Tobacco Smoking and Mental Health

By Jerry Nelson

Most adults are aware of the health risks of smoking tobacco. Research shows that smoking may also have an affect on mental health. While the motivation for smoking varies from person to person, knowing why some people smoke may help those who want to stop.

The physical, or biological, elements of smoking deal with how the cerebral matter reacts to nicotine. As an individual smokes, nicotine hits the brain in about ten seconds. The first drags on tobacco can alleviate a mental funk and melancholy while improving attentiveness and the ability to focus. It also helps in decreasing displeasure and anxiety. It may also relax the muscles and dampen the appetite.

Regular smoking and exposure to nicotine can lead to physical modifications in the brain. These changes, at the molecular level, lead to withdrawal when the nicotine level drops. Smoking again will temporarily reduce the symptoms of withdrawal, but it reinforces the habit.

Social factors also often help drive smokers to keep smoking. Many teenagers and young adults experiment with tobacco, especially cigarettes. If a friend or relative smokes, a young person is prone to adopt their attitude towards smoking. With the transition into adulthood, people are at a greater risk of smoking if they also abuse alcohol or drugs. Substance abuse can increase the odds of running headlong into stress. Many adults say they smoke to help relieve that stress and relax.

Smoking and Depression

The number of adults diagnosed with depression, who smoke,  is significantly higher, as much as 2 to 1, as the rate for those not suffering from depression. When depression is present in a person’s life, they may have a particularly hard time when they attempt to quit smoking. Nicotine triggers the flood of dopamine, the brain chemical that triggers those “feel good feelings.” Dopamine is often meager in individuals with depression. Smoking, though, triggers the brain to turn off its own switch for pumping out dopamine. In the long term the supply of dopamine decreases which triggers people to smoke more.

Smoking and Schizophrenia

Studies show that people with schizophrenia are also more likely to smoke. The most common reason given is that people with schizophrenia will use smoking for the control and management of their symptoms. Smoking may also help relieve some of the downside of medication they may be taking.

Does Smoking Improve Mental Health?

Many individuals with mental health issues state that they smoke to manage their symptoms. Actually, they have usually started smoking before the problems started. Heavy smoking, by itself, does not usually lead to fewer mental health problems. However, any short term benefit gained from smoking are normally wiped out by the health risks of long term smoking.

Ways to Quit

Trying to stop smoking through willpower — “cold turkey” — alone is probably the least effective method. Planning ahead and having support will help increase the odds of successfully quitting tobacco.

Getting Support

The stress of stopping smoking usually can be easier if you talk about your goal with friends and family. Enlist their help and support. It can be more challenging to quit if you live with others who smoke, so making it a group effort may be the way to go.

Nicotine Therapy and Medication

Devices and aids such as nicotine patches, nicotine chewing gum, electronic cigarettes and anti-depressants have shown to help smokers without mental health problems to quit smoking. They may also be helpful for people with depression or schizophrenia.

For more suggestions on stopping smoking and which options may be best for you, talk to your physician or pharmacist. They are best equipped to point you in the right direction for services in your area.

Could a Selfie Be Key to Medical Negligence?

By Jerry Nelson

Joan Rivers

When comedienne Joan Rivers died unexpectedly several weeks ago, medical malpractice was thrust back onto center stage. Ironically, Joan herself, the lady who popularized the phrase, “Can we talk?” may hold the answers to questions that medical malpractice lawyers will be asking. So far, the conversation about Rivers’ death centers on the word “consent.”

Rivers’ personal physician is said to have taken a “selfie” with the sedated actress moments before she went into cardiac arrest and lapsed into a coma. Under the privacy laws in America, photographs taken in a private place require permission. The clinic in which the tragedy happened is obviously private. Whether or not the image is ever published, doesn’t matter. The intrusion occurred the instant the shutter was snapped.

In the middle of all of the legal issues, the “selfie” may hold the secret to questions about what happened that day.

First, did Rivers consent?

Doubtful. Most stars guard their privacy, even more so when inside a clinic or hospital. Rivers was obsessed with cosmetic surgery and had become increasingly self-conscious about her appearance. Would Rivers have given her permission to have her picture taken while lying on an operating table, without make up? The estate may have a case against the doctor for invasion of privacy.

