It’s been one heck of a chaotic year for the world of American sports, one that most of us are unlikely to forget anytime soon. COVID-19 initiated lockdowns and event cancellations in March of last year, and every professional sports league has had to make its own decisions about how to proceed safely. After several delays and ever-changing protocols, viewers were left with a whirlwind fall sports season that had all four major sports leagues (MLB, NHL, NBA, NFL) broadcasting at the same time. The constant change and lack of regular season schedules have sent Americans into a frenzy, and that doesn’t include just professional sports. College-level play all the way down to the pee-wee level has been disrupted for players and parents alike.

How COVID Restrictions Have Affected the Mental Health of Players

It didn’t take long for the mental health of professional athletes to decline. If you have a full-time job where you’re physically active for most of the day and night, constantly pushing your body to the limit, coming to a complete stop is more than abrupt — it’s paralyzing to some extent. A massive drop in endorphins alone could cause immediate mood changes. How does a 200 pound basketball player adjust to gyms and parks being closed and practices being called off?

With the increased distribution of vaccines, some medical experts believe the US can get back to some semblance of normalcy by summer’s end.

A study released in October by Stanford University and exercise social network Strava revealed that over 22% of professional athletes were feeling depressed on over half the days of the week between March and August in 2020, when restrictions were at their peak. Endurance athletes (runners and cyclists) fared even worse; they were over 7 times more likely to have little interest in doing things. The study also revealed a significant hit in finances, with 47% of sponsored athletes seeing a reduction in lucrative opportunities.

The sudden decline in mental health back in the spring certainly wasn’t isolated to professional players. A poll from the NCAA showed that over 37,000 college athletes learned they had increased levels of depression and stress in the first several weeks of the pandemic, reportedly caused by all the surrounding uncertainty. This included fears of exposure (43%), decreased motivation (40%), anxious feelings (21%), and depression/sadness (13%). Close to 80% of student athletes said they found it difficult to keep up with their training, in some cases because their training locations were closed. Another survey from the University of North Texas covering all three divisions of college play found that 26% of athletes reported various levels of depression. The study also revealed a drop in student psychotherapy.

How COVID Restrictions Have Affected the Mental Health of Sports Fans

As for the fans, all sports came to a halt in the spring of last year, when none of us really knew what we were dealing with in regard to COVID-19. According to market research firm MRI-Simmons, a study released in July revealed that 64% of Americans missed sports in general. Out of the group that described themselves as “sports deprived,” the biggest complaint was being unable to watch and spend time with family (31%). This further highlights one of the biggest problems COVID has caused: lack of connection. Movies, plays, concerts, church, festivals, fairs, you name it — it disappeared. With sports, we had to settle for endless repeats of classic games until well into summer.Basketball and Hoop - Gentle Path at The Meadows

Then came the response. Every league had their own plan for how to tackle the pandemic. The topic of season scheduling and pro athletes getting tested became a nationwide debate. The NBA tested their full squads through private labs, sending several rounds of players into quarantine, a move that caused instant backlash in light of what the public saw as superior treatment with testing. The NHL was praised by following whatever the latest CDC guidelines were, but no one beats the UFC’s response. The MMA league secured an island off the coast of Abu Dhabi they deemed “Fight Island,” and no one was allowed onto the island without several rounds of negative COVID testing. Then, finally, many sports made their return in the fall. Unfortunately, the 2020 Summer Olympics had to be postponed until the summer of 2021, suspending the hopes and dreams of thousands of other athletes around the globe.

Sports Coping in 2021

In the meantime, hockey and basketball have returned. The NHL will have another shortened season this year and will run until May, and the NBA runs until the finals in July. By that time, baseball will already be in full swing (slated to begin on April 1) and football will be around the corner. We also have our favorite NCAA basketball teams headed into March Madness. Just the smallest sense of normalcy may bring us all a greater sense of calm.

And let’s not forget, there’s a light at the end of the tunnel. With the increased distribution of vaccines, some medical experts believe the US can get back to some semblance of normalcy by summer’s end. Until then, the warm spring weather will bring back outdoor game viewings, cookouts, and tailgating as we continue safe social distancing.

