Dr. Barbara Carol Holder, PSYD, MFT

Those suffering with a substance abuse addiction are often unable to cease their behavior without some form of medical intervention. Studies have found that repeat use of certain drugs can figuratively rewire the brain, resulting in alterations to neural pathways associated with dopamine. This means that repeat drug users may become reliant on consuming the substance in order to function. For example, those with alcohol addiction ("alcoholism") become physically dependent on alcohol and may experience extreme withdrawal symptoms when avoiding alcohol entirely; in rare cases, medically unsupervised withdrawal can lead to death.

Behavioral addictions are similar to substance abuse addictions; however, people with behavioral addictions are addicted to a behavior or emotion associated with certain behaviors, as opposed to drugs. In addition to gambling, common behavioral addictions include food, video games, social media, shopping, and pornography addictions. When performing the activity, people experience euphoria (a rush of dopamine) that slowly lessens over time, meaning they build a tolerance and dependency on a behavior. For example, people who are addicted to shopping may need to purchase more items or spend more money to feel the same rush that once fueled their addiction.

Addictions can be assessed through a variety of means such as diagnostic screening, abuse assessment, or psychiatric evaluation. Treatment can help patients recover from their addictions and manage mental and physical health conditions related to their addiction. People with addictions may be treated in rehabilitative treatment facilities, hospitals, and other clinical settings.

Addiction treatment for substance abuse may include:

• Detoxification (withdrawal from an addictive substance)
• Pharmacotherapy (prescription medications), such as buprenorphine-naloxone (Suboxone), disulfiram, and naltrexone to ease withdrawal symptoms
• Overdose treatment, such as the administration of naloxone (also known as Narcan)

Addiction treatments for both substance abuse and behavioral addictions may include:

• Addiction therapy and psychiatric care, such as cognitive behavioral therapy (CBT)
• Prescription medicine for co-occurring psychiatric disorders
• Twelve-step programs and support groups, such as Alcoholics Anonymous (AA) or Food Addicts Anonymous (FA)

Addiction treatment has expanded to include care for patient substance abuse in non-clinical settings. A number of community programs now provide at-risk substance users a safe place or means to use drugs and mobile doctor's services for drug-associated illnesses and injuries. Behavioral addictions are also gaining increased attention as researchers and mental health professionals seek to better understand and treat them. For example, some researchers are assessing the connections between video game addiction and childhood risk factors. More and more, mental health experts are recognizing the importance of meeting people with addictions where they are at, using more advanced treatments. Addiction treatment is intended to care for people with addictions with compassion and respect.

Collectively, anxiety disorders are the most common mental health issues diagnosed in the United States -- even more common than depression. Women are more likely than men to be diagnosed with anxiety, and it is extremely common for a person with anxiety to have another illness at the same time, such as depression, a physical illness, or substance abuse.

Treatment for anxiety usually involves medication and psychotherapy together. Medications used may include antidepressants (which also work for anxiety), anti-anxiety medications, or beta blockers (which can be used to control the physical symptoms of anxiety). Psychotherapy can be useful to teach patients new ways of thinking and reacting so that they can manage their feelings of worry and fear. Support groups can also be very effective for anxiety, and they can be a form of treatment themselves for social phobias. Stress management, relaxation techniques, and meditation all help reduce feelings of anxiety or of being out of control. Finally, having a strong support network of family and friends is an excellent way to help manage the difficulties of life with anxiety.

Episodes may be a mixture of both manic and depressive symptoms. In such an episode, individuals with bipolar disorder may feel sad, empty, and hopeless but have a high level of energy at the same time. Sometimes, changes in mood are less dramatic. For example, individuals may feel happy and think everything is fine, but people around them may notice their mood changes. Episodes like this are called hypomania. If an individual is hypomanic and does not receive proper treatment, their condition will likely worsen.

Generally considered a lifetime illness, the disorder begins in the late teen or early adult years. Bipolar disorder has no known cause, but research has shown that it tends to run in families. To diagnose it, a psychiatrist carefully assesses an individual's moods and behavior patterns. They may also be asked to keep a daily record of their moods and other factors that can help with diagnosis and determining the right course of therapy. Counseling is a typical form of treatment, as is a group of medications that can control symptoms, called antipsychotics.