Addiction during the holidays: Recovered or not, it’s important to be prepared

by Adi Jaffe


The holidays are a stressful time for everyone. Between gift-giving, travel, and keeping up with all parts of the ever-complicated modern family unit, nearly anyone can find themselves driven towards the nearest coping mechanism, whatever that may be. However, for recovering addicts, or those still struggling with an active addiction, the holidays can be a particularly troubling season that can invite a destructive relapse. As with all mental and physical health issues, education and awareness are a powerful first line of defense. By going over some of the most frequently asked questions about addiction and the holidays, we can attempt to shed some light on these issues for addicts and their families to help combat them before, not after, they become bigger problems (like a relapse).

Why Are The Holidays So Difficult For Addicts?

Obviously, as just mentioned, the pressures of the holidays are difficult for everyone. But for addicts, these same issues of money, family and general stress are amplified, often because they are the same age-old issues that lie at the root of the addiction and the beginning of drug use and abuse in the first place. If the recovering addict has not had the opportunity to openly confront family issues in the past, either with the family itself or with a therapist or counselor, the potential for relapse can be great. A vast amount of research shows how stress can bring even long-dormant behavior back to the surface, which should serve as a warning to substance and behavioral addicts alike (like sex addicts or compulsive gamblers). On the other end of the spectrum, addicts without a stable family or group of friends are often left feeling alone and isolated during the holidays, another powerful source of the shame and boredom that can drive addictive behavior.

What Are Some Of  The Hidden Struggles That Can Intensify Addiction/Trigger A Relapse?

Most often, these struggles emerge from one of two likely scenarios. In the event of a still active addiction, attempts to hide the problem from friends and family and the resulting stress can, paradoxically, intensify the addictive behavior. And whether the addiction has been treated or not, gathering with family in a familiar place can frequently cause someone to face many of the underlying issues that can be the root causes of a drug addiction or compulsive behavior. To paraphrase Tolstoy, all unhappy families are unhappy in their own unique way, and whether one’s particular family is overly judgmental, enabling, angry, or whatever else, it can serve to restart self-destructive patterns of behavior. For some recovering addicts, there may be a family-imposed secrecy around the recovery itself, which can be trying at a time when the whole family is gathering, ostensibly to celebrate one another. Even the house (including the room where an addict used to act out) and certain family members (like that cousin they used to smoke weed with) can be important cues that may re-trigger cravings and old behavioral patterns. Additionally and importantly, if there is a family history of any kind of past abuse, this can obviously serve as a particularly powerful and insidious trigger for addicts, whether recovering or not. In fact, recent research suggests that these old, root stimuli may be much more powerful for drug addicts than re-experiencing the drug itself.

What Are Some Strategies For Surviving The Holidays?

First and foremost, one must be prepared. Since most people at least know and are aware of the potential issues that might arise within their own families, it is crucial not to try to “wing it.” If you know that your family is going to be asking lots of uncomfortable questions, practice some appropriate answers and don’t feel obligated to discuss any aspect of your recovery that you’re not comfortable discussing. If your family is overly focused on achievement or likes to bring up stories from the past that are triggering or shameful, rehearse your reactions to them. If you have a friend or significant someone who can help, do a little role-play trying out different answers and see how they feel as you actually say them out loud. It will never be exactly the same as you practice, but being prepared can go a long way towards taming the body and brain’s natural stress responses. Just as importantly, if you know you’re liable to encounter events or people that formerly facilitated addictive behavior, role play those likely scenarios and know how you plan on turning down or avoiding those substances or behaviors. For instance, figure out how exactly you’re going to tell your cousin you aren’t going to smoke in the basement with him before you have to actually do it. It will sound a lot less forced and strange the second time around and you will have already experienced some of the associated anxiety. If you’re going to be alone, make distinct plans for your activities and do the best you can to find healthy situations to participate in, even if they seem new or slightly uncomfortable at first. For instance, go ahead and join that group of strangers for a Christmas eve dinner or Christmas day movie instead of spending those times along. After all, uncomfortable or not, a new, healthy experience will be vastly preferable to sliding back into the same old destructive patterns of the past.

Should I Use New Years To Confront My Addiction?

