Mental Health and Trauma

Drugs affect your body, emotions, and thinking. Short term effects are different for every drug but can include anxiety, depression, mood swings, and short-lasting euphoria. The long-term effects are much more serious for those who consistently abuse drugs. They can develop anxiety, depression, psychosis, schizophrenia, and some drugs—mostly hallucinogens—can make you feel detached from the real world.

 Substance Abuse:

Substance abuse is often used interchangeably with substance addiction, but they both mean different things. Substance abuse is the excessive use of illegal drugs, alcohol, or prescribed medicine. It is taking more than the intended amount. A person taking more painkillers than intended is abusing the drug, but it isn’t until they develop a tolerance and a dependence for it that it turns into an addiction. 

Substance Dependence:

Substance dependence is when the brain develops a tolerance from repeated use of a substance and feels as if they need it to function. Those with chronic medical conditions tend to develop a dependence but that does not always mean they will become addicted. Withdrawal can become a symptom and happens when the dependence on the drug is so extreme that when the drug is not in use, a person can become severely irritated, fatigued, depressed, or in some instances experience hallucination and seizures. Other symptoms of withdrawal include tremors, insomnia, chills, changes in mood, and changes in appetite. After repeated use, the effect of the substance lessens and the person begins to require more in order to get the same satisfying, “feel-good” effect.

Substance Addiction:

Abuse, dependence, and addiction tend to be used interchangeably but this action is harmful and feeds into the stigma. Substance abuse does not always lead to dependence and dependence does not always lead to addiction. Addiction is when a person has abused a drug so much that they’ve developed a tolerance and eventually lose control of themselves. Addiction is a disease. It can be controlled and many do voluntarily stop using whatever drug they are addicted to, but for some, when their brain adapts to the satisfaction, they crave it so much that it is physically and mentally straining for them to stop.

It is especially dangerous for teenagers. Our brains do not fully develop until we are around 25 years old which means you are far more susceptible to dependence and addiction when  you begin to abuse drugs.

What Influences Drug Use:

People of every background can develop a substance addiction. There are three main levels of analysis when it comes to behaviors and mental processes: biological influences, social-cultural influences, and psychological influences. Simply, this means people start abusing, develop dependencies, and become addicted to substances for a variety of reasons.

Biological influences include genetic predispositions (genetically influenced traits that make you  more likely to develop a condition). For example, if a person was adopted and grew up with their adopted parents, they still have a high chance of developing an addiction if their biological parents had one as well. This is also true for identical twins if one twin was addicted to a substance. Basically, people born with certain genes are more prone to become addicted to a substance.

Social-cultural influences and psychological influences tend to work hand in hand. Social-cultural would refer to the surroundings that a person grew up or is currently in while psychological is the stress, lack of purpose, and disorders that may have derived from those surroundings. This is where we see people using drugs and substances to cope with what they feel inside. For example, those with a history of physical abuse, aggressive behavior, and psychological disorders such as depression, anxiety, anorexia, borderline personality disorder (BPD), or post-traumatic stress disorder, are more likely to develop an addiction. Other forms of social-cultural influences include negative peer pressure and the acceptance of drug use within a community. These contribute heavily to the stigma surrounding substance abuse.

Types of Drugs:

Drugs are substances that affect a person’s mental and physical state when consumed. There are seven categories that drugs fall into based on their effects. Stimulants, depressants, opioids, hallucinogens, dissociatives, inhalants, and cannabis are the drug types, and each affects your brain, behavior, senses, and mood in a different way.

Legal Drugs can include prescribed and over-the-counter medicines, caffeine, alcohol (with age restrictions), and tobacco. These can still lead to dependence and addiction if they are abused.

Illegal Drugs can include cocaine, heroin, ecstasy, methamphetamine, and psilocybin. Being caught with these drugs can sentence a person to time in prison.

Stimulants are drugs that excite the body’s central nervous system and quicken body functions. They make you feel like you are “speeding up.” When taking stimulants, the pupils dilate, energy rises, heart and breathing rate increases, and blood sugar levels take off, which causes a drop in appetite. Some examples include Caffeine, Nicotine, Amphetamines, Cocaine, Methamphetamine (also called “speed”), Ecstasy, Adderall, and Ritalin. Stimulants are consumed in powder, pill, food, or beverage form.

Risks when abused:

1. Anxiety
2. Paranoia
3. Psychosis
4. High body temperature
5. Depression
6. Heart failure
7. Stroke
8. Seizures

Reasons People Take Stimulants:

Stimulants are often prescribed for ADHD and narcolepsy. Stimulants increase dopamine levels in those with ADHD which helps regulate attention and they help increase alertness in those with narcolepsy in order to keep them awake throughout the day.

