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Alicia_MSW
Alicia_MSW, Psychotherapist
Category: Mental Health
Satisfied Customers: 516
Experience:  Specializing in mental health counseling
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I am worried about my 28 year old son. Abused illicit drugs

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I am worried about my 28 year old son. Abused illicit drugs in his late teens, early twenties but says he has stopped. Has always had low self esteem, lacking confidence and a worrier. The problem is he goes for so long, maintains a job, then goes on a drinking binge and then will not go into work on a Monday, then can't face going into work on the Tuesday or Wed as he feels really bad, keeps saying he feels paranoid about facing people. His most recent job he was doing well, had joined the gym, plays five a side football x3 per week, then same thing happened, but as there was no problem with his work, gave him another chance and was geared up to going in on Monday, but when the morning comes he says he can't face people because he feels paranoid. I work in Community Mental Health myself and think what he says about feeling paranoid is ?a long term effect of the drug abuse. I had taken him along to a counsellor who was going to work with him using the CBT approach, but after initial appt agreed to go back but again half another before the appt said he wasn't going as he couldn't face it. I know he needs to cut down or stop drinking but keeping saying he is paranoid is really worrying me. Hasn't gone to GP as I feel you get a 10 minute slot, no time to listen and prescribe Diazepam or something similar.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Alicia_MSW replied 2 years ago.
Hello,
Thanks for your question. I'm happy to try to help. I can appreciate your desire to find an appropriate holistic or alternative remedy for your son, especially as it seems that traditional methods are not providing much benefit and/or he's not responding well to them.
An alternative treatment such as Reiki, acupuncture (which is used pretty extensively in most traditional substance abuse programs) or another energy-based medicine might be a good place to start. You could also consider a consultation with a Traditional Chinese Medicine practitioner (who also performs acupunture, Chinese massage and prescribes herbal remedies): http://www.atcm.co.uk/
However, it sounds like there are a number of potential issues going on with your son right now, and the most worrisome to me (and to you, from what you've said in your message) is the paranoia and the binge drinking.
My initial recommendation would be to have an evaluation at a substance abuse treatment center, because they might be able to address both issues simultaneously, especially if the drinking is instigating the feelings of paranoia. They'll have a psychiatrist on staff as well, although I do also hear your concerns about him simply being prescribed medication without the underlying issues being addressed. You might be interested in reading the following article, which explains some of the research regarding acupuncture and substance abuse (alcohol included): http://www.acupuncture.org.uk/index.php?option=com_k2&view=item&id=384:substance-abuse-and-acupuncture-the-evidence-for-effectiveness&Itemid=105
If you're interested in finding an acupuncturist who can help with the alcohol problem, you can look here as a starting point: http://www.nadauk.com/
Another alternative option to consider is biofeedback.
You can read more about this treatment here: http://www.altmd.com/Articles/Biofeedback-Therapy-for-Alcoholism-and-Substance-A
It's a very effective method for treating alcohol addiction as well as a number of psychological disorders. If you're not already familiar with biofeedback, it's essentially a method that teaches the patient ways of handling and managing their brain's electrical activity through the use of special machines, breathwork and mindfulness techniques.
You can find a qualified practitioner in the UK here: http://www.naturaltherapypages.co.uk/energetic_medicine/Bio_Feedback or here: http://www.worldwidehealthcenter.net/directory-6.html
It sounds like a combination of one of these treatments (acupuncture, biofeedback, or possibly even massage therapy, which has been found to be effective at managing alcohol withdrawal symptoms - it's something to consider) combined with a more conventional approach (CBT is a good place to start, but he has to be willing to commit himself to the treatment process. I'd also consider a group modality such as AA) would be beneficial, if he doesn't want to attend a conventional substance abuse treatment program.
However, I'd like to provide you with more information about where you can seek a more holistic-minded substance abuse program, just as an example (although there are many similiar programs out there as well): http://www.abbeycarefoundation.com/treatment-programme/holistic-alternative-therapy/
A program like this, which incorporates alternative treatments, may be his best bet at this point, although you'll have to discuss it with him to see what he's willing to do. I think he would benefit from a structured programme since he is having so much difficulty engaging in a regular routine right now.
I hope that helps. Please let me know if you need additional assistance. Best wishes.
Alicia_MSW, Psychotherapist
Category: Mental Health
Satisfied Customers: 516
Experience: Specializing in mental health counseling
Alicia_MSW and 3 other Mental Health Specialists are ready to help you
Expert:  DrPsychologist replied 2 years ago.
Hello. The good news is that your son has a mother who obviously deeply cares about him. The bad news is that substance abuse is a very dangerous disease - both physiologically and psychologically.

In order to be able to help you help your son, I would need more information. Otherwise, I would be making recommendations based on assumptions - yours or mine - which could be wholly inaccurate.

Here are some important questions:
1. When your son says that he feels "paranoid" does he mean socially anxious (distressed by social situations, fear embarrassment or criticism by others) or that he truly feels paranoid (which is a thought disorder)? The difference here is the bizarre quality of the thoughts. For example, is he worried that his coworkers will criticize him or that they might be able to read his thoughts?
(If you do not know the answer to this, then it is imperative that you ask him, as your speculation will prove unhelpful if incorrect).
2. Have you ever noticed or has your son reported any signs of hallucinations (auditory are most common but visual ones are also prevalent - hearing things or seeing things that are not really there. For example, voices coming from walls, shadowy figures, etc.
3. Is your son taking Diazepam or any similar medication? These meds in and of themselves have side effects of increased alcohol consumption/are addictive and cause paranoia and suicidal thoughts in a subset of the population.

