Firstly, alcohol IS a drug. Make no mistake about this. It is separated from other drugs because it is legally and readily available. Medications prescribed by doctors are also drugs which alter brain chemistry, and long term usage will lead to the prescription of higher and higher dosages as the body builds up a tolerance. If you are reliant on ANY form of mood altering chemicals then the chances are that you are addicted. People from all walks of life and of all colours, creeds, religions or social status can become addicts. So many people throughout the world are suffering from a variety of addictions including alcoholism.
We tend to think of an alcoholic as a down and out, a person living on the streets begging for money and eating out of dustbins. This is simply not the case. Anyone can become an alcoholic no matter what their status is in life and no matter what race religion colour or creed they belong to. Alcoholism has no favourites. There is still a stigma attached to alcoholism and most people who have come to the point where they realize they may be drinking too much will say "I think I may have a problem with alcohol" or "I may be a problem drinker" or feel that they need to cut down on their alcohol consumption. The truth is, if you ever have to ask yourself the question "Do I have a drinking problem?" the chances are that you do, and you may well be an alcoholic.




An obsessive and compulsive need for and use of habit-forming substances or behaviors characterized by tolerance and by well-defined physiological symptoms upon withdrawal.

Addiction has been referred to as "A disease", "A terminal illness",

"An allergy", "A condition" - or just a weakness of willpower. The inability to stop or to know when you've had enough. We believe that addiction is a learned behavioural pattern that does not need to be "cured" - it needs to be changed and regulated.

A person can be addicted to a number of things including:

Mind altering drugs and substances of all descriptions, including cigarettes and prescription medication, alcohol, gambling, sex and pornography, shopping, work, violence, money, posessions and many other things outside of the person which are used to subdue or repress a person's emotions, to help them to escape from their deeper unresolved issues, or to help them feel better about themselves when in truth they may be suffering from very low self-esteem due to a variety of reasons.

A person's brain is trained to identify the addictive behavioural patterns as life sustaining mechanisms and therefore addicts will obsess and crave their addictions of choice without reprieve, until they are compelled to use or act out to enable them to "feel better"




Trauma is defined as the emotional response someone has to an extremely negative event. While trauma is a normal reaction to a horrible event, the effects can be so severe that they interfere with an individual’s ability to live a normal life. In a case such as this, help may be needed to treat the stress and dysfunction caused by the traumatic event and to restore the individual to a state of emotional well-being


Trauma can be caused by an overwhelmingly negative event that causes a lasting impact on the victim’s mental and emotional stability. While many sources of trauma are physically violent in nature, others are psychological. Some common sources of trauma include

  • Rape

  • Domestic violence

  • Natural disasters

  • Severe illness or injury

  • The death of a loved one

  • Witnessing an act of violence


Trauma is often but not always associated with being present at the site of a trauma-inducing event. It is also possible to sustain trauma after witnessing something from a distance. Young children are especially vulnerable to trauma and should be psychologically examined after a traumatic event has occurred to ensure their emotional well-being.

While the causes and symptoms of trauma are various, there are some basic signs of trauma that you can look out for. People who have endured traumatic events will often appear shaken and disoriented. They may not respond to conversation as they normally would and will often appear withdrawn or not present even when speaking.

Depression and Trauma

Depression and trauma have high comorbidity rates, and feelings of despair, malaise and sadness can last longer than a few days or even weeks. When a trauma occurs, post-traumatic stress disorder often occurs. The Department of Veteran Affairs estimates that depression is between three to five times more likely to occur in trauma victims who develop PTSD than in the general population.

Dual Diagnosis: Addiction and Trauma

When the symptoms of Post-Traumatic Stress Disorder (PTSD), depression and anxiety become too much to cope with through normal means, many victims of trauma turn to substance abuse. As mentioned, victims are much more likely to develop addictions than other members of the general population. It is essential for the loved ones of a trauma victim to look out for the symptoms of addiction after trauma, even if the addiction is the only outward sign of PTSD.

