What is Drug Addiction?

Drug Addiction

By Dr. Beverly Howze

 

Dr. Beverly Howze

Dr. Beverly Howze

 

Drug addiction is a complex brain disease. It is characterized by compulsive, at times uncontrollable, drug craving, seeking, and use that persist even in the face of extremely negative consequences, explains Dr. Beverly Howze.

 

Dr. Beverly Howze knows that for some drug seeking becomes compulsive, in large part as a result of the effects of prolonged drug use on brain functioning and, thus, on behavior. For many people, drug addiction becomes chronic, with relapses possible even after long periods of abstinence.

 

Why do people take drugs?

In general, people begin taking drugs for a variety of reasons:

 

To feel good. Dr. Beverly Howze has found that the most abused drugs produce intense feelings of pleasure. This initial sensation of euphoria is followed by other effects, which differ with the type of drug used. For example, with stimulants such as cocaine, the “high” is followed by feelings of power, self-confidence, and increased energy. In contrast, the euphoria caused by opiates such as heroin is followed by feelings of relaxation and satisfaction, states Dr. Beverly Howze.

To feel better. Dr. Beverly Howze states that some people who suffer from social anxiety, stress-related disorders, and depression begin abusing drugs in an attempt to lessen feelings of distress. Stress can play a major role in beginning drug use, continuing drug abuse, or relapse in patients recovering from addiction.

To do better. The increasing pressure that some individuals feel to chemically enhance or improve their athletic or cognitive performance can similarly play a role in initial experimentation and continued drug abuse.

Curiosity and “because others are doing it.” In this respect adolescents are particularly vulnerable because of the strong influence of peer pressure; they are more likely, for example, to engage in “thrilling” and “daring” behaviors.

 

If taking drugs makes people feel good or better, what’s the problem?

At first, people may perceive what seem to be positive effects with drug use. Dr. Beverly Howze  knows they also may believe that they can control their use; however, drugs can quickly take over their lives. Consider how a social drinker can become intoxicated, put himself behind a wheel and quickly turn a pleasurable activity into a tragedy for him and others. Over time, if drug use continues, pleasurable activities become less pleasurable, and drug abuse becomes necessary for abusers to simply feel “normal.” Drug abusers reach a point where they seek and take drugs, despite the tremendous problems caused for themselves and their loved ones. Dr. Beverly Howze  has found that some individuals may start to feel the need to take higher or more frequent doses, even in the early stages of their drug use.

 

Why do some people become addicted to drugs, while others do not?

As with any other disease, vulnerability to addiction differs from person to person. In general, the more risk factors an individual has, the greater the chance that taking drugs will lead to abuse and addiction. “Protective” factors reduce a person’s risk of developing addiction.

 

What factors determine if a person will become addicted?

Dr. Beverly Howze knows that there is not a single factor determines whether a person will become addicted to drugs. The overall risk for addiction is impacted by the biological makeup of the individual – it can even be influenced by gender or ethnicity, his or her developmental stage, and the surrounding social environment (e.g., conditions at home, at school, and in the neighborhood).

 

Which biological factors increase risk of addiction?

Dr. Beverly Howze estimates that genetic factors account for between 40 and 60 percent of a person’s vulnerability to addiction, including the effects of environment on gene expression and function. Adolescents and individuals with mental disorders are at greater risk of drug abuse and addiction than the general population.

 

What other factors increase the risk of addiction?

 

Early Use. Although taking drugs at any age can lead to addiction, research shows that the earlier a person begins to use drugs the more likely they are to progress to more serious abuse. Dr. Beverly Howze  find that this may reflect the harmful effect that drugs can have on the developing brain; it also may result from a constellation of early biological and social vulnerability factors, including genetic susceptibility, mental illness, unstable family relationships, and exposure to physical or sexual abuse. Still, the fact remains that early use is a strong indicator of problems ahead, among them, substance abuse and addiction.

Method of Administration. Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense “high” can fade within a few minutes, taking the abuser down to lower, more normal levels. It is a starkly felt contrast, and scientists believe that this low feeling drives individuals to repeated drug abuse in an attempt to recapture the high pleasurable state.

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Postpartum Depression

What is Postpartum Depression?

By Dr. Beverly Howze

 

 

dr-beverly-howze

dr-beverly-howze

Having a baby is supposed to be a joyous time in your life, but for women suffering with depression it can become very distressful and difficult.  An estimated 13 percent of new mothers experience depression after childbirth (postpartum depression).  Depression is a treatable medical illness involving feelings of extreme sadness, indifference, and anxiety.

