Adjustment Disorder Resources

by Band Back Together | Jul 6, 2018

What is An Adjustment Disorder?

Adjustment Disorder (also known as Situational Depression) is a stress-borne type of mental illness that involves the development of extreme emotional or behavioral symptoms brought on by major life events. These stressful life events include moving, to losing your job, to getting a divorce, losing a child or other major stressors and life events. It’s important to note that not all of these precipitating events have to be negative life changes; adjustment disorder can be brought about by marriage or having a baby as well.

An adjustment disorder can happen to anyone, at any point in their life. Children and teens are affected at the same rate, while female adults are twice as likely to develop adjustment disorders.

Like other mental illnesses, the cause is generally complex; a mixture of genetics, environment, life experiences, and temperament are involved in the development of adjustment disorder.

What Causes Adjustment Disorders?

Adjustment disorders are caused by a major life stressor which can be any number of things. In children and teens adjustment disorder may be brought on by a number of things, including:

• Problems at school
• Marital problems in parents
• Family problems
• Issues with sexuality

In adults, adjustment disorder may present after any of the following:

• Marital problems
• Economic struggles
• Work problems

All ages may be affected with adjustment disorder after the following events:

• Death of a loved one (especially if it was a sudden death)
• Major life changes
• Major trauma
• Major medical diagnoses

It’s impossible to predict who will develop adjustment disorder, even if the precipitating event is the same, but it’s important to note that the development of adjustment disorder may be brought on by both internal and external factors.

External factors that may lead to the development of adjustment disorder can include social support availability, economic conditions, recreational or occupational opportunities.

Internal factors that may lead to the development of adjustment disorder can include social skills, IQ, coping mechanisms, and genetics.

The development of adjustment disorder is often a combination of internal and external factors in a person’s life.

What Are The Risk Factors For Adjustment Disorder?

While no one cause has been indicated for the development of adjustment disorder, and not everyone reacts the same way to the same stressors, adjustment disorder can be caused by any one of the following:

• Diagnosis of a major, chronic illness
• School problems
• Going away to school
• Relationship breakup
• Divorce
• Becoming unemployed
• Having a baby
• Physical trauma
• Surviving a disaster – tornado, hurricane
• Retirement
• Losing a loved one
• Challenging life circumstances
• Exposure to violence
• Additional mental health issues.

In addition, those who are under constant stress – living in a bad area – may hit a point in which they breakdown and develop adjustment disorder.

Former life experiences may also play a role in the development of adjustment disorder. If changes and adjustments are challenging and you lack social support, you may be more apt to develop adjustment disorder.

Those who experienced stressful situations in childhood – over or under-protective parents, divorce, moving often – may make an adult or adolescent feel as though they have no control over their life, which means when stressors occur, coping may be more challenging.

What Are The Symptoms of Adjustment Disorder?

Symptoms of adjustment disorder include distress uncharacteristic of what would be expected by the major life event and cause major impairment at work, with one’s social life, or educational abilities and occur within 3 months of the known stressor.

The symptoms for adjustment disorder may not meet the criteria for another mental illness, such as major depression or anxiety disorders, and do not last longer than six months from the onset of the precipitating event.

Symptoms of adjustment disorder, which vary wildly between people, can include the following:

• Agitation and restlessness
• Anxiety
• Fears
• Worry
• Tension
• Trembling or twitching of the extremities
• Physical complaints without medical cause
• Heart palpitations
• Depressed mood
• Social withdrawal and decreased social functioning
• Occupational impairment
• Various conduct disorders – stealing, fighting, vandalism.

It is important to note that while these symptoms are the ones most often experienced by those diagnosed with adjustment disorder, adjustment disorder presents itself differently in every person.

What Are The Subsets Of Adjustment Disorders?

Adjustment disorder is often categorized into subtypes based upon the symptoms. These subcategories of adjustment disorders are:

1. Adjustment Disorder with Anxiety: Symptoms include feeling nervous, worried, difficulty concentrating, feelings of being overwhelmed. Children may experience intense separation anxiety.
2. Adjustment Disorder with Depressed Mood: Symptoms include sadness, feeling tearful and hopeless, and loss of pleasure in previously enjoyable activities.
3. Adjustment Disorder, Mixed Type – Anxiety and Depression: Symptoms include depression and anxiety.
4. Adjustment Disorder with Conduct Disturbances: Symptoms include problems such as fighting, reckless driving, and not paying bills.
5. Adjustment Disorder, Mixed Type, Emotional and Conduct Disturbance: Symptoms include depression, anxiety, and behavioral problems.
6. Adjustment Disorder, NOS: For those whose symptoms aren’t better described by the other types of adjustment disorder, often have symptoms that include problems with work, family friends, somatic complaints.

