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The state bureau that issued his medical license first tried to persuade him to enter treatment. Many states have "impaired physician (and nurse)" programs, where doctors and nurses are identified and offered a plan in which a medical license may initially be suspended but restored when it is safe to do so. These programs, which include agreed-upon treatment, drug testing, and monitoring, are often effective, but Dr. Brown proved not yet ready and kept using. When he was told that his license would be terminated, he and his wife packed their belongings and headed to another state, imagining he could beat his addiction and start anew someplace else. Much the same applies to serotonin, which is a chemical often implicated in cases of anxiety and depression. Like noradrenaline and adrenaline, serotonin is a neurotransmitter. means it carries messages from the brain that help instruct other parts of the body to carry out specific functions. While much about the action of serotonin remains mysterious and a subject of controversy, it is generally understood that the functions serotonin triggers in the body are those related to happiness and well-being, such as social responses, positive feelings, natural sleep patterns, and sexual responses. Low levels of serotonin, therefore, have been linked to mental disorders associated with feelings of depression and anxiety. Having too little serotonin is also believed to be linked to migraine headaches, as the great author Joan Didion describes in one of her essays, "In bed," published in her collection The White Album. (This essay is definitely recommended reading for anyone suffering from anxiety and panic attacks, as the symptoms are very similar to the experience Didion describes when treating of her own lifelong struggle with recurring migraine headaches.) Admitting there's a problem is the first step in having your act together and most of us who are living sloppy and problematic lives don't want to admit anything's wrong or that maybe we're contributing to the problem. We don't want to admit we're wasting time and energy on things and people that don't matter. We don't want to admit we have problem areas in our lives that can be zeroed in on and corrected. We're too proud. Our ego doesn't let us reveal the truth. It's too afraid of the embarrassment. It's too afraid of the exposure and vulnerability. If anything affects your thoughts, emotions, behavior, reactions, performance, success, and habits in a negative manner, it's a potential problem area, it requires your attention, and you need to start being honest with yourself about it. It can't be overlooked.

It can't wait until later. It requires immediate attention and immediate decisions - fix it or eliminate it and then move forward and forget about it. You don't have time for the same problems to keep popping up in your life, bugging you, and causing distractions and chaos. Honestly and humbly pinpoint and identify your problem areas. Identify the enemies. Identify what's holding you back and negatively influencing your thoughts, emotions, and behavior, decide what to do about it, and then take action. Identify the distractions and eliminate them. Identify the reasons you're not on track and make the proper adjustments. Identify the sources of your frustration, sadness, anger, and resentment, disconnect from them, and put an end to the nonsense. Be honest about the relationships that are taking value instead of giving it. Be honest about your time-wasting activities. Be honest about your limiting beliefs and mindsets and how they're holding you back. Be honest about everything you can, potentially, improve. Emotionally smart people are able to identify their own emotions. This means learning to tell other people how you feel. It means taking responsibility for your own emotions by starting sentences with `I feel . .' Look at the series of positive and negative words below. Make a note of the words you think describe you best. Why have you chosen those particular words? If you were to change your negative words to positive ones what would you have to do?

Again, it is important to understand that serotonin is not simply a "happiness" chemical. While low levels of it are linked to anxiety and depression, these conditions cannot be simply treated by infusing large amounts of serotonin into the body, and antidepressant medications operate in far more complex ways than that. As we saw above, the important thing in neurochemistry is maintaining a balance between the various chemicals our brains need to function. Too much or too little of any can cause serious mental disturbances. As the great American author Jack London once wrote, in words that still ring true a century later, speaking of the "laws of organic chemistry" in the body: "One pays according to an iron schedule--for every strength the balanced weakness; for every high a corresponding low." Consider each of the things you don't like and ask yourself what you could do to change the situation. Research suggests that you are far more likely to carry out your plans if you write them down. Not speaking up at meetings Need to think about this before I go to the meeting so that I have my comments worked out ahead of time. Distraction techniques are helpful when you are worried and keep having thoughts that are making you feel uncomfortable or are undermining your efforts. Distraction is a way if taking your attention away from what is happening on to something else. If you take your attention away from your symptoms they often diminish. When you find yourself in this position, you need to decide not to think about your thoughts and then engage your mind with something else. Have you ever been in a situation where you have felt better because you were doing something else? Paying attention to what is going on around you - try guessing the ages of people in the room, or listen to someone else's conversation, or decide to count as many round objects as you can see in the room. Physical activity - try cleaning, tidying up, or finding tasks to do. Engage in some form or mental activity - recite your times tables, say the alphabet backwards or do a crossword. Emotional Intelligence is about learning to being emotionally smart. It is not always the person with the highest IQ who does best. Emotionally smart people get the most from managing their own and other people's emotions. If you can learn the skills of emotional smartness it will help you overcome your anxiety. But addiction is a fierce companion and not easily shed by crossing state lines.

