The Challenges of Dual Diagnosis to the Recovering Addict

Hurtful or helpful, people like to label other people. Some labels assigned to me invoke pride like old paratrooper, veteran, and father. Other labels, ex-con and ex-junkie are two which were tough for me to get used to. The hardest one, so far, was mental patient. As painful as it was to acknowledge, I have some mental issues besides addiction. As someone in recovery, you are going to have to ask yourself some tough questions. The first being 'was I self-medicating?' The only reason I have been able to accrue so much clean time is by addressing mental issues; I would of much rather left alone. That was combined with finding a doctor I could trust without reservation. Indeed, an honest assessment of the past seven years shows, once the mental issues were taken on, real recovery began taking root. Regardless of laws, good intentions, or the hay thrown to the sheep on the morning shows, having a mental illness or condition is something which a public admission may have dire consequences.

Honesty is truly the basis for recovery. Whether it be when assessing addiction, sexual trauma, child hood nastiness, or the host of things that makes it a life less normal, it has to be somewhat objective. Maybe the "allergy" model works in your case but not in mine. It went far deeper than being a buzz-hound who saw a couple bad moments in Central America. By nature, emotional response is subjective. That does not mean that at some point, an individual's emotional reaction cannot objectively be called abnormal. Thanks to some celebrity's efforts depression is not considered an ugly word and condition as it once was. Hopefully the term bipolar will lose some of its sting. Maybe it will lose its current catch all status as well. No matter, deep down we knew that our problem was more than the drugs. Indeed, they most likely were how we hid from our problems; a panacea that took on a life of its own. I know is not easy to admit one has a mental disease. I have fought that very notion for almost 40 years.

Try to remember that difficult moment at your first or second meeting, when you screwed on your courage, and said aloud "I am an addict." Can you recall the peace that came from that heartfelt admission? It was a plateau that is still helping us to this day. Well, there is another moment like that ahead outside of the steps. Seek an honest evaluation, from a mental health professional. Most folks new in recovery do not have any medical insurance. If you are a veteran, hit the links that accompany this article. They will assist you in finding help within the VA system. If you are a civilian, there are many community based organizations, churches and programs that can and will help you. Once you are being seen by a mental health professional, DO NOT say answers you think sounds good. DO NOT say what you think the shrink wants to hear. For once, it really is about you and an honest assessment is a keystone in developing a treatment plan. It is hoped this all does not read like some cheer leading puff piece for shrinks. It took a long time to overcome a distrust of doctors and psychiatry. Being grounded in mathematics, it was tough for me to accept anything which was not a "hard" science. Once a treatment plan is reached, it is vital to stick to it. This will most likely involve the use of prescription drugs. Now the great debate begins.

For a long time, I had what I thought were philosophical and religious problems with psychotropic drugs. In hindsight, with the help of a healthy amount of clean time, I know that was a hypocritical view. With no guidance at all, I was jamming poison in my arm to rid me of the pain of being a human. New to recovery and new to mental health, beware of advice claiming your program will suffer with prescription drugs. To self-righteously eschew a doctor's advice is a form of its own madness. Of all the models of addiction presented, the diabetes model is a personal favorite. Diet, exercise, doctor's recommendations and environment are key. Those same elements make up a strong program of recovery and mental health. It is nobody's business, barring your sponsor, about your prescriptions. This is assuming the honesty needed for recovery extends to your desire for mental health.

So you have been to counseling by a mental health professional and are now beginning to take your medications. This is when the real honesty comes into play. Finding the right dosage is tough and requires a little due diligence. The side effects eventually settle down and one day you will notice you feel OK. Not high, not manic, not blue, but how people are supposed to feel. This is when honesty and objectivity becomes crucial. The rewards are very real. During the adjustment period, keep track of the side effects, the symptoms, and how you feel. Pick up an affordable notebook to keep track. Make as many entries as needed and divide it by the dates. Add your feelings about recovery and it will come in handy, if you ever begin a journey through the twelve steps.

The main reason I have managed to stick with a recovery program so long, is based on finally addressing my mental health issues. It took a long time to accept something as simple as a chemical imbalance could affect my daily mood. Not taking anything away from recovery fellowships, one has to be ready for a recovery program. Kicking it time and time again, limping back miserably to the rooms after each fall may not be due to your program, sponsor, or home group. An inexplicable relapse has not happened, once I really started working on my mental health. To my fellow veterans, there is nothing weak about being rattled by combat. To my civilian friends, it is not normal to be on top of the world with boundless energy for a week, only to crash and burn for two days afterward. Small wonder we self-medicated. Existence itself was purgatory. As long as our caregivers know about our addictions, the medications will be solely for mood adjustment. The first step applies here. We have to admit we need help and go seek it.

Let's wrap up this time together today. You know whether your addiction was due to self medicating. If that was the case, long-term recovery needs a solid emotional underpinning. Once you find a mental health professional you are comfortable with, you have to tell them about your addiction. After a treatment plan is reached, you have to stick to it. Keep a journal for many reasons but make sure you keep track of symptoms, side effects, and feelings. While you and your doctor are working out your medication and dosage, step up your involvement in your recovery program. Do not let well meaning but misinformed people steer you away from legitimate medications. Give those medications time to work, and work with your caregiver to get the dosage(s) correct. Finally, remember a mental illness is just that, an illness. It is not a sign of weakness, nor a moral shortcoming, or something to be ashamed of. As always, I appreciate you reading this and us spending time together. If you stayed clean, just for today, I am very proud of you.