Midlife Women and AddictionMost treatment programs — whether they’re for drugs and alcohol, gambling, or eating disorders — are targeted to people under 40. But the number of midlife women with addictions is on the rise. By the year 2020, 4.4 million Americans 50 and older will have drug and alcohol problems, almost triple the number in 2001, according to estimates from the U.S. Substance Abuse and Mental Health Services Administration. And many of the women will hesitate to seek help. "Women feel more ashamed of their problems than men, and older women even more so," says Stephan Arndt, PhD, a University of Iowa professor who has studied addictions in people over 40. "Once in treatment, however, they usually encounter other women just like themselves."And they’re motivated to get better. "Midlife women," Arndt says, "often look at the second half of their lives and think, ‘Do I want to spend time maintaining, yet trying to hide, an addiction?’"Moreover, recovery may come more naturally to women. Brenda Iliff, director of clinical services at the Hazelden Women’s Recovery Center, in Center City, Minnesota, says women are "wired for connection." And recovery, she explains, "is about reconnecting with family, friends, communities, and colleagues."Women often emerge from treatment with a strong focus on their values and try to reflect them in their lives, notes Carol Colleran, executive vice president of the Hanley Center, a rehabilitation facility in West Palm Beach, Florida. "That, in and of itself, helps them stay clean," she says.If you’re a midlife woman struggling with an addiction, that’s inspiring news. Here, four equally inspiring stories.AlcoholismHer philosophy had always been "If I work hard, I can play hard." A stay-at-home mom in Chicago, Janis Robinson, now 48, devoted herself to her two kids and household chores Monday through Friday. But on weekends she and her husband would go out to dinner or entertain friends, and she’d always have several glasses of wine.The couple divorced in 2001, however, and Robinson’s life became more stressful. With her children, ages 4 and 8, in private school, she went back to work — as the head of diversity at the University of Chicago Graduate School of Business — and had many more responsibilities. "I was angry and unhappy, so I began kicking up my heels on the weekends," she says. "I’d get together with other single moms on Friday, Saturday, and Sunday nights, and while the kids hung out, we’d party."The weekend revelry didn’t seem like a big deal when the children were young, but as they got older, their schedules became more demanding. "It’s hard to get up early and take your kids to soccer or basketball practice when you’re hung over," she says.Her turning point came in 2005, while she and her daughter were on a ski trip with friends in Colorado. Robinson’s attorney called to tell her that her ex-husband was planning to sue for full-time custody of the children, and she fell apart. "I went straight to the liquor store, bought a bottle of vodka and drank it all," she says. She passed out, and when her daughter couldn’t awaken her the next morning, Robinson was rushed to the hospital."I was humiliated and frightened," she says. "My husband picked up my daughter, and my two sisters, who live in Colorado, took me home with them. My mom was there, and she and my sisters asked, ‘What’s your plan? What are you going to do about this?’ I said I was going to go into treatment."Because she couldn’t afford a months-long absence from her job (by that time, she was an insurance broker), Robinson enrolled in the Hazelden Foundation’s intensive outpatient program in Chicago. She attended its classes for three hours every evening after work for six weeks, then continued going several times a week for almost a year. She also went — and still goes — to 12-step meetings three times a week during her lunch hour.Robinson has been sober two years, although it hasn’t been easy. "The kids live mostly out of state with my husband, so I don’t see them nearly as often as I’d like," she says. "But I’m grateful every day for my sobriety, and I’m so much happier in most ways. I have a great network of sober friends. I feel healthier physically and emotionally, more centered and peaceful. Facing this challenge in middle age has given me incredible strength. I feel like I could do almost anything."Gambling AddictionAmy Blackmarr, 50, went to Las Vegas for the first time about 20 years ago. "It was so exciting, like an adult fairyland: the lights, the magic, the mystery," she says. But she was a struggling writer approaching 30, so gambling didn’t exactly fit into her budget. She avoided it for a decade, until she moved to Kansas City for graduate school. A sprawling, Vegas-style casino was only 50 miles away, and she started going once a month, with a friend, and then once a week. Soon Blackmarr was going alone, playing the slot machines all night."It wasn’t about the money. It was the risk, the adrenaline, the intensity," she says. "But I knew it wasn’t healthy for me. From the beginning, I wasn’t able to leave when I thought I should. I’d set a time or money limit, but I’d never stick to it."After a year or so, Blackmarr owed $60,000 on seven credit cards, a crushing burden for a grad student bringing in about $20,000 a year writing nature essays. She figured the only way she could dig herself out was to move away, so after finishing her PhD, she fled to Georgia, near where her father lived. She worked as a librarian, hoping to write and embrace a quieter life. For nearly three years, she succeeded, but then her father — who had a heart condition, early Alzheimer’s, and bipolar disorder — began deteriorating. Blackmarr took over his care and offset the stress by gambling at the nearest casino, which was two hours away. "I’d do what I needed to do for my father, work, drive to the casino, and stay till 4:30 a.m. Then I’d go home, shower and do it all over again without having slept. I was living on adrenaline. It was crazy."In 2004, she met a musician at an open microphone night and married him a year later. "I couldn’t believe I was fortunate enough