Need help - dual diagnosis and won't do 12 step
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Originally Posted by GrouchoTheCat 
This is weird, I just put something about this exact issue in another post.
What the heck, I'll put it here too. It's worth reading twice
From the book: "Beyond the Influence".
Be sure to schedule an initial consultation with the therapist. During this interview, ask the therapist to explain his or her beliefs about alcoholism. Listen carefully to the answer. Here is the general answer you are most likely to get: "I believe alcoholism is a disease." At that point, ask: "What exactly do you mean by the word disease?" If you hear some thing along the lines of "Alcoholism is a symptom of other life problems" or "Alcoholism is a maladaptive behavior rooted in psychological conflict," say, "Thank you very much for your time," and schedule an interview with another therapist. What if the therapist says something like, "Alcoholism is a disease, I have no question about that fact. Still, it seems to me that you might also be depressed-have you ever considered taking medication for your depression?" This happens often, and here's how you should respond: "Do you think that my depression is caused by alcoholism or that it is an independent problem?" The answer to this question will tell you whether or not the therapist is considering a dual diagnosis.
Dual diagnosis is an extremely controversial topic in alcoholism treatment circles. In many treatment centers the majority of alcoholics are labeled dual-diagnosis patients and treated for both alcoholism and, say, chronic depression or chronic anxiety; treatment for psychological disturbances often involves the use of various medications including antidepressants, sleeping pills, mood elevators, or sedatives. Too often the diagnosis is made on the basis of the patient's presenting symptoms-the recovering alcoholic is clearly anxious, depressed, or suicidal-and no effort is made to review the patient's history to determine if the anxiety or depression existed prior to the use of alcohol and/or other drugs.
When the primary problem is alcoholism, it is highly likely that the secondary symptoms of depression, suicidal thoughts, anxiety, and panic attacks will improve rapidly over a period of several days or weeks of abstinence, eventually disappearing without the need for medication. A dual diagnosis, in these cases, would constitute a misdiagnosis, for the disruptions in thought, mood, and behavior are not separate disorders at all but consequences of alcoholism. In most cases these symptoms will abate after several weeks of abstinence and disappear after several months. If the psychological symptoms continue unabated or worsen as time goes on, the need for medication can be reevaluated.
Some recovering alcoholics do benefit from antidepressant medication in the early stages of recovery, but in determining who is a candidate for medication, this essential question must be asked: Is the recovering alcoholic's depression related to the lingering effects of the disease and thus destined to lift over time, or is the depression a separate disorder that predated the drinking and will continue despite abstinence? If the depression is not severe or debilitating, many alcoholism experts and clinicians will advise you to wait three or four months (or longer, in some cases) before taking medication. They don't want you to suffer unnecessarily, but they also don't want to jump to conclusions or suggest therapies that might
jeopardize your sobriety.
Although many recovering alcoholics have experienced relief from depression, anxiety, insomnia, and obsessive-compulsive disorders by taking the class of antidepressants known as SSRIs, these drugs are not, unfortunately, without their problems (see Chapter 11). Our general rec ommendation is to approach all long-term drug treatments with caution.
What the heck, I'll put it here too. It's worth reading twice
From the book: "Beyond the Influence".
Be sure to schedule an initial consultation with the therapist. During this interview, ask the therapist to explain his or her beliefs about alcoholism. Listen carefully to the answer. Here is the general answer you are most likely to get: "I believe alcoholism is a disease." At that point, ask: "What exactly do you mean by the word disease?" If you hear some thing along the lines of "Alcoholism is a symptom of other life problems" or "Alcoholism is a maladaptive behavior rooted in psychological conflict," say, "Thank you very much for your time," and schedule an interview with another therapist. What if the therapist says something like, "Alcoholism is a disease, I have no question about that fact. Still, it seems to me that you might also be depressed-have you ever considered taking medication for your depression?" This happens often, and here's how you should respond: "Do you think that my depression is caused by alcoholism or that it is an independent problem?" The answer to this question will tell you whether or not the therapist is considering a dual diagnosis.
Dual diagnosis is an extremely controversial topic in alcoholism treatment circles. In many treatment centers the majority of alcoholics are labeled dual-diagnosis patients and treated for both alcoholism and, say, chronic depression or chronic anxiety; treatment for psychological disturbances often involves the use of various medications including antidepressants, sleeping pills, mood elevators, or sedatives. Too often the diagnosis is made on the basis of the patient's presenting symptoms-the recovering alcoholic is clearly anxious, depressed, or suicidal-and no effort is made to review the patient's history to determine if the anxiety or depression existed prior to the use of alcohol and/or other drugs.
