Mental health articles

Self-Destructive Behaviors Depression and anxiety are also associated with self-destructive behaviors— alcohol or other drug abuse; disordered eating; excessive gambling or spending; Internet, television, or video-game abuse; self-cutting; or self-destructive sexual activity. Th ough momentarily exciting or soothing, such behaviors ultimately dig a deeper hole of suff ering. As with avoidance, treating selfdestructive behaviors begins by assessing students’ readiness to change. Denial, minimization, and rationalization are to be expected when people are confronted about their behavior, especially young people, whose idea of a good time naturally runs to experimentation and recklessness. (For a discussion of helping students face up to their damaging actions, and on harm reduction versus abstinence as treatment goals.) Even when students say they want to control themselves, it’s hard to quit cold turkey or even cut down when the activity feels good or numbs bad feelings. (To be sure, resisting the impulse to act and withstanding the attendant anxiety until it ultimately wanes is precisely the point of exposure and response prevention, the treatment for curbing compulsive behaviors [Rachman & Hodgson, 1980].) To abstain from a behavior, students need alternative behaviors to put in its place. Brainstorming with students about constructive substitutes is therefore crucial: “What would be realistic for you to do at those moments of temptation?” Th us when tempted to take a drink or gamble or selfcut or binge, students may plan to call a friend (or a sponsor), do a relaxation exercise, take a walk, write in a journal, or count to 10 and then reconsider. Over time, the new behavior becomes more automatic, and the temptation of the original behavior loses its potency. A subset of self-destructive behaviors that can both refl ect and cause mood and anxiety problems is erratic, unhealthy patterns of sleep, diet, studies, and self-care. Unhealthy living habits are, of course, endemic to college campuses, where it seems that everyone gets away with studying and eating and sleeping at odd hours, but such practices can be poison for depressed, anxious, and potentially manic students. Th erefore, to the extent they can, these students should be counseled to go to bed and arise at set times, eat regular and healthy meals, and study and socialize according to a fi xed schedule—the name for this approach in the treatment of bipolar disorder is social rhythm therapy (Harvard Medical School, 2001). Steady habits steady the emotions. Even humble routines like regularly scheduledshowers and laundry runs and telephone calls home can counteract a feeling of spinning out of control.

Tags: anxiety, depression