Maybe they’re being secretive and have even stolen money from your wallet. Maybe their physical appearance has changed with rapid weight loss or red eyes. Maybe you’ve noticed a change in their sleep habits, energy level and mood. Maybe you’ve actually found marijuana or other drugs in their room.

Naturally, the thought and possible confirmation of your child using drugs trigger a rush and range of emotions: anger, frustration, disappointment, sadness, fear.

If you think your child is using drugs, how do you approach them? Where do you start?

Two parenting experts shared their insight below.

1. Be direct and calm.

“This issue is too serious for subtlety,” said John Duffy, Ph.D, a clinical psychologist and author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens. He suggested readers approach their kids “directly and immediately.”

Avoid letting your anger and frustration spill over into the conversation. According to Lisa Kaplin, Psy.D, a psychologist and life coach who teaches parenting classes, “The best way to approach your child is with delicacy, not drama. If you approach them with panic, anger, aggression or accusations, you can be sure your child will tell you absolutely nothing.”

Yelling, threatening and lecturing your child typically leads them to withdraw, sneak around and lie, she said.

Duffy also suggested approaching your child “from an emotional space of genuine concern for well-being.” He understands that being calm and centered is a lot to ask of parents. “But it is, without a doubt, the approach that works best in my experience.”

It’s common for kids to deny their drug use, or to respond casually (e.g.,” It’s just pot, and I don’t smoke it that often, anyway”). If this happens, “give a brief response in which you tell them that you do not want them to use drugs of any kind,” Kaplin said. Reiterate your house rules about drugs and alcohol use and “the consequences that come with that behavior.”

2. Talk when your child is lucid.

Don’t try to have a serious conversation when your child is drunk or high, Duffy said. “This might seem like common sense, but I have worked with many parents who have attempted to lecture an inebriated teenager.”

3. Ask open-ended questions.

It’s more likely that your child will be honest, and talk about their drug use if you ask open-ended questions. According to Kaplin, these are several examples: “Can you tell me more about that?  How did you feel in that situation? What will you do if that happens again? How can I help you with this?”

If your child admits to using drugs, again, “ask them with open-ended, non-judgmental questions about what drugs they have used, how often, and if they plan on using again.” You also can ask “for their input on how to proceed.”

4. Don’t punish your child.

Avoid punishing your kids, Duffy said. It rarely works. For instance, “Taking a cell phone away will never keep a drug user away from using.”

5. Show your support.

If your child reveals their drug use, “Thank [them] for being honest with you,” Kaplin said. Let them know that you’re “here to help them. Tell them you love them.”

6. Get your child treatment.

It’s key to take your child to see a qualified therapist who specializes in working with teens and young adults. When talking about professional help, don’t negotiate with your child, or take “no” for an answer, Duffy said.

Instead be brief, firm and clear, he said. Duffy gave the following example of what you might say to your child: “It is clear to us that you have been using something, and we are really concerned for your safety. As your safety is our domain as Mom and Dad, we are going to pull rank here and schedule an appointment for someone for you, and all of us, to talk to about this issue.”

Depending on the situation, you can “give [your child] options regarding therapists or treatment centers,” Kaplin said.

Even if your child is over 18 years old, Duffy suggested having a similar conversation. While you can’t force your older child to attend therapy, you can leverage other things, such as your financial position, he said.

It’s also important to get clear on your limits, communicate them to your adult child and follow through, Kaplin said. For instance, “can your child still live with you if they’re using drugs? If not, when must they leave and will you help them with treatment or other living arrangements?”

Knowing your child is possibly using drugs is stressful, scary and painful. And it can be incredibly hard to have a calm conversation. If you feel yourself losing control, take a break, and return when you’ve cooled off. Whether your child admits to using drugs or not, having them see a qualified therapist is critical.

Further Reading

Here’s more on symptoms of teen substance abuse, what parents can do, and reasons your child might use drugs and how to help them.

I often have thought of getting a fresh start somehow. I got that opportunity, but in an unfortunate way.

A failed suicide attempt left me completely disabled, unable to work and with a severe hypoxic brain injury that affected many aspects of my life. I had to start from rock bottom and completely rebuild my entire life.

Before the suicide attempt, I had a great job, made great money, bought a new car and had lots of friends that I hung out with often. In retrospect, I had everything and I was proud of myself for working so hard and doing so well.

Behind the scenes, I had a bad drinking problem and was constantly self-medicating my anxiety and depression.

Now I have no job, car, or friends. But I no longer have a drinking problem and do not self-harm or attempt suicide. It is so frustrating having to wait on things that are out of my control and coping with daily life along with a mental illness and a physical disability.

When I asked for a fresh start, I never imagined this would be it. It’s a thousand times harder than it was before, when I had a great life.

I didn’t consider what happened if I survived drinking antifreeze and taking hundreds of anti-anxiety pills. I don’t have a clue where I got the idea or the impulse to do that. I have no recollection of doing it and had no plans to kill myself in the past.

The previous week I was in a great mood, got along great with my family and didn’t feel overly depressed or down. I had just stopped taking a powerful anti-depressant anti-anxiety medication that I had been on for awhile because I switched jobs and lost my health insurance and the medication was outrageously expensive.

Because of that choice I made, I got what I wished for — and a whole lot more that I wouldn’t wish on my worst enemy. I went from being extremely independent to being completely dependent on everybody for everything. I went from working 40 to 60 hours a week to sitting in bed all day, bored and broke.

Eventually, I will work again and function like my old self, but the wait is nearly agonizing on a mind that is so used to being busy. Patience has never been a strong asset of mine, but the last year and a half of having no choice but to wait has taught me that patience truly is a valuable virtue.

Some days it’s impossible for me to see past the clouds of depression to the other side of the storm where it is sunny and calm and holds peace of mind. But I know I can make it through this day, too, and nothing lasts forever — especially emotions. Feelings aren’t facts and too often I trick myself into forgetting that and jump to impulsive, extreme conclusions.

I have to remember that this is a journey and it isn’t always pleasant. I can’t lose sight of my dreams or give up on hope, because then I have nothing to work toward or look forward to.

By inhibiting a small region of the prefrontal cortex — region of the brain responsible for planning and thought — the scientists were able to break the mice’s habits, but, to their surprise, the mice immediately began forming new behavior patterns.

Until now, psychologists and behavioral therapists believed that habits were hidden in the illusive “subconscious.”

But the MIT study shows that the brain is not just aware of habits: it controls them completely, moment by moment. And no matter how long the habits have existed, we can now shut them off, as by the flip of a switch.

