Just as no one wakes up in the morning and says, “Gee, I think today is a good day to become an addict,” the same is true about biochemically-based mental illnesses. The fact is that mental illnesses and addiction often run in families and often in tangent – so that the bipolar may also have a drug problem due to attempting to treat the symptoms by using recreational drugs and getting hooked.

I have heard the same thing over and over. “If only he loved me more he’d stop drinking/using” or “If she only took her pills she would not be depressed.” or “He’s just on the pity pot.” Variations on the above from parents, children, and spousal units go on seemingly endlessly.

It might be that an addict or alcoholic can be tough loved to health, but add into the mix a major mental illness such as schizophrenia or bipolar disorder, and the picture changes radically.

Many years ago, in a galaxy far, far away I had a good friend who was a medical professional who had bipolar disorder. This person was religious about seeing the shrink, taking meds, doing talk and group therapy. However, there is something known as “breakthrough” where brain chemicals can shift, sometimes rapidly and radically. One day my friend awoke convinced the CIA was monitoring everything and we got a call that this person had shaved their hair and destroyed all their furniture looking for “bugs.” They didn’t do anything wrong. They could not help what happened.

When we add in a chemical addiction we add in shame and blame to the shame and blame already associated with mental illness. These folks are even more likely to be considered weak-willed. “If only” they did this or that then life would be fine and recovery assured. Except that is not the way it works.

All the psychoactive medication in the world will not fix a breakthrough. A breakthrough may cause someone to stop taking medication. Severe depression may so immobilize someone that they can’t recruit enough internal resources to do what they need to do. It is like the death spiral of a plane in an old WWII dogfight (air warfare) movie.

Tough love does not help someone who is immobilized emotionally due to mental illness. Holding their feet to the fire may cause them to withdraw further. It is perplexing for individuals in the drug treatment field since they’re used to confronting a person on their dysfunctional behavior. It is often more than perplexing to 12 step members who are trying to cure one problem and potentially exacerbating another.

One must first dry a person out from whatever drug of choice they have before treating the mental illness, but there is no magic bullet. And therein lies the problem.

It does not mean that no one with a dual diagnosis ever recovers. They do. But it is a far more difficult recovery. It takes far more group support from their 12 step group members and an understanding that medications that might be verboten for someone else might be required for a person in DD recover.

If we add to the above issues the issue of being Deaf or Hard of Hearing, and without adequate access to interpreters to assist with the mental health or drug treatment process and it seems an almost insurmountable problem. While much of the 12 step material is fairly easy to understand, if a person has only a 3rd grade reading level much of it is unintelligible.

It is critical that we both insure the adequate education of the Deaf and Hard of Hearing, but that we also provide adequate resources to assist in mental health and substance abuse treatment. Failure to do so causes individuals to end up on the streets or in jails and prisons when with care, they might be functional members of society.