Relapse

"Commonly we’ve said ‘relapse’ when people start using drugs again.

I guess the coincident ‘remission’ would be when people aren’t using drugs…. but
I think that’s not really the best use of the term.

We wouldn’t say that someone with diabetes has relapsed because now they’re not doing their diet and exercise or taking their medicine right.

We would say they were 'non-adherent to care-plan'...

and if they were in ‘relapse’, what that means is their sugar is high, in spite of treatment.

So I think that what remission SHOULD mean, in addiction, is that they are without the original symptoms of addiction, which are those low dopamine symptoms in the mid-brain and that’s the way I talk about it to my patients.

They’re in remission as long as they’re feeling well and when they stop feeling well it’s time to look at their medical situation BEFORE they start using the drug."


That's a quote from the interview of Dr. Howard Wetsman that I mention here http://recoveryfromgamblingaddiction.blogspot.com/2008/06/biology-of-addiction-interviewbook.html

As someone who DID 'relapse' after a significant amount of clean time (20 months)...I can tell you that it was a PROCESS.

I mean...I wasn't fine and happy...then out of the blue, just 'decide' to start gambling again.

It built up.

The thoughts.....turned into desire....and eventually a craving.....and...there was a gradual return to 'old' ways of thinking....justifying it....rationalizing the unrational....maybe i could control it THIS time.....I DESERVE it...blah blah blah

the problem is.....once that begins happening....the PHYSICAL changes are beginning to take place....and those PHYSICAL changes...make it difficult for us to intervene on our own behalf.

THe longer we let it go....the worse off we become...the more difficult it is to seek help.


Ya know....when people stop attending g.a. meetings...the assumption is often that they are 'back out there'....and.....I have seen many people show up at meetings, in a great deal of pain, having gotten caught up in the cycle again.....

that is probably the norm...

after a long absense, if someone DOES show up...they are suffering.

What we NEED to do....is to learn how to take care of ourselves...BEFORE we end up in hell.

If, at the first signs of 'relapse' (addictive thinking) we take steps...then we can stay 'adherent to care-plan' ('drug' free)...

This is do-able.

we go back

This sucks.

Addiction, I mean.

I have seen so many people go from hell...the hell of the cycle....to freedom...and we blossom...become human again...we smile...we cannot believe that we were ever stuck back there...cannot believe that happened to us....but...we know now..we know..that we are free...we are unstoppable.

then

for whatever reason....many of us get to that point.....

and then we go back.

we say...when we are at our worst...who am I? who have I become? this is not like me! it's like i am a different person!

and now...as an observer....seeing people that I know...talking with them intimately on a regular basis......

I can honestly say..that from the OUTSIDE..... it looks like two different people as well.

in almost every way.

worried about a friend today :(

Emotions

I have seen therapists off and on for years.

I have had a few ‘aha’ moments about my past…but to be honest…I never spent a whole lot of time delving into that stuff….

Usually…the morning of my appointment..while I am showering, applying makeup, dressing…I am thinking…about what happened since my last visit…what do I need to talk about??

Sort of like… bringing a friend up to date with my life.

It is amazing what that does for me….having a safe place to talk about…ANYTHING.

I went to lunch with my best friend today. We became friends when we were three years old.

There is nothing that we cannot share with one another.

I knew, before we got there that she has been going through sort of a rough time…so we spent the hour together…talking about what’s going on….our victories…funny stories…our stresses…our pain…grief.

We didn’t SOLVE anything.

When we left….both of our situations were exactly the same as they were when we arrived.

But we felt good.

Both of us.

I see it here too….someone will come across this blog and send me an email ….telling their story..or will post for the first time at gamcre or safe harbor.….finally..finding a place where they can share their story…where there are others…like them…who ‘get’ it.

FINALLY....some RELIEF.

But…it’s not just about the gambling…I mean…we need to tell those stories…but….it’s all the OTHER crap too….

The things that we think we should ‘just suck it up’….or…that….we shouldn’t be compaining..after all…others have it worse than we do….or…that no one wants to hear us whine…or….thinking that we are just having a pity-party…

Trying to ‘stuff’ our feelings….is dangerous for us.

Gambler’s Anonymous says that this is an ‘emotional’ illness.

Our emotions.

Do you know that there are thousands of words that can be used to describe emotions?

Not long ago…my list was pretty basic…

I felt:

Good, bad, angry, happy, sad or scared.

Period.

Now…I was FEELING a lot more than that…anxious, nervous, shame, guilt, hopeless, helpless, pleasure, joy, love…grief.

I FELT all sorts of things.

I couldn’t name them when I tried.
More importantly, I rarely tried.

For me….that was how I practiced AWARENESS in the beginning.

As often as I thought about it (and I tried to think about it a lot)…I would ask myself….’how am I feeling?’

