The Link Between Mood Disorders and Addiction

About 20% of Americans with an anxiety or other mood disorder (like depression) also have an alcohol or other substance use disorder.

Do you get anxious when you have to speak in front of an audience, take a test, or talk with a superior? Or maybe when you are facing debt, in an argument with someone you care about or at the precipice of a potentially life-altering decision? Every human being faces experiences that cause anxiety, but some feel it more than others. Research indicates that there is a genetic predisposition to anxiety; some of our nervous systems are more prone to anxiety than others. According to the National Institute of Mental Health, nearly 40 million people in the United States have suffered from some kind of anxiety disorder, including panic attacks and phobias. When you face anxiety, how will you handle it?

(Note: While this blog post focuses primarily on the link between anxiety and addiction, I have witnessed, with my clients, that this information can be generalized to other mood disorders as well.)

Individuals who come from unstable families and lack secure attachment often experience generalized anxiety; they may turn to drugs to calm themselves down. Many teens begin to abuse alcohol in their adolescence; it is their way of managing social anxiety.  A friend of mine abused prescription medications after her brother’s suicide; it was her way of muting her overwhelming feelings of loss. Many addicts relapse; it is their way to escape reality. Several of my clients suffering from post-traumatic stress disorder (PTSD) experience major anxiety; they have a difficult time regulating their nervous system responses and often turn to addictive substances for comfort.  Some people, however, face anxiety head on with exercise, self-care, hobbies, a balanced diet, etc. While everyone experiences some form of anxiety or a mood disorder (like depression) during their lives, only some individuals combat their anxiety with addictive substances.

The question begging to be asked is–does a mood disorder like  anxiety or depression cause addiction? No. So is there a link between anxiety and addiction? That answer is a resounding yes. Can it lead to it? Absolutely.

Anxiety consists of the excessive need for control; ignoring psychological and physical signs of stress; the unending need for approval; perfectionism; and strong reactions within the body and mind. The physical and psychological symptoms of anxiety are similar to withdrawal symptoms from drugs and alcohol. An addict will turn to substances, or other addictive behaviors to calm an anxious state. The avoidance of uncomfortable physical agitation and painful emotions are some of the key components that maintain the connection between addiction and anxiety. Both anxiety and addiction strengthen as the addictive behavior continues. Substance abuse can mask anxious feelings preventing the addict from receiving proper treatment for anxiety.

People who experience anxious moments, but who do not have anxiety disorders, will be able to go about their day when the crisis passes; people with anxiety disorders cannot stop the effects of their anxiety disrupting their everyday life. Professional, social, familial, and academic obligations will be interrupted and damaged by the sense of panic, stress, and foreboding that comes as a part of the condition. Social anxiety disorder frequently “travels in the company” of alcohol or drug abuse, as people with social anxiety disorder might try to make use of alcohol or cocaine to help make them feel more comfortable and less inhibited in social settings.

For individuals struggling with anxiety, substances offer an escape. For others, substances bring a feeling of relative normalcy (self-medication). For some, anxiety is a factor of their personality that also includes aspects like impulsivity that make the anxious person more likely to use substances.  Although not entirely understood, there is a connection between anxiety disorders and substance abuse. About 20% of those with an alcohol or substance use disorder also have an anxiety or mood disorder. In fact, many of my clients with an addiction (mostly sex addiction) are self-medicating their anxiety and depression with their addiction! It is also important to note that addiction can happen without any substances; you can be addicted to an eating disorder, gaming, sex, exercise, etc. The point is that mood disorders can either reinforce or be reinforced by addictive substances.

Treating substance abuse without treating the anxiety that causes it is a fruitless endeavor. 

Treating substance abuse without treating the co-occurring disorder can lead to higher rates of relapse. Due to the similarity of drug and alcohol withdrawal symptoms and anxiety symptoms, both need to be treated at the same time. The treatment for anxiety and addiction is referred to as dual diagnosis and it is important to find an addiction treatment facility, or a therapist, that can address both the addiction and the anxiety.

It is only through therapy that clients can make tangible strides towards restoring a sense of balance and stable mental health to their lives. Simply walking away from treatment after detox is ineffective…and might even prove more harmful. Now is the time to address the symptoms of anxiety and addiction that feed off of each other and keep you in the self-defeating cycle. Allow me to help you break the dependence on the substance or behavior, you have used to manage your anxiety and distress, as well as provide sustainable ways to cope with your mood disorder. Happiness is possible. Healing is possible. Contact me today to get started.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.


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Beware the Sting of the Internet: Simple Ways to Protect Your Home from Porn

“There is no dignity when the human dimension is eliminated from the person. In short, the problem with pornography is not that it shows too much of the person, but that it shows far too little.”  ~ Pope John Paul II

Every second…

  • 28,258 users are watching pornography on the internet
  • $3,075.64 is being spent on pornography on the internet and
  • 372 people are typing the word “adult” into a search engine.

Every day…

  • 37 pornographic videos are created in the United States
  • 2.5 billion emails containing porn are sent or received
  • 68 million search queries related to pornography (25% of total searches!) are generated, and 
  • 116,000 queries related to child pornography are received.

In addition to these frightening numbers, 40 million Americans regularly visit porn sites; 35% of all internet downloads are related to pornography; 34% of internet users have experienced unwanted exposure to pornographic content through ads, pop up ads, misdirected links or emails; and 33% of porn viewers are women. There is no doubt, pornography is everywhere. It is accessible just as it is addictive. So how can you protect yourself and your home from pornography? Since the web is accessible on so many devices nowadays, I want to go over some free and relatively easy ways to block pornography in your home.