Visit the living room of the average family that is “living with,” or should I say “drowning in,” addiction and you are likely to find a family that is functioning in emotional extremes. Where feelings can explode and get very big, very fast or implode and disappear into “nowhere” with equal velocity. Where what doesn’t matter can get unusual focus while what does matter can be routinely swept under the rug. A family in which small, fairly insignificant behaviors can be blown way out of proportion while outrageous or even abusive ones can go entirely ignored and unidentified. Where things don’t really get talked about but instead become shelved, circumvented or downright denied.

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While building a tribe can be scary at times, like other things in recovery, it can also be exciting. Our best friends were once strangers, ones we probably met because we weren’t staring at our screens. Now, go: put your phone down (unless you’re attending an online meeting), and build your village. That’s what it takes to heal. And, healing, by the way, can and does happen.

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Individuals in recovery have generally spent a lot of time avoiding their painful, shameful, or fearful reality. Using chemicals, relationships, busyness, spending, eating, not eating, fantasy, gambling, sex, etc. to escape reality.

What is your reality anyway?

As a baby, your brain was in a receptive mode and you downloaded and duplicated everything around you. As you grew up, you kept imprinting within you, all of the thoughts, feelings, beliefs, and things that happened and you became you.

From Pia Mellody’s Model of Developmental Immaturity, we learn that this programming creates a belief system. You interpret everything that you perceive through your own belief system, particularly as you interact with others. That’s why people frequently disagree about a shared experience. For example, let’s say that Jason had a disagreement with his sister while they were at a social event and shared about it with several friends. Sara identifies with Jason’s sister, feels empathy, and defends her. Jennifer is reminded of being embarrassed by her mother in public and feels pain and shame. Mark feels annoyed about the very topic of conversation and thinks about something else. Everyone has his or her own reality.

In emotional recovery work, it is extremely helpful to understand your reality and how to work with it. First, your reality is your experience in the present moment and includes your body, thoughts, feelings, and behaviors. Think of a recent time when you felt reactive in an interaction with someone and experienced some strong feelings come up. Now, breathe, take a moment, and fully experience the sensations in your body. Those sensations inform you about your feelings. Identify what the feelings are. Is it pain, hurt or sadness, or is it fear or anger? If you are not used to identifying your feelings, it can take some practice. Truthfully, your feelings are generated by the thought you had. When you are reactive, it’s hard to think straight and it can take some time to identify what the actual thought was, or where in your history it originated.

The most helpful way to think about this is with curiosity and owning it rather than judging yourself or blaming someone else. You are in a disempowered victim mode when you blame someone else for your reaction and that keeps you stuck. When you own that your reaction came from your own programming, then you are empowered to understand yourself better and can change.

So how do we do that? How do we change our reactivity, our thoughts, and feelings, and why go through the trouble?

Scott Peck wrote, “Mental health is staying in REALITY at all costs.” You’ve had those experiences when you are fully present, connected with yourself, aware of your senses, and feeling alive. Joy, passion, love, and the sense of connection with yourself are present moment experiences. You miss out on life when you are not present. Everyone checks/spaces-out at times; it is the human condition. However, the more present you are, the happier and healthier you will be.

Here are the steps to working with your reality when you are triggered or become reactive:

  • Take slow deep breaths and be curious about what you are experiencing and why it is coming up.
  • Notice and describe to yourself the sensations you are feeling in your body and identify the emotional feeling word or words that fit. (Hurt, fear, anger, irritation, shame, guilt, for example.)
  • Stay present and curious about the feelings or issues that are underneath the surface feelings. It could be abandonment, feeling threatened or unsafe, used or manipulated, blamed, shame, guilt, or a memory of an incident from your past. You could discuss this with a therapist.
  • When appropriate, you can own your own experience in the present moment and share it with that person you were reactive to by using your talking boundary. For example, in the previous story, Jennifer becomes very quiet and moody. She might share with Jason, “When I heard you say that your sister made a scene at the family dinner, what came up for me was a time when my mother was embarrassingly loud and rude in public and I’m feeling some shame and pain.” In sharing her reality in this manner, Jennifer’s friends will understand her better and she will likely have a sense of relief from the pain and shame.

Only do this when you feel like a functional adult. Listen to the other person’s reality. Be open to getting to know them and to learn about yourself.

Practicing this will likely bring insight as to how the programming in your brain hijacked the situation and gave you a distorted reality. That insight creates a new reality, even a new neuropathway in your brain. This practice begins to create a new, healthier, happier reality, which makes it easier for you to be present. So who needs reality? We all do.

