With the holidays come family traditions, decadent treats and, of course, holiday parties. And where there are holiday parties, there is usually a steady flow of alcohol. During this time of year, drinking becomes a socially acceptable, if not expected, part of the celebrations. Not surprisingly, both alcohol sales and drunk driving accidents skyrocket.

In these next few weeks, a lot of people will drink who would ordinarily abstain, and more serious problems arise for people who have spent the rest of the year struggling to keep their drinking under control. Here are five signs alcohol is detracting from the fun rather than making your holiday merry and bright:

#1 Using Alcohol to Cope with the Stress of the Season

When alcohol stops being a fun way to mingle at the holiday party and becomes the focus of every special occasion or the only way you can cope with the stress of the season, it’s time to reassess the role alcohol is playing in your holiday celebrations. Although alcohol may seem to relax you or help you forget your problems, the effects are short-lived. As a depressant, alcohol use actually amplifies stress in the long term.

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Helping someone into treatment for addiction is a gift that yields a lifetime of returns for the individual struggling with chemical dependency, but its benefits extend much further than that. Loved ones, typically driven by unselfish motives to help turn the addict’s life around, also stand to benefit in very personal ways:

Improved Quality of Life

Living with an addict is traumatic and life-altering in ways only affected loved ones can fully understand. Everyone in direct contact gets swallowed up by the addiction. Once a respite from the outside world, the home becomes a battlefield where trust and honesty are replaced with worry, resentment and a constant state of alert. Rates of domestic violence and mental illness go up. Daily life becomes unworkable.

Treatment improves quality of life not only for the addict, but also for the people who live with and care for them. In a study from the Central Institute of Mental Health (CIMH) in Mannheim, Germany, loved ones reported significant improvements in quality of life scores (from 60.6 to 68 on a 100-point scale) after the addict completed inpatient or outpatient treatment. These changes impacted not only their social relationships and living environment but also their own mental and physical health.

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There is little evidence that depression or suicide rates rise during the holidays, but the season is certainly known for its excesses. Although just as many people (if not more) need help for drug and alcohol addiction, fewer people reach out for treatment in the last couple months of the year. Addicts generally object to being away from home during family gatherings at Thanksgiving or Christmas, but for some families, seeking help during the holidays could be the greatest gift you give this year. Here are a few ironies that keep addicts sick over the holidays:

#1 Drug use is more common yet people are less likely to get help.

Even in the face of serious consequences, some addicts put off getting help so that they can get through the holiday festivities without disappearing off to rehab. Some party even harder around the holidays, flying under the radar of loved ones because it is socially acceptable to overdo the celebrating. Unfortunately, the stress of the season can exacerbate substance abuse, leaving an addict spiraling out of control.

The day before Thanksgiving, described in the media as Black Wednesday, is one of the biggest partying nights of the year, with the National Health Institute estimating that 10.8 million underage drinkers binge that day. According to Nielsen reports, alcohol consumption increases dramatically in December and in the week leading up to the New Year. All of this alcohol fuels as much as a 25 percent increase in alcohol-related traffic incidents, prompting President Barack Obama to declare December National Impaired Driving Prevention Month.

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When most people contemplate addiction, they think about cigarettes, alcohol, and illicit drugs like crystal methamphetamine, cocaine, and heroin. And certainly those substances are highly addictive—they are incredibly difficult to quit once a person is hooked, and prolonged use/abuse typically results in any number of negative life consequences. But these obvious potential addictions are far from the only possible problem areas.

Though addiction has traditionally been viewed purely in terms of substances, the American Society of Addiction Medicine now embraces a much broader definition that encompasses not only drug and alcohol abuse, but process (behavioral) addictions. Of course, everything we ingest is a substance of some sort, and everything we do is a behavior of some sort, so just about anything can become an addiction. Below is a short list of things many of us eat, drink, or do on a regular basis that can and sometimes do turn into addictions.

1) Guzzling Caffeine

Caffeine is a stimulant that occurs naturally in coffee, tea, and yerba mate plants. It is also added to numerous consumer products, including a wide variety of sodas, some candies, and most “energy” drinks. Regular caffeine users, even those who take in as little as 100 milligrams per day—the amount in half a cup of coffee—can develop physical dependency and experience withdrawal symptoms such as headaches, irritability, nausea, and fatigue when they don’t get their fix. While some people may think they just like coffee or other caffeinated products, many actually consume caffeine to stave off withdrawal symptoms (morning lethargy, mid-afternoon headache, etc). For the most part, the consequences of caffeine addiction are mild, though some people do experience anxiety or rapid heartbeat when caffeine is consumed to excess, and others may miss work or social engagements while dealing with symptoms of withdrawal.

