Balancing Your Life

Someone you know grew up with a problem drinker. One of every five college students is the adult child of an alcoholic (ACOA). Students who identify themselves as children of alcohol abusers report more problems due to their drinking than other students. These consequences include damaged interpersonal relationships, drinking to relax, and concern from others about their drinking habits.

Identifying the ACOA 
(Adult Child of an Alcoholic)

People who grow up with an alcoholic adult in the family often have certain personality characteristics. See how often the following statements reflect how you feel now or how you have felt as a child. These are typical statements for people who were raised with an alcoholic parent. They are also common to those reared by parents who don’t drink much but who were themselves raised by an alcoholic.

1. I’m usually involved in so many activities that I barely have time for myself.
2. I fear criticism.
3. It’s important for me to always do the “right thing.”
4. I think one of my parents has a drinking problem.
5. If I don’t give in to my friends, I feel guilty.
6. I have a need for perfection.
7. It’s difficult for me to feel close to others.
8. My parents fight when one of them drinks.
9. I have lost sleep over my parent’s drinking habits.
10. I care for others but don’t really know my own needs.
11. I usually cannot express my own emotions.
12. I’m a nice person but my friends/boy-or girlfriend complain/complains that I won’t get close.
13. I feel different from other people.
14. I am afraid that alcohol use will cause my parents to divorce.
15. I’m leaving home as soon as I’m old enough.
16. It’s my fault that my family has so many problems.
17. People praise me for all my accomplishments, but I never think that I’ve done enough.
18. I wish my home could be more like those of my friends who do not have a parent with a drinking problem.
19. I stay away from home because my parent drinks.
20. I take care of others, but no one takes care of me.
21. People tell me I have a lot of potential but that I lack self-confidence.
22. I have felt sick, cried, or had knots in my stomach after worrying about a parent’s drinking.
23. Others’ approval is very important to me.
    

Score: A score of at least 4 to 6 positive responses indicates a strong identification with the typical characteristics of an ACOA. If you would like to discuss this further, support groups such as MTSU ACOA group or the local Al-Anon chapter are good sources of help.

(These questions are modified or adapted from the Children of Alcoholics Screening Test (CAST), Jones: The Family Recovery Press, 1982; the Recovery COA Quiz and the Did You Grow Up With A Problem Drinker Quiz from Al-Anon, 1984.) 

What causes depression?  Many things may “set the stage” or predispose one for depression. Some of the most significant things include your background, the skills and beliefs you use to cope with change, any biological vulnerabilities you may have, including genetic predisposition, hormonal imbalances, or other serious physical problems. In many cases depression occurs without any external factors whatever, being induced solely by chemical factors. The loss of personal worth and self-esteem is the most common immediate cause of depression. External events such as the breakup of a friendship or romance, divorce/family separation, death, or stress may trigger depression. Internally, psychological factors such as lack of coping skills, unrealistic standards and assumptions, or the feeling of not getting enough love from parents or significant others can also cause depression. In some cases, multiple causes may be tightly related, creating a downward spiral.

What is depression?

Regardless of the cause, the common denominator of depression is a chemical imbalance in the brain. In simple terms, the “feel good” chemicals are either depleted by overwork or not adequately manufactured because of our gene pool. Depression can come in “all shapes and sizes” from a mild funk to clinical depression. Everyone gets down sometimes. Depression may be a problem when it lasts consistently for two weeks or more. Some types of depression are:

Depression – depressed or irritable mood, or loss of interest or pleasure in all, or almost all, activities, and associated symptoms for at least two weeks. The symptoms represent a change from normal functioning, and occur for most of the day, every day. (See below for a list of symptoms.)

Manic Depression (bi-polar disorder) – strong mood swings from despair to euphoria with no significant stimulus.

Dysthymia – a long term low level funk which depletes energy and relationships.

Seasonal Affective Disorder (SAD) – depression that appears connected to the seasons and seasonal changes.

What are the symptoms of depression?

Two things seem to typify depression: a deep sense of sadness, and/or apathy, and a lack of interest in things you used to enjoy. Other symptoms may include: a change in appetite, weight loss or gain; lack of energy, fatigue; change in sleep patterns; problems with concentration and decision making; feelings of excessive or inappropriate guilt, worthlessness, or hopelessness; worry; restlessness; headaches; stomach aches; sexual problems; and thoughts of death and suicide or attempted suicide.

What can I do about depression?

Treatments for depression include medication , cognitive therapy, and combinations of the two. The recent explosion in psychiatric drug research has produced many new and promising treatments with fewer and less severe side effects. The first step in dealing with depression is to speak to a professional who can help determine your range of options, and the most appropriate treatment(s). Positive self talk, diet, exercise, journaling, counseling, healthy thinking, and a strong personal support network are helpful in preventing and moderating bouts of depression.

