SAD? Are You Experiencing Seasonal Affective Disorder?



The holidays are over, the lights are down, you’re already tanking on your New Year’s resolutions and you’re feeling glum. You just weighed yourself and realized that the fruitcake you hate, but ate anyway, has given you an additional five pounds. You feel hopeless as you dig your car out of the snow in the freezing temperatures to get to work in the dark. You sigh as you exit your office in the evening, realizing you haven’t seen the sun all day. Then you really feel depressed when you realize there are still two to three months of winter left.

If this sounds familiar, you could be suffering from the usual winter blues along with the rest of us. Cold weather, short days, the come down from the holiday season and the revving up of the flu season all conspire to make January, February, and even March some of the most miserable months of the year. Are you struggling with the typical winter blahs or do you have something more serious?

What is SAD?

Maybe you’ve heard of seasonal affective disorder, or SAD, or maybe this is a new concept, but it’s true that you can have a very real and serious mood disorder related to the seasons. SAD is a kind of depression that sets in sometime in the winter, or even late fall, and usually lasts until spring starts to warm and light the earth again. SAD is more than just the typical winter blues. Here are some of the symptoms you might experience:

  • Feeling depressed, worthless, and hopeless, most of the time
  • Lack of energy, fatigue
  • Sleeping more than is normal
  • Difficulty concentrating
  • Craving carbohydrates and gaining weight as a result
  • Losing interest in normal activities
  • Irritability, especially when interacting with others
  • A heavy feeling in the arms and legs
  • Being hypersensitive, especially to the comments and reactions of other people

Why SAD? Why Me?

As with major depression and other mental health disorders, there is no single, definite cause for SAD. We do know that it is seasonal and that it is related to natural changes caused by the seasons. For instance, not seeing the sun as often in the winter may play a role in the onset of SAD. It may be that the extra darkness disrupts your circadian rhythm, or your biological clock. We also know that lack of sunlight causes levels of serotonin, a neurotransmitter, to drop in your brain. Serotonin affects mood and the drop off could be a trigger that starts depression.

Certain people are more vulnerable to suffering from SAD than others. While your best friend might feel a little sulky about the shorter days and the miserably cold weather, you get full-blown SAD. It’s impossible to predict with certainty who will get SAD, but there are risk factors. Being younger, female, having a family history of SAD or depression, and of course, living in the colder climates all put you at a greater risk.

There is Hope for SAD

The good news in all of this is that there are treatments for SAD. If you think you might be struggling with this, see your doctor. You can try light therapy, which makes use of a light that mimics the sun to brighten your mood and get your neurotransmitter levels back in balance. Exercise and getting outdoors more often also help, as do other healthy lifestyle practices like eating well and getting enough sleep. If these changes aren’t enough your doctor may suggest pscyotherapy or antidepressants.

Winter sucks, at least if you live somewhere cold enough to know what a wind chill factor is. It doesn’t have to hurt as much as SAD hurts, though. If you are feeling miserable beyond what is typical for January,  February or March,  get some help. You can beat this, and remember, spring is just around the corner.

Alcohol Abuse & Treatment

Alcoholism can have numerous negative effects on a person’s life. Personal relationships often do not survive the stress of alcohol dependency. Alcoholics can also experience career, health, and legal problems. The Control Center offers alcohol rehab services that help individuals and their loved ones overcome the immediate effects of alcoholism and learn coping strategies that can lead to long-term sobriety.

Alcohol Rehab Services at The Control Center

The Control Center creates personalized alcohol rehab treatment plans that combine effective services to meet each patient’s individual needs. People undergoing alcohol rehab services may need to begin with a medical detoxification plan. This plan:

  • Minimizes alcohol withdrawal effects
  • Eliminates alcohol use under the supervision of trained medical professionals
  • Uses medications, when appropriate, to control one’s cravings for alcohol
  • Helps establish a break in alcohol use to promote long-term sobriety

Alcohol Rehab and Mental Health Services

Alcohol dependency often exists with underlying mental health issues. The Control Center incorporates mental health counseling into each person’s alcohol rehab plan to make sure that he or she has the necessary tools to overcome alcohol addiction. Some popular mental health services include:

  • Neuropsychological Assessment that help identify mental health issues
  • Individual Counseling that teaches healthy strategies for coping with triggers that lead to alcohol use
  • Group Therapy that provides recovering alcoholics with an opportunity to share their experiences with each other and create a supportive network that encourages sobriety
  • Couples and Family Therapy that helps mend the relationships damaged by alcohol abuse and creates a stronger support system that promotes sobriety both during and after alcohol rehab

Holistic Services for Alcohol Rehab 

The Control Center often includes alternative therapies in a patient’s individualized alcohol rehab plan. These holistic services can help recovering alcoholics maintain control over their thoughts, emotions, and behaviors so that they do not have to turn to alcohol. Some alternative therapies used at The Control Center include:

  • Meditation
  • Yoga
  • Creative Visualization
  • Breathing Exercises

If you worry that your alcohol use is causing damage to your health, career, and relationships, contact The Control Center to learn more about how an personalized alcohol rehab plan could help you.

Weight-Loss Surgery Increases Risk of Alcohol Addiction

Via ABC News

Andrew Kahn was only a social drinker before his weight-loss surgery. He never imagined he would develop problems with alcohol because he had bariatric surgery. But he did.

The 61-year-old from Fort Lauderdale, Fla., who had his gastric bypass surgery in 2003, eventually developed alcoholism and was treated at a rehabilitation facility for his addiction.

“I never had any guidance or education about that,” said Kahn. “If I was given the choice between being obese and becoming an alcoholic, I would have thought about [my decision] more.”

The American Society for Metabolic and Bariatric surgery estimates that approximately 72 million people are obese in the United States and 200,000 people have bariatric surgery each year.

Kahn’s alcohol addiction may not be a unique result of gastric bypass surgery. New research suggests that having Roux-en-Y gastric bypass surgery, where the size of the stomach is reduced and the intestine is shortened, thus limiting how much a person can eat, can increase the risk of alcohol-use disorders.

The study, conducted by researchers at the University of Pittsburgh Medical Center, adds to mounting evidence of a link between have the popular gastric bypass surgery and the symptoms of alcohol-use disorders.

Before the surgery, the nearly 2000 study participants completed a survey developed by the World Health Organization that is used to identify symptoms of alcohol abuse.

The patients then completed the survey one and two years after their weight-loss surgery. The study found 7 percent of patients who had gastric bypass reported symptoms of alcohol use disorders prior to surgery. The second year after surgery, 10.7 percent of patients were reporting symptoms.

The findings were published Monday in the Journal of the American Medical Association.

“There have been previous studies that show there is a change in alcohol sensitivity in gastric bypass,” Wendy King, a research assistant professor in the department of epidemiology at the University of Pittsburgh Medical Center, and the study’s lead author.

King’s study is the first to show that with this increased sensitivity there is also an increased risk of alcohol use disorders (AUD), the term used to describe alcohol abuse and dependence.

Dr. Mitchell Roslin, a bariatric surgeon at Lenox Hill Hospital in New York City, said the link between gastric bypass surgery and increased alcohol use has been attributed before to the shifting addiction theory and that this is false. The shifting addiction theory is that if a person has an impulsive drive to eat and the ability to eat large amounts of food is taken away, then he will shift his addiction to another addictive substance, like drugs or alcohol.

“A gastric bypass patient has a small pouch [for a stomach] so alcohol goes straight into the intestine and is absorbed rapidly,” said Roslin. “When it is absorbed rapidly, there is a high peak and rapid fall.”

The higher absorption rate makes alcohol more addictive, he added.

Indeed, before his surgery, Kahn would have two drinks, then feel sleepy and go to bed. After the surgery, he said he felt the alcohol would go through his system faster, which allowed him to drink more.

“It wears off so quickly so you can keep going and going,” said Kahn.

Gastric bypass is the most commonly performed bariatric surgery in the United States and represents 70 percent of all surgeries performed during the study. Laparoscopic gastric banding, where an adjustable band in placed around a patient’s stomach and limits how much food the stomach can hold, did not have an associated risk with increases in alcohol problems.

