This section will guide you in how to help someone with an addiction. It is important for family members and friends to recognise the signs and symptoms of addiction.
The BONDS Clinic treats lots of patients who are addicted to alcohol. Alcohol misuse and addiction is common and if you are suffering with this, you are not alone. If someone is dependent on alcohol, it is important to seek help to detox and not to stop suddenly. If a dependent person stops suddenly, there can be a risk of seizures or worse.
Common signs of alcohol addiction:
Common symptoms of alcohol addiction:
In general, if someone is addicted to something, they tend to:
Be cautious though: Both symptoms and signs can be due to other causes. Therefore, it is much more useful to look for groups of lots of these symptoms and signs rather than just one or two in isolation.
Denial
Denial is a common coping strategy for many problems, including addiction. Being honest with ourselves about a serious problem like addiction can be painful and difficult, but unless we accept that there is a problem first, it is impossible to start on a path to recovery. It is very common to hear a patient say “I can handle it, one more session won’t hurt, I can control it”.
Fear
Fear can feed both denial and anger. For instance, fear of stigma, fear of loved ones learning that there is a problem, fear of withdrawal, or fear of treatment.
Anger
Anger is a common reaction to being questioned or pushed on the subject of misuse or addiction. Anger usually stems from feeling defensive an argument with loved ones are very common in misuse.
Avoidance
Avoidance is also linked to denial and to fear: a person will start to avoid those who have questioned them or who have been suspicious that there is a problem with misuse. They may not want to talk to you or see you, and may make lots of excuses to avoid interacting with loved ones / friends.
Overcoming these barriers can be difficult. In such circumstances, interventions can sometimes help, whether the intervention is from loved ones or with help from health professionals. We have found that family therapy sessions can be useful, and sometimes cathartic.
One of our most fundamental principles at The BONDS Clinic is mutual respect and a non-judgemental approach with our patients. This allows people to feel safer and helps with their fear and avoidance. This same approach is important at home too. Without it, people with addiction will feel more isolated, more afraid, and more likely to lose hope. Then they are less likely to seek treatment or to stay in treatment. This is a recipe for disaster and risks a person spiralling out of control, alone and unsupported, whereas compassion can have a huge impact on a person seeking treatment and then sticking with it in the long term.
However, compassion is not the same as enabling substance misuse. Practical examples of compassion are:
1. Avoid shaming or guilt
If we aim for respect and compassion, it becomes more natural to avoid a “blame culture” or making a person feel guilty or shaming them. People with addiction nearly always feel a lot of guilt, so if we put more blame and guilt on them, they are likely to respond with anger, denial and avoid you after that. This puts more distance between them and everyone else which just risks them getting worse. It can be very difficult to avoid blaming or shaming a person since they will very likely have already caused strife for loved ones or broken your trust, but it is really important to recovery that we avoid blame and shame.
Don’t enable
If we try hard to be compassionate and avoid blame, there is a risk that some people then just enable the person’s addiction. Enabling a loved one’s misuse is usually because of a desire to help and support but enabling just makes things worse in the long term. Common ways of enabling:
Sadly, a person with substance or alcohol misuse may continue with denial until they are faced with the cold, hard reality of consequences. It can be very difficult to draw a line in bailing them out, but ultimately, a compassionate approach will combine care and love with a constructive approach of helping them get better. This means being kind and caring but also supporting them to seek treatment and to stick with it in the long term.
Relapse
This same approach of compassion, avoiding blame or enabling is really important if there is a relapse. None of us wants to see a relapse and none of us wants to downplay it, BUT if there is no compassion and there is lots of blame or enabling, then if a person relapses, they are more likely to hide it and not seek help. This usually just snowballs, and a small, temporary and reversible relapse can escalate rapidly and go back to how they were before treatment, or even worse. Therefore, we strive very hard with our patients to use a compassionate and constructive approach to relapse. We ask, “what can we learn from this relapse and how can we work on reducing the risk of this happening again?. You can’t change the past, but you can change the future.