DNS

The Domain Name System (DNS) is the Internet protocol that converts website names (domain names) to IP addresses. Filters at this level prevent the DNS resolution for the blocked sites, so their content never loads. This is the fastest way to block sites. Every device needs DNS to connect to the Internet, so this type of filtering works everywhere. All you have to do is open the device Settings, look for Network Settings or Wifi Settings and change the DNS servers (also called NameServers) to the IP address provided by your Internet Filter. Click here and refer to step one for specific instructions on how to open the settings, get to the appropriate filters, and block the known IP addresses. This article also has incredibly clear and helpful steps for setting up “clean” server providers on each of your devices. (It is important to note that if you are using your phone’s internet, versus wifi, you can bypass any filtering settings on DNS.)

PARENTAL CONTROL

When you make changes or set up filters on your device(s), you will need to set up parental control options that will disable your children from altering any of your settings or removing the filters you have put in place. This can be done on most TVs and devices like Roku, Amazon Fire Stick, and Chromecast. Each device might have a different name for Parental Control, but it is generally called Parental Control or Restrictions. On IOS (iPhone/iPad), you can do it by going to Settings-> General-> Restrictions and filtering the content you do not want to allow your children to see. On that page, if you scroll down to Allowed Content, I would recommend setting:

  • Movies: PG-13
  • TV Shows: TV-14
  • Books: Restrict explicit content
  • Apps: 12+
  • Siri: Explicit language filtered
  • Websites: Restrict adult content

ROUTER

Too many families miss the significant step of controlling their wireless router. You are responsible for every digital click that occurs on your WiFi network–every babysitter, every relative, every friend. Please make sure you have eliminated the bad stuff before they even decide to connect their device to your home’s network!

BROWSER HISTORY

Once you set up a filter to block pornographic content and enabled parental control, I recommend doing spot checks every day or every couple of days to see what online sites are being visited in your home. Older kids will learn to clear their browser history, but younger kids are not aware of that trick. Some devices (like Mac), even allow parents a way to prevent browser history from being deleted! Be aware of “incognito mode,” which is an internet browser setting that prevents browsing history from being stored. If you want to prevent this and have iOS, delete the app store to prevent more apps from being downloaded and ensure Safari is the only browsing app–Safari does not allow private browsing.

SPONTANEOUS FOLLOW-UP

Every few days, go through your children’s messages and social media apps like Instagram, Facebook, Whatsapp, etc. Look at the photos they are viewing and sharing, as well as with whom they are talking. Scan the photo library on your child’s cell phone as well; although younger kids may not be sexting yet, by the time they hit their tweens they may begin participating in this type of behavior. Be sure to look at your children’s deleted photos and messages because kids these days are smart! 

USE YOUR WORDS

At the end of the day, parents ultimately want their children to make good choices on their own–without filters or blockers or any kind. No parent wants to feel like a bossy, overseeing nag. Having a solid foundation where mutual trust and communication are employed will be the best way to help your kids be open with you. If they know they can come to you with questions, concerns, or mistakes without you getting upset, they will be more likely to be honest and open. So start today. Talk with them. Be real with them. Tell them that you will always be there to help them in any way you can.

Other practical tips include paying for ad blockers that potentially have offensive material, limiting or disabling data on your child’s device, restricting the YouTube app on your/your child’s device, enabling the PIN and call your Cable provider to block porn pay-per-view, and being sure to report offensive material if you do see it in a browser search (this will help improve their filtering). Be sure to keep in mind that whatever filtering tools you choose to go with will need to be installed on every device your child may use to go online: game consoles, cell phones, tablets, Kindles, personal laptops, computers, etc. 

One final tip: Lean on the many available resources to protect your home. Though the internet is full of pervasive material, there is also so much information on how to avoid and protect your family against it. You don’t have to do this alone; feel free to contact me with any questions, or to schedule a session. My door is always open!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Reconnecting with Reality: 10 Tips to Kick A Phone Addiction

“The price of anything is the amount of life you exchange for it.” ~ Henry David Thoreau

A survey was recently conducted where participants were asked, “If you had to break a bone or break your phone what would you prefer?” The results were astounding: 46% percent of people would prefer to have a broken bone than a broken phone! Before the smartphone era, the average American spent just 18 minutes a day on the phone; today that figure is up to three hours. Three out of 24 hours of our day is being spent staring at a tiny screen…that is 1/8th of our day! Is that how we would prefer to spend our time or would we like to break that cycle and spend our valuable time on something more productive and satisfying?

The urge to pick up our devices is similar to other forms of behavioral addiction. Like gambling or shopping addiction, a small shot of dopamine is released in various regions of the brain through phone usage. That is what keeps us coming back for more, even when we know it is not in our best interest to do so. Instead of improving our lives, technology is actually getting in the way of us living and enjoying our lives. How can we overcome our addiction to distraction so we can focus on the things that actually matter? Here are ten practical suggestions we can implement immediately:

  1. Scheduled screen time. Set a timer for 15 minutes. When it goes off, spend a quick minute checking your phone’s notifications and be done. Push back the alarm to go off every 30, 45, or 60 minutes. You can even ask for help and accountability from your friends and family; tell them you will not be responding to messages as frequently as you used to.
  2. Remove distractions from the home screen. Most of us have Twitter, Instagram, Facebook, etc at the forefront of our screens. If we make those apps less accessible, we will not use them as much. Keep the apps that you want to encourage yourself to use (like those for reading or learning a new language) front and center, and banish anything you want to limit your time with to folders on your second page of apps (or if you have an Android phone, off the screen entirely).
  3. Disable push. An incredibly simple way to cut down on distractions is to turn off “push” notifications for as many apps as you can. Just head to Settings > Notifications to control your preferences. 
  4. Moon mode. On iPhones, there is a little icon of a moon if you swipe up to control brightness and wifi and whatnot. That little moon represents “do not disturb,” and it is kind of magical. It is a glorified silent mode, ideal for nighttime settings or undistracted time at work. Use DND and airplane mode to silence incoming distractions. 
  5. Use a filler. Instead of opening social media to scroll aimlessly, open a different app and be productive. Replace bad habits with good ones like learning a new language through Duolingo, creating flashcards for anything with Anki, self-reflection journaling with Vertellis, or using any number of apps to read or listen to a good book.
  6. Go old school. Many people use their phones as an alarm clock. But because the phone is easily within reach while in bed, many people find themselves scrolling right before bed and first thing in the morning. Cut that bad habit by reinstating your old-school alarm clock.
  7. “Alexa, do what my phone used to do for me.” You can ask these smart devices to play music for you, to check the weather, to read you a text,…the list goes on and on. Use Alexa instead of your screen!
  8. Grayscale. Time Well Spent, a nonprofit focused on changing our relationships to technology, recommends switching your phone to grayscale to make it less appealing. On an iPhone, find “Display Accommodations” and then turn on “Color Filters.” On a Samsung device, find “Vision” and then scroll down to “Grayscale.”
  9. Put it away. Unless there is an important phone call we are waiting for, we really do not need our phones within arms reach at all times. My dad leaves his phone on top of the refrigerator unless he needs it. Think about it–a smoker trying to kick the habit will still reach for a cigarette if it is sitting right in front of him. Ditto for phones; remove the temptation by stashing yours in your bag while at work or in a drawer when you want to have a real conversation at home.
  10. Don’t stop! Keep trying. Stay accountable. iPhones come with a built-in tracking system so we can see just how much time we have spent on any given app each day. There are also apps like Freedom, Moment, and Space that can help us see where we are spending our time and help us set limits. 

No doubt, Steve Jobs’ inventions, in the field of technology, have changed the world. But what most people do not know is he would not even let his children use an iPad. He told The New York Times, “We limit how much technology our kids use in the home.” Steve knew the power and addictive nature of these devices. So let’s be like Steve and limit our use of technology and break the cycle of addiction. The ten suggestions above can get us well on our way to getting off the phone and back to real life connection. If you are reading this on your phone, text or email someone you are thinking about. Let them know you care. Set a time to see them.  And then put the phone away.

(As always, if you find you have questions or would like to schedule a session, please do not hesitate to contact me today!)

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Clear and Present Danger: Teens and Vaping

“We see clear signs that youth use of electronic cigarettes has reached an epidemic proportion, and we must adjust certain aspects of our comprehensive strategy to stem this clear and present danger.” ~ FDA, September, 2018

There’s a new cool kid on the block according to statistics published by Child Mind Institute. Smoking cigarettes has taken a backseat to the accessible and underestimated–yet still highly addictive–e-cigarette. E-cigarettes are now the most frequently used tobacco product among adolescents; some 2.1 million middle and high school students used e-cigarettes in 2017! This is far surpassing traditional combustible cigarettes. What is the e-cigarette? How does it work? Is it harmful? Because so many individuals are using these devices, it is important to be educated on this new behavior, especially popular amongst teens and young adults.

What is vaping?

Vaping devices include e-cigarettes, vape pens and advanced personal vaporizers (also known as ‘MODS’). When the device is used, the battery heats up the heating component, which turns the contents of the e-liquid into an aerosol that is inhaled into the lungs and then exhaled. Vaping is the act of inhaling and exhaling the aerosol, commonly referred to as vapor, which is produced by an e-cigarette. The difference between traditional tobacco cigarettes and e-cigarettes is that e-cigs do not contain nor produce tobacco smoke, but rather an aerosol. The vapor created by e-cigarettes consists of many fine particles which contain varying amounts of toxic chemicals that have been linked to cancer, as well as respiratory and heart disease.

E-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. E-cigarettes have many names, including e-cigs, JUUL (JUUL Labs, Inc. is the name of the leading electronic-cigarette company), ENDS (electronic nicotine delivery systems), e-hookah, and so much more. JUUL, the newest and most popular vape device, is sleek and tiny (reminiscent of a flash drive), and can be charged in a USB port. It comes in several enticing flavors like crème brûlée, mango and fruit medley. Every JUUL product contains a dose of nicotine, with one pod or flavor cartridge containing about the same amount of nicotine as a whole pack of cigarettes. The JUUL’s subtle design makes it easy to hide, which certainly explains why it has become so popular among middle and high school students. It now accounts for about 72 percent of the market share of vaping products in the United States and more than half of the e-cigarette market. E-cigarette company, JUUL Labs, Inc. recently exceeded a $10 billion valuation faster than any company…including Facebook! 

Is vaping bad for you?

Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. Though it is speculated that e-cigarettes expose the user to fewer toxic chemicals than traditional cigarettes, nicotine is the primary agent in both and it is highly addictive. Nicotine causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.  Additionally, many e-cigarette users get even more nicotine than they would from a tobacco product because you can buy extra-strength cartridges (a higher concentration of nicotine) or you can increase the e-cigarette voltage to get a greater hit of the substance.

Although e-cigarettes have been marketed as an aid to help you quit smoking, they have not been approved by the Food and Drug Administration (FDA) as a smoking cessation device. In fact, a recent study found that most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to smoke both traditional and e-cigarettes!

Why does vaping appeal to teens?

There are several reasons why e-cigarettes are grabbing the attention of the young people: First, many teens believe that vaping is less harmful than smoking (the packaging does little to convey the risks; it says 5% nicotine, which sounds like nothing, so teens think 95% is water weight or vapor). Second, e-cigarettes have a lower per-use cost than traditional cigarettes. Finally, vape cartridges are often formulated with flavorings such as apple pie and watermelon that appeal and seem less harmful to younger users.

What are the effects of vaping?

Vaping drugs affects how someone thinks, acts, and feels. Some may argue that vaping does not include nicotine, but most do. Even those without nicotine still have chemicals in them that irritate and damage the lungs and other internal organs. Vaping also slows brain development and affects memory, concentration, learning, self-control, attention, and mood. It serves as a gateway drug and increases the risk of other types of addiction later in life. Because this drug was only introduced to the public in 2007, there is limited research on the long-term effects.