When the primary problem is alcoholism, it is highly likely that the secondary symptoms of depression, suicidal thoughts, anxiety, and panic attacks will improve rapidly over a period of several days or weeks of abstinence, eventually disappearing without the need for medication. A dual diagnosis, in these cases, would constitute a misdiagnosis, for the disruptions in thought, mood, and behavior are not separate disorders at all but consequences of alcoholism. In most cases these symptoms will abate after several weeks of abstinence and disappear after several months. If the psychological symptoms continue unabated or worsen as time goes on, the need for medication can be reevaluated.
Some recovering alcoholics do benefit from antidepressant medication in the early stages of recovery, but in determining who is a candidate for medication, this essential question must be asked: Is the recovering alcoholic's depression related to the lingering effects of the disease and thus destined to lift over time, or is the depression a separate disorder that predated the drinking and will continue despite abstinence? If the depression is not severe or debilitating, many alcoholism experts and clinicians will advise you to wait three or four months (or longer, in some cases) before taking medication. They don't want you to suffer unnecessarily, but they also don't want to jump to conclusions or suggest therapies that might
jeopardize your sobriety.
Although many recovering alcoholics have experienced relief from depression, anxiety, insomnia, and obsessive-compulsive disorders by taking the class of antidepressants known as SSRIs, these drugs are not, unfortunately, without their problems (see Chapter 11). Our general rec ommendation is to approach all long-term drug treatments with caution.
I've heard too many stories of those who've gone off their meds and committed suicide in AA -- should be a lightbulb for many.
One needs a qualified psychiatrist in dealing with these matters. Fortunately, I finally found the BEST.
Just a couple of other thoughts.
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There are 12 step groups for dual diagnosis (mental health issues combined with chemical dependency). here is a link to an organization that has an excellent website for people with dual diagnosis and they have a meeting schedule.
http://draonline.org/
http://draonline.org/
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Originally Posted by CarolD
Sorry....I have no clue.
Pherps your doctors do?
I do apologize for thinking you were Karen
this time I copied and pasted...
Welcome to our Alcoholism Forum Kathryn D
Pherps your doctors do?
I do apologize for thinking you were Karen
this time I copied and pasted...
Welcome to our Alcoholism Forum Kathryn D
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Originally Posted by raerae6
There are 12 step groups for dual diagnosis (mental health issues combined with chemical dependency). here is a link to an organization that has an excellent website for people with dual diagnosis and they have a meeting schedule.
http://draonline.org/
http://draonline.org/
We are just in the stone ages when it comes to addiction science, for some reason. Depression was finally realized as legitimate (no more ECT in many cases, except I know a woman who recently had an implant to her vagus nerve -- no SA issues), hence all the new drugs for that and ads on TV. When was the last time you saw an ad for an alcoholic or addict and the latest new drug for them ? (and these things are soooooooo biochemical). Just shows what we're up against. We're still in the stone ages and the stigma is huge.
I'd encourage all the 12 steppers to throw out the anonymity piece of things in order to move things along, but that would be like sacrilege.
AA only works for 5% of the population. Seems a shame that not more advances have been made to really deal with this major life threatening and public issue, but on well
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Hi, i just ran into this after I saw your other thread. From what you say above it sounds like you might be a good candidate for "health realization". My ex bf went to a treatment center where they practiced this. He had addiction only without mental health issues, but they did treat both at the place he went to. It was run by an organization called meridian. He liked it better than 12 steps. This is not a 12 step program. It is about learning to make different choices. It has been applied to other things besides addiction.
There is a book about it that I know of called "the serenity principle".
Here is more information.
http://www.answers.com/topic/health-realization
"The person who practices Health Realization learns that even though insecure and negative thoughts may always arise, they do not have to be taken seriously; we can choose whether to react to them or not. When we choose to stop reacting to them, our minds quiet down and positive feelings emerge spontaneously. Thus the student of HR also learns that he or she has health and well-being already within them, ready to emerge as soon as his/her insecure, negative thinking calms down. When this happens, s/he also gains access to "common sense," a clear-sighted and highly ethical way of relating to the world, and s/he can tap into the universal capacity for creative problem-solving or "inner wisdom." When a person truly grasps the understanding behind Health Realization in an experiential way, an expansive sense of emotional freedom and well-being often results."
