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Bipolar Disorder and Addiction

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“When I first got diagnosed with bipolar 1 disorder,  I was in denial. For months after hearing doctor after doctor telling me the same thing I would still hide my meds, take drugs and do anything to prove I wasn’t crazy. But the hospital visits and psych ward continued to prove I was wrong. I was crazy.

“But being bipolar doesn’t mean your crazy. The more I learn about my disorder (reading articles, books and even digging into my past) I notice that I am not alone. I notice that these moments of clear insanity have a purpose, they have a name. There are reasons to me madness and now I finally have an opportunity to treat it.

“Its important that we are knowledgable about our (or your loved ones) diagnosis because it gives us the power and courage to live with it. This is an article I have found very helpful to myself as I live with bipolar and co-occurring addiction. It’s informative and concise, clearly describing the highs and lows of bipolar disorder.” -Love, Robyn

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Bipolar disorder, once commonly known as manic depression, is a serious mental disorder that is characterized by sudden and intense shifts in mood, behavior and energy levels. Like substance abuse, bipolar disorder poses a risk to the individual’s physical and emotional well-being. Those afflicted with bipolar disorder have a higher rate of relationship problems, economic instability, accidental injuries and suicide than the general population. They are also significantly more likely to develop an addiction to drugs or alcohol. According to statistics presented by the American Journal of Managed Care:

  • About 56 percent of individuals with bipolar who participated in a national study had experienced drug or alcohol addiction during their lifetime.
  • Approximately 46 percent of that group had abused alcohol or were addicted to alcohol.
  • About 41 percent had abused drugs or were addicted to drugs.
  • Alcohol is the most commonly abused substance among bipolar individuals.

If you are struggling with bipolar disorder and with a drug or alcohol problem, you may have a Dual Diagnosis of bipolar disorder and substance abuse. Having a Dual Diagnosis, or a co-occurring disorder, can make recovery more challenging. Bipolar individuals may experience periods of intense depression alternating with episodes of heightened activity and an exaggerated sense of self-importance. This emotional instability can interfere with your recovery program, making it difficult to comply with the guidelines of your treatment plan.

Dual Diagnosis rehabilitation programs are designed to meet the needs of clients who are faced with this complex psychiatric condition. Staffed by specially trained and credentialed mental health professionals and addiction specialists, these centers offer care that integrates the best treatment strategies for bipolar disorder with the most effective treatments for addiction.

How Are Bipolar and Addiction Related?

There is no easy explanation for the high rate of substance abuse and chemical dependence among bipolar individuals. One reason for this phenomenon is that a large percentage of individuals attempt to self-medicate with drugs and alcohol in an effort to numb the painful symptoms of their bipolar disorder. Symptoms of bipolar disorder such as anxiety, pain, depression and sleeplessness are so alarming, that many individuals will turn to drugs and alcohol as a means for offsetting the discomfort, if only for a little while. On the other hand, the National Institute of Mental Health notes that drinking and using drugs may trigger depressed or manic moods in someone with bipolar disorder.

Age and gender may play a part in the relationship between bipolar and addiction. According to the journal, Bipolar Disorder and substance abuse is more common in young males than in other population groups.

Young men are more likely than females or older men to take dangerous risks or to act on serious self-destructive impulses. In elderly individuals with bipolar disorder, the incidence of substance abuse is much lower.

Clinical researchers believe that brain chemistry may influence both bipolar disorder and substance abuse. People with bipolar disorder often have abnormal levels of serotonin, dopamine and norepinephrine, according to WebMD. These chemicals affect vital functions like appetite, metabolism, sleep and your body’s response to stress. They also affect mood and emotions. Heavy use of drugs or alcohol can interfere with the way your brain processes these chemicals, causing emotional instability, erratic energy levels and depression. People with bipolar disorder may turn to drugs or alcohol out of an unconscious need to stabilize their moods. Unfortunately, substance abuse has the opposite effect, making the symptoms of bipolar disorder worse.

