historyteach

This is a great thread. I especially like the information about the dual diagnoses. I've long known that both issues need to be treated together. Without which, relapse is very common. That need is not addressed in RI. Only one rehab allows medications for mental illness. Even the Salvation Army (in RI), refuses to accept people with medication for depression, anxiety, bipolar or any other mental illness. The doctors and hospitals continually refused to look at the issue - despite their own research which I've shown them. (There are excellent research hospitals here in RI and in Mass.) And now, the prison doctor will only give Trevor an anti-depressant and not a mood stabilizer for bipolar. It's really maddening! Especially when I saw the difference it made in Mass.
But, it's also true that medications do not work as intended when the addict continues to use. That doesn't necessarily completely negate their effect, however. But, no doubt, it interfers.
The article on dual diagnoses really helped me to see how the interrelated issues contribute to a further loss of self esteem.
Thanks for sharing that!

Shalom!

Hopefloats

Gabe, is there anything available as to what the doctors are finding AS the most successful treatment with a dual diagnoses. If I missed it, let me know. As with recovery, I like how the counselor told us that saying there is only a 15 percent success rate after rehab, he added that this IS because the addicts are not following the things that they need to follow. That IF they do, the success rate is 80 percent. That put a different spin on how we can view this.

I am imagining it is the same with the treatment of other disorders. I am very interested but still learning about this as I go along. You know I have to say again that responsibility for "self" has to play a major role. This is where the "whole" person has to be treated.

Another difficult thing is we have different doctors that believe different things. Some go for medication alone, and we know there is a money trail in all of that. Some offer alternative care, and combine that with conventional medicines.

Did ya think I could ask SO many questions? lol Never mind...don't answer that

Hope

Gabe

I'm no expert Hope.
I'm just posting what I've been finding on the internet regarding all this.
From what I've read, it looks like addiction gets a lot of focus and treatment, and the secondary or co-existing disorder goes ignored or untreated a lot of times.
This could possibly shed some different light on the posts I've read from Anons that say the addict in their life is sober, but still exhibiting "trouble signs".
I don't think successful recovery takes place unless the "whole person" is treated.
It's like trying to get well and treating your broken leg, but ignoring your pneumonia.

minnie

Gabe, I actually see addiction as being the secondary disorder. But then that's probably a whole new thread.....

roses2005

Response to JUSTME57
First off, congrats on 26 months of sobriety. I myself just celebrated my one year in September. I think everyone myself included, have been guilty of lying. Especially in active addiction( they sadly go hand in hand ) The way I look at it is I walked seventeen miles into the woods, and now I must walk seventeen miles out. Trying to rebuild trust is extremely exhausting, however little by little it does happen.Just know as long as you keep on keeping on honestly, it gets better and better. Especially around the holidays, we all just want to get along. I will keep you in my prayers. Try and have a wonderful holiday season.
Sincerely, Jennifer e-mail me if you like

[email protected]

Hopefloats

I love treating the "whole" person the best.
I appreciate all the info. We have a long way to go, I suppose, but the more we learn the better off we are...
Hope

Gabe

Yeah, I would have to agree with that.
Which means (in many cases) the secondary disorder gets treated while the primary one goes ignored.
Oy!

historyteach

Exactly! I've been doing research for quite some time, and here are some helpful resources. An integrated approach, treating both the mental illness and the substance abuse as co-occuring and BOTH as primary issues is seen as the best possible treatment. It includes a long term approach; assistance in housing, jobs, relations... for best treatment policies.

http://ps.psychiatryonline.org/cgi/c.../full/52/5/597
Precis includes % of DD and Mass use of info. Also where to get actual report online.
Kenneth Minkoff, M.D.

http://ps.psychiatryonline.org/cgi/c...full/51/9/1126
Discussion on the development of clinical understanding of dual diagnosis since the 1980s, including medical, moral, psychosocial risk and phenomenological. Argues development of integrated treatment programs, addressing both disorders as well as the delaying of public policy and programs based on wrongful emphasis on diagnosis and illness.
Robert E. Drake, M.D., Ph.D. and Michael A. Wallach, Ph.D.

http://www.nami.org/Template.cfm?Sec...ontentID=10333
Definitions of and consequences of dual diagnoses with call for, methodologies and factors involved in integrated treatment.
Nami

http://www.toad.net/~arcturus/dd/ddhome.htm
Developing A Cross Training Project For Substance Abuse, Mental Health
And Criminal Justice Professionals Working With Offenders With Co-Existing Disorders (Substance Abuse/Mental Illness)
Bert Pepper, M.D. & Edward L. Hendrickson, M.S.
Complete curriculum included, with overheads

http://www.toad.net/~arcturus/dd/ddhome.htm
Improving Services for Individuals at Risk of, or with,
Co-Occurring Substance-Related
and Mental Health Disorders
A SAMHSA Conference Report and A National Strategy
A Report of the National Advisory Council
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
Rockville, Maryland
January, 1997

http://pn.psychiatryonline.org/cgi/content/full/38/8/2
What’s needed for successful dual diagnoses treatment including liscenses, cost, use of data and treatment modes.

http://www.medscape.com/viewarticle/420310
Dual Diagnosis: Advanced Clinical Applications CME
Edward C. Senay, MD
Info on two dimensional typology; commonologies between SA and MI and treatment resources.

Hope this helps some of the questions. I hesitated to post here, because the thread is actually about low self esteem. But, Gabe, your statement above suggested it's appropriateness.

Shalom!






1.

