Taking Step 1 with Bipolar Disorder

Timothy Kuss, LADC, LMFT
I am in recovery from bipolar disorder and chemical dependency. I also currently work as a CD counselor and family therapist in outpatient and residential CD treatment. I believe that taking step 1 for Bipolar Disorder is a lot like taking step 1 for our addiction. Many of us go through a period of denial. People in our family also go through a period of denial about our bipolar disorder.

Mental illness carries quite a stigma and is often seen as untreatable. Sometimes it is seen as a permanent disability, especially if we’ve seen family members or acquaintances suffering long hospitalizations and recurring tragedy related to episodes over the course of decades. Most people don’t understand that with today’s medications and therapy, hospitalizations can be avoided fewer, or at least briefer. Tragedies can be averted and clients can lead relatively normal lives and have careers and families.

My own Step 1 with bipolar disorder was delayed due to a series of misdiagnoses of Schizophrenia. Bipolar disorder, unfortunately, shares a typical age of onset with schizophrenia of 20 as well as the potential for psychosis during manic episodes. My experience with delusional thoughts was probably heightened by the fact that I had used LSD and other hallucinogens frequently. I was hospitalized and treated for an incorrect diagnosis with anti-psychotics such as Thorazine and Haldol, which made me feel and look like a zombie. Such an error in diagnosis served to make me deny my mental illness. However, fortunately this resulted in volunteering myself for long-term chemical dependency treatment.

Twenty-five years later while continuing my sobriety I had a series of manic episodes resulting in short hospital stays and finally got the diagnosis of bipolar disorder. My reaction was one of relief. They finally got it right! As I learned more about the symptoms of bipolar disorder, I was finally able to understand what had been happening to me. As a professional I have encountered many clients with the same reaction of gratitude after finally getting the right diagnosis. Many have had co-occurring addiction and mental illness.

Unfortunately, many of us struggle with the need to take medications to treat our Bipolar Disorder. I tried to wean myself off them at first, just as I had done with those incorrectly prescribed antipsychotics. Today, I understand that my mood-stabilizing meds do not have any negative side effects. They are my insurance policy. They keep me out of the psych wards and out of potentially life-threatening situations that seem to predictably occur when I get psychotic. During my last psychiatric hospitalization I spent 3 days in intensive care due to high blood pressure that resisted medical efforts to bring it down. I have also put myself in dangerous situations when manic, like when I wandered outside in the dead of winter with no clothing and only a sleeping bag and tennis shoes for cover. Another time, I became paranoid of aliens trying to kill my daughter and almost put her in grave danger.

OUR step 1 includes recognition of some “crazy” behavior and thinking. Others also with bipolar disorder can laugh with us about these old episodes just like other drunks can laugh with us about our crazy earlier drinking episodes. Accepting unmanageability comes with accepting that reality is different from our delusions. We were powerless as individuals to cope with our illness. But together and with help we can be in recovery. Step 2!

In summary, Step 1 of our dual recovery includes recognition that our chemical use increased our mental health dysfunction(symptoms). This is different than saying that the chemical use caused the symptoms. I proved after 25 years of sobriety that I can STILL have symptoms WITHOUT using. I can see, however, a constant stream of clients entering the doors of our MI-CD program because their chemical use led to repeated hospitalizations for psychosis. I’m pretty sure that I wouldn’t have struggled with 5 years of psychiatric admissions if someone had helped me understand that I had to stop using chemicals.

As a family therapist I have seen many co-dependents struggle with accepting the reality of the dual diagnosis of a loved one. To help them with their fears I have done my best to help them understand how addiction and mental illness coexist. Besides referring them to Alanon or Naranon I also refer them to NAMI, the National Alliance for the Mentally Ill, which has both education and support groups for clients and family members. In dual recovery just as with following the twelve steps of alcoholism or other addictions, we all need to practice recovery one day at a time.

I do.