[Tryingtobehappy5]

Hey everyone

I havent been on in a long time, for 10 months I took my meds regularly, didnt drink as often and didnt have any episodes that were bad enough to cause a disturbance in my life. So I didnt come around because Bipolar wasnt in my mind other than twice a day at med time and I liked it that way.

2 weeks ago some depression started and I got sick and couldnt take the meds one day because of my throat. After that I just couldnt make myself take them anymore. Then I started drinking again and I have been drinking a lot.

I have been mostly non-compliant since the bipolar issues started except for that 10 months and I know the trainwreck I am headed for and I dont want it. But it feels impossible to go back on the meds and quit drinking. I believe I am bipolar and I believe I am an alcoholic and I know how horrible this all is but I feel like I am watching myself make these decisions with no control over it.

I had a T appt today and we talked about the no control thing and how that is not true. We also talked about how if I was just gonna go this route I might as well just get as drunk as I can mess things up and be forced IP instead of dragging this out and causing more harm in the meantime. That sounds stupid but in my messed up mind it almost makes sense and I feel really dumb when I think about it.

I dont know what I want here and I feel bad that I am only a regular when I need help but I need the help bad enough that it is worth it to come back even if i dont deserve to. I want to take the control back and not have to go IP to get back to normal, how can I do that myself?

Feel free to tell me I am being stupid, I know I am but if you have any suggestions or things that have helped you I would sure appreciate them.

Hi Tryingtobehappy. You're not being stupid. You're just in a very tough spot, a place most all of us here have been...sometimes multiple times. And most all of us understand not wanting to have mental illness on the mind 24/7. I certainly won't be judging you for being away, and am happy you feel comfortable returning, when you need the support.

You clearly know that the alcohol exacerbates and even brings on mood issues. It's a rough bugger to kick, I know, and it's highly unlikely that you'll do well while abusing it. You must quit it, at least until your moods are stabilized. And then, frankly, abusing alcohol is not an option. Some can go back to occasional light drinking, but others cannot.

Do you have a day program (Intensive Outpatient or Partial Hospitalization) available as an option? That might be a good choice, if you want to avoid inpatient. Some IOPs even offer evening options, in case you work. There, a psychiatrist and therapist can assist you with alcohol withdrawal and getting your moods stabilized again. I think that's a much better option than white knuckling, which often fails. Or fails more often than the IOP option. If an IOP wouldn't work, then maybe inpatient rehab would be the way to go, but I do NOT want to think of you putting your life (or others') at risk to reach a "bottom".

Possible trigger:

I have a history of alcohol abuse. My father only recently managed to get sober (after several hospitalizations and almost dying). He's an alcoholic. I seem not to be, but know that drinking too much "X"s out the usefulness of my bipolar medications. Also, drinking on my meds makes me more prone to blackouts. Once, I almost poisoned myself and could have died from choking on vomit. Not a pretty story, though true!

There doesn't seem to be a really good place on PC for those with mood disorders AND addiction issues. There is an addictions forum, but doesn't cover "dual diagnosis" well, in my view. But do ask for support for that combo here. You and I are not the only ones here who have dealt with both bipolar disorder and alcohol (or other drug) dependence/abuse.

Note: I detoxed from alcohol in a dual diagnosis ward at my local psych hospital, 14 years ago. I attended dual diagnosis IOP/PHPs a few times before switching to regular psych. It wasn't an easy task kicking the drinking habit. My moods were severe (manic) and the urge to self-medicate strong. But I did manage. You can, too. Even though I have an occasional drink (pdoc disapproves), some people can't. I know that my abuse could start up again, under certain circumstances. Especially, if I were to quit medications!

[Moose72]

Not to mention that combining the meds with alcohol can exacerbate liver problems.

[bpcyclist]

Another dual-diagnosis person here. I am very sorry you are struggling. I have been there--repeatedly.

