Let’s Celebrate A Hopeful Recovery from Dual Diagnosis

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November 7, 2017

The National Alliance on Mental Illness reported that 50 percent of individuals with severe mental health disorders are affected by substance use. In addition, 37 percent of alcohol users and 53% of drug abusers also have at least one serious mental illness.

Double trouble but there is hope because researchers are looking into the connection between these disorders and Physicians are developing treatments integrating the recovery program and treatment plans. Also, researchers are looking into the relationship between early substance use and the increases in likely future problems with alcohol and drugs. I believe the more we know about something, the better we are able to find solutions. I started on the path of substance abuse as a young teen. I have continued to work through this along with the mental illness conditions I am experiencing.

My Story

This may be the most difficult of all the pieces I have written so far for Challenge The Storm. I have written about personal and scary things before, suicidal ideation, self-harm, and hospitalization. I have many medical issues that I have shared and talked about with different people over the years. I believe the reasons it is so difficult to write about is because it involves addictive behavior, drugs, and alcohol. The stigma attached to admitting you are out of control with regards to the use of those substances feels like people are thinking you are a “bad person.”

At the age of fourteen, I had my first alcoholic drink and my first experience with marijuana. At the same time, I was experiencing panic attacks and generalized anxiety, although I was not diagnosed at the time. I used alcohol and drugs to self-medicate. I had a ruminating worried mind, even as a teen and these substances, quieted this voice in my head, at least temporarily. In my case, three pregnancies in my early 20’s stopped my substance usage dramatically. I don’t ever forget drinking until I blacked out or needing to have a drink or two every day. I also know from my hospitalization in 2010, how easy it was for me to fall back into heavy drinking.

My younger sister has dealt with so many of the same issues as I have, at an even younger age. I share her story also to further witness to the prevalence of early substance abuse and mental illness. I also want to help others to realize they are not alone and it’s okay to talk about.

My sister Emily’s Story

“I remember being about 11 or 12 years old and wondering what would make me smile each day. I had no idea that this was depression, at the time, but I distinctly remember feeling like something good had to happen in order for me to feel joy. Feeling natural highs was unknown to me.

I was about that same age when I discovered that drinking alcohol or smoking weed would help me avoid my sadness. I loved being drunk and high because reality was distorted and my life made sense. When I was drunk, life was fun. I could laugh much more easily and my self-esteem was elevated, with every drink I took. I never sat and wondered, “How can I feel good”, it just naturally happened and I loved it. Smoking weed mellowed out my anxiety and allowed me a sense of peace, that I didn’t know without it. I never wondered if I had a substance abuse problem. I only wondered where my next high or drink would come from.

Unfortunately, my love for these “fake highs” grew stronger and intensified. By the time I was 14, I was high or drunk every day. I didn’t know it then but my mental health was a precursor for my desire to live in an altered state of being. My family lived in student/family housing and it seemed like all the young kids drank or smoked. I later wondered if that was just how young kids dealt with their parents being students? I definitely lacked in a traditional family setting and my childhood was not a bed of roses; yet, I saw kids who had it much worse than me and they seemed just fine. I often compared myself to kids who lived in tough situations and wondered why they didn’t get high like I did. I would later be diagnosed with depression and anxiety disorder and learn that because of my mental health, I was much more likely to want/need substances to alter my reality.

My battle with depression and anxiety have offered me a lifetime of struggle to stay away from substances since I know my true answers will never come from a bottle or a drug. I have been lucky enough to pursue degrees and careers and be quite successful in them. However, I know that striving for ultimate mental health recovery, for me, means staying away from drugs and alcohol.”

Early Drug Use

“The likelihood of developing a substance use disorder is greatest for those who begin use in their early teens. For example, 15.2 percent of people who start drinking by age 14 eventually develop alcohol abuse or dependence (as compared to just 2.1 percent who wait until they are 21.” Source: https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/introduction

This article will attempt to address many of the issues surrounding substance abuse and mental illness, such as is there a causal effect and what types are therapies are used.  My own therapist has explained to me that at places like Hazelton in Minneapolis Minnesota, dual programs are used and also by psychotherapists around our area. One thing, in particular, stuck out in our conversations.  When there is a Dual Diagnosis, the emphasis will put the recovery of the substance abuse atop of the mental health, if there is any decision needed focus.  This makes sense to me and if I was not controlling my usage, I can see it would very important to seek immediate help for that issue. I started to wonder if one caused the other and I found some research that looked into that.

Is there a causal relationship?

Researchers are continuing to study whether any causal relationship exists, the following three scenarios provide an illustration of what research has shown to date: 

  1. Drugs of abuse can cause abusers to experience one or more symptoms of another mental illness. The increased risk of psychosis in some marijuana abusers has been offered as evidence for this possibility.
  2. Mental illnesses can lead to drug abuse. Individuals with overt, mild, or even subclinical mental disorders may abuse drugs as a form of self-medication. For example, the use of tobacco products by patients with schizophrenia is believed to lessen the symptoms of the disease and improve cognition.
  3. Both drug use disorders and other mental illnesses are caused by overlapping factors such as underlying brain deficits, genetic vulnerabilities, and/or early exposure to stress or trauma.

Source:  https://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental-illnesses/why-do-drug-use-disorders-often-co-occur-other-men

Treatment for Dual Diagnosis

There is evidence that with help, people with a dual diagnosis can stabilize and recover. A large part of the treatment for dual diagnosis involves behavioral interventions. Types of behavioral therapy commonly used in dual diagnosis treatment include:

  • Dialectic behavioral therapy, which has the goal of reducing self-harming behaviors that often accompany mental health conditions and substance use disorders.
  • Integrated group therapy, which seeks to treat the symptoms of both substance use disorders and mental health illnesses all at once.
  • Cognitive behavioral therapy, which works to minimize problematic beliefs and behaviors and develop healthier thinking and behavioral patterns to sustain sobriety.
  • Individual psychotherapy, which treats behaviors related to substance abuse and/or particular behavioral or mental health problems.”  Source:  https://www.rehabs.com/about/dual-diagnosis-rehabs/

For more information on treatment, check out the work of Kenneth Minkoff, MD, a board-certified psychiatrist with an additional certificate of qualifications in addiction psychiatry; a dedicated community psychiatrist, and currently is a clinical assistant professor of psychiatry at Harvard Medical School. He is recognized as one of the nation’s leading experts on integrated treatment of individuals with co-occurring psychiatric and substance disorders (ICOPSD) or “dual diagnosis.”


There’s a party goin’ on right here
A celebration to last throughout the years
So bring your good times, and your laughter too
We gonna celebrate your party with you
~ Kool and the Gang (1981)

Life with addiction and/or mental illness goes on. We will still have birthday and graduation parties, Happy Hours with our colleagues, and everyday life with friends and family who may use alcohol and drugs.  We might have knee surgeries required pain management. We may continue to experience symptoms of our mental diseases.  Each and every day we will face our challenges and celebrate the progress we have made.  Living each day is a CELEBRATION!!

Amy Krolak

Amy Krolak

I am a 50+ grandmother, mother, wife, sister, daughter. I have worn many hats in my life: student, library aide, bookseller, special education para, computer room monitor, substitute teacher. I am focusing on writing, taking creative writing courses, writing articles and short stories.

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