medication vs substance abuse

[Silla]

I wasn't sure whether to put this in one of the addiction forums or the mental health forum. This forum probably has more experience with medication, and I've been around 12-step groups enough to know that some people are very strongly biased against medication. I've got some addiction questions too, but I'd be happy with feedback from anyone.

I have bipolar disorder. Bipolar I with psychotic features is the official diagnosis. I HAVE to take medication. I really have to. I am also in NA because I've been addicted to benzodiazepines and alcohol. I'm 17 days clean. Something is working.

But I'm still taking my medication (non benzos) My sponsor knows of this, and we have an agreement that I have bipolar disorder and need to take certain medications, I am still clean.

Here's the issue. I'm getting into mania right now. I've barely slept all week. I'm overspending. I'm taking walks at 2 am in the big city. I'm not eating. I can't finish anything. (this post actually took about an hour to write.) I'm cruising craigslist for guys. I've started seeing shadows. Big big warning signs, and it's taken a turn for the worse in the last two days especially. I NEED to do something.

I saw my psychiatrist. He took me seriously when I said I wasn't sleeping. He wants me to take ativan to help get me down. I told him that I couldn't take any benzos because of my addiction history. He said just for a few days. I can't do it. I don't care what he says, I can't take a benzo and still call myself clean. I can't take a benzo without it maybe leading to a relapse.

So I don't know what to do. He increased one of my other medications, but right now it hasn't helped. I talk to him on the phone on Friday and I can bring up my concerns then...

But I think I need to let my sponsor know what's going on. This is where I need advice about combining a mental health diagnosis with 12 step recovery. I could tell her that I'm getting manic and the doctor prescribed ativan but I'm not taking it because I need to stay clean, but what could she say? She knows nothing about bipolar disorder and I'm hesitant to let her see that side of me. I know I need to be honest with her, but I feel like I'd be sticking her in a tough spot. What could she tell me? She won't understand bipolar because she has no experience with it. I think. I don't know. What do I say?

[historyteach]

(((Silla)))
I'm so sorry that you're in such a difficult situation.
I do know that there are *some* people in a 12 step program who have to take meds normally not acceptable in a 12 step program for their health. That decision is between you and your doctor, and AA has a pamplet specifically on the subject. Barto has posted it on this forum in the past. But, it still leaves you with the problem of re-awakening your addiction. And that's a very big problem for sure.

Do you have a very trusted friend or family member who can hold the meds and give it to you *only* as needed and as prescribed? That's how some members deal with this issue? Because bipolar is also a life threatening situation. And your symptoms are clearly a danger to yourself already. Looking for men on Craigs list is dangerous! And I'm sure you know that. So you need to find a way to find some help for yourself and soon.

Again, taking the meds is not spicifically against the 12 step program *if* and only if you take it at the direction of your doc and only the way it is prescribed. You have a life threatening disease. You need to protect yourself and if you have someone who can help you with the dispensing of the meds, to keep you safe from your addictive personality, you should be able to handle it.

You are in a difficult situation. I wish you well.
Let us know how it goes.

Shalom!

[nandm]

Welcome to our mental health forum.

History Teach has posted some good information.

Here is my experience. I am an alcoholic who works the program of AA. I have run across many who do not understand mental illness and have the mistaken point of view that taking medications for these conditions is wrong and the person is not sober if they do. What I know from my experience is that I would not be sober if I let my mental disorder be out of control by not taking my meds. I am bipolar and have PTSD as well. I have prescriptions for mood stabilizers, anti-depressants, as well as an anti-anxiety agent (Klonopin). At one point I was also prescribed a sleep medication.

It is extremely important the the person with bipolar disorder find a way to get sufficient sleep as sleep disturbances can aggravate or induce manic states. That said, since you are concerned about taking a benzo you might consider speaking with your doctor about possibly using Seroquel or Trazadone to help you with the sleep problems. Neither drug is a benzo and they are pretty good with helping someone sleep.

My personal stance on people that state no "mind altering" medications to others in recovery is that until one has walked in my shoes they have no idea what it is like to live with a mental illness. None of us woke up one day and said please let me be bipolar. But it is our responsibility to do what we can to treat the disease rather than letting it destroy our lives. Please do not listen to those that are uniformed and have no experience with mental health issues. I just avoid these individuals as arguing with them is non productive. I do try and educate them when the opportunity arises. Please continue to take your medications and don't let the naysayers get you down.

Hope to see you come back with an update soon.

[Silla]

thanks guys.

I called my sponsor and left her a long rambly message about it so I'll see what she says. I know that staying sane is more important than staying "clean" but I honestly think that if I started taking benzos again I'd be right back where I was, taking 10 or more pills a day. I might have to figure this out without the ativan.

If my sponsor thinks that I shouldn't take extra medication (she's ok with my bipolar meds so far) then I'll find a new sponsor. This is scary and it's definitely more important and life threatening. I'm moving to a new city (probably partly responsible for the mania) and once I'm there, there's a Dual Recovery Anonymous meeting, which combines mental health diagnoses with addiction. They will understand, at least.

He did increase my seroquel to try and head this off but it hasn't worked yet.

Thanks for being there... I'll see what happens but if it comes down to it, I'll take the benzo. As long as I'm not too far gone. At least I can recognize it now and do what I can to stop it. Which I guess might include the benzo. It was clonazepam that I had the trouble with anyway.

[historyteach]

Do you have a trusted friend or family member that can hold it for you and dispense it as prescribed? The friends I know who have to take addictive meds - and who stay clean - do that for themselves. Please find someone....maybe your sponsor?

Shalom!

[Isaiah]

My thought was one with Historyteach, do you have someone that can dose it for you? I myself get my medications filled twice a week, it's a nuisance but it does the job. I couldn't overdose and I don't get the impulse to either. Something to talk about.

I can't imagine how it is going through this sort of conflict. Addiction and mania are both potentially threatening, and hopefully a good middle ground opens up.