I agree with BirdDancer. If there is any way for you to avoid having to hit some kind of gigantic rock bottom to turn this thing around, that would really be very much to your benefit. I was not able to avoid that eventuality. I am alive, and that is terrific, but I lost absolutely every single thing in my universe, including my freedom. Multiple long involuntary hopitalizations. Etc. I do not recommend that as a good path forward. It is very traumatic, in and of itself.

Sending you support. You can do this!! But alcohol is not going to help you get where you would like to be, in my opinion. Wishing you the best.

[Tryingtobehappy5]

Thanks to all of you I appreciate the responses and acceptance even though I havent been active on here.

Unfortunately no IOP here only IP which I know I can go voluntarily I just really dont want to. I work and have a family that I dont want to leave. Only went voluntary once and since then it has always been involuntary and after getting extremely bad. I barely survived an episode at the end of last year, well they almost all get to that point but that should have really been my rock bottom it was as bad as it could possibly get.

We have one dual diagnosis IP program but it takes long to get into and I got rejected last time I applied because the drinking was too out of control apparently.....

I did a rehab program in the summer and that seemed to help for a while but bipolar symptoms fuel the drinking and then the opposite as well obviously.

I dont want it to get so bad that I am involuntarily locked up again. I just need to find some kind of way to get back on track. I realize its as simple as popping some pills and not drinking it just feels so hard.

[Rick7892]

I too self-medicated with alcohol. I live in a town of about 10,000 people, where I am now getting mental health care over the phone because they claim it is so rural.

For me, AA has been helpful to stop and stay stopped drinking and also to cope or at least not make my mental health worse through the effects of alcohol. It is my ONLY dependable support face-to-face group and ONLY dependable mental health where I live. There are 2-3 AA meetings/day at different times of the day in this rural town. There are meetings all over the U.S. and ways to find them, so one can drop in on a meeting while traveling and be accepted. Donations are only suggested, so it is affordable.

It is solution-oriented among peers who also had a drinking problem. While many may think it is a program about not drinking, the longer I am in it the more I realize it is a program of learning how to live (or cope) with life (including my mental health) with its ups and downs without having to drink. This is done by living one day at a time. There is no cure to drinking in AA--that approach resonates with my mental health not being cured either.

Re: mental health medications. This can be a problem for people with mental health who take meds and go to AA because some members insist we are not working a good program, if we take meds. That is their prejudice. That is not in the AA literature. For example, see Alcoholics Anonymous : A.A. Member-Medications and Other Drugs Yet this remains an issue. I choose to not engage in this battle and seldom talk about my mental health issues or meds. Recently, someone spoke up about their mental health, and I did so to--and several of us did. Actually I think it was about 25% of the people who were there did. More could have mental health issues but chose to be silent.

Yet, for some, the issue of the negative stuff some people in AA say about mental health disorders or meds can be a reason to not go. I once had a good counselor here who said she knew several of her clients were bothered by this and stopped going to meetings. This is sad because in my experience drinking doesn't help my mental health. It made it worse. I choose "Take What You Need and Leave the Rest" about AA meetings which is occasionally said at meetings.

Where I live, there is no religious connotation to meetings, but that may vary with geographical area. I am not religious, but I find that when I let go of stuff that it takes a burden off me and I live a bit lighter.

I went to a dual diagnosis meeting for a month here that had poor moderation. 2 weeks in a row a woman was talking about knifing men and that she carries a knife. I am a male and that was too much for me. That wouldn't be condoned in the AA meetings that I go to.

I came back to this PsychCentral Bipolar forum after a gap of several years because it is here I get mental health peer support from others. I continue AA as another source of support.

To those who try AA meetings, I suggest that you only talk about your drinking issues and not go into mental health and medication issues. Get a feel for the meetings, and maybe over time there are some that you feel comfortable talking about mental health with respect to your drinking. Treating drinking alone helps.

Anyway that's my experience. Others may have different experiences and more negative experiences that make it not worthwhile for them. I understand that. But for me, it is the "last house on the block."

I hope you find a way to deal with your drinking issue to live sober, whether it is rehab, church, counselors, self-help books, or various peer recovery groups such as AA. For many of us, willpower is not enough to keep sober on an ongoing basis, so practicing an ongoing program helps.

