An interview with JS, a substance abuse counselor who works with people from all walks of life.
JS is a certified substance abuse counselor who works at a residential treatment center in northern Virginia. The following article is about his work, thoughts on relapse, what it’s like to lose a client, stigma, and valuable advice for anyone considering a career in addiction counseling.
Interview: “They Are Just People”
JS works at an intermediate-length residential center for adults with substance use and mental health disorders. The clients live in shared dorms and adhere to a daily schedule that includes counseling, psychoeducation, groups, 12-step meetings, and medication therapy.
Once a client successfully completes the inpatient portion of treatment, they transition to “re-entry.” In re-entry, clients reside in sober living homes and receive continuing care services. They are able to look for employment, start working, and “re-enter” the larger community. JS provides counseling and support services for this component.
Inspired to help
JS has personal experience with addiction. “I am a person in recovery… About a decade ago I found myself in a very dark place and had to get help… I met a substance abuse counselor [who] changed my life. He educated me, engaged me, and challenged me. He was instrumental in turning my life around.”
With his counselor’s encouragement and support, JS made the decision to get back on track. He realized that he wanted to help others who struggled. “My own experiences with addiction allow me to have an incredibly deep empathy for the clients I serve and the fulfillment I receive in return is unreal.”
“Addiction does not discriminate”
JS works with people from all walks of life. He’s worked with individuals who are homeless to young fathers to successful businessmen; from people in their teens to adults in their late 80’s. “There is no age, sex, gender, race, sexual orientation, religion, occupation, or economic class that is safe from addiction.”
As for the substances abused, the list is never ending, but JS regularly sees people addicted to alcohol, opiates (including heroin), cocaine, methamphetamine, and PCP. Many of the clients he counsels also have mental illness such as depression, anxiety, or bipolar disorder.
No typical days
According to JS, “typical” days don’t exist where he works. “There is no way to describe a typical day in this field. One day I could be [providing therapy] and another day could involve a trip to the emergency room or helping out with chores… I never know what to expect and I never get bored.”
Effective treatment planning is important for substance abuse counselors; JS meets with his clients to develop an individualized service plan. Clients come up with their own goals, and JS supplies interventions to help them achieve their goals over the next couple of months.
According to JS, client goals vary, ranging from attending 12-meetings to obtaining a driver’s license to enrolling in school; basically, a goal can be any life skill a person may need for success. Corresponding interventions could include providing bus tokens to get to AA meetings, linking to driving school, and helping to fill out college applications and apply for financial aid.
JS explained that adults who have been incarcerated or dealing drugs for a living miss out on major milestones such as learning to drive, attending college, renting an apartment, etc. Furthermore, basic skills that many of us take for granted, such as filling out an online form or depositing a check can be overwhelming for someone newly in recovery who never learned how.
JS meets with his clients at least once per week for therapy sessions. I asked what comes up in a typical session and his response was “anything and everything.” Sessions may involve reviewing goals, learning coping skills, poop jokes (his clients are all men), or processing childhood trauma.
Substance abuse and relapse
“Not good” was JS’s response when I asked what the success rate was for someone who completes re-entry. He explained that this is a reflection of the general rates of recovery in substance abuse, which are low. “It can be disheartening, working with someone for months and when they leave, they relapse in less than a week.”
JS explained that while relapse is a deterrent to the field for some counselors, he sees it differently. “For me, it will never be a deterrent. My battle with addiction was not easy, nor was it accomplished in a single attempt. Relapse is a part of my story. I would not be here if people gave up or lost hope that I could get better. For that, I will never give up or lose hope that my clients can recover, no matter how many times they relapse.”
For JS, losing a client, not relapse, is the hardest part of the job. “I’ve worked with many clients who didn’t make it. I’ve lost clients to overdose, suicide, and homicide. It never gets easier.”
JS grieves for his lost clients. “I find myself wading through the stages of grief until I reach some level of acceptance.”
What everyone needs to know about substance abuse
“The people I work with are just people. They are your sister, your cousin, your neighbor, or the guy in line at the grocery store. They are people with families, jobs, hobbies, and dreams.”
JS discussed ignorance and stigma; he shared that individuals with substance use disorders are often subjected to mistreatment, even from professionals in the field. “There are substance abuse counselors who perpetuate harmful addiction myths, once widely accepted as fact, but discredited by the scientific community decades ago.”
“The lack of compassion when it comes to substance abuse is mindboggling and painful to encounter. Often, it stems from a lack of understanding or knowledge about substance abuse and those with substance use disorders. They are just people who are struggling with something far beyond their control. And those in treatment? They are just people trying to get better. And in case I didn’t make it clear; they are just people.”
Advice for new substance abuse counselors
“Be willing to learn. The field of addiction treatment is constantly changing. Standard practices from 20 years ago are now ineffective and outdated. If you want to do this work, be open to learning the newest treatment models, medications, and research on addiction. This field is not static, and we do our clients a major disservice when we quit learning.”
As a last piece of advice, JS suggested self-care for substance abuse counselors as a way to combat burnout. “Identify ways to decompress. This job is not easy. Some of the people you help will die. Compassion fatigue is a real thing and you must take care of yourself to care for others.”