to find the right guy in my 40s," she says. She told her husband, Chase, about her gambling, and he accepted it. But because she toned down the craziness after he entered her life, she says, "I don’t think he understood what a problem it could be."In 2006, they moved to New Haven, Connecticut, so Blackmarr could enroll in Yale University’s divinity school. Within a few months, she realized that the ministry wasn’t her calling and dropped out, which made her feel like a failure. For comfort, she turned to the thing that had always made her feel better. "Chase and I started going to the nearby casinos, and within six weeks I was gambling our rent money away," she says. "The decline happened very quickly. I could feel Chase’s disappointment, feel him pulling away. He couldn’t stand to see me irrational and unable to think, which is how I got when I played slots. He stopped going with me, but he couldn’t talk me into staying home."Blackmarr’s casino highs were offset by desperate lows and a sense of hopelessness; she felt her life was completely out of her control. "I don’t think I really would have killed myself, but there were times, coming home from the casino in the wee hours, when I considered driving into the guardrail," she says. "The sense of shame, self-loathing, and disgust was almost unbearable."Knowing her marriage — and maybe her life — were at risk, she used her research skills to find a good treatment program for gamblers. She found one nearby, Problem Gambling Services. Since February 2007, Blackmarr has participated in cognitive behavior therapy sessions, which have helped her understand why she was drawn to the slots. "I had suffered a series of losses: my family sold my grandfather’s farm, which was the setting of my first book; I lost two beloved dogs; my dad was in a terrible car wreck," she says. "Gambling helped me bury the pain."Blackmarr believes that her age was an advantage in her treatment. "I was able to bring some wisdom to the process that I didn’t have when I was younger," she says. "I was determined to hang on to what really mattered to me — my marriage and my writing.""I still fight the urge to gamble, but it’s much less strong," she says, though she has had three lapses since completing treatment. She is still her father’s main caregiver — long-distance, since she’s in Connecticut and he is still in Georgia. And she continues to see a counselor every week. "I’m rebuilding my credit by paying off my debt," Blackmarr says. "More important, I’ve reforged the trust with my husband. Our life is wonderful, in spite of everything, because we love our careers and we love each other. We’re rich in all the ways that really count."Eating DisorderWhen she was 17, Barb Delaney was in a near-fatal car accident. "I lost my nose and had nine surgeries over the next four years to reconstruct it," says the 44-year-old mother of two, who lives in Springfield, Virginia. The accident destroyed more than her face. "It devastated my self-confidence," she says. "I had always been self-conscious because I was a little overweight, but after the accident, it got really bad. I was in college and just wanted to fit in, which is pretty hard when your face is constantly changing."With her appearance determined by her doctors, Delaney took control of the only thing she could: her weight. "I’d eat very little, or eat a lot and then throw up," she recalls. "I became really thin, and that made me feel a little better about myself."She married in 1988. "I was hoping that my eating problems might get better, but though I managed to resolve my bulimia in college, during my two pregnancies, I couldn’t help worrying about my weight," she says. Nonetheless, Delaney ate well, and both of her children — a daughter in 1990 and a son three years later — were born healthy.Her career was also thriving. The family had moved to Hawaii, and Delaney became the director of two child development centers. But her marriage was faltering. "We didn’t really know each other well when we got married," she says. "Matt’s a wonderful man, but we weren’t really right for each other." In 1999 they divorced, a split that she describes as "a good thing for both of us."The stress of single parenting took a toll, though. By the time she was in her late 30s, Delaney weighed just 85 pounds; her health was precarious. "I had been in and out of the hospital several times, and I had an intravenous feeding tube for several months," she says. "One day my daughter and I went to Costco, and I couldn’t lift a case of Coke. I was ashamed. You’re supposed to have it all together in your 40s, and I was a mess. I didn’t own a house, I had a beat-up car, I was divorced — and I had this terrible eating disorder. For a person like me, who likes to do things right, that was very difficult."The turning point came in the summer of 2005, when her parents, her brother and five of her close friends staged separate interventions. "My brother said, ‘It will make a lot of people feel so much better if you go and get some help,’" Delaney recalls. "Those were the magic words. I’m not one to do things for myself, but I’ll do almost anything for the people I love, especially my kids. I realized what a burden my illness was on them and how frightened they must be about my health. So I agreed."She went to the Renfrew Center in Philadelphia, an inpatient facility that treats people with eating disorders and has a program for women over 35. Although they spent a lot of time with the younger patients, Delaney and the other women her age had their own groups, where they talked about the things that were important to them.According to Susan Ice, MD, medical director of the Renfrew Center, the percentage of women over 40 seeking treatment for anorexia has doubled in the past 10 years (from 5 to 10 percent). "What we see is women who’ve had a minor problem for years getting worse in middle age, triggered by divorce, empty nest syndrome, and the stresses of caring for aging parents," she says. "Also, many women who have always struggled with their bodies are thrown when they begin to see the signs of aging, so they start dieting as a way to