If you are vaping, or participating in other addictive behaviors, and want to quit, there is hope! You CAN do it–you can kick this addictive habit and behavior. Start by deciding why you want to quit; own your reason and stick by it. Then, pick a day to quit. Get rid of your vaping supplies.  Avoid your triggers. Tap into available resources like apps, family members, friends, support groups, a therapist, and healthy hobbies. Get the help you need and deserve. I am your cheerleader; please do not hesitate to contact me today to schedule a session! 

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The Opioid Epidemic: Just a Prescription Away

Opiods - Cluff Counseling, Marriage & Family TherapyWhen a person takes a prescription drug for a nonmedical reason, it can quickly lead to addiction and the need for drug treatment. In fact, 25 percent of people who misused prescription drugs by age 13 ended up with an addiction at some point in their life.

One of my clients recently recounted some of the horrors of her childhood. When she was younger, her mother began misusing prescription drugs. My client remembered going with her mother to sketchy parking lots for exchanges, and her mother being completely under the influence of these powerful drugs. Every day when my client came home from school, she feared finding her mother passed out or dead on the bathroom floor. The addiction wreaked havoc on this family. It took years for the mother to get her addiction to prescription drugs under control.

The mother, of my client, was initially prescribed the pills to help combat her pain from a surgery. She never intended to terrify and permanently scar her children by what they saw when she was under the influence. But the temporary relief (or high) that the drugs gave her grew to be a necessity she could not live without. This is the case for most addicts of prescription drugs–they never intended to get hooked to the drugs meant to improve their health.

…But prescription drugs are powerful. Many people believe that prescription drugs are safer than illegal street drugs because they are prescribed by a doctor. When, in reality, they are just as dangerous. Prescription drugs are legal and more accessible than harmful drugs. More people report using controlled prescription drugs than cocaine, heroin and methamphetamine combined! Prescription drugs are in second place, behind marijuana, when it comes to illicit drug use. Additionally, prescription drugs often serve as gateway drugs–hooking people to the high and leaving them needing something stronger. Approximately three out of four new heroin users report misusing prescription opioids prior to using heroin!

Let me tell you the facts behind this opioid epidemic: The US makes up only 5 percent of the world’s population, yet consumes approximately 80% of the world’s prescription opioid drugs. 3.3 million Americans report misusing prescription painkillers. In the US alone, an estimated 54 million people over the age of 12 have used prescription drugs for nonmedical reasons in their lifetime. Prescription opioid overdose rates are highest among people ages 25 to 54 years. Here are the most commonly misused prescription drugs:

  • Prednisone or Cortisone. Used to treat rheumatoid arthritis, lupus, asthma, allergies and many other conditions. Side effects: High blood sugar, increased chance of infection, and thinning bones (osteoporosis). Natural alternative: Raw, whole food diet.
  • Methotrexate ­& Other Chemotherapeutic Agents. Used to treat breast, head, neck, lung, blood, bone, lymph node and uterus cancers. Side effects: Fetal death, livery and kidney toxicity, lung disease, intestinal bleeding. Natural alternative: Whole food diet, natural oils, vitamin C, fasting,
  • Coumadin or Warfarin. This drug is an anticoagulant, or a blood thinner, used to prevent the blood clots from forming or migrating. Side effects: Hemorrhaging. Natural alternative: Vitamin C, Vitamin E, OPC 165 (all natural antioxidant blend).
  • Cholesterol-lowering drugs. Used to promote excretion of bile build-up in intestinal tract to lower cholesterol circulation. Side effects: Inflammation of the muscles (myositis). Natural alternative: Whole foods, fish, spinach, avocado, oats, nuts, beans.
  • Prozac and antidepressants. Used to balance serotonin levels in the brain (serotonin is a neurotransmitter that affects mood, agitation, anxiety and sleep). Side effects: Nausea, weight gain, fatigue, insomnia, sexual problems, blurred vision, constipation, anxiety, trouble sleeping, and more. Natural alternative: Regular exercise, therapy and a whole food diet.
  • Ritalin, Cylert, Dexadrine, Adderal. Used to increase, maintain or improve levels of alertness and attention. Side effects: Abdominal pain, loss of appetite, anxiety, depression, dizziness, hypersensitivity, and suicidal thoughts. Natural alternative: Yoga, regular exercise, a musical instrument, whole food diet.
  • Beta Blockers and Calcium Channel Blockers. Used to lower blood pressure. Side effects: Shortness of breath, palpitations, congestive heart failure, increased death rate. Natural alternative: Reduce sodium intake and alcohol consumption, regular exercise, whole food diet.

I agree that natural alternatives are not remedies for severe medical issues like cancer. However, I believe healthy, natural lifestyle choices will enhance one’s overall health and can prevent further maladies in the future. When we are not supplying our bodies with proper nutrition, disease can manifest itself. This is usually when most people will resort to prescription drugs. These drugs only cover up the problem, but are never actually dealing with the root cause. The human body is a remarkable machine naturally built to function optimally on its own, but it can only do so when we provide it with all of the essential nutrients that it needs!

Taking a long-term medication that alters any of the body’s natural functions can be dangerous. But if taken for a short time and used properly, these drugs can be of great help, health, and healing to the consumer. I find it of the utmost importance to state that I firmly believe there is a place for prescription drugs. When used properly, they can alter and/or correct chemical imbalances and lessen pain to greatly improve one’s quality of life. Many (if not most) of my clients couple prescription medication with counseling to make leaps and bounds of progress in their lives. While I personally cannot prescribe medications, I support the proper usage of them, and often encourage clients to seek necessary medication in addition to attending therapy. Please contact me today if you would like to combine the power of properly used prescription drugs with personalized therapy. I am here to help you!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Trichotillomania: The Hair-Pulling Urge

Trichotillomania The Hair-Pulling Urge - Cluff Counseling - Lewisville TherapistHave you heard of trichotillomania? This is a hair-pulling disorder that serves as an anxious response. The individuals with this disorder may sit to watch TV and involuntarily pull out all their eyebrows!