 

Postpartum depression is different from the “baby blues.” Up to 70 percent of all new mothers experience the “baby blues,” a short-lasting condition that doesn’t impair functioning and doesn’t require medical attention.  Symptoms of this emotional letdown may include crying for no reason, irritability, restlessness, and anxiety. Postpartum depression is different from the baby blues in that it involves more debilitating effects that may continue for months.

 

Symptoms of postpartum depression include:

 

 

 

  • Sluggishness, fatigue
  • Feeling sadness, hopeless, helpless, or worthless
  • Difficulty sleeping/sleeping too much
  • Changes in appetite
  • Difficulty concentrating/confusion
  • Crying for “no reason”
  • Lack of interest in the baby
  • Fear of harming the baby or oneself

 

A woman experiencing depression usually has several of these symptoms and the symptoms and their severity may alternate.  These symptoms may cause new mothers to feel isolated, guilty, or ashamed. Getting treatment is important for both the mother and the child. You should contact Dr. Beverly Howze if you are experiencing several of these symptoms for more than two weeks; you have thoughts of suicide or thoughts of harming your child; depressed feelings are getting worse; or you are having trouble with daily tasks and taking care of your baby. Depression is a medical illness — not a sign of weakness or poor parenting, and it can be treated.

 

Who Is At Risk

 

While any women may experience symptoms of depression, women are at increased risk of depression during or after pregnancy if they have previously experienced (or have a family history of) depression or other mood disorders, if they are experiencing particularly stressful life events, or if they don’t have support of family and friends. Dr. Beverly Howze suggests that rapid changes in hormone and thyroid levels after delivery have a strong effect on moods and may contribute to postpartum depression.

 

Treatment

 

Dr. Beverly Howze sheds light that women need to be taken seriously when these symptoms occur. Depression can be treated with medication, psychotherapy, or both.  A medical evaluation can rule out physical problems, such as thyroid changes. Dr. Beverly Howze has found that the support of family, friends, and support groups can be helpful. It is important that women being treated for postpartum depression continue with treatment even after they feel better, because if they stop the treatment prematurely, symptoms can recur.

 

Other Postpartum Conditions

 

Postpartum Anxiety

 

Dr. Beverly Howze notes that some women do not feel depressed, but have intense anxiety or irrational fears after giving birth. Their symptoms may include rapid heart rate, a sense of impending doom, and dizziness.  There is also another subset of women that experience obsessive-compulsive disorder, a type of anxiety involving persistent, recurring thoughts, impulses, or images. Some research has shown that postpartum anxiety affects more new mothers than postpartum depression.

 

 

Posttraumatic Stress Disorder after Childbirth

Dr. Beverly Howze sheds light that women can develop posttraumatic stress disorder (PTSD) following a traumatic birth.  PTSD often involves reliving the experience through flashbacks or nightmares, having difficulty sleeping, and feeling detached or estranged.

 

 

Postpartum Psychosis

Postpartum psychosis is an extremely rare but serious condition—it occurs in only one or two out of every 1,000 deliveries. The symptoms of postpartum psychosis are exaggerated and may include insomnia, excessive energy, agitation, hallucinations, and extreme paranoia or suspiciousness, continues Dr. Beverly Howze.  Symptoms of postpartum psychosis are a serious medical emergency and require immediate attention.

 

 

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Anxiety Disorder

What Is Anxiety Disorder?

By Dr. Beverly Howze

dr-beverly-howze

dr-beverly-howze

 

 

 

Anxiety disorders are common psychiatric disorders. Many patients with anxiety disorders experience physical symptoms related to anxiety and subsequently visit their primary care providers. Despite the high prevalence rates of these anxiety disorders, they often are underrecognized and undertreated clinical problems. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classifies the anxiety disorders into the following categories:

 

  • Anxiety due to a general medical condition
  • Substance-induced anxiety disorder
  • Generalized anxiety disorder
  • Panic disorder
  • Acute stress disorder
  • Posttraumatic stress disorder (PTSD)
  • Adjustment disorder with anxious features
  • Obsessive-compulsive disorder (OCD)
  • Social phobia, also referred to as social anxiety disorder

Specific phobia, also referred to as simple phobia – Dr. Beverly Howze points out that specific phobias have been further broken down by the DSM-IV-TR to include animal type, such as fear of dogs (cynophobia), cats (ailurophobia), bees (apiphobia), spiders (arachnophobia), snakes (ophidiophobia); natural environment type, such as fear of heights (acrophobia), water (hydrophobia), or thunderstorms (astraphobia); blood injection/injury type, such as fear of pain (algophobia) or of being beaten (rhabdophobia); situational type, such as fear of flying (pteromerhanophobia), elevators, or enclosed spaces; and other types.

