Question: Can a person be addicted to plastic surgery? My mom won’t stop getting stuff done to her face, her boobs, her but even her ankles. I have lost count by now but she has had way more than 10 operations over the last few years. We have no money to pay the bills but she always finds money for surgeries. And in my opinion the surgeries she is getting now are no longer making her look better. She is starting to look weird, like a person who has had too much. I have tried talking to her about it but she does not listen and it is always just one more thing that she needs to fix. Are doctors really allowed to just keep taking money for this? Can’t they at some point say that this is not necessary and not a good idea? I don’t know what I can do to get her to stop doing this. Do you have any advice for me?

William Anderson Says...:

Plastic surgery addiction is a new disorder that is not yet well documented, studied and categorized in the professional literature. However, it is happening enough and causing enough suffering, witnessed by family and friends and mental health professionals, that I'm sure it soon will be. Professionals are now looking at it as a behavioral addiction related to Body Dysmorphic Disorder, obsession and compulsion, and perfectionism.

Like all addictions, it is difficult to intervene when the addict has no interest in changing and is mainly concerned with defending and retaining the addiction. Your mother needs mental health and psychiatric treatment. You will need to talk with other family members and perhaps her friends and work to develop a strategy to get her into treatment. You can also meet with professionals at an addictions treatment facility to discuss the matter and ask them to help you develop a strategy.

In the meantime, you can contact the doctors' offices directly. Call all of the doctors' offices that your mother could call on and put them on notice. They don't have to break confidentiality and discuss their knowledge of your mother with you. They simply need to hear you out to avoid lawsuits and losing their license. With what you describe, it is obvious to the doctors what is going on. Those who, because they are ethical, refuse to indulge her, may be able to make a psychiatric evaluation a condition of working with her. That would motivate your mother to see a psychiatrist and that could initiate a change. With those who are unethical and would indulge her, you can discourage this by letting them know that your mother needs psychiatric care and that they will be risking their license to practice as well as damages in lawsuits if they take advantage of her. Let them know that you will be aggressively pursuing disciplinary action by the state licensing board as well as damages if they participate in your mother's disorder.

It sounds like your mother is fortunate that you are there to do these things. Please write back and let me know how things go.

Question: Are steroids addictive? My brother started using them in high school. He justified the decision as he was going to get big so he’d get a football scholarship. The scholarship didn’t happen but the steroids are still ongoing like 5 years later. Now he’s like the hulk but he can always find some reason why he needs to take just one more cycle. I know this isn’t good for his health but I have tried to respect his decisions over his own body. Now I am wondering how in control he really is.

William Anderson Says...:

Yes, steroids can be addictive, like all things that give pleasure or help to avoid pain. When that occurs, parts of the brain are stimulated to generate new programs, so to speak. Drive and desire are created, sometimes so powerful that they can take control. These addictions can overpower a person's conscious will or seemingly enslave the person to satisfy those drives and desires, even when it is against the person's best interests. Addictions can be chemical, as they are with painkillers and cocaine, or they can be behavioral, like gambling or Internet addiction, though all addictions are really chemical in nature when you take into account that the operation of the brain is conducted by neurochemicals.  

If your brother is intelligent enough to understand the risks and damage he is doing to his body with steroid abuse, but he continues to do it anyway, assume that the brother you love and respect is no longer in control. The addiction is. When an intelligent sane person realizes that what they are doing is hurting them, they stop it. When the attachment or addiction is strong enough to overcome their intelligence and will, that's the "insanity" of addiction.  

It sounds like the rewards of using steroids have your brother hooked, addicted. You may want to respect your brother's decisions over his body, but they have been rendered irrational and unhealthy. Your love for your brother would be better expressed by helping him to face the fact that he is addicted to something that can do irreparable harm. Get other family members involved and see if you can get him into treatment.  

Question: If I get out of touch with reality (not in a good way) sometimes when I smoke strong pot does this mean that I am one of the kinds of people that are at risk of schizophrenia? I know that marijuana can increase a person’s risk of getting schizo in their 20s. When I smoke sometimes it is fine and fun but sometimes I get really scared and I think I am going to die or that people around me want to hurt me.

William Anderson Says...:

You are describing paranoia, which can happen when you smoke pot, and it can also be a symptom of mental illness. You won't know for sure which it is until you stop smoking pot.

