News broke on Tuesday that the heroic Ranger's outfielder, Josh Hamilton, had a relapse in his long battle with alcoholism. Many Rangers fans are wondering why Josh can't kick the habit and what this means for his future.

So, why can’t people just quit the addictive behavior?

All addictions are unintentional and they begin with the decision to use. No one starts drinking with the idea that they will ever become addicted. But addiction sneaks up on you and before you know it, you can be drawn into a world of confusion and torment. Voluntary users become compulsive users and then you bottom out as a true addict when drugs or alcohols define your life.

The real issue is that addiction is not a moral failing or a lapse in will. At the end of the day, addiction is a brain disease. New research shows that there are literal brain changes in the structure and function of key brain processes that are fundamental in handling emotions, exercising self-control, and reading situations correctly. Addicts are stripped of their accuracy in understanding the world.

How do addictions get started and become worse over time?

Internal Shift: The person begins to turn toward behavior that is relieving his stress. Getting high is fun and it changes his mood for the better in the beginning. He denies how dangerous his usage is as he begins to betray others and himself with repeated use.

Lifestyle Change: A behavioral dependency on the alcohol or drug now emerges. Life is now altered to accommodate the addiction even if he becomes reckless and self-destructive. He moves deeper into the self-sabotaging behavior as he builds his life around getting high.

His Life Destructs: The addiction has now taken over. The individual relies on getting high and ignores or rationalizes the destructive aspects of his behavior. At this point, nothing matters to the addict but the acquisition of the substance. The obsession with the addiction causes a trance state. People don’t matter, commitments don’t count, and honesty isn’t even a part of the conversation.

Unstoppable: People become convinced that they cannot stop the drinking. Since there are significant changes in brain structure that are critical to judgment, decision making, learning, memory, and behavioral control, the slide into addiction is accelerated.

How do you know that someone is at rock bottom?

A chronically addicted person tends to psychologically regress suddenly and severely, with no warning. They go down like a stone. Once the addiction switch is flipped, it is incredibly difficult to reverse the emotions and behavior. Insight is gone, judgment is gone, and perspective is shot. If the addictive substance—whatever it is—is strong enough, all bets are off. He begins to destroy every area of his life—his job, his relationships and even his health. Addiction hijacks the mind and better judgment.

What do we tell our children about people like Josh Hamilton who struggle with addiction?

This is a prime opportunity to teach kids about addiction and the inevitable struggles of recovery. Remember these points:

Teachable Moment: Make stories about addiction struggles a part of the conversation. You want your child to be armed with knowledge of addiction so he is never start the cycle. Remember that the child who stays away from drugs, tobacco, and abusing alcohol until age 21 is virtually certain to steer clear of these substances forever. Teens who learn about the risks of drugs or alcohol from their parents are much less likely to try them.

Still A Good Person: Most kids already know what addiction is, since Americans consume two thirds of the worlds’ illegal drugs. Celebrities who have struggled with addictions are always in the news so a lot of kids understand that you can be a talented, good person and still have an addiction.

Constant Battle: Break the addictive behavior down into understandable language. Explain that alcoholism is a disease and that it is a lifelong struggle to overcome it. Tell them that relapse is a part of recovery and that all that matters is how the alcoholic handles their next choice.

There’s Always Hope: Teach them to believe in recovery, believe in the person’s ability to fight against this illness, and to celebrate the gains that people show as they power on to a better tomorrow.

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Why are relationship violence rates so high?

These numbers speak to a deepening problem in American couples. Too many modern couples replace words and negotiation with intimidation and bullying. Relationship violence can easily get out of control. We are more exhausted, less affluent and less conscientious about doing the right thing even when no one is watching. We live in a society now that rewards the intimidation of others. Bullis believe that if they don’t get their way, that they can threaten or intimidate others to control the outcome. Such behaviors in general society have transferred to our marriages. These violent habits now thrive in intimate relationships where there is no witness and very sadly, no accountability.

How does this kind of relationship violence get started?

Malignant Trend: We already knew that about 70% to 80% of distressed couples could resort to occasional pushing and shoving when there is chronic tension. But this survey speaks to a more malignant trend in relationships. Relationship violence usually starts suddenly with a slap or a shove. There is shock at the beginning as the intensity and the frequency progressively increase.

