A Letter to My Addict

Greetings from your mother,

My Dear,

Life is not easy. It’s not easy if you are a drug addict or even if you are not an addict. It’s all about evolution. The strong survive.  It’s not just about physical strength; it is more about mental strength. Do you have the will to survive?  Do you have the strength to make it one more day?

As a person who has never been a drug addict or an alcoholic, I can only speak from that perspective. My insight into your world is only through observation. I do not wish to walk in your shoes. But I can tell you what it is like to walk in mine – if you are serious about sobriety.

Every day I have unfulfilled wants and they are not centered on anyone else. It may seem selfish, but I believe that the center of one’s being can only revolve around oneself. I want things, I want different feelings, I want changes in others, I want, I want, I want. It really never ends. I believe that desire is no different for a drug addict or non-addict.

Daily there are people out there telling you, no – a boss, friends, parents, spouses, and girlfriends – that is just a part of life.  Disappointment and hurt is as much a part of living as joy, happiness and love. Hurt is the same for an addict as it is for a non-addict. The difference is how we react to and cope with our emotions, whether they are good or bad.  I don’t know what drugs do for an addict to help cope with disappointment. I don’t know how drugs heighten the joy of happiness. But I do know that my life would be very monochromatic without the peaks and valleys.

I have no doubt from observing you that you hated every day that you were using drugs. I can see how your life was out of control, spiraling into a pit of hurt and despair. You became so lost that the helping hands of others could not even be grasped.

I see your struggles with being clean. More pain than joy. It’s a time in your life where the scales are not balanced. You are working so hard to survive but everyone is saying, no.  There are so many frustrations.  What is the use, you may wonder?

There is one place where no one will say no. There is one life that will accept you. The life of drug use that you have known for the last several years. That is the easy path to take.

But, please know that the immediate pain you feel now will eventually fade.

Just as when my father died, there was terrible pain for me. I wanted to pick up the phone and call him, but I knew I couldn’t. I wanted one last time, for old times’ sake, but I couldn’t. I flashed back to all the good times, but they were not to be any more. I believe that feeling of loss is something similar to what you are experiencing in order to live on. Your old life must die – and there is tremendous pain with that death. Each day you will want to use just one more time. Time may heal all wounds but sometimes the scars are there forever.

In time, the scales will balance and you will experience more joy than pain. But for now you must travel the difficult path and find the will to survive. You will become stronger each time you choose to steer away from that dangerous and tempting path at the fork in the road. It may be hard to see because the path to recovery is difficult.  But please know you are not walking alone – hands of help are reaching out to you with your every step.

Adopted from Ron Grover with thanks.

Written By: Dr. Talat Habib


Nishan Rehab Pakistan


Overcoming Drug Addiction

Overcoming drug addiction and sobriety can feel like an impossible goal during struggling with drug addiction. But recovery is never out of reach and change is possible with the right treatment and support, and by addressing the root cause of your addiction. The road to recovery often involves bumps, pitfalls, and setbacks. But by examining the problem and thinking about change, you are already on your way. Bellow is following ways which we can adopt for treatment & recovery:

1: Decide to make a change

The biggest and toughest step toward recovery is the very first one: deciding to make a change. Change is never easy and it involves many things, including:

  • The way you deal with stress
  • Who you allow in your life
  • What you do in your free time

2: Explore your treatment option

It is time to explore your treatment choices. As you consider the options, keep the following in mind:

  • There is no magic bullet or single treatment that works for everyone.
  • Treatment should address more than just your drug abuse
  • Commitment and follow up is needed.
  • There are many places to turn for help; the level of care you need depends on your age, drug use history, and other medical or psychiatric conditions. In addition to doctors and psychologists, many clergy members, social workers, and counselors offer addiction treatment services.

3: Reach out for support

  1. Having the support of friends and family members is an in valuable asset in recovery.
  2. Build a sober social network
  3. Consider moving in to a sober living home
  4. Make meetings a priority

4: Learn healthy ways to cope with stress

  • Exercise releases endorphins, relieves stress, and promotes emotional well-being. Try running in place, jumping rope, or walking around the block.
  • Step outside and savor the warm sun and fresh air. Enjoy a beautiful view or landscape.
  • Yoga and meditation are excellent ways to bust stress and find balance.
  • Play with your dog or cat, enjoying the relaxing touch of your pet’s fur.
  • Put on some calming music.
  • Light a scented candle.
  • Breathe in the scent of fresh flowers or coffee beans, or savor a scent that reminds you of a favorite vacation, such as sunscreen or a seashell.
  • Close your eyes and picture a peaceful place, such as a sandy beach. Or think of a fond memory, such as your child’s first steps or time spent with friends.
  • Make yourself a steaming cup of tea.
  • Look at favorite family photos.
  • Give yourself a neck or shoulder massage.
  • Soak in a hot bath or shower.