Gabe

Thanks for the resources Teach.
And no apologies necessary.
This thread went onto a few secondary topics, and that's fine with me.
I think understanding what we're dealing with is very important.
Even though we know that treatment is up to the individual with the problem, awareness on our part helps a great deal.

historyteach

No problem, Gabe!
I agree, awareness and understanding what we are dealing with is important.
And, yes, it is up to the individual to get help. Just seems like it's made really rediculously impossible at times, ya know? But, then again, there's a whole lotta money to be made with untreated dual diagnoses by lawyers, courtrooms, hospitals, prisons, police....

Shalom!

Jazzman

Well then count me in on that one cuz other than some shortcomings as a person I don't consider myself having any kind of disorder. I can tell you that cocaine as a VERY addictive drug, screwed up in the head or not! Remember, your exposure to chemical dependencies covers only a very small piece of the chemical dependency pie,(I'm assuming only alcoholism). Opiates... there's another one... I hope you're fortunate enough to never have a front row seat to that mess.

minnie

Jazz, I admit I was very simplistic in how I worded that post. I would never disagree about the addictive properties of any drug, alcohol included. I do see that a person can get physically addicted - my question would be why a person put themselves into a postion to get addicted in the first place? I think that goes right back around to the original topic of the thread - low self-esteem.

As I was growing up, I didn't have great self-worth or self-respect. However, I did have enough to know that escaping from my life by taking narcotics was not going to solve my problems - instead, I took a less obvious route by focussing on other people's problems. I was offered drugs many times at university, and bar the odd spliff, I always declined. Why did I decline and so many others didn't? Please don't think I am being "holier-than-thou" about this - I am simply intrigued by the process.

Five

I read a study recently that "high self esteem" was associated with higher levels of violence and racisim!!!!!!!!!!!!!!!

I dont really believe it is anything so tangable to be given much thought. Just roll with it...

minnie

Five, that reminds me very much of the transactional analysis position of "I'm OK - You're not OK." Interesting.

Jazzman

Then I can certainly convey "my process". I absotivly had low self esteem. I grew up in a "self medicating" house hold, (alcoholic Father also taking valium and what ever else the Dr. prescribed based on his complaints). I also had a codependent Mother leaning slightly on the overbearing side. The kind of Mother that would not let me as a toddler, cary my plate full of spaghetti to the dinner table for fear of dropping it. I was a teen in the 70s and had many "self medicating" options available. I experimented with many drugs and stuck w/ the ones I liked dropped the ones I didn't. For the most part I viewed my "druggie phase" as something I outgrew. But it did take several things to occur concurrently. I had successfully completed some challenging goals I had set for myself and as I succeeded at each one, my self image and self esteem grew with each success. Only recently did I realize it was growing self esteem that made me choose to walk away from drugs and not simply outgrowing a stage in my youth. As a matter of fact, it was the very 1st reply by Equus to my very 1st post here at SR that made me realize that! To paraphrase my question in my 1st post, "Why was I able to beat my addiction and my ex not able to?

Quote:

Originally Posted by equus

Did you know that possibly one of the biggest factors effecting motivation is the confidence to believe we can achieve? Without believing I am capable of doing 'X' all the extrinsic and intrinsic motivation in the world is not going to be reason enough to try.

All this is EXACTLY related to self esteem the way I see it. Whether you beat an addiction or avoid addictive behavior in the 1st place is up to an individuals level of self esteem and self image. If you care enough about your self, why in the world would you poke yourself in the eye?

minnie

I knew we didn't have that much of a different viewpoint.

minnie

You know, I am coming round to the viewpoint that most (?all) dysfunctional behaviour boils down to low or non-existent self-esteem. Five, I know you have a problem with terms like self-worth and self esteem, but I also know that you highly rate CBT, which seems to me to be about replacing negative thought patterns with more useful ones.

I don't actually base these thoughts on my own experience as much as reading the stories of others on these boards and readins elsewhere. I have gone back several times to the Recovery Stories Board to see if I was reading something that wasn't there, but I can't avoid the fact that most stories relate "not fitting in" or "feeling left out", if not outright state that the author just "didn't feel good enough." What would have happened to these people if they had been raised to be "enough"?

Gabe

Oh, there's the sixty-four thousand dollar question.
And that word...enough.
It seems to creep up in recovery board threads a lot.
As in "I didn't ever feel like I was enough" and "I don't think he loves me enough."
Reminds me of some dialogue from the movie "The Divine Secrets of The Ya-Ya Sisterhood".
Sidda, the daughter of the alcoholic is having a conversation with her father, Shep, the husband of the alcoholic. It goes something like this:
Sidda: Daddy, did you get loved enough?
Shep: Enough? What's enough? My question is...did you?
I love the Shep character. What a big ole Codie.

Jazzman

Becasue I waisted 5 or 6 years of my life being waisted, I wonder what I COULD have acheived had I cared enough about myself? Four year degree instead of a two year degree? Maybe even a Masters? Ach..
For me, I would rather focus on the good lessons I learned from my experience. I learned how NOT to raise my kids w/ low self esteem. I look at them know and think....
It was worth it.

minnie

Yes, I picked the word "enough" because I had read it on here a lot. Maybe it's all about "unconditional love" - ie that we are loved for who we are, not our behaviour and that we feel that love from a child. How many times do we hear mothers in the supermarket screaming "You are such a bad boy!" at a child? Their behaviour might be bad, but THEY aren't, but that is the message they are getting.

And Jazz, yes, focussing on the lessons learned and passing those experiences on to the next generation is the key. I think that is what I am driving at here.