The APA has proposed revisions to several diagnoses listed in the DSM, including substance use and addictive disorders, personality disorders, depressive disorders, and anxiety disorders. The revisions were based on updated research findings, field testing of the criteria, and the last round of public comments in 2011.

The public will have until June 15 to provide feedback to the DSM-5 Task Force and Work Groups.

You can click here to read the key changes to note during this round of public comment.

Contributed by Nikki Seay.

The original idea of codependency was used to describe the responses and behaviors that people develop when living with an alcoholic or an addict. Over the years, however, the meaning of codependency has expanded into a broad definition that describes a dysfunctional pattern of living and problem solving that keeps someone from having healthy relationships.

Whether you are struggling with an addiction to drugs and alcohol or issues of codependency on their own, you should be aware of the signs of codependency to determine if you need to enter a codependency treatment program.

Codependent Traits

Many different behaviors and signs can determine if you are codependent. One main behavior trait of codependents is low self-esteem. Codependent people seek any outside influence or relationship that can make them feel better about themselves.

The self-esteem of a codependent is developed around what other people need instead of being developed on its own. Most children who are codependent feel responsible for other family members or their behaviors. For example, if a family member were depressed, the codependent child believes his job is to fix the problems that are causing the depression.

As an adult, people end up relying on the codependent for help in moments of crisis. When codependents try to provide for everyone else and ignore their own needs, they are creating an unfulfilling relationship.

Codependent people are often caretakers for their partners in relationships. They feel an overwhelming need to be with them no matter what the situation may be. The other person may often blame the codependent for any problems in the relationship, while the codependent works very hard to make excuses or cover up problems that their partner has.

An example of this would be a woman who is married to an abusive man, but makes excuses to stay in the relationship with him. The woman will say that his abuse is not that bad, or she may even say it is not his fault for abusing her.

Codependents also have an addictive nature and most will abuse alcohol or drugs to cope with their esteem problems. With so many people suffering from addiction and codependency, it is not uncommon to find a dual diagnosis treatment facility is needed. Other compulsive behaviors associated with codependency are gambling, sexual relationships, and stealing.

How Do I Know if I am Codependent?

There are certain traits that point to someone being codependent. Asking yourself the following questions can help you to determine if you are suffering from codependency:

• Do you focus your thoughts on other people instead of yourself?
• Will you go to great lengths to gain the approval of other people?
• Do you have strong feelings of helplessness or need?
• Did you experience some kind of abuse or neglect as a child?

Codependency Treatment Programs

If you believe you are codependent, there are many different codependency treatment programs available to help you.

The first step to try at home would be self-help books. You can find a large number of books that focus on codependency.

When you need more help than a book, outpatient treatment may be a great option. Outpatient codependency treatment can provide you therapy needed to address and recover from your co-dependency issues, scheduled around your existing obligations.

When help that is more intensive is needed, you can choose to enter a residential codependency treatment program. Residential treatment lasts at least 30 days and lets you take the time to focus on yourself while correcting the emotional dysfunction at the root of this disorder.

If you are struggling with both codependency and a drug or alcohol addiction, a dual diagnosis treatment facility can help you to address each disorder to make a complete recovery from both.

Dr. Sobel, a psychologist and Venice surfer, responded to news of the devastating earthquake by making several trips to Haiti to work with trauma survivors. As she got to know the stories of Joselyne and Josianne, orphaned in the aftermath of the earthquake and terrified each night as they heard sounds of gender violence just outside their tent, she knew that she could not just return to Los Angeles without taking further action.

Creating the Global Adolescent Project

Instead, she helped create the Global Adolescent Project (GAP), a nonprofit organization whose mission is to educate, encourage, and empower disenfranchised youth globally.

Dr. Sobel found that there was a dire lack of services available to adolescents, who were literally lost in the gap between help for small children and organizations for adults. Many of these youth were left to fend for themselves, or expected to care and provide for their younger siblings with no adult support.

Two years later, the Global Adolescent Project has grown, and there are more than two dozen youth being assisted with tuition, shelter, mental health support, and small business training. Dr. Sobel says that she has several hundred more applicants in Haiti, and has received inquiries for help from several locations around the globe.

Stories of Courage: A Benefit for Haiti Teens

The Stories of Courage fundraiser on Saturday, May 12, will help provide even more support to more teens. The benefit will honor the stories of teens who were orphaned by the earthquake in Haiti, and their challenges and triumphs.

