When Mental Illness Strikes

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.


  1. I have Bipolar 2, and I think I’ve heard everything you said from one family member or another….and I’ve never relied on self medication….but it was always assumed that I did. I always knew there was a lot of addiction in my family so I tried hard not to put myself in that position. Not that I never indulged, and often when I was manic, but never on a regular basis.

    People do not understand that if you have been stable for a while, what happens if suddenly you aren’t. No one in my family trust me, they all think I’m “crazy”, some think I’m dangerous. (I shouldn’t say, no one, there are a few who understand, but they have issues of their own)

    I cannot imagine if I had already lost my hearing before this happened to me. I went to a new psychiatrist this past week and was terrified I wouldn’t be able to communicate with her. Many voices simply do not come across my CI where I can understand them. Thankfully, even though she was soft spoken she understood and looked straight at me as she talked. In that hour, I’ve never felt so validated. A good doctor can really make the difference…..she even knew all about my other chronic illnesses.

    I agree we MUST help those who cannot understand. We must not judge people without knowing what is going on. People with mental illness and hearing problems need help not judgement and degradation.

    Thank you for writing this. I seriously thought about forwarding it to some people, but I realized it wouldn’t help. They don’t care why I’ve acted certain ways (many I obviously don’t remember), they just know I have and I’m on the S**t list.

  2. Dear Wendy,

    Thanks so much for what must have been a very difficult post to write. I applaud your courage. I commend your brave spirit. If there is anything I can do to help you and your family members iron out things, please don’t hesitate to ask. Forward them this blog. Ask them to dialog with me. I’ll be more than willing to do it.

    I could write forever on mental health and substance abuse and the misunderstandings society has regarding them. Add in hearing loss and it is truly terrifying.

    The reality is that most mentally ill individuals are at greater risk of harm from others than to others. Society thinks that the mentally ill homeless are representative of the mentally ill and that someone who kills who happens to have other problems is representative of all the mentally ill.

    I will never forget my friend – who is so kind, gentle, and professional, who did everything possible to control the bipolar – going off the edge into psychosis. My friend did nothing wrong. I know other in my present day life who have the same problem. They did NOTHING WRONG. It is like saying, “You are to blame for developing breast cancer because you have bad genetics.”

    I am so sorry to hear that your family is unwilling to learn about mental illness and be a support to you. It is not easy when there is a mentally ill family member. However, while it isn’t easy for the family member, it is 1000% easier than it is for the person who suffers.

    I had another friend who was doing “life on the installment plan” in prison because every time he had a breakthrough he would do something crazy – like steal a credit card and fly to Hawaii and then come around and not understand how he got from point A to point B. Once the breakthrough happens the person is no longer in control. And, honestly, I don’t think he should have gone to jail for it – mental health care, yes, but not jail.

    One quarter of Americans at any one time suffer from stress, anxiety, depression and other mental illnesses. That doesn’t include those of us who have biologically based brain disorders which are largely genetic and out of the control of the individual.

    We must stop abusing people with mental illness. And, honestly, the more we learn about addiction, the more it becomes aware that it is largely genetically based. I know individuals who never drank, smoke, or used, who got addicted after dental surgery or a c-section or the like. It is not like they asked for the problem.

    I was talking to an individual the other day when I was very anxious and that person told me that being newly straight is like being in a state of the highest anxiety each and every moment of every day. It is hard for me to wrap my mind around. But I accept that this is true.

    Addiction kills. And mental health issues kill the mentally ill.

    I am so thankful you have a good mental health provider. Stay strong. Reach out when you need to. I’m here.

    1. Thank you so much for your generosity.

      I have finally made peace about my family, and this may sound uncaring, but I don’t want to reach out to them any more. I have a cordial relationship with my father and sister….and I don’t think we can have more. And that’s ok with me. There are other family members who will not speak to me at all, and that too is ok with me. I is actually easier this way. I’m surrounded by those who love me for me. My husband knows all about everything, has seen my breakthroughs with medication, and is still here. He says I can’t get rid of him. : )

      Frankly, it’d be easier on me if my whole family would just leave me alone. My mother was the one who held the family together. She and I were very close, she was my advocate before I was even diagnosed. But she died nearly 20 years ago now, and my relationship with my family has been up and down a lot since then. Mostly down.

      I once had my therapist read a bunch of emails my sister sent me, she said that my sister has a lot of issues of her own that aren’t mine. She even suggested it might be better for me to severe the relationship. She was right. My sister and I didn’t talk for years, but as my father has gotten older we felt we should make some kind of peace. (I was actually happier when we weren’t talking, but didn’t know it)

      I may sound callous, but it’s hard to reach out so many times to a family and be treated as an acquaintance. I believe they love me the way they know how, but I think it’s only because we are related. I don’t think they would speak to me otherwise.

      I’m sorry, I’ve rambled about my life.
      I appreciate your offer, and I’m glad to know you are there if I need to reach out.

      I know I may not help much, but I’m always here to listen.

      1. I hear you about families. It was just an offer if you were of the mind that it could help.

        It has long been said that we do not chose the family we are born to. Rather, we find our family of the heart – the ones we are meant to be with – along life’s winding path.

        My closest sister is related to me by love, not blood. My brother, on the other hand, is blood and beloved. One can never tell about life – it arranges us in the oddest ways.

        Remember, I said Mental Illness and addictions run in families. You may be the “identified patient” but often it is the other family members who are truly screwed up. In fact, usually the IP is the scapegoat for the really sick family members.

        Hope you are enjoying the summer weather.

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