Self-Injury: Cutting

Self-injury, also known as self-mutilation, is defined by intentional injury/harm to oneself. Although there are many different forms of self-injury, one of the most common and the focus of today's blog is cutting. Cutting is generally NOT a suicide attempt but rather an unhealthy way of coping with painful emotions. In conversations with multiple people who have cut in the past, they have reported that is was cleansing for them and one reported "it released the bad blood." It can have similar effects as substance use since it causes spikes in endorphin levels as your body is trying to compensate for the physical pain.

As noted by the Mayo Clinic information website-Through Self-injury, the person may be trying to:

• Manage or reduce severe distress or anxiety and provide a sense of relief
• Provide a distraction from painful emotions through physical pain
• Feel a sense of control over his or her body, feelings or life situations
• Feel something, anything, even if it's physical pain, when feeling emotionally empty
• Express internal feelings in an external way
• Communicate depression or distressful feelings to the outside world
• Be punished for perceived faults

 http://www.mayoclinic.com/health/self-injury/DS00775/DSECTION=causes

Cutting generally starts in early adolescence and is more common in females than males. However, there are adults who cut as well. Having friends who cut increases the risk for a person to start cutting and people who have stressful and/or traumatic family lives have higher incidences as well. Once again, it is an unhealthy way of coping with painful emotions. There are risks of infection, scarring, feelings of guilt/shame and/or possible fatal consequences from cutting to deep or doing it while under the influence.

If you are cutting:

• Try to find another way to get a similar release ie; hold a piece of ice in your hand, go for a walk/run or other physical exercise- positive ways to release endorphins
• Recognize your triggers that lead to cutting and make a plan in advance to distract or soothe yourself to avoid getting to that behavior
• Learn positive coping techniques such as; deep breathing/relaxation, expressing your painful emotions through talking, writing or art, spend time with people who make you happy.

If you are a friend or loved one of someone who is cutting:

• Try not to be judgmental
• Learn as much as you can about it
• Let them know you care
• Share your coping techniques with them

For more information on cutting visit the Mayo Clinic website at: http://www.mayoclinic.com/health/self-injury/DS00775

or to find a local therapist in Ulster County that is skilled in this area call: (845) 339-9090 x113- MHA information and referral hotline.

Ulster County NY Mental Health Crisis INFO

SUICIDE PREVENTION & SUPPORT

National Suicide Prevention 24 Hour Lifeline 1-800-273-TALK

WALK-IN CRISIS CENTERS

Family of Woodstock, 16 Rock City Road, Woodstock 845-679-2485

Family of Ellenville, 221 Canal Street, Ellenville 845-647-2443

Family of New Paltz, 51 North Chestnut Street, New Paltz 845-255-8801

7 Days/Week, 9:00am - 9:30pm

Monday - Thursday 10:00am - 5:00pm, Friday 10:00am - 4:00pm

Monday - Friday 9:00am - 4:30pm

Family of Woodstock, 39 John Street, Kingston 845-331-7080

Monday - Friday 9:00am - 11:00am; 1:00pm - 4:00pm

EMERGENCY MENTAL HEALTH SERVICES

845-334-4244

HealthAlliance of the Hudson Valley

Kingston Hospital, 396 Broadway, Kingston

7 Days/Week, 24 Hours/Day

CRIME VICTIMS ASSISTANCE

Family of Woodstock 24 Hour Hotline 845-338-2370

JustConnect Teen Hotline 845-331-5565

Ulster County Crime Victims Assistance Program 845-340-3443

Sexual Assault/Domestic Violence & Hotline 845-340-3442

INFORMATION, REFERRAL & SUPPORT GROUPS

MHA: Mental Health Association in Ulster County 845-339-9090

CRISIS INTERVENTION & SUPPORT

ULSTER COUNTY SUICIDE RESPONSE COORDINATING COMMITTEE

Ulster County Department of Mental Health 845-340-4173

Binge Drinking

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FACTS ABOUT MENTAL ILLNESS AND VIOLENCE

