The following are descriptions of common mental health problems that affect some college students. While the symptoms may vary from student to student, the following descriptions may help provide you with some basic information about these disorders.
If you have concerns that you, or a friend of yours, may be affected by one or more of these problems or disorders, please call the Counseling Center to consult with our staff.
Anxiety is often described as intense worry or a sense of being fearful. Students may have a sense of tension, discomfort, unrest, feel jittery, or on edge much of the time. Those who are anxious often have a preoccupation with negative thinking and a sense of doom. Counseling can help students learn coping skills to diminish the negative physical and psychological effects of anxiety and stress.
Millions of people suffer from anxiety disorders such as...
- Generalized Anxiety Disorder (GAD) involves consistent exaggerated worries about everyday events and activities, expecting the worst even when there's no rational reason to. GAD lasts at least six months and may be accompanied by headaches, nausea, fatigue, trembling, and muscle tension. People who suffer from GAD often worry about are often things that are out of their control, and can spend hours trying to find ways to feel more in control.
- Social Phobia: an overwhelming fear of scrutiny, humiliation or embarrassment in social situations. As a result of this discomfort, social situations are often avoided.
- Obsessive Compulsive Disorder (OCD): Recurrent, unwanted obsessions/thoughts or compulsive rituals/behaviors that sufferers feel are out of their control. Performing rituals such as counting or repeated hand washing often provides only temporary relief, as this illness is often chronic and subject to relapses.
- Post-Traumatic Stress Disorder (PTSD): People who have experienced a traumatic event such as natural disaster, a car crash, child abuse, rape, assault or war may have flashbacks, nightmares or a numbing of their emotions. They may also feel depressed, irritable, angry and easily startled or distracted.
- Panic Attack/Panic Disorder: When intense fear strikes without warning; it could be a panic attack. Symptoms include rapid heart rate, sweating/hot flashes, trembling, shortness of breath or hyperventilation, tingling in the fingers or toes, nausea, chest pain, headache and dizziness, abdominal distress, and/or a sense of impending death. Many people go to the ER after they feel these symptoms thinking it's a heart attack. Panic attacks start abruptly and often last about ten minutes.
Taking care of yourself is important. There are things you can do to manage anxiety.
- Get some exercise. Doing this can improve your mood by helping you to relax, increase your stamina, release natural "tranquilizers," and improve your sleep.
- Follow good nutrition habits to fortify your body.
- Avoid harmful substances, such as alcohol, nicotine, caffeine, and other drugs. While they appear to cause a break in your symptoms, they will likely end up making them worse.
- Relax with pleasurable activities, tune in to activities you have enjoyed in the past and engage in them again.
- Argue against negative thoughts. When such thoughts occur, take note of them and evaluate them, then respond to them with more rational helpful thoughts. Recognize that you may have to work at feeling better.
- Comfort yourself with companionship from family and friends. While it might feel easiest to avoid others, look for opportunities to connect with others when you can.
- Develop a good social support system. This is one of the best methods of feeling more relaxed.
- Use relaxation exercises. Try ten minutes of slow, deep breathing, guided imagery, or progressive muscle relaxation, or listen to CDs with recorded relaxation exercises. Yoga can also be helpful.
- Meditate or pray, if doing so makes you feel more relaxed.
- Get enough sleep...about eight hours. Too little or too much sleep is not helpful.
- Utilize time management, make lists, and prioritize tasks.
- Consider saying "no" to people who ask for too much.
- Practice good communication skills and being assertive.
- Laugh! Humor is a wonderful stress reliever and mood enhancer.
Remember...you don't have to live with stress and anxiety, and it's important to get the appropriate help if you feel like you need it.
The following YouTube videos offer a variety of relaxation exercises you can try to reduce anxiety in your daily life.
- GUIDED MEDITATION - "The Summer Meadow"
- Positive Thoughts (self-hypnosis meditation)
- Relaxation Technique for Stress and Anxiety - Manage Your Stress
- A Journey through the Bamboo Forest: A Relaxation Exercise for Reducing Test Anxiety
- Progressive Relaxation: Self-Hypnosis
- Best Breathing Exercises on the Net
- Powerful Breathing Exercises
- Progressive Muscle Relaxation
- Free Relaxation Exercise #1 (Female Version)
- Meditation in 5 Days
- 15 Minute Sitting Meditation (with download)
Right now, many of us are worried about COVID-19 and feeling isolated from others, and we may feel helpless about what will happen or what we can do in such a situation. When things feel uncertain or when we don’t generally feel safe, it’s normal to feel stressed.