By Nancy Minister, MA, Workshop Facilitator for Rio Retreat Center at The Meadows

Our capacity for empathy and closeness is formed and strengthened through the quality of our childhood relationships. From conception onwards, we resonate in tune or out of tune with those who bring us into this world. Our nervous systems are fashioned by nature to resonate with the nervous systems of others to achieve a sense of balance and connection (Schore, 1999) and these early interactions become the neurological templates upon which later interactions are built. Did we feel safe and held in our parents’ arms? How did we experience their touch? Were they interested and able to read our little signals and our attempts to communicate with them and did they respond in an attuned and caring manner? Or did we feel dismissed or even as if we were a burden or somehow a disappointment? A combination of both? Could we put a smile on their faces just by being part of their lives? These early experiences knit themselves into the very fabric of our mind/body system and pattern our capacity for intimacy.

We fall back on our more primitive systems of defense-such as a


fight, flight, or freeze-only when we fail to find a sense of resonance and safety in these early connections. (Porges, 2007). We have built into us our personal security system that assesses, in the blink of an eye, whether or not the situations that we’re encountering are safe or in some way threatening  (Porges, 2004). Neuroception, a term coined by Stephen Porges,  former Director of the Brain-Body Center at the University of Illinois at Chicago, refers to a perceptual mind/body system that has evolved over time to enable humans and mammals to establish mutually nourishing bonds and/or to tell us when we might need to prepare for danger. It involves our innate ability to use intricate, meaning-laden, barely perceptible mind-body signals to establish bonds and communicate our needs and intentions. While many of these communications are conscious, still more occur beneath the level of our awareness in that part of us that is our animal self (Porges, 2007) and these interactions, both conscious and unconscious, form a foundation upon which further intimate interactions grow.

According to Porges (2004), our neuroception tells us if we can relax and be ourselves or if we need to self-protect. If the signals that we’re picking up from others are cold, dismissive, or threatening, that neuroceptive system, which is part of how we process-relational trauma, sets off an inner alarm that is followed by a cascade of mind-body responses honed by eons of evolution to keep us from being harmed.   In trauma engendering interactions, “people are not able to use their interactions to regulate their physiological states in the relationship . . . they are not getting anything back from the other person that can help them to remain calm and regulated. Quite the opposite, the other person’s behavior is making them go into a scared, braced-for-danger state. Their physiology is being up-regulated into a fight/flight mode,” says Porges.  This kind of failure to successfully engage and create a sense of safety and cooperation can be experienced as traumatic by a helpless and vulnerable child.

Relational trauma can occur at very subtle levels of engagement or a lack thereof, as well as in its more obvious forms of living with abuse, neglect, illness, or addiction.  And this mind-body system sets off the same kinds of alerts whether we’re facing the proverbial sabor-toothed tiger in the pine forest or a “sabor-toothed” parent, older sibling or spouse in our living room or bedroom.

Trauma in the home and in our early experiences has a lasting impact. When those we rely on for our basic needs of trust, empathy, and dependency become abusive or neglectful, it constitutes a double whammy. Not only are we being hurt or dismissed, but the very people we’d go to in order to restore our sense of calm and connectional the ones causing it. Our neuroceptive system is up-regulating and bracing for danger with the very people we wish to run to for safety. “Trauma impels people both to withdraw from close relationships and to seek them desperately (Herman, 1997). The profound disruption in basic trust, the common feelings of shame, guilt, and inferiority, and the need to avoid reminders of the trauma that might be found in social life, all foster withdrawal from close relationships. But the terror of the traumatic event intensifies the need for protective attachments; therefore, the traumatized person frequently alternates between isolation and anxious clinging to others”, says Judith Lewis Herman in her book Trauma and Recovery.

Later as adults when we partner and parent, we important our attachment styles from early family relationships into our new adult families, we tend to repeat and recreate in other words, what we experienced as children or, in one of those psychological conundrums exactly the opposite.