Emotional Symptoms of Trauma

Emotion is one of the most common ways in which trauma manifests. Some common emotional symptoms of trauma include denial, anger, sadness and emotional outbursts. Victim of trauma may redirect the overwhelming emotions they experience toward other sources, such as friends or family members. This is one of the reasons why trauma is difficult for loved ones as well. It is hard to help someone who pushes you away, but understanding the emotional symptoms that come after a traumatic event can help ease the process.


Physical Symptoms of Trauma

Trauma often manifests physically as well as emotionally. Some common physical signs of trauma include paleness, lethargy, fatigue, poor concentration and a racing heartbeat. The victim may have anxiety or panic attacks and be unable to cope in certain circumstances. The physical symptoms of trauma can be as real and alarming as those of physical injury or illness, and care should be taken to manage stress levels after a traumatic event.


Short-Term and Long-Term Effects of Trauma

All effects of trauma can take place either over a short period of time or over the course of weeks or even years. Any effects of trauma should be addressed immediately to prevent permanence. The sooner the trauma is addressed, the better chance a victim has of recovering successfully and fully. Short-term and long-term effects of trauma can be similar, but long-term effects are generally more severe. Short-term mood changes are fairly normal after trauma, but if the shifts in mood last for longer than a few weeks, a long-term effect can occur.



We generally use the word "stress" when we feel that everything seems to have become too much - we are overloaded and wonder whether we really can cope with the pressures placed upon us.

Anything that poses a challenge or a threat to our well-being is a stress. Some stresses get you going and they are good for you - without any stress at all many say our lives would be boring and would probably feel pointless. However, when the stresses undermine both our mental and physical health they are bad. In this text we shall be focusing on stress that is bad for you.

The difference between "stress" and "a stressor" - a stressor is an agent or stimulus that causes stress. Stress is the feeling we have when under pressure, while stressors are the things we respond to in our environment. Examples of stressors are noises, unpleasant people, a speeding car, or even going out on a first date. Generally (but not always), the more stressors we experience, the more stressed we feel.

The way you respond to a challenge may also be a type of stress. Part of your response to a challenge is physiological and affects your physical state. When faced with a challenge or a threat, your body activates resources to protect you - to either get away as fast as you can, or fight.

If you are upstairs at home and an earthquake starts, the faster you can get yourself and your family out the more likely you are all to survive. If you need to save somebody's life during that earthquake, by lifting a heavy weight that has fallen on them, you will need components in your body to be activated to give you that extra strength - that extra push.

Our fight-or-flight response is our body's sympathetic nervous system reacting to a stressful event. Our body produces larger quantities of the chemicals cortisol, adrenaline and noradrenaline, which trigger a higher heart rate, heightened muscle preparedness, sweating, and alertness - all these factors help us protect ourselves in a dangerous or challenging situation.

Non-essential body functions slow down, such as our digestive and immune systems when we are in fight-or flight response mode. All resources can then be concentrated on rapid breathing, blood flow, alertness and muscle use.

When we are stressed the following happens:

  • Blood pressure rises

  • Breathing becomes more rapid

  • Digestive system slows down

  • Heart rate (pulse) rises

  • Immune system goes down

  • Muscles become tense

  • We do not sleep (heightened state of alertness)

Most of us have varying interpretations of what stress is about and what matters. Some of us focus on what happens to us, such as breaking a bone or getting a promotion, while others think more about the event itself. What really matters are our thoughts about the situations in which we find ourselves.

We are continually sizing up situations that confront us in life. We assess each situation, deciding whether something is a threat, how we can deal with it and what resources we can use. If we conclude that the required resources needed to effectively deal with a situation are beyond what we have available, we say that that situation is stressful - and we react with a classical stress response. On the other hand, if we decide our available resources and skills are more than enough to deal with a situation, it is not seen as stressful to us.

How we respond to stress affects our health

  • We do not all interpret each situation in the same way.

  • Because of this, we do not all call on the same resources for each situation

  • We do not all have the same resources and skills.

Some situations which are not negative ones may still be perceived as stressful. This is because we think we are not completely prepared to cope with them effectively. Examples being: having a baby, moving to a nicer house, and being promoted. Having a baby is usually a wonderful thing, so is being promoted or moving to a nicer house. But, moving house is a well-known source of stress.

