I have a brief update to give on the last blog, which talked about the website/app Hims. It was reported to me that a person doesn’t even see a doctor on that site and can get antidepressant medication. The update that was given this week is that there is a texting conversation with the doctor before the prescription is written. No at all ideal, but slightly better than just a self-survey.
I’ve learned something new in the past few months. It’s now come up twice. A friend of mine is a psychiatrist (for those who don’t know the distinction, a psychiatrist has attended medical school and has received extra training in mental disorders and medication) explained to me that many people suffering with Bipolar Disorder cannot tolerate marijuana AT ALL. He said it causes a higher incidence of paranoid psychosis for this group than for the general population. He told me to pass along to all of you that if you have Bipolar Disorder, you should NEVER use marijuana.
Let me give a short clarification on what Bipolar Disorder is. Many people have a misunderstanding because the term “bipolar” is used as slang for mood swings. Bipolar Disorder is a difficult mental illness for someone to live with. It causes times of mania or hypomania, which means periods of little to no needed sleep with some combination of euphoria, anger/agitation, impulsive decision-making, sexually irresponsible behavior, rapid speech and/or thoughts, and grandiose ideas. These periods are followed by a marked and profound period of depression. The depression is intense and miserable. One client described it to me as “mashed potatoes. It’s as though everything has the color of mashed potatoes and the flavor of mashed potatoes. The world is devoid of life.” The depression can last for years on and off without any interruping mania for some. The pattern and timing of depression and mania varies from person to person.
I’m sure you can understand that someone dealing with the unpredictability of Bipolar Disorder might be drawn to marijuana. However, it is understood to be something that will destabilize the Bipolar Disorder over time and can even add in psychosis. The bottom line: It’s not worth the risk. By the way, I’m not a fan of it for others either. I know that alienates some of you, but the long-term effects of cannabis just don’t justify the short-term pleasures.
Making new, sober friends after rehab is essential. Image courtesy of photostock at FreeDigitalPhotos.net
Leaving rehab is usually a celebratory time. People discharge rehab feeling very strong and certain they will not relapse on drugs. They have gone over and over what they need to do in order to stay sober. Any good rehab will warn its clients how easy it is to lapse back into the old lifestyle. Plans are set, barriers against using drugs or alcohol are put in place, and the person goes home.
Here are some tips for staying sober:
1. Get plugged in. Find a recovery group that has strong, consistent members. Teenagers often feel awkward about walking into new situations. However, this is truly life or death and it is worth overcoming the embarrassment. Alcoholics Anonymous and Celebrate Recovery are two types of groups that can be very helpful. There is a Celebrate Recovery just for teenagers called The Landing.
2. Find a new hobby. Old habits and activities remind teens of when they used to use drugs or alcohol. New hobbies don’t have the old associations. If you used to get stoned and then listen to loud music, it’s time to hike instead. If these are hobbies where a social group can be joined, even better.
3. Recognize that it is easy to stay sober around sober people. Your teenager no longer has a physical need for their drug because they overcame that in rehab. There will be a psychological attraction to the drug for a long time after the physical need has disappeared. Teenagers who come home and immediately get involved with wholesome kids have a much lower rate of relapse. On the contrary, teens who come home and see old friends have a high rate of relapse.
4. Be honest. Parents, you need to allow your teenagers to tell you if they are having cravings. They need to be able to tell you without you getting really upset. If they can come to you, then you can help them through it. Discuss your plan for this ahead of time. Agree that if they are having a craving you will take them down to the beach and just walk with them, or something like that.
5. Do not assume you are immune to relapse. Teenagers comes out of rehab overconfident. This means they call old friends and sit to the side while friends use. Before long they just take a drag on a cigarette. Then it’s, “I just used pot once. That’s not really a serious drug though.” Quickly they are all the way back into it whatever they went to rehab for in the first place.
Following these 5 tips will really help your teenager keep their sobriety after rehab. It is a challenging thing to do. With the right attitude and focus though, it’s entirely achievable. Probably the most important two tips on this list are the ones discussing social groups. Teenagers are heavily, heavily influenced by peers. Being around clean and sober people makes recovery much easier.
Helping teens grow and families improve connection,
A psychiatrist prescribes medication to help with your psychological struggles. There are some certified to work with teens and children.
