The Link Between Insomnia and Mental Illness

“I’ve always envied people who sleep easily. Their brains must be cleaner, the floorboards of the skull well swept, all the little monsters closed up in a steamer trunk at the foot of the bed.”  ~ David Benioff (co-creator of Game of Thrones)

Surely you have experienced a poor night’s sleep. You wake up feeling unrested, groggy, like you got hit by a train… And the fun lasts throughout the day with slow reflexes, foggy brain, inability to concentrate, impatience, stress, worry, anxiety and even headaches. It is absolutely no surprise that sleep quality has a direct impact on your physical and mental health. Today I am going to highlight the connection between insomnia and mental illness, in hopes that those experiencing it can get the help they deserve.

Insomnia is defined as the inability to get the necessary amount of sleep to function efficiently during the daytime. It is a sleep disorder that is characterized by difficulty falling asleep, waking up often throughout the night, having trouble going back to sleep, and waking up too early in the morning. In essence, insomnia results in feeling tired upon waking. Understandably, said fatigue can lead to difficulties functioning during the daytime and have unpleasant effects on work, social and family life. 

You likely already knew all of that about insomnia. But what you may be unaware of is that insomnia can be indicative of more serious issues, including medical issues like sleep apnea, or even mental illnesses like anxiety, depression, schizophrenia, bipolar disorder, and attention deficit hyperactivity disorder (ADHD). Sleep issues can even be a sign of an impending condition such as bipolar disorder. Many existing medical and mental health conditions can be worsened by sleep-related problems because lack of sleep slows recovery from mental illness. People with depression who continue to experience insomnia, for instance, are less likely to respond to treatment for depression. They are also at greater risk of relapse than those without sleeping problems.

Many people do not know there is an undeniable link between insomnia and mental health issues. More than fifty percent of insomnia cases are related to depression, anxiety or psychological stress, and many anxiety disorders are associated with difficulty sleeping. For instance, obsessive-compulsive disorder (OCD) is frequently associated with poor sleep. Panic attacks during sleep may suggest a panic disorder. Poor sleep resulting from nightmares may be associated with post-traumatic stress disorder (PTSD). The severity of sleep issues can determine the type of mental illness a person my experience. For example, early morning wakefulness, low energy, inability to concentrate, sadness and a change in appetite or weight can be indicative of depression. A sudden dramatic decrease in sleep accompanied by an increase in energy (or the lack of need for sleep) may be a sign of mania

Poor sleep patterns can not only be indicative of mental health issues, but it can also significantly worsen them. Insomnia makes it difficult to process and react to appropriately to negative emotions. Severe sleep problems can decrease the effectiveness of certain treatments. Treatment of sleep disorders has also been studied in relationship to schizophrenia, ADHD and other mental illnesses. All of the scientific data shows the connection between medical and mental illnesses: good sleep is necessary for recovery—or prevention—in both types of conditions.

There was a research trial done where fifty-one percent of individuals who overcame depression after psychological treatment (therapy) or medication were still experiencing insomnia. Insomnia tends to persist unless it is directly targeted for treatment. Insomnia can either be short-term or long-term; short-term insomnia is very common and has many causes such as stress, travel or other life events. It can generally be relieved by simple sleep hygiene interventions such as exercise, a hot bath, warm milk or changing your bedroom environment. Long-term insomnia lasts for more than three weeks. This is when you need to be examined by a physician with a potential referral to a sleep disorder specialist (a psychiatrist, neurologist or pulmonologist who have expertise in sleep disorders) for assistance. A balanced diet, regular exercise, meditation and relaxation, good sleeping habits, herbal remedies, medication and therapy are powerful actions that can help relieve insomnia. 

Living with insomnia is hard. The constant exhaustion and inability to sleep is an ailment which may require medical attention to overcome. Remember that insomnia often comes paired with a mental illness. Only as you work through both ailments will you find lasting relief. But it is doable, and I am here to help! Please do not hesitate to contact me today!

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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When Stealing Is a Compulsion, Not a Choice

“A kleptomaniac is a person who helps himself because he can’t help himself.” ~ Henry Morgan

Although kleptomania is a relatively rare mental illness–affecting 6 in 1000 or 1.2 million Americans–you have likely heard someone referred to as a “klepto.”  An example of a public figure, who is thought to struggle with kleptomania, is Winona Ryder, one of the lead actresses from Stranger Things. She was caught stealing over $5,000 worth of designer clothes from Saks Fifth Avenue in 2001.

Kleptomania is a mental health disorder summarized as the recurrent inability to resist urges to steal. Very rarely do kleptomaniacs steal items of great worth; more often than not, they steal items that they do not need, that they could afford to buy, and that have little to no monetary value…like a keychain.  People affected by kleptomania do not compulsively steal for personal gain, on a dare, for revenge or out of rebellion; they steal simply because the urge is so powerful that they cannot resist it. Such episodes nearly always occur spontaneously, with little to no premeditation or forethought. Kleptomaniacs tend to steal from public places like stores and supermarkets. Some may even steal from friends or acquaintances. The stolen items are either stashed away, never to be used, or potentially donated, given away to family or friends, or even secretly returned to the place from which they were stolen. Kleptomania can cause much emotional pain to you and your loved ones if not treated.

