Sober… & Still Crazy

December 10th, 1985 marks the start point of my sobriety. I have been working in the field of addiction/psych for twenty plus years now.

Before going further I feel the need to state that ‘I do not believe a person has to be recovery (or recovered) in order to work effectively with those that have addiction and/or co-occurring disorders; such as depression, bipolar disorder, trauma, grief, abandonment, etc.’

I have several close friends that work in the field that do not have ‘addiction issues.’ What they do have is excellent clinical experience coupled to a sound academic background. Empathy, compassion, and the ability to listen are the qualities and hallmarks required of a good counselor.

When I first began in the field working shelters and open detox units, I was always fascinated by the patients that never seemed to sleep, those that never seemed able to get out of bed, and those that appeared to be carrying on conversations with people that were not there.

In later years I realized my fascination in part was more than likely due to my ‘other’ issue which came to a head ten years into my sobriety.

The other issue is being a person with Bipolar Type II Disorder. At the time my wife and I were going through couples counseling (thirty-two years married as of this month – guess counseling works, huh?) During the course of our sessions the therapist would continually have to ask me to not interrupt my wife when she was talking and then the therapist would have difficulty trying to get me to ‘come up for air’ once I started on a roll. After a few sessions like this, the therapist suggested that I see a psychiatrist she worked closely with.

Long story short, I was diagnosed with Bipolar II Type Disorder. For me, this was marked by minimal sleep, always having multiple projects going on (with few of them ever being completed), rapid, pressured, tangential speech, and a mercurial temperament. After weeks of running on minimal sleep my mood would become dark and foreboding. AA often refers to this state as a ‘dry drunk.’ I refer to it agitated depression.

When I was on the comedy scene people with my traits were viewed by many as ‘normal.’ People spoke of performers as often times having an “Artist’s Temperament.”

One of my favorite quotes is by Arthur Schopenhauer, “Every person takes the limits of their own field of vision for the limits of the world.”

In other words, if the people you are hanging with have similar traits then everyone is that way, right? In much the same way when I have a patient that says, “All my friends drink the way I do, so how can I be an alcoholic.” Birds of a feather…

For those of us that are “Dualies” (people with substance abuse & co-occurring disorders), there are support groups such as DBSA (Depression Bipolar Support Alliance) and DRA (Dual Recovery Anonymous - 12 Step based). In these groups people can identify with someone that not only used what they did, but also have their same co-occurring issue. (I will do a future blog on these two groups).

This is not to say that traditional 12 Step groups cannot form the foundation of a dual-diagnosed person’s recovery. Of course they can. One learns how to socialize again or for the first time without a drug or drink, and the common purpose is not to drug or drink.

Rarely however will the traditional meeting be enough for those of us with a co-occurring disorder(s) to maintain sobriety and balance. Just ask the people in the dual-diagnosis day treatment program I work in. They will tell you that they cannot discuss their other mental health issues without being ostracized by some members. So they have a meeting after the meeting to discuss those ‘other’ issues with people they know to be of the same bent.

I intentionally have not gone into detail regarding medications or practices I employ to maintain stability for a simple reason. What works for me may not for someone else. Therefore I do not want to set-up an expectation. A person with substance abuse and a co-occurring disorder should have his or her plan of action based on their specific issues and nuances; an individualized treatment plan in other words.