Patrick C's Story
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Patrick C's Story of Dual Recovery
In order to explain my story, I have to tell a little bit about my childhood. I can’t say anything particularly “bad” happened to me – no physical abuse, no sexual abuse, my parents’ marriage was always strong and we never had any financial concerns. I was the youngest in a large family and was able to be the center of attention fairly easily.
But there were also constant “moods” in the household. There was always someone in a “mood” – that’s what we called it. It would be years before anyone would hear anything like “bi-polar”, or “chronic depression” but that’s what it was. The brother I shared a room with was in a “mood” pretty much all the time. What I remember most was the rages, the constant complaining and the eating binges. And through it all my parents said he was ‘going through that phase.’ Even as a child, this struck me as odd because he had always been in “that phase”.
My greatest fear was that someday, I too, would go through “that phase”. I liked positive attention, I didn’t want people to feel about me as I knew they felt about him. So, I learned that I must always “act happy” whenever I was around anyone. I should never complain or fly into a rage, or anything that would make people think that I was in “that phase”. The problem was that I didn’t usually feel happy, I was filled with this constant feeling of impending doom or worthlessness, but I knew I was supposed to act happy, outgoing, friendly and confident. So, I got really good at wearing masks. When I couldn’t wear the mask, I isolated. It was always one or the other. I isolated a great deal. I remember a pattern developing in 2nd grade where I would wake up and know that I just couldn’t go to school that day. I was just too scared even though I couldn’t put my finger on why I should be scared. I just was. And so I would tell my mother I was sick and stay home and stay in my room. I would do this for a stretch of a few days and then go back. I kept this pattern up for all of my school years. And I remember beginning in fourth grade praying to God to just let me die. I couldn’t bring myself to kill myself but I wanted to die so badly.
At fifteen, I met alcohol. I loved it immediately – it made the mask so much easier to wear and quieted the negative feelings inside me. It immediately became a central aspect of my life. I didn’t drink daily but I did do it every weekend. And all week long, I’d be counting down until I could do it again. College was much the same way except that I didn’t always wait until weekend and my drinking now often included sex. Through those four years the feelings of anxiety and despair rose right along with the alcohol. I could still “act” happy but the only time I felt happy was when I had a drink in my hand, or lines of cocaine on my mirror. I did drugs a good deal but my drug of choice was always alcohol.
Somehow despite all this I made good enough grades to get into a good graduate school. (I had to go to graduate school because I terrified at the prospect of trying to have to work.) I vowed to myself that once I got to graduate school, I would ‘get my act together’. I didn’t. Things only got worse, more drinking, more drugs, more feelings of despair and daily thoughts of suicide, so I dropped out. I pretended to my family that I was still in school and tried my best to “act together” at least when I went home on vacations. I quickly degenerated into a total mess. A few months later, I got a DUI.
A night in jail made me realized that I was an alcoholic. I returned to my hometown, told me family that I was alcoholic and that I needed help. They were stunned. I think they had known something was wrong but I wanted to believe the act so much that they were in denial. I went to a therapist within a couple of days and in that first meeting she confirmed that I was definitely an alcoholic. She also said that she thought there was something else going on – like clinical depression. She admitted that clinical depression was outside of what she could handle because she couldn’t make the diagnosis nor prescribe medication, so I should have that checked out by a psychiatrist. I really had no idea what she was talking about but I was willing to try anything. I made an appointment with a psychiatrist. The psychiatrist ran some tests and found that there was definitely depression, but that it was alcohol-induced, sobriety should clear it up. And so I went back to the original therapist and threw myself into AA.
I went to meetings every day and therapy twice a week. She did make me get retested for depression again after a couple of months sober and the diagnosis was the same. With therapy and AA, things definitely did get better. My life did seem much more manageable. But never as better or as manageable as I pretended to everyone. I blamed myself and was too ashamed to admit to anyone that my emotions were still pretty dark. I kept hoping it would get better if I just worked a little harder. And I was a really good actor, sometimes I even fooled myself.
