Is dual diagnosis correct after 17 days of rehab?
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Join Date: Jul 2012
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Is dual diagnosis correct after 17 days of rehab?
My 37 yr old husband has been using drugs, high levels of spice in particular, and drinking heavily for about 3 years now. He was clean for almost two years prior to this, but wasn't attending meetings and practicing recovery steps. Prior to his clean years he has used many different drugs and was "out" for many years, at least 6. He attempted IOP once before, but was immediately redirected by an immediate diagnosis of mental illness that put him on heavy antipsychotics that distracted him completely from the fact that his drug and alcohol abuse brought him to IOP, and he soon after quit IOP.
Today he is 17 days into a 28 day rehab program. He went there completely on his own and made all the arrangements. He told the doctor when he arrived at rehab he wanted to leave rehab completely drug free, of any kind including prescription medication (I know partially this is because I live a holistic lifestyle). He recently stopped all medications he was on for detox, and what not. Now they are turning more towards a dual diagnosis of AOD abuse and hypomania. The symptoms they are seeing are racing thoughts, inability to maintain a single thought process from beginning to end, etc..My question is...isn't this normal 17 days into rehab? My gut says that years of constant drug and alcohol abuse has clogged his brain to the point of imprisoning his feelings and thoughts, and that now that he is completely chemical free they are trying to all come out at once. I feel family and individual therapy will be the most important treatment because he needs to verbally get these thoughts and feelings out once and for all in a safe environment with a therapist. After rehab he plans on going to therapy regularly, and has set plans for his recovery with NA/AA and group meetings. I feel completely confident in his attempt at sobriety this time around. However, since we are now again being redirected to a dual diagnosis so quickly, I have fear that he will yet again become chemically dependent on a drug that only helps with symptoms, does not cure the problem, and end up with a long list of side effects causing a whole new problem for us to deal with.
Am I wrong in thinking that before putting him on medication for hypomania, he should first be given the time to get settled into regular therapy and begin lifestyle changes with his family. If after weeks of therapy and getting into a new lifestyle he is still having these racing thoughts and difficulty, I may feel different, but for now I am completely against him starting a new medication. HELP!!!!!!
Today he is 17 days into a 28 day rehab program. He went there completely on his own and made all the arrangements. He told the doctor when he arrived at rehab he wanted to leave rehab completely drug free, of any kind including prescription medication (I know partially this is because I live a holistic lifestyle). He recently stopped all medications he was on for detox, and what not. Now they are turning more towards a dual diagnosis of AOD abuse and hypomania. The symptoms they are seeing are racing thoughts, inability to maintain a single thought process from beginning to end, etc..My question is...isn't this normal 17 days into rehab? My gut says that years of constant drug and alcohol abuse has clogged his brain to the point of imprisoning his feelings and thoughts, and that now that he is completely chemical free they are trying to all come out at once. I feel family and individual therapy will be the most important treatment because he needs to verbally get these thoughts and feelings out once and for all in a safe environment with a therapist. After rehab he plans on going to therapy regularly, and has set plans for his recovery with NA/AA and group meetings. I feel completely confident in his attempt at sobriety this time around. However, since we are now again being redirected to a dual diagnosis so quickly, I have fear that he will yet again become chemically dependent on a drug that only helps with symptoms, does not cure the problem, and end up with a long list of side effects causing a whole new problem for us to deal with.
Am I wrong in thinking that before putting him on medication for hypomania, he should first be given the time to get settled into regular therapy and begin lifestyle changes with his family. If after weeks of therapy and getting into a new lifestyle he is still having these racing thoughts and difficulty, I may feel different, but for now I am completely against him starting a new medication. HELP!!!!!!
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Join Date: May 2012
Location: Massachusetts
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While the symptoms that are coming out now may well be associated with withdrawal, they need to be managed. If he's only in a 28 day program, it is doubtful that he'll be able to manage them all on his own with just meetings and therapy. It is not uncommon to use medication to treat these symptoms, then taper off as recovery progresses.