5: Keep triggers and cravings in check

  • Make a break from old drug buddies.
  • Avoid bars and clubs
  • Be up front about your history of drug use when seeking medical treatment
  • Use caution with prescription drugs.
  • Pick up a new hobby.
  • Adopt a pet.
  • Get involved in your community.
  • Set meaningful goals.
  • Look after your health.

7: Don’t let relapse keep you down

Relapse is a common part of the recovery process from drug addiction. While relapse is understandably frustrating and discouraging, it can also be an opportunity to learn from your mistakes and correct your treatment course.

  • Negative emotional state (such as anger, sadness, trauma or stress
  • Physical discomfort (such as withdrawal symptoms or physical pain)

The important thing to remember is that relapse doesn’t mean treatment failure. Rather than giving up, get back on the wagon as quickly as you can. Call your sponsor, talk to your therapist, go to a meeting, or schedule an appointment with your doctor. When you’re sober again and out of danger, look at what triggered the relapse, what went wrong, and what you could have done differently. You can choose to get back on the path to recovery and use the experience to strengthen your commitment.

Miss Sumera Hassan

Clinical Psychologist

Nishan Rehab Multan



Alcohol and Women

Addiction of alcohol is increasing day by day very fast in the world. Most researches related to substance abuse and dependence was focused on men only until the early 1990s. That trend has now changed and studies were also conducted on women. The U.S. National Survey on Drug Use and Health was conducted in 2008 and it was found that 11.5% of males ages 12 and older had a substance abuse or dependence problem, compared with 6.4% of females. Alcohol is the most commonly abused substance in the United States. About 7% to 12% of women abuse alcohol, compared with 20% of men. But research also suggests that since the 1970s, this gender gap has been narrowing, as drinking by women has become more socially acceptable.


There are so many reasons to increase the use of alcohol in women and they also face difficult challenges in other following respects.

  • Women develop alcohol dependence more quickly than men do. Alcohol-related problems such as brain atrophy or liver damage also occur more rapidly in women than in men.
  • They tend to progress more quickly from using an addictive substance to dependence
  • They also develop medical or social consequences of addiction faster than men, often find it harder to quit using addictive substances, and are more vulnerable to relapse. These gender differences can affect treatment.
  • Women develop medical or social consequences of addiction faster than men, often find it harder to quit, and are more vulnerable to relapse.
  • Several biological factors make women more vulnerable to the effects of alcohol like;
  • Women tend to weigh less than men.
  • A woman’s body contains less water and more fatty tissue than a man’s. Because fat retains alcohol while water dilutes it, a woman’s organs sustain greater exposure.
  • Women have lower levels of two enzymes — alcohol dehydrogenase and aldehyde dehydrogenase — that break alcohol down in the stomach and liver. As a result, women absorb more alcohol into the bloodstream.

Treatment of alcoholic women   


Psychotherapy, self-help groups, and medications are all available to help people stop drinking. According to a large study of alcohol dependence in both men and women, drug therapy and a specialized behavioral therapy helped patients of both sexes abstain from drinking and overall, men and women responded equally well to treatment. Women with alcohol problems were less likely to enter treatment, once they began treatment they were just as likely as men to recover. Mixed-gender treatment programs are more effective for alcohol dependent women.

Abdul Mateen Khan

Clinical Psychologist


Nishan Rehab Multan


Positive Psychology and Addiction Treatment

Positive psychology is possible the scientific study of the strengths and virtues that individuals and communities to thrive. This field is based on the belief that people want to live meaningful and satisfying lives, to cultivate what is best for themselves, and their experiences with love, improve work and play.
In effective addiction treatment, positive psychological approach takes part in a vital
role in achieving long-term addiction healing goals. Usually, addicts are told that they
have a disease; that they will have to manage it for the rest of their lives; to expect
relapse and that from a statistical perspective, most will expire from their illness. This is an enormously demoralizing prognosis to provide to someone. A positive psychologist would reframe the situation, suggesting that addiction is a behavioral disorder and even the most well-established behaviors can be changed. Despite the fact that not denying the negative statistics surrounding addiction recovery, a reframing of the opportunity to recover into something achievable is empowering and motivating to many who suffer from substance abuse.
After encouraging the addict by suggesting that recovery is possible not just for a
selected few, the positive psychologist then begins to work with the addict to re-
envision life and begin a process of self-discovery in which the addict comes to know
what activities and interaction are most important to him/her. There are no limits. For

