Dr. Gross January 2024 Newsletter

January 2024

Old Dog, New Trick?
Deborah V. Gross, MD, FASAM, DABAM, LFAPA

New Year’s Resolutions seem to be falling out of favor. By Day 5 of 2024, when I started working on this newsletter, I’d already seen numerous emails, articles, and commentaries in which people talked about opting out of the whole “resolution” business toward something more positive. The word itself (resolution) has always struck me as rather grim, conjuring images of gritted teeth and an unpleasant, squinty-eyed staring down the barrel of a new year. At this point in my life, I’m pretty grateful just to be in a new year! 

Tanya Sichynsky, in her NYT Cooking newsletter, The Veggie, from January 4, told the story of someone whose plan is to focus on resolutions this year as “silly side quests that just exist to wedge more joy into my life.” For example, she resolved to smile at every child she saw. Great, huh? No squinty-eyed gritting of teeth there!

I’ve made my share of harsh, perfectionistic new year’s resolutions, but this year, my preferred mental image is of open arms, open eyes, and an open, grateful mind and heart. In that spirit, to the amusement of some young people I know, including a couple of grandchildren, I am determined to learn how to connect with people on a social media platform. My goal is to be a voice against stigma and to support people seeking recovery from addiction and other mental or emotional struggles. 

Cats led me to X (formerly Twitter), for the pure entertainment of watching the videos (Finn and Mia are favorites). Along the way, I saw people using X to connect around recovery efforts, both seeking and offering support.

I’ve been a writer since at least 4th grade, when I wrote a poem called “The Silver Tree.” I’ve been a physician, psychiatrist, and addictionologist for decades. I recently published what I call a “personal workshop” in a three-book set for disordered eating, designed to be used in multiple settings— formal treatment, mutual help groups (e.g., OA or EDA), and by readers on their own. Everyone deserves access to good, research-based information and advice whether or not they can afford or are ready for formal treatment. Surely, I told myself, if I can do all that, I can figure out this new-fangled way to speak out and support people on their journey! If you are such a person, know that I see you and am absolutely in your corner! 

At the moment, all I know how to do on X is “heart” the cats and people who catch my eye, so I’ll likely need your help, too! I’ve treated people in psychotherapy for 40 years, and if I’ve said it once, I’ve said it a zillion times: It’s a process, not a race! If we don’t give up, we make progress. And if we make progress and don’t give up, we are on the journey. Progress, not perfection! That’s as true for an old lady trying to learn to use social media as it is for anyone else on a new path to anywhere! 

Lately on X, I’ve seen an image that says, “Stigma Kills.” This is flat, unvarnished truth in a two-word sentence. Why do we humans find it necessary to be so judgy with one another sometimes, particularly over things that can’t be helped? If I’m born a certain way, would that not mean Someone (if you believe in a Someone) made me that way? And even you don’t believe in a Someone, why kick a person who’s already down? Whether by inherited illness like addiction or mood disorder, by psychological injury like PTSD, or by general misfortunes in life, what can possibly be gained by rejecting or attacking suffering people?

When I was a young psychiatrist first in practice, the stigma around even depression (prevalence 24% in women and 13% in men) was so great that people who came to see me lived in fear that someone would see them entering or leaving my office, even though in those days I lived and worked in big cities where the likelihood of any one person running into any other one person on any given day was vanishingly small. To ease their fears, I used very little office signage and assured them that, should we meet in public, I would give no indication that I knew them unless they acknowledged me first. In my office, when they said things like, “My family doesn’t believe in therapy” (or medication or mental illness or addiction or treatment…), I would say, “Well, then I guess it’s a good thing this is science and not religion, eh?”

In recent years, the stigma around some things by some people in some places and some situations seems to have eased a bit, though this remains highly dependent on where you live, what you do, and the family you come from. Patients or former patients in public places now sometimes drag people over to meet me, introduce me as their “shrink,” and joke that “everyone knows you have your hands full since they already know I’m crazy.” Confidentiality being what it is, I learned to just smile and say hi. 

I wondered over the years whether the relentless publicity around celebrity mental health struggles and/or trips to “rehab” might ease some of the stigma. Or maybe public mental health information campaigns would help. Or, more recently, perhaps the amazing willingness of people to put their most private info on social media meant that things were loosening up. Unfortunately, the research says otherwise. Instead of making people kinder or more accepting toward self or others, the studies so far indicate that the more time people spend on social media, the more unhappy they are. The jury’s still out, but my guess is that it will turn out like most things human–it depends. Food can bring sustenance and pleasure or turn into a weapon of self-destruction. Medication can save lives and ease suffering or contribute to addiction and death. Perhaps our use of modern communication tools will be similar, though my husband still routinely refers to a certain well-known platform as “farce book….”