Just the other day, a friend posted on Facebook about the irresistible urge to pull out all her eyelashes. There she sat on her bed, smiling and eyelashless, asking for help. Do you or someone you know struggle with the urge to pull out hairs? If so, this post is for you.

What is trichotillomania?

Trichotillomania (pronounced tri-ko-til-o-MAY-nee-uh), is a mental disorder that involves recurring, irresistible urges to pull hair out from the scalp, eyebrows or other areas of the body. Those with trichotillomania know it is unnecessary (and painful!) to pull out hairs, but they often cannot stop on their own. This is different from the occasional urge you may feel to rid yourself of an ingrown hair or that one chin hair that plagues you. It is incessant. It never goes away. And it provides an odd sense of satisfaction. The common symptoms of trichotillomania include:

  • Repeatedly pulling out hair from the scalp, eyebrows or eyelashes (and sometimes from other body areas)
  • Tension while resisting or before the actual act of pulling, accompanied by a sense of pleasure or relief once the hair is pulled
  • Noticeable hair loss (bald areas on the scalp or other areas of the body)
  • Biting, chewing, eating, or playing with pulled-out hair

Many people who have trichotillomania also pick their skin, bite their nails, or chew their lips. Pulling hairs from pets or dolls or from materials like clothes or blankets, may also be a sign. Most of those with this disorder try to pull hair in private to hide the disorder.

For people with trichotillomania, hair pulling can be either focused or automatic. Focused is when the hair pulling is done intentionally in order to relieve tension or distress. Other times it is automatic–it simply happens without the person realizing what he or she is doing. Regardless of the intent behind the hair pulling, the result is noticeable hair loss, scarring and other damage (like infections) to the skin on the specific area where hair is pulled. Healthy regrowth may also be stunted due to excessive plucking. Regardless of whether the hair pulling is focused or automatic, it is indicative of a mental illness–an anxious response–that can affect anyone.

What causes trichotillomania?

Although it is unclear exactly what causes trichotillomania, it is likely due to a combination of genetics, age, stress, and other present disorders. More often than not, those struggling with trichotillomania also face depression, anxiety, or obsessive-compulsive disorder. With such, anyone could be prone to this disorder. Studies show that the age of onset for trichotillomania is varied, but commonly manifests itself between 9 and 13 years of age. Trichotillomania seems to be more common in children than adults, but that is because adolescents and adults are more likely to hide the disorder and not admit their need for help. With preschool-aged children, both boys and girls are equally affected, yet 70-93% of preadolescents and young adults are female. There is no reported difference between ethnic groups.

Is there a cure for trichotillomania?

Without treatment, trichotillomania can be a long-term disorder. Symptoms can worsen over time with triggers such as stress and chemical changes (like hormonal changes of menstruation in women). Many clients with this disorder have tried for months or even years to stop pulling their hair without success. Relapses nearly always occur because this is such an involuntary and easy-to-practice disorder.

If you read and relate to this post, contact me today. I know that you want to stop pulling out your hair! So many individuals with trichotillomania feel embarrassed or ashamed by their appearance as a result of hair pulling. Trichotillomania is a habit and a mental health disorder you can work through to overcome, or help your child overcome.  As always, my door is open! Click here to schedule a session now.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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How to Talk to Your Child About Porn, Part II

How to Talk to Your Child About Porn, Part II - Cluff Counseling - Lewisville Therapist

No parent wants to talk with their children about pornography. It can seem overwhelming, uncomfortable, and maybe unnecessarily early–depending on the age of your child. While there may be validity to all those feelings, I urge you to communicate openly, honestly, and early with your child about the fallacies and dangers of pornography… before they learn about it elsewhere.

Children are now learning to use electronic devices at a very young age, and often stumble upon inappropriate pictures or videos. Like many others, you may be caught off guard and quite surprised by how early in your child’s life this happens. Upon entering puberty, pre-teens may be curious about sex and sexuality as their brain, body, and hormones change and develop. Your children may hear things in the playground or at a friend’s house. Inevitably, they will want to know more and asking Mom or Dad about sex can be embarrassing. You can be ready for this conversation by preparing some talking points and creating an environment of open communication. You will be grateful you did so!

Last month, I posted the first part in this two-part series on talking with your children about pornography. The world is different than it was 20 years ago; the ease and and convenience of viewing porn at our fingertips–plus the increased dependence on technology–is a recipe for disaster. We must adapt to the pervasive and dangerous drug that is sweeping through our internet, TVs, phones, and homes. It is everywhere. Your children will see porn; it is a matter of when, not if. My wish with this post is to help you prepare for when you decide to talk with your children about pornography. I know it seems like a daunting, horrible thing to need to talk about, and you may want to put it off as long as possible, but I urge you to read this post and mindfully consider what will be best for your child(ren).

Part 1 focused on 9 foundational points that will help guide you as you prepare for this conversation (or hopefully the first of many conversations) with your children. Click here to read that post in its entirety. To briefly summarize, those 9 points are:

  1. Build trust.
  2. Talk about it sooner rather than later.
  3. Prepare for it now.
  4. Explain why porn is problematic.
  5. Teach that porn is inaccurate.
  6. Treat pornography the same for your daughter as you would your son.
  7. Teach them (especially daughters) that their worth is more than skin deep.
  8. What to do if my child comes to me with a porn addiction.
  9. Make it an ongoing conversation.

