Change Your Brain Every Day - Substance Abuse: How Can You Help A Loved One Overcome Addiction? with Dr. Jennifer Farrell

Episode Date: January 18, 2018

In this episode of The Brain Warrior’s Way Podcast, Tana Amen is joined by Dr. Jennifer Farrell, a Psychiatrist and Addiction Medicine Specialist. We discuss how the moral vs. medical mindset affects the barriers of communication that tend to exist with one who suffers from addiction, as well as strategies for rebuilding that healthy connection.

Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel Amen. And I'm Tana Amen. Here we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions. The Brain Warriors Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using brain spec imaging to better target treatment and natural ways to heal the brain. For more information, visit amenclinics.com.

The Brain Warriors Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit brainmdhealth.com. Welcome to the Brain Warriors Way podcast. Welcome back. I'm so excited today to have Dr. Farrell with us. You are one of our addiction specialists. Yes, I'm board certified in psychiatry, addiction psychiatry, and addiction medicine. I love that. So that is a big part of what we see here at Amen Clinics. And this is really important, not only because we have so many patients that come through,

but this touches the lives of so many people. It certainly has touched my family. I mean, I had an uncle who was a heroin addict. I always say that the one gift he gave me was that he scared me so badly. I don't know if you've ever seen the show The Walking Dead. So it's about zombies. Yeah, that's why I haven't seen it. Right. So way before there was a Walking Dead show, when I was four, five, six, I didn't know what zombies were, but my uncle and his friends scared me

because that's what they reminded me of. So it scared me so badly that it always like scared me away from doing drugs. But addiction runs in my family and it's a scary thing. It's a really scary thing. And for those of us who haven't been addicted to drugs, it's really hard to understand it, but we're heavily affected by it. So I've seen so much of it here, but I don't by any means pretend to sort of understand the dynamics.

And I'm so happy to have you here because I've certainly struggled with my own issues, lots and lots of them, but not this one. And so I really want to understand it. I think a lot of people who have family members who are struggling really want to understand it because I recently even had a situation with someone in our family who we had to really want to understand it because I recently even had a situation with someone in our family who we had to really work through this process.

And my husband being a psychiatrist did better with it. I'm going to be really honest. I'm just going to be really vulnerable for a minute and go, I didn't really get it. And it's frustrating. It is. So I'm trying. Yeah. It's very difficult to understand because the average person doesn't have a medical mindset. We have kind of a moral model and we look at what's right and what's wrong and, you know, injecting yourself with heroin, you know, we look at that as, you know, bad. And so we don't have the medical understanding of why people make the decisions they make when they're using, how they become addicted, why they just can't stop. Because we want to say logically, well, if you're using these substances and it's ruining

your life, then you should stop. Or go get help at least. Right, or go get help. And I think that people who are suffering would agree with you logically, but there's something going on with them emotionally that's preventing that. So I'm really glad we're here to have this conversation today just to really kind of talk about how important it is to recognize and treat addictions because it's not like other areas of medicine. You know, I had an ear infection. I went to the doctor. He looked in my ear. He said, you need some antibiotics. I said, fine. I was done.

And no one was affected. And no one judges you, right? Nobody judged me. Well, he actually did. It was kind of funny. He said, what are you doing here? And I said, well, I can't look in my own ear. Right, right. But he's like, you know what you need to do. And so I did get judged just a little bit, but. Well, and I had thyroid cancer. And so same thing, you know, you go, you get, people feel sorry for you. They don't like get mad at you. Right. Exactly. But when you have someone who has a substance use disorder, you not only have to deal with the health issues that can go along with that, the liver problems, the heart problems, you name it. But in addition to that, it affects the way that they parent. It affects their relationships with their siblings,

with their coworkers, with their neighbors. It affects their careers, their ability to work or go to school. And so there's this ripple effect of one person's medical issue that can affect not only the community, but actually the economy. When we look at the numbers of what alcoholism, for example, costs our country. So recognition of that and treatment then also has that ripple effect. Well, and if I can add one thing to that from a personal perspective, generational. It's generational. I'm astounded at how it just sort of seems to get passed along.

And I don't know why. Is it genetic or is it because, I mean, I know some of these answers, but I want people to hear them. And I know them logically. I don't understand totally. And I'm just, you know, I'm trying to really understand it better because it affected my own family. So I don't quite get all of the dynamics of why, when you know that it affected you as a child, why are you passing it down and not getting help and allowing it to affect your children? Well, there are genetics involved, for sure. And we know that addictions run in family. There's a lot of research on genes for alcohol use disorders and other things.