I can’t count how many times in psychotherapy I have reminded someone that it is inaccurate to compare our insides (emotions, thoughts, beliefs about ourselves) to other people’s outsides (photos of perfect rooms and cakes and children). If we can remember that, perhaps we can turn things around. Social media “transparency” hasn’t altered the strong, dangerous current of stigma that runs through our culture. Perhaps only we humans can do that. Stigma does kill people. It discourages them from seeking help, and without treatment, many addictions and mental illnesses can be fatal. Stigma also prejudices people against themselves, and it’s no respecter of persons. Most physicians, for example, have resources for treatment, but we also have higher than average rates of addiction, suicide, and some mental illnesses, and lower than average rates of seeking help. 

Call or text: 988. Chat: 988lifeline.org

January 29th is SAMHSA’s 20th Prevention Day!

Share your story of strength and hope, or read other people’s stories at:

I am one person with one voice. So are you. Together, we can fight stigma. We can talk openly and give people accurate information to counter the mean-spirited, prejudicial nonsense that is stigma. Changing this dark culture of harshness and shame requires thinking and speaking humanely about things that stigma keeps underground in darkness—mental illness, psychological trauma, addiction, depression, eating disorders, and all the rest. The fight against stigma is a fight against ignorance. It’s a vicious circle. Ignorance wins if stigma rules, and if stigma rules, darkness and danger and ignorance continue. My goal this year—besides proving, at least to myself, that this old dog can learn a new trick—is to shine the light and open some doors, maybe even some minds. Join me, won’t you?

Happy New Year!

Dr. Deborah Gross Discusses Journalist Burnout During SPJ Florida.

Listen to the entire session by clicking here…https://debmd.com/2021/12/22/burnout-in-the-age-of-covid-19/.

From SPJ: “Dr. Gross cited studies showing that as high as 90% of journalists and medical professionals are burning out during the COVID-19 pandemic. She compared the two professions and illustrated how constant deadlines, pressure and responsibility will overwhelm any individual’s ability to cope or compartmentalize long-term. During the session, she offered some coping mechanisms for attendees and emphasized the need for immediate and ‘ruthless’ self-care.”

Know the Dangers of Sober January

Know the Dangers of Sober January

It’s a New Year and you’ve resolved to stop drinking alcohol and/or using drugs. It’s a great decision to take control of your actions and your body. Being that we are only a few days into the New Year, many of you are taking on the Sober January or Dry January mantra. However, if you have been a consistent drinker or user of drugs, quitting cold turkey may be dangerous for you. You may view yourself as a casual drinker or recreational drug user and not know the damage alcohol and drugs have already done to your body and/or brain.


As our understanding of addiction and substance use disorders, including alcohol use disorder, have evolved, both are now classified as chronic diseases. Diseases require medical attention and a medical plan. They are not about moral failings or decision making, but rather physiological and psychological changes to a person’s body.


Why is quitting cold turkey dangerous? While your will says you want to stop drinking and/or using drugs, your body, including your mind, is working on its own. Addictive drugs and alcohol change a person’s brain chemistry. Alcohol, for instance, is a depressant and to compensate for the effects of alcohol, the brain will produce large amounts of stimulants, such as norepinephrine. When a person stops drinking or using drugs, the brain will continue to produce large amounts of these stimulants. This production can lead to dangerous withdrawal symptoms.


When is the most dangerous time for someone detoxing? The most dangerous period is within the first 48 hours of someone consuming their last drink of alcohol or consumption of drugs. Initial symptoms may feel like the flu, a bad cold, or Covid. Initial symptoms may last for up to a week before delirium tremens (DT’s) occur (reduced blood flow to the brain and other body systems).


What are the symptoms of withdrawal? Withdrawal symptoms may include, but are not limited to, hallucinations, tremors, seizures, nausea and vomiting, psychotic episodes, nightmares, and insomnia.


Why does someone need medical supervision? Quitting alcohol and drugs without proper medical supervision can be dangerous to a person’s health. Doctors, nurses, psychiatrists, and counselors who are trained in addiction medicine can create personalized treatment plans, which may include prescriptions to counter-balance the withdrawal symptoms, as well as counseling to discover the underlying reason for the alcohol and/or drug use. Additionally, a long-term medical plan can help with a successful, long-term recovery.


