Alcoholism and depression--dual diagnosis

Here are my ideas on dual diagnosis, also called comorbidity. 85 to 90 percent of alcoholics, depending on the population, do NOT have a coexisting (or pre-existing) mental health disorder such as depression. Often any depression or anxiety is due to the CNS depressant effects of chronic excessive alcohol use, which will dissipate with a substantial period of abstinence. If an individual has both depression and alcoholism, obviously, if the depression is severe enough to endanger the person through suicide or self-harm, then the depression will need to be stabilized immediately. However, talk therapy or even antidepressant medications for the depression will often NOT be very effective if the alcoholic continues to drink. So, generally, absent danger-to-life issues, the alcoholism should be treated first, that is, the drinking stopped and alcoholism treatment completed. Usually, if the depression is related to the alcoholism, it will not be a problem after 30 days of sobriety and treatment. Check out my website for more information and professional help.
Jan Edward Williams, MS, JD, LCADC
www.alcoholdrugsos.comjwilliams@alcoholdrugsos.com
443-610-3569

Why is spirituality important in recovery?

Addiction is so powerful that developing a relationship with a source of spiritual strength can help the recovering person to fully access all of his/her innate fortitude and will power to stay away from the first drink or drug. The source of spiritual strength can be the recovering individuals in the rooms of the 12 Step Programs such as AA or NA.

God, a Higher Power, nature, or whatever you call your spiritual power source, often can be experienced in the simple act of one alcoholic or addict helping another.

Spirituality

Sometimes people are turned off by recovery in the Twelve Step Programs such as Alcoholics Anonymous because of issues they may have with organized religion. The strength of 12 Step Programs is that they urge each individual to develop his/her own understanding of a source of spiritual strength. Perhaps the best place to start, I think, is with the willingness to be open to the support of others in recovery who have learned how to not drink by using AA principles. The strength of the group can be the foundation of spiritual growth.

Recovery Community

Check out this website for good recovery information and support: http://onlinerecoverysupport.ning.com/

Courage to change the things I can

The Serenity Prayer: God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. How does an individual in recovery find the courage mentioned in this prayer? As with most aspects of recovery, developing the "courage to change the things I can" is an ongoing process. The progress that you can achieve will most often come from improving and strengthening your relationship with your source of spiritual strength, your Higher Power. Ways to improve and strengthen that relationship include use of daily spiritual disciplines (morning and nightly prayer, spiritual readings and reflections), helping others, and asking for help from others, in recovery, attending 12 Step meetings and listening and sharing. Fear is normally a huge issue in early recovery. Ask in morning prayers and throughout the day for the strength to take risks and do what you are supposed to do. Over time, you will reach the point where fear, though present (fear seems to be part of being human), rarely will prevent you from doing "the next right thing."

Is there a Cure for Addiction?

Most persons knowledgeable about addictions would simply answer: "no." Addiction to alcohol or other drugs is not cured by time abstinent from use of the addictive substance. There is no therapy that can teach an addict or alcoholic to use without problems over any significant period of time. Because of changes in brain chemistry and other pschological habituation factors, few, if any, individuals once addicted can return to normal, non-harmful use. The answer to addiction is abstinence from the addictive substance. Long term abstinence usually can be maintained only through comprehensive treatment that addresses the physical-medical, emotional-mental, and spiritual issues that are particular to each individual.

Seniors

Seniors do well in treatment for drug or alcohol problems, provided the service providers understand the special needs of seniors. "Patient, gentle, respectful" are traits that counselors must have especially with seniors. Older persons may have had recent losses, may be in chronic pain, and may be overwhelmed by a host of problems that are associated with being elderly. It is most unfortunate that even physicians fail to understand the special issues of the elderly. I just read about a study that as their patients age, physicians tend to spend less time with them. Physicians also tend to not even probe for drug or alcohol problems in the elderly, assuming that problems with balance, memory, blood pressure, sleeping, etc. are due to ageing rather than to medications and/or alcohol use.