Find out what's involved in getting a diagnosis of a drinking problem or alcoholism.

An important warning sign is clearly regular, heavy drinking. The ceiling for low-risk alcohol use advocated by the U.S. government is  one standard drink per day for women and two standard drinks per day for men. Because of age-related changes in the body, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends that men and women older than 65 years consume no more than one drink per day.

At-risk alcohol use, or problem drinking, is defined as more than seven drinks per week or more than three drinks per occasion for women; and more than 14 drinks per week or more than four drinks per occasion for men. Heavy drinking is often defined as more than three to four drinks per day for women and more than five to six drinks per day for men.

To diagnose a drinking problem or alcoholism, your doctor will ask you:

• about your history of using alcohol and other drugs
• about any alcohol-related problems that you might have had at work, at home or with the law, including arrests or episodes of driving while intoxicated
• about any physical symptoms of alcoholism

Although these questions can be embarrassing to answer truthfully, your doctor should view alcoholism as a disease or illness that can be treated (alcoholism treatment), and will not respond to you as if you had a reason to be ashamed. And your doctor is in a better position to help you if you can be straightforward.

Your doctor will examine you, carefully checking for signs of poor nutrition and alcohol-related liver or nerve damage. The doctor will also:

• order blood tests to check for anemia, vitamin deficiencies and abnormal levels of liver chemicals.
• possibly ask you to fill out a questionnaire such as the CAGE screening test or the Michigan Alcohol Screening Test (MAST) to help in the diagnosis of alcoholism.

Sources:

• American Family Physician (Feb. 1, 2002 issue)
• 10th special report to the U.S. Congress on alcohol and health: highlights from current research from the Secretary of Health and Human Services. U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism 2000:429-30; NIH publication no. 00-1583.

next:

The manic phase of Bipolar I Disorder is often misdiagnosed as Narcissistic Personality Disorder (NPD).

Bipolar patients in the manic phase exhibit many of the signs and symptoms of pathological narcissism - hyperactivity, self-centeredness, lack of empathy, and control freakery. During this recurring chapter of the disease, the patient is euphoric, has grandiose fantasies, spins unrealistic schemes, and has frequent rage attacks (is irritable) if her or his wishes and plans are (inevitably) frustrated.

The manic phases of bipolar disorder, however, are limited in time - NPD is not. Furthermore, the mania is followed by - usually protracted - depressive episodes. The narcissist is also frequently dysphoric. But whereas the bipolar sinks into deep self-deprecation, self-devaluation, unbounded pessimism, all-pervasive guilt and anhedonia - the narcissist, even when depressed, never forgoes his narcissism: his grandiosity, sense of entitlement, haughtiness, and lack of empathy.

Narcissistic dysphorias are much shorter and reactive - they constitute a response to the Grandiosity Gap. In plain words, the narcissist is dejected when confronted with the abyss between his inflated self-image and grandiose fantasies - and the drab reality of his life: his failures, lack of accomplishments, disintegrating interpersonal relationships, and low status. Yet, one dose of Narcissistic Supply is enough to elevate the narcissists from the depth of misery to the heights of manic euphoria.

Not so with the bipolar. The source of her or his mood swings is assumed to be brain biochemistry - not the availability of Narcissistic Supply. Whereas the narcissist is in full control of his faculties, even when maximally agitated, the bipolar often feels that s/he has lost control of his/her brain ("flight of ideas"), his/her speech, his/her attention span (distractibility), and his/her motor functions.

The bipolar is prone to reckless behaviors and substance abuse only during the manic phase. The narcissist does drugs, drinks, gambles, shops on credit, indulges in unsafe sex or in other compulsive behaviors both when elated and when deflated.

As a rule, the bipolar's manic phase interferes with his/her social and occupational functioning. Many narcissists, in contrast, reach the highest rungs of their community, church, firm, or voluntary organization. Most of the time, they function flawlessly - though the inevitable blowups and the grating extortion of Narcissistic Supply usually put an end to the narcissist's career and social liaisons.