Kleptomania vs. Stealing

Kleptomania is different from flat-out stealing. Ordinary theft (regardless of whether it is planned or impulsive) is deliberate and motivated by the usefulness of an object or its monetary worth. Kleptomania, on the other hand, is the recurring impulse to steal items even though said items are not needed for personal use or monetary value. Often a sense of entitlement comes with stealing, a feeling of “I deserve this”. Stealing is driven by need or want; kleptomania is a compulsion. 

Causes

The causes of kleptomania are unknown. Some scientists believe that kleptomania is part of an alcohol or substance addiction. Some think it is due to an imbalance of the brain chemical, serotonin–which helps regulate mood and emotions (low levels of serotonin are common in people prone to impulsive behaviors). Others consider it to be a deviation of an impulse control disorder like eating disorders or obsessive-compulsive disorder.  Although, in theory, anyone can have kleptomania, it seems its onset generally occurs in late adolescence or early adulthood among women. 

Symptoms

Signs of kleptomania are commonly misdiagnosed as everyday theft, but there are a few telltale symptoms and signs that accompany clinical kleptomania, such as the following:

  • Stress
  • Thoughts of intrusion
  • Powerful urges to steal items not needed
  • Inability to resist the compulsion to steal
  • Feeling pleasure, relief or gratification while stealing
  • Release of pressure following the theft
  • Feeling terrible guilt, remorse, self-loathing, shame or fear of arrest after the theft
  • Return of the urges and a repetition of the kleptomania cycle

Effects

Aside from the emotional turmoil that would accompany dealing with the previously listed symptoms, the physical and social effects can include arrest, incarceration, being labeled a thief, developing substance abuse problems, being ostracised from loved ones, losing a job, having poor self-image, and even incurring a criminal record. Additionally, if left untreated, kleptomania can lead to other impulse-control disorders, alcohol/substance abuse, eating disorders, depression, anxiety, and even suicidal thoughts.

Kleptomania comes with a great deal of shame and guilt, as well as the potential for serious legal consequences. Uncontrollable stealing can prevent anyone battling kleptomania from living a productive life. This mood disorder is destructive to both the kleptomaniac and their loved ones, but the good news is that help is available. Although it cannot be cured, kleptomania can be managed with a combination of pharmaceutical and behavioral treatments. I am available to offer professional support to help you or your loved one live a fulfilling life, free from the grips of kleptomania. Please do not hesitate to contact me to today. Help is one click or call away!

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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Hypochondriasis: When Worrying About Your Health Goes Too Far

“All the powers of imagination combine in hypochondria.” ~ Mason Cooley

If you were to google the symptoms from hunger pains and a low-grade fever, the internet might tell you you have appendicitis or another life-threatening illness. It is likely that you have had something similar happen–thinking a minor sickness is actually something far more concerning. While this may be laughable for many people, some individuals genuinely and subconsciously worry they have contracted (or may contract) a very serious illness from day-to-day life. This type of excessive worry is uncontrollable for some, and is a type of mental illness called hypochondriasis.

While hypochondriasis is the proper name for this illness, you have likely heard of it referred to as health anxiety, illness anxiety disorder, hypochondria, or that someone struggling with this mental illness is a “hypochondriac.” It is defined as the excessive worry of being or becoming seriously ill–even with the absence of worrisome physical symptoms. You may believe that normal body sensations or minor symptoms are signs of severe illness, even if or when a thorough medical exam does not reveal a serious medical condition.

This mental illness, like several others, is difficult in the fact that it is relentless–it never stops. No matter where you go, you worry about germs and contracting deadly sicknesses; it is as if the rest of your life is merely background music to the constant worrying that is hypochondriasis. This severe distress can majorly interrupt your life.

Symptoms of illness anxiety disorder involve preoccupation with the idea that you are seriously ill, based on normal body sensations (like the sounds of a hungry stomach) or minor signs (like a minor rash). Signs and symptoms may include:

  • Being preoccupied with having or getting a serious disease or health condition
  • Worrying that minor symptoms or body sensations are indicative of a serious illness
  • Being easily alarmed about your health status
  • Finding little or no reassurance from doctor visits or negative test results
  • Worrying about a specific medical condition because it runs in your family
  • Having so much distress about possible illnesses that it is hard for you to function
  • Repeatedly checking your body for signs of illness or disease
  • Frequently making medical appointments for reassurance (or even avoiding medical care for fear of being diagnosed with a serious illness)
  • Avoiding people, places or activities for fear of health risks
  • Constantly talking about your health and possible illnesses
  • Frequently searching the internet for causes of symptoms or possible illnesses

The causes for hypochondria are unclear, but there are three common hypothesis. First, you may have a difficult time accepting the uncertainty of an uncomfortable or unusual symptom in your body, which may lead you to search for evidence that would provide a more concrete answer–often resulting in an unnecessarily serious diagnosis. The second option is that you have had a parent or other family member excessively worry about their own or your health. The third possibility is that you have had a past experience with a serious illness that has created an overwhelming fear or paranoia surrounding unusual physical sensations.