Students or workaholics may abuse stimulants in hopes of enhancing their performance and productivity while others become addicted to the feeling of the rush.

Depressants affect the body’s central nervous system just as stimulants do, but instead of creating a feeling of  “speeding up” they make you feel like you’re “slowing down”. Depressants can be prescribed for anxiety, insomnia, obsessive-compulsive disorder, and other medical issues that make it difficult to fully relax. This includes Barbiturates, Phenobarbital, Xanax, Valium, and alcohol.

Alcohol is often mistaken as a stimulant in low doses since it increases heart rate and makes people feel more impulsive. However, this happens because alcohol slows down the part in our brains that controls judgment and inhibitions.

Risks:

1. Death
2. Inability to concentrate
3. Slowed heart rate
4. Extreme sleepiness
5. Decrease in self-awareness
6. Increase in harmful tendencies
7. Dizziness
8. Confusion

Reasons People Take Depressants:

Depressants can be prescribed to help calm nerves and relax muscles. When taken illegally or abused, it’s usually because depressants can provide temporary relief from anxiety and anguish. Risk number 5 is “decrease in self-awareness” but for some, it’s the reason they become addicted. When you become less aware, you can temporarily forget about a failure, breakup, or loss of a loved one. Most of us have seen the fictional character that drinks to forget. Some of us have seen it play out in real life. And others have experienced it. The desire to suppress heavy, negative emotions can often compel someone to abuse a depressant.

Opioids are one of the most addictive types of drugs and in the 2020 pandemic, opioid accounted for 75% of drug overdose deaths. They are painkillers that produce a strong euphoric feeling. While in use, pupils become smaller, breathing slows, and the body relaxes. Opioids can include Heroin, Morphine, Vicodin, OxyContin, Codeine, and Percocet.

Risks:

1. Depression
2. Seizures
3. Anxiety
4. Irritability
5. Muscle cramps
6. Hypertension
7. Insomnia
8. Diarrhea
9. Nausea and vomiting

Reasons People Take Opioids:

Opioids are often prescribed for pain relief after surgery or injury, which is usually where some develop an addiction. Sometimes it takes only a few days to go from abusing opioids to becoming addicted to it which is one of the reasons there is an opioid crisis in America. Tolerance develops quickly and withdrawal becomes insufferable. Opioids can drive people to euphoria and then send them crashing down in hours.

Hallucinogens are also known as psychedelics, which means mind-manifesting. They alter a person’s reality. Hallucinations generally begin with geometric shapes like spirals or lattices and then evolve into other images of past emotional experiences or tunnels with a light at the end. Then, people tend to feel “separated” from their bodies and experience dreamlike scenes which can lead some into extreme panic and self-harm. Oddly enough, these sensations are similar to those of near-death experience. Some examples of hallucinogens are Psilocybin (magic mushrooms), Peyote, and LSD (acid).

Risks:

1. Fear
2. Anxiety
3. Psychosis
4. Increased blood pressure
5. Paranoia
6. Flashbacks

Reasons People Take Hallucinogens:

Hallucinogens are usually taken for social or recreational purposes to have fun, deal with stress, or to simply experience something new.

Dissociatives are a subcategory in Hallucinogens. These cause people to feel as if they are disconnected from their bodies and are extremely dangerous since it gives people a sense of invincibility. They interfere with the glutamate in the brain which controls pain perception. These include ketamine, DXM, PCP, and nitrous oxide.

Risks:

1. Depression
2. Anxiety
3. Hallucinations
4. Numbness
5. Memory loss
6. Suicidal thoughts

the Reasons People Take Dissociatives:

People take dissociatives similarly for reasons they take hallucinogens.

Inhalants are taken by inhaling gasses or fumes. These, like opioids, produce a feeling of euphoria but are usually from everyday household items since those addicted simply just want a “whiff” of whatever they can get. These include everything from nitrous oxide (usually taken in balloons), aerosol sprays, room deodorizers, paint, gasoline, school glue, and any household cleaning fluid.

Risks:

1. Loss of smell
2. Brain Damage
3. Nosebleeds
4. Increased heart rate
5. Loss of consciousness

Reasons People Take Inhalants:

People who take inhalants aren’t always looking for a high but may simply be too young to understand why they shouldn’t smell everything. Young children can easily attain these household items and may inhale them by accident. Others who take inhalants tend to do it for the feeling of being high or intoxicated.

