Often you contact our clinic with questions about a personal substance abuse problem or the addiction of a loved one, most often a partner or a teenager or adult offspring.

Addiction is all about the head

Addiction is all about the head. This is often said, and it has to be said that it is absolutely true. The alcoholic will get rid of the physical addiction fairly soon. The next and much more difficult task is to change his thinking. And how can our thoughts be influenced? One way is through targeted attention work.

Negative thoughts or thoughts about alcohol will lose their power over us if we don't pay close attention to them. This is usually not easy to do because they are intrusive. But we can learn to work with attention just by training its controlling component, which is called mindfulness. Mindfulness is a kind of distributor of attention that determines what internal or external content will be the main focus of attention.

The Mindfulness Method works on the basis of a now unquestionable assumption, namely that the cognitive function of mindfulness can be trained and strengthened very effectively. This is nowadays already confirmed by magnetic resonance imaging.

In the study participants who practiced mindfulness regularly for eight weeks, completely new, effective synaptic connections were made in the brain in the prefrontal cortex and limbic system. In simpler terms, there was an increase in the density of the grey cortex in areas where emotions are regulated by thoughts and which are not very effective without prior training. This is why emotions so often win out over thoughts.

What drugs are dangerous and addictive?

These are mainly drugs for anxiety or insomnia that contain benzodiazepines and certain analgesics (pain killers). Sleeping pills containing the active ingredient zolpidem can also be dangerous.

Simply put - we should be careful with any medication that brings immediate relief and only take these drugs in exceptional situations, never for a prolonged period of time.

Are there any safe psychiatric drugs?

Yes, modern preparations against anxiety and depression are already very gentle. However, the effect of these drugs is not immediate; patients feel relief only after a certain period of time, when the neurochemical environment in the brain is altered.

Is it possible to drink alcohol if we take medication for anxiety and depression?

It must be said that alcohol is a very bad helper in the case of any psychological difficulty. It may bring short-term relief, but in the long term it upsets the neurochemical balance in the brain and thus exacerbates psychological problems.

Not to mention the risk of addiction, which is much higher for anxious people, for example. The most dangerous is the combination of alcohol and drugs from the range of anxiolytics, neuroleptics and hypnotics with zolpidem (stilnox, hypnogen, etc.). With third and fourth generation antidepressants, the combination with alcohol does not have such dramatic effects as with the above-mentioned preparations.

Why do we feel stronger anxiety after alcohol, in a hangover?

It's a disruption of the environmental balance in our brains. Mental well-being and a relaxed state depends, in simple terms, primarily on the levels of the neurotransmitters glutamate and gamma-aminobutyric acid in the brain. Ethanol activates the production of GABA and decreases the production of glutamate, thereby inducing a relaxed state.

This state lasts, of course, only for the duration of intoxication. If we sober up, the opposite situation occurs, there is too little GABA and too much glutamate, which causes considerable anxiety in more sensitive individuals.

Why is it advisable to have a diagnostic consultation before starting therapy?

This is very useful for the following reasons: during the diagnosis, we can find out not only the severity of the problem, but also any associated problems that may be triggers for the first, obvious diagnosis.

This is typically the case with addiction diseases. It is also necessary to select an appropriate psychotherapeutic method, decide whether it would be appropriate to supplement the therapy with medication and select a therapist who is personally suitable. This initial step speeds up and streamlines the whole therapeutic process.

What is a safe daily dose of alcohol?

Unfortunately, we have to give an unequivocal answer to this question, namely, none. Many studies have disproved the belief that a glass of red wine a day, for example, is good for health. However, a certain amount of alcohol may be low-risk for a healthy person.

The World Health Organisation considers a low-risk daily intake of alcohol to be around 3-4 dcl of wine for an adult male and around 2 dcl for an adult female. This means approximately two large beers for a man and one for a woman, or two shots of spirits for a man and one for a woman.

What to do if we have an alcoholic in the family?

If the person shows signs of strong dependency, there is not much room for manoeuvre for the loved ones. If we continue to make excuses, iron out or even fix all of the addict's problems and troubles (typically paying debts, making excuses at work, etc.), we will unfortunately be actively participating in making the addict's situation worse.

The term "enabler" of addiction is used in addictionology. We need to realize that it may be us, our home or our children who may be the only motivation for the alcoholic to change. While this is a very difficult decision emotionally, at some point there is no choice but to confront the alcoholic with the choice: treatment and me or alcohol but without me.

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