Anhedonia: Not Feeling Pleasure In Sobriety

Anhedonia

One of the major reasons why people relapse, especially in early recovery, is due to anhedonia and therefore a subsequent lack of knowledge of this issue . The best way to describe anhedonia is a state of ‘blah’.  A current dissatisfaction with sobriety or somebody’s current reality.  Anhedonia consists of two primary factors: The first is biochemical and the second is psychological.

First let’s focus on the biochemical.  When somebody ingest drugs or alcohol they release dopamine into the brain and this continues over a period of time, for years sometimes, and every time they put a drug in their body dopamine is released in the brain. What eventually happens is the brain says, ‘that’s it I’m done, I don’t need to produce this naturally any more’. Now dopamine is responsible for a lot of things, it’s responsible for a reward that keeps us safe and alive and keeps us moving forward as individuals. If we don’t have dopamine or a natural production of dopamine, we’re gonna feel that ‘blah’ feeling.

When somebody enters a recovery center or any kind of treatment environment and they are no longer having a chemically altered amount of dopamine going off in their brain throughout the day, whenever they put the drug in their body, what will happen is as they go through everyday activities during that initial phase of sobriety they’re not going to feel very good.  They’re not going to feel that reward.  That’s the biochemical reason of why somebody’s going to feel anhedonia.  The second thing to discuss when really understanding anhedonia is the psychological effects that somebody’s going to be experiencing while in early sobriety.

To really understand, let’s take a look at somebody while in active addiction. This is usually a pretty exciting lifestyle, now it’s negative excitement a majority of the time, but excitement nonetheless.  This is somebody who might be participating in illegal activity, somebody who’s probably putting themselves in pretty dangerous situations.  They may be dealing with some pretty shady people or running from the police or maybe even just the excitement provided from being dishonest to the people around them, trying to hide their stash or just get away with the substance use or anything involved in the substance use.

One thing all of these types of behaviors do is get the heart beating and it can start to produce adrenaline, all of these behaviors will create excitement.  But what about that individual when they decide to go into treatment? They’re not going to be receiving that same kind of excitement and what this can do is lead to a comparison: ‘I understand those were negative behaviors but the way I interpreted it while in active addiction was, ‘that was very exciting!  Now that I’m in treatment, I have a schedule, I have a routine, and I’m not receiving that same kind of adrenaline pumping excitement that I’m used to.’

This can often lead to other psychological set-up behaviors.  A person may now awful-ize sobriety or even romanticize past using. So, with both the biochemical and the psychological effects, somebody can have anhedonia.  Anhedonia can be consistent during somebody’s recovery process, at least the initial phase, it can also spike during different months of their process.  It can get elevated during activities that maybe somebody has formerly had a relationship with. 

If somebody grew up surfing and they loved surfing, every time they go out surfing they get that dopamine reward — if that same individual later on in life, decides to get sober and they go out surfing, there’s a good chance they’re not going to get the same reward they used to. That dopamine deficit can easily lead somebody to ‘awful-ize’ their sobriety or even hyper-focus on things from their past that would produce that dopamine, like substance abuse.

Here we see where a lot of people tend to relapse.  You may have someone in treatment waking up at the crack of dawn, going out to the ocean and experiencing that joy, that excitement, getting the heart beating, getting the adrenaline going as they’re out there, they’re riding the waves, etc.  Now they’re doing this sobriety thing  and it’s a structured, controlled environment but they’re still creating a new relationship with that excitement. For a lot of people who were bad addicts and may still very much crave drugs, they then go from the beach, then they’re going to the gym, and they’re participating in intense workouts. So when they’re doing that, it’s going to kickstart that natural dopamine production.

In treatment, we have the ability to assist somebody through that initial phase in this way, without the use of any kind of medications, at least anything that’s actually gonna do more harm than good. Ultimately what’s going to happen is, we can help somebody get through that initial physical phase of anhedonia. Then on the clinical side, someone in treatment is going to come into the office or group and they’re going to get lessons from clinical staff or peers and they’re going to learn about things like anhedonia. They’re going to learn in real time how to use coping skills.

All of this works together well, but anhedonia is gonna act as a one-two punch as far as the biochemical factors and the psychological factors.  We use the same kind of recipe combating it: address the physical and the psychological aspects.  The problem often seen however, is people making permanent or life-threatening decisions based on temporary uncomfortability or boredom, and that’s why people will relapse from anhedonia.  From this prospective, it becomes necessary for the addict to enter an environment where they’re given the opportunity to promote brain healing, along with gaining the knowledge of why they’re acting or feeling a certain way, which can set somebody up with an ability to maintain long-term, sustainable sobriety.