The best prevention and treatments for hypochondria are simple. First, see your doctor for your routine check-ups to ensure optimal health. He/she can help reassure you that you are healthy, and this professional diagnosis may be useful to fall back on if you start worrying about your overall health. Second, if you have problems with anxiety, seek professional guidance from a mental health counselor as quickly as possible to help stop symptoms from worsening and impairing your quality of life. Third, learn to recognize when you are feeling stressed, how stress affects your body, and how to manage your stress (think meditation, exercise, a healthy diet, self-care, etc). And lastly, stick with your treatment plan to help prevent relapses or worsening of symptoms.

Just as you would go to a medical doctor with a broken limb or an unresolved alarming health concern, you should see a qualified, trained and experienced therapist to treat your mental needs. Hypochondria is a very real and debilitating mental illness. There is a way to work through your excessive worries and fears of sickness. I am here to help. Please contact me today with questions or 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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Supporting A Loved One Through Alcohol Addiction

Each Al-Anon Family Group has but one purpose: to help families of alcoholics. We do this by practicing the Twelve Steps of AA ourselves, by encouraging and understanding our alcoholic relatives, and by welcoming and giving comfort to families of alcoholics.

It can be so difficult to know your place if you have a friend or family member struggling with an alcohol addiction. You may not know what to say or how to help; you may feel like their addiction is straining your relationship; you may resent their choices. While it is true that you cannot force a person to get help for alcoholism, there are various ways you can support them and encourage them to seek treatment.

You have likely heard of Alcoholics Anonymous (or AA). In April, I wrote a post that detailed the basics of Alcoholics Anonymous. I tried to cover everything from what it is, to how it started, its main tenets, if it works, and how it applies to those who do not believe in God. I detailed the strength that comes from utilizing this specialized support group of complete strangers who understand the path of the alcoholic’s addiction.  This is a program of recovery for specifically for alcoholics; Al-Anon, however, is different. It is a program of recovery for people who are affected by someone else’s drinking, whether that be a friend or family. It is one of many resources available to support those indirectly affected by alcoholism. This post is dedicated to how you can support a loved one through alcohol addiction.

There is no one exact formula that will tell you how to support someone facing an addiction to alcohol. Every person is different and, therefore, each person’s recovery process will be unique. Some people may rely heavily on their support system and want to involve you in each step during treatment; others may be more reserved and may only come to you when they need a listening ear or want to talk. The best thing you can do for a loved one who is recovering is to motivate and support them every step of the way. Here are several specific ideas for how you can get involved and offer support:

  • Learn about his/her condition. Understanding that, over time, alcohol rewires a person’s brain and causes it to function differently, sheds light on why he/she cannot simply choose to stop drinking alcohol.
  • Know the warning signs. Some signs are recognizable while others are subtle. Several telltale signs of a potential drinking problem are irrational behavior, lack of interest in hobbies and ignoring responsibilities. (This step is particularly important for those who have not yet recognized the need for help to overcome an alcohol addiction.)
  • Offer to help research alcohol rehab programs and types of therapy. Deciding on where to go for treatment is one of the most important factors in a person’s recovery journey.
  • Attend support group meetings or counseling sessions with your loved one. This will give you insight to their journey as well as guide you in how to handle different situations. (AA meetings are generally open, which means you can attend with your loved one. These meetings offer a great deal of support and advice for living with someone who has a drinking problem.)
  • Attend Al-Anon meetings. Just as those facing alcohol addiction will attend AA meetings, you should attend Al-Anon meetings. Here you will find support as you meet others who also love someone with an alcohol addiction, and will be able to personally work through the 12 steps of Al-Anon. Visit this website to find a meeting near you.
  • Help with the post-rehab recovery plan. Be constant as your loved one navigates life as a recovering addict.
  • Be optimistic. Addiction recovery is a steady uphill battle that will come with victories and defeats. When setbacks come, try not to be critical and face the future with hope. When progress occurs, celebrate it and continue pushing forward.

Family and friends should understand that the recovery process can come with many ups and downs–for both parties. When things get difficult, remember that having a steady support system will make a profound difference for your loved one. Your support will surely influence whether or not he/she seeks help for their drinking problem, will buoy him/her through treatment, and will increase the likelihood that he/she will maintain sobriety after treatment. Your role is crucial!

More than 15 million people struggle with an alcohol use disorder in the United States, but less than eight percent of those receive treatment.  Alcoholics Anonymous is a free resource available to all that will offer tools to both the individual facing the addiction, as well as his/her loved ones. Alcoholism affects everyone, including family members and friends of the alcoholic. This can damage relationships and cause you to feel a wide range of emotions like disappointment, anger, doubt and denial. Although your primary goal is likely to get your loved one help, be sure to get the help you might also need. In many instances, speaking with a counselor is helpful and even necessary. If you feel you could use professional help, I invite you to contact me today or schedule a session. Whether you are the one facing the addiction, or the one offering support, I am here to help you every step of the way!