2) Snacking on Junk Food

Here’s a scary thought: Brain imaging shows that high-sugar, high-fat foods activate the same regions of the brain as heroin, opium, and morphine. In other words, processed sugar and fat (along with processed wheat and salt) stimulate the rewards center of the brain, causing many people to “binge” eat with cookies, chips, soda, and other “junk” foods. (Have you ever seen anyone binge-eat with salad greens? Probably not, because healthier, naturally grown foods don’t cause the same reaction in the brain.) So the next time you decide to unwind after a hard day with a pint of ice cream or a bag of cheese doodles and find yourself thinking, At least I’m not an alcoholic or an addict, you might want to think again.

3) Popping Prescription Pills

Prescription drug abuse is the intentional use of a medication without a prescription, in a way other than prescribed, or for the experience or feeling it causes. The number of people using prescription medications is very much on the rise. This is especially true with young people. After marijuana, prescription medications are now the most commonly abused substances among high school seniors, with Vicodin and Adderall topping the list. Much like “hard” drugs such as heroin and cocaine, these doctor-prescribed medications flood the brain with dopamine. Over time this can produce cravings, tolerance, withdrawal, and all of the other symptoms (and consequences) of illicit drug addiction. The dangers of prescription medications are often underestimated because many people think that a doctor would never prescribe something that could harm them. This line of thinking makes it very easy to rationalize addictive behavior. The individuals most at risk for prescription medication addiction are adolescents, women, older adults, people with a family history of addiction, and those with an underlying psychological condition such as profound childhood trauma, anxiety, or depression.

4) Having Sex

Watching and masturbating to porn, having regular sex, having an affair, visiting a strip club, and even being sexual with a prostitute does not, per se, make someone a sex addict. Sexual addiction occurs when an individual loses control over his or her sexual behaviors, tries to stop but can’t, and experiences negative consequences as a result of his or her sexual acting out. Individuals who struggle with compulsive and addictive sexual fantasies, urges, and behaviors sometimes lose hours, even days, to the pursuit of sex, and their sexual acting out continues despite relationship, career, financial, and even legal problems. Thanks to the increasingly affordable and anonymous access to online sexual content (porn, virtual sex) and anonymous and/or casual sexual encounters (set up through chat rooms, dating sites, and “adult friend finder” smartphone apps), compulsive sexual behavior is affecting more and more people, at ever-younger ages. In fact, one recent study on hypersexual disorders found that for 54 percent of sex addicts the problematic behavior started before the age of 18.

5) Tanning

Most readers probably remember Patricia Krentcil, a.k.a. “Tan Mom,” the 44-year-old woman with skin like shoe leather who was, in April of this year, charged with child endangerment after her 6-year-old daughter suffered first-degree burns in a tanning booth. Krentcil’s addiction is sometimes, perhaps jokingly, referred to as “tanorexia.” However, an addiction to tanning is a very real and very unfunny issue. Studies show that people who frequently use tanning beds experience changes in brain activity during their exposure to UV rays that mimic the patterns seen with drug use. Other studies show that frequent tanners exhibit classic symptoms of addiction, such as craving and withdrawal. So it appears that tanorexia may cause, in addition to skin cancer and other dermatological issues, psychological and emotional problems common to addiction.

This article is not meant to scare readers. After all, most people who drink coffee, eat junk food, and engage in other seemingly innocuous behaviors are able to do so in moderation. It is only when people lose control over the activity that it becomes problematic (in terms of addiction). If you or someone you know is concerned about one of the five activities delineated above or any other seemingly harmless behavior, try to stop for 30 days. If you are able to quit without experiencing cravings or withdrawal, you are probably not addicted. If, however, you become irritable, experience headaches, crave the substance/behavior, or are simply unable to stop, there may well be a problem that probably needs to be addressed with the assistance of a qualified professional.

David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of addiction treatment programs that includes Promises Treatment Centers, The Ranch outside Nashville, Right Step drug rehab in Texas, and The Recovery Place rehab in Florida.

Among the most tragic consequences of addiction is the devastating – and sometimes lifelong – impact on the children of an addict. More than 28 million Americans are children of alcoholics. Prescription drug addiction has been rising over the past decade, with more stories about moms keeping their addiction secret. While many of these children go on to lead healthy, productive lives, they also struggle in a way that is characteristic of their upbringing. For example, we know that children of alcoholics:

• Are up to four times more likely to struggle with alcoholism and other drug abuse than other kids.

