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

1 comment:

  1. Great Post Karl.There are many people diagnosed with bi polar who are dual diagnosed prescribed medications too much and use it along with,other opiate drugs as that is extremely dangerous.If you drink alcohol with your meds you can die.Life is so precious,but a lot of families and individuals have bi- polar like myself. You can do it, but it takes work with you.You cannot get out of it, wwithout your work, you need that first time, the hardest, you have to admit to yourself and others, you are a recovering addict.Accept you are an addict and get the help right away.