The manic phase of bipolar sometimes requires hospitalization and - more frequently than admitted - involves psychotic features. Narcissists are never hospitalized as the risk for self-harm is minute. Moreover, psychotic microepisodes in narcissism are decompensatory in nature and appear only under unendurable stress (e.g., in intensive therapy).

The bipolar's mania provokes discomfort in both strangers and in the patient's nearest and dearest. His/her constant cheer and compulsive insistence on interpersonal, sexual, occupational, or professional interactions engender unease and repulsion. Her/his lability of mood - rapid shifts between uncontrollable rage and unnatural good spirits - is downright intimidating. The narcissist's gregariousness, by comparison, is calculated, "cold", controlled, and goal-orientated (the extraction of Narcissistic Supply). His cycles of mood and affect are far less pronounced and less rapid.

The bipolar's swollen self-esteem, overstated self-confidence, obvious grandiosity, and delusional fantasies are akin to the narcissist's and are the source of the diagnostic confusion. Both types of patients purport to give advice, carry out an assignment, accomplish a mission, or embark on an enterprise for which they are uniquely unqualified and lack the talents, skills, knowledge, or experience required.

But the bipolar's bombast is far more delusional than the narcissist's. Ideas of reference and magical thinking are common and, in this sense, the bipolar is closer to the schizotypal than to the narcissistic.

There are other differentiating symptoms:

Sleep disorders - notably acute insomnia - are common in the manic phase of bipolar and uncommon in narcissism. So is "manic speech" - pressured, uninterruptible, loud, rapid, dramatic (includes singing and humorous asides), sometimes incomprehensible, incoherent, chaotic, and lasts for hours. It reflects the bipolar's inner turmoil and his/her inability to control his/her racing and kaleidoscopic thoughts.

As opposed to narcissists, bipolar in the manic phase are often distracted by the slightest stimuli, are unable to focus on relevant data, or to maintain the thread of conversation. They are "all over the place" - simultaneously initiating numerous business ventures, joining a myriad organization, writing umpteen letters, contacting hundreds of friends and perfect strangers, acting in a domineering, demanding, and intrusive manner, totally disregarding the needs and emotions of the unfortunate recipients of their unwanted attentions. They rarely follow up on their projects.

The transformation is so marked that the bipolar is often described by his/her closest as "not himself/herself". Indeed, some bipolars relocate, change name and appearance, and lose contact with their "former life". Antisocial or even criminal behavior is not uncommon and aggression is marked, directed at both others (assault) and oneself (suicide). Some biploars describe an acuteness of the senses, akin to experiences recounted by drug users: smells, sounds, and sights are accentuated and attain an unearthly quality.

As opposed to narcissists, bipolars regret their misdeeds following the manic phase and try to atone for their actions. They realize and accept that "something is wrong with them" and seek help. During the depressive phase they are ego-dystonic and their defenses are autoplastic (they blame themselves for their defeats, failures, and mishaps).

Finally, pathological narcissism is already discernible in early adolescence. Full-fledged bipolar disorder - including a manic phase - rarely occurs before the age of 20. The narcissist is consistent in his pathology - not so the bipolar. The onset of the manic episode is fast and furious and results in a conspicuous metamorphosis of the patient.

More about this topic here:

Stormberg, D., Roningstam, E., Gunderson, J., & Tohen, M. (1998) Pathological Narcissism in Bipolar Disorder Patients. Journal of Personality Disorders, 12, 179-185

Roningstam, E. (1996), Pathological Narcissism and Narcissistic Personality Disorder in Axis I Disorders. Harvard Review of Psychiatry, 3, 326-340

• Watch the video on Common Professions of the Narcissist

The narcissist naturally gravitates towards those professions which guarantee the abundant and uninterrupted provision of Narcissistic Supply. He seeks to interact with people from a position of authority, advantage, or superiority. He thus elicits their automatic admiration, adulation, and affirmation - or, failing that, their fear and obedience.

Several vocations meet these requirements: teaching, the priesthood, show business, corporate management, the medical professions, politics, and sports. It is safe to predict that narcissists would be over-represented in these occupations.

