Addictions: How DO You STOP That??!

Almost every day I hear a friend—or a patient—talk about being “addicted” to something: chocolate, exercise, email, a TV show. Are these really addictions? No—not if you follow the classic definition of addiction—but they’re still potentially problematic.  

 

Let me explain: Addiction, by definition, means being psychologically and physically dependent on something. If you’re addicted to alcohol, tobacco or drugs, for example, you’ll experience withdrawal symptoms like a rise in blood pressure, nausea, sweating and tremors if you stop taking it. That’s because these substances change body and brain chemistry.

Nowadays, many people also use the term “addiction” to refer to a “need” to repeat a behavior such as gambling, eating, having sex, exercising, working, shopping or surfing the Internet. These things are technically compulsions, not addictions. If a compulsive gambler doesn’t get to the casino, he might feel uncomfortable, but he’s not going to get the shakes.

Of course, a compulsion can be quite serious—just imagine a gambler who finds himself in significant debt or someone who keeps having affairs despite the toll that it’s taking on her marriage. The important question isn’t whether something really is an “addiction,” but whether or not it’s having a destructive impact on your life. If you’re simply a zealous fan of Glee, it’s probably not destructive (unless you’re so obsessed that you’re missing your best friend’s wedding to watch the show). But plenty of compulsive eaters and shoppers can wreak havoc on their health, relationships or financial security.

One of my patients, Kate (names have been changed to protect privacy), often spoke of her intractable shoe addiction. An outgoing woman in her mid- 40s, she revealed that she had many more shoes than she could use or afford— and yet she found it nearly impossible to pass up a pair that caught her eye. When she was stressed out, she bought shoes. When she felt sad, she bought shoes.

If Kate forced herself not to buy shoes for a week or two, she did not get physically ill. But she was rarely able to resist shoe shopping for much longer than that, even though she had racked up so much debt that her family was in danger of losing their house and her husband was thinking of leaving her.

Another patient, a 33-year-old woman named Meg, came to me as a “last resort” before getting gastric bypass surgery. A compulsive eater, she had been secretly eating entire bags of candies, cookies and chips for years. She frequently ate until she felt sick. As soon as she finished cramming in the food, she was immediately overcome with guilt. She knew that overeating was slowly killing her, but she couldn’t stop.

What causes compulsions?A number of different factors—biological and environmental—can play a role. First of all, we think there is a genetic component, since compulsive behaviors seem to recur in families. Meg, for example, mentioned that her 15-year-old son was playing video games day and night, and his grades, friendships and sleep habits were suffering—all signs that he was developing a compulsion, too. An imbalance of chemicals in the brain called neurotransmitters may also be to blame. And you can also be genetically predisposed to having this imbalance.
Compulsions also often go hand in hand with anxiety and depression. The excitement of gambling, the comfort of eating, the high of the purchase all temporarily drown out feelings of sadness and worry. But of course as soon as the moment is over, that bad feeling returns, and so does the urge to repeat the soothing behavior.

Experts also think that in some cases, compulsive behaviors trigger the same neurological pathways and pleasure centers in the brain as drugs do, hence the feeling of a “high” when you perform them. Unfortunately, the more you activate those pathways, the stronger they become, making it extremely difficult to quit. Your environment makes a difference, too. If you saw your mother relieving tension by repeating a behavior (like cleaning, shopping or eating), you might do the same.

Of course, there’s nothing wrong with occasionally (or even regularly) enjoying many of these behaviors. So how do you know when it’s crossed the line? Ask yourself these questions:

1. Are you preoccupied with planning and doing the behavior?For example, are you having trouble concentrating on and/or are behind at work because you’re spending time shopping online and/or taking long lunch breaks to shop?
2. Is the behavior negatively affecting one or more areas of your life?Are you fighting with your husband over debt you have from shopping?
3. Are you secretive about the behavior most of the time? Do you keep the shopping bags in the car and sneak them inside later?
4. Have you tried your best to stop the behavior but couldn’t (or stopped for a bit only to restart)?
If you answered yes to any of these questions, you may be struggling with a compulsive behavior and need some help.