How is Adjustment Disorder Diagnosed?

A diagnosis of adjustment disorder can be acute or chronic, is based upon the following criteria.

• The reaction the person is having is clearly tied to a life stressor (whether or not the person is aware of the root cause).
• Within three months of the stressor, behavioral and emotional symptoms develop.
• The symptoms experienced seem excessive compared to “normal” reactions to the same stressor and/or symptoms cause major impairment in work, social functioning, or school.
• The symptoms are not better explained by another diagnosis.
• The symptoms are not related to grief and grieving.
• The symptoms do not last over six months from the end of the stressor, unless the person is suffering complex adjustment disorder, in which case symptoms may last longer than six months.

How is Adjustment Disorder Treated?

Treatment for adjustment disorder, like most mental illnesses, is aimed at managing symptoms to allow the person to reach a level of social and occupational (or scholastic) functioning comparable to what was normal before the precipitating event.

A mental health professional will often recommend that a person suffering from adjustment disorder begin a course of therapy. This type of therapy can be individual, behavioral, family therapy, and self-help groups.

As adjustment disorder is a relatively short-term mental illness, realistic and attainable short-term goals should be created with the onset of treatment.

The goals set during therapy are generally centered around the social supports available to the person, which includes: friends, family, and the community. While social support is explored, the therapist often works with the person to help with coping skills and abilities to manage stress.

For children and teens, family therapy in addition to teaching the individual how to cope with stressors in his or her life is often recommended.

Occasionally, prescription medication may be utilized to eliminate some of the symptoms of depression and anxiety. Medications may be prescribed in conjunction with therapy.

What Are Complications Associated With Adjustment Disorder?

Generally speaking, most adults who have adjustment disorder recover within six months without complications. People who have other mental health issues, addictions, or chronic adjustment disorder are more likely to develop greater long-term mental health problems. In adults, these problems can include:

• Major depressive disorder
• Addictions to substances or alcohol
• Suicidal behavior and thoughts.

Teenagers who have adjustment disorder – especially chronic adjustment disorder with behavioral problems – are at greater risk for the development of:

• Major depressive disorder
• Addictions
• Suicidal behavior
• Schizophrenia
• Bipolar Disorder
• Antisocial personality disorder

What Is The Prognosis For Adjustment Disorder?

Adjustment disorder, while a challenging disorder in the short-term, is often treated properly and people who have the disorder recover without lingering symptoms. Recovery is often more favorable for those who have no previous history of mental illness and have adequate social support during treatment and recovery.

How Can I Help Myself Heal From Adjustment Disorder?

When you’re suffering from adjustment disorder, it may feel hopeless; like your world has crashed and burned, and you may not see the light at the end of the tunnel. Here are some tips for coping with adjustment disorder:

• Go easy on yourself – allow yourself the time to process your feelings and work through them.
• Don’t let anyone tell you “you’re not getting over this fast enough.” Recovery takes time.
• Don’t engage in negative self-talk while dealing with adjustment disorder. You’re going to be fine.
• In fact, your mantra is “everything is okay. I am okay.” Say that when you’re lowest or most anxious.
• Force yourself to talk to people – adjustment disorder can be very isolating. Don’t isolate yourself, even if it feels good.
• Tell people that you’re hurting. There’s no shame in this. Just make sure the people you tell are those you can trust.
• Find a hobby that brings you joy and throw yourself into it.
• Keep a healthy diet and stick to a regular sleep routine.
• Find a local support group and attend it. There is tremendous strength in numbers.
• Ask others how they cope with stressors and see if you can learn to practice some.
• Do something nice for yourself every day.
• Remind yourself often that you can get through this.
• Utilize and learn proper coping skills and stress management like yoga, meditation and time with loved ones.
• Ask your therapist for some suggestions to manage stress.

If Your Child Has Adjustment Disorder…

Parents who see their children struggle with adjustment disorder are often stuck feeling helpless and hopeless. Here are some tips for helping children with adjustment disorder:

• Tell your child that their feelings are normal; that emotions aren’t wrong.
• Explain that sometimes our emotions can be scary; but that’s okay.
• Remind them that while it hurts now, it won’t always hurt.
• Be supportive and understanding.
• Show your love to your child.
• Talk to your child about his or her feelings.
• Allow your child to choose things he or she likes to do around the home.
• Allow your child to make simple decisions about the things he or she eats or watches on television.
• Make sure the school knows that your child is coping with adjustment disorder and have the teachers let you know how he or she is doing in school.
• Find a hobby or something fun that your child likes to do and encourage participation in that.

Can You Prevent Adjustment Disorder?

