Friday, August 13, 2010

Alcoholic Myopathy

What Is Alcoholic Myopathy?

Type 2 muscle atrophy
Myopathy means muscular disease, and generally refers to a disorder in which muscle weakness develops due to some malfunction of the actual muscle fibers. In addition to muscle weakness, symptoms of myopathy may also include muscle cramps or spasm and muscle stiffness. While some recovering alcoholics may have never heard of alcoholic myopathy, it more common than one may think. Some research indicates that about one third of heavy long-term drinkers, aka alcoholics, develop skeletal myopathy.

The history of the myopathy related to alcoholics can be traced back to the 19th century, when there were reports of “alcoholic paralysis” which is believed to be referencing the muscle disease known today as alcoholic myopathy. Most specifically, in the mid 1800's, Magnus Huss wrote Alcoholismus Chronicus in which he reported identifying muscular weakness in patients resulting from alcohol use. Later, in the 1950’s and 1960’s, researchers went on to discover two distinct types of alcoholic myopathy: acute alcoholic myopathy and chronic alcoholic myopathy.

Acute Alcoholic Myopathy

Acute alcoholic myopathy develops suddenly, during an episode of binge drinking or immediately following during withdrawal. Acute alcoholic myopathy is also called “alcoholic rhabdomyolysis”. It can come on rapidly over the course of a few hours and can advance over a few days before receding over the week, given the individual abstains from alcohol. Acute myopathy can present mild to severe symptoms as a result of myonecrosis, the breakdown of muscle tissue.

Symptoms of acute alcoholic myopathy may include muscle pain and swelling in addition to the classic weakness. Often the acute symptoms are reported upon awakening from an alcoholic stupor; they may also accompany withdrawal symptoms and delirium tremens. Tests have revealed that acute alcoholic myopathy affects type I muscle fibers, which can heal rapidly; however type II muscle fibers are involved in chronic alcoholic myopathy.

Typically, full recovery from acute alcoholic myopathy occurs in a matter of days or weeks; however, in extreme cases when kidney failure or hyperkalemia (abnormal potassium level in the blood) occur, the alcoholic may actually die during the episode of acute myopathy. Otherwise, research has shown it takes about 7 to 10 days for the serum creatine kinase levels (reflecting the health of the muscle) to return to normal range.

Chronic Alcoholic Myopathy

In contrast to the acute form, chronic alcoholic myopathy develops much more gradually and lasts far longer. While the acute version may include muscle pain, chronic alcoholic myopathy is usually painless. The absence of pain and gradual onset may explain why it is frequently overlooked and not diagnosed until the symptoms have been present for several years. The recovery time for chronic myopathy is slower and can take many months (again, given the patient abstains from alcohol use).

Chronic alcoholic myopathy is associated with long term alcohol abuse (i.e. years of daily alcoholic drinking). It evolves slowly, over weeks or months as opposed to its acute counterpart which can develop in a matter of hours or days. The main symptom of chronic alcoholic myopathy is muscle weakness and atrophy. It affects proximal muscles, and type 2 muscle fibers. Interestingly, long term corticosteroid use can lead to similar type 2 atrophy as well, a.k.a. “steroid myopathy”.

Other disorders which may co-occur with chronic alcoholic myopathy include peripheral neuropathy. While with myopathy the primary dysfunction exists within the muscle itself, with neuropathy the dysfunction pertains to the nervous system (i.e. nerves or brain). Some research suggests peripheral neuropathy is associated in 72% of cases.

What Causes Alcoholic Myopathy?

Studies have linked the damaging effects of toxic ethanol (drinking alcohol) to alcoholic myopathy. The injurious effects of acetaldehyde as well as ethanol have been directly linked with alcoholic myopathy. Interestingly, acetaldehyde is also a prime suspect in the cause of hangover symptoms.

On a molecular level, the exact mechanism behind how alcohol produces myopathy remains elusive. Various studies and theories have been presented. Impaired IGF-1 signaling, protein deficiency, vitamin and mineral deficiencies, and other factors have been considered. For example, some research results suggested that protein deficiency and ethanol contributed to muscle atrophy in rats given alcohol and those underfed protein had the greatest myopathic effect.

Research suggests that ethanol consumption and malnutrition can lead to alcoholic myopathy, and most likely it is a combination of both working synergistically to produce the myopathy. The long term effect of alcohol abuse itself tends to cause malnutrition, so long term daily drinkers set themselves up to be malnourished, and thus also more vulnerable to the possibility of chronic myopathy.

Treatment for Alcoholic Myopathy

If the root of alcoholic myopathy is ethanol consumption and malnutrition, obviously abstinence from alcohol and proper nutrition are the best place to start. Alcoholic myopathy generally begins to reverse once the individual achieves complete abstinence from alcohol. So if you are a newly recovering alcoholic experiencing chronic myopathy, it is important to know the recovery typically takes many weeks or several months.

As the recovery time frame varies, proactive steps such as nutritional interventions may help to accelerate the recovery process. Physical therapy and acupuncture are sometimes utilized as well to target the effects of chronic myopathy.

Here is a quick response from a neurosurgeon who answered an online inquiry from an individual who asked: is there any treatment for alcoholic myopathy? The MD answered…
“Alcoholic myopathy is a tough condition:
1. stop alcohol
2. correct liver dysfunction
3. get a muscle biopsy to be sure the dx is correct.
4. See a nutritionist
5. Be followed carefully by a darned good neurologist
6. slow rehab with careful attention to enzyme changes.”