That meant…PHYSICALLY…..and EMOTIONALLY.

I did some looking online…finding lists of words that I might use in my exercises….

Strange…how IDENTIFYING what I was feeling was….ummm….not comforting…no..ummmmm empowering??? Yeah, maybe that’s it.

Whatever I feel is ok.

No matter what I feel, ‘numbing’ at a machine is not an option.

It really doesn’t make the feelings go away you know…it just allows us to ignore them for a while.

Problem is….when we STOP numbing (and from time to time…I had to pause from my gambling)…all of THAT cr*p was there…PLUS, I was ADDING to the stress in my life with the GAMBLING consequences that I was creating.

Becoming AWARE of how I feel…and sharing that in a safe place…no matter WHAT it is that I feel….are necessary….if I am going to overcome this ‘emotional’ illness…..these things are *absolutely* necessary.

How understanding the biology of addiction helps ME.

Gambling is no longer something that I crave….it’s not an issue that I must deal with daily. The thought to gamble rarely occurs to me.

but

I still do think of it sometimes.

Friday night my husband and I attended a concert...it was held at a casino (many are these days)...I had to pick up the tickets at the box office (I made the purchase online, so *I* had to be the one to do it..with a photo i.d. and the credit card that I'd used online)...and...we were running late -- and maybe just not thinking....he pulled up to the casino door and I jumped out to run in real quick and get the tickets.

The casino was packed full of people.

I had to walk to the other end of the casino to get to the box office (a very long walk)..

and the line at the box office was long.

There wasn’t going to be anything ‘quick’ about this.

I had the opportunity.
I had the money.
and...the crazy-a** voice did start talking.

the thing is...I now understand...that....even if I just put in a $5 bill and walk away....just a few minutes at a machine will change me....it will start things happening inside of my head that cannot easily be undone.

The changes that will occur...will make me want to gamble more...and because of those changes in my brain...NEXT week...the CHOICE of whether or not to gamble...will be much more difficult to make....

and before you know it, I am full blown back in the cycle.

I understand that....spending a few minutes at a machine (for *ME*) is NOT 'just' spending a few minutes at a machine...it is the beginning .....

the beginning of losing who I am again.


note: to the person who attempted to email me -- that link did not work properly and I recieved notification that an error occured when someone attempted to send mail.

The email did not arrive, I am unaware of who sent it or what it said.
I have removed the link that wasn't working but can be reached using the link in the right hand column, just under the submit button.
I apologize.

The biology of Addiction - Interview/Book

The Doctor that I was seeing has recently published a book.


My review at amazon.com follows:


Dr. Wetsman was my physician.
Many of the answers given in this book were told to me in his office..they made a difference in how I viewed what was wrong with me and what I was/am able to do about it.
This information empowered me..knowing that I am NOT bad and I am NOT stupid...but more importantly..that I am not alone...that I can be O.K...and that I can be 'happy, joyful and free'.



He was interviewed recently, I had to register in order to hear it, but registration was free...hearing the interview was well worth it...it can be heard at this link:

http://www.reachmd.com/xmsegment.aspx?sid=3118

The book is
Questions and Answers on Addiction by Howard Wetsman

I have no interest in sharing this information....except that....it made a difference in my life.

Serenity

So I was talking with a friend recently, and we agreed that there are two 'tools' that we learn in 'recovery' that cover just about all of the obstacles that we encounter....

one of them is the Serenity Prayer.

that 'prayer' word was a huge stumbling block for me for a long time....so I didn't PRAY it.....I just thought that the PHILOSOPHY was ingenius....

when something happens...that is upsetting, or difficult or painful...

Can I do anything about the situation?

If so.....do it.

If not......acknowledge that fact....and try not to let it ruin my day.

when I have a situation that i have NO CONTROL over...it is simply going to happen....it IS THIS WAY

then...

whether or not I am upset about it.....only means...that I am a wreck inside

or I am not.

that's it.

the situation is still whatever it is.

It's about acceptance.

that doesn't mean that I have to accept everything HAPPILY....or that I will never GRIEVE...

It simply means...that...when I have no control over circumstances....I will limit my negative reaction to it...to the best of my ability.


lol - to the best of my ability.


I get better with practice.


I went from being a nervous wreck all of the time....to now....pissing my husband off on a regular basis...when *HE* gets all worked up about something that is out of his hands.....

I mean....if we are running late, for instance, for any particular function....once we are late..WE ARE LATE... freaking out about it isn't gonna get us there any sooner!

This isn't about 'recovery'...this is about being HUMAN!!!

My kids....I could take a lesson from them...

I remember driving them to school one morning...and my son had a big test...I asked if he had studied...'No' he replied.

NO?

NO????

and he sat there...calmly...this 12 year old...

while I was freaking out.