Clients who have been traumatized in their intimate relationships can find it difficult to simply be in comfortable connection with others. The dependency and vulnerability that is so much a part of both adult and childhood intimacy can trigger a person who has been traumatized in their early interactions into the defensive behaviors that they relied on as children to stay safe and to feel whole rather than splintered. To heal this form of relational trauma, we need to understand what defensive strategies we used to stay safe as kids and then shift these behaviors to be more engaged and nourishing both within our relationships and ourselves as adults. After all, if we constantly brace for danger and rejection, then we are likely to create it. It can become a self-fulfilling prophecy.

Ask yourself these questions:

  1. How did I experience the arms, gaze, and connection of my mother, father and other primary caregivers (animals may also have been experienced as primary attachment figures)?
  2. How am I recreating these experiences both of a sense of safety and “braced for danger” in my intimate relationships today?
  3. Which styles are undermining closeness?
  4. What can I do to foster change first within myself and within my relationship?

When emotional pain remains split off, it becomes somehow invisible to the naked eye, but it does not disappear. When we enter committed relationships in adulthood, our powerful urge to attach, triggers our early experiences of attachment and we tend to do what we know, we recreate our attachment patterns from a childhood of yesteryear, relationships in our adult relationships of today. We need to repair childhood hurt in some way, and if the repair doesn’t happen at or near to the moment of the pain, it will need to happen later. Being in loving and committed relationships and raising children is nature’s second chance at repairing our own childhood wounds.  But without understanding the dynamics of how early pain can become an unconscious driver for recreating the same kinds of dysfunctional patterns that we grew up with, we may easily and rather seamlessly bring the most painful parts of our past into our relationships today. And we won’t even recognize what we’re doing.


Herman, J. L.  1992.  Trauma and Recovery.  New York: Basic Books, a Division of Harper Collins Publishers.

Porges SW. (2007). The polyvagal perspective. Biological Psychology 74:116-143.

Schore, A.N. (1999). Affect Regulation and the Origin of the Self. Mahwah, NJ

Written by:

Tian Dayton PhD

Advocacy Message by Sis Wenger CEO of NACoA

Addiction encourages trauma and trauma can encourage addiction. This process becomes a vicious circle or negative feedback loop, with trauma contributing to addiction, which in turn fuels more trauma, which encourages still more addiction, and so on and so on. The Claudia Black Young Adult Center treats substance and process addictions, recognizing them to be primary disorders which reinforce each other and are often fueled by traumatic experiences. Here are some examples of how this process plays out:


Brent grows up with a highly critical father. Nothing Brent does is ever good enough. His father routinely compares Brent to his two older brothers, who are both excellent athletes and consistently get high grades (TRAUMA). In contrast, Brent struggles in school, and his father repeatedly accuses him of being stupid and lazy (TRAUMA). (Later, in his twenties, Brent discovers he has a learning disability.) Brent’s mom, a professional singer who is on the road most of the time, is distant, busy, and preoccupied (TRAUMA). She leaves most of the child-rearing to her husband. In high school, Brent becomes part of a group who spend much of their time partying together. Collectively, they find solace in drinking and smoking weed (USING DRUGS TO SELF-MEDICATE). By the time Brent is twenty-five, he is addicted to alcohol and pills (ADDICTION). One night, driving home drunk from a party with his buddy Gary, the car hits a patch of ice, spins out, and crashes into a deep culvert. Gary breaks both legs (TRAUMA); Brent suffers a serious brain injury (TRAUMA). He is prescribed pain pills, which only further fuels his out-of-control drug use (ADDICTION).


Kim grows up with a severely alcoholic father and a hypercritical mother (TRAUMA). From the time Kim is in kindergarten, her mother is preoccupied with Kim’s body and weight. Soon after Kim turns nine, her dad goes into rehab and stops drinking. A month after that, her mom reveals that she has had a

long-time boyfriend and runs off with him (THE TRAUMA OF ABANDONMENT). For the next eight months, Kim’s parents fight over her in an angry and acrimonious divorce (TRAUMA).

At fourteen, Kim is exercising excessively to keep herself thin. She binges on junk food, then sticks her finger down her throat and vomits it up (BULIMIA NERVOSA). She also begins to party—drinking excessively and taking large amounts of opiates. One night, when drunk, she passes out and is raped by several guys at a party (TRAUMA). One of them posts a video of the rape on social media (TRAUMA).

Kim’s humiliation, shame, and inability to reach out to her parents continue as does the partying, binging, bulimia, drinking, drug use, and the sexual assaults (TRAUMA). By age twenty-four, Kim uses heroin and alcohol addictively (ADDICTION). By age thirty-one, she has attempted suicide three times.