After the move, Dr. Brown tried to take emergency-room call to make some money and gain access to supplies of hospital opioids. But hospitals are now good at making sure a physician is properly licensed to care for patients. Unemployed and almost constantly miserable from withdrawal, Dr. Brown agreed at his wife's pleading to return to their home state and take the licensing board up on its offer to help. Those in the field of addictions appreciate that both risk and protective factors influence whether a person will develop a substance use disorder. Among the risk factors for addiction are a parent who relied on alcohol or drugs or had a mental illness; childhood trauma, from neglect or abuse; and adult trauma from war, forced emigration, or a natural disaster, such as a hurricane or flood. Neighborhood risk factors include poverty, unstable housing, racism, and violence. Those fortunate to have had supportive, engaged families and households free of violence and addiction benefit from these protective factors. Faith in a higher power, whether through a formal religion or not, is a strong protective factor and a vital tool in recovery for those who develop addiction and are working on their recovery. Education and employment opportunities are protective as well. Dr. Brown grew up in a tough inner-city neighborhood. He was bullied and beaten for being a good student with aspirations. His father was an alcoholic, frequently unemployed, and given to violent outbursts at both his wife and his son when intoxicated. But as a young man Brown studied hard, was active in after-school programs, and exited his circumstances through education and faith-based activities. He had both risk and protective factors--which were instrumental in his developing a substance use disorder and his capacity to recover, respectively. Most people have a combination of both, but some, such as Billie Holiday, just have the deck stacked against them. Opioid withdrawal is painful, though rarely life threatening--generally only so when other drugs are involved or a person has other medical illnesses that compromise cardiac or lung functioning. Dr.

Brown admitted himself to a detoxification facility, where he received methadone in steadily decreasing doses to mitigate his withdrawal symptoms and thereby help keep him from going AWOL to secure drugs. In ten days he was opioid-free, and he remained for another eighteen days of a traditional twenty-eight-day program to receive counseling and attend 12-step recovery groups, Narcotics Anonymous in particular, as well as relapse prevention groups. There was a focus on healthy living as well, with attention to sleep, good nutrition, exercise, and relaxation techniques such as meditation and yoga. He did not choose medication-assisted treatment, which could probably have been buprenorphine, which attaches to the brain's opioid receptors and helps to control cravings. Understanding these and other potential causes of anxiety can be helpful in deepening your awareness of what is happening inside your mind. At the end of the day, however, the causes of anxiety are a lot less important than what we can do about it in the future. Always remember: regardless of where a particular person's anxiety came from, or how it started, many of the same methods for treating and managing anxiety will still apply. In the earlier days of the practice of clinical psychology, psychotherapists often devoted much more attention to discovering where particular mental disturbances came from, and how they originated in a given person's case (in medical terms, this is known as the etiology of an illness). Influenced by Freudian psychoanalysis, many earlier practitioners of psychotherapy believed that it was important to isolate particular triggering events or symbols in a person's past that first induced them to develop a mental disorder (or neurosis, in Freudian terms). Over time, however, these methods bore little fruit. Modern clinical experience has shown that tracing mental illnesses back to earlier events in a person's biography often has little impact on their ability to recover from them in the present. Human memory, moreover, is extremely malleable, meaning it is subject to change, and the events of one's past do not determine one's present and future. Finally, dwelling on earlier occurrences can even be counter-productive; as it can lead to people feeling trapped by the past and can reinforce the memory of traumatic events. Meanwhile, modern clinical practice has often shown that enormous progress can be made even when a patient has no knowledge of any earlier event that could have led to symptoms of anxiety, panic, or related phenomena. Contemporary psychotherapists are therefore a lot less concerned with a person's past than they are with the future. Modern-day professionals do not go looking for "recovered memories" through hypnosis; nor do they interpret dreams or sexual symbols from a person's childhood, or look for "archetypes" in a supposed "collective unconscious." Indeed, many clinical psychologists today would consider those practices to be forms of pseudoscience. You can't have your act together without moving on from the stories, lying, and excuses - the stories you keep using to justify where you're at and why you do what you do, the lies you repeat to yourself about who you are, and the excuses you use to justify why you're not accepting responsibility, getting it together, and becoming the person you want to be. It has to go. All of it. You can't simultaneously have your act together and still, hang onto these things.