It’s important to note that there’s no sure-fire way to prevent the development of adjustment disorder, but the development of healthy coping skills and learning to be resilient may work in your favor during times of adversity, trauma, or tragedies. Some ways to increase your ability to manage stress and become more resilient include the following:

• Laughing and finding things to keep you laughing.
• Maintaining a healthy lifestyle
• Feeling good about yourself
• Having – or creating – a support network.
• Call upon your inner strength if you know a stressful situation in your future.

Additional Resources For Adjustment Disorder:

ChildMind Institute offers information and advice for parents of children with mental disorders

Make The Connection help for veterans who suffer from adjustment disorder

Page last audited 7/2018

Addison’s Disease Resources

by Band Back Together | Jul 6, 2018

What is Addison’s Disease?

Addison’s disease (also called chronic adrenal insufficiency, hypocortisolism, and hypoadrenalism) is a very rare endocrine disorder that occurs when the adrenal glands are damaged and do not function properly. The damaged adrenal glands produce insufficient amounts of the hormones cortisol and aldosterone, which results in a number of non-specific symptoms such as pain and weakness. Under certain conditions, though, the symptoms of Addison’s Disease may progress to Addisonian Crisis, which is a severe condition that can include extremely low blood pressure, death, and coma.

Addison’s Disease is named after Thomas Addison, who first described the condition.

Addison’s disease occurs throughout all age groups and both sexes, and can be life-threatening if not properly treated. Treatment of Addison’s disease involves taking replacement hormones to replace the insufficient amounts produced by the damaged adrenal glands, which behaves to mimic the beneficial effects from the natural hormones.

1. Primary adrenal failure may be caused by damage by the immune system. Certain infections can also cause adrenal crisis.
2. Secondary adrenal failure occurs when there is a reduction in the production of corticotropin, which is produced by the pituitary gland. Corticotropin causes stimulation of the adrenal gland. Secondary adrenal failure can also occur when corticosteroid use is abruptly discontinued in those with another chronic illness.
3. Tertiary adrenal failure occurs when the hypothalamus does not produce enough hormone to stimulate the pituitary gland to release the corticotropin

What Causes Addison’s Disease?

Addison’s disease is caused by damage to the adrenal glands, leading to insufficient amounts of the hormone cortisol and aldosterone. The adrenal glands are located just above the kidney, and are a part of the body’s endocrine system, they produce hormones that control virtually every organ and tissue in the body.

The adrenal glands of the body are made of two sections:

1. Medulla – the interior portion of the adrenal gland that produces adrenaline-like hormones.
2. Cortex – the outer layer produces a group of hormones called “corticosteroids,” which include androgens (male sex hormones), glucocorticoids, and mineralcorticoids.

These hormones are essential for survival. Let’s explore the role of these hormones:

• Androgens: these are the male sex hormones that are produced in small amounts by the adrenal glands in men AND women. Androgens are responsible for sexual development in men and women, and influence libido, muscle mass, and a sense of well-being for both sexes.
• Glucocorticoids – these hormones, which include cortisol, influence the ability of the body to convert food into energy as well as aid in the inflammatory response of the immune system, and help the body respond to stress.
• Mineralocorticoids – these hormones, which include aldosterone, maintain sodium and potassium balance within the body to ensure normal blood pressure.
  

Addison’s disease develops when the cortex of the adrenal glands are damaged and don’t produce sufficient amounts of the hormones.

Any condition that leads to damage of the adrenal glands is called “Primary Adrenal Insufficiency.”

Possible causes of damage to the adrenal glands can include:

An autoimmune condition that causes the immune system to mistakenly attack the adrenal gland is the primary cause for Addison’s Disease. Other causes for adrenal failure can include:

• Certain infections like HIV, fungal infections, and tuberculosis.
• Other infections of the adrenal glands
• Cancer that’s metastasized into the adrenal glands
• Bleeding into the adrenal glands (from hemorrhage or use of blood-thinning agents)

Secondary Adrenal Insufficiency occurs if the pituitary gland is diseased. The pituitary gland creates a hormone called adrenocorticotropic hormone (ACTH), which stimulates the adrenal cortex to produce hormones. Improper production of ACTH can lead to insufficient production of the hormones created by the adrenal glands, although it’s worth noting that the adrenal glands are not damaged.

Secondary Adrenal Insufficiency can occur among those who’ve used corticosteroids to treat chronic conditions such as arthritis or asthma, and then abruptly stop treatment with corticosteroids.

Addisonian Crisis if Addison’s disease remains untreated, an Addisonian Crisis can be provoked by physical stress, like an injury, infection, or illness.

Risk Factors for Addison’s Disease:

While there are no certain risk factors that lead to the development of Addison’s Disease, there are a number of additional autoimmune diseases that increase the risk for the autoimmune-type of Addison’s disease. These risk factors include:

• Cancer
• Chronic thyroiditis
• Dermatitis herpatoformis
• Graves’ disease
• Hypoparathyroidism
• Hypopituitarism
• Myasthenia gravis
• Pernicious anemia
• Testicular Dysfunction
• Type 1 diabetes
• Vitiligo

What Are The Symptoms of Addison’s Disease?