There are extended care rehabs which practice a holistic approach and don't prescribe medication. But if he is experiencing racing thoughts, mania, etc., the odds on him staying clean when he returns to his normal environment are not good. That's probably why the doctors want to medicate the symptoms. The medications used are typically not ones that are usually drugs of abuse, and are tapered off as symptoms are brought under control.
There are extended care rehabs which practice a holistic approach and don't prescribe medication. But if he is experiencing racing thoughts, mania, etc., the odds on him staying clean when he returns to his normal environment are not good. That's probably why the doctors want to medicate the symptoms. The medications used are typically not ones that are usually drugs of abuse, and are tapered off as symptoms are brought under control.
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Join Date: Jun 2012
Location: Knoxville, TN
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Over 50% of all bi-polars( includes hypo-mania as type2 ) become addicts..My daughter just went through all this. They put her on meds ( Lamictal ) as if she were hypomania, but are reserving a final judgement after she has more sobriety ( she has 6 wks) under her belt.
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hi - I definitely understand your thoughts and your concerns. My ex husband had a severe addiction to crack and he went to multiple rehabs. At the time, they said that they would address his mental health issues AFTER he was sober for a year. He never got that year because his bipolar was not diagnosed or treated. He wasn't able to hang on to any sobriety until that happened.
From what I understand, the philosophy is changing and the dual diagnosis is treated concurrently. People that are trained in this know how to (and work towards) adjust medications as recovery continues. For example, my husband initially was treated with antipsychotics as well as Lamictal. Now he only takes the Lamictal. There are a lot of new drugs and combinations of drugs that are used instead of just Lithium.
I've heard the statistic that 70% of drug and alcohol users have an underlying mental illness (even if it's just depression). I think that the mental health issues have to addressed along with the detox and sobriety issues....all at the same time. It's tough though because many of the symptoms are reflections of each other and it's difficult to tell which is which.
I know for me, I tried to treat an anxiety/panic disorder holistically and wasn't able to get over "the hump" without medication. It's not a lot but it's what I needed. It was difficult for me to come to terms with that initially due to my holistic perspective (I work in healthcare). It's made me realize that an integrative approach to health is best for me.
Is there anyone at the treatment facility that you can address your concerns with? I know it really helped me when the right people were able to help me with the information that I needed.
From what I understand, the philosophy is changing and the dual diagnosis is treated concurrently. People that are trained in this know how to (and work towards) adjust medications as recovery continues. For example, my husband initially was treated with antipsychotics as well as Lamictal. Now he only takes the Lamictal. There are a lot of new drugs and combinations of drugs that are used instead of just Lithium.
I've heard the statistic that 70% of drug and alcohol users have an underlying mental illness (even if it's just depression). I think that the mental health issues have to addressed along with the detox and sobriety issues....all at the same time. It's tough though because many of the symptoms are reflections of each other and it's difficult to tell which is which.
I know for me, I tried to treat an anxiety/panic disorder holistically and wasn't able to get over "the hump" without medication. It's not a lot but it's what I needed. It was difficult for me to come to terms with that initially due to my holistic perspective (I work in healthcare). It's made me realize that an integrative approach to health is best for me.
Is there anyone at the treatment facility that you can address your concerns with? I know it really helped me when the right people were able to help me with the information that I needed.
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He is in a dual diagnosis treatment facility and is being treated for both aspects of his illness. My concern is that so much of the focus has been shifted from AOD abuse to mental illness. His biggest issue is his AOD abuse, and always has been. If I had to split it up, I'd say he has 90% addiction issues with 10% mental illness. He is such a manipulator that I truly believe he is subconsciously manipulating the situation, again. He abused SSRI's in the past, as well as any other prescription he could get his hands on. I truly believe total abstinence is the only answer.
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I agree with Anvil here.....when he is in treatment it's a great time to step back and put the focus back on you.
It's a lot to diagnose and design a treatment plan and most family members are just too close to the person to be adjective. Thank heavens he is in a treatment facility and it's for them to sort it all out.
