Mental Illness and Addiction

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The second step in the Alcoholics Anonymous 12 Steps is rather telling—“Came to believe that a power greater than ourselves could restore us to sanity.” While the diseases of addiction and mental illness are two are separate issues, they are not mutually exclusive. In so many cases, where there is one, the other is there also.

Let’s deal with the AA assertion that a power greater than ourselves could restore us to sanity. Keep the religious element out of it and just look at the sanity part. A person has been using his/her substance of choice for some time, be it alcohol, or cocaine, or heroin, and their habit has gotten to the point where they no longer have control over when they use, how much they use, or even whether or not they want to use.

Why don't they stop?

The first step said “our lives had become unmanageable.” Unmanageable has turned into insanity. Why else would somebody continually do something that is so obviously harmful to their health and well being? They insist on using, even though family and friends have begged them to stop.

Everyone sees what is going on, everyone knows the dangers, everyone fears for their very life, but they persist. They know better. Everyone else is wrong. Left to their own devices, they will surely die. That is the end game of heroin addiction—the user is dead. Alcoholics can literally drink themselves to death. This is not about substance of choice as much as it is about the insanity that the substance creates.

In order to clear the fog from the user’s brain, they must be put in a safe place and taken off their drug of choice. This detoxification process is necessary to get the drug out of their system and allow for treatment to begin. The most important aspect of treatment is the addict’s ability to comprehend reality, make an intelligent, informed choice and work at recovery. They can’t do it on drugs.

Recovering addicts have remarkable stories about how they escaped the clutches of addiction, and they look back at their time in slavery and lament what that did to their friends and families. They wonder how it got so crazy.

Alcoholism/drug addiction robs its victim of reason and sanity, and what was once a bright, intelligent and rational person has been transformed into a bottom-feeding parasite. It’s not what they set out to do and it certainly isn’t what they wanted, but over time and under the right conditions, it happened.

Addiction in and of itself is a form of mental illness. It’s not just a bad habit that has gone too far, it’s the absence of choice, as the individual is no longer in charge of his/her life. The drug owns them. Just as a person with bipolar disorder cannot regulate the extreme emotional swings in their life, an addict cannot say no to the drug.

Dual Diagnosis Addiction and Mental Illness

In so many cases, where there is addiction, there is also mental illness. People might cringe at the thought of mental illness, as there is a stigma attached to that condition, so for sake of illustration, let’s focus on something very common—depression. Instead of a long, clinical explanation of depression, let’s limit it to feeling “blue,” or just being down. That’s easy.

A person comes home after work. It’s been a long day and they’re tiered, worn out from the boss complaining to them, coworkers blaming them for their own mistakes, and the person in the other department has dropped the order that should have been shipped that day.

It’s time to relax and unwind. They fix a drink. That’s so common that we don’t even think about it. It’s no big deal because millions of people do that. The problem is they use a drug, in this case alcohol, to help them deal with the problem. There is a pleasurable and immediate result.

The problem isn’t going away, and the psychological impact on a long day at work isn’t being processed effectively, but for the moment they feel better. They even feel good. People who have “the blues” tend to gravitate to alcohol, because it calms them, relaxes them and they feel “better.”

But what if the alcohol fuels the depression? What if alcohol causes someone to go from feeling stressed to feeling angry? You can blame their behavior on the alcohol, because everybody knows that old Harvey here is a mean drunk. But what is Harvey really experiencing?

Alcohol and Depression

Harvey did not choose to be depressed. He may have allowed his depression to fester, but he surely didn’t ask for it to come into his life. He did, however, chose to take the drink. That may seem unfair, because one person, depressed or otherwise, can take a drink, even many drinks, and never become an alcoholic, while Harvey has one or two and he’s in trouble.

It’s a sticky situation, because addiction has that element of self-infliction. If Harvey has morphed into being an alcoholic, because over time he drank more and more to chase the blues, he is going to need treatment. Obviously, Harvey drinks so they want to deal with that, but the operative question in so many cases is simply “What hurts?” There is a co-morbidity at play, that is two things that are going on at the same time.

A treatment center can dry him out, but all you have then is a dry drunk, because they haven’t dealt with the depression. Harvey’s solution was to drink, but he has now come full circle and is back to his emotional regulation issues.

Connection between Addiction and Mental Illness

Chicken and egg issue? The national Institute on Drug Abuse (NIDA) says that there is a relationship between drug addiction and mental illness. Mental illness can lead to drug addiction, especially when the person will “self-medicate” and try to relieve symptoms by using a substance.

If a mental illness is already present, or even dormant, drugs can exacerbate the condition. The conditions may both stem from a common origin, either because the person is predisposed to the illness, or they may be more vulnerable than others, or their brain is just wired to respond to a certain drug in an extreme way.

The danger to the person who is afflicted with both mental illness and addiction is the danger of their not being receptive to treatment, or unwilling to comply to treatment programs.

If they have a history of psychosis, there is most likely a wide path of emotional damage in their relationships with loved ones and friends. Co-morbid patients require a comprehensive treatment program, one that deals with the substance and the root cause of their suffering. The dangers of not getting treatment are obvious. Left unchecked, either the mental illness or the addiction will harm the patient.

and Finally Remember:

"Ask and it will be given to you; seek and you will find; knock and the door will be opened to you. For everyone who asks receives; he who seeks finds; and to him who knocks, the door will be opened."
- Matthew 7:7-8

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