The cerebral narcissist is likely to emphasize his intellectual prowess and accomplishments (real and imaginary) in an attempt to solicit supply from awe-struck students, devoted parishioners, admiring voters, obsequious subordinates, or dependent patients. His somatic counterpart derives his sense of self-worth from body building, athletic achievements, tests of resilience or endurance, and sexual conquests.

The narcissistic medical doctor or mental health professional and his patients, the narcissistic guide, teacher, or mentor and his students, the narcissistic leader, guru, pundit, or psychic and his followers or admirers, and the narcissistic business tycoon, boss, or employer and his underlings - all are instances of Pathological Narcissistic Spaces.

This is a worrisome state of affairs. Narcissists are liars. They misrepresent their credentials, knowledge, talents, skills, and achievements. A narcissist medical doctor would rather let patients die than expose his ignorance. A narcissistic therapist often traumatizes his clients with his acting out, rage, exploitativeness, and lack of empathy. Narcissistic businessmen bring ruin on their firms and employees.

Moreover, even when all is "well", the narcissist's relationship with his sycophants is abusive. He perceives others as objects, mere instruments of gratification, dispensable and interchangeable. An addict, the narcissist tends to pursue an ever-larger dose of adoration, and an ever-bigger fix of attention, while gradually losing what's left of his moral constraints.

When his sources become weary, rebellious, tired, bored, disgusted, repelled, or plainly amused by the narcissist's incessant dependence, his childish craving for attention, his exaggerated or even paranoid fears which lead to obsessive-compulsive behaviours, and his "drama queen" temper tantrums - he resorts to emotional extortion, straight blackmail, abuse, or misuse of his authority, and criminal or antisocial conduct. If these fail, the narcissist devalues and discards the very people he so idealized and cherished only a short while before.

As opposed to their "normal" colleagues or peers, narcissists in authority lack empathy and ethical standards. Thus, they are prone to immorally, cynically, callously and consistently abuse their position. Their socialisation process - usually the product of problematic early relationships with Primary Objects (parents, or caregivers) - is often perturbed and results in social dysfunctioning.

Nor is the narcissist deterred by possible punishment or regards himself subject to Man-made laws. His sense of entitlement coupled with the conviction of his own superiority lead him to believe in his invincibility, invulnerability, immunity, and divinity. The narcissist holds human edicts, rules, and regulations in disdain and human penalties in disdain. He regards human needs and emotions as weaknesses to be predatorily exploited.

next: Misdiagnosing Narcissism - The Bipolar I Disorder

• Watch the video on Can Narcissist Feel Love?

Narcissists "love" their spouses or other significant others - as long as they continue to reliably provide them with narcissistic supply (in one word, with attention). Inevitably, they regard others as mere "sources", objects, or functions. Lacking empathy and emotional maturity, the narcissist's love is pathological. But the precise locus of the pathology depends on the narcissist's stability or instability in different parts of his life.

From "The Unstable Narcissist":

(I have omitted below large sections. For a more elaborate treatment, please read the FAQ itself).

"Narcissists belong to two broad categories: the "compensatory stability" and the "enhancing instability" types.

I. Compensatory Stability ("Classic") Narcissists

These narcissists isolate one or more (but never most) aspects of their lives and "make these aspect/s stable". They do not really invest themselves in it. The stability is maintained by artificial means: money, celebrity, power, fear. A typical example is a narcissist who changes numerous workplaces, a few careers, a myriad of hobbies, value systems or faiths. At the same time, he maintains (preserves) a relationship with a single woman (and even remains faithful to her). She is his "island of stability". To fulfil this role, she just needs to be there physically.

The narcissist is dependent upon "his" woman to maintain the stability lacking in all other areas of his life (=to compensate for his instability). Yet, emotional closeness is bound to threaten the narcissist. Thus, he is likely to distance himself from her and to remain detached and indifferent to most of her needs. Despite this cruel emotional treatment, the narcissist considers her to be a point of exit, a form of sustenance, a fountain of empowerment. This mismatch between what he wishes to receive and what he is able to give, the narcissist prefers to deny, repress and bury deep in his unconscious. This is why he is always shocked and devastated to learn of his wife's estrangement, infidelity, or divorce intentions. Possessed of no emotional depth, being completely one track minded - he cannot fathom the needs of others. In other words, he cannot empathise.