It is important to learn that what matters more than the event itself is usually our thoughts about the event when we are trying to manage stress. How you see that stressful event will be the largest single factor that impacts on your physical and mental health. Your interpretation of events and challenges in life may decide whether they are invigorating or harmful for you.

A persistently negative response to challenges will eventually have a negative effect on your health and happiness. Experts say people who tend to perceive things negatively need to understand themselves and their reactions to stress-provoking situations better. Then they can learn to manage stress more successfully.

Perception of stress affects heart attack risk - people who believe their stress is affecting their health in a big way are twice as likely to have a heart attack ten years later, researchers at the University of Western Ontario found.

In another study carried out at Pennsylvania State University, the investigators found that stress was not the problem, but rather how we react to stressors. It appears that how patients react to stress is a predictor of their health a decade later, regardless of their present health and stressors.

Lead researcher, Professor David Almeida said "For example, if you have a lot of work to do today and you are really grumpy because of it, then you are more likely to suffer negative health consequences 10 years from now than someone who also has a lot of work to do today, but doesn't let it bother her."

Some of the effects of stress on you

Possible effects of stress on your body:

  • A tendency to sweat

  • Back pain

  • Chest pain

  • Childhood obesity - researchers at The Children's Hospital of Philadelphia published a report in Pediatrics in October 2012 explaining that a number of stressors from parents can increase the risk of obesity in their children.

  • Lead researcher, Elizabeth Prout-Parks, M.D., said "Stress in parents may be an important risk factor for child obesity and related behaviors. The severity and number of stressors are important."

    Examples of stressors include mental health problems, poor physical health, financial strain, and trying to manage in a single-parent household.

  • Cramps or muscle spasms

  • Erectile dysfunction

  • Fainting spells

  • Headache

  • Heart disease

  • Hypertension (high blood pressure)

  • Loss of libido

  • Lower immunity against diseases

  • Muscular aches

  • Nail biting

  • Nervous twitches

  • Pins and needles

  • Sleeping difficulties

  • Stomach upset

Possible effects of stress on your thoughts and feelings:

  • Anger

  • Anxiety

  • Burnout

  • Depression

  • Feeling of insecurity

  • Forgetfulness

  • Irritability

  • Problem concentrating

  • Restlessness

  • Sadness

  • Fatigue

Possible effects of stress on your behavior:

  • Eating too much

  • Eating too little

  • Food cravings

  • Sudden angry outbursts

  • Drug abuse

  • Alcohol abuse

  • Higher tobacco consumption

  • Social withdrawal

  • Frequent crying

  • Relationship problems



When someone calls you insulting sexual names, talks about you in a sexual way that makes you feel uncomfortable (like commenting on your body), or spreads sexual rumours about you, this is known as sexual harassment. This could happen in person, over the phone, or online.

If someone intentionally grabs or touches you in a sexual way that you do not like, or you’re forced to kiss someone or do something else sexual against your will, this is classed as sexual assault. This includes sexual touching of any part of someone’s body, and it makes no difference whether you are clothed or not.

If you are forced to have penetrative sex with someone, or someone has sex with you without your consent or agreement, this is rape.

Was it my fault?

​​Whatever the circumstances, nobody has the right to force you to have sex, have sex with you without your consent, or sexually assault or harass you. If this happens to you, it is not your fault. However, many people worry about reporting rape and sexual assault to the police because they:

  • had been drinking alcohol or taking drugs at the time

  • are in a relationship with or know the person who attacked them

  • have had a sexual relationship with that person before

  • had been kissing or touching that person before the attack

  • were with someone of the same sex (gay or lesbian relationship)

  • didn’t say ‘no’ or didn’t fight back

  • can’t really remember it properly.

  • are too embarrassed to speak out.

Some survivors of sexual assault and rape take many years to acknowledge that they’ve been a victim and find it hard to take steps to get help. But it’s never too late. Holding on to painful memories and feelings can seriously affect your life.

Yes, men can be sexually harassed, assaulted or raped. This could happen to gay or straight men, and is not related to your sexuality. You can be sexually assaulted by a male or a female. It’s important to understand that this doesn’t mean you are weak. Often men feel like they should be able to stop it because they are male, however the shock and level of violence or threat of violence means that stopping a sexual assault or rape is extremely difficult. Sexual assault and rape is about the abuse of power. It is never your fault and the police will take it seriously.