• Exhibit more symptoms of depression, anxiety, and other emotional and behavioral disorders than children from non-addicted families.

• Score lower on academic achievement tests and have other difficulties in school.

• Take on too much or too little responsibility to compensate for the lack of parenting they receive from an addict.

• Struggle in interpersonal relationships as a result of mistrust and deficits in communication skills (50 percent of children of alcoholics marry an alcoholic).

• Are more likely to witness domestic violence and become victims of abuse, incest, neglect and other childhood traumas, sometimes resulting in removal from the home.

In the midst of active addiction, the addict can do little to help themselves, not to mention their children. So what can spouses, relatives, friends, neighbors and others do to help when they see a child suffering in an addicted home?

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Not so long ago, addiction was seen as a “man’s problem.” In recent years, addiction research has broadened its focus to include the differential impact addiction has in the lives of both men and women. We know more than ever about the biological and psychosocial factors that affect how men and women experience addiction.

So in the battle of the sexes, who “wins” in addiction recovery? At first glance, men may appear to have the upper hand as women tend to progress more quickly into chemical dependency and face serious consequences faster than men. However, women are less likely to struggle with addiction than men and fare just as well in treatment. In the end, it’s a draw. Neither sex is better or worse off; they simply experience addiction and recovery in different ways.

Prevalence

Who Wins: Women

Drug and alcohol addiction are more prevalent among men than women. According to the National Institute on Alcohol Abuse and Alcoholism, men are twice as likely as women to meet the criteria for drug addiction in their lifetime (though rates of prescription drug abuse are about equal). The disparity appears to be even greater for alcohol abuse, with men struggling at three times the rate of women.

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Setting boundaries is an essential skill in life, especially for people in recovery. Addicts often grow up in dysfunctional homes, where boundaries were either too rigid (leading to suppressed emotions or distant relationships) or too enmeshed (depriving them of a sense of personal identity). Later in life, their interpersonal relationships may continue to be defined by old roles and patterns, increasing the risk of depression, anxiety and addictive or compulsive behaviors.

As part of recovery, addicts learn how to set boundaries and to respect other people’s boundaries in return. In the addiction field, treatment providers often refer to this process as embracing the authentic self. While it may sound like psychobabble, it is really a process of discovering who you want to be, how you want to interact with other people, and taking responsibility for the consequences of your choices.

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People can become addicted to any number of substances or behaviors, including drugs, gambling, sex and food, but can you become addicted to another person? In some sense, yes – it’s called codependency, and it can be extremely damaging to both individuals.

Codependency can arise in any type of relationship, but we most commonly think of the addict and their highly enmeshed spouse or partner. By denying the existence of a problem, trying to control the addict’s drug use or rescuing them from the consequences of their actions, the partner enables the addiction. The partner feels needed and the addict feels justified in maintaining their drug habit. It’s a win-win that actually ends up being lose-lose.

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A critical task of addiction recovery is restoring empathy. By sharing stories and reaching out to help others in recovery, addicts gradually repair the empathy deficits caused by drug and alcohol abuse. But is it possible to have too much empathy? When does being “too nice” become a problem?

The Empathy Spectrum

Human beings have an innate capacity for empathy, but because of biology, environment and other factors, we each inhabit our own unique space on the empathy spectrum. People with autism spectrum disorders, for example, may struggle to interpret basic emotions whereas people with certain brain anomalies are hyper-empathetic. For instance, people with a condition known as mirror-touch synesthesia have hyperactive mirror neurons, cells that fire when we see others in pain. So they actually feel physical pain when they see someone else suffering.

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Every parent wants to raise a smart kid. It seems logical that intelligence would correlate to better grades, a higher paying job and improved satisfaction with life. Yet studies show that a high IQ can get us into all kinds of trouble. Not only are brainiacs more likely to max out their credit cards and declare bankruptcy, but they’re also at greater risk for substance abuse.

According to the National Longitudinal Study of Adolescent Health, a high IQ in childhood is associated with a higher risk of getting drunk and binge drinking. Youth who were “very bright” (with an IQ over 125) engaged in binge drinking roughly once every other month while children with an IQ below 75 engaged in binge drinking less than once a year. Similarly, the National Child Development Study in the U.K. showed that the more intelligent participants were in childhood, the more alcohol they consumed in adulthood.

