binge drinking collegeHave you heard a college student say this before?

“I don’t drink every day so I’m not an alcoholic.”

When most people picture someone with a drinking problem, they probably imagine someone who drinks every day and can’t function without alcohol. But even those who aren’t dependent on alcohol yet routinely drink to excess, i.e., binge drinkers, are in danger of experiencing long-term consequences.

The National Institute on Alcohol Abuse and Alcoholism is very clear about the high costs of college drinking: Alcohol poisoning, assault, unsafe sex, sexual abuse, injury, academic problems and death are some of the agonizing consequences of binge drinking.

So what is considered binge drinking?

Many people may feel that having a drink to take the edge off is a good way to start socializing. And though it’s true alcohol decreases inhibitions, those who drink to excess often find themselves consuming more drinks than they had intended. For women, that means consuming four or more drinks over the course of a couple of hours and for men it’s five drinks. (Keep in mind that this number may be lower depending on a person’s body mass and that blood-alcohol levels continue to increase after the last drink is consumed, which increases the chances of alcohol poisoning.)

Important factors in the development of binge drinking include:

  • Learned patterns regarding drinking
  • Genetic factors
  • Attachment to family or significant caregivers
  • Core beliefs about oneself and
  • The age at which someone starts drinking

So how do these factors play into the college experience?

College is an exciting and eye-opening time filled with new challenges, relationships and environments. It is a time of testing independence and discovery. For most, this is exactly what they have been anticipating.

In times of exponential change like this, many of the underlying beliefs that people hold about drinking and how it relates to them socially can be intensified. Brain development continues to mature well into the 20s, which means the brain can be prone to increased risk taking; so learning stress-management skills during the college years is vital.

Drinking to fit in

Four out of five college students drink alcohol and half of them binge drink. “Drinking to fit in” is one of the top reasons for drinking in college. Young adults being treated for alcohol-related issues endorse social anxiety, social fears (like not fitting in) and difficulty creating new relationships as reasons for their drinking.

For those who drink, it seems that alcohol becomes a social equalizer of sorts. If those entering college have the perception that drinking helps them fit in and those who are already in college uphold similar beliefs, then it can be difficult to challenge this association.

This perception, coupled with increased feelings of loneliness and isolation, puts young adults at a greater risk for developing excessive drinking habits like binge drinking. Those who are likely to turn to alcohol due to stress are likely to develop excessive drinking habits that can lead to dependency on the substance. Dependency on alcohol ultimately leads to drinking alone, which is the paradox of “drinking to fit in.”

Decreasing risk

Young adults who are able to evaluate their actions and motives for coping are better able to channel stress into manageable outlets. This usually stems from the ability to recognize and utilize significant people in their life who are reliable, which creates increased feelings of safety and decreased loneliness.

Such young adults tend to feel safer in exploring their new environment without turning to alcohol. Finding sober activities, creating a structured homework environment, touching base with important social support and utilizing and evaluating coping skills are all ways to decrease binge drinking behavior.

The bottom of the glass

In the end, severe consequences are not just a result of daily drinking: Those who engage in less frequent drinking but who drink greater amounts are also in danger. If you or someone you know is binge drinking, discuss the risks. Explore how they might seek help or handle stress without turning to alcohol.

If you or someone you know is unable to limit their drinking, dependency on alcohol may be developing. Remember that after your last drink, your blood-alcohol level continues to rise and symptoms of alcohol poisoning may develop. Most people feel responsible for alcohol-related tragedies when they may have missed the signs and did not seek help.

Whether you plan on drinking at college or not, please learn more about the risks associated with drinking and have emergency numbers ready to call. It may not be the popular thing to do, but it’s the right thing to do.




narcissistic personality disorderAmbition’s dark side regularly captures our attention. The relentless quest for status, fame and power is not only off putting but also damaging to the extent that the quest comes at a cost — getting to the top by climbing over the backs of others, potentially injuring them in the process.

Narcissistic personality disorder

Psychiatry, in its inclusive spirit, has a diagnosis for the dark side of ambition: narcissistic personality disorder. Here are some of the pertinent diagnostic criteria: grandiose sense of self-importance; preoccupation with fantasies of unlimited success, power and brilliance; belief of being special and unique; requiring excessive admiration; entitlement; interpersonal exploitation; envy; and arrogant attitudes. Dark indeed.