Stress can be a normal reaction, but sometimes it can also take a toll on our mental health. We don’t always know it is happening. You might feel more on edge than usual, angry, helpless or sad. You might notice that you are more frustrated with others or want to completely avoid any reminders of what is happening.
Coping Strategies to Consider
- Keep things in perspective. While it is totally OK and normal to have some worry about COVID-19, keeping things in perspective can help to manage this. Often anxiety increases when we face new or unknown challenges. All of us have experienced a new or unknown challenge thus we are not alone in this. Reflect on what you have done in the past to support yourself in times like this, and share these resilience-building resources with others via phone and video calls.
- Stay connected with your social support system. Maintain connections with others by talking on the phone, and texting or chatting with people on social media platforms. Talk to trusted friends about what you are feeling. You don’t have to be alone with your worry, and you might find it comforting to share what you are experiencing with others.
- Challenge yourself to stay in the present. Perhaps your worry is compounding...you're not only thinking about what is currently happening, but also projecting into the future. When you find yourself worrying about something that hasn’t happened, gently bring yourself back to the present moment. Notice the sights, sounds, tastes and other sensory experiences in your immediate moment and name them. Engaging in these mindfulness activities is one way to help stay grounded when things feel beyond your control.
- Practice Meditation and Mindfulness. There is no shortage of on-line resources to help you meditate and take a mindful approach to life. Because it comprehensive and supported by research, one resource we recommend is the Headspace app. Take a minute to review its free resources and subscription plans!
- Stay physically active. Get outdoors, but stay at least six feet away from others – take a walk, hike, bike ride, meditate, or take up bird watching. You can also enjoy indoor exercise, such as stretching, yoga, tai chi or qi gong, or join an on-line exercise class. Exercise, fresh air and sunshine will help both your physical and mental health.
- Seek additional help when necessary. Individuals who feel that they are in crisis during this time can reach out to the crisis support services and mental health counseling that are available for speaking to a professional:
- Rensselaer Counseling Center – counseling consultations for students will be conducted via phone. To schedule an appointment, email the Counseling Center or call (518) 276-6479.
- Contact your health insurance company to find an in-network provider list and understand what services may be covered.
- If you are enrolled in the student insurance plan (CDPHP) call their Crisis Hotline 1-888-320-9584 provides 24-hour assistance and crisis management. A caring professional is available, day or night, to offer support.
- Betterhelp – A teletherapy counseling website available 24/7 at a cost for subscription. More information can be found using the American Psychological Association’s Psychologist locator tool or Psychology Today’s "Find a therapist" tool.
Resources for Immediate Crisis Support
- Rensselaer On-call Counselor - Call the Department of Public Safety at (518) 276-6611 and request to speak with the counselor on call.
- SAMHSA’s National Helpline - Also known as the Treatment Referral Routing Service, this confidential and free substance use and information service is available in English and Spanish 24 hours a day, 365 days a year. 1-800-662-HELP (4357)
- NAMI HelpLine - The National Alliance on Mental Illness, or NAMI, provides advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives.
- National Suicide Prevention Lifeline - The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. Contact them by calling 1-800-273-8255 or texting TALK to 741741.
Check out these suggestions for joyful distractions from Harvard University.
You might also decide to take a virtual vacation!
Depression is a medical condition that can affect a person's ability to work, study, interact with people, or take care of themselves. Depression symptoms can last for months or even years if left untreated.
Depression is a complex set of symptoms that can include difficulty with motivation, emotion, cognition, and changes in behavior. When a person is depressed, it is common for them to experience intense feelings of sadness, hopelessness, poor appetite, lack of energy, low motivation, negative thinking, and social withdrawal. In some cases, thoughts of suicide will be more likely in a depressed individual.
Unfortunately, depression is not always easy to spot. Individuals may express their feelings of depression through drug or alcohol abuse, irritability, sexual promiscuity, risk-taking behaviors, aggression, or social withdrawal.
Many factors can contribute to the onset of depression, including the presence of other emotional disorders, constant self-criticism, having unrealistic expectations, stress, poor nutrition, physical illness, personal loss, and relationship difficulties.
