Challenges Behind Dual Diagnosis

Dual DiagnosisOne of the challenges of a dual diagnosis is how to handle psychiatric medications. Members of recovery programs like AA and NA emphasize the need to stop using mind-altering chemicals, but we hear from psychiatrists or other professionals that because of our other issues we must take mind- and mood-altering medications to function, temporarily or for the rest of our lives.

What to do, since a relapse into either addiction or mental illness will have devastating results?  And when we realize that although it’s called dual diagnosis, our situations may involve three or more problems, for example alcoholism plus bipolar disorder plus an anxiety disorder, it can seem truly impossible.

When the subject of dual diagnosis comes up in 12 Step meetings, people express views that tend to be both varied and emphatic. We may feel pressured to take our guidance from whoever seems most sure of his or her opinion, especially an old-timer with many years of sobriety – but it’s better to look to the program’s literature. Some AA members have always faced this question, so Alcoholics Anonymous World Services published a pamphlet in 1984 titled “The AA Member – Medications & Other Drugs”, for alcoholics facing dual diagnosis situations.  It says that if (1) we are seeing a psychiatrist or other doctor who knows our alcoholic/addictive history, (2) that doctor has experience working with alcoholics and addicts, (3) we take our medications exactly as prescribed, and (4) we immediately report any side effects to the doctor, then we are doing the right thing, and taking the meds may be necessary to stay sober. As for people in meetings, consider this: telling people what to do with their meds amounts to prescribing – any group member doing this is playing doctor, practicing medicine without a license.

The difficulty of getting clean and sober and getting mental illness under control in the first place makes it more important for anyone facing a dual diagnosis than just about anyone else to have the help of a balanced treatment team such as we offer at Life Works, addressing the needs of the whole person.

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