Tuesday, October 25, 2016

The Pain (and Pleasure) of Addiction and Mental Illness

As human beings, we typically seek out pleasurable experiences as opposed to painful ones. But when it comes to those living with addiction and mental illness the pursuit of pleasure can often end up with the person being in pain.

There’s an old saying that says, “No one ever asked to be born as an addict.” And I echo that sentiment. For those of us who have been afflicted with this brain disorder (and yes, I believe it is a brain disorder) it has helped to keep people enslaved to behaviors that are difficult to overcome. Drugs, food, sex, gambling, shopping, and even internet/social media use can all be a harbinger of fractured relationships, lost jobs, and even death.

Sure, when I took that first drink and drug it was fun and felt good. But this quickly changed and I found myself caught up in the obsessive and compulsive disease known as addiction.

Many people live with a dual diagnosis of mental and addiction disorders (7.9 million adults in a 2014 National Survey on Drug Use and Health (NSDUH). These co-occurring conditions are often more difficult to manage than they are alone. I happen to be one of these people having lived with Bipolar Disorder and a co-occurring substance use disorder.

For those who struggle with addiction daily, it can be extremely painful – mentally, emotionally, physically, spiritually, socially, and even occupationally and financially. Basically, addiction affects one’s sense of wellness (or lack of).

In my case, my addiction not only affected my mental health but I also experienced problems with my relationships with family. It also affected my behavior. I lied, stole, and cheated to obtain my drug of choice. I am not proud of this but this is what using led to harmful behavior.

As both a Credentialed Alcoholism and Substance Abuse Counselor (CASAC) for over 12 years, and also being in long-term recovery, I have met literally hundreds of individuals who have (and are still living) with the horrors of addiction.

There’s another adage that says that your worst day clean is better than your best day using. This may seem to be an abstract concept to some however I have to agree. I vividly remember this one so-called good moment. It was a sunny and cool October day. I had scored some of my favorite substance for myself and some friends and we proceeded to get high. I even bought an album later that day (OMD’s “Crush). But despite all of this I was still dealing with the effects of my addiction. My mental health was comprised and I subsequently ended up in one of the area hospital mental health units.

And then there’s the worst day clean. I’ve told this story many times. I was seven years clean and my wife was pregnant with our first daughter. As a result of a medication change I found myself in a full-blown manic episode that resulted in a 3-month leave from work (as a Counselor at Buffalo General Hospital) and a crippling depressive episode that took every bit of resolve for me to recover from.

But it was also during this time that I truly felt the love and support of my family and friends. My friend Mark took me to recovery meetings and allowed me to simply hang out with him. The love I received through the actions of those around me was the evidence of God working in my life. For every person who helped me during this time I felt God’s love. So yes, it was an incredibly hard experience to live through but I wouldn’t change any of it. It was through this good fortune that I was able to learn how to better take care of myself. This was in the spring of `1995 and I have not had a manic episode since.

And what about the pleasure of addiction and mental illness? You’re probably saying, “What’s so fun about that?” Well, I believe we can “flip the script” and use our mental health and addiction disorders and enjoy life. Now before you think that I’m being Pollyanna, I must first say that recovery is a process and isn’t the same for everyone. It’s also hard work. But once one is able to gain some traction and make even small progress then it’s possible to enjoy what life has to offer.

Despite the fact that I still consider myself as someone who lives with a mental health and co-occurring addiction disorder, I have had a multitude of pleasurable experiences. Sharing time with my friends and loved ones, running and cycling, enjoying the beauty of music – both recorded and live, and traveling to places that I once never could have imagined I’d to are all things that help to make life a little bit better.

The key for me has been to, despite how difficult things could have been, was to keep moving forward, sometimes an inch at a time. As long as I kept moving then there was hope.

Today I embrace both the pain and pleasure life brings. Yes, living with a mental and addiction disorder have often magnified these things but they simply make life that much more worthwhile. If we had no pain we could not experience pleasure.

Be well!

Tuesday, October 18, 2016

Mental Illness, Addiction, and the Stages of Change

When it comes to living with certain mental health conditions, such as anxiety, depression, or bipolar disorder, for instance, some people struggle with the idea of accepting the fact that they live with what can often be a tremendously debilitating and even life threatening illness. The same can be said for addiction.

This can be especially true for those who are newly diagnosed. The idea of living one’s life like this can be devastating. When I had my first episode I had no understanding of mental illness nor did I understand the link between my bipolar and my addiction. I just knew that I didn’t want to continue to live this way.

 But it was hard to come to terms with the fact that I had a condition that was potentially lifelong. Despite being in therapy I still struggled to understand the consequences associated with drug use and mental illness.

 Eventually, however, I did go through a process to learn that I was doing myself considerable harm by continuing to use and not adhere to my treatment plan. This process is analogous to the treatment method called, “MotivationalInterviewing.” MI was developed by Professor William R Miller, Ph.D. and Professor Stephen Rollnick, Ph.D. in 1983. In this type of therapy, the individual, with the assistance of a therapist, is able to be guided to make specific changes in behavior to achieve a desired goal. The key is that the individual is in the driver’s seat.

