Saturday, May 23, 2015

Memorial Day Wishes

From the Staff at The Coleman Institute.

Friday, May 22, 2015

Under Pressure: The Science of Stress & What You Can Do

by Gabi Pinto-Coelho

Stress: it’s everywhere. 

While we usually associate it with our lives at work, there is no guarantee that its gray cloud will dissipate once you get back home. We have dinners to make, kids (and maybe even parents) to take care of, homes to clean, errands to run, the list goes on. In our fast-paced culture, it seems like stress is inescapable.

We all know that stress is harmful to our health. Sometimes, we can literally feel its effects in the form of tense shoulders, a headache, or that overwhelming desire to hit the pillow the moment we are able. But what many people don’t know is how exactly stress affects us on a biological and neurological level. Stress has the rather unwelcome ability to change our brain activity and even the function of our cells.

Research has shown that stress is a risk factor for the development of addictions and vulnerability to relapse. Exposure to stressors, especially for a prolonged period of time, leads to an inability to control impulses. Unsurprisingly, this increases the risk to use, and ultimately, abuse substances of any kind.

New research has linked chronic stress to the shortening of telomeres, which are like disposable caps at the ends of your chromosomes. Telomeres protect your genetic material from deterioration. So, what’s the big deal? Over time, your telomeres will naturally shorten as your cells replicate. This process of gradual telomere shortening is a normal, expected part of aging. However, research has shown that exposure to chronic stress will accelerate the telomere aging process. Have you ever noticed how people who are very stressed look a little ragged, tired, and older than they really are? Scientists suspect that part of this has to do with our shrinking telomeres. This accelerated telomere shortening also puts us at risk for age-related and chronic health conditions.

The good news is that scientists have researched lifestyle factors effective for protecting yourself against the effects of stress on your life and your telomeres. Most of these lifestyle factors are not surprising, and are always a part of a healthy lifestyle. 

These more obvious factors include: not smoking, regular exercise, and maintaining a healthy weight. Perhaps the most interesting of proven protective measures is meditation. While it is well-known that meditation and other mindfulness practices are useful for reducing stress in general, recent research has demonstrated a connection between meditation and a slowing of the erosion of telomeres. For those struggling with addiction, meditation has proven time and again to be a helpful tool to manage cravings and avoid relapse.

Stress affects almost everyone, but those suffering with addiction are especially vulnerable to its effects, on both an emotional and a biological level. That means that living a healthy lifestyle is vital to the well-being of anyone recovering from substance abuse. 

We hear it all the time but it is worth repeating: take time to take care of yourself. Not only will you feel better, but you just might lengthen your telomeres, reduce your chances of relapse, and prolong your life.

Tuesday, May 5, 2015

Thinking, Re-thinking, and Over Thinking

by Gabi Pinto-Coelho

As a lifelong overachiever and over-doer, I am all too familiar with thinking, thinking about my thinking, rethinking it all. Lather, rinse, repeat. Especially, when there is a big decision to be made, I tend to find myself in a seemingly endless vortex of thought. Now you might be thinking (get it?) - what is wrong with thinking? Isn’t the power of our intellect a wonderful thing? Can’t we solve a lot of problems by brilliant thoughts?

Yes, and no. To be clear, there is absolutely nothing wrong with thinking. In fact, thinking is what separates us as superior biological beings and sets us comfortably at the top of the food chain. You don’t see orangutans going to college or whales inventing the iPhone. However, I would argue that thinking too much actually devolves us as humans. Before you immediately think that I must be off my rocker, I want you to remember a time when you were overwhelmed with thoughts about something in your life. Perhaps it was a big life decision; maybe it was something at work. Most people, when plagued with over thinking, experience any or all of these problems:
  • ·         Anxiety
  • ·         Depression
  • ·         Insomnia
  • ·         Fear
  • ·         Indecision “paralysis”
  • ·         Withdrawal or feeling a disconnect from relationships
  • ·         Taking out your emotions on others

Really, the list could keep going, but I’ll stop there. Chances are, at least one of those “symptoms” of over thinking have rung true for you at some point in your life. Experiencing any of these symptoms actually dampens the ability of your true intellect. You might have deluded yourself into believing that all this extra brain chatter is helpful, but in reality, it clouds your ability to think clearly. Furthermore, over thinking clouds another, often neglected part of your intellect: your intuition. There is no point in making any kind of decisions from the foggy, overworked mind.

