Addiction/Mental Illness

Old 12-08-2005, 09:33 AM
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Addiction/Mental Illness

My AH has a "dual diagnosis" meaning he suffers from a mental illness (clinical depression) and alcohol addiction. In his case the depression symptoms appeared first and he found that heavy drinking made those symptoms "go away" or at least numbed him to them. So he drank everyday. Then one day, maybe he was having a good day and felt less blue, he found that even though he was happy if he didn't drink he didn't feel so good physically. His hands were shakey, he felt sort of edgey. So he takes a drink and voila! Those odd physical feelings went away. He has now officially crossed the threshold of alcohol addiction.

Now, one condition starts to feed off the other. He's feeling depressed, so he drinks. In a lucid moment he realizes that he's tied to the bottle and that thought makes him depressed, so he drinks. It becomes a viscious cycle and if he ever has any desire to seriously recover both conditions must be recognized, treated, and controlled. All prescriptions for anti-depressants say "Don't take with alcohol". That's because they don't work with alcohol. Might as well take sugar pills if drink with them as they won't do anything for you.

The therapy/counseling my AH got after his second suicide attempt in June of '04 did nothing for him as they only concentrated on the mental illness. He was drinking again within 2 weeks of his hospital discharge so all those lovely AD pills he was talking and all that therapy/counseling was worthless! And because he was trying to convince all involved that he had quit drinking he made the switch from beer to vodka. Easier to hide and a few chugs of straight 80 proof vodka gets you to where you want to be a hell of a lot faster than beer!

Fast forward to this year, early November. Another suicide attempt. Back in the hospital. This time around I insisted that BOTH conditions be properly treated and I backed up my insistance by saying his current condition (physically and mentally) was a result of the ineffective treatment plan that was devised for him last time around.

My point for posting this you might ask? My point is that a large portion of society still has a "thing" about mental illness and many people still think it's something you can just "snap out" of. Many A's suffer from mental illness but they fear the stigma so they deny it exists. I believe some A's that attempt recovery fail at it time and time again because some form of mental illness is also present but going unoticed and untreated. It's sort of funny, in a sad sort of way, that to some people the whole world knowing that you're an A is ok but having a mental illness - "Oh my! What will the neighbors think!" I can talk my head off about my husband's addiction to some people and they're very supportive but if I then bring up the suicide they get totally creeped out and I have to shut up. When someone tells you point blank that you're gonna die soon if you keep drinking and you don't try and stop because you don't care then doesn't the drinking sort of become a form of passive suicide?

Of course not all addicts suffer from mental illness and not all people with mental illness become addicts. But to properly help those that do have both issues people have to open their eyes and their minds to see the whole picture. If they don't then recovery for some A's will sadly, always remain an ellusive dream.

Thanks, Janet
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Old 12-08-2005, 09:43 AM
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Good on you for posting this!!

I agree with what you say about the metal illness thing and I think THAT is nuts! I mean it's a physical organ with blood an' all - who the hell would seriously think it can be immune from illness?

I know where you're coming from - we've been through MONTHS of D being refused psychiatric help, re refered then refused again. We fell on one counsellor who had experience in both mental health and addiction but she was moving counties so we didn't have her for long - I think SOME of the counselling since has done more harm than good.

Because D doesn't attempt suicide we're at the bottom of the list, compounding that is that Psych services want alcohol services to pay and the same vice versa!

Regarding other people, apart from friends only work really knows and I've had the opposite response, they've been helpful and thoughtful regarding meant illness but if I mention addiction it's a case of EVERYTHING being - oh well that's life with an addict!

It doesn't really matter which way round it is - just less stigma would help!
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Old 12-08-2005, 10:00 AM
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Originally Posted by TomsGirl
Now, one condition starts to feed off the other. He's feeling depressed, so he drinks. In a lucid moment he realizes that he's tied to the bottle and that thought makes him depressed, so he drinks. It becomes a viscious cycle and if he ever has any desire to seriously recover both conditions must be recognized, treated, and controlled. All prescriptions for anti-depressants say "Don't take with alcohol". That's because they don't work with alcohol. Might as well take sugar pills if drink with them as they won't do anything for you.
Thanks for bringing this up. My daughter is also "dual diagnosis" She has borderline personality disorder and she is an alcoholic.

