Show:
Treatment That Works
The Things I Cannot Change
The Things I can Change
Mental Health and Addiction
Peace with the Past
100
  • True or False: Research-backed psychological treatments are available for most mental health concerns

True

Explanation: The vast majority of mental health concerns are treatable with psychotherapy, and tend to respond even better to therapy combined with medication.  If you haven’t tried therapy before, or only tried one approach, there are a number of options still available to you.  And medications, as well!

100

True or False: If your anxiety or depression has been a major factor for most of your life, it means it will always be a major factor for most of your life.

False

  • Although you may always have some predisposition towards depression and anxiety, it’s very possible to have the symptoms of depression and anxiety well-controlled and be on the periphery of your awareness, rather than front-and-center.  Successful and healthy coping with mental health concerns is possible for just about everyone, it’s just about finding the management strategy that’s right for you.


100

True of False: Our mental and emotional heath does not require attention and care.  “Normal” people can ignore their mental health and still handle their life without feeling overwhelmed or having problems.

 Answer: False, of course! 

  • Explanation:  Just as we brush our teeth and shower daily, we also need to care for our mind.  We should be spending time every day, ideally 10 minutes or more, to take care of our emotional health in healthy ways.
100

What are the three factors in the biopsychosocial model?

  • Answer: Biological , psychological, and social factors


  • Successfully managing addiction requires attending to and making improvements in all three of these categories!  If you neglect one, it could pull you back into active addiction.
100

True or False:  You can be diagnosed with major depressive disorder if you feel sad or depressed for several days in a row.

  • Answer: False


  • Explanation:  Being diagnosed with major depressive disorder takes two weeks of continual depressive feelings in a row, not just a few days.  The main idea here is that everyone feels depressed from time to time, and can feel depressed for any number of reasons.  When we call depression a disorder is when it lasts for a very long time.  There is also a greater chance that someone’s depression is a diagnosable condition if it tends to come on for no warning – that there is no identifiable reason for the depression beginning.
200
  • What is the name of the therapeutic technique where you confront something that you’re scared of directly?

Exposure

Explanation:

  • Fear and anxiety comes from seeing risk – if you think something is risky or dangerous you’ll feel anxiety, and if you don’t, then you won’t.  Anxiety and fear often persist because of avoidance – people often avoid confronting a fear head-on.  Exposures allow you to teach yourself that the feared stimuli isn’t actually as risky as you think it is.
200
  • What is the difference between a delusion and a hallucination?
  • : A delusion is a belief that you have that is not based in reality, and that does not change when presented with reality-based information.  A hallucination is some sort of sensory experience that is not real – it can be involve any of the five senses, but the most common are visual (visions, “seeing things”) or auditory (hearing noises or voices that are not there). 


Explanation:

The clearest way to differentiate a delusion from a strongly-held belief is that the belief does not shift at all when presented with contradictory information; the new information is generally explained-away, dismissed, or ignored.  Although it’s fairly common at times to experience mild hallucinations (such as when you are falling asleep or just waking up), hallucinations are more clinically significant when they occur when someone is otherwise fully awake and aware.  Clinically significant hallucinations are generally intrusive and unwanted for the person who experiences them.

200
  • True or False: Boundaries with others are always healthy and helpful
  • Answer: False


  • Explanation: Healthy boundaries are necessary to protect yourself from potentially toxic relationships and relational dynamics.  But sometimes we create boundaries which keep others away from us – we struggle to be vulnerable, which stops us from forming healthy connections.  Learning what healthy boundaries are for you, and how to set/maintain them, is essential!
200
  • True or false: Strong emotions are the #1 reason for relapses
  • Answer: True


  • Explanation: Strong emotions, either positive or negative, are the primary reason for relapse.  When your emotion-mind kicks in too strongly, it’s easier to forget about your goals and fall back into old (coping) habits.
200
  • If you have PTSD, what does your body do at night that turns regular dreams or nightmares into traumatic nightmares, where you may wake up in a cold sweat or with a racing heart?
  • Answer: Your body produces adrenaline when dreaming about the event.
  • Explanation:  When your body produces adrenaline while remembering the traumatic event, it kicks the nightmare into a higher gear and causes the physiological reactions that many people experience when they wake.  Part of treatment is changing your relationship to the past event, so adrenaline is no longer produced.


300
  • What is the name of the skill you can develop that allows you to watch your thoughts and feelings, rather than get swept up by them?
  • Mindfulness


explanation:

  • Mindfulness means being fully present in the present moment and not getting lost in thoughts or feelings.  We often think our thoughts and feelings are always true, or always need to be listened to – this is not the case!  Building skill in mindfulness allows us to see the patterns of our mind, and realize that our thoughts are just that – thoughts.  We build skill in mindfulness through mindfulness meditation.
300
  • Name four of the Big 5 personality factors.
  • Openness to experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism.


Explanation: 

  • Personality can be organized into 5 main categories, which can be abbreviated as “OCEAN.”  Everyone completed the Big Five Inventory in their intake materials – this is one way to determine how much of each personality factor you have, and how it compares to others in your age group.  Your personality is largely consistent over time, although does change in some ways as you age or make major life changes (like sobriety!).  Openness relates to how open you are to new things/ideas, Conscientiousness relates to how organized/meticulous you are, Extraversion relates to how much you enjoy and are energized by being around others, Agreeableness relates to how considerate and empathetic you are around others, and Neuroticism relates to being nervous and insecure (as opposed to confident and calm).
300

Name two healthy techniques you can use to lower your level of stress and anxiety when you’re feeling anxious

  • Explanation: When you’re feeling worked up and anxious, this means you ideally need to use an intervention that engages your parasympathetic nervous system to calm you back down again.  The first three techniques above do this, and are the best first step in deescalating your body.  The others are also research-supported approaches to lowering anxiety and stress.
300

What is a “shame spiral,” and how can it trap you in addiction or turn a “lapse” into a full-blown relapse?

  • Answer: A shame spiral is when you feel negative, use a substance to try to feel better, but then feel shame about using and continue to use in an attempt to cope with those negative feelings. 


  • Explanation: If your primary coping skill is something that causes more problems than it solves, you’re going to quickly find yourself in a very negative place.  The solution here is to deal with negative feelings in a way that’s healthy and sustainable.  If you feel shame, responding with something that will just make you feel more shame is counterproductive, even if you may feel better for a moment.
300
  • What is the difference between guilt and shame?

Guilt is when you feel bad about something that you did.  Shame is when you feel bad about who you are as a person.


Explanation: 

  • Explanation: Guilt is normal and useful – it tells you that something you did is not in-line with your values, and can inspire you to take action to improve on yourself.  Shame is generally counterproductive, however, as it involves devaluing yourself as a person and can lead to feeling stuck and hopeless.
400
  • What is the most commonly-prescribed medication type that works for both depression and anxiety?
  • Selective Serotonin Reuptake Inhibitors (SSRIs)


Explanation:

  • SSRIs are the first-line medication in most circumstances for both anxiety and depression.  They tend to have very low side effects, and increase the serotonin in your brain.  Serotonin is like mental grease – if you’re stuck in an emotional or mental loop (like anxiety, depression, obsessive-compulsive disorder, or anger), adding serotonin allows you to use skills and techniques to successfully get out of that loop.  The medications work slowly, usually taking about 2 weeks and perhaps a dose increase to have an effect.  This also means you can’t take them reactively if you’re feeling a strong emotion…which is good!  They help you use healthy coping skills, rather than being an unhealthy coping behavior themselves.
400
  • Name two mental health conditions that are highly biologically-based, and in most cases requires medications to properly treat or control symptoms.

:  Psychotic disorders (e.g., schizophrenia), mania/bipolar disorder, and ADHD.  If someone answers depression give them another chance on that answer, as it’s on the borderline (see below).

Explanation: 

  • Some mental health conditions are strongly related to biology – there’s not really a way to resolve symptoms or patterns with psychotherapy alone.  Symptoms of bipolar disorder (particularly mania) and schizophrenia are both very difficult to control without mood stabilizers and antipsychotic medications, respectively, but with the right medications can be very well-controlled (after which therapy can be far more effective).  ADHD also has a strong biological basis (generally low dopamine) and generally requires medication to control symptoms, although in some cases improves significantly as the individual ages into their 30s and 40s.  Other disorders, like unipolar depression, can have a strong biological basis in some cases – those cases often do require medication to control symptoms. But this is not always the case with depression, and is definitely not the case for anxiety-related disorders.  Medications can certainly help, but are not always as critical.
400
  • What is the alternative to judging yourself on the outcome of your behaviors or efforts?
  • Answer:  Focusing instead on your process, rather than just on the outcome.
  • Explanation: We can’t always control the outcome of our efforts: we may get downsized from a job no matter how hard we work, or someone may not want to repair a relationship with us no matter how successful we are in sobriety or how earnest in making amends.  If you judge yourself based on these outcomes, your feelings about yourself are not under your control, which puts you in a vulnerable place.  If you instead focus on your process (things like making sure you’re living up to your values every day, or doing your job to the best of your ability) you’ll take back this control, feel better about yourself, and likely find that the outcome is still positive most of the time.
400
  • What are two reasons benzodiazepines (like Valium, Xanax, Ativan, and Klonopin) are bad ideas for managing chronic anxiety, particularly for people in recovery?
  • Answer: 1) Benzodiazepines are addictive, and 2) they take the place of learning internal coping skills.
  • Explanation: Benzodiazepines cause an immediate anxiety-relieving effect, and are also chemically addictive in nature – using them for an extended period of time will build tolerance, and eventually physical dependency.  Using them reactively to cope with anxiety also continues the association between “I feel X” and “I put X substance in my body to change that feeling.”
400

What is the definition of a belief that is a “stuck point”?

  • Answer:  A belief that causes emotional discomfort or harm, regardless of how accurate that belief is.
  • Explanation: Oftentimes after a trauma, someone’s beliefs shift – they may feel unsafe in situations where they previously felt safe, or mistrustful in situations where they previously would be more open to trust.  When these beliefs interfere with regular life they are called “stuck points” because they cause the person to feel “stuck,” unable to make progress.
500
  • Name one of the 3 primary treatments shown by research to be effective for PTSD.
  • Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), or Eye-Movement Desensitization Response (EMDR)

Explanation:

  • The three therapies mentioned above are well-supported through research to help reduce symptoms of PTSD, like intrusive thoughts, nightmares, feeling hypervigilant, and being quick to anger.  Some other therapies also show promise, like mindfulness-inclusive interventions like ACT and DBT, but the three above are considered the gold-standard.
500

Name three primary symptoms of borderline personality disorder.  

Symptoms can include: unstable personal relationships, mood swings, intense anger, fears of being abandoned, self-harming or suicidal behavior, paranoia or difficulty with trust.


Explanation: 

  • Borderline Personality disorder can be very disruptive to living a normal life, as well as maintaining stable relationships with others.  Many people with borderline personality disorder experienced significant abuse in their childhood, forcing them at a very young age to figure out how to cope with an impossible psychological situation: the people who are supposed to be safe protect them are unsafe and hurting them instead.  This creates a tremendous amount of internal distress and conflict without any effective way to cope with it, which is why the symptoms above occur.
500
  • Name three techniques of the five techniques that have been identified as “mental hygiene,” and can count towards your 10 minutes per day.
  • Answer:  Meditation, Positive Psychology interventions (e.g., gratitude exercises), Cognitive-Behavioral interventions (e.g., thought challenging), immersion in nature, and prayer.
  • Explanation: Just as we bathe and brush our teeth daily to care for our bodies, our minds and emotions require regular care, as well.  Engaging in 10 minutes of mental hygiene daily can have a positive impact on your emotional and mental health long-term.
500
  • Why is substance use linked so strongly with having experienced very upsetting or traumatic events as a child?
  • Answer:  Symptoms of trauma, in particular, can be very disturbing and agitating on a daily (and nightly) basis.   The idea of creating a period of time with relief or peace, or a night without nightmares, can be very appealing.  This is particularly true for children, who have fewer emotional resources, so if you experience traumatic events as a child the option to escape from those feelings is very strong.  The coping habit becomes established, and then stays through adulthood.
  • Explanation: Symptoms of PTSD can be extremely distressing and pervasive, often intruding into sleep with traumatic nightmares. In addition, if the traumatic event occurred during childhood, young minds often struggle to understand the situation, or why people that they had thought were safe are actually unsafe.  All mental health concerns are linked to increased substance use, but the far-reaching and intense aspects of PTSD cause this link to be the among the strongest.
500

What is the difference between a bad memory and a traumatic memory?

  • Answer:  Traumatic memories create an adrenaline response, causing the person to feel the physical sensation of fear or fight/flight when remembering the event.
  • Explanation: At the core of PTSD is a confusion between the past and the present – someone sees something in the here-and-now that reminds them of a traumatic event, and has a mental and/or physical reaction as if that event is happening again.  The primary goal of the exposure-based components of PTSD therapy is to change traumatic memories into bad memories.