There seems to be little information on specific nutritional information to benefit individuals suffering from alcoholic myopathy. After further research, a follow up article is posted with more detailed suggestions for a proactive holistic approach to potentially accelerating recovery from alcoholic myopathy - check out article on "Nutrition in Alcoholic Myopathy Treatment".

Thursday, July 15, 2010

PTSD in Sobriety

Connection between PTSD and Alcoholics/Addiction

PTSD (Post-Traumatic Stress Disorder) and alcoholism / addiction often go hand in hand. Self-medicating symptoms of anxiety and depression associated with PTSD can lead to substance abuse. Also, active alcoholics or addicts may be more susceptible to experiencing certain types of trauma based on circumstances and potential risky behavior sometimes associated with addiction. Therefore while people who have endured trauma are more likely to have drinking problems, people with drinking problems are also more likely to have experienced psychological trauma of some kind.

What is PTSD

Post Traumatic Stress Syndrome can develop after exposure to an event that causes psychological trauma. The exposure can involve actually experiencing the event or witnessing the trauma. Symptoms of PTSD may include nightmares or flashbacks, sleep disturbances, avoidance or negative responses to associations with the trauma (i.e. people, places, situations), emotional numbing, anger, hypervigilance, or anxiety. The symptoms must be present for more than a month after the event, otherwise it may be “acute stress disorder” which is short-term. Untreated, the symptoms of PTSD can be experienced for years beyond the initial trauma. Finally, for the official diagnosis of PTSD, the set of symptoms must impair normal life functions i.e. in work or relationships. Note: “unmanageability” comes to mind.
People commonly associate PTSD with individuals who have suffered an obvious major trauma such as with combat veterans and abuse or rape survivors… Indeed, there is a prevalence of PTSD in those populations but it is certainly not limited to those.

ACOA and PTSD


PTSD is not always caused by a single traumatic event; it can be from a series of intense or even more subtle traumatic experiences. Adult Children of Alcoholics (ACOA) are an example of a subgroup that may be particularly likely to have endured traumatic events in childhood leading to PTSD as an adult. Abuse, neglect, or other psychological trauma may be experienced as the result of growing up in an alcoholic environment, in which one or more parents or caregivers were untreated alcoholics / addicts.

Many recovering alcoholics and addicts are also ACOA. Adult Children of Alcoholism in particular should consider ruling out PTSD if suffering any of the symptoms associated with post-traumatic stress. While they may not recall one particularly traumatic event, an ACOA may have experienced a series of less intense but traumatic experiences which can lead to PTSD alike.

Which Came 1st: the PTSD or the Addiction?

It’s sort of a “chicken or the egg” situation. Trauma can lead to unhealthy coping mechanisms in an effort to numb the pain, and thus lead to substance dependence. By the same token, when engaging in behaviors that accompany an addictive lifestyle, an alcoholic or addict is more likely to be in a situation where trauma can occur. Or both may be the case; some alcoholics may experience traumatic events prior to active addiction as well as during their active years. Binge drinkers may even not recall exposure to a traumatic event if it occurred during a blackout!

Dealing with PTSD in Sobriety


Regardless of when the trauma occurred - before or during active addiction - untreated PTSD is sure to affect an individual after starting the process of addiction recovery. As most therapists will tell you, you have a much better chance at healing your psychological traumas if you first put down the alcohol and drugs. Once the initial fog lifts and you are sober, it can be your first time really experiencing the effects of PTSD if you have been self-medicating with booze or drugs for years.

In early sobriety, previously numbed anger or anxiety associated with PTSD may surface. The alcohol and drug use could have mased sleep disturbances otherwise present with PTSD, thus resulting in sleep difficulties or insomnia in recovery (see related article on dealing with insomnia in sobriety). Certainly anger, anxiety and sleep problems can only aggravate the daily struggle to stay sober in early recovery. These symptoms alone do not necessarily equate to PTSD but it is a good idea to consider ruling it out.

“You’re as sick as your secrets.” Intrusive thoughts regarding old memories can surprise the newly recovering alcoholic who may have thought he/she had dealt with the memories or left the past in the past. Consider how many people relapse in anticipation of step 4, or when between step 4 and 5. Imagine uncovering memories of old traumas which trigger heavy emotions… leading to the danger of picking up a drink or drug before sharing it all with a sponsor.

Even when the recovering alcoholic with PTSD makes it through the 5th step with a sponsor, he/she may be disheartened by a lack of relief that may have been anticipated based on the experiences shared by others who successfully complete the 5th step who do not suffer from PTSD and thus may find more relief from the steps alone.

Treatment for PTSD in Sobriety

Clearly if there are concerns of potential PTSD in sobriety, it is crucial to seek treatment. The 12 steps are a great tool that will help support the process of addressing the PTSD, but outside help is recommended for recovering alcoholics/addicts who may suffer from post-traumatic stress. Remember, A.A. literature states: “God has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitate to take your health problems to such persons.”

The ideal treatment for any disorder is one which treats the underlying cause of the disorder. Let’s face it: PTSD is not a deficiency of medication… although sometimes people suffering from PTSD can end up on anti-depressants or anti-anxiety drugs from their primary physician or psychiatrist. Medication alone is not appropriate treatment for PTSD; the drugs only serve to medicate some of the symptoms in that case. This is why the typical recommendations for treatment of PTSD involve psychotherapy (not psychiatry), typically in the form of a cognitive behavioral therapy.