Smoking pot is dangerous. While a lot of people don't want to hear it, it can create long-term mental problems like depression and mental confusion. It's a drug. It's not mother's milk. It can damage your brain. Also, it is illegal even though a lot of people have convinced themselves it's no big deal. Getting caught and charged will create a permanent record that will haunt you and create big problems for the rest of your life.

Stop smoking pot and your life will get better. If you still have these episodes of paranoia, make an appointment to see a psychiatrist and get it checked out.

Question: I am in college at a big party university. I have experienced pretty major trauma I guess dealing with several deaths of family members, including my dad, and a close friend all within the last year. My best friend just had to leave school to go to rehab due to an overdose. Over the past we did coke pretty regularly but not on a daily or even weekly basis. Whenever we could get it we did, and then it would be gone shortly. This year we started buying just one time after another and our tolerance built up so, we decided to try something stronger. We did crack together once but that was it. I haven't done coke in about two and a half months now, and I stopped drinking mostly. My drinking was definitely out of control for a little but now i have no interest in getting drunk and blacking out. I never drank and did coke together though. I smoke marijuana multiple times daily and usually til i fall asleep and I see it is kind of out of control. It is my incentive for nearly everything i do school wise. I sometimes snort my adderall and klonopin, and in the summer I was snorting Xanax and vic and blew-through both prescriptions quickly. I have remained away from coke but I still snort these other things and I always contemplate buying coke just one more time but hold myself back from finding it. I don't know if I should just focus on quitting weed but I really don't want to right now at all. I have found myself fending for more pot, worrying about Incan get more so I don't run out. Sometimes I'll really get the urge to snort something or do coke so I'll just snort an adderall. Sometimes it definitely helps me deal with emotions about my life. I don't know if or how this would be treated or if they treat weed because you can't get physically addicted. But I beg to differ on that because recently for a short period of time I wasn't able to smoke at all and I felt horrible for two and a half days. Exhausted stomach ache headache irritable. Anyway I just don't know what to do that fits my situation to fix the problem if there even is one. Do I need to get help?

William Anderson Says...:

Yes, you definitely need to get help. You have somehow gotten into thinking that doing drugs and getting high all the time is normal. It's not, and it will ruin your life if you don't get things turned around. Most colleges have counseling centers that have trained therapists who can help you with all these difficult issues you are struggling with. Get up and go there and start talking about all this stuff with a trained substance abuse counselor. Your life will get better as soon as you do.

Question: I have only been doing cocaine for a couple of years and I already have a big hole in my septum and you can even see that my nose is starting to flatten out. It really hurts and I know that it is permanent and it makes me really feel down when I think about it. I am trying to quit but it’s really hard. I am using a little less than I used to. I always swore I’d never use crack because that was a line I would not cross. Should I switch to crack instead of snorting while I am trying to quit so that I won’t do more damage to my nose? I cannot afford any expensive rehab right now.

William Anderson Says...:

You are in bigger trouble than you realize. If you do not get clean and sober right now, you will most likely die an ugly death very soon. You need to get into treatment and get off cocaine altogether to avoid things getting worse. Your thinking is not rational and if you stay on the path with the thinking you have right now, things will get much worse right away.

Sell everything you have, if that's what it takes to pay for treatment, and get into treatment. If you become homeless, it would be better to start over again clean and sober than to die with assets.

If you won't have enough even if you sell everything and no family that can help you, I'm sure we could find a program that would be available if you can prove you have no assets and no income.

You are at high risk right now and your letter shows that you are not thinking rationally. Please trust me and get up and go to your local public Crisis Center or Detox as soon as you read this and get help to find a treatment center. I don't know where you are located, so I can't tell you where one is near you, but write back if you need help finding where to go. We here at Choose Help will find you help.

You are wrong that the disfigurement of your nose is permanent. Once you recover and get your life back on a healthy path, you can have surgery to repair your nose. If you survive, anything is possible. However, you are on the on the path to an early death, and that is permanent.

Get moving. Best wishes.