Help me, I think I’m depressed!

If you have experienced two or more symptoms for two or more weeks, you may contact the Counseling Services at 615-898-2670 to schedule a confidential appointment with a counselor. If you are suffering with compelling thoughts of suicide and/or making plans to commit suicide, please get help now. If you cannot reach the Counseling Services, you may contact the Counseling Services Crisis Team at 615-893-0770.

Am I depressed, or am I anxious?

Depression and anxiety often overlap considerably, and are often difficult to differentiate. The area of overlap generally consists of negative emotions (feeling “stressed”, upset, etc.) There are two specific ways to differentiate between anxiety and depression, but these are not foolproof. First, depressed people very often cease to enjoy things that formerly brought them pleasure, while anxious people rarely do this. Second, anxious people often experience hyperarousal, that is their body reacts as if they were fearful (heart palpitations, shortness of breath, break out in a sweat, feelings of choking, numbness, etc.); depressed people rarely do this. However, if one is both anxious and depressed, these symptoms may be experienced simultaneously.

What are the symptoms for anxiety?

Anxiety is formally defined as unrealistic or excessive worry about two or more life circumstances for six months or longer, in which one is worried or anxious more days than not. This anxiousness may be expressed as worry about academic, social, or athletic performance. The following specific symptoms are often present: trembling or feeling shaky; muscle tension; restlessness; shortness of breath or smothering sensations; palpitations or accelerated heart rate; sweaty hands; dry mouth; dizziness; nausea, diarrhea, abdominal distress; hot flashes or chills; frequent urination; trouble swallowing/lump in the throat; feeling on edge; exaggerated startle response; difficulty concentrating; trouble going to sleep/staying asleep; irritability.

How do I find out if I’m depressed or anxious?

If you think you may be depressed or anxious, you can make an appointment at Counseling Services for a brief assessment (at no cost to you). Based on the results of the assessment, you and a counselor can then explore options available to you.

What is an eating disorder?

An eating disorder may develop when an individual seeks to resolve an inner conflict or stress through their eating habits–either being excessively restrictive, compulsive, or addictive in their consumption of food. There are basically two types of eating disorders: anorexia and bulimia. An anorexic may become bulimic. Some experts consider compulsive overeating to be an eating disorder also.

What are the symptoms of an eating disorder?

All sufferers of eating disorders hold two things in common: a distorted body image and low self-esteem. Anorexia is seen in an intense fear of becoming fat, failure to maintain a minimal body weight, and in the advanced stages includes the symptoms of malnutrition. Anorexia is often clearly visible through the emaciated appearance of the individual. Bulimics on the other hand are often near normal weight. Bulimia, from the Greek word meaning “hunger of an ox” is seen in an eating pattern of bingeing–often related to emotional triggers, not physical hunger- and secretive purging through self induced vomiting, laxatives, severe diets and exercise. Both disorders are often initially experienced in the teenage years and predominately affect women. Similar to alcoholism or addiction, compulsive overeating is uncontrolled eating in response to emotional stress. A person may either binge, often in secret, or simply consistently overeat. A weight 20% above healthy body weight recommendations may indicate a problem with compulsive overeating. Eating disorders are often accompanied by alcohol and/or drug abuse.

What can I do about an eating disorder?

Because of the risk of complications from dehydration, abuse to the gastrointestinal systems, and malnutrition; a medical assessment and collaboration between therapist and doctor is imperative in treatment of anorexia and bulimia. Early detection and a strong program of behavioral modification and therapeutic support, initially in a hospital setting, seems to be the most effective means of addressing an eating disorder. There are many sources of help and support: friends, family, counseling with a mental health professional or clergy, support groups, medical personnel, and eating disorder clinics.

Help me, I think I may have an eating disorder!

If you feel out of balance; are insecure, a perfectionist, lacking in confidence and feel fat even though your weight is well below the weight chart recommendations for your age and height, if your behavior (i.e. starvation diets, excessive exercise, purging) is putting you at risk; or if your friends tell you that they are concerned that you may have an eating disorder, you may contact the Counseling Services at (615) 898-2670 to set an appointment with a trained counselor in a safe, confidential place for support. If you are suffering with compelling thoughts of suicide and/or making plans to commit suicide, please get help now! Contact the Counseling Services at (615) 898-2670 or Mobile Crisis at 1-800-704-2651.