Acts of self-injury are often so horrifying that it makes it harder for people to be thoughtful about what these acts mean. There is a tendency to panic when you see someone you care about bleeding from self-inflicted wounds, or covered with scars. Such panic interferes with thinking, and makes it harder for people to understand the motives behind self-injury.

Further complicating the matter is the way that self-injury looks like it must be a suicide attempt even though it usually isn't. An act of self-injury which might make sense if understood as a suicide attempt become all the more difficult to comprehend when the self-injurious person denies that they are trying to kill themselves and is telling the truth.

So why do people self-injure? What are they trying to accomplish when they harm themselves? The following list of 6 motivations seems to cover most of the common scenarios that people who self-injure describe.

The 6 Reasons why people are most likely to self-mutilate

1. Distract themselves, alter the focus of their attention, or regain control over their minds when experiencing pressing, unavoidable and overwhelming feelings or thoughts.

2. Release tension associated with strong emotions or overwhelming thoughts.

3. Feel something physical when they are otherwise dissociated and numb.

4. Express themselves or communicate and/or document strong emotions they are feeling and cannot otherwise articulate.

5. Punish themselves.

6. Experience a temporary but intense feeling of euphoria that occurs in the immediate aftermath of self-harm.


BORDERLINE PERSONALITY DISORDER (BPD)... a serious mental illness that centers on the inability to manage emotions effectively. The disorder occurs in the context of relationships: sometimes all relationships are affected, sometimes only one. It usually begins during adolescence or early adulthood.

While some persons with BPD are high functioning in certain settings, their private lives may be in turmoil. Most people who have BPD suffer from problems regulating their emotions and thoughts, impulsive and sometimes reckless behavior, and unstable relationships

Other disorders, such as depression, anxiety disorders, eating disorders, substance abuse and other personality disorders can often exist along with BPD

The diagnosis of BPD is frequently missed and a misdiagnosis of BPD has been shown to delay and/or prevent recovery. Bipolar disorder is one example of a misdiagnosis as it also includes mood instability. There are important differences between these conditions but both involve unstable moods. For the person with bipolar disorder, the mood changes exist for weeks or even months. The mood changes in BPD are much shorter and can even occur within the day.

Officially recognized in 1980 by the psychiatric community, BPD is more than two decades behind in research, treatment options, and family psycho-education compared to other major psychiatric disorders. BPD has historically met with widespread misunderstanding and blatant stigma. However, evidenced-based treatments have emerged over the past two decades bringing hope to those diagnosed with the disorder and their loved ones.

Causes of Borderline Personality Disorder

Research on the causes and risk factors for BPD is still in its early stages. However, scientists generally agree that genetic and environmental influences are likely to be involved.

Certain events during childhood may also play a role in the development of the disorder, such as those involving emotional, physical and sexual abuse. Loss, neglect and bullying may also contribute. The current theory is that some people are more likely to develop BPD due to their biology or genetics and harmful childhood experiences can further increase the risk.

What does the name “Borderline Personality Disorder” mean?

Historically, the term “borderline” has been the subject of much debate. BPD used to be considered on the “borderline” between psychosis and neurosis. The name stuck, even though it doesn’t describe the condition very well and, in fact, may be more harmful than helpful. The term “borderline” also has a history of misuse and prejudice—BPD is a clinical diagnosis, not a judgment.

Current ideas about the condition focus on ongoing patterns of difficulty with self-regulation (the ability to soothe oneself in times of stress) and trouble with emotions, thinking, behaviors, relationships and self-image. Some people refer to BPD as “Emotion Disregulation.”


Most people have felt sad or depressed at times. Feeling depressed can be a normal reaction to loss, life's struggles,

or an injured self-esteem.

But when feelings of intense sadness -- including feeling helpless, hopeless, and worthless -- last for many days to weeks and keep you from functioning normally, your depression may be something more than sadness. It may very well be clinical depression -- a treatable medical condition.

How Do I Know If I Have Depression?