Cannabis, also known as marijuana, acts similarly to a hallucinogen but also has depressant-like effects and has a high potential for addiction. In the United States, it is increasingly becoming used for medical purposes, but most of the time, it is abused by people who do not medically need it. Examples include marijuana leaves, hashish, hash oil, and Sativex.

Risks:

1. Depression
2. Chronic anxiety
3. Less immunity to illness
4. Reduced sperm count for men
5. Sedation
6. Slowed reaction times
7. Disorientation

Reasons People Take Cannabis:

People take Cannabis for medicinal purposes but are also often taken for recreational uses or to deal with stress.

What are mental health disorders?  

Mental health disorders are characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior.

Please remember that self-diagnosing and diagnosing through online generalized tests can be harmful and misleading. If you wish to know if you have a disorder, talk to a parent or guardian so you can meet with a trained professional that can legally diagnose you – a psychiatrist. 

Mood Disorders: 

• Bipolar disorder- Depression that includes alternating times of depression and mania (rapid changing emotions.)
• Major depressive disorder- Prolonged and persistent periods of extreme sadness.
• Cyclothymic disorder- A disorder that causes emotional ups and downs less extreme than bipolar disorder.
• Premenstrual dysphoric disorder- Mood changes and irritability that occurs during a woman’s premenstrual phase of their period {link to period section of anatomy}
• Persistent depressive disorder- A long-term (chronic) form of depression.

Personality Disorders: 

• Borderline personality disorder- Patterns of instability in personal relationships, intense emotions, and poor self-image.
• Dependent personality disorder- A pattern of needing to be taken care of and submissive and clingy behavior. People with this disorder may have difficulty making daily decisions without reassurance. 
• Narcissistic personality disorder- Needed admiration and lack of empathy for others.
• Obsessive-compulsive personality disorder- Preoccupation with orderliness, perfection, and control. A person with this disorder may be overly focused on details or schedules, not allowing time for leisure or friends, excessively working, and may be inflexible in their morality and values.
• Paranoid personality disorder- A pattern of being suspicious of others and seeing them as mean or spiteful.

Anxiety Disorders:

• Generalized anxiety disorder- This includes persistent anxiety and worry about activities or events. It often occurs along with other anxiety disorders or depression. 
• Separation anxiety disorder- A childhood disorder characterized by anxiety that is excessive for the child's developmental level and separation from parents or others with parental roles.
• Social anxiety disorder- Involves high levels of anxiety and fear during social situations due to feelings of embarrassment, concern about being judged or viewed negatively, and self-consciousness.
• Panic disorder- this can involve repeated episodes of sudden feelings of intense anxiety, reaching a peak within minutes. 
• Agoraphobia- This is a type of anxiety disorder where an individual has a fear of situations where it would be difficult to escape, or help won’t be readily available.

Psychotic Disorders: 

• Schizophrenia- People with schizophrenia have changes in behavior and things such as delusions and hallucinations that can last longer than 6 months.
• Brief psychotic disorder- People with this illness can have sudden, short, periods of psychotic behavior, this is often in response to a very stressful event. Recovery can often be quick, usually less than a month.
• Shared psychotic disorder- This disorder happens when a person in a relationship has a delusion and the other person in the relationship adopts it as well.

Trauma-related Disorders

• Reactive attachment disorder- This is a rare condition in which infants or young children don’t develop a healthy attachment to their caregivers due to neglect.
• Disinhibited social engagement disorder- Similarly to reactive attachment disorder, children are neglected at a young age and do not develop a normal attachment to their parents. Children grow up and see their parents and strangers at the same level.
• Post-traumatic stress disorder (PTSD)- PTSD is triggered by experiencing or witnessing terrifying events. Symptoms such as intrusive flashbacks, nightmares, or difficulty sleeping can last for years and affect day-to-day life.
• Adjustment disorder- Most of the time, people can adjust to big changes in just a few months, but adjustment disorder is when you experience more stress and feelings of depression for an extended, extreme amount of time.

What are eating disorders?

Eating Disorders are characterized by severe and persistent disturbance in eating behaviors and are associated with distressing thoughts and emotions. Eating disorders can be very serious conditions that can affect physical, psychological and social functions. Eating disorders can be a type of coping mechanism for trauma and other things. There are many different types of eating disorders.

