Patti is a widowed mother of three sons who has been treating her depression and OCD for the past four decades. She has had some degree of success, although as she has aged, she has grown ever more unreliable and untrustworthy, and has neglected her physical health. This is in spite of chronic use of medication for her mental health, and hundreds of hours of therapy.
Her sons had run out of ideas as to how to get her to take better care of herself and to be honest with them. After all, if medical professionals could not help, what could they do.
However, after falling out with her long-time psychiatrist, she has begun to see a new provider who has recognized that Patti suffers from alcoholism. All of the treatment Patti has been receiving for the past four decades has been compromised by her continued abuse of alcohol. Alcohol has countered the effects of her medication, and her habit of lying to therapists has rendered therapy almost ineffectual.
With time spent in rehab, along with a more responsible approach from her new psychiatrist and therapist, she has begun to turn her life around, winning back the trust of her children, improving her mental and physical health, and living life with a renewed vigor.
Mental health and alcoholism
Patti’s story is far from unique. Mental health and alcoholism go hand-in-hand. Many alcoholics began drinking in order to relieve the symptoms of mental illness. Conversely, alcoholism itself can lead to mental illness through a deterioration of coping mechanisms, healthy life choices, and alcohol’s chemical effects.
Treatment that ignores the connection between mental health and alcoholism is often ineffectual and can even mask the real issues. As became clear for Patti, antidepressants and other mental health medications can be harmful when used in conjunction with alcohol. Therapy does not have the desired effects if the individual is dishonest about their alcoholism and uses alcohol rather than the techniques offered by the therapist.
On the other hand, recovery from alcoholism will not last without treating co-occurring mental illnesses. It will simply leave the individual without the damaging coping mechanisms they’ve been using. They are likely to start using alcohol again as soon as they face challenges they are not equipped to overcome in a healthy way.
Common co-occurring mental illnesses
Certain mental illnesses often co-occur with alcoholism. These include but are not limited to:
- depression: to numb the symptoms of depression, individuals use alcohol when other coping mechanisms don’t work. Consequently, they neglect to learn healthy mechanisms, exacerbating the problem
- bipolar disorder: even in the manic phase of bipolar disorder, sufferers can begin to use alcohol to cope. Unlike with depressive episodes, this is not to numb the pain, but rather to allow them to turn off thoughts that won’t stop cycling
- insomnia: similarly, alcohol can, in the short term, make it easier to turn one’s mind off to help them fall asleep. However, it ultimately lessens the quality of sleep and worsens the effects of insomnia
- obsessive-compulsive disorder (OCD): people suffering with OCD often turn to alcohol to numb out obsessive thoughts
- various personality disorders: people with personality disorders often turn to alcohol for a number of reasons, such as making it easier to socialize, crying out for help and attention, and more
Treating mental health and alcoholism
Patti learned that treating her mental illness in isolation could never be fully effective. While it helped her survive for many years, she sabotaged relationships, caused physical harm to her body, and numbed out much of what was going on in her and her family’s lives. Only when she treated both could she finally get passed the blocks which had been hampering her life for so long.
This is the case for most people suffering from co-occurring mental illnesses and alcoholism. If they only treat their alcoholism, they are likely to relapse. If they only treat the mental illness, much of the work will be undone by their continued alcohol abuse.
The best treatment centers take a dual diagnosis approach, ensuring that residents are given the tools they need to recover in all aspects of their lives.
Parallel treatments
In some respects, this will mean that residents follow two related but separate treatment courses. They will work with the program provided for their alcoholism, fully committing to following through and ending their alcohol use. They will also work with a therapist to treat their mental illness and learn healthy coping mechanisms.
These are inevitably connected. Some of the steps residents go through to recover from alcoholism will focus on exploring the underlying cause of the problem. Furthermore, the therapist will work with the resident in learning to use healthy coping mechanisms as opposed to alcohol when faced with challenges.
Mutually effective treatments
On the other hand, certain treatments are effective for treating both mental illness and alcoholism at the same time. Mindfulness is one poignant example. Courses that use mindfulness, such as mindfulness-based stress-reduction (MBSR) and dialectical behavior therapy (DBT), have been proven effective at treating a range of mental illnesses. At the same time, the principles on which they are based have long been used as essential factors of addiction recovery.
One of the fundamental principles taught in recovery centers is that one cannot focus on working with the entirety of their lifetime. Rather, one can succeed by focusing on the present moment. That’s all one has control over, after all. This is essential in order to approach recovery in a way that is not overwhelming or unrealistic.
Furthermore, much of the suffering caused by mental illness and alcoholism stems from a lack of knowledge of how to effectively navigate painful feelings which can only be experienced in the moment.
Effective long-term treatment
In order to avoid spending endless time and money on ineffective treatment of either mental illness or alcoholism, both need to be treated at the same time. Someone suffering from both simply cannot treat one in isolation without leaving the door open to further problems.
As Patti learned, treating both is the key towards living a revitalized, healthy life. Always choose a treatment center or program that takes a dual diagnosis approach. This way, you can achieve greater results for both your mental health and continued recovery.
References:
- Mary W. Kuria, David M. Ndetei, Isodore S. Obot, et al., “The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence,” ISRN Psychiatry, vol. 2012, Article ID 482802, 6 pages, 2012. https://doi.org/10.5402/2012/482802
- Boisvert, R., Martin, L., Grosek, M. and Clarie, A. (2008). Effectiveness of a peer-support community in addiction recovery: participation as intervention. Occupational Therapy International, 15(4), pp.205-220.
- Mancebo, M. C., Grant, J. E., Pinto, A., Eisen, J. L., & Rasmussen, S. A. (2009). Substance use disorders in an obsessive compulsive disorder clinical sample. Journal of anxiety disorders, 23(4), 429–435. doi:10.1016/j.janxdis.2008.08.008
- Robert E. Drake, Carolyn Mercer-McFadden, Kim T. Mueser, Gregory J. McHugo, Gary R. Bond, Review of Integrated Mental Health and Substance Abuse Treatment for Patients With Dual Disorders, Schizophrenia Bulletin, Volume 24, Issue 4, 1998, Pages 589–608, https://doi.org/10.1093/oxfordjournals.schbul.a033351
- Young, M. E., DeLorenzi, L. d. and Cunningham, L. (2011), Using Meditation in Addiction Counseling. Journal of Addictions & Offender Counseling, 32: 58-71. doi:10.1002/j.2161-1874.2011.tb00207.x