According to the DSM-5, a manual used to diagnose mental disorders, depression occurs when you have at least five of the following symptoms for at least two months: 

  • A low mood during most of the day, particularly in the morning

  • Fatigue or loss of energy almost every day

  • Feelings of worthlessness or guilt almost every day

  • Impaired concentration, indecisiveness

  • Insomnia (an inability to sleep) or hypersomnia (excessive sleeping) almost every day

  • Markedly diminished interest or pleasure in almost all activities nearly every day

  • Recurring thoughts of death or suicide (not just fearing death)

  • A sense of restlessness or being slowed down

  • Significant weight loss or weight gain


A key sign of depression can be recognized by “numbness” of emotions, or loss of interest in activities you once enjoyed. For a diagnosis of depression, these signs should be present most of the day either daily or nearly daily for at least two months. In addition, the depressive symptoms need to cause clinically significant distress or impairment. They cannot be due to the direct effects of a substance, for example, a drug or medication. Nor can they be the result of a medical condition such as hypothyroidism.

Symptoms of Depression

According to the National Institute of Mental Health, people with depressive illnesses don't all experience the same symptoms. How severe they are, how frequent, and how long they last will vary depending on the individual and his or her particular illness. Here are common symptoms people with depression experience:

  • Difficulty concentrating, remembering details, and making decisions

  • Fatigue and decreased energy

  • Feelings of guilt, worthlessness, and/or helplessness

  • Feelings of hopelessness and/or pessimism

  • Insomnia, early morning wakefulness, or excessive sleeping

  • Irritability, restlessness

  • Loss of interest in activities or hobbies once pleasurable, including sex

  • Loss of pleasure in life

  • Overeating or appetite loss

  • Persistent aches or pains, headachescramps, or digestive problems that do not ease even with treatment

  • Persistent sad, anxious, or "empty" feelings

  • Thoughts of suicide or suicide attempts


While these are common symptoms of depression, they may also occur in patterns. For example, a person may experience depression with mania or hypomania -- a condition called manic depression or bipolar disorder. Or the syndrome of major depression may occur in a seasonal pattern (a condition formerly called seasonal affective disorder).


There are several types of manic depression.

People with bipolar II disorder have at least one episode of major depression and at least one hypomanic -- mild elation or high -- episode. People with bipolar I disorder have a history of at least one manic -- extreme elation or high -- episode, with or without past major depressive episodes. A patient with unipolar depression has major depression only and has never had a full hypomanic or manic episode. A new category, though, in the DSM-5 allows for the presence of some symptoms of mania or hypomania during a full depressive episode in someone who technically hasn't met the full criteria for bipolar disorder (called major depressive disorder with mixed features). That suggests the line between unipolar and bipolar disorder can sometimes be blurry.


How Common Is Depression?

It is estimated that, by the year 2020, major depression will be second only to ischemic heart disease in terms of the leading causes of disability in the world. But people with depression sometimes fail to realize (or accept) that there is a biological and/or psychological cause to their depressed moods. As a result, they may search endlessly for external causes.

In the U.S., about 14.8 million adults suffer from major depression, according to the National Institute of Mental Health. The suicide risk in people with this type of depression is the highest rate for any psychiatric condition. For people between the ages of 10 and 24, suicide is the third leading cause of death. Unfortunately, most people with clinical depression never seek treatment. Left undiagnosed and untreated, depression can worsen, potentially lasting for years and causing untold suffering, and possibly suicide.


Warning signs of suicide include:

  • Thoughts or talk of death or suicide

  • Thoughts or talk of self-harm or harm to others

  • Aggressive behavior or impulsiveness

  • Isolation

  • Unusual mood changes

Previous suicide attempts increase the risk for future suicide attempts and completed suicide.

Are There Different Types of Depression?

There are a number of different types or subtypes of depression including:


Are There Other Types of Depression?

Other types of depression that can occur include:

  • Double depression -- a condition that happens when a person with chronic, low-grade depression (dysthymia) experiences an episode of major depression.

  • Secondary depression -- a depression that develops after the development of a medical condition such as hypothyroidismstrokeParkinson's disease, or AIDS, or after a psychiatric problem such as schizophreniapanic disorder, or bulimia.

