Running makes you high

As many of you may be aware, I’ve had a rather rocky relationship with different substances during my life. Although managing to remain drug and alcohol free, I sometimes still tend to act in the obsessive and compulsive manner characteristic of addictive personalities. Be it working obsessively, throwing myself into new projects or suddenly deciding to give my motorbike a complete overhaul. With all the relevant investigating in the internet, buying the correct tools and of course instructional books to guide me. In fact in my obsessive compulsive way, I am never happier than when I have a plan or project on the go. Recently I lost two weeks of my life as I suddenly decided it was a good idea to import good quality handmade iron and brass beds from England to Spain. Within two weeks I’d set up a web site, a Facebook page, contacted with suppliers and organized an import company. I eventually realized that selling beds on a long term basis wasn’t something that I really wanted to do. By the way I still think they’re great beds and you can buy them here. But I digress.

My latest project has been on myself and has to be said one of my most ambitious projects of late. It all started “within” as we psychologists like to say. I was having a typical anxiety attack at work, like you do. It didn’t help being the wrong side of 45, smoking like a chimney and my only physical exercise was turning the television from the football to formula 1. After having what felt subjectively like a heart attack and being told objectively by my doctor that there was nothing wrong with me I decided to put my money where my mouth is and put together a Behavioural Program for myself (me being a behavioural therapist and all that).

I stopped smoking (more about that in another article), cut out fatty fried foods and started what began as a bit of light exercise. Light exercise quickly changed to running once or twice a week which became signing up for 10k runs with a group of ex-pats that I have the misfortune to knock about with occasionally. This has now become a weekly occurrence with running sessions during the week in preparation for the weekend run, not to mention a delighted but bewildered wifey.

You see it turns out that running is the perfect sport for obsessive and compulsive addictive types like myself. Addicts can be accused of being many things, such as irresponsible, immature, narcissistic and self- centered, but being lazy isn’t one of them. There is nothing more entrepreneurial than an addict trying to get high. A great capacity for suffering and the ability to drag oneself out of bed in the morning to find a way to score is a great skill that can be put to good work when you have to find the motivation to go out running on a rainy, windy autumn evening.

But why would you want to do that? I hear you asking, as I too have asked myself many times. It seems that it is all down to our endorphins, also known as endogenous opioid peptides that function as neurotransmitters that attach themselves to areas in the limbic system (also known as the reward system) and to our prefrontal cortex, where we rationalize. These two areas are also known to activate when we are in love. They are the areas that move our emotions and can alter our consciousness. No wonder that for years people commented on what was anecdotally referred to as “runners high”, where a feeling of euphoria was experienced by runners after completing a race.

This of course would go a long way to explaining why I am feeling grumpy this week as I have not been able to run or participate in a race at the weekend. I’m strung out! The neuro- receptors in my limbic system are screaming for endorphins, they want endogenous opioid peptides and they want them now! Next week I’ll be giving them it because I like that feeling, I’m a great fan of euphoria, I always have been. 

I believe we all are and we have an innate desire to change our consciousness. We do like a bit of euphoria and we can’t seem to help ourselves. We take mind altering substances like coffee and nicotine, we drive fast, we throw ourselves out of airplanes or we climb mountains, we love orgasms and we submit ourselves to 10k races. Why? I suggest because of our innate desire to alter our consciousness. 

For me running is one of the most gratifying ways of getting high, and I’ve tried various. It’s a moment of self discovery as you delve deep within yourself to overcome self doubt and physical pain. You are alone but in company, attached but at the same time detached. When you hit the magical moment, usually after about 20 minutes where body and breathing become one it is a transcendental moment, where I feel at one with the universe and is only surpassed by the euphoria of reaching the finish line.

Anxiety

 

 Anxiety as a physical response

We can all experience anxiety from time to time. Most people can relate to feeling tense, uncertain and, perhaps, fearful at the thought of going to an interview, going to the dentist, asking someone out on a date or starting a new job. You may get worked up about feeling uncomfortable, making a fool of yourself or what kind of impression you are making. In turn, these worries can affect your sleep, appetite and ability to concentrate. Normally when things go well, the anxiety disappears.