First of all, a lot of people do not know the difference between a psychologist, psychiatrist, counselor and therapist. Let me start by clarifying what those terms mean. Counselor is the most general term. It can refer to a therapist, psychologist or psychiatrist. Counselor is also the term used for a person with an associate degree or certification in addiction counseling. A therapist refers to either a psychologist or a master’s level person with a license. A therapist is someone who will spend an hour with you on a regular basis talking about ways to work through your struggles, and can also do psychological testing. A psychologist has a doctorate (either a Ph.D. or a Psy.D.), can do psychological testing, and can do therapy. A psychiatrist is a medical doctor, who completed medical school and a residency. The psychiatrist can do therapy, but typically chooses to refer out for therapy. The psychiatrist evaluates patients to determine whether medicine can help a psychological condition, and if so, prescribes that medication.
Sometimes people hesitate to take medicine for a psychological condition, preferring to address the problem in therapy. Usually your therapist will let you know when it is time to seek a psychiatric evaluation. It is also a good idea to see a psychiatrist if you feel extremely depressed, are considering suicide, have been hallucinating, or have extreme anxiety like panic attacks. There are other conditions where seeing a psychiatrist is advisable as well. For example, if you suspect your child has ADHD, then you can get a diagnosis and treatment from a psychiatrist. Use your therapist or primary care doctor as a guide in terms of when to contact a psychiatrist, and often they will have good referrals to give you.
When you go to your psychiatry appointment, come prepared. Keep a list of your symptoms, what caused them, and what time of day they occurred. Be extremely honest about any drugs or alcohol you use. Your psychiatrist is required to keep everything confidential, so don’t be afraid to tell him or her. If you smoke marijuana every so often, your psychiatrist NEEDS to know this. The reason it is so important to give your psychiatrist this information is that you are being given medication. Alcohol and illegal drugs interact with legal medication, affecting how well the medicine works. In some cases you actually are putting yourself in danger by mixing certain medications with certain drugs or with alcohol. Your psychiatrist isn’t going to be judgmental of you, believe me. Your psychiatrist has heard it all, and I mean ALL. You will not shock your psychiatrist. He or she has seen some of the seemingly most normal looking people take drugs, have an alcohol problem, lose touch with reality, make poor decisions, participate in extremely risky behavior, and anything else you can think of. Just keep in mind that your psychiatrist can only help you to the extent that you share everything about what is going on with you.
Also come to your appointments with a list of any physical symptoms you might be dealing with. Remember, this is a medical doctor. Sometimes psychological problems are caused by a physical problem or a disease. Your psychiatrist is trained to look for signs of physical disease and help you connect the dots. They are also trained to look for the opposite (physical problems caused by psychological impairment).
So, is it time to call a psychiatrist? Perhaps, and especially if you’re considering taking medication to deal with a psychological struggle. Consult with your therapist or primary care doctor to find out. If you don’t have a therapist or primary care doctor, you can call a psychiatrist directly for an evaluation in most cases.
Helping teens grow and families improve connection,
Sexual addiction affects adults and teens alike. Image courtesy of photostock / FreeDigitalPhotos.net
More and more teens are engaging in pornography use. The majority of the use seems to be on their phones. Adolescents are very private about their cell phones. It is harder for parents to monitor what they search than when there was a family computer.
According to Covenant Eyes, a company that sells a way to block certain web content from either accidentally coming up, or from coming up as the result of a search, the statistics are unsettling. For teens, a 2010 national study indicated that about 25% of teenagers have viewed nudity online by accident. Over 1/4 of 17 year olds have received a “sext” at some point. 9 out of 10 teenage boys have been exposed to pornography by time they reach college. The same is true in almost 6 out of 10 teen girls.
Recently in my private practice I have been receiving desperate calls from parents whose teen children are addicted to internet porn. The parents feel helpless and frustrated. For starters, there is more shame in admitting you need help to stop a sexual addiction than even a drug addiction. It seems easier for a parent to call me and say their teenager is addicted to marijuana, alcohol, or even methamphetamine than to online pornography.