II. Enhancing Instability ("Borderline") Narcissist

The other kind of narcissist enhances instability in one aspect or dimension of his life - by introducing instability in others. Thus, if such a narcissist resigns (or, more likely, is made redundant) - he also relocates to another city or country. If he divorces, he is also likely to resign his job. This added instability gives these narcissists the feeling that all the dimensions of their life are changing simultaneously, that they are being "unshackled", that a transformation is in progress. This, of course, is an illusion. Those who know the narcissist, no longer trust his frequent "conversions", "decisions", "crises", "transformations", "developments" and "periods". They see through his pretensions and declarations into the core of his instability. They know that he is not to be relied upon. They know that with narcissists, temporariness is the only permanence."

We are, therefore, faced with two pathological forms of narcissistic "love".

One type of narcissist "loves" others as one would attach to objects. He "loves" his spouse, for instance, simply because she exists and is available to provide him with narcissistic supply. He "loves" his children because they are part of his self-image as a successful husband and father. He "loves" his "friends" because - and only as long as - he can exploit them.

Such a narcissist reacts with alarm and rage to any sign of independence and autonomy in his "charges". He tries to "freeze" everyone around him in their "allocated" positions and "assigned roles". His world is rigid and immovable, predictable and static, fully under his control. He punishes for "transgressions" against this ordained order. He thus stifles life as a dynamic process of compromising and growing - rendering it instead a mere theatre, a tableau vivant.

The other type of narcissist abhors monotony and constancy, equating them, in his mind, with death. He seeks upheaval, drama, and change - but only when they conform to his plans, designs, and views of the world and of himself. Thus, he does not encourage growth in his nearest and dearest. By monopolizing their lives, he, like the other kind of narcissist, also reduces them to mere objects, props in the exciting drama of his life.

This narcissist likewise rages at any sign of rebellion and disagreement. But, as opposed to the first sub-species, he seeks to animate others with his demented energy, grandiose plans, and megalomaniacal self-perception. An adrenaline junkie, his world is a whirlwind of comings and goings, reunions and separations, loves and hates, vocations adopted and discarded, schemes erected and dismantled, enemies turned friends and vice versa. His Universe is equally a theatre, but a more ferocious and chaotic one.

Where is love in all this? where is the commitment to the loved one's welfare, the discipline, the extension of oneself to incorporate the beloved, the mutual growth?

Nowhere to be seen. The narcissist's "love" is hate and fear disguised - fear of losing control and hatred of the very people his precariously balanced personality so depends on. The narcissist is egotistically committed only to his own well-being. To him, the objects of his "love" are interchangeable and inferior.

He idealizes his nearest and dearest not because he is smitten by emotion - but because he needs to captivate them and to convince himself that they are worthy sources of supply, despite their flaws and mediocrity. Once he deems them useless, he discards and devalues them similarly cold-bloodedly. A predator, always on the lookout, he debases the coin of "love" as he corrupts everything else in himself and around him.

next:  The Professions of the Narcissist

Laws regarding school exclusion in the UK (suspending or expelling a student).

The 1993 Education Act changed the law on exclusions - the official term for being suspended or expelled.

Now only two kinds of exclusion are permitted:

A fixed term exclusion for a specific number of school days. Under this option a pupil cannot be excluded for a period totalling more than fifteen school days in one term.

A permanent exclusion The 1993 Act abolished the category of indefinite exclusion. A headteacher can also send your child home from school - perhaps because of the way your child is dressed or because your child is sick. This is not the same as an exclusion.

Although the Education Act is clear on the kinds of exclusions which can take place, there is no law which says which offences lead to an exclusion. This is left to the judgement of individual head teachers. The law does not set out school rules, so each school has its own.

Each school should have a set Behaviour Policy and a set Exclusion Policy which should be available to all parents to view or copies available if parents wish to take a copy home.

