Personal Statement : Physical Emergency

Recovery is the process of participating in a group or program providing treatment and support for a longstanding psychological or behavioral problem, such as abuse, addiction, grief, or trauma (Melemis, Steven, 2015). As a non-addict it seems easy enough to make a decision to stop drinking and follow through with that decision when temptation presents itself, but for an alcoholic it is not the simple. However, an alcoholic struggles with the temptation on a daily bases. Relapse prevention begins with addressing social interactions, emotional triggers, and developing positive coping mechanisms. Recovery and relapse requires is a process that should be done with others around to support each step and each phase of the

It is estimated that 40 to 60 percent of people relapse after receiving drug addiction treatment. The vast majority of relapses occur within the first 30 to 60 days after treatment. Additionally, it is estimated that half of people who receive treatment for drugs and alcohol will be re-admitted into a treatment facility within five

Once a person who is done with rehab they may or may not keep attending the course but they still need to maintain aftercare. “Even effectively treated people with addictions will confront unexpected situations after they leave a treatment program and return to their home environment. These situations may produce intense periods of craving to re-use alcohol and other drugs. Lapse, defined as re-use of alcohol or drugs at least once following treatment, occurs in at least 50% of those who complete treatment. The most dangerous period for lapse is the first 3-6 months after completion of formal treatment. Relapse, defined as return to excessive or problematic use, is less common, occurring in approximately 20-30% of those who complete formal care in the prior year” (McLellan). After care is very hard to do because the subject is done with rehab there may be no counselor or support for them. At times it is recommended that the person keep attending rehab and also for the persons family to help them with coping. When the person gets out of treatment it is important that the families, friends, and patient prepare for the chance of a relapse or lapse happening. Early detection and understanding the proper procedures to take if a re lapse appears to be coming will help to prevent a full blown relapse to happen. Family and friends should agree to respect and follow the plan that the person out of treatment wishes to follow with

The inevitable happened more than once and I went through a number of relapses until I realised that I had to put myself first and only by getting sober for myself would I be able to even hope for the other things to come along and hopefully stay. I was hopefully optimistic that by showing how seriously I was taking things and how hard I was working at it my family would see and understand and would forgive me for the years of hurt, pain and disappointment I had caused

A major depressive episode is not a disorder in itself, but rather more of a description or symptoms of part of a disorder most often depressive disorder or bipolar. A person suffering from a major depressive episode must have a depressed mood or a loss of interest in daily activities consistently for a minimum of a two-week time span (Psych Central, 2013). In diagnosing the mood must reflect a change from the person’s normal mood. A person’s daily activities and functions, such as work, social routines and friends, education, family, and relationships must also have been negatively impacted by the change in their mood. A major depressive episode is also identified by presence of five or more of the following symptoms. The patient can show signs of significant weight loss or weight gain even not dieting or trying to lose or gain weight. The patient will also display a change in appetite almost everyday, either with an increase or a decrease in their normal eating habits. The weight change is typically set at an increase or decrease in weight of more than 5% per month. The patient will display a depressed mood almost the entire day and this sadness, emptiness, loneliness, crying, and distant is observed by others or indicted by the patient, is typically

People who are not depressed or have never come to contact with clinical depression, are more often than not inclined to judge someone who is clinically depressed and call them dramatic, self-indulgent, or even worse tell them that they are just “under the weather.” Diagnosed clinical depression is not something that one can just shrug off, in fact it’s a disease that will cause the mental health state of an individual to decrease. Though depression isn’t something one can physically see like the flu, depression causes the patient to feel the effects as if it were a physical disorder. These symptoms include but are not limited to, fatigue, muscle aches headaches, etc. Though sadness can also cause an individual to feel these symptoms, sadness is temporary. Whereas depression, lingers and tends to become part of the patient’s everyday life, like a best friend. Though everyone at some point in their lives will experience sadness, the underlying question of why some people experience sadness that leads into full on depression remains. The article titled “Sadness, Depression, and Avoidance Behavior” by Allan M. Leventhal, primarily discusses an explanation to why some individuals are more prone to depression and subsequently will become clinically depressed, and why others are not. Furthermore, the article offers a clear separation between sadness and depression.

struggle with a substance abuse disorder. Nearly 70% of patients will relapse, and most will relapse multiple times.

Throughout the majority of my life, I had dreams of becoming an attorney and did not consider medicine as a profession until much later in my academic career. I had previously pictured myself pursuing a career in intellectual property rights and hoped to become a patent attorney, given my interest in the scientific field. My interest in patent law led me to take science courses that piqued my curiosity. I soon found myself involved in undergraduate laboratory research, focused on discovering new drugs to treat chronic pain syndromes while preventing drug tolerance and limiting the side effects of conventionally used narcotic pain medications. During my last year of college, I was accepted into law school, however I ultimately did not feel that I was truly pursuing my passion and decided to withdraw my acceptance. I then found myself with a college degree and an unclear direction in life, unsure of what new career I wanted to pursue. Shortly after graduating, I discovered a medical scribe vacancy in my hometown's Emergency Department (ED). Working as a scribe in the ED was a profound experience that undoubtedly shaped my career path and inspired me to become a physician and apply to medical school.