A dual diagnosis complicates matters for the alcoholic. It makes it so much more difficult for them to stay sober because in many cases, they are drinking to medicate the mental illness. And then there is the issue of meds.
Some of the meds they gave my daughter this year actually made her more psychotic, and she ended up in a psych ward for a week. (we think she reacted badly to one specific medication)

In addition to all this, many folks refuse to acknowledge that they suffer from mental illness. My daughter admits she is an alcoholic, but refuses to accept that she has a mental illness, even though it was diagnosed when she was in the psych ward this year.

It's just adds to the difficulties and complications.

Robin
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Old 12-08-2005, 10:21 AM
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Toms Girl this is not directed at you, but those who might be reading and scratching their heads. It is very important that the mental illness be treated effectively. It may take trying different medications to find one that works. Some anti-depressants take up to 6 months to work effectively in the system. Their are some that can actually increase the urge to use drugs or alcohol. For our loved ones who are dually diagnosed this can be very difficult because they are looking for a quick fix. It IS so important to work in a cooperative manner with your doctor, as I said sometimes it takes trial after trial as the chemistry make up is so different in all of us and when the chemical make up of the brain is effected by the use of drugs or alcohol is is painstaking. A tremendous support group is The Alliance for the Mentally Ill. They are truely working around the issues of stigma. It is also very important to have doctor who believes in the theory of dual diagnosis, many don't. It is also important that if mental illness is suspected it is properly diagnosed. Dealing with this issue takes much time and patience.
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Old 12-08-2005, 10:53 AM
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It is also important that if mental illness is suspected it is properly diagnosed.
Unfortunately that in itself is a challenge if the psych team won't asses because they want alcohol services to deal with it (fat chance when he's managed to stop by himself)!! All we have is his GP's diagnosis - a long and confusing list, major depression, agoraphobia, panic disorder, 'some' mania and I nearly forgot the one psych nurse who did see him diagnosed social anxiety (no sh!t Sherlock!!).

You may sense a little frustration! In the end we've done more for ourselves than we were given help, D's determination to never give up and possibly mine to not let go!

BLAH!! Maybe it will go easier next time, this time he seems to perhaps be out the woods!
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Old 12-08-2005, 11:08 AM
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Originally Posted by equus
You may sense a little frustration! In the end we've done more for ourselves than we were given help, D's determination to never give up and possibly mine to not let go!
It's very frustrating dealing with dual diagnosis. There are so many difficulties. I'm glad you and he are fighting for treatment. Sometimes if you make enough of a stink, the authorities might start to take notice. Also, you might make it easier for the next person who needs treatment.

Robin
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Old 12-08-2005, 12:11 PM
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Thank you all - it's good to see a thread like this!

Besides being an Al-non (heck, everyone I know + care about is an A) - I'M an alcoholic (sober 13 yrs), addict (clean 23 yrs) and (ta daaaa) bi-polar (diagosed 25 yrs ago)!

The mental illness stigma doesn't just exist in the Health/Recovery fields. It exists in recovery programs as well.
Have had several woman over the years try to tell me that I'm NOT bp - after knowing me for all of 2 minutes.
"Well, but were you diagnosed as bi-polar before you became an alcoholic?"

It's frustrating - for me - and everyone around me! (grumble grumble)

Too many people seem to think that just because mental illness (of whatever flavor) originates in the brain, that it is controllablable by sheer will alone. Yeah, right. Tell that to the diabetic about their pancreas - "You don't REALLY need insulin . . . "

Dual-Diagnosis means you get to work *TWO* (at least) programs = the mental health one (take your meds, keep your appointments) AND the Recovery one (go to mtgs, SHARE, work the steps).

It stinks that in this day and age, mental illness has such a stigma attached to it. Add any kind of addiction to that and oooooooh boy! you must really be a nasty person!

ummm - think I may have ranted a bit??? Just hits close to home, esp this time o' year.

