The Holiday Season can be a wonderful time of thanksgiving, giving and sharing, enjoying food and festivities with family and friends. It can also be a very difficult time for someone coping with their addictions, and trying to maintain their recovery, especially with ever-present alcohol at parties and dinners, and the stress that family get-togethers can sometimes elicit, as well as issues with seasonal depression. Dr Inaba shares his thoughts.

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Transcript:

CNS: Hi and welcome once again to the CNS addiction pod cast, I’m Howard LaMere here with Dr. Darryl Inaba. Darryl it’s the end of November and the holidays are upon us — this can be a wonderful time, a joyous time, getting together with family and friends. It can also present a lot of issues, especially those of us that have friends and family members involved in one way or another in substance abuse and addiction.

Darryl: Now I’ve always seen in my career I’ve been working in this field, that the holiday times, especially in the intense holiday times coming up in late November through the first of the year are real challenging, real difficult for not only people with substance abuse but also people with mental health issues as well. I’m not sure if there’s any real definitive statistics in studies that’s been done but it seems like we’ve had a lot more threatened suicides. We had a lot of people who were down-trod, who were very upset about what was going on in their lives and enough so to make suicide gestures and threaten suicide. Another time of year that’s difficult, believe it or not, is spring time. In spring time we actually have I think more suicides and less threatened suicide. So these are you know, like I said, spring time is the time of renewal, time of change, and if you’re going to change maybe that’s the time they do it. During the holiday season, people who aren’t in trouble with drugs or don’t have mental health issues they’re exuberant, they’re, they’re expressing joy and cheer and how everything’s wonderful and everything’s great and they just…

CNS: That can present a real contradiction there for someone…

Darryl: It, it really exaggerates to people struggling with their addiction or with depressions and mental health, how difficult their lives are and the contrasts and contradictions as such that it becomes overwhelming to many people. There are a number of people who are both depressed and have major drug problems to co-occurring disorder problems and especially in those individuals the holiday season can be a real challenging, difficult time of year. They’re going to see relatives, they’re going to be with friends, they’re struggling still with stigma of addiction. It’s a very difficult thing for them to take that first step where they can accept they have a biological problem. A problem with their brain that prevents them from controlling their use of drugs and alcohol, and for that reason they succumb to the stigma that continues to permeate our society that maybe they’re weak, or they’re bad or they’re stupid, they’re crazy, they’re amoral, they’re criminal, and this time of year if they’re struggling in their addiction and going through relapses, or even if they’re not going through relapses, just having “stinking thinking” about wanting to use again. All the good cheer and the happy times of the holidays, really conspires to reinforce how desperate they are and how difficult in with the difficult situations they are and so they develop what I call “the holiday blues” actually get very, very depressed this time of year and don’t know what to do. They don’t know if they should spend time with their relatives or friends. I often think there’s not enough fun in sobriety, we certainly have a lot of twelve-step groups and different activities where they’re clean and sober activities during holiday times to cheer people up and keep them from feeling too bad. But I don’t think there’s enough of that, I think there really needs to be much more alternative activities that addicts and alcoholics can participate in that are totally drug free and have no semblance of promoting the drug culture that’s more highly active during the holiday times, than it is the rest of the year. So that other problem is that, during this time of year with the families getting together, the parties at work, and the parties that all the normies are having, as you know the featured thing at the parties is always going to be alcohol and then for the more, food, and alcohol and you’ve got the pot and you’ve got all kinds of things going on so, the triggers, and the things that can cause a relapse and a slip in an addict are just huge this time of year and with that, the addict and people with depression run that risk of being involved with activities where everyone is happy and carousing but doing so under the influence that only triggers their craving and their “stinking thinking” and that might raise up in a slip which ultimately results in a relapse. So it’s a real tight rope that addicts have to walk this time of year and it is difficult for all of them.

CNS: So what then can the recovering person do to, to secure himself? That’s one question and the other question is, for the family members or their friends, what can they do to secure their selves and, and not create this awkward situation for the person in recovery?