But the fruits of ambition also capture our attention. President Kennedy’s challenge to put a man on the moon in a decade launched an extraordinarily ambitious project with spectacular success and spinoffs with substantial social benefits.

But ambitions need not be so grand to be fruitful. For many of us, identity is forged by our life projects that embody our ambitions, be they great or more modest. And ambitious projects need not be as tangible as putting a man on the moon. Raising and caring for a family is ambitious and perhaps the ambition most crucial to our collective well-being. We might say that ambition accounts for much of our cultural progress and achievement. Without ambition, we stagnate as individuals, institutions and societies.

Ambition: virtue and vice

Perhaps we should think of ambition as a double-edged sword — potentially a virtue and a vice. Ambition goes awry when it is driven more by the status of the self than the value of the project. But we should not think of healthy ambition as selfless.

I was inspired to write this piece by the thinking of a contemporary philosopher whom I greatly admire, Christine Korsgaard. She articulates the ideal integration of the self with ambitious projects. Befitting her profession, she gives the example of wanting to write a book (on Kant’s ethics) that would be good enough as to be required reading in all ethics classes. She acknowledges that this desire could be perceived as “raw vanity” (the dark side). But she sees the desire differently; in her own words, excerpted from her book, Self-Constitution: Agency, Identity and Integrity:

“I think that such a book would be a good thing and my ambition is not conceivable without that thought. It is an ambition to do something good …. I think someone should write a book on Kant’s ethics good enough that it will be required reading. I think that this is something for which there is a public reason.

This doesn’t, however, mean that my ambition is just a disinterested response to that public reason …. I don’t just want it to be the case that someone writes the book. I want to be the someone who writes that book.” (pp. 210-211, emphasis in original).

Self-ConstitutionKorsgaard goes on to acknowledge that the personal component to ambition is often essential to carrying out the arduous work of one’s projects. She is keenly aware that this personal ambition might lead one to subvert others’ efforts to carry out the same project, for example, undermining a colleague’s attempt to write the book. She wisely asserts, “This is not an expression of ambition, but rather a very familiar perversion of it.”

More broadly, I think this “perversion” includes ambitious self-enhancement devoid of investment in worthy projects for their own sake. The desire to be “Number One” is ubiquitous in our culture. We must ask: For what purpose? Toward what end? Sheer shelf-aggrandizement will not do. With such misguided directions of ambition, we move from what we psychologists call “healthy narcissism” (as Korsgaard brilliantly exemplifies) to “pathological narcissism.” And who wants that?


APA (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5. Washington, D.C. American Psychiatric Association.

Korsgaard, C.M. (2009). Self-Constitution: Agency, Identity, and Integrity. New York: Oxford University Press.


CI logoMy name is not Anonymous, but it will suffice for this blog post because I must be, well, anonymous.

Volunteering to help others in a crisis

I’m one of hundreds of suicide/crisis hotline volunteers around the United States, and who we are is not important relative to our callers. Their crises are what we focus on, and we use an alias because the only thing callers need to know about us is that we have a sincere desire to help them get to a point where they can help themselves.

I get nervous on the drive over to the hotline location. I’ve been trained well on the crisis model, but there’s no script and these calls are high stakes. I want to say just the right things to help people validate their feelings, but it’s a challenge because I never know what kind of calls I’ll get. Here are just a few of the people I’ve tried to help:

  • A man with a diaper fetish.
  • Many distraught teenagers who have broken up with their girlfriend or boyfriend.
  • A girl who had been sexually abused by both her biological mother and father, and having left that abusive situation was raped in a group home.
  • A husband crying because his wife found another liquor bottle hidden in their house, and it was the last straw – she wanted him to leave forever because of his drinking. “You could stop anytime you want to,” she screamed at him.
  • A wife whose husband had cheated on her and then wouldn’t let their daughter go to a friend’s quinceañera because he thought she’d have sex with her boyfriend that night.
  • Elderly people who were isolated and lonely.
  • People who want to end their life because the emotional pain they’re experiencing is too overwhelming to bear. (We have specific ways of caring for these callers. Our job is to buy time in the hope that the help we provide will allow the callers to reconsider and come to a different decision.)