Again, I recommend reviewing that post because I explained each point in greater detail that will offer clarity and guidance as you apply them. The most important thing about this talk is that you deliver it with the needs/preferences/personality of your individual children in mind. Follow your innate parent gut and speak with love.

What do I say?!

It is 100% natural to have no idea where to begin. Might I suggest that you begin by asking questions and then LISTEN. Encourage two-way conversation. Questions may include (but are not limited to) the following: What do you know about pornography? Do any of the kids at school ever talk about it? What do they say? Have you ever seen it? Did someone show it to you? Or did you find it yourself? You may be surprised and/or horrified by their responses, but try to remain calm. Reassure your child(ren) they are not in trouble. Try to find out how they found it and why they were searching for it. If they have seen it, ask when/where they saw it and how it made them feel. Then discuss those feelings.

Because children are generally pure and tender, they may feel “yucky” for what they have seen.

Explain to them that pornography teaches attitudes towards sex and sexual behaviors that are inaccurate and unhealthy. I highly recommend utilizing the suggestions found in Kristen Jenson’s book Good Pictures Bad Pictures: Porn Proofing Today’s Kids. She explains how to make it a comfortable conversation about what pornography is, why it is dangerous, and how to reject it. By explaining porn in a developmentally appropriate way (found in the book), young kids are able to porn-proof their own brains. If having this conversation is making you feel nervous, remember that professionals actually encourage parents to have this talk with their children. Avoiding the subject will only lead your children to satisfy their curiosity by searching elsewhere!

You may choose to discuss some of the false content portrayed in pornographic material (such as lack of respect and consent, violence, and dangerous sexual practices) to help them understand why you are concerned about them viewing it. Talking about these feelings will help them understand that this is for their protection and not just another rule you wish to impose upon them.

Then help them prepare for the future. Ask them what they could do if someone tries to show them pornography again and let them suggest options. Discourage them from seeking it out and encourage them to come to you with further questions. Explain that you will put protection up to help avoid further exposure in your home (through parental controls on smartphones, TVs, computers, blocking certain sites, installing filters, etc). You can even work with your child to find ways to protect against pornography! Your children might surprise you by agreeing with or even suggesting certain ‘house rules’, such as not deliberately visiting these sites, avoiding searches with potentially dangerous keywords, using devices in open areas at home and not behind closed doors, being offline by a particular time of night, no sleepovers, keeping phones in mom and dad’s room at night, etc. Together come up with consequences, and then as the parent, enforce the rules.

Okay so at what age do I do this?

This will depend on you. There is no hard and fast rule. Devorah Heitner, author of Screenwise: Helping Kids Thrive (and Survive) in Their Digital World, says parents can talk about potential issues as early as third grade, because even the youngest children can pretty easily find things like pornography online. I know several families who have this chat as early as eight years old. Basically, follow your gut. If you are thinking about this already, there is probably a reason! And remember my final suggestion from Part 1 of this post, to make this an ongoing conversation. Let your children know that you are always available and willing to continue the discussion, and encourage them to come to you before looking elsewhere. And as they grow and progress developmentally, I invite you to tailor this same conversation to their understanding.

No one looks forward to having the pornography chat with their children. But you must have this conversation in order to protect and prepare them. If you still have questions or concerns after reading this series on talking with children about porn, please feel free to contact me! Please remember–pornography is not just a male or an adult problem, it is a human problem. The children in your life need protection from pornography. They need to understand what it is, why it is harmful, and have a plan when they see it. And they need to have our support through loving, mentoring relationships, and know that we will be there for them when (not if!) they see porn. Keep it short. Be honest. Try to make it part of an ongoing and open discussion about sexuality and sexual development. Let’s have the wisdom, courage, and compassion to face this problem head on so that our youth will not have to face it alone.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

How to Talk to Your Child About Porn, Part I

How to Talk to Your Child About Porn, Part I - Cluff Counselingn - Lewisville Therapist“For some reason, we don’t talk very much to youth and children about one of the strongest urges and biggest temptations they will face. Our reluctance sets them up to be taught primarily by the internet, other children or teenagers, or even Hollywood.” -Joy D Jones

Children are now learning to use electronic devices at a very young age, and often stumble upon inappropriate pictures or videos. Like many others, you may be caught off guard and be quite surprised by how early in your child’s life this happens. Upon entering puberty, pre-teens may be curious about sex and sexuality as their brain, body, and hormones change. Your children may hear things in the playground or at a friend’s house. Inevitably, they will want to know more and asking Mom or Dad about sex can be embarrassing. You can be ready for this conversation by preparing some talking points and by creating an environment of open communication in your home. You will be grateful you did so!

Last month, I posted about how women can also fall prey to the temptations of pornography. Pornography is not just a male problem, it is a human problem. Knowing that women and girls are just as susceptible creates more of a sense of urgency to combat the pervasive nature of pornography. Your children will see porn; it is a matter of when not if. My wish with this post is to help you prepare for when you talk with your daughter or son about avoiding pornography. I know it seems like a daunting, horrible thing to talk about, and you may want to put it off as long as possible, but I urge you to read the following points and mindfully consider what will be best for your child(ren):