The fundraiser will be hosted by Danny Nucci, who has been featured in Titanic, Eraser, and The Rock. Also performing will be the Hawaiian band Local Blend and comedienne Zara Mizrahi. Caribbean food will be served, and a silent auction will be held featuring Haitian art, as well as locally donated items.

The Stories of Courage fundraiser is being hosted by Michael Roy, LCSW, founder and executive director of Clearview Treatment Programs, and will be held at Clearview Center in Venice Beach from 5:00 p.m. to 8 p.m.

Tickets may be purchased for $100.00 online at couragefundraiser.eventbrite.com.

If you cannot attend, but wish to send a tax-deductible contribution, visit www.globaladolescentproject.org and become a monthly donor. You can also send a check payable to Global Adolescent Project, 11340 W. Olympic Blvd., Suite 155, Los Angeles, CA, 90064.

Mother’s Day weekend is a great time to support these inspiring young people, who have lost their own mothers and are trying to create new lives for themselves.

For more information about Global Adolescent Project and the Stories of Courage fundraiser, contact Dr. Nancy Sobel at drnancy@globalteens.org or 310-503-6439.

The study also found that 16 percent of teens abuse drugs by the age of 18. With these statistics, it is believed that most alcohol and drug abuse begins at a very early age.

“It’s in adolescence that the onset of substance abuse disorders occurs for most individuals. That’s where the roots take place,” said lead study author Joel Swendsen, director of research at the National Center of Scientific Research in Bordeaux, France.

One of the reasons this information is so concerning is because teens are still mentally developing. Their brains have not yet reached maturity, so drugs have the potential to do permanent brain damage when abused.

Susan Foster is the vice president and director of policy research and analysis at the National Center on Addiction and Substance Abuse at Columbia University in New York. Although Foster did not participate in the study, she did find the data to be extremely troublesome.

“The reason we worry about it is that the earlier they use these substances the earlier they become addicted to it,” she said.

Teen Substance Abuse Statistics

The study interviewed 10,123 United States teens between the ages of 13 and 18 years old. Of the approximately 3,700 teens between the ages of 13 and 14, around 10 percent drank alcohol regularly. The number of those who drank regularly jumped to about half in the approximately 2,300 17- to 18-year-olds interviewed. According to the study, the median age for alcohol use (with or without abuse) was 14 years old.

For drug abuse, about 60 percent of teens said they’ve had an opportunity to use drugs, such as marijuana, cocaine, sedatives, stimulants, and pain medication. One in 10 13- to 14-year-olds admitted they used at least one of the drugs listed, and that number increased to about 40 percent in the oldest age group. Marijuana was found to be the most common drug used, with number two being prescription drugs.

The researchers found differences between the kind of youngsters who transitioned from social alcohol use to regular use. Boys were found more likely to transition between the usage groups, while African-Americans and other non-white groups were the least likely to do so.

“These findings may contradict common assumptions but are consistent with previous investigations in adult and adolescent samples,” noted the researchers.

Foster’s organization published a detailed report on the substance abuse of adolescents last year and found these numbers consistent with past research.

“Like any other disease, it’s very complex,” Foster said. “There are a lot of … factors that come together.”

Foster hopes the new study is helpful for parents, healthcare practitioners, and addiction treatment professionals alike. “I think a lot of people don’t understand yet the nature of the problem,” Foster said.

Here is a look at some of the many medications used to treat Bipolar Disorder:

Lithium

Lithium is used to stabilize your mood and prevent the highs and lows experienced with Bipolar Disorder. Lithium has been used for many years to treat Bipolar Disorder. If you are prescribed lithium, your doctor will perform periodic blood tests to monitor your thyroid and kidney. Some of the common side effects of lithium are restlessness, dry mouth, and GI upset.

Anticonvulsants

Anticonvulsants are a type of mood-stabilizing medication used in Bipolar Disorder treatment. Examples of anticonvulsants include valproic acid (Depakene or Stavzor), divalproex (Depakote), and lamotrigine (Lamictal). Doctors also find that the anticonvulsant asenapine (Saphris) can be helpful when treating mixed episodes. Common side effects of anticonvulsants are weight gain, dizziness, and sleepiness. It is rare, but certain anticonvulsants can cause skin rashes, blood disorders, or liver dysfunction.

Antipsychotics

Antipsychotic medications may offer help to people who don’t respond to an anticonvulsant. Examples of antipsychotics include aripiprazole (Abilify), olanzapine (Zyprexa), risperidone (Risperdal), and quetiapine (Seroquel). Only one antipsychotic medication is approved by the Food and Drug Administration (FDA) to treat Bipolar Disorder: quetiapine. Naturally, side effects depend on the specific medication, but can include weight gain, sleepiness, tremors, blurred vision, and rapid heartbeat. Antipsychotic medication use also has the potential to affect memory and attention, and cause involuntary movements.

