CAUTION: Please do not instantly adopt as truth everything you read on these topics. Please look for supporting information from other sources; look for authority and experience underlying opinions; look for research; and, most of all, please begin to talk with and listen to others who have gone through what you are going through. Find out what works for them. Become aware. This is not a time to hide your feelings or to ignore your instincts.

Please keep coming back.

This page will continue to grow.

04/23/07

Contents (you must scroll down to find the item listed):

1. Bipolar Dual Diagnosed--Identifiers--Article

2. Quick and Dramatic--Letter

3. Holistic Paradox, Last Things First--Essay

4. Dual Diagnosed--resonant behavior--Essay

5.  Bipolar or Dual Diagnosed--Respect the Symptoms

1. BIPOLAR DUAL DIAGNOSED--Identifiers

Article by James A Rist

  Dual diagnosis, in the context of bipolar disease with addiction/alcoholism/substance abuse, has always presented difficulty to diagnosticians, because the symptoms of one disease tend to hide among the symptoms of the other disease. This article should help you to see where symptoms may "overlap" and, with a little honest personal inventory or the help of a health professional, to help you to see whether you or your loved one should seek direction or help.

http://www.bipolarworld.net/Bipolar%20Disorder/Dual_Diagnosis/dual_diagnosis_.htm

I like to use the information from The National Institute of Health for two reasons:

1) The information and definitions "fit" into the legal environment;

2) The information is a composite from many reliable sources.

The following internet pages should give you a good handle on addiction and alcoholism:

http://www.nlm.nih.gov/medlineplus/ency/article/001522.htm

http://www.nlm.nih.gov/medlineplus/ency/article/000944.htm 

The following page should give you insight into bipolar disease:

http://www.nlm.nih.gov/medlineplus/ency/article/001528.htm

The symptoms of bipolar disease and the symptoms of addiction/alcoholism/substance abuse, as before mentioned, may overlap from one disease to another, so I have presented a chart of identifiers for dual diagnosis. Bear in mind that I have prepared this chart based on my own experience and experience only casually drawn (as opposed to official research or survey) from hundreds of others like me in my network of recovery and support.DUAL DIAGNOSIS IDENTIFIERS

Some or all of these may exist in your profile

You may be able to add other identifiers, based on you own experience in recovery--for instance, rage is a prominent part of my profile in my own manic state and often part of my nature and behavior when I was "in my cups" with alcoholism.

Remember however, if I have episodic extremes of mood or excesses in my use of alchohol or drugs, the identifiers are merely indicators or signposts, if you will, that there may be trouble ahead. They do not necessarily mean that I have a disease, but I DO need to give these identifiers fair consideration when I see them in myself!

James Rist

© 2007 www.cerebral-storm.com

www.cerebral-storm.com

www.blessedtobebonkers.com

2.  "Quick and Dramatic"--First Posted on www.mdjunction.com January 28 2007

My name is Jim, and I am bipolar, alcoholic/addicted. That is my identity, but not necessarily my destiny.

Truth plays a great role in my recovery.

Thank you for your essay, ______. Can we agree that diet, exercise, discipline, recreation, and social interaction are at the foundation of good mental and physical health? If we can agree, then we should put that appeal on the back burner for awhile. Okay?

You posted the following:

"This news item explained that this man, a father of two, had suffered for 20 from bipolar. Bipolar was actually a common occurrence in his family line, and he was frustrated with the lack of improvement in his condition despite the long term treatment of lithium therapy. In his desperation he tried a "vitamin and mineral" supplement long given to pigs for a similar condition. His improvement was fast and dramatic. So dramatic in fact that investigators at the University of Calgary (Alberta, Canada) did a preliminary study with 10 people suffering from bipolar disorder - and achieved the same quick and dramatic improvement."

For the benefit of those of us who are dual diagnosed, I would like to ask you and others, when you cite experience other than your own, to give us direct access to the third party or third party account of his own experience.

Yes, I believe there is some truth in what you wrote. The chaotic mind, however, may find some difficulty in seeing and employing that truth. Ask any therapist, doctor, or clinician why the bipolar patient acknowledges the value of suggestions such as dietary, exercise, or spiritual remedies; but why the patient paradoxically is unable to employ the remedies with any lasting effect. Ask the patient the same question.

The answer to that question, when known, will probably reveal or suggest the cause for the disease.

