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Most Treated Disorders in Adults

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Anxiety Disorder

Everyone knows what it’s like to feel anxious, the “butterflies” in your stomach before that first date, the “jitters” before giving a speech, the sweaty palms or racing heartbeat that often accompany challenging or dangerous situations. These feelings are normal.
But what if you were to find yourself feeling anxious most of the time instead of just under specific circumstances? What if you couldn’t even find a particular reason for feeling this way? What if you found yourself avoiding certain everyday routines or activities altogether in an effort to curb the stressful feelings they cause? What if you simply were to become “paralyzed” by your own nervousness? This is what life is often like for those suffering from one of the group of biologically based mental illnesses known as anxiety disorders.

The different types of anxiety disorders are:

Panic Disorder

Those suffering from panic disorder experience reoccurring and unexpected panic attacks-instances of extreme fear or discomfort that start abruptly and build to a rapid peak, usually within ten minutes. Panic attacks are characterized by such physical symptoms as heart palpitations, sweating, trembling, shortness of breath, the sensation of choking, chest pain, nausea, dizziness, disorientation, fear of losing control or dying, numbness, chills, and hot flushes. Additionally, panic attacks are usually accompanied by a sense of looming danger and the strong desire to escape. Attacks can be brought on by specific triggers or can occur “out of the blue.” The frequency of attacks tends to vary according to the individual.
To be diagnosed with panic disorder, one’s panic attacks must have been followed by at least one month of steady worry about having more attacks, concern about why the attacks have happened and what they mean (fears of having a serious physical illness or “losing one’s mind” are common), or a significant change in behavior brought about by the attacks (many feel the need to avoid certain situations or remove themselves from particular environments).

Panic disorder is diagnosed more often in women than in men. Although the age of onset varies considerably, it is most commonly experienced for the first time between late adolescence and the mid-30’s. Up to one-half of those diagnosed with panic disorder also have agoraphobia.


Defined as exaggerated, involuntary, and irrational fears of particular situations or things, phobias are generally divided into three separate types.
Specific (or simple) phobia-this type of phobia is brought about by a specific object or situation such as flying, heights, needles, or snakes. Specific phobias are generally more common in women than in men and usually first appear during childhood.
Social phobia (social anxiety disorder)-limited specifically to social situations, this particular phobia is typified by extreme fear of meeting new people and of being embarrassed, humiliated, or judged by others. Social phobia appears to be diagnosed equally among the sexes. Usually first appearing in mid-teens, social phobia sometimes arises from a history of childhood shyness.
A diagnosis of specific or social phobia requires that exposure to the feared object or situation induces anxiety (often in the form of panic attacks), that the individual experiencing the phobia recognizes the irrational nature of their fear, and that the anxiety caused by the phobia become disruptive to the individual’s lifestyle.

Agoraphobia-those with agoraphobia have an intense fear of being trapped in particular places or situations or of not being able to find help if they experience anxiety or a panic attack. Fears of those with this type of phobia often center around being alone in an open area or being in a large crowd. Often, those with agoraphobia avoid such situations altogether; being subjected to such situations causes notable anxiety or panic.
It is important to remember that diagnosed phobias cause severe impairment-everyone has certain fears and experiences times of shyness and anxiety.

Obsessive-Compulsive Disorder (OCD)

OCD is an anxiety disorder characterized by persistently intrusive and inappropriate thoughts, impulses, or images that run through one’s mind (obsessions) and repetitive behaviors that one feels they must do (compulsions). Common obsessions include fear of contamination, fixation or lucky or unlucky numbers, fear of danger to oneself or others, need for order or exactness, and excessive doubt. The most common compulsions performed in response to these obsessions include ritualistic hand washing, counting, checking, hoarding, and arranging.

Although most people experience such thoughts and behaviors at some times, OCD is considered to occur when these obsessions and compulsions are experienced for more than an hour each day in a way that interferes with one’s life or causes great anxiety.

Equally common in males and females, OCD often appears earlier in males. Generally, the disorder first begins in adolescence or early adulthood, although it may start in childhood.