Antidepressants

Depending on your unique Bipolar Disorder symptoms, your doctor may prescribe you an antidepressant. In some people, antidepressants can trigger manic episodes. This could be cancelled out if taken together with a mood stabilizer medication. Older antidepressants, like tricyclics and MAO inhibitors, may cause some potentially dangerous side effects when taken and require careful monitoring.

Symbyax

Symbyax is a combination Bipolar Disorder medication that uses the antidepressant fluoxetine and the antipsychotic olanzapine. Symbyax works as a depression treatment and a mood stabilizer in one pill. Symbyax is an FDA-approved medication that specifically treats Bipolar Disorder. The side effects include weight gain, drowsiness, and increased appetite.

Benzodiazepines

Benzodiazepines can help to improve anxiety and sleep. Examples of benzodiazepines include clonazepam (Klonopin), lorazepam (Ativan), diazepam (Valium), chlordiazepoxide (Librium), and alprazolam (Xanax). Benzodiazepines are generally used to alleviate anxiety for a short time. Common side effects include drowsiness, loss of muscle coordination, and problems with memory.

Bipolar Disorder Treatment

While receiving Bipolar Disorder treatment, you must remember to be patient when taking new medications for Bipolar Disorder. It may take some time to figure out which drug combinations best manage your Bipolar Disorder symptoms.

It is also very important for you to communicate openly and honestly with your Bipolar Disorder treatment team about any adverse side effects. Once you find the right medication and dose strength, along with any needed therapy, your Bipolar Disorder symptoms will improve.

Although this idea seems extremely odd, there are already documented cases of teens suffering from alcohol poisoning after drinking hand sanitizer. In two San Fernando Valley, Calif., emergency rooms, doctors have treated six teenagers suffering from the effects of drinking hand sanitizer.

Public health officials are now concerned that these first few cases may only be the beginning of problems to come. Medical experts warn parents to watch for the danger signs of getting drunk on hand sanitizer.

“All it takes is just a few swallows and you have a drunk teenager,” Cyrus Rangan, director of the toxicology bureau for the Los Angeles County public health department, told The Los Angeles Times. “There is no question that it is dangerous.”

Dangers of Hand Sanitizer

Hand sanitizer is 62 percent ethyl alcohol, and it makes a 120-proof liquid that is more potent than tequila or vodka. Some teens are using salt to separate, or distill, the alcohol from other ingredients in hand sanitizer.

Bottles of hand sanitizer are not expensive and are extremely accessible. Teenagers can easily find the systematic directions for distillation by doing a search on the Internet.

Once distilled, the sanitizer becomes a potent liquid similar to hard liquor. Just a few drinks can cause slurred speech and a burning sensation in the stomach. The liquid can make teens so intoxicated that they require around the clock monitoring in an emergency room.

“It is kind of scary that they go to that extent to get a shot of essentially hard liquor,” Rangan said.

Dr. Robert Glatter, an ER physician practicing at Lenox Hill Hospital in New York City, told CBS News he has taken care of several teens who drank hand sanitizer while at school. These teenagers presented to the ER with symptoms of alcohol intoxication, dizziness, nausea, and vomiting. Many of those teens stated they drank the sanitizer only as a “dare” by other classmates.

“They denied drinking any ‘alcohol,’ had no smell of alcohol on their breath, but when their blood alcohol was quite elevated, they later admitted to drinking the hand sanitizer,” Glatter said.

Glatter believes that it is essential to place warning labels on these hand sanitizers and to educate parents of the potential risks.

These new cases surprised doctors, as there were no such cases reported last year. The incidents have also raised new concerns for the lack of parental education linked to the problem.

“Officials in institutions where these products are available — including hospitals, schools, offices, health clubs, and day care centers — have a duty to inform people about the alcohol content in these products, and subsequent dangers if ingested,” said Glatter.

What You Can Do

In order to combat the problem, if parents purchase hand sanitizer, they should always purchase the foam hand sanitizer rather than the gel form. Foam sanitizer is much harder to distill and teens might be less likely to drink it.

In addition, parents should not leave sanitizer lying around the house and should monitor it like any other alcohol or medication.

Alcohol and drug addiction treatment centers may be required for teens who abuse alcohol in this manner for a long time. If you suspect your teenager may be abusing drugs or alcohol, take the time to gather the right information about addiction treatment programs, along with detox treatment programs available in your area.

Contributed by Nikki Seay. 