A particularly effective and clinically supported modality in this field is EMDR (Eye Movement Desensitization and Reprocessing). EMDR has been rated by the APA in the highest category of effectiveness and research support for treating trauma, based on the extensive clinical research performed validating it as a significantly effective treatment modality for PTSD in particular. EMDR can safely accelerate the healthy processing and healing from the traumatic memories underlying PTSD. To learn more about this effective modality, visit the EMDR Institute.

Note: the long term emotional stress of PTSD can contribute to physical stress on the body as well – see related article on nutritional support during stress to address the physical aspect.

In summary, when present PTSD is a crucial component to address in sobriety. Whether newly recovering or sober for a number of years, whenever this becomes evident it is necessary to address. You need not suffer silently with PTSD, and the symptoms can put you at risk for relapse. As with alcoholism, there is a solution! Utilize all the tools and outside resources available to effectively deal with PTSD in sobriety, and subscribe to this blog for more health information pertaining to recovering alcoholics and addicts.

Wednesday, June 9, 2010

Natural Cures For Insomnia

Dealing with Insomnia in Recovery

Getting enough sleep is essential for recovering alcoholics and addicts, as insomnia and poor sleep can not only negatively affect your health but also can contribute to risk for relapse. The slogan H.A.L.T. reminds us of four common risk factors to watch for daily. “T” is last but not least! Tired? Are you sleeping enough and getting a good night’s sleep?

Alcohol affected your sleep and the quality of it. Whether you are in early sobriety or have long term recovery, research suggests that recovering alcoholics regardless of recovery time have a higher incidence of insomnia than the general population. The studies also suggested that difficulty falling asleep is more of an issue in recovery than staying asleep.

The Caffeine Factor in Insomnia

When newly sober, some recovering alcoholics and addicts start drinking lots coffee even if they were never coffee drinkers in the past. It is easy to justify the caffeine habit, which typically doesn’t end you up in jails or institutions, in contrast to the booze or other drugs you kicked. But in early recovery, a healthy sleep cycle is often one of the last things to finally normalize. When a sponsor hears from a newcomer that he/she is having trouble sleeping, the immediate reply is typically “how much coffee or soda are you drinking?” and “and how late in the day do you have your last cup?” Experience dictates to rule out this common and significant factor first, as caffeine is a known culprit to disrupt sleep!

The Depression Factor with Insomnia

Depression and insomnia often go hand in hand. Until recently, professionals had assumed the link between depression and insomnia was that the depression caused the insomnia. However, when they studied patients with both who were treated for the depression, they were surprised to find that depression relief did not result in insomnia relief. Newer studies actually suggest that treating the insomnia will in turn likely help relieve the depression for those who suffer from both.

Some research provides evidence that 55 to 60 percent of patients with depression who do not respond initially to antidepressant medication improve with the addition of tryptophan supplementation. Tryptophan has been used not only for insomnia, but also in the treatment of depression either alone or in combination with antidepressants.

Diet for Healthy Sleep

Here is yet another health issue that can be helped significantly with the proper diet. Again - like with weight loss, mood, energy, etc – the key in eating is balancing your blood sugar. If you eat right throughout the day, you are more likely to get to sleep easily and sleep better through night. Frequent small meals throughout the day, made up of lower glycemic foods, will help balance your blood sugar and thus support your goal of insomnia relief. For more information on a healthy eating plan in recovery click this link.

Meditation and Hypnosis for Insomnia

Meditation is known to provide all sorts of health benefits, including relief for insomnia and sleep problems. Research presented last year investigating the effects of daily meditation on insomnia sufferers found that all of the following improved in the patients using meditation: sleep latency, total sleep time, total wake time, wake after sleep onset, sleep efficiency, sleep quality and depression. Regardless of you amount of time in recovery from alcoholism or addiction, it is never too early to start incorporating some form of meditation into your daily life, especially if you are experiencing insomnia!

Guided meditations and hypnosis audio programs can also be very effective for those suffering with sleep problems. Hypnosis helps your mind and body relax, and can help your brain learn how to easily go into an alpha state (for healthy sleep) and utilize the subconscious to reduce worry and anxiety that tend to pervade the daily thoughts of insomnia sufferers. You can seek out a local hypnotherapist, or save money by trying out an audio download online. Licensed hypnotherapist Steve G. Jones is a well-known expert whose very affordable recordings come highly recommended - check them out at this link and you can find an audio program specifically for insomnia there.

Natural Supplement for Sleep Problems

You have may have heard of tryptophan in terms of Thanksgiving, a holiday definitely not associated with insomnia! The real culprit behind post-thanksgiving dinner sleepiness is this essential amino acid present in the turkey, L-Tryptophan. Tryptophan is a precursor to serotonin production followed by melatonin - which aids in sleep. Serotonin is also the feel good neurotransmitter so supplementation with a quality L-tryptophan product has also been shown to improve mood. Note that you can also take tryptophan day and/or night. A dose before bedtime is ideal for helping those who have trouble falling asleep. A dose in the daytime can also help elevate your mood and will not make you sleepy. L-tryptophan also is useful in times of stress or grief, when quitting smoking, and when quitting drinking!

The other great thing about natural supplements like L-tryptophan to support a healthier sleep is that they are not “habit forming”. Obviously recovering alcoholics and addicts in particular ought to consider prescription drugs as the alternative and seek healthier options first, leaving medication as the last resort. Sleep medications such as Ambien can be addictive, and is meant for short-term use only, so it is nice to have a natural solution that is safe to use long-term that addresses insomnia symptoms and also perhaps the underlying cause of the sleep problems.

