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Being aware of warning signs can help identify addictions in self and in others

With the COVID-19 pandemic continuing, many communities are seeing a rise in substance use and abuse. But there are signs to watch for in ourselves and others that can help those in need.

Kim Chaudoin  | 

Person sitting on steps

Life can often feel overwhelming. There are bills to pay. You have a stressful assignment at school… or you recently received a poor performance evaluation at the office. There is trouble at home or your friends don’t call you anymore. That painful injury just won’t go away. Your heart has been broken by a loved one or you are in an abusive relationship. A family member is chronically ill or your car just broke down and you don’t have enough money to pay the repair bill.
 
Add to the common stressors of life the COVID-19 pandemic that has impacted millions around the globe and has left many feeling isolated or lonely, recovering from illness, out of work, anxiety-ridden and depressed and it is not surprising that many communities are facing another crisis — a rise in substance use and abuse.
 
For those battling substance abuse disorders (SUDs), the pandemic has been particularly challenging with access to regular treatment and counseling having been impacted as cities across the United States shut down for months in response to the pandemic. For some, that led to relapses.
 
During this time, others have developed new dependencies as they turned to various substances as a way to cope with the uncertainty, anxiety, sadness and hopelessness.
 
DeAndrea Witherspoon Nash, assistant professor of psychology and counseling, leads Lipscomb University’s Master of Science in Clinical Mental Health Counseling program with a specialization in addiction. She says it is not surprising that in such an unusual time for our nation substance use increases.

DeAndrea Witherspoon Nash

Dr. DeAndrea Witherspoon Nash

“During periods of stress or prolonged stress, we tend to seek relief in familiarity. We go to what works to get immediate relief from what we are presently experiencing,” says Witherspoon Nash.
 
For those who may be concerned that their personal use of alcohol or drugs is becoming excessive or high-risk, Witherspoon Nash recommends asking yourself these questions:

  • Am I drinking or using more than I intended to, or perhaps using at times that are out of the norm (drinking during the week or getting high in the morning)?
  • Do I need more of the drug to achieve my desired effect?
  • Am I covering up my use?
  • Do I have difficulty stopping or have I been unsuccessful in attempts to cut back?
  • Do I use alone?
  • Do I feel isolated?
  • Am I defensive when a loved one talks to me about my use or personality changes?
  • Am I neglecting my hygiene, daily responsibilities, and/or relationships?
  • Do I find my favorite leisure activities or hobbies less enjoyable or do I not enjoy them at all?

Self-care is important, says Carla Porter, who works in geriatric depression research at Vanderbilt Psychiatric Hospital in Nashville.

Carla Porter headshot

Carla Porter

“We've all heard how important it is to take care of ourselves, but in an age where we're running from one engagement to the next, it's easy to forget to stop and just breathe,” says Porter, a second-year student in Lipscomb’s Clinical Mental Health Counseling program with a specialization in addictions. “With school, work, homework, social events, health concerns, and car troubles, sometimes we feel as if we're drowning. It's important to come back up for air before we really do.” 
 
“During the pandemic, I've seen a rise in depression and addiction,” she continues. “As our schedules have been disrupted, we've struggled to know what to do from one moment to the next. We've asked ourselves, what's the point of it all, anyway? The minute we got a chance to breathe, we didn't remember how to.”

Porter admits that the ongoing pandemic has caused her to struggle with her own self-care. She says she had to make an effort to enjoy the little things like her morning coffee, taking a walk outside and talking to her fish at my apartment. 

“My body and spirit are at peace when I take the time to enjoy life,” she explains. “I've had to learn to make an effort, even if I don't feel like it, and it's made my experience of the pandemic easier to bear.”

Porter recommends also being aware of others around you who “look worn down or are on edge.” 

“Ask them what's going on. Chances are they haven't made time for basic self-care practices. If you yourself are feeling worn down, take a break and do something for yourself,” says Porter. “Make the time to go outside, grab lunch with a friend, or exercise for a few minutes. Don't let those precious moments pass you by because you're too busy to enjoy them.”