But, if we can solve a lot of problems with brilliant ideas, what is wrong with thinking a lot about something? The answer comes to us from neuroscience. You may have heard of the “shower principle” - that when you are not thinking about a problem (as when you are showering), the answer will come to you on its own (light bulb moments). Well, guess what? The shower principle is proven by science. Over and over again, research has shown that we cannot force sparks of inspiration, brilliant ideas, or a well thought-out decision. It just so happens that we delude ourselves into believing that we can over think our way out of our problems. 

With this mindset, we feed the beast of over thinking, justifying it as “necessary” to our end goals. While it can be true that thinking leads us to solutions, this is true if and only if we are thinking clearly. Thinking clearly comes from a place where overall brain activity is relatively quiet, and from there you can allow both your intellect and intuition to run on full power. Let’s be honest: under that definition, most of us rarely think clearly in our daily lives. Now, before you become outraged with incredulity, allow me to share: this is also a fact proven by neuroscience.

As my high school science teacher would say, “If science proves it, your opinion is irrelevant.” So, if science has proven that over thinking does not work, your views on it don’t really make a difference. This is not depressing. Au contraire, this is actually liberating - you no longer have to tell yourself that you “have to” keep thinking, rethinking, and over thinking. In fact, it is detrimental to your problem-solving process to give in to the beast of over thinking.

So, what do you do if you feel like you are starting to go back into those old habits? It’s actually quite intuitive:
  1. First and foremost, just notice that you’re starting to go back to old patterns. Don’t beat yourself up over it, don’t freak out, just recognize that you are heading down that unhelpful, but habitual path. When trying to change a habit, you have to acknowledge where you are starting. Start where you are.
  2. Try a slow-paced physical activity - go for a walk, swim some slow laps, take a leisurely bike ride, practice yoga or tai chi. Whatever works for you. It is very hard (almost impossible) for the mind to go from being overworked to being calm without some kind of transition. This slow-paced physical activity gets you out of your head and rooted back in reality.
  3. Sit quietly for a few minutes and just focus on your breathing. You don’t need to change or control breathing in any way, just focus. Each time the mind wanders, gently, but precisely, bring your focus back to your breathing.
  4. Come back to whatever it is you need to do.

You might be thinking, “I don’t have time to take a walk and sit quietly - I’ve got stuff to get done!” This is the voice of the over thinking beast, and its brother, the overdoing beast. You think that if you just push a little harder for a little longer, you’ll get things done. 

But yet again, neuroscience puts us in our place: thinking clearly and being as productive as possible require a quiet brain. So, the next time you find yourself over thinking, take the risk and just step away. Move a little. Breathe deeply. Watch what happens.

Friday, April 17, 2015

Forgiveness & Nonexistent Apologies

by Gabi Pinto-Coelho

For most people making positive change in their lives, there usually comes a time when you start looking at your relationships. You celebrate the ones that are positive influences in your life, you let go of long-gone relationships that kept you down in the past, and you start to examine (and re-examine) the rest. That gray area can be pretty ugly, but that’s where the real growth happens, in my opinion.

This gray area includes relationships with people that have hurt you (for the purposes of this blog, I am only talking about emotional/psychological pain). Some people stay in relationships feeling constantly hurt, but keep trying to make things work for any number of reasons. Others might respond to the pain they feel by holding a grudge. In reality, neither of these options is “moving on” from the situation.

If you are continuing to hold onto a relationship that keeps bringing you down emotionally, there are some important questions to ask yourself. In this case, you’ve got to consider:
  • ·         Is this relationship worth my time, my emotions, and my energy?
  • ·         What would my life be like without this relationship, as it stands now?
  • ·         If you are trying to change this relationship, is it just you that wants change or is the     other person invested in change, too? 
  •        Has this other person demonstrated his/her willingness to change or have they only     talked about it?

You get the picture here - you have to decide if the other person deserves you and everything you have to offer.

I’m certainly not a therapist, a psychologist, or a psychiatrist. But, I am a human being who has had to cut people out of my life. An ex-boyfriend that I dated for several years was caring but extremely depressed. Much of our relationship involved me trying to “fix” him and make him feel better. My lack of “success” in this endeavor made me feel like I wasn’t enough. The idea of breaking up with him because he couldn’t be an equal partner in the relationship seemed cruel and cold. But after three years, I realized that it is not my responsibility to fix someone else. 