The symptoms of Addison’s Disease are often non-specific and typically develop over the course of several months. Symptoms of Addison’s Disease can include:

• Chronic diarrhea
• Hyperpigmentation (darkening of the skin)
• Extreme hypotension, possibly fainting.
• Extreme muscle weakness
• Changes in blood pressure or heart rate
• Hypoglycemia
• Muscle and/or joint pain
• Fatigue
• Craving salt
• Slow or sluggish movement
• Depression
• Nausea/vomiting
• Loss of libido
• Body hair loss
• Unintentional weight loss

Acute Adrenal Failure (Addisonian Crisis) Symptoms:

For some people, the signs of Addison’s Disease may appear very suddenly. Symptoms of Addisonian Crisis can include the following:

• Severe, extreme vomiting and diarrhea
• Dehydration
• Hypotension
• Loss of consciousness
• Pain in the lower back, legs or abdomen
• Hyperkalcemia

How Is Addison’s Disease Diagnosed?

A physician will diagnose Addison’s disease with the help of blood testing and imaging after taking an inventory of presenting symptoms.

Laboratory Blood Tests are able to measure cortisol, sodium, potassium and ACTH levels in the blood. This will indicate whether or not an adrenal insufficiency may be present. Antibodies will also be measured to ascertain if autoimmune Addison’s disease is present.

ACTH Stimulation Test – this test measures the level of cortisol in the blood before and after an injection of synthetic ACTH. ACTH works by stimulating the adrenal glands to produce cortisol. If there is damage to the adrenal glands (primary adrenal insufficiency), the response to ACTH in the blood will show reduced or absent amounts of cortisol.

Insulin-Induced Hypoglycemia Test – if the doctors suspect secondary adrenal insufficiency, this test may be performed. It works by checking the blood glucose and cortisol levels at various intervals after an injection of insulin. In healthy people, blood glucose levels fall and cortisol levels rise.

Medical Imaging Scans – these imaging studies, which can include an ultrasound and/or an MRI can be used to ascertain the size of the adrenal glands as well as check for any abnormalities that may give reason for the adrenal insufficiency. An MRI of the pituitary gland may be performed to ascertain whether or not Addison’s disease is caused by secondary adrenal insufficiency.

What Is Treatment For Addison’s Disease?

Treatment for Addison’s disease involves replacement corticosteroids and hormone replacement. This treatment will control the symptoms of the disease and most people receiving this treatment are able to lead normal lives. Some options for treatment may include the following:

Androgen Replacement Therapy – Many women with insufficient androgen levels find that taking androgen replacements can do wonders for their well-being, libido, and sexual satisfaction.

Corticosteroid Injections – if oral medications aren’t tolerated, corticosteroid injections may be necessary instead.

Oral Corticosteroids – oral steroid treatment may be used to manage Addison’s Disease.

Also included in treatment of Addison’s Disease is the ingestion of large amounts of sodium, especially during hot weather or if diarrhea is present. Dosages may increase if there is an illness, operation, infection, or other stressful situations.

Addison’s disease requires life-long treatment, including regular medical care and monitoring. During times of injury, infection, or stress, additional dosage of corticosteroids may be necessary. It is recommended that those with Addison’s disease wear a medical alert bracelet in case of emergency.

Addisonian Crisis: an Addisonian crisis is a life-threatening situation leading to hypotension, hypoglycemia, and high levels of potassium. This is a medical emergency. Treatment for an Addisonian Crisis includes:

• Dextrose
• Hydrocortisone
• Saline solution

What Are Some Complications of Addison’s Disease?

Some complications are possible if too much or too little medication is administered. Problems that can occur with Addison’s Disease are:

Illness – during illness, oral dosages of medication may be adjusted to mimic the normal response of the adrenal glands to the stress on the body. Significant fever or injury may require triple dosages. When a person with Addison’s recovers, the dosage will be returned to normal.

Pregnancy – women with adrenal insufficiency who become pregnant, should be treated with the standard hormone replacement therapy. If the first trimester involves nausea and vomiting, she should switch to injections of the hormones.

Surgery – as cortisol is a stress hormone, those with Addison’s Disease who need surgery under a general anesthesia need to be treated with IV glucocorticords and saline until the person is able to eat and drink. The dosage will be adjusted until the person recovers from surgery.

What is An Adrenal or Addisonian Crisis?