Posttraumatic stress disorder (PTSD)

Personally experiencing or witnessing a violent or tragic event that resulted in feelings of intense fear, helplessness, or horror can sometimes cause PTSD. Events that often lead to the development of this anxiety disorder include rape, war, natural disasters, abuse, and serious accidents. While it is common to experience a brief state of anxiety or depression after such occurrences, those with PTSD continually re-experience the traumatic event through ways such as nightmares, hallucinations, or flashbacks; avoid all things associated with the event (often displaying an accompanying sense of detachment); and exhibit increased arousal (e.g. difficulty sleeping, irritability, difficulty concentrating, extreme alertness, jumpiness).
Those diagnosed with PTSD experience symptoms for longer than one month and are unable to function as they did before the event. PTSD usually appears within three months of the traumatic experience, but in some circumstances can surface months or even years later. PTSD can occur at any age.

Similar to PTSD is an anxiety disorder known as acute stress disorder. Also in response to a traumatic event, acute stress disorder involves symptoms of re-experience, avoidance, and increased arousal as well. The main difference between the two disorders is twofold. First of all, acute stress disorder features a greater element of dissociation-those with the disorder experience detachment, a sense of withdrawal from reality, or even sometimes amnesia. The other major distinction between PTSD and acute stress disorder is in the length of time the symptoms are experienced. Acute stress disorder is only diagnosed if the disturbance occurs within four weeks of the traumatic event and lasts for a minimum of two days and a maximum of four weeks. What is first sometimes thought to be acute stress disorder is often eventually diagnosed as PTSD.

Generalized anxiety disorder (GAD)

Individuals with GAD experience excessive anxiety and worry about several everyday events or activities. Furthermore, the anxiety in those with GAD is difficult to control and causes notable complications in daily work and social settings. Physical symptoms of the disorder include edginess, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. To be diagnosed with GAD, one must experience this excessive anxiety for the majority of days during a period of six months or longer.

Most of those with GAD claim to have felt anxious for their entire lives and the disorder is first seen in childhood or adolescence. However, adult onset of the disorder is not uncommon.

Other anxiety disorders

Certain persons can experience anxiety in response to a general medical condition or from substance abuse. Others exhibit certain signs of particular anxiety disorders without meeting all the criteria for an official diagnosis.

How common are anxiety disorders?

Anxiety disorders are the most common mental illnesses in the United States. These serious brain disorders are estimated to affect more than 20 million Americans (approximately one in nine) every year

Are anxiety disorders associated with other disorders?

Most definitely, it is quite common for one anxiety disorder to coexist with another or several others. Furthermore, those with anxiety disorders frequently also suffer from depression, substance-related disorders, and/or eating disorders. In fact, it is estimated that over half of those diagnosed with panic disorder or OCD have depression too.

What causes anxiety disorders?

Several factors seem to contribute to the development of an anxiety disorder. Much new research suggests that these disorders both run in families and are the result of one’s brain chemistry. Certain life experiences and one’s general personality are also thought to influence the likelihood of having an anxiety disorder.

How can anxiety disorders be treated?

Effective treatments are available for anxiety disorders. While the symptoms of the various anxiety disorders do differ, both medication and talk therapy have proven helpful in alleviating many of the problems of those faced with each of these illnesses.

The most common medications used to treat anxiety disorders are antidepressants and benzodiazepines. There are a variety of drugs of both types that have proven quite helpful. So, if a particular medication does not seem to work, others are available. And, many new drugs are on the horizon.
The forms of talk therapy most often effective in treating anxiety disorders are behavioral therapy and cognitive-behavioral therapy. Behavioral therapy involves relaxation techniques and gradual exposure to the thing or situation that causes the anxiety in an attempt to reduce symptoms.

Bi-Polar Disorder

Bipolar disorder, also known as manic-depression is a type of mental illness that involves a disorder of affect or mood. The person’s mood usually swings between overly “high” or irritable to sad and hopeless, and then back again, with periods of normal mood in between.

The high (manic) mood associated with manic-depression is sometimes a pleasurable, euphoric and productive state but can involve potentially dangerous lapses of judgment, impulsive and potentially ruinous behavior, and, in the most severe forms, can involve extreme agitation and loss of reason (psychosis). The depressed phase is similar to, and can be confused with, major depression, and involves feelings of sadness, hopelessness and helplessness.

