Alcoholism

Alcoholism and Mental Health

The blog posted earlier today is the seventh of nine installments of blogs on this Voiceamerica session found on mymindmyhealth.com.

Is There a Relationship Between Addiction and Mental Illness?

We work with people who either have a propensity to mental illness, which is triggered, or already have a mental illness, which is worsened, by drug use. With today’s drugs, we see such powerful changes of brain chemistry that mental illness results, even without other risk factors.  It’s discouraging in many respects, because, although we create better treatments for the mental illnesses themselves, people bring them on and make them treatment-resistant by substance abuse.

One of our colleagues in the Addiction world, Chana (pronounced “Hana,” like the road to Hana, Hawaii) Carro is a licensed independent Substance Abuse Counselor, with over 24 years’ experience.  She says, “This is an enormous tragedy.  We made a very large advance when we decided that we should treat mental illness and active addiction as co-occurring disorders, that we weren’t going to give preference to one over the other.” In reality, it’s very challenging to make the correct diagnoses because patients aren’t going to tell us about their addiction issues.

Chana described a recent case where information was sought about a patient admitted to the mental health hospital on a court-ordered evaluation.  Collateral information she received indicated that this person had a longstanding history of methamphetamine abuse, with no prior family history of mental illness, but with a very long, inter-generational history of drug and alcohol use.  When she spoke to the professional in charge of this patient about why the diagnosis of schizophrenia might not be accurate in the face of such active addiction, she was told, “Well, I just want you to know that four or five people have seen this person over the last 15 years and every single one of them has agreed that this is the diagnosis.”  As Chana says, “Well, you can call a giraffe an elephant for 15 years and get a whole lot of people to say that that’s what it is, but if a giraffe is a giraffe it’s not going to be an elephant, no matter how many people call it that!”  Some of the challenges of drug abuse are that it’s so prevalent;  it’s glamorized in social media;  and many people don’t see it as a reportable component of their medical complaints.  It’s difficult to treat if it’s not known.  There are ways to improve treatment outcomes when we do know.  We’ll discuss the involvement of a “Higher Power” next time.

Vernon and Louise Barksdale

The Diminishing Return of Addiction

IMG_1163What do addictions have in common?  The addict is always chasing the high. One of our colleagues in the Addiction world, Chana (pronounced “Hana,” like the road to Hana, Hawaii) Carro is a licensed independent Substance Abuse Counselor, with over 24 years’ experience.  She calls it “euphoric recall.”  A person has pain, distress or dis-ease.  He engages with a substance or a behavior.  That engagement produces a desired result, sometimes intentionally, sometimes quite unintentionally.  The result is perceived as desirable.  There’s an inclination to want to repeat it.  “It worked.  Great!  Let’s repeat it.”

As Chana explains, “The problem with addiction is diminishing return, so at the very beginning, it works.  You don’t feel so sexy on the dance floor.  You’re too scared to dance.  You take a hit of marijuana.  Take a drink.  Take some coke.  You’ll feel like the life of the party.  Over time, however, there’s a propensity for tolerance, and so the person needs more and more to get the same result.  What are people chasing when they come to us in desperation? They say, ‘It doesn’t even work anymore and I can’t stop.’  What are they really saying?   They are really saying not only have they physiologically engaged their body now so there are all those elements involved, but they can’t forget the beauty of that initial encounter.  They can’t forget that initial way in which their needs were met, that honeymoon, and they’re chasing it sometimes for years.”  We know from our experience in Addiction Medicine that they are chasing the wrong honeymoon.   They should have been getting it from their spiritual connection from the beginning.

The honeymoon with your higher power, when it’s a spiritual way, doesn’t have diminishing return.  It gets better, deeper, more enriching, and more satisfying over time.  An addictive substance can never continue to provide you with what you were looking for.  As Chana describes, “It’s like being really hungry and eating Styrofoam.  No matter how much Styrofoam you eat…”  The addict may think, “If I just drop enough acid…”  Of course, any effect dissipates over time and then they need MORE.  Next, we’ll share information on the relationship between addiction and mental illness.