We applaud your decision to take control of your health and want to do all we can to help you be successful. At Pathway Healthcare we create patient-centered treatment plans on an outpatient basis. We have fourteen locations throughout Alabama, Mississippi, Tennessee, and Texas. Call today to schedule your appointment 844.728.4929 or visit www.pathwayhealthcare.com.

Good Self Care is Not Selfish

“You’ve got to be kidding” is a common response from women when I talk to them about resting. Even young women who’ve never lived independently often do not understand real rest. It isn’t about sleep. It’s about being calm, fully present, and awake to your life. Entire books have been written about women doing too much. We multitask madly, worry about everything, feel guilty about everything, and take care of everybody else better than we do ourselves. These are generalities, but they’re also realities for many women. I’ve seen it more times than I can count over my decades of psychiatric practice. Full time job, full time mothering, partnering, homemaking, and a dozen other things equals one worn out woman with zero sense of herself. Know ye this: Taking care of yourself is not selfish!

True rest is hard to come by in our world of overstimulation and excess. When we have three seconds, we grab our phones to answer an email or send a text. Our days go by faster and faster as we stuff them ever fuller. Sometimes we stay busy to avoid pain—the busy defense. As in, “I’m not anxious. I’m too busy to be anxious.” Or, “I’m not sad. I have too much to do.” Or, “I can’t be depressed. Look how much I get done.”

Physical hunger, emotional hunger, intellectual hunger (boredom), relational hunger (loneliness), and spiritual hunger leave us empty. When we feel empty, we try to fill the hole with an endless, meaningless stream of stuff—drugs, alcohol, food, control over food, perfection, sex, money, relationships, clothes…. None of it covers the emptiness of not living mindfully from our real selves….

Body, mind, and spirit need rest to function. Choose one rest day per week and practice resting. Yes, I’m serious. Don’t read, don’t sleep, don’t listen to music, don’t talk or text or answer the phone. Put the phone in the other room and turn it off if that’s what it takes. The point is to do nothing. Set a timer for 20 minutes so you don’t clock-watch. Sit in a pleasant, quiet place—preferably outside or near a window. Lift your eyes up and out toward the bigger world. Without judging, notice small details—sky, birds, trees, scents, sounds—whatever is there. Just notice. Don’t do anything about it, with it, or to it. When the timer goes off, sit quietly as long as you need and take that peace and quiet with you through your day.

**Excerpted from “90 Ways in 90 Days: A Personal Workshop for Women with Disordered Eating” by Deborah V. Gross, MD. Now available on Amazon

Dr. Deborah Gross is licensed to practice psychiatry in all of Pathway Healthcare office locations (Alabama, Mississippi, Tennessee and Texas). She treats men and women.

Co-Occurring Disorders and Domestic Violence

Co-Occurring Disorders As It Relates to Domestic Violence

October is domestic violence awareness month and it is important to bring to light the issues that cause domestic violence. Domestic violence is much more than physical assault. Domestic violence can also include non-physical behaviors such as: emotional abuse, verbal abuse, sexual abuse, financial abuse, spiritual abuse, and elder abuse.

As a society, we are doing a much better job at not turning a blind eye to domestic violence and the stigma associated with it. However, it is simply not enough to focus on the actions of the perpetrator, but we must also understand what causes the behavior and what the outcomes might be. As we continue to study things such as trauma, PTSD, mental health disorders and substance use disorders, we are continuing to find the relationship between domestic violence and co-occurring substance use and mental health disorders.

As we begin to better understand the correlation between the co-occurring disorders, we can see how there is hope in treating both those who are victims of domestic violence and the people who commit domestic violence. As we study the disease of addiction and mental health, we can determine what genetic and environmental factors contribute to these diseases and how they may present in each person. For instance, a child who was brought up in a home that experienced violence and/or active substance use (drugs or alcohol), would be at an increased risk of becoming a victim or a perpetrator of domestic violence (based on ACE scores).

“The World Health Organization reports that women who reported partner violence at least once in their lifetime are nearly 3 times as likely to have suicidal thoughts and 4 times as likely to attempt suicide. Compared to those who have never been abused, survivors are 6 times as likely to have a substance use disorder.”[1]

Therefore, it is important for a person who has experienced or is experiencing domestic violence to undergo an evaluation by a psychiatrist or licensed counselor to determine the amount of trauma one has experienced and how that may be affecting or could affect decision making or one’s mental health. Additionally, simply incarcerating the offender without properly treating the offender, may result in a re-offense because underlying issues have not been addressed or dealt with.