'I can't believe you don't CARE about this....you're not even UPSET!'

he said...calmly...'I DO care mom...but I forgot to study. I wish I had, but it's too late now....there's nothing I can do about it....getting upset isn't gonna get me a good grade'.

I was furious.

*HE* just didn't 'get' it. ha ha

* * * * * * * *

God grant me the serenity to accept the things I cannot change;

courage to change the things I can;

and wisdom to know the difference.

Some of the 'steps' I took....to be free

(not in any particular order)

I recognized that I was depressed and contacted a Dr., seeking treatment. I began taking medication.

I began seeing a counselor for individual therapy.

I gave up all access to money. I couldn’t have stopped without doing this…at least for a short time…given the opportunity to gamble (money)…I did.

I educated myself:
I read everything I could get my hands on regarding compulsive gambling.
I read the ‘Big Book of AA’ and discovered that my ‘illness’ looked remarkably like alcoholism is described in that book…..determined that my problem is ‘addiction’…not necessarily gambling.
I attended gambler’s anonymous meetings.
I went to coffee with g.a. members AFTER meetings….I’d ask questions….I wanted to learn from the people who were doing this successfully.
I joined online support groups for compulsive gamblers.
I LEARNED TO LISTEN.
I learned about the physiology of addicts.
I learned that I had to find a way to rid myself of fear and shame.
I learned about urges and complacency…resentments and forgiveness.
I learned about the 12 steps.
I learned about cross-addiction and roadblocks and feelings and gratitude….
I learned that….what I really needed to learn was a better way of LIVING.


I made friends with other compulsive gamblers…mostly online…..at all stages of addiction and recovery.

I worked some of those twelve steps.

Any time I would find a way to gamble…I would put a new roadblock into place….to prevent me from doing THAT particular thing again.

I began practicing relaxation (breathing etc) techniques.

I began practicing awareness.

I began practicing honesty.

I began practicing delayed gratification.

I spent almost NO MONEY on myself for years…in an effort to free my family from the debt that I’d created.

I’m getting to know me.

The REAL me….not any other person’s vision of who I am….or even my OWN vision of who I SHOULD be.

I reach out to others….so that they might know….there is a way.



If I were giving advice to someone who is new to recovery…I would say…to talk to as many successfully recovering people that you possibly can…and learn what they have done…and what they continue to do….to be successful.

Then make a plan.

If a slip occurs…acknowledge that the plan needs to be modified :) and make a change.

Keep listening.
Keep learning.
Remain Open-minded.

Rule out nothing.


Today…I spend very little time at meetings or on web-sites…but I continue to read, and blog…and I am in touch with many many people in recovery.

I do *SOMETHING* for my recovery every day (if nothing else...I am constantly practicing Awareness, relaxing, honesty, acceptance, gentleness).


Ahhhhhh…yes….the spirituality thing.
Hmmmmmm

I don’t preach.
It never did any good when people were preaching at me! :)


I am discovering my own spirituality.

Can recovery be successful without it?

I know people who are.

I’m sort of glad that I’m not one of them, though. :)


Find your way.
You deserve your life.

We are sick, sick people.

It really bothers me when people say that.

I mean….

I acknowledge that the biology in (most of) us is different of that from ‘normal’ people…which would probably qualify as ‘sick’.

I even call it an illness.

And I believe that it is.

But…I hear someone say ‘I am SOOOO sick’ or ‘I am sick, sick, sick’…in *MY* mind that translates to something like:

I am bad and I repulse myself.


And I’m not and I don’t.

And neither should you.


I don’t hear cancer patients sitting around…belittling themselves that they are sick sick people (in a self-demeaning sort of way).


Neither should we.


Yeah…I *KNOW* we’ve hurt people…I *KNOW* we’ve done some crappy things….maybe TERRIBLE things.

OK.

Now we get it….now we know what’s wrong…and what we can do to change things.

It’s not easy….

Because…there is a part of us that doesn’t WANT to change….THAT part of the brain isn’t affected by consequences….it just wants (or needs) to feel good…and it knows how.

For a while,
For me
It was a war….

A war within myself

And everything was at stake.

Much love to you.
Try.

Stopping gambling isn't gonna fix it

This ‘illness’ really isn’t about gambling at all.

This ‘illness’ is about how I feel when I am *NOT* gambling.

How I feel when I am not gambling isn’t ‘normal’.

If I *DID* feel ‘normal’ when I wasn’t gambling…then gambling wouldn’t have affected me in the way that it did….my body would not have NEEDED to do more of it.

And stopping gambling isn’t gonna FIX the problem…..because my problem isn’t gambling!

If I simply stop gambling….my body is going to discover OTHER ways of obtaining the feeling that it desires.

That is why cross-addiction is such a danger….