Preliminarily my thoughts are as follows:
You need take your son to a psychiatrist or at least a psychologist who can evaluate him for psychosis and refer to a psychiatrist as needed ASAP. If your son is indeed suffering from paranoia then no amount of holistic medicine will prove useful for him. (An analogy - if he was diagnosed with cancer and needed chemotherapy you similarly would not take him for acupuncture or massage, you would take him to an oncologist). While a primary care doc might seemingly be helpful, they only have 6 weeks or so of psychiatry rotations throughout all of medical school. The fact that they prescribe more than 80% of psychiatric meds does not mean they are qualified to treat psychiatric illnesses.

If you feel uncomfortable asking your son the above questions or if he would feel uncomfortable answering them, then you really need to have him seen by a psychiatrist or psychologist.

Please let me know if I may be of further assistance.

Best of luck to you and to your son.
Expert:  Alicia_MSW replied 2 years ago.
Hello again,

Just for your reference, since you did specifically request information regarding holistic and alternative treatments, you should be aware that they should not be used as a replacement for conventional treatment. However, there are studies that show the effectiveness of certain holistic treatments for substance abuse disorders. The best option is to have an evaluation for the symptoms of paranoia and then to see if there's an integrative approach that would best suit your son.

Acupuncture is widely used in many clinics, and there are a number of significant studies that show its benefits. While it's not a replacement for conventional treatment, it certainly has uses as an adjunct therapy. If you'd like to read more about these studies, you can refer to this article, just as an example: http://www.ndsn.org/sept95/guest.html
(although you can also use google scholar to obtain a list of clinical studies that also support its supplemental benefits.)

Massage therapy has also shown benefits for patients suffering from substance abuse:
http://www.integrative-healthcare.org/mt/archives/2005/05/massage_the_mis.html, although that's just one of the many articles available online. Medication is not always a cure, but to be safe, your best bet is to have him evaluated at a clinic that incorporates both holistic and conventional treatments, as in the link I provided you in my first message - especially to address the symptoms of paranoia. As a side note, if your son had cancer and needed chemotherapy, you might not bring him only to an acupuncturist, but interestingly enough, acupuncture is widely used as a supplemental treatment for patients with cancer who are undergoing chemotherapy.
http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/patient/page1

That's food for thought. I wish you lots of luck with your decision!
Expert:  DrPsychologist replied 2 years ago.
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Customer: replied 2 years ago.
Reply to Dr Psychologist

Re son saying he feels paranoid, it is definitely more of a social anxiety (distressed by social situations, fear embarrassment or criticism by others), especially when he has done something he knows is wrong/or is embarrassed about and just can't face them rather than truely paranoid. I have a close relationship with my son and most of the time he can talk quite openly about things to me. I can honestly say that I have never ever been aware of him experiencing hallucinations and I think this is something that he would tell me if he had.
The counsellor he had his first appointment with last week is also a trained mental health nurse as well as having a PhD in counselling, he thought he was moderately depressed and identified a couple of issues he could successfully work through with him but again did decided not to go to the second appt half an hour before the time. I am to speak to him tonight about going back for another appt. I am not convinced he is too depressed, he has applied for another job today, has now gone off to the gym for a swim. I think he feels down and is never happy, but he is happy, before he lost his last job he had for 7 weeks, had joined the gym, saving up for a new car and motivated to keep in shape. I should also say that he has recently split up with his girlfriend of over a year and has been really down and feeling bad about this, which I have explained is a normal reaction.
He is taking no medication.
Expert:  DrPsychologist replied 2 years ago.

Mom,

Thanks for relaying the info about your son, particularly that he does not have psychotic symptoms and that he recently broke up with his longtime girlfriend. I think that is a key factor to his distress. When people are depressed they often do not appear down but more anhedonic (lacking pleasure or interest from activities they once enjoyed). They often isolate themselves and may have difficulty with attention and concentration, which can lead to difficulties/being reprimanded at work (possibly hence feeling paranoid at returning to work). This is a vicious cycle as it leads to greater self-loating and distress, depressed mood, and avoidance of activities.

It sounds like your son is trying to do things that will make him feel better - going for a swim, seeing a therapist - and that at times he can muster up the energy and motivation for such while at other times it becomes much more difficult.

Since depression is diagnosed as more than 2 weeks of depressed mood/anhedonia plus these other symptoms it would be helpful for him to seek a medication evaluation if these symptoms have persisted for more than two weeks. It has been widely noted that medication plus psychotherapy is more beneficial for clinical depression than either alone. This does not mean that there is anything wrong with your son nor that he will need meds for years if perscribed. What it may mean is that he needs a boost to kick start him back on track. To find a psychiatrist in your area you can ask for a referral from the therapist that he saw or if he has insurance you can call (together if possible) the insurance company and schedule an appointment with someone who is in network. If he chooses not to go to the appointment or to therapy he may feel worse so it is imperative that he attend these appointments just the same as if he had cancer and needed to see an oncologist. To help him increase motivation to go you can use a simple motivational interviewing technique where you put the conflict of going versus not going back in his lap rather than you taking one side (that he should go) and he takes the other side (that he does not want to go). Saying something like, "You tell me that you don't want to go to your appointments and at the same time you say that you feel depressed/anxious/badly." If the therapy appt was helpful to him you can add that he did find it helpful. If he did not find it helpful, prehaps it was not a good fit with that particular therapist because of her age, gender, theoretical orientation, etc. It is important that he take some responsibility for his care since he is an adult, although your help is certainly imperative at this point. Hope that helps. Please let me know if you have any further questions.

 

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