• Tue. Dec 5th, 2023

Health Administration

Come One, Come All To Health Administration

Ask Natalie: Mental Health and Recovery

by Natalie Gray

The Manning Times has asked it’s readers to send in their questions about mental health and recovery for the past few weeks, and now, we present the first set of answers from Clarendon County Behavioral Health CEO, Natalie Gray.

How is addiction a disease versus a choice? I want to believe that my father cannot control his drug addiction but I am torn between him making a conscious choice to get high versus having an uncontrollable disease. 

This question is often the subject of debate, and the answer can vary.  While, yes, individuals choose to use alcohol or other drugs initially, eventually use can affect the brain. This often generates a cycle of use/withdrawal/craving.  Addiction itself can be a choice when an individual acknowledges the addiction but fails to seek help.  Help can take years for some people, and their pathway to recovery can differ based on their drug of addiction, method of use, length of use, and maybe most often, their mental health and social determinants of health.  

According to NIDA (National Institute on Drug Abuse), a person who uses drugs can have three areas of the brain affected: the brain stem, the limbic system, and the cerebral cortex.  The brain stem regulates all of the bodily functions like breathing, blood flow, and food digestion.  It links the brain with the spinal cord and lets the brain know what’s happening to the body.  The limbic system controls our emotional responses such as pleasure or pain. This area is commonly the area that generates cravings.  The cerebral cortex is the “gray matter” in humans, and it is comprised of 4 areas called lobes.  Some areas process information from our senses allowing us to see, hear, feel, and taste.  The frontal cortex is the thinking center and powers our ability to think, plan, solve problems and make decisions. 

A person’s mental health and environment can also contribute to the severity of their use.  Someone with a family history may have genetic factors that affect their ability to use substances.  Adverse childhood experiences (often referred to as ACE’s) such as neglect and trauma play a role as does social determinants of health like poverty, poor access to medical care, and lack of education.  When someone suffers from a mental health condition such as anxiety, depression, bipolar, or another mental health condition, they may use substances to cope/alleviate their symptoms.

The bottom line is that there is help and healing available. A person doesn’t have to stay in the addiction cycle.

What is the best way to approach a family member about addiction? I am seeing my brother drink more and more and am concerned it is becoming a problem but I do not want to cause confrontation.

Sometimes, the direct approach works especially when done with care and concern.  Family members are often the ones directly affected by a loved one’s use.  Have a conversation and ask a few questions like:

•Does your use concern you?

•Has it cost you jobs or relationships?

•Have you suffered physically because of your use? (i.e. takes time to recover from a night of partying or cravings to use that one feels they cannot control)

•Do you take risks when using (like driving a car, unprotected sex with strangers, or sharing needles)?

•Do you spend more time trying to get what you need (such as alcohol, cocaine, methamphetamines, and other substances) than you plan?

•Have you wanted to or tried to quit and just can’t?

These questions asked of someone may help them determine the emotional, financial, and physical cost of their use. If they do not feel comfortable discussing it with you, then refer them someone for an assessment of their use.  For some people, harm reduction is an option rather than total abstinence.  

What are the signs of depression in teenagers? How can I tell the difference in depression and anxiety versus just regular teenage hormones and mood swings?

Teenagers have a tough time in our world these days. They are faced with more and more pressure because their world has been expanded more than any other generation.  Couple that with the normal stages of physical and emotional development and environmental factors, and there may be a recipe for both depression and anxiety.  

Depression is defined as a mood disorder that causes a persistent feeling of sadness and loss of interest while anxiety is fear or worry you cannot control. Some signs of depression in a teen may be lack of energy, sleeping too much or too little, easily irritated, little or no appetite or eating too often, and withdrawal from family and friends.  Symptoms of anxiety can range from excessive worry about school, peers, or extracurricular activities, constant concern and worry for the safety of self or loved ones, and inability to relax and/or concentrate (among other things).  According to NIMH (National Institute of Mental Health), 13% of all teenagers struggle with depression and anxiety disorders.  

What can you do to help? If you have a concern about someone who may be battling with depression, anxiety, or both, seek help through a professional to assess and identify any issue.  Treatment can vary depending on the severity of the condition.  Cognitive Behavioral Therapy (CBT) is one form of treatment used, and it addresses how emotions, thoughts, and behavior are all connected.  The examination of that process may help identify faulty thinking. In addition, it is recommended that a nutritious diet, physical activity, sufficient sleep, predictable routines, and social support are also important factors in treating anxiety and depression in youth.  Some anxiety and depression are considered normal in developmental stages of growth and maturity, but if it becomes too much, seek out help.


Natalie Gray, M.Ed., LPC, MAC, AADC-CS is the Chief Executive Officer of Clarendon Behavioral Health Services in Manning, SC. She entered the Behavioral Health field after a successful 20-year career in Business/Accounting. She has a Bachelors in Business Administration from Southern Wesleyan University and a Masters in Community Counseling from Clemson University.  Natalie has worked managing residential and outpatient Mental Health and Substance Use Disorder programs since 2010. She has co-authored a curriculum for family transformation and her passion is working to heal individuals and families affected by substance use and co-occurring disorders. 



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