How Healthy Eating Can Help You With Addiction Recovery
Written by Munis Topcuoglu, Editor at EHN Canada.
Healthy eating helps you with addiction recovery by allowing your mind and body to work better and heal faster. It helps you maintain your recovery by supporting your mind and body to function well consistently, thus maintaining your good health. Eating a healthy diet helps you with addiction recovery in a number of specific ways such as stabilizing your mood, improving your focus, increasing your energy, and making you better at resisting cravings for addictive substances and behaviors. Conversely, nutrient deficiencies can make addiction recovery more difficult by making you more susceptible to depression, distraction, fatigue, and cravings. Substance use disorders can make you are especially vulnerable to nutrient deficiencies, for a number of behavioral and biological reasons—but healthy eating can help correct your nutrient deficiencies and greatly improve your odds of successfully achieving recovery and maintaining it long term.
Healthy Eating Means Getting the Right Nutrients and Calories in the Right Quantities
Your mind and body use up nutrients and energy constantly, so healthy eating requires that you get sufficient nutrients and energy regularly from the foods you eat. Healthy eating means getting enough of all the nutrients you need to function well and be healthy, but not excessive amounts of any nutrients that would be enough to harm you. Healthy eating also means getting enough calories (energy) that you need for performing healthy physical activity and maintaining a healthy body weight, but not so much that it would cause you to gain an unhealthy amount of body fat.
There are two main categories of nutrients, macro-nutrients and micro-nutrients. Macro-nutrients are basic building blocks and energy sources for your body; you must get them in relatively large amounts, such as 10’s or 100’s of grams per day. In comparison, micro-nutrients have specialized functions in your body; you need them in much smaller amounts, such as micrograms or milligrams per day.
The three macronutrients are protein, fat, and carbohydrate.
Protein is used for building and repairing all the cells in your body. It is especially important for muscle and connective tissue, but is also necessary for producing hormones and neurotransmitters. Proteins are composed of amino acids. There are some amino acids that your body needs but cannot produce: these are called “essential amino acids.”
Fat is a preferred energy source, but is also essential for your nervous system, building cell membranes, and producing hormones. There are some fats that your body needs but cannot produce: these are called “essential fatty acids.”
Carbohydrates are an optional energy source. Appropriate carbohydrate intake depends on your physical activity levels and your genetics. Excessive carbohydrate intake can disrupt your metabolism, cause you to gain unhealthy body fat, and lead to diabetes and cardiovascular disease.
The two main groups of micro-nutrients are vitamins and minerals. Vitamins are organic molecules and minerals are chemical elements. Each vitamin and mineral has specialized roles within your body and they are all required in small amounts for your mind and body to function properly. Your body cannot produce vitamins or minerals.
Essential nutrients and healthy foods
Essential nutrients are nutrients that your body requires to function properly but cannot produce, they are the following: essential amino acids, essential fatty acids, vitamins, and minerals. Since your body cannot produce them, you must get them from the food you eat.
Healthy eating means getting all the essential nutrients that you need. Therefore, healthy foods are foods that contain high amounts of essential nutrients; they are usually whole, unprocessed, and fresh. In contrast, unhealthy foods contain low amounts of essential nutrients and are often refined, processed, and contain preservatives.
Addiction Makes It Difficult to Eat Healthy, Often Resulting in Nutrient Deficiencies
Addictive substances and behaviors can make healthy eating more difficult in a number of ways. They can also prevent you from getting enough nutrients despite a normally healthy diet. When you don’t get enough of a particular essential nutrient in your body, you develop a nutrient deficiency. Addictive substances can interfere with healthy eating and cause nutrient deficiencies in the following ways.
Reducing your appetite
When your appetite is reduced and you regularly eat less food, you might not get enough nutrients and energy even if the foods you eat are normally healthy foods.
Increasing cravings for unhealthy foods
When you have cravings and eat a lot of unhealthy foods, it can be difficult to get all the nutrients you need, since unhealthy foods contain low amounts of essential nutrients.
Reducing how well you absorb nutrients
Getting enough nutrients requires that you absorb the nutrients from food in your digestive system. Since some addictive substances can reduce your ability to absorb nutrients, you might not get enough nutrients even if you have a normally healthy diet.
Depleting nutrients in your body
Getting enough nutrients means that the amount of each nutrient you get equals the amount your body uses up. Some addictive substances can cause your body to use up nutrients in much larger quantities than normal, or they can destroy nutrients in your body. When either of these happens, you might not get enough nutrients even if you have a normally healthy diet.
Reduce your motivation to eat healthy
Staying motivated to eat healthy requires maintaining the belief that healthy eating will produce positive outcomes for you. It also requires the confidence that you will succeed at healthy eating long enough to experience those positive outcomes. Addiction can make it more difficult to maintain a positive outlook on the future and can also negatively affect your confidence.