Though seeing a psychotherapist is likely your best bet, there are some things you can try on your own:

Start by admitting that you have a problemYou can’t address quitting until you’re honest with yourself. In this same vein, it can be very helpful to tell someone else (like a spouse or close friend) that you think you have a problem. This makes it more concrete and easier to deal with. And it makes you more accountable for taking steps to change it.

Think about what’s driving the behaviorUnderstanding the reasons and emotions behind your behavior will help you focus on working through those issues. Are you hitting the gym night and day to avoid looking heavy as you age? Are you constantly surfing the Internet because you’re feeling depressed and lonely and want to be distracted by something?

Try to interrupt or at least postpone the behaviorIf you find yourself going to check Facebook yet again, try to hold back for one hour. You don’t have to postpone it longer and longer each time. It’s better to be erratic about it, so the next time delay by 2 hours, then 10 minutes, then a full day. This helps you feel some control over the behavior; the point is to remind yourself that you’re in charge, not your compulsive behavior.

Change the way you do itIf you can’t stop eating sweets every day, try having an apple or granola bar every time you want that candy bar. (You’re still eating, but you’re eating something else.) Do your exercise routine out of order. This can help shake up the ritualistic nature of compulsive behavior—which is part of why we keep going back to it; it becomes a habit.
For some compulsions (like gambling or eating candy), you may find that it’s best to stop doing it completely because even a little bit of it will throw you back into a pattern.

 

Finally, if you feel you need more help, consider seeing a therapist. A combination of psychotherapy— to understand the roots of the behavior— and cognitive-behavioral therapy—to give you tools to change the actual behavior—is often what works best. In Kate’s case, we were able to work through her shoe-shopping compulsion by focusing on her underlying depressed mood. She still struggles from time to time, but she has greatly benefited from individual as well as group therapy sessions (not dissimilar to AA).

Sometimes, medication can also help. If a compulsive behavior is serious and doesn’t get better with talk therapy, a psychiatrist may prescribe an antidepressant. These drugs affect levels of serotonin and norepinephrine—two brain chemicals that have been linked to compulsive behavior as well as the anxiety and depression that may accompany it.
Gail Saltz, MD , a psychiatrist and psychoanalyst, is a clinical associate professor of psychiatry at New York Presbyterian Hospital, a TODAY show contributor and author of Becoming Real and Anatomy of a Secret Life

http://today.msnbc.msn.com/id/42382372/ns/today-today_health/

5 Things NOT To Do On Airplanes!

Every time you get on an airplane, it's a crap shoot. No, I'm not talking about safety but rather the person you'll be sitting next to. All walks of life end up flying at one point or another. Maybe you're stuck sitting next to someone who doesn't quite understand that his actions impact others around him. Or maybe YOU are that person.

 

For that reason, I thought it would be fun to go through the top five things you really shouldn't do on an airplane.

1. No bare feet -- It should go without saying that being cooped up on an airplane with others mere inches from you is painful enough with everyone clothed. Just because it's a long flight does not mean you can get as comfortable as you get at home. Sure, go ahead and kick your shoes off, but you better be wearing socks. And if your feet smell, put those shoes right back on to make sure that you contain the stink. This one applies in all classes. I was in business class on a flight last year where the seats were angled out. Sure enough, a guy across the way put his bare feet right up there for all to see (and smell) as they walked down the aisle. Don't do it.

2. Don't abuse the recline -- Coach passengers have few things that they can control in the flying experience, but one is the angle of their seats. For most, there is a realization that if you recline your seat, it will impact the person behind you. There are those few gems out there, however, who simply don't care and jack that seat back as far as it will go. You have the right to recline, but try to be considerate. Don't be that guy who sees a cart rolling down the aisle with dinner on that long flight and decides to lean back. It's hard enough to eat on an airplane, but it's impossible with the seat bending back into your face. (Note: Some airlines have seats that recline into themselves, so go ahead and recline away in those. You'll only impact your own legroom.)

3. Don't be an overhead hog -- Everyone knows that there is likely going to be more demand for overhead bin space than actual space up there, so why not do your part to help get as much up there as you can? Put your roller bag wheels-in instead of sideways, if it fits. Don't take up a ton of space by placing a coat along the entire bin, as I've seen almost any time the temp dips below 50 degrees. More important, if someone asks if she can move your bag around to try to fit her own, let her. Think of it like a big Tetris puzzle, and you don't want to leave an empty space.