[Tryingtobehappy5]

Thanks Rick,

I will think about going back to AA. I have gone a fair bit in the past year or so and like it overall but started to feel like I dont belong if I keep failing. No one has ever said that its just a feeling I have.

We only have it twice a week here but I could go when it is on next, it does seem to help at least a little. Next meeting is on Tuesday so if I go I will likely drink until Monday. Somehow going there does make me stop even if just for the night. Sometimes one night of the right choices puts me back on track for a while too.

I am lucky to have a good T who I see as often as needed which sometimes is 2 to 4 weeks but right now it is every week so I have that plus AA if I choose to go.

[Rick7892]

Originally Posted by Tryingtobehappy5

... I will think about going back to AA. I have gone a fair bit in the past year or so and like it overall but started to feel like I dont belong if I keep failing. No one has ever said that its just a feeling I have.

We only have it twice a week here but I could go when it is on next, it does seem to help at least a little. Next meeting is on Tuesday so if I go I will likely drink until Monday. Somehow going there does make me stop even if just for the night. Sometimes one night of the right choices puts me back on track for a while too.

I am lucky to have a good T who I see as often as needed which sometimes is 2 to 4 weeks but right now it is every week so I have that plus AA if I choose to go.

Glad you have a good therapist that is also available!

Where I go, people who have trouble keeping sober are welcomed back after they have come back because 1) we like to see people try to keep sober
2) when people who have gone back out and come back we get to hear that drinking hasn't helped!

With only 2 meetings per week in your area, the meetings may have few people, so the people who come may be very happy to have more people.

Perhaps online recovery meetings or forums may be helpful.

I hope things work out well for your sobriety, if you go to AA or not!

[fern46]

I think you are off to a good start. Being honest with yourself about where you are is key. I am not a substance abuse expert and I think you've received some great advice here to consider. I will add a few strategies I would leverage if it were me. Also, you mentioned this should be easy. It is and it isn't. It is a bi of a paradox. You're deep into a pattern of subconsciously driven behavior and it will keep repeating until you establish new behaviors to replace it.

I'd start by clearing my living space of alcohol and as many of my physical triggers as possible. I would then make it a point to stay out of scenes where it is available to buy. No walking into gas stations. I'd have my groceries brought to my car, delivered or purchased by someone else. If needed, I'd go so far as to write my no drinking goal down and place it in places that remind me of drinking or where I usually have the 'I want a drink thought'. I would also become as strong and clean as possible through exercise and diet.

I'd make a schedule and stick to it. I would make sure my brain was fully engaged throughout the day. This would include plenty of self care time to reduce stress triggers for drinking. Writing it down with to do lists helps.

I'd look into my past and get to the root of why I began drinking to self medicate. I would work to address those wounds. I'd also keep a journal to see what thoughts and emotions precede wanting to drink. If you can be conscious of the patterns, you can then train yourself to recognize them in the moment and shift yourself out of them and into an altrrnate location.

I'd spend time brainstorming up some future plans for yourself. How do you want to feel? What do you intend things in your life to look like when you're clean and more balanced? What kinds of dreams do you have for yourself? I would then spend time each day aligning myself with those goals and remembering what I'm fighting for. Write these down and review them often.

I would address this spiritually. I would perhaps create a few self supporting mantras. Maybe I'd meditate. Maybe I'd use the serenity prayer. Maybe I'd have an uplifiting and inspiring song I play or sing to myself. Maybe I'd reach out each day for whatever higher power I believe in and ask for support and strength. Perhaps I would find a group that shares my beliefs and spend time in fellowship with them.

Finally, I'd choose a team of people to help me. I'd do this internally and think about the aspects of myself that give me strength in a fight like this. I would consider the aspects of myself that are weak and buddy them up in my mind with my stronger parts. I would then create an external team. I would consider people who can help me medically, mentally, emotionally and spiritually. I would consider people who can gently support me and those who offer tough love. I'd seek support online in places like these for times when I am alone and need support.

