Substance abuse/addiction and bipolar disorder

What are your experiences with dual-diagnosis? Is there a trick to breaking the cycle? The meds won't work if you're using, but it's damn near impossible to stop using when any moment you're not fked up you're punching holes in the walls or self harming.

I just spent 12 days involuntary to "sober up and chill out" and as soon as I got home I ruined that and I know if I don't cut the sh.it I'm just gonna spiral and end up back in those fuc.king restraints. I got rid of everything, but it's not like I can't just walk down the street and get more.

Hi MuddyBoots. My experience was that my alcohol abuse worsened my episodes from no hospital bad to hospital bad. After my 1st, in a dual diagnosis ward (with detox), I tried to stop 100%, going to AA almost every day. Sometimes twice per day. Then about 88 (or so) days later, I drank again. Then some more sober days, and more AA Then a "slip". Repeat. However, I went from a relatively safe home drinker to going out to bars for the "slips". Being on heavy psych meds, I became vulnerable to bad blackouts. And driving drunk. I was in and out of the hospital because of this. It was mostly because of worsening mixed manic states with psychoses more than needing full detox. But then I'd again accumulate many sober days, then another slip. Once I nearly poisoned myself by drinking too much while on a heavy med cocktail.

There came a time when my alcohol cravings were very strong. An IOP psychiatrist tried prescribing meds to help curb them. One did nothing, but another did help a bit. However, what helped more was actually not these, but a particular bipolar med cocktail. When I started the new one, I seemed to lose the desire to self medicate. Also, I lost the manic side of my episodes. In my case, unlike perhaps yours, it was mania that really fueled my drinking. When that was gone for me, it was easy not to drink.

How would you tell the difference if you're just problem drinking because you're in a mood episode or because you're a genuine alcoholic?
I'll use drinking for this example, though I'm more of a polyaddict. Could one responsibly drink outside of a mood episode, but then as an episode develops the drinking becomes problematic again, but when the episode subsides you can drink normally again?

@MuddyBoots. I had two relatively successful attempts at staying sober, but wound up going back out to drink more. I've had over 20 years of sobriety now, though.. After the first year, or so, the urge to drink seemed to disappear altogether. I still go to 4-5 AA meetings a week. I know this approach isn't for everyone, but it worked for me and I have a steady group of good friends who have stayed sober. It helped me knowing I wasn't alone. To be honest, I don't think I would have been sober this long without AA, but perhaps I'm just weak.

You're the only one who can determine whether you're ready to stop using. No one can force you to seek help. There's a saying in AA, that "it takes what it takes" to make a decision. If I recall correctly, you've tried NA before. There are folks in AA who have drug problems that dwarfed their drinking problems. I have a good friend whose drug of choice was heroin. The only requirement to attend AA is a desire to stop drinking. If that 's the case, you'll probably be welcomed with open arms despite the fact you favor other substances over alcohol.

As @Soupe du jour pointed out, our psych meds don't mix well when we abuse other substances. If I'm depressed, the absolute worst thing I could do is pour a depressant (alcohol) into my system. I've had suicide attempts that were probably more like self abuse since I'm still alive and kicking. Each time I did this I was either drunk or zonked out on benzos.

Whatever you decide to do, you'll be in my thoughts. You don't have to be alone in this.

Sorry, but one more thing...I would be kiddng myself if I thought I could have one drink in an episode, or even when I'm asymptomatic. I, too, have an addictive personality. I also abused weed, and I still struggle with a food addiction which is, in part, due to the fact I'm taking APs. I'm the only one who can decide to put the fork down when I'm full. Again, perhaps I'm just weak, but going to Weight Watchers meetings does help. I'm a big proponent of support groups...as if you couldn't tell...

I guess I don't really want to get better. I'm just so comfortable in this chaos. My therapist says because I grew up in a tumultuous environment I'm going to seek out more chaos because that's what I'm used to. Guess I'm just used to the smell of sh.it.

But no one that isn't paid to irl seems to give a damn so maybe they know I won't really hurt myself too.