4. No talking loudly to strangers -- There are some people who love to talk to their seatmates on airplanes; there are others who dread the thought. There's nothing wrong with talking to your seatmate if there's a mutual interest, but keep the volume down to avoid bugging those around you who really don't care where you're from and what you do for a living. And just because you're talking to someone doesn't mean that he wants to talk to you. Be very careful to observe the warning signs -- fidgeting, quietness, looking away from you, opening a magazine, etc. Some people aren't rude, but they don't want to talk to you. Take a hint.

5. Don't make dumb jokes -- It's amazing how many people out there still think it's funny to say, "I've got a bomb," or something equally stupid. Oh sure, it's hi-larious to you, but it's only going to get you thrown off the plane and into heavy questioning. You might have no better way to spend your time, but when you delay that flight, you'll have a hundred or more new enemies who wish you'd never boarded.
This list is far from exhaustive. Just let your conscience guide you (if you have one). Be nice to people and respect the rights of others and you'll all be much happier when you get where you're going.

http://www.cnn.com/2012/02/21/travel/snyder-airline-passenger-behavior/index.html

Survey Finds Many Married Couples Still 'Intensely In Love'

Sue and Bob Frause, who have been married for 37 years, say one of the keys to their long romance is to not take the little stuff too seriously. "It's got to be fun, otherwise, why bother?" says Sue Frause.

Sue and Bob Frause of Langely, Wash., have been happily married for 37 years. Or, as they might title the story of their lives: "Couple, happily married for 37 years."
One of their goofier common interests: the pair often slips into headline-speak, a result of their shared background in communication careers. (It's usually used to soften the edge of a request that might otherwise be considered naggy, explains Sue Frause. For example, she says, rather than calling her husband out for not doing the dishes, "I'll walk by the kitchen and go, 'Man leaves dishes in sink, woman throws pot out window' .... then and then he laughs and I laugh and it's not an issue.")

Sometimes it seems like a couple that's still in love after decades together actually is rare enough to warrant a news headline. Most of us assume that the sparks that fly during those dizzy, dreamy first days of a relationship fade with time. (Or, as Oscar Wilde phrased it: "One should always be in love; that is the reason one should never marry.")

But that doesn't have to be the case, a growing number of studies are suggesting.
In a new national survey of married Americans, 40 percent of those who'd been married at least 10 years said they remained "very intensely" in love with their partner. The study sought to determine whether long-term romantic love was just a rare phenomenon, and the researchers, led by Daniel O'Leary, a clinical psychologist at Stony Brook University in Stony Brook, N.Y., were surprised to find just the opposite. Even for the longest marriages -- three decades or more -- 40 percent of women and 35 percent of men said they were still madly in love.

The report, done by social psychologists at Stony Brook University and Harvey Mudd College, is already published online, and will appear in the March issue of the journal Social Psychological and Personality Science.

The report gathered data through a randomized telephone survey done over about four weeks in August and September of 2007, and the study results were drawn from the 274 married individuals across the U.S. who completed the survey. On average, the respondents were in their mid- to late-40s, and had been married for around 20 years. (A second survey was conducted in the fall of 2009, surveying just New York state residents. Just 33 percent of those living in New York state said they were still intensely in love with their long-term partners. But the researchers expected that -- those in the Northeast tend to report lower levels of happiness and well-being in general.)

They also wanted to find out some of the reasons why love sometimes does last for the long haul: Those who said they remained "intensely" in love were also more likely to think positively about their partner and to think about their partner when they were apart; they also reported more frequent hugs, kisses and, yes, sex. Lasting love was also associated with common interests -- especially those that were new or challenging -- and general life happiness. On the other hand, the results also identified two things that don't matter when it comes to long-term love: education level and money.

"The idea is we don't have to assume that it's just going to be serving the oatmeal to each other" as the decades slip by, says Arthur Aron, a social psychologist at Stony Brook University and one of the authors of this study.