Julie, Leo, and Bryce

In late 1998, Julie fell while riding a horse (TRAUMA). Her pelvis was seriously injured, and her doctor prescribed oxycodone during her recovery. In the process, she became addicted to pain pills (ADDICTION). Three years later, Julie’s husband, a firefighter, was one of the first responders to the 9/11 attacks. He was in one of the towers when it collapsed; his body was never found (TRAUMA). Suddenly widowed, with traumatized boys ages seven and nine, Julie began to drink herself to sleep each night (ADDICTION). As the months and years passed, Julie’s drinking and pill usage kept her in bed longer and longer (ADDICTION). She became moody and unpredictable. The boys became more self-sufficient, asking less and less of her. This enabled Julie to take even more pills and alcohol (ADDICTION). By the time Leo, the oldest child turned fifteen, Julie was profoundly depressed, sometimes nearly manic, occasionally overly reactive, and at times disengaged from everything. She provided little structure or support for the boys other than meals, clothing, and an occasional hug (THE TRAUMA OF ABANDONMENT). In response, Leo threw himself into school and school-related activities. The younger boy, Bryce, stayed in his room, compulsively surfing the internet and playing video games, becoming steadily more isolated from everyone and everything. Eventually, through an intervention led by her physician, Julie was able to stop using and get into recovery. She woke up to an older son in community college who was quite responsible, and a younger son who was showing signs of gaming and porn addiction (ADDICTION).

The Bottom Line

Trauma and addiction routinely cause, encourage, and reinforce each other. Because they so often interact, they need to be treated together and not as two separate, unrelated conditions.

As a therapist, whenever I see one, I’ve learned to always look for the other. Even when trauma and addiction are quite serious, it is possible to recover from both.

Written by Claudia Black, Ph. D. Clinical Architect of the Claudia Black Young Adult Center at The Meadows

Author: Unspoken Legacy: Addressing the Impact of Trauma and Addiction Within the Family

My therapist prescribed me to drink more alcohol. I had described symptoms of post traumatic stress disorder (PTSD), yet once again, the diagnosis was completely missed. Even worse, this uniformed therapist suggested that I drink wine “medicinally,” beginning in the morning, to help cope with what he said was high anxiety. What makes this horrible advice even more dangerous is the fact that upward of fifty percent of those with PTSD also battle substance use disorder.

PTSD is often missed, and trauma is frequently dismissed. It is no wonder that so many of us who struggle don’t know it. Many of us already think “what happened to me wasn’t that bad,” so PTSD is nowhere on our radar. Using specific language like the words “trauma” and “PTSD” isn’t about labeling but rather about serving as a compass for help. This PTSD Awareness Month, let’s work to get the truth out about posttraumatic stress disorder, thus, getting more help to more people:

1. Trauma can be viewed as anything less than nurturing that alters your view of yourself and how you relate to the world. Mike Gurr, Executive Director of The Meadows Ranch, tells patients, “If it’s important to you, it’s important.” 

2. Traumas not deemed PTSD-worthy, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), can lead to PTSD symptoms just as severe as traumas that do qualify.

3. Among those who experience trauma, up to 20 percent will go on to develop PTSD.

4. Those who develop PTSD are not weak. In fact, PTSD has a lot to do with genetics and biology. As one example, based on hormone levels, researchers can predict—prior to deployment—which soldiers will develop PTSD in the war zone.

5. Sexual assault, more than combat or any other type of trauma, is most likely to result in PTSD.

6. Women are twice as likely as men to develop PTSD.

7.  Some individuals who don’t meet the rather strict diagnostic criteria for PTSD in DSM-5 experience just as much impairment as those with full-blown PTSD. Researchers call this partial PTSD; it deserves help.

8. One reaction during a trauma—lesser known than fight or flight—is freeze. Think deer in the headlights. Without seeking professional help, people who freeze during trauma might ask themselves for the rest of their lives, “Why didn’t I do anything?”

9. People who develop PTSD did do something during their trauma. They survived. Fighting, fleeing, and freezing are all biologically appropriate responses to a trauma.

10. The average lapse in time between the onset of PTSD symptoms and a diagnosis is twelve years!

11. PTSD is often misdiagnosed as bipolar disorder, borderline personality disorder, depression, schizophrenia, and anxiety.