The researchers formed habits through repetition and aural cues in mice running through a simple maze over the course of a few weeks. Once they had shown that the habit was fully ingrained, the researchers broke it by interfering with a part of the prefrontal cortex known as the infralimbic (IL) cortex. Using optogenetics, a technique that allows researchers to inhibit specific cells with light, the researchers blocked IL cortex activity for several seconds as the rats approached the point in the maze where they had to decide which way to turn.

The mice’s brains turned from a reflexive, habitual mode to a more cognitive and engaged mode, focused on a goal. Once the mice had broken their old habits, they formed new ones, which the researchers were then able to break again. But the researchers were in for another surprise: the mice immediately regained their original habit. This suggests that habits are never really forgotten, just overwritten or replaced with new ones.

From an evolutionary standpoint, habits make survival simpler by allowing us to make decisions almost automatically, freeing our brain to think about other things as we perform routine tasks. Our brain tends to find familiar, repeatable behaviors out of a sense of security. The problem with “automatic” behaviors is that they leave us vulnerable to forming negative habits, such as procrastinating on bigger projects or smoking cigarettes when driving.

Many fledgling habits go unnoticed because people rarely engage in meta-cognition when undertaking everyday tasks, where habits are likely to form. In fact, as behaviors are repeated in a consistent context, there is an incremental increase in the link between the context and the action — the behavior becomes more automatic. Our habits are a reflection of how we choose to spend time interacting with the world, guided by our short and long term goals — some of which we have had since childhood or seem inexplicable.

When we enjoy certain stimulation, chemicals such as dopamine are released into the brain, relieving stress, improving mood, and providing a sense of reward. But as we repeat the behavior, our tolerance builds, requiring more stimulation to trigger the dopamine receptors.

Sometimes we keep using just to feel normal (dependence), but if the consequences of our behavior become significant and harmful, and the behavior cannot be controlled, our habit is then considered a behavioral addiction, or a process addiction; if it involves illegal or misused substances, it is considered a drug addiction. Those who form “drug habits” often struggle with them for the rest of their lives due to the lasting effects of dependence and dopamine withdrawal on the brain. Like the mice, our old habits are always lurking in the back of our minds.

The ability to break habits in mice may seem like the nexus of a “cure” for addictive behaviors, but it is unclear how inhibiting the IL cortex will affect humans, whose prefrontal cortex is considerably more complex. It is not absurd to imagine a surgery or drug which could hinder the IL cortex in humans, allowing us to escape our negative habits and live reasonably, consciously, unburdened by our old, learned behaviors, but it may not be necessary.

The key to breaking bad habits is becoming aware of the behavior (through friends, family or any support group available); identifying the factors which trigger and encourage its persistence; and altering them however possible.

Similar to describing the feeling of a dream, the context of a habit is important, too: look for indicators and symbols in your everyday life that may stand for something of greater significance and purposefully change their meaning. Keeping a varied schedule is also a passive way to curb habit formation (variety is the spice of life!).

Once you’ve broken the habit, however, remember the mice: you must seek new, positive behaviors that give you a cerebral boost, such as exercising creativity or problem-solving, to keep your brain balanced and healthy.

Or not.

The holidays are stressful. There are the challenges of too much family, not enough family, not enough money, continual exposure to food and alcohol, and perhaps worst of all, the gap between our actual life and our fantasy life. As if gazing into the perfect happy scene within a snowglobe, we might fall into a trance of how our life should be.

We might feel torn apart by nostalgia and grief over the good times and good people of the past, and wracked with guilt and inadequacy for failing to create a more wonderful life for ourselves. We might feel scared about our dissatisfaction and hypnotized by the promise of fulfillment just beyond the hard glass.

Addictive and codependent behaviors thrive during this season of fantasy.

We use our drugs and habits to escape the pain, while imagining how we will miraculously make changes, always tomorrow, or next week, or next year. We frantically try to keep our idea of the all-good holiday alive through our codependent behaviors, imagining that we have the power to make sure that everyone else is happy and no one gets upset, while suppressing our own feelings of anger and disappointment.

So what should we do about our addictive or codependent behaviors during the holidays? Should we just give up and wait until January 1? Or is there hope for progress now?

One option involves using the holiday season to take an honest and compassionate look at our current behaviors. Instead of using up all of our mental energy imagining how our life used to be better, or how our life should be different, or how we need to change, we can turn our minds and eyes toward simply observing present reality.

We can watch our relationships with alcohol, marijuana, cigarettes, chewing tobacco, prescription and non-prescription drugs, gambling, pornography, video games, television or Internet videos, social media, food, exercise, work, and shopping. We can ask ourselves: How much are we using? How much of our time does it consume? How much money are we spending on our habits? How long have we been using? Is it increasing, decreasing, or remaining constant?

We can watch our relationships with our loved ones. We can ask ourselves: How much of our energy is being devoted to worrying about or trying to control other people’s addictive behaviors? How much are we being controlled by fear of others’ reactions to our boundaries or limits?

Then we can ask ourselves: why are we doing this? What purpose does it serve? What immediate rewards do we attain? In what ways are our behaviors fulfilling our needs? Are there feelings of shame, anger, sadness, loneliness, anxiety, or depression tangled up in our habits? How do these feelings lead to our behaviors? How do these feelings result from our behaviors?

How are our habits affecting our physical health? How are our behaviors affecting our relationships with others? How are our drugs, habits, or relationship patterns affecting our work life? What are the short- and long-term benefits and costs?

As we watch and explore our behaviors in an open and neutral manner, we set the stage for our growth toward increased health. We emerge into the New Year with information about ourselves that we need in order to develop a plan of action, if we so choose, toward change. And by being more honest with ourselves and more present in the life we currently are living, we have broken the paralyzing spell of fantasy: We have begun moving toward a better life.

I was able to stop drinking but, like many recovering addicts, I find holidays particularly tough. They can be a dangerous time when recovering from addiction.

My family and friends celebrate the holiday season as many people do — with lovely meals and gifts, gratitude and festive drinks.

I recall my first Christmas sober, three years ago, and the concerted effort my family made, celebrating with more eggnog and less rum. They knew that, early in my sobriety, I was triggered by even the sight of alcohol. Driving past a liquor store would cause my heart to beat quicker. But as the years have passed, and I have become more comfortable in my sobriety, so have they.

Last year, I was surrounded by the bottles I once loved, the liquids I still adore in memory, as my family held their annual Christmas party. No longer did they tip-toe ’round my sobriety and while I was grateful for this sense of normalcy, I was frightened.