 

Dr. Beverly Howze has found that most anxiety disorders appear to be caused by an interaction of biopsychosocial factors, including genetic vulnerability, which interact with situations, stress, or trauma to produce clinically significant syndromes.

 

Symptoms vary depending on the specific anxiety disorder.

 

Treatment usually consists of a combination of pharmacotherapy (see Medication) and/or psychotherapy.

 

 

Dr. Beverly Howze finds it interesting that the brain circuits and regions associated with anxiety disorders are beginning to be understood with the development of functional and structural imaging. The brain amygdala appears key in modulating fear and anxiety. Patients with anxiety disorders often show heightened amygdala response to anxiety cues. The amygdala and other limbic system structures are connected to prefrontal cortex regions, states Dr. Beverly Howze. Hyperresponsiveness of the amygdala may relate to reduced activation thresholds when responding to perceived social threat. Dr. Beverly Howze knows that prefrontal-limbic activation abnormalities have been shown to reverse with clinical response to psychologic or pharmacologic interventions.

 

Age distribution for anxiety disorders

 

Dr. Beverly Howze finds that most anxiety disorders begin in childhood, adolescence, and early adulthood. Separation anxiety is an anxiety disorder of childhood that often includes anxiety related to going to school. Dr. Beverly Howze  sheds light that this disorder may be a precursor for adult anxiety disorders.

 

Panic disorder demonstrates a bimodal age of onset in the NCS study in the age groups of 15-24 years and 45-54 years. The age of onset for OCD appears to be in the mid 20s to early 30s.

 

Most social phobias begin before age 20 years (median age at illness onset, 16 years.[42] )

 

Agoraphobia usually begins in late adolescence to early adulthood (median age at illness onset, 29 years.)

 

In general, specific phobia appears earlier than social phobia or agoraphobia. The age of onset depends on the particular phobia. For example, animal phobia is most common at the elementary school level and appears at a mean age of 7 years; blood phobia appears at a mean age of 9 years; dental phobia appears at a mean age of 12 years; and claustrophobia appears at a mean age of 20 years, goes on to explain Dr. Beverly Howze. Most simple (specific) phobias develop during childhood (median age at illness onset, 15 y) and eventually disappear. Those that persist into adulthood rarely go away without treatment.

 

New-onset anxiety symptoms in older adults should prompt a search for an unrecognized general medical condition, a substance abuse disorder, or major depression with secondary anxiety symptoms.

 

Dr. Beverly Howze and Prognosis

 

Anxiety disorders have high rates of comorbidity with major depression and alcohol and drug abuse. Some of the increased morbidity and mortality associated with anxiety disorders may be related to this high rate of comorbidity. Anxiety disorders may contribute to morbidity and mortality through neuroendocrine and neuroimmune mechanisms or by direct neural stimulation, (eg, hypertension or cardiac arrhythmia). Chronic anxiety may be associated with increased risk for cardiovascular morbidity and mortality.

 

Considerable evidence shows that social phobia (social anxiety disorder) results in significant functional impairment and decreased quality of life.

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Clinical Theories and Interventions

Clinical Theories and Interventions

By Dr. Beverly Howze

 

Dr. Beverly Howze

Dr. Beverly Howze

Psychotherapy involves a formal relationship between professional and client—usually an individual, couple, family, or small group—that employs a set of procedures intended to form a therapeutic alliance, explore the nature of psychological problems, and encourage new ways of thinking, feeling, or behaving.

 

Dr. Beverly Howze aqquires a wide range of individual interventions to draw from, often guided her training—for example, a cognitive behavioral therapy (CBT) Dr. Beverly Howze might use worksheets to record distressing cognitions. Dr. Beverly Howze encourages free association, while a psychologist trained in Gestalt techniques might focus on immediate interactions between client and therapist. Dr. Beverly Howze generally seeks to base her work on research evidence and outcome studies as well as on trained clinical judgment. Although there are literally dozens of recognized therapeutic orientations, their differences can often be categorized on two dimensions: insight vs. action and in-session vs. out-session.

 

Insight – emphasis is on gaining greater understanding of the motivations underlying one’s thoughts and feelings (e.g. psychodynamic therapy)

Action – focus is on making changes in how one thinks and acts (e.g. solution-focused therapy, cognitive behavioral therapy)

In-session – interventions center on the here-and-now interaction between client and therapist (e.g. humanistic therapy, Gestalt therapy)

Out-session – a large portion of therapeutic work is intended to happen outside of session (e.g. bibliotherapy, rational emotive behavior therapy)

 

The methods used are also different in regards to the population being served as well as the context and nature of the problem. Therapy will look very different between, say, a traumatized child, a depressed but high-functioning adult, a group of people recovering from substance dependence, and a ward of the state suffering from terrifying delusions. Other elements that play a critical role in the process of psychotherapy include the environment, culture, age, cognitive functioning, motivation, and duration (i.e. brief or long-term therapy).