Symptoms of Bipolar Disorder

We all go through intense episodes of sadness, elation, anger or despair. But for someone who meets the diagnostic criteria for bipolar disorder, these episodes are all-consuming and uncontrollable. There are four major types of mood episodes that characterize bipolar disorder: mania, hypomania, depression and mixed episodes — each of which has a set of unique symptoms:

Symptoms of Mania

Mania is the “high” end of the mood spectrum for bipolar individuals. Symptoms may include:

  • Moments of tremendous optimism and significant pessimism
  • Grandiose feelings
  • Rapid talking
  • Little sleep
  • Impaired judgment, irrational behavior
  • Delusional behavior
  • Hallucinations

Symptoms of Hypomania

Symptoms are similar to those found in manic behavior but less intense. Hypomanic individuals are usually capable of managing their day-to-day lives, but they experience a higher than usual level of happiness, irritability or energy. You may feel that you’re capable of taking on more responsibility, or that you need less sleep. People in your life may find that you’re more talkative or sociable. You may also be more prone to engage in risk-taking behaviors, like substance abuse. Hypomanic periods are extremely productive for some people, and because psychotic symptoms do not occur in hypomania, it might seem that you don’t really have a problem.

Symptoms of Depression

At the “low” end of the bipolar spectrum is depression, an emotional state that is often characterized by sadness, tearfulness and despair. Depression in bipolar disorder may last for days or weeks, depending on your mood cycle. These periods are dangerous for Dual Diagnosis individuals, who have a higher risk of self-injury and suicide when they’re using drugs and alcohol during a low period. When you’re depressed, you may experience:

  • Hopeless feelings
  • Loss of interest in things that used to make you happy
  • Fatigue
  • Changes in appetite
  • Self-loathing
  • Suicidal thoughts

Symptoms of Mixed Episodes

The symptoms of bipolar disorder aren’t always clearly defined. In a mixed episode, behaviors reflect a combination of mania and depression. For example, you may have suicidal feelings and a loss of interest in your daily activities, combined with racing thoughts, pressured speech and a loss of sleep.
You may feel the urge to drink or take drugs in an attempt to balance out these unpredictable mood swings, but intoxication is only a temporary fix that won’t provide permanent relief. To achieve a full recovery, you need professional treatment that helps you stabilize your moods as you deal with the cravings and destructive impulses that characterize addiction.

 

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The Ultimate Mood Tracking App: Optimism

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“I am completely in love with this app called Optimism. It is incredibly useful for those that are struggling through addiction and co-occurring disorders. It keeps track of everything from sleep to triggers. I remember searching for some type of workbook where I could record my mood and all that nonsense to find patterns so as to prevent mania and depression. This app helps me do that and more! Not only does it just intake the information and allow for extra notes, it literally gives you data summaries over whatever period of time you want. It is simple, thorough and so convenient, I would recommend this for even people that are SANE! Please read the specs below and give it a try. I promise you won’t be disappointed!” -Love and light forever, Robyn

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Optimism is a mood charting app that helps you develop strategies for managing depression, bipolar or other mental health conditions.
*Note: a network connection is needed to use this app.*

The app helps you to:

  • Develop and monitor health strategies
  • Learn the “triggers” of a decline in your mental health
  • Recognize the early warning signs of a decline.

Detailed charts and reports are available within the app or by immediate email delivery. These form a feedback loop, providing concrete starting points for exploring things that are affecting your mental health.
The charts and reports can be invaluable for working with a health professional. They provide a detailed history that is fast and easy to review.
The Optimism app is not intended as a substitute for professional medical advice, diagnosis, or treatment. The advice of a qualified health professional should always be sought for questions regarding a medical condition.

In a nutshell, the purpose of self-tracking is to learn more about yourself and achieve better health.

  • By using the Optimism apps you can monitor the patterns in your life, to identify the negative influences (or “triggers”) that impact on your health, and the early warning signs that your health is deteriorating.
  • Optimism can help you find the small things, as well as the big, that help you to stay well. It can show you the impact of positive strategies that you adopt on your well-being.
  • It helps you to plan for better health. By bringing together your knowledge of your triggers, early warning signs and symptoms, and wellness strategies you can develop a plan for remaining well. That is the key. The purpose of the software is to plan for wellness, not just keep a record of illness.
  • Rather than be a passive recipient of treatment, or just seek treatment in reaction to a new episode, Optimism can help you to have more involvement in your health and a greater sense of control. In general people achieve better health outcomes when they educate themselves and are proactive with their health.
  • There are many health professionals who love Optimism. By tracking your mental health you can provide your clinician with a precise, detailed history. It removes the problem of memory recall and gives an accurate picture of what has been happening. It gets to the bottom of what is or isn’t working, which helps them to give more relevant, appropriate advice and treatment.

Every person’s illness is different. “One Size Fits One”. For many people treatment is difficult, a slow process, or not entirely successful. Optimism is designed to help increase your chance of success.

Why We Smoke SO Much!