Take your attention and energy away from your goal of healthy eating
Especially when you first start, healthy eating requires that you pay careful attention to choosing the foods you eat. Shopping for and preparing healthy foods also usually requires more time and energy compared to unhealthy foods. Addictions can be distracting and take your attention away from healthy eating. They can also get in the way of healthy eating by draining your time and energy.
Nutrient deficiencies and too few calories
As described above, recovering addicts often do not eat healthy and do not get enough nutrients and calories. If you are a recovering addict, you may have nutrient deficiencies that are harming your mind and body in ways that make getting sober and staying sober much harder. A caloric deficit (eating too few calories) can also make getting and staying sober much harder.
Healthy Eating Makes Addiction Recovery Easier—Nutrient Deficiencies Make It Harder
There are a number of factors that are essential for addiction recovery and recovery maintenance. These factors are positively affected by healthy eating and negatively affected by nutrient deficiencies.
Mood and confidence
A positive outlook and confidence in your ability to overcome challenges makes it easier to accomplish difficult tasks. Healthy eating can help maintain a stable positive mood whereas nutrient deficiencies can make you more vulnerable to anxiety and depression. For example, research has shown a relationship between folic acid (vitamin B9) deficiency and depressed mood, and also a relationship between thiamine (vitamin B1) deficiency and decreased self-confidence (Ottley, 2000).
Focus and awareness
Focusing on achieving your goals combined with maintaining awareness of yourself and your environment are very useful practices. Healthy eating can improve your ability to focus and maintain awareness whereas nutrient deficiencies can make you more vulnerable to distractions. An example is magnesium deficiency, occurring especially frequently in recovering addicts, which has symptoms including confusion and insomnia (Flink, 1985).
Motivation, drive, and energy
Consistent motivation, drive, and energy are necessary for problem solving and overcoming obstacles. Healthy eating can help maintain high levels of motivation, drive, and energy whereas nutrient deficiencies can cause you to experience more ups and downs that jeopardize your success. A well-known example is iron deficiency which can cause apathy and abnormal fatigue (Ottley, 2000).
Experience of cravings and ability to resist them
Feeling cravings less intensely and being able to resist them are both critically important. Healthy eating can make your cravings for addictive substances and behaviors less intense, it can also strengthen your willpower to resist them. Conversely, nutrient deficiencies can make your cravings more intense and weaken your willpower. One example is a study which showed that alcoholics treated with a traditional therapy combined with nutritional therapy had less alcohol cravings and were more successful at abstaining compared to alcoholics treated with only traditional therapy (Biery et al., 1991).
Too Much of Certain Macro-Nutrients Can Also Make Recovery and Maintenance Harder
Certain macro-nutrients consumed in excess can harm you and make addiction recovery and recovery maintenance more difficult, a few examples follow.
Too much sugars (simple carbohydrates) can cause you to have unstable energy levels, intensified cravings, and lower willpower. Sugar is a reinforcing substance which has demonstrated cross-sensitization with other addictive substances such as amphetamine and alcohol in rodent models (Hoebel et al., 2009).
Fat: ratio of Omega-6 to Omega-3
Researchers believe that a high ratio of omega-6 to omega-3 (two fatty acids) can increase systemic inflammation which contributes to the development of chronic conditions such as arthritis and cardiovascular disease (Patterson et al., 2012) and also depression (Berk et al., 2013).
Some addictive substances cause kidney damage. If you have kidney damage, there is evidence which suggests that excessive protein consumption can make it worse (Levey et al., 1996).
For Best Results Make Healthy Eating a Part of Your Addiction Recovery Plan
Healthy eating will ensure that the food you eat is helping your addiction recovery and not holding you back. It will ensure that the food you eat is protecting you from relapse and not increasing your risk.
Healthy eating is challenging for anyone and to succeed you need a clear plan for how you will start eating a healthier diet and for how you will develop habits to keep eating healthy for the rest of your life. The following list is a good starting point:
- Eat whole, fresh, unprocessed foods.
- Avoid fast food—completely, if possible.
- Avoid refined sugars—completely, if possible.
- Avoid highly processed vegetable oils (e.g. canola)—completely, if possible.
- Cold-pressed olive oil and other minimally processed vegetable oils are okay in small amounts.
- Avoid grains—completely, if practical. If you are very physically active or trying to gain weight, go with white rice.
- Consume unprocessed, whole-food sugars and starches sparingly (e.g. fruit, sweet potatoes, squash) unless you are very physically active or trying to gain weight.
- Eat a variety of different foods whenever possible.
- Eat meat that is grass-fed, organic, or naturally raised.
- Eat fish that is wild-caught or organic.
