Quit Smoking Tip of The Week: Fight Post-Cessation Depression!

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Quitting smoking can momentarily bring on a more depressed mood as your body adjusts its hormone balance and the nicotine receptors slowly start to decrease back to a normal level. Think of it this way- when you smoke a cigarette, nicotine attaches to naturally occurring receptors in your brain. When this happens, you get a flood of dopamine (the feel good hormone). As time goes on and your smoking becomes a habit, your brain develops even more receptors allowing more nicotine to bind to receptors, resulting in a huge flood of dopamine. Well, your brain is not used to having this much dopamine readily available and down regulates this amount. Think of it as you listening to uncomfortably loud music and putting earplugs in to lessen what you can hear (Sleight, VJ. (2016, September 18) A craving is just your brain screaming, “WHERE’S MY NICOTINE?” Retrieved from https://www.linkedin.com/pulse/craving-just-your-brain-screaming-wheres-my-nicotine-vj/). This is what your brain does with dopamine.

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Once you stop smoking, your brain will take a while (a few weeks usually) to adjust to the lessened amount of dopamine that is being produced. Your brain is still down regulating the amount of dopamine being produced, leading to even less dopamine being processed in your brain than before you started smoking. So, you’ve turned the music down but you haven’t taken the earplugs out yet (Sleight, VJ.). The time it takes is different for everyone’s brain to adjust to the normal hormone levels now being produced (some only days, some up to a few weeks) and this could by why some people experience depressed symptoms after quitting tobacco use and some do not. It could also be the reason for increased agitation and feelings of anxiety as part of the withdrawals.

Also, as we dive into the winter season in Michigan we need to be aware that seasonal depression is among us. Up to 10% of adults will experience SAD, Seasonal Affective Disorder (Mental Health America, http://www.mentalhealthamerica.net/conditions/sad).

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Here are a few things that you can do consistently throughout the week to help fight the onset of depression or to just increase your happiness in general: 

  • Keep a Gratitude Journal
  • Savor the moment. This could be any moment- having dinner with a friend, talking with a loved one, walking outside, etc. Savor it by being completely present in this moment- no thoughts of the past or future, electronics put away, thoughts on what you feel, see and hear in that moment.
  • Be kind to someone. This could be someone that you know, or a complete stranger. But the idea is to act with kindness without expecting anything in return. Open the door for someone, smile at a stranger, give someone a compliment.
  • Spend less money on things and more on experiences (but free experiences are an added bonus). We get used to and bored with things. Experiences are encoded as memories that we can cherish forever, and they foster personal growth.
  • Make a new social connection or strengthen a friendship that you currently have. Say hi to a stranger, call a friend that you haven’t spoken to in a while, check-in on your neighbor.

These are just a few! I encourage you to do some of your own research, try out new things and see what works for you to lessen the seasonal blues. I strongly believe in taking care of your mental health and reaching the highest potential as possible regarding your happiness– we all deserve it! If you would like to work on more specific coping mechanisms with a smoking cessation counselor one on one to develop an individualized approach with tangible resources to help you quit with less distress, reach out to Amber Jager at (313)446-9817 for persons living in the Detroit area, and Erin Suprunk at (734)961-1077 for persons living in the Ypsilanti and Jackson area to see if you qualify for FREE smoking cessation services!

Please take into consideration that the combination of these activities are meant to be a part of lifestyle changes in order to help increase general happiness and fight off mild feelings of depression, but are in no means meant to treat Major Depressive Disorder or other extreme conditions that need to be treated by a physician. If you are experiencing suicidal thoughts or experiencing extreme or worsening depression, call the National Suicide Prevention Hotline at 1-800-273-8255. The Lifeline provides 24/7, free and confidential support for people in distress, and prevention and crisis resources for you or your loved ones.

National Suicide Lifeline

Tobacco Reduction – What’s In A Quit Kit?

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By: Kayla Gamino (UNIFIED Tobacco Treatment Specialist)

An ample part of UNIFIED’s tobacco reduction program includes creating quit kits for clients.  During the initial assessment, we bring out the quit kit while discussing possible quit dates.  Each client accessing tobacco reduction services receives 1 quit kit for their time working with the tobacco treatment specialist.  Each quit kit includes: a journal, pens, candy/gum, educational tools, and fidget toys.

Journal- The journal is an especially important piece of the quit kit.  The journal is a good tool to help keep track of a person’s smoking habits prior to their quit date.  Many clients use it to write down when they have cravings, what they are doing when they have cravings, and how they are feeling when they have a craving.  This will help the tobacco treatment specialist and client to better come up with coping mechanisms and a quit plan together for when the client experiences cravings.  For example, if Mike records that he has a craving every time he is feeling bored then coming up with things for Mike to do while he is bored can help combat cravings.