Sue Frause, 61, says she and Bob, 66, believe intensity is good when it comes to love - but not when it comes to day to day issues that can get heated. They say one of the secrets to their relationship is that "we've learned to diffuse things that have become amplified so it's not that big of a deal," she says. "... It's got to be fun, otherwise, why bother?"

She says both of them strive to keep the romance alive, even in the simple things. He husband Bob, 66, recently made her a CD mix of love songs. For Valentine's Day, she's making him the same dinner she first made him when they were were dating. "I call it 'Sentimental Stroganoff'," she says.
Last January, Aron authored a study that looked at brain scans of adults in long-term marriages who said they still felt in love now as they had at the beginning of their relationship. They compared those images with brain scans of couples who had just fallen in love. The scans found similar activity in both types of couples in the ventral tegmental area, the reward-processing region of the brain.

OK, but how do you make sure love sticks around? This may be that rare instance where advice found in women's magazines is right: Try something new together. You could take a class, start a new hobby or learn a new sport -- but it could be even simpler than that. Aron and his wife recently decided to do something together they hadn't done in years: hang out at a bar.

And, as it turns out, you may be doing your part simply by reading this post. We assume that love can't last because that's what we hear again and again. But knowing that isn't always the case may be the first step to lasting love."There is actually a possibility that it's not just a fairy tale, that there are people that live happily ever after," Aron says. "Some people actually do it."
TODAY.com contributor Diane Mapes contributed to this post.

http://todayhealth.today.msnbc.msn.com/_news/2012/02/06/10332187-many-married-couples-still-intensely-in-love-survey-finds

Madonna: An Interview From The Vaults

Madonna impressed with her performance at the Super Bowl. Here, in our latest visit to Rock's Backpages – the world's leading archive of vintage music journalism – Kris Needs catches up with the Material Girl for Flexipop! magazine, when she visited London in May 1983, months before her first hit.

'It's important to exude sexuality on stage' … Madonna in 1983.

 

These days I wake up more and more feeling death's breath around the corner as I near the winter of my years. It's so hard being a drunken bum and working for Flexipop!. I should have been a ballet dancer.

This was the conclusion I came to after talking to the gorgeously perky Madonna, over here recently to say hello and do some club sets.

"The thing about dancing – what it taught me all those years – is it gives you an amazing sense of discipline in forcing yourself to do things that you know are good for you but you don't really want to do. It's self-preservation. A lot of people in the music industry wreck themselves. I know that my lifestyle is a lot different from a lot of other people because of the training I've had. It can be a real long life if you make it that way."

And a short one if you don't, I suppose [hack, wheeze, etc]. (This advice was obviously inspired by the alcohol-marinated apparition sitting before her who'd just been to a booze-sodden lig hosted by Noel Edmonds to launch this new invention called the CD.)

Not to worry, though. Madonna's first single – the Rusty Egan-remixed Everybody – is real hangover-repellent, made for the legs and those who find it taxes the old brain too much to lurch along and scoop up the latest hot funk item in over-priced import shops. Madonna performs to backing tapes with three handpicked black dancers she found in the New York clubs. She's quite aware of her power to turn legs to jelly but refuses to do it blatantly.

"I think it's really important to exude sexuality on stage, but I don't think I have to entice men. I don't think people have to be aroused sexually by what you wear. I get over that by way of being sexy just by the way I sing and move on stage.

"The way we dress is sort of playful-innocent: Bermuda shorts, ankle socks and shoes, crazy hats. I don't wanna wear something that I'm going to fall out of. I don't feel comfortable like that. But I'm really physical onstage, y'know? I move around a lot."

Madonna wants to take her music out of ghetto-elite typecasting. "I feel I'm trying to get rid of a lot of stereotype. I come out there and I'm white and look like a boy on stage. I refuse to act the way someone expects me to."

Though she said hello to the big, wide world in Detroit, Madonna was magnetised by New York City as soon as she got out of school; played in a few groups, studied ballet and started writing songs. Now she lives in the heart of the junkie cesspit called the Lower East Side.

"I live in a supposedly dangerous area, near 'Needle Park'. They're always selling stuff in the street outside my apartment building. I don't like it but I like living amongst all the squalor. It's good inspiration.