Violence Becomes the Norm: The woman is intensely harmed—hit hard, kicked, violently attacked, choked, beaten, shot or slammed against a hard surface by her partner. Her denial kicks in and she pretends that this is either her fault or a normal part of life.

Witnesses to Violence in Family of Origin: Many women of the current generations have witnessed domestic violence in their parents’ relationships. When they grow up with violence, they are twice as likely to accept or normalize violence in their own relationships.

Overwhelming Trauma: The emotional damage is exponentially worse when you are traumatized at the hands of your partner. The person who is supposed to protect and honor you is now torturing you with bullying and intimidation. Twenty nine million women say that they have suffered this type of severe and frightening physical violence from their boyfriend, spouse or intimate partner.

Why do men move to violence against their wives?

There are two broad categories of men who become violent in relationships:

Men Who Control at All Costs:

• Controlling and contemptuous personalities.
• Regards the wife as a possession, not a person.
• Anger issues
• An inability to take responsibility for his behavior.

Emotional Dependence on the Wife/Girlfriend:

• When she elects to reject him or disagree, he is devastated.
• He becomes psychologically disorganized and seeks to isolate her and reestablish control.
• If he cannot resume control and/or connection, his obsession will lead him to a total self-destruction that can include dangerous behaviors.

What are the warning signs of potential violence?

Physical Violence: Once he crosses the line, you have changed the relationship forever.

Symbolic Violence: This behavior includes the destruction of objects dear to the partner. The intention is to intimidate the other person. Wedding pictures, personal items like perfume or lingerie or even violence against a beloved pet are all efforts to symbolically intimate.

Fast Paced Relationships: When the pace is accelerated at the beginning, this is a control strategy.

Persistence: Anyone who will not hear “no” as an answer is trying to control you. Too often, when men say “no” that is the end of the conversation. When the woman says “no” in a potentially violent relationship, this marks the beginning of the negotiation.

What can women do to protect themselves?

Unavailability at All Costs: If you fear your partner, you must surrender your daily life to separating from him. Remember that you cannot reason with him, convince him or soothe him since he is intent upon reclaiming you as a possession. He only wants to regain control.

Worst Safety Threat is Your Own Denial: Women underestimate threat and do not recognize the warning signs such as a history of possessiveness, intimidation and sexual jealousy. These are the psychological "signposts" warning you of potential danger. Pay attention.

Intuition is Best Defense: Respect your own intuition and don't talk yourself down. Stop debating and prosecuting your own observations. Thirty one thousand women die each year in America and the majority die at the hands of an intimate partner.

Speed is Your Best Protection: If you are threatened, respond quickly. Do not hesitate and remain frozen. Experts estimate that you have approximately five seconds to make a difference in your own self defense. A failure to act may cost you your life.

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Eating disorders affect up to 70 million people worldwide with 24 million Americans suffering from this disorder according to the National Institute of Health. While current studies indicate that 95% of eating disorders affect girls between the ages of 11 and 25, new research reports that record numbers of older women are now affected by eating disorders.

So, why would an older woman develop an eating disorder at this time of life?

There are four principle reasons that women develop a midlife eating disorder:

Control and Eating Disorders: Control is the common denominator between all eating disorders. A current trauma or dramatic change in her life that makes her feel vulnerable and helpless can precipitate an eating disorder. Husbands leave, parents die and friends move away leaving her without the support system she has known for years. An eating disorder can become a comfortable, familiar “friend” during these dark times. Micromanaging your food intake either through restricting food or binging with food can leave you flush with a momentary exhilaration in an anxious life.

Social Pressure: Women are subjected to continued pressure to look young and being super thin is associated with being young. The $40 billion dollar diet industry is all too willing to help her strive for the ideal body type found in only 5% of American females. Most eating disorders begin with body dissatisfaction and shedding pounds gains her enormous social approval.

Undiagnosed Depression or Anxiety: Depressive and anxiety disorders commonly co occur with eating disorders. Eating disorders are cruel masters and the constant striving for perfection can wear any woman out. If binging is the disorder of choice, the extra weight causes increased self-loathing and depression.