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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Continuing the Conversation on Teen Suicide: How to Help

“Don’t you know things can change / Things’ll go your way / If you hold on for one more day / Can you hold on for one more day?” ~ ”Hold On” by Wilson Phillips

Our community has felt the rippling effects of tragic suicides over the last year. We continue to grieve the loss of students and loved ones we miss so dearly. We know our community is not the only one experiencing the difficult aftermath of suicide, so we want to raise our voice to raise awareness.

Over the last few months, I have written two posts on the subject of teen suicide. Because this is such an important topic, I decided to split up my posts to do each one justice. First, I gave a general overview of teen suicide. Then I discussed the warning signs. Finally, I want to offer my personal and professional advice about how you can help.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

As I said, I dedicated an entire post to the warning signs someone considering suicide will likely exhibit. Please refer to that for a greater understanding on that subject. The main indicators are suicidal talk, self-harm, hopelessness, and neglecting appearance/friends/important activities.

If you see any of these warning signs in a friend or family member, the first thing you could do is talk about it. While it may be uncomfortable to discuss suicidal thoughts and behaviors, it may end up curbing a suicide attempt and saving a life. It is worth it! Some ideas to start this conversation could be something like, “I have been feeling concerned about you lately,” or, “Recently, I have noticed some differences in you and wondered how you are doing.” Similarly, you could say, “I wanted to check in with you because you have not seemed yourself lately.” If the person admits to feeling suicidal, you can then ask things like, “When did you begin feeling like this?” or, “Did something happen to make you start feeling this way?” as well as, “How can I best support you right now?” and even, “Have you thought about getting help?” Finally, words of comfort might include, “You are not alone in this. I’m here for you.” Another powerful idea is, “I may not be able to understand exactly how you feel, but I care about you and want to help,” as well as, “When you want to give up, tell yourself you will hold off for just one more day, hour, minute—whatever you can manage.”

If someone confides in you that he/she is considering suicide, evaluate the seriousness of the situation. Those at the highest risk for committing suicide in the near future have a specific suicide plan, the means to carry out the plan, a time set for doing it, and an intention to do it. Here is a suggestion for how to assess someone’s risk to suicide:

Low: Some suicidal thoughts. No suicide plan. Says he or she won’t attempt suicide.

Moderate: Suicidal thoughts. Vague plan that isn’t very lethal. Says he or she won’t attempt suicide.

High: Suicidal thoughts. Specific plan that is highly lethal. Says he or she won’t attempt suicide.

Severe: Suicidal thoughts. Specific plan that is highly lethal. Says he or she will attempt suicide.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

If it seems the person is in the low to moderate range, offer empathy and a listening ear. Let your loved one know that he or she is not alone and that you care. A teen’s school counselors, teachers, or administration are trained and equipped to help too! If you are afraid to talk to someone face to face, call or text a crisis line for advice and referrals. Where applicable, you can help your friend/family member locate a treatment facility or take them to doctor appointments. Overall, I highly recommend encouraging the person to see a certified mental health professional as soon as possible.

If the person is in the high to severe ranges, and a suicide attempt seems imminent, call a local crisis center, dial 911, or take the person to an emergency room immediately. Remove anything that could be potentially harmful, like guns, drugs, knives, and other lethal objects from the vicinity. Do not, under any circumstances, leave a suicidal person alone!

If you are the one experiencing suicidal thoughts or feelings, surround yourself with people you trust and get help. There are so many resources available today, including the National Suicide Prevention Hotline (24 hours a day at 1-800-273-8255) as well as counselors in the schools. They can be trusted to help you. Remember that suicide closely affects at least six people–often many more! Absolutely no one will be better off with you gone…quite the contrary, actually. You matter. You are worthy of love and life. Life is worth fighting for. Do not give up on yourself!

A suicidal person may not ask for help, but that does not mean help is not wanted. People who take their lives do not want to die—they simply want to escape the hurt. Suicide prevention starts with recognizing the warning signs and taking them seriously. If you think a friend or family member is considering suicide (or if you are considering taking your own life), be brave. Speak up. Get help. Talking openly about suicidal thoughts and feelings can save a life, including yours!

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Continuing the Conversation on Teen Suicide: Warning Signs

“There’s no need to go and blow the candle out / Because you’re not done. / You’re far too young / And the best is yet to come.” ~”Lullaby” by Nickelback

Suicide is devastating to family, friends, and a community. The loss from suicide leaves a gaping hole in families, neighborhoods, schools, and communities; each suicide intimately affects at least six other people. Parents, siblings, classmates, coaches, and neighbors may be left wondering if they could have done something to prevent that young person from turning to suicide. In this post I will go over the suicide warning signs someone who is contemplating suicide might exhibit. In a future post, I will discuss how to help this person, or get help if you are the one considering suicide.

