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Since today is not only St. Patrick’s Day, the biggest drinking day of the year, but also my 21st anniversary of sobriety, I wanted to talk to Patrick about dual diagnosis, since he is also a recovering alcoholic.
I asked him this:
I’m intrigued by your recovery from addiction and how that colors your perception of mental illness. Awhile back I interviewed Dr. Ken Duckworth, medical director of NAMI. He helped me tremendously understand the culture clash between recovery from alcoholism, the AA way, and recovery from a mental illness. Said Duckworth: “In the substance abuse culture, the person is generally viewed as the agent of the problem, and they are held accountable and have consequences for their relapses. In the mental illness culture, the person is often viewed not as the agent of the problem, but as the victim of their illness. We tend to hold people a little less accountable for bio-chemical processes.” As you did your research, did you run up against that clash yourself?
Patrick replied:
Yes, the idea was that we alkies sort of brought this on, whereas schizophrenics had it done to them. I think this question opens up a big philosophical debate that depends on one’s point of view. I tend to come down on the side that says while no one is to blame, ultimately we are responsible for our own recovery.
My family is a portrait in dual diagnosis. We are a study in the intersection between recovery from the experience of hearing schizophrenia’s voices and recovery from the experience of hearing alcoholism’s voices. I began to wake up to my alcoholism in my mid-twenties, a good five years after my sisters tumbled into what is considered the most severe form of mental illness. So my frame of reference for “insanity” was a bit skewed from what most people have in mind when they see the second of the twelve steps up there on the wall for the first time. The suggestion that there was something that could “restore us to sanity” really troubled me because it implied that I had “schizophrenia.”
I got an immediate resentment because, as I looked around the room, I did not see what I’d seen on the psych wards. I saw no one talking to invisible friends. I saw no one twitching and drooling from the side effects of meds. So in my mind, I saw no insanity and felt the second step mocked my sisters by not taking them seriously. This resentment kept me out on the lash for another twenty years, basically.
Meanwhile, the booze made me forget about my problems in a way no therapist could. And then it stopped working, my medicine turning on me. The mounting paranoia, and the anxiety was making me snap, the cocaine induced psychosis, seeing imaginary cops in trees, on my knees literally staring through keyholes looking for cops. Mad stuff that shot me to the moon and left me there.
So when I finally made it back in, I believed I was myself insane. I no longer had issues with the verbiage.
I could finally see that the very issue that fueled my drinking problem–my resentment at losing my two sisters to schizophrenia–was the very thing that was pushing me off the edge of sanity myself. When I saw that, I came to a screeching halt.
“Stalking Irish Madness” only breezes over those years because I felt it was off-topic from schizophrenia and did not want to make this book all about me. That said, I did learn a big lesson that helps me each day. And that is the notion that mental illness may differ for each of us, but mental wellness is largely the same. However we get there–and yes, we are all heading back to the shore from different points at sea–is ultimately a matter of how we swim with these voices in our heads. Whether they are the voices that tell the “alcoholic” to have a drink, or the voices that tell the “schizophrenic” to take his own life, we all have voices.
Your average, ordinary, bog-standard alkie like myself hears the first-person voices of the superego that we all hear. My sisters hear these voices, but they also hear third-person voices. They hear full conversations and this puts their experience outside the medical model. If we are honest, then it’s clear that even the most well screwed on among us struggles with voices of one kind or another–voices of self doubt or regret or guilt or despair or envy or anger or the thousand forms of fear that comprise the human condition.
The important thing is that we are able to acknowledge the power of the voices in our heads, and that we feel free to talk about the voices in our heads. We need to share with each what the voices are telling us if we are serious about mental well being. We need to manage our voices so that they don’t manage us.
It’s the wisdom of the ages–a problem shared is a problem halved. Or as Jesus said, whenever two are gathered in my name. We need each other, obviously. Stars are born of other stars.
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Therese Borchard is the author of Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes and The Pocket Therapist: An Emotional Survival Kit. Subscribe to Beyond Blue, visit her website, or follow her on Twitter @thereseborchard.
Meet others on the journey in
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Therese Borchard is the author of Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes and The Pocket Therapist: An Emotional Survival Kit. Subscribe to Beyond Blue, visit her website, or follow her on Twitter @thereseborchard.
posted March 18, 2009 at 11:09 am
Congratulations Therese from a fellow Class of 89! Isn’t it weird to be a young oldtimer?