This type of automatic response known as anxiety is useful in certain situations. Feeling nervous before  an exam can make you feel more alert, and enhance your performance. Problems start to arise when anxiety becomes prolonged and begins to overwhelm us. In this case it's negative effects end up affecting us in a way that anxiety suffers tend to have less concentration and perform worse.

Evolutionary basis

Anxiety and fear have kept us alive for thousands of years, and contributed directly to the success of our species. If we were living in a cave and discovered that a sabre toothed tiger was sniffing around outside, it's very probable that anxiety and fear would trigger the release of hormones, such as adrenalin. Adrenalin causes your heart to beat faster to carry blood to the main muscles such as biceps and quadriceps where it's going to be most needed. You breathe faster to provide the extra oxygen required for energy. You sweat to prevent overheating. Your mouth may feel dry; as your digestive system slows down to allow more blood to be sent to your muscles. Your senses become heightened and your brain becomes more alert.

These changes make your body able to take action and protect you in a dangerous situation either by running away or fighting. It is known as the 'fight or flight' reflex. Once the danger has passed, other hormones are     released, which may cause you to shake as your muscles start to relax.

This response is useful for protecting you against physical dangers like a sabre toothed tiger, or jumping out of the way of an on coming car. But, the response is not so useful if you want to run away from a letter from the tax man, an exam, public speaking, a driving test, or having an injection. This is because, if there is no physical threat and these problems require a different type of answer. You have no need to physically run away or fight, the effects of adrenaline subside more slowly, and you may go on feeling agitated for a long time.

Reducing anxiety

Prison is one of the environments where people experience prolonged high levels of anxiety and stress. If there's one thing that people find stressing it is a feeling of not being in control. Lack of control can really send our anxiety levels spiralling and people in prison generally have a subjective feeling that their lives are in the hands of others and that they are unable to make decisions and are generally powerless. The anxiety that feeling powerless can create is extremely toxic to the body, both physically and psychologically. I recently did some stress and anxiety workshops in Extremera prison in Madrid. Using techniques based on mindfulness and Acceptance and Commitment Therapy, all participants claimed a reduced subjective feeling of anxiety during the sessions and that the simple techniques could easily be applied by themselves without the supervision of a therapist.

For anyone who is interested in mindfulness in a variety of settings

http://www.upaya.org/uploads/pdfs/DunnBenefitsofMeditationinCorrectionsSettingrev7110.pdf

Substitution treatment of injecting opioid users for prevention of HIV infection.