In a school the people finally responsible for behaviour are the headteacher and the governors. (School rules must not infringe the 1976 Race Relations Act and the 1975 Sex Discrimination Act.)

According to the Department for Education and Skills (DfES) guidelines, exclusions should be used sparingly, in response to serious breaches of school policy or law. Permanent exclusion must be used as a last resort. All the facts should be taken into account including the pupil's age, previous record, health and other relevant issues before the head teacher makes a decision to exclude someone.

The guidelines also specify the following:

Exclusion is not appropriate if pupils dress in a certain way for religious or cultural reasons. 'To exclude in such circumstances might constitute unlawful indirect discrimination under the Race Relations Act 1976'.

Exclusion is not appropriate for things like not doing homework or not bringing dinner money (if this happens on an occasional basis).

Exclusion is not an appropriate response to non-attendance - in other words truancy. If your child fails to attend school regularly the school should work closely with the Education Welfare Service to sort out the problem without excluding your child.

Pregnancy is not a reason to exclude a pupil. It may be advisable to have a period of education away from school (e.g. home tuition), but this is not related to an exclusion.

Schools can detain pupils after school finishing time without the consent of a parent, but are required to give at least 24 hours written notice.

If a headteacher wants to exclude your child, there are certain procedures he or she must follow.

Essay on the personal impact of the internet.

While there are those who understandably complain that the net provides a forum for hate groups and makes pornographic material accessible to children, the information highway has also proven to be a tremendous resource for both global and personal transformation. In numerous instances, it has made the world both smaller and, at the same time, broader.

The net, a world without geographic borders, has made it possible for people from all over the world with diverse spiritual and political backgrounds to connect with one another. Michael and Ronda Haubon, authors of, "Netizens: On the History and Impact of Usenet and the Internet," observe,

"Easy connection to people and ideas from around the world has a powerful effect. Awareness that we are members of the human species, which spans the entire globe, changes a person's point of view."

On the net prospective employees and employers are brought together, parents, professionals, activists, and special interest groups network, buyers and sellers hook up, those in need are linked to resources, and the displaced are united with old friends, while countless individuals make new ones every day.

The old clichés, "let your fingers do the walking" and, "the world is at your finger tips" take on a whole new meaning on the internet. Once on the world wide web, a student is able to locate information for a school report, a patient can become better informed about his illness, an employee might discover new tools to improve her job performance, an investor is able to receive updates on the stock exchange, and a new mother possesses access to a vast number of resources for parents.

In this fast paced and complicated world complete with numerous challenges that confront us on a daily basis the internet provides information, explanations, and potential solutions. The intention of this column is to point you to some of the best resources available on the web that address issues that concern you. Has the internet touched your life? If it has, we would love to hear about it. If it hasn't yet, just give us, and it a little more time.

June 1999 Edition

From Columbine to Columbia to Any Town USA

Like so many Americans, I'm still attempting to come to terms with the unfathomable tragedy that struck without warning at Columbine High, a school not so unlike our own schools here in Columbia. The residents of Littleton shared the same civic pride in community accomplishments as we do here in the Midlands . Before April 20th, 1999 what distinguished us from Littleton was largely a matter of geography and demographics. Today we are worlds apart.

We can't begin to comprehend the horror and grief that has devastated Littleton, Colorado. We can respond with heart-felt sympathy and deep compassion for their suffering, but we can't possibly know how the residents of Littleton feel. Still, as fellow citizens of the United States, we do share with Littleton a chilling distinction. Our schools have witnessed more mass murders perpetrated by students than any where else in the world.

There have been numerous explanations rendered as to why in at least nine separate instances during the past twelve months American students have murdered fellow students. Many have concluded that parents aren't involved enough with their children, guns are too accessible, and that the violence is a reaction to child abuse and neglect, or to the massive amount of violence portrayed in the movies and on television. Other explanations include that teens are feeling increasingly alienated and empty, schools are too crowded and understaffed, families are too stressed, and that we're failing to provide adequate role models, and to pass on proper morals and values to our children. The list of "why's" goes on and on and on.

