I watched an episode of Intervention last night. The woman involved in the intervention, Marci, was heavy into alcohol and drugs, including smoking crystal meth. Prior to the intervention, she had lost her home, her marriage, and custody of her children. By the end of the show, she agreed to treatment, was diagnosed as having bipolar disorder, received effective treatment, and experienced a complete turnaround.

Several things struck me about Marci’s story:

• Nobody, not even Marci’s family and closest friends, seemed to ever suspect an illness. They focused on the symptoms – the problem behaviors – to the total exclusion of any underlying illness. This matched my own first encounter with bipolar. The thought that my wife could be ill never crossed my mind. Until I met bipolar, I thought sick people lie in bed, and you bring them bowls of chicken soup. I never imagined an illness could have such symptoms.
• Family and friends were completely blindsided and confused about how to deal with the situation. Seeing the anguish in the ex-husband’s face was like looking in a mirror ten years ago when bipolar broke into our home and ravaged our family.
• Marci is a beautiful soul. She reminded me of my wife – very personable and fully engaged in life. She rode her bicycle everywhere and interacted positively with everyone she encountered. I have noticed these qualities in several people with bipolar – and it’s certainly not something you want to see medicated out of someone.

The point of this post, however, is that although I realize that mental illness and substance abuse can form a vicious cycle in which each fuels the other, I believe that the mental illness usually comes first. I think screening anyone who has a substance abuse problem for mental illness is probably a good idea. Unfortunately, I think our system tends to focus too much on the problem behaviors – instead of calling a doctor, we call the cops.

Please post a comment to share your experiences and insights regarding substance abuse and mental illness. And, Marci, if you happen to read this, we wish you and your family the best.

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    Last reviewed: 4 Sep 2009