  • Treatment-resistant depression -- a condition that doesn't respond to medical treatment with antidepressants, and may be longstanding or chronic. For chronic treatment-resistant depression, psychotherapy is often a good course of action.

  • Masked depression -- a depression that is hidden behind other psychological personality disorders, for which no medical cause can be found.


Bipolar disorder is a mental illness marked by extreme shifts in mood ranging from mania to depression. It is also called bipolar disease or manic depression.

Bipolar disorder is a mental illness marked by extreme shifts in mood, from high to low. This condition is also called bipolar disease or manic depression.

People with bipolar disorder may have trouble managing everyday life tasks, at school or work, or maintaining relationships. There is no cure, but there are many treatments that can help you manage the symptoms.

What are the symptoms?

During an emotional high or “mania,” a person with bipolar disorder may feel excited, impulsive, euphoric, and full of energy. During manic episodes, they may engage in behavior such as:

  • spending sprees

  • unprotected sex

  • drug usage

Hypomania differs from mania in that it may not result in any difficulty at work, school, or in social relationships. However, people with hypomania still notice changes in their mood.

During an emotional low or depression, a person may experience:

  • deep sadness

  • hopelessness

  • loss of energy

  • lack of interest in activities they once enjoyed

  • periods of too little or too much sleep

  • suicidal thoughts


What are the types?

Bipolar I

Bipolar I is defined by the appearance of at least one manic episode. The person may experience hypomanic or major depressive episodes before and after the manic episode.

Bipolar II

People with this type experience one major depressive episode that lasts at least two weeks. They will also have at least one hypomanic episode that lasts about four days.


People with cyclothymia have episodes of hypomania and depression. These symptoms are shorter and less severe than manic and major depressive episodes, but they fluctuate frequently. Most people only experience a month or two at a time where their moods are stable.

Rapid-cycling bipolar disorder

Rapid-cycling bipolar disorder causes faster changes in mood than other types of bipolar disorder. A person with this type may have four or more episodes of major depression, mania, hypomania, or mixed symptoms within a year.

How is bipolar disorder diagnosed?

To be diagnosed with a manic episode, the symptoms must last at least a week or cause the person to be hospitalized. The person must experience symptoms almost all day every day during this time.

Depressive episodes must last for at least two weeks. You must also meet at least five of the listed criteria in the Diagnostic and Statistical Manual of Mental Disorders.

Bipolar disorder can be difficult to diagnose because mood swings can vary. It’s even more difficult to diagnose in children and adolescents. This age group often has greater changes in mood, behavior, and energy levels.

Bipolar disorder often gets worse if it is left untreated. Episodes may happen more frequently or become more extreme. But if bipolar disorder is treated, it is possible to lead a healthy and productive life.

How is bipolar disorder treated?

There are several available treatments that can help you manage your bipolar disorder. They include medication, counseling, and lifestyle changes.

Recommended medications may include:

  • mood stabilizers, such as lithium (Lithobid)

  • antipsychotics, such as olanzapine (Zyprexa)

  • antidepressant-antipsychotics, such as fluoxetine-olanzapine (Symbyax)

  • benzodiazepines, a type of antianxiety medication, may be used for a short time for people with bipolar disorder, such as Xanax (alprazolam)


Recommended psychotherapy treatments may include:

Cognitive behavioral or Psychodynamic therapy

You and a qualified counselor talk about ways to manage bipolar disorder. The counselor will help you understand your behavioral patterns and how your subconscious affects your thinking. They can also help you come up with positive coping strategies.


Psychoeducation is a kind of counseling that helps you and your loved ones understand the disorder. Knowing more about bipolar disorder will help you and others in your life manage it.

Interpersonal and social rhythm therapy

Interpersonal and social rhythm therapy focuses on regulating daily habits, such as sleeping, eating, and exercising. Balancing these everyday basics can help you manage bipolar.




One 2 One Therapeutic Support is an international organization, offering help to clients worldwide through online sessions and also personally at our physical location in Cape Town, South Africa. All qualifications are under the auspices of the MHCPC (Manor House Centre for Psychotherapy and Counseling) and the BACP (British Association for Counseling and Psychotherapy) in The United Kingdom and Great Britain. MHCPC UK registration no. 1131804.

We do not have a South African Registration.

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