Facts about Mental Illness and Violence

• It is important to note that behavioral health research and practice over the last 20 years reveal that most people who are violent do not have a mental disorder, and most people with a mental disorder are not violent.*
• In fact, studies indicate that people with mental illnesses are more likely to be the victims of violent attacks than the general population. *
• Demographic variables such as age, gender and socioeconomic status are more reliable predictors of violence than mental illness.*
• Misconceptions about mental illness can cause discrimination and unfairly hamper the recovery of the nearly 20 percent of all adult Americans who experience a mental illness each year.
• Family, friends, employers and school personnel can be a line of “first response” if they notice a person is behaving differently and is of concern.  The choice to seek treatment is more likely if others are compassionate and supportive.   Mental health treatment can be effective and can enable a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.
• Treatment is effective and people recover from mental illnesses to live productive lives in our communities.

 *Source: http://www.samhsa.gov/mentalhealth/understanding_Mentalllness_Factsheet.aspx

Coping with Natural Diasters

In the wake of hurricane Sandy and residual stress from the prior year's hurricane Irene, coping with the stress/distress and trauma from a natural disaster can be overwhelming. From simply having no electricity for days to total devastation of your home and/or many other losses, these events are STRESSFUL.

First and Foremost, here are some common responses to a natural disaster:

• Disbelief and numbness
• Fear and anxiety about the future
• Loss of feeling secure in the world
• Self doubt
• Magical thinking, superstition and omens
• Disorientation; difficulty making decisions or concentrating
• Heightened response to noise, surprises, jumpiness
• Uncomfortable being alone
• Nightmares and reoccurring thoughts about the event
• Irritability and anger
• Sadness and depression
• Feeling powerless
• Changes in eating patterns; loss of appetite or overeating
• Crying for “no apparent reason”
• Headaches, back pains and stomach problems
• Difficulty sleeping or falling asleep
•  Sense that life is out of balance
• Physical discomfort, aches, cold-like symptoms
• Feeling guilty that others have suffered more than you have

So how do you get back into the routine of life and find a way to try re-establish some normalcy?
Research has shown that the way in which a person takes care of him or herself during the first few days following a traumatic event will help to minimize the development of future psychological reactions to the event.  Understanding the reactions of your body and your emotions can help you deal with the trauma of the event.

Be Gentle With Yourself

Your body and brain work together in reaction to things that happen to you.  As a result, you experience both emotional feelings and physical reactions to events.  Sometimes these reactions are pleasurable, such as when you receive praise from someone.  Other situations cause reactions of stress and discomfort.  Physical reactions can range from muscle tension, headache, elevated blood pressure, stomach distress, nausea, pain and almost any king of physical symptom.  Emotional reactions to a trauma can include anxiety, panic, depression, anger, panic, depression, anger, sleep disturbance and irritability, to name just a few.  

Try to Eat Well and Exercise Within Your Capabilities

People respond differently to traumatic events.  It is hard to predict who will react strongly and who will show little reaction to a particular event.  If you have strong reactions, it does not mean that you are mentally weak or mentally ill.  Reactions to traumatic events are considered “normal reactions to abnormal events.”  If you find that after several weeks you are still unable to cope with your feelings, you may want to consider getting extra help through a mental health professional.  This does not mean you are mentally ill, but simply means that your reaction needs more attention.

Additional ways to care for yourself after a Traumatic event:

•         Avoid Alcohol use.  Although you may feel like going home and relaxing with a glass of wine, it is very important that you avoid alcohol for at least 24 hours.  The reason is that alcohol works on the way which you preserve memories of recent events.  Because alcohol tends to “numb” your feelings, its influence causes your memories to be preserved in unpredictable ways.  It is very important that your brain have the opportunity to deal with all aspects of a traumatic event so that you will less likely to be bothered by it later in ways that you may not understand.