- Grass-fed butter is a great source of healthy fats and fat-soluble vitamins.
- Consume grass-fed milk or cheese only if you, personally, can tolerate dairy.
- Eat vegetables as tolerated and needed for regular digestion.
- Consume nuts and seeds sparingly.
However, each individual’s nutritional requirements are different, due to a wide range of factors. Professional consultation can help you design a personalized plan for your own specific needs and develop a deeper understanding of your unique nutritional requirements.
EHN Canada Facilities Can Help You Eat Healthy, Achieve Recovery, and Maintain It
The comprehensive drug rehab and other treatment programs at EHN Canada facilities include nutrition planning through consultation with our staff dietitians. Our nutrition planning aims to get you eating healthy with the following objectives for successful long-term addiction recovery:
- Stabilize your mood and improve your resilience;
- Increase your focus and energy levels;
- Reduce your cravings for drugs, alcohol, and addictive behaviors;
- Heal the damage caused to your body by alcohol or substance abuse;
- Improve any other medical conditions you may have;
- Develop habits of self-care and a healthy lifestyle.
Please Call Us for More Information
If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.
- 1-800-387-6198 for Bellwood Health Services in Toronto, ON
- 1-587-350-6818 for EHN Sandstone, in Calgary, AB
- 1-800-683-0111 for Edgewood Treatment Centre in Nanaimo, BC
- 1-888-488-2611 for Clinique Nouveau Depart in Montreal, QC
Online Treatment and Support
If you’d like to learn more about our online treatment and support options, please call us at 1-800-387-6198 or visit onthewagon.ca.
Further Reading About How Specific Nutrients Can Help Addiction Recovery and Recovery Maintenance
Protein Part 1
Protein Part 2
Vitamins & Minerals
Berk, M., Williams, L. J., Jacka, F. N., O’Neil, A., Pasco, J. A., Moylan, S., … & Maes, M.
(2013). So depression is an inflammatory disease, but where does the inflammation come from?. BMC medicine, 11(1), 200.
Biery, J. R., Williford, J. J., & McMullen, E. A. (1991). Alcohol craving in rehabilitation: assessment of nutrition therapy. Journal of the American Dietetic Association, 91(4), 463-466.
Flink, E. B. (1985). Magnesium deficiency in human subjects—a personal historical perspective. Journal of the American College of Nutrition, 4(1), 17-31.
Hoebel, B. G., Avena, N. M., Bocarsly, M. E., & Rada, P. (2009). Natural addiction: A behavioral and circuit model based on sugar addiction in rats. Journal of Addiction Medicine, 3, 33-41.
Levey, A. S., Adler, S., Caggiula, A. W., England, B. K., Greene, T., Hunsicker, L. G., … & Teschan, P. E. (1996). Effects of dietary protein restriction on the progression of moderate renal disease in the modification of diet in renal disease study: modification of diet in renal disease study group. Journal of the American Society of Nephrology, 7(12), 2616-2626.
Ottley, C. (2000). Food and mood. Nursing Standard (through 2013), 15(2), 46.
Patterson, E., Wall, R., Fitzgerald, G. F., Ross, R. P., & Stanton, C. (2012). Health implications of high dietary omega-6 polyunsaturated fatty acids. Journal of nutrition and metabolism, 2012.x
Colleen Lamond, an interview with our Team Lead of Admissions.
Meet the front lines of Bellwood Health Services Team Lead of Admissions
Colleen Lamond has been working with Bellwood for 8 years. She is the lead of admissions team and is one of the many faces people meet when starting their journey here at Bellwood. We asked how working in this field has changed her perspective:
“Everyday I am changing and I am learning, to the point where I have fundamental changes in how I navigate my life…how I communicate or share with my family and friends, how I impact others or how others’ experiences impact me, ways to cope with my own stress… Sometimes, it happens overnight and I wake up the next morning and I have such a profound awakening for something I learned the day prior…Whether it’s working with my team or working with a client or another organization…”
Leading a team of 8 staff can almost feel like leading a family so we talked to Colleen about how she would describe the family here at Bellwood and EHN Canada, which came together in 2014:
“We are a new, blended family that has come together…we are skillfully, mechanically and structurally sound, but the glue that binds us is our strong embrace of family-centered values.”
With most health care facilities, there is a lot of people looking for information to make sure they can get the best possible help for themselves or their loved ones and the screening process can help answer those questions. When talking to Colleen, I asked, “what is the question you get a lot that you wish people knew the answer to before coming here?”:
“Bellwood has very comprehensive programs that will leave no stone unturned. We will treat with the biopsychosocial model, so we look at what are your physical needs?…What are your mental health needs?… What are your social needs? So how do we work with you and how you relate to your family, your friends or other people? How do we work on any underlying traumas, mental health needs, your thinking patterns?”