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Recommended Memoirs About Mental Illness & Addiction
UPDATED MAY 22, 2021
The Big Fix: Hope After Heroin (2017) by Tracey Helton Mitchell
Amazon Description: “After surviving nearly a decade of heroin abuse and hard living on the streets of San Francisco’s Tenderloin District, Tracey Helton Mitchell decided to get clean for good.
With raw honesty and a poignant perspective on life that only comes from starting at rock bottom, The Big Fix tells her story of transformation from homeless heroin addict to stable mother of three—and the hard work and hard lessons that got her there. Rather than dwelling on the pain of addiction,Tracey focuses on her journey of recovery and rebuilding her life, while exposing the failings of the American rehab system and laying out a path for change. Starting with the first step in her recovery, Tracey re-learns how to interact with men, build new friendships, handle money, and rekindle her relationship with her mother, all while staying sober, sharp, and dedicated to her future.
A decidedly female story of addiction, The Big Fix describes the unique challenges faced by women caught in the grip of substance abuse, such as the toxic connection between drug addition and prostitution. Tracey’s story of hope, hard work, and rehabilitation will inspire anyone who has been affected by substance abuse while offering hope for a better future.”
Come Back: A Mother and Daughter’s Journey Through Hell and Back (2008) by Claire Fontaine & Mia Fontaine
Amazon Description: “In powerful parallel stories, mother and daughter give mesmerizing first-person accounts of the nightmare that shattered their family and the amazing journey they took to find their way back to each other. Claire Fontaine’s relentless cross-country search for her missing child and ultimate decision to force her into treatment in Eastern Europe is a gripping tale of dead ends, painful revelations, and, at times, miracles. Mia Fontaine describes her refuge in the seedy underworld of felons and addicts as well as the jarring shock of the extreme, if loving, school that enabled her to overcome depression and self-loathing. Both women detail their remarkable process of self-examination and healing with humor and unsparing honesty.
Come Back is an unforgettable true story of love and transformation that will resonate with mothers and daughters everywhere.”
Drinking: A Love Story (1997) by Caroline Knapp
Amazon Description: “It was love at first sight. The beads of moisture on a chilled bottle. The way the glasses clinked and the conversation flowed. Then it became obsession. The way she hid her bottles behind her lover’s refrigerator. The way she slipped from the dinner table to the bathroom, from work to the bar. And then, like so many love stories, it fell apart. Drinking is Caroline Kapp’s harrowing chronicle of her twenty-year love affair with alcohol.”
A Drinking Life: A Memoir (1994) by Pete Hamill
Amazon Description: “Hamill explains how alcohol slowly became a part of his life, and how he ultimately left it behind. Along the way, he summons the mood of an America that is gone forever, with the bittersweet fondness of a lifelong New Yorker.”
Drunk Mom: A Memoir (2014) by Jowita Bydlowska
Amazon Description: “Three years after giving up drinking, Jowita Bydlowska found herself throwing back a glass of champagne like it was ginger ale. It was a special occasion: a party celebrating the birth of her first child. It also marked Bydlowska’s immediate, full-blown return to crippling alcoholism.
In the gritty and sometimes grimly comic tradition of the bestselling memoirs Lit by Mary Karr and Smashed by Koren Zailckas, Drunk Mom is Bydlowska’s account of the ways substance abuse took control of her life—the binges and blackouts, the humiliations, the extraordinary risk-taking—as well as her fight toward recovery as a young mother. This courageous memoir brilliantly shines a light on the twisted logic of an addicted mind and the powerful, transformative love of one’s child. Ultimately it gives hope, especially to those struggling in the same way.”
Dry: A Memoir (2003) by Augusten Burroughs
Amazon Description: “You may not know it, but you’ve met Augusten Burroughs. You’ve seen him on the street, in bars, on the subway, at restaurants: a twentysomething guy, nice suit, works in advertising. Regular. Ordinary. But when the ordinary person had two drinks, Augusten was circling the drain by having twelve; when the ordinary person went home at midnight, Augusten never went home at all. Loud, distracting ties, automated wake-up calls and cologne on the tongue could only hide so much for so long. At the request (well, it wasn’t really a request) of his employers, Augusten lands in rehab, where his dreams of group therapy with Robert Downey Jr. are immediately dashed by grim reality of fluorescent lighting and paper hospital slippers. But when Augusten is forced to examine himself, something actually starts to click and that’s when he finds himself in the worst trouble of all. Because when his thirty days are up, he has to return to his same drunken Manhattan life―and live it sober. What follows is a memoir that’s as moving as it is funny, as heartbreaking as it is true. Dry is the story of love, loss, and Starbucks as a Higher Power.”
Girl, Interrupted (1993) by Susanna Kaysen
Amazon Description: “Kaysen’s memoir encompasses horror and razor-edged perception while providing vivid portraits of her fellow patients and their keepers. It is a brilliant evocation of a “parallel universe” set within the kaleidoscopically shifting landscape of the late sixties. Girl, Interrupted is a clear-sighted, unflinching document that gives lasting and specific dimension to our definitions of sane and insane, mental illness and recovery.”