We've all heard how important it is to take care of ourselves, but in an age where we're running from one engagement to the next, it's easy to forget to stop and just breathe. With school, work, homework, social events, health concerns, and car troubles, sometimes we feel as if we're drowning. It's important to come back up for air before we really do.  — Carla Porter, second-year CMHC student

Witherspoon Nash says there are also symptoms to be aware of with friends or family members that might indicate there is a potential SUD concern. According to the National Institute on Drug Abuse, the following are warning signs for youth and adults that may indicate a potential SUD:

  • Lack of interest in hobbies or leisure activities once enjoyed
  • A drastic change in appearance/hygiene
  • Increased and consistent sadness, hostility, or anxiety
  • Excessively tired or little need for sleep
  • Change in eating habits
  • Increased isolation or sense of secrecy; Withdrawn behaviors
  • A decline in work or academic performance
  • Money is unaccounted for
  • Change in peer group
  • Deteriorating relationships with family members, colleagues, and friends

“It is important to remember that there are many reasons why someone may be exhibiting these behaviors,” explains Witherspoon Nash. “If you are concerned about your own use or that of a family member, colleague or friend, it is important to seek help from a mental health professional who can assess for the presence of a mental health or substance use disorder.”

While seeking help from a mental health professional is recommended, there are also several strategies for self-care that can be helpful. Witherspoon Nash says these include knowing what your triggers are (e.g., familiar people, places, and things) and developing a solid relapse prevention plan.
 
“The key is developing an individualized, adaptable plan that takes into account seasons of change,” says Witherspoon Nash. “Plans often include practical go-tos such as maintaining a routine, practicing healthy eating and sleeping habits, staying connected to others, attending medical and mental appointments, engaging in sober leisure activities, and a commitment to service, to name a few.”

Two women in counseling setting

If you know of someone who does have an SUD, Witherspoon Nash says listening is important.
 
“Be that safe place and nonjudgmental ear. “We must learn how to listen with the intent to understand instead of listening to respond. There is a shroud of shame and guilt surrounding addiction that contributes to secrecy and isolating behaviors, out of fear of being rejected or judged. Friends or family may say, ‘If you loved me you would stop’ or ‘If you cared about how much you are hurting yourself you wouldn’t drink.’ There has to be a willingness to understand that addiction is a disease and not a moral or spiritual failing.”
 
If you are thinking about having that talk and you don’t know where to start, Witherspoon Nash has a few practical tips:

  • Express that you are concerned. Be mindful and specific with your examples of why you are concerned using “I” statements- “I am concerned when I see you drink that much.” Keep checking in and verbalize how much you care. Find additional talking points here and here.
  • Timing is key. Face-to-face is ideal, but during this time Google Duo, FaceTime, or any other platform that allows you to see your loved one may be most helpful. Because of the sensitive nature of this talk, emotions may run high. Avoid addressing any concerns when someone is under the influence and if needed, take a break from the conversation and address your concerns at another time. Be sure to follow-up.
  • Keep the door open. Express that you are available to talk and to help. Keep checking in and know what resources are available in your community. Most importantly remember that change takes time.
  • Maintain healthy boundaries. Be aware of any direct or indirect ways to enable substance use behaviors. In the context of addiction, a practical definition of enabling are behaviors I participate in that prevent someone from experiencing a natural consequence such as covering up or making excuses for someone, giving money, etc. An example of implementing a healthy boundary is offering to take a friend to a 12-step meeting or to treatment instead of driving them to purchase alcohol.
  • Take care of yourself. Reflect on how you are emotionally, mentally, spiritually, and physically impacted. Reach out for support and take it one day at a time. (See below for links to connect with Al-Anon, NAMI, and PAL support groups.)

Resources

A number of local, state and national resources are available for those who are exhibiting high-risk behaviors, those who have substance use disorders and loved ones seeking to begin their journey of healing.

Support Groups

Treatment Locators

Nashville Area Treatment Centers


 Learning about treating substance use disorder through an addiction lens and a mental health lens creates a unique perspective for counseling professionals — and one that is increasingly needed in communities across the nation. Lipscomb University’s Master of Science in Clinical Mental Health Counseling program with a specialization in addictions is the only faith-based, CACREP-accredited university in the south that offers this unique program and equips students with the knowledge and expertise that make a difference on the front-lines of treating those with a substance use disorder.