example, at the seminar one researcher who works with suicidal geriatric individuals

shared this story: She had a wheelchair bound, elderly woman say that what was most
essential in life to her was saving seals. Instead of telling the woman that she could not save seals because she was too old and in a wheelchair or provide any other excuse, the woman was encouraged to look into what it would take for her to save seals. She decided that while she could not physically work with seals, she could be involved via the internet in those types of activities and fundraise to support the work. This is exactly the type of visioning process that is successfully used with addicts, to help them imagine a world beyond using and to give them tangible goals to work toward that will help them maintain their recovery.
Consequential recovery is achieved when the pain of the past is worked through and
goals for the future are set and worked towards. Part of the problem of addiction is a
lack of ability to visualize a different future, a future in which happiness, good work,
and strong relationships are the structure of daily life. Using positive psychology,
therapists are able to help addicts plan for and believe they can attain the kind of future of which they previously could not even dream of.
Written By: Sarfraz Haider
Clinical Psychologist,
Nishan Rehab Multan

Chemicals Effects of Drug Abuse and Addiction on Body

There are many chemicals effects of Drug Abuse and addiction. Different drugs can affect the body in different ways because of their chemical structures. In fact, some drugs can even change a person’s body and brain in ways that last long after the person has stopped taking drugs, maybe even permanently.

Depending on the drug, it can enter the human body in a number of ways, including injection, inhalation, and ingestion. The method of how it enters the body impacts on how the drug affects the person. For example: injection takes the drug directly into the blood stream, providing more immediate effects; while ingestion requires the drug to pass through the digestive system, delaying the effects.

Most abused drugs directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and feelings of pleasure. When drugs enter the brain, they can actually change how the brain performs its jobs. These changes are what lead to compulsive drug use, the hallmark of addiction.


More deaths, illnesses and disabilities stem from substance abuse than from any other preventable health condition. Today, one in four deaths is attributable to illicit drug use. People who live with substance dependence have a higher risk of all bad outcomes including unintentional injuries, accidents, risk of domestic violence, medical problems, and death.

Health Problems

The impact of drug abuse and dependence can be far-reaching, affecting almost every organ in the human body. Drug use can:

  1. Increasing vulnerability to infections & weaken the immune system,
  2. Injected drugs can also lead to collapsed veins and infections of the blood vessels and heart valves. Drugs can cause cardiovascular conditions ranging from abnormal heart rate to heart attacks.
  3. Drugs can cause nausea, vomiting and abdominal pain.
  4. Drugs can also cause the liver to have to work harder, possibly causing significant damage or liver failure.
  5. Addiction cause seizures, stroke and widespread brain damage that can impact all aspects of daily life by causing problems with memory, attention and decision-making, including sustained mental confusion and permanent brain damage.
  6. Drugs can produce global body changes such as breast development in men, dramatic fluctuations in appetite and increases in body temperature, which may impact a variety of health conditions.

Effects on the Brain

Although initial drug use may be voluntary, drugs have been shown to alter brain chemistry, which interferes with an individual’s ability to make decisions and can lead to compulsive craving, seeking and use. This then becomes a substance dependency.

  • All drugs of abuse – nicotine, cocaine, marijuana, and others – effect the brain’s “reward” circuit, which is part of the limbic system.
  • Drugs hijack this “reward” system, causing unusually large amounts of dopamine to flood the system.
  • This flood of dopamine is what causes the “high” or euphoria associated with drug abuse.


  1. Aggressiveness
  2. Hallucinations
  3. Addiction
  4. Impaired Judgment
  5. Impulsiveness
  6. Loss of Self-Control

Birth Defects:

In the United States nearly 4 percent of pregnant women use illicit drugs such as marijuana, cocaine, Ecstasy and other amphetamines, and heroin. These and other illegal drugs may pose various risks for pregnant women and their babies. Some of these drugs can cause a baby to be born too small or too soon, or to have withdrawal symptoms, birth defects or learning and behavioral problems. Additionally, illicit drugs may be prepared with impurities that may be harmful to a pregnancy. Finally, pregnant women who use illicit drugs may engage in other unhealthy behaviors that place their pregnancy at risk, such as having extremely poor nutrition or developing sexually transmitted infections.