I love this interview with Patrick Tracey – I too struggled with the idea of being restored to sanity when I reached the 12-step halls, not because I had a sister with schizophrenia but because of my own parallel battle with psychotic depression. The idea that we could simply ask God to restore us to sanity implied to me that if I remained mentally ill (which I did) it was because either I wasn’t working the steps the right way or God didn’t see fit to intervene in my life. It took a lot of talks with a sponsor for me to realize that I could be freed of the portion of my insanity that was linked to alcoholism, but that I needed professional help as well for my depression.
posted March 18, 2009 at 12:04 pm
but also my 20th anniversary of sobriety (yah!! Except for the one-night relapse in college but I don’t count that)
?????????????? – day one from the one night relapse in college
posted March 18, 2009 at 12:42 pm
i lisa michelle johnson is suffering with depression and diagnoise as bipolor ive been strugging with depreeion for a long time i just didnt know quite what it was ive had in side treatment and out it some what help i curently takeing medication it seems to work but ive also tried to self medicate but it didnt work. so my only option are to take the medicate like i said it seems to have worked for me.but istill have my days but not as bad as if i got of the medication so the the store that was told i can some what relate to it ive been there befor where the medicateturned back some times you have to try t different medication befor you get the exact one thats rigt for you. igot my frist diagoise at the age of 36 years of age and i here i am 38 years. so all of the storys i can relate and was happy that she shared them .thank you
posted March 18, 2009 at 1:51 pm
I know this sounds like “easier said than done” but I am 60 years old and at least 40 was spent in and out of alcoholism and drug addiction. I been through it all the AA, the rehab, nothing really worked until I made the right decisions. Yes, God has alot to do with it. When you let him live inside of you, thats when you know you are on the right path. It didn’t happen right away there were many relapses, but every day is one day at a time. Just knowing there is someone on your side that wants you to succeed keeps you alive. When you see other people die by using drugs and drinking themselves to death, it should start to make you think of why we are here in the first place. We are here for others not for ourself. It’s not about you or me. There is a blessed life, please trust God. Don’t let the father of this world (Devil) lie to you and make you believe you can’t have a great life. He (Devil) is here to “steal,kill, and destroy you.” john 10:10 Before long those demons will quit chasing you.
posted March 18, 2009 at 4:23 pm
AA DOES WORK,IF YOU LET IT,I ALWAYS BELEIVED IN GOD.THE GOD OF THE CATHOLIC CHURCH,AA INTRODUCED ME TO GOD ‘of my own understanding” A GOD THAT IS MY DAILY FRIEND AND COMPANION,THAT WAS IN 1977,AM 81 NOW,STILL A PRACTICING CATHOLIC,BUT YEAH,WHAT AN AWSOME GOD I HAVE,HAVE WORKED WITH MENTALLY ILL FOLKS FOR YEARS,SOME CAN BE HELPED BY MEDICATION,SOME COUNCELING,OTHERS JUST HAVE TO LOVE AND PRAY OR THEM
posted March 21, 2009 at 3:01 am
I, too, hear voices and have for years. My voices are cops – real cop voices from the 911 center and the Sheriff’s department here in Chattanooga, Tennessee. I recognized their voices during psychosis. (Long story) I can totally relate to looking for the cops. And I can relate to that Schizophrenia is MADE.
You have to voice your opinion and deal with the stress. Medicine does not always work with everyone. I have been on medication, twice, now. The first time because I was scared and the 2nd time because I was soooooooooo angry at the cops. I was on medication the first time from 1997 to 1999. I went back on medication in 2005 to 2007.
You have to look back at your life and see what happened, how you felt, how they made you feel and compare it to how you feel today. I have looked back at some really scary traumas and try to turn them into something that I can deal with, whether find something funny that I could have said or done, or something like that. You have to to deal with it. You say, laugh at a trauma? It depends on the trauma and I am only talking about MY traumas. Somethings you can not laugh at like death, etc. and threatened death, in my case, was not funny then, but, now I can look at the situation for what it really was. Something somebody says because they want to coerse you into doing something. Long story and that is why people don’t understand unless it has happened to them. We all are different and we deal with things differently.
Some things still trigger me, but, mostly now I am upset that people do not understand and sometimes I think that they don’t want to understand what us “mental” people have to deal with.
So tell your story over and over and over and to anyone that will listen. It will not only help you, but, it will help people to understand, too.
Sharon Anne Goodner
posted April 9, 2009 at 3:53 pm
I am a 36 year old woman who can relate to this story. I was diagnosed with depression & panic disorder six years ago and I am an alcoholic. In September of 2008 I voluntarily admitted myself into a residential rehab facility because the self medicating had gotten out of control. I tried to manage too much for way too long and I ended up trying to take my own life. I’d like to say that from the moment I woke up in the hospital everything was different but that’s not the truth. It took alot of work, prayer, perserverence, and faith. My life has completely turned around. I rely on God today. We work as a team and because of that I have hope today. The voices that I hear are different now. I was on the bus awhile back and I was getting frustrated with not having a car and I prayed. Moments later the bus driver stop for a man in a wheel chair and the voices in my head said, “Continue to be humble and walk or take the bus… because you can.” And “Be grateful for what you have” Since then, I have been bleesed with a car and much more. I love God and AA and mostly the fact that “I never have to go through anything alone ever again”
posted May 21, 2009 at 1:42 pm
there is a definate link between alcohol and depression/anxiety – I can relate to the woman above re self-medicating. Everyone in my family drinks to excess. I did not drink for most of my adult life. I was diagnosed when I was 50 with anxiety disorder/panic attacks and depression. I did not think I was depressed……….good job, great kids, good husband…but I did have anxiety and panic attacks.