She went on to say:
“We’ll also help you get physically well again with the medical care, with the nutrition, with the recreation training and so forth…I think that takes people by surprise at times, how you think you’re going to come in and you’re going to learn the skills for your addiction, how do I not use, when in actuality, you’re going to learn how to navigate your life in a whole different way that makes it a lot easier not to use. How do I create a life whereby it is easier not to use?”
We had a great time talking to Colleen, she is an adorable person, strong team player and a valuable asset to what makes Bellwood an incredible work environment. Looking forward to see what the future has to bring for her.
Breathing under water: living with health, wholeness, serenity and addiction
B Y L E E H A U S M A N N M A , I C C A C
“Breathing Under Water”
I built my house by the sea.
Not on the sands, mind you;
not on the shifting sand.
And I built it of rock.
A strong house
By a strong sea.
And we got well acquainted, the sea and I.
Not that we spoke much.
We met in silences.
Respectful, keeping our distance,
but looking our thoughts across the fence of
Always, the fence of sand our barrier,
always, the sand between.
And then one day,
— and I still don’t know how it happened —
The sea came.
Without welcome, even
Not sudden and swift, but a shifting across
the sand like wine,
less like the flow of water than the flow of blood.
Slow, but coming.
Slow, but flowing like an open wound.
And I thought of flight and I thought of
drowning and I thought of death.
And while I thought the sea crept higher, till
it reached my door.
And I knew then, there was neither flight, nor
death, nor drowning.
When the sea comes calling you stop being
Well acquainted, friendly-at-a-distance,
And you give your house for a coral castle,
And you learn to breathe underwater.
~ Unpublished poem by Sr. Carol Bieleck,
It’s approximately 7:30 on a cold, clear February morning. I am standing at the floor-to-ceiling windows admiring the skyline of downtown Vancouver from our hotel room at Executive Suites. Our tentative plan is to take a side trip to Edgewood in Nanaimo and visit former clients. When travelling, I always bring my own instant coffee. I have gone from being an epicure of fine wines and hard drugs to a connoisseur of coffee. Our suite comes well equipped with an electric kettle for my morning indulgence. This suite also features a luxurious whirlpool tub which juts out into the walking space of our room. I pour the hot water into my favorite mug from home. As I am stirring, I walk towards the windows to admire the view and suddenly I am on the floor, coffee mug smashed on the marble edge of the tub, blood gushing from my hand. Nausea wellsup in my stomach as I realize what happened. I tripped over the whirlpool tub. I look at my left hand and two fingers are cut open. It doesn’t look good.
My partner calls for a taxi to take us to St. Paul’s Hospital. It’s a challenge for me to get into the cab with a smashed up hand and white bath towel soaked in blood. The driver gives me a frown of disapproval, warning me not to get blood on his seats. As we drive up to the emergency doors of the hospital, my hand is throbbing and the nausea increases. The staff at St. Paul’s is efficient and compassionate. After an agonising insertion of four needles to freeze my hand, I see the emergency doctor who quickly and competently sews up my fingers. No tendons were severed, but he suspects a nerve was sliced. This needs to be looked after when I return home.
Seven days later, I am prepped at SunnyBrooke Hospital for emergency hand surgery. I change into gowns, the standard one in front, one in the back. I am asked to lie on a hospital bed, answer a series of questions while an IV is inserted into my wrist. I ask, “What is this for?” The nurse says, “Just something to relax you.” I hadn’t expected this. The hand surgeon had said I didn’t need anything. Then without warning, the dopamine hits my brain and I’m getting ecstatic in the anticipation of mood altering drugs. I can’t believe it! I have been clean and sober for over twenty years, but when this information hits my brain I am feeling considerable anticipation and excitement. The anesthetist is standing over me in the operating room. I hear the shuffle of instruments, and then the drug hits! Ah, I’m feeling it, that first intense rush in my lower throat, then the captivation of my brain with intoxication, warmth and relaxation, like a mother’s hug. But I’m an addict, and it’s never enough. And I can’t believe what I do next. I have the audacity to say to her, “Did you know that if one dose is good, two will be better?” Through the haze, I hear her say, “Uuumm? Ok.”
“It all comes flooding back. How well
I know these rules. I teach this. I live
this. Active addiction, it’s just one
step away, one drink away, one
More. Never enough. No “Off” button. Never safely use again. Can’t stop at one. Obsession of the mind. Allergy of the body. Powerless. It all comes flooding back. How well I know these rules. I teach this. I live this. Active addiction, it’s just one step away, one drink away, one drug away.