Question: I used to do a lot of LSD. I have done more than 500 hits of acid, along with a lot of other drugs, but LSD was always my drug of choice. I have heard many times that doing a lot of LSD can cause chromosomal changes in your body and that these can be passed on to your children. I do not know if this is true or not. I am now in my late 30s and a few years away from the drug life I used to live and I want to have children now with the great guy I am engaged to be married to. But I am worried about my past and whether or not I am going to be putting a child at risk. Should I be worried about mutations?

William Anderson Says...:

Worry will not solve anything and can make you sick. Instead, take action.

Make an appointment tomorrow with an MD who specializes in obstetrics, gynecology and reproductive medicine. These are the doctors who help people with fertility problems, but they also deal with genetics issues and should be able to put your mind at rest, setting you on the best course for having a great life with a great guy and a great family.

If, when you make the appointment, they ask what your interest is, tell them you are interested in starting a family and want to consult with the doctor about possible risks due to family history. If they want more detail than you want to share with the office staff, tell them you'll discuss that with the doctor.

Trying to figure this out without going to an expert in genetics and reproductive medicine is a mistake.

A worry-free future with a family can be yours, and you can be on the way tomorrow.

Question: I am trying (and mostly failing) to control my drinking and cocaine. I have a great apartment that is in a very vibrant part of downtown. I can walk to a dozen really great coffee shops and art galleries and great stores and restaurants within 10 minutes from my front door and I can walk to work in 15 minutes. I also share the apartment with a friend who rents it from his Aunt at a very reduced rate, so it is a much nicer place than I could otherwise afford. The problem is that when I walk out at night it’s not a dozen coffee shops that are in my immediate vicinity, it’s 50 great clubs and pubs and bars that line the streets. I love the nightlife so this has always been great, but now that I am trying to quit drinking and drugs I find the constant temptation very difficult to deal with. Should I move out to the suburbs? I am worried that I will move to somewhere boring and terrible and I’ll feel the same temptations I do now…but I’ll be living somewhere I hate. Will moving make it easier for me? Or am I blaming my neighborhood for an addiction that is really just inside me and so wherever I live doesn’t really matter?

William Anderson Says...:

We often hear the "Geographic Cure" scorned. People point out that you can't run away from the problems that are inside you. It's true that moving will not cure everything if you don't work on the problems inside, but if you are working hard to change inside, moving away from the environment you describe can really help, even save your life.

Get out of there ASAP and find a place to live that will encourage a healthier lifestyle. At the same time, get to work on the problems inside.

In Behavioral Medicine, we recognize the power of environmental cues or stimulus control, and in 12-step groups we talk about the power of people, places and things. So, it is widely recognized that changing your place of living or work and relationships is sometimes absolutely required in order for things to get better. If you don't, things get worse, they don't stay the same. You say you are mostly failing at trying to control your drinking and using, that you are frequently out of control. You are describing alcoholism and cocaine addiction. These things don't stay as they are. They either get better or they get worse. Which will it be for you?  

You have a choice to make. Addiction to alcohol and cocaine is a downhill spiral that often gets worse, perhaps losing it all, or you change things now, and you get better. Life gets better.

You say that you you'd have to give up a great place at a great deal, and you're afraid a new place will be boring, not so appealing. That's what addiction is about. You get attached to things that are killing you and it's hard to let go. Lots of people don't ever let go, and they die in their addiction, never having broken free of it.

If you haven't started going to meetings, connect up with some people who go to AA meetings. You'll find people everywhere, near you now and at your new place, who have been where you are and gotten out and they will help you. You need friends to make life work, but the friends you have now, in the clubs and nightlife, are more likely to drag you down than lift you up. If it is not already a life and death decision, it may soon be. Which way do you want to go?

Get moving on this, and write back if you want.

Question: I left a response under a question that was directed to you. And it led me to ask is having a few glasses of wine or champagne on a weekly basis considered addiction? I will have a drink Friday night (3) glasses ; Saturday night (3-4) glasses. Sunday nothing. Monday maybe some champagne with dinner and then Wednesday maybe (1-2) glasses off wine. repeat. Is this odd? or okay? I definitely feel happier when I pop that cork (chuckles to self) but in the back of my mind I hear my mother saying "OMG You'd better watch yourself You need some prayer" And Im thinking to myself Im young in my mid 20s vegetarian holistic lifestyle yoga buddhist lifestyle let me have my fun. So I guess I figured since I live alone and have no one to bounce the idea off of; let me ask a professional? Am I just paranoid?