Most everyone is familiar with the New Year’s Resolution as a method of planning major life changes. Of course, most everyone is also familiar with the limited success rate of these resolutions, and of the effectiveness of “going cold turkey” in general. Depending on the addiction, there are certainly things that individuals can do to help themselves- for example, research suggests that when trying to quit smoking setting a quit date and beginning to use replacement patches or supplements in anticipation of that date (in other words, while still smoking) can help reduce the amount of smoking while approaching that quit date, making it easier when the day finally arrives. If you’re planning to quit a “harder” drug than nicotine, you may want to set a whole schedule for reducing drug use prior to the quit date itself. The important thing is to be completely realistic in order for the change to stick. If you’re drinking a bottle of vodka a day, attempting to go completely dry within a week can be extremely dangerous to your health, and will not likely result in a permanent change. Once again, education and preparation are key. Prepare for any sort of quitting by looking online on sites like AllAboutAddiction and WebMD, and identify the medical and psychological issues that are likely to accompany your attempt. Look to see if your problem is one that you can handle alone, or if it is recommended that a doctor help you with the process. Remember that your goal should be lifetime change, not a temporary one. Though it might seem counter-intuitive, if your holidays promise to be especially difficult or stressful, you may want to hold off on trying to quit during them and look at them as a time to lay the groundwork for your post New Year quit attempt rather than going for a full on cold turkey try. Such pragmatism may well help you achieve your true goal.

Four ways to avoid getting sick during the holiday season

By Madison Park, CNN


(CNN) — The Badger family holidays are filled with medical catastrophes.

One year, Melissa Badger’s niece stopped breathing at the Thanksgiving table because of a strep infection. In 2003, Badger’s son came down with a severe fever and ended up in the emergency room on Christmas. On Christmas Eve 2005, Badger tripped on ice while delivering presents to needy families and sprained her ankle.

This year, Badger’s husband complains of cold-like symptoms — fatigue, coughing and a sore throat. Badger struggled with a bug going around her office that was giving everyone stuffy noses and cold symptoms.

“Now, we get to worry about that lingering cold all of us have, since we’re hosting family this Christmas Eve,” said Badger. Hosting family means more than 30 people at their Beloit, Wisconsin, home.

Illness for many of us seems to knock at the most inopportune moments — after finishing a year-end project, before a holiday or after taking exams.

It had Shannon Duffy, who spent this Thanksgiving in bed with the flu, asking: “Is too much excitement and anticipation of the holiday season a bad thing? Or is it that my immune system just gets so overloaded with life stresses that when I step back and take a break, it is like an open invitation for the flu bug to intervene?”

With Mom sick in bed, Duffy’s sons had to microwave their TV dinners for Thanksgiving.

“I’ve been sick a lot during the holidays,” said the Palm Springs, California, resident. “If it’s not Thanksgiving, it’s Christmas.”

There are a few theories why sickness comes at the worst time.

“The holidays are a virus-distribution system,” said Dr. William Schaffner, chair of the department of preventive medicine at Vanderbilt University. “They help us distribute the viruses, influenza and other common cold virus from person-to-person because of close contact.”

1) Achoo to you, and you, and you

Flu season reaches its height in late fall and early winter. This is because viruses circulate better in the colder weather, said Dr. Philip Tierno, director of microbiology and immunology at New York University’s Langone Medical Center.

It’s not only cold and flu bugs that become active during colder seasons. CDC: Seasonal FluView

Other viruses, such as the norovirus and rotavirus, become more active during winter. Norovirus, known as the stomach flu, easily spreads through contamination in food, drink and surface contact. The virus is found in the stool and vomit of infected people. Rotavirus also causes diarrhea, vomiting, fever, and abdominal pain.

Advice: If you’re sick, cough into the crook of your arm.

If someone is coughing or wiping his or her nose, don’t hug or kiss the person. Use common sense, Tierno said.

5 Immunity boosting tips for moms

2) The sea of humanity … at the mall

Think of the holiday traditions: catching a show, shopping at a crowded mall, attending holiday parties.

All this means you’re indoors in crowds and exposed to everyone’s germs. As people cluster indoors, they use the same doorknobs, banisters and surfaces after wiping their noses or sneezing.

“During the winter season, we’re more subject to crowding, touching something that’s not hygienic and crowding,” Tierno said.

People get less fresh air, too.

“They don’t open up windows to get fresh air. They don’t go outside as much during cold weather. They decide to stay in, so any virus that may be present would be more easily spread,” he said.

Advice: Practice frequent hand-washing (at least 20 seconds wiping both the top, bottom of hands and between the fingers prior to eating and drinking) or use hand sanitizers.

Occasionally open the window to let fresh air circulate.

Must-know winter health & safety tips

3) Germs fly free

Air travel means if there’s a small flu outbreak on the West Coast, that virus could be in New York in less than five hours.

“Human travel is synonymous with virus travel,” said Shaffner, an infectious disease expert.

When family members travel across the country, they’re bringing along pathogens that have been in their communities and exposing them to new places.

It’s not only the act of being in an enclosed cabin of a car, bus, train or plane, Shaffner said.