Louise Barksdale

 

Why is Addiction so Prevalent?

 

We’ve been sharing thoughts on addiction in general and the relationship to spirituality or lack of spiritual connection.  It’s a very personal journey.  There could be a family of many children.  All are doing well except one, to the dismay of everyone in this otherwise stable religious milieu.   That one child is the quirky person who doesn’t “get it.”  He doesn’t get fulfillment through the religion, so develops an addiction.  Depending on how destructive the behavior becomes, it has an impact on the family at large.

Destructive behaviors may quickly develop and fill the void.  With our highly technical world, we’ve got a lot more things to fill that void. It gets more and more difficult for people to take that “journey without distance” internally, to find that inner sense of connection.

One of our colleagues in the Addiction world, Chana (pronounced “Hana,” like the road to Hana, Hawaii) Carro is a licensed independent Substance Abuse Counselor, with over 24 years’ experience.  She says, “In other times and in other lands, where people are much more involved on a daily basis with the procurement of food, clothing and shelter, they have less opportunity to be involved in these kinds of behaviors or to look for, or have less accessibility to, substances.  In our culture, we are adrift in a sea of leisure and we have much more opportunity.  We also have much less extended family involvement.  We have much less contact with our neighbors.  We have many, many more voids.”

She goes on to explain, “When a person is involved in the pursuit of addiction, their relationship to the substance or the behavior could be understood in some sense as an idolatrous involvement, meaning that you’re seeking from that substance or from that behavior something that it cannot provide.  Your soul cannot be nourished in the way that it needs to be.”  The use of any mood altering substance, beyond a certain level of use, acts like a toxin in the mind, disrupting connection or the ability to connect spiritually.

Chana makes a distinction between the excess of the permitted and entry into the forbidden.  In the early years of the 12 Step Programs, overeaters were described as among the “not so sick.” That would be a case of excessive reliance on the permitted.  There’s nothing unholy about eating in itself.  There’s nothing particularly destructive about it.  If you persist in overeating, however, you have very destructive consequences.  It is not qualitatively the same as entering the world of an altered brain in heroin, crack cocaine or methamphetamine abuse.  Why does it happen?

Louise Barksdale

Boredom is Bad for Addiction

As a Psychiatrist and Addictionist, Vernon spent many years working in the worlds of Medicine, Metaphysics and science and also in the worlds of emotions and Psychology.   In our last blog, we described an addict as someone trying to fill a hole in himself with something.  One of the things that are anathema to an addict is boredom.  It is torture to be bored.  In behavioral addictions, we see drug addiction, alcohol addiction, hypersexuality, things that are thrilling.  Addicts are seeking a thrill.  They’re trying to escape their own reality because it’s unsatisfactory or painful and it can be boring.  People are seeking, pleasure, relief, excitement.  Is it a spiritual deficit they are trying to fill?  Is it needing something to fill empty time?

 One of our colleagues in the Addiction world, Chana (pronounced “Hana,” like the road to Hana, Hawaii) Carro is a licensed independent Substance Abuse Counselor, with over 24 years’ experience.  She says, “if we are creatures who are a creation of God, a part of us remains always a part of God.  Until something enriching and satisfying spiritually fills that place, then I think you can substitute addictions.”  She feels that “when there is spiritual hunger for completion, for a spiritual relationship with the Creator of the universe, until that’s filled properly, people are going to try a whole variety of things to get those needs met.”

Is this a universal experience across cultures and belief systems?  Is there this internal yearning for some form of a right relationship with a “higher power,” as they say in Alcoholics Anonymous, however you define it?  Is that what people are looking for, regardless of the culture, or the part of the world that they are in?

Chana agrees that it is a human lack.  Whatever way our culture gives us an avenue for finding proper spiritual fulfillment, people yearn for that.  What about people who have been raised in very spiritually sound milieus, whether in an Eastern tradition or a Western tradition, and they still have that hunger?  What are we to make of that?  It isn’t enough to just have an external accessibility, an external means.  This is an internal affair.  This is a personal journey that they need to be on.  Next time, more on the universality of this spiritual need.

Louise Barksdale