In the book, Alcoholics Anonymous, it is written that "...at times the alcoholic will have no effective mental defense against taking the first drink." Why? The answer to that question would explain the cause of alcoholism.

I would like to hear the ten people involved in the Canadian research tell of their recovery experience. That in my mind is the only truth I can accept, first hand personal experience. In the matter of mental illness and addiction I encounter many faulty opinions. I implore you, ______, and everyone commenting on these diseases, to recognize the vulnerability of the diseased mind--to respect the deadly nature of misdirection among those who have the diseases--to understand that one faulty opinion seeded into the diseased mind may take root and grow to tragic consequences. The best way to avoid deadly consequences to others is to share my EXPERIENCE rather than my opinion. I leave opinion to the "experts", who, in a commercial sense at least, seem MORE than willing to say, "I've never actually done this, but I believe it will work for you."

To someone chronically afflicted with BP/addiction/alcoholism, the way out is probably not "quick and dramatic."

For the record, I believe that your suggestions will probably help us in recovery; I believe that there is a cure for my diseases; I believe that my diseases could have been prevented. Why do I believe these things? ...because I want to believe them! Does that sound like hope?

It is my experience that my hope and my belief are powerful and essential tools to my recovery. It is my experience that no remedy works effectively for my diseases without hope and belief. Your experience, however, might be different....

Thanks, ________!

Jim R

www.blessedtobebonkers.com

www.cerebral-storm.com

3.  Dual Diagnosed--"First Things Last"

Holistic Paradox

I have to bow to the holistic foundation for wellness--diet, exercise, discipline, recreation, social interaction, rest, and spiritual maintenance. I believe these principles of wellness contribute heavily to prevention of disease and recovery from disease.

Many have suggested that the period of time between a normal, balanced, and functional state (baseline) and the diagnosed state of bipolar disease and/or of addiction has a direct influence on the rate and resilience of recovery from bipolar disease and/or addition. As a corollary, I have observed that the longer the diseases remain untreated, the more that "normal" and functional baseline seems effectively to vanish, giving way to a modified baseline of chaos, distress, dysfunction, and desperation--a phenomenon of fundamental change which may be referred to as a psychic change. If these statements are valid, then they would help to explain the difficulty in treating one who is chronically ill with bipolar disease or addiction/alcoholism; and they would offer support to the urgent need for early diagnosis.

http://www.mcmanweb.com/article-114.htm

What do we do when such chronic diseases have destroyed the patient's holistic foundation for wellness, when the chronically ill patient is faced first and foremost with rescue and salvage? May we simply place the patient in a healthy environment and invoke healthy habits and pursuits with any reasonable expectation for effective and durable recovery? The equation seems logical and complete, doesn't it? One final question remains, however: "Does the patient possess a state of mind and reason and a level of willingness sufficient to engage the treatment?

My current treatment plan includes prayer, group support, therapy, writing, and service to others. I have used this foundation for my recovery for more than four years, and, yes, I admit that these things did indeed "rescue" me from my hopeless state; and, yes, I need to do more now to strengthen and perpetuate that recovery. There is no question in my mind now that continued ill health in any respect MAY yet trigger my relapse.

I received my diagnosis (bipolar disease) in October 2003, with a prescription for Wellbutrin--antidepressant. The medicine MODERATED my depression long enough to review my history and prognosis, for I am also a recovering alcoholic (sobriety date 09/13/02). By January 2003, the medicine apparently had begun to induce rapid cycling of my mood swings, but I was well into my recovery from alcoholism, and that was my salvation.

Management of Bipolar disease involves a foundation of medication. On the other hand, management of alcholism/addiction involves a foundation of personal change, employing both holistic tools (spiritual healing, physical healing, step by step ongoing personal assessment, peer counselling, occasional professional support, service to others) and heuristic tools (an ongoing trial and error attempt to adapt flexible principles of recovery to individual needs and lifestyles).

http://www.psycom.net/depression.central.bipolar_abstracts.html 

http://www.mja.com.au/public/mentalhealth/articles/sacks/sacks.html 

http://www.aabangalore.com/medical.html 

The heuristic part of recovery actually takes full force in the later stages of recovery, and it is in many ways an extension of the holistic principles (self appraisal, spiritual and physical restoration, taking responsiblity, and ultimately interaction with others who are looking to recover). I am referring at all times, of course, to the method of recovery suggested by AA.

http://www.aa-louisiana.org/steps.htm

The point I wish to make is that the fluke of alcoholism in my profile gave me access to tools which I use also to manage and recover from my mental illness. I now apply these tools, rather than medication, and I find, by contrast to those who take the meds, that my progress has at no point been quick or spectacular. I have found, however, a feeling of peace, security, and solidity in my slow recovery--qualities which my meds-taking friends have found to be elusive in their recovery.

