Alternative Lifestyles – difficult to share with family and friends_Question

Posted on Wednesday, May 20th, 2015 at 4:54 am.

Dr. Beth, I am a married woman and my husband and I have been married for 25 years.  We have an unusual dilemma and I wondered if you can help us.  My husband and I have raised a family with two wonderful daughters. Both are out on their own and very successful in their careers and relationships. Now that we have the privacy, we have decided that we would like to open our marriage up to include new people in our lives both as friends and potentially as sexual partners.  We are on the same page about this but aren’t sure how to go forward. Also, should we share or not share this with our current friends or our daughters? We could use some advice.


Alcoholism – How to diagnose it_Answer

Posted on Friday, May 15th, 2015 at 4:26 am.

I get this question frequently.  I think the information from the Mayo Clinic, one of the nation’s most highly regarded medical clinics, provides one of the clearest definitions of alcoholism:

“Alcoholism is a chronic and often progressive disease that includes problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect (physical dependence), or having withdrawal symptoms when you rapidly decrease or stop drinking. If you have alcoholism, you can’t consistently predict how much you’ll drink, how long you’ll drink, or what consequences will occur from your drinking.”

The Mayo Clinic staff also list the symptoms of problem drinking and alcoholism.

“Alcoholism signs and symptoms include those below. You may:

  • Be unable to limit the amount of alcohol you drink
  • Feel a strong need or compulsion to drink
  • Develop tolerance to alcohol so that you need more to feel its effects
  • Drink alone or hide your drinking
  • Experience physical withdrawal symptoms — such as nausea, sweating and shaking — when you don’t drink
  • Not remember conversations or commitments, sometimes referred to as a “black out”
  • Make a ritual of having drinks at certain times and become annoyed when this ritual is disturbed or questioned
  • Be irritable when your usual drinking time nears, especially if alcohol isn’t available
  • Keep alcohol in unlikely places at home, at work or in your car
  • Gulp drinks, order doubles or become drunk intentionally to feel good, or drink to feel “normal”
  • Have legal problems or problems with relationships, employment or finances due to drinking
  • Lose interest in activities and hobbies that used to bring you pleasure

If you binge drink or have other problems with alcohol, you may have many of the signs and symptoms above, although you may not feel as much of a compulsion to drink compared with someone who has alcoholism. Also, you may not have physical withdrawal symptoms when you don’t drink. But this pattern of drinking can still cause serious problems and lead to alcoholism. As with alcoholism, you may not be able to quit problem drinking without help.”


Your husband may or may not be a problem drinker but this information should help you (and your husband, if he is open to looking at his behavior) figure it out.  Remember, you cannot force insight onto another person and your husband would be the one who needs to take the initiative to get help, if appropriate.  If you feel you would benefit from support for yourself, Al-Anon is an excellent resource and offers free meetings for anyone who is concerned about the drinking of a family member or close friend.  There are lots of meetings held in Northern Colorado and the contact information can easily be found online and in the phone book.


Alcoholism – How do you know_Question

Posted on Thursday, May 14th, 2015 at 4:18 am.

Dr. Beth, My husband drinks a lot and I don’t know whether or not he has a problem with alcohol. I hate to think he might be an alcoholic and I’m not even sure that I know the difference between someone that just likes to drink and someone with a drinking problem. He talks about cutting back or quitting but he never sticks with his plans for very long.  How can I tell if he really has a problem?


Depression – two different types_Answer

Posted on Tuesday, May 12th, 2015 at 4:46 am.

You are asking an excellent question.  There are, in fact, two overall categories of depression:  situational depression and biologically-based depression. A person may experience one or both of these and sometimes a combination of these two types. This classification system refers to the origin or basis of the depressive illness. The symptoms may be the same, but there are important differences between situational and biologically-based forms of depressive illness.

Just as the name implies, situational depression is triggered by a difficult life situation. It may be any type of situation that results in profound discouragement, sadness or loss. Examples includes a variety of experiences, such as being a victim of sexual assault, long-term emotional or physical abuse, a car accident, death of a loved one, relationship loss, long-term unemployment, personal illness or injury, chronic pain or any number of other painful life events.  The initial reaction to such situations are usually grief, anger or a combination of these. Grief and anger are not the same as depression, but prolonged grief or a chronically stressful situation over time can turn grief into depression.

