Alcohol and its Dangers

ALCOHOL
-Alcohol mixed with depression mixed with cold medicine can leave you suicidal. Alcohol and antahistamines have a synergistic, depressing effect, and at high levels can be lethal.
-Alcohol can be the most dangerous when people drink a lot very quickly – drinking games, can’t taste alcohol (jello shots, everclear, etc).
-Drinking on an empty stomach particularly risky.
-If person becomes unconscious, is impossible to arouse, or seems to have trouble breathing, call immediately.
-Don’t drink alone and if you find your friend wandering off alone, follow her. Do not let anyone go “pass out” alone. Make sure someone checks on them to make sure their okay.
-When drunk people pass out, their bodies continue to absorb the alcohol they just drank. The amount of alcohol in their blood can then reach dangerous levels and they can die in their sleep. Keep checking on someone who has gone to sleep drunk.
-Drugs can be deadly when combined because they increase the other’s effects.
-The rapid absorption of high concentrations of alcohol can suppress centers of the brain that control breathing and cause a person to pass out or even die. Absorption is increased when on an empty stomach.
-If the drinker consumes more than the amount than the liver can handle, then the additional alcohol simply accumulates in the blood and body tissues and waits its turn for metabolism.

-Continued drinking increases the enzymes that metabolize alcohol and these enzymes can either lessen the effects of critical medication for diabetes or blood thinning or can increase the breakdown of Tylenol and can be toxic to the body.

-40% of college students report blackouts – alcohol affects the NMDA receptors and block formation of new memories.

-Alcohol affects the frontal lobe (in charge of executive functioning, making decisions) and the hippocampus. If start in adolescents, can actually prevent these structures from forming fully.

-In general, the areas that are affected are memory formation, abstract thinking, problem solving, attention and concentration, perception of emotion.

Dangerous combinations with other drugs:
-It is dangerous to combine alcohol with anything else that makes you sleep.
-This includes other sedative drugs such as opiates (heroin, morphine, or Demerol).
-Barbiturates or Quaaludes – unconsciousness or event death. The effects of alcohol may be totally unexpected in the presence of other sedative drugs. (downers, blue heavens, blue velvets, blue devils, nembies, yellow jackets, Mexican yellows, purple hearts, goof balls, reds, red devils, pink ladies)

-Valium-like drugs cause severe drowsiness in the presence of alcohol, increasing the risk of household and automobile accidents.

-Antibiotics – nausea, vomiting, convulsions

-Antidepressants – alcohol increases the sedative effects of tricyclic antideprssants and impairs both mental and physical skills. Ask doctor how it interacts with alcohol.
-Sleep medications like Ambien
-Antihistamines found in cold medicines – excessive dizziness and sedation, particularly dangerous.
-Antipsychotics – thorazine – impaired coordination and fatal suppression of breathing.
-Pain relievers – morphine, codeine, etc. – magnifies the sedative affects of both increasing the risk of death from overdose. Even a single drink can increase the effects.
-Energy drinks – enhances pleasant buzz of alcohol but does not diminish the depressant effects. If a person feels as if she is alert and unimpaired, she might feel that drinking more alcohol is safe when in fact it may not be.

Special considerations for Women:
•The percentage of women who drink alcohol has increased from 45 to 66 percent over the past forty years, and that as many as 5 percent of women are heavy drinkers.
•There is a chemical called alcohol dehydrogenase (ADH) that breaks down some of the alcohol in the stomach before it gets absorbed into the blood. Women appear to have less of this in their stomachs so compared to men, more of the alcohol they drink gets absorbed into the blood. In fact, after a given dose of alcohol, a woman may achieve a blood alcohol level 25 to 30 percent higher than a man.
•Birth control pills slow down the rate at which alcohol is eliminated from the body. Can feel the sedating effects of alcohol for a longer period of time than a woman who is not.
•Women are at a greater risk for liver damage than men.
•The pancreas are more likely to be damaged in women.
•Alcohol increases risk of breast cancer.
•Women seem more likely to show deficits in cognitive function.