Second, did Rivers consent to the biopsy?

Rivers went to the clinic for a planned endoscopy. During the procedure, a biopsy was done. Reports seem to indicate that the biopsy was unplanned as well as performed by a physician who did not have privileges which would allow him to conduct that procedure at that facility. If the reports are true and Rivers did not give her consent, medical malpractice may have occurred. Medical malpractice is another term for medical negligence.

Finally, did physicians fail to use reasonable care?

To ask the same question in a different way, would a reasonably competent physician, under similar circumstances, have done what the physicians at the clinic did? If the answer is no, then the comedienne’s estate will, more than likely, win in a malpractice lawsuit.

If there is a lawsuit, each side will be able to hire expert witnesses. The witnesses will appear before the jurors and offer contradictory opinions served up with conviction. Lawyers call this a “…battle of the experts.” When the last witness has testified, the jurors, who may be confused and conflicted, will have to rely on their common sense.

A civil lawsuit may be the last thing the physicians need to worry about though. Medical negligence crosses the line into criminal medical negligence if a physician’s actions are egregiously reckless.

If the Rivers’ case is compared to that of Michael Jackson, there are similarities. Jackson’s physician was convicted of involuntary manslaughter for administering Propofol outside of a medical facility and fumbled in attempts to save the singer. The jury found the physician was “grossly negligent.”

Medical negligence help is usually available, but in the midst of all the unanswered questions, the “selfie” may reveal a callous indifference to Rivers’ welfare. Maybe the doctor cared more about themselves than protecting Rivers’ life.

Autism : What You Thought You Knew May be Wrong

By Jerry Nelson

A Michigan mother put two grills with smoldering charcoal in the back of her van and told her 15-year old daughter the two of them were boing camping. The daughter, Issy, had just been released days before from a residential program for autistic kids. Kelli, the mother, claimed she couldn’t take the stress of raising an autistic child anymore and planned the murder-suicide. Fortunately, her attempt failed, both survived. But the episode did help to focus attention on an often talked about – and little understand — affliction of millions of American children.

Individuals with Autism Spectrum Disorder, ASD, interact with other individuals in quite different ways compared with how the rest of the populace behaves. If the symptoms are not severe, the individual with ASD may just appear to be socially clumsy, maybe offensive in some of their comments or just “out-of-synch” with others. When the symptoms are more severe, the individual can appear to not have any interest in other people at all.

What is Autism

What is autism and what are the early warning signs? According to the APA, autism is a neurodevelopmental affliction indicated by on-going deficits in communicants and interactions with others.

Risk Factors

Identifying the events that put a youngster at greater risk for developing autism is controversial. The idea of a connection between vaccines and ASD is raging now at fever pitch. Expectant moms who take anti-depressants, parental smoking and substance abuse are also factors which have been discussed as possible triggers of autism.

Myths About Autism

A person with ASD feels emotions – love, joy, sadness – just like everyone else. Where they differ is often they may not be able to express their feelings like everyone else does. The myth that people with ASD have no feelings is one of ignorance, not conspiracy.

Another myth about people with autism is that all people with ASD have an incredible gift or “savantism” for numbers or music. It is true though that a large proportion of people with ASD do have high IQs and a unique talent for computer science. The Deutsch software company SAP AG announced in May that it will be employing hundreds of individuals with autism as software testers and programmers.

6 More Myths About Autism or ASD

ASD is a Form of Mental Retardation

Mental retardation never enters the discussion within the diagnosis of ASD. The relatively few incidents where both are co-occurring, the conditions are completely unrelated. Between 2 and 5 percent of individuals with autism do simultaneously show some measure of mental retardation though. While it is imaginable for ASD and mental impairment to co-exist within one person, autism is categorized as a neurodevelopmental affliction, not an intellectual handicap.