Biological depression often results from an inherited genetic predisposition toward depression (or anxiety), but can also be caused by traumatic brain injury and possibly related to the chronic abuse of hard drugs (such as methamphetamines) and alcohol. Biological depression can range from mild to severe.  Situational depression is usually connected to a triggering event, while biological depression may involve a trigger or may occur entirely independently of any trigger. Most depressive illnesses develop gradually, though they may also occur rather suddenly in some circumstances.

Both types of depression are best treated with therapy and sometimes, but not always, require the use of an anti-depressant medication.  Anti-depressant medications are most frequently needed in cases of biological depression or situational depression that has become more entrenched and biological in nature.  Situational depression sometimes activates underlying biological depression.

When a person has biologically-based depression or has experienced several depressive episodes in their life, long-term medication treatment may be needed, but most situational depression does not require long-term use of anti-depressant medication. The good news is that both types of depression are highly treatable, so if you or someone you know is suffering from any form of depression it is wise to seek the advice of your general physician or a mental health professional.


Depression – two different types_Question

Posted on Saturday, May 9th, 2015 at 8:45 pm.

Dr. Beth, I’ve heard that there are two types of depression, situational depression and biological depression.  I don’t really understand the difference. How do you know if you have one type of depression or the other?


Relationships after death of spouse_Answer

Posted on Thursday, May 7th, 2015 at 4:34 am.

I talk to many women and men who have been widowed later in life. Some had really satisfying relationships and others were quite unfulfilled in their marriages.  Many of these people are now in their 60s, 70s and 80s and were in one (or more than one) long-term relationship during their lives, sometimes relationships that lasted for several decades.

I have found great variability in how people feel after losing a partner or spouse later in life.  Some of the men and women I have spoken with grieve for a time and then have the desire to have the love and companionship of a new partner relationship.  They are not happy with the idea of being single for the remainder of their lives and whether their marriage was good or bad, they want to try again.

Some people want to try again because their long-term relationship was satisfying–they are optimistic about the potential for finding happiness again with a new partner.  Other people want to be in a new relationship because their marriage was not good.  They are optimistic that they can find a more satisfying partner with whom they can share the remainder of their lives.

Other people I speak with are quite certain that they are not interested in seeking a new marriage or relationship partner.  They are happier being in control of their time and living circumstances without having to compromise their needs and balance their preferences with the desires and needs of a partner.  It is refreshing to be independent and accountable only to one self and these individuals do not want to return to what they perceive as a more restrictive lifestyle. Many of these men and women say that they enjoy their own company. They find peace and contentment in solitude and spending time with friends, but do not need or want a partner.

Interestingly, these women and men make their choices for the same reasons:  some choose to be on their own because they were in an unsatisfying marriage and don’t want to risk repeating another version of that experience.  Others want to be single because their relationship was so good. These individuals feel that they have successfully experienced this part of life and have no need to do it again with another partner.

Widows and widowers make these choices for all kind of reasons and there is no good or bad to any of these choices.  The choice to find another partner fits for some people and the choice to enjoy being single fits for others.  There is nothing wrong with you for not wanting to date or have a partner. It is just one of several different life choices that men and women make after the death of their spouse.


Relationships after the death of a spouse_Question

Posted on Tuesday, May 5th, 2015 at 4:14 am.

Dr. Beth, I am in my mid-70s and my wife died 7 years ago.  We had been married 45 years and had a really good marriage for the most part.  She was my best friend and my partner in life and I still miss her, though I think I have adjusted my life so that I am OK even though she is gone.  In the last couple of years I have dated a couple of women and they have been very nice and interested in me, but I find I just don’t have the desire to establish another long-term committed relationship or marriage. My heart just isn’t in it.  I enjoy my friends and my time alone which I spend writing, painting and hiking or snowshoeing in the mountains.  I like my solitude and time alone as well as some time with friends.  Is there something wrong with me because I don’t want to date or be seriously involved with someone and I feel content picturing my life without another life partner?