The surgery is over and the benzodiazepines wear off. I’m prescribed Tylenol 3s. My daughter picks me up and drops me at home. I take the Tylenol as prescribed the first time, but the second time I think, “Two are good but four are better.” My addict is back, but not for long. I reach out to my partner, a good member of Al anon. He comes to take them away. A sigh of relief. The next day, I am at work and everything is back to normal, except my bandaged hand. Am I going to drink or use drugs again? No, I won’t. How can I say that with such conviction and so conclusively? It’s because I have learned to breathe under water.
Breathing under water is my ability to face a life crisis or have a brush with mood altering substances and not return to my addiction. When faced with difficult challenges and feeling like I am gasping for air, I have learned to accept the things I can’t control and let things be. I can drop into a place within myself that allows me to keep breathing without becoming consumed by external circumstances. “The New Testament called it Salvation, Buddhism calls it Enlightenment and the 12 Steps call it Recovery.” (Richard Rohr, “Breathing Under Water”)
I am a woman, a mother, a partner,a therapist, an active AA member, and I am an addict. My addiction is my treasured gift.
When I hit bottom, a timely Grace saved my life and led me to the rooms of 12 Step recovery. This crisis has been an opportunity for great spiritual growth. Using the tools laid before me through the 12 Steps, I was able transform my thinking, my belief system and my interactions with this world. I opened up to a new way of seeing, a new level of clarity, and a higher level of consciousness. I had no success until I acknowledged that all my human strength and willpower weren’t enough to fight this disease. I was going to drown. But instead, I surrendered. I was then taught to breathe under water through the “Work” of recovery. My journey began with rigorous honesty and humility. I had to admit I was at the end of my human capacity to stop my addiction and learn to surrender. In this surrender, I found a strength far greater than my own.
Hope replaced the hopelessness. The idea of faith was presented to me, but one that was expansive and inclusive. I then made a decision to turn my will and life over to the care of this power. Once I had built a foundation of faith, I was able to summon the courage to do a fearless, moral inventory. I needed to examine my life and my actions and take responsibility for harm I had done to myself and others. “The unexamined life is not worth living,” stated Socrates. Working through the Steps helped me to identify unhealthy patterns of behaviour. In my case, pride, ego, self-righteous anger, gossip, people-pleasing, and judging and controlling were all qualities that needed to be addressed. It required humility to realize my limitations while acknowledging my strengths. The paradox of humility is that I am both great and small. Continued daily mindfulness and reflection helps address issues in the moment, stopping them from growing into resentments or tensions. Self searching has become a habit and helps me to achieve and maintain emotional sobriety. I am able to sustain this through a meditation practice and service to others.
“In my case, pride, ego, self-righteous
anger, gossip, people-pleasing, and
judging and controlling were all
qualities that needed to be addressed.
It required humility to realize my
limitations while acknowledging my
strengths. The paradox of humility is
that I am both great and small.“
Breathing under water isn’t always easy. Some days I wonder, “Am I going to drown?” No, I am not. I have built a foundation for living that I step into with ease. When the waves of life threaten to disrupt my serenity, my work in recovery has taught me to drop into my centre and draw from the internal resources of faith, strength and love. I am then able to breathe under water. Inspiration for this article is taken from Richard Rohr’s book, Breathing Under Water, Spirituality and the Twelve Steps.
Lee Hausmann MA, ICCAC joined Bellwood Health Services in 2011 as a therapist focusing on individual and group therapy and has been involved in the field of addictions for over 20 years.
Lee holds a Master of Arts Degree in Addiction Counselling from the Hazelden Graduate School of Addiction Studies in
Minnesota. During her post-graduate specialization, she also completed her clinical training which included new patient
assessments, chemical dependency diagnosis, treatment planning, and aftercare recommendations. Lee is also a member of the Canadian Addiction Counsellors Certification Federation and holds an ICCAC certification.
In addition to her work at Bellwood, Lee maintains a private practice helping both men and women address their chemical dependency. She founded Women of Substance — an organization that supports women in recovery and their spiritual growth.
Intensive Outpatient Programs: A Flexible Option for Addiction Treatment Could be the Solution
Substance use disorders are pervasive and can affect everyone. Research has demonstrated that about one in ten Canadians reports having a substance use issue, and these individuals include professionals, those who are employed or self-employed and those who have other daily responsibilities and commitments such as homemakers and caregivers. At times, substance use disorders are problematic to the point that the individual needs to seek help from addiction counsellors and mental health professionals. Traditionally, when substance use is problematic, residential programming has been the conventional option for addiction treatment. However, taking an extended amount of time off could be a barrier in getting the help that is needed, especially for those who are employed or have daily commitments. It is for this reason that treatment providers also offer Intensive Outpatient Programs (IOPs). For those in need of addiction treatment, IOPs allow people to work and honour their daily commitments while also attending regular, outpatient treatment sessions in order to address their problems and to learn the tools that can help them maintain sobriety.