Shawn Hubler in a thought provoking piece for the Los Angeles Times entitled, "A Shooting that Burst the Suburban Bubble," observed, "...these massacres have less to do with public policy than with private pain." I very much agree with Ms. Hubler, the actions of Harris and Klebold may very well have had far more to do with a private pain that was manifested all too publicly and horrifically rather than with public policy. However, I would like to suggest another possibility as well. Bill Moyers once observed that, "the largest party in America today isn't the democrats or the republicans, it's the party of the wounded." He's right I think, we've all been wounded. Wounded by a barrage of bad news, political scandals, jobs that so often feel futile, and the signs that surround us of dying cultures, dying children, dying species, and maybe even a dying earth. It's my humble opinion that children have always acted out not only their own pain, but also the pain of the adults in their lives.

Like so many of us, Hubler searches for "any good to be gleaned from this latest sorrow." Is it possible that the tragedy that occurred at Columbine high might lead us as a society to examine what it is that we truly need to do in order to begin as a culture to heal from the collective wounds that haunt us? Wounds that I sadly believe just happened to be manifested this time in Littleton?

We can blame parents, blame the schools, blame anyone or anything that we want to. Still, I believe that no amount of finger pointing should ultimately distract us from accepting our shared responsibility, a responsibility placed squarely on the shoulders of members of a culture whose primary messages for far too many years have been predominantly echoes of "buy me" " and "shoot em up".

While we grapple with possible explanations in an attempt to make sense of this recent absurdity, and consider solutions that all too often merely address symptoms, perhaps it's time that we revisit the basics. Our children require love, guidance, and our focused attention. It's difficult to adequately provide them with the former when so many of us are rushing around attempting to keep up with the numerous details and obligations that make up our lives. Why are we in such a hurry? Why are we working so hard? Will a newer model car, larger house, or more expensive tennis shoes make our children or ourselves happy? "Of course not!" we answer. Is the accumulation of more and more possessions we then spend untold hours paying for and maintaining ultimately what our lives are all about? What are our actions teaching our children? And what about the often repeated question, "whose watching the children?" According to a recent article in the local newspaper, library staff are overseeing a significant number of our offspring when school doors close. The library or the streets are more attractive options to far too many of our youngsters than returning to empty houses..

It's parents I suspect who are taking the toughest questions to heart right now. How can we protect our children? How can we best keep the lines of communication open? How do we assist our children in making sense of this tragedy? How do we best provide our children with the skills and tools they need to cope with this complicated world? And while I strongly believe that the full weight of these issues should not reside on the shoulders of parents alone, I recognize that as a parent I need to be prepared to carry a significant share of the load.

The internet, while certainly no panacea, offers some helpful information and resources for parents who are looking for some guidance and support. Still, I feel the need to make one last comment to those of you who are childless. From my perspective, you're not entirely off the hook, because guess whose waiting in line to be in charge when you're old and helpless...

Helpful Articles:

Parenting Teens: Are we Having Fun Yet?***

How to Get Your Teens Talking***

How to HelpYour Child Avoid Violent Conflicts

Learning How to Recognize the Warning Signs***

Plain Talk About Dealing with the Angry Child***

Respecting the Children in Our Care***

Can We predict Teen Violence?***

Helpful Hints for Healthy Parenting***

Violence and Discipline Problems in US Public Schools

Recommended Websites:

Connect For Kids: Guidance for Grown ups***

The Family Education Network***

Family.Com

Fathermag.com

Father's World

National Fatherhood initiative

The Parents Place

Parents Talk

Parent Time***

Mom's Online***

next: A Room with a View

Parenting a depressed child can be very difficult. Here are suggestions for helping your child with depression.

Parenting is already a tough job. Parenting a child with depression is even tougher. Keep in mind that depression is a medical condition. Your child is not acting this way on purpose.

Here's what you can do to help your child with depression:

Honor your child's feelings. It is difficult to see your child sad and in pain. Your first response might be to try to cheer him or her up. Don't. Trying to make depressed children and teens happy makes them feel like depression can be willed away. It is more helpful to listen. Acknowledge their feelings, and take them seriously.