It is his recovery and these are his issues. Have you had any experience or exposure with working on the anon side of addiction? I knew nothing about addiction when I first was exposed to an addict and it took some intense looking at myself and my issues to determine what is my stuff and not someone elses. I quickly learned that my input and perspective on what someone needed for recovery was really different than what actually was needed. I was putting my focus on the wrong person....not myself. Just some thoughts.
It's a lot to diagnose and design a treatment plan and most family members are just too close to the person to be adjective. Thank heavens he is in a treatment facility and it's for them to sort it all out.
It is his recovery and these are his issues. Have you had any experience or exposure with working on the anon side of addiction? I knew nothing about addiction when I first was exposed to an addict and it took some intense looking at myself and my issues to determine what is my stuff and not someone elses. I quickly learned that my input and perspective on what someone needed for recovery was really different than what actually was needed. I was putting my focus on the wrong person....not myself. Just some thoughts.
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Originally Posted by Mandala76 
He is in a dual diagnosis treatment facility and is being treated for both aspects of his illness. My concern is that so much of the focus has been shifted from AOD abuse to mental illness. His biggest issue is his AOD abuse, and always has been. If I had to split it up, I'd say he has 90% addiction issues with 10% mental illness. He is such a manipulator that I truly believe he is subconsciously manipulating the situation, again. He abused SSRI's in the past, as well as any other prescription he could get his hands on. I truly believe total abstinence is the only answer.
As anvilhead said above, though, it's time to put the focus back on you.
Best,
ZoSo
To thine own self be true.
Join Date: May 2009
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Originally Posted by Mandala76
Today he is 17 days into a 28 day rehab program. He went there completely on his own and made all the arrangements. He told the doctor when he arrived at rehab he wanted to leave rehab completely drug free, of any kind including prescription medication (I know partially this is because I live a holistic lifestyle). He recently stopped all medications he was on for detox, and what not. Now they are turning more towards a dual diagnosis of AOD abuse and hypomania. The symptoms they are seeing are racing thoughts, inability to maintain a single thought process from beginning to end, etc..My question is...isn't this normal 17 days into rehab? My gut says that years of constant drug and alcohol abuse has clogged his brain to the point of imprisoning his feelings and thoughts, and that now that he is completely chemical free they are trying to all come out at once. I feel family and individual therapy will be the most important treatment because he needs to verbally get these thoughts and feelings out once and for all in a safe environment with a therapist. After rehab he plans on going to therapy regularly, and has set plans for his recovery with NA/AA and group meetings. I feel completely confident in his attempt at sobriety this time around. However, since we are now again being redirected to a dual diagnosis so quickly, I have fear that he will yet again become chemically dependent on a drug that only helps with symptoms, does not cure the problem, and end up with a long list of side effects causing a whole new problem for us to deal with.
Am I wrong in thinking that before putting him on medication for hypomania, he should first be given the time to get settled into regular therapy and begin lifestyle changes with his family. If after weeks of therapy and getting into a new lifestyle he is still having these racing thoughts and difficulty, I may feel different, but for now I am completely against him starting a new medication. HELP!!!!!!
Am I wrong in thinking that before putting him on medication for hypomania, he should first be given the time to get settled into regular therapy and begin lifestyle changes with his family. If after weeks of therapy and getting into a new lifestyle he is still having these racing thoughts and difficulty, I may feel different, but for now I am completely against him starting a new medication. HELP!!!!!!
The fact that two separate doctors at two separate rehabs have diagnosed him with mental illness + addiction speaks very strongly to me that there is in fact an underlying mental illness. It sounds like they are saying he's bipolar? There is no cure for bipolar and there is no cure for addiction. I also am VERY strongly for holistic lifestyles and medicine, but I also have mental illness and there are just some medicines I need to take. There is no food, herb, activity or lifestyle that can treat my mental illness the way my medicine can. I have tried it both ways for many, many years and it was not until I got my illness medically under control that I was even able to begin to address my addiction to cigarettes. I still have not beat that addiction but I keep working at it.