Autistics Can’t Maintain Healthy Relationships

A primary symptom in a determination of ASD is a hindrance in forming healthy social relationships. Several of the first signs of ASD occur in early in life where the individual may avoid looking another person directly in the eye as well as display a displeasure when interacting with others. Often the child will prefer solitude and may reject physical contact such as affectionate hugs from parents. The autistic struggles with comprehending nonverbal cues like physical actions and facial expressions. This can create, for them, a difficulty in connecting socially. If a person will be patient, it is possible for the individual with ASD to maintain loving, healthy relationships.

Autistics are Not Very Talkative

Autism is a spectrum disorder so the intensity of the autistic traits will vary from person to person. One main characteristic of ASD is the challenge of interpreting and expressing emotions verbally. Adult autistics may develop verbal tics such as strung-out echolalia, the repeating of the same phrases or a simple fixation on single words. Others may copy the speech of other adults with little or no tonal affectations, having missed verbal and nonverbal speech nuances. Only the extreme cases persist in being mute throughout their life.

All Autistics Are Alike

As with any developmental disorder, there is a wide range of severity from case to case. Autism is considered a spectrum disorder because of these differences. On one end of the scale, the afflicted needs constant assistance in daily life and on the other end of the spectrum, autistics may function perfectly in mainstream society with a minimal amount of care. Some autistics will experience some intense symptoms and others may be lacking some symptoms entirely.

Lacking Empathy

One of the largest challenges that get in the way of an autistic forming healthy relationships is the idea that they somehow cannot feel compassion or empathy. Despite one of the requirements for a diagnosis of ASD involves a difficulty in reading and understanding nonverbal expressions of emotions, the autistic still has the ability to feel and process emotions.

Poor Parenting Causes Autism

Many people wrongfully assume that the parenting skills an autistics’ parents are to blame. The true origins of autism are still being debated in the medical community, but no one is pointing fingers at parental involvement as a possible cause. Research has shown that the most likely cause of autism is biological and genetic – something the parents have no control over. Regardless of what science will eventually reveal as the cause of ASD, the possibility of poor parenting skills never is discussed.

While there has been much discovered through research and study, there remains much more that is unknown. As with any affliction, the best guidance can be gotten from a family physician. A source of support in many communities are any number of the self-help groups that have sprung up around family and friends of autistic individuals.

Addicted to Opiates: The Staggering Impact of Prescription Painkillers

By Jerry Nelson

Prescription Addiction

An in-depth look at the types of prescription painkillers, rise in opioid overdoses and who is at risk for abusing these legal drugs.


Prescription opiates, which have been formulated to alleviate pain, continue to rise on the scale of abuse and addiction. So much so, that the Obama administration recently hosted a summit discussing the effects of prescription opiate abuse; particularly the immense number of overdoses. Simultaneously, the United Kingdom is addressing concerns of a dramatic increase of abuse with the prescription painkiller Fentanyl.

Types of Prescription Painkillers

Prescription painkillers are given to persons who have undergone a surgery, incurred an injury or suffers from chronic pain. They are generally meant for short term use; however because of their strong effects, ability to stimulate the areas of the brain that perceive pleasure and potential for a tolerance to rapidly build, they often become abused. In turn, this leads to an addiction.

Some of the most common prescription painkillers which are abused include:

Hydrocodone: Often combined with acetaminophen. Brand names include Vicodin, Lorcet or Lortab.

Oxycodone: Most commonly prescribed as OxyContin but also included in Endocet, Percocet, Percodan and Roxicet.

Morphine: Brand names may include Avinza or Kadian. It is also given intravenously.

Codeine: Often combined with paracetamol and given to people with a heavy cough.

Propoxyphene: Brand names include Darvocet, Propacet and Darvon.

Hydromorphone: Given to people in severe pain. It is sold under the name of Dilaudid.

Meperidine: A light sedative, it is sold as Demerol or Meperitab.

Painkiller Prescriptions Double in 17 Years

According to the US Center for Disease and Control, “drug overdose death rates in the United States have more than tripled since 1990 and have never been higher. In 2008, more than 36,000 people died from drug overdoses, and most of these deaths were caused by prescription drugs…14,800 were caused by prescription painkillers.”