I was not frightened because I felt I would relapse and pour rum in my eggnog. I was frightened because alcohol, once a fast and best friend, surrounded me.

I spent a couple of hours talking to people, just enough to pass for being social, and then locked myself in a spare room with a book. The hours passed and laughter become light conversation until the house was blissfully quiet again.

With this year’s holiday season quickly approaching, I plan to deal with the situation differently. I plan to stay sober, just as in previous years, but with less fear.  I have, thankfully, found and maintained relationships with those who are also recovering addicts. I asked them how they felt about sobriety and the holidays. They find it difficult as well. It’s a bit like walking into a bar except you cannot walk quickly away.

A friend who has over a decade of sobriety under her belt told me that the longer one stays sober the easier it becomes to attend events with alcohol and not feel anxious and afraid. Another, new in his sobriety, recognizes his limitations. If he feels uncomfortable in a situation he gracefully leaves. Maintaining sobriety is the most important thing a recovering addict can do.

Addiction is a dangerous disease and the road to recovery is paved with events, holidays and gatherings that remind us that we may still be fragile. But it is this knowledge that allows us to grow.

This year, when I see a bottle of red wine, I will not hide in a spare room with the door locked. I will remember that my sobriety is defined by sanity and in order to stay sober I need to expose myself to the things which scare me.

Someone enjoying eggnog and rum? That’s a good place to start.

There’s a space between normal behavior and an official diagnosis called “almost addicted” that has serious consequences, according to Dr. J. Wesley Boyd, MD, Ph.D, an assistant professor at Harvard Medical School and author of the book Almost Addicted: Is My (or My Loved One’s) Drug Use a Problem?

People who are almost addicted still struggle because of their drug use. They may have problems in their personal or professional lives. They also might meet criteria for drug abuse or dependence in the future — at which point it becomes tougher to treat. Intervening now can lead to healthy changes and prevent a full-blown crisis, said Dr. Boyd, also a staff psychiatrist at Cambridge Health Alliance.

Warning Signs of Almost Addiction

People with drug problems are easy to spot. This is actually the biggest myth about drug use, Boyd said. One of his first patients was a professional who was using hundreds of milligrams of oxycontin, every day, for over a year. His wife had no idea. His co-workers had no clue. And there were no complaints about his work performance.

(He finally got caught after a pharmacist called the police. Fortunately, after treatment, years later, he was still drug-free.)

But there are signs to look for. In Almost Addicted Boyd features the Drug Abuse Screening Test (DAST) along with other key questions. These are some of the obvious and not-so-obvious signs he mentioned:

• Abusing prescription drugs
• Inability to get through the week without using drugs
• Feeling guilty about drug use
• Having loved ones worry about your drug use
• Being told by loved ones that your behavior is strange
• Losing friends over drug use
• Losing a job over drug use
• Engaging in illegal activities to get drugs
• Not giving your full effort at work because of drug use
• Writing work emails or doing other things online while under the influence and regretting them later
• Divulging important information about work while under the influence
• Embarrassing your family
• Berating loved ones while under the influence
• Cheating on your spouse while under the influence

How Loved Ones Can Help

There are many things loved ones can do, Boyd said. These are his suggestions:

Don’t enable the behavior. Don’t make it easy for your loved one to keep abusing drugs, Boyd said. Consider how you might be feeding their habit. Take the example of a mom who was giving her teenage son money for lunch and the mall. He kept asking for more money more often. Turns out, as he told Boyd, he was using the cash to buy drugs.

A loved one also might make excuses for a family member who misses work after a night of drug use. “Covering for the behavior allows it to continue longer than it might,” Boyd said.

Talk to your loved one – and stick to the facts. When approaching your loved one, be as straightforward and objective as possible, Boyd said. It’s certainly easier said than done, but try to keep your emotions out of the conversation.

“Whether they’re almost or full-on addicted, most people live in denial,” he said. So if you tell someone “I think you’re abusing drugs,” they’ll likely just deny it. Instead, let the facts drive your conversation. Say “I noticed your eyes were bloodshot and you showed up late to work.”

Ask others to step in. If your loved one is in denial, gather support. For instance, if the person is religious, ask a clergy member to speak to them, Boyd said. If they’re not religious, ask a primary care physician, he said.

Employ leverage. If your loved one refuses help — or again is still in denial — Boyd encourages families to employ any leverage they can (within legal limits, of course). In the adolescent substance abuse program at Boston Children’s Hospital, Boyd and his colleagues use the 7 Cs of leverage: cash, credit card, checks, car, cell phone, computer and curfew.

When you have little or no leverage, rely on the law. For instance, while it’s incredibly difficult, if your loved one is facing legal charges, Boyd advises families to “let the law run its course.” Often, he said, these individuals will be put on probation, which includes drug testing. As he said, “any period of enforced sobriety is better than no sobriety.”

What You Can Do

If you’re the one who’s almost addicted, consider your relationship with the drug openly and honestly, Boyd said. See a mental health professional who specializes in substance use or a primary care physician, he said. Attend support groups such as Narcotics Anonymous or Alcoholics Anonymous. “The only request for going to these meetings is the desire to stop using your substance,” he said.

Some people may be able to quit on their own, Boyd said. For instance, since her teenage years, Boyd’s mom smoked two packs of cigarettes every day. After learning she had early emphysema, she quit cold turkey.

However, if any aspect of your life is at risk – such as your ability to work or keep your home – or there’s an immediate threat to your health, seek professional help right away, he said.

No one is immune to addiction, Boyd said. One of his supervisors, a substance abuse expert, used to say, “As far as I know the reason I’m not a heroin addict is that I haven’t tried heroin.”

Even casual use can become too much. If you’re almost addicted, seek help. If your loved one is almost addicted, offer help.

Learn more about Dr. J. Wesley Boyd at his website. More on the book Almost Addicted here.

Knowing that food cravings are much like other addictions can be disheartening and you might despair that you will not be able to make changes.

The good news is that there are several effective strategies to delay eating craved food and weaken your habitual response to food.

Acceptance vs. Fighting Your Urges

Many turn to dieting, in an attempt to fight urges to eat.  But fighting urges has two problems: it often makes them stronger, rather than weaker; and when we lose the fight and ultimately give in to our cravings, we learn that we can’t control them and lose motivation.

It might seem counterintuitive, but accepting your cravings, rather than trying to fight them, is one of the most effective methods for changing your response to food.

In an experiment conducted by Dr Robyn Vast, participants learned to control urges to eat chocolate by accepting that they would have these urges.  They underwent training to notice thoughts and cravings related to eating the chocolate.  Rather than try to push these thoughts away, they were instructed to think of them as merely thoughts, not a physical need that must be acted upon.