In summary, if you try just one natural remedy for insomnia give trytophan a try. For a comprehensive approach to combat insomnia both physically and mentally, add in a little meditation during the day and listen to a hypnosis audio at bedtime. In addition to working the 12 steps, recovering alcoholics and addicts can take a proactive approach using natural methods like tryptophan to curb insomnia and thus strengthen relapse prevention and enjoy better health in recovery.

Monday, May 24, 2010

PAWS in Sobriety

PAWS is not some cute AA acronym that stands for something like Please Act Wisely Sober; PAWS is actually a diagnostic term for a set of symptoms called Post Acute Withdrawal Syndrome that can occur for a long time after you put down the alcohol or other addictive drugs. Research has suggested that up to 95% of recovering alcoholics and addicts when tested show the presence of brain dysfunction. Essentially, that is PAWS – symptoms from a dysfunction in the nervous system after quitting booze and drugs. Not to be confused with Wet Brain Syndrome, PAWS is a temporary condition. Do not panic, this too shall pass! However, you can take positive action to help get through it faster and with more ease!

Symptoms of PAWS

When you first detox off alcohol and/or drugs, acute withdrawal is experienced. After a week or two of continuous abstinence from alcohol and drugs, Post Acute Withdrawal Syndrome may be experienced and can last for 3 months to 2 years into sobriety. For most people, PAWS is regenerative - meaning over time and with proper care the symptoms will diminish and damage can be repaired.

Symptoms of PAWS can include difficulty solving simple problems, reacting either overemotionally or having emotional numbness, sleep disturbances, memory problems, inability to think clearly at times, difficulty managing stress, and sometimes problems with physical coordination may present as well. The cognitive symptoms can lead to diminished self-esteem as well. Note, not all of these symptoms may occur and each does not happen constantly but rather periodically. The severity and length of occurrence of PAWS varies individually; it does not look the same for everyone.

What Causes PAWS

Damage to nervous system from the alcohol and/or drugs causes the physiological nature of PAWS, in combination with the other component of PAWS which is the emotional stress of having to deal with life without the old coping mechanism of drugs or alcohol. How much brain dysfunction your addiction has caused + how much psychosocial stress you experience in sobriety = the severity of PAWS. With proper care, it can be reversed.

Taking Action Against PAWS

“… and courage to change the things I can”. This is one of those things you can take positive action to help get through it more rapidly and in a healthier manner. PAWS causes symptoms that are not particularly conducive to your sobriety. In fact, recent research supports the belief that PAWS can contribute to incidents of relapse. As part of a relapse prevention strategy, it is important to address the physical aspects of your alcoholism which includes taking proactive steps to treat PAWS. Your first couple years sober are difficult enough without the added challenges of PAWS symptoms like sleep disturbances and trouble thinking clearly.
Education is always a good start (Education leads to proper Action which leads to Results!). Getting a better understanding about PAWS can ease some of the anxiety and confusion, and help prevent self-esteem problems that can result in the absence of such awareness.

Next, find healthy ways to manage your stress. Stress can be caused by PAWS and also stress exacerbates the symptoms of PAWS so stress management is key! Working the 12 steps with a sponsor is not only the best method for relapse prevention in general, but also a great component to stress management. Meditation is highly recommended! Find what works for you, it can be as simple as setting time for deep breathing daily. Specific nutritional recommendations can really give you the edge on managing stress as well, see this article for details.

Last but not least, get educated about ways to improve your physical health most specifically in terms of your nervous system. If you do just one thing physically to support your nervous system, supplement with a high quality B vitamin Complex. Bill Wilson, A.A. founder, was a big proponent of supplementing with B vitamins to support recovery! To learn about options for a more detailed and custom approach for your nutritional needs in recovery, see this article.

You are not powerless against PAWS. Post Acute Withdrawal Syndrome can be treated by applying the recommended actions listed above, and you can enjoy a long healthier life sober!

Wet Brain in Sobriety

Wernicke-Korsakoff Syndrome, alcoholic encephalopathy (brain damage), Korsakoff psychosis, Wernicke’s disease… all these names refer to what is most commonly called by people in recovery as “Wet Brain”. What’s the real story with Wet Brain Syndrome?

You have probably heard the scary stories about the dangers of LSD - people who dropped acid one too many times or had a bad trip just once who would then suffer random hallucinations and psychotic episodes the rest of their life despite never doing acid again. Perhaps the closest thing to that phenomenon of acid flashbacks for alcoholics would be Wet Brain Syndrome since it involves neurological damage and symptoms that can last long after putting the plug in the jug. When “partying” back in the active days, despite maybe a few jokes about killing brain cells, rarely do heavy drinkers think the alcohol could slowly cause such very serious neurological impairment as is the case with Wernicke-Korsakoff Syndrome. And much like the disease of alcoholism itself, wet brain can sneak up on the heavy drinker, as it develops gradually.

Symptoms of Wet Brain

In reality a much better comparison of Wet Brain would be to Alzheimer’s. Dementia, short term memory loss, and confabulation (false memories) characterize wet brain syndrome. Also, Wet Brain aka Wernicke-Korsakoff Syndrome, typically includes problems related to eye movements, balance and gait, and loss of coordination. Some of these symptoms resemble drunkenness; like with the acid flashbacks, despite absence of the drug, the neurological effects can prevail long after the initial damage was inflicted. Other signs include fatigue, irritability, and sleep disturbances. Late stage Wernicke-Korsakoff syndrome can even result in coma and death.

If you are in early in sobriety, sometimes concerns of Wet Brain are confused with actually suffering from PAWS. PAWS stands for Post Acute Withdrawl Syndrome which can include symptoms such as inability to think clearly, memory problems, sleep disturbances, emotional overreactions or numbness, sensitivity to stress, and problems with coordination. PAWS is temporary, whereas Wet Brain is typically more permanent. Experts suggest PAWS starts a week or two after abstaining from alcohol and can last for 3 months to 2 years into sobriety!