Use encouraging statements rather than punishment. Instead of yelling, "Turn that television off! You haven't done your homework yet!" say "When you finish your homework, you can watch television."

Separate the deed from the doer. If your child constantly forgets to take his or her lunch money to school, don't say, "You are so forgetful! You can't remember a simple thing like your lunch money!" Instead, say something that focuses on the behavior, not your child, like "I know it has been hard for you to remember your lunch money. What can we do to make sure it gets put in your book bag every morning?"

Focus on consequences rather than punishment. For example, if your child breaks a lamp during a temper tantrum, use a logical consequence (like having your child help glue the lamp back together or use his or her allowance to have the lamp repaired) rather than issuing an unrelated punishment (like sending your child to his or her room for the rest of the evening).

Help your child build a "feeling vocabulary." Many people have difficulty finding the words to describe how they are feeling. Helping children and teens to label their feelings gives them a vocabulary that will enable them to speak about feelings. For children, posters and coloring pages that contain lists or drawings of various emotions can be helpful.

Show unconditional love and support. Many depressed children and teens feel unloved and unlovable. Say, "I love you" often. Hug or pat him or her on the back. With young children, be sure to cuddle together.

Encourage your child to engage in activities. Consider the activities your child enjoys and suggest doing those together. But don't force, threaten, or bribe him or her to do so. If your child is not feeling well enough to participate, honor that feeling.

Create good sleeping habits. Children and teens with depression often have difficulty sleeping. This leads to more irritability and exhaustion. Sticking to a consistent bedtime, stopping caffeine intake, and getting regular exercise can improve the quality and quantity of sleep.

Understand that depression is a medical condition. Although it is often difficult to keep your cool when your child is acting out, it is important not to punish or say hurtful things. Your child can't help feeling and behaving the way he or she does. You can be angry at the depression while still feeling love and concern for your child who is hurting

Sources:

• Families for Depression Awareness

I met an old friend who was a severe alcoholic and addict like I was. I was hanging out with him one day during the Spring Break from college. He was detoxing very badly. He had convulsions and nausea. He was in real bad shape. I really wanted to help him.

We went down to the city to get his drugs and my booze. We then went back to his apartment. I felt his pain when I saw him lying on his couch complaining that he didn't have enough to stop his nausea and shakes. I wanted to help him so bad because I could not stand to see him suffer like that.

The only thing that came to mind was the AA meetings (Alcoholics Anonymous) I had been to. I knew those people were living happily. I thought of some of the things that they had told me at the meetings. I wanted to pass the information onto my friend so he, too, could get healthy. But there I sat, in the middle of it all, with a drink in my hand. I was just as bad as him on many occasions. I, too, looked like that but I could not see myself. I sat there with a drink and could do nothing but be on display as a bad example of someone who tried to quit drinking.

 I had very little alcohol left to keep me going for that day. I mixed my vodka with water and tried to cure some of the shakes and anxiety from the withdrawal of the earlier drinking spree. I sat there in my room alone and drank my last drink. It was vodka and water. It was 8 years, 11 months, and 2 days after my very first drink.

Both the very first and the very last drink were mixed vodka concoctions, both were alone in my room, and both were on a Spring break from school. Was this coincidence or something to start me thinking along the lines of "spiritual awakening"? After all I had been through with the police, the jails, the courts, the withdraws, the rehabs, I still did not hit my bottom.

Only now, I finally hit bottom when I saw that guy on his couch just as sick as I was and I could not help him. I was worthless, useless, helpless, hopeless, and powerless!! But I knew there was a way out. I went to an AA meeting by myself for the first time. I walked through the doors and when I did, I took that first step. STEP 1:We admitted we were powerless over alcohol--that our lives had become unmanageable.

next: Chapter 7: The Beginning of a Spiritual Awakening
~ all Raw Psychology articles
~ addictions library articles
~ all addictions articles

Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment.