If Addison’s disease is untreated or not properly controlled, an adrenal crisis can occur if the individual is physically injured, ill, or fighting an infection. Symptoms of adrenal crisis include reduced consciousness, difficulty breathing, abdominal pain, and/or low blood pressure. Warning signs include:

• Unable to take medication due to vomiting
• Stress, injury, trauma, infection, or dehydration
• Weight gain
• Swollen ankles

Living With Addison’s Disease:

Addison’s Disease is a chronic condition that requires medical management and adherence to all medication prescribed. Coping with a chronic illness can feel overwhelming at times. Here are some tips for living with Addison’s Disease:

Find a local support group and join it. Finding people who are going through what you are going through can be immensely comforting.

Write about your feelings and your fears, either in a journal, or here on Band Back Together.

Stay in contact with your doctor. An ongoing relationship with a doctor you trust is vital to management of Addison’s Disease.

Keep extra medications on hand as missing even one dose can be dangerous to your health.

Wear a medical bracelet. That way, if you’re incapacitated, EMT’s will know how to care for you.

Additional Addison’s Disease Resources:

National Adrenal Diseases Foundation: non-profit organization dedicated to providing support, information and education to individuals having Addison’s disease as well as other diseases of the adrenal glands.

Pituitary Network Association: international non-profit organization for patients with pituitary tumors and disorders, their families, loved ones, and the physicians and health care providers who treat them.

The Addison’s Society of Canada: Offers Canadian support and information to people who have been diagnosed with Addison’s Disease

Last audit 7/2018

Major Depressive Disorder Resources

by Band Back Together | Jul 6, 2018

Band Back Together is not Crisis Intervention. If you’re in crisis or having thoughts of suicide, please contact local emergency services or the Suicide Prevention Hotline (800) 273-TALK. Band Back Together also doesn’t offer counseling or other direct services.

What is Major Depressive Disorder?

While sadness is a normal part of the human experience – we all feel sad some of the time as a natural result of grief, loss, isolation, loneliness, or other psychologically painful life events. Sadness is natural. However, when sadness becomes more than feeling blue for a lot longer, it can become Major Depressive Disorder (MDD).  Major Depressive Disorder (also known as recurrent depressive disorder, clinical depression, or unipolar depression) is a form of depression that is characterized by an all-encompassing depressed mood and/or decreased interest in pleasurable activities nearly every day for at least two weeks. To be classified as a major depressive disorder, there must not be a history of manic, mixed, or hypomanic episodes. Major Depressive Disorder can either be a single episode or recurrent and is just as much an illness as diabetes. In fact major depressive disorder is one of the most common form of mental illness in the United States, in 2015, nearly 7 percent of Americans over age 18 had an episode of MDD.

Depression is more than just a feeling of having the blues or feeling miserable. It isn’t a weakness; nor is it something a person can simply snap out of.

Some people never do seek treatment for major depressive disorder. Those who do learn that depression is a chronic illness that typically requires long-term treatment possibly including medication, therapy, and/or psychological counseling.

When to Get Emergency Help:

If you think you may hurt yourself, someone else, or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you’re having suicidal thoughts:

• Call your doctor or mental health professional.
• Call a suicide hotline number — in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Use that same number and press “1” to reach the Veterans Crisis Line.
• Reach out to a close friend or loved one.
• Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

What Causes Major Depressive Disorder?

It’s uncertain to scientists what precisely causes major depressive disorder to evolve in certain people and not others. However, there are several factors that can increase the risk of developing the condition. A combination of genes and stress can affect brain chemistry and reduce the ability to maintain mood stability. Insufficient production of neurotransmitters such as serotonin, norepinephrine and dopamine can cause major depressive disorder. In neurology, differences in brain structures between people that are and are not depressed have also been noted.Changes in the balance of hormones might also contribute to the development of major depressive disorder.

Depression may also be triggered by:

• alcohol or drug abuse
• certain medical conditions, such as cancer, pain, and/or hypothyroidism,
• particular types of medications, including steroids
• changes in sleeping patterns may also contribute to depression

Who Is At Risk For Major Depressive Disorder?

Anyone can get Major Depressive Disorder, but there is a high hereditary link, either due to genetics, or learned behaviors. While children and adolescents can and do get Major Depressive Disorder, symptoms often begin in the late twenties. People who have a history of traumatic experiences, have had family members that have attempted or completed suicide, or have few personal relationships are also at risk for developing Major Depressive Disorder.Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.

This list is by no means all-inclusive or meant to diagnose Major Depressive Disorder. Most people who have MDD experience symptoms strongly enough that they begin to affect daily life – be it school, work, home life, relationships with others.

If you suspect you may have depression, please call your doctor or a mental health practitioner.