What Causes Wet Brain

Wet brain is caused by gradual brain damage from thiamin (vitamin B1) deficiency. For alcoholics, this syndrome technically known as Wernicke-Korsakoff, develops gradually as a result of a deficiency of thiamin which leads to brain function decline and even neuron death. Chronic excessive alcohol consumption leads to a multitude of vitamin deficiencies, including that of vitamin B1 a.k.a. thiamin. Thiamin plays a crucial role in glucose metabolism, and anything that inhibits the crucial creation of glucose (which the brain relies on to function) can thus cause the brain to rapidly decline in function.

Active alcoholics typically have a poor diet which contributes to vitamin and mineral deficiencies, however even with healthy eating habits the heavy drinking will interfere with absorption of thiamin.

Can Non-Alcoholics Get Wernicke-Korsakoff Syndrome

While wet brain is mainly associated with alcoholism, sometimes non-drinkers can develop Wernicke’s disease as well. There are other ways to become thiamin deficient and therefore susceptible to Wernicke-Korsakoff syndrome, as with the following conditions: severe malnourishment, Chron’s disease, stomach surgery (gastric bypass or stapling), eating disorders involving starvation or vomiting, and even side-effects of chemotherapy.

Can Wet Brain Be Treated

The successful treatment of wet brain depends mainly on the stage of its progression. Early onset of wet brain can be treated and often reversed entirely if caught in time. Anyone exhibiting signs of Wernicke-Korsakoff Syndrome should be given thiamin immediately. Doctors typically administer thiamin intravenously at first. For those looking to supplement on their own, the closest thing to IV is taking a supplement in an isotonic form (for 90-95% absorption, versus 100% with IV, and as little as 20-30% with tablet supplements). In this case, it is recommended to take a B complex supplement rather than choose an individual B vitamin as the various Bs work synergistically together.

Late stage wet brain may be referred to as “Korsakoff psychosis” due to the serious permanent nature of its symptoms. Unfortunately, in its later stages the disease is not reversible.

Patients with Wernicke-Korsakoff Syndrome are sometimes treated with medications used for Alzheimer’s disease when thiamine treatments are ineffective. A more natural alternative to those drugs is Cognitin, a natural cognitive support formula. Cognitin contains the antioxidants acetyl L-Carnitine and alpha lipoic acid (both very beneficial to brain function), and contains vinpocetine (derived from periwinkle extract) which has been used for decades around the world to treat Alzheimer’s and dementia, and is becoming more widely used for general cognitive support.

Do All Recovering Alcoholics Have Some Brain Damage

On a more subtle level, it is probable that all recovering alcoholics have suffered various degrees of cognitive impairment over the course of active drinking years. With this in mind, even the younger and seemingly healthier recovering alcoholics who have no fear of wet brain can benefit from supplementing with a quality vitamin B complex in sobriety (see related article). In fact, researchers have found that supplementing with thiamin (part of B Complex) can also help prevent the development of Wernicke-Korsakoff Syndrome a.k.a. Wet Brain in heavy drinkers.

Friday, May 7, 2010

Good Grief

GOOD GRIEF?
Dealing with grief and loss in recovery, while excruciating, can be the most significant experience to aid in personal growth and secure a strong relapse prevention foundation. “Pain is the touchstone to all spiritual progress.” Once you get through something that feels so painful that it should kill you, but you survive it -and you survive it without a drink or drug- you then know you can get through anything without a drink or drug. After all, isn’t that basically what sobriety is all about… learning to cope with feelings without picking up a drink or drug? Grief kicks up all the toughest feelings we encounter in life: Shock, anger, despair, sadness, depression, loneliness, guilt, remorse, fear and anxiety. If we can endure the roller coaster of bereavement, a certain level of acceptance awaits us. “And acceptance is the answer to all my problems today”.

In early sobriety, we actually gain our first experience at enduring grief without a drink or drug. Having read Caroline Knapp’s memoir “Drinking: A Love Story”, it was easy to grasp the reality that we actually had a relationship with alcohol/drugs. Perhaps it was your best friend who betrayed you in the end, or your lover that abused you but you kept going back for more. Quitting that relationship cold turkey does produce grief effects. It’s the loss of your liquid courage, your instant oblivion, your coping mechanism to just about any undesired feeling or situation. Not to mention the loss of your perceived identity in relation to the drink- i.e. as the outgoing partier, or whatever the case may have been. The anxiety of “who will I be without my good ol’ pal, Captain Morgan (or Jack Daniels perhaps)?”

Stages of Grief in Recovery

First of course there’s the denial. With addiction, that’s a major symptom of the active disease anyway. With the loss of a loved one, especially if it’s sudden and unexpected, during the initial shock and denial it may actually not feel real – you think, how could something so awful be real? It feels like a nightmare and you just keep expecting to wake up from it.

In the stage known as Bargaining, closely linked to denial, we may try foxhole prayer... “Please God, if you just get me out of this situation, I’ll never [drink] again”. We sometimes flip this concept and it becomes what we’d call Reservations. Reservations are those dangerous exceptions you hold on to in which you justify “if this happens… then I can drink”. Like, I can stay sober but if so-and-so dies, all bets are off. That is how an alcoholic reserves her/his right to drink… under certain circumstances. This obviously is discouraged, and why newcomers are encouraged to drill it into their brains: “don’t drink even no matter what” or sometimes heard “don’t drink, even if you’re a$$ falls off”.