Mental health specialists refer to bipolar disorder by type: Type I bipolar disorder involves extreme upswings in mood (mania) coupled with downward spirals. In Type II, the upward swings are more mild (hypomania), but the frequency and intensity of the depressive phase is often severe. Since the elevated mood states of Type II are relatively mild, they are often missed and the bipolar nature of the illness goes undiagnosed.

Consumers affected by Bipolar Disorder

Manic-depression affects more than 2% of the general population over a lifetime. Unfortunately, due to the stigma surrounding the illness, misdiagnosis, and the propensity of those with manic-depression to deny that anything is wrong, only a fraction of these people ever receive treatment. Although the illness can occur at any age, fully half of cases begin before age 20. The disorder occurs about equally in men and women, and, because it tends to run in families, there appears to be a strong genetic link. In addition, this illness can have profound effects on friends and family members.

Symptoms of Depression

  • Persistent sad, anxious or empty mood
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in ordinary activities
  • Decreased energy, a feeling of fatigue
  • Difficulty concentrating or making decisions
  • Restlessness or irritability
  • Inability to sleep or oversleeping
  • Changes in appetite or weight
  • Unexplained aches and pains
  • Thoughts of death or suicide

Symptoms of Mania

  • Extreme irritability and distractibility
  • Excessive “high” or euphoric feelings
  • Increased energy, activity, restlessness
  • Racing thoughts, rapid speech
  • Decreased need for sleep
  • Unrealistic beliefs in one’s abilities and powers
  • Increased sexual drive
  • Abuse of drugs or alcohol
  • Reckless behavior such as spending sprees
  • Rash business decisions, or erratic driving
  • In severe cases, hallucinations and loss of reason

Treatment options

Medication: Varying medicines are effective in the treatment of bipolar disorder. Several types of antidepressants can help relieve the depressive phase of the illness, including the newer selective serotonin reuptake inhibitors (SSRIs), which are often combined with a mood-stabilizer such as lithium. SSRIs have proven to be effective, safe, and have relatively minor adverse effects. Lithium salts have been used for many years to stabilize mood swings and remain an important part of manic-depressive treatment. In addition, anticonvulsants, medicines initially used for treating epileptic consumers, have recently proven very effective in treating mania. In acute mania, doctors may also prescribe antipsychotics to help control hallucinations and restore rational thinking. Long-term stability can be enhanced with lithium, and other alternatives are under investigation.

Psychotherapy: Talking therapy can be an important part of treatment for consumers, as well as for their friends and family members. Talking therapy can help eliminate behaviors, thought patterns, problems with current relationships or difficulties in managing the illness that may be caused by or contribute to the disorder.

Borderline Personality Disorder (BPD)

Symptoms of BPD

  • Mood swings
  • Periods of intense depression, irritability, and/or anxiety lasting from a few hours to a few days
  • Inappropriate, intense or uncontrolled anger
  • Impulsiveness in spending, sex, substance use, shoplifting, reckless driving, or binge eating
  • Recurring suicidal threats or self-injurious behavior
  • Unstable, intense personal relationships
  • Extreme black-and-white views of people and experiences, sometimes alternating between “all good” idealization and “all bad” devaluation
  • Persistent uncertainly about self-image, long-term goals, friendships and values
  • Chronic boredom or feelings of emptiness
  • Frantic efforts to avoid real or imagined abandonment

Treatment for BPD


  • Reduces anxiety, depression and impulsivity
  • Helps one deal with harmful patterns of thinking and interacting
  • Fails to correct ingrained character difficulties
  • Antidepressants
  • Anticonvulsants
  • Neuroleptics


Short-term hospitalization when necessary during times of extreme stress, impulsivity or substance abuse

  • Generally difficult and long term
  • BPD symptoms often interfere with therapy
  • Usually effective

What is BPD?

  • Fairly common biologically based disorder
  • Characterized by impulsivity and instability in mood, self-image and personal relationships
  • Diagnosed more often in females than in males

Causes of BPD

  • Unclear, but psychological and biological factors may be involved
  • Originally thought to border on schizophrenia
  • Related to serious depressive illness
  • Associated with neurological and attention deficit disorders
  • Difficulties in psychological development during childhood due to such things as abuse or neglect may create identity and personality problems
  • More research is needed

Simultaneously present disorders

  • Serious depressive illness, including bipolar disorder
  • Eating disorders
  • Alcohol/drug abuse
  • Sleep disorder


Depression has a variety of symptoms, but the most common is a deep feeling of sadness. People with depression may feel tired, listless, hopeless, helpless, and generally overwhelmed by life. Simple pleasures are no longer enjoyed, and their world can appear dark and uncontrollable. Emotional and physical withdrawal is a common response of depressed people.