Factors that may increase the risk of developing or triggering depression include:

• Certain personality traits, such as low self-esteem, and being too dependent, self-critical, or pessimistic
• Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems
• Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide
• Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren’t clearly male or female (intersex) in an unsupportive situation
• History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
• Abuse of alcohol or recreational drugs
• Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
• Certain medications, such as some high blood pressure medication

What Are The Symptoms of Major Depressive Disorder?

The main symptom of Major Depressive Disorder is a pervasive feeling of sadness, loss, anger, or frustration that interferes with daily life for more than two weeks, however there are often additional symptoms a person experiences.

Other symptoms of MDD may include:

• Agitation, restlessness, and irritability
• Change in appetite and weight
• Difficulty concentrating
• Fatigue
• Feelings of hopelessness, worthlessness, self-hate, and guilt
• Loss of interest in activities that were once enjoyable
• Thoughts of death or suicide
• Social isolation – ignoring social requests, preferring to stay in alone
• Changes in sleeping patterns

Symptoms in Older Adults

In older adults, MDD may look a bit differently than it does to those younger which unfortunately means that older adults may be under-diagnosed with MDD. Here are some specific symptoms of major depressive disorder in the elderly:

• Memory difficulties or personality changes
• Physical aches or pain
• Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
• Often wanting to stay at home, rather than going out to socialize or doing new things
• Suicidal thinking or feelings, especially in older men

Symptoms in Children and Teens:

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

• In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
• In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Diagnosis of Major Depressive Disorder:

Physicians or mental health practitioners will take a mental health history and discuss your mood as well as other symptoms with you. Health care providers may request blood or urine tests to rule out any physical/medical causes of depression. If this your symptoms come and go, it may be diagnosed instead as Major Depressive Disorder, Recurrent.

What Are The Complications of Major Depressive Disorder?

Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn’t treated, resulting in emotional, behavioral, and even physical health problems that affect every area of your life.

Examples of complications associated with depression include (but are NOT limited to):

• Excess weight or obesity, which can lead to heart disease and diabetes
• Pain or physical illness
• Alcohol or drug misuse
• Anxiety, panic disorder or social phobia
• Family conflicts, relationship difficulties, and work or school problems
• Social isolation
• Suicidal feelings, suicide attempts or suicide
• Self-mutilation, such as cutting
• Premature death from medical conditions

How Is Major Depressive Disorder Diagnosed?

it’s important to call your doctor, and ALWAYS remember that you know yourself better than any physician. You may have to be your own advocate for treatment and care of major depressive disorder. It is VITAL to be honest with your therapist, doctor, or other members of your care team. You may not find the right doctor or therapist the first time you visit one. Do not hesitate to say “this relationship isn’t working for me,” and obtain a referral for another therapist/doctor/care team. They work for you, not the other way around.

Your doctor may determine a diagnosis of depression based on:

• Physical exam. Your doctor may do a physical exam and ask questions about your health. In some cases, depression may be linked to an underlying physical health problem.
• Lab tests. For example, your doctor may do a blood test called a complete blood count or test your thyroid to make sure it’s functioning properly.
• Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.
• DSM-5. Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

How Is Major Depressive Disorder Treated?

Treatment for Major Depressive Disorder often include antidepressants and therapy. While both are singularly effective, the combination of the two are often the best course of treatment, especially for severe depression. If depression is so severe that someone is feeling suicidal or cannot function in daily life, they may need treatment at a psychiatric facility to assist them in maintaining their own safety.

Mental Illness Resources

by Band Back Together | Jul 2, 2018

Addiction Recovery Resources

by Band Back Together | Jun 29, 2018

What Is Addiction Recovery?

It takes a lot of guts to face up to addiction – no matter what the drug of choice. Some people are addicted to drugs or alcohol, but other people may be addicted to things like gambling, sex, hoarding, or other types of behaviors. Many people feel completely overwhelmed by their addiction, powerless against defeating it, and feel like there’s no way out. Sobriety may seem like an impossible, unattainable goal, but recovery is never out of reach, no matter how far down you believe you have gone.

Change is scary, but change is possible, and you have it within you to kick the habit. Addiction is NOT a life sentence.

Step One Addiction Recovery: Decide to Make A Change

Deciding to make a change is usually the most challenging part for most addicts. Giving up the comfort of your drug of choice, facing a change, and realizing that many things will have to change to work the path toward recovery can seem daunting and scary.

Preparing For Change:

1. Keep track of your reasons for changing.
2. Write down specific reasons that you want to get sober: keep it on you all the time to pull out when you’re facing a trigger or urge.
3. Set specific, measurable and attainable goals, like a quit date or dates that you’ll begin to cut down
4. Consider past attempts to kick the habit (if applicable) and what about those attempts worked and didn’t work. Addiction recovery is not a one-size-fits-all treatment: what works for you may not work for another person.
5. Build a support network of friends and family to help you through this change. If you’re alone, try beginning one of the 12-step programs as they are full of people who have been where you are and know how to change.
6. Get rid of reminders of your addiction from your home, car, and workplace. Dump your pipes, throw out your cigarettes, dispose of alcohol, or dispense of other triggering reminders of your addiction. These are incredibly unique things that may not affect all addicts equally. Throwing them out can be incredibly difficult, but so very worth it.