 In my case, I had experienced many substance use and mental health relapses. It came down to the fact that I was sincerely afraid that my life could become a series of psychiatric institutionalizations; a life that I never wanted. So the first thing I had to do was to move out of what is called the “pre-contemplation” stage. This is where I had to change my mind-set and get out of the denial belief system that I was stuck in.

If you’ve read my earlier post, How Did I Get Here?, you’ll know that the pivotal moment was when I met with my therapist and was delivered an ultimatum to either go to rehab, go to a recovery meeting, or end up back in the hospital. When faced with the prospect of another hospitalization or telling my boss I had a drug problem I was able to move through the next stage of change, “contemplation,” and weigh the pros and cons of my choices.

 From there I transitioned into the “preparation” stage where I mentally “psyched myself up to go to the meeting. This was an important step because this is where I had come to the realization that I needed to do something.

 This then led to the “action” stage where I actively began to attend recovery meetings and at the same time started to become medication compliant which resulted in my condition stabilizing. In the action stage, one establishes a routine of lifestyle behaviors that are healthy and productive. Essentially this is where the proverbial rubber hits the road. For me this meant making new friends who were supportive of my recovery and staying away from the “people, places, and things” associated with my former drug use.

 In the Stages of Change model, once a person establishes a pattern of sustained behavior change for anywhere between 6-9 months, the individual enters into the “maintenance” stage. It’s during this time that the changes made in the action stage are continued and the recovery process is solidified. When I entered this period I was regularly attending meetings and was actively participating in service-based opportunities and group activities. My drug addiction was arrested.

 I did experience another stage, “relapse,” when I had over one year clean. I did not use however I did have another manic episode which resulted in a brief stay in the hospital. Fortunately I had a great deal of support from my friends in recovery and was able to get back on my feet. I re-established my routine and resumed my journey on the path to wellness.

 Motivational Interviewing has helped literally millions of people since its birth over 30 years ago. But one doesn’t necessarily have to be in formal treatment to utilize the Stages of Change. In the end it is about coming to terms with one’s life and to learn how to develop the behaviors to help oneself recover in a way that serves to create a new beginning.

photo credit - Ian Cleary

Tuesday, October 11, 2016

The Importance of Family Support in Mental Health and Addiction Recovery

If you read my recent blog post, Song for My Father, then you will have an idea of how beneficial it was for me to have his support when I was in the throes of my active Bipolar Disorder condition. I consider myself very fortunate to have someone who was so willing to help me when I was unable to help myself. My mother was supportive in her own way. She was the textbook example of “tough love.” She didn’t stand for any crap,

But as I said, I was fortunate. Some families experience a great deal of dysfunction due to their loved one’s mental illness and/or addiction. It’s been known to tear some families apart. Sometimes the affected person’s actions are so unpredictable, and even at times dangerous, that family members have no choice but to set strong boundaries about what is expected from the person.

 In both my professional career and personal interactions with people who are successful in their recovery, one thing is clear. The more supportive the family the better. This is not to say that things are always as smooth a glass; in fact this often is not the case. However, in the long run, if family members are accepting and willing to help then there may be a better outcome.

 One of the keys to family understanding and support is education. Psychoeducation can be extremely valuable when it comes to learning why the family’s loved one is undergoing such a difficult experience. There are any number of programs and supports for families. My primary go to is NAMI (National Alliance on MentalI Illness). NAMI is one of the United States oldest grass roots advocacy organizations. Comprised primarily of families of those living with mental health disorders as well as peers, NAMI provides many services including an educational program (Family-to-Family and In Our Own Voice), support groups, as well as a number of online resources and programs such as NAMI Faithnet and NAMI on Campus  NAMI’s online information is all supported by research and vetted by mental health professionals. There is a TON of information that can be of use to anyone who may want a good introduction to mental health.

 Another great resource is Mental Health America, another U.S.-based advocacy organization. The MHA has information on local affiliates that have a variety of support groups, including those for families. There’s also a resource page that provides information on a variety of mental health supports.

 Over the years I’ve had conversations with family members of a person struggling with a mental health disorder or addiction that are at their wits end about what to do to help their loved one. And to be truthful, there have been times when the best I could do was to listen. Sometimes just having a place to vent without being judged can be helpful. So often families too suffer in silence. The stigma associated with mental illness and addiction can be crushing to the point where the fear of disclosure suppresses any desire to seek help. But this cannot be a barrier to seeking help. For instance, joining a support group can go a long way to help ease the burden of caring for someone who is struggling by hearing from others who have had similar experiences.

 In the end, my personal belief is that we must exhaust all possible resources before we decide to withdraw care from our loved one. You just never know when s/he may turn the corner, whether it be by finding the proper combination of medications or is connected with an effective therapist. Also, for young people, sometimes it is a matter of maturity and acceptance of their condition to help with the realization that there is hope.