If your child is struggling with this, or you are struggling with this, the first thing to do is set aside your shame. Shame makes us hide. We feel mortified about something we are doing, or some part of who we are. When we feel ashamed of something, it is very difficult to talk about it. However, getting it out in the open is how healing begins. Think about when you have a wound, it needs to be cleaned out and it needs air to heal. If you hide away your wound then it just begins to spread infection to other parts of the body. Sexual addiction is like that (as are any other addictions). If you don’t discuss it, even if that is incredibly difficult to do, it starts to affect other areas of life; addiction makes the most honest people into liars, the most responsible people into schemers, and emotionally closes off the most open and loving people.
Therapy is one of the best places to talk about sexual addiction. It is confidential and free of judgment. You will not shock your therapist. Your therapist should be able to help you pick a path back to health. This is not easy. Many people assume if you want to stop a sexual addiction then just stop looking at the porn. If it were that simple I doubt anyone would have the addiction. Whether or not the images are viewed, they still exist in your teen’s mind’s eye. It takes a lot of work and time to get to the place where those images don’t pop up each time your teenager thinks about sex.
Patrick Carnes is one of the leaders on treating sexual addiction. He wrote a book called Out of the Shadows that is very helpful for those with addiction, and the people that love them. If you’re reading this because you want help, but you’re afraid to say that out loud, then I recommend you start with this book.
If you or your child is struggling with sexual addiction and you are ready to say that out loud, don’t wait any longer. Go and get the help you or your teenager needs.
Helping teens grow and families improve connection,
People have a hard time believing marijuana is addictive. Indeed, for many people it is not. It is similar to alcohol in that most people who use it do not become dependent. Most can use it in a social, recreational situation. However, like alcohol, there are some who cannot control their use.
Someone who is addicted to marijuana always says that other people do not understand it. They say it has health benefits, and that it is not an addictive drug. They say of course they could stop if they wanted to. They ignore the irritation of their loved ones, and they ignore the signs that it is a problem. Their productivity is lowered, and their emotional range is blunted. They tend to use it several times per day. It is often the center of their social group.
Heavy marijuana users tend to need it to fall asleep. Their anxiety becomes so high that it is hard to quiet their minds before falling asleep. What is ironic about this is that the majority of people who abuse marijuana claim it isn’t addictive. However, if your teenager needs it in order to get to sleep, their body is dependent on it.
According to drugabuse.gov, 1 in 6 teens who use cannabis end up addicted to it during their lifetime. For those who use it daily, the number skyrockets to 1 in 4. Nearly 1 in 5 teenagers who enter a drug rehab facility go to treatment because they can’t quit using marijuana.
As a therapist who works with teens that have drug problems, I find that the teens who abuse marijuana are initially resistant to the idea they are addicted. This is much more true than the teens who abuse other drugs. I have yet to sit down with an opiate, meth, cocaine, or anxiolytic (such as Xanax) addict who thinks there is absolutely no problem with their drug use. Yes, some of these drug users are in denial about how intense their addiction might be, but they all agree that it would be better to be sober. This is not true with adolescents abusing marijuana. Most of them maintain a moderate level of functioning, so they argue that they’re completely fine. It takes a lot of work to break through a marijuana addict’s denial wall because addiction to marijuana is more subtle.
If this describes your teenager, my heart goes out to you. You might even feel torn about whether marijuana is addictive yourself. One thing that may help you understand is according to http://adai.uw.edu/marijuana/factsheets/potency.pdf, marijuana is 2 to 7 times more potent than in the 1970s. Also, teens tend to smoke the flower buds of the cannabis plant, which is stronger than the leaves previous generations tended to smoke. Many now use “dabs,” which is concentrated THC inhaled through a vape pen. According to justthinktwice.gov, dabs are approximately four times as strong as the highest grade marijuana; they are absolutely addictive. Previous generations also were more likely to begin use in their 20s, but now that is starting 5-10 years sooner.
If this blog is hitting home a little too closely, your teen has possibly begun to have a marijuana dependence. They will argue with you that they feel fine, but it is still a problem behavior. If you want your teen to be engaged, present and productive, then encourage them to quit. If they cannot or will not quit, get them help.
Helping teens grow and families improve connection,
Hello, I’m Lauren! If you notice your teen struggling, you might be feeling helpless, hopeless, frustrated or concerned as a parent. Try to remember, there is hope. I want to help your adolescent feel better. My hope is for them to enjoy their life again. I want them to feel confident they can handle whatever situations arise.