I hope this helps.
There is a book about it that I know of called "the serenity principle".
Here is more information.
http://www.answers.com/topic/health-realization
"The person who practices Health Realization learns that even though insecure and negative thoughts may always arise, they do not have to be taken seriously; we can choose whether to react to them or not. When we choose to stop reacting to them, our minds quiet down and positive feelings emerge spontaneously. Thus the student of HR also learns that he or she has health and well-being already within them, ready to emerge as soon as his/her insecure, negative thinking calms down. When this happens, s/he also gains access to "common sense," a clear-sighted and highly ethical way of relating to the world, and s/he can tap into the universal capacity for creative problem-solving or "inner wisdom." When a person truly grasps the understanding behind Health Realization in an experiential way, an expansive sense of emotional freedom and well-being often results."
I hope this helps.
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Glass Prisoner, are you a M.D.? It is dangerous to say that her bi-polar will go away if she stays sober and "works a good program." AA is obviously the solution for YOU but some people need outside help in dealing with issues. My mood swings, depression ect.. have never gone away after long periods of being sober.
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Originally Posted by Kathryn D
I've heard too many stories of those who've gone off their meds and committed suicide in AA -- should be a lightbulb for many.
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Originally Posted by liveweyerd
Please be aware that mental illnesses are real and often are the precursor to self-medicating.
There is a great deal of misinformation and stigma related to mental illness. Chemical imbalances in the organ of the brain are no different than chemical problems in other organs such as in diabetes.
Before we speak of these things with authority, it is best to educate ourselves and be informed of the issues we are addressing.
There is a great deal of misinformation and stigma related to mental illness. Chemical imbalances in the organ of the brain are no different than chemical problems in other organs such as in diabetes.
Before we speak of these things with authority, it is best to educate ourselves and be informed of the issues we are addressing.
Some people get depressed as a situational thing. Some people become depressed as a result of their addiction, for others it is the other way around.
For some it is a biological thing just like Live said above. No different than any other organ that doesn't function correctly.
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Kathryn, if you have been sober for over 6 months (unless I have misread your posts) and you say you are not an alcoholic why are you on an alcoholic forum? If your shrink has the diagnosis down pat and you have been sober over 6 months then it seems that the "alcohol dependance" would be gone if you are not an alcoholic. I am no doctor and I know I do not know all the particulars in you story so I am just asking questions and not judging or diagnosing in any way, simply asking questions.
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My Gf is Bi -polar.
But it was a big different when she got sober.
Back in the days before bi-polar became a household name,
it was call manic depressive
I could had easily been diagnosis with bi-polar, when i
first got sober.
my shrink told me I was passive agressive..
I that the samething as saying that I'm smart but
had self esteem issues ?
I read somewhere in a book refer to it as reverse pride.
Egotistic...very, very egotistic..but not adbrasive.
I'm glad i don't like to pop pills anymore.
When my gf first started taking her meds..
Oneday she'll bouncing off the wall, the next day
go into a deep depression.
She works the 12 steps..it's not that big of a deal.
She dose it on her own pace.
Never the less....first things first.
Don't drink no matter what..if you don't stop drinking,
everything else is not going to work.
Get your priority straight.
But it was a big different when she got sober.
Back in the days before bi-polar became a household name,
it was call manic depressive
I could had easily been diagnosis with bi-polar, when i
first got sober.
my shrink told me I was passive agressive..
I that the samething as saying that I'm smart but
had self esteem issues ?
I read somewhere in a book refer to it as reverse pride.
Egotistic...very, very egotistic..but not adbrasive.
I'm glad i don't like to pop pills anymore.
When my gf first started taking her meds..
Oneday she'll bouncing off the wall, the next day
go into a deep depression.
She works the 12 steps..it's not that big of a deal.
She dose it on her own pace.
Never the less....first things first.
Don't drink no matter what..if you don't stop drinking,
everything else is not going to work.
Get your priority straight.
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Sorry, Kathryn...didn't mean to offend. I have what I think of as a mental illness but didn't mean that as a put down to you.
I am backing out of this thread....I have had several friends who have bipolar diagnosis but are not, nor am I alcohol abusive, dependent or alcoholic.
I meant to be suportive. sometimes I say things wrong and when we cannot see another, their body language and tone, it is hard to interpret.
I am backing out of this thread....I have had several friends who have bipolar diagnosis but are not, nor am I alcohol abusive, dependent or alcoholic.