81% of subjects who were taught this technique were successful in resisting the urge to eat chocolate, compared to 56% of a group taught different cognitive techniques and 43% of a group who were not taught any techniques.

This technique is similar to one used with drug and alcohol addictions, called “urge surfing.”  When “urge surfing,” you notice your urge and attend to it without acting.  You notice how these urges come and go like waves, at some times intense and at others weak.

Additional Strategies to Fight Food Cravings

Other techniques that delay acting upon cravings can weaken the strength of your cravings over time.  Some of them include the following:

• Imagine you are eating the craved food.  Simply imagining the food will increase your craving, but imagining eating the food can decrease your craving.
• A new study found that exercise can cut food cravings (found in the journal, Medicine & Science in Sports & Exercise).
• Distract yourself with scents of flowers or by chewing gum.  This delay in satisfying a craving can weaken the urge.
• Set a timer when you experience a craving and then distract yourself with something else.  Often when the time is up, the craving has passed.

In order to curb your cravings you may need to think about food and eating differently.  We are not in a war with food that requires us to avoid it, restrict it or fight what we long for.

Instead, we can recognize that our longings and desires for certain foods are just thoughts, often triggered by our environment, hormones or a desire for comfort.  Try telling yourself, “That’s a thought about craving food” the next time a craving hits, and then move on with what your were doing and see if you notice a change in how often you give in to a craving.

Is it cupcakes, potato chips, bread, a big bowl of pasta, cheese fondue, fried chicken, pizza, ice cream or something else?

Do you crave something creamy that melts in your mouth or a salty crunch that takes the edge off?

If you do, you’re similar to 100% of women and 75% of men who reported food cravings in the last year, according to a report in the Wall Street Journal.

Cravings, once considered the body’s way of signaling that we’re missing important nutrients, are now understood to be something quite different.  If they were merely a signal that we were short on, say, magnesium (a nutrient found in chocolate), then why do we tend to crave salty and sweet snacks, rather than healthier options of nutrient rich foods?

Bran, pumpkin seeds and molasses all contain magnesium, but rarely rank high on anyone’s cravings list.

Instead, The Wall Street Journal reports that studies suggest that cravings are a complex combination of different factors.  Social, cultural, psychological and environmental cues all play a part in whether you experience a craving or not. Craving mom’s apple pie or creamy mashed potatoes are often more about the emotion they evoke than the taste of the actual food or the nutrients found in them.  A hot dog at a ball game or popcorn at a movie are often more about the environment than hunger.

Cravings are powerful things.  They are triggered by our environment, our internal need to soothe ourselves or evoke a particular feeling, our cultural expectations and by the people around us.  Not only are they triggered by a wide variety of circumstances, they also affect our bodies like an addiction.

Research on the brain indicates that food cravings activate the same parts of the brain as drug and alcohol cravings.  And, like drug and alcohol, giving in to the craving results in a release of dopamine, the neurotransmitter in the brain that plays an important role in the experience of pleasure.

But, when we give in to cravings too often, our dopamine receptors become flooded.  The neurons compensate for this overload of dopamine by becoming less sensitive.  What this means is that with continued overindulgence, more and more food is required to create the same pleasurable experience.

Instead of craving one cookie, you crave a whole box, and even that doesn’t feel satisfying.  Pam Peek, a physician and author of the book “The Hunger Fix” notes that food addiction changes the brain in the area associated with impulsivity and addictive urges.

The idea that we are constantly surrounded by circumstances that cause us to crave food—often that which is sugary, salty or otherwise unhealthy—can be disheartening.  However, studies show that as we learn to delay gratification and hold off on satisfying our cravings, our urges become weaker.

Although curbing cravings can be difficult, particularly if you’re already in a pattern of indulging, you don’t need to live at the mercy of your cravings.

Often, we view our mental health, physical health and lifestyle as existing on separate planes – and there’s good reason for that.  How we care for our mental and physical health, and who we go to for help, differs. Lifestyle can often be an afterthought or seen as unrelated to our health in any substantial way.

But, when we take a closer look, our physical health is tied to all aspects of our life.

Take the example of heart disease.  Heart disease is currently the leading cause of death for both men and women in the United States. In 2010, coronary heart disease alone was projected to cost the United States $108.9 billion.

This is a physical health problem for which we would see a medical doctor for treatment.  Depending on the extent of the problem, treatment might include medications, surgery or other medical interventions.  In this day and age, your physician would likely provide you with information about lifestyle, but treating the disease with medical intervention is the primary focus.

But in the case of heart disease it’s connection with both lifestyle and mental health is basic.  It’s a mistake to treat heart disease medically, while overlooking or undervaluing how lifestyle and mental health impact the course of the disease.  According to Antonio Puente, PhD, a psychologist who has worked closely with the American Medical Association, psychology is linked to all health-related problems.

Heart disease, for example, is exacerbated by lifestyle choices, such as eating a diet high in saturated fats and cholesterol, physical inactivity, obesity and excessive use of alcohol.

Heart disease is also affected by our mental health.  For example, high stress levels can increase blood pressure and create additional strain on the heart.  Anxiety and depression often decrease our adherence to treatment and cause us to cope unhealthy ways, say by drinking too much alcohol or by smoking. Medical health problems often exacerbate mental health problems.  The result is often a reciprocal relationship, in which physical health problems intensify anxiety, depression and other mental health problems, which results in decreased treatment compliance, problematic coping and more physical health problems.

Puente contends that medical health problems respond well to behavioral interventions.  Psychologists have the expertise to help people change unhealthy lifestyle choices, cope more effectively and improve their mental health.  That, along with knowledge of scientific evidence, can have a significant impact on how you prevent and manage conditions like heart disease.

The mistake we so often make when we go to a medical doctor is to overlook the mental health and lifestyle choices that are fundamental to our physical problems.  Treating health problems by acknowledging the impact of lifestyle and mental health can be challenging, but the impact can be life changing.

Digestive problems, including bloating and irritable bowel syndrome (IBS), are an increasing concern.

Have you ever noticed that you’ve just eaten something and can hardly remember what it tasted like? Kind of like eating on autopilot? Our busy and stressful modern-day lifestyles may have to do with this. Our minds are so busy planning our next move that we don’t allow time to savour the food we eat, or allow time for it to digest.

It takes 10 minutes for your brain to detect the body’s signals that you’re feeling full. Eating quickly can mean that you could easily consume way too much food before your body tells you to stop, leaving you feeling uncomfortably full.

I believe that how we eat our food is just as important as the food we eat, and this is where mindful eating comes into play.