A need in common

What do these callers all have in common? An urgent need to talk to someone who does not know them, who cannot see them, who will actively listen and who will not judge them for anything they say or don’t say. Sometimes, I’m so actively listening that my head is bowed and my hands cup the earphones of my headset so I can hear every word. It’s important to get into the rhythm of each caller’s speech so you don’t talk over them — that way I have a better chance of helping them expand their options.

Taking care of myself

When I leave my shift, I close my ring binder of training notes and say to myself that I’ve done what I could. Enough callers thank me each shift to make up for the ones who still feel powerless when they hang up. (The best thank-you I’ve received so far is from a Vietnam vet who told me he would not put a shotgun in his mouth and pull the trigger that night because he felt better talking to me.) When I get home, I count my blessings and take care of myself. I have a mug of hot chocolate, an Epson salts bath and call it a night.

National network

There’s a network of United States hotlines so if one city is short of staff/volunteers, the calls roll over to people who are available. Volunteers are never alone, there is always a paid staff member there, and staff members are usually the ones who work the phones in the deepest dark of night up till dawn.

If you’re even slightly interested in volunteering on a crisis hotline, I urge you to contact your local office and at least go through the training. Then decide. If it’s not a good fit for you, no worries; you will have learned valuable communication skills. If you do end up volunteering, you’ll know that you’re having a direct and positive effect on people’s lives.


Navigating Mood and Food during National Nutrition Month

by Kim George, RD March 16, 2015

I am a nutrition geek. The science behind how our body and brain work is so amazing to me. The foods we eat help our brain work efficiently, and I love being able to teach others the link between food and mood. National Nutrition Month March is National Nutrition Month, and while my colleague, Tessa, […]

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Woman’s Obituary Highlights Child Abuse

by Michele Arnold January 25, 2015

I read the obituary of Marianne Theresa Johnson-Reddick with interest. She tortured people by her cruelty. This abusive mother did not get a free pass to the afterlife. Two of her eight children let the world know how they were all “abrasively exposed to her evil and violent life” in her obituary. “Mom” ran a […]

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Grocery Store-based Screening Better than Lucy’s Mental Health Advice

by Nancy Trowbridge January 22, 2015

On the shelf of my cubicle sits a Hallmark-brand Peanuts tree ornament with Charlie Brown seeking Lucy’s 5-cent psychiatric help. It reminds me of watching every holiday Peanuts TV special while growing up and the mental health setting where I work today. Hallmark moments create a warm feeling, don’t they? A kind of Hallmark moment […]

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Is Depression a Brain Disorder? Yes and No

by Jon G. Allen, PhD December 12, 2014

Thirty years ago, I submitted a manuscript for publication and received the following response from the editor: “There is nothing new here, but some ideas warrant repeating.” The manuscript was published. I have already written about the problems in reframing psychiatric disorders as brain disorders, but I was inspired to write yet another post about […]

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Of course I’m envious!

by Herman Adler, MA October 17, 2014

A few years ago I wrote a blog post about the trait of stubbornness and its application to personality disorders. This time, I’m here to delve into the complicated and misjudged trait of envy. According to the DSM-V, the trait “often envious of others” is among the traits of narcissistic personality disorder. Two perfectly reasonable […]

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Tackling the Problem of Domestic Violence

by Dallas Adams, LCSW October 10, 2014

Why write about domestic abuse and violence in a mental health blog? Especially since these two behaviors are not caused by mental illness? I write about domestic violence and abuse here because domestic violence and abuse can result in physical injury, psychological trauma and, in severe cases, even death. The devastating consequences of domestic violence […]

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Quiet: A Book for Introverts

by Jon G. Allen, PhD October 3, 2014

Being a prototypical introvert, I was drawn to Susan Cain’s popular book, Quiet: The power of introverts in a world that can’t stop talking. Cain’s subtitle could have been shorter: “In praise of introversion.” Sadly, her subtitle also could have been: “In defense of introversion.” The basic premise of her book: About a century ago, […]

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