•     Avoid caffeine.  Caffeine is a stimulant.  You need to relax and be calm.  The stimulation of both caffeine and a traumatic event may make it harder to cope and settle down.

•        Communicate about the event  Your mind needs to process what happened so that it can resolve your personal feelings.  Talk with your co-workers, manager, EAP counselor, family member and friends.  Bottling up your feelings will inevitably cause them to appear later in unpredictable ways.  You may want to bring home the phone numbers of some of your co-workers to give support to one another in the coming days.

•      Ask for Nurturing and Understanding when you return home. Sometimes friends and family may not understand the feelings you experience following a traumatic event.  Ask your loved ones to help you relax by being supportive and understanding.

•       Use natural methods to relax.  A warm bath, massage and/or soothing music are much better means of relaxing after a traumatic event then alcoholic beverages.  Think in terms of pampering yourself after a difficult experience.  Exercise within healthful limits is also great way to deal with stress.

•       Seek help if the stress symptoms do not diminish after a reasonable amount of time.  You may want to consider getting some additional help through a mental health professional.  Prompt attention to traumatic stress can often minimize long-term effects. 

Taken from: Ways To Care For Yourself After a Traumatic Event- CISM literature

Local Ulster County New York Disaster Resources

American Red Cross
Ulster County Chapter
Ulster County Chapter
21 O'Neil Street
Kingston, NY 12401
Phone: (845) 338-7020

24 Hour Emergency:
(845) 338-7021

_________________________________________________

        FEMA ASSISTANCE

      FEMA provides funding and assistance to local residents (renters and homeowners) and businesses who have sustained loss of or damage to property that is not covered by insurance. Contact your insurance company first: If you are NOT covered for the storm damage by your insurance company, you may be eligible for federal aid. You will need to obtain a letter from your insurance company saying you are not covered for damage from the storm. 

      1-800-621-FEMA (3362)

__________________________________________

      Mental Health Association In Ulster County
      (845) 339-9090

Aging & Depression

Aging is an inevitable and normal part of human development. Development across the lifespan contains a series of stages from the prenatal period which is from conception to birth, through childhood, adolescence and into early, middle and then late adulthood. From the time we are born to the moment we die, we have taken momentous strides as well as losses as each of these stages present their own accomplishments as well as challenges. 

Depression is not a normal part of aging.

However, depression is one of the conditions most commonly associated with suicide in older adults and is often under-recognized and under-treated. Although only about 1 to 2% of older adults have major depression at some time, about 15% experience symptoms of depression. Also, many of these symptoms may be looked over due to similar symptoms caused by other health problems. For instance, symptoms such as fatigue, sleeping difficulty, cognitive issues and bodily complaints may be incorrectly interpreted as a sign of aging rather than of depression. Older adults also may express signs of depression differently than younger adults. For example older adults may communicate depression through physical complaints rather than through expressing emotional difficulties. However, depression in older adults is not significantly different than those in younger adults, meaning there is no need for different assessment tools. 

Emotional responses of sadness, grief and melancholy are normal. However, persistent feelings of depression that impacts a person’s ability to function is not. As we age, we may experience chronic or debilitating illnesses, loss of friends and loved ones, job retirement, financial issues and/or feelings of loss on control which can weigh heavy on our mental health and emotional well-being. For instance, weakening eyesight and hearing loss as well as the difficulty of getting around may cause feelings of insecurity, unhappiness or fear. All which could lead to social isolation, lowered self-esteem and even hopelessness. Another prime example is the transition from many years in the workplace to retirement with a potential loss of daily meaning or activity. These experiences can readily lead to chronic depression.

Also, there is some evidence that natural body changes associated with aging may increase a person’s risk of experiencing depression. For instance, studies suggest that lower concentrations of folate in the blood and nervous system may contribute to depression, mental impairment, and dementia. Researchers also suspect that there may be a link between the onset of depression in older adults and Alzheimer’s disease.