Written By: Miss Sumera Hassan

Clinical Psychologist

Nishan Rehab Multan

Teenage and Drinking

Article written by:  Abdul Mateen Khan

Today in the world, drinking is increasing very fast in teenagers. The average age of an American girl when she has her first drink is 13; for a boy, it is 11. Young people drink who are more likely to be the victims of violent crime, be involved in alcohol-related traffic accidents, and to have depression and anxiety. Other risky behaviors too are involved in early drinking. Young people, who start alcohol at the age of 21 or before, are more likely to be:

  • Involved in violent behavior
  • An attempt was suicide
  • Engage in unprotected sex or multiple partners to have sex
  • Develop alcohol problems later in life

 Factors affecting risk of developing a drinking problem

A number of factors influence a teen or young adult’s drinking behavior and whether it will become a problem. These include;

  1. Race and ethnicity. Some racial groups, American Indians: such as Native Alaskans and for example, are more at risk than others of developing alcohol addiction.
  2. A Teen with an alcoholic parent or sibling is four times more likely to develop a problem with alcohol than someone without a family history.
  3. The presence of mental health disorders. Often alcohol problems go hand in hand with mental health problems: such as depression, bipolar disorder, anxiety, and schizophrenia.
  4. Personality traits. Teenagers believe alcohol makes it easier to socialize; for example, they tend to drink more than those who do not believe that their spirit loosens social inhibitions.
  5. Influence of family and peers. Teens are at greater risk for developing alcohol related problems when alcohol is readily available at home or among their peer group.
  6. Men are more likely to drink heavily than women, but women at lower levels become addicted and in shorter duration of use.

Dangers of drinking while young

The years between 18 and 25 years are a time of great change, as teenagers spread their wings and leave home, many of them for the first time. Although these can be exciting years, the widespread use of alcohol means that years can be risky too. The highest prevalence of problem drinking occurs among young adults aged 18 to 25 years old, almost 42% of those admitted to binge drinking at least once a month (consuming five or more drinks in rapid succession for men, four or more for women).

Many of us usually think of the university as the environment in which the elderly and adolescents under 20-somethings drink heavily. However, several studies show that excessive drinking is widespread among young adults, regardless of whether or not they attend college. College students tend to drink less frequently than non-students, but when they do imbibe-at parties, they tend to drink more.

Frequent use of alcohol among adolescents and young adults is alarming for several reasons;
• Alcohol is a major factor in fatal crashes. About a third of drivers aged 21 to 24 who died in a car accident in 2009 had a blood alcohol level high above the legal limit.
• Drinking can have lasting effects on health. Some researchers believe that excessive alcohol consumption at this age, when the brain is still developing, may cause lasting changes in brain functions like memory, coordination and motor skills at least among susceptible individuals.
• Drinking can lead to sexual assault and rape. Each year, approximately 97,000 students between the ages of 18 and 24 are victims of sexual assault related to alcohol.

 How to recognize and treat alcohol poisoning

Binge drinkers are eight times more likely than other college students to:

  • Miss classes
  • Fall behind in schoolwork
  • Be injured

Because alcohol is a central nervous system depressant, drinking too much, too fast, slows some bodily functions (such as heart rate, blood pressure, and breathing) to a dangerous level, causing the drinker to lose consciousness.

Possible signs of alcohol poisoning include:

  • Unconscious or semiconscious state
  • Slow respiration—eight or fewer breaths per minute, or lapses between breaths of more than eight seconds
  • Cold, clammy, pale, or bluish skin
  • A strong odor of alcohol on the breath and coming from the skin

How to talk to teens about responsible drinking

These are some of the other important reasons:

  • Alcohol has harmful effects on developing brains and bodies.
  • For adolescents ages 15 to 20, alcohol is implicated in more than a third of driver fatalities resulting from automobile accidents and about two-fifths of drowning.
  • Drinking interferes with good judgment, leading young people into risky behavior and making them vulnerable to sexual coercion.
  • Teenagers who use alcohol and tobacco are at greater risk of using other drugs.
  • Teenagers who drink are more likely to develop behavioral problems, including stealing, fighting, and skipping school.
  • Underage drinking is illegal.

  Start the conversation early

While most people recognize the importance of discussing alcohol with kids, they aren’t always sure when to initiate this discussion. Adolescents are often nervous and confused as they face their first opportunities to try alcohol and are often interested to hear your thoughts on the subject. Set the stage early by letting your teenager know that he or she can talk to you about anything, without judgment or lecturing.