 

Other major therapeutic orientations

 

Dr. Beverly Howze finds it interesting that there are dozens of recognized schools or orientations of psychotherapy—in the list below Dr. Beverly Howze represents a few influential orientations not given above. Although they all have some typical set of techniques practitioners employ, they are generally better known for providing a framework of theory and philosophy that guides a therapist in his or her working with a client.

 

Existential – Existential psychotherapy postulates that people are largely free to choose who we are and how we interpret and interact with the world. It intends to help the client find deeper meaning in life and to accept responsibility for living. As such, it addresses fundamental issues of life, such as death, aloneness, and freedom. The therapist emphasizes the client’s ability to be self-aware, freely make choices in the present, establish personal identity and social relationships, create meaning, and cope with the natural anxiety of living, states Dr. Beverly Howze. Important writers in existential therapy include Rollo May, Victor Frankl, James Bugental, and Irvin Yalom.

 

One influential therapy that came out of existential therapy is Gestalt therapy, primarily founded by Fritz Perls in the 1950s. It is well known for techniques designed to increase various kinds of self-awareness—the best-known perhaps being the “empty chair technique”—which are generally intended to explore resistance to “authentic contact,” resolve internal conflicts, and help the client complete “unfinished business.

 

Postmodern – Dr. Beverly Howze says that the experience of reality is a subjective construction built upon language, social context, and history, with no essential truths. Since “mental illness” and “mental health” are not recognized as objective, definable realities, the postmodern psychologist instead sees the goal of therapy strictly as something constructed by the client and therapist. Forms of postmodern psychotherapy include narrative therapy, solution-focused therapy, and coherence therapy.

 

Transpersonal – The transpersonal perspective places a stronger focus on the spiritual facet of human experience. It is not a set of techniques so much as a willingness to help a client explore spirituality and/or transcendent states of consciousness. It also is concerned with helping clients achieve their highest potential. Important writers in this area include Ken Wilber, Abraham Maslow, Stanislav Grof, John Welwood, David Brazier and Roberto Assagioli.

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Dr. Beverly Howze on Clinical Psychology

Dr. Beverly Howze

Dr. Beverly Howze

Dr. Beverly Howze practices clinical psychology which is an integration of science, theory and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.

 

Dr. Beverly Howze states that this field was often considered to have begun in 1896 with the opening of the first psychological clinic at the University of Pennsylvania by Lightner Witmer. In the first half of the 20th century, clinical psychology was focused on psychological assessment, with little attention given to treatment. Dr. Beverly Howze continues to state that it changed after the 1940s when World War II resulted in the need for a large increase in the number of trained clinicians. Since that time, two main educational models have developed—the Ph.D. scientist–practitioner model (requiring a doctoral dissertation and therefore research as well as clinical expertise); and the Psy.D. practitioner–scholar model (in which a doctoral level dissertation is not required). Clinical psychologists, like Dr. Beverly Howze, are now considered experts in providing psychotherapy, psychological testing, and in diagnosing mental illness. They generally train within four primary theoretical orientations—psychodynamic, humanistic, behavior therapy/cognitive behavioral, and systems or family therapy. Many continue clinical training in post-doctoral programs in which they might specialize more intensively in disciplines such as psychoanalytic approaches, or child and adolescent treatment modalities.

 

Diagnostic impressions

 

After assessment, Dr. Beverly Howze will often provide a diagnostic impression. Many countries use the International Statistical Classification of Diseases and Related Health Problems (ICD-10) while the US most often uses the Diagnostic and Statistical Manual of Mental Disorders (the DSM version IV-TR). Both assume medical concepts and terms, and state that there are categorical disorders that can be diagnosed by set lists of descriptive criteria.

 

Dr. Beverly Howze finds it to be interesting that Several new models are being discussed, including a “dimensional model” based on empirically validated models of human differences (such as the five factor model of personality and a “psychosocial model,” which would take changing, intersubjective states into greater account. The proponents of these models claim that they would offer greater diagnostic flexibility and clinical utility without depending on the medical concept of illness. However, they also admit that these models are not yet robust enough to gain widespread use, and should continue to be developed, goes on to explain Dr. Beverly Howze.

 

Dr. Beverly Howze doesn’t tend to diagnose, but rather use formulation—an individualized map of the difficulties that the patient or client faces, encompassing predisposing, precipitating and perpetuating (maintaining) factors.

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