Blessings,
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Old 12-08-2005, 01:10 PM
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Feel free to rant Blue, you are speaking for many of us here! To get a small clue of what my AH has had to deal with since childhood, I'll tell you what his mother said to him as he was lying in the hospital after he almost bled to death after his second suicide attempt. No kiss, hug, or "Thank God you are alive my child". No, none of that. Just a nasty look on her face and the following words hissed out "Shape Up!" Thank goodness she and Dad left after that or I would have physically thrown the "B" out of his room. Haven't seen nor talked to them since and THAT was my H's decision. One of the best ones he has ever made in my humble opinion.
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Old 12-08-2005, 06:47 PM
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Hey, guys...also glad to see this post...my AH is clinically depressed and alcoholic, has been on and off his meds for years, and on and off alcohol, more on than off. Aside from the various stigma attached to each disease, there is varying theory on treating folks with both. We had his last psych. tell us the drinking was the ONLY issue...not at all worried that he was suicidal at the time! That there was no reason to find out why he's depressed or why he drinks. Then there's also the conflicting recommendations as to how loved ones are to "treat" them...depression experts say be nurturing, supportive, help them, etc. Alanon says to detach, let them fail and hit bottom...so what do we do? When things get really bad, I fear he'll get suicidal if I'm not supportive, but fear he'll never stop drinking if I'm always there for him. His depression tells him he doesn't need the meds, but it also tells him he needs alcohol. Mine actually used the excuse of the meds saying right on them that you shouldn't take them when drinking for not taking them! We even had an ER doc tell him he should take the pills even if he IS drinking! I stepped in on that one and told her NOT to even consider saying that he SHOULD be drinking in the first place! She almost made it seem he should go ahead and drink, as long as he took his meds! Add to all this that he developed heart failure 3 years ago, and has all kinds of meds to take (which he is rarely consistent with), and all kinds of risks with the drinking. Life gets so complicated! Glad we all have each other to rely on, eh?
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Old 12-08-2005, 07:33 PM
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The therapist my AH had after his second attempt freely admitted she had no experience dealing with alcoholism. Her job was to get him to where he could go back to work. Well she got him well enough to be able to return without feeling too self consious about the nasty scars on his neck where he cut his throat (yes, lots of sarcasm there) but she didn't get him well enough to be able to last at his job. He was fired within 4 months of returning. So he's home, collecting unemployment for 30 weeks and he's got nothing else to do but drink, and drink, and drink. Great therapy he got, just great! When the money ran out he took some of his coin collection, sold it, got a motel room for a few days and tried the suicide again. That second DUI was a lifesaver for him, literaly. That accident was the work of God I have no doubt and more importantly, he thinks so too.

ByAThread, you're husband not taking his meds because they say "Don't take with alcohol", now that is classic A logic!
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Old 12-09-2005, 12:24 AM
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This thread is an all good idea!! We do share frustrations but I bet we have found solutions too, not ones that fix everything but experience strength and hope we can share about the small things we've found worked.

We're not alone, it is different to dealing with addiction alone - I wonder how many of the guests that have wandered through here have been amazed by this thread too.

So here's my cards on the table. I have found things that seem to be functional, helpful and productive. I'm not from an Al-Anon base, I use research to get the outside information, we also had a counsellor who used an approach which involved both of us as a team to tackle D's drinking. A large chunk of what I could share sometimes does clash with 12 step principles - but there have been Al-Anons here that can view it as acceptable, especially when addiction is not the only problem.

My personal opinion is that as relatives we don't get anywhere near enough information on how to help effectively rather than in ways that don't work. It's not that the information isn't out there - it is, it's not that the evidence of it being functional isn't out there - it is, it's that we don't get it and can be left questioning ourselves if we attempt to seek it.

I went through feeling all the pain of whether I should detach or support and I was both supported and criticised by those involved in recovery. Ultimately I opted to go by what worked with us and to learn more through research and to trust the proffessionals that appeared able to do their jobs, willing to share their reasoning and above all else LISTENED!

So wha do people think? Maybe a fresh thread sharing things that helped us, maybe it could form a sticky? Something SPECIFICALLY for F&F's dealing with dual diagnosis. A little hidey place where it's ok to say it is different.
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Old 12-09-2005, 12:34 AM
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Tomsgirl, I am alcoholic/bipolar . Is he better? What meds did he take? How did he stop drinking. Did he - i have a millon questions. are you there
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Old 12-09-2005, 12:42 AM
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I am kinda at a loss when I read threads like this because I can't get my head around the fact that there are alcoholics without an additional mental health problem, such as depression, personality disorder, anxiety disorder etc. As I have mentioned before, I can understand that a physical addiction can and does occur after prolonged exposure to alcohol, but does that prolonged exposure happen without a co-existing medical issue such as depression? From the personal testimonies I have heard and read, I really am not so sure. Or am I just exposed to self-selecting individuals?