“Traditional… treatment approaches often conceptualize relapse as an end-state, a negative outcome equivalent to treatment failure. Thus, this perspective considers only a dichotomous treatment outcome—that is, a person is either abstinent or relapsed.” (Larimer, 1999). For a substance dependent individual like Rosa, equating abstinence to failure is counter-productive and ineffective. Considering her history of pain management, we can expect that Rosa may feel emotional and physical discomfort without her opiate and alcohol combination. A setback in treatment would be negative, but doesn’t warrant “giving up” on established treatment goals. Relapse may be anticipated with the relapse prevention model, but it is considered to be a part of “the

One way that someone could prevent a relapse is by having support from the patient’s family. In a study done by Mei Yang “Most participants (13 of 18) spoke of lacking family or social support during abstinence periods.” With this research it’s obvious that the lack of support from peers and family members has an impact on relapse. Without support from others, the patient feels as if there is no reason to stay abstinent. Even after going to a rehabilitation program Yang’s research stated “In China, relapse rates for drug use after discharge from treatment were generally above 90% after one year.” The period after being released from rehab are especially critical because this is the first time the user is out on their own making decisions. The decisions that the person makes right after leaving rehab are the most valuable and can decide how their abstinent period will go. Granted that sometimes when the user leaves rehab not being around the parents can be beneficial in ways. In a study done by Peter

A person enduring the trials of alcoholism will often suffer from a relapse. It is improbable, not impossible, that any person pursuing a life free from alcohol dependency will not have multiple relapses, which often are impulsive and craving like. Alcohol dependency is often a chronic and relapsing illness (“Factors In Alcoholic Relapse”). The best preventive measure to a life independent of alcohol is the understanding of the factors prior to relapse. During the recovery from alcohol dependency a relapse is often precipitated by emotional stress, boredom, and lack of support.

A relapse prevention is a vital part of a client success in preparing for discharge and a continuum of care. The first is to identify if the client has of a history relapse. The second if the client has experience long term recovery in the past. What kind of support will the client have to help support his/her recovery once he/ she return home? The other issue I would have client consider in writing a relapse plan is his legal obligation. The client maybe working so returning back to his place of employment will need to be address.

The third and final stage of recovery is known as late recovery, and involves a client finding growth and meaning in life. In this stage, relapse may be less frequent as a sense of purpose is found. As this stage is found only by enduring great challenges, a client may not be as tempted by relapse and the act of back tracking in their recovery may seem tiresome and unworthy of their time. However, though a deep awareness of the consequences of substance abuse is profound, relapse is still possible if an addict forgets that he or she has a disease that is incurable and succumbs to the enticement of “just this one time can’t hurt” or has the thought that “I have been clean for so long. I am cured.” Bill W. stated in his book Alcoholics Anonymous that “This is the baffling feature of alcoholism as we know it-this utter inability to leave it alone, no matter how great the necessity or the wish” (pg. 34). Complete abstinence is the only choice for those with the disease of addiction, and so many recovering addicts forget this simple realization in the late recovery stage.

Having to experience withdrawal first hand, and the difficulties that come with trying to abstain, I will have more empathy for my clients who are going through their own addictions. I can now realize that although cognitive behavioral therapy is helpful, it is not the only method with dealing with an addiction. Motivational interviewing is a good technique as well as implementing the stages of change model into therapy. A plan of action needs to be in place, as well as a means on coping, which I did not have in my experience. As noted in my log, I have no clear means of coping; in fact I often report not coping, but rather waiting the thoughts out. Someone who is addiction to a more powerful drug or behavior will be set up for failure. I also had no plan of action in place in case I did relapse or to prevent myself from relapsing. This could include daily activities such as exercising to get the same euphoria (feel good feelings) effect, or journaling when times were rocky. I stated several times that my triggers were other people who had an energy drink around me, chaos, being tired, and stress. These are similar to almost every person(s) of

DATA: Today’s group has been facilitated by Kirsten again, and includes relapse, what it is, and how each client can prevent it. Being that relapse is a process, it is an ongoing situation that can be interrupted, rather than a static event that is over and cannot be changed. It involves the individual reverting to old attitudes, beliefs, values, and risk behaviors. These are part of a progressive pattern, and will worsen until the process is interrupted or changed. Relapse is not a sign of failure, and, at times, may be part of the recovery process. There are times when individuals are more vulnerable to relapse, specifically, when they are too hungry, angry, lonely, or tired (HALT), and need to be aware of this vulnerability, and take