Those are a few strategies I'd deploy and they are a collection of spiritual, mental, emotional and physical strategies. They also fight this in the past, the moment and the future. Take whatever resonates and feels like it might assist you on your journey. I wish you all the best and I hope you keep reaching out. We're all here for you.

Rick did an outstanding job of discussing AA, in my opinion. I'm glad you are considering it, Tryingtobehappy. Especially since other treatment options are limited or harder to fit into your life. After my detox and dual diagnosis IOPs, AA was considered mandatory. Like Rick wrote, I took what was relevant and helpful, but left the rest. I am not religious, so didn't participate in that portion. I had an AA member tell me not to take meds. I stopped talking to her. In AA, they say to avoid triggering people, places, and things. I counted her as one. She represented a minority there, though. Most members in my area understand the need for meds in cases of mental illness, just as Rick said about his meeting members.

Fern, I like your suggestions.

[Tryingtobehappy5]

I am going to go back to AA, I like the people and what I get out of it. I like what you said Rick about why others would welcome me back and people in my group have said things like that too. I guess I just needed a reminder and I dont do well with calling them even though I have their phone numbers.

Thank you fern for all of those suggestions! I will definitely start putting them to use although it will probably take a while since there is a lot there. I already eat healthy and do jiu jitsu and kickboxing so I have the exercise and socialization from that which has been great for me since I started in June. I think I will start with making a bit of a schedule for myself because I dont do well with my unplanned time. That is one thing I talked with my T about as well so I guess it is important. Of course getting rid of the alcohol will be another one I start with in the next couple of days. I know I should just do it now but Im not sure Im ready. I will start paying attention to my thoughts when the cravings kick in though I think that will be important to figure out if I want more control in the future. Luckily we only have one store in my town that sells alcohol so it is easy to avoid.

BirdDancer I havent had any problems in my group they all seem very accepting but I mainly stay away from talking about the mental health side of things although I have mentioned it a couple of times. Others there have talked about meds helping them and one even suggested one for the cravings but I had already tried it with no luck. Some there are religious but more are not so that isnt a problem either. I really do like it there.

[fern46]

Originally Posted by Tryingtobehappy5

I am going to go back to AA, I like the people and what I get out of it. I like what you said Rick about why others would welcome me back and people in my group have said things like that too. I guess I just needed a reminder and I dont do well with calling them even though I have their phone numbers.

Thank you fern for all of those suggestions! I will definitely start putting them to use although it will probably take a while since there is a lot there. I already eat healthy and do jiu jitsu and kickboxing so I have the exercise and socialization from that which has been great for me since I started in June. I think I will start with making a bit of a schedule for myself because I dont do well with my unplanned time. That is one thing I talked with my T about as well so I guess it is important. Of course getting rid of the alcohol will be another one I start with in the next couple of days. I know I should just do it now but Im not sure Im ready. I will start paying attention to my thoughts when the cravings kick in though I think that will be important to figure out if I want more control in the future. Luckily we only have one store in my town that sells alcohol so it is easy to avoid.

BirdDancer I havent had any problems in my group they all seem very accepting but I mainly stay away from talking about the mental health side of things although I have mentioned it a couple of times. Others there have talked about meds helping them and one even suggested one for the cravings but I had already tried it with no luck. Some there are religious but more are not so that isnt a problem either. I really do like it there.

Incremental change is definitely the way to go. You already have so much going for you!

Originally Posted by Tryingtobehappy5

BirdDancer I havent had any problems in my group they all seem very accepting but I mainly stay away from talking about the mental health side of things although I have mentioned it a couple of times. Others there have talked about meds helping them and one even suggested one for the cravings but I had already tried it with no luck. Some there are religious but more are not so that isnt a problem either. I really do like it there.

I'm glad to read this. It sounds like a positive environment to begin recovery.