People with high IQs are also more likely to smoke marijuana and take other illegal drugs compared with those who score lower on intelligence tests, according to a study from Cardiff University in Wales. Researchers speculated that individuals with a higher IQ are more willing to experiment and seek out novel experiences. In addition, smart teens aren’t likely to see occasional drug use as particularly harmful, though they may not understand the serious risk of addiction or be able to accurately assess their own risk factors.

‘Too Smart’ to Be an Addict

In addition to being more likely to use drugs, people of high intelligence are typically less willing to admit a problem and seek professional help and harder to treat when they arrive in treatment. Here are a few reasons that intelligence can actually become a handicap to recovery:

Intellectualization. Intellectualization is a defense mechanism in which addicts argue over logical flaws and over-analyze insignificant details to prove they do not have a problem. What they discover in treatment is that addiction is not an illness that can be approached intellectually. Smart people do foolish things in the pursuit of a high. Even years into recovery, extremely bright people relapse because they tell themselves, “I can handle one drink/hit. I’m a new person and I know too much about my disease to ever go back to where I was.”

Clinton McCracken, a research scientist who specializes in addiction, learned this lesson the hard way. In 2010, he published a cautionary tale called “Intellectualization of Drug Abuse” in The Journal of the American Medical Association documenting his own drug problem. Believing that his intelligence and training would protect him from addiction, McCracken was disillusioned when his daily marijuana habit and intravenous opiate abuse led to the death of his fiancée and loss of his postdoctoral fellowship.

Although tragic, McCracken’s story is not unusual. Like many doctors, lawyers and other high-functioning addicts, he was able to continue functioning at a high level until something happened that shook his illusion of control and almost overnight ruined his personal and professional life.

Overconfidence. Well-educated professionals, and particularly health care workers with expertise in addiction, tend to believe their own intelligence will allow them to control a drug or alcohol habit. Since their best thinking has paid off for them in the past, they believe, “Others can’t control their drug use, but I know more than them. I can.”

Perceived Incompatibility with the 12 Steps. In the rooms of Alcoholics Anonymous and related 12-Step programs, it is sometimes said that everyone has enough intelligence to be able to follow the Steps, but some have too much. There are a number of reasons highly intelligent addicts believe themselves to be at odds with 12-Step recovery. For one, they resist the wisdom of others. Rather than taking recommendations at face value (e.g., advice to avoid people, places and things that trigger the urge to use), they want to learn and experience every lesson for themselves – sometimes the hard way. Highly intelligent addicts, who tend to over-analyze every aspect of addiction and recovery, may have difficulty embracing concepts like humility, powerlessness and surrender, believing firmly in their own willpower and logic.

Because the intellectually gifted face unique obstacles in overcoming addiction, they often fare best in specialized addiction treatment programs for professionals. In these programs, care is provided by a team of fellow professionals who understand when to challenge defenses and when to offer support. Particularly for those who are treatment-resistant, general and profession-specific support groups can help them remain open to feedback from peers who are also in recovery.

A Loftier Pursuit: Emotional Intelligence

Where IQ falls short in furthering our health and happiness, research suggests emotional intelligence could pick up the slack. Defined, in part, as the capacity to identify and regulate one’s emotions, emotional intelligence improves our interactions with others and equips us with the skills to navigate a changing world. It is also a protective force against addiction.

In a study from a university in Barcelona, researchers found that students with high emotional intelligence were less likely smoke tobacco or marijuana than those with fewer emotion regulation skills. Emotional intelligence has also been linked to lower rates of stress and depression and better overall satisfaction with life.

Addiction doesn’t care how smart you are or how much money you make. Your wits may serve you well in many areas of life, but you simply can’t think your way out of a drug or alcohol problem. Certainly, learning about the disease and understanding its biological roots is an important part of recovery. But a much bigger – and more challenging – goal is developing the emotional intelligence and practical coping skills to change your daily life

David Sack, M.D., is board certified in addiction psychiatry and addiction medicine.  Dr. Sack served as a senior clinical scientist at the National Institute of Mental Health (NIMH) where his research interests included affective disorders, seasonal and circadian rhythms, and neuroendocrinology.  He currently serves as CEO  of Elements Behavioral Health, a network of addiction treatment centers that includes Promises in California, The Ranch in Tennessee, The Recovery Place in Florida, and Right Step and  Spirit Lodge drug rehabs in Texas.

Smart kid photo available from Shutterstock