I meant to be suportive. sometimes I say things wrong and when we cannot see another, their body language and tone, it is hard to interpret.
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To answer you question Kathryn....here is a listing of non-12 step recovery centers. Most deal with dual diagnosis, some do not. http://www.soberrecovery.com/links/a...ntcenters.html
These are some dual diagnosis programs
http://www.soberrecovery.com/links/dualdiagnosis.html
And here are some links to non 12-step programs websites
LifeRing Secular Recovery
http://www.unhooked.com
SMART
http://www.smartrecovery.org/
SOS - Secular Organisations for Sobriety
http://www.secularsobriety.org
Women for Sobriety
http://womenforsobriety.org/
Information and analysis about addiction treatment and harm reduction:
http://www.peele.net/
A useful AA reference:
Online AA resources (not official AA):
http://www.recovery.org/aa/
Moderation Management, the one group that deals with moderate drinking; useful for the guidelines:
http://moderation.org/
Some variations on 12 Step:
Agnostics AA:
http://agnosticaa.org/
Hope that helps. Take care.
These are some dual diagnosis programs
http://www.soberrecovery.com/links/dualdiagnosis.html
And here are some links to non 12-step programs websites
LifeRing Secular Recovery
http://www.unhooked.com
SMART
http://www.smartrecovery.org/
SOS - Secular Organisations for Sobriety
http://www.secularsobriety.org
Women for Sobriety
http://womenforsobriety.org/
Information and analysis about addiction treatment and harm reduction:
http://www.peele.net/
A useful AA reference:
Online AA resources (not official AA):
http://www.recovery.org/aa/
Moderation Management, the one group that deals with moderate drinking; useful for the guidelines:
http://moderation.org/
Some variations on 12 Step:
Agnostics AA:
http://agnosticaa.org/
Hope that helps. Take care.
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Yes, on the dual diagnosis site I origionally posted for you, they told of some people who had gone to AA and were also on psych meds. Some of the AA people told them that all drugs are bad and that they shouldn't even take their meds. That is one of the advantages of a dual type meeting instead of a regular AA meeting.
As often as I hear this and the fact that I have heard exactly the opposite said in the rooms of AA I half way wonder if it is not an urban myth.
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Originally Posted by Tazman53
]Kathryn, if you have been sober for over 6 months (unless I have misread your posts) and you say you are not an alcoholic why are you on an alcoholic forum? If your shrink has the diagnosis down pat and you have been sober over 6 months then it seems that the "alcohol dependance" would be gone if you are not an alcoholic. I am no doctor and I know I do not know all the particulars in you story so I am just asking quest
ions and not judging or diagnosing in any way, simply asking questions.
ions and not judging or diagnosing in any way, simply asking questions.
I'm 47 years old. I have lived my entire life according to this mandate, and I am smart.
It is very difficult for me to discount my existence to a bunch of people who know less than I do.
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Originally Posted by Tazman53
Notice it said "Some of the people", these people needed to read the BB a whole lot closer, the founders of AA were all for and encouraged seeking help for phsycological problems and taking meds prescribed by doctors, I have heard this discussed in the rooms in my area and have yet to hear one single person, old timer or newbie say that one should stop taking meds prescribed by a doctor, as a matter of fact I have heard people encouraged to stay on thier meds and continue to seek therapy if they were having problems out side of alcoholism.
As often as I hear this and the fact that I have heard exactly the opposite said in the rooms of AA I half way wonder if it is not an urban myth.
As often as I hear this and the fact that I have heard exactly the opposite said in the rooms of AA I half way wonder if it is not an urban myth.
Do you not understand people have commited suicide as a result of AA misguided efforts?
There is no need to say anything else, except WAKE UP
Ok, misunderstood. You are correct.
Forward we go...side by side-Rest In Peace
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Hi Kathryn...
You have been given links by members.
You are correct....our SR members
are not medical professionals nor
do we profess to be.
Here is a link for info on suicide
with resources and
that explains our SR position.
http://www.soberrecovery.com/index.html
This thread is now closed so we all
can move forward.
You have been given links by members.
You are correct....our SR members
are not medical professionals nor
do we profess to be.
Here is a link for info on suicide
with resources and
that explains our SR position.
http://www.soberrecovery.com/index.html
This thread is now closed so we all
can move forward.
Last edited by CarolD; 07-02-2007 at 09:36 PM.
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