keep their bodies the same."Delaney stayed at the Renfrew Center for three weeks, not as long as the counselors thought she should stay but the longest she could stand to be away from her kids. Still, she put on 13 pounds and gained something even more important: new coping skills. "After years of starving myself, it’s hard not to reject food. But if I give myself some quiet time to calm myself after I eat, it really helps," she says. "And I understand that getting better is something I need to do for me."Now, at five-foot-five and 105 pounds, Delaney is still very slim. "But I’m much healthier than I was, and every day I find myself doing a little better — eating more, getting stronger," she says. "The best part is, I have more energy, so I can enjoy everything more. I love my job, and I adore my kids. Going through treatment was one of the best things I’ve ever done. It set me on a healthy course, the first one I’ve been on in years."Addicted to CocaineBy the time Allison Simon, now 42, and her husband moved to the affluent New Jersey town of Woodcliff Lake, in 2001, their four-year marriage was shaky. "We fell in with a very social, partying crowd, which helped us escape our problems with each other," she says.When their son was 3, Simon got pregnant again. She stopped drinking but jumped back into the party scene within two months of giving birth to another boy. One night, two of her new friends pulled her into a bathroom and offered her cocaine. "I hadn’t done coke since college — and I only did it a few times then — so I thought, what the heck. This will be a lark," she says.A couple of months later, Simon used cocaine again and bought some for "special occasions." At first it was a weekend thing, she says, but as the months passed, she started snorting it during the week, whenever she needed a little boost. "I felt distraught about my marriage, but coke made me feel good," she says. "I could forget our problems when I was using it."As her drug use escalated, Simon’s marriage deteriorated. "My husband and I were fighting a lot," she says. "He was spending more time with the guys; I was spending more time with the girls — and the girls liked to party. I knew I was getting out of control, but physically and mentally, I was so convinced I needed cocaine to survive that I couldn’t even bring myself to ask for help."In 2006, says Allison, her husband filed for divorce. "I begged him not to," she says. "I wasn’t happy in our marriage, but my own parents had split and I was terrified of being divorced — of putting our kids through that trauma and giving up on the dream of a happy family. I was depressed, my confidence was at an all-time low, and I was scared to death of being a single parent with no job."To block the pain, Simon kicked up her cocaine habit, making it a daily ritual. "I’d usually wait till three or four in the afternoon, so I had already picked the kids up from school when I started. But sometimes I’d party all night," she says. "I was meeting the boys’ physical needs — they were clean and well-fed, their homework was done — but I was pretty checked out emotionally."Finally, the family’s former live-in housekeeper, who had become a friend, called Simon’s mother to say her daughter needed help. That same day, Simon’s father arrived. "He said he thought I needed to go to a treatment program," she says. "I was embarrassed, because 40-year-old moms aren’t supposed to be addicts. But I was also relieved. I knew I had to stop, and that I couldn’t do it on my own."Simon’s parents took her to Caron, a drug and alcohol treatment center in Wernersville, Pennsylvania, where she stayed for four months. "Leaving my kids for that long was incredibly difficult," she says. "As a parent, it’s impossible not to have some guilt about that, even if you know you’re doing the right thing for your own health."Now, with more than a year of sobriety behind her, Simon attends a 12-step meeting for addicts almost every day and feels better than she has in years, despite the fact that her life is, in some ways, more stressful. "My husband and I are embroiled in a tough custody battle, which is very difficult. But overall my life is amazing," she says. "I have my wits about me again, and I’ve realized I can handle a lot more than I thought I could. I just started a new sales job, and I love earning my own money. I’ve made many new friends in recovery, and the friendships are based on a really deep, shared bond. My relationship with my children is better than ever, because I’m present when I’m with them. I love waking up early with them and doing fun things. There’s no greater high than that."Best Treatment Programs for Midlife WomenAfter recognizing several years ago that women over 40 didn’t want to spend all their time in groups listening to young girls talk about their problems with their parents, the Renfrew Center, an inpatient facility in Philadelphia, started treatment groups designed for older women with eating disorders. "The groups focus on situations specific to midlife women, such as job stress and aging parents, as well as physical changes that happen in middle age," says Susan Ice, of the Renfrew Center. "Women get the chance to talk about these issues. That’s key, because treatment is all about figuring out what purpose the disorder serves in your life and what issues are driving it."The program directors at the Hanley Center, an alcohol and drug rehabilitation facility in West Palm Beach, have taken a similar age-based approach. "We offer a hormonal assessment, which helps women see how those shifts may be affecting their moods, their relationships, and their addictions. And we have groups that are geared toward the things midlife women are dealing with — the empty nest, divorce, guilt and shame, and body image problems," the Hanley Center’s Carol Colleran says. "We’ve had good feedback, especially from women who’ve been through treatment before. They told us that they never really had the chance to look at these issues, and that it really helped." For more information go to:renfrewcenter.com hanleycenter.org Originally published in MORE magazine, July/August 2008.