Outpatient programming is not for everyone but when appropriate, it can be a meaningful and effective treatment option to address a serious health issue such as a substance use disorder. As with any other treatment programs, recommending an IOP must be part of the individual’s treatment plan. This means taking into consideration any physical, emotional or behavioral problems relevant to the person’s care. The treatment plan must consider the needs of the client and begins with a comprehensive assessment of the individual. Once the assessment is complete, a professional can decide on the best level of care that will meet the client’s needs.
There are multiple factors that must be considered when determining whether or not someone is a good match for an IOP. For example, one of the primary considerations is the level of medical need such as a history of withdrawal symptoms, as well as existence of medical conditions that require monitoring. Professionals will also consider whether or not the individual has other emotional/cognitive/behavioral problems that may require closer attention by a mental health professional. In order to meaningfully participate and keep up with the program, the person must also have a sufficient level of motivation to be able to maintain sobriety while attending scheduled meetings. This often means that the client must have a stable and supportive home environment that will be able to foster a successful recovery.
IOPs typically take a group approach, providing clients with opportunities to learn from and support one another while developing communication skills and socialization experiences that do not involve the use of drugs or alcohol. Such programs that cultivate a supportive environment, also establish a safe and trusting relationship between group members, as well as the counsellor. Those that are further along their path of recovery can provide guidance and support for newer members, helping them refine the new skills and tools they are learning.
Clients typically participate in a variety of groups that make up an IOP program. Such groups can include psychoeducational sessions or lectures, where individuals can begin to understand the nature of addiction and how it has been impacting their mind, body and social life. These sessions are often also accompanied by relapse prevention and skills training, as well as a selection of videos that may help clients with their understanding of the material. Other groups may consist of teaching some very concrete skills such as assertiveness training, refusal techniques and stress management strategies.
As with any other treatment program, intensity and client retention are vitally important for outpatient programs. Research shows that successful outcomes are closely related with the length of program and how often clients are able to attend. It is also important that once the client completes the intensive component, they attend regular aftercare meetings and create a close network of supports that will help them maintain a successful recovery going forward. Such meetings can also serve as a safety net in case the person begins to struggle and may require more intensive support in order to prevent a full on relapse.
Successful outcomes also depend on client’s individual characteristics. For example, research has found associations between severity of substance use and treatment success. There is also something to be said about how long someone has been struggling with an addiction, the severity if their cravings and how many previous attempts at treatment may have had. Finally, symptoms of co-occurring mental health problems such as depression or anxiety can also impact an individual’s recovery. Overall, it is best to leave the decision of selecting an appropriate treatment modality to a professional who is able to consider a variety of factors that may be contributing to the maintenance of the addiction. However, when appropriate, participation in an IOP can be a realistic, meaningful and effective means of addressing alcohol and substance use disorders.
Mindfulness: From Distraction to Stillness
Stillness. The calm surface of a lake at dawn. The silence of an empty chapel. The soft quiet of a night full of stars. How we wish at times for our minds to settle, and just be still. For the pointless worries to stop, that ceaseless chatter. What we should have done, what we should be doing, what we should be preparing for. The tyranny of the shoulds. Our minds are constantly doing, always trying to fix things, change things, make things better. Trying to close the gap between where we are, and where we think we should be. From the second we get up in the morning, to the time we fall asleep at night. What should I have said to her on the phone last weekend? What can I do about my weight? All big questions, to be sure, but do they never stop? Why can’t we shut our minds off? It’s something I hear in the office all the time. I can’t focus, doc. I can’t turn my brain off. It won’t let me sleep. It must be ADHD. Isn’t there a pill you can give me?
Modern society doesn’t help. There’s always another distraction out there. Something else to do. Cellphones, Facebook, Twitter, Google. More channels on TV. More ads. Faster cars. Better hair. Whiter teeth. Another thrill, another sensation. Don’t stop, or you might miss something. A constant need for ‘more’. It isn’t hard to see where addiction fits in.
What’s the answer? How does one stop ‘doing, doing, doing’, and just ‘be’? How do we learn to control our minds, and not have them running in circles, taking us with them? For a few, the diagnosis really is ADHD, and treatment for this can help. For most of us though, the problem isn’t that we can’t pay attention, but that we’ve forgotten how to. This is where the gentle practice of mindfulness can help. Mindfulness is the awareness that emerges through paying attention, in the present moment, to things as they are. It’s what happens when you start to notice what’s going on, both outside you, and on the inside, in your thoughts and feelings. Noticing what it’s like to eat an apple and enjoy it, rather than ‘scarfing’ down lunch so fast you can’t remember 10 minutes later what you just ate. Noticing what your thoughts are, but then remembering that they’re just thoughts, and that you don’t have to react to them.