Go Ask Alice (1971) by Alice
Amazon Description: “It started when she was served a soft drink laced with LSD in a dangerous party game. Within months, she was hooked, trapped in a downward spiral that took her from her comfortable home and loving family to the mean streets of an unforgiving city. It was a journey that would rob her of her innocence, her youth—and ultimately her life.”
The Heroin Diaries: Ten Year Anniversary Edition: A Year in the Life of a Shattered Rock Star (2017) by Nikki Sixx
Amazon Description: “When Mötley Crüe was at the height of its fame, there wasn’t any drug Nikki Sixx wouldn’t do. He spent days—sometimes alone, sometimes with other addicts, friends, and lovers—in a coke- and heroin-fueled daze.
The highs were high, and Nikki’s journal entries reveal some euphoria and joy. But the lows were lower, often ending with Nikki in his closet, surrounded by drug paraphernalia and wrapped in paranoid delusions.
Here, Nikki shares the diary entries—some poetic, some scatterbrained, some bizarre—of those dark times. Joining him are Tommy Lee, Vince Neil, Mick Mars, Slash, Rick Nielsen, Bob Rock, and a host of ex-managers, ex-lovers, and more.
Brutally honest, utterly riveting, and surprisingly moving, The Heroin Diaries follows Nikki during the year he plunged to rock bottom—and his courageous decision to pick himself up and start living again.”
Lit: A Memoir (2010) by Mary Karr
Amazon Description: “Lit follows the self-professed blackbelt sinner’s descent into the inferno of alcoholism and madness–and to her astonishing resurrection. Karr’s longing for a solid family seems secure when her marriage to a handsome, Shakespeare-quoting blueblood poet produces a son they adore. But she can’t outrun her apocalyptic past. She drinks herself into the same numbness that nearly devoured her charismatic but troubled mother, reaching the brink of suicide. A hair-raising stint in ‘The Mental Marriott,’ with an oddball tribe of gurus and saviors, awakens her to the possibility of joy and leads her to an unlikely faith. Not since Saint Augustine cried, ‘Give me chastity, Lord-but not yet!’ has a conversion story rung with such dark hilarity. Lit is about getting drunk and getting sober, becoming a mother by letting go of a mother, learning to write by learning to live. Written with Karr’s relentless honesty, unflinching self-scrutiny, and irreverent, lacerating humor, it is a truly electrifying story of how to grow up–as only Mary Karr can tell it.”
Loose Girl: A Memoir of Promiscuity (2008) by Kerry Cohen
Amazon Description: “Loose Girl is Kerry Cohen’s captivating memoir about her descent into promiscuity and how she gradually found her way toward real intimacy. The story of addiction–not just to sex, but to male attention–Loose Girl is also the story of a young girl who came to believe that boys and men could give her life meaning.”
A Million Little Pieces (2005) by James Frey
Amazon Description: “At the age of 23, James Frey woke up on a plane to find his front teeth knocked out and his nose broken. He had no idea where the plane was headed nor any recollection of the past two weeks. An alcoholic for ten years and a crack addict for three, he checked into a treatment facility shortly after landing. There he was told he could either stop using or die before he reached age 24. This is Frey’s acclaimed account of his six weeks in rehab.”
My Fair Junkie: A Memoir of Getting Dirty and Staying Clean (2018) by Amy Dresner
Amazon Description: “Growing up in Beverly Hills, Amy Dresner had it all: a top-notch private-school education, the most expensive summer camps, and even a weekly clothing allowance. But at 24, she started dabbling in meth in San Francisco and unleashed a fiendish addiction monster. Soon, if you could snort it, smoke it, or have sex with it, she did.
Thus began a spiral that eventually landed her in the psych ward–and then penniless, divorced, and looking at 240 hours of court-ordered community service. For two years, assigned to a Hollywood Boulevard “chain gang,” she swept up syringes (and worse) as she bounced from rehabs to halfway houses, all while struggling with sobriety, sex addiction, and starting over in her forties. In the tradition of Orange Is the New Black and Jerry Stahl’s Permanent Midnight, this is an insightful, darkly funny, and shamelessly honest memoir of one woman’s battle with all forms of addiction, hitting rock bottom, and forging a path to a life worth living.”
Parched: A Memoir (2006) by Heather King
Amazon Description: “In this tragicomic memoir about alcoholism as spiritual thirst, Heather King—writer, lawyer, and National Public Radio commentator—describes her descent into the depths of addiction. Spanning a decades-long downward spiral, King’s harrowing story takes us from a small-town New England childhood to hitchhiking across the country to a cockroach-ridden “artist’s” loft in Boston. Waitressing at ever-shabbier restaurants, deriving what sustenance she could from books, she became a morning regular at a wet-brain-drunks’ bar—and that was after graduating from law school. Saved by her family from the abyss, King finally realized that uniquely poetic, sensitive, and profound though she may have been, she was also a big-time mess. Casting her lot with the rest of humanity at last, she learned that suffering leads to redemption, that personal pain leads to compassion for others in pain, and, above all, that a sense of humor really, really helps.”