The World Health Organization estimates that approximately 1 million people worldwide die each year from suicide. For those who are not in the grips of suicidal depression and despair, it may be difficult and even confusing to understand what would drive so many individuals to take their own lives. However, a suicidal person is in so much pain that he or she can see no other option. This is why knowing what to look for can prevent suicide and provide help and hope as an alternative.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

WARNING SIGNS

There are many potential warning signs to suicide; the following are some of the most common red flags to look for:

  1. Self-harm or suicidal talk. Take any talk or mention of suicide very seriously. This is not just a warning sign, it is a cry for help!
  2. Talking or writing a lot about death or dying.
  3. Hopelessness. Though subtle, studies have found that hopelessness is a strong predictor of suicide. This hopelessness is often accompanied by “unbearable” feelings, a bleak future, and feeling like there nothing to look forward to.
  4. Loss of interest in day-to-day activities.
  5. Neglect of his/her appearance.
  6. Big changes in eating or sleeping habits.
  7. Withdrawing from friends and family. Increasing social isolation and the desire to be left alone.
  8. Dramatic mood swings or sudden personality changes, such as switching from outgoing to withdrawn or well-behaved to rebellious.
  9. Self-loathing and self-hatred. Feelings of worthlessness, guilt, shame, and self-hatred; feeling like a burden that no one would miss.
  10. Self-destructive behaviors. Increased alcohol or drug use, reckless driving, unsafe sex.
  11. Seeking out lethal means, such as weapons and drugs.
  12. Getting affairs in order. Making out a will, giving away prized possessions, making arrangements for family members.
  13. Saying goodbyes. This might include unusual or unexpected visits or calls to family and friends and saying goodbye to people as if they will not be seeing each other again.

These signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide. Take these red flags very seriously!

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

If you see or experience any of these warning signs, do not dismiss them! I will write a detailed post on what to say and how to help in these situations next week. If you need immediate help, I suggest approaching a teacher or school counselor–they are trained to assist you and your classmates with this delicate yet urgent matter. Additionally, the National Suicide Prevention Hotline is available for calls and chats 24 hours a day (1-800-273-8255), and most communities have hotlines you can text for immediate anonymous help. In dire circumstances, call 911.

Knowing these warning signs could save a life. Pay attention to your peers. As always, please do not hesitate to contact me with questions. If you are battling thoughts and feelings of hopelessness and self-harm, please click here to schedule a session. My door is always open for 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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Alcohol Anonymous: Strength in Numbers

Alcoholics Anonymous

“When I stopped living in the problem and began living in the answer, the problem went away.”

~ Alcoholics Anonymous

According to the 2015 National Survey on Drug Use and Health, 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime. While it may not lead to an addiction for some, it does for others. Alcohol has touched all of our lives in one way or another, whether it is personally or through someone we care about. Because April is Alcohol Awareness month, I want to dedicate a post to one of the most helpful, renowned support groups for those working to overcome an addiction to alcohol: Alcoholics Anonymous.

WHAT IS ALCOHOLICS ANONYMOUS (AA)?

Alcoholics Anonymous is an international group of men and women who have had or are working to conquer a drinking problem. AA is open to all races, politically neutral, self-supporting, and is available almost everywhere. There are no age or education requirements, and membership is open to anyone who wants to do something about his or her drinking problem.

HOW DID AA START?

Alcoholics Anonymous was founded by Bill Wilson and Dr. Bob Smith, who were both recovering alcoholics. In 1935, Alcoholics Anonymous began as a community-based fellowship which encouraged sobriety for other recovering alcoholics. These two men developed the 12 steps to aid their attendees, and later introduced the 12 traditions to help further define the group’s purpose and achieve continuity for AA groups across the country (and later around the globe). AA paved the way for other support groups; today Narcotics Anonymous, Gamblers Anonymous, and Overeaters Anonymous are just three of the many groups that have modeled themselves after the AA meeting concept.

WHAT ARE THE MAIN TENETS OF AA?

The original steps are still intact and many former addicts credit the group with helping them through recovery. The 12 steps that govern all AA group meetings are presented in linear fashion, but participants see them as an ongoing circle. The following steps may be revisited until the recovering addict is comfortable in that stage of their recovery process:

  1. Admit powerless over alcohol
  2. Accept that a higher power, in whatever form, will restore your sanity
  3. Make a decision to turn your will and life over to a higher power
  4. Take a moral inventory of yourself
  5. Admit to a higher power, another human, and yourself the nature of your wrongdoings
  6. Accept that a higher power will remove your character defects
  7. Humbly request the higher power remove your shortcomings
  8. List people you hurt during your addiction and be willing to make amends
  9. Make amends to those people unless it would harm them
  10. Continue to take a personal inventory, and when you’re wrong, admit it
  11. Use prayer and meditation to connect with the higher power
  12. Carry the message of AA to other alcoholics and continue to practice the principles of the 12 steps in your daily life

DOES AA WORK?

Because AA is anonymous, some members of the group do not participate in studies since it could breach anonymity. Many want their participation in AA to remain unidentified, in line with the group’s original intention. Additionally, participants might not want to admit to relapse. A New York Times article stated that AA claims that up to 75% of its members stay abstinent.  Alcoholics Anonymous’ Big Book touts about a 50% success rate, stating that another 25% remain sober after some relapses. Though it is difficult to know just how effective it is, it is safe to say that many people have been helped by regularly attending AA. Just how effective depends on the participant.

CAN AA WORK FOR THOSE WHO DON’T BELIEVE IN GOD?

