If you have not been personally impacted by substance abuse or alcoholism, then my guess is you know someone who has. It becomes even more challenging if a dual diagnosis (substance abuse and mental illness) is involved. You want to help the person yet may be more likely to enable their behavior because their mental health is not good.

You can see how it destroys families. It can wreak even more havoc as people have different ideas on how to help the user, or set firmer boundaries. Over time, you may even have to cut this person out of your life unless they get clean or sober.

With a dual diagnosis some people choose to self-medicate their disorder because they don’t like what the doctor had prescribed. I had one client who was diagnosed with schizophrenia tell me that cocaine got rid of the voices in his head better than anything that was prescribed.

On the flip side, the abuse of drugs or alcohol can lead to anxiety, depression or other mental health issues. It’s a chicken and egg kind of thing. Clearly we want to get these clients treatment for their mental illness so we can help them refrain from using harmful substances.

Another interesting factor is that two people can drink the same amount. One may become an alcoholic because of a genetic predisposition. The other may have no negative impact from their drinking. Some people may become addicted to a drug the first time they use. Others may need to use for a longer period of time before that occurs.

Risk factors for dual diagnosis

There are several things that make a person more likely to become addicted. The first thing is a genetic predisposition. If you grew up in an alcoholic home or drugs were are around, you are also at greater risk. Another factor is growing up in a chaotic home. If your parents are not around or if you don’t have good coping skills you may also be more vulnerable.

Just because these risk factors are there, does not mean the person will abuse substances.

How the person with a dual diagnosis thinks

Denial

Denial is the biggest barrier to treatment. Often times the person thinks they don’t have a problem. All their friends’ use/drink too, thus it is seen as normal. Yet they don’t consider that they have surrounded themselves with these people so they can continue to use and think that nothing is wrong with them. I’ve had clients say, they don’t have a problem. If their partner would stop bothering them about it or bringing it up, there wouldn’t be a problem.

Skewed perception

Even though it may be obvious to everyone else around the substance user there is a problem. They think they are being picked on or start to see themselves as victims. This may make them drink/use even more. No one understands them. They continue to get angry and justify their actions.

They want instant relief

When things get tough, they become impatient. They want their drug of choice so they don’t have to deal with is going on in the current moment. The feelings they are having are too much and they know as soon as they get their substance, that the uncomfortable feelings will go away immediately. Unfortunately once they stop, the feelings are right there waiting for them.

They become selfish

The addict becomes more self-centered and entitled. They believe they should get what they want, when they want it. If you stand in their way, then you are the problem. They don’t care who is impacted, or what events or obligations they miss in order to get their substance.

Manipulation

These people are master manipulators. They know exactly what you want to hear in order to get what they want. If you have dealt with an addict, you know they will promise to stop using. They tell you it will never happen again. Things might be OK for awhile, but then they go back to the way it has always been.

The addict may ask for money for food, gas or housing. Yet you find that it has been used to support their habit. I’ve heard that if you are dealing with an addict, assume that whatever is coming out of their mouth is a lie. Of course you want to believe the person because you love them.

Shame and dual diagnosis

It’s hard to see, but underlying all addictions and dual diagnosis is much shame. The person doesn’t want to hurt the people they love, yet they continue to do so. They want to stop, don’t know how to do stop, or feel they can’t do it.

Getting help is so critical for dealing with dual diagnosis. There are all types of treatment options, from AA, NA, individual therapy, group therapy, medication, intensive outpatient, partial hospitalization and residential treatment. You can also detox at some of these places so you don’t have to go through the horrible side effects that occur if you stop using your drug of choice.

If you or a loved one suffers from alcohol/substance abuse, give me a call at 713-304-6554 and we can come up with a specific plan for your needs.

Take care,

Debbie Grammas