Stress - PowerPoint

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 Persistent or
Chronic Stress
 & Addiction

   A Challenge or Condition Which
      Forces Physiological and
   Neurological Systems to Move
       Outside of the Norm.

 Moderate and Controllable Stress is
       Vital to Development.
• Unpredictable Stress – Don‟t really know
  when it‟s going to happen so you have to
  be ready
  – In a state of high alert – “Waiting for the
    other shoe to fall”
• Prolonged Stress – constantly living in
  “fight, flight or freeze” – This type of
  stress does not necessarily have to be
  – For instance if Mom drinks everyday and when
    she does you are responsible for the kids,
    supper, the dishes, homework …
• Persistent Stress – Happens
  on a regular basis, over and
  over again, no matter what.

• Chronic Stress – persists over
  time, “this is how it has always
  been and always will be”
The Brain is Designed to
Change in Response to Pattered
Repetitive Stimulation.

Neurosystems Activated Repeatedly can
       Change in Permanent Ways.

The More the Systems are Activated the
  More it Evolves – Becomes Engrained.
 Severe, Unpredictable,
 Prolonged or Chronic Stress
• Compensatory Mechanisms are Over
  Activated or Fatigued
  – The Brain learns to function in a constant state
    of “fight, flight or freeze”.
• Can Not Restore Normal Equilibrium
• The New „Forced‟ Homeostasis Requires
  more Energy to Maintain
  Neural Systems Respond to Sustained
     or Chronic Stress by Altering
       Neurochemical and Synaptic

o Stress Changes the way the Brain Functions.

o With severe, prolonged or unpredictable
  stress the changes can be permanent.
• As a neurotransmitter, norepinephrine
  helps to regulate arousal, dreaming, and
• As a hormone, norepinephrine acts to
  increase blood pressure, constrict blood
  vessels, and increase heart rate -
  responses that occur when we feel
  – What happens if we live in a state of stress?
• Center for processing, interpreting and
  integrating emotions
• Plays central role in determining how
  much emotional value to place on Sensory
• Stores memories of Fear
• Amygdala does not have a sense of time.
  – Can‟t distinguish between old fear & current
• Endogenous Opioids – Responsible for
  Numbing Pain During Trauma
• Creates a Rebound Effect when
  Numbing Effects Begin to Wear Off.
• Numbing Effect can be Recreated with
  Alcohol or Opiate use.
• Once the Brain Creates a Connection
  Between AOD use and the Numbing
  Effect Cravings Start.
• Brain will often experience „numbness‟ in
  response to little reminders of trauma –
  the brain releases endorphins.
• Eventually the Brain over compensates for
  the increased levels of endorphins by
  releasing suppressants.
• As the suppressant system becomes
  stronger a Deficit is created – resulting in
  endorphin withdrawal.
Alcohol Increases
Endorphin Activity

   • Thus Alcohol aids in fighting the
   • As would Heroin and Cocaine.
   • AOD use reproduces the
     „numbing effect‟.
 • Memories brought up in
   therapy cause endorphin
 • The Numbing effect can
   interfere with a persons
   ability to engage in therapy.
 • May also increase or restart
Stress Alters the Arousal Baseline

    • Internal calm is rarely achieved
    • More sensitive to similar stressors.
    • Will have sensitized alarm response
      – Over reading verbal & nonverbal cues
        as threatening.
      – Often leads to violent behaviors as a
        defense mechanism.
Stress Sensitization

   • Hyper vigilance – waiting for the
     other shoe to fall.
   • Increase Startle Response
   • Affective Labiality – mood swings
   • Anxiety
   • Dysphoria – depression
   • Difficulty Concentrating
Lasting changes to:
• Hypothalamus – controlling memory
• Amigdala – interpretation of threat &
• Pituitary and Adrenal Systems –
  stress and mood regulation
• Nuerotransmitters – mood regulation
  –   Epinephrine
  –   Norepinephrin
  –   Dopamine
  –   Serotonergic
Neurological Changes are often
Unnoticed or Misdiagnosed

            Often looks like:
            o ADHD
            o Depression
            o Bipolar Disorder
  PTSD Symptoms in Children

• Impulsivity        • Dissociation
• Distractibility    • Chemical Dissociation
• Attention          • Sleep Problems
                     • Aggression
• Hypervigilance
• Dysphoria,         • Regressed or Delayed
• Numbing
• Social Avoidance
   Females             Males
tend to present   tend to present
  more internal    more external
   symptoms:        symptoms:

   o Anxiety        o Impulsivity
  o Dysphoria        oAggression
 o Dissociation     o Inattention
  o Avoidance      o Hyperactivity
Alcohol and Other Drug Use
• Often an attempt to self-medicate

• Chemical Dissociation

• Attempts to cope with Affect
  – difficulty regulating emotional distress

• There is an extremely high correlation
  between abuse, affective disorders and
  addiction, especially in women.
Trauma, Addiction and Women

       • Women substance abusers are 39 –
         52% more likely to have a Dual
         Diagnosis of Addiction and PTSD
          – commonly originating from repetitive
            childhood physical or sexual assault.

       • Women who have been traumatized
         have an quicker onset of addiction
         than do women who have not
         experienced trauma.
   Addiction and Trauma Among Men
• Studies suggest that the correlation between PTSD
  and Addiction is higher in men that:
   – Witnessed Domestic Violence
   – Experienced Covert sexual abuse (Played the Role of Spouse
     to Parent)
   – Witnessed the abuse of siblings
      • These rates are higher than men who were the victim of abuse
   – Were victims of violent crimes or combat veterans

   Related to the inability to create any change in these
     types of situations
• Adolescent males are commonly misdiagnosed as
  having a conduct disordered or ADHD.

• Men often labeled Antisocial or Bipolar
   – The symptoms of addiction and PTSD are very similar to all
     of the above.

• Violence, Anger or Disregard for others are often a
  „mask‟ to defend against further victimization.
   – Misdiagnosis easily done without sufficient
• Some of the social maladjustments arising
  from abuse are:
  – Alcoholism & drug addiction
  – Self-injury, prostitution, promiscuity
  – Eating or sleeping disorders
  – Inability to trust, perfectionism, phobias,
    avoidance of both intimacy and emotional
  – Anxiety / depression
  – Distrust of perceptions or feelings
  – Negative personal beliefs / Low self esteem
     The Cycle of Depression and Negative
• Victims of Abuse often have extremely negative
  thoughts about themselves and others.

• These thought process become engrained.
   – Similar to a path through the woods

• These engrained negative thoughts feed the
  depression just as the depression feeds negative

• Must Retrain the brain to think differently – „fake it
  till you make it‟
Therapy Options

 • Group or Individual Psychotherapy
 • EMDR – Eye Movement Desensitization
   and Reprocessing
 • Medication
 • Cognitive Behavioral therapy
Research shows:
    • Medication and Therapy together
      have higher rates of success than
      either do alone.
    • Relapse rates decrease when Mood
      Disorder, PTSD and Addiction are
      treated simultaneously.
    • Untreated PTSD significantly
      increases relapse rates.
Research also shows
  • The effectiveness of therapy is
    determined as much or more by
    the therapist than by theoretical
    – How does the therapist or counselor
      make you feel?
  • This is vital to successful
    therapeutic experience.

   Years From Now They Won‟t
     Remember What You Told
        Them but They Will
     Remember How You Made
            Them Feel.
A Place Called „There‟ Counseling

Autumn Austin, MA, LPC, CGP, CSAC
   1135 Four Lakes Dr. Suite A
      Matthews, NC 28105