The first time I read through the twelve steps, I was surprised how often God was referred to. While the faith-based program of AA may be effective for some, it does not work for everyone — particularly those who do not subscribe to God as a higher power.  Might I offer a solution: AA founder, Bill Wilson, encountered the term “higher power” in the book, Varieties of Religious Experience, by William James. In this book, James offers many examples from Christian traditions, as well as non-Christian examples. One of the best examples of “higher and friendly power” is borrowed from Henry David Thoreau walking in the midst at Walden Pond feeling a sense of connection to pine needles. He cited other examples of a “higher power” to potentially include moral principles, patriotism, civic engagement, and even a higher or better self. Therefore, the term “higher power” does not have to be a faith-based term and thus varies from participant to participant.

You could go to an AA meeting in Los Angeles, London or Lima and each one would be carried out in a similar fashion. This is because the steps and traditions of Alcoholics Anonymous are the foundation for every meeting. In each meeting, members will get to know one another, discuss progress and relapses, and support each other through sponsor programs. Although it can be difficult going to an AA meeting with complete strangers and admitting to such a personal issue, it is the only place where every participant knows exactly how you feel. They have been where you are and can support you in your journey. That is powerful. To quote AA literature: “The feeling of having shared in a common peril is one element in the powerful cement which binds us.”  This instantaneous bond cultivates a unique feeling of community and understanding that is incredibly helpful to those recovering from alcohol addiction.

The only real way to find out if Alcoholics Anonymous can help you is to give it a try. See for yourself if you think the help and support from others struggling with the same problem can help you stay sober. As Alcoholics Anonymous has no dues or fees, you have nothing to lose in choosing to visit a few meetings. I strongly encourage it. Call now at 877-600-9205 or go online and use a meeting finder to find a meeting in your area. Click here if you are local to the Dallas/Ft. Worth area and could benefit from community resources. In like manner, if you feel you could use professional help, I invite you to contact me today or schedule a session to begin your journey toward recovery. I am here to help you along the uphill road of addiction recovery!

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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Healthy Brain, Happy Life

Healthy Brain, Happy Life

“The mind of man is capable of anything.” –Joseph Conrad

There are certain things you and I have learned to do to take care of our bodies. These include brushing our teeth, washing hands, wearing sunscreen in the sun, eating a balanced diet, and trying to fit in regular exercise. There is so much knowledge about how to keep the body physically healthy! In like manner, new research has yielded valuable information about things that can be done to promote a healthy brain.  In recent years, research on the brain has made leaps and bounds, and has impacted my practice for the better.  Much of what I do–especially helping clients who are battling anxiety, depression, or other diagnosable mental illnesses–is impacted by this research. It can positively impact you, too. Today I want to share some of the findings that will help promote a healthy brain.

The benefits of keeping the brain healthy are innumerable. The following action list will not only help keep your brain young and healthy, but also positively impact other parts of your body, health, and life in general. Read the list, then consider one or two things you can start doing today to rejuvenate your brain. Your brain ten years from now will thank you!

  1. Mental stimulation. Keep learning and challenging your brain. Mental exercise is believed to activate processes that help maintain individual brain cells and stimulate communication among them.  Any mentally stimulating activity should help to build up your brain. You can try reading, taking courses, trying word puzzles or math problems…even Sudoku! Similarly, experiment with activities that require manual dexterity as well as mental effort, such as drawing, painting, and other crafts.
  2. STAY HEALTHY! Taking care of your body will adversely promote a healthy brain. So exercise; it will lower your blood pressure and cholesterol levels, and reduce stress. Meditate. Eat healthy foods; a diet rich in omega-3 fatty acids, low in saturated fat, full of the nutrients found in leafy green vegetables, along with whole grains can help keep your brain healthy throughout your life. Get quality sleep; give your brain a rest by shutting it off for 7-9 hours a night. This is when it will reset, heal, and be restored to full health. Avoid tobacco, drugs, alcohol and other harmful substances that alter how the brain functions. Be sure to care for your emotions (read: self-care). A “reset” or self-care/personal time is everything for managing the emotions that affect both mind and body!
  3. Prioritize brain space. I am guilty of expending precious mental energy remembering where I put my phone or remembering what was on my mental grocery list. The suggestion here is to take advantage of calendars and planners, maps, shopping lists, file folders, and address books to keep routine information accessible. This way it is easier to concentrate on learning and remembering new and important things.
  4. Repetition, repetition, repetition! When you want to remember something you have just heard, read, or thought about, repeat it out loud or write it down. That way, you reinforce the memory or connection. (If you just met Emily, for example, use her name when getting to know her better: “So, Emily, where did you meet your husband?”)
  5. Be social. When you are socializing, the blood circulates to several different parts of your brain as you are listening and formulating responses. Strong social ties have been associated with a lower risk of dementia, as well as lower blood pressure and longer life expectancy. So get off your phone, Instagram and Netflix, and go interact with your friends!
  6. Protect your head. Head injuries increase the risk of cognitive impairment. Wear a helmet when you are biking, skiing, snowboarding, rafting, horseback riding, scootering, using a motorcycle, or any other activity that could potentially result in a head injury.
  7. Think positively. There is a well-known effect in the psychology of education referred to as the “Pygmalion effect.” If you set high standards for yourself and believe that achieving them is possible, they become possible. Thinking positive thoughts has a profound impact on the brain!