If you have problems with depression, you are not alone. Depression affects about 19 million people in the US every year, and research suggests that nearly half of all college students have felt so depressed that they found it difficult to function during the last school year.
On a more positive note, depression is treatable, and medication and/or counseling can help. The majority (80-90%) of people who receive either medication or counseling for depression experience significant improvement, and almost all individuals gain some relief from their symptoms.
Causes of Depression
Although there is no single cause for depression, there are many factors that contribute to it, including traumatic life events, environment, medical conditions, genetics, and the lack of good social supports. Some factors that may increase the chance of depression include a history of abuse, conflict, certain medications, personal problems, and substance abuse.
Signs of Depression
If you have been feeling miserable more often than not over the past two weeks or more, and you've stopped enjoying things that used to be fun, you might be depressed. Check the symptoms below. If you are experiencing three or more, it is likely you are experiencing a bout of depression.
- Difficulty concentrating, remembering details, and/or making decisions
- Fatigue and decreased energy
- Feelings of guilt, worthlessness, hopelessness and/or helplessness
- Insomnia or excessive sleeping
- Persistently sad, anxious, irritable or empty mood
- Loss of interest in previously enjoyable activities
- Withdrawal from friends and family
- Significant change in appetite and/or weight
- Anger and rage
- Feeling restless or agitated
- Persistent physical symptoms such as headaches, digestive problems, or chronic pain that does not respond to routine treatment
- Substance abuse problems
- Recurrent thoughts of death or suicide
Ways to Ease Depression
Taking care of yourself is important. There are things you can do to alleviate depressed mood.
- Change your normal routine by taking a break for a favorite activity or something new — even if you don't feel like it.
- Look for and initiate social contact. Social support and spending time with friends is one of the most effective methods of treating depression.
- Exercise to work off tension, help you relax, and perhaps improve your ability to sleep.
- Avoid known stressors
- Avoid negative thoughts and put-downs that might make you feel worse
- Avoid making long-term commitments, decisions, or changes that make you feel trapped or confined — it is better to put them off unit you feel you are better able to cope.
If you are not sure if you are improving, contact the Counseling Center to discuss having an evaluation.
Ways to Help Someone Who Is Depressed
If you have a friend who seems to be depressed and you're concerned about their welfare, the best thing you can do for them is offer your personal support and refer them to other resources. If you notice signs of distress, ask your friend to meet in private. Express your concern, point out what you've observed, let them know you care and want them to get help.
At the same time, it is also important to remember that you are not personally responsible for your friend's well-being. Share your concerns with a professional, or talk to your RA, LA, class dean, or a counselor at the counseling center.
It is not uncommon for people who are depressed to think about suicide. If you or someone you know is considering suicide, seek help immediately. If you know someone has made a suicide attempt, even if very minor, it is very important that they seek help. One of the best predictors of a future suicide attempt, is a past history of having made an attempt.
If you think that you or someone you know may be depressed, or is considering harming themselves, contact the Counseling Center at (518) 276-6479.
Resources for More Help
- National Suicide Prevention Lifeline 1 (800) 273-8255 — A free, 24 hour hotline available to anyone in suicidal crisis or emotional distress.
- Ulifeline — An anonymous online resource where you can learn more about emotional health and ways to help yourself or a friend if you are struggling with your thoughts or feelings.
- The Jed Foundation — An organization working to reduce emotional distress and prevent suicide among college students.
- Half of us — Partnered with mtvU and the Jed Foundation to initiate a public dialogue to raise awareness about the prevalence of mental health issues and connect students to the appropriate resources to get help.
- WebMd Depression
- In-depth depression information including symptoms, medications, and resources.
- National Mental Health Awareness Campaign
- APA's College Mental Health Page
- American College Health Association
- Campus Health and Safety
Do you feel your thoughts are dominated with issues related to body image, weight, or shape, or do you have rigid patterns of food management which creates problems or concerns? If so, counseling can help to sort out any feelings and thoughts you may have which lead to problematic patterns of food intake and exercise.
Signs of an Eating Disorder
You may have an eating disorder if you feel that your behavior is consistent with any of the concerns mentioned below.