A Piece of Cake: A Memoir (2007) by Cupcake Brown
Amazon Description: “There are shelves of memoirs about overcoming the death of a parent, childhood abuse, rape, drug addiction, miscarriage, alcoholism, hustling, gangbanging, near-death injuries, drug dealing, prostitution, and homelessness.
Cupcake Brown survived all these things before she’d even turned twenty.
And that’s when things got interesting. . .
Orphaned by the death of her mother and left in the hands of a sadistic foster parent, young Cupcake Brown learned to survive by turning tricks, downing hard liquor, and ingesting every drug she could find while hitchhiking up and down the California coast. She stumbled into gangbanging, drug dealing, hustling, prostitution, theft, and, eventually, the best scam of all: a series of 9-to-5 jobs.
A Piece of Cake is unlike any memoir you’ll ever read. Moving in its frankness, this is the most satisfying, startlingly funny, and genuinely affecting tour through hell you’ll ever take.”
Prozac Nation: Young and Depressed in America (1994) by Elizabeth Wurtzel
Amazon Description: “Elizabeth Wurtzel writes with her finger in the faint pulse of an overdiagnosed generation whose ruling icons are Kurt Cobain, Xanax, and pierced tongues. In this famous memoir of her bouts with depression and skirmishes with drugs, Prozac Nation is a witty and sharp account of the psychopharmacology of an era for readers of Girl, Interrupted and Sylvia Plath’s The Bell Jar.”
Smashed: Story of a Drunken Girlhood (2005) by Koren Zailckas
Amazon Description: “Garnering a vast amount of attention from young people and parents, and from book buyers across the country, Smashed became a media sensation and a New York Times bestseller. Eye-opening and utterly gripping, Koren Zailckas’s story is that of thousands of girls like her who are not alcoholics—yet—but who routinely use booze as a shortcut to courage and a stand-in for good judgment.”
Tweak: Growing Up on Methamphetamines (2009) by Nic Sheff
Amazon Description: “Nic Sheff was drunk for the first time at age eleven. In the years that followed, he would regularly smoke pot, do cocaine and Ecstasy, and develop addictions to crystal meth and heroin. Even so, he felt like he would always be able to quit and put his life together whenever he needed to. It took a violent relapse one summer in California to convince him otherwise. In a voice that is raw and honest, Nic spares no detail in telling us the compelling, heartbreaking, and true story of his relapse and the road to recovery. As we watch Nic plunge into the mental and physical depths of drug addiction, he paints a picture for us of a person at odds with his past, with his family, with his substances, and with himself. It’s a harrowing portrait—but not one without hope.”
With or Without You: A Memoir (2014) by Domenica Ruta
Amazon Description: “Domenica Ruta grew up in a working-class, unforgiving town north of Boston, in a trash-filled house on a dead-end road surrounded by a river and a salt marsh. Her mother, Kathi, a notorious local figure, was a drug addict and sometimes dealer whose life swung between welfare and riches, and whose highbrow taste was at odds with her hardscrabble life. And yet she managed, despite the chaos she created, to instill in her daughter a love of stories. Kathi frequently kept Domenica home from school to watch such classics as the Godfather movies and everything by Martin Scorsese and Woody Allen, telling her, “This is more important. I promise. You’ll thank me later.” And despite the fact that there was not a book to be found in her household, Domenica developed a love of reading, which helped her believe that she could transcend this life of undying grudges, self-inflicted misfortune, and the crooked moral code that Kathi and her cohorts lived by.
With or Without You is the story of Domenica Ruta’s unconventional coming of age—a darkly hilarious chronicle of a misfit ’90s youth and the necessary and painful act of breaking away, and of overcoming her own addictions and demons in the process. In a brilliant stylistic feat, Ruta has written a powerful, inspiring, compulsively readable, and finally redemptive story about loving and leaving.”
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An extensive, completely free collection of articles on social skills and getting past social awkwardness. It’s written by someone who’s struggled socially himself, and who has degrees in psychology and counseling.
“I had absolutely no direction in my life. I was a loose cannon. An unguided projectile… I viewed life in a negative, nihilistic, cynical, and overall pessimistic way.”
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Guest Post: My Experience with Depression
Depression, also known by some as the silent killer. And for good reasons.
Little did I know I was going to find this out firsthand.
Early on in life, before the age of 16, everything was perfect. I had loving parents and, in general, a loving family. I had plenty of friends. I excelled in sports and did well in school.
Things were easy back then. The only ounce of responsibility I had was making sure I got passing grades. And what if I didn’t listen in school and got detention as a result? Well, he’s still a young kid who’s figuring out life. Got into a fight? Well, he’s still a young boy who doesn’t always thinks before he acts.
But my perfect world didn’t last.
My Experience with Depression
Around the age of sweet 16, my life started changing rapidly.
I stopped feeling happy and optimistic. At first, I thought it was just a phase everyone my age went through and that it would pass as quickly as it came. But it didn’t. I had a difficult time adjusting to my ever-changing environment and handling the pressure I believed was being put on me.