If children are involved as witnesses to the domestic violence or are also suffering some level of the violence, they will also need evaluation and treatment so to not perpetuate the cycle of abuse (whether as a victim or a perpetrator).

It is important to note, however, that domestic violence isn’t necessarily caused by the substance use, but it can contribute to the violence. Some perpetrators may use drugs or alcohol before committing an act of domestic violence. Substance use and mental health disorders affect a person’s control in some way. Not being able to clearly control one’s behavior and not being able to comprehend the consequences of one’s behavior contributes to domestic violence. Additionally, because people often act differently when under the influence of drugs or alcohol or during a mental health episode, the domestic violence issues can look different for different people, and different from past situations.

The only way to end the cycle is to admit there is a problem and get help. Both parties are affected and one party cannot fix the other by staying in the situation when there is danger involved. Professional help can help determine what is triggering the need for drugs and/or alcohol, as well as diagnose any underlying mental health issues. Once these issues are discovered, a plan of action can be put in place to help everyone involved.

There is hope and we help people. If you are experiencing domestic violence or have experienced past domestic violence, we want to help you find healing and get on a healthy path. We offer individual treatment plans on an outpatient basis to find what is best for you. We also offer family counseling. We have a team of professionals who can help with medical needs, including treatment for substance use and alcohol use, and mental health needs, including psychiatrists and licensed counselors.

We have offices in four states (Alabama, Mississippi, Tennessee and Texas) spread across fourteen locations. We accept most insurance plans, Medicare, Medicaid and cash pay. We are accepting new patients in all our offices. Call 844.728.4929 or visit www.pathwayhealthcare.comfor more information.

If you are not the one suffering from domestic violence but you know someone who is, please share this with them and let them know there is help and hope available.


The Five Leading Mental Health Issues Veterans Face and How Pathway Healthcare Can Help

The Five Leading Mental Health Issues Veterans Face and How Pathway Healthcare Can Help

More and more veterans are returning from duty carrying more than just physical wounds. While the VA is doing a better job of increasing awareness for mental health and accessibility for services, there is still much work to be done. The top five issues veterans face are depression, PTSD, substance use disorder, anxiety and SMI (serious mental issues such as schizophrenia and bipolar disorder).

Currently, the VA system has approximately 170 VA medical centers. Because the locations are often not close to every veteran, the VA has over 1,000 authorized medical centers throughout the United States. These authorized medical centers encompass different levels of care. At Pathway Healthcare, we are honored that we are one of the authorized medical centers and able to treat veterans, as well as their families, for mental health care, addiction and substance use disorder care, and primary care through the VA Choice Program and Champ VA.

We are grateful for the sacrifice and service of our military men and women and their families. Our psychiatrists, licensed counselors, and medical doctors are available to discuss a treatment plan with you on an outpatient basis.

If you or a loved one are suffering with a mental health issue or a substance use disorder, please know there is hope and help. Contact us today at 844.728.4929 to find a location near you.

Suicide and Self-Care: Protect Your Risk From One With the Other

Suicide and Self-Care: Protect Your Risk From One With the Other


Everyday we are faced with any number of stressors that can stretch us emotionally, mentally and physically. Knowing beforehand that these stressors can affect us helps us better understand how to deal with the stressors. Proper self-care is important to keep us healthy. Self-care is not selfish care. It is actually care that will help us help not only ourselves better, but also help others.

Below are some options for proper self-care:

  1. Find a therapist, counselor or psychologist whom you trust and feel free to speak with. Often times, having a trusted non-biased person to talk to about your fears, your struggles, your questions, and your doubts can bring these issues to light so they can be addressed in a safe manner. The more we bottle our feelings and think they have no value or need to be addressed, the larger the crisis can become internally. Be honest with the medical professional you choose. If you only give them part of the story, they can’t help you fully. Remember, they are there to help you because they want to, not because they have to.
  2. Make the time to do something physical: take a walk, a bike ride, exercise, yoga, stretching, hit some golf balls, tennis balls or baseballs to relieve stress and anxiety. Physical activities release endorphins that can help with mental health clarity.
  3. Find stories of hope. Many times when you are struggling with anxiety and hopelessness you feel completely alone. However, there are many who have walked in your shoes and have survived and are thriving. Discover what gave them this hope to live. Don’t dwell on negative stories, but instead find hope in the positive ones.
  4. Find resources that can help you. For many people, stressful times trigger emotional and mental health responses that do not happen when “life is normal.” Unemployment, a health crisis or diagnosis, a move, the loss of a friendship or marriage, or the sickness of a loved one can be hard to balance and manage alone. However, know that there are many resources available to help. 
  5. Do not stop taking prescribed medication. If you are feeling unstable emotionally or mentally at the moment, do not stop taking or increase your dosage without first talking with your medical professional. Sometimes it may be necessary to adjust your medication, but do not make that choice alone. Again, remember, your medical professional is there to help you.
  6. Helpers find help; don’t burn-out. Many people find themselves to be helpers; always helping others but rarely helping themselves. Without proper self-care, helpers can be buried under the weight of it all. Know that you can only help others when you have been helped yourself. Proper self-care is important for the helpers, too.