  1. Build trust. Your child needs to know that he/she can count on you to talk about the hard things and that your love is unconditional. It is impossible to have influence when there is no trust. Invest time in your relationship with your child to help them feel loved and accepted. Not only will discussions about sexual matters be more effective when you have a trusting relationship with your child, but they will feel safe coming to you with sensitive questions.
  2. Talk about it sooner rather than later. Kids are curious. Be the one to teach your children. If you do not, the Internet, Hollywood, or their friends will do it for you (and who knows how good of a job they will do)!
  3. Prepare for it now. This might entail talking with other moms, reading the latest research, contacting a reputable therapist for guidance, or conversing with your spouse/partner–whatever it is, plan and prepare today for this conversation with your children. It needs to be done correctly or else they may feel shame, guilt, or heightened curiosity–which could lead to further (and maybe secretive) internet searches.
  4. Explain why porn is problematic. For some families, this might include religious convictions. But regardless of your religious views, we can all agree that pornography depicts erotic material unsuitable for young children. It is imperative to help your child understand that explicit material is literally harmful for the developing brain (as taught by Kristen Jenson in Good Pictures Bad Pictures Jr.: A Simple Plan to Protect Young Minds), and that it can lead to unrealistic expectations of oneself, unhealthy relationships with others, and even addiction.
  5. Teach that porn is inaccurate. Children (and adults) need to be reminded that porn stars get plastic surgery, that sex depicted in porn is unrealistic, and that the high porn gives is temporary at best. Having a frank conversation about the mechanics of sex will lead you perfectly into the realities (and fallacies) of pornography. Educate your children on the male vs. female sexual response, and teach them that pornography is a literal production and not a true representative of typical sexual encounters. If you have not yet done so, this may be an advantageous time to talk about masturbation as well.
  6. Treat pornography the same for your daughter as you would your son. Whatever pointers/rules/guidelines/lessons/lectures/rules you have in place for your son, they need to be the exact same for your daughter!  Use the same protective measures with your daughter as you do with your son. Help them to develop an “internal filter” against pornography from an early age by teaching them what pornography is, why it is harmful, and how to reject it with a plan when they are exposed to it.
  7. Teach them (especially daughters) that their worth is more than skin deep. Society will teach your children–daughters especially–that their outward appearance is what really matters, and pornography definitely builds on that. Your children need to know that their worth is so much deeper than what they see in the mirror. Compliment them on their accomplishments or character traits as much or more than their appearance. As I stated in point four, porn stars are not meant to look real; many of their bodies are surgically, hormonally, and photographically enhanced. No one should expect–or expect others–to look that way!
  8. What do I do if my child comes to me with a pornography problem?  It is incredibly difficult to have a child confess a pornography problem. But the very best advice I can offer is to remain emotionally neutral. It is critically important that you not become unglued in front of your child, as this will increase their shame as well as make them less likely to listen and open up to you in the future. Be encouraging and supportive. Remember, porn is the enemy, not your child!
  9. Make it an ongoing conversation. Help them know that while the topics of sex, pornography, or masturbation are certainly not easy things to discuss, that you are always available to talk with them. Teach them that your chat is not a one-time occurrence and that you are and will always be a safe place to ask questions!

These nine points are guidelines for you to use as you navigate the when and the how of talking to your children about pornography. Next month I will share part two of this post, which will include specifically what to say to your children, as well as when–what age–to say it.   

Absolutely no one wants to have the pornography chat with their children. But you must have this conversation in order to protect and prepare them. Keep it short. Be honest. Try to make it part of an ongoing and open discussion about sexuality and sexual development. The children in your life need protection from pornography. They need to understand what it is, why it is harmful, and have a plan for when they see it. And they need to have our support through loving, mentoring relationships, and know that we will be there for them when (not if!) they see porn.  Let’s have the wisdom, courage, and compassion to face this problem head on so that our youth will not have to face it alone.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

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Men Are Not the Only Ones Addicted to Porn

Cluff Counseling - Men Are Not the Only Ones Addicted to Porn - Denton TherapistOne study found that 76% of females, between the ages of 18 to 30 years old, watch pornographic material. Although we may most commonly hear about men being addicted to pornography, women can be as well. Because the stereotypical porn addict is a man, women tend to feel shame and isolation when they “go against the norm” and become addicted to pornography. No one is exempt from falling prey to addiction–especially when pornography is so easily accessible!

There are many myths circulating about pornography usage. First is the myth that it is an accepted societal norm that men view pornography.  Second, is the idea that women do not view porn. Think about a movie where you see a girl deleting her browsing history as her boyfriend walks in the door…or a scene when a woman is caught with stacks of porn magazines under her mattress. If you are unable to think of such a scene, it is because men are the ones depicted as being hooked on pornography. Not women.

A recent German sex study showed that women are just as easily at risk of becoming dependent upon porn as men. In fact, one study reports that half of young adult women agree that viewing pornography is acceptable; a 1/3 of these young women reported using porn regularly.

The truth is that pornography is highly addictive. It truly is like a drug. It has a chemical effect on the brain that first leads to compulsion and then addiction. Substances like cigarettes, alcohol, and drugs bring foreign chemicals into the body (whether it is sniffed, injected, drunk from a glass, lit on fire and smoked, etc). Behavioral addictions, like gambling and viewing porn, bring no new chemicals or substances into the body, but achieve the same effect: the brain releasing dopamine, resulting in a temporary high.

Fight the New Drug–a website dedicated to increasing awareness and providing a community for healing from pornography addiction–gives the best example of what pornography is and does to the brain:

“Porn is basically sexual junk food. When a person is looking at porn, their brain is fooled into pumping out dopamine just as if they really were seeing a potential mate. Sure, filling your brain with feel-good chemicals might sound like a great idea at first, but just like with junk food, it’s more dangerous than it seems.”

Pornography appeals to one of our primary human needsthe need to belong and connect. Because of this, both men AND women are at risk. One article cautioned readers that thinking only men are pulled into viewing pornography is ignorance. Yes, porn has been criticized for hooking males with its focus on and objectification of female bodies. But there are, in fact, women viewers of pornography.  Pornography leaves no one exempt–men and women alike. The truth is that pornography is incredibly addictive–to anyone finding him- or herself in its wake.

According to several studies, men prefer watching visual erotica (pictures and movies) and women prefer actually engaging in interactive erotica (chat rooms, social media sites featuring explicit material, and webcams). Whatever its form, pornography not only impacts the brain–making its user need more and more all the more frequently–but it also harms the user’s attitudes and perception about real life sex, intimacy, and relationships. Pornography may negatively influence a woman in the following ways:

  • Unrealistic expectations around sexual behaviors and performance.
  • Reduced intimacy with real-life partners.
  • Personal sense of inadequacy.
  • Lowered self-esteem.