I was also having problems sleeping. I was told this was ‘normal’ for where I was in recovery and that it would pass. 3 months passed with no improvement. 6 months passed, no improvement – it was actually getting much worse. I’d sleep about five hours and wake and couldn’t fall back asleep. I tried everything – herbal tea, warm milk, baths, exercise, but nothing worked. Finally at around 8 months I went to my medical doctor for help. He knew I was in recovery so he was hesitant to prescribe anything addictive or any of the usual sleep medications because they had depressants. He recommended a medicine with a side effect of drowsiness. It was an anti-depressant called Trazadone but I only needed to take a very small dosage to help me sleep. I really thought all my problems were behind me now. I could sleep, I was back in school, and I was sober. And I could hide all my anxieties, fears, and self-loathing well enough to fool everybody. I didn’t expect it would ever be any different. My doctor continued letting me refill the Trazadone for a little over a year, at which point he said that he was worried that there might be something more to this than simple insomnia. I didn’t really know what he was talking about but agreed to go see another doctor for my sleep disorder.
It wasn’t until I walked into the other doctor’s office that I realized that he had sent me to a psychiatrist. I was shocked – how could anyone think that I needed a psychiatrist, now? I was nearly two years sober! I had been in therapy for two years and I had worked through most of my “issues”. My troubles were behind me! All I had was a problem sleeping! And once again I was being presented with an evaluation. I answered what I considered “honestly”. Though I have to admit that I was sort of rewording the questions in my head before I answered and my answers weren’t completely full. Somehow I would think, ‘not as much as when I was drinking’ and say “no”. Or I would answer based on how I acted not how I felt. What I remember thinking most was that I had to answer the questions, “right” so he would give me a prescription for Trazadone so I could sleep. My fear was that he was going to think that I was going to abuse the pills or try to kill myself with them. So, I wanted to let him know that I was “okay”. The other thing that crossed my mind was that he was doing a really good job describing my older brother, whom I was, of course, nothing like.
He did not say I was “okay”. He said I was clinically depressed. In fact what he said was that the only time he had ever gotten the responses that I had given was when someone had grown up in a household with someone who had a mental illness. One would express it, the other would mask it out of fear of being confused with the other. My answers fit the one who would mask. As soon as he said it, I knew in my heart he was right. I knew it but I couldn’t deal with it. It was just too much. To me, it seemed like he was saying all that work in therapy and in recovery was just a waste. I thought it meant that I had been fighting the wrong demon. And I was afraid that I would be letting down all those people who had helped me so much in getting clean. I knew he was right but told him he was wrong. He agreed to refill the Trazadone as long as I gave some thought to the other. He suggested that I discuss it with my therapist, my sponsor, my sober friends and my family, to see what they thought. I did discuss it with all of them. I even brought it up in an AA meeting. All agreed that the doctor was full of hot air. None of them knew what a good actor I was.
Shortly after that I moved to the Northwest. I threw myself into AA there as well. I got a new sponsor, I got sober friends and I did service work. What I did not do was look for a job. I couldn’t, every time I tried to I had an anxiety attack. I would temp here and there but I couldn’t pull myself together enough to really hit the pavement and find full-time work. And gradually I began deteriorating emotionally. A few months of a Seattle winter and I was very close to suicide again. I did go to meetings but I really couldn’t do much else. I thought the problem was that I wasn’t working my program hard enough. I committed to doing the Steps again. I did more service work. I worked with newcomers. But I was still a mess. If I wasn’t at a meeting, I was isolating in my apartment. It took supreme effort to even get the energy to go to the grocery store. I felt like I was in the bottom of a well. And the thoughts of suicide grew stronger and stronger. Nothing seemed to work, I couldn’t ‘snap out of it’. I had reached the planning stages when I suddenly remembered that earlier diagnosis of clinical depression. It was just a flash out of the blue but I knew immediately that that was it.
I made an appointment with my doctor for the next week. I somehow stumbled through the following days just barely holding on in a sort of a fog. It didn’t take the doctor long to write me out a prescription for Prozac. I reacted well to it. No bad side-effects. Within a few weeks we had determined the best dosage and I could feel the medication’s affects. I had a spring in my step and felt like a huge burden had been lifted from my shoulders. A few weeks after that I had a good job and life seemed better than I could have ever imagined. I was so grateful that I had not given into my suicidal impulses.