Previous Eating Disorder Returning: Eating disorders are complex, chronic mental health illnesses that can lie dormant during the childrearing years to return at midlife when there are fewer distractions and less applause.

Why are these disorders so difficult to detect in older women?

We associate eating disorders with a young girl’s struggle. By midlife, most people think you should be over those vain concerns about your body. But tragically, highly negative beliefs about your body never leave most women. We develop a self loathing toward our bodies early in life (78% of 17 year olds despise their bodies according to one study), we never consider if we are logical or rational in our self appraisal and we reinforce our negative self appraisal constantly by comparing ourselves to all the celebrities that have obvious eating disorders!

Most midlife women tend to escape notice from medical professionals since we are so adaptive in so many other areas of our lives. We often do not realize that we even have a problem. In addition, our friends and colleagues praise us when we are razor thin. No one ever stops to ask if all that exercising, food restriction or binging are really healthy for us.

Do the same eating disorders affect both young and older women and what are the signs?

Both age groups seem to develop similar disorders. However, the older woman may evolve quicker to the binge eating disorder than her younger peer. But there are important facts to keep in mind about eating disorders in any age category:

Deadly Disorders: Eating disorders have the highest mortality rate of any mental illness. Twenty percent of people suffering from anorexia will prematurely die from complications related to their eating disorder. These disorders can be deadly since the malnourishment strikes at the very metabolic and cardiac systems that are foundational for good health.

Three Distinct Disorders:

Anorexia Nervosa: No one sets out to develop an eating disorder. We “back into them” usually in response to a growing dislike for our bodies. This disorder usually begins at age 17 just as she is headed out into the world. Symptoms include a relentless pursuit of being thin, obsession with being perfect, an obsessive fear of gaining any weight and a denial of emaciation.

Bulimia Nervosa: The woman engages in binge eating and then inappropriate methods of preventing weight gain including purging or excessive exercising.

Symptoms Include:

• Rituals built around eating large amounts of food within a 2 hour period
• Feels out of control with the eating.

Binge Eating Disorder affects about 3 percent of Americans. Some experts believe that the disorder is rising faster than anorexia and bulimia. Women who binge hide their disorder and ask for help much later in life.

What should we do if we are worried about a woman we love?

• Educate yourself about eating disorders first and acknowledge that they are dangerous. Remember that these disorders gradually build and are much easier to treat the earlier they are diagnosed.
• Approach her with compassion and support when you express how concerned you are for her. Lead with empathy before you give advice.
• Remind her of her lifetime of accomplishments—the children she has reared, the career she has built and tell her that this is a surmountable challenge.
• Encourage her to get a professional evaluation with a psychologist specializing in eating disorders.

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With Charlie Sheen’s latest public tantrum denouncing the writer and creator of his top rated show, Two and a Half Men, CBS has canceled the show for the rest of the season. With a long-standing history of addiction and failed rehabilitation, Sheen seems to be in serious trouble.

So how do you know that someone is at rock bottom?

Sudden Regressions: Chronically addicted people tend to regress suddenly and severely with no warning. Once the addiction switch is flipped, it is incredibly difficult to reverse his emotions and behavior. He has no insight and no judgment. He begins to destroy every area of his life—his job, her relationships and even his health. Addiction hijacks the mind and better judgment.

Addiction Takes Over: Self-destructive behavior is the inevitable and predictable end point of a long and down ward spiral. The addict’s emotional outbursts indicate that his addicted brain has taken over fully since there is no demonstrated ability to censor his words or his behavior. His recklessness and self-destructiveness may well continue.

Psychologists often diagnose two other serious problems that contribute to the addiction illness:

Bipolar Disorder: The leading contender is bipolar illness, which is a type of depression in which the mood becomes elated and then depressed. People can cycle in and out of explosive, grandiose manic episodes and then be flat on their backs with a debilitating depression in the same hour.

Narcissistic Personality Disorder: This disorder is often present in the addicted person and remains undiagnosed due to the overwhelming addiction. The individual is arrogant, grandiose, entitled, shameless, vengeful and highly impulsive. Striking out at others even if it results in unfortunate consequences is common when the person becomes enraged or frustrated.

Remember that other unaddressed psychiatric disorders that accompany addictions often sabotage treatment in the end.

Celebrities who are under pressure to perform are especially vulnerable to addictions. Unfortunately, money often insulates people from the accountability that is necessary to overcome a serious addiction. They become more and more entrenched in the addiction because their power allows them to control the treatment. We are seeing this in the tragic examples of Lindsay Lohan and the late Michael Jackson.

We do know that male addicts can function in the workplace for decades without detection. The alcohol or drug problems are concealed carefully. However, when their performance at work is affected, they have crossed a line and surrendered to the addiction.

Separation stresses such as a marital dissolution can impact a fragile personality intensely causing regression and a return to the addiction. Addictions make people very self-centered and they have minimal accountability so the marriage ending feels like an injury or wound they find intolerable. Engaging in the addiction becomes a way to sooth their embarrassment and to escape the pain and agitation.

Remember that the drugs and alcohol have hijacked the mind of the addict and they have minimal abilities to rescue themselves.

Intervene, stay firm, set your boundaries firmly and refuse to participate in the addictive behavior. While it is the hardest thing you will ever do, you have to refuse to accept the addiction as inevitable and unchangeable. Believe in recovery, believe in their ability to fight against this illness and light the way back to health for the addict who is truly lost.

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Swine Flu Anxiety

April 30, 2009

Dr. Sylvia Gearing, TXA 21 News

As the global epidemic rages, North Texans are bracing for the onslaught of this deadly virus. While many of us are naturally anxious, it is important to know when normal anxiety crosses the line.

Swine flu makes us nervous for a variety of reasons. Swine flu is the ultimate enemy. It has infiltrated our country in a matter of days, is highly contagious and is potentially lethal. In the face of such news, it is easy to overreact as we see our mobilized public health officials issuing warnings, closing schools and calling us to new levels of caution.

That being said, as with any adversity, large or small, remaining focused on the positive and in a problem-solving mode are essential skills. The public must remain calm, realistic and maintain a proper perspective of what this disease is and what it is not. When you repeatedly dwell on scary news without remembering the steps to protecting yourself, it is natural to spin into a terrifying sequence.

Swine flue anxiety affects us in a variety of ways.

• Psychological Immunity: if you are a worrier, your psychological immune system may already be depleted. Many of us have been worrying about the economy for months so a health scare is not something we need to bother with. At this point, many of us are mentally exhausted.
• Vulnerability to Anxiety: Some people’s brains are built to generate anxiety. If you struggle with anxiety, you are more likely to dwell on this health crisis in a self defeating way. Remember that your brain does not differentiate between real events and fantasized events and will generate the constant warnings to keep you safe. That adrenaline and cortisol for fighting and fleeing will “amp up” your system continuously.
• Proximity to Danger: If you have experienced a traumatic situation with a virulent disease or a catastrophic event, you may be more anxious about this one.

Emotionally effective people know how to think and feel based upon objective reality. They are good at matching their reaction to the situation. If you are becoming less emotionally effective about swine flu, these are the symptoms you will see:

• Loss of Critical Thinking: Failing to keep the situation in perspective means that you are losing objectivity and are failing to maintain perspective about what you can do to protect yourself. You may be thinking in an illogical manner or overestimating your risk.
• Overarching Anxiety: If you are constantly feeling overwhelmed, you have lost perspective. You should be concerned but not overwhelmed.
• Lack of Proactive Healthy Behaviors: If it is only danger that dominates your mind, then you are not employing intelligent self-protective steps to guard your health. Sleep, eating and exercise all fall by the wayside when we are too anxious.

If you are feeling overwhelmed by anxiety, use these strategies:

• Get the Facts: Gather the latest information from the media that will help you to accurately determine your risk so that you can take reasonable precautions.
• Keep Your Network Going: Talk to other people about what they are hearing and seeing. Such conversations foster a sense of normality and provide great outlets for sharing feelings and releasing tension.
• Practice Resilience: Differentiate between viewing yourself as effective and strong versus viewing yourself as vulnerable and in danger.
• Maintain a Hopeful Outlook: Your mental health is one of the keys to staying healthy. Stress leads to an alarm reaction, mobilization and exhaustion. Ironically, by stressing about the disease, you make yourself more vulnerable to it. Distract yourself and break up the negative thinking.

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