King said this is to be expected as gastric banding does not change the anatomy and thus the metabolism of alcohol like gastric bypass does.

The study also found that the increase in alcohol-use disorders was not seen until the second post-operative year as opposed to the first year after surgery.

“This emphasizes that continuing education about alcohol use is needed until the second year after surgery. With follow up [patients] need to hear about consumption and what is appropriate,” said King.

Dr. Leslie Heinberg, the Director of Behavioral Services for the Bariatric and Metabolic Institute of the Cleveland Clinic, thinks these increases are causes for caution more so than concern. Patients should be educated before their surgery about the changes that will occur in how they will absorb and metabolize alcohol.

“Given that the increased rates of alcohol use disorders post-operatively are equivalent to what is seen in the general population, it shouldn’t be a reason to avoid a life-saving procedure,” said Heinberg. “Rather, it points to the importance of education, informed consent and continued monitoring.”

King said her study highlights one of the risks of the surgery but it is important for patients to take in context all of benefits and risks and work with doctors to determine what is the best option for them.

“Bariatric surgery is the most effective treatment we have for obesity. It would be shame if people walked away thinking gastric bypass was a bad procedure based on this [study],” said King.

Andrew Kahn said that he did not have the opportunity to know that alcohol addiction may occur after his surgery and he wants other patients to be informed about these risks. He initially lost over 70 pounds after his surgery, but in the six months he was heavily drinking, he gained 35 of those pounds back and became depressed. He eventually attended a detoxification program and has been sober since 2010.

Kahn said he would not have had an alcohol problem if he did not have gastric bypass. Still, he wouldn’t have traded in the surgery if given a second chance.

“Gastric bypass saved my life,” he said.

The D.S.M. Gets Addiction Right

Via NY Times

When we say that someone is “addicted” to a behavior like gambling or eating or playing video games, what does that mean? Are such compulsions really akin to dependencies like drug and alcohol addiction — or is that just loose talk?

This question arose recently after the committee writing the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.), the standard reference work for psychiatric illnesses, announced updated definitions of substance abuse and addiction, including a new category of “behavioral addictions.” At the moment, the only disorder featured in this new category is pathological gambling, but the suggestion is that other behavioral disorders will be added in due course. Internet addiction, for instance, was initially considered for inclusion but was relegated to an appendix (as was sex addiction) pending further research.

Skeptics worry that such broad criteria for addiction will pathologize normal (if bad) behavior and lead to overdiagnosis and overtreatment. Allen J. Frances, a professor of psychiatry and behavioral sciences at Duke University who has worked on the D.S.M., has said that the new definitions amount to “the medicalization of everyday behavior” and will create “false epidemics.” Healthinsurance companies are fretting that the new diagnostic criteria may cost the health care system hundreds of millions of dollars annually, as addiction diagnoses multiply.

There is always potential for misuse when diagnostic criteria are expanded. But on the key scientific point, the D.S.M.’s critics are wrong. As anyone familiar with the history of the diagnosis of addiction can tell you, the D.S.M.’s changes accurately reflect our evolving understanding of what it means to be an addict.

The concept of addiction has been changing and expanding for centuries. Initially, it wasn’t even a medical notion. In ancient Rome, “addiction” referred to a legal dependency: the bond of slavery that lenders imposed upon delinquent debtors. From the second century A.D. well into the 1800s, “addiction” described a disposition toward any number of obsessive behaviors, like excessive reading and writing or slavish devotion to a hobby. The term often implied a weakness of character or a moral failing.

“Addiction” entered the medical lexicon only in the late 19th century, as a result of the over-prescription of opium and morphine by physicians. Here, the concept of addiction came to include the notion of an exogenous substance taken into the body. Starting in the early 20th century, another key factor in diagnosing addiction was the occurrence of physical withdrawal symptoms upon quitting the substance in question.

This definition of addiction was not always carefully applied (it took years for alcohol and nicotine to be classified as addictive, despite their fitting the bill), nor did it turn out to be accurate. Consider marijuana: in the 1980s, when I was training to become a doctor, marijuana was considered not to be addictive because the smoker rarely developed physical symptoms upon stopping. We now know that for some users marijuana can be terribly addictive, but because clearance of the drug from the body’s fat cells takes weeks (instead of hours or days), physical withdrawal rarely occurs, though psychological withdrawal certainly can.