Regardless of its cause, depression can have serious physical effects on older people. The mortality rate for elderly men and women suffering from both depression and feelings of loneliness is higher than for those who report satisfaction with their lives.

So, what are some of the symptoms of depression? Symptoms include:

·         difficulty concentrating, remembering details, and making decisions

·         fatigue and decreased energy

·         feelings of guilt, worthlessness, and/or helplessness

·         feelings of hopelessness and/or pessimism

·         insomnia, early-morning wakefulness, or excessive sleeping

·         irritability, restlessness

·         loss of interest in activities or hobbies once pleasurable, including sex

·         overeating or appetite loss

·         persistent body aches or pains

·         persistent sad, anxious, or "empty" feelings

•  thoughts of suicide, suicide attempts

Depression can and should be treated. It is important to take care of your mental health just like you would treat physical health issues. Untreated depression can worsen daily health issues, create problems with your relationships, increase chances of drug/alcohol abuse and lead a person to death by suicide.

Talk to you doctor, therapist or other health professional to get more information and/or a referral to someone that can help you find treatment. 

For local Ulster County residents contact the MHA at (845) 399-9090 x113 for a list of mental health providers in your area.

Relationship Effectiveness

Effectively communicating to someone we care about in a conflict situation can sometimes be a daunting task, especially when the intensity of emotions are high. Pulling from a Dialectical behavioral therapy (DBT) approach, these are some tips on how to be effective communicating in a relationship that you want to keep.

1. Be Gentle- Be respectful, courteous and even-tempered. Imagine how you would want someone to approach you during/after a conflict. Remember that this is a person you care about and you want to improve the relationship with.

• Approach the person when you are calm and able to be temperate in your approach.
• Do not attack the person verbally, physically or use hostile body language, ie; clenching fists, furrowed eyebrows, dominating space.
• Do not use manipulative or threatening statements such ; "You cant see your son if you dont..." or "I'll kill myself if you..."
• Do not Judge. Do not says things like "if you were a good person, you would..." or use "you should..", "you shouldn't..."
• If it gets to heated take a break and come back when calm.

2. Be Attentive- 

• Try to actively listen to what the other person is saying. Try to understand their point of view or opinion. If you don't understand it, acknowledge you don't understand and ask them to re-explain it or just accept that that is their own perception and that is okay.
• Do not interrupt or talk over the other person.
• Validate or acknowledge the other person's feelings, thought's and difficulties. Validate them out loud by saying statements such as; "I can see that you are feeling....", "I realize this is hard for you...", "I know that you tried your best to..."

3. Use a balance of emotion and rational- Also known as the "wise mind," take in your emotions as well as use your reasonable thoughts. Try to keep a balance between both so that you don't go deep into one or the other. Too much emotion can make it difficult to overcome the conflict and not enough emotion can make it feel cold.

Disassociative Identity Disorder (DID)

Recently, I have been watching the TV show "United States of Tara," which is a fictional show about a woman living with disassociative identity disorder (DID), once known as multiple personality disorder. The show incited a curiosity to understand DID better. So here is what I learned: Disassociative identity disorder effects between .01-1% of the general population. It is characterized by having at least 2 or more personalities/identities, known as "alters," that have control over the person's behavior and/or thoughts. It is also distinguished by memory variations, depending on the alter, as well as the inability to recall specific personal information that is more far reaching than just forgetfulness. The alters have their own gender, race, age, class etc. and have their own distinct gestures, way of speaking and movement. Sometimes the alters can be animals and/or imaginary people. When one of the personalities takes over the person's behaviors/actions and thoughts, it is known as "switching." Switching can happen over seconds, minutes or days. There are usually 2-4 alters that are present at diagnosis but often between 13-15 appear during treatment. Stressful life events or environmental triggers can cause a person to switch from one identity to the next.
Some other symptoms that may accompany DID are:

• Depression
• Mood swings
• Suicidal tendencies
• Sleep disorders (insomnia, night terrors, and sleep walking)
• Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or "triggers")
• Alcohol and drug abuse
• Compulsions and rituals
• Psychotic-like symptoms (including auditory and visual hallucinations)
• Eating disorders 

The cause of DID is not completely understood but believed to have both environmental and biological basis. Majority of the people with DID have had some type of reoccurrent and of life threatening disturbances before the age of nine, including persistent neglect or abuse. Findings have shown that DID is highest among families where parents are often frightening and unpredictable. 