Depression can strike at any time, but most often appears for the first time during the prime of life, from ages 24 to 44. One in four women and one in 10 men will confront depression at some point in their lives.

Symptoms of Depression

Depression is diagnosed if a person experiences 1) persistent feelings of sadness or anxiety or 2) loss of interest or pleasure in usual activities in addition to five or more of the following symptoms for at least 2 consecutive weeks:

  • Changes in appetite that result in weight losses or gains not related to dieting
  • Insomnia or oversleeping
  • Loss of energy or increased fatigue
  • Restlessness or irritability
  • Feelings of worthlessness or inappropriate guilt
  • Difficulty thinking, concentrating, or making decisions
  • Thoughts of death or suicide or attempts of suicide

Depression is diagnosed only if the above symptoms are not due to other conditions (e.g. neurological or hormonal problems) or illnesses (e.g., cancer, heart attack) and are not the unexpected side effects of medications or substance abuse.

Treatment of Depression

Unfortunately, depression cannot be controlled for any length of time simply through exercise, through changes in diet, or by taking a vacation. But it is among the most treatable of mental disorders. Between 80 percent and 90 percent of people with depression respond well to treatment, and almost all patients gain some relief from their symptoms.

Before a specific treatment is recommended, a psychiatrist will conduct a thorough diagnostic evaluation, consisting of an interview and physical examination. Its purpose is to reveal specific symptoms, medical and family history, cultural setting, and environmental causes of stress to arrive at a proper diagnosis and to determine the best treatment.


Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, “uppers,” or tranquilizers; they are not habit-forming; and they generally have no stimulating effect on people not experiencing depression.
Antidepressants usually take full effect within 3-6 weeks after therapy has begun. If little or no improvement is noted after 6-8 weeks, the psychiatrist will alter the dose of the medication or will add or substitute another antidepressant. Psychiatrists usually recommend that consumers continue to take medication for 5 or more months after symptoms have improved.


Psychotherapy, or “talk therapy,” may be used either alone for treatment of mild depression or in combination with antidepressant medications for moderate to severe depression.

Psychotherapy can involve only the individual consumer or include others. Family or couples therapy helps to address specific issues that can arise within these close relationships. Group therapy involves people with similar illnesses. Depending on the severity of the depression, treatment can take a few weeks or substantially longer. However, in many cases, significant improvement can be made in 10-15 sessions.

Depression is never normal and always produces needless suffering. With proper diagnosis and treatment, depression can be overcome in the vast majority of people.


Schizophrenia, a disease of the brain, is one of the most disabling and emotionally devastating illnesses known to man. But, because it has been misunderstood for so long, it has received relatively little attention and its victims have been undeservingly stigmatized. Schizophrenia is not a split personality, which is a rare and very different disorder.
Like cancer and diabetes, schizophrenia has a biological basis; it is not caused by bad parenting or personal weakness. Nor are individuals being treated for schizophrenia more prone to violence than the public, despite media focus on exceptions.
Schizophrenia is, in fact, a relatively common disease, with an estimated one percent of the U. S. population being diagnosed with it over the course of their lives. While there is no known cure for schizophrenia, it is a very treatable disease. Most of those afflicted by schizophrenia respond to drug therapy, and many are able to lead productive and fulfilling lives.


Schizophrenia is characterized by a constellation of distinctive and predictable symptoms. The symptoms that are most commonly associated with the disease are called positive symptoms that denote the presence of grossly abnormal behavior. These include thought disorder, delusions, and hallucinations.
Thought disorder is the diminished ability to think clearly and logically. Often it is manifested by disconnected and nonsensical language that renders the person with schizophrenia incapable of participating in conversation, contributing to his alienation from his family, friends, and society.
Delusions are common among individuals with schizophrenia. An affected person may believe that he is being conspired against (called “paranoid delusion”). “Broadcasting” describes a type of delusion in which the individual with this illness believes that others can hear his thoughts.
Hallucinations can be heard, seen, or even felt; most often, they take the form of voices heard only by the afflicted person. Such voices may describe the person’s actions, warn him of danger or tell him what to do. At times, the individual may hear several voices carrying on a conversation.
The deficit or negative symptoms that represent the absence of normal behavior are less obvious than the “positive symptoms,” but equally serious. These include flat or blunted affect (i.e. lack of emotional expression), apathy, and social withdrawal.