Open up and listen

Ask open-ended questions, and listen to the answers without interrupting.

  • Talk openly about your family history. If your family has had problems with alcohol, your child should know about it. Be open about your own experiences, too.
  • Set clear expectations, and communicate your values. Youngsters are less likely to drink when they know that parents and other important adults in their lives have strong feelings about it.
  • Control your emotions. If you hear something that upsets you, take a few deep breaths and express your feelings in a positive way.
  • Ask about your teenager’s friends. Express an interest in getting to know them better. Getting to know these friends and their parents will help you understand your teenager’s world.

By Abdul Mateen Khan

Clinical Psychologist


Nishan Rehab Multan


Schizophrenia—Brain Disorder

Schizophrenia is a brain disorder that affects the way a person behaves, thinks, and sees the world. People with schizophrenia often have an altered perception of reality. They may see or hear things that don’t exist, speak in strange or confusing ways, believe that others are trying to harm them, or feel like they’re being constantly watched. This can make it difficult to negotiate the activities of daily life, and people with schizophrenia may withdraw from the outside world or act out in confusion and fear.

The most common early warning signs of schizophrenia include:

  • Social withdrawal
  • Hostility or suspiciousness
  • Deterioration of personal hygiene
  • Flat, expressionless gaze
  • Inability to cry or express joy
  • Inappropriate laughter or crying
  • Depression
  • Oversleeping or insomnia
  • Odd or irrational statements
  • Forgetful; unable to concentrate
  • Extreme reaction to criticism
  • Strange use of words or way of speaking

Signs and Symptoms of Schizophrenia


A delusion is a firmly-held idea that a person has despite clear and obvious evidence that it isn’t true. Delusions are extremely common in schizophrenia, occurring in more than 90% of those who have the disorder. Often, these delusions involve illogical or bizarre ideas or fantasies. Common schizophrenic delusions include:

  • Delusions of persecution – Belief that others, often a vague “they,” are out to get him or her. These persecutory delusions often involve bizarre ideas and plots (e.g. “Martians are trying to poison me with radioactive particles delivered through my tap water”).
  • Delusions of reference – A neutral environmental event is believed to have a special and personal meaning. For example, a person with schizophrenia might believe a billboard or a person on TV is sending a message meant specifically for them.
  • Delusions of grandeur – Belief that one is a famous or important figure, such as Jesus Christ or Napolean. Alternately, delusions of grandeur may involve the belief that one has unusual powers that no one else has (e.g. the ability to fly).
  • Delusions of control – Belief that one’s thoughts or actions are being controlled by outside, alien forces. Common delusions of control include thought broadcasting (“My private thoughts are being transmitted to others”), thought insertion (“Someone is planting thoughts in my head”), and thought withdrawal (“The CIA is robbing me of my thoughts”).


Hallucinations are sounds or other sensations experienced as real when they exist only in the person’s mind.

Disorganized speech

Fragmented thinking is characteristic of schizophrenia. Externally, it can be observed in the way a person speaks.

Disorganized behavior

Schizophrenia disrupts goal-directed activity, causing impairments in a person’s ability to take care of him or herself, work, and interact with others.

Negative symptoms

  • Lack of emotional expression – Inexpressive face, including a flat voice, lack of eye contact, and blank or restricted facial expressions.
  • Lack of interest or enthusiasm – Problems with motivation; lack of self-care.
  • Seeming lack of interest in the world – Apparent unawareness of the environment; social withdrawal.
  • Speech difficulties and abnormalities – Inability to carry a conversation; short and sometimes disconnected replies to questions; speaking in monotone.

Types of Schizophrenia

  • Paranoid schizophrenia — a person feels extremely suspicious, persecuted, or grandiose, or experiences a combination of these emotions.
  • Disorganized schizophrenia — a person is often incoherent in speech and thought, but may not have delusions.
  • Catatonic schizophrenia — a person is withdrawn, mute, and negative and often assumes very unusual body positions.
  • Residual schizophrenia — a person is no longer experiencing delusions or hallucinations, but has no motivation or interest in life.
  • Schizoaffective disorder–a person has symptoms of both schizophrenia and a major mood disorder such as depression.

Schizophrenia Treatment

Keeping up with medicines & through therapy, people can develop social and work skills to recover their lives and relationships. If you or someone you love has schizophrenia, please contact Nishan Rehab to makes all the difference.