There is no "cure" for DID but long-term treatment can be successful if the person is committed to treatment. Treatment often consists of talk therapy, medication, hypnotherapy and other adjunct therapy. 

Mindfulness Skills for Everyday Use

The state of being mindful refers to being aware of your body, emotions, thoughts and sensations as well as the environment around you and interactions. The thought of being fully aware of all these things at once can seem like a challenge to even the most advanced multi-taskers. However, being present in the moment allows you to just notice these different concepts and only requires some attention. It make take some time in the beginning of learning to be mindful but practice makes new neural pathways! When cueing in on different sensations, feelings and thoughts, it may be helpful to first try this when you are in a quiet space with some time to yourself. For this exercise we will explore our different senses and how they can help us be mindful.

1.) Sit or lay in a comfortable position, if sitting put both feet flat on the ground.

2.) Take one large inhale, then exhale slowly through your nose. This is just to clear your mind and relax you slightly to help you release any tension from the day.

3.) Lets first focus on sound. What sounds do you hear going on around you? What sounds in the next room or outside? What about the sounds of your own body, your breath, your heartbeat, your stomach? What sounds do you hear in your head, is there an inner monologue? Just sit/lay listening  to every noise that comes and just notice the tone, the volume and  how the sounds mix. Take about 2-5 minutes and just focus on sound.

4.) Now lets move on to smell. What do you immediately smell? What does it smell like? Fruity, sour, musty, sweet, mild, fragrant, flowery, smokey, leathery? What kind of adjective can you think of to put to the smell? As i sit in my office all i can think of is "officecy." Just notice how the smell makes your body react. Does it make you cringe, relax, smile, tense up? Take another 2-5 minutes to explore your sense of smell in this moment.

5.) Taste. You probably arent eating at this exact moment but maybe you still have a taste from something you ate, chewed, drank or smoked earlier. What do you taste? Take a mental scan of you tongue, from the far back to the tip. What words can you put to the taste? maybe one part tastes sweet, while another bitter or sour. If you are having a difficult time exploring taste without an object, you may want to try this one while your eating. Take a couple minutes again to explore your sense of taste.

6.) Feel/touch. What does your body feel like right in this moment? Do you notice any tension or an ache in a part of your body? Just take notice of how your body is contacting the outside world. If you are sitting, how does the chair feel under your body or your feet on the ground? What sort of sensations do you feel inside or outside your body? What about the air around you, do you feel a breeze or the pressure from the air surrounding you? Take 2-5 minutes to explore how your body feels.

7.) Lastly, is sight. Take in all of your surroundings. What do you see? What colors, shapes, words, lines and movement comes across your line of vision? Do you notice anything that maybe you didnt see before? Use your eyes to fully experience this moment.

When you find that you need to take a moment out of your day and be fully present, try using one of your senses to pull you into mindfulness. Like stopping to feel a cool breeze across your arms on a warm day or drinking your cup of coffee, savoring the aroma and the taste. These moments of mindfulness may help bring you great joy.

PTSD & Returning Veterans

Dear Let’s Talk About It,

My twin brother, John, is in the Army and has served a1year tour in Iraq and just returned 6 months ago from a year long tour in Afghanistan.  When he got back from Iraq he bounced back to himself quickly but this time he is having problems. He lives in the apartment over mine and I hear him walking around all night, he has gotten into 2 car accidents and is often angry and jumpy for no reason. Last weekend he drank a case of beer in 1 night, alone in his apartment. It isn’t getting better it is only getting worse.  John is the one all the other soldiers call when they are having problems but won’t get help for himself. When I tell him I am worried he says he can handle it and doesn’t want to talk about it because it only makes it worse. My parents say to leave him alone but I am concerned he is in over his head. What should I do?A.