Who gets it?

While schizophrenia can affect anyone at any point in life, it is somewhat more common in those persons who are genetically predisposed to the disease. The first psychotic episode generally occurs in late adolescence or early adulthood.
Studies have shown that some individuals with schizophrenia recover completely, and many others improve to the point where they can live independently, often with the maintenance of drug therapy. Fortunately, this accounts for the majority of cases.

However, approximately 15 percent of people with schizophrenia respond only moderately to medication and require support throughout their lives, while another 15 percent simply do not respond to existing treatment. New therapies may offer hope for the treatment of these most seriously affected sufferers.

How is it treated?

Hospitalization is often necessary in cases of acute schizophrenia. This ensures the safety of the affected person. Once the most troubling symptoms are controlled by medication, the person often does not require hospitalization.
Depending on the seriousness of the disease, the person may utilize day programs, rehabilitation facilities, and be treated in an outpatient setting. This allows the psychiatrist to adjust medication dosages as necessary over the course of the disease. The person may also need assistance in readjusting to society once his or her symptoms are controlled.
Supportive counseling or psychotherapy may be appropriate for these individuals as a source of friendship, encouragement, and practical advice during this process. Relatives and friends also can assist in rebuilding the person’s social skills. Such support is very important.

Antipsychotic Medications

Antipsychotic drugs are used in the treatment of schizophrenia. These medications help relieve the delusions, hallucinations, and thinking problems associated with this devastating disorder. These drugs appear to work by correcting an imbalance in the chemicals that help brain cells communicate with each other. As with drug treatments for other physical illnesses, many patients with severe mental illnesses may need to try several different antipsychotic medications before they find the one, or the combination of medications, that works best for them.

Possible Antipsychotic Medication Side Effects:

As a group, antipsychotic drugs are safe, and serious side effects are relatively rate. Some people may experience side effects that are inconvenient or unpleasant, but not serious.

Most common side effects: dry mouth, constipation, blurred vision, and drowsiness.

Less common side effects: decreased sexual desire, menstrual changes, and stiff muscles on one side of the neck and jaw.

More serious side effects include: restlessness, muscle stiffness, slurred speech, tremors of the hands or feet, and agranulocytosis, which suppresses the production of white blood cells (when taking clozapine) and requires monitoring.

Tardive Dyskinesia is the most unpleasant and serious side effect of antipsychotic drugs causing involuntary facial movements and sometimes jerking or twisting movements of other parts of the body. This condition usually develops in older patients, affecting 15 percent to 20 percent of those who have taken older antipsychotic drugs for years.

Substance Abuse and Addiction

Addiction is a serious illness. Health, finances, relationships, careers—all can be ruined. The abuse of drugs and alcohol is by far the leading cause of preventable illnesses and premature death in our society. The importance of substance abuse treatment cannot be overstated, and fortunately many effective treatments are available. The road to recovery, however, begins with recognition.

Consequences of use


People often drink alcohol during social occasions; it tends to loosen inhibitions. Unfortunately, the recklessness often resulting from excessive drinking is a leading cause of serious injuries and accidental deaths. In addition, alcohol is the most common cause of preventable birth defects, including fetal alcohol syndrome. Of course, excessive drinking can also lead to alcoholism; an illness that tends to run in families and is often associated with depression. Alcoholism can have devastating effects on health, including serious liver damage, greater risk of heart disease, impotence, infertility, and premature aging.


The most widespread and frequently used illicit drug is marijuana. It is associated with the following consequences:

  • Short-term memory loss
  • Accelerated heartbeat
  • Increased blood pressure
  • Difficulty with concentrating and information processing
  • Lapses in judgment
  • Problems with perception and motor skills


In addition, years of marijuana use can lead to a loss of ambition and an inability to carry out long-term plans or to function effectively.