Anyway, I do think a separate sticky would be useful, but perhaps the difference is not one of dual diagnosis or not, but whether we are dealing with someone who seeks help or not?

Sorry if I've derailed the thread at all as it is really not my place to do so, but I am very interested in this from a bigger picture perspective.
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Old 12-09-2005, 12:49 AM
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Minnie

I have had this MOOD DISORDER as you call it since i was 9. So there was no prolonged exposure
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Old 12-09-2005, 12:56 AM
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Dizzy - I didn't use the term "mood disorder". Also, I was simply acknowledging the fact that addiction is partly a physical phenomenon as well as a mental/psychological one. My question is whether the physical aspect ever happens without the psychological or whether the latter exists previously.
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Old 12-09-2005, 12:59 AM
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Minnie, I'm sorry!! I'm falling apart here. You were there, im sorry.
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Old 12-09-2005, 01:00 AM
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Or am I just exposed to self-selecting individuals?
What on a recovery board?? Yes I would think that's likely but there's tons of research out there using randomised groups etc. My advice would be to stop looking at one type or one cause, or even one category for causes. However it's only based on my own hunches so take it with a pinch of salt!

Whether any of us can say we have perfect mental health is debatable, whether we can say that about any addict is debatable. I think the difference between general terms of health and illness surround the impact on someones life. We are ill when we get a cold but it passes with few life consequences, I think menatal health (being physical) is the same, we can have 'bugs' which pass or persistant health problems. GOOD diagnosis doesn't look to label UNLESS a life is being hindered and damaged and then there's a complex system that comes into play where things like addiction are taken into account.

What I'm trying to say is that non addicts will have brief periods 'bugs' of reduced mental health, addicts who are abusing themselves physically and mentally will likely have more but not ALL will have persistant problems.
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Old 12-09-2005, 01:13 AM
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Whether any of us can say we have perfect mental health is debatable
Too true.

My exposure to alcoholics has, as far as I am aware, been only with those in, or not in, "recovery" - not only on these boards but IRL as well. So, I guess that they are self-selecting on that basis. Individuals who "recover" without the "recovery" movement will not necessarily be apparent.

As far as labels are concerned, I don't even like using the term "alcoholic" anymore. Useful as shorthand, I guess, but too simplistic for me.
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Old 12-09-2005, 01:41 AM
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As far as labels are concerned, I don't even like using the term "alcoholic" anymore. Useful as shorthand, I guess, but too simplistic for me.
Minni, all they are is shorthand - it's our culture that tries to use them to define whole people. Diagnostic labels exist so that information, research, treatments can be discussed and shared. You're using it in the best possible way. In my opinion the worst possible way is when they are used as more than that.

Now we're in more peaceful times (in our house) sometimes I feel like I wish D had managed to get assessed properly, I wish I had a label for what happened. I know what I think but always feel like I can't say it because it wasn't identified, he didn't get assessed. I don't want a label for him, he has a name already and I like it - I want a label for what happened, I want to talk about it, I want the shorthand, I want to be able to access the right research. We lived through 'something', the labels given don't cover that 'something', they don't cover why it all kicked off at once, they're not confirmed.

In short labelling people I hate! Labelling what happens to people so we can share information, learn and understand better, I'm all for that.
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Old 12-09-2005, 02:45 AM
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Originally Posted by dizzyj
Tomsgirl, I am alcoholic/bipolar . Is he better? What meds did he take? How did he stop drinking. Did he - i have a millon questions. are you there
Dizzyj, He takes zoloft and trazadone and yes, he is better. As for stopping drinking, he went to a rehab hospital for 11 days, goes to AA, and he's going to an outpatient program at the rehab hospital 3 days per week. But, he's gone through this routine before yet took up the bottle again. The difference this time is I believe he finally hit his rock bottom and realized that going any lower than what he experienced this time equates to dead.
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