Thoughts and Feelings

Although we don’t yet completely understand the connections between thinking and the body, we do know that positive or healthy thinking can: help improve mood, self-esteem, and sense of well-being; decrease depression, anxiety, and hostility; lessen pain and other bodily symptoms; speed recovery from surgery; enhance immune function; and extend longevity. We also know that to a great extent, our emotions are determined by how we think about events. This “self-talk”, whether positive or negative, is so powerful that it determines not just our emotions, but the condition of our physical and mental health as well.

Positive Thinking: Nature or Nurture?

The good news is that to a large extent our “self-talk” patterns are learned, and can be unlearned; they are not genetically predetermined, and therefore are not completely out of our control. Changing the way we think is one of the most powerful things we can do to improve our health.

Negativity and Rose Colored Glasses

None of us perceives the world in a completely accurate way. Data is filtered and distorted. We tell ourselves irrational and inaccurate stories, and then behave as if our stories were true. Both negative and positive thinkers distort reality, albeit in different directions, but it seems that the positive distortions of healthy thinkers are most often beneficial. Optimism leads to hopefulness, not helplessness. Negativism greatly limits the potential for creative action.

Assessing Your Distortions

You may find the following checklist useful in helping you look objectively at the direction of your thinking. You do have editorial privilege on your stories. When you find that you’re operating from a distorted pessimistic story or thought, use the checklist to find out why, and then revise your story to reflect a more positive outlook.

1. Have I correctly identified what’s really bothering me?  It may be difficult to pin down the real source. Who have you been with lately? Is there some specific event or person that might have triggered the negative thoughts?
2. Am I thinking in all or nothing terms?  Beware of the globals like totally, completely, always, never…they’re almost “always” wrong. Avoid black and white thinking.
3. Am I assuming every situation is the same?  You can choose to respond differently in every situation. Don’t get locked in to a future state that’s based on the past.
4. Am I assuming the worst?  Stop catastrophic thinking and “awfulizing”. Small events become disasters, and crises become unmanageable. Maintain perspective.
5. Am I making an unfair or unrealistic comparison? So what if you are not Michael Jordan on the basketball court? Rather than compare your present performance to some unobtainable ideal, try comparing it to your recent past performance; competing against yourself will provide measurable gains.
6. Do I have the evidence to support my conclusion? You may find yourself leaping to conclusions, or assuming you can read other people’s minds (even we can’t do that). Stick to what you know.
7. Are my worries worth worrying about?  Make sure you have a good reason to worry. If you think you do, try writing the problem, and then writing solutions. Paper and pencil have a way of helping clear the fog.
8. Am I blaming myself for something beyond my control?  Quit blaming, and start accepting responsibility, but only for those things that you can really control. Things like the weather, the stock market, and your professor’s choice of tie don’t qualify.
9. Am I expecting perfection?  If so, you will have to learn to love disappointment; give it a rest. Why hold yourself or others to impossible standards? Try rewriting the story about your mistake as one about an opportunity to learn and grow.
10. What difference will this make next week, in a year, or in ten years?  Our mistakes do not become historical markers. Most people tend to remember the good things and let the other stuff go. They’ll forget your stuff too. Try not to take or make things more serious than they really are.

What is self-esteem?

Self-esteem is an individual’s ability to “esteem” or value him or herself. A person’s sense of self worth may vary from day to day, influenced somewhat by the events and the people around them, but, like the weather which may be variable, rainy one day and sunny the next, one can discern a pattern of summer or winter high self-esteem or low self-esteem.

What does high self-esteem look like?

Persons with high self-esteem feel their power and know their limits . They have enough confidence to act independently and assume responsibility. They can express a broad range of emotions, spontaneously and appropriately. They can claim their accomplishments and be humble at the same time. They enjoy new challenges. Just like a prized possession, they value and take care of themselves. At the same time they are tolerant of others and of frustration. They feel capable of influencing others.

What does low self-esteem look like?

Persons with low self-esteem feel powerless and have no limits . Low self-esteem may clearly be reflected in a person’s appearance both through body language and a neglected unkempt person. Or low self-esteem may be masked by externalizing: when a person bases their values not on their intrinsic worth as a person but rather on things or people outside of themselves such as designer clothes, six digit incomes, or by being the “perfect student” or the “perfect spouse.” Persons with low self-esteem will downplay their talents and feel insignificant. They are often insecure in their relationships and are easily influenced and manipulated by others. They will avoid new opportunities that create stress. They may be easily frustrated, become defensive and blaming.

How can I build my self-esteem?

Celebrate your strengths and achievements. Acknowledge and forgive yourself for your weaknesses. Use your mistakes as learning tools. A balanced self-assessment, which recognizes and accepts both one’s strengths and weaknesses , is the foundation for strong healthy self-esteem. Connect with others, compare and compete with yourself. Use healthy thinking. Trust yourself and the process of life.