I was actually thinking about anti-craving medications. There are, I think, more than a few. My brother took Antabuse, but that's pretty rough for many. When I was in dual diagnosis IOP, they gave me naltrexone pills. That was not helpful. However, then the IOP psychiatrist prescribed acamprosate (brand Campral). That actually was fairly helpful for me. I think there are even some medications for bipolar disorder, itself, that can be somewhat helpful for getting through alcohol withdrawal and maybe also cravings. Tegretol and Depakote? And just recently, my psychiatrist went to some psychopharmaceutical conference and learned of a fairly new naltrexone injection. He suggested I ask about that for my father. He said that the injection seems to be even more efficacious than the pill form. The advantage (especially for my dad) is that dad likely wouldn't remember to take the pills daily. I think I will still ask about this when my father returns home from his assisted living, if he does. In all of these cases, one must be sober when starting them.

When I was in detox, I was given the benzo Librium to help ease withdrawal symptoms, but drinking while on benzos, as you surely know, is a particularly bad idea! If you expect withdrawals, please have a doctor guide you (psychiatrist or general practitioner). During detox, I was also given certain supplements (B vitamins???) I forget exactly what.

We're here for you!

[Tryingtobehappy5]

Naltrexone is the one I tried, I didnt find any difference while on it and I tried it for quite a while.

When I was starting to have cravings when the depression came on a few weeks ago and I was still on my meds I was thinking of asking my GP if I could go on antabuse because most of the time I am ok in the morning and will take my meds(I take them all in the morning now for that reason) then later in the day will start to want to mess up. I thought that way I already would have taken it when the cravings came which would stop me from acting on those cravings because I know the reaction is apparently pretty bad and I currently dont get sick at all so that would be a big change for me.

However I didnt go to the Dr and I really regret it now. I guess I dont know if it would have changed anything but maybe if I had gone in and let them know I wasnt doing well before I quit the meds and drank they could have helped me stop this before it started.

I have never heard of acamprosate and just heard of tegretol a little, didnt realize it had any effects regarding substance abuse. I will look into those a little more and maybe call for an appt.

Would you call the Psychiatrist to go on one? I have never called my P for an extra appt but Im not sure if that would be more helpful than talking to my GP. And now of course its a long weekend. Kind of a bad time to think about making an appt.

I dont think I will have any withdrawals I have only been drinking heavy for around 2 weeks, I have gone on a benzo once for withdrawal but that was a different P, I dont think this one or my GP would go for that considering my history of abusing the medications they give me they are extra cautious.

Originally Posted by Tryingtobehappy5

Naltrexone is the one I tried, I didnt find any difference while on it and I tried it for quite a while.

When I was starting to have cravings when the depression came on a few weeks ago and I was still on my meds I was thinking of asking my GP if I could go on antabuse because most of the time I am ok in the morning and will take my meds(I take them all in the morning now for that reason) then later in the day will start to want to mess up. I thought that way I already would have taken it when the cravings came which would stop me from acting on those cravings because I know the reaction is apparently pretty bad and I currently dont get sick at all so that would be a big change for me.

However I didnt go to the Dr and I really regret it now. I guess I dont know if it would have changed anything but maybe if I had gone in and let them know I wasnt doing well before I quit the meds and drank they could have helped me stop this before it started.

I have never heard of acamprosate and just heard of tegretol a little, didnt realize it had any effects regarding substance abuse. I will look into those a little more and maybe call for an appt.

Would you call the Psychiatrist to go on one? I have never called my P for an extra appt but Im not sure if that would be more helpful than talking to my GP. And now of course its a long weekend. Kind of a bad time to think about making an appt.

I dont think I will have any withdrawals I have only been drinking heavy for around 2 weeks, I have gone on a benzo once for withdrawal but that was a different P, I dont think this one or my GP would go for that considering my history of abusing the medications they give me they are extra cautious.

If I were in your shoes, I'd call the psychiatrist's office first. I'd let them know exactly what you want to do and inquire if they can help, or if you should call your general practitioner. I imagine going inpatient could come up. Or maybe not. If you are dead set against inpatient, you'll have to mention it. Either way, I think you should have some guidance. I hope you don't have alcohol withdrawal symptoms, but the whole process could be trying, psychologically. Plus, hey, if you are symptomatic with your bipolar disorder, you've got that to fight since it makes drinking more likely.