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” When I first started smoking, I thought I was cool. Then I stopped. When I picked up smoking several years later, it was a way to get high. Then I stopped.  It wasn’t until I found myself in recovery that I really started smoking like a chimney. My parents were concerned and frankly annoyed my this new habit. There was a sense of relief  however, when they discovered in their NAMI class (National Alliance on Mental Illness) that this was commonly seen in people who have mental disorders and addiction. So I went on their website and found the article that explains it all! So if your a smoker, you may relate to this bit of text! It does focus on mental illness but a lot of the information can be useful to all.” -Peace, Robyn

Smoking and Mental Illness

People living with mental illness have a very high rate of smoking. A study by The Journal of the American Medical Association reported that 44.3 percent of all cigarettes in America are consumed by individuals who live with mental illness and/or substance abuse disorders. This means that people living with mental illness are about twice as likely to smoke as other persons.

A positive note is that people who live with mental illness had substantial quit-rates, which were almost as high as the group without mental illness. NAMI has led many changes in our mental health system─getting access to the tools to quit smoking is a way to improve the quality and quantity of life. Improving lives is a new advocacy pursuit.

The Connection between Mental Illness and Smoking

There is no one single, certain reason why so many people who live with mental illness smoke. It may be a combination of brain effects, psychological effects and the social world in which we live.

From a brain-based perspective, research is being done to determine if and how nicotine is involved in some of the brain’s memory functions. If nicotine is a factor, then this could explain why so many people living with an illness like schizophrenia or other illness involving cognitive deficits may smoke. Even though smoking is thought to enhance concentration and cognition, the effects are short in duration.

Researchers and the medical community have a great deal to learn about how smoking impacts the brains of those living with mental illness. It is known that people diagnosed with schizophrenia often smoke before the onset of symptoms and that they smoke more often and inhale more deeply than smokers without schizophrenia.

While we still have a lot to learn about why people smoke, there is plenty of information to support the serious health risks of smoking. So while there may be good reasons why you were attracted to smoking, the key is to figure out ways to increase rates of quitting. Nicotine isn’t a health problem on its own, but when smoked and combined with hundreds of other chemicals that are present in cigarettes the practice of smoking is toxic.

Psychologically, all addictions soothe cravings. People often find themselves relaxed and less tense when their addiction is fed. This is true of cigarette smoking. Smoking can also be part of a social norm, one where people in your social circle all hang out and smoke. Some people who live with mental illness learned to smoke in a hospital or in group-living settings. These examples help illustrate how the mental health culture needs to move forward to reduce the tie between socialization and smoking.

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Facts About Smoking

People die from smoking-related illnesses. Every year, smoking kills about 200,000 people who live with mental illness. Smoking harms nearly every organ of your body and diminishes your overall health. Smoking is a leading cause of cancer and of cancer-related death.

Smoking also causes heart disease, stroke and lung disease. With the increased risk of heart disease from second-generation atypical antipsychotic medications (SGAs), individuals living with mental illness must try to quit.

Inhaled cigarette smoke is made up of 4,000 chemicals, including cyanide, benzene, ammonia and carbon monoxide to name a few. There is no safe tobacco product, so switching to a smokeless or chew product will not eliminate your risk of smoking-related diseases.

People are finally waking up to the fact that smoking is a true health hazard, and people need to quit in order to live longer. More psychiatric facilities are going smoke-free, and NAMI is advocating for access to smoking cessation in outpatient settings.

State mental health commissioners and state medical directors are committed to changing the way the public mental health culture relates to smoking. Check out their toolkit (http://www.nasmhpd.org/general_files/publications/NASMHPD.toolkitfinalupdated90707.pdf) to see what policy changes and strategies they are using to create a healthier mental health system environment.

Smoking’s Effects on Symptoms and Medications

Research shows that people living with mental illness do not have worse symptoms after they quit. It is understandable that this is a concern with quitting smoking. Quitting is hard work, and it may take many efforts to be successful. Be sure to get support, talk with your doctor, set a quit date and explore the tools for success (Link to tools for success section) that are available to help you quit.

If you are a smoker and you quit, you can usually get the same treatment results from lower doses of psychiatric medications. Smoking increases the breakdown of medicines in your body, so smokers need to take higher doses to get the same results as someone who does not smoke. Without cigarettes you may need to take less medication. An additional benefit is that a dose reduction will likely reduce side effects of medicines, such as weight gain and other side effects.

Who Have I Become by Best Coast

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When I listen to this song I think back to when I was using and how I began to lose myself, question myself and hate myself. It was a dark place but now that I am out I can really reflect and see how my life has changed. Do some reflection yourself and enjoy the pop tunes from the fun and upbeat band, Best Coast.

