Sick and Suffering: Dual Diagnosis in Recovery Part 2
“Start by doing what’s necessary, then do what’s possible; and suddenly you are doing the impossible.”- St. Francis of Assisi
In the first blog on dual diagnosis, we discussed mental illness for those in recovery already practicing recovery and well rooted in this way of life. For those who are new to both recovery and battling a mental illness; particular actions can be extremely helpful with some distinctions that might make all the difference.
In 2005 I went to treatment yet again, a state-run facility in Pennsylvania. Usually, these are 28-day programs, but after a bio-psychosocial evaluation, they kindly offered me 90 days. I was diagnosed with bipolar 1 yet again and put on medication immediately. After fourteen years of not getting sober for more than ninety days, I was to start a journey of recovery that would last over a decade before my slip of ten weeks.
When I was discharged, I was given a month of prescriptions by my case manager which I took. That was four months of treatment for my mental health that I had never had prior. After arriving in Florida, I was unable to get myself into the hands of professionals for ongoing mental health treatment. Years later the pain would drive me on to an over five-year journey of seeking professional help before I found what worked for me. How could I possibly determine if those stabilizing medications, in the beginning, were the one piece of the missing link above and beyond a sponsor and the steps? The answer is I couldn’t.
The Problem: Overlapping Symptoms
Almost everyone appears bipolar in treatment. On one side there is the fear and panic of being out of society for 28 days and no control over what will happen to the life you exited combined with the guilt and shame of feeling like a failure. There will be tears. On the other hand, there may be moments of laughter at the hilarity of it all, after all, you can’t cry all day. Sleepless nights are the norm. Often the symptoms of mental health and alcoholism look identical. Depression, manic behavior, poor decision making, inappropriate responses, grandiosity, poor sexual and financial choices, high-risk behaviors, in general, are common in both.
The Solution: THe Rule Out Method
Because of the overlap in symptoms the only definite way to rule out if you genuinely have a mental illness, which is highly over diagnosed, is to get sober. By sober I’m not implying clean time, but authentic recovery. A period of at least 6 months of working steps and living daily spiritual practices is a great baseline to see if these issues persist or not.
As mentioned in the part 1 blog on dual diagnosis if we are immersed in a recovery lifestyle post spiritual awakening (as per the 12th step) and still experiencing these unwanted behaviors the problem is likely biochemical and cannot be solved by “prayer” or “helping others.”
The Catch? Treat Both
In that 6 months of recovery or more, it’s highly important to treat both. That means two teams a spiritual team (the sponsor and supports) and a professional team (psychiatrist and therapist). It also means two programs independent but not in conflict. This paradox can be tricky. A heroin addict that doesn’t fully disclose that they cannot take narcotics may be prescribed a sedative for anxiety. The same thing goes if you’re under the care of a doctor who doesn’t quite understand addiction, they may prescribe benzos for sleep. Not being honest and disclosing vital information to your doctors is counterproductive and dangerous.
Some people in the 12 step fellowships with zero medical experience will also give uneducated advice about medications. Some are even so bold as to tell a sponsee they don’t need medication. This is equally as dangerous. If one is unsure about their mental health diagnosis, it’s best to get time in recovery before making any impulsive decisions about treatment for mental health diagnosis.Above all, and I can’t emphasize this enough, medical professionals are medical professionals and your sponsor is your sponsor. The two things are completely separate and the only thing that qualifies ANYONE to provide medical advice is years of schooling, experience, and the letters MD or RN after their name…. Time after time mental health patients begin to feel better after a certain period of medications and conclude they no longer need the meds, not accounting for the high probability that the meds are a part of the feeling better. Not being medication compliant is a common path to relapse for many dual diagnosis recovery members. The most important rule is having two teams, and don’t run either yourself. Give yourself the best shot at success.