Anger is another stage of grief. The A.A. big book warns “if we were to live we had to be free of anger” … but anger is normal stage of grief; it’s what we do with it that matters. As always, step work with a sponsor helps. It is important when the anger comes to get it out, for example screaming when you can (i.e. alone in car so your neighbors don’t think you’re a lunatic), working out is great for this stage- focus on your anger as you lift weights or whatever exercise you engage in.

Typically just beneath the anger we find sadness. Depression is another symptom of grief. When going through grief, sudden bursts of crying are normal and common. Experience dictates that they become fewer and farther between when you actually let it out when these come on. You may fear “if I start, I’m afraid I won’t be able to stop” but this is not true. How often in meetings (or in general!) do we see people ashamed to cry in public? Letting it out not only will help you, but by example in showing your true feelings of grief you may help countless others too.

Is it the -ism Talking or the Grief?

In recovery, dealing with the depression phase of grief in particular can be confusing. There can be a fine line between grief talking and your disease (stinkin’ thinkin’) talking. How do you know when you are experiencing normal depression/sadness as a stage of grief, versus your addict mindset taking over which is serious cause for concern? Keeping your sobriety first- focusing on your program and keeping it simple. If you are working your program then you know you are not shifting into dangerous “dry drunk” territory and thus whatever emotions are coming up are likely to be the grief and they WILL pass and ease up with time. When in doubt, talk it out with another alcoholic and/or share on group level.

Note- it is common and normal to have thoughts of wishing you could join your lost loved on the other side. This can be scary to experience some suicidal-related thoughts. Again, share them. …Ideally with a professional. Be aware that unless these thoughts get to the point of having a specific plan you wish to carry out, you do not have to fear being institutionalized for sharing these feelings with a professional. It is a common phase of the grief. This too shall pass, really.

Remember that the stages are not always linear… Don’t panic if you feel like “wait, I got through this stage, why am I [angry, sad, whatever] again?” The stages don’t always progress in order and only once… much like the roller coaster of emotion experienced during your first year sober. Just remember that it will even out eventually, so hang on and use your support during the ride.

Tools to Support your Healthy Journey Through Grief

Spiritually…
Thankfully for all the intense emotions that accompany grief, the 12 steps can be applied for support, relief, relapse prevention, and ultimately character growth. Throughout the stages of grief during sobriety utilize your support system as much as possible- friends, family, sponsor, therapist, whatever the case may be. It is easy to isolate during grief and feel very alone, which is particularly dangerous for recovering alcoholics and addicts. Whatever type of prayer and meditation you practice, use it! And again, share share share.

Emotionally…
Intense and sudden grief in particular can lead to symptoms of Post Traumatic Stress Syndrome. Seeking outside help is something of which Bill Wilson was a big fan. An effective scientific and holistic modality called EMDR is often utilized in the psychotherapy field to resolve PTSD and can be very helpful during your grief process. EMDR can help to safely accelerate healing and help process the various emotions during grief to help you on your journey to a place of emotional acceptance. To learn about this particular modality, visit the EMDR Insitute and you can search for licensed certified practitioners near you.

Physically…
Last but not least, grief takes a serious toll on us physically. Being so drained emotionally we can tend to neglect our physical health which during times of grief also suffers a great deal from the stress. Read this important related article on nutritional support during stress. A little support physically can really go a long way in supporting you mentally and emotionally during your stages of grief.

Tuesday, May 4, 2010

Nutritional Support During Stress

Need for Nutritional Support During Stress

Our adrenal glands physically endure the biggest brunt of all our emotional stress and thus benefit from nutritional support especially during times of stress. If you are not familiar with these crucial glands, adrenals are involved with the well-known Fight or Flight reaction. The adrenal glands secrete hormones that influence all the major physiological processes in your body. Stress can fatigue them. When your adrenals become weak or burnt out, this can cause you to feel fatigued, and be less equipped physically and mentally to handle the prolonged emotional stress. Also, you will be prone to other health issues as weak adrenals lead to lowered immune health. You can probably think of at least one person you know under constant stress who is also chronically sick. Adrenal fatigue can also make you more prone to allergies, inflammation, weight gain, and other health challenges.

What else taxes the adrenals aside from emotional stress? Physical stressors to the body such as sugar and caffeine… the very things many of us are prone to reach for when we are already feeling emotionally stressed! One of the many functions of the adrenal glands is related to regulating your blood sugar! Especially during times of stress it is best for us to avoid sugar.

For Serious Adrenal Fatigue

If you are seriously concerned about the health of your adrenal glands, you can request to have them tested via labwork. Good doctors that specialize in integrative medicine (docs who are up on the current tests and various modalities available in addition to conventional medicine) can easily hook you up with a saliva test and/or bloodwork to test your adrenal function looking at all the hormone levels your adrenals are supposed to secrete! It is best to use a test that requires samples at various times of the day (usually a take home kit then mailed to lab or returned to doc) because hormone levels are meant to fluctuate and have different parameters that should be evaluated at different times of the day.

Great Supplement for General Support

Bliss anti-stress formula is a highly recommended herbal supplement for daily nutritional support of your adrenals, or even just to use on particularly stressful days/weeks as needed. The natural ingredients are a unique blend of adaptogenic herbs- meaning they help your body (adrenal glands) adapt to stress better. If you adrenals are working too hard, they may need to chill out. If they are weak, they may need a boost. That’s why adaptogenic herbs are great in this manner. You can read up on the ingredients, benefits, research FAQ, etc on Bliss by clicking HERE then scroll down. If you have questions regarding taking Bliss when on medications i.e. for anxiety or depression, you can print out the info from that link to bring it to your physician.