Drug addiction is a complex illness. It is characterized by compulsive, at times uncontrollable drug craving, seeking, and use that persist even in the face of extremely negative consequences. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence.

The path to drug addiction begins with the act of taking drugs. Over time, a person's ability to choose not to take drugs can be compromised. Drug seeking becomes compulsive, in large part as a result of the effects of prolonged drug use on brain functioning and, thus, on behavior.

The compulsion to use drugs can take over the individual's life. Addiction often involves not only compulsive drug taking but also a wide range of dysfunctional behaviors that can interfere with normal functioning in the family, the workplace, and the broader community. Addiction also can place people at increased risk for a wide variety of other illnesses. These illnesses can be brought on by behaviors, such as poor living and health habits, that often accompany life as a drug addict, or because of toxic effects of the drugs themselves.

Because drug addiction has so many dimensions and disrupts so many aspects of an individual's life, treatment for this illness is never simple. Drug treatment must help the individual stop using drugs and maintain a drug-free lifestyle, while achieving productive functioning in the family, at work, and in society. Effective drug abuse and addiction treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences.

Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment. Extensive data document that drug addiction treatment is as effective as are treatments for most other similarly chronic medical conditions. In spite of scientific evidence that establishes the effectiveness of drug abuse treatment, many people believe that treatment is ineffective. In part, this is because of unrealistic expectations. Many people equate addiction with simply using drugs and therefore expect that addiction should be cured quickly, and if it is not, treatment is a failure. In reality, because addiction is a chronic disorder, the ultimate goal of long-term abstinence often requires sustained and repeated treatment episodes.

Of course, not all drug abuse treatment is equally effective. Research also has revealed a set of overarching principles that characterize the most effective drug abuse and addiction treatments and their implementation.

To share the results of this extensive body of research and foster more widespread use of scientifically based treatment components, the National Institute on Drug Abuse held the National Conference on Drug Addiction Treatment: From Research to Practice in April 1998 and prepared this guide. The first section of the guide summarizes basic overarching principles that characterize effective treatment. The next section elaborates on these principles by providing answers to frequently raised questions, as supported by the available scientific literature. The next section describes the types of treatment and is followed by examples of scientifically based and tested treatment components.

Alan I. Leshner, Ph.D.
Director
National Institute on Drug Abuse

Source: National Institute of Drug Abuse, "Principles of Drug Addiction Treatment: A Research Based Guide."

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A short essay on the importance of creating family rituals and what rituals mean to children.

Life Letters

Every year since you were a little tyke, we've made baked goods and chocolates together for friends and neighbors during the Holidays. Your expectations of Christmas always include our goody making ritual as well as Dad's chocolate mint cake.

Tucking you into bed used to involve a rather lengthy and specific ritual; there was a story, a witch chasing ceremony, a little back rub, and always a glass of apple juice placed beside your bed in the event that you got thirsty. Even now, bedtime almost always concludes with an "I love you," from me, and an "I love you more," from you.

Rituals are as old as the earliest civilization. They can mark occasions by utilizing a special event to represent a far grander scheme. They help to create meaning and they foster lasting memories. They can solidify, celebrate, commemorate, validate, and comfort.

There are numerous benefits to rituals. Perhaps the greatest reason that I want to engage in them with you is that they offer us the opportunity to make a connection that may very well span both space and time. Whether I'm physically present or not, I can hope to be a part of many of your special occasions, if I can manage to create special times now that you find worthy of remembering later.

We don't engage in them as often as we used to - you've gotten older and more discriminating, and I've gotten busier and more distracted. Still in this uncertain and unpredictable world, children need rituals to help them feel safe, contained, and cared for. They don't have to be complicated, and yet those few moments we invest may provide our children with gifts to carry with them for a lifetime.

You're growing so fast and changing so quickly. New clothes, perfume, jewelry, and posters have replaced the toys that used to greet you on Christmas morning. But you still demand the chocolate mint cake, and you continue to be excited about delivering our goodies. So while I'm required to give up a little more each year, I can still count on certain special activities that have become an integral part of our lives together. And more importantly, you can count on them too.

Love, Mom

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