I can relate, Muddy. I was the same way when I was drinking. I knew beer was contributing to my downward spiral, but didn't really want to quit...it's easy accept chaos when we're active in our use. All I can share (I'm sounding like a broken record) is "it takes what it takes." I was almost literally at the gates of hell at the end of my addiction. I chose to seek help. No one forced or guilted me into stopping. Having been in AA for 20 years, I've known my share of people whose lives were snuffed out by their addiction. Death forced them to stop using. Please seek some kind of safety net before addiction really kicks you in the backside. You're obviously an intelligent and articulate woman. The world would be a less kind and informed space without you...whether you believe it, or not.

I do believe some people are bona fide alcoholics (or other types of addict), while there are also self-medicators of severe mental illnesses. Obviously there are people who are both at the same time.

I can't say for others (or you) how to tell which category applies. I will say that regardless, if you find you can't drink responsibly or moderately at times, it's best to stop. If a person trials moderate drinking and gets the same bad results, maybe "alcoholic" might apply. Albert Einstein said that insanity is doing the same thing again and again and expecting different results. A total reversal can be the only way to regain sanity.

You know, it's not that bad being sober. In fact, being so can open the doors to a very new and different appreciation of life. It can seem not to be in the beginning, but persistance and patience can really pay off...but I know how hard the two "p"s can be. I'm referring to more than just drinking here.

I understand being sober isn't bad, but you hit the nail on the head when you said it doesn't seem like it in the beginning because getting sober is pretty fking hard. I don't think I've had a positive feeling since the last time I drank.

I'm starting to think I'm not "a true schizoaffective." It's probably all substance induced. I think I just get a bad emotion, maybe a little more extreme than the nonmentallyill bear because trauma, use to escape, and boom, symptoms.

In my twenties I self medicated with alcohol. I stopped and got help when I got an OWI.

I know it was just self medication because when I was put on meds and feeling better I didn't want to drink anymore. In fact, now I just have the occasional drink during special occasions and don't particularly like the feeling of being drunk.

When I was an active drinker I would drink straight vodka throughout the day, including while at work. It got really bad before it got better but somehow I made it through. I also detoxed alone, at home, which probably wasn't the best idea, but somehow I did it!

I used to trick myself by saying, "if I take my meds in the morning it will get rid of the bipolar, so I can go ahead and drink at night because the meds would have worn off and it won't be so bad, they're technically not mixing."

Talk about chaos!

I hate to say this, but I ended up in jail for 10 months and rehab for 14 months because I refused to stay sober and kept mixing my meds with substances. I wish I could say meetings and AA helped but I can't buy into the brainwashing aspect of it, which is of course, just my opinion.

Today I am sober two and half years and living my best life. I take my meds regularly and sleep very well. Everyone finds their place in their sobriety different; it just takes hard work. I wish you the best, I know you can do this.

I started by moving out of the city, finding a sober girlfriend, staying on my meds, staying busy. NA works for lots of people - I've gone to plenty meetings and they sure can be insightful.

I still dream about using at night time, maybe a couple times a month or more, after almost a year sober.

Don't expect it to go away. Take it very seriously, once you're serious. That's my advice.

I attend AA meetings @LadyShadow, but don't think it's brainwashing. "Take what you need & leave the rest," is one of the mottos in the program. If I I don't agree with something, I speak my own truth. I'm an athiest, so initially found references to God annoying. There are many good messages around the tables of AA, though. I choose to focus on the fellowship. Congrats on your extended sobriety! It doesn't matter how you do it, as long as you can cut the chaos out of your life.

The using dreams really suck, @insideoutsider. I haven't had one in several years, but I remember waking up, heart thumping & in a cold sweat. Nasty business!

Yeah it's not pleasant. Never got cold sweats I'd imagine that would be very uncomfortable. My dreams tend to revolve around either trying to get some, having wasted some, trying to get away with doing some, and sometimes just going all out crazy on it.

I find myself still trying to imagine what it felt like, when awake during the day. Or I'll watch movies and be like "yep that dude is high a ****".

Some people have a harder time with it than others, but that doesn't mean weakness. It could be lots of things - dopamine deficiency, impulsivity, needing an escape from life situations, even just being at the wrong place at the wrong time or connecting getting high with other normal tasks and normalizing the destructive behavior.

At the end of the day, everyone can be taken down by drugs unfortunately.