12. Known as delayed expression PTSD (or delayed onset), symptoms can surface years after the trauma happened.

14. Although not included in DSM-5, clinicians and researchers widely agree that “complex PTSD” is a separate and unique form of the illness, one derived from exposure to multiple traumas, particularly in childhood.

15. People with PTSD are not crazy. PTSD is actually a normal reaction to an abnormal experience—a trauma.

16. PTSD can be passed on through DNA from parent to child, known as intergenerational trauma. Children of Holocaust survivors might struggle with PTSD symptoms even though they have never experienced a trauma directly themselves.

17. One of the greatest protectors against developing PTSD is social support.

18. People with PTSD are not dangerous. Many don’t even experience anger as a symptom.

19. PTSD looks different in everyone. Analyzing the various ways that the hallmark symptoms can manifest, there are 636,120 possible presentations of PTSD!

20. PTSD is no longer categorized as an anxiety disorder. Some with PTSD experience the disorder more as shame or grief-based and less as anxiety or fear.

21. Alongside PTSD often comes problems like eating disorders, substance use, depression, and insomnia.

22. Trauma can be stored in the body as chronic pain.

23. People with PTSD can’t just “get over it” any more than someone can just get over a broken leg. PTSD is a brain injury, one that needs treatment.

24. When people with PTSD are triggered, they have essentially lost access to their prefrontal cortex, the rational, decision-making part of the brain. This isn’t their fault, yet they can learn to take steps in accountability by seeking support.

25. Longtime “gold standard” evidence-based treatments for adults with PTSD include Eye Movement Desensitization and Reprocessing (EMDR), Prolonged Exposure, and Cognitive Processing Therapy, all of which involve exposure to the trauma memory.

26. Avoiding trauma-related thoughts, feelings, situations, and things can be a central maintaining factor of PTSD. (e.g., If someone avoids driving after a car accident, the likelihood of developing PTSD increases.)

27. To heal, living an exposure-based life can be key. We need to approach thoughts, feelings, situations, and things that scare us. (e.g., In the previous example, with support, get out on the highway and drive.)

28. A newer, promising exposure-based treatment called Writing Exposure Therapy can be completed in as little as five sessions.

29. Somatic Experiencing® (SE), a body-oriented trauma treatment with a growing body of evidence, does not require a person to directly revisit trauma memories.

29. PTSD is not a life sentence. While the trauma can’t go away (it’s history), with treatment, PTSD symptoms can and do.

30. Posttraumatic growth describes the positive transformation that can grow out of adversity, out of trauma and PTSD.

I stopped seeing the therapist who encouraged me to drink wine for breakfast. Ultimately, I connected with excellent treatment providers, and I recovered from PTSD, albeit slowly. With help, research shows and personal experience proves, we can take our lives back from the treacherous illness. No one chooses to have PTSD, but people can and do choose to get better.

A Senior Fellow with The Meadows and advocate for its specialty eating disorders program, The Meadows Ranch, Jenni Schaefer is a bestselling author and sought-after speaker. For more information:

References: American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (Arlington, VA: American Psychiatric Publishing, 2013).
D.M. Sloan, B.P. Marx, and D.L. Lee, “A Brief Exposure-based Treatment vs. Cognitive Processing Therapy for Posttraumatic Stress Disorder: A Randomized Noninferiority Clinical Trial,” JAMA Psychiatry, 75(3) (2018): 233-239.E.C. Berenz and S.F. Coffey, “Treatment of Co-occurring Posttraumatic Stress Disorder and Substance Use Disorders,” Current Psychiatry Reports 14(5) (2012): 469–477.J. A. Gordon, “Update from the NIMH” (presentation given at the Anxiety and Depression Conference, Washington, DC, April 5-8, 2018).
M.J. Friedman, T.M., Keane, P.A. Resick, Handbook of PTSD, Second Edition: Science and Practice (New York, NY: Guilford Press, 2015).
National Center for PTSD (2016, October 3). How Common is PTSD? Retrieved from
P. S. Wang, P. Berglund, M. Olfson, H.A. Pincus, K.B. Wells, and R.C. Kessler, “Failure and Delay in Initial Treatment Contact After First Onset of Mental Disorders,” National Comorbidity Survey Replication, 62 (2005).
R. A. Josephs, A.R. Cobb, C.L. Lancaster, H. Lee, and M.J. Telch, “Dual-hormone Stress Reactivity Predicts Downstream War-zone Stress-evoked PTSD,” Psychoneuroendocrinology, 78. (2017): 76-84.
R. Yehuda, N.P. Daskalakis, L.M. Bierer, H.N. Bader, T. Klengel, F. Holsboer,  E.B. Binder, “Holocaust Exposure Induced Intergenerational Effects on FKBP5 Methylation,” Biological Psychiatry, 80(5). (2016): 372-80.
S. E. Back, A. E. Waldrop, & K. T. Brady, “Treatment Challenges Associated with Comorbid Substance Use and Posttraumatic Stress Disorder: Clinicians’ Perspectives,” American Journal of Addiction, 18. (2009): 15-20.