I really wish that was the end of my story. It was not. Once the dosage was set, I thought the problem was fixed. I checked back in at six months. Again at a year and then it was 2 years later that I went back. I never joined a support group for depression. I never went to a doctor that specialized in depression, just my medical doctor. I never even learned much about the disease or my medication. Occasionally, I would miss a day or two or more and knew that was bad but didn’t worry about it too much. I had a hard time talking about it and really didn’t like to think that I had a mental illness. Being an alcoholic didn’t bother me at all but I couldn’t even get the words – “mentally ill” out of my mouth.
Things were really good for a few years. But I did notice that things were getting harder. I had less energy. I was isolating more. I was acting out sexually. I sort of considered that it might be the depression but pushed it out of my mind. I blamed my job. I blamed the Northwest. I blamed my relationship. I blamed myself for not working my AA program harder. And things just kept getting worse and worse. I became obsessed with the idea that if I could just move back home, everything would be fine. I could tell I was slowly moving slowly downhill and then not so slowly and then one day I found myself in a hole. I couldn’t even leave my house without my heart pounding in my chest. I was filled with constant fear and terror. I tried going to work and just turned around at the front door, I just couldn’t go in. My thoughts were so jumbled and confused I don’t know what I thought. I know what I did. I took a leave from my job, stuffed what I could in a suitcase and flew home for some ‘rest’.
Once back home things didn’t get much better. I did go back to where I had gotten sober 8 years earlier for some meetings but I was an outsider now. I had been gone too long, the faces had changed. I remember talking in a rambling way in one of the meetings and discussing my depression and the fear that had resurfaced. That was very hard for me to do because of the shame I had of it. And someone came up to me afterwards and said something really weird – that I should limit to shares to the topic of ‘alcoholism’. That really threw me in the state I was in and all I could feel was embarrassment and shame. I still went back but didn’t discuss the depression again.
All I can say is my mind was really confused during this period. I knew I needed to see a doctor but was confused by the rules given to me by the HMO. I was out of state and didn’t know if my emotional state qualified as an emergency. I was too ashamed to ask. I decided I would pay for it myself, I called a doctor and when asked if I had insurance, I hung up. I was just in a daze. Mainly I sat in my parent’s backyard and read. I did decide that I would not go back to the Northwest and resigned my position there. I told my housemates that they could have all of my belongings. My state gradually did begin to improve a little. I was able to go out and socialize. I was even able to pick up some consulting work fairly quickly. I was still in a bad state but the worst was over.
I guess I had been back about 2 months when I was handed a drink at a party that I thought was juice. I knew as soon as it hit my mouth that it had alcohol in it. And even though I had not had a craving for a drink or had not planned on drinking, as soon as that alcohol hit my mouth, I was so glad I had a drink in my hand. I drank it and had another. And I felt better than I had in over at least a year. All the anxiety and depression seemed to just drain out of me. This was 3 days before my 8th year anniversary. I knew it was a mistake, I knew I would regret it the next day but it felt so good not to feel.
The next day I went back to AA and admitted what I had done and picked up a 24-hour chip. And was drinking again within a few days. And another new chip. And another. After a couple of months I was just too ashamed to keep going back and stayed away. I also stopped taking my anti-depressants altogether. The next 15 months consisted of drugs, alcohol, isolating, acting out sexually and doing my best not to think about what a disaster my life had become. I was able to pick up odd consulting jobs, designing databases or web sites – mostly work I could do from home. I wasn’t drinking daily, I would not drink for a couple of weeks and then binge. Then I got arrested. Nothing major but I did have to spend a night and a day in the city jail. It’s hard to deny that your life has become a disaster when you are in lock-up. I thought about suicide for awhile but just couldn’t do that to my family. My love for them is really what had always stopped me from going through with any plans. Since I wasn’t going to kill myself, I prayed for my Higher Power to show me the way out of it. I didn’t want to kill myself. Then I had a moment of utter clarity. I needed to stabilize my depression and quit drinking. I would have to really deal with the depression this time and really get treatment for it as well as recovery from the substance abuse. I had sort of known this for months, but I didn’t know how to go about getting it. I had lost my health insurance with my last job. I figured it would have to wait until I got health insurance and I never seemed to get it together enough to get health insurance. It didn’t even occur to me to go through a public agency until I was sitting in jail.