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Fentanyl Facts

fentanyl treatment

Fentanyl is a synthetic opioid painkiller.  It’s one of the most potent narcotics on the market and highly addictive. The fast-acting painkiller is prescribed for severe and chronic pain.  Prescription Fentanyl comes in the form of tablets, a nasal spray and lozenges.

The most popular form of Fentanyl is a patch that releases the drug slowly over three days. These patches can be abused by scraping out the gel contents and eating or smoking the entire dose all at once to get high.  Fentanyl’s potency is so deadly, it can be up to 100 times more toxic than the same amount of morphine and up to 50 times more toxic than heroin.

As little as 2 mg of powdered Fentanyl can cause an overdose and death. That’s about the same amount as two grains of salt. This highly dangerous chemical owes its rise to the legacy of Oxycontin. The popular brand-name prescription painkiller was taken off the market in 2012 after reports of addiction and overdoses exploded.  According to police, it’s the rise of illicit Fentanyl, often manufactured by chemists in China and processed by dealers for street sale in Canada, that is increasingly leading to overdose deaths.

As illicit production of this drug is swiftly taking the place of Oxycontin, it is often cut into other drugs like heroin or pressed into fake oxy tablets. When it’s cut into other drugs, it’s easy to get the dosages wrong. Imagine a batch of cookies with an uneven number of chocolate chips in one cookie, versus the rest. Sometimes the Fentanyl is mixed into other drugs secretly to make them more powerful which also significantly raises the risk of overdose or death.

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Signs of Bipolar Disorder

bipolar treatment

Bipolar disorder is a serious condition where a person’s mood can swing from feeling veryhappy or “up” to very sad and “down.” The “up” mood is known as a manic episode and the “down” mood is called a depressive episode. The fluctuation between the two of these moods can cause a child to be hyper productive one moment and show signs of depression the next. While it can be diagnosed in children, it is usually developed later during the teen years or early adulthood.

Bipolar usually lasts a lifetime. There is no known cause for bipolar disorder. Children with bipolar disorder can also have other problems including: substance abuse problems, ADHD and Anxiety disorders.  Suicidal thoughts can also be a problem.

Only a professional therapist or physican can officially diagnose bipolar disorder. However, here are some signs: Severe temper outbursts that are verbal, or aggressive behavior toward others and things. The temper outbursts occur three or more times a week and are inconsistent with a child or teens age. Irritable mood that changes without warning. Extreme sadness or lack of interest in things. Rapidly changing moods that can last for long periods of time. Rage. Hyperactivity, agitation, and distractibility. Sleep problems. Impaired judgment, impulsivity, racing thoughts, and pressure to keep talking. Poor decision making skills and impaired judgment with reckless behavior. Possible promiscuous behavior may be a signal as well.

In the event the preceeding symptoms should be observed in a child or teen, a medical professional should be consulted. They will be able to assess whether these symptoms are possibly due to a different cause. Remember, children are still growing and developing and this may cause some of these symptoms. It’s also important to understand there are different kinds of bipolar.  A medical professional will help determine what treatment would be best suited. Treatment for bipolar disorder can be done with medicine and therapy.  Usually a skills based approach with the parent and child will be helpful as well.

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Exercise and the Brain

Exercise treat addiction

Apart from fitness, physical exercise also has beneficial effects on the brain. A regular routine of aerobic exercise can improve memory, thinking, skills, moods and have protective effects against aging, injuries and neurodegenerative disorders. It is noteworthy that these effects are specific to aerobic exercise, the kind of exercise that accelerates heart and respiratory rate such as running, cycling, swimming, etc. Non aerobic activities such as stretching or muscle building do not have the same effect.

The positive effects of aerobic excercise appear to result from increased blood flow to the brain and subsequent increase in energy metabolism. It is worth noting that a certain degree of intensity in these activities is required to achieve the beneficial outcomes described. Aerobic exercise increases the production of several growth factors of the nervous tissue known as neurotrophins. Among these are BDNF, for brain-derived neurotrophic factor. BDNF exerts a protective effect on existing neurons and stimulates formation of new neurons from neural stem cells in a process called neurogenesis.

BDNF appears to coordinate its action with at least two other growth factors: insulin-like growth factor or IGF and vascular endothelial growth factor or EGF. EGF levels also increase following aerobic exercise, BDNF then interacts with IGF to induce neurogenesis while EGF stimulates growth of new blood vessels, a process known as angiogenesis. Together these processes improve survival of existing neurons produce new brain tissue and constitute the brain’s enhanced plasticity.

These factors underlie the exercise-induced protective effect against degenerative diseases and injuries. Changes in BDNF levels ar eobserved throughout the brain but are most remarkable in the hippocampus, the area that is responsible for memory retention and learning. In fact, regular exercise has been shown to increase the size of the hippocampus and improve cognitive functions, while even a single workout can produce significant changes in BDNF levels and subsequent improvements in learning performance.