What else can you supplement with to support your body in coping with emotional stress? Try a quality highly absorbable B Complex. B vitamins are also essential for helping your body cope with the effects of stress. If you are a recovering alcoholic or addict, you should seriously consider supplementing with B Complex anyway (Read more here). Giving your physical health extra nutritional support during stress can aid you in the difficult emotional challenge of stress, particularly in times of grief but also in daily life.

Sunday, April 18, 2010

Derek Steele - An Addiction Success Story

Derek Steele was addicted to alcohol and drugs by age 10, homeless at 20, and a sober multimillionaire by age 35. Pretty awesome success story, right? An example of how spiritual health in recovery also influences financial health in recovery! Check out the book trailer:



HealthInRecovery will be offering a free giveaway of Derek Steele's new book, Addict at 10. Details to follow!

Monday, March 15, 2010

Drinking, Obesity, Liver Disease Risk

Two new studies in the British Medical Journal report research that suggests even a small amount of daily drinking (as little as a third or half a drink a day!) plus obesity increases the risk of liver disease in men and women. 

Drinking + Obesity = Double Trouble for your Liver

So you’ve put down the drink.  Maybe it’s been a matter of days, or years.  Either way, that is awesome.  Just by stopping the daily or binge drinking episodes, you have already decreased your risk for liver disease.  Let’s take it a step further.  Now that you are sober, have you ever given your liver some support, via healthy dietary changes and/or nutritional supplementation?  If not, you can read more about how to be proactive in this way at our older article- click here.

Having removed the first half of the equation, let’s look at the other factor: obesity.  The American Obesity Association utilizes Body Mass Index (BMI) to evaluate your degree of risk based on excess weight.   Here are the risk parameters:
  • BMI > 25 defines overweight and marks the point where the risk of disease increases from excess weight.
  • BMI > 30 defines obesity and marks the point where the risk of death increases from excess weight.
  • Waist circumference of > 40 inches in men and > 35 inches in women increases disease risk.
You can quickly have your BMI calculated by clicking here.

If you are ready to improve your body composition to lose fat and preserve lean muscle, a lifestyle change is what you need… not a diet!  Diets don’t really work, in fact they contribute to the obesity problem overall.  Start by educating yourself on the correct healthy way to lose weight.  Check out this highly recommended Health Guide to learn the essentials.  If you would like to contact a weight loss/lifestyle coach, .  Come back for future blogs with more information on liver disease, obesity, weight management, and other health issues pertaining to recovering alcoholics and addicts.

Wednesday, February 10, 2010

Best Natural Methods to Quit Smoking in Recovery


Looking for the best natural methods to quit smoking in recovery? When trying to kick nicotine and the other 4,000 chemicals in cigarettes, chances are you probably don’t want to use a method that continues to add chemicals to your body. Recovering alcoholics and addicts especially are less likely to want to use drugs to try to kick another drug habit. Most have tried to quit smoking in the past, and typically 2 or 3 unsuccessful attempts precede the final victory. Maybe the conventional methods have failed you in the past (i.e. nicotine gum, patches or meds), or perhaps you just prefer to go the natural route anyhow. Many smokers look to methods from natural medicine when ready to really quit for good.

Secrets to Success in Quitting Smoking: Natural Therapies

Physically… Acupuncture is a commonly recommended natural modality for smoking cessation support. Certified acupuncturists can administer a specific protocol of treatments on certain points of the body, geared to minimize the cravings during withdrawal. Typically the practitioner will suggest one or two sessions a week during this stressful period. You can search for an acupuncturist near you.  Don't like needles?  Try Emotional Freedom Technique- EFT is like emotional acupressure for self-care.  You can work with an advanced certified practitioner and even work by phone or Skype. 

Mentally… Chances are you have tried to quit smoking in the past, so doubt and negative thinking may sabotage your efforts this time around. You can give yourself the mental edge with some hypnotherapy. You can of course seek out a certified hypnotherapist, or for a more affordable option try downloading an audio program to listen to daily and every night before you go to sleep. Hypnotherapists have created guided meditations and recorded hypnotherapy for smoking cessation which you can even download as an MP3 for instant gratification. Program your brain with positive thoughts to set yourself up for success and replace the negative obsessive thinking.  Click here to check out this great recommended program by an acclaimed hypnotherapist. 

Spiritually… Don’t forget you can apply the 12 Steps to nicotine addiction as well! If you are not sure how, visit http://www.nicotine-anonymous.org/

Secrets to Success in Quitting Smoking: Natural Supplements 

What do people report as the main reasons behind their fear of quitting smoking in recovery? They typically relate it to their perception that cigarettes reduce "negative affect," (referring to depression, anxiety or irritability), and that these underlying conditions may trigger a relapse, in the absence of the perceived calming effect of cigarettes. So the real issue seems to be what sobriety is all about anyhow- learning to cope with emotional stressors with healthy tools rather than picking up any drug, including a cigarette. But the stress of quitting smoking itself on top of the other potential daily stressors does indeed have physical and emotional ramifications. Natural supplements offer a safe helpful solution, especially for those who prefer not to add pharmaceuticals to their sober regimen.

http://www.shop.com/maryvo/Bliss+trade+Anti+Stress+Formula-559052307-p+.xhtmlPhysical withdrawal causes stress in the body, and obviously the normal daily stressors that trigger the urge to pick up a cigarette may feel exacerbated during withdrawal. Stress affects the adrenal glands (our fight and flight guys!). Most recovering alcoholics have beaten up their adrenal glands pretty well over the course of their drinking days- and even with stress that continues into sobriety. Smoking hasn’t helped the adrenals either! The best herbal support to recommend given all these factors is one which supports the adrenal glands and your body’s ability to cope with stress. 