Mindful eating is a powerful tool for weight loss, stress reduction, and increasing nutrient absorption. Best of all, it doesn’t cost a thing and requires little interruption of daily life.

Mindful eating helps you to feel more pleasure when eating. By noticing and enjoying the pleasurable tastes and sensations during a meal, you’ll feel more satisfied and therefore less likely to want to eat more.

So How Do You Eat Mindfully?

1. Put aside an extra five to ten ninutes for eating and digesting
2. Minimize extraneous distractions (turn down or turn off the radio, TV or phone)
3. If friends or family ask you what you’re doing, politely say “I’m just noticing/enjoying my food!” Then rejoin the dinner conversation.
4. Count the number of times you chew each bite (aim for thirty).
5. Enjoy sensations, flavors, sounds, smells, and sights one at a time, as if you’re doing a wine tasting.
6. It’s OK if you get distracted and drift off. This is completely normal. If this happens, you haven’t failed. When you realize this has happened, simply acknowledge it and come back to noticing.
7. After the meal, sit still without eating for five minutes. Every one or two minutes, pay attention to sensations in your stomach and feelings of fullness. Just see what you notice.
8. If you don’t have time in your schedule to eat mindfully for every meal, that’s OK. Perhaps start off with one meal per day or one day per week and notice how it feels. If you like it, then maybe do it a little more, bit by bit.

There’s enough doom and gloom and negativity in the world around us. Eating is one of those simple pleasures that we’ve forgotten about. Eating mindfully is a way to get back in touch with the pleasure of food, and it comes with many benefits to our health and well-being. As the Buddhists say, “it’s not what you eat, but how you eat it.” So why not give it a try?

As often is the case with advice for managing your weight, finding a solution is easy — putting it to practice in your daily life can be much harder! The psychological issues surrounding weight management and healthy relationships with food can be complex. Psychology can help uncover these issues and provide you with a plan for long-term, meaningful change.

Frank Bruni was a fat kid.  He was also the New York Times food critic from 2004-2009 and the best-selling author of Born Round: The Secret History of a Full-Time Eater.  In his deeply moving memoir, he explains the problems and perils of being fat and the emotional struggle food caused him as a child and an adult.  He said he wanted to write his memoir to show  “what food could do to trip people up.”

Apparently food can do a lot to trip you up.  Being obese can have a devastating impact on life. A child born in this century has a one in three chance of developing diabetes and an alarmingly high percentage will suffer obesity-related conditions such as cancer, asthma, high blood pressure and heart disease.  Those numbers go up dramatically in the Hispanic and African-American communities:  Right now 40 percent of these children are overweight or obese.

With these statistics, is it any wonder that Michelle Obama would introduce Let’s Move to combat childhood obesity?

I was a fat kid too. Nutrition and exercise have always been passions of mine as an adult, and I take an interest in movements and programs that help children and families learn to live healthier lives.

The solution to childhood obesity seems clear: It lies in early correction and prevention through diet and exercise.  This will help curtail lifelong health problems, financial burdens and issues associated with social bias. Movement, along with diet, is a key ingredient in the formula for change. We need to make time for it and use that time well. While a walk around the block will help, there are some powerful, inspiring programs that are leading the way to something a bit more engaging and dynamic. 

One organization, the Jump for Joy Foundation, is making a real difference.  J4JF is one of the most proactive fitness nonprofits nationwide, especially when it comes to childhood obesity prevention.  It works through the power of inspiration and knowledge. J4JF is the brainchild of former UNLV students and camp co-founders Anthony Alegrete and Branden Collinsworth. “We want to make it cool for kids to be fit,” Collinsworth says. “Because we’re competing with Facebook and video games, we want to make it one of the coolest experiences that they’ve ever had and something they can take with them the rest of their lives,” adds Alegrete.

As the research shows, Alegrete and Collinsworth know what they are up against.   The duo formed a partnership after Alegrete began employing Collinsworth as a personal trainer. The results were remarkable enough that Alegrete told Collinsworth they had to do the same for kids.

The fitness expert and the businessman joining forces made a win-win situation.  But there is a twist to the story.  Ironically, Alegrete struggled with being underweight.  Over time, he gained 20 pounds of muscle and got into the best shape of his life. “Without Branden,” says Alegrete,  “I never would have found this direction.”

I met Branden in the Masters of Applied Positive Psychology program at the University of Pennsylvania. He is learning to bring the science of positive psychology to children to help create a positive social identity.  Naturally, I wanted to learn more.

The first J4JF camp in 2010 drew three kids, but since then — through social media, the press, and word of mouth — they have became the “cool” guys of fitness and nutrition.  They have now had over 100 events and camps and have helped over 3,000 kids.  Although J4JF is housed at the Pearson Community Center in North Las Vegas, they also take their program on the road when necessary. They expose children to healthy social identities by offering such fun, friendly and diverse activities as basketball; dance; mixed martial arts; football; jump rope and hiphop.

The men make exercise fun and hip by bringing in celebrity athletes and entertainers and giving parents tools and education. Past celebrities have included professional boxer Lightning Lonnie Smith; KB of the Jabawockies High Profile and Prodigy dance crews; Hey Reb, the UNLV mascot,  professional breakdancers; UFC fighters Gilbert “the Hurricane” Yvel, Kevin Randleman, Stephan Bonner, and Larry Mir; UNLV football stars; and even James Brewster Thompson, the world record holder in rope jumping.  He wowed the camp-goers by jumping with a 6-pound metal chain for his “rope” and three people on his back.

Kathryn Tristan, author of the forthcoming book Why Worry? Stop Coping and Start Living (available December 4, 2012), reveals three common tactics that can backfire.

Q: What are some anti-anxiety strategies that actually don’t work?

A: Often people use three common coping strategies that do more harm than good. In a nutshell, these are pills, booze, or avoidance.

Scientific studies suggest that 1 out of 2 people in the U.S. will suffer at some time in their life from anxiety, depression, or addiction. That means you, me, someone in our family, a friend, etc., is currently or will be dealing with one of more of these life-altering issues.

Why?

It all begins with how we worry and handle our challenges and stresses. Worry is at the nucleus, the core, and the heart of these very serious and debilitating problems. We don’t handle worry productively or even realize how we can help ourselves.

Pills: Medications can be a wonderful asset. Drug companies spend billions in research to develop medications that can provide therapeutic help. The problem is relying on them and not solving the problems and stresses that seeded the need for them. Medications may or may not work. They also may be addicting or have side effects.