The excessive use of pornography can even affect a woman’s relationships with herself. One woman reported that she felt cheap, dirty, useless, insignificant, and unworthy of love or belonging. When she reached out asking for help as a 15 year-old girl, her adult-confidant did not believe someone as young and innocent as her could have such a problem. No one believed that she had a pornography addiction and needed help. She was a slave to her addiction for five more years, endlessly trying and failing to conquer her addiction on her own. She eventually reached a point of such deep self-loathing that she nearly tried to end her own life.

Most addicts strive day and night to keep their addiction a secret. It becomes an endless quest to feed the addiction while simultaneously living a double life. This is tiresome, unfulfilling, and–in the end–useless. Most of the men and women I work with know their addiction is unhealthy and want help to overcome it. While they once may have thought that viewing a little pornography would be liberating and fun, they soon find themselves a captive to its grasp. They wind up isolated, unhappy, and unsatisfied–it is a downward spiral. The only thing that is truly liberating is breaking free from addiction.

Tell somebody.

Begin breaking free by thinking of someone you trust or admire. Tell him or her what you are struggling with. It will be difficult, but having a trusted person on your side will help you not feel so alone.

Ask for help.

Next, ask a trusted friend to be your accountable buddy. Ask them if you could reach out to them when you are close to acting out, or give them permission to periodically ask how you are doing in regards to pornography. Researching and then making an appointment with a therapist is another way you can ask for help. Sometimes, just having someone else on your team–and not shouldering the burden of addiction alone–makes all the difference.

If you are a woman battling a pornography addiction, you are not alone. This is not a battle that only men face! I am here to tell you that addiction is addiction, and anyone can become addicted to the addictive, prevalent “substance” that is pornography. Anyone! Along with there being an increased awareness of this addiction, there is also help more readily available for all–male or female, child or adult.

Your sex life, virtual or physical, is one of the most intimate aspects of who you are. By opening yourself up to a new level of scrutiny, you will also open yourself up to new levels of freedom, healing, and grace. Addiction recovery is not an easy road. (In fact, I would dare to say that the only easy road is the one where you give up and stop trying.) But you are bigger and better than that! Yes, your addiction may feel stifling, but your will-power to overcome it, coupled with counseling from an experienced therapist, is stronger than even the strongest porn out there. Hope and healing is available today, now. Contact me or click here to schedule a session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

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When Addiction Raises Your Child

When Addiction Raises Your Child - Cluff Counseling - Lewisville TherapistAccording to The US Department of Health and Human Services, more than 8.3 million children currently live in a household where at least one parent is addicted to alcohol or drugs. Do those children notice their parents’ addiction? How does it affect them?

Addiction comes in all sizes and severities. There are addictions to substances like alcohol, tobacco, prescription drugs and illegal drugs (heroin, cocaine, methamphetamine, PCP/angel dust, hallucinogens, etc); there are impulse control disorders like kleptomania, pyromania, and gambling; and then there are behavioral addictions to food, sex, pornography, video games, smartphones, working, exercising, spirituality, cutting, shopping, etc. Because addictive behaviors are often done in isolation, the impacts of the behaviors, to loved ones, are often thought to be minimal.

Due to the many faces of addiction, its impacts can vary greatly. For example, a mother may physically leave her home to frequent bars, clubs, hotels, casinos; as a result, her children may suffer from neglect or abuse by her or others. Other addictions can take place at home and do not require a physical absence–like the father who abuses substances or gets involved in pornography/sex addiction from home. In such cases, his children may inadvertently experience psychological or emotional absence that can cause relational issues later in life. Depending on the age(s) of the child(ren), they may miss out on/not learn important things like how to brush their teeth or take care of their personal hygiene, table manners, stress management, problem solving, communication, how to make/keep friends, conflict resolution, etc. One woman, a new mom, recently told me she is not familiar with any nursery songs to sing to her daughter because she was never sung to herself.

This same woman shared with me the consequences she experienced of having a mother who was addicted to prescription pain medications. She said, “It was terrifying. Every day I dreaded coming home from school because I was afraid my mom would be passed out or dead on the bathroom floor. I was young–maybe third or fourth grade?–but I knew something was seriously wrong. I felt powerless. In order to feel like I had some semblance of control over my life, I formed OCD behaviors; I started pulling out all my eyelashes and even patches of hair off the top of my head. I even resorted to bullying a nice girl in my neighborhood! Eventually, the girl’s mother told my mom and I was put in therapy.” My heart goes out to this woman, as well as the other adult children of addicts whose stories I hear.

The real-life example above illustrates how children–even when they do not fully understand their parent’s addiction–feel its effects, and behaviorally act out their confusion and pain. They may wind up bullying, self-harming, or practicing OCD behaviors (obsessive-compulsive disorders) like cutting, eating disorders, etc. Many of these children go on to distrust authority figures, have commitment issues, and may wind up facing addiction themselves. Although these behaviors are often maladaptive, they are simply the way the child copes and tries to take care of him/herself. It is important that teachers, mentors and other adult family members recognize these as such, instead of punishing the child, and help them learn adaptive ways of coping (watch for a future blog post on specific ways you can help!).

If you are battling addiction, please remember–there is help! Just recently, I posted about the possibility of relying on a support animal through addiction and/or trauma. Not long before that I went into detail on support groups and group therapy which is accessible nationwide. And last summer, I posted about the benefits of therapy in general. The truth is, help is out there. In fact, it is readily available if you make (and follow through with) your decision to get help. So please, I urge you to contact me or schedule a session–not just for your own sake, but also for your family’s.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources: