Ms. Jacqueline C. Oshiver, LCSW, NJ LMFT 37FI00197000, NY LCSW 035353

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.

These problems and others can make a job seem unbearable. For example, a demanding or detached supervisor can contribute to poor job satisfaction and work anxiety. Similarly, a lack of control in one's job, such as the inability to work on a project or make day-to-day decisions, can diminish one's workplace morale. Many workers in these situations find themselves dissatisfied and eager to leave their jobs or even to become fired. However, resignations and job losses can pose equally challenging career difficulties. Job loss or unemployment can trigger financial stress as well as feelings of isolation, depression, and diminished self-confidence. People experiencing job loss may feel dissatisfied with other job prospects or fear their career opportunities are limited.

For many, mental health therapy can improve negative emotions and behaviors arising from career difficulties and both those with jobs and those experiencing job loss may benefit from therapy. Therapists may listen to people's career difficulties and provide advice for navigating a number of work-related problems. Online counseling can be particularly helpful for career issues in the modern workplace in that direct access to a therapist throughout the day can help alleviate recurring pressure and anxiety arising from one's job. Many people find that therapy or counseling for career difficulties can improve their overall job performance and disposition. For example, therapists can guide people to develop and hone essential skills, such as building the self-confidence necessary to deliver a presentation or the sustained focus needed to complete a lengthy project. For those experiencing job loss or unemployment, therapy can help with feelings of isolation, depression, and diminished self-confidence. Therapists may encourage some to seek other job prospects and opportunities. Like some problems in other areas of life, difficulties in the workplace can be debilitating for some, and consultations with a therapist can help some overcome initial feelings of being overwhelmed.

Career counseling is another option for those with career challenges. Career counselors help people develop professional skills and gain the tools necessary to further their careers. A career counselor may help with job applications, coach practice job interviews, proofread resumes, and provide networking strategies to move someone towards his or her ideal career. Career counseling can also help people navigate work problems like lack of motivation, indecisiveness, and burnout, so that they might better enjoy their current position.

Some people decide to switch career paths in order to achieve happiness and fulfillment. Through personality and aptitude tests, therapists and career counselors can help people identify occupations or industries that are better suited to them. Therapists and counselors also take into account a person's intellectual and physical strengths, as well as what a person values in work, whether that be job security or opportunity for creativity and challenge. Therapists and career counselors may recommend people complete certification courses or educational degrees to shift towards their ideal careers.

Career difficulties are a widespread issue that nearly everyone who works has or will endure at some point in time. Many people find that mental health therapy or career counseling can greatly improve their career satisfaction and overall happiness.

We don't yet know what causes depression, but it's thought that it is a combination of genetic, biological, environmental, and social influences. Because of this, the most effective treatments for depression combine medication with psychotherapy. Therapy, especially cognitive-behavioral therapy, can be extremely helpful in resolving the negative thoughts and feelings that come with depression. It gives patients new tools that they can use themselves to cope when their depression is making them feel down.

Some of the common medications used to treat depression include antidepressants such as SSRI's (Prozac, Paxil, Zoloft) or atypical antidepressants (Cymbalta, Wellbutrin). It's important to remember that these medications have different effects on everybody, and no one medication works right for everyone. Patients may have to try a couple before finding the one that works just right for them. If the first medication they try doesn't work, they should talk to their doctor about trying something else. In extreme cases where medication is not enough, electro-convulsive therapy and hospitalization may be the answer to keeping a severely depressed person safe.

Depression is a difficult illness to deal with, but it is more common than believed and there are many people who can help. With the right treatment, individuals with depression can get back to fully enjoying life again.