Step Two Addiction Recovery: Treatment Options

Treatment should focus not only on your addiction but on any other problems and mental illnesses you may have. There is no single treatment that works for every person and therefore your treatment should be tailored to your specific needs. Treatment requires deep commitment and follow-through on the part of the addict as well as his or her family. Addiction is known as a family disease, which everyone playing a part. While you, the addict, go to treatment (whatever you choose), your family also requires treatment as well. Make sure they prepare and complete treatment before you’re sober.

There are many places to look for help for addiction treatment and recovery. Not every addict requires extensive detox and weeks in rehabilitation centers, but some do. Here are some options for addiction recovery – do remember that it’s not going to be a one-size-fits all problem – that you can try:

1) Inpatient Addiction Rehab: Many people first begin their addiction recovery in Inpatient Rehab. Inpatient rehabs do offer structured treatment programs that should be designed to address all facets of each person’s addiction and tendencies. During inpatient rehab, addicts in recover reside in a substance-free facility and receive around-the-clock medical care and therapeutic support. In the first part of inpatient addiction rehab generally involves detoxing under strict medical care provided by nurses and doctors. Inpatient rehabs may be the best option for people battling chronic addiction, as well as those who suffer from a co-occurring mental or behavioral disorder (example: anxiety, depression, bipolar disorder..

2) Outpatient Addiction Rehabs are another form of total addiction care and treatment. Outpatient programs may offer many of the same kinds of effective treatments and therapies as inpatient rehabs, however in outpatient rehab, you’re allowed to live at home during the addiction recovery process. You can continue working and caring for your families while attending scheduled treatment sessions throughout the week. It’s important to remember that outpatient rehabs do not take place in a residential facility; which means you’re at a higher percentage of encountering triggers and relapse. Generally, outpatient rehabs are a step-down from an inpatient addiction rehab; still providing the support and therapies associated with addiction recovery without the structure of an inpatient program. Outpatient addiction rehabs tend to follow a progression from PHP to IOP setting.

• PHP or Partial Hospitalization Programs are generally the first step-down from traditional inpatient rehab in which people slowly relearn to acclimate from the highly-structured inpatient program in a much less restrictive ways. PHP programs tend to be much more involved in the therapy process, generally providing therapy 6 days per week about 5 hours a day. This allows patients to go home in the evening and be with their family. Partial hospitalization programs do not involve any sort of detox.
• IOP’s or Intensive Outpatient Therapy generally involves using less and less restrictive types of therapy to allow people to slowly acclimate to their lives in a measured, controlled manner, with therapy 10-12 hours a week about 3 days a week. IOP does not include any type of detoxification process

3) Continued Addiction Therapy can include regular meetings with a personal therapist, attending group meetings, and working the recovery program you’ve learned throughout the rehab process.

Use a state by state (in the US only) addiction recovery treatment facility near you.

Step Three Addiction Recovery: Support Network

Make recovery support group meetings a priority. It can be easy to feel overburdened with the amount of meetings per day to attend, but they really are vital for continued recovery and sobriety. Look at it like this: If you had time to go to the bar or get high, you have time to make it to meetings. In meetings you can find many people who understand what you’re going through and how to best support you.

Having close family and friends is invaluable for someone in addiction recovery, providing you have some.

Make sure to build a sober social network to replace any non-sober networks. Until they get sober themselves, you’re going to have to cut those people out to prevent triggering. Don’t visit bars, old hangouts, or places you used to use. You don’t want the chance to relapse.

You can find sober social networks throughout your meetings. If you don’t know where to find meetings, ask in therapy or consult your therapist.

Consider living in a sober-living home (especially if you don’t have a stable, safe, drug-free home environment) during the recovery period – this time is absolutely vital to your recovery.