Shortly after starting the meds (less than a year) I left my husband, moved to another state, took a drastic cut in pay and had less time with my children. We made it through (without alcohol) until 2 years ago. I suddenly started craving cigarettes and dry wine. I told my doctor and he said this was a sign of dopamine deficiency from all the seratonin reuptake antidepressants I had taken. I tried to get off the meds with no success. I keep drinking to excess and I have gone to one chapter of AA which I did not care for at all….maybe just need to find a separate group, I have felt suicidal, been in 3 day dry-out and then dry on my own for 10 days but started drinking again first sign of conflict……I think this blog is great because in reading the personal info shared in the privacy of my computer it helpd me see there are others like me out there. Have a wonderful day to everyone who reads this.
posted December 27, 2009 at 12:33 am
First people come to us and we work on phsyical sobriety – then mental
sobriety then spritual sobriety, getting the proper medication for many is essential. http://www.soberliving.com
posted March 18, 2010 at 11:30 pm
Thanks for the input. My son was diagnosed schizoaffective and abuses drugs. Drug of choice is cocaine. We have struggled with the “what do we do now? question for years. My husband is ready to give up, but I can’t seem to make myself kick out my son. I guess I’m probably the textbook definition of an enabler. But how do you play the “tough love” card when your child has a mental illness? It’s been hard to find a place that treats dual diagnosis where we live. They say they do but turns out it’s a 12 step program that employ’s a psychiatrist that sees the patient once a week for 15 minutes and meets with the family to discuss options. NOT what I’m looking for, my son needs extended care and a group of therapists to work on social skills, daily living skills, hygeine skills, finance skills ….. etc. etc. etc. My husband and I won’t be here forever and I don’t want him to end up in a home where all they do is over medicate to keep him quiet. I sound desperate, but if you don’t have a fist full of money, are you supposed to continue to watch your child spiral out of control over and over again until eventually he’s either in jail or dead? Okay, maybe I am desperate.
posted March 20, 2010 at 3:38 pm
Dee Dee: We have a son with same diagnosis. He will be 21 soon. We struggled with putting him out on the street but did not because of his mental illness. However, I think we would have eventually if he didn’t turn his life around. I actually started ministering to the homeless with a local church to get a glimpse of what it’s like to be homeless. I credit his “recovery” to Prayer and Meds…plus Nagging…do not underestimate the power of nagging…keep it simple and repeat it as often as neccessary. His meds are an antidepressant and abilify…medium low dose. His prayers are varied but he really likes a certain short St. Jude novena. And my nagging mantra was you can hang out with straight people…go to NA. He went on Sept 27 and has been clean ever since. I basically forced him. I was firm, but not angry. It worked.
I actually filmed him on my cell phone at his worst so he could see it and I reminded him while filming him that he could go to NA…take his meds…and pray. He is now a full time student at a community college making straight A’s so far. If someone would have told us last year at this time that our son would be able to go to college and be full time and get A’s we would have smiled politely and said thanks but he hasn’t been able to concentrate for about 5 years. We are paying for a service called, AHEADD, to help him stay on task and to help him advocate for any special services community college can provide for his disability. AHEADD is nationwide, but only in select cities. We live in Pittsburgh. OVR paid for some of the AHEADD program. God Bless you and your son. I am praying for you to believe in yourself and the choices you are making for your son.
posted March 28, 2010 at 1:03 am
I have finally come across the term ‘dual diagnosis’. I just thought my 21 year old son was a drug addict and despite several attempts to stop using heroin he just couldn’t stay clean. He is a straight A student in a very prestigious ivy league business school, yet over the last three years he has had to take a ‘medical’ leave of abscence because he could not finish the semester. Needless to say, we lost the tuition for these unfinished semesters. Every summer he would go to an out patient rehab program. Just two weeks ago he tried to commit suicide for the second time by an overdose of heroin. When that didn’t work he cut himself. Still, his body refused to die. Finally out of frustration he called the paramedics and was rushed to the hospital. It took 110 sutures to close the wounds. He has been to psychiatrists for years and tried all sorts of heavy duty meds. He has been diagnosed as bi-polar while others have diagnosed him as severly depressed. Antidepressants don’t seem to work and the antipsychotic drugs make him feel like he can’t think well. I now believe he has a mental illness that has led him to the drugs and the illness and the drugs feed on each other. He cannot stay in Philadelphia where he goes to school and he will have to come out to Los Angeles to get the help he needs. I am desperate to find out how or where he can go for help. Are there places that address both issues at the same time? I realize I am powerless to make these life choices for him. He has no place to live in LA. His mother won’t take him and I live with my 85 year old father and take care of him so there is no place he can stay. I have been advised that he should enter a 90 day residential facility that address both problems. Money is tight, although I do have medical insurance. He wants help but we just do not know where to turn
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