Written By: Maryam Malik

Clinical Psychologist

Nishan Rehab Islamabad





Alcohol Use Disorder

Alcoholism, is a primary, progressive, potentially fatal and chronic relapsing mental disorder which is one of the most widespread forms of addiction globally. Alcohol consumption is classed as world’s third largest risk factor for pre-mature mortality and loss of health (WHO report, 2011).

Pakistan, an Islamic state, where 95-98% religious values are followed, in which the alcohol sale and use is strictly prohibited by law is witnessing a surge in alcohol abuse and consequent alcohol use disorders in recent years (Haviland, 2013; Walsh 2010). Consequently, alcoholism is turning in to a growing problem in Pakistan.

The excess amount of drugs activate the brain reward system, which reinforces the behaviors and production of the memories (producing the feeling of pleasure), which later on create the dependency over the drugs.

Alcohol use disorder is only caused by the excess or abusive usage of drugs. According to the prevalence studies of Alcohol Use Disorder it is found that its prevalence is higher among 18-24 years old who uses illicit drugs.

There are many persons who use drugs but they don’t have any problems, it is important to note that those people are not addict they may be users only. According to the progression and recovery of this disorder, it develops in stages beginning from user to abuser and addict where major areas of life functioning get disturbed.


Alcohol use disorder is a common disorder. In the United States, the 12-month prevalence of alcohol use disorder is estimated to be 4.6% among 12- to 17-year-olds and 8.5% among adults age 18 years and older in the United States. Rates of the disorder are greater among adult men (12.4%) than among adult women (4.9%).

According to the prevalence studies in Pakistan it is found that among 6.7 million drug users there are one million users who are suffering with alcohol use disorder.

Diagnostic Criteria

We diagnose many people in our surrounding but we have no standardized tool to diagnose other, but in rehabilitation facility at Nishan we are using DSM-5 to diagnose patient with alcohol dependency. Diagnosis is the ladder for the treatment. You cannot treat anyone until you don’t diagnose a person clearly. According to DSM-5 following are the important diagnostic criteria for the diagnosis of Alcohol Use Disorder.

  1. Alcohol is often taken in larger amounts or over a longer period than was intended.
  2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
  3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
  4. Craving, or a strong desire or urge to use alcohol.
  5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
  6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
  7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
  8. Recurrent alcohol use in situations in which it is physically hazardous.
  9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
  10. Tolerance, as defined by either of the following:
    1. A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
    2. Markedly diminished effect with continued use of the same amount of alcohol.
  11. Withdrawal, as manifested by either of the following:
    1. The characteristic withdrawal syndrome for alcohol.
    2. Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

Severity of disease

According to DSM-5 we can make a sense of severity of the disease. There are three categories which are as follow.

  1. Mild: Presence of 2-3 symptoms
  2. Moderate: Presence of 4-5 symptoms
  3. Severe: Presence of 6 or more symptoms

Journey of treatment starts from diagnoses and accomplish after If you are facing a problem of Alcohol Use Disorder contact us.

Written By: Fayyaz Ahmed

Clinical Psychologist

Nishan Rehab Islamabad


Anger is a normal, healthy emotion, but it comes as a chronic, explosive rage out of control, can have serious effects on your relationships, health and state of mind.

With insight on the real reasons for the anger, anger management tools allow you to keep your temper to get your life from piracy. The feeling of anger is neither good nor bad. Like any emotion, it is to transmit a message, stating that the situation is worrying, or unjust, or threatening. If Kneejerk your response to anger, however, explode, this message should never be an opportunity to promote. So while it is normal to feel angry if abused or poorly made, anger is a problem when you put it in a way that harms. This is where the anger management game comes. The goal of anger management is not the feelings of anger to suppress, but the message behind the feelings to understand and to express them in a healthy way, without losing control.  When you do this, you will not only feel better, you are also more likely to get your needs met, better able to manage conflicts in your life, and strengthen your relationships. Mastering the art of anger management needs work, but the more you practice, the easier it will be.

Out-of-control anger can hurt your relationships affect your judgment, to get in the way of success, and have a negative impact on the way people look. Employed by your high level of stress and anger, operation makes it more prone to heart disease, diabetes, weakened immune system, insomnia and hypertension. Chronic anger consumes huge amounts of mental energy and clouds your thinking, making it difficult to concentrate or enjoy life. It can also lead to anxiety, depression and other psychological problems. Constructive criticism, creative differences, and heated debate can be healthy. But binding only alienated colleagues, bosses or customers and undermine their respect. It causes permanent scarring the people you love most and gets in the way of friendships and working relationships. Explosive anger makes it hard for others to trust you, to speak honestly, or to feel comfortable and is particularly harmful to children.