Originally posted by gerimagsakay

Pens- The pens are good for when the client needs to journal.  We put 2-3 different colored pens in each quit kit to make it easier for the client to be able to journal. Pens can also act as a fidget toy.

Candy/Gum-  Each quit kit comes with a variety of candy.  We use Twizzlers, Life Savers, and mints normally.  The Twizzlers can help with the hand to mouth habit of smoking.  It is a similar shape to a cigarette.  The Life Savers, mints, and gum are good at combating the oral fixation that often comes with smokers.

Originally posted by fadedmapdots

Educational Tools-  In each quit kit, we put a pamphlet for the Michigan Tobacco Quit Line.  In the pamphlet, it gives little facts on how smoking affects the body as well as the number to the Quit Line for clients to utilize.  We also include a UNIFIED Tobacco Services palm card that has contact information and HIV and Tobacco use facts.  As an added bonus, we include the Michigan HIV/STD Hotline number.

Fidget Toys-  Each quit kit includes rubber bands that are used by switching wrists when a craving occurs.  It helps to keep the hands and mind busy.  Additionally, each client gets to choose another fidget toy.  We have two different options.  One is a bike chain fidget toy that is small enough to fit in a pants pocket.  The other is a Bendeez toy that can be molded into different shapes.  Both are used to help combat boredom and keep the hands and mind busy.

Originally posted by cracked

All of these items have gotten positive feedback from current tobacco clients.  If you are a current tobacco user and you think that a quit kit would be beneficial to your quit/reduction attempt, please contact UNIFIED- HIV Health and Beyond to meet with a Tobacco Treatment Specialist!

Introduction to UNIFIED’s Tobacco Reduction Program

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By: Kayla Gamino (UNIFIED Tobacco Treatment Specialist)

A session with the tobacco treatment specialists is different for everybody.  We meet you wherever you’re at and will continue to be there for you every step of the way.  It all starts with a referral from your case manager.  At each visit, they will ask about your tobacco use and assess your readiness to quit.  If you both decide that you are a good candidate for the tobacco program, the case manager will fill out a referral form with you and give it to the tobacco treatment specialists (TTS).

So how is your readiness to quit determined?  Through The FIVE A’s; ask, advise, assess, assist, and arrange.

  • Ask- Your case manager is required to ask every client about their tobacco use at each visit and record it in our records.
  • Advise-  If the client answered that they were a tobacco user, then the case manager will advise them to quit their tobacco use and discuss the benefits of doing so.
  • Assess-  Next, the case manager will assess the clients willingness and readiness to make a quit attempt.  If the client is interested in talking to the TTS about tobacco reduction, the case manager will then make the referral to the tobacco treatment specialist.  In some cases the case manager will refer the client, with the client’s consent, to the TTS before they are considered “ready” in order to get the client thinking about quitting and to help establish the relationship between the client and the tobacco treatment specialist.
  • Assist- At this point, the case manager and the tobacco treatment specialist have touched base and the client is now being assisted by completing sessions with the TTS.  During the sessions, the client and TTS will discuss reduction strategies and possible nicotine replacement therapy options.  These sessions can go many ways depending on the clients needs.  Some clients need to talk about outside sources that are affecting their tobacco use, while others simply want information on tobacco and health.
  • Arrange-  The TTS will arrange follow-ups with the client.  Depending on the clients stage of change and the client’s schedule, the TTS will likely meet weekly or biweekly with the client.  These follow-ups can be by phone or in person.  In some instances, the TTS will also meet the client at their home or a local business.  This is the point in the treatment where the TTS tries to meet the client wherever is easiest for them in order to help make the client more successful in their quit attempt.
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Originally posted by firelordasami

How we assess a client’s stage of change:
The Transtheoretical Model

The transtheoretical model is a behavior change model that was specifically created with tobacco cessation in mind.  The 5 stages of change are precontemplation, contemplation, preparation, action, and maintenance.  It is important to know that the stages of change are not linear (that they don’t go in a single straight order).  Someone can go from being in action to contemplation in an instance.

  • Precontemplation- the client is not ready to quit or is not even considered quitting.
  • Contemplation- the client is considering quitting in the next 6 months.
  • Preparation- the client is ready to quit within the next 30 days.
  • Action- the client is currently on their quit attempt.
  • Maintenance- the client has successfully quit for 6 months.
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Because the transtheoretical model is not linear, a client can attempt to quit many times before being successful.  It is important to know that the tobacco treatment specialists are aware that not everyone will be successful right off the bat.  The specialists are there to help the client every step of the way in a completely non-judgmental environment.  Whether you’ve been working with them for months and relapse, or you met with them once and decided the program isn’t for you, they will always be there for you when you are ready to talk again.

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Want to learn more about UNIFIED’s tobacco reduction program? Visit us online at http://miunified.org/Get-Help/Services/Tobacco-Reduction-Services for more information.

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