I didn’t know what I wanted for my future. My friends and schoolmates already knew what they were going to study when they went to college the next year. I, however, did not. I had no direction in life. I was a loose cannon, an unguided projectile, an immature and wild kid, busy with partying and drinking.
I started getting into frequent fights; I’m not a violent person, but the anxiety, negative emotions, feelings of helplessness, and an overall sense of feeling lost in this world led to physical confrontations with others. The fights were a reflection of my poor mental state.
Then I turned 18. My parents told me it was time to start taking responsibility for my choices and actions because this time “it was for real.”
In college, I decided to pursue the field of nutrition. Not because I had a strong desire to become a dietician, but rather, because people I knew from my home town were going this route, and I figured since I was interested in exercise/health, it might be a good fit.
Newsflash, it wasn’t.
I quit school two months in. Turns out choosing what course to study based on friends rather than what you want in life is not the smartest idea. (Who would’ve thought, right?)
The following year, I gave it another try. This time I studied occupational performance. Long story short, I managed to earn a college degree despite my depression.
After I graduated and started working as an occupational therapist in a physical rehabilitation center, things got better. I was motivated to help people relearn lost skills, improving their quality of life.
But in time, my thoughts turned dark again, becoming negative and nihilistic. I slept less and my sleep quality was poor. I would randomly wake up at night and cry because I felt so terrible. I withdrew from friends and family. I even discovered a way to measure the severity of my depression; when my mood worsened, I craved alcohol. Drinking was a way to self-medicate.
I continued to plow away at work, but an excessive sense of responsibility, perfectionism, and anxiety was eating away at my mental health. I was head deep into my depression.
One day, I woke up and found I couldn’t get out of bed. I had nothing left in the tank. I realized I needed to take some time off work to deal with my depression and get my life in order again. I called my parents and asked to come home.
At first, I didn’t leave the bedroom. There were successive days I didn’t get up to eat or shower. I was in constant mental pain. It was hell on earth.
One evening, I managed to get out of bed and sat down to eat dinner with my parents. They were silent, and looked tired and sad. Until this moment, my depressive haze prevented me from seeing how my illness impacted my family. I decided: that’s it, no more. It was my guilt that fueled the decision to fully contend with my mental illness.
Up until now, I was only living for myself, not participating and valuing what my parents, family, and others did for me. So, something needed to change. I needed to turn my life around. And with my life, my attitude.
I started seeing a psychologist and taking antidepressants. I took a sincere look at self, including undesirable traits I’d been afraid to face. I set goals for myself. And when I had zero desire to get out of bed, I pushed through. I made sure I did something useful every day.
After several months of therapy and medication, life became manageable. I talked more, was less irritable, and as a result, my life and that of those around me improved. At times I even looked forward to things!
How Depression Changed Me
Although the depression was tough on me, and there were times I didn’t know if I was going to make it, it brought about some positive changes.
I became more mature and resilient; I learned to put things in perspective and take necessary responsibility. But the two most significant aspects that changed were my so-called “intellectual arrogance” and the pessimistic way I viewed life.
Before, I considered myself a fairly intelligent fellow. The problem with this was that I overvalued intelligence, viewing other aspects in life as inferior.
Moreover, my attitude was overwhelmingly cynical and negative. What I failed to realize is that focus shapes experience. And if you only pay attention to the negative, you miss the beauty life has to offer. Now, I actively search for the good and beautiful things happening around me.
What Helped Me Get My Depression Under Control
In addition to medication and therapy, I found the following to be helpful:
Seeking help. We can’t do everything on our own, no matter how much we’d like to. There are times when you will need help to cope with your depression. In addition to professional help, seek support from family and trusted friends. You may find that feeling heard and understood is what carries you through the darker days.
Setting goals. I had no desire to do anything in life. I had no goals. For severe depression, I would advise setting smaller goals you think you would mind doing the least (minimal effort) and/or goals which you found important in the past (before your depression took over).
Taking responsibility. Although depression can be debilitating, practice taking responsibility for the things in life under your control. For me, it was easy to blame others for everything that went wrong, believing the world to be wretched and unfair, but it didn’t do me any good.
Exercising. Mental health and physical health go hand-in-hand. Exercise releases endorphins, the “feel good” brain chemicals related to pleasure. If you don’t enjoy exercise, try a hobby that requires some level of physical exertion. As an additional benefit, engaging in exercise can take your mind off the stressful things in life.
My Depression Warning Signs
For me, there are clear signs that indicate my depression is coming back or worsening. Keep in mind that warning signs vary from individual to individual. What might be a warning sign for me may not for you.
My desire to do anything decreases. Hobbies I enjoy like weightlifting and running suddenly mean very little to me. But it’s not just about hobbies. Things like getting out of bed and showering suddenly become difficult because I have zero motivation or energy.
My thoughts get darker and more negative. It becomes increasingly tough to see the positive things in life or the positive in people. I become cynical and pessimistic.
Overthinking. I tend to overthink when things go bad, which is basically what depression is for me: feeling bad.
Anxiety. Negative thoughts and overthinking lead to increased levels of anxiety. My anxiety about the little things in life may seem insignificant to others who don’t have a mental illness, but a simple act such as calling or visiting a friend can freak me out and lead to rumination.