Explore what’s really behind your anger

Anger problems often result from what you have learned as a child. If you see others in your family cry, hit each other, or throw things, you may think that is how the anger expressed.

Anger is often a cover for other emotions

To bring your anger appropriately expressed, you should be in touch with what you really feel. Is your anger meeting other emotions such as shame, insecurity, pain, shame or vulnerability?

If your knee-jerk reaction in many cases is anger, it is likely that your temper is to cover up your true feelings.  This is especially likely if you grew up in a family where expression of feelings strongly discouraged. As an adult, you may have a hard time; the feelings of others by anger have recognition. Anger can be such as depression, trauma or chronic stress is also a symptom of underlying health problems.

Identify anger warning signs and triggers

Anger fuels “fight or flight” response of the body, so while you may feel you simply cannot explode without warning, no physical warning signs about your body ready to react. Recognizing the signs dissertation allows you to take steps to manage your anger before it boils over.

  • Note that anger feels in your body. Is your stomach knotted hands or your jaw clenched, your muscles tense? Feel wet or washed? Is your heart beating or you are breathing faster?
  • Identifying negative thinking patterns had caused anger. You can think of external things he did, denying people or situations causing your anger. But anger problems have more to do with negative thinking, color. As a rigid view of how things should understand be and get angry when reality does not match or perhaps overlook the positive things while letting small irritations mount; Or do we blame others for bad things happened rather than taking responsibility for your own life?
  • Recognize situations did cause anger. Stressful events not forgive anger, but understanding how synthesis events affect you can help you avoid unnecessary aggravation. You get into a fight every time you go out for a drink with some friends? Or is the movement in your daily drive you crazy movements? Think of ways to prevent the composition activates or see the situation differently, so as not to cause anger.


 Manage stress

The more stressed you are, the more likely you are to lose your temper.  But no matter how stressful your life seems, there are steps you can take to relieve the pressure and regain control.

Connect regularly with friends and family. There is nothing more calming to your nervous system than communicating face to face with people who care about you. Your friends don’t have to be able to fix your stress; they just need to be good listeners.

Practice relaxation techniques. A daily relaxation practice  can help reduce stress and boost feelings of well-being. Try yoga, progressive muscle relaxation, or meditation.

Adopt a healthy lifestyle. Getting enough sleep, eating well, reducing your caffeine, alcohol, nicotine, and sugar intake, and making time for fun in your life can increase your resistance to stress and make it easier to manage anger.

 The more stressed you are, the more likely you are to lose your temper. But no matter how stressful your life seems, there are steps you can take to relieve stress and to regain control.

There is nothing more soothing to the nervous system as a face to face communication with people who care about you. Your friends will need to determine your stress may not be; you just need to be good listeners.

A daily practice of relaxation can help to reduce stress and increase prosperity. Try yoga, progressive muscle relaxation or meditation.

Getting enough sleep, eating well, reducing your caffeine, alcohol, nicotine and sugar consumption and entertainment in your life, your strength increase stress and make it easier to manage anger.

Manage anger in the moment

In some cases, the argument with your boss, for example, decision to make time for a walk or hit the gym may not be useful. These tips can help you to cool down at the moment:

While it may not seem contradictory, coordination with the way your body feels when you are often angry reduces the emotional intensity of anger.

Deep, slow breathing helps to address the increase in tensions. Breathe deeply from the abdomen, getting as much air as possible into the lungs.

Take advantage of the relaxing power of the senses-sight, smell, hearing, touch and taste. You could try playing in a favorite place or pressing a stress ball.

Roll your shoulders when I connect, for example, or gently massage the neck and scalp.

Concentrate to let you catch your rational mind with your feelings count. If you are still out of control from the moment you feel you reach ten, start counting again.

Ask yourself: How important is the grand scheme of things? Is it really worth it angry? Is my answer to the situation correctly?

Try to find professional help

If you have tried these anger management techniques and are still spiraling out of control, you may need more help. There are many therapists, courses and programs for people with anger management problems. To ask for help is not a sign of weakness.


Consider professional help for anger management, if:

You constantly feel frustrated and angry, no matter what you try.

Your temper causes problems at work or in your relationships.

You avoid new events and people, because you know that you cannot control the feeling of calm.

You get in trouble with the law because of your anger.

Their anger has never lead to physical violence.

If your loved one has an anger management problem

You may feel that you’re constantly walking on eggshells, but do not forget to blame the anger management problem for your loved one. And there is no excuse for physical or verbal abuse.