Substitution treatment of injecting opioid users for
prevention of HIV infection.
Gowing L., Farrell M., Bornemann R. et al.
Cochrane Database of Systematic Reviews: 2011, Issue 8, Art.
No.: CD004145.
Updated review conducted for the respected Cochrane collaboration finds that methadone
maintenance and allied treatments for opioid dependence consistently and significantly
reduce the risk of transmission of blood-borne viruses and curb the spread of HIV.
Summary Drug injectors are vulnerable to infection with HIV and other blood borne
viruses due to the collective use of injecting equipment as well as sexual behaviour. This
review aimed to assess the degree to which this risk is affected by the prescription of
drugs such as methadone to be taken by mouth which substitute for the opiate-type
drugs the patient is dependent. It assessed impacts on behaviours which place people at
high risk of viral transmission and on actual rates of HIV infection. With one exception, it
considered all sorts of studies, not just randomised trials, as long as the treatment and
outcomes were relevant and participants were opioid dependent drug users, most of
whom were currently or recently injecting. The exception was studies which required
patients in treatment to at the same time recall their past risk behaviour before and after
starting treatment. Non-English language studies were included. The studies were
expected largely to relate to methadone, but evidence relating to other oral preparations
(buprenorphine, LAAM, codeine and slow release morphine) was also considered.
A search discovered 38 studies involving about 12,400 participants. Just two randomly
allocated patients to substitute prescribing versus other treatments. In the remaining
studies, findings would have been complicated by influences other than substitution
treatment resulting in potential bias. All but six were solely concerned with methadone
treatment, 32 with treatment in a service specialising in addiction treatment, and 26
were set in the USA. Due to differences between the studies, no attempt was made to
combine their findings in to an overall quantitative assessment of the impacts of the
treatments. Instead the reviewers assessed whether effects were consistent across the
studies and across different types of studies.
http://findings.org.uk/count/downloads/download.php?file=Gowing_L_12.txt (1 of 5) [07/09/12 11:33:55]
 Overall studies consistently find that after entering oral substitute prescribing treatment
(generally involving methadone), patients move to being at substantially lower risk of
HIV infection due to behaviours linked to their drug use, but less consistently in respect
of their sexual behaviour.
Across 17 studies it was consistently found that starting oral substitution treatment was
associated with significant falls in the proportion of patients who continued to inject and
in the frequency of injecting. These reductions typically occurred in the first one to three
months of treatment and were sustained for at least the first year. However, reductions
were not necessarily sustained after treatment ended, particularly if termination had
been involuntary.
Treatment was also consistently associated with a significant decrease in the sharing of
injecting equipment, possibly due to reduced injecting. These benefits were sometimes
sustained after treatment ended, though not in a study in which patients were forced to
leave due to subsidised treatment no longer being available. In some studies similar
reductions in sharing were achieved by other treatment modalities.
Like another Cochrane review, the featured review also found that illicit opioid use
(injected or not) significantly decreased after entering treatment and did so consistently
across all relevant studies.
Since there were few studies, it was difficult to be conclusive, but the data also
suggested that sex-related risks of viral transmission were also reduced due to fewer
people having multiple partners or exchanging sex for drugs or money, though condom
use was affected little if at all. In six of the seven studies to assess this, the overall drugrelated
risk of HIV infection assessed by composite scales was significantly reduced. The
same was true of the seven studies which assessed risk due to drug use or sexual
behaviour.
Four studies assessed relationships between the proportions of people who became HIV
positive (seroconversion) and their participation in methadone treatment. All found that
participation as such, or more extended or continuous participation, was associated with
a lower rate of seroconversion. This suggests that reductions in risk behaviour do
translate in to actual reductions in cases of HIV infection. Substitution treatment may
also protect individuals already infected with HIV against further infection with other
strains of HIV, or other blood-borne viruses.
The authors' conclusions
The reviewers concluded that oral substitution treatment for injecting opioid users
reduces drug-related behaviours with a high risk of HIV transmission, but has less effect
on sex-related risk behaviours. On this basis, provision of this treatment should be
supported in countries with emerging HIV and injecting opioid use problems as well as
those with established populations of injecting opioid users.

Working in Madrid and homesickness

Challenge of corporate relocation
Yes, there are very real reasons that many of us rise to the callenge of being relocated – but once you’re living abroad, it may just be that you suddenly realise that home ties are very strong.