Booze: Having a glass of wine with a meal, or a beer with a pizza can be very enjoyable. But if you are guzzling four martinis every evening to feel better, you are creating more problems than you are solving.

Avoidance:  Avoiding or ignoring problems can be a coping strategy that allows one time in order to derive some clarity. But often when we begin to avoid things that we fear, the circle of fear enlarges and can quickly shrink our comfort zone. Without solving the problem in some way, storms remain on the radar ready to downpour on a moment’s notice.

As always, balance is the key.

Learn more about Tristan and her upcoming book at her website.

Fortunately, a number of treatment practices exist that can assist an individual in adopting positive behaviors. If you or a loved one has been diagnosed with a mental health condition and has problem behaviors, consider talking to a mental health provider about the benefits of Positive Behavior Support (PBS).

What is PBS?

Positive Behavior Support (PBS) is a philosophy for helping individuals whose problem behaviors are barriers to reaching their goals. It is based on the well-researched science of Applied Behavior Analysis (ABA). A key component is understanding that behaviors occur for a reason and can be predicted by knowing what happens before and after those behaviors.

PBS interventions are designed both to reduce problem behaviors and increase adaptive, socially appropriate behaviors. These outcomes are achieved through teaching new skills and changing environments that might trigger problem behavior. Prevention of problem behaviors is the focus, rather than waiting to respond after a behavior occurs. PBS strategies and interventions are appropriate for children and adults diagnosed with a variety of mental health conditions such as schizophrenia, depression, autism, and intellectual disability.

Who is Trained in PBS? What Do They Do?

Mental health professionals, such as psychologists and behavior analysts, are trained to complete assessments and design PBS interventions. They conduct assessments, called structural and functional behavioral assessments, to determine when, where and why problem behaviors occur. For example, a mental health professional may conduct an assessment of a student who is identified at risk for expulsion and alternative school placement due to profanity and disruptive behavior in the classroom. The goal would be to learn what the student is achieving by using those behaviors.

A typical assessment would include several observations in different locations to determine which behaviors are problematic. It then would identify the environmental triggers that predict when those behaviors will and will not happen. The mental health professional would talk with the student, his or her family, teachers, other treatment providers and friends to answer questions about the problem behaviors.

From there, the professional would develop treatments that match the reason that the student is using the problem behaviors. These treatments include developing strategies to replace problem behaviors with appropriate behavior.

By learning and using new skills, an individual can stop using problem behaviors. For example, an individual diagnosed with schizophrenia may break the ceiling fan in her home because she believes that the fan is yelling at her. The mental health professional will teach her coping skills such as mindfulness, deep breathing, journaling, asking for help, or muscle relaxation. This gives her other, more acceptable behavior options to use the next time she believes that the fan is yelling at her.

While the mental health professional may lead the development of PBS treatments, the individual leads the implementation by learning and using these new skills or replacement behaviors. Additionally, key people in the individual’s life such as family, friends and co-workers learn how to implement PBS treatments to change the environment to support the individual.

Why use a PBS Approach?

PBS emerged in the 1980s to understand and address problem behaviors. As a holistic approach to treatment of mental health conditions, PBS has many attributes:

• It is person-centered. Using a person-centered approach, PBS addresses the individual and respects his or her dignity. This includes listening to the individual, recognizing the individual’s skills, strengths, and goals, and the belief that the individual can accomplish his or her goals. Treatments are developed to fit the specific individual rather than a “cookbook” approach.

• It causes positive changes. Through environmental changes and reinforcement of adaptive behaviors, individuals can reduce problem behaviors. Coping mechanisms such as relaxation can take the place of the problem behaviors. PBS minimizes the need for punishment or restrictiveness such as restraint, seclusion, or removal of privileges.
• It is outcome-focused. PBS places an emphasis on outcomes important to the individual and to society. These behavioral outcomes, such as fewer aggressive incidents, have the ability to make homes, communities, hospitals, and schools safer.
• It provides collaborative support. PBS involves collaboration with those who support an individual, including caregivers, support providers, doctors, nurses, teachers, aides, nurses, social workers, and team leaders. This collaborative process keeps everyone involved in the individual’s treatment and allows for new behaviors and skills to be supported in all settings.

Does PBS Work with Other Treatments?

PBS may be practiced alongside other treatment interventions as part of a multidisciplinary approach to mental health treatment. For example, an individual who is prescribed medication by a physician or psychiatrist for mental health conditions such as schizophrenia, autism or impulse control disorder could benefit from PBS. An individual who sees a dietician to help with specific nutritional needs such as in Prader-Willi Syndrome, or receives occupational, speech, or physician therapy, may also benefit from PBS techniques.

PBS is consistent with other treatment approaches that are person-centered or recovery-based. This means that they can work well when used together. PBS interventions are inconsistent with restrictive or punishment-based interventions. PBS interventions are used instead of these approaches.

Since PBS is a holistic approach, and clinicians consider all aspects of an individual when assessing and developing interventions, it is helpful for a PBS clinician to become a member of an individual’s interdisciplinary team. PBS-trained professionals have experience working directly with other health care professionals to design treatments. For example, a PBS-trained professional may work with speech therapists to develop communication boards for non-verbal individuals who engage in self-injurious behaviors such as head-banging or skin-picking.

Without treatment, the consequences of mental illness are astounding: disability, unemployment, substance abuse, homelessness, incarceration, and suicide. While medication and other interventions have proven to be beneficial in many mental health conditions, a multidisciplinary approach that includes a behavioral component can offer support mechanisms critical in the treatment process.

Talk to a mental health professional about the benefits of PBS.

Diverse opinions on either side of the many issues in our society are common; the people in power still argue about gay marriage and abortion, religion and taxes. It’s fair enough for people to take sides, but when it comes to medical marijuana, it is worth the debate.

Like all social and political issues that start slowly and suddenly catch fire, the opinions regarding the use of medicinal marijuana are exhausting. ProCon.org, an accredited website that focuses exclusively on the use of medicinal marijuana asks the question: “Is medical marijuana an effective treatment for depression, bipolar disorders, anxiety, and similar mood disorders?”

Let’s find out.

ProCon intelligently presents the reader with both sides of the argument and feedback derived from diverse and educated sources.

Frank Lucido, MD, a private practice physician, stated in his article on the topic:

With appropriate use of medical cannabis, many of these patients have been able to reduce or eliminate the use of opiates and other pain pills, Ritalin, tranquilizers, sleeping pills, antidepressants and other psychiatric medicines…

This might be a stretch: Psychiatric medication will always have a predominant place in the treatment of mental illness and recovery. This aside, Lucido makes a valid point: It is possible that medicinal cannabis — when used correctly — can be of some notable benefit to psychiatric patients.