Do you have a program? Please look into Al-Anon and Nar-Anon. Take care of YOU FIRST. Let Go and Let God.
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You write "Am I wrong in thinking that...."
You may hold any personal opinion you wish, but this is not your area of expertise, and I would humbly let go.
There absolutely are mental illnesses which must receive specific medication.
I understand your wish that he be clean of all mind-altering substances which keep him imprisoned in active addiction.
But medicines for certain forms of mental illness are vital. Many people have buried loved ones who died of mental illness because they did not receive the necessary medicine. Major depression can result in suicide. Mania can result in fatal risk-taking.
I would let go, and pray his treatment team be divinely guided to the best decisions for his care.
Drug abuse creates permanent brain damage. What kind and how severe depends on the individual addict. But talk therapy will not cure the organic damage.
You may hold any personal opinion you wish, but this is not your area of expertise, and I would humbly let go.
There absolutely are mental illnesses which must receive specific medication.
I understand your wish that he be clean of all mind-altering substances which keep him imprisoned in active addiction.
But medicines for certain forms of mental illness are vital. Many people have buried loved ones who died of mental illness because they did not receive the necessary medicine. Major depression can result in suicide. Mania can result in fatal risk-taking.
I would let go, and pray his treatment team be divinely guided to the best decisions for his care.
Drug abuse creates permanent brain damage. What kind and how severe depends on the individual addict. But talk therapy will not cure the organic damage.
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Learn2Live....He is actually at the same rehab he was at the first time, and being diagnosed by the same doctor, and he openly admitted to the doctor that he completely lied the first time to get a prescription from him.
This time around my AH has completely done all this on his own, I haven't had a thing to do with it. Because this is a "family disease", the focus is on the entire family, not just him. These exact words coming from his therapist. I have supported him through it by doing each and everything he and the facility are asking me to do, including family therapy and different exercises. Its not so much that I want him to live holistically as I do, its that I don't want history to keep repeating itself.
This time around my AH has completely done all this on his own, I haven't had a thing to do with it. Because this is a "family disease", the focus is on the entire family, not just him. These exact words coming from his therapist. I have supported him through it by doing each and everything he and the facility are asking me to do, including family therapy and different exercises. Its not so much that I want him to live holistically as I do, its that I don't want history to keep repeating itself.
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Join Date: May 2009
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I understand. Believe me, I do. But you cannot control whether or not history is going to repeat itself, anymore than you can control whether or not your AH gets clean. It seemed to me from reading your post that you are very worried and stressed out by all this, which is completely understandable. But he hasn't been successfully treated so far in his life, right? So, it seems now that it is OK for you to just sit back, take really good care of yourself while your AH does what he needs to do, work your own program, and wait to see how this pans out.
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I think it's a good thing that his rehab is addressing mental health issues he may have, if they are addresses and treated he has a better chance of recovery. It's one of my "issues" that so many rehabs and recovery programs are hard line no meds for anything. Abusing ssri? How? My daughter has taken quite a few different meds but they never give her any that have street value.
I would leave this between him and his doc.
I would leave this between him and his doc.
Sobriety date 12/19/2011
Join Date: Jun 2012
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Since you are on a Holistic kick already, I will share what I did. I used Perelandra flower essences and the book MAP - Medical Assistance Program. It is was my saving grace from all those racing thoughts. I also have the Perelandra Essences book. I take the flower essences everyday, you can get them preserved in vinegar.
This is what works for me, I won't go into details, but it truly works.
This is what works for me, I won't go into details, but it truly works.
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Join Date: Jul 2012
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Thank you everyone...every little bit of feedback helps (the positive and the negative). I find myself wondering if there are any addicts out there that experienced this same "racing mind" feeling halfway through a 28 day program after detox from spice and alcohol abuse...and what they did about it, or if it just went away over time. Its more for curiosity, I know I cannot tell my husband what to do...I learned that years ago when everytime I would ask him to do the dishes he wouldn't 
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