Lyrics:

Sometimes I hate myself for loving you…
And my dreams are just dramatic versions of
My real life.
And life is short, but so am I.
What does it matter anyway?
Just a small price that I pay to feel the same way every single day…
Every single day…

I want to be somebody else.
Sick of myself and how I feel.
Don’t recognize who I see in the morning.
Used to be so clear.
And now I’m waking up to strangers with their shadows on my face.
So quickly I remember what it felt like to be in this place…
To be in this place…

The day is done and he has won
again I’m running from the one
I love, but I don’t know
if its true.
Do I love you?

The day is done and he has won
again I’m running from the one
I love, but I don’t know
if its true.
Who have I become?
Who have I become?
Who have I become?

And now I’m tired
Oh so tired of this story being told.
When did I wake up and
Suddenly my soul has grown so old?

You’re never wrong.
You’re never right.
It’s never told in black and white.

To my surprise
I realize
That I am always on the run…
Always on the run…

The day is done and he has won
again I’m running from the one
I love, but I don’t know
if its true.
Do I love you?

The day is done and he has won
again I’m running from the one
I love, but I don’t know
if its true.
Who have I become?
Who have I become?
Who have I become?

It’s always coming up so wrong.
And I am always on the run.
It’s always coming up so wrong.
And I am always on the run…

 

P.T.S.D. And Childhood Trauma Linked to Addiction

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“This is a wonderful article that focus’ on P.T.S.D that can develop from childhood trauma and how it is linked to Addiction. I may not have experienced much trauma due to my up-bringing but I can fully understand the diagnosis of P.T.S.D after I was faced with the traumatic experience of an extreme manic outbreak while I was living abroad in India. Its hard not to think of something so dramatic everyday and live in extreme regret and torture from the memories. I hope your able to find as much appreciation for this problem and its connections to addiction recovery as much as I have.” -Love, Robyn

by Kevin VaLeu

We live in an addictive age. In the last five years of my life I have come across and counseled more people struggling with cocaine, marijuana, alcohol, anorexia, sex, and a whole host of other addictions then I did in the previous five years.

Are people becoming more immoral? Or is there something else causing people to turn to substances and sex. Perhaps these next statistics will shed light into what I believe is the underlying causation of our culture’s craziness.

1) The turn of our century (2000) marked the first time in American history that the majority of our children (over 50%) were raised without both biological mother and father in the same home.

2) Even if both mother and father are in the home it doesn’t mean they are in any better shape if they are being abused or neglected. 61% of all children experience some form of neglect.

3) Greater than 1 out of 3 girls will be sexually molested during their childhood or teenage years.

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What does this mean? We live in a day and age where children are experiencing trauma at unprecedented levels from molestations, abuse, abandonment, neglect, and dysfunctional or fragmented homes. When traumatized children slip under the radar of effective treatment they will find illegitimate, illicit and unhealthy coping mechanisms to medicate the long unforgotten pain.

Link Between Trauma and Addictions

Research shows that 50-60% of women and 20% of men in chemical dependency programs report a history of childhood sexual abuse. When you include people that have experienced P.T.S.D. (Post-Traumatic Stress Disorder) or childhood trauma the number can climb as high as 99% of them having substance abuse problems.

How Trauma Affects the Brain

In order to understand how trauma makes one more susceptible to addictions, we need to understand two types of memories at work in the brain: 1) Explicit Memory–this is a memory that we can deliberately call up or put away at any time. We have a sense of control over it and we know it is just a memory; 2) Implicit Memory–these memories have coded in them not only a picture of a past event but the resulting feelings, sensations, and emotional response that went with it. These memories happen outside our control.

These memories are adaptive or automatic, which means they can “pop up” or shoot into our minds involuntarily upon some stimuli or current event that reminds us of a past trauma (called association). This is why a current event can trigger a flood of negative emotions that are identical to the emotions we felt at the time of the trauma. In fact, this is why people with PTSD are continually being tortured from their memories because when something “triggers” their past they are actually reliving the painful past trauma over again. Its no longer just a memory they recall, its all the emotions, feelings, and sensations engraved upon that memory card they recall and relive in the present.

This is why many Vietnam veterans with PTSD experience such painful flashbacks. They aren’t just remembering the past, they are actually reliving it. The bomb they see coming at them in their memory is a real bomb coming at them right now.