Anger management problem dealing with loved ones

While another person who cannot control his anger, you can control how you react to it:

  • Set understandable limits on what can and will not be tolerated.
  • For waiting time when you are both calm to talk with your loved one for his anger problem. Do not carry, if any of you is already angry.
  • Remove yourself from the situation if not calm your loved one below.
  • Consider counseling or treatment, if you have a hard time standing up for them.
  • First put your safety. If you feel unsafe or threatened in any way, contact your loved one away.

Written By: Sarfraz Haider

Clinical Psychologist,

Nishan Rehab Multan

Dealing An Addicted Friend

There are certain established and assertive ways to talk to a friend who is taking drugs and ruining his/her life. First thing you will do is to gain optimal knowledge about drug abuse. It is a good idea to learn all you can about drug abuse before talking with your friend. Without understanding basic concept of addiction, it would be hard for you to convince your friend for quitting drugs and come to normal life.  It will also allow you to better empathize when he is talking about his own addiction. You can go to internet, search about addiction so you should be equipped before start talking with a friend about atrocities of drug addiction both on your friendship and also on his family relationships.

Addiction is having one of the hallmarks and it is DENIAL. Therefore, keep in mind your friend may not see his drug problem the same way you see it. He might not believe he even has a drug problem. If he cannot see he has a problem, then he will probably not see he needs to make any changes in his life regarding his drug use. Help him to see his substance abuse problem clearly. Help him to see the facts of his drug abuse. After gaining insight about drug addiction, you will be better able to narrate problems associated with drug addiction and at the end of the day it’s his choice about quitting drugs.

You must have very logical reasons why your friend should quit drugs and you must share with your friend the reasons you are concerned about his drug abuse. State specific times you have been worried about your friend when he has been using drugs. Mention your concerns about his health or other ways you have noticed his addiction has impacted his life. Also, tell him how his addiction has impacted your life as well as your relationship with him. Reassure your friend that you do not want him to live life this way any longer. Show his how much you care about him and inform him that you do not want him to suffer from this abuse any further.

Stay positive and restrain from being condescending or shaming your friend about his drug dependence. It can be tempting to want to judge another person when you do not walk in his shoes, but refrain from making this mistake when talking with your loved one about his habit of taking drugs. Being harsh might only push the person farther away, making it more difficult to help him get sober in the future. Help him to see the positive effects of quitting him drug abuse. Assist him in clearly seeing the ways his life can be different if he chooses to stop using drugs. Praise him any chance you can when he makes strides toward dropping his drug use. Let him know you worry about him, and gently continue to point out you can only help his in the future if he seeks treatment for his addiction. However, remind him constantly you will be there to support him whenever he needs it.

Remember to point out facts instead of emotions when talking to your friend about his addiction. Refrain from trying to guilt him into giving up his drug abuse problem, and realize threatening another person to desert a drug dependence never works either. Negative thoughts or feelings is often what create drug habits in the first place, so avoiding talking down to him and belittling him. Be honest as you communicate about how his addiction has affected you and your relationship with him. Persons with a drug habit are often unaware of how the addiction is influencing relationships overall, so keep in mind how you choose to communicate you want for him to get help because it can make a huge difference in how he responds to the information you present to him.

Do not forget to take care of yourself through this process. It can be exhausting talking to a friend with a drug abuse problem. Therefore, make sure you are seeking the help you need while you are helping an addicted loved one. Arrange to do things you enjoy. Doing things you love brings joy to your life and makes you happy. Make sure you are eating a proper diet and getting enough sleep too. Also, ask for help when you need to do so. Although it may sometimes feel like it, caring for yourself is not a selfish act.

Remind yourself often recovery for your friend is possible. Even when it does not seem like recovery is possible, sobriety is always achievable. Although it may feel as though you are getting through to your friend, continue to have conversations with him that will allow him to see the effects of his drug abuse. You never know when something might get through and stick in his brain to help push him toward seeking help.

There is no one way of talking to a friend who is addicted to drugs. Your friend can choose to take your advice or not, but remember it is not your fault if he chooses not to follow through with the aid you provide him. Do not blame yourself if your friend chooses not to allow support for his drug addiction. However, talking with him about his addiction can assist him in seeing how his addiction is impacting the people he loves and potentially pushing him to get the cure he needs for his addiction

If you, or someone you care about, needs help for a drug or alcohol addiction, contact one of our therapists today at 0300-2255606.

Written by: Dr. Talat Habib

                     Director Nishan Rehab Pakistan