In the final stages of recovery from alcoholism (and I am finding this to be true for my recovery from mental illness as well), most of us begin to focus more acutely on other aspects of health, such as diet, exercise, social interaction, recreation, discipline-forming pursuits, and spiritual pursuits.

Many question why these fundamental needs do not receive more attention at the BEGINNING of recovery. My only reply to the question is that "the clock is ticking", so to speak, and most of us who have been in the chronic stages of illness are seeking emotional survival, first and formost. As a result, few if any of us in early recovery have the will, the presence of mind, or the resources to engage in a fully balanced regimen of mental and physical management--desperation, you might say, demands an attitude of "first things first." ( You might also say "first things last" in the context of a balanced holistic approach.) That is the main dilemma for successful treatment of late stage chronic mental illness or chronic addiction. And..., that may help to explain the paradox of relapse which can and often does occur even though the patient has engaged all the holistic principles of wellness. I wish I could cite examples of such relapses from public documents, but reports are hard to find, since most efficacy reporting is offered by the purveyors themselves of holistic alternatives. (...nothing negative reported.) I have friends, who, if they would break their anonymity, could verify relapse under fully healthy circumstances. Often they will say such as, "I just felt too good, resulting in a reckless change in my behavior."

http://www.lakesidemilam.com/drmara.htm

Most health professionals and most of the afflicted will agree that sometime, early in the illness, balanced care and management would have arrested the diseases. However the irony of the diseases in their early stages is that they present false feelings of wellness which camouflage the diseases themselves so effectively that even trained health professionals frequently fail to identify the symptoms.

The preceding paragraph points to the ultimate irony of these diseases and, in my mind, the subtle flaw in pharmaceutical treatment. The meds not only provide the main focus for treatment, but the meds also hide the roots of these diseases by inducing a transient feeling of well-being in the patient. When the meds fail, as they most often will do, the patient relapses to a mind set such that it will not permit him a reasonable assessment of his condition. Rather, the patient (and the prescribing doctor) scramble frantically for a new medication or a different dose or combination of meds. I suggest, when this occurs, that the meds are well past the point of serving their therapeudic objective--that the patient has been tragically induced to rely on the meds well beyond the often "one-time-window" of opportunity for essential psychic change--change of the type I and others have chosen to pursue through peer identification, interaction, and support and through therapy and counselling. Here I can see a parallel possibility in holistic treatment.

Where one school of holistics may for instance focus on diet as the treatment, or on any singular component of wellness as a cureall, the patient may receive again that "transient" feeling of well being (as with the meds). Again, when the feeling of wellness fails, the patient becomes frantic for an alternative, placing all reason aside and plunging into a round-robin pursuit of alternative remedies. Again, the patient will have missed a perhaps "one-time window" of opportunity for full assessment and full treatment.

So the paradox of "first things last" really applies to the rescue phase of treatment, where it may be necessary to acknowledge my critical needs first--where it may be necessary to set an objective which is more modest than total health. The objective of my rescue has been to seek a level of reason, clarity of mind, and understanding which will facilitate a good choice for the longer term--to present a "window of opportunity" through which I can move from mere relief to optimistic recovery.

http://www.morningsiderecovery.com/dual_disorders.php  (I do not necessarily endorse the treatment facility, but merely cite the method.)

In the long term, the choice of treatment and its objectives is really up to you, isn't it? I have already stated MY treatment of choice. My objective is remission.

Thanks, for coming to this forum and for being a part of my recovery!

Jim Rist

 © 2007 www.cerebral-storm.com

CAUTION: Please do not instantly adopt as truth everything you read on these topics. Please look for supporting information from other sources; look for authority and experience underlying opinions; look for research; and, most of all, please begin to talk with and listen to others who have gone through what you are going through. Find out what works for them. Become aware. This is not a time to hide your feelings or to ignore your instincts.