Alcoholism and Mental Illness

Restless, irritable and discontent. Sound familiar? Do you have bipolar disorder and have those feelings on a regular basis? These feelings are common among those diagnosed with bipolar, however, they are common among alcoholics, as well. In fact, “restless, irritable and discontent” are specifically expressed in the Big Book of Alcoholics Anonymous. It is in the chapter “The Doctor’s Opinion.” Why do I bring this up? Because I believe there is a stronger bond between alcoholism and mental illness than many alcoholics will accept.
Alcoholism and mental illness

Dual diagnosis is the condition of living with a mental illness and a substance abuse problem. About a decade ago I was placed in a psych ward under suicide watch. Because I had only six months of sobriety, the doctors assigned me to the dual diagnosis floor. Most of the people there were still in the midst of their addiction, in addition to their psychological disorder. The interesting thing I found is that when the hospital admitted someone into the psych ward they were not asked “If” they have a drug and alcohol addiction, they were asked directly, what “Is” your addiction. Because the rate of those with a mental disorder and an addiction is so high they just assume you have a drug and alcohol problem.

Here’s a group of feelings which may sound familiar:

Prolonged sadness
Unrealistically high expectations
Overwhelmed by simple choices
Short temper

Of course, everyone experiences some, or all, of these feelings at some time in their life, however, you’ll hear those with bipolar, and those who are alcoholics, speak of living with these feelings all of the time. They may go away for a little while, but they always come back and sometimes with a vengeance.

I’ve attended thousands of A.A. meetings over the years and shared about all these feelings, and heard others share them as well. About five or so years ago I started attending Depression and Bipolar Disorder Support Alliance (DBSA) meetings. DBSA meetings are not 12 step meetings. They are peer led meetings where people just share what is going on with their lives and to receive support. What I noticed was, if I closed my eyes, the meetings sounded identical. The same fears, the same pain, the same emotions. People in the A.A. meetings were saying the same things as those in the DBSA meetings. Here’s more feelings you may connect with:

Low self-esteem
Behavioral problems, such as overspending or sexual promiscuity
Struggle to develop meaningful relationships with other people
Overly sensitive
Absenteeism and lack of performance on the job
Hard to think clearly or concentrate
Feeling intense guilt for minor mistakes

During the time that I was in the psych ward, my doctor pulled me aside to tell me that I’d likely be on medication for the rest of my life. He proceeded to tell me that I must continue with my A.A. meetings. “But” he said “all the 12 stepping in the world isn’t going to cure your depression.” That made sense to me, but it seems to elude the comprehension of many in A.A. I’ve seen people in A.A. who are discouraged from taking a doctors suggestion regarding medication. We have one very hardcore group in the L.A. area that stresses they don’t take anything that will affect them from the neck up. I find that funny since you see gallons of caffeine going down their throats and oceans of nicotine flowing through their lips, just like you’ll find at any other A.A. meeting.
To tell an A.A. member that is diagnosed with clinical depression, or bipolar disorder, that the problems they are dealing with are because they aren’t working a strong enough program is not only dangerous – it’s cruel. Sadly, it happens.

I love Alcoholics Anonymous. A.A. got me off of alcohol and saved my life. One of the ways it saved me is that it sobered me up enough to realize that something more is wrong with me. Through sober glasses I was able to seek medical aide and get the help I needed. What saddens me is that I’m not allowed to share it. Joe, over there, talks about the fact that his truck broke down and he didn’t drink over it. Sue, over there, talks about her mother’s death and that she didn’t drink over it. I, however, cannot talk about staying sober during an extreme manic period. I cannot openly feel thankful that I was depressed, yet took my meds, and I didn’t have to drink over it. What happens if I do that? I’ll be stopped and told we don’t discuss outside issues in meetings. Having a broken down truck is not an outside issue, but having bipolar disorder is.

I want to make it clear that I don’t believe that everyone with bipolar disorder is an alcoholic, any more than believing that every alcoholic has bipolar. I do believe it’s time for A.A. to grow up. The big Book of Alcoholics Anonymous was written in the late 1930’s and, amazingly enough, most of it rings true today, but, there’s been a lot of advancements in psychiatry over the last 80 years or so. It’s time for A.A. to catch up, accept that alcoholism and mental illness can be intertwined, and stop telling people to just work a better program.

10 comments on Alcoholism and Mental Illness

    1. Thank you, Lora. It’s a subject I’ve been wanting to write for a long time and finally got around to it.

  1. When I was in high school, I took the high part literally. I didn’t have much of an option — I worked full time, I went to school full time, and my family made it clear that I was ‘making up’ my health problems. Military? Can’t have a top secret clearance and a mental health disorder, so I was drinky drinky bird. I managed to sober up for the most part before even getting diagnosed, but. I can certainly understand why, ESPECIALLY in America, substance dependencies are comorbid. 🙁

    1. Sounds like we had a similar experiences drinking while in high school, Raeyn. I wasn’t in a military family, though. I just wanted my brain to shut up.

      1. Oh, I wasn’t in a military family — I WAS in the military. My parents forced me to go to college on my own dime because how dare them I cost them an SSD check (never mind me working full time meant that I covered my own ass financially). Considering I still don’t know what I want to study (and I refused to get into huge debt to ‘find myself’), I figured putting off growing up six years and letting Uncle Sam call the shots was the smart thing.

        1. Ah, I misunderstood. I turned 50 last year and I still do not know what I want to be when I grow up.

          1. I reckon… if there’s some sort of ‘true path’, it’ll make itself clear in time. For now, life is pretty good and that is okay by me. 😀

            1. That’s funny. I just finished writing Wednesdays post and that’s pretty much what it says.

  2. I don’t think I ever came right out and said in a meeting, “I have such and such diagnosis.” But I have said on several occasions, “I’m one of those people with ‘grave emotional and mental disorders.'” 🙂 I also stick with the people who are dual diagnosed because they get it/get me. We have a double whammy. Nothing like feeling like a unique alcoholic – oh Lordy!!!

    The hardest thing for me was not knowing whether my symptoms were due to me not working my program hard enough or due to needing a med adjustment. That used to frustrate me so badly. Overtime I have come to know the difference but it took several years of getting to know myself and my diseases better. Did you ever have this problem?

    1. “grave emotional and mental disorders.’” Oh, that’s so me too. I never outed myself either but I’ve seen it happen and the way the individuals were treated was not pretty. One eventually killed himself, though I can’t say the issues are related. When I had issues to deal with I usually leaned on the side of the meds. It seems to have worked out okay.

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