- Anorexia Nervosa –This is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss. Signs that you may have anorexia include missing your period, obsessing about being thin, or skipping meals and avoiding food-related social situations.
- Bulimia Nervosa –This is another potentially life-threatening eating disorder characterized by a cycle of binge eating and compensatory behaviors such as self-induced vomiting, laxative abuse, or excessive exercise in an ineffective attempt to compensate for a binge.
- Binge Eating Disorder (BED) –This type of eating disorder is characterized by recurrent binge eating without the regular use of behaviors to try to "make up" for the binge eating.
Signs of "Disordered Eating"
While you may not have an actual eating disorder like those mentioned above, disordered eating can still take a toll on your mental, emotional, and mental well-being, and it can be a real problem that could potentially lead to an eating disorder if it continues.
Answering "yes" to one of the following questions can be a sign of possible eating problems.
- Regularly calculate fat grams and calories?
- Weigh yourself often and find yourself obsessed with the number on the scale?
- Exercise to burn off calories and reduce your guilt from eating, not for health and enjoyment?
- Often feel it is difficult to control when and what you are eating?
- Feel ashamed or guilty after eating?
- Constantly worry about the weight, shape or size of your body?
- Feel like weight loss, dieting, and/or control of food has become one of your major concerns?
Most people experience some level of drive in order to improve their performance on some tasks, whether it's to run faster, score more points in a team's basketball game, or earn a higher grade on the next math test.
Perfectionism, however, is not a healthy pursuit of excellence. Those who strive for excellence in a healthy way take pleasure in trying to meet high standards and are more easily able to cope with the human side of their errors. Perfectionism, however, results in struggles with personal doubt and fears of criticism, and disapproval. Often times, perfectionism impairs performance and leads to chronic procrastination.
- Setting unreasonable standards that are beyond one's grasp
- Never being satisfied by anything less than something being done to perfection
- Becoming depressed when faced with failure or disappointment
- Avoiding challenge because of a fear of failure
- Being preoccupied with fears of failure and disapproval
- Frequently procrastinating because a task seems too overwhelming to do perfectly
- Becoming overly defensive when criticized
Here's a thought for the day: "While achieving perfection is impossible, chasing perfection can result in catching excellence."
Healthy striving involves:
- Setting standards that are high but within reach
- Enjoying the journey as well as the outcome
- Bouncing back quickly from failure or disappointment
- Accepting failure so that it does not create an impediment to success
- Seeing mistakes as opportunities for growth and learning
- Make a list of the advantages and disadvantages of trying to be perfect. When you make your own list of costs and benefits, you may find that the costs are too great.
- Increase your awareness of the self-critical nature of your all-or-nothing thoughts, and how they extend to other people in your life. Learn to substitute more realistic, reasonable thoughts for your habitually critical ones. When you find yourself criticizing a less-than-perfect performance (whether it's your own or someone else's), make yourself stop and think about the good parts of that performance. Engage in stress-reducing activities.
- Be realistic about what you can do. Set more realistic goals, and you will gradually realize that "imperfect" results do not lead to the negative consequences you expect and fear.
- Set strict time limits on each of your projects. When the time is up, move on to another activity. This technique reduces the procrastination that typically results from perfectionism.
- Learn how to deal with criticism. Criticism can be viewed as a personal attack, which may result in responding defensively. Concentrate on being more objective about the criticism, and about yourself. Remind yourself that with challenge will come some error. Remember that criticism is a natural thing from which to learn, rather than something to be avoided at all costs.
Learning to accept failure is an important aspect of building the resilience needed to adapt to challenges. You might find this article, titled How to Have a Successful Failure, helpful.
These problems may involve difficulty with initiating or maintaining social or intimate relationships, or getting out of an unhealthy relationship. Counseling can help with improving communication skills, and promoting problem solving and identification of core issues.
Common Sleep Disorders
Sleep disorders are very common on most college campuses and can include insomnia, circadian rhythm disorders and the parasomnias.
Insomnia is characterized by disturbed nighttime sleep and is usually identified when a person has difficulty falling asleep, and/or staying asleep. It is also not unusual to have frequent awakenings during the night, and some people who suffer from insomnia report that they don’t feel refreshed after sleeping. About 60 million Americans a year have insomnia frequently or for extended periods of time, which leads to even more serious sleep deficits, and which almost always affects job performance and well-being the next day.