Ruminating. Intrusive thoughts run through my head and there’s no “off” switch.
Irritability. I become increasingly irritable; I’m in a foul mood all of the time and the smallest things piss me off.
Increased desire to self-medicate. I experience a strong desire to drink. Alcohol impacts the brain by triggering a release of dopamine. This rush of dopamine creates feelings of pleasure and happiness.
Decreased sleep quality. My overall sleep quality gets worse, partly due to constant overthinking and ruminating. Anxiety and stress are also big factors. And when I’m able to fall asleep, I wake up throughout the night.
Depression is a terrible disease that may go unnoticed if the signs aren’t recognized or known. A person with depression might attempt to maintain a positive front, possibly because they don’t want to complain or they’re afraid of being misunderstood.
There are multiple symptoms of depression; my symptoms went hand-in-hand, playing off one another and creating a vicious circle of negative thoughts that sucked the energy and lust for life from me.
Depression symptoms are different for different people. Learning to identify the symptoms will help you to recognize depression in others. Furthermore, an increased awareness enhances empathy and enables you to better support someone with depression.
I give the following advice to anyone with depression:
Don’t give up.
Seek professional help.
Seek support from your family and close friends.
Set goals and work hard to achieve them.
Take responsibility for the things you can control.
Is there a cure for depression? No. Do I think I will ever be totally depression-free? Maybe. What I do know for sure is that my illness is manageable and livable at the moment. I look forward to what the future has in store for me. Which is a lot more than I anticipated at first.
About the Author:
Kevin Mangelschots is a writer and occupational therapist with seven years of experience in the field of physical rehabilitation. He is a long-time fitness enthusiast. Kevin lives in Belgium and has created a platform for other bloggers to share their life stories where he writes about his own experience with depression at retellinglifestories.com.
A resource list with links to useful sites, free assessment tools, low-cost trainings, printable PDF toolkits/guides, and more
This is a resource guide for suicide prevention and recovery. The suicide resources include links to educational sites, a list of free assessments, links to trainings, recommended books, helpline information, links to online support communities, recommended mobile apps, and more.
Lifetime – Suicide Attempt Self-Injury Count (L-SASI)InstructionsScoring | (Source: University of Washington Center for Behavioral Technology) The L-SASI is an interview to obtain a detailed lifetime history of non-suicidal self-injury and suicidal behavior. Citations: Linehan, M. M. &, Comtois, K. (1996). Lifetime Parasuicide History. University of Washington, Seattle, WA, Unpublished work
Non-Suicidal Self-Injury Assessment Tool Brief Version | Full Version | Assessment tool created by Cornell Research Program on Self-Injury and Recovery
Suicidal Behaviors Questionnaire | SBQ with Variable Labels | SBQ Scoring Syntax | (Source: University of Washington Center for Behavioral Technology) The SBQ is a self-report questionnaire designed to assess suicidal ideation, suicide expectancies, suicide threats and communications, and suicidal behavior. Citations: Addis, M. & Linehan, M. M. (1989). Predicting suicidal behavior: Psychometric properties of the Suicidal Behaviors Questionnaire. Poster presented at the Annual Meeting of the Association for the Advancement Behavior Therapy, Washington, DC
Suicide Attempt Self-Injury Interview (SASII)SASII Instructions For Published SASII | SASII Standard Short Form with Supplemental Questions | SASII Short Form with Variable Labels | SASII Scoring Syntax | Detailed Explanation of SPSS Scoring Syntax | (Source: University of Washington Center for Behavioral Technology) The SASII (formerly the PHI) is an interview to collect details of the topography, intent, medical severity, social context, precipitating and concurrent events, and outcomes of non-suicidal self-injury and suicidal behavior during a target time period. Major SASII outcome variables are the frequency of self-injurious and suicidal behaviors, the medical risk of such behaviors, suicide intent, a risk/rescue score, instrumental intent, and impulsiveness. Citations: Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., Wagner, A. (2006). Suicide Attempt Self-Injury Interview (SASII): Development, Reliability, and Validity of a Scale to Assess Suicide Attempts and Intentional Self-Injury. Psychological Assessment, 18(3), 303-312
University of WA Suicide Risk/Distress Assessment Protocol | (Source: University of Washington Center for Behavioral Technology) Reynolds, S. K., Lindenboim, N., Comtois, K. A., Murray, A., & Linehan, M. M. (2006). Risky Assessments: Participant Suicidality and Distress Associated with Research Assessments in a Treatment Study of Suicidal Behavior. Suicide and Life-Threatening Behavior (36)1, 19-33. Linehan, M. M., Comtois, K. A., &, Ward-Ciesielski, E. F. (2012). Assessing and managing risk with suicidal individuals. Cognitive and Behavioral Practice, 19(2), 218-232
(Updated 5/20/20) A list of movies about mental health and substance abuse – includes PDF printable discussion questions
The following is a list of movies about addiction and mental disorders that are appropriate to show in treatment settings. This post includes movie summaries and downloadable PDF handouts with questions for discussion.