William Anderson Says...:

Does this drinking cause any problems? If it does and you still drink, you need to look at that. When you have something that causes problems, you just get rid of it, unless.....

Have you taken the standard questionnaires? What do they say? Google around. You'll find lots of "Am I an alcoholic?" tests.

Regarding addiction, please read the answer I just posted about "Addictive Personality". It will give you a better idea about habits vs. addiction.

You can also look into the DSM criteria for substance dependence, the clinical diagnosis used when people have an addiction. I discuss the DSM substance criteria in my article about food addiction: http://theandersonmethod.com/food-addiction/ 

The fact that you're wondering indicates something, but I'm not sure what, and a little healthy fear is not a bad thing. Just because you're afraid of something dangerous does not mean you are paranoid, and alcoholism is dangerous.

Have others remarked that you drink too much? That's a red flag.

My gut sense from your description does not sound like addiction or alcoholism, but check out all that I referred to and let me know what you think. It's interesting and valuable info, whether or not you are at risk.

Question: Is there such a thing as an addictive personality? I have heard this term used for a long time but I don’t know if this is a real medical term or not. I think that if it is real then I must have one. I used to smoke a ton of weed and then one day I managed to give it up – but then I got really into online gaming and WoW and that became like another addiction to me. Then I gave that up and decided to get healthy and got really into exercising and now my GF is giving me a hard time about how much time I spend every day in training; it’s almost like I’m addicted to exercise now like I used to be addicted to weed and I’m just going through life substituting one addiction for the next. I’d like to be able to do something in moderation for once, like a normal human being – but I’m not sure how to change myself, like a leopard can’t change its spots, and being like this just seems to be the way I’m hardwired. I get into something that could be an OK thing (even weed) and then I just lose control over how much I do it until it becomes a not OK thing, and then I move onto the next thing and repeat the pattern all over again.

William Anderson Says...:

Addictive Personality Disorder (Addictive Personality) is not a recognized diagnosis in medical and psychiatric officialdom, but many, including medical and mental health professionals, think it should be. It is observed by reliable reporters that some individuals have a predisposition to addiction and many think that this apparent reality should be studied and, when the predisposition is pathological, classified as a disorder in the same way that we have created diagnoses like Obsessive Compulsive Personality Disorder and Narcissistic Personality Disorder. I personally am in favor of officially recognizing that some people have an Addictive Personality, a greater tendency to become addicted than other people. To me, there is no doubt about this. 

First though, I think that it's important to recognize that the tendency and drive to repeat rewarding behavior is natural, an important characteristic in human beings, required for us to develop the ability to survive. We would perish if this tendency to repeat pleasurable behavior were absent.

Learning and conditioning occur when we do something and it feels good, where our brain experiences stimulation of the reward centers of our brain. A power is tapped that drives us to repeat the behavior. Eat something tasty, and you'll create a "program" that will have you seeking it, sometimes with an appetite or craving that will not be satisfied until you get it, even if you have to go to extremes to get it. Have you ever gotten a hankering for some ice cream for instance, and gotten up and into the car to go get it? Ever found yourself just reaching for something when you got home, even when you weren't hungry? We are hardwired to form habits that tickle those pleasure centers. That's why we survived, this learning or conditioning process motivating us to make efforts to engage those habits and go after those things that helped us to survive. That's normal and healthy, a natural part of us, the way we are made. Otherwise, it's easier to just lay there and not move, which would result in cessation of all life. Motivation has to do with seeking reward or pleasure, and avoiding pain and discomfort (like withdrawal symptoms).

However, sometimes this learning process creates habit and drives that are powerful to the extreme, where the habits and drive compel a person to act, even when they want to stop, even when the habit hurts instead of helps. The person is unable to control their behavior and appetites with their conscious will, where they continue doing something in defiance of their will. Here, we are talking about uncontrollable habit and addiction. And it seems to me that some people are more prone to this "super learning" than others. Their friends are able to decide what to do or stop doing, and they have no problem. The addictive person though, seems to have a problem with self-control, and with everything that is rewarding, they get carried away and have difficulty finding balance and ease. The habit controls them rather than they controlling the habit.