Take charge of your brain health. Everyday you and I make choices that affect the health of our brains both today and in the future. Prepare now for a healthy, happy future by exercising your brain and your body, meditating, ingesting healthy foods, getting quality sleep, and thinking positively. As always, should you have questions, or if you feel you would like to talk about your mental health, I invite you to contact me or schedule a session with me personally. 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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Intuitive Eating: Giving Your Body What It Wants

“Eating today has become this idea that the food on your fork can either kill you or cure you. It’s gotten to a point of almost religious fervor.” ~ Evelyn Tribole

Babies cry, eat, and then stop sucking when they have had enough milk. Children naturally balance their food intake from day to day — eating when they are hungry and stopping when they feel full. But adults have all types of stipulations on when they can eat, what they can eat, and how much they can eat. At some point, we stop letting their internal clocks guide us in feeding our hunger, and instead rely on society’s norms to guide our nutritional intake. Children have something to teach us about what, when, and how much we eat: It’s called following our intuition or intuitive eating.

In honor of March being National Nutrition Month, I want to talk about our relationship with food. There are so many diets today; Keto diet, Nutrisystem, Weight Watchers, South Beach, Dukan, Paleo, Vegan, low-carb and Atkins diets to name a few. There are all sorts of “fad diets” out there that eliminate certain food groups, have you count carbs, measure waistlines, and include a range of rules to achieve weight loss. And while [temporary] success may come from these diets, many individuals and dietitians in the country have found that more often than not, weight that has been lost that way does not stay off forever.  

Have you heard of intuitive eating? In 1995, two dietitians in Southern California grew tired of watching their clients see success in weight loss through dieting, only to gain it back over time. One of these dietitians, Evelyn Tribole, said, “We were banging our heads against the wall because the way we were working wasn’t working. We were sick of the insanity [our clients] were going through: They’d restrict themselves and lose weight, but then they’d gain it back and they’d blame themselves.” So she and her colleague, Elyse Resch, went back to the drawing board and their book, “Intuitive Eating A Revolutionary Program That Works” was born.  

At the time, Americans were just starting to realize how tiresome the shame and fear around food and ineffective weight loss was. In their book, Evelyn and Elyse encourage readers to do something that might sound backwards and dangerous:

Eat what you want, with no rules about what to eat, how much of it, or when.

Intuitive eating has 10 tenets, which I urge you, my readers, to read, ingest (pun), and practice. In a future blog post, I will go over these 10 principles of intuitive eating in greater detail and offer actionable steps. For the purpose of this overview post, I wish to focus only one of these 10 tenets, the one that may surprise you the most about intuitive eating: No foods are off limits, and there is no such thing as a “good” or “bad” food.

I imagine you are thinking, woah woah woah, this just sounds like a free-for-all. I see where you are coming from and I validate that concern. But step back and allow me to explain. Often times, the reason you and I crave pizza is because we tell ourselves it is a wonderfully delicious sinful indulgence. But if we look at pizza as what it truly is (bread, tomato sauce, cheese, and pepperoni)–not necessarily anything good or bad…just food!–then the guilt associated with pizza evaporates. Sure, you may gorge on pizza for the first couple days of eating intuitively (and preliminary studies have found this occurs frequently for those new to intuitive eating), but eventually the body will tell you it has had enough pizza and wants something else. It may surprise you how quickly your body will tell you to pass up the post-workout donut and instead eat something nutritious!

It is undeniable that different foods have different nutritional benefits. Tribole and Resch are not aiming to tear down public-health initiatives that tell society to eat vegetables. At the very root of intuitive eating is the training to teach you to pay attention to how food makes your body feel.  If you untangle food from the stress, shame, and labels that society has put on things you eat, how do you really FEEL eating that donut or that celery juice? The fact is that while you may fill up on Five Guys, if you truly pay attention to what your body wants, you will inevitably crave the variety and nutrition represented by the “healthy” foods you once had used as punishment in your dieting days.

Intuitive eating means breaking free from the yo-yo cycle of dieting and learning to eat mindfully and without guilt. Intuitive eating is about trusting your inner body wisdom to make choices around food that feel good in your body, without judgment and without influence from diet culture. You were born with the skill to eat, to stop when you are full, to eat when you are hungry, and to eat satisfying foods. Intuitive eating is a return to that instinctual skill.

Intuitive eating is not a weight-loss program. It is not a diet. It is a way of life, a complete paradigm shift with what you eat and why you eat it. It has been found to improve body image, to promote mindfulness practices such as meditation, and encourage exercise — all of which is intended to better attune people to their bodies. This will allow you to mitigate binge- and emotional-eating tendencies…by listening to your body!

Calorie counting, carb avoiding, and waistline measuring are miserable lifestyles. The lifelong pressure to diet wears people down and does not lead to a healthy relationship with food. Though I am not a certified dietitian, I have experience in helping clients struggling with rules and negative beliefs around what they eat. I have seen firsthand how effective and life-altering intuitive eating can be. If you need help working through unhealthy eating habits, I would be happy to assist you and point you to helpful resources. Please contact me or schedule a session today to get started on the path to a healthier relationship with both food and your body.