Anxiety Management in Children and Adolescents

What do you do when your child is suffering from anxiety related to sports, school, friends, etc? Is it healthy for your child to feel a little bit of anxiety -- is it sort of like exposing them to some germs so they can build up an immunity? No one wants to see their child suffer or struggle or feel pain or sadness or nervousness or hurt, but if we take away the source of these so-called "negative" emotions are we really just setting up our kids for a world of hurt?

As hard as it is, it may be necessary to let your child feel these negative emotions related to school, sports, friends, etc. -- it's life. It will help them build up a defense to it, it will expose them to it and thereby prepare them for the future when they are on their own without their parents to protect them. How much is too much? How do you decide when your child is feeling anxious because it is a natural part of their response and when it is extreme and needs to be managed?

When in doubt, seek help. Find a therapist, a psychologist, a doctor and consult. Don't assume that all negative emotion is bad for your child. Help them learn to cope with the bad stuff -- teach them the skills to manage them, not avoid them.

For further information or help with your child's anxiety, contact Dr. Brenna Tindall at www.drbrennatindall.com

Stages of Grief

Recently, in Fort Collins, a 14 year old high school girl was struck by an SUV on her bike and was killed. There really is no good way to deal with death, especially of a child. Many people know about the 7 stages of grief but does this really help us sort through the mess of emotions we feel when someone close to us dies. Here are the 7 stages:

1. SHOCK & DENIAL-You will probably react to learning of the loss with numbed disbelief. You may deny the reality of the loss at some level, in order to avoid the pain. Shock provides emotional protection from being overwhelmed all at once. This may last for weeks.

2. PAIN & GUILT-As the shock wears off, it is replaced with the suffering of unbelievable pain. Although excruciating and almost unbearable, it is important that you experience the pain fully, and not hide it, avoid it or escape from it with alcohol or drugs.
You may have guilty feelings or remorse over things you did or didn't do with your loved one. Life feels chaotic and scary during this phase.

3. ANGER & BARGAINING-Frustration gives way to anger, and you may lash out and lay unwarranted blame for the death on someone else. Please try to control this, as permanent damage to your relationships may result. This is a time for the release of bottled up emotion.
You may rail against fate, questioning "Why me?" You may also try to bargain in vain with the powers that be for a way out of your despair

4. "DEPRESSION", REFLECTION, LONELINESS-Just when your friends may think you should be getting on with your life, a long period of sad reflection will likely overtake you. This is a normal stage of grief, so do not be "talked out of it" by well-meaning outsiders. Encouragement from others is not helpful to you during this stage of grieving.
During this time, you finally realize the true magnitude of your loss, and it depresses you. You may isolate yourself on purpose, reflect on things you did with your lost one, and focus on memories of the past. You may sense feelings of emptiness or despair.

5. THE UPWARD TURN-As you start to adjust to life without your dear one, your life becomes a little calmer and more organized. Your physical symptoms lessen, and your "depression" begins to lift slightly.

6. RECONSTRUCTION & WORKING THROUGH-As you become more functional, your mind starts working again, and you will find yourself seeking realistic solutions to problems posed by life without your loved one. You will start to work on practical and financial problems and reconstructing yourself and your life without him or her.

7. ACCEPTANCE & HOPE-During this, the last of the seven stages in this grief model, you learn to accept and deal with the reality of your situation. Acceptance does not necessarily mean instant happiness. Given the pain and turmoil you have experienced, you can never return to the carefree, untroubled YOU that existed before this tragedy. But you will find a way forward.

Does it help being able to identify where you are in the process? Maybe, maybe not. Perhaps it helps to know that the way you are feeling is supposedly universal and others are experiencing the same intensity of emotion. The bottom line is that we do not know how to cope with death in our society. It is something that we don't talk about, don't prepare for. As humans, we can prepare for a lot of things -- but death is something we know nothing about. We have no idea what it feels like, what happens to us after.....so, is death such a horrible thing simply because of the unknown. If we knew our loved one was, in fact, in a happier place or that their death was painless and beautiful -- would it make our grief any easier?

The bottom line, no matter what, is that grief is never handled the same way by anyway and if you see someone struggling suggest they see a psychologist, a counselor, a therapist -- someone. Even if they don't want to talk about it, it is critical that they have someone who will make them communicate their internal world so it does not eat away at their soul.

My heart goes out to the family of the beautiful girl who was killed this week in Fort Collins and to any other parents who have lost their child. I can't imagine the pain that comes along with it.