“Remember we’re talking about being on an airplane, getting to the airplane, making your way through the crowds and other crowds in the other end,” he said. “It is just as important as the airplane.”

Advice: The Centers for Disease Control and Prevention recommends everyone older than 6 months old be vaccinated for influenza. Get your flu vaccine to reduce chances of getting sick.

Dr. Sanjay Gupta talks to Sebelius about flu shots

4) You’re super-stressed before vacation

End-of-the-year projects, reports, final exams — it could be all that work before break that spikes a stress hormone in your body.

“The increased cortisol level induces likelihood of infection during the holidays,” said Dr. Robert Hasty, assistant professor of internal medicine at Nova Southeastern University’s medical school.

Cortisol is a natural hormone that responds to stress, lowering immunity and making you more susceptible to infections.

The interval between acquiring a virus and becoming sick takes about 48 to 72 hours. You may have become infected when you were stressed and the symptoms may start to show right when you go on holiday break.

Advice: Stress might be unavoidable, but try getting enough sleep and hydrating.

Prevent the stress hormones from wreaking havoc by better planning, avoiding traffic, buying presents earlier.

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Needy Boss with Holiday “Separation Anxiety?”

by Lynn Taylor

Published on December 12, 2010


Just as you’ve reached the final item on your pre-holiday checklist on your rare lunch break, your boss pops in to discuss what he’s busy working on. As you nod distractedly, you realize he’s waiting eagerly for your answer on your projects. As you turn off your computer and signal that you have to leave, the boss just keeps a long conversation going longer. Why now?

Holidays are already stressful when you’re in a hurry to finish up loose ends so you can make it out the door. Your boss may be a “Terrible Office Tyrant” or “TOT,” suffering from the equivalent of separation anxiety in children. The signs include a last minute barrage of questions, unreasonable requests or other obstacles as you try to ease into your holiday plans. And you end up with “vacation guilt syndrome.”

Needy Behavior

Why, when you’re about to take time off, does your boss start acting like a clinging child, yelling, “Mommy, don’t go!?” Most toddlers develop separation anxiety at some point because they lack the assurance that things and people exist when they can’t see them. They fear you’ll never come back. (Don’t get any ideas!) It’s legitimate for a manager to want to ensure that all bases covered when you’re gone, but when it causes unnecessary guilt or stress, that’s when you’ve entered the “TOT Zone.”

This may be an opportunity to set needed boundaries, albeit with a great deal of empathy and diplomacy. It certainly is a challenge, given the high unemployment rate – and the intimidating bad boss behavior you’re facing in the moment. But a little patience will go a long way in maintaining, if not solidifying your relationship. It will also soothe your nerves as you’re sipping your tropical drink somewhere far away.

Reassure That You’re Not Abandoning

TOTs small and adult-sized, can be fearful of abandonment, particularly if, in the case of the latter, it could hurt their own jobs or projects. Some TOTs can’t handle it when their employees leave the building for lunch, much less for an extra day or two. They need someone around constantly or they get frustrated with the pending projects.

Needy behavior may seem benign at first but can quickly cascade into one of 19 other classic bad boss traits, ranging from stubbornness,bullying, demanding and whining to moodiness. The trick is to be available as necessary and to reassure – but without compromising your own limits.

Taming A Needy TOT

If your boss suffers from holiday TOT separation anxiety, then follow these tips so you can have a truly relaxing vacation.

• Make solid plans in writing for who covers what while you’re on vacation.

• Provide a “to-do list” for your boss, which will reassure and suggest that your TOT can also take off without thinking about you.

• Once you have a plan in place, ask questions of your boss to see which areas are of most concern, if necessary.

• Remain unapologetic when requesting or taking the allotted time off if you’ve given ample notice. Everyone needs a break.

• Reassure the boss that a little break now will translate into a happier, more productive start to the New Year.

• Set clear limits; you don’t want to be skiing after already getting the ‘big freeze’ from the boss.

Remember, neediness is common in human nature. But you shouldn’t let your boss’s apprehension consume your life or let your holidays be hijacked. By managing your manager (or “parenting up without patronizing”) you’ll also humanize your workplace. You’ll have a healthier, happier start to 2011, and this skill will be of benefit with any future vacations, anywhere you work. Bon voyage!

