“There is no point treating a depressed person as though she were just feeling sad, saying, ‘There now, hang on, you’ll get over it.’ Sadness is more or less like a head cold- with patience, it passes. Depression is like cancer.” Barbara Kingsolver
Living with the “Double Whammy”–addiction and depression recovery–I have had to learn relapse prevention for both. Luckily for me, I decided in 1976 that I would go all in with addiction recovery. I elected at 3 months sober to go to a very modest home for alcoholic women. At the time, it was the fashion to go to country-club style treatment in North Carolina. But I knew that I needed to be in that modest home. While there, we worked the first 3 steps and I found the God of my understanding. I have never had anything happen to me that was more important to me than staying sober.
The 12 steps taught me the way out of addiction. But they didn’t help me with depression. Luckily, for me, I have dysthymia which is milder than other depression types and it comes and goes. I have had to learn everything about my depression by myself. I am sure that is true for most of us with co-occurring or dual diagnosis. The mental health field can provide labels, medication, and sometimes, if you are very, very lucky, good counseling. But we have to become our own mental health expert. It is an individual journey.
I had clinical depression for two years–1986 to 1988–when I was 10 years into addiction recovery. It was a very shocking experience. I didn’t know how to talk about it. Whatever I said in AA meetings, I was advised to work the steps harder. I was going to a daily noon meeting where I felt safe and secure. But outside, in the real world, I was having a very tough time functioning. Drinking or using was never an option. I call living with addiction and depression recovery the “double whammy”.
Denial is a tricky companion. In 1988, after being sober for 12 years, I was working at a psychiatric hospital in marketing giving lectures about depression in geriatric homes. One day I looked at my giant flip chart of the 18 symptoms of depression and realized I had at least 15 of the symptoms. It was OK for me to be a recovering alcoholic, but not OK to have depression. I left that lecture and went back to the hospital, looked up my favorite doctor, and told him that I needed help. Within 3 weeks, I felt better than I had ever felt in my life. So I had lived with depression for as long I could remember. I used alcohol to self-medicate.
I remember how long it took me to wrap my head around the fact that I had self-hatred. I kept rationalizing that I thought of myself as a good person. I didn’t accept it until I read in the ACA Red Book about my hatred coming from not being able to heal my family of origin while I was a child.
These deep-rooted faulty self-concepts kept me looking for people to “save” for almost 70 years. I guess I had quite a Messiah complex. Talk about a slow learner and a hard head. I believe these self concepts added to my depressive personality from my childhood. If you carry the weight of the family on your shoulders, it is hard to lighten up and let life flow.
Responsibility is a wonderful quality to have but over-responsibility kept me from becoming all I could be. I have been gifted with what I call the double whammy–depression and addiction. I believe my wound is depression and addiction was the bandage. We are each our own mental health ‘doctor”. We each have our own answers. And mental health ebbs and flows. So change is not only necessary but is also vital if we want to be truly human, truly alive.
“No one will come and save you. No one will come riding on a white horse and take all your worries away. You have to save yourself, little by little, day by day. Build yourself a home. Take care of your body. Find something to work on. Something that makes you excited, something you want to learn. Get yourself some books and learn them by heart. Get to know the author, where he grew up, what books he read himself. Take yourself out for dinner. Dress up for no one but you and simply feel nice. it’s a lovely feeling, to feel pretty. You don’t need anyone to confirm it.” Charlotte Eriksson
What is Dual Diagnosis?
As intuitive as the term “dual diagnosis” may seem, it actually doesn’t mean having two mental health conditions. Dual diagnosis (also referred to as a co-occurring disorder) is a term used when someone experiences a mental illness and a substance use disorder simultaneously. Therefore, “dual diagnosis” itself is not a diagnosis, but rather a specific combination of diagnoses.
But this seems like a rarity, right? What are the odds a person would experience both a substance use disorder and a mental illness?
Well, of the 21 million people in the U.S. with a substance use disorder, 8 million also live with a mental illness. In other words, it’s not an exception—it’s much more common than you may think. Laura Greenstein writing for NAMI (National Alliance on Mental Illness)
Common mental disorders that co-occur with substance use disorders include:
- Bipolar Disorder
- Generalized Anxiety Disorder
- Panic Disorder
- Obsessive-Compulsive Disorder
- Attention Deficit Hyperactivity Disorder
- Post-Traumatic Stress Disorder
- Eating Disorders
I have had a 43+ (1976) year recovery journey with dual diagnosis. I am not a medical authority and I always advise anyone to see professionals. This is what I know-
- If you have had sadness, emptiness, loss of hope for two weeks or more, you have depression.
- Go immediately to a psychiatrist. This is the doctor who can prescribe medications. Psychologists or social workers can not prescribe medication. Be patient with the process. It takes 4-6 weeks to see the results from any medication. You may have to try several to find the ideal one for you.
- After your medication has proven effective or after you have begun medication, you may choose to begin talk therapy.
- Find a support network of 3-5 people who support your decision to get well which includes taking medications. Addiction can be helped by the 12 steps. Other mental problems usually need medication. These are two separate conditions.
“When you come out of the grips of a depression there is an incredible relief, but not one you feel allowed to celebrate. Instead, the feeling of victory is replaced with anxiety that it will happen again, and with shame and vulnerability when you see how your illness affected your family, your work, everything left untouched while you struggled to survive. We come back to life thinner, paler, weaker … but as survivors. Survivors who don’t get pats on the back from coworkers who congratulate them on making it. Survivors who wake to more work than before because their friends and family are exhausted from helping them fight a battle they may not even understand. I hope to someday see a sea of people all wearing silver ribbons as a sign that they understand the secret battle, and as a celebration of the victories made each day as we individually pull ourselves up out of our foxholes to see our scars heal, and to remember what the sun looks like.” Jenny Law