Stimulants (for example, cocaine, “crack,” amphetamines) give a temporary illusion of enhanced power and energy. As the initial elevation of mood fades, however, a depression emerges. Stimulant abuse can lead to serious medical problems.

  • Heart attacks—even in young people with healthy hearts
  • Seizures
  • Strokes
  • Violent, erratic, anxious, or paranoid behavior


Cocaine use during pregnancy may result in miscarriages, stillbirths, or low-birth-weight babies who may be physically dependent on the drug and later may develop behavioral or learning difficulties. Excessive crack use can lead to a permanent vegetative, or zombie-like, state. Long-term amphetamine abuse can result in psychotic effects, such as paranoid delusions and hallucinations.


Heroin, which can be smoked, eaten, sniffed, or injected, produces an intense—but fleeting—feeling of pleasure. Serious withdrawal symptoms begin, however, after 4 to 6 hours:

  • Chills
  • Sweating
  • Runny nose and eyes
  • Abdominal cramps
  • Muscle pains
  • Insomnia
  • Nausea
  • Diarrhea


Heroin use during pregnancy may result in miscarriages, stillbirths, or premature deliveries of babies born physically dependent on the drug. Those who inject heroin are introducing unsterile substances into their bloodstream, which can result in severe damage to the heart, lungs, and brain. In addition, sharing needles is one of the fastest ways to spread diseases; it is currently the leading cause of all new HIV and hepatitis B cases.


Hallucinogens are drugs such as LDS (“acid”) or the new “designer” drugs (for example, “ecstasy”) that are taken orally and cause hallucinations and feelings of euphoria. Dangers from LDS include stressful “flashbacks”—re-experiencing the hallucinations despite not having taken the drug again, sometimes even years later. Excessive use of ecstasy, combined with strenuous physical activity, can lead to death from dehydration or an exceptionally high fever.


Inhalants are breathable chemicals—for example, glue, paint thinner, or lighter fluid. They are commonly abused by teenagers because they are easy to obtain and because they produce mind-altering effects when “sniffed” or “huffed.” These chemicals reach the lungs and bloodstream very quickly and can be deadly. High concentrations of inhalant fumes can cause heart failure or suffocation. Long-term abuse of inhalants can cause permanent damage to the nervous system.


Sedatives are highly effective medications prescribed by physicians to relieve anxiety and to promote sleep. Unfortunately, harmful effects can occur when they are taken in excess of the prescribed dose or without a physician’s supervision, such as when they are obtained illegally. Combining sedatives with alcohol or other drugs greatly increases the likelihood of death by overdose. Women who abuse sedatives during pregnancy may deliver babies with birth defects (for example, cleft palate) who may also be physically dependent on the drugs.


The U. S. Surgeon General has confirmed that nicotine in tobacco products has additive properties similar in severity to those of heroin. Quitting is difficult because of the unpleasantness of withdrawal, which involved feelings of irritability, frustration, anger, anxiety, insomnia, and depression. However, continued smoking may lead to far more dire circumstances:

  • Lung cancer
  • Heat attacks
  • Emphysema
  • High blood pressure
  • Ulcers


The first step on the road to recovery is recognition of the problem, but often this process is complicated by a lack of understanding about substance abuse and addiction or, worse, denial. In these cases, what often prompts treatment are interventions by concerned friends and family. Many health centers and other institutions offer screenings free of charge for various disorders throughout the year. For example, screening tests for alcohol abuse are usually offered in early April.
Because substance abuse affects many aspects of a person’s life, multiple forms of treatment are often required. For most, a combination of medication and individual or group therapy is most effective. Medications are used to control the drug cravings and relieve the severe symptoms of withdrawal. Therapy can help addicted individuals understand their behavior and motivations, develop higher self-esteem, and cope with stress. Other treatment methods that may be used as part of the rehabilitation process include the following:

  • Hospitalization
  • Therapeutic communities—highly controlled, drug-free environments
  • Outpatient programs, including methadone maintenance for heroin addiction


Finally, in addition to treatment, self-help groups for substance-abusing individuals (Alcoholics Anonymous, Narcotics Anonymous) as well as their family members (Al-Anon or Nara-Anon Family Groups) are useful in providing support and reinforcing messages learned in treatment. These organizations can be found on the Internet of in your local telephone directory.


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