Please note that some of the films on this list are graphic and may not be appropriate for children or adolescents.
Hint: The handouts contain spoilers; do not provide until after the movie ends.
Movies About Addiction & Mental Illness
Disclaimer: This post contains affiliate links. As an Amazon Associate I earn a small commission from qualifying purchases.
103 minutes (1 hour, 43 minutes), R-rating for language and drug use
Summary: Julia Roberts plays a mother, Holly, whose 19-year old son, Ben, surprises her by returning home for Christmas. Ben is newly in recovery; his addiction has placed a tremendous strain on the family in the past. Ben’s younger siblings are happy to see him, but Holly, fearing that he is not ready, is apprehensive. That evening, the family attends church. When they return, they find their home burglarized and the dog missing. Ben blames himself, believing someone from his past took the dog to get his attention; he leaves to look for the dog. Holly goes with him, but they’re later separated, and Holly attempts to track Ben. Eventually, she ends up at an abandoned barn where she finds her son on the floor, unresponsive. The movie ends with her administering Narcan to Ben.
127 minutes (2 hours, 7 minutes), R-rating for strong language and content relating to drugs, sexuality, and suicide
Summary: Winona Ryder plays Susanna, a young woman with borderline personality disorder, who is sent to a psychiatric hospital after a suicide attempt in the late 1960s. She befriends Lisa (Angelia Jolie), who carries a diagnosis of sociopathy (antisocial personality disorder). Initially, Susanna is in denial about her mental condition and is not open to treatment. However, she reaches a turning point after a tragedy.
123 minutes (2 hours, 3 minutes), PG-13 rating for mature thematic elements including substance abuse/recovery, some sexual situations, language, and brief violence
Summary: Trevor (Haley Joel Osment) starts a chain reaction of goodness for a social studies project with a plan to change the world for the better. In this film, Trevor is a high school student whose mother, Arlene (Helen Hunt), struggles with alcoholism and whose father is abusive. He rises above unfortunate circumstances with the kindhearted idea to do a good deed, but instead of requesting payback, asking the receiver to “pay it forward” to at least three people – and on and on. While the movie has a bittersweet end, the message is uplifting and powerful.
Summary: Charlie is an unpopular high school freshman, a “wallflower,” who is befriended by two seniors, Patrick and Sam (Emma Watson). The movie is about their friendship and Charlie’s personal struggles with the recent suicide of his friend and his own mental illness. Throughout the film, Charlie has flashbacks of his aunt, who died in a car accident when he was 7. It’s eventually revealed that Charlie’s aunt molested him; a sexual encounter with Sam triggers Charlie’s repressed memories. Charlie has a mental breakdown.
Other great resources for using clinical films as therapeutic interventions include the book Movies & Mental Illness: Using Films to Understand Psychopathy, 4th ed. (by Danny Wedding and Ryan M. Niemiec) and the site Teach With Movies.
If you’re a counselor or therapist, you’re probably familiar with Therapist Aid, one of the most well-known sites providing free therapy worksheets. But Therapist Aid isn’t the only resource for free therapy tools! This is a list of additional sites with free therapy worksheets and handouts.
See below for links to over 100 websites with free therapy worksheets and handouts for both clinicians and consumers.
(Click here for free worksheets, handouts, and guides posted on this site.)
Stress Management – Patient Handouts | A collection of handouts on stress management; some of the other sections, including “General Health and Wellness” and “Nutrition” have links to handouts as well (Source: UMASS Medical School Department of Psychiatry)
Attitudes and Behaviour | 9-page PDF packet on criminal thinking (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Motivation To Change | 16-page PDF packet on motivation to change criminal behavior (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Peers & Relationships | 12-page PDF packet on how associates impact criminal behavior (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
Personal Development | Handouts on resilience, communication, etc. (Source: Workplace Strategies for Mental Health)
A list of uncommon strategies for coping with stress, depression, and anxiety. Includes a free PDF version of the list to print and use as a handout.
Effective coping skills make it possible to survive life’s stressors, obstacles, and hardships. Without coping strategies, life would be unmanageable. Dr. Constance Scharff described coping mechanisms as “skills we… have that allow us to make sense of our negative experiences and integrate them into a healthy, sustainable perspective of the world.” Healthy coping strategies promote resilience when experiencing minor stressors, such as getting a poor performance review at work, or major ones, such as the loss of a loved one.
Like any skill, coping is important to practice on a regular basis in order to be effective. Do this by maintaining daily self-care (at a minimum: adequate rest, healthy meals, exercise, staying hydrated, and avoiding drugs/alcohol.)
As an expert on you (and how you adapt to stressful situations), you may already know what helps the most when life seems out-of-control. (I like reading paranormal romance/fantasy-type books!) Maybe you meditate or run or rap along to loud rap music or have snuggle time with the cats or binge watch your favorite show on Netflix. Having insight into/awareness of your coping strategies primes you for unforeseeable tragedies in life.
“Life is not what it’s supposed to be. It’s what it is. The way you cope with it is what makes the difference.”