Internet Safety 101

New groups offered at Arete Psychological Services with therapist on how to protect yourself against predators and bullies on the internet. Learn to navigate social networking without putting yourself at risk. Contact brenna@drbrennatindall.com to join a group for parents, young adults, or teenagers.

Group led by Dr. Brenna Tindall therapist specializing in family issues.

Relationship-- Couples Therapy- Easy Exercise to Get on the Same Page

Steven Hayes and Kelly Wilson discuss the importance of people completing values clarification exercises in their search for growth and health in their book Acceptance and Commitment Therapy. This process is about figuring out what your individual values are (family, education, work, physical exericse, etc.) and then clarify those values to a finite level so you can really figure out what each value really means to you. For example, if you say that family, in general, is a value to you it gives you no information about whether you are living a life consistent with "family" values or not. Instead, clarify the value "family" and really figure out what it is about. So, for one person they may clarify family in the following way:
FAMILY
- having children (yes, but how many children?)
- having two children
- marriage (yes, but what kind of marriage? Common law? Same sex?)
- having a marriage to someone of the opposite sex
- having dinners together at night (yes, but how many times during the week will you have dinner together?)
-having dinner together four nights per week and one time on the weekend

As you can see, the process of clarification takes some time and most people just say getting married is a value, but have no idea what that actually means when you break it down. Why this is important is that once you clarify the value, you can determine whether your daily actions are in lign with those values. In other words, are you doing/acting/behaving in a way that is consistent with your values. If you said Family, for example, is your number one value and yet you are not married, don't have children, aren't having dinner together every night and instead refuse to get into relationships for fear of getting burned ---then, you have an inconsistency between what you say is important and what you are doing. If you had let Family be a general term without clarification -- you may have been able to answer the question differently. If you had just said Family is my value and think to yourself that you spend time on the phone each week with your sister so you are living consistenly with your values ---then, we have a problem. So, first step. Determine 10 values that are important to you in the grand scheme of things. Remember, GOALS are something with a definitive ending, that you can actually reach, accomplish. VALUES, on the other hand, are something that you move towards and try to work at.....it is a lifelong direction and sometimes you will be moving towards your values and sometimes away. But, it's easier to move towards them if you know what they are -- so clarify, clarify, clarify. Some of the ten values that are normally clarified are:
citizenzhip
intimate relationships
parenting
family
physical exercise
social
etc.

I use this exercise with couples in a little different way.

One way to determine if you're relationship is healthy or that you are on the same page with your partner is to do a Couples Relationship Values Clarification. Use the following value domains:

Finances, childrearing, sexual intimacy, nonsexual intimacy, romance,
communication, extended families, religion/spirituality, recreation, conflict, career, chores/duties, gender roles, holidays/present giving.

Each partner should take each value and break it down. What does finances mean to them? Is this saving every penny until retirement? Is it to take one vacacation per year under a $1000 dollars? The value clarification needs to be specific, as in what things are important to each of you in each of those areas? Where do you stand with them, how do you feel about each?

It is always surprising how differently each partner defines/clarifies each value. The most interesting, surprising one is always the sexual intimacy category and most partners have no idea what is important to the other person. Try this with your partner. After you've each clarified each value domain, rank order them in terms of importance. Then take each domain and ask yourself, "on a scale of 1-10 with one being least and ten beng most, how closely am I living up to these values and working towards them?" So, each value domain will have a rank order of importance AND each domain will have a number of how closely you are living your life in alignment with it. If you see an inconsistency between the two numbers, then set short term goals to increase the consistency. Also, you can rank order you partner's value domains in order of how important you think they make them.....and then have them do yours. They rarely match up!

Enjoy!