Almost everyone occasionally suffers from short-term insomnia, usually as a result of stress, jet lag, diet, or many other factors. Fortunately, mild insomnia often can be prevented or cured by practicing good sleep habits, such as the twelve principles of sleep hygiene outlined below.
Parasomnias are unusual behaviors during sleep. Some of these events include sleepwalking, night terrors, active dreams, nightmares, and teeth grinding. Often, these incidents occur without the individuals awareness after the fact and are sometimes identified by room or hall mates.
Circadian Rhythm Disorders appear as a disruption of the normal sleep cycle, and can include having a non-24 hour sleep wake cycle, jet lag, and delayed or advanced sleep phase syndrome. Delayed sleep phase syndrome is more common in the college population and consists of difficulty waking up early in the morning and a tendency to stay up late at night.
Symptoms much like jet lag are common in people who study late at night. Because these people's study schedules are at odds with typical sleep-regulating cues like sunlight, they often become very tired while studying and often have difficulty with concentration and memory during those hours. As a result, they may be affected by insomnia or other problems when they try to sleep.
Sleep Cycle Problems
The consequences of disrupting one's sleep cycle vary from person to person, but in general can cause some profound effects. You may have a sleep cycle problem if you:
- Consistently do not get enough sleep, or the sleep you do get is not restful.
- Struggle to stay awake while driving.
- Have trouble staying awake when doing something passive, such as studying.
- Have problems concentrating at work or school.
- Have friends or family members tell you that you are often sleepy.
- Begin to respond to things slowly.
- Have trouble remembering things or have difficulty in controlling your emotions.
- Feel the need to nap several times a day.
Alterations to the sleep cycle often consist of one or more situations. For example, students traveling for a job or co-op interview may find their sleep cycle disrupted by jet-lag. More commonly, however, students are affected by their attempts to do more each day or by their attempts to overcome poor time management or procrastination. These attempts might include eliminating certain activities like exercise or cutting back on their regular sleep time in hopes of catching up the next day, or ultimately skipping the sleep cycle entirely and "pulling an all-nighter."
Unfortunately, many students underestimate the impact of sleep cycle disruptions. In addition to the physical symptoms listed above, recent research has begun to focus on how sleep cycle disruption can reduce academic performance.
Let's consider the potential impact of a two-hour disruption in the sleep cycle of a student who normally sleeps between midnight and 8:00am. If this student goes to sleep at 2:00am and still wakes up at 8:00am, they are sleep deprived, and to compensate for that loss they may need as much as four hours of extra sleep the next day. In addition to being affected by some of the physical symptoms, recent research has emphasized how this seemingly insignificant two-hour loss affects academic performance.
Sleep Loss and the Learning Process
Because of problems with time management, procrastination, or work overload, students are often in a position of trying to study or learn new material the night before a test, and in many cases sleep is sacrificed in the hope of getting ready for an exam. Several recent studies have clearly demonstrated that loss of REM sleep creates a dramatic reduction in the retention of recently learned information.
So if the sleep cycle is reduced by as little as two hours, then much of what might have been read or studied earlier that night is lost, and as a result, the student's learning efficiency is reduced and their grades are negatively affected. Unfortunately, most students are unaware of the impact of lost sleep and as a result they tend to look for external explanations for their academic problems by saying, for example, that "the test was too hard."' Sadly, they ignore the other factors such as their poor time management or poor sleep hygiene which often continue to cause academic problems.
Related Sleep Factors
While using sleeping pills may seem like a good short-term solution if you need to stay awake from time to time, doing this can negatively affect one's sleep cycle. Other factors can also influence the sleep cycle and create sleep problems: disorders such as depression; constant worry; and sleep apnea, which is a physical disorder that may influence the quality of sleep. In addition, recent research has shown that excessive time on-line often impacts an individual's regular sleep schedule, as does substance abuse.
Good Sleep Hygiene
Being a good sleeper involves several factors. For example, maintaining a relatively consistent sleep schedule is one of the most important factors for good sleep. Going to bed at 2:00am, when you normally sleep at 12:00, creates a disruption in the sleep pattern for the following night, and often leads to attempts to "make up" for lost sleep by napping during the day. Another factor of good sleep hygiene is the avoidance of heavy meals just before bedtime, and also avoiding caffeine, alcohol and nicotine for six to eight hours before going to sleep.