Healthy lifestyle
We all know what a healthy lifestyle looks like, but many don’t know that healthy habits can actually be important treatments in mental health and in addiction. For example, regular exercise and healthy eating have been shown to help in depression*
Around 70% of our patients with substance or alcohol misuse have a mental health disorder. Lots of lifestyle factors can affect mental health, and a strong association between mental health and addiction has been seen in the thousands of patients treated with The BONDS Clinic treatment programmes over the years. Obesity [8], diet [9], sleep problems [10], pollutants in the environment [11], and high stress levels [12] may all potentially disrupt an important part of the body’s hormones, the “hypothalamic pituitary adrenal axis”. This can result in chronic inflammation in the body. Both this inflammation and brain hormone disruption have been linked to depression [13,14]. Improving healthy habits can help mental health and addiction.
5. Loved ones need support too
Supporting someone through addiction and misuse can be very important but also very draining. It is really important to look after your own mental and physical health. The following can help:
An intervention is usually a group of people coming together to meet with the person with the addiction. It can be family, love ones, friends, work colleagues and may include a professional.
Denial and guilt can be big barriers to seeking help for addiction. It is often difficult for a person to see how truly serious their addiction has become. Sometimes a crisis point is reached where something sudden and shocking happens such as a bad car accident due to drink-driving or drug-driving, a fall and bad injury due to being intoxicated, or an arrest, to name just a few, and families or loved ones may say “enough is enough, we want to stage an intervention”.
Sometimes an intervention can be the start of a person finally admitting there is a problem and being willing to seek treatment.
It is important to focus on the positive and to be constructive. In most cases, there needs to be a frank and fair discussion about how bad the problem and how worried everyone is, but then this needs to be followed by compassionate support and a discussion about potential options for treatment. Using threats or a confrontational approach is just likely to make the person suffering from addiction feel defensive and angry and increase their denial. It is important to try to remain calm and explain that the intervention is just because everyone cares about the person with the addiction and just wants to help them be well and happy. Even with this approach, there may be a lot of resistance to seeking help, but an intervention can be an important first step towards recovery and to “getting back to life”.
If you’re concerned for yourself or a loved one, please contact us for more information on how to help someone coping with addiction.
We place an important emphasis on helping friends and family to develop an understanding around addiction and dependency. We know it’s difficult to support a loved one through addiction, detox and recovery. As a loved one of a patient, you don’t always have all the tools and knowledge to provide the right support and to look after yourself throughout. The BONDS Clinic know it’s important for a patient’s recovery to have the best possible home environment to return to, we have tailored our therapy to provide you with all the right tools.
Therefore, at The BONDS Clinic we offer a comprehensive Family Support Program which aims to assist immediate family, loved ones or others who have been impacted by a patient’s addiction and the co-occurring challenges that may arise.
References:
(*reference to put in footer: Exercise for depression. Rimer J, Dwan K, Lawlor DA, Greig CA, McMurdo M, Morley W, Mead GE. Cochrane Database Syst Rev. 2012 Jul 11; (7):CD004366.)
8. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies.
Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, Zitman FG
Arch Gen Psychiatry. 2010 Mar; 67(3):220-9.
9. Association of Western and traditional diets with depression and anxiety in women.
Jacka FN, Pasco JA, Mykletun A, Williams LJ, Hodge AM, O’Reilly SL, Nicholson GC, Kotowicz MA, Berk M.Am J Psychiatry. 2010 Mar; 167(3):305-11.
10. Roth T. Insomnia as a risk factor for depression. Int J Neuropsychopharmacol. 2004;7:S34–S35
11. Air pollution and symptoms of depression in elderly adults.
Lim YH, Kim H, Kim JH, Bae S, Park HY, Hong YC. Environ Health Perspect. 2012 Jul; 120(7):1023-8.
12. Can stress cause depression? van Praag HM. Prog Neuropsychopharmacol Biol Psychiatry. 2004 Aug; 28(5):891-907.
13. Cytokines sing the blues: inflammation and the pathogenesis of depression. Raison CL, Capuron L, Miller AH.Trends Immunol. 2006 Jan; 27(1):24-31.
14. New drug targets in depression: inflammatory, cell-mediated immune, oxidative and nitrosative stress, mitochondrial, antioxidant, and neuroprogressive pathways. And new drug candidates–Nrf2 activators and GSK-3 inhibitors. Maes M, Fišar Z, Medina M, Scapagnini G, Nowak G, Berk M. Inflammopharmacology. 2012 Jun; 20(3):127-50.