A regular exercise program progressively increases BDNF baseline level and makes it respond steadier over time. However, it also appears that some cognitive functions are enhanced immediately after a single workout, while others only improve following a consistent exercise routine. A single aerobic session can promote positive emotions, suppress negative feelings, reduce the body’s response to stress and sometimes, after intense exercise, induce a euphoric state known as runner’s high.

These effects may persist for up to 24 hours and are thought to result from exercise induced up-regulation of several neurotransmitters involved in mood modulation these include dopamine, a neurotransmitter of the brain reward pathways, as well as serotonin, commonly known as the substance of well-being and happiness, whose low levels in the brain have been associated with depressive disorders. Also, the consequent production/release of beta endorphin or endogenous morphine, an endogenous opioid which is related to psychoactive chemicals involved in pain modulation, stress and anxiety reduction may be helpful for those who suffer from accompanying disorders.

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How PTSD and Substance Abuse are Connected

Addiction Trauma PTSD

Traumatic events can leave a person feeling unstable long after the event has passed. Sometimes trauma can cause post-traumatic stress disorder or PTSD.  PTSD occurs when trauma and associated feelings are not resolved. Symptoms of PTSD include sleep disturbance, nightmares, flashbacks, anxiety and depression, excessive fears, impulsivity and addictive behaviors. People with unresolved trauma often turn to alcohol and other drugs as a means to self-medicate. While this may alleviate their stress temporarily, it is never a long-term solution and eventually substance abuse becomes yet another source of pain and trouble for an already suffering person.

Poor lifestyle choices can also put a substance abuser at greater risk for re-traumatization or PTSD.  Impaired driving, being in dangerous situations to get drugs or alcohol and drugs effects on a person’s judgment or alertness can lead to an increased risk of re-experiencing traumatic events. Whatever the cause for the correlation, the fact is that people suffering addiction very often have the additional problem of unresolved trauma. In these cases it is always best to treat the drug and alcohol addiction first but not to stop there.

The trauma survivor may work very hard to get and stay sober only to find other compulsions replacing drugs and alcohol, but once recovery from addiction is underway a person suffering from unresolved trauma will benefit greatly from trauma-focused therapies like PTSD intervention, body psychotherapy, which targets physiological responses, art and equine therapy or medications for depression and anxiety.

A licensed therapist can help find the best treatment plan for each individual. The bottom line is that resolving past trauma may require professional help but it is essential to living a truly healthy and gratifying sober life. For more information or to get help, contact Oceanside Malibu.

Adderall

Adderall

Adderall is the brand name for a mixture of amphetamine salts that were developed for treatment of attention-deficit/hyperactivity disorder, or ADHD. Since 2007, prescriptions have doubled in the U. S and even those who don’t have a prescription are using it. An estimated 30% of university students used Adderall at some point as a study enhancer. So, what affect does this substance have on a person?

As Adderall is a combination of amphetamine salts, it is a close relative of methamphetamine, commonly known as meth. When the drug is ingested, it takes effect on the brain within an hour of use.  It affects neuroreceptors in the central nervous system, increasing the effect of serotonin and dopamine. In patients with ADHD, genetic studies have indicated that these individuals may have dysfunctional dopamine release. Because of the lack of dopamine, it is theorized that the brain is constantly seeking out stimulants, resulting in the distractibility commonly seen in ADHD patients. The dopamine and serotonin released by Adderall overcomes this deficit in ADHD patients, causing increased focus and making you feel less distracted.

Adderall also causes the release of norepinephrine, which activates the sympathetic nervous system, initiating your fight-or-flight response. This results in your body moving blood and energy towards the major organs and away from your limbs and digestion, which essentially increases alertness.  Although some studies have found that the substance can increase repetitive learning tasks, it does not make a difference when it comes to most cognitive tasks or complex learning techniques like those needed for an exam. So with students taking Adderall, any increase in studying skills may be from the fact that the drug gives you energy, and can help keep you awake for a night of studying because it is similar in chemical structure to meth.

The benefits of Adderall in academic circles is still up for debate, however the long-term detrimental effects of abusing the drug are clear.  Consistent release of serotonin and dopamine causes the brain to stop producing them naturally over time. Therefore, you would need to keep taking more and more of the chemical to get the same effect, making it highly addictive.  Long-term users of Adderall developed an inability to feel pleasure without a chemical stimulant, and these effects can linger even after you stop taking the drug.

Adderall abuse is a growing problem, so much so that millenials have sometimes been referred to as Generation Adderall. The abuse of Adderall in our culture is following a similar pattern to the current opioid crisis. This means that, as a society, we may need to seek measures to protect ourselves and our loved ones.

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