People stop smoking because the BEHAVIOR is causing them problems….but
The underlying ILLNESS still exists…so they begin to over EAT (for example).

Some activities are more addictive than others because those activities affect the human anatomy in certain ways……and people like me, who have this illness…..are susceptible to those activities because our anatomies are lacking in certain areas.

I mentioned that medication may be helpful…but there are other things we can do as well.
Things that…sort of aid our anatomies in self-correcting.

I believe that 12 step programs are one mean to this end….

We need to know that we are not alone.
We need to feel like we are a PART of….like we BELONG….like we are UNDERSTOOD…and we are O.K….we are NOT less than….we are NOT bad…

That…someone cares…..
That…we are not hopeless…..we can DO this…and that others, who DO understand…are WANTING to HELP US…..

That….people who thought that they had nothing to live for…..are leading happy lives…and that no matter how bad things look…or feel to us…..that the possibility exists that WE can too.

And we can.
Many of us are.
I am.
You can too.

Medication to help compulsive gamblers?

I am not a doctor.

I have heard g.a. members pooh-pooh the possibility of medication helping a compulsive gambler to stop.

But…medications have certainly caused people to START…

http://www.oregonlive.com/metrosouthwest/oregonian/index.ssf?/base/metro_southwest_news/121064553193970.xml&coll=7

They say there is no ‘magic pill’…and I agree…there is no quick-fix…
But

Our brain chemistry is certainly affected by gambling….

And it’s important to get our brain chemistry back to ‘normal’….

Many people do this without using medication…but…doesn’t it make sense that medication COULD be helpful for some of us?

Isn’t depression fairly common amongst us?

I can only share my own story…

My mom died in 1996.

Sometime after her death, I had an appointment with my Primary Care Physician…I don’t recall what for…but she recognized immediately that I was depressed..she even had to convince me to try an anti-depressant….she prescribed Wellbutrin in a small dose.

I took it for a few months..felt better…didn’t need it any more…stopped taking it.

Then became depressed again.

That’s sort of been my experience with anti depressants…..some time later…when I was really really bad, I’d see her…or some other dr….for whatever symptoms were bothering me at the time, and they would prescribe one anti depressant or another…

I’d feel better…
I’d stop taking it…
I’d get depressed again.

As stupid as it sounds…I didn’t see the pattern.

In 2002, when the sh*t hit the fan at my house, I knew I was depressed and made an appointment with a psychiatrist.

He prescribed something.

I began taking it.

I stopped gambling…using meds, therapy, g.a., and giving up all access to money.

I didn’t gamble for 20 months.

During that 20 months…I was doing great, right? So I stopped the meds….and therapy….and g.a……and I was carrying money again.

And I was fine.

Until I wasn’t.

When my life began to fall apart again…..and I was grieving…and became depressed…I began to gamble.

Eventually I contacted my therapist….and my psychiatrist….and got back on meds.

I continued to gamble.

My therapist urged me to see a DIFFERENT dr….one who specializes in addiction…I did.

He taught me TONS about addiction.

He said that he thought I was on the WRONG medication (for me)….and weaned me off of what I was on…

And put me on..Wellbutrin….a much stronger dose than I had taken all those years ago…. (I currently take 450 mgs)

He discouraged (and eventually withheld) meds for anxiety…he said ‘a pill is the OLD way…RECOVERY is the NEW way’…

But I remain on Wellbutrin.

I was on it for a while….many months….and continued to gamble….it was NOT a magic pill….it did not instantly make me ‘better’ and make the desire to gamble leave me…it wasn’t like that.

But

When I finally had enough

This time…when I decided….

Enough

It was much easier (than it was in 2002) to walk away.

Much
Much
Much
Easier.

I’m nearly 20 months gamble free now.

I last saw my dr. in January…he has given up his private practice in order to train other dr’s in addiction..and run some facilities for addicts…

I was heartbroken.

He said ‘the good news is…you don’t need me any more. Your recovery is stable.’

I agreed….and we talked for a while.

He gave me prescriptions….and said that my dosage is stable…I can get future prescriptions from my regular dr.

I asked…’will I need to take medication forever?’

He said ‘I don’t know if you will always NEED to…but is there any particular reason to NOT want to take it…and...is it worth the risk to experiment with it? after all...stable is stable.’.

I was aware…a year or so before….when he parted company with his partner…there was a difference in opinion…his partner felt like there was a place for medication…in the BEGINNING of recovery…and that once the addict had broken free…the medication should be discontinued….my dr. felt like medication should be part of an ongoing treatment program.

I know people who no longer gamble who were never medicated for depression…

perhaps I could’ve broken free without it.

I don’t know. I don't really care.

All I know is…stable IS, indeed, stable…

And

If I was struggling to break free….I would seek help wherever I thought I could find it.

I repeat...I am not a doctor.

Take care of you.