I self-medicated away my late teens and 20s. I was treated for depression with Zoloft through my late 20s and way into my 30s. I was diagnosed as Bipolar II when I was 37. I am now 45 and I have a life finally. I am almost done with a BA degree. I don’t start a dozen projects and not finish them. I don’t stay up all night watching TV anymore. I don’t binge drink to the point of oblivion anymore. I take Trileptal and Zoloft but in the lowest dose possible and still keep me functioning. If I take a higher dose of either I loose that special something that makes me who I am. I am creative, I am intelligent, I am successful (maybe not by the world’s standards but by my own). I can tolerate crowds a little better and can enjoy my extended family in short doses without major anxiety. If I look back I realize I was truly bipolar since around age 16. I stayed up all night once and cleaned the house and cooked breakfast for my family. I cooked for 20 although my family was only 6 people. I OD’d and spent a few days in the medical wing of a hospital and the one psych visit I had during those four days determined that I was “attention seeking.” If I dwell too long on the “what if” I become stuck so I just move on and try not to think about the things I did that cause me and my family shame. I praise God (although I am a follower of Christ I am not religious) that I lived in that state as long as I did and I praise God that someone paid attention and I now can really live.

For me, the illness came first, though it wasn’t recognized. The substance abuse exacerbated the illness. I believe the symptoms started in childhood, and I abused drugs and alcohol at ages 18-19, but I wasn’t diagnosed as bipolar until 23 or 24.

i want to tell you about my experience as a clinician as well as a patient. i worked for the state mental health office here in louisiana as a counselor until about 2 years ago. i have a masters in social work. during the last year and a half of my employment, our policies changed from the highest authority to require treating mental illness AND substance abuse together rather than closing the door and sending our patients all over town to other clinics. there were so many people who would identify substance use during a mental health eval and would be told “we don’t treat that you’ll have to go to addictive disorders.” well if that happened to me i’d get frustrated probably and just forget about it. too much hassle! so in an effort to treat all those who were falling through the cracks, all staff were cross trained to screen for both areas, mental illness and sub abuse. the state office of addictive disorders was also required to screen for mental illness on their patients. if the screens were positive in either clinic we then set up treatment in an appropriate facility and we continued mental health treatment while they got help for the sub abuse from persons specifically trained in that arena. we even opened a new inpatient facility specifically for dually-diagnosed individuals only. the “catch phrase” we heard so often in mental health during this cross training phase was, “substance abuse in mentally ill patients is an expectation Not an exception.” meaning- make sure to screen for both disorders every time! not to say all mentally ill are users just reiterating the importance of asking the right questions and covering all bases. so even though its changing slowly, screening processes are leaning more towards evaluating for both disorders which is what we need more of.

on another note, i can relate to so many of the other posts about this- i began drinking at age 13-hard liquor. about a year and a half ago my mood got so bad i finally broke down and went to a psychiatrist for myself for the first time. i found out something that i had never heard of before, even while i was in college. i was told that mania can increase urges to use. when i first started drinking i would carry whiskey in a bottle in my back pack to school and hide it in my locker and sip on it between classes. i had severe depression since even before then and sometimes i would even cut myself. i hid it all, the drinking the cutting, everything. i was never treated for any of it. i was never diagnosed with anything. when i was about 22 i saw a general practitioner for physical complaints, tests were done and there were no medical problems and he diagnosed me with anxiety and depression. like so many other ppl i only got partial relief from the meds and ended up quitting them. about 3 years ago and after years of off and on trials with different anti depressants one physicians assistant suggested i try something for mood stability. i took it for a month and gave up after no change. i know now it wasnt the right med or dose i needed. even after all this time i still never made any connection with the drinking and my mood or behavior. i just never thought it was a big deal-alcoholism is all over my family. and yes i was self medicating. about a year and a half ago i was tried on mood stabilizers for the first time due to excessive rage, suicidal thoughts, and homicidal thoughts. the worst ever. my psych said that it was mania even though i never thought i experienced the “elation” i always thought defined a manic episode. over time i admitted to my doc the “risk taking” behavior typical of mania- promiscuity, shoplifting, drunk driving, you name it. i never once in my life identified those as manic symptoms because they always happened when i was intoxicated. in 2006, i was with my family in dallas, tx at a nascar race- we’re talking 100,000+ people there. i kissed a total stranger in front of my husband then left with him. some dangerous things occurred and i had a blackout. i finally found my family again hours later. this is not something i would ever do just so you understand the degree of what i’m getting at. the psych explained that although these events occurred during intoxication it was indeed mania. she said that the mania increases the urges to use. after even more analyzing i realized the pattern associated. for as long back as i could remember, a couple of times a year i would have these uncontrollable urges to go out of town for a drinking binge during which this behavior occurred. i have family in new orleans so i’d get one of my girlfriends and we’d go for a “girls night out.”i used to plan my drinking binges like i was going on a 3 week vacation. from where i was going to who i was bringing with me to a full itinerary all revolving around getting drunk and other things i’m embarrassed and ashamed to mention. to put it simply- the mania increased the cravings to use and i obsessed about it constantly. in early 2008 at age 31 after trial and error i finally found a good med combo for me and since then my anger/rage is under control, i haven’t had any suicidal thoughts but most surprising of all and what really solidifies what the dr told me was that i no longer have those crazy urges to get drunk out of my mind. i hope that by my telling all of this will somehow be an example of what can happen when mental illness and substance abuse are not treated appropriately. if you have friends or family that use and need help/or appear symptomatic of bipolar i suggest you stress the importance of screening for Both disorders at the same time!!!!! it is good to know a lot of states are focusing their policies on treatment for co-occuring disorders. if you don’t feel like your dr is giving you the proper treatment for BOTH of your problem areas then please keep searching for a dr who will!!! it is definitely a life or death situation.

OMG, i haven’t read all of the comments but still.. i can totally relate to what others has commented here. Im a male, 18 year old student who’s going through the very same thing. I thought i was suffereing from depression but last yeaer i found out that im actually suffering from bipolar disorder. I honestly thought that i was crazy. One moment, i was intoxicated with pretty much everything. The next, im completely depressed by the smallest of things. To cut the story short, i think the cause(BD) came first before the effects(substance abuse)

I have the same problem with my daughter. I hope someone has some information for us

I saw the episode on Marci. While I fought(fight) my own battle with substance abuse it was always clear that this was a way of avoiding the pain of the trauma suffered as a young child. Yesterday my psych doc told me that my “ups”(when I felt normal) were actually hypomanic states and I was Bi-Polar 2; If my ‘normals’ are labeled as “manic” I don’t want to be any lower, I would rather go on with my suicide plan- let the depression take me out if the good times are too good. I believe the chicken and the egg applies here- did the mental illness cause the substance abuse or did the substance abuse cause the mental illness?? I am told “keep it in the today”. Today is lousy, give me my pills and let me done and over with it.

Bobbi, today may be lousy, but who knows what wonderful things lie in your tomorrow? As many have stated, it can take great patience to find the right meds, but once found, life becomes wonderful to live. My heart breaks for the pain inside you, but