But I think part of the problem is not just the genetic vulnerability for addiction, but we also have to look at the environmental factors. And so kids who are raised by alcoholic parents have issues that are unique compared to people who aren't raised in that kind of environment. So not everyone who's raised in that environment will have a bad outcome, but there's a lot of chaos in homes where there's substance use. And so that can kind of affect the way those kids raise their kids, and so you can kind of see this effect. But again, there is something inherently different

about the way many addicts respond to substances compared to people who don't have that genetic vulnerability. Somebody who doesn't have a propensity toward addiction, let's say of pain medicines, will have surgery, they'll take their prescribed pain medicines after surgery, they'll feel horrible, they'll feel nauseous, they'll feel sick, they'll feel sedated, they'll feel awful. Yes, I felt the same way after having my wisdom teeth

taken out, it was just, I'd rather have the pain. What I've heard time and time again from my patients who become addicted is from the first time they take it, they have a completely different response. My uncle said that. They feel euphoric. They have high energy. They're not getting sick and nauseous. It's a completely different response. And so there's something about the way their body metabolizes it and then we know that over time with repeated use when you keep hitting those receptors that there's these chemical messages going back to the cells and we're actually getting a change in the cellular DNA so as the person's going they're changing their own DNA with their substance use so it's more complex than even we really have a good understanding with. But there are so many factors that go into the vulnerabilities for addiction.

Interesting. Okay. So it's hard for families. Yes. And they probably don't always make it easier for people to get treatment. What can we do? Well, understanding is, I think, the beginning and being open to having a dialogue. I think probably one of the biggest barriers that I see with people getting treatment is just this big

stigma around addictions. And a lot of people have kind of a judgmental viewpoint, a moralistic viewpoint of you should do this or you shouldn't do this. And so people feel very judged. Some people don't know how to talk to their family about them, about their concerns. They don't want them to be mad at them or it may disrupt some other kind of family dynamic. But I think that understanding what is a healthy youth pattern versus what isn't and learning how to talk to that person can be very helpful creating an environment that is less judgmental like how dare you do this you're ruining the family instead of coming in and well okay well there's this issue that's going on and we need some help and we

want to come from a helping standpoint can you know how you talk to the person can actually contribute to whether or not they're willing to go in and deal with some of these issues. So it can be really frustrating as somebody who's, I've actually recently dealt with this with some family dynamics and from the family perspective, I think maybe reaching out and getting some help on how to do this could be helpful. Because I know in our case, and we're fairly savvy, I'm fairly savvy, just from, trust me, I don't claim to understand it or to know anything about it, but just having been sort

of primed on how to handle it. Having approached someone repeatedly with, there's no judgment, we just want to be able to help, like all the right, sort of the right things to say, but then repeatedly having that problem with them not doing that. And then when they don't and the lying, the constantly lying to you and telling, and it erodes at the trust. Yes. And then when you ask them why, they feel bad. They genuinely feel bad and they don't really understand why they're lying to you about it. And they're like, but I'm afraid. And we're like, but I thought we just had this talk.

We're not expecting you to do it perfectly. But after a while, it starts to be exhausting. It is. For the caretaker. And you can't be a successful addict unless you're a successful liar. Oh, that's so interesting. No, I'm not using. Is everything okay? Yes, everything's fine. And people have to lie to maintain their addiction. How exhausting. It is. Well, it is exhausting. And I have a lot of compassion for people who are going through this. This is how up in this field no one you know goes to kindergarten and says when I grow up I

want to deal with right absolutely you know you kind of find you find your gifts in life and you go into that but people don't want to lie people don't want to be addicted but the addiction is so strong that it pulls them in and kind of locks them in so I do work with a lot of families. I coach a lot of families. And then we use, when I can finally get someone in my office, a type of communication called motivational interviewing. And that's really not sitting down and telling the person,

everything in your life is going horribly. You know, you have to change this. It's just looking at, okay, what are you using? What do you like about it? What do you not like about it? What's working in life? What isn't working? What are your goals?

And then helping them find their own internal motivation for change. So write down for me, you know, the three key things in your life that are important to you. And is your alcohol use getting in the way of these? I like that. Okay, so what would you think we should do about this and they sort of figure out a process yes rather than being told i will guide them through a treatment plan i will come up with a treatment plan i can have the best treatment plan on the planet but if it doesn't feel like that person's treatment plan she's not going to do it right so finding helping that person find her own internal motivation.