A simple way to begin being mindful is to take a minute and just focus on your breathing. Try it. Let your breath be your ‘anchor’. Notice how each breath in fills you with energy, and how each outward breath lets go of tension. Sit with your breathing for a moment, and notice what happens. Let whatever happens happen. You might notice how the soles of your feet feel on the floor. You might become aware of all the sounds around you. Notice it, and then come back to being aware of your breathing. A thought might cross your mind. Just notice it, like it’s a cloud crossing the sky. Then gently let it go, and come back to your breathing. You don’t have to react to every thought. Thoughts and feelings come and go all the time, like bags coming down the baggage chute at the airport. If you choose, you can sit with them and let yourself experience them. On the other hand, you can let them go, and just come back to your breathing. You can control what you pay attention to, and for how long. You can learn to control your mind, rather than letting your thoughts and impulses run away with you. It’s a skill, which means it takes practice, but it’s a skill worth learning. And the payoff, ultimately, is stillness.
By: Dr. Charlie Whelton, M.D., FRCP(C), ASAM Certified
Binge Eating Disorder Deserving of More Recognition and Treatment Options
Eating Disorder Awareness Week is February 1–7, 2015 and Bellwood Health Services is using this opportunity to raise awareness of Binge Eating Disorder – the most common but least talked about type of eating disorders.
When asked about eating disorders, most people immediately think of Anorexia Nervosa. Although anorexia is a very serious and sometimes life threatening eating disorder, years of movies, and magazine articles focusing on celebrities struggling with this issue, has given us the idea that it is also the most common of all eating disorders. In fact, it is actually the least prevalent of the eating disorders.
Research has found that binge eating disorder affects 3.5% of women and 2% of men, with an average lifetime duration of 8.3 years (Hudson, Hiripi, Pope & Kessler, 2007). This means that binge eating disorder affects more people than anorexia and bulimia combined, and can be life-long problem.
The primary symptoms of binge eating disorder are consumptions of large quantities of food, and the individual feels as though they have no control over this consumption. The individual often eats large amounts quickly, and secretively. Unlike bulimia, the individual does not attempt to compensate for food intake through purging or over-exercising. Binge eating disorder affects men and women fairly evenly, and the affected age group is broader than other forms of eating disorders.
According to Lauren Goldhamer, Eating Disorders Therapist at Bellwood Health Services, there are many misconceptions about binge eating that have helped keep it in the shadows. “Most people feel shame, and hide the problem from others. In fact, in front of others, they may eat normally or even appear to be dieting to conceal the problem. You usually cannot determine if someone is struggling with binge eating based on their body size. For these reasons, the problem can be ‘invisible.’”
Bellwood Health Services is one of the few residential eating disorders treatment programs in Canada that treat binge eating disorder. “The lack of quality or available treatment options are often reasons why there are not more people seeking help for the problem,” states Ms. Goldhamer. Other reasons why few people tend to seek treatment include:
- Feelings of shame and guilt that could result from others learning about the problem
- A belief that it is not a serious issue and that they do not deserve help the way those with anorexia or bulimia do
- Difficulty in discussing their concerns with their family physician
Mental Illness – Let’s Reduce the Stigma! Let’s Talk.
1 in 5 people are dealing with a mental illness. As you may know, today is “Bell Let’s Talk” day, and this is an initiative carried out by Bell Canada, in order to work towards reducing the stigma of mental illness. These anti-stigma campaigns are trying to target the deeply ingrained biases that many of us have when it comes to talking about addiction, and mental illness. The root of stigma comes from our upbringing, our family of origin, a lack of understanding, and perhaps a lack of personal experience. The stigma around mental illness is a significant issue in our society today, as many people still feel shame and embarrassment for visiting a therapist, taking medication, or requiring accommodations.
The stigma concerning mental illness has a deep effect on the individuals who are struggling with these issues. The effects of stigma can be compared to carrying an extra weight, as these individuals may react to the stigma by choosing not to speak about their illness. Coping with the stigma associated with mental health adds an extra burden to these individuals, and maintaining stigma in our society can lead to individuals not choosing to get help for fear that they will be ostracized , or viewed differently.
The workplace is one environment in which it is especially difficult for individuals to speak about mental illness. As a treatment centre that focuses on treating individuals and families with addiction and mental health issues, we encourage all employers to be progressive and informed about their workforce. To assist with fostering an environment that is free of stigma here are some guidelines:
– Be supportive, non-judgmental, and accommodating of all employees, regardless of their health issues, or the position that they hold within the company
– Provide diversity education, and educate all staff about the basics of mental illness, and how to practice work-life balance
– Foster an environment that is safe, supportive and encourages employees to feel comfortable coming forward to ask for any accommodations they may require
– Provide a range of effective Employee Assistance Programs as an added support for employees
With each person on the planet that starts breaking down the barriers related to mental illness, the closer we will find ourselves to a world where people do not feel shame for seeking the help that they need.