Psychologically Healthy Workplaces

We must increase well-being in the workplace.

by Christopher Peterson


Consider these recent survey results:
• 69% of US employees report that work is a significant source of stress.
• 41% say they typically feel tense or stressed out during the workday.
• 51% say they are less productive at work as a result of stress.
• 52% report that they have considered or made a decision about their career such as looking for a new job, declining a promotion, or leaving a job because of workplace stress.
• Healthcare expenditures for employees with high levels of stress are 46% higher than those with low levels of stress.
• Job stress is estimated to cost U.S. industry more than $300 billion a year in absenteeism, turnover, diminished productivity and medical, legal, and insurance costs.
• For the average company, turnover costs more than 12% of pre-tax income and for those at the high end of stress, these costs can reach almost 40% of earnings.
• 52% percent of employees say that job demands interfere with family or home responsibilities.

These are all terrible statistics, and we of course want to reduce workplace stress and its determinants. However consider another recent survey – asking why people stay at a given job – and note that workers do not cite low stress. Rather, they point to positive features of work, precisely those of concern to positive psychology:
• Exciting and challenging work.
• Opportunities for career growth, learning, and development.
• High-quality co-workers.
• Fair pay.
• Supportive management.

Which leads me to mention an American Psychological Association program that identifies – locally and nationally – and honors workplaces with these sorts of features, dubbed psychologically healthy workplaces:
• Employee involvement.
• Work-life balance.
• Employee growth and development.
• Health and safety.
• Employee recognition.

Psychologically healthy workplaces are demonstrably good ones, from the perspective of management and workers. Compared to typical workplaces, they are less stressful, have lower turnover, and higher worker satisfaction (and everything that follows from that). These results are unsurprising but important.

Such workplaces often have innovative practices and features, from cafeterias to on-site daycare to paid sabbaticals to compressed work weeks. Appreciate that it is not the practices per se that matter but what they mean within the corporate cultures.

There is a story I remember from decades ago, when the Japanese automakers first began to eclipse the Big Three automakers of Detroit. Detroit automakers sent folks to Japan to learn what was going on there. It was discovered that Japanese autoworkers did group calisthenics before their shifts. So, went the logic, Detroit autoworkers should be asked to do the same thing.

That did not work well, obviously, because group calisthenics have a hugely different meaning in Japan than in the US.

Here is the positive psychology point – actually two of them. First, it is not enough to decrease stress in the workplace; we must also increase well-being. Second, practices to do so must make sense within a workplace. It’s not rocket science, dear readers, just a matter of talking to workers and heeding what they might suggest.

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Alcohol – Blackouts, Brownouts and how they affect your body

Published on November 21, 2010


With the holiday season upon us, many Americans engage in heavier-than-usual drinking, especially in those family gathering that can bring on the stress that reminds you why you left home in the first place. Still, I’m pretty sure that the majority of you want to actually remember what you did last night or on Thanksgiving?

Aside from short bursts of heavy drinking, drinking heavily over a long time period (I mean years) can affect the brain and cause lasting damage including, but not limited to, slips in memory. These memory slips can be due to lack of blood flow to brain areas that are important for memory consolidation and are more commonly known as blackouts. Contrary to what most people seem to believe, blackouts often occur in social drinkers and are don’t seem to be related to age or level of alcohol dependency.

Blackouts and the BAC (blood alcohol concentration) rate

Amnesia, or memory dysfunction, can begin to occur even with as few as one or two drinks containing alcohol. However, as the amount of alcohol intake increases so does the probability of memory impairment. Although sometimes heavy drinking alone will not cause blackouts, heavy drinking associated with drinking alcohol on an empty stomach or “chugging” alcoholic drinks often does cause blackouts.

The estimated BAC (blood alcohol content) range for blackouts begins at levels .14%- .20%. Individuals who reached high BAC levels slowly experienced far less common occurrences of blackouts. Additionally, while blackouts can lead to forgetting entire events that happened while intoxicated, some individuals experience an inability to recall only parts of an event or episode unless prompted to do so (these are often called brownouts).

Blackouts can occur to anyone who drinks too much too fast. In a survey of college students, males and females had experienced an equal number of blackouts, although the men had consumed a significantly larger amount of alcohol than the females.

Although brain damage could potentially occur from heavy alcohol consumption, there is no evidence that blackouts are caused by brain damage per se. However, if brain damage is caused from excessive alcohol use, some studies show improvements in brain function with as little as a year of abstinence. Regardless of the possibility of reversing any effects, alcohol use causes damage in different areas of the body (including the liver), and those damages have been shown to occur more quickly among females.

by Adi Jaffe

Citations:

1. White, Aaron M., Signer, Matthew L., Kraus, Courtney L. and Swartzwelder, H. Scott(2004). Experiential Aspects of Alcohol-Induced Blackouts Among College Students, The American Journal of Drug and Alcohol Abuse,30:1,205 — 224

2. Alcohol Alert (2004) . Alcoholic Brain Damage. Alcohol Research & Health, Vol. 27.