Having a loved one with a chemical dependency is one of the most challenging and heartbreaking situations we can face. These illnesses can last far longer than acute conditions like injuries or heart attacks, and they are far more difficult to treat because the patient may not want to treat the problem.
Further complicating the road to recovery is the presence of mental illness. Sadly, almost one-third of people with a mental illness will end up with an addiction problem of some kind. And roughly half of people with an addiction problem will ultimately develop a mental illness.
As a result, persons with both conditions are an even greater challenge for loved ones and friends. This situation is known as a dual diagnosis–the presence of both a substance dependency and a mental illness of some type.
A dual diagnosis for men can stem from a number of different conditions. Here are several areas where the presence of both an addiction and a mental illness can create challenges for treatment.
Once known as manic-depressive behavior, bipolar disorder involves drastic mood swings from exuberant happiness to severe and dark depression. It can make daily life difficult for the patient, leading to a desire to manage the symptoms by simply overwhelming them with an outside force that is more powerful. Alcohol, as a depressant, can be used in this way; the patient ingests enough to stabilize the mood to an impaired middle. Stimulants like cocaine may be used to try to pick up the low times and create constant euphoria.
Behind the scenes of treating these patients is their unwillingness to return to their up-and-down life. They may fully understand the impact that their chemical dependency has had on them, but they feel that even that misery is still better than their bipolar times. Some who escape their addiction may subsequently be afraid to medicate their bipolar for fear of returning to an addict’s life.
Post-Traumatic Stress Disorder
Veterans returning from Iraq and Afghanistan have flooded this area of mental illness. Unlike bipolar disorder, which a patient is born with, PTSD is environmental. Exposure to extreme danger and fear for prolonged periods of time forces a rewiring of the patient’s brain to a high-strung level of paranoia and alertness that can preclude a normal daily life.
The overwhelming emotions of their experiences in combat or other intense situations can become so powerful that even an improved environment cannot help. Instead, the patient begins to treat symptoms with chemical abuse. Their reality is so horrifying that they seek out alcohol or drugs to numb themselves and escape from reality. The combined effects of growing tolerance to the substances and avoidance of treatment of the underlying problem can cause the addiction to grow rapidly to dangerous and deadly proportions.
This condition is marked with an overwhelming desire to have things in order and to follow rituals. This can include everything from how clothes are arranged in a closet to which foot is placed on which stair while walking. Near-constant handwashing and other germophobic behaviors are also evident.
Because this condition cuts through the patient’s entire waking day, some escape from it by seeking alcohol or drugs to distract them. Unfortunately, tolerance and the condition’s persistence, just as with PTSD, cause an escalation that can prove deadly. As soon as the fog of intoxication clears, the OCD behaviors return. This can mean the patient may need to have both conditions treated simultaneously, which is a challenge for some inpatient facilities and an overwhelming workload for patients.
Addiction itself is a mental illness that is incredibly complex and difficult to treat. When it has come about as the result of another mental illness, the hill is even steeper. Skilled, experienced treatment and limitless family support is critical for the patient’s success. The road is long, but when it’s properly identified, it can be traveled.
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