War and/or exposure to combat can be traumatic and take a serious toll on a person’s mental health. According to the National Center for PTSD, Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF), are the longest combat operations since Vietnam, meaning that military personnel often spend long or multiple tours in a combat situation. They are at a high risk for death/injury, seeing the death or injury of others and need to be on high alert at all times. Often times when veterans/active duty members return home from war, they take a while to readjust. While in combat they needed to be extremely alert and aware of every detail in their surroundings. However, when they return that asset needed in war does not translate or is no longer needed at home. This can leave returning soldiers to act “jumpy” or “on “edge.” When symptoms like your brother’s persist, it may mean something more. Post-traumatic Stress Disorder (PTSD) can form after a person experiences a traumatic event. A traumatic event is defined as an event that is perceived as life-threatening, involving fear and possible a sense of no control over the situation and persists for more than a month. Although some have a delayed reaction to PTSD and it may form 6 months down the road. Either way, PTSD may enhance issues such as; alcohol/drug abuse, problems with relationships or at work, feelings of hopelessness and depression as well as physical ailments. Some symptoms may include:

• Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
• Bad dreams
• Frightening thoughts.
• Staying away from places, events, or objects that are reminders of the experience
• Feeling emotionally numb
• Feeling strong guilt, depression, or worry
• Losing interest in activities that were enjoyable in the past
• Having trouble remembering the dangerous event.
• Being easily startled
• Feeling tense or “on edge”
• Having difficulty sleeping, and/or having angry outbursts.

As a loved one concerned for your brother the VA suggests;

1.)    Learn as much as you can about PTSD to understand better what your brother is experiencing and what sort of options may help him.

2.)    Offer to go to doctor visits with him or encourage him to talk to his doctor about what he may be experiencing post-combat.

3.)    Let him know that you are there if he wants to talk but that it’s okay too if he doesn’t want to talk.

4.)    Encourage him to contact friends, family and/or his military buddies to help provide love and support. If he does not have a lot of social outlets, he may consider joining a group for veterans.

5.)    Lastly, invite him out for some physical activity as that may help him process the stress hormones and sweat them out.

Eating Disorders Informational Video

Suicide & Suicide Prevention Video

Tips to improve your resilience

Working on your mental well-being is just as important as working on your physical health. If you want to strengthen your resilience, try these tips:

·         Get connected. Build strong, positive relationships with family and friends, who provide support and acceptance. Volunteer, get involved in your community, or join a faith or spiritual community.

·         Find meaning. Develop a sense of purpose for your life. Having something meaningful to focus on can help you share emotions, feel gratitude and experience an enhanced sense of well-being.

·         Start laughing. Finding humor in stressful situations doesn't mean you're in denial. Humor is a helpful coping mechanism. If you can't find any humor in a situation, turn to other sources for a laugh, such as a funny book or movie.

·         Learn from experience. Think back on how you've coped with hardships in the past. Build on skills and strategies that helped you through the rough times, and don't repeat those that didn't help.

·         Remain hopeful. You can't change what's happened in the past, but you can always look toward the future. Find something in each day that signals a change for the better. Expect good results.

·         Take care of yourself. Tend to your own needs and feelings, both physically and emotionally. This includes participating in activities and hobbies you enjoy, exercising regularly, getting plenty of sleep and eating well.

·         Keep a journal. Write about your experiences, thoughts and feelings. Journaling can help you experience strong emotions you may otherwise be afraid to unleash. It also can help you see situations in a new way and help you identify patterns in your behavior and reactions.

·         Accept and anticipate change. Expecting changes to occur makes it easier to adapt to them, tolerate them and even welcome them. With practice, you can learn to be more flexible and not view change with as much anxiety.

