Dual Diagnosis??
 

I am really very conflicted and wondering if anyone out there has any experience with dual diagnosis… My husband went to rehab a few months ago for heroin use and was diagnosed as bi-polar while there. He relapsed shortly after returning home but now says he is not using. When he used before he really went full steam and pawned literally everything we own, stole from my family, and was exhibiting obvious drug seeking behavior. Long story kinda short, we moved into my parent’s home a few weeks ago and his behavior since then has just been…off. We have literally zero dollars, no car, and he has only left the house maybe 4 or 5 times without me. I just have this gut feeling that he is still using something. He barely sleeps, and when he does he will wake up at like 2 in the morning and eat everything he can find in the refrigerator. He is still very much obsessed with money, as in, he freaks out on a daily basis because we don’t have any. His moods change from one minute to the next and it is extremely stressful. I also know that he is still in contact via telephone with his dealer. My question is this: Is this behavior typical of someone with bi-polar disorder, or am I just ignoring the signs that point to drug use? He does not have insurance until November 1, so he is not currently on any prescribed meds. I am planning on buying a drug test Friday and asking him to take it (I am sure that will go over well). I guess it is just that his behavior is so confusing to me. At least when I knew he was using I had some idea of what to expect. I am afraid maybe he is using something other than heroin that I am not familiar with the side effects. Sorry to ramble, I am just overwhelmed by confusion. I love my husband and we are trying to make it work, but if he is using (anything) then he cannot be in my life. I am just wondering if anyone out there has experienced anything like this. Any and all thoughts are appreciated.

For what its worth, my guess Grateful, is that he's still using. If he is bipolar and is not under a doctor's care with medication for that condition, it would be very difficult for him to stop using heroin. Originally, he was probably self medicating. Heroin is commonly used by addicts struggling with depression because its makes them feel soooo much better. As my RAD says, its hard to feel satisfied using legal depression medication after discovering the best medication EVER for depression.

A person without medical depression, recovering from heroin addiction will experience severe depression for weeks and/or months after they stop using because the brain must relearn to produce endorphins. This emotional pain from lack of endorphin production is greatly increased for a bi-polar RAs.

Frankly, every addiction counselor that I have spoken with regarding my RA's depression and drug use insisted that she receive immediate pharmaceutical and counseling treatment for her depression, otherwise she would certainly relapse.

Although this is just my opinion, I believe that without treatment for his depression, he is just being set up to fail.

Thank you Andrea. He is wanting to find a psychiatrist as soon as his insurance kicks in, so hopefully that will help. My gut is just telling me it's more than mental illness...and my gut hasn't been wrong so far. Maybe I am just trying to delay the inevitable.

Oh Grateful, I am sure you are right and it is more than mental illness. I would bet he is using. Its just that he really doesn't have a chance for recovery until he receives treatment for his bipolar disorder. That will at least give him a chance.

While being treated for depression, my RAD relapsed multiple times. But each time the relapse was shorter and less destructive. I just know that if her depression was not being treated, she would have been lost.

I don't put a lot of faith in dual diagnosis made on people in active addiction or new to recovery. I don't know if he's using or not.

Regardless, how does it matter?

Neither addiction, sobriety or bipoloar excuses lies, manipulation and crime.

Is there a reason why your children are exposed to someone who behaves the way he has? Don't they deserve stability in their lives?

you know...i really do appreciate the input from everyone, but this is the second time i have gotten a response that just made me feel like i am a crappy mom. you do not know me. just because you went through what i am does not make you me. i realize that my children deserve better and i am doing the best that i can. i really enjoyed coming here and reading every day and learning from everyone, and i honestly wish i would have just kept doing that and never posted. i can appreciate that you are trying to be brutally honest, but telling me i am failing my children (when i already doubt myself every second of every day), does not make me want to share. i came here for support and i honestly feel like the judgment overshadows that support. please do not ask me to read the "why people respond.." sticky, i have read it 4 times today. i am not looking for anyone to solve my problems, i have learned a lot from this site and naranon that is helping me heal myself. having people throw in my face that i am hurting my children is, i feel, completely counter-active to my sanity and health. i never once mentioned my kids in this post because i have no questions regarding them. they are getting into counseling on nov. 1st and i am being the best, most loving mom i know how to be. sorry again to ramble, i just really wish people would think before they verbally smack someone who is already an emotional disaster. that being said. i am done posting on here. i will continue to read and take in all the education i can. thanks to those who were truly helpful and non-judgmental.

Grateful, I am sorry you are upset. We all understand how painful addiction is`. Often times, I felt hurt and shamed by a response. However, I needed to hear the truth over and over again (still do). My denial ran deep. In hind sight, I can't thank the people who "shook" me up and out of denial enough.

I did the best I could with the knowledge I had, I made many mistakes and I work on forgiving myself daily. But I needed to hear what I so desperately wanted to deny.

ETA - please keep posting, it really does help!!

My husband was diagnosed as bi polar too and is/was in major denial over it. Once he was off the hardcore drugs like heroin, he would show the signs with major agitation and repeating his words in mania and then dipping down to where he could barely get out of bed. But he was just convinced it was part of his recovery, but as he got more sober, it got worse and he started self-medicating with weed, which I was told makes bipolar worse actually. So many layers, from the actual drug use and god knows what it did to their brains, to the addict behavior, to mental illness, it is hard to pull them apart to really see what is happening. There are dual diagnosis treatment facilities, my husband was in one briefly in a hospital outside of NYC but even with the bipolar medications, his addict behavior was full swing.