Nicholas King, a professor of biomedical ethics at McGill University recently published a review in the American Journal of Public Health which discusses the potential contributing factors to the rise in deaths related to prescription painkillers. Dr. King says “The cause that we found the most evidence for was quite simply a massive increase in prescribing of these painkillers.”

However, this had nothing to do the with the infamous “pill mills” in states like Florida or online pharmacy shopping; rather, Dr. King and his colleagues determined the rise in prescription painkiller deaths can be linked to prescriptions having doubled over the past 17 years.

He believes that the doubling of prescription painkillers began in the late 80’s and 90’s with doctors pushing drugs like oxycodone to people who did not have serious illnesses like cancer, (which, prior to this time, was the only way to get these strong drugs) but who simply displayed moderate pain. By 2013, Canada and the U.S. consumed 99.9% of the world’s hydrocodone, 87.3% of the world’s oxycodone, 60.1% of its morphine, and 51.8% of its methadone.

It is important to note that strong opioids, like the ones being discussed in this article, are unavailable in more than 150 countries and, when they are available, they often cost more in low- and middle-income countries.

Who Is at Risk for Developing an Addiction to Prescription Opioids?

Television shows and movies may depict a drug addict as someone who is jobless, uneducated or is a minority. However, people with an addiction come from all professions, educational levels, ethnicities and backgrounds.

According to the American Pain Society, “although people with chronic pain are more likely than others to receive prescriptions for opioids, the risk of developing a painkiller addiction depends on more than just prolonged exposure to these drugs.” Moreover, people using opioids for non-medical purposes are most likely to obtain them from friends, family members or associates rather than going to a doctor for a prescription. The APS also revealed that persons who have a personal or family history of alcohol or drug abuse are more prone to developing a prescription painkiller addiction.

Apart from the aforementioned, teenagers and young adults are more likely to abuse opoids. This may be in relation to pressure these individuals often go through at school or work as well as, personal curiosity.

Finally, a group of people at risk for prescription painkiller addictions, and who often go unnoticed, are adults over the age of 65. This group is regularly prescribed opiates; often without an in-depth consultation or questions by a doctor. Moreover, these seniors may not realize the effects of taking more than the prescribed amount; thereby, they unintentionally increase their tolerance and overall use.

Getting Treatment for an Opioid Addiction

A painkiller addiction creates long term changes in the brain. People who undergo treatment at a hospital or addiction rehab will likely experience unpleasant withdrawal symptoms and intense cravings. In many instances, a rehab center with treatment programs for prescription opioids will offer medications like Suboxone or methadone to ease the symptoms. Centers like Holistic Light, an addiction treatment center in Costa Rica and Panama serving patients from US, offer cognitive behavioral therapy, individual counseling, equine therapy, de-stressing activities like yoga, meditation and Tai Chi, as well as, maintaining a healthy diet are all proven to aid in the recovery of a painkiller addiction.

Rehabilitation treatment for opiate abuse and addiction can be costly; however, it is far less costly, in comparison with the cost of the addiction and continuous use of the drug itself.

Counting Coup in Recovery

By Jerry Nelson
Counting Coup in Recovery

Counting Coup in RecoveryThe Indians in North America had a ritual that was bolder than the slaying of their enemies. Warriors gained prestige by being the first to touch the enemy dead or even touching the enemy’s defensive positions. A warrior could also show his bravery by stealing the enemy’s horses. The possibility of injury or death had to be present for the act to be included on the “coup stick” which was kept as a record of brave attempts.

While usually a “coup stick” was held as the enemy was touched, a warrior could also count coup by touching the enemy with his hand or even a bow.

Americans need to learn to count coup on the enemy as well. But for us, the enemy isn’t flesh and blood. It’s inertia, narcissism and extremism.

In recovery, as we count coup on these three, we do it so that a vitality and diversity in life can shine through us. Thoreau said it best when he said, “live deliberately.” Counting coup is a method for recovering the way our basic nature used to live before we got transformed by status and possessions. Counting coup is our act of transcending a false reality so that we are released to find new ways to be free from the padlock of possessions, egos and self-centered drive. We can find ways that un-stifle our creativity and allow us to live as free, healthy people in an otherwise egocentric world. The freedom we once sought through drugs, alcohol and relationships is finally ours as we count coup.

In 21st century America, the cord which links our human-nature to mother-nature has been severed. Many of us have become puppets who wear masks of humanity but are actually blind, flesh-and-blood robots with wads of money where our brains are and people who have replaced hearts with fists. Raised in a society that is intent on destroying the world, it’s not our fault that we were raised cut-off from mother-nature and surrounded by other robots each seeking to make it to the top of the pyramid by walking over the empty shells of others. But it is our fault if we remain so.

When we walk up to and touch — count coup — our ego, our narcissism and our trending towards extremism, then we can begin to live a life of recovery.

Little Things Swing Big Doors

By Jerry Nelson
Little Things Swing Big Doors

Little Things Swing Big Doors

“Little hinges swing big doors,” W. Clement Stone

I don’t remember where I first heard that saying, but life has taught me that it is true. Life turns and changes on the smallest and seemingly inconsequential events. Occasionally a major event will intrude in our lives to set us on a different course, but usually it’s just a small, change encounter. A brief passing of a stranger. Of “being in the right place, at the right time” that brings large changes into our ordered lives.

I don’t need to list the randomness of events that can alter life’s journey. You can look back in your own existence and — if you’re honest — identify dozens of times that a chance encounter, or a serendipitous event, sent your life down a path which was different from what you were expecting.

A few years back, there was a little book called “Don’t Sweat the Small Stuff.” I understand the meaning and the meaning resonates with me. But in my life I’ve found there are no little events.

With all that said, what are a few of the “little things” that makes a big difference for us alcoholics? The list could be long, but here’s a couple that came to mind for you to think about.

Listening. When people listen, they are communicating. They are communicating more than what we want to hear, we’re communicating with each other that we care about the person.

Attitude. No one wants to be around a pessimist or a grouch. Everyone agrees that attitude is contagious. If we want to maintain a positive, healthy recovery, we need to remember that it starts with us. Recovery is an inside job, remember?

Consistency. We’ve been all over the map in our actions while we were drinking. Now that we’re in recovery, we need to show people that they can know what to expect from us. We need to demonstrate consistency in our values, our approach to life and much more. While sometimes, as people get used to the “recovering us,” they will be pushed and challenged some. But our family and friends do not need to be thrown back into the life of wondering what-he-will-do-next.

Trust. The more that we show we are trustworthy, the more people will trust us. The less “waffling” and the more engagement, the more — and better — communication we demonstrate, we can earn trust and become valuable to our family, our jobs and society.

The list could go on, but I hope this short list of “little things” gets you to thinking. There are big things we need to do in recovery of course, and yes we should work daily on our recovery.

But also pay attention to the little things.

Which Path

By Jerry Nelson
which path

I’m standing in the woods. In front of me are three paths. I’ve never seen the paths before, but I’ve been down all of them , in their turn, at one time in life or another. The fear of taking the wrong path keeps me from taking any path.

I’ve been standing here in this spot for a week, unable — or unwilling — to move, to make a choice, to decide on which path.

The path I’m on and the three that are in front of me aren’t real paths — they only exist in a writer’s imagination. The indecision and paralyzation is real though.

About a week ago, I got the go-ahead from Psych Central to start my own blog hosted on their website. My qualifications for this? I’m not sure there are any. Rather, I’m not sure I have any qualifications.

Continue reading… »

Welcome to One Sober Life

By John M. Grohol, Psy.D.

Grappling with sobriety — and learning to live without alcohol in your life — is a one-day-at-a-time challenge for most. It’s not easy living every day, waking up, and making the decision not to drink.

What’s it like to go through that experience? How do you do it, day after day? What happens when you feel like you want to relapse? What kinds of things can help in those dark, desperate times?

That’s why I’m pleased to introduce One Sober Life with Jerry Nelson. A former addictions counselor, he’s led the sober life for over 30 years. So he might know a thing or two on the topic. You can learn more about Jerry here.

Please give Jerry a warm Psych Central welcome!


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