Check out Bliss anti-stress formula, which contains a great blend of adaptogenic herbs- they help your body adapt to stress naturally, help stabilize your mood and decrease feelings of anxiety. That’s key especially during this critical period while trying to kick the nicotine habit, when stress seems to be your greatest enemy mentally, and physically. Click here to read about the benefits, ingredients and science behind Bliss to see if it is right for you (you can print out the info there if you want to check with your doctor first). 

http://www.shop.com/maryvo/Isotonix+reg+L+Tryptophan-561800343-p+.xhtmlThe other supplement to consider for increasing your chances for success in quitting smoking is L-trytophan, an essential amino acid which is the precursor to serotonin production. Serotonin is the “feel good” neurotransmitter. According to WebMD, taking L-tryptophan seems to improve the effectiveness of conventional smoking cessation treatment. L-tryptophan naturally improves mood, and supports healthy sleep, both of which are particularly important when trying to quit smoking. And another researched benefit is that L-tryptophan can “help promote healthy reactions in daily and stressful situations”! 

The body cannot produce this essential amino acid so it must be obtained through diet and supplementation. It is best utilized in an isotonic-capable form which also contains niacin and B6 to assure its proper absorption. Click here to learn more about or order the best L-tryptophan supplement available.

Secrets to Success in Quitting Smoking: Eating Correctly 
 


diet for quit smoking, balance metabolism, The final natural method that you may not be aware of is a certain eating plan to support your efforts. Another common deterrent to attempting to quit smoking is the feared weight gain. It is true that people sometimes gain 5 or even 10 lbs when they quit. However if you are armed with the correct knowledge to eat the right way, this can be avoided. The best way to avoid gaining weight is to eat a low-glycemic meal or snack every few hours. This will not only naturally help keep you from storing excess fat, it will also help curb cravings and balance your blood sugar levels- which were negatively affected by smoking. Nicotine affects blood sugar, so it affects your metabolism. To help restore a healthy metabolism, learn to use a low glycemic plan to balance your blood sugar. This is the healthiest way to eat in general anyway! Get this great health guide and journal for all the info you need to support your healthy lifestyle change. That will complete your comprehensive plan to finally quit smoking, using the best natural methods to give you the healthy edge to ensure your long term success.

Quitting Smoking In Recovery

Rates of smoking are much higher in alcoholics in recovery than in the general population.
Recovering alcoholics who smoke may think they already quit their worst habit and justify their continued cigarette smoking and nicotine addiction. Many folks in recovery fear trying to quit smoking may put their sobriety at risk, and rationalize that its safer to continue smoking. However, the most common cause of death in long-term recovering alcoholics is related to the health consequences of cigarette smoking! As for sobriety, perhaps they are truly hanging on to their “drug of choice”. 

Old timers talk about the days of AA when newcomers cleaned ashtrays because everyone was permitted to smoke inside meetings. Despite the fact that it’s rare today to find a smoky meeting anymore, there are still plenty of active smokers to walk past on your way inside. Since the beginning, AA’s focus has been solely on alcohol, hence NA forming specifically for narcotics addiction… and there still seems to be a general tolerance for the continued use of nicotine by these recovering alcoholics and addicts alike. 

In the past and sometimes still today, newcomers have been encouraged to not worry about quitting smoking until they get a significant amount of sober time. There is even a tale in the Big Book about a man in early sobriety who relapsed after his wife “nagged” him to quit cigarette smoking! This was likely further fuel for justifying continued nicotine use in sobriety. (Note: it was his “fit of anger” reaction to her nagging, not an attempt at quitting smoking, that led to his relapse.)

Today, many clinicians report that quitting nicotine during initial treatment of alcoholism could actually increase chances of staying sober. Think about it- the typical triggers of relapse are various emotional stressors that lead to the desire to numb feelings or “check out”. In our active addiction, the drug of choice is used to quell stressful unwanted feelings (i.e. anxiety, depression, anger, grief, etc). The sooner one develops tools for managing these stressors without the use of drugs (including nicotine!) the better. Also, if given the chance wouldn’t it make sense to withdraw from everything at once and get it all over with from the start? But unless directed to do so in an inpatient treatment facility, most reading this will not have that chance. 

Here’s a thought for the day: If you are still reaching for that nicotine on a stressful day, are you truly clean and sober? Technically, at least, you are not drug-free. Regardless of your position on this controversy, having put down the alcohol and narcotics addiction… with a clear head today, don’t you now want to be as healthy as possible? For yourself, and for your loved ones? Once sober, we come to a point where we realize we are no longer on a destructive course to an early grave- simply by no longer engaging in the dangers of active alcoholism/addiction. So it makes sense to want to take better care of our bodies since they are going to be around longer than perhaps previously anticipated, and a healthier lifestyle dictates a better quality of life as we continue to age. Quitting smoking is a major lifestyle factor that we do have control over.

Recovering alcoholics and addicts who smoke are more likely to get heart disease, lung disease and cancers of the head, mouth and throat. They are also at risk for an earlier death than those in the general population. It is hard to be happy, joyous and free when battling serious physical maladies. We can take actions today to help ensure happier healthier days and years ahead. Quitting smoking in recovery is possible and tips for quitting smoking naturally are addressed in the next article!