·         Work toward a goal. Do something every day that gives you a sense of accomplishment. Even small, everyday goals are important. Having goals helps you look toward the future.

·         Take action. Don't just wish your problems would go away or try to ignore them. Instead, figure out what needs to be done, make a plan and take action.

·         Maintain perspective. Look at your situation in the larger context of your own life and of the world. Keep a long-term perspective and know that your situation can improve if you actively work at it.

Schizophrenia

Dear Let’s Talk About It,

My youngest son Seth is 22 years old has been through a lot of ups and downs in the past year. Two weeks ago he was hospitalized after the police found him wondering the streets talking to himself. The hospital psychiatrist diagnosed him with Schizophrenia. I am in complete shock and am devastated my son is so ill. What kind of future will Seth have living with Schizophrenia? E.C.

It is not an easy occasion when your child is diagnosed with a disorder such as Schizophrenia. It is very understandable to feel shocked and even devastated. However, the more you can learn about Schizophrenia, it symptoms and patterns, the better equipped you will be to help your son as well as handle your own emotions. To give you a brief overview, Schizophrenia is a life-long brain disorder which can interfere with thought patterns, cause difficulty distinguishing reality from fantasy, cause hallucinations, make it difficult to identify emotions and relate to others. The onset of Schizophrenia typically occurs in young adulthood, such as your son’s age of 22. It is uncertain the cause of Schizophrenia but may include genetic and environmental influences during development. Although there is no “cure” for Schizophrenia, it is a treatable and manageable medical condition. There are medications that can help improve symptoms but it is also important to have other supports such as; peer to peer support groups, a psychiatrist and support from family and friends. Also, it is important for you to create a support network for yourself to help you cope with the tough times and connect with other families who have a loved one with Schizophrenia. For local support contact NAMI (National Alliance for the Mentally Ill) of Ulster County at (845)679-9944.

Methadone Maintenance & Pregnancy

Dear Let’s Talk About It,

I have been on methadone maintenance for six 1/2 years and have found it very helpful in my recovery from heroin/morphine.  My life is back on track; I am married and have a good job. However, I am now pregnant. If I decide to stop taking Methadone, I’m worried I may relapse but I am also worried that the Methadone is not good for my unborn child. What do you think is the safest decision? D.M.

First and foremost, this is a great question to bring up with your doctor and treatment specialists since they know you and your history best. To answer your question from my view, I think the central theme here is whether methadone maintenance during pregnancy is safer than relapse to heroin/morphine use? I would say YES. Methadone maintenance has been around since the 1960’s and, although controversial, is considered one of the most effective treatments for opiate addiction. Methadone is a synthetic narcotic that blocks heroin’s access to the brain, which helps eliminate drug cravings and symptoms of withdrawal. Relapsing and using heroin/morphine during your pregnancy has greater consequences such as; sharing needles which risks infection, unsupervised withdrawal symptoms that can lead to miscarriage or a variety of birth defects, reduced prenatal care, side-effects and potentially high-risk behavior. However, to be honest, methadone also has its risks such as; low birth weight, smaller than normal head size and withdrawal symptoms for the newborn. However, all of these risks are closely monitored to reduce any possible complications. Pregnant women have been treated with methadone for over 25 years and NIDA has reported that methadone maintenance while pregnant is "strongly advised" over any attempt to undergo opiate detox while pregnant. For more information on methadone maintenance and pregnancy, visit www.methadoneandpregnancy.com or www.samhsa.gov. For local support contact The Methadone Management Program in Kingston NY at (845) 943-6022.

Bi-Polar I & II

Dear Let’s Talk About It,

My sister was just diagnosed with Bi-Polar II. I didn’t even know that 2 different types existed! So what is the difference between Bi-Polar I and Bi-Polar II? M.S.