Research into the topic of medical marijuana makes it evidently clear that both sides of the debate are in good company.

A patient perspective is an equally important aspect of such a debate. Bearing this in mind, I spoke to a man who utilizes medicinal marijuana on a regular basis to treat insomnia and anxiety. He also takes an atypical antidepressant. I was able to speak to him about the process of acquiring medicinal marijuana, his opinion on its effectiveness, and his perspective on its legalization. To protect his anonymity and privacy, his last name will not be used.

Justin is 29 years old. He works in a busy office and lives with his partner in a condominium downtown. They want children one day. He is easy to talk to, and there is nothing distinctly different about him. He is not the kind of person one might expect to use medical marijuana.

I asked Justin if he has a history of drug abuse. It is often assumed that those who regularly use cannabis, medicinal or not, are former addicts. His response did not surprise me. Like most 20-somethings who spent four years in university, Justin admitted to drinking too much once in a while and occasionally smoking marijuana, but he was no different than the majority of his friends in taking part in such campus culture.

Justin had struggled with depression and anxiety for most of his life. It had recently worsened due to the stress of a new job. Although he had been on an antidepressant for a couple of years, he found that it did not work well enough.

Justin went to see his primary care physician when the frequency and severity of his insomnia and anxiety increased. After asking some questions, she asked him if he had ever considered medicinal marijuana.

“It wasn’t really something I expected her to say. I’ve been her patient for years now… It came out of left field, to say the least,” Justin recalled. (Personal interview, July 1, 2008)

Justin walked out of the doctor’s office with a prescription, but it was in stark contrast to all the prescriptions he’d received over the years. Rather than the local pharmacy, this one directed him to a medicinal marijuana store. Justin told me he was not sure what to expect. Using marijuana to combat anxiety and insomnia was not something he’d initially considered.

I asked Justin about his experiences in obtaining medicinal marijuana for the first time. He said he wasn’t sure what to expect.

“The store had no windows, and the sign was [barely] large enough to recognize. To be honest, I wanted to turn around, but the experience was much different than I had envisioned. The man I spoke to asked me about my symptoms in detail. He explained which strains would help me sleep and which would help my anxiety level.”

Justin left the store with a small amount of medicinal marijuana and a card explaining that he was legally able to have it on his person. He received an official card in the mail a few weeks later that would keep him from being arrested for possession.

Why did Justin and his doctor consider medicinal marijuana to treat his symptoms?

“She gave me other options,” he said. “I could have moved up my antidepressant, but I always suffered with side effects that made it hard to function, or I could take drugs for anxiety like Ativan, but drugs in that class have a huge potential for addiction and tolerance…I started to think of medicinal marijuana as I think of my antidepressant: a drug that helps me function on a basic and important level. I was able to sleep, and unlike waking up with a ‘drug hangover,’ as I have experienced when using prescribed sleeping pills, I woke up ready for the day. My anxiety also diminished.”

Medicinal marijuana is not the same as “street marijuana.” It is free of dangerous additives and often is grown indoors. Not all patients who are prescribed medicinal marijuana report a positive experience, though that is often the case. Justin found its use positively affected his quality of life.

“People need to view medicinal marijuana as a tool that is often safer than prescribed medications,” he said. “I understand the controversy. Society needs controversy in order to come to a conclusion. I believe it’s only a matter of time. We need to look at the bigger picture: People can purchase cigarettes and liquor, but we cannot, without prescription, utilize medicinal marijuana.”

Both sides of the debate offer valid points on the effectiveness of medicinal marijuana in the area of psychiatry. Research is important, and much can be gleaned from it, but just as important, perhaps, is the valuable feedback from those who use and rely on medicinal marijuana for the alleviation of psychiatric and physical ailments.

References

Lucido, F. (2005). Implementation of the compassionate use act in a family medical practice: Seven years clinical experience. MedBoardWatch.com. Retrieved from http://drfranklucido.com/implementation-of-7-year-plan.htm

ProCon.org. (2008, May 30). Is medical marijuana an effective treatment for depression, bipolar disorders, anxiety, and similar mood disorders? MedicalMarijuana.ProCon.org. Retrieved from http://medicalmarijuana.procon.org/view.answers.php?questionID=000226

Pantoliano is also the founder of No Kidding, Me Too! (www.nkm2.org), a nonprofit organization “whose purpose is to remove the stigma attached to ‘brain dis-ease’ through education and the breaking down of societal barriers.” He produced and directed the documentary No Kidding! Me 2!!, an intimate look at the experiences of Americans living with mental illness.

Pantoliano has more than 100 movie, TV, and stage credits, and won an Emmy Award for his work on “The Sopranos.” His first book, the memoir Who’s Sorry Now? The True Story of a Stand-up Guy, was a New York Times bestseller. He was born in Hoboken, N.J., and today lives in Connecticut.

Q: In the introduction of Asylum, you say that you wrote the book “to eliminate the shame and obliterate the blame.” Why do you think there’s so much shame surrounding “brain dis-ease”?

A: It’s a question that’s been asked in the last 200 years, 2,000 years. I’ve been thinking up quotes that have caught my attention since I got into this advocacy and I put them on Joey’s pages. One of the things I like to quote is from Socrates:

“…madness, provided it comes as the gift of heaven, is the channel by which we received the greatest blessing.  …the men of old who gave things their names saw no disgrace or reproach in madness; otherwise they would not have connected with it the name of the noblest of all arts, the art of discerning the future, and called it the manic art…  So, according to the evidence provided by our ancestors, madness is a nobler thing than sober sense… madness comes from God, where as sober sense is merely human.“

What I do for a living requires a lot of states as an actor. They trained me to utilize my God-given gift by a series of exercises and getting yourself into a meditative state. Concentrated relaxation was important.

When you have inspired moments in your work, how do you take credit for that? You really have nothing to do with that. What if we chose not to call it mental illness? The fact we’re a bit more sensitive to our environment, it’s applicable to what we pick up, and so it’s the manic art.  The dopamine and serotonin are just pumping; it’s an unrealistic high you’re creating. And when you run out, [when you’re] on low, you’re crashing down.

I found out that Abraham Lincoln had melancholia and was dyslexic. He didn’t write long speeches. There’s evidence that the evening before he went to Gettysburg, he talked to his driver about the battle and actually wrote his notes on the back of an envelope.

These inspired moments create our heroes. And then history decides to eliminate what they deem negative. The future Americans don’t need to know that he had melancholy or that his wife died in a mental asylum.