Yeah. Yeah. Why do I want to do this? That makes sense. That actually makes sense. And yeah, and I just think if there is something we can tell family members to give them hope, I think that's a really important thing. Because it's hard.

It's hard being the family member. It's not just hard being the addict. It is. It's hard being the family member. Well, that's what we're talking about. It has this ripple effect and it affects everyone around that person. And so when that person gets better, that ripple effect, you know, it will spread also. Um, I would encourage, you know, I always tell people, if you can't get your family member in to come see me, come see me, let's talk about the situation. And then I'll say, we'll offer them a phone conversation with me. And I'll just say, this is who I am. This is my background. This is what I do. And if there's ever a time you'd like to talk to me about it, let's talk about your health. If you don't want to talk about, you know, drinking or not drinking, we don't have to do that,

but your family's concerned about your heart. So let's come in and talk about that. Or let's look at your liver. It's once they see that there is actually a physician who has a nonjudgmental approach, then you can get treated. You know, and to the people who come at this from a judgment perspective, I know I got really angry at one point, really angry. And then people manage their anger in different ways. For me, I was praying and I was meditating. Okay, I'm like, I was praying and meditating about this anger because I knew that it wasn't useful. It's not a useful way to manage not only my state, but my energy.

I wasn't going to get anywhere with it. It wasn't going to help the person I was trying to work with, and it wasn't going to help me. So I was like, what is something better that I can do with this? So I was praying, I was meditating and it sort of just left. The anger left. And what I realized is that it wasn't that I was actually angry. Anger is a place I go to when I'm scared. And so I don't know if other people do that same thing. I wasn't actually mad.

Anger is because I grew up in chaos. I grew up in a lot of chaos with a lot of addiction and a lot of just craziness around. And so anger is the place I go to when I'm scared. Anger is the place I go to for survival. And so the minute that I felt really scared about the situation, it's like, oh, I'm going to fight. Like it's just, that's that. And I don't know if other people have that same issue, but when I could recognize it, the anger left me and I was able to have a really honest conversation and I don't right, wrong or indifferent. It came out very differently than it would have when I was angry. And I was so sad. And I just said, look, I'm, I'm worried. I'm just worried about you because

this feels bigger than what I can do. And it's above my pay grade. I don't know what else to do for you. And you can't do it for anyone. And they have to do it themselves. Right, and I'm used to being able to jump in and fix things, and I can't. You can't protect them. You can't do it for them. And it's very frustrating, especially when you're the type of person who's very nurturing

and you're a caring type of person. You can't go in and fix it. And it's really hard for parents or loved ones watching the person's life crumble apart. And people do get angry because anger is a fear response. So if I'm afraid of something, I can either back into the corner or I can come out fighting because it makes me look stronger and gives me this sense of power. It gives this false sense of control. But you're right. It's tapping into that compassion and being willing to let go and just saying, I can't do anything about this. I can't control it.

I'm sad. I'm scared. And it was just a very different conversation than if I had walked in with my normal way of responding to things. So, well, that's really helpful. Is there anything else you'd like to let people know? You know, I think that I want to get back to that point on the stigma and how much of a barrier that is for people really coming in to get treatment. I helped start a clinic for pregnant substance use, women with substance use disorders. And, you know, that's the biggest barrier is they're afraid if they go see the doctor, their children are going to get taken away. They, you know, CPS will get called and all this. So they're afraid to go in. And so, but they can't stop using because this is a medical condition. And so there's a lot worse outcomes.

And so we, if we as a society can reduce the stigma and encourage people to go in and get help, then that's when people can actually get better. It makes a huge difference in people's lives. One of the biggest barriers to women getting treatment is child care. You know, so we also need in my field to talk about and address more what we can do to meet people's needs practically. But as a family member with someone let's say who has children or other responsibilities coming in to help with those issues so they can get treatment and removing some of these barriers I

think can be very helpful as well. Oh that's such a good point. So Dr. Farrell, Dr. Farrell works at Amen Clinics and here in our Costa Mesa office. And if you know someone, if you're struggling or you know someone who is struggling, I think you are amazing. You do a great job. Our patients love her. Come see me. Yeah. She's very empathic and kind. So I'm really glad we talked about this because it just touches so many people's lives. So thank you so much. Absolutely. Thank you for listening to the Brain Warriors Way podcast. Go to iTunes and leave a review and you'll automatically be entered into a drawing

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