Bi-Polar disorder, also known as manic-depression, is an organic brain disorder where a person’s mood, energy level and activity make unusual shifts. It is not just the simple ups and downs that people experience throughout their lifetime but rather a lifelong disorder that can cause significant distress. Mania or manic episodes refer to when a person is in an overexcited state. This may come through in symptoms such as; difficulty sleeping, feeling jumpy or wired, easily distracted and/or highly agitated. Depressive moods are when a person has symptoms such as; feeling tired, lack of motivation, thoughts of death/suicide, loss of interest and/or feeling empty or without cause. Bi-polar I is marked by manic episodes that last at least seven days or are so severe the person needs to be hospitalized. As well as depressive episodes that last two weeks or longer. Bi-polar II is similar but is defined by depressive episodes and hypomanic episodes, which are not as severe as manic episodes. People in a hypomanic state may be energetic, productive and feel good which is not necessarily a bad thing. On the other side, when a manic episode becomes extreme, a person may develop psychotic symptoms such as hallucinations or delusions. This may lead to reckless behaviors and/or hospitalization. For more information and support locally, contact the Mental Health Association of Ulster County at (845) 339-9090 x109.

Eating Disorders

Dear Let’s Talk About It,

My best friend called last night & told me that she has been struggling with an eating disorder for almost four years. We spend a lot of time together as our daughters are the same age & I can’t believe that I didn’t notice. What can I do or say to help her through this? B.B.

Eating disorders and disordered eating are more common than people may realize. It is estimated that one in a hundred American women binges and purges to lose weight. Briefly, eating disorders are a broad range of behaviors and beliefs, where a person is so preoccupied with food and/or weight that it causes significant distress in their lives. It is uncertain the exact cause but may be influenced by bio-psycho-social factors, meaning; genetics, emotional health and cultural and/or social influences. In fact, it is not always easy to see that someone has an eating disorder such as you mentioned about your friend. They may look like they are at a healthy weight or even overweight. But it is less about actual appearance and more about their eating behaviors and beliefs about their body and/or appearance. So as a friend what can you do to help support her through this struggle? The National Eating Disorders Association (NEDA) suggests to first, learn more about eating disorders, especially the type your friend may struggle with. This way you can understand more about what to look for and what it’s all about. Second, be honest. Talk openly about your concern for your friend, ignoring it will not help her. Third, be caring but firm. It’s important to be supportive and compassionate but help her to take responsibility for her actions and behaviors. Ultimately, it is her that will need to take the steps to recovery. Lastly, you may want to help her explore treatment options and how to access them before her eating disorder gets to the point where it becomes life threatening. For local resources contact the Ulster County Eating Disorders Coalition at (845) 339-9090 x115 or on the web at www.eatingdisordersny.com.

Alcohol Addiction & Recovery

Dear Let’s Talk About It,                                                                                                                         

I have been in recovery for alcohol addiction for eight years and I recently relapsed. My younger sister passed away suddenly and one week later I was laid off from my job of twenty-two years. I’m so mad at myself and I don’t think I’ll ever get better. How do other people manage to stay sober? M.B.

Maintaining sobriety after addiction is a challenging and life-long process. So I’ll start by commending you for your five years sober. Relapse is the return to using and the using lifestyle after a period of abstinence. However, relapse does not mean that your efforts toward recovery are over or starting from scratch. Relapse can be seen as a transitional phase of recovery, a blip on the road map. Relapse is not a failure but a learning opportunity to strengthen your coping mechanisms and figure out what needs to be changed. Losing your sister as well as your job are two major life stressors that call on all your best skills to cope. When these coping skills are not sufficient or you don’t have the proper supports, relapse can happen. The best way people manage to stay sober is by; having a strong social support network using friends, family, support groups (ie: AA/NA), a sponsor and/or a therapist; learning a variety of coping techniques such as meditation/deep breathing, emotion regulation, identifying triggers, etc.; living a positive lifestyle by exercise, good nutrition, positive thinking, regular sleep and generally taking care of your mind, body and spirit. Once again, this is not an easy process but it is a rewarding one. For a local recovery program contact Bridgeback in Kingston NY at (845) 943-6091.