We are all creatures of habit with a potential to get addicted. Some have this tendency to a higher degree than others. When the habits are healthy, don't cause a problem, and the person controls this easily, it's a sign of good health. If they are unhealthy, cause problems and the person cannot control things, it's a disorder.

So yes, some people have a greater tendency to compulsive habit than others and sometimes it's a good thing. They do great work, get things done reliably without great effort, and can add and delete habits at will. They have a beneficial addictive personality. Some get hooked on everything rewarding that comes into their path and they can't control it, even when its dangerous. They have an addictive personality disorder.

If you have the one that is beneficial, great! Maybe you can fine-tune it and make it work even better, with greater self-mastery. If you have the one that makes your life a mess, you need to see an addictions professional, because without gaining this mastery, you are at the mercy of higher powers, and not the good kind.

Question: I’ve grown up with a really tight circle of friends. They are more like brothers to me than just friends and I owe my life to these guys. They have literally saved my life on more than one occasion. They would never turn their back on me and I can never imagine turning away from them. We all smoke a lot of weed. it’s like a huge part of what we do. I have started to realize that I don’t really want to be high all the time. I’m 23 now and I can see some of the people I went to high school with are starting to get good jobs and stuff and I’m still just sitting around with nothing to show for myself. I need to get serious about my life but as soon as I get high in the morning any good plans I had to get stuff done and make some progress just gets shelved for another day. So I keep telling myself that I need to slow down with the weed, but I just don’t seem to be able to do it. I mean I want to, but when I’m offered I just can’t seem to say no. I mean sometimes I’ll say no, but eventually I’ll always fold and say yes. I have enrolled at JC for the last two semesters and both times I’ve screwed it up because I missed too many classes and did too little work. And this is all because I was high every day. I can’t keep doing this to my life. So I feel like I am stuck. I can’t stop hanging out with my friends, there’s no way I could do that to them. But I also want to quit weed and get my life together, and I just can’t seem to stop smoking when I am around them. How can I be a stronger person and learn to just say no without having to turn my back on the people I love.

William Anderson Says...:

Listen to yourself:

"I have enrolled at JC for the last two semesters and both times I’ve screwed it up. I missed too many classes and did too little work. And this is all because I was high every day."

"As soon as I get high in the morning any good plans I had to get stuff done and make some progress just gets shelved for another day."

"I’m 23 now and I can see some of the people I went to high school with are starting to get good jobs and stuff and I’m still just sitting around with nothing to show for myself."

You know what you need to do to prevent your life from going nowhere, becoming a useless unproductive miserable mess. You need to stop smoking weed. And you have discovered through experience what addicts, whether its alcohol, cocaine, cigarettes or weed, find out: You can't just do a little, on weekends or special occasions. The weed takes over and you lose the ability to control it. You can't hang around the people, places and things that keep its company. The weed takes over and you end up in the same mess again.

You need to stop smoking pot now, or risk really screwing up your life.

You may have believed the lie that weed is harmless and you can do it and still have a successful life. But you have learned by experience that this is a lie. You have proven it. You are going nowhere smoking weed with others who will be going nowhere too, if they are stoned all the time. Maybe some people can smoke occasionally and the weed doesn't take over, but you have found out you can't, and you can't hang out with pot-smokers without the weed taking over. There are many good people who are like you, and they are OK, as long as they stay away from pot.

You are going to have to make a choice. Do you want to move on to a better life like those you knew from high school who are making their lives work, or do you want to go nowhere but downhill with the pot smoking crowd?

It is hard to part company with those you love and are attached to, and it is not that they are bad people. You love them, and it will be hard to watch them self-destruct if they don't clean up their act too. But, like many young people who partied with peers, you'll watch some of them clean their act up and create great lives, and you'll watch some of them become alcoholics, pot-heads and addicts, going nowhere and miserable. Which are you going to be?

Find an addictions counselor who you can talk to about this. He will verify what I am saying, which is important, because those who want you to keep smoking with them will have their own agenda and their own opinions to tell you. A good addictions counselor can hook you up with support groups and educational material that will help you. And then, some day you may be able to help someone else out of this mess you are in. You can help your friends more by getting clean than by going down the tubes.

Best wishes to you. I hope you make the right choice.