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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Living Your Best Life, ADHD Aside

“ADHD is not about knowing what to do, but about doing what one knows.” ~ Russell Barkley

Attention deficit hyperactivity disorder (ADHD), previously known as ADD, can present challenges for adults across all areas of life. It can be taxing on your health, your job, and your personal and professional relationships. Your symptoms may lead to procrastination, trouble meeting deadlines, difficulty maintaining relationships, and impulsive behaviors. You may wind up feeling alone, and as though friends and family do not understand what you are dealing with. Fortunately, there are skills you can learn to help manage the symptoms of your ADHD. You can improve your daily habits, learn to recognize and use your strengths, and develop techniques that help you work more efficiently, maintain organization, and interact better with those around you.

Over the last several years, awareness about ADHD has increased, and the stigma surrounding this mental health issue has decreased. There are many resources available for adults living with ADHD. Below, in the resources section, I have included links to articles that include specific tips for managing stress and boosting mood, ideas for staying focused and productive at work, suggestions for managing money and bills, advice for managing time and staying on schedule, and instructions to get organized and control clutter. In this post, however, I will share the basic, overarching principles you will find helpful to live your best life despite having ADHD.

  1. Create structure. This is possibly the biggest help to combat ADHD. Make a routine and stick to it every day. Establish rituals around meals, school, work, free time, as well as your morning and evening routines. Simple tasks, such as laying out your clothes and items for the next day, meal prepping, and daily planning can provide essential structure.
  2. Break tasks into manageable pieces. The demands of school, work and life can leave anyone feeling overwhelmed, frustrated, and hopeless. Whatever task you are faced with, break it down into bite-sized (so to speak) steps that you CAN do. Then tackle those one by one until you accomplish your end goal.
  3. Simplify and organize your life. Create order in your home or work space. Often, the tendency to get distracted makes organizing clutter difficult. But if everything has a designated place, cleaning up will be efficient and easy. This will allow you to focus on the things that really matter. In addition, having an orderly living or work space will offer you a haven from the chaos of everyday life.
  4. Limit distractions. Individuals with ADHD welcome easily accessible distractions. Television, video games, and the computer encourage impulsive behavior that must be regulated. In addition to decreasing time with electronics, I recommend increasing time doing engaging activities outside the home as an outlet for built-up energy (see next).
  5. Encourage exercise. Physical activity burns excess energy in healthy ways, which will decrease impulsivity. Exercise will help to improve concentration, decrease the risk for depression and anxiety, and stimulate the brain. Did you know that many professional athletes have ADHD? Experts believe that athletics can help those with ADHD find a constructive way to focus their passion, attention, and energy.
  6. Regulate sleep patterns. Bedtime may be an especially difficult for individuals suffering from ADHD. The lack of sleep exacerbates inattention and hyperactivity; therefore, getting quality sleep is paramount! Not too long ago, I wrote a blog post on nightly rituals that will help you “sleep like a baby.” In addition to the suggestions in that post, I recommend eliminating stimulants like sugar and caffeine, and decreasing television time to help get better rest.
  7. Encourage out-loud thinking. Those with ADHD can lack self-control and often speak compulsively, or without thinking. Try verbalizing your thoughts and reasoning. If you do not have someone supportive with whom you can confide, I recommend keeping a journal. It is important to understand your thought process in order to be able to curb impulsive behaviors.
  8. Take breaks. It is 100% normal to become overwhelmed or frustrated with yourself as you try to manage the behaviors and impulses that accompany ADHD. Give yourself breaks, schedule them (include them in step one, when you “create structure”!). Scheduling alone time is important. Good break options include going for a walk, reading a book, taking a relaxing bath, or anything that promotes self-care.
  9. Believe in yourself. Remember that ADHD causes legitimate stress. Do not minimize your feelings of anxiety and frustration. While so doing, it will be important to remain positive and hopeful. Recognize your progress. Believe that you can work through the obstacles before you. Have confidence in yourself and be positive about the future.
  10. Get help. The final suggestion I would like to allow others to help. You do not need to manage ADHD on your own! Allow close family or friends to be part of your journey; rely on them for support and to help you make progress. Additionally, get individualized counseling with a licensed, experienced therapist. I have several patients who have learned the necessary skills to be in control of their ADHD.  I am your advocate and can be you personal cheerleader! Contact me today to schedule a session. Furthermore, some individuals find that receiving medication can help immensely help them in managing their ADHD symptoms. Finally, look into local support groups near you. This is an incredibly helpful resource!

Before I end, I want to leave you with some reminders that have been helpful to those I have worked with. Be willing to make some compromises and recognize that perfection is not realistic. Remember that while ADHD may not be visible on the outside, it is real. You are dealing with a hard thing, so please remember that when the going gets tough! Third, take things one day at a time and remember to keep everything in perspective.

Take heart. You can learn to live with manageable ADHD symptoms and be in control of your life. Let ADHD be an explanation, rather than an excuse. Be patient and remember that change will not happen overnight. These ADHD self-help strategies require practice, patience, and a relentlessly positive attitude. As I always say, my door is wide open and I am here to help. I accept new clients for in-person sessions. Contact me today!

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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