Even in the darkest of times, there is always hope. Do not try and suffer alone. We would love to be a part of the team that helps you navigate proper self-care. Call us today at 844.728.4929 to schedule an appointment to speak with one of our licensed counselors or psychologists. We are all in this together.

(The suicide prevention line for confidential support available 24/7 for everyone in the United States (1-800-273-8255)).



A Statement From Our CEO for Our Military Members and Their Families


I know that these are hard times for everyone and our veterans and active duty military, and their families, have not been immune from difficulties. Fear, anxiety, depression, anger, and despair are rampant, and an urgent crisis.

I want to remind you there is hope. Please do not struggle alone.

If you need help, call someone – reach out to one of our Pathway Healthcare offices, or some other mental health resource. Help is available and hope remains.

With all sincerity,

Scott Olson

Co-Founder/CEO and United States Air Force Veteran

Summer Days and the Dangers of Alcohol


Summertime is all about outdoor BBQ’s, lounging by the pool, being out in the sun by the beach or at the lake, hanging out with family or friends…all with a cool drink in your hands. A lot of people think about and consume beer, canned or fresh cocktails, spritzers, hard seltzers, hard teas and lemonades, and wine coolers. There are unlimited options and advertisers do their best to convince you these drinks are “cooling”, “refreshing” and/or “relaxing.” What could possibly be better? 

However, combining the summer heat and alcohol can be dangerous. It can lead to anything ranging from a really bad day to a downright deadly one if you don’t understand how summer and alcohol mix. 

Summer heat is the first danger to be alert to. Most people are not drinking any or enough water to stay safely hydrated. When someone is not hydrated enough, several things start to happen: 

1) You get hot in the heat and begin to sweat, which is totally normal. This is how the body cools itself off. But this loss of fluid is a problem if you don’t have fluid going in to make up for what is going out. 

2) You grab an alcoholic drink to hydrate, but alcohol is a diuretic. Basically, it makes you urinate more so in turn, you lose more fluid. 

3) After sweating and urinating, you are more dehydrated than when you started. Add in a little buzz from that beer or other alcoholic drink (or two, or three), and you also don’t particularly care or realize you are dehydrated. 

4) If you happen to vomit for any reason, the fluid loss is even worse. 

5) Every drop of sweat and alcoholic drink is creating a vicious cycle. 

Eventually, your cooling system is going to breakdown in this scenario. Your body only works in a small temperature range. Alcohol can mess up your ability to know that you are in danger. As it gets worse, the warning signs of severe illness can be ignored. Heat stroke can occur which is life threatening and requires immediate emergency medical attention. (The signs of heat stroke are: headache, dizziness, disorientation, confusion, loss of consciousness, hallucinations and seizures). During a heat stroke, your body temperature is high, and your organs are “cooking”. A lot of these symptoms seem like how a drunk person might act so your friends may not notice a problem, especially if they have also been drinking. 

Another summer alcohol danger is the lack of safety awareness that comes with alcohol intake. Otherwise normal summertime activities can become dangerous when alcohol gets mixed in. Alcohol can decrease you gag reflex. Suddenly you can’t clear your airway as well in the water and you can get water in lungs easier and drown. This is compounded when your judgment is impaired and you are less aware of your limits and distance and swim out farther than you should or can’t find your way out of the water because the alcohol has you a bit confused or disoriented. Boating accidents, car accidents, slips, trips, and falls all increase with alcohol leading to injuries as severe as paralysis and death. 

If you are struggling to control your alcohol consumption, please call us at Pathway Healthcare for an assessment and treatment plan. We can help you reduce or completely eliminate your alcohol intake which will lead to better health overall. Thankfully, there are many alternatives to alcohol on the market that actually hydrate the body so you can enjoy the summer heat outdoors safely.

Pathway Healthcare – 844.728.4929 or visit http://www.pathwayhealthcare.com/to find a location near you.

Author: Shelly Southworth, BSN RN