Feeling creative or like playing around with your mood? Collage it online with this mood collage tool from Tian Dayton Ph. D. and Senior Fellow at the Meadows.

Once you have the collage you like, take a screenshot of it and journal about these questions:

  1. Has my mood changed at all through collaging it and if so, in what ways?
  2. Does collaging my mood make it lighter or more conscious and if so what would you say about that?
  3. What parts of my collage pop out to me and why?
  4. What parts do I want to carry forward into my day?
  5. What parts do I want to change?
  6. What is the most positive light in which I can see my collage?

Hope you had fun…pass it along….

Mood collage online tool:

Click here for the Mood Collage

When you think of management of your mental health, what comes to mind? Maybe you meditate or take yoga, perhaps you participate in group activities to stay connected to others, or maybe you focus on getting enough sleep. Do you ever think of the role food plays in all of this? You should. That’s because studies show that the foods you choose to consume play a big role in your mental health status. Here’s what to choose, and what to lose.

What to Choose:

 A Mediterranean Diet Pattern

Several studies show a connection between consumption of a Mediterranean diet and positive mood. Perhaps this is because the diet has such an impact on overall brain health. One study found that people that ate more fruits, vegetables, and whole grains had lower rates of depression over time. These are just three of the main components of the diet, in addition to fish and skinless poultry, legumes, extra virgin olive oil, and nuts.

 Omega 3 Fatty Acids

An animal study out of the Indiana School of Medicine found that omega 3 supplementation could have a potential “therapeutic benefit” for both anxiety and alcohol abuse. Another demonstrated the impressive anti-inflammatory impact of regular consumption of fatty fish, which is high in omega 3 fatty acids. Inflammation is the base of the majority of diseases worldwide and plays a role in depression. Other sources of omega 3 fatty acids include chia, hemp, and flax seeds, walnuts, and lake trout.

 Vitamin D

Several studies have linked vitamin D deficiencies to increases in depression. While vitamin D is poorly absorbed through food sources, it is well absorbed through the rays of the sun and supplementation with D3. Since spending too much time in the sun can increase the risk for melanoma, it is advised to have your vitamin D levels checked and then supplement with a D3 option. If you are taking a fish oil pill, you should pair the two together. Doing so will enhance the absorption of vitamin D, a fat-soluble vitamin.

 Fermented Foods

Getting more fermented foods in the diet (such as tempeh, miso, sauerkraut, and pickles) can enhance gut health. I’ll be focusing on the gut-mind connection in my next column but for now, consider adding some of these foods to your diet at least three times a week, or beginning a probiotic supplementation plan.

 What to Ditch:

You now know which foods you should add to your diet, now let’s focus on the ones to take out. Sugar, fast, fried, and ultra-processed foods and trans fats should all be decreased in the quest for better mental health. That’s because these foods have been found in studies to be a bad mix for good mood. Additionally, sugar holds addictive properties and has been proven to increase the risk of several chronic conditions.

The Meadows Behavioral Healthcare family of programs realize that food choices affect the overall success of treatment. Many nutrients have connections with depression, anxiety, and addiction. Few treatment programs realize this connection and I am proud to be associated as a Senior Fellow of this organization.

Next month, I’ll be focusing on getting the best foods for a better gut!

Written By Kristin Kirkpatrick, MS, RDN, Senior Fellow of Meadows Behavioral Healthcare

“You cannot ‘not’ communicate.”