Types of eating disorders:

• Anorexia nervosa- Anorexia is characterized by self-starvation and weight loss. Anorexia has the highest mortality of any psychiatric diagnosis other than opioid use disorder.
• Bulimia nervosa- Bulimia nervosa is typically dieting, or eating only low calorie foods.
• Bulimia- Bulimia is an emotional disorder involving distortion of body image and obsessive desire to lose weight. This involves overeating and self-induced vomiting, purging (self induced processes to remove matter from the body), or fasting.
• Binge eating disorder- Binge eating is defined as eating a large amount of food in a short period of time, it is also associated with loss of control over what or how much you're eating. Binging usually happens in episodes.
• Avoidant restrictive food intake- Avoidant Restrictive Food Intake Disorder (ARFID) is defined as an eating disorder that involves a disturbance in eating resulting in failure to meet nutritional needs.
• Pica and rumination disorder-  Pica is an eating disorder in which a person repeatedly eats things that are not foods with no nutritional value. This can last for over a month and is severe enough to need clinical attention.
• Orthorexia- This occurs when a person becomes so obsessed with healthy eating that they cause more harm than good to their body. Including severe food restrictions.
• Rumination Disorder- This can be characterized by regurgitating food that may then be chewed, swallowed, or spit out. 
• Avoidant Restrictive Food Intake Disorder (ARFID)- This can be similar to anorexia but doesn't present with body image issues. Instead a person may restrict food for other reasons, like being picky.

What is self-harm?

Self-harm is hurting yourself as a way of dealing with difficult situations. After self-harming you may feel a sense of relief, but it could also cause worse feelings. It is very important to know what risks come with self-harm. Self-harm can be addictive and difficult to stop.

Reasons people self-harm:

• Stress
• Processing negative feelings
• Distracting yourself from something else
• Trying to develop a sense of control
• Punishing themselves 
• Feeling numb
• Expressing emotions
• Anxiety

Examples of self-harm may include:

• cutting yourself 
• poisoning yourself 
• overeating or under-eating
• exercising excessively 
• biting yourself
• picking or scratching at your skin 
• burning your skin
• inserting objects into your body
• hitting yourself or walls
• misusing alcohol
• overuse of prescription and recreational drugs
• pulling your hair
• having unsafe sex
• getting into fights where you know you will get hurt

Potential effects of self-harm:

• Scars
• Infections
• guilt/shame
• Addiction
• Uncontrolled bleeding
• Feeling helpless or worthless

During intense urges to self-harm, it can be hard to do anything else.

Some alternatives to self-harm can be:

• changing your environment- going outside or changing your environment can offer distractions for the urge to pass. 
• Talking to someone can be great emotional support
• Listening to music is a very common way to distract from self-harm 
• Exercise
• Dance
• Go for a run
• Indulging in hobbies

Learning to recognize triggers can be a great way of controlling yourself. Triggers are what give you the urge to hurt yourself.  Triggers are discussed in the section below

What are triggers?

A trigger is a psychological stimulus that prompts the involuntary recall of a previous traumatic experience. Trigger stimuli are not only frightening or traumatic experiences but can also be scents or pieces of clothing.

Different types of triggers:

• External triggers- Sounds, sights, smells, and textures that evoke responses based on past experience.
• Internal triggers- Strong feelings that come apparent based on past trauma.
• Symptom triggers- A physical change can trigger larger mental health issues.

Coping Strategies for triggers:

• Learn to identify: Learning to identify triggers can help you control the environment around you. Who or what was involved, where, when, and why something took place.
• Make a plan to address your triggers: Making a plan to address triggers and emotional reactions can help calm the trigger down. Talking to loved ones or your treatment team about how they can best help you.
• Find the right therapy: Specific types of therapy have been shown to be effective in addressing triggers, such as exposure therapy and EMDR therapy.
• Practice self-care: Prioritizing your mental health can help you build resilience against possible triggers. Talking to someone is a great way to start, such as a loved one, friend, or therapist. Writing about your experiences can also be a great way to get your feelings out without having to talk to someone.

Examples of Triggers:

• Yelling or loud voices
• Certain smells, sounds, sights, or feelings that relate to the trauma
• Being alone
• Arguments
• Loud noises
• Being ridiculed or judged
• Violence
• Sexual harassment or unwanted touch
• Physical illness or injury

Some people believe people with mental health problems can be dangerous when in fact, they are not at a higher risk of being attacked or harming themselves than hurting other people.

Stereotypes:

• Unfortunately, many people believe that those with mental illness have brain damage or are crazy
• It is also a popular misconception that those with mental illness cannot be cured.

Effects of negative stereotypes:

• Negative stereotypes create unhealthy views of personal identity among those who suffer from mental illness
• People who suffer from mental illness may believe that it defines them.
• Those with mental illness may be reluctant to seek help or get treatment because of these negative stereotypes.