[Tryingtobehappy5]

I didnt call the Pdoc, my H didnt seem to think Pdoc can help when I said I was thinking about calling and that just sort of shut me down

Now I have to wait until Tuesday to do anything if I decide to because Monday is a holiday here.

I am worried about this weekend because I am working evenings so I feel energetic at night and H is working nights and wont be home if the drinking turns bad. I will have to try to have some self control and not let it get out of hand but that doesnt usually work so well, I usually just drink until I pass out or end up in the drunk tank.

[Nammu]

You may believe you're bipolar and you may believe you're an alcoholic but it doesn't sound like you've accepted it yet. Acceptance is a ***** to swallow. It's gonna come down to the bottom and where that is for you.

safe landings

[Tryingtobehappy5]

Nammu I thought I had accepted it and life was so good for a while, it makes me so sad that things have ended up this way again.

I dont think I have a bottom, if my episode a year ago that ended with lifeflight, time on the cardiac ward and then a month IP in psych wasnt enough I dont think anything will be.

[bizi]

I need to go to bed just wanted to say hello, sorry you are struggling.
bizi

[PsychoPhil]

TryingToBeHappy, it's good to hear from you. I'm so glad you were doing well for 10 months. You can do it again, all best to you!

[Rick7892]

Sending good wishes your way!

[Tryingtobehappy5]

Well I tried making a schedule and failed. I tried calling the pdoc today and he didnt call back now I dont even want to talk to him. Tonight I am trying not to drink but I will probably only make it one night without alcohol and thats only because I cant get what I want at this time of night.

Huge failure and Im so sick of being a failure, no one can help me if I dont help myself and obviously Im failing at helping myself. The meds are useless, the therapy is useless. Life is crap and I cant get control back.

[Nammu]

Meds can't work if your abusing alcohol and therapy is also compromised. It's a start that you are tired of the same old have you looked into inpatient alcohol treatment to help you stop?

[Tryingtobehappy5]

I went to rehab for 3 weeks in the summer. I did manage 3 months sober then which is the longest I have gone in the past 3 years.

The meds quit working before I started drinking. But yes the drinking has definitely made things worse in every way.

[fern46]

Originally Posted by Tryingtobehappy5

Well I tried making a schedule and failed. I tried calling the pdoc today and he didnt call back now I dont even want to talk to him. Tonight I am trying not to drink but I will probably only make it one night without alcohol and thats only because I cant get what I want at this time of night.

Huge failure and Im so sick of being a failure, no one can help me if I dont help myself and obviously Im failing at helping myself. The meds are useless, the therapy is useless. Life is crap and I cant get control back.

Take a look at what you wrote here. I think it is probably indicative of the types of thoughts you have looping around in your brain. You cannot change habits and negative behavior without changing your thoughts and emotions. I could explain the neuroscience behind that, but it would take a while. Suffice to say that the thoughts are set in a subconscious pattern that keeps looping and the loops then drive your behaviors and the choices you make.

It is extremely difficult to keep these kinds of thoughts from coming up. That takes a lot of meditative practice. However, you can learn to be more aware of them when they surface. You can learn to catch yourself and then then rewrite them so that you train your brain to end up in a new place of more beneficial thinking. Over time, the new destination will become the pattern when you are triggered.

For example, you said 'I will probably only make it one night without alcohol'. You can be on the lookout for these types of defeatist thoughts and then after they surface, think to yourself something like 'my old pattern has been to give in to this and buy alcohol. It is my will to stop drinking and I know I can go for as long as I want if I force myself to make better choices. I can do this'

'I'm a huge failure' can come up and then you can pair it with 'I have failed in the past and it hurts. I forgive and love myself anyway. We all make mistakes. I have had many successes in the past as well. I am going to be successful again.'

The goal is for your thoughts to end up in a different place each time. Pairing this up with feelings that shift from failure into self love and acceptance makes it even better. This type of approach serves to rewire your patterned thinking and emotions.