Life Transitions / Getting older – How to cope with an ‘older’ body_Answer

Posted on Sunday, May 3rd, 2015 at 9:31 pm.

Aging typically brings unwanted changes in our energy and in the strength, stamina and flexibility of our bodies.  Even women and men in the best of shape find that they can’t run quite as far or as fast as they used to and can’t do the backbends, handsprings and cartwheels of their yesteryears. It is natural to go through feelings of disappointment and discouragement as we discover these limitations.

The people I’ve talked to who seem the happiest have found a way to grieve and let go of their former capabilities without giving up being active and engaged in physical activity. Often you can still engage in the same activities but find lower intensity levels of participation that still provide joy, fulfillment and growth. These may involve the activities you loved in the past or newly discovered interests. Many times you can still participate in the activities you once felt passionate about but in a slightly different way.

For example, someone who loves horseback riding might let go of jumping or endurance riding but continue with dressage, reining or trail-riding.  A dancer may shift from intensely athletic forms of dance such as ballet, jazz or modern dance but still enjoy ballroom dancing, line dancing or swing. Marathon runners may opt for shorter races or may take up jogging, swimming, bicycling or hiking as an alternate activity.  While there are certainly a few people of all ages who can continue their activities at the same level of intensity as when they were younger, this is not true for the majority of us.

The best way to move beyond grieving our limitations is to find new passions to embrace or old passions to embrace in new ways. This is true whether we are talking about our physical, mental or professional abilities. Grieving is natural but prolonged grief robs us of the possibilities of our now. Our capabilities and energy levels usually continue to change over time, so don’t put off engaging in the activities you love and can still do now.  In 5, 10, or 15 years, some of those activities, too, may exceed your grasp. Find and exercise your passions today.


Life Transitions / Getting older – How to cope with an ‘older’ body?_Question

Posted on Friday, May 1st, 2015 at 12:40 am.

Dr. Beth, When I was young (teens and twenties), I was a dancer, I acted, played soccer and did gymnastics.  Over time, I gave up pretty much all of those activities, largely just due to life circumstances  (getting involved in school, work, relationships, having kids, etc.)  Now I’m in my mid-50s.  I only have one child left at home and he’s a senior in high school. I have time to start doing the things I love again. But now I have a few old injuries that crop up and I just don’t have the flexible body for gymnastics or the types of dance I used to enjoy.  I feel discouraged and I’m not sure how to handle these new limitations in a healthy way. I need some ideas for coping.


Life Transitions_Answer

Posted on Monday, April 27th, 2015 at 1:22 am.

We all know that our sense of identity and our priorities shift as we move through various life stages.  Some of these transitions are fairly gradual and we just live our way into the next stage of life with minimal muss and fuss.  Other transitions are rapid, even precipitous. Going through puberty, getting married and having a child are usually rather dramatic changes that shake up and reshape our sense of our identities and priorities.

Moving into a new age decade seems to be a common time when people consciously or unconsciously reevaluate their life directions. For you, it sounds like turning 50 is one such moment of transition. Many people have significant psychological shifts at this time.  For those who have had children, this is often the time that the children are usually out of the house and have lives of their own. The hard-driving work of establishing a career is mostly behind you and it is time to reevaluate.

It is quite normal to be feeling a shift in your priorities around work/life balance, your interests and perhaps your relationships as well.  Around age 50, a lot of people begin to recognize that there are likely more years of life behind them than there are ahead of them. Indications of our mortality ranging from our own health problems to the unexpected deaths of some of our relatively younger adult friends can bring our own mortality into sharp focus.

I encourage you to flow with the changes and realize that it will take months, maybe a year or more to get your bearings with your evolving values and priorities.  Some decisions like change decisions like working less overtime or discontinuing certain services positions may be made fairly quickly, but I would encourage you to take more time to make decisions like moving, quitting your job or getting a divorce.  The impulses you feel around some of these issues will probably wax and wane quite a few times over the next months or year or two.  Just be reassured that you are going through a developmental evolution that is quite natural. I trust that you will come out on the other side of this transition with a newly fashioned and more grounded sense of self and life purpose for this decade of your life.


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