Virginia Satir, Therapist (June 26, 2019-September 10, 1988)
Healthy coping varies greatly from person to person; what matters is that your personal strategies work for you. For example, one person may find prayer helpful, but for someone who isn’t religious, prayer might be ineffective. Instead, they may swim laps at the gym when going through a difficult time. Another person may cope by crying and talking it out with a close friend.
Note: there are various mental health treatment approaches (i.e. DBT, trauma-focused CBT, etc.) that incorporate specialized, evidence-based coping techniques that are proven to work (by reducing symptoms and improving wellbeing) for certain disorders. The focus of this post is basic coping, not treatment interventions.
On the topic of coping skills, the research literature is vast (and beyond the scope of this post). While many factors influence coping (i.e. personality/temperament, stressors experienced, mental and physical health, etc.), evidence backs the following methods: problem-solving techniques, mindfulness/meditation, exercise, relaxation techniques, reframing, acceptance, humor, seeking support, and religion/spirituality. (Note that venting is not on the list!) Emotional intelligence may also play a role in the efficiency of coping skills.
A sport psychology study indicated that professional golfers who used positive self-talk, blocked negative thoughts, maintained focus, and remained in a relaxed state effectively coped with stress, keeping a positive mindset. Effective copers also sought advice as needed throughout the game. A 2015 study suggested that helping others, even strangers, helps mitigate the impact of stress.
Examples of coping skills include prayer, meditation, deep breathing, exercise, talking to a trusted person, journaling, cleaning, and creating art. However, the purpose of this post is to provide coping alternatives. Maybe meditation isn’t your thing or journaling leaves you feeling like crap. Coping is not one-size-fits-all. The best approach to coping is to find and try lots of different things!
The inspiration for this post came from Facebook. (Facebook is awesome for networking! I’m a member of several professional groups.) Lauren Mills sought ideas for unconventional strategies via Facebook… With permission, I’m sharing some of them here!
Unconventional Coping Strategies
Crack pistachio nuts
Fold warm towels
Smell your dog (Fun fact: dog paws smell like corn chips!) or watch them sleep
Peel dried glue off your hands
Break glass at the recycling center
Pop bubble wrap
Lie upside down
Watch slime or pimple popping videos on YouTube
Sort and build Lego’s
Write in cursive
Observe fish in an aquarium
Solve math problems (by hand)
Use a voice-changing app (Snapchat works too) to repeat back your worry/critical thoughts in the voice of a silly character OR sing your worries/thoughts aloud to the tune of “Happy Birthday”
Listen to the radio in foreign languages
Go for a joy ride (Windows down!)
Watch YouTube videos of cute animals and/or giggling babies
Walk barefoot outside
Draw/paint on your skin
Play with (dry) rice
Do (secret) “random acts of kindness”
Play with warm (not hot) candle wax
Watch AMSR videos on YouTube
Recite family recipes
Find the nicest smelling flowers at a grocery store
Use an app to try different hairstyles and/or makeup
People-watch with a good friend and make up stories about everyone you see (Take it to the next level with voiceovers!)
Wash your face mindfully
Buy a karaoke machine and sing your heart out when you’re home alone
On Instagram, watch videos of a hydraulic press smash things, cake decorating, pottery/ceramics throwing, hand lettering, and/or woodwork
Shine tarnished silver
Create a glitter jar and enjoy
Tend to plants
Color in a vulgar coloring book for adults
Click below for a PDF version of “Unconventional Coping Strategies.” This handout can be printed, copied, and shared without the author’s permission, providing it’s not used for monetary gain.
12-step recovery groups, while not a substitute for treatment, can play a crucial role in recovery and continued sobriety. AA/NA (and similar) meetings are available all over the world and are open to anyone with a desire to stop using or drinking.
The following list, while not comprehensive, will link you to both well-known and less-familiar 12-step and other support groups for recovery.
What questions are people asking about mental health? Quora posts indicate that misconceptions and myths related to mental illness and addiction prevail. Read the top 40 most unsettling questions on Quora.com.
I turned to Quora (an online platform for asking questions) to see what people today are asking about mental illness. What I found ranged from thought-provoking to comical to disturbing.
Continue reading for 40 of the most unsettling questions I came across. The following Quora question posts illustrate some of the misconceptions surrounding mental disorders.
40 of the Most Disturbing Posts About Mental Illness (on Quora)
1. “Is mental illness really an illness?”
2. “Is mental illness catchable?”
3. “Do people with mental disorders have friends?”
4. “Are people who self-harm just looking for attention?”
5. “Is drug addiction really just a lack of willpower?”
6. “Can a person be intelligent and a drug addict?”
9. “Why should one feel sorry or sympathetic for drug addicts, given most of them chose this life?”
10. “Instead of ‘rescuing’ drug addicts who have overdosed, wouldn’t society as a whole benefit from just letting nature take its course?” (If that was the case, shouldn’t we then withhold all types of medical treatment and preventative or life-saving measures… to allow nature to take its course?)
11. “Is there any country in the world that won in the war against drugs by killing the users or the drug addicts?”
12. “Why should we lament drug addicted celebrities dying of drug-related causes? It’s their fault for starting a drug habit.”