Need help - dual diagnosis and won't do 12 step
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Join Date: Jun 2007
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Need help - dual diagnosis and won't do 12 step
I've been Dx'd with Bipolar 1 disorder and alcohol dependence. Notice, I don't say the word alcoholic, as even my shrink says it's pejorative (and it's not even noted in the DSM IV as such, any longer). At any rate, I am looking for help in locating a non-12 step based rehab program that also knows/deals with bipolar disorder.
I attended my first AA meeting 30 years ago...sorry, no way in heck...not going to happen.
I believe in science and need help. Thanks!
I attended my first AA meeting 30 years ago...sorry, no way in heck...not going to happen.
I believe in science and need help. Thanks!
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Join Date: Nov 2006
Location: Murrieta, Ca
Posts: 2,683
Well, alcoholism and alcohol dependence are, in my book, two different things. One can be an alcoholic without being physically dependent on the substance. I was both. In any case, it's semantics.
It's common for Doctors to diagnose practicing alcoholics as Bi-polar. The symptoms are similar. I'm not saying that you're not bi-polar, but I'd make a fair wager that if you abstained from alcohol and worked a good recovery program, you're bi-polar symptoms would lessen or go away.
You went to one meeting, 30 years ago, and are making a decision about your life based on that ? I'd seriously re-consider, and at the very least no matter what program of recovery your choose, you're going to have to be honest, open minded, and willing to change.
As far as science, for a really good description of how alcohol affects the mind and body of an alcoholic (and how an alcoholics body is actually different), check out the book "Under The Influence".
It's common for Doctors to diagnose practicing alcoholics as Bi-polar. The symptoms are similar. I'm not saying that you're not bi-polar, but I'd make a fair wager that if you abstained from alcohol and worked a good recovery program, you're bi-polar symptoms would lessen or go away.
You went to one meeting, 30 years ago, and are making a decision about your life based on that ? I'd seriously re-consider, and at the very least no matter what program of recovery your choose, you're going to have to be honest, open minded, and willing to change.
As far as science, for a really good description of how alcohol affects the mind and body of an alcoholic (and how an alcoholics body is actually different), check out the book "Under The Influence".
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Join Date: Jan 2007
Location: Lobstah Land
Posts: 1,122
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.
Forward we go...side by side-Rest In Peace
Join Date: Jun 2002
Location: Serene In Dixie
Posts: 36,740
At any rate, I am looking for help in locating a non-12 step based rehab program that also knows/deals with bipolar disorder.
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
Coffee Drinker
Join Date: Jan 2007
Location: Lobstah Land
Posts: 1,122
I think that "Under the influence" was published in the 70's.
The book was completely updated and re-written as "Beyond the influence", published in 2000 byBantam, written by, Katherine Ketcham (who was a co-author of "Under the influence") and William Asbury (with others).
Beyond has more information on the celluar and biological stuff as the science has advanced considerably. Much of the discoveries involving the neurotransmitters and that interaction with alcohol and other drugs actually stems from parkensons research. (No telethons for alcoholism!).
Highly reccommend it.
You first attended AA 30 years ago, would you elaborate?
The book was completely updated and re-written as "Beyond the influence", published in 2000 byBantam, written by, Katherine Ketcham (who was a co-author of "Under the influence") and William Asbury (with others).
Beyond has more information on the celluar and biological stuff as the science has advanced considerably. Much of the discoveries involving the neurotransmitters and that interaction with alcohol and other drugs actually stems from parkensons research. (No telethons for alcoholism!).
Highly reccommend it.
You first attended AA 30 years ago, would you elaborate?
Forward we go...side by side-Rest In Peace
Join Date: Jun 2002
Location: Serene In Dixie
Posts: 36,740
needtobefree....
I got sober with it in '89
and
I use a book wittten in '35
to live in recovery joy
Bes of luck on your journey...
That book, wasn't it written in the 70's?
and
I use a book wittten in '35
to live in recovery joy
Bes of luck on your journey...
Member
Join Date: Nov 2002
Location: Bristol TN/VA
Posts: 12,431
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.
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Thread Starter
Join Date: Jun 2007
Posts: 43
Originally Posted by GlassPrisoner 
Well, alcoholism and alcohol dependence are, in my book, two different things. One can be an alcoholic without being physically dependent on the substance. I was both. In any case, it's semantics.
It's common for Doctors to diagnose practicing alcoholics as Bi-polar. The symptoms are similar. I'm not saying that you're not bi-polar, but I'd make a fair wager that if you abstained from alcohol and worked a good recovery program, you're bi-polar symptoms would lessen or go away.
You went to one meeting, 30 years ago, and are making a decision about your life based on that ? I'd seriously re-consider, and at the very least no matter what program of recovery your choose, you're going to have to be honest, open minded, and willing to change.
As far as science, for a really good description of how alcohol affects the mind and body of an alcoholic (and how an alcoholics body is actually different), check out the book "Under The Influence".
It's common for Doctors to diagnose practicing alcoholics as Bi-polar. The symptoms are similar. I'm not saying that you're not bi-polar, but I'd make a fair wager that if you abstained from alcohol and worked a good recovery program, you're bi-polar symptoms would lessen or go away.