Darryl: The first part of that question is, what can an addict do, right now the addict has to be more in touch with their addiction. They have to be more willing to participate in group activities and treatment and things like that where they can express and they can testify that they’re going through this depression, they’re going through the craving, they’re feeling sorry for themselves about all the differences and things they have caused through their addictions throughout the past year, resentments, they have to be able to process all that and the sad part about that is that most treatment programs, even the ones that I directed at the Haight Ashbury, you get so much pressure from your staff to close down and not have services and not have anything, especially on the eves like Christmas eve and New Years eve or nothing on Thanksgiving day and unfortunately those are the times when people need it the most and it’s just a wrestling job to try and keep services open and live and therefore you know recognize that staff have a need, they have a valid need to be able to take time off. But some how balancing that with the need to keep all services open so that addicts can address their issues and make use of what is available to help them refrain from going into a real funk about the holidays. Now what can their friends do, what can their families do, what can their significant others do? The big thing is, the awareness, that the more the community has to become aware that this is a difficult time for addicts. That addicts are not like them, that they get triggered and they go into craving from, sort of glorifying drug use and the things that are done at the parties and things like that and maybe make that sacrifice and I think that it’s imperative for the family of somebody who’s trying to remain in recovery, to make the sacrifice to not have any booze, not have any of those things at the party and to celebrate these activities in deference to that a family member has a serious life-endangering illness that they want to protect them with, because they’re normies so they don’t need to drink. If they do that I think they’ll be more helpful to the addict than they realize.

CNS: Now in that article that I handed you earlier from I think it was the Huffington Post, it talked about for the family members who may be have been abused by the addict emotionally, how they can, or might think about going about setting up boundaries and conditions for the family event. Now I’m wondering, I mean that’s a valid thing to do, but I’m wondering if that is going to trigger even more resentment in the person that’s grabbling with recovery issues?

Darryl: Well the family issues are huge and, and they haven’t…

CNS: The family of course, in and of itself, not withstanding drugs and alcohol, I mean there, there can be pressures there, you know… especially at the holiday times.

Darryl: Yeah, you don’t need to be in recovery to have family problems get to you, with your family and getting through old resentments and angers and all that stuff that happens with family. But, but family issues are just huge in dealing with addiction and the recovering addict and alcoholic and they aren’t addressed enough in programs. There’s not enough focus on a family components in the program where the family members learn about the disease, learn about the condition and disorder and learn what their family member is going through and then learn how to communicate differently, how to act differently, how to be different as a person enters into recovery. You’re going to have a changed person. He or she’s going to be totally changed and, in order to be healthy the family has to change. The addiction certainly results in some power other family members have, that this is how to identify the problem, he or she is always the root of all the evils that are happening to the family and that’s going to change and when that changes, it changes the dynamics of the family and how they interact together. There’s going to have to be a change on the addict themselves, to accept and recognize that often times the family members are furious at them. They’ve been run through the ringer with all the machinations that addiction occurs and trying to help this individual and then getting sabotaged and the person not following through and how he or she might have defamed the family or, or manipulated and you know really took advantage of people they loved the most, and so there’s going to be a huge bunch of that resentments and the fear and a valid one, that this is merely a respite, another manipulation and the persons going to show up for Thanksgiving and again steal something or do something drastic. So the family members have to work in a system with other recovering families like systems like AL-Anon, strong family programs and treatment to address all these issues and to set up boundaries and set up ways of interacting and re-interacting in new ways of interacting with each other and if it’s done correctly within the context of a treatment system, then I don’t believe it will be a trigger, an extra trigger for the addict. What it will be is an understanding that all of community being their immediate family, maybe even their friends or fellow employees, but there’s a community systems approach to helping them maintain recovery and changing their lives around. So if it’s done in that context, I think its great, if it’s done purely from an individual unilateral context that a mother, a parent or something is saying, well they’re not going to put up with this anymore and the person shows up and these are the rules without any kind of negotiation or explanation or any kind of, of process to develop it, then you’re right, and then it can become another trigger for that addict to say well you know, I’m never going to be any thing more in the eyes of my family I might as well use and get it over with.

CNS: Sounds like, sounds like we need psychologists at every dining room table everywhere but I don’t think that there’s enough to go around. But I think it is, it points out that the perception of addiction is changing albeit gradually and that’s a good thing that, that we’re beginning to be able to understand that this is more of a disease than a social weakness or a moral weakness.

Darryl: The wonderful thing is that when an addict really embraces recovery, embraces that they have a disorder, that they’re not really responsible for, but their treatment of it is totally their responsibility, and if they enter into that system and work the best that they can be at being healthy, the wonderful thing about this is not only does their health improve and their lives improve but usually the families’ lives improve, the significant others lives improve, the community, their neighbors, it affects everybody around them. As an addict, during their practice of their addiction affects everybody around them in a negative way and addict in recovery affects everybody around them in a real positive way, and everybody gets healthy. So that’s the wonderful thing about the treatment of addiction.

CNS: Well I’m sure more stories will evolve here in the next few weeks and I think we’ll get a chance to hear some of them. As ever any folks listening are more than welcome to drop us a comment or a question and if it is a question and we’ll try to address it in a future program, just stop by our website cnsproductions.com. Darryl thanks, happy holidays.