The Psychology of Dual Diagnosis

I am  powerless over my mental disorder. I am powerless over my addiction. It has taken me a long time to admit these facts. Before I was able to admit my powerlessness, my life was unmanageable. I was unable to handle life without drugs and alcohol or to take care of my mental health. I thought that drugs and alcohol would make me feel better. They did, at first. I have some fond memories of partying and hanging out. But ultimately, those substances had control over me. Today, I truly accept the fact that I am an alcoholic and a drug addict with an underlying mental disorder. I accept both diagnoses.

Being honest with myself did not come easy. I wanted to blame others for my dilemma. As I reviewed my past, I saw that I lied, cheated, stole and manipulated people. I was dishonest, self-centered, self-seeking, inconsiderate and frightened. I lived in absolute opposition to the truth. I tortured myself with cocaine, crack, opiates, marijuana, LSD, mushrooms and booze. I found out that I suffered from a mental obsession to use drugs and get drunk, and that once I took a substance into my body I unleashed physical cravings that spiraled out of control. I would lose all touch spiritually and mentally, in full flight from reality.

Drinking and taking drugs frequently made my mental disorder symptoms worse. No words can describe the torture I felt. I spent a week in a psychiatric hospital in the mid 1990s. I was a week from being homeless in 2008. I was overrun with despair and self-pity. Drugs, alcohol and my mental illness had mastery over me. I only stopped using drugs and drinking when I was incarcerated or hospitalized. When released, I started all over again.

I really have to focus on my first problem: addiction. At some stage of my drinking and drugging, I reached a point where, as soon as I started using, I would lose control over the amount I would use. Craving became sufficient reason in and of itself to keep using. I was both physically and mentally impaired. I literally could not resist. So I had to be honest with myself that once I put alcohol or drugs in my body, it seemed virtually impossible for me to stop. Accepting that fact is key: once the substance is in my system I lose control and cannot stop. I have to remember that addiction is a disease that tells me I don’t have it.

The process of addiction may be a gradual one. For me, I found over time that I built up a tolerance to various addictive substances. Most recently, it was opiates. I could take a number of Percocet tablets and literally feel only a slight “buzz.” I needed more and more to get the same effect. Not only that, I was becoming dependent on it. Before I knew it, I needed a pill just to relax and not feel any pain. When I tried not to take Percocet, my back pain and overall body aches increased and I became restless and irritable.

I had to be mindful of the second part of this picture. Is my struggle with addiction compounded by a mental disorder? With regard to mental health, it is wise to seek professional help. But we must come to a point where we “own” our particular diagnosis. When we’re told we have a mental disorder, we have to take it seriously. We have to take a look at our life experience and see where our mental health gets us in trouble. Our mind will lie to us — about its own health and about our addictions. We need to search our own experiences and honestly ask ourselves  Am I powerless over alcohol and drugs? Do I have a mental disorder?

We become honest by discovering our own truth. Understanding comes through awareness and acceptance of conditions as they are. We know we have problems. That much is obvious. But the truth is hard to accept. In order to recover, however, the truth must be accepted. We come to know this as a fact in our recovery. Admitting powerlessness is not a sign of weakness. It simply means that when it comes to substance abuse and struggling with mental disorders, we are not in charge. Willpower has no meaning when it comes to controlling our use of drugs and alcohol and our mental processes. We certainly had a distorted view of ourselves and the world around us before we addressed our addiction and mental illness.

Honesty sets us free. Once we accept our powerlessness, many of us experience being freed from active addiction and from the obsession to use again. Here is the paradox of recovery: that in accepting our powerlessness, we become empowered to stop using drugs and alcohol and to work on our mental health. This comes at a great relief. With recognition and acceptance, we are free. We never need to go back to drugs and alcohol again. Instead of being filled with our addictive thoughts of self-destruction, remorse, despair, rage and sadness about our past, we look with great joy and comfort at these precious moments we are now given. Admitting complete defeat is not what we wanted, but it is what we needed. For me, there was a part deep down inside that always wanted to be free. I was so tired of living a life of active addiction. I kept saying I would do something about it tomorrow. Not now. Not today. Obviously, a part of me was still committed to getting drunk and high.

I came to realize that my addiction was greater than my will. It was a monster with an insatiable appetite, and I let it take from me all my self-sufficiency and my will to resist its demands. If you still think you can handle that monster, try this simple test. Go ahead and stop. Now, stay stopped. Do without. If you can do this, there is no addiction. But if you cannot stop and stay stopped, no amount of willpower will change the fact that you’re addicted. You need a program to help you stop. It won’t be easy at first, but it is more than worth the effort.

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