Accordingly, most doctors have accepted changes to the definition of addiction, but many still maintain that only those people who compulsively consume an exogenous substance can be called addicts. Over the past several decades, however, a burgeoning body of scientific evidence has indicated that an exogenous substance is less important to addiction than is the disease process that the substance triggers in the brain — a process that disrupts the brain’s anatomical structure, chemical messaging system and other mechanisms responsible for governing thoughts and actions.

For example, since the early 1990s, the neuropsychologists Kent C. Berridge and Terry E. Robinson at the University of Michigan have studied the neurotransmitter dopamine, which gives rise to feelings of craving. They have found that when you repeatedly take a substance like cocaine, your dopamine system becomes hyper-responsive, making the drug extremely difficult for the addicted brain to ignore. Though the drug itself plays a crucial role in starting this process, the changes in the brain persist long after an addict goes through withdrawal: drug-using cues and memories continue to elicit cravings even in addicts who have abstained for years.

Furthermore, a team of scientists led by Nora Volkow at the National Institute on Drug Abuse have used positron emission tomography (PET) scans to show that even when cocaine addicts merely watch videos of people using cocaine, dopamine levels increase in the part of their brains associated with habit and learning. Dr. Volkow’s group and other scientists have used PET scans and functional magnetic resonance imaging to demonstrate similar dopamine receptor derangements in the brains of drug addicts, compulsive gamblers and overeaters who are markedly obese.

The conclusion to draw here is that though substances like cocaine are very effective at triggering changes in the brain that lead to addictive behavior and urges, they are not the only possible triggers: just about any deeply pleasurable activity — sex, eating, Internet use — has the potential to become addictive and destructive.

Disease definitions change over time because of new scientific evidence. This is what has happened with addiction. We should embrace the new D.S.M. criteria and attack all the substances and behaviors that inspire addiction with effective therapies and support.

Can These 6 Questions Tell You If You’re Clinically Addicted to Facebook?

Via The Atlantic

American medical discourse is chock full of addictions these days. There’s video game addiction, porn addiction, gambling addiction, Internet addiction.

And of course: Facebook addiction. At least, that’s according to Norwegian researcher Cecilie Schou Andreassen, who says people who can’t get enough of the social network show many of the same signs of withdrawal and mood swings associated with gambling junkies.

Although Facebook is not a chemical like alcohol or cocaine, she said in an email to The Atlantic, Facebook users can fit the criteria for addiction that are applied to other things.

All addictions, chemical and non-chemical, appear to comprise six core components: (1) salience (the activity dominates thinking and behaviour), (2) mood modification (the activity modifies/improves mood), (3) tolerance (increasing amounts of the activity are required to achieve initial effects), (4) withdrawal (occurrence of unpleasant feelings when the activity is discontinued or suddenly reduced), (5) conflict (the activity causes conflicts in social relationships and other activities), and (6) relapse (tendency for reversion to earlier patterns of the activity after abstinence or control).

The problem, however, is this: how do you measure addiction to a website? Her attempt, which was published earlier this year in Psychological Reports, is called the Bergen Facebook Addiction Scale. Originally, participants were asked 18 questions and those answers were correlated with a variety of other psychological tests and measures of problematic media usage.

Six of the initial 18 questions have been kept by the researchers as the most predictive of Facebook addiction. To a first approximation, these questions are a way of measuring whether you have a problem with Facebook. Each of them correlates with one of the six components listed above and can be answered: very rarely, rarely, sometimes, often, or very often. Here they are (we’ve listed the component of addiction the question addresses in parentheses after it).

How often during the last year have you…

  • spent a lot of time thinking about Facebook or planned use of Facebook? (Salience)
  • used Facebook in order to forget about personal problems? (Mood modification)
  • felt an urge to use Facebook more and more? (Tolerance)
  • become restless or troubled if you have been prohibited from using Facebook? (Withdrawal)
  • used Facebook so much that it has had a negative impact on your job/studies? (Conflict)
  • tried to cut down on the use of Facebook without success? (Relapse)

Not everyone is sold on the idea, though. Mark Griffiths, a British psychologist at Nottingham Trent University, says the notion of Facebook addiction actually obscures more than it reveals.