While regular daily exercise is helpful in promoting beneficial sleep, avoid any high-level activities for a couple of hours before bedtime.
The twelve principles of sleep hygiene
- Get the right amount of sleep.
Each person needs a certain amount of sleep. Studies show that most of us need between seven and eight hours of sleep a night, and that sleep becomes deeper and more continuous when we sleep in one relatively continuous period of time. Naps can take away from nighttime sleep.
- Maintain a regular schedule.
It's important to maintain a regular bedtime and wake time seven days a week...this means weekends too!. Get up at the same time each morning, even if you had a bad night's sleep the night before. Experience shows that it may take several nights of bad sleep for the body to begin to achieve good and regular sleep, so don't become frustrated!
- Sleep at night.
Figure out the time that you need to awaken; for most people, this means the earliest time you need to be up for class. From that time, count back the number of hours you need to sleep, add 30 minutes, and you have your bedtime. For example, let's say the earliest time you need to be up for your 8:00 Calculus class is 6:30. If you need seven hours of sleep a night, and add on another 30 minutes, you'd need to go to bed at 11:00.
- Avoid alcohol, especially in the evenings.
Many people try to drink alcohol to help them sleep. While alcohol may help you fall asleep, it will actually have the opposite effect and wake you up later in the night. Furthermore, with continued drinking, the sleep-inducing effect disappears.
- Avoid caffeine after lunch.
Too much caffeine, particularly late in the day, will keep you up during the night. Therefore, it's recommended that you avoid drinking caffeine after noon and limit your caffeine intake to no more than two cups of coffee or soda a day. Avoid eating a lot of chocolate, too.
- Avoid nicotine in the evenings and during the night.
Smoking relaxes you, right? Well, remember, it's also a stimulant and, like coffee, will make it harder for you to fall asleep and shorten the time you will sleep during the night.
- Exercise any time before dinnertime.
Exercise is definitely good for you and can actually promote deep sleep. However, exercise too close to bedtime is invigorating and can make it harder to fall asleep. Therefore, avoid exercise within three to four hours of bedtime.
- Make your sleep environment comfortable and sleep-inducing.
Make sure you have a comfortable bed and a bedroom that's conducive to sleep. Block out unnecessary light, wear earplugs to reduce the effect of noise around you, and make sure your mattress and pillows are comfortable.
- Establish a bedtime ritual.
Just before bedtime is not the right time to pay bills, begin a mystery novel, or think about the stresses in your life. A wind-down period is essential for a relaxing bedtime routine. Earlier in the evening, make a list of ways you might begin to resolve your problems so you aren't worrying about them at night.
- Reserve the bed for sleeping only.
Spending excessive amounts of time in bed doing other tasks weakens the association between sleep and the bed. Eliminate bedtime activities that have nothing to do with sleep.
- Sleep when you are sleepy; otherwise, get out of bed.
If you're not asleep after 15 to 20 minutes of lying in bed, get up and engage in some sedentary activity, such as reading or watching TV, until you begin to feel sleepy. At that point, return to bed.
- Keep in mind that sleep helps the learning process.
According to research, sleep helps secure memories and aids in at least some types of learning. Students who study hard all week and party on the weekends may lose a lot of what they learned. Sleep deprivation on critical nights after learning may cause a 30% loss.
Take a look at the following symptoms and consider whether or not any apply to you. If you answer "yes" to one or more of these questions, you may have a problem with alcohol and/or drug abuse and may benefit from a further evaluation.
- Do I sometimes forget or deny things that happen when I was intoxicated or high on drugs?
- Does my drinking or drug use sometimes causes problems with school, work or my relationships?
- Do I sometimes set limits or make promises to others about how much I will drink or use drugs and then do not follow through?
- Do I sometimes lie about or try to hide the frequency and/or amount of my drinking or drug use?
- Do I sometimes behave very differently when intoxicated or high on drugs than when sober or clean, almost as if I'm a different person?
- Do I have a very high alcohol tolerance, in that I can drink a lot without feeling highly intoxicated?
- Do I sometimes feel guilty, embarrassed, or remorseful about things I said or did while intoxicated or high on drugs?
- Do I occasionally drink or use drugs in the morning or early in the day to treat a hangover, or to avoid the shakes or other withdrawal symptoms?