I thumbed through the phone book and found the local mental health agency so I could get some help with the depression. The alcoholism and drug abuse, I figured I would get help from AA. At least that’s what I think I thought – I was pretty much in a depression daze. The mental health agency referred me to a substance abuse clinic where they said I would also get help with the depression. I had an appointment set up in two weeks for an interview to determine what treatment group to put me in.
I started to get worried about this during my initial interview. I explained my situation to the substance abuse counselor. I explained my diagnosis and told her that I really needed help with my depression. She started telling me that my depression was probably alcohol-induced and would pass once I was a few months sober. I stared at her in disbelief. I thought that maybe she had not heard me correctly, that the depression had been diagnosed while I was two years sober. That I had had a major episode before I started drinking. She told me not to worry, in a few weeks I could meet with the psychiatrist if I passed my drug screens. I was disappointed that I would have to wait but accepted it. A couple of weeks later I started an intensive outpatient treatment program.
The group I was placed in was strictly for substance abuse but I didn’t know that at the time. I was a month clean by then but still a mess. I was in a daze, barely able to leave my house. I had a couple of clients that I was doing small projects for but I was able to do most of the work from home. Group started and all the work in it was on substance abuse. A couple of weeks later I was able to start my medication and a couple of weeks later I started to really feel the effects. In group though, I noticed fairly early on that the issue of mental illness just wasn’t to be discussed. I’d say ¾ of the people in my group were on medication but the topic was always substance abuse.
If I talked about my depression, the counselors listened politely but really didn’t say anything. I was researching on my own by this point because I really knew that I needed “something” more. I guess I was four weeks into the program, feeling much better by then that I really started to make my feelings about the program clearer. I wanted help understanding my depression. I understood alcoholism, I needed to understand the other half of my illness. Finally in a one on one session with my counselor, she admitted that she really didn’t have any training in depression. She was trained in substance abuse. And the other counselor didn’t even know what dual-diagnosis meant. My mouth gaped. Did I mention that my home is in Louisiana? We’re a little behind the rest of the country on some issues.
The rest of my time in the program was trying to educate my counselors. We had many back and forths but luckily I had found enough information on the Internet that I was confident that I was heading in the right direction. It also helped that I had had so much sober time and knew the lingo so well. Finally the time came for me to give my First Step. That itself had been sort of a battle because the First Step format they had given me was solely on substance abuse. I thought that would be limiting it and forcing me to deny the problems that had been caused by depression. They finally said I could include something about depression if I wanted to. I wrote it all out, it was such an eye-opening experience for me. I could see how the theme of depression and substance abuse had gone hand in hand all my life. When I wasn’t denying the alcoholism, I was denying the depression.
I handed it to my counselor and set up an appointment to see her the day before I would give it to group. It was a real break-through I think for both of us. I won’t go into all the details but she agreed that what I had “added on” about depression was what she wanted the group to hear the most. The effect on the group was pretty dramatic as well. Others who were taking medication prescribed at the clinic were shocked to find that they were “dually-diagnosed” – they had never heard the term. Two people who had never talked about their depression admitted that they had tried to commit suicide years before they ever picked up a drink or drug and had never put together the connection of their using with their depression. Everyone wanted to learn more. I showed them some of the stuff I had found on the Internet and told them about “The Dual Disorders Recovery Book.”
It’s amazing how quickly it all came together after that. The counselor had me meet with a new assistant director of the clinic, who did know what dual diagnosis meant. And she was saddened but not really shocked to hear my story. She knew they were behind and had been trying to get others at the clinic to learn more about it. With her help we started our city’s first DRA meeting at the clinic. I was a bit nervous at the first meeting because I was the only one who had ever actually read any of The Dual Disorders Recovery Book. The others were there, I think partly out of curiosity and partly because they cared about me. We read, Chapter 2 – Hope and Healing a Comprehensive Approach. We finished the chapter and there was quiet for a minute and then everyone started talking at once. We’ve been meeting now for 3 months. Most of the people in our group were the people in my group at the clinic. A few more have joined us. The clinic has actually started referring people to our group.
Most of us have been in recovery a while but all this information is brand new and I can’t tell you what a difference it has meant to all of us. For us, it’s like the missing piece to the puzzle. We still go to other meetings at NA, AA or CA but this group is the one we call home. This is where we go to really learn about our disease.
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