In addition, as we grew up, all of our basic assumptions about people (e.g. can they be trusted), ways of relating, and behaving towards people are formed on these implicit memory cards. This explains why you get tense or tighten up at the bank whenever you run into a particular man that reminds you of your cruel step-father.

In order to successfully treat a person with PTSD they have to be guided to convert their implicit memories into explicit ones.

Trauma is Recorded in the Limbic System which sits on the Vegus Nerve.

An interesting physiological discovery is that our traumatic memories are housed in our limbic system. This might not mean much if it weren’t for that fact our limbic system is on top of our Vegus Nerve. When the vagus nerve is stimulated by pain, fear, other distresses, and at an extreme, fainting may occur since such stimulation of the nerve affects the pace of the heart. Such stimulation also causes nausea and cool, clammy skin.

Its now easy to see how memories not only affect our emotions but also our physical bodies.

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Emotional Disregulation & Tension-Reduction Behaviors (Addiction):

When an implicit memory is jarred the body automatically releases the hormones of cortisol and adrenaline to give it power or enable it to go into the “flight” or “fight” (emergency) mode. However, for a person that has experienced emotional trauma, there response mechanism is a bit different. When a person with PTSD has their “flight” or “fight” system alerted they experience the current stress at a visceral or guttural level (soul depth) and have to shut down the hippocampus. Similar to a computer that is slowed down by too many programs running in the background, the mind shuts down certain parts (in this case the hippocampus) because it is too difficult to run it while in emergency mode. Implicit memories can cause one to live in a constant state of being overwhelmed. Past traumas that induce implicit memories also damage mood regulation. It is easy to see how the extra strain on a brain from trauma would affect our ability to stay an even keel.

When the mind tries to remember what has happened during a traumatic moment a person experiences emotional disregulation. There are three coping strategies a person may employ in dealing with emotional disregulation:

1) Avoidance: A person doesn’t want to talk about the trauma, think about the trauma, or be around anybody or anything that reminds them of the trauma.

2) Dissociate: They disconnect from reality which, without realizing, turns off the integrative links connecting the pre-frontal cortex to the limbic system. This means one disconnects from their experiences, which on the one hand helps them escape from the painful anxiety that would normally come, but on the other hand is detrimental from an emotional stand point. You lose the ability to feel anything through this numbing process; even the ability to empathize for others. This is damaging to the psyche.

3) Tension-Reduction Behaviors (leads to Addictions): When trauma occurs the brain fires up, becomes overactive and makes a person feel they cannot deal with it without the aid of some type of pleasure to “settle things down.” This is the point where a person may turn to drugs, alcohol, sex, gambling, etc. It is here, at this stage of the process, that lends itself toward addictions.

Box of Dreams

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When I got home from rehab I felt completely lost. Out of work and nothing to do, I turned to one of my favourite coping skills: ART. My mom had  told me she made a box and filled it with symbols of her hopes and dreams and one day they all came true in there own way. So I became inspired to do something of the same…

I took an old shoe box and collaged as much as I could! Anything like inspiring or uplifting images and words all toped off with a bit of glitter! Instead of filling it with objects, I left it empty with a single notebook inside. Now everyday when I wake up, I head into my dream box and write down what I’m grateful for. Some days I’ll even get a card in the mail from someone I just wrote about that same day! Its a great reminder of your goals and aspirations all while growing the relationship you have with your higher power through this small meditation! Try it out on a rainy day and keep the box someplace where you will always be reminded.Share your photos too!

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What you need:

  • A box
  • Old magazines or newspapers
  • Scissors
  • Glue
  • GLITTER (optional 😛 )
  • A notepad/notebook to fit inside
  • A pen
  • A desire to change!

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Whats next?

Wake up every morning and get creative again! Thank your higher power, write what your grateful for, write about your dreams and aspirations, or inspiration you find at meetings! Return the book in the night and do it all again tomorrow! You can even do as my mom suggested by placing small items of symbolic importance in the box and hide it under your bed. Every night before you drift off to sleep, count off all the items in your head as you pray to your higher power.

This is a great coping skill to practice, from making it to using it everyday. You will find your spirits uplifted and heart fill with love as you recount all the things that make you happy in life.

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Peace and Love, Robyn

Breath Control by MC Yogi

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This is one of my favourite sounds to listen to when I feel the stress building and my temperature rising because it reminds me to BREATHE! Its such a simple song but the lyrics are exactly what you need in those times of high stress. Deep breathing is one the best known coping skills because its so simple and so effective. This song can help you focus on your breath, taking inhalations and exhalations to “just let it all go.”