Step Four Addiction Recovery: Manage Stress

Drug use, abuse, and addictions (of many kinds) may be triggered initially by unhealthy attempts to self-medicate with drugs and/or alcohol to relieve stress. To combat substance abuse and addiction, one must learn other ways to manage stress. Some of these include:

• Exercise – which releases endorphins (the bodies “feel good” hormones
• Yoga and meditation
• Calming music
• Deep-breathing
• Petting your animal
• Tell someone close that you’re feeling stressed
• Go to a meeting
• Go for a walk
• Soak in a hot, relaxing bath
• Try smelling fresh flowers, extracts, or coffee bean

Step Five: Controlling Cravings and Triggers

• Avoiding bars and clubs.
• Breaking up with old drug or other addiction buddies.
• Telling any medical professionals about your history of drug addiction up front so you can work together to find an alternative means of controlling any type of pain or discomfort.
• Using prescription drugs, especially those with a high potential for abuse (sleeping pills, painkillers, anti-anxiety medications) with extreme caution, make certain your doctor knows your history of addiction before you start to take these medications

• Talk to someone about your craving while in the middle of it.
• Change your thoughts and challenge formerly held beliefs. It’s easier to remember the positive aspects of drug use and not the negative ones. Make a list (or look at a list) of benefits and consequences if it helps to remind you of why you quit.
• Urge Surf – imagine yourself as a surfer riding the wave of a drug craving, staying on top of it until it crests, breaks and turns into foam, generally cravings only last 10-15 minutes
• Distract yourself while in the middle of a craving.
• Read a book, go jogging, focus your attention on something else until the urges subside.
• Don’t resort to junk food as an alternative – it will only add stress and pounds.

Step Six Addiction Recovery: Build a Meaningful Drug-Free Life

Now that you’ve overcome your addiction, you may find that you have a lot of free time and emotions that you’re not used to having. At first, it can be helpful to go to recovery meetings (12-step or other) as often as you can to gain a sober support network but eventually, you’re going to have to recreate your life. This time, you can do it the way YOU want it to be done. That’s not to say it’s easy, but it is worth it. Here are some ideas for building up your life again:

• Adopt a pet. Pets are wonderful at making you feel loved, needed, and wanted.
• Find a new hobby – it doesn’t have to be lame.
• Learn about the things you (sober you) enjoy. They may be markedly different than things you once enjoyed.
• Give yourself some time to reenter the real world and understand that it can be incredibly difficult at first. That’s okay – just keep going.
• Get involved in your community – replace your addiction with other wholesome activities. Volunteer, join a club, or become active in your neighborhood.
• Take care of your health.
• Get rid of the people in your life who are not good for – or to – you. You deserve better.
• Practice great self-care
• Don’t be too hard on yourself
• Learn to forgive, it’ll help you and everyone around you
• Take stock of what your biggest strengths are and see if you can find something to do regularly that showcases the things you’re great at, those that you enjoy, and those that make you feel good and accomplished
• Set meaningful, attainable goals to work toward rather than the end goal – it’s much more satisfying to accomplish things at once rather than focus on the bigger goal.

Step Seven Addiction Recovery: Relapses Happen

Relapse is a very common (albeit frustrating and discouraging) part of the recovery from addiction and abuse. Consider it an opportunity to revamp your treatment plan and learn from mistakes. It doesn’t mean you’ve lost everything, only that you need to try again. Relapse is incredibly common, but no less discouraging. Understand that you can get sober – and stay sober – once again. Now, you’ll have the advantage of having been through it before. Don’t let anyone else cause you guilt or shame for relapsing – only an addict knows an addict.

Relapse does NOT mean you failed. Get back on the wagon, call your sponsor and your therapist, go to a meeting, check into rehab, and don’t beat yourself up for it.

Common Relapse Triggers:

• Physical discomfort
• Anger, sadness, trauma, or stress.
• Feeling happy – oddly enough, once things are going excellently in your life, you may feel like “celebrating” with your drug of choice
• Testing personal control – “plenty of people can have one drink, why can’t I?”
• Urges, triggers, and temptations – these are a challenging part of an addict’s recovery: urges, triggers, and temptations can sneak up out of the blue. If you can remind yourself that this is a temporary thing, most urges only last about 10 minutes. Try focusing on something else
• Fights and conflicts with others – if you’ve always coped with conflicts by using your drug of choice, this can be a struggle. Try to remember all of the reasons that you opted to get sober in the first place
• Social pressures – well meaning people are often guilty of pushing an addict to “join in the fun” or “get with the party” without knowing that he or she struggles with addiction. Enough social pressure can cause someone to feel as though they really can still use.

Coping with an anger management issue is already a complex and arduous struggle, but when combined with substance abuse, it feels impossible. Whether anger led to your addiction or addiction led to your anger, the two fuel each other in a dangerous cycle. You can’t address one and not the other, but learning to overcome your anger while in addiction recovery doesn’t come easily.

The Connection Between Addiction And Anger:

Though many don’t realize it, substance abuse often co-occurs alongside anger, aggression, and violent tendencies.

Sometimes, the anger comes first and leads to addiction:

• Anger issues lead to problems at work or home, leading the afflicted person to cope by using substances
• Rage becomes so overwhelming that a person seeks to numb the pain with substances
• The many stresses fester, leading a person to take out their anger and frustration by indulging in drugs or alcohol