"Detroit is a more desolate, desperate place. At night everyone locks themselves away. There's always elements of danger in New York but people are always out on the street. I don't feel scared there at all."

Another record is set for release soon – a double A-side coupling two self-explanatory titles: Burning Up and Physical Attraction.

Later that day she turned in an energetic performance at the Camden Palace, leaving many in no doubt that this girl was no flash in the pan.

I'm gonna buy me some shorts.

http://www.guardian.co.uk/music/musicblog/2012/feb/07/madonna-interview

The pink ribbon's ugly new image

In one swift move, the Susan G. Komen For The Cure foundation has undermined its pro-woman, pro-health, pro-solidarity image.

By pulling funding from Planned Parenthood for breast cancer screenings -- not to mention after Republican activist and abortion rights opponent Karen Handel came on board as vice president of public policy -- and couching the decision as new protocol, Komen’s turned into an org women won’t want to be associated with. Not all women, of course. But there will be a lot us who'll not longer be able to look at the pink ribbon as simply “breast cancer awareness.” They’ll think: What self-respecting, abortion rights supporter who cares about women’s rights and women's health would be caught wearing a pink ribbon now, much less buying any of the many products that display the pink insignia? With one decision, Komen turned the pink ribbon into an ugly and polarizing symbol.

Opinionators and senators are also lamenting Komen’s move. Here's a roundup chronicling some of the critique.
Andrew Rosenthal of the New York Times writes: “[Komen] have not only made it harder for women to have abortions, but also to get birth control counseling, prenatal care, and now cancer screenings.”

Kevin Drum of Mother Jones writes: “The right's recent jihad against Planned Parenthood is about as loathsome as anything I've ever seen come out of them. They simply don't care anymore how many people they hurt or how much harm they do to anyone they disapprove of.”

Erin Gloria Ryan of Jezabel writes: “Komen's brand is imploding and seriously alienating young women and politically progressive supporters who were drawn to the cause expressly because of their non-political approach to a non-political disease. But when a charity hires a woman like Handel, a woman who must always attach politics to a woman's body, and allows her to project her political beliefs into her work, Komen ceases being a viable charity and starts being a self-righteous political organization for rich ladies who like hanging around with celebrities. It's a social club, and the only thing it's curing right now is people's desire to raise any more money for them.”

Megan McArdle at the Atlantic writes: “In that environment, you can see why an organization that does not itself have a mission to support abortion access would want to pull back from funding Planned Parenthood, even for related services. Unfortunately, while they easily could have declined to fund PP without much backlash, de-funding them sends an extremely explicit message that is probably going to cost them significant public support. Which is a pity, because early detection and treatment of breast cancer is a mission that we should all be able to agree on.”

Senators Lautenberg, Murray, Mikulski, Boxer, Cantwell, Gillibrand, Menendez, Wyden, Blumenthal, Shaheen, Begich, Merkley, Tester, Akaka, Sanders, (Sherrod) Brown, Leahy, Baucus, Cardin, Feinstein, Franken, and Kerry write in a letter re-posted on the Washington Post:

More than 90 percent of the services provided by Planned Parenthood are primary and preventative including wellness exams and cancers screenings that save lives. Each year, Planned Parenthood health clinics provide 750,000 breast exams, 770,000 pap tests and nearly 4 million tests and treatments for sexually transmitted diseases. Twenty percent of all women in the U.S. have visited a Planned Parenthood health center....
Komen funding for Planned Parenthood has provided nearly 170,000 clinical breast exams and resulted in 6,400 referrals for mammograms. In 2011 alone, grants from Komen provided Planned Parenthood with roughly $650,000 in funding for breast cancer prevention, screening, and education. According to a recent statement by Komen, “In some areas of the U.S., our affiliates have determined a Planned Parenthood clinic to be the best or only local place where women can receive breast health care.”

It would be tragic if any woman -- let alone thousands of women -- lost access to these potentially life-saving screenings because of a politically motivated attack.

Hear, hear.

http://opinion.latimes.com/opinionla/2012/02/komen-controversy-pink-ribbon-ugly-new-image.html