You went to one meeting, 30 years ago, and are making a decision about your life based on that ? I'd seriously re-consider, and at the very least no matter what program of recovery your choose, you're going to have to be honest, open minded, and willing to change.
As far as science, for a really good description of how alcohol affects the mind and body of an alcoholic (and how an alcoholics body is actually different), check out the book "Under The Influence".
Nonetheless, my Dr. put me on an antipsychotic, which was clearly not warranted. I told him so and it was ok. See, therein lies the benefit from knowing a shrink for over three years. I am on an anti-convulsant, which has made a world of difference.
I don't use the word alcoholic. Even he says it's pejorative, as even according to the DSM IV. I have had enough treatment to keep up with the venacular. It works for me.
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Thread Starter
Join Date: Jun 2007
Posts: 43
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.
Well, thank you Ted. Six months into sobriety I started have panic attacks, although they were not my first psychiatric thingy into thing. I got my first signs at 8. See, this is one thing that really bugs me about the recovery movement. I mean, my God, there is so much stuff. So many people subscribe it to addiction, or whatever, when the psychiatric stuff was there, long before.
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Join Date: Jun 2007
Posts: 43
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.
Open Minded
Join Date: Jun 2007
Location: NZ
Posts: 226
Hi, good to meet you as it were. We share some concerns re dual diagnosis and methods of attaining recovery. I hope you find the help you are looking for soon. I just found some help through the local health authority addiction services this morning, they have dual diagnosis teams and a lot of support services on offer. It might be worth checking out your end.
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Join Date: Nov 2006
Location: Murrieta, Ca
Posts: 2,683
The truth is I am pretty smart, but have no self-confidence.
I wasn't always like this. It's crushed my heart to end up in this place, but I guess God never gives one more than one can handle.
Interesting about the God comment, I thought you were anti 12 step ?
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Originally Posted by GlassPrisoner
Well, alcoholism and alcohol dependence are, in my book, two different things. One can be an alcoholic without being physically dependent on the substance. I was both. In any case, it's semantics.
It's common for Doctors to diagnose practicing alcoholics as Bi-polar. The symptoms are similar. I'm not saying that you're not bi-polar, but I'd make a fair wager that if you abstained from alcohol and worked a good recovery program, you're bi-polar symptoms would lessen or go away.
You went to one meeting, 30 years ago, and are making a decision about your life based on that ? I'd seriously re-consider, and at the very least no matter what program of recovery your choose, you're going to have to be honest, open minded, and willing to change.
As far as science, for a really good description of how alcohol affects the mind and body of an alcoholic (and how an alcoholics body is actually different), check out the book "Under The Influence".
It's common for Doctors to diagnose practicing alcoholics as Bi-polar. The symptoms are similar. I'm not saying that you're not bi-polar, but I'd make a fair wager that if you abstained from alcohol and worked a good recovery program, you're bi-polar symptoms would lessen or go away.
You went to one meeting, 30 years ago, and are making a decision about your life based on that ? I'd seriously re-consider, and at the very least no matter what program of recovery your choose, you're going to have to be honest, open minded, and willing to change.
As far as science, for a really good description of how alcohol affects the mind and body of an alcoholic (and how an alcoholics body is actually different), check out the book "Under The Influence".
I have the book Under the Influence and have read it.
I have a real, qualified shrink who's Dx's me with bipolar so I bet you're statement that my Dr. is wrong, a shot in the dark. I've been with him over three years.
I welcome any suggestions about where to go for a non 12 based program with dual diagnosis. That's all I'm looking for. No offense, but in the conventional treatment scheme of things, I've probably surpassed you. Just looking for new ideas. Thanks.
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Originally Posted by GlassPrisoner
I've heard alkies described as huge egoists with an inferiority complex.
Yup, that's the ego deflation thing. It hurts, we don't like it. But alkies need some humility, need to be humbled. It opens our minds to ideas that aren't ours.
Interesting about the God comment, I thought you were anti 12 step ?
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Originally Posted by needtobefree
Hi, good to meet you as it were. We share some concerns re dual diagnosis and methods of attaining recovery. I hope you find the help you are looking for soon. I just found some help through the local health authority addiction services this morning, they have dual diagnosis teams and a lot of support services on offer. It might be worth checking out your end.
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Originally Posted by GlassPrisoner
Yup, that's the ego deflation thing. It hurts, we don't like it. But alkies need some humility, need to be humbled. It opens our minds to ideas that aren't ours.
Do you realize that AA was written by men, for men? Perhaps ego deflation was necessary, but it certainly isn't for women who have been raped and victimized at the hand of men, including those in AA.
Open Minded
Join Date: Jun 2007
Location: NZ
Posts: 226
I live in New Zealand, if you live in this area I can definately help you out. I'm pretty good at searching on the net though, if you want to pm me I'd be more than happy to help.
New Zealand is nicknamed 'Godzone' btw, I understand the bible belt thing :0)
New Zealand is nicknamed 'Godzone' btw, I understand the bible belt thing :0)
Open Minded
Join Date: Jun 2007
Location: NZ
Posts: 226
We double posted - the book in the different for women thread is amazing, in the introduction she's talked about many of my concerns. I come from an abusive background too, right from the beginning. I wish I could say something more ... please go read that thread.
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