Homesickness can manifest itself in many different ways, and it can affect each and every single one of us who makes the bold step of moving away from our home country and our comfort zones.  Knowing the signs of it and what to look out for are almost as important as knowing how to deal with it – especially if you’ve relocated abroad with your family and you want to make sure your spouse and children are settling in to their new home country and routine and are not missing home.
  Homesickness is a longing for the familiarity of home.  And a longing that cannot be satiated is one that can grow and become more and more difficult to deal with, which is why it is important to recognise homesickness and address it head on.
When we relocate abroad the majority of us are buoyed up by the thrill of the challenge and the wonders of the new world we’re about to encounter and embrace. This initial excitement can cause the stresses, trials and tribulations that go hand in hand with relocation to be taken on the chin. We can feel temporarily invincible by our optimism and excitement.  Knock backs and hurdles are dealt with one after the other, and they are offset by the delights of the new life we’re beginning.  This is the reality for most people when they move abroad – this reality lasts anywhere from a few days, through to a few weeks, up to a few months. 
But eventually a new reality dawns! Normally in Spain in the form of BUREAUCRACY
This is the reality of everyday life, the reality that actually, you are the same person with the same issues and challenges in life, but you’re just living in a new location and without the support of family and friends and familiarity.  It is when this reality bites that homesickness can first manifest itself.
This has been dubbed as getting ‘expat flu’ in the past, because it’s about now that expats usually succumb to some physical ailment or other that’s probably a result of the body collapsing after the stresses, strains, excitements and highs of the recent period.  But looking at the bigger picture, expat flu is also an emotional symptom and it can last for a lot longer than any bug or cold that you get. 
Many expatriates say that it took them up to 2 years to settle in and truly embrace their new life abroad…and we can certainly concur with this.  Yes you can find a home, get a car, put all your belongings in place and even start work within just a few weeks of arriving.  But it takes at least 2 years to learn language fluency, to gain deep familiarity with the ways, the customs, the rules and the culture of your new home; it also takes this long to forge deep and lasting emotional bonds with one or two new good friends.  And it is establishing these ties and meeting these goals that bring a lasting permanent relief from homesickness – and unfortunately, these things cannot be rushed.
But this does not mean you have to suffer homesickness for 2 years!  You just have to learn to achieve a balance between your old life and your new life, you have to decide what is fundamentally important to your underlying happiness, you have to communicate with family and friends and you have to work hard every single day to beat the blues.
The very first thing that most people miss is other people – as in, the significant people in their life who they have left behind.  If you’re working in Madrid, these people may be your children, your parents or your friends. They are irreplaceable. Remember if you are working in Madrid and have brought your wife and children with you But that doesn’t mean you can’t learn to cope with your missing them in your life.  The first thing you have to do is stop being so fatalistic and negative and thinking that you will miss these people forever, that you will never have them in your life again!  Open regular communication – get Skype – have webchats, phone calls, send email, send cards and snail mail greetings, invite them to stay.  And – book a trip back home as soon as you can. 
The next thing you will probably miss is familiarity.  This is a hard one to pin down because it means something different for each and every one of us.  It can mean you miss being comfortable with how your job works, or how to achieve the weekly chores and shopping, it can mean you miss knowing how everything works.  Even things as mundane as knowing how the milk cartons are. Eva hoffman referred to this in her book "Lost in Translation" as "..being excluded from the unspoken culturally shared ideas about what constitutes, beauty, ugliness, good food, bad food..." You can be presented with this longing on a daily basis in different forms.  One morning you may wake up to no hot water and again be faced with just how little you know about how your new country works – who do you call?  How do you explain the problem?  When can it be fixed?  How much will it cost?  In reality you’d have the same dilemmas in the UK, but you could trust the good old Yellow Pages or perhaps even a neighbour to give you the number of a plumber who would indeed come out quite quickly – and charge you a fortune for the privilege!  Or missing familiarity could be presented to you as you face a smaller challenge each day such as finding something the whole family will eat for dinner!
This is something that requires a two-pronged approach to dealing with.  Firstly you can begin to recreate familiarity around you.  If you have your own personal belongings with you, that’s great, it means you can settle down of an evening in an environment that, if not 100% familiar, at least has traces of ‘home.’ There is a great ex-pat community in Madrid, get out and about. Get photos and mementos of home sent out to you and put them up.  Think about getting a satellite TV package through which you can watch all the old rubbish you used to enjoy – alternatively, check out BBC iPlayer and ITV Player online – you can gain access to all the channels’ offerings and these can give you a reminder of home and a window back on your old life.  Find the odd British product in the shop (there's plenty in Madrid), or ask for a food parcel from home.  These little things may seem trite to a non-expat reading this article, but they can make all the difference to an expat missing home.


It is not a case of black and white, i.e., it is not a case of you’re abroad forever and will miss home forever, (unless you’re a fugitive, and then we cannot really help you!), neither is it a case of your never finding happiness abroad.  You have choices – if it all gets too much you can go home, but then why did you move abroad in the first place?  Try remembering that which motivated you to make the move, and at the same time try embracing the very real fact that it takes time to adapt to a such a massive transition.  Additionally, take regular trips back home and satisfy your longing for rain, for fish and chips, a pint in the pub and a traffic jam.  We understand and appreciate that travelling home can be expensive and also difficult to organise when you have work commitments for example – but it is not an impossible dream to fulfil if you set your mind to it.  Also, invite friends and family to stay – their holiday based enthusiasm for your new location will probably reignite your passionate and positive feelings for your new home location too.  And finally, one day you’ll wake up in the UK on a visit to family and be about to board your flight overseas again, and you will realise that this time, the outward flight from Britain is taking you home.  Your heart and head will have finally united and both will firmly believe that Britain is where you used to live, but your home is abroad and abroad is your home! 
It takes time to get over homesickness fully and to completely embrace your new life, warts and all.  But in the meantime, there is plenty you can do to alleviate your less than positive feelings and get the very most out of your time abroad.  Go easy on yourself, but don’t shy away from the challenge – ultimately it is one of the most rewarding things you can do on an ongoing and lasting basis!