“Orthorexia”: When Healthy Eating Becomes a Problem
Orthorexia is a relatively new term used to describe a type of problematic eating and food preoccupation. As orthorexia is somewhat unknown, there is some confusion about what it actually means, and whether or not it is an emerging eating disorder, distinct from anorexia nervosa and bulimia nervosa.
The term orthorexia first appeared in a 2001 book by Steven Bratman entitled Health Food Junkies: Orthorexia Nervosa – Overcoming the Obsession with Healthful Eating. The author, who is a physician specializing in holistic medicine, coined the term and defined it as an “unhealthy obsession with healthy food.” The root “ortho” comes from the Greek meaning “correct” or “right” and “rexia” implies that it is an eating disorder similar to anorexia but with an emphasis on correct or “pure” eating. The term orthorexia is not listed in the dictionary, nor is it an official diagnosis, and as a result there are no associated criteria for diagnosis. However it may useful to think about the idea of having an “unhealthy obsession with healthy food.” Can one take an interest in healthy eating too far? If so, how far is too far? Can the interest in healthy eating lead to negative physical and mental consequences? In my everyday life experiences and in my experience as a therapist working with clients who have eating disorders, I have seen examples that I would define as “taking an interest in healthy eating too far.” I have seen the obsession with healthy eating affect people’s lives, health and happiness. I have seen this become a contributing cause of death.
I believe an interest in healthy eating can be seen as part of an attitude and behaviour continuum that ranges from those who know about, and try to make wise choices in their food selection most of the time, to those who cannot eat food that is deemed “imperfect,” even if it means starving themselves.
I personally know of an example whereby an individual let their obsession with healthy eating ultimately lead to their premature death. Not long ago, I received a call from a friend whose elderly father was in the hospital with a medical illness. My friend was very concerned because while in the hospital, his father refused food and water. For years, this man had controlled his diet by choosing foods that he thought were healthy. He tried to buy everything organic, would not eat certain food for reasons that to me seemed obscure, was vegetarian, mostly vegan and drank only bottled water. He felt good about making these choices and generally talked about them with an air of pride. However, when in the hospital, he was not eating or drinking. He stated he considered the water to be unsafe because it came from the tap, and the hospital food, which was not organic, would make him sicker. Had it not been for these attitudes and fears, which led to his refusal to eat while in the hospital, his medical issue probably could have been treated successfully.
Although this story may seem extreme, it is not uncommon. For example, someone can start out with good intentions to improve their health, but this can spiral out of control. The ways in which it can spiral out of control include limiting or avoiding social eating when the food provided is not considered healthy enough, becoming preoccupied with food and health in general. This in turn can affect mental health and happiness, and even the ability to focus on other important aspects of life such as recreation, school and career. What started out as a seemingly “normal” interest in a healthy diet ironically becomes unhealthy.
Part of the problem is that all the messages we currently get from media, Internet, books etc. about healthy eating and healthy foods can be very confusing. Almost any food you choose can be seen as either healthy or unhealthy depending on the source of the information. If you were to follow all the advice, there would be literally nothing left to eat! And don’t forget, many sources of information such as the Internet and TV can be sensational, and not based on scientific evidence. One extreme reaction to this type of information is to try to restrict all foods that are considered “bad”, as evidenced in those exhibiting “orthorexic-type” behaviours. The other is to disregard all nutritional information, because it is impossible to meet these standards. These individuals end up eating a predominance of fast food and foods with little nutritional value.
What is ideal, however, is the idea that one can develop a balanced, middle ground approach to diet and nutrition. Granted, this is not sexy or exciting. However, it can be maintained in the long term, and would not negatively impact one’s emotional and physical well-being. In a balanced approach, one thinks of healthy eating “guidelines” rather than rules or absolutes. Food is neither good nor bad, and all food can be eaten in moderation. An example of a healthy eating guideline is “whole grains are better than processed grains – I aim to have whole grains about half the time.” Or that “desserts or other “fun foods” taste great and add to pleasure in life. I can allow myself to have a portion of these foods daily.” This balanced approach is one which promotes recovery from eating disorders, and which I espouse in my own life.
If you are finding yourself preoccupied with healthy eating, or other eating concerns, it can be very helpful to seek counselling. The diagnosis or label (“orthorexia”, bulimia, etc.) is not the important thing. What is important is whether food is interfering with your life; making you feel overwhelmed, taking too much time and energy, affecting relationships, self-esteem or your mood. If this is the case, a therapist, especially one familiar with eating disorders, can be of great help.