Topic Tuesday **CLOSED**: Supporting recovery through substance abuse and mental illness

Welcome to the conversation @Jo

Thanks for sharing that with us. It sounds like that stategy was helpful for you and your son, which is great to hear!

Yes, that is so true !

Hi everyone, I’m @Hobbit! Thanks for having me here on these forums tonight. I actually am used to these forums, although I haven’t been on them for quite some time.But it's good to be back!

I think people self medicating with alcohol and drugs due to mental illness is actually quite understandable. I know, I did it!

Many rehabs and treatment centres do nowadays acknowledge dual diagnosis, although the process still seems somewhat unclear. A lot of workers would say that you need to confront the AOD stuff first and then deal with the mental illness afterwards. I sort of agree, although it's very hard when both are at the foreront of a person thoughts and actions.

What I have found quite successful is to acknoweldge that there is an underlying issue that most likely is causing the addiction, and not to focus so much on the symptoms, but to keep looking at what the symptoms cause is. THis is actually called Trauma Informed Care, and required a great deal of patience from the carer/dfamily member to do.

SOmetimes, it boils down to a load of support, which might also mean "backing away" quote often when needed.

What do other people think?

We can talk more about this furhter.

Yes, we had to try it a few times but in the long run and with a lot of tough love and persistence, we did it.

Hi @BatGuano, I'm wondering what your thoughts are on if people drink/take illicit substances to be substance affected rather than be affected by MI? Is like a form of self-medication, combined with dealing with stigma?

@Jo I'm curious to know, how/if it was hard to say 'no', in the times when he asked for money? How did you manage that?

You are right @BatGuano - there is still less stigma on AOD use than MI. I guess that is because people can see tangibly what the problem is with AOD use, and see a way to confront it. I guess for people with dual diagnosis, there is that double stigma going on.

I think the main side effect of negative stigma is social exclusion and isolation. And this is the merry go round. Once a person is excluded from a socety, they naturally tend to isolate from it, which can cause things like depression to really kick in, which can be band-aided with substances.

SOcial inclusion is a key here I think.

Sometimes he was absolutely adamant and panicky/hyper etc. and I gave in. Other times we were able to talk it through and he then chose not to go through with it. It took quite a few attempts before it actually worked but finally it did.

Hi @Jo, I remember my fasther was often giving me money, which in hindsight enabled me for years. It wasn't until my family started putting boundaries in place with me that I started to turn around. (Although I must admit that was a very rocky road to begin with)

There is some good information there about Trauma-informed care and I believe this is a very important aspect of viewing dual diagnosis myself.

@Jo it sounds like you did a great job at setting some boundaries with your son, which can be very difficult to do! @Hobbit What kind of boundaries do you put in place as a carer for someone with dual diagnosis? Are they the same boundaries for MH as they would be for AOD?

Which leads me onto boundaries. I thought I would pose this question:

What kind of boundaries do you put in place as a carer for someone with dual diagnosis? Are they the same boundaries for MH as they would be for AOD?

You might find that setting the boundaries are easier than actually enforcing them. A boundary without consequences may be worthless. Maybe you could observe your loved one over a period of time and write down what behaviours you find unacceptable. The list might be helpful in being able to better observe what common arguments you have with your loved one so you might be able to diffuse them or avoid them. It is perfectly fine to acknowledge that it may be painful but you can say that you can’t be around your loved one when they are using/drinking – Al Anon calls this detachment with love. Some of the best consequences may arise when you create distance from your loved one, e.g. if your loved one is late for something, don’t call them/nag, just wait 15 minutes and then continue on without them. Having solid boundaries might be hard on you and your loved one but it is the healthiest thing for you and your loved one. The sooner your loved one is forced to accept responsibility for their actions or hit rock bottom, the sooner it will be for them to become motivated and change

What does everyone else think?