I remember that one of the first things my addiction therapist told me at our initial meeting was that sobriety was going to be something to look at as a process. She told me that if I stumbled along the way, that was to be expected.

I have to say that when I first heard her say that, it seemed like she was saying that I should expect to relapse. I entered into drug addiction therapy with the mentality that I only had one shot to get this right. I really thought that if I failed, if I slipped at all, my family would be so disappointed in me. I thought that if I messed up one time, everyone who had put their faith in my commitment to sobriety would just throw their hands up in the air and leave me for good. I had no clue what I was setting myself up for with such an “all or nothing” thought process.

There is no reason for anyone to go into drug addiction treatment with the idea that your program will play out like anyone else’s program. It’s like they say: everyone is different. This is the same for drug addiction treatment. You have no idea what you are going to feel and you have no idea what your goals will look like until you get there and begin working toward a sober life.

Set Aside Unrealistic Expectations

When you enter into drug addiction therapy with a certain set of expectations, it can have an adverse affect on your ability to surrender to the process. I know when I entered drug addiction treatment, I had an idea that I would get better in 90 days and, once I got out, I’d just pick up my life right where I had left off before drugs took over.

I told myself that once I came clean with my family and admitted I needed help to fight my drug addiction, they’d expect me to do what I had told them I would do. I felt like I had to go into drug addiction treatment, become a healthy version of my old self, and make everyone proud of me again.

It wasn’t until later in my drug addiction therapy that I understood what kind of pressure I was putting myself under. In truth, I almost set myself up for a relapse before I even started treatment.

Expect to Get Your Life Back 

Don’t get me wrong, no one should enter into drug addiction treatment with the notion that you are going to relapse, no matter how hard you fight it. The key is to enter treatment with nothing but the expectation that you are there to get your life back. However long that may take is inconsequential.

Don’t put constraints on your program before you are even working it! When you accept the fact that you are doing what you need to be doing at that very moment, you can learn to live day by day.

You can’t waste your time and effort worrying about a relapse that hasn’t even happened. It takes away from your happiness when you live in fear of what may or may not happen down the road.

Once you take the first step of getting drug addiction treatment and therapy, your world will begin to change if you let it. Sobriety will come if you follow your program and rely on your counselors to guide you. Trust yourself – your new life depends on it.

Michael Jackson had a lethal mixture of Valium, Klonopin, and propofol in his system at the time of death. Heath Ledger had a combination of Oxycontin, Vicodin, Valium, Restoril, Xanax, and Unisom coursing through his veins when he died. While the main drug involved in Whitney Houston’s death was cocaine, toxicology reports also showed Xanax and Flexeril in her system. 

Tragic stories like these receive a massive amount of media attention. However, countless people die every year from fatal medication combinations, or poly-substance abuse. Some of these deadly combinations include mixing stimulants like speed with alcohol or other downers, along with mixing opiates and benzodiazepines. In fact, most fatal overdoses are the result of poly-substance abuse. 

When you combine prescription medications, the results are always unpredictable and you put your life in danger. So, what can happen inside your body when you decide to mix prescription drugs? 

Your body will generally have one of two responses when mixing prescription medications: 

The medications work independently. This scenario is the best one because the medications continue to function as they are meant to. For example, when you combine aspirin with Valium, there is no interference in the action of both medications. Another example would be taking birth control pills and Valium. Neither medication has an adverse affect on the other when taken together. Of course, it’s always suggested that you check with your doctor or a pharmacist to see the potential interactions of the prescription medications you are taking. 

The medications increase each other’s action. This is when things start to get dangerous. This scenario occurs when medications affect the brain in the same manner or when one drug increases the concentration of the other.

For example, mixing Valium and Clopine can have deadly consequences. When you take a depressant like Valium and add the additional sedative effect caused by Clopine, the outcome is a severe slowing of respiratory and cardiovascular functions. You experience the intended sedative effects on a much stronger level than needed, causing the possibility for overdose. 

Sedatives and depressants both slow your heart rate, along with your breathing rate. There is a high possibility you may pass out, completely stop breathing, or even vomit when passed out and aspirate (choke) on your own vomit. Any of these situations can lead to death.

Prescription Drug Abuse a Leading Cause of Death 

Some staggering statistics show that prescription drug abuse was the second leading cause of addiction treatment in 2008. Even more disturbing is a study done by the University of California at San Diego. Researchers studied more than 50 million death certificates of United States citizens from 1983 to 2004. What they found may shock you. 