I also think that we perpetuate the stigma and shame. As different organizations continue to try to end the stigma, they’re creating it. They try to raise money to find the cure for the passion. I believe [brain dis-ease] is a result of our environment.

We as a species [need to] learn to embrace the warning signs. All it is in most cases is that we’re warning ourselves that we’re afraid of losing something.

I actually got a message from a musical performer and he said, “I have this terrible anxiety, I don’t know what to do with it.” I asked, “When do you get it?”

“Right before I go on.”

I told him, “But everybody gets that. That’s good. It’s your inspiration starting to kick in. You want to work inside of it.” I think that TV, commercialized advertising has given us so many new diseases.

That’s what we should do with mental health. Get these people to advertise that it’s actually cool to talk about your emotional life, cool to have feelings and be out there. It’s what makes you unique.

[But I also learned] that I have a mood dis-ease that’s driving me to feel this way. This is fixable, and we are not alone.

Q: In your book you talk candidly about your struggles with clinical depression and what you call your “seven deadlies”: food (overeating or starving); vanity (such as status symbols); shopping and shoplifting; success; sex; alcohol; and prescription drugs. Can you talk more about your struggles?

A: What I discovered first of all, when I started working with a psychiatrist, Dr. Telly, was that I was sublimating my mood swings with alcohol and the abuse of painkillers. I was killing the pain inside of me but ultimately killing myself.

Even though everything was great and I should’ve been feeling wonderful, I had nothing but confusion. What was I confused about personally? When did this happen? Where did my smile go? Why do I feel this way?

I was turning 50, and I wasn’t ready for it. My friend had committed suicide and all of the coping mechanisms that I’d created weren’t working anymore. The feeling was the same. When I was home back in N.Y., I realized that in numbing my pain, I couldn’t compartmentalize my pain only. I had to numb everything. My joy, my happiness. I couldn’t feel anything.

I never thought my mom was mentally ill. She wasn’t crazy.

In 2005 I made a movie called Canvas, in which I played a loving father of a 10-year-old son. We find out that my wife is sick and has schizophrenia with auditory hallucinations. The film focuses on what happens to the family and how her illness affects the neighborhood. (Everyone becomes embarrassed and they withdraw from us.) As Marsha Gay Harden, who plays my wife, began putting her character together, she started reminding me of someone — my mother.

I never thought my mom was mentally ill. She wasn’t crazy. She wasn’t seeing things. I just thought she was Italian-American. When I started getting better, I realized that the feelings I was having resembled what my mom went through in her early 50s.

I was wrong. [Her behavior] wasn’t willful. I thought my mom chose to be miserable and she could’ve fixed it if she wanted to. Then I realized I had what she had. She was not responsible.

When the movie came out, everybody praised my performance. Everywhere I went I met marvelous examples of recovery. [In fact] There’s an 80 percent full recovery rate of all forms of brain dis-ease.

Q: What has helped you recover?

A: What changed my life was having had a spiritual awakening and going through the 12-step program. I was as sick as my secrets. A lot of what was troubling me was the past that I stuffed down as well as my feelings.

In the first step in recovery, you admit that you are powerless over fill in the blank, sex, drugs, gambling, alcohol. I couldn’t just play, I had to bet the house. I couldn’t have a piece of cake, I had to have the whole pie. I was powerless over life, and [my life] had become unmanageable.

I was taking a leap of faith. There was a power greater than myself.  I chose to believe that there was a God.

If you’re an atheist, you can praise the universe or the sun to help you stay away from [problems like] gambling. Make that leap of faith and ask for help today.

In the next step, you say that “I believe in you,” and you let him do it. Then, you admit everything you’ve ever done in your life, including all the shitty things. You tell them to another human being; you can tell it to clergy, your sponsor, your psychiatrist. In doing that, a big weight is lifted.

Then you make a list of all the people you harmed and amend that. And to every person you ever screwed, you say you’re sorry — unless to do so would injure them any further.

[Today] I also go to the gym, I do yoga, I try to meditate, I try to take a nap, take a walk.

Doctors say that if you change your behavior, if you move a muscle [that can] change the thought. When you’re in crippling depression, you get up and put on your favorite movie, dance or jog.

I also can’t have anything with sugar. It alters my state of mind. That’s why I go to meetings; I can talk about the cravings, what pissed me off this morning. Yesterday I wrote a long letter to my wife and daughters, because I was frustrated that they don’t clean up after themselves. I learned that in the 12-step program.

That’s what I’m doing today. I’m semi-retired. I’ve been semi-retired since I’m 18 years old.

Q: In the book you also include the words of your wife, Nancy, who shares what it was like living with you when you were severely depressed. What would you like families to know if their loved one is struggling with a form of brain dis-ease?

A: They should just listen. I went to Iraq with Lisa Jay and Dr. Bob Irvin from McLean Hospital, where the soldiers shared their experiences with us. The biggest pain in the ass of all is when they tried to talk about how they felt, but people would just compare [their problems].

Talk to one another, say how you feel and leave your rank outside the room.

Q: In Asylum, you write that in many ways your dysfunctional life was rewarded by being an actor. For instance, you channeled that trauma into your acting roles. Many people worry that treating their brain dis-ease will sap their creativity. Do you think that’s true?

A: When my doctor, Dr. Telly, pitched the idea of medicine, I was worried because my emotions are my instrument, my business.  In my work I could always feel my feelings. In my first acting class I was told that you got to keep the child inside of you alive. You have to be as innocent as a lamb and as ferocious as a tiger.

It was just in my life that I couldn’t [feel my feelings]. In my family life, I was taking a beating.

But Dr. Telly said that this medicine is so miniscule that if you were pissed off, you’d have the appropriate response. And if I didn’t like it once I started taking it, I could stop.

When I started taking antidepressants, I didn’t have to take the alcohol or Vicodin. [Before] I thought that I made myself nuts with the kind of work I learned, creating a non-linear reality to the reality that was happening in [my performances]. But the doctor said that what I did was create a craft that could sublimate pain into a character. And so there were baby earthquakes instead of having the big 9.4.

Q: Anything else you’d like readers to know?

A: The reason why I’m talking about [brain dis-ease and my struggles] is that I’m hoping [it will get people talking]. I gave the book to a mailman, because he wanted a copy. I saw him today and he said, “Joe, I’m reading your book, and I’m liking it so much and I can relate to it.” People are writing me, they see what I’m talking about and they want to feel better too. That’s the whole point of this. You know, we can heal ourselves. We can be healed.

For more information please visit http://www.nkm2.org, and follow Pantoliano on Facebook and Twitter.