety.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

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