Everyone comes to their own conclusions in their own time, and it is never easy. However, if you decide that someone not worth your energy, you’ve got to cut the cord. If you decide it is worth it, then you need to set some boundaries for yourself. How do you know when you are giving too much? What does the other person need to do to demonstrate a change in behavior? There are no easy questions or simple answers, that’s for sure.

Sometimes this whole “cutting of the cord” can happen way too rigidly, and that’s how grudges happen. I have an incredibly strong, insightful, loving, intelligent, and funny father. But he will be the first to admit that he is a grudge-holder. His current record for grudge-holding is a whopping 13 years. When he thinks someone has “wronged” him, he is so adamant about cutting ties that he refuses to forgive. In his attempt to prevent putting effort into unworthy relationships, he is actually spending more energy on being angry. An oft-mentioned quote on grudges says, “Holding a grudge is like drinking poison and waiting for the other person to die.”

Ultimately, it’s not only about cutting the cord, it’s about how you cut it. Too often in the process, we get hung up on whether someone else apologizes and if it’s sincere or adequate. In reality, the apology is irrelevant. After you’ve decided something is not worth your energy, anything else remotely positive is gravy. 

It seems a little radical, but what you should really be focused on is forgiveness. Without forgiving the offending party, you end up holding a grudge. Forgiveness is not an admission that the other person is “right” or “deserving.” Forgiveness has nothing to do with the other person and everything to do with you and your own peace & happiness. 

Forgiveness is a gift that you give yourself so that you can let go and move on. 

Tuesday, March 31, 2015

CAUTION - Contaminated Heroin in VA!

by Peter R. Coleman, MD

Last month, we received an urgent appeal from the Virginia Department of Health to be on the lookout for patients who may be suffering with contaminated heroin. It turns out that a increasing number of people have been showing up in emergency rooms with severe reactions after using heroin. Many have had to be admitted to the ICU. And, it is likely, that without treatment, this contamination can be fatal.

It appears the heroin has been cut with a powerful stimulant, similar to adrenaline. The addicts start to show symptoms of chest pain, anxiety, panic, sweating, fast heart rate and trouble breathing. 

This is quite different from the usual picture of someone who has had an overdose. The symptoms of an opiate overdose are the opposite of this – sleepiness, lethargy, and slow breathing, and if severe, the breathing stops completely. The usual treatment of an overdose is to give an immediate injection of Narcan® (Naloxone Hydrochloride)
to reverse the opiate effects, but Narcan® has not been helpful in these recent cases of contaminated heroin. These patients need to be admitted to the hospital and stabilized.

This is a very serious problem and, unfortunately, is only too predictable. Many people are now switching from painkiller pills to street heroin because it is so much cheaper. When people buy street drugs, they have no idea of what they are actually getting. 

Recently, there have been clusters of overdose deaths because sometimes a batch of heroin is contaminated and/or much more potent than usual. 

Let’s all work together to combat this horrible and deadly disease.

Friday, March 27, 2015

Why Do People Use Drugs?

by Peter R. Coleman, M.D.
I have been pondering this question for many years. On the surface, it seems kind of obvious - because you feel good when you drink alcohol or take drugs. But this is a little simplistic.

It seems to me that there are three main categories of the reasons why people use addictive drugs, including alcohol:

1.     They produce a euphoria
2.     They relieve emotional distress by changing our moods
3.     They promise some spiritual relief

The first category is the one that I have predominately focused on in the past. It is an effect that all addictive drugs have - namely releasing a surge, or an increase, in Dopamine in the brains reward pathways. Dopamine is the brain molecule that is released when we eat food or have sex. It is a very powerful driver of behavior - just look at how many overweight people there are - and how hard it is for many people to control those impulses. 

All addictive drugs release extra Dopamine and this is one of the big reasons why we like to take them - they produce a euphoria. Addictive drugs release more Dopamine and produce more of a euphoria than our brains were ever meant to get. No wonder we like taking them. No wonder prohibition did not work. Cocaine is probably the most powerful example, but all drugs do it.

The second category is also very important. Addictive drugs are called “mood altering drugs” for a reason - they alter our moods (emotions). We all have emotions and many of the emotions we have are not very pleasant -  fear, anger, sadness, loneliness, boredom. 

Our emotions are not necessarily supposed to be pleasant. They are a form of pain, and pain is meant to be painful because it helps us to stop doing something. Our emotions should be our best guides for future behavior. They tell us what to avoid so that we can make some different, and hopefully, better choices in the future. But, many times, we want to avoid these negative feelings. We don’t want to feel shy or lonely. We don’t want to feel awkward at a party, so we have a couple of drinks and before you know it we are not feeling so bad. We have enough courage to start up a conversation with a stranger. Drugs are very powerful at altering our mood. The most powerful in this category are the sedative drugs, like Valium, Xanax and alcohol.