In 1983, out of the 50 million studied, 92 people died at home as a result of mixing medications, drugs, and alcohol. Fast-forward to 2004. Out of that same 50 million, 3,792 people died at home from mixing medications, drugs, and alcohol. Fatal errors made with medications rose from 3,954 in 1983 to a frightening 22,770 in 2004. 

Mixing a prescription drug can have permanent effects on you and the people who love you. If you are struggling with a prescription drug addiction, the very best thing you can do is to reach out and ask for drug addiction therapy. If you are struggling with a drug addiction and a co-occurring disorder that requires you to take prescription medications, such as depression and anxiety, reach out to a dual diagnosis treatment facility to get treatment for both.

Researchers from Johns Hopkins University discovered valuable information while studying drug addiction in 1972. According to the researchers, the human brain has special neurons whose job is to serve as a receptor site for all opiate drugs. Heroin, morphine, Oxycontin, and codeine each have specific receptors in the brain. 

How Opiates Work in Your Body 

Once an opiate finds its way to the brain, it quickly activates the opiate receptors. The brain then produces the same type of effect that belongs in the area of the brain involved. Opiates generally produce two effects: pleasure and pain relief. 

The brain produces special and unique substances called endorphins, which activate each opiate receptor. Endorphins are thought to be involved in a number of bodily functions, such as breathing, nausea, vomiting, pain, and hormone supervision. They are also the body’s very own “feel good” drugs. Once you feel pain or extreme stress, endorphins go to work proving you with a sense of calm and rationality. Endorphins are your natural response to external problems. 

Once activated, endorphins make their way into the space that lies between nerve cells. They prevent your brain’s neurons from firing and, in turn, produce a very analgesic effect. It is also possible for endorphins to excite the neurons in your brain. When endorphins work their magic, you will feel high and feel little to no pain. It goes without saying that the manufacture and release of endorphins increases when you get very excited, exercise, or are extremely stressed out. 

Using Opiates Safely 

If your doctor prescribes opiates to treat a specific condition and you take the medication as directed, there is an extremely low chance you will develop a drug addiction. On the other hand, if you take opiates in excessive doses or against the direction of your doctor, a drug addiction can easily develop.

Opiates activate the reward system of your brain when or if you develop an addiction. While it is true that you can experience a few brief moments of pleasure by abusing opiates, the outcome will never change — you will find yourself battling an addiction that will require you to enter drug rehab.

Generally, rock bottom refers to a time or an event in life that causes an addict to reach the lowest possible point in their disease. It is a time when the person feels like things cannot get worse for them. Their life has been damaged so badly that it seems like there is nothing good left to destroy. 

A Different Meaning for Everyone 

Most addicts need to hit their own personal rock bottom before they can ever begin the addiction recovery process. The key to understanding the concept of rock bottom is to be aware that it is a unique process for everyone. For one person, it could be loss of a marriage; for another person, it may be the loss of a job or a home. There is not a tried and true method to predict what your personal rock bottom moment will be. 

Addiction changes your life in so many ways. You can often find yourself saying or doing things that you never would have considered doing before you developed an addiction. You may have sworn that you would never cheat or steal, but suddenly find yourself doing these kinds of things in order to get your drug of choice. 

You may find yourself in a position that an addiction caused you to lose the trust of your family, and it hurts you so badly that it becomes your own rock bottom. Maybe your rock bottom came when you were in a car crash due to drinking excessive amounts of alcohol. It all depends on what you perceive as a rock bottom in your life. 

You really have to find yourself doing things like these in order to hit a bottom. Only a rock bottom can make you feel so uncomfortable that you want to find sobriety. 

Finally Hitting Rock Bottom  

There are addicts who hit their rock bottom quickly. Others don’t hit a rock bottom for years. You don’t need focus on developing a bottom that looks like someone else’s bottom. You don’t need to sink to a specific deep, dark depth in your life in order to enter drug or alcohol addiction treatment. 

If you have been addicted to drugs or alcohol for many years, you may feel like your situation is so dark or hopeless that you will never hit a rock bottom. Maybe you have gone through addiction treatment before, only to relapse almost immediately after your discharge from the program. You may find yourself asking what kind of tragedy it will take to make you give up your addiction. 

While these feelings are overwhelming at times, they can also be a sign that you are looking toward the steps to seeking recovery. In some situations, you may even avoid landing in the worst rock bottom scenarios by becoming scared straight.

For example, if drugs have caused you to seriously fall behind on your rent, you may be in danger of losing your home. The very thought of being homeless and without a roof over your head may be enough to make you seek help. 

No matter what your own rock bottom is, it’s never too late to reach out and ask for help.