“The real issue here concerns [...] what people are actually addicted [to],” Griffiths writes in the latest issue of Psychological Reports. “Facebook addiction as a term may already be obsolete because there are many activities that a person can engage in on the medium.” In other words, to say that we’re addicted to “Facebook” doesn’t really accomplish very much when the service’s value derives from what people do with it.

Griffiths adds that if the concept of Facebook addiction isn’t quite specific enough, it could also be attacked on the grounds of being too narrow. There’s no reason to think you wouldn’t find the same habits and attitudes on other social networks that Andreassen discovered with respect to Facebook.

“There is a fundamental difference between addictions to the Internet and addictions on the Internet,” Griffiths writesSo, by analogy, you wouldn’t say that you were addicted to going to bars if you were an alcoholic. Griffiths argues that there are specific activities on the Internet that one could be addicted to, but measuring Facebook itself is not the right level of analysis. “The field needs a psychometrically validated scale that specifically assesses social networking addiction rather than Facebook use,” he concluded.

In other words, Andreassen’s research appears to have kicked off a debate in addiction research that won’t be settled soon.

But here’s one parting thought: even as we begin talking more about this thing we call “addiction” to digital media, attitudes toward the technology are still evolving. It’s not unimaginable that what we consider unnatural today will eventually lose its cultural stigma down the road. After all, you don’t see many people talking about being addicted to talking on the telephone. But go back to the 1970s and you see plenty of headlines like this one: “Younger Generation Has Phone Addiction” and “Telephone Addiction Problem for Parents.”

Is ‘Hitting Bottom’ Just a Myth?

Via NY Daily News

BILL: “When I had no other option twelve years ago,” writes Jason, “I went to my first AA meeting. Been sober ever since. So I know how powerful hitting bottom can be. While my wife is not a drunk, she can’t quit cigarettes. She joined a Nicotine Anonymous group a year ago, but it does not help. Do I have to wait till she hits some tobacco bottom – lung cancer? – before she quits?”

DR. DAVE: Wasn’t one of your old jokes that you never smoked — so you were easy to spot: the one drunk in the bar with a martini in both hands?

BILL: That’s why I turned for help to Dr. Peter Ferentzy, PhD – author of “Dealing With Addiction – why the 20th century was wrong.”

“The governing approach to addiction is a joke,” he told me. “Hitting bottom rarely helps. Consider this: if someone is happy at work and happily married but doesn’t quit, ruining the marriage and work situation will LESSEN the odds of quitting. If anything, the anxiety will increase the smoking. The more Jason’s wife has to live for, the greater the odds of her kicking (tobacco, alcohol, crack, whatever). Few kick when their lives are in turmoil. The best approach is love and nonjudgmental support. The worst approach is ‘tough love.’”

DR. DAVE: “The real problem in stopping smoking,” says the noted tobacco-dependence researcher, John Hughes, M. D., “is not relapse … it is getting through the first week. Forty percent of smokers who try do not even abstain for two days and 60 percent do not make it for a week.” That’s why there are 7 day Stop Smoking residential treatment programs — the agreed on time most critical for cessation.

BILL: Dave, why does it sound as if kicking smokes is more difficult than going sober?

DR. DAVE: This is an addiction I can talk about pretty intimately Bill—both bottom and addiction. When I quit 20 years ago, I was pushing 3 packs a day. While I don’t buy all of Dr. Ferentzy’s philosophy on hitting bottom actually feeding the addiction, I agree that controlled crises are a much better solution.

BILL: Three packs a day. You?

DR. DAVE: The last 2 years of my PhD dissertation were brutal. There I was working on research about the damage drugs was causing young adults — with an ashtray next to my old IBM Selectric Typewriter overflowing with Marlboro Menthols….

BILL: What a visual! The addicted Doc in a cloud of writer’s “fog”…

DR. DAVE: Since 1992, the only thing littering my draft journal articles are crumbs from Tim’s Cascade Potato chips…

BILL: A compulsion to talk about another day. So what was your bottom?

DR. DAVE: My oldest daughter Katie came to me crying. I thought “Ah, a hard day at school—coming to get consoled by her dad.” No — she was really upset because I was killing myself by smoking! Once she punched through my denial, all of a sudden I was looking at a world filled with daily struggles to get from one cigarette to the next!

BILL: How did you finally get through those crucial first seven days and stay stopped?

DR. DAVE: My daughter’s tears made me face that I needed something to barricade me from the world while turning me into a non-smoker 24/7.

BILL: And you found – ?

DR. DAVE: – that the Seventh Day Adventists had been doing stop smoking cessation work as a world community service for 20+ years. And lo and behold, they had a seven-day residential treatment program at a lodge overlooking the Columbia River near where I lived.

BILL: So, if you can get through 7 days of Adventist proselytizing and withdrawal, you’d be home free?

DR. DAVE: No proselytizing Bill — I couldn’t tell you any principles of the Seventh Day Adventists; except they apparently aren’t real fond of meat—nor caffeine.

BILL: And for our readers who want to follow that path?

DR. DAVE: Well, they could call a local Adventist Health program. If they don’t have a residential program, they should have a daily program. Readers say they create the same experience I did by staying at a hotel next to the hospital for seven days. Here’s the website for my “treatment center” — Jason and his wife could always start there: Northwest Adventist Hospital.


A Game to Help Doctors Ask Tough Questions

As Dr. Danielle McCarthy listens to a man beg for a prescription for painkillers, she weighs her possible responses.

Dr. Danielle McCarthy, right, used an interactive game to speak with a patient about his pain.


A 31-year-old emergency room physician, she listens patiently as the man tells her that “every morning I wake up in pain,” describing the agony he continues to endure, three years after being injured in a car wreck.

He has tried physical therapy, acupuncture and chiropractic treatment, he says. Nothing works except pills, he insists, as his voice grows louder and more demanding.

Their exchange is similar to conversations that take place on almost every shift at Northwestern Memorial Hospital here, Dr. McCarthy said. But it is fiction — part of an interactive video game designed to train doctors to identify deceptive behavior by people likely to abuse prescription painkillers. The patient is an actor whose statements and responses are generated by the program.

The video game was designed based on research by Dr. Michael F. Fleming at the Northwestern University Feinberg School of Medicine and draws on technology used by the F.B.I. to train agents in interrogation tactics. It teaches doctors to look for warning signs of drug abuse, like a history of family problems, and to observe nonverbal signs of nervousness, like breaking eye contact, fidgeting and finger-tapping.

The game, which is in its final phase of testing, is aimed at primary care and family doctors, who often feel uncomfortable and unqualified assessing their patients in this regard.

“This isn’t something medical students have traditionally been trained for,” Dr. Fleming said. “These are hard conversations to have.”

It can be a thorny matter, Dr. McCarthy said, because physicians are trained to help patients, but they do not want to enable drug abuse. “You don’t want people to be in pain,” she said. “And you’re put on the spot. I’ve had patients yell at me. I’ve never been hit, but once or twice I’ve felt physically threatened.”

In 2009, for the first time, the number of deaths from drug overdoses surpassed those from highway traffic accidents, according to Gail Hayes, a spokeswoman for the Centers for Disease Control and Prevention. She said misuse of prescription medication has been largely the cause. About 75 percent of overdoses involved prescription drugs, she added.

So health care professionals are searching for better ways to distinguish patients who can be trusted to use prescription pain medications properly from those out to abuse them. According to the C.D.C., prescription drug abuse is the fastest growing drug problem in the United States, fueled by the use of highly addictive opioid analgesics like OxyContin.

The Web-based interactive video game, which will soon be available online for a fee to medical schools and health care providers, includes about 2,000 statements by the patient, ranging in tone from charming to irate. A doctor can choose from 1,500 questions and responses, selecting one from five to seven options that appear on the screen when it is time to speak to the patient.

The dialogue is drawn from research by Dr. Fleming, based on interviews with more than 1,000 patients who were receiving opioids for pain. “We have 95 percent of what a patient and doctor would say or do,” he said.

Sharp skills are needed to assess a patient’s motives, he said, because an objective measurement, like from a blood test or an X-ray, is not available to gauge pain, and the opioids can be highly addictive.

The game’s software was developed by Dale E. Olsen, a former professor of engineering at Johns Hopkins University. He is the founder and president of Simmersion, a company that has created simulation training programs for the F.B.I. The game’s development was financed by a $1 million grant from the Small Business Administration and the National Institute on Drug Abuse. Dr. Olsen, who has a Ph.D. in statistics, said the game would cost users about $50 an hour. It is designed to be used for 10 sessions of 15 to 20 minutes each. He said customers would most likely include medical schools, as well as private and government health care providers.

The game encourages doctors to adopt a more collaborative and less accusatory approach with patients, Dr. Olsen said. “The goal is to build rapport,” he said.

Dr. McCarthy, wearing headphones and blue scrubs, faces the computer screen, where the patient, named Tom, a trim man with a neatly cropped beard, is asking for pain medication.

The physician asks Tom to describe his pain. Tom points vaguely to his lower back. She asks about whether he has ever had any problems with pills. He acknowledges that he once accidentally took too many pills, but that it was “no big deal.”

When she asks him to submit to a drug screening, he is testy, but agrees to do so if she insists — “and then I want my pills.”

At the end of the interactive portion, the game awarded Dr. McCarthy high marks for communication skills, for asking for a drug test and for declining the request for a prescription. She lost points for not asking enough questions.

Dr. McCarthy nodded at the screen in acknowledgment of her score. She explained that there are time constraints in her work.

“We move pretty quickly in the emergency room,” she said. “We’re not usually going to have time for 60 questions.”

She sometimes has had a hunch that a patient was exaggerating or fabricating pain, she said. She found the training useful, she said, because it offered new suggestions of responses to patients.



Marijuana Addiction & Treatment at The Control Center

Marijuana addiction, like addictions to other substances, can cause serious problems in an individual’s life. Dependency on the drug can harm personal relationships, affect work performance, and lead to legal troubles. For some people, though, marijuana abstinence takes more than just the decision to say “no.” They need an effective marijuana addition treatment plan that addresses the physical and mental issues of their dependency.

Marijuana Addiction Treatment

Marijuana Addiction Treatment Services

The Control Center uses a variety of therapies to create individualized treatment plans that help marijuana addicts reach their goals. Each individual receives a personalized treatment schedule that might include:

  • Spiritual Therapy
  • Specialty Psychotherapy
  • Nutritional Consultation
  • Medical Management
  • Neuropsychological Assessment

Addressing Mental Health Issues

A reliable marijuana addiction treatment needs to address mental health issues that might co-occur with physical dependency. The Control Center uses a variety of mental health programs and alternative practices to address these issues, making it possible for addicts to learn healthy coping skills that enable them to attain long-term sobriety. Some of the most successful mental health services include:

  • Couples and Family Therapy to develop stronger relationships and a social system that supports marijuana abstinence
  • Spiritual Therapy that includes meditation, yoga, breathing exercises, and creative visualization to help addicts develop rich inner lives and helps them regain control of their behavior
  • Eye Movement Desensitization and Reprocessing (EMDR) that helps individuals recover from traumatic experiences that might underlie their addictions

Long-term Sobriety is Possible

The Control Center’s personalized marijuana addiction treatments can help individuals find healthier ways of coping with the stressors that they encounter in life. For many people, long-term sobriety depends on this step. The Control Center offers outpatient services to help addicts maintain control over their lives, even during stressful periods that could potentially lead to relapse. The Control Center also supports off-site MA, NA, and AA programs for long-term sobriety.

No matter what level of addiction you or a loved one faces, The Control Center can develop a marijuana addition treatment program that helps each person achieve a successful recovery. Contact The Control Center today to learn more about taking back control of your life.

Eating Disorders Information and Treatment

Eating disorders can take a heavy toll on a person’s health. Binge eating can lead to a wide variety of health problems, such as high cholesterol, obesity, and poor heart health. The underlying reasons that people binge eat, however, are usually psychological. Therefore, an effective binge eating treatment plan needs to address mental health as well as physical health. The Control Center provides personalized plans to address each person’s unique needs.

Addressing Underlying Issues

 Binge eating is usually the result of a mental health disorder that has not received proper attention. Therefore, failing to address the mental health aspects of binge eating makes it nearly impossible for binge eating treatment to work. The Control Center uses a number of mental health services to promote long-term health:

  • Neuropsychological Assessment to help diagnose any underlying mental health issues
  • Specialty Psychotherapy that addresses mental health issues such as low self-esteem, depression, and anxiety
  • Spiritual Therapy that uses meditation, yoga, breathing exercises, and creative visualization to help individuals foster a balanced approach to life

Binge Eating Treatment Services

 The Control Center uses several services to help individuals stop binge eating so that they can integrate healthier dietary and lifestyle choices. The professionals at The Control Center work carefully with each patient so that he or she may develop a better understanding of:

  • Mental health issues that can influence eating behaviors
  • Addiction backgrounds and difficulties with self-control
  • How family history can influence eating and exercise habits
  • Ways that an individual’s medical history should influence lifestyle choices
  • The positive and negative aspects of his or her nutritional history
  • How physical exercise affects physical and mental health

Healthy Living for Life

 The Control Center is dedicated to helping people with problems with binge eating develop healthy habits that will last for a lifetime. To meet this goal, binge eating treatment plans often include individual, group, and family therapy in addition to:

  • Nutritional Consultations that teach healthy eating practices
  • Medical Management that helps individuals prone to binge eating stay in recovery during and after their outpatient treatment

If binge eating has started to have a negative effect on your life, contact The Control Center to learn more about how a personalized binge eating treatment could help you regain control of your life.

Our Staff: Dr. Deborah Sweet, Psy.D. and Dr. Farzin Yaghmaie, M.D., M.A.

We would like to introduce you to some of the amazing staff we have here at The Control Center. This will help you get to know who we are, and why we love to do what we do!

Dr. Deborah Sweet, Psy.D.

Clinical Psychologist

Expertise: Addiction TherapyTrauma, EMDR, Compulsive Shopping

Deborah Sweet, Psy.D. is a licensed psychologist who specializes in helping people recover from a variety of addictions and traumas with a specialty in chemical dependency and spending addictions. Dr. Sweet uses talk therapy, CBT, solution-focused, and 12 Step Recovery models. Since many addictions are rooted in trauma, she blends Somatic Experiencing and EMDR treatments to help clients with a sense of resilience. Three areas that are frequently affected by trauma are a sense of choice, a sense of safety, and a sense of self. EMDR and Somatic Experiencing provide a different kind of access to traumatic material. Dr. Sweet has also helped individuals and business owners with their issues around spending and financial recovery since 1997. As a compulsive shopping expert, Dr. Sweet offers a gentle yet direct approach regarding resistance and motivation around money, saving, and shopping. In addition to psychological help, she offers practical tools on how to deal with money, shopping, and financial resources. She is an active member of the American Psychological Association, CPA, LACPA, and the Women’s Association for Addiction Treatment.

Dr. Farzin Yaghmaie, M.D., M.A.

Clinical Psychiatrist


Expertise: Mental Health DisordersAddiction Medicine, Detoxification

Dr. Yaghmaie is a psychiatrist specializing in the treatment of mood, anxiety, and addiction issues. He completed his medical residency and psychiatric training at UCLA, where he was chief resident of the UCLA Integrative Substance Abuse Programs and the West Los Angeles Veterans Administration Opioid Treatment Program. He has extensive training and experience in the evaluation of addiction, detoxification, and treatment of chemical dependency with medication and therapy. Dr. Yaghmaie has academic and research training from UC Berkeley, where he studied integrative biology and endocrinology. He has numerous professional publications and has been a sub-investigator researching medication development for the treatment of opiate and methamphetamine dependence. Dr. Yaghmaie is currently a psychiatrist at The Control Center and also has a private practice in Beverly Hills.