The third category is the most interesting, and one that has become more apparent to me lately. We like taking drugs, including alcohol, because they alter our reality. Drugs plunge us into a new world, a kind of magical world where there seems to be endless possibilities. Under the influence of drugs, we can enter "Alice’s Wonderland" and talk with rabbits. Under the influence of pot, music seems better than it actually is, and jokes can seem funnier than they actually are. Under the influence of alcohol, we can believe we are actually very good looking and can dance really well. If we take pain killers, we can believe that we have superhuman energy, physical and emotional pain are lessened, and some of the rules of other mere mortals don’t really apply to us.  But, unfortunately, these perceptions under the influence of mind altering drugs are not quite real. 

At some point, all of us have to confront and ultimately accept reality. Part of this acceptance of reality process is a spiritual one. As we grow up and mature, we all have to ask ourselves some of those ultimate questions. Who am I? Why am I here? Is this all there is? How can I be happy? Drugs can seem to give us a short cut to the answers to some of these questions, but of course, they are providing a distortion of reality. It is never possible to see something clearly when you are looking through distorted glasses.

In order to have a shot at recovery, patients need to first get clean off the drugs and wait for the brain to heal and be able to function normally. But, then, we need to be thinking about the above three reasons we use drugs so that we can fill up the holes that they leave when we stop. 

After we give up drugs and alcohol, we need to find solutions and answers to replace what the drugs were doing for us. We need to find pleasure in things other than drugs. We will still get a Dopamine feeling from pleasurable activities, but we need to get that Dopamine in healthy ways - things like spending time with loved ones, hiking, hobbies, eating a good meal. We also need to get used to the amounts of Dopamine that these experiences can realistically give us - not the exaggerated amounts that drugs produced. We need to find ways of dealing with our emotions without just covering the feelings up with alcohol or drugs. 

This is where one of the biggest payoffs of recovery lies. Once we learn how to really feel and identify our emotions, we can learn how to change our behavior so that life goes more smoothly. We can avoid future problems and stop making the same mistakes over and over again. And, we need to grow spiritually. We need to learn and practice honesty, acceptance, love, and tolerance. We need to find things we are passionate about and bring meaning to our lives. 

As we explore and grow in each of these areas of our lives, we can find true happiness - not some drug induced sham of happiness.


Monday, March 23, 2015

Let The Genie Out!


by Joan R. Shepherd, FNP

It was so gratifying to see Chris (name changed for patient privacy) today! He had detoxed from Oxycontin a couple months ago and came to The Coleman Institute for a Naltrexone implant.

We have the expectation that when people return for their 2nd implant, many aspects of their lives will be better. If they were skinny and scrawny, they have probably gained back some of the weight they needed. If they were a little chunky, they have often lost a few pounds. Their eyes, skin and hair are “brighter”. Their energy is better, they are sleeping more, and their problems with anxiety and depression are slowing improving. Money is in the bank again, relationships-if not easier-are infused with more honesty.

So, I was not surprised when Chris reported all the above to me on this 2 month return trip. What is even vastly cooler (my English professors would roll in their graves at that turn off phrase; mea culpa) for Chris is his phenomenal re-connection to his creative self. It is like the opiates were bonds that shackled his artistic soul—once they were cut away—OMG—the Genie has catapulted out of the bottle!

His day job is web design, and I can only imagine how that has improved.  His love is water coloring and he has started again.  

He described a painting he did for a friend who wanted some kind of an angel image. Chris painted an angel hovering over a tree, loosening the noose on a guy attempting to hang himself.
Chris is also the creator of some of the most beautiful tattoo art I have seen. He is currently working on having the names of his four children tattooed on various parts of his body, each name drawn in a unique, original calligraphic style.

Creativity is a gift we all have access to, whether in the form of  artwork, inspiring people with your preaching, masterfully operating heavy equipment, designing a birthday battle party for your children complete with homemade shields and swords or doing whatever it is that speaks to our hearts. Chris is convinced that this surge of creativity is directly related to his ability to FEEL again. Without the opiates on board, his heart is again receiving messages.

Please contact us if you have compromised your creativity by allowing opiates, booze or benzo's to take over; who knows how your Genie will respond.