Changing patterns of dysfunctional behavior

It appears to be human nature to engage in dysfunctional patterns of behavior. What are these dysfunctional behaviors? Anything that is a not-so-great response to certain triggers we all have. For example, typical triggers people experience are stress, boredom, loneliness, isolation, anger, etc. If we don't recognize these triggers and find functional, healthy ways of dealing with them then they lead us to engage in maladaptive, dysfunctional behaviors like starving ourselves, bingeing, over-exercising, road rage, addictive behaviors related to substances, sex, and so on. One important factor in this is that we first identify what are high risk factor situations which may or may not trigger us. So, for some people high risk factors may be their mother-in-law visiting. Granted, a mother-in-law could also be a trigger! So, if you know one of your high risk factors is your mother-in-law visiting and tha a trigger associated with this is anger, then you can figure out a way to escape the dysfunctional cycle of behavior that these two things will create. One example of a dysfuncitonal cycle of behavior in this instance would be taking an extra Valium, perhaps, so that you don't yell at your husband or mother-in-law. Another might be just going on a tirade and storming through the house throwing things. More probably, would be passive-aggressive behavior such as giving your husband the silent treatment or refusing to talk at dinner or only answer your mother-in-law's questions with one word answers stopping the conversation. This is a more minor example, but who out there hasn't engaged in this type of behavior?

More complicated, however, are instances where we fall into a dysfunctional cycle of behavior without realizing it or knowing how to stop it. This happens especially with addiction -- both addiction to substances or addictions to compulsive behaviors like bingeing, starving yourself, or viewing pornography. Most often people with report that they "can't control themselves" and that "before I knew it I was drinking a bottle of wine and couldn't stop myself." This means your mind and body are on autopilot and has simply being reinforced one too many times that these responses make you feel better for a little bit. Take the example of drinking as a dysfunctional response to rejection, for example. In some cases, a high risk factor for young women could be social settings or a fraternity party or going to a club. A trigger in this instance is seeing another hot girl getting hit on instead of you or being ignored by all the guys. Without even thinking about it, young women will start throwing back shots of alcohol and making themselves so drunk that they don't have to think about the rejection, the low self-esteem, their poor self-image. For a short time, the alcohol acts as a social lubricant and makes them feel better. If you do this often enough, soon you're drinking whenever you feel badly and now you're dysfunctional behavior is controlling your life. I encourage people to follow a standard breakdown discussed both by Steven Hayes and Kelly Wilson in their book, Acceptance and Commitment Therapy, as well as by the DUI curriculum in Colorado created by Dr. Dave Timken. They call it different things but added together, they work.

1. Identify the EVENT -- what are the circumstances? (example: fired from job)

2. What THOUGHTS are you having with regard to this, what shows up in your mind automatically? (examples: "I'm such a loser." "Nobody wants me." "I'm never going to be able to pay my bills." "The person who fired me is a b...")

3. What FEELINGS/EMOTIONS are you experiencing? (examples: anger, self-pity, frustration, fear)

4. Now what are the MALADAPTIVE ACTIONS you can take in this situation and what are the ADAPTIVE actions you can take? Maladaptive take you further away from how you want to live your life, further away from making a positive, proactive, healthy choice. Adaptive actions are healthy choices which get you closer to your ultimate goal in life, good decision making.

Examples of maladaptive actions in this situation might be to punch your boss, to scream and yell at your boss, to go home and take it out on your partner, to go the bar and get drunk, etc.

Examples of adaptive actions might be: ask for a reference letter so you can get a new job, go to a yoga class, go home and talk to your partner about how badly you're feeling, cry, call a friend and discuss it, re-vamp your resume, etc.

Thoughts and feelings are automatic, uncontrollable things that show up whenever we experience an event. They just are what they are and we can't really control them or make them go away. Feelings, in particular, even "bad" ones are important to our progression, evolution, well-being, actualization. Feelings are messengers which tell us how to respond and what we need to be doing in a situation. Pay attention to your feelings even if they are not great ones. But, the area we really need to focus on are the ACTION areas -- because what we CHOOSE TO ACTUALLY DO is what is important. We, as humans, can think one thing, feel another, and still choose to do something completely different. We can think that we want to punch our boss, we can feel that we are fat but what matters is that we stop long enough to choose adaptive actions rather than maladaptive ones.

Infertility Resource- Non-profit --Hiring for Hope

I'd like to direct people to an up-and-coming non-profit organization founded by Tegan Acree. this organization is called Hiring for Hope and its mission is to provide hope, resources, funding, support, answers, etc. to the thousands of women facing infertility. Contact Tegan at the following email address for information: tacree@hiringforhope.org

You can also follow this amazing organization on twitter -- search for Hiring for Hope!