I have the diagnosis of bipolar I do not use drugs I say go with your gut you know him best and the gut is usually right, if I understood correctly he is not on meds yet? please know that many times it takes trying various meds in order to get what is right for that person and can be very frustrating also if his diagnosis is accurate you will need to take care of you more there are sites that have great information on how to help someone with this diagnosis as well as yourself. I wish you the best feel free to PM me anytime.

He's freaking out, climbing the walls and remains in contact with his drug dealer. Trust your gut.

Obviously, it was my question that seems to have provoked your reaction. Asking a question is not passing judgment or a smack down. It's actually the opposite. You are the strong and sane party in this relationship. It's your job to protect your minor children.

" I will not expose my children to someone in active addiction or early recovery" is a boundary intended to protect minor children from the brutal chaos and inconsistentcies of addiction.

Grateful, first and foremost I believe that each person is doing the best they can. I believe you are doing the best you can. This is not easy. It takes time to get one's mind clear on the situation, especially when you are so deeply involved.

My son was also diagnosed with bipolar. I paid for his medicine out of my pocket, believing it would stop his desire to self-medicate. It didn't. He just carried on using. I now believe that bipolar often develops as a direct result of addiction. You cannot mess with your brain on a daily basis and not affect it somehow.

It does sound as if your husband is still using especially as he is still in contact with his dealer, although I thought when using heroin they sleep a lot and when stopping is when they have major problems with sleeping.

Is he actually taking actions of someone in recovery, like going to meetings? Even if he did stop and is doing nothing else, he will not become healthy easily. Is it possible for him to go and live somewhere else until he is further along recovery to prevent you from having to be exposed to his bad behaviour?

I don't want to derail this too much but I'm curious how they go about diagnosing mental illness in a drug addict. I mean no disrespect, I'm honestly asking. My sister is also a heroin addict, and if she has a mental illness I really don't know how we would know unless she stopped doing drugs for long enough to establish a solid baseline on which to measure.

It seems like drugs have such an incredible effect on people that it would be extremely difficult to know exactly what was causing different behaviors without removing the drug and then waiting through the several-year physiological withdrawal and rebuilding period.

However they do it it sounds like a difficult struggle. In your case I would definitely trust your gut - it doesn't lie. Also, if you feel like something is wrong, then it's wrong, it doesn't even necessarily matter what might be causing it, you have to protect yourself and your children first. Trust yourself. :hug:

My mom is bipolar and a drug addict and so is my step-daughter. I think that some people with mental illness self-medicate by using illegal drugs. (Not all, of course,) I think you should trust your instinct about his behavior. Is he participating in a recovery program?

My daughter was diagnosed with both Bipolar and Schizoaffective disorders and other disorders while in rehab. This treatment center that did so is on the short list of private pay dual diagnosis rehabs recommended by that world class rehab in Minnesota.

By the end of her last stint in rehab, her prescribed medications were running about $3000 a month, out of pocket, my pocket. I was told to seek permanent disability on her behalf as she would never be able to work and would need to be medicated for life.

She relapsed shortly after returning home with her drug of choice, heroin and moved out and did so without her prescribed medications.

Fast forward to today. She has been clean for quite some time. She is married and a competent mother to an almost 2 year old. She is employed and is self-sustaining. She takes no medications, prescribed or otherwise. There is nothing to suggest she is bipolar, let alone or psychotic.

I am highly skeptical of diagnosis made on anyone in active addiction or early recovery.

My sister is bipolar and addicted to meth. When she is off the drugs she does not always think rationally and can be very moody. When she is on the drugs she is erratic, paranoid, hallucinates, disorderly, can get violent. We can tell the difference. When she is off the drugs we can at least hold a halfway coherent conversation with her. Go with your instinct, you know him best.

grateful....you are right for coming to this site. a lot of great information here.

you know, just ignore the posts that annoy you. and just take what is helpful. that is what i do...otherwise i would be cussing out people privately left and right....lol!

honestly, you never know who is behind a screen name giving you advice about your life...remember that. a lot of them have been through hell and speak from experience. take what you need and move on.

girl, i have had former crack addicts/prostitutes who used to sleep with their dealers telling me how to fix my marriage...really? lol.

so try not to take it personal...even though it is hard not to.

you are a great mom...that is why you are here!!

Some of the better rehab counselors and addiction therapists are recovering addicts. In fact, one the wisest posters here, that helped many, is a recovering addict. I try not to judge people from their past.

In my son's case he was diagnosed at age 6 way before his drug us began his DX changed through the years as they wait for certain things at certain ages etc.. his DX is schizoaffective , outtolunch I assume your daughters Dx was made years ago? The reason I ask schizoaffective is a combo of bipolar and schizofrenia.

I agree some show what appear to be mental illness symptoms after they are not using and this causes some wrong DX at times.

I would agree with the people who say he is still using.

I am in school for this, about to have a degree. Whoop!

Anyway, if he is medicating for the bi-polar, he is probably using the heroin to bring his mood up when he is depressed. Which, believe it or not, doesn't work, because heroin is a depressant. So guess what, he gets more depressed, and uses more heroin, and it never stops.

That is why he should be on medication. And if he isn't you can almost guarantee he is using heroin because he is self-medicating. My ABF does it with alcohol. You can't fix the addiction without fixing the reason for the addiction in the first place.

Something like 85% of all addicts have co-occurring disorders. And most don't even know it because they are so sure they are just addicts, they don't realize they are hiding a mental disorder in there somewhere.