In the world of communication theory, this is a common adage. Simply stated, it means that no matter how hard you try, it’s impossible to refrain from communicating to those around you. Since the majority of communication occurs through non-verbal cues that are transmitted both consciously and subconsciously, we are communicating whether we want to or not. Even silence is communicating something. So when couples or family members say, “Our problem is that we don’t communicate with one another,” they are misinformed. They are communicating a great deal. It’s more likely that they aren’t communicating very effectively and they often don’t like the messages that are being exchanged.

In the world of communication theory, this is a common adage. Simply stated, it means that no matter how hard you try, it’s impossible to refrain from communicating to those around you. Since the majority of communication occurs through non-verbal cues that are transmitted both consciously and subconsciously, we are communicating whether we want to or not. Even silence is communicating something. So when couples or family members say, “Our problem is that we don’t communicate with one another,” they are misinformed. They are communicating a great deal.  It’s more likely that they aren’t communicating very effectively and they often don’t like the messages that are being exchanged.

As human beings, we have the ability to transmit and detect very subtle cues from one another. It could be compared to an emotional Wi-Fi system that each of us possesses, sending out signals to the people in our proximity. Those people, in turn, have a corresponding Wi-Fi system that automatically receives and interprets those signals. This is happening whether we want it to or not. Unfortunately, these signals are subject to a great deal of misinterpretation.

So where do these Wi-Fi signals come from and how are they transmitted?  Well, it’s a complex process that happens faster than our conscious mind can keep up with and more subtle than we can perceive. Most of these signals are made up of different body gestures called micro-expressions; tiny movements that are almost imperceptible to the naked eye, especially if you’re not paying attention to them. They consist of small adjustments of the facial muscles, constriction or dilation of the pupils, movements of the limbs and extremities, body posture, tone of voice, and breathing patterns to name a few. Most of these signals are involuntary, and usually, the person transmitting them doesn’t know that they are doing it. In addition, the person who is receiving these signals may know something is being communicated but is seldom able to identify the source of these signals. To make matters worse, the receiver usually doesn’t have enough information to interpret these signals accurately. Thus, you get a dialogue that looks something like this:

Mom: “Jeffry, I see that you got a C on your geometry test. Are you having trouble understanding the material?”

Jeffry: “No, Mom, I just had a bad day when I took the test. I’m doing fine in the class.”

Mom: “No need to get defensive, Jeffry, I’m just concerned about how you’re doing in school.”

Jeffry: “Well, you don’t need to jump all over me about it Mom. It’s not like I’m a bad student.”

Mom: “I’m not ‘jumping all over you.’  I just asked a question. I don’t appreciate the tone you’re taking with me.”

Jeffry: “I don’t have a ‘tone.’  I don’t know what you’re talking about. You’re getting all ballistic over a stupid test!”

The next thing you know, both Mom and Jeffry find themselves locked in a battle over who’s attacking who and which of them is being overly sensitive.  Both of them find themselves frustrated by the conversation.  It’s a common scenario that can sometimes lead to hurt feelings, resentment, and disrupted attachment between family members.  What Mom and Jeffry don’t notice is the role each of their respective micro-expressions is playing in the unfolding drama.  There is a great deal more to this conversation than just the words they are using and the content they are conveying.

How many times have you had a family member say to you, “What was that look about?” or “What’s the matter?  I can tell something’s bothering you,” and you have no idea what they are talking about?  Often, these micro-expressions are communicating emotional states that you may not be aware of in the moment.  Consequently, a whole assortment of miscommunication happens in a short amount of time.  If left unexamined and unaddressed, these miscues can lead to some disruptive outcomes for families.

Here at The Meadows, we prioritize healthy communication between family members. One aspect of our intensive Family Matters Workshop is fostering clear, direct communication. This includes, but is not limited to, the words that each family member says to one another.  Each individual must also gain a better awareness of their own emotional states and micro-expressions, as well as those of their loved ones.  This is an essential component of healthy communication.

The Rio Retreat Center at The Meadows offers customized intensive workshops for families that are struggling to communicate effectively as well as numerous other relational problems.  If you would like to know more about our Family Matters Workshop or any of our other workshops, contact our intake department at 1-800-244-4949 for more information or visit our website at

Written by:  John Parker, MS, LMFT, SATP, CSAT, Therapist at Rio Retreat Center