This was certainly the case for me.

So if your loved one is struggling, remember that no one asks to be born with a mental health challenge or addiction disorder. For the vast majority, they want relief from their condition just as much as you do.

Tuesday, October 4, 2016

Mental Health and the Intersection Between Faith and Science

Since the days of Sigmund Freud, one of the predecessors of modern-day psychotherapy, the world of mental health has had a variety of approaches to treatment and recovery. In some faith traditions mental illness has been seen as a curse. People who are afflicted have been tortured and stigmatized. Folks have often been told to pray on it and that this action is the only way to being delivered from one’s affliction.

The same could be said for individuals who have been treated through a medical-based approach. While many people have been aided by modern day medications and psychotherapy, others still suffer, often in silence.

So what is the answer? Well, that’s the $64,000 question. If it were so simple to address mental health challenges and successfully treat people, then the world would be a much better place.

As for myself, I am a seeker. In my lifetime I’ve tried to connect with the God of my understanding in a variety of ways. Prayer, meditation (which I truthfully struggle with, church-related practices and 12-Step recovery have all been ways I’ve tried to establish a relationship that is so often elusive. BUT…I still try.

It’s been my experience that there a variety of factors that have contributed to my mental and emotional stability. I try to practice spiritual wellness through the aforementioned methods. I continue to read and do research on mental health. I exercise, get proper sleep and do my best to eat properly. I have developed healthy relationships and pursued a career path that I find fulfilling. My home environment is stable and safe and my finances are fortunately in check.

But for me it’s the spirit that was the Genesis of my well-being. When I was in the “wilderness” years of my young adult life, I yearned to have a life that was “normal” (which I now know is a misnomer). So what did I do? I prayed and hoped that one day things would get better.

When I made the decision to stop using I took the steps to become affiliated with a Pilgrim-St. Luke's United Church of Christ (now Pilgrim-St. Luke's and El Nuevo Camino UCC). I chose my church primarily because of the minister, a pastor who had confirmed me when I was 14. I became a member on Pentecost, and ironically, this was my pastor’s last day serving this community of faith as he was relocating to Florida to lead a congregation there.

But I decided to stay. At first my attendance was somewhat spotty, however my 12-Step recovery home group began to meet there so I was the liaison between the group and the church.

This was the first time I learned the lesson about how faith communities can partner with groups that promote recovery in any number of ways. So the church became a larger part of my spiritual practice. In the years since (I joined in 1988) I have been able to serve in a variety of capacities: Moderator (President of the congregation), Deacon, Sunday School teacher, Youth Advisor, Usher Coordinator, and most recently Trustee.

This level of service has provided me with many valuable life lessons.

So what does all this have to do with mental health? Well, to begin, it is through service to others that I have been given the opportunity to be in community with a group of people who have been supportive of me. Also, by learning about the teachings of my religious practice, I have come to realize that there is strength in acknowledging that I need help to get through many of life’s ups and downs. This is also true for my 12-Step program. The fellowship and love that I have experienced through both of these venues has been a source of strength and comfort.

Another way that I’ve been able to “give back” is through my participation on the United Church of Christ Mental Health Network Board of Directors. This national group of clergy and lay leaders is forging new ground within the UCC to create a safe space for those living with mental health challenges within our church communities.

One way that we have initiated this is through the WISE Covenant. WISE stands for: Welcoming, Inclusive, Supportive, and Engaged. This effort was officially sanctioned by the UCC at its General Synod meeting in 2015. Essentially, the WISE Covenant is a structured program to help churches be more welcoming and accepting of those individuals who may live with mental illness. Currently we are in the process of planning two WISE trainings for congregations in Nebraska and Florida. This exciting work has the potential of transforming churches in a remarkable way.

Last week we had our annual “face-to-face” board meeting where the WISE Covenant was a central part of the agenda. The following day there was a one-day conference sponsored by the Interfaith Network and Pathwaysto Promise. This event featured a number of presenters who spoke on a variety of topics, including cultural competence with Mental Health First Aid, WRAP (Wellness Recovery Action Plan), and one on the concept of the importance of companionship, to name but a few.

This program focused on how spirituality and science are not mutually exclusive and that the two approaches can work together to help people learn how to live healthy lives.

What I’ve come to realize is that my Higher Power works through people. And it is through this manifestation that healing occurs. Over the last 28 years of recovery from addiction I have been blessed to have wonderful support from friends and family. But I also had to learn to ask for help. As the old saying goes, “A closed mouth doesn’t get fed.”
There are a number of resources such as NAMI Faithnet that can serve as a guide to utilizing one's faith to support recovery.

I believe that by using all the tools that I’ve had available, whether it be psychotherapy, medication, faith, social connections and other wellness practices, it’s been possible for me to achieve a life that can be better than the one that I had before. But then again, it is a journey after all.
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