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PFA Tips: Addictions and Neurodiversity Part 2 – Getting Help


By Rick Silver, MD and John Yearick, LCPC, Thrive Emerge

Download a printable version of  “Addictions and Neurodiversity Part 2 – Getting Help


In “Addictions and Neurodiversity: Defining the Problem”, we discussed how the reward center in the brain has learned that if it repeatedly engages in an addictive behavior, it will get “squirts” of dopamine, the pleasure neurotransmitter. Electronic games are a lot more than just incredible graphics and fast action. They have been designed to provide fast, powerful, frequent rewards to the user. Think about addictive drugs, like cocaine: I engage in the behavior (use) and within seconds I feel great – not just a little good, but really great. So video games are essentially, on a brain level, potentially highly addictive, easily accessible electronic drugs.

For some (not all) of our kids playing online, they are alone in their rooms, in the dark, in the middle of the night, using electronic drugs for hours on end and upending their normal lives. No wonder we’re worried about our loved ones.

What changes when my loved one goes from overuse to true addictions?
For individuals farther down the road of true addictions, we see a key behavior that differentiates them from the overuser: try to take the addictive object away (read phone or computer or drug), and you trigger a reward center which is now screaming for its fix and cannot tolerate its absence. Remember: the brain – and by extension the body – has been rewired; and by removing access to the drug, we cause the entire nervous system to shift into threat mode.

The heavy user might be pissed off when you block access to the internet, but they are relatively more able to tolerate it and settle down. For the addicted person, this a truly intolerable situation — and anger, even rage, will ensue.

How can I tell if my loved one is ready for help?: The Stages of Change
There are five stages of change that an individual can go through when working to overcome an issue.
First is Pre-Contemplation: The individual doesn’t recognize a problem and ignores consequences.

Second is Contemplation: The individual begins to see the problem and starts to think about making some changes.

Third is Preparation: The individual decides to stop or reduce the negative behavior and creates a plan including family involvement and professional help.

Fourth is Action: The person follows their plan, including abstinence or limiting the problematic behavior, attending support groups and getting treatment.

Fifth is Maintenance: After a period of 4-6 weeks of desired and sustained behavior change, the person enters the maintenance stage.

How can I talk to my loved one and support their recovery?
Although this depends on the stage of change, a compassionate approach is important. Although difficult to watch someone struggle and resist your support, remember that the problem started as a way for them to cope with a threatening world.

Set and maintain boundaries that promote healthy functioning and less overuse. For example, turn the internet off or confiscate electronics, let the person know that substance use will not be tolerated in the home, and follow through with appropriate consequences after explaining the reason the boundaries have been put in place.

Make changes that allow the person to experience home life in a more healthy and inclusive manner — eat meals together, create time for healthy activities and check in with your loved one regularly to offer support.

Contact a professional who can guide you and your loved one on the journey of recovery. Remember that you are a support system for your loved one, and they are going to need your support to institute environmental changes in the home. Recovery is a lifelong journey.

What if they have a serious problem and are not ready for help?
Here are some indicators of a serious problem:

Risky Use – your loved one’s substance use or overuse has begun to increase. Grades may be slipping, they withdraw from enjoyable activities, their health is slipping and your relationship changes in an unhealthy manner.

Dependence – your loved one has developed a physical and/or psychological need for the substance or behavior. You may notice:

  • physical symptoms such as shaking when not using
  • physical evidence of use on the body
  • irritability when not engaging in the addictive behavior
  • isolating from the family more to hide the use
  • acting erratically and irrationally as they experience withdrawal or are under the influence.

Addiction – your loved one continues the addictive behavior despite severe consequences to functioning in multiple areas. You may notice:

  • a loss of reality and control in the person
  • physical evidence of use on the body
  • behaviors centered around the use — stealing, blackouts, chaotic behavior, extreme isolation, and manipulation.

We encourage you to seek help before your loved one reaches this level of usage, such as mental health counseling and early intervention programs.

If your loved one is experiencing a severe problem but is not ready for help after you ask them, it is time for a change! Reach out to a professional treatment center for substance use or addictive behaviors to discuss options. Your loved one’s health and wellbeing are at stake!

What resources are there for my overusing or addicted loved one?

1. On-line Treatment: There is now a large collection of therapists who will treat a patient via telemedicine which can be a great starting point.

2. Residential Treatment: This level of treatment is anywhere from 14-28 days, and the patient attends and stays at the treatment center to go through detox to start the process of recovery.

3. Intensive Outpatient Programs: This level of treatment is a group treatment, that is a minimum of 9 hours per a week, which allows the patient to structure their day around recovery with the support of others.

4. Alcoholics Anonymous and Narcotics Anonymous: Programs that allow for the person who is addicted to feel support with others who can relate to the individual’s experiences.

5. Al-Anon and Nar-Anon: Programs that allow the family of the addicted person to be supported, heard, and gain some direction of how to best care for yourself and the individual struggling with addiction.

6. Mental Health Treatment: Dealing with underlying mental health issues is a very significant part of long-term recovery. Some examples of treatment include Dialectical Behavior Therapy, Cognitive Behavioral Therapy, and medication management.

7. County Health Departments: A resource that can refer you for treatment and help you contact other resources in your community.


Additional Resources

PFA Tips: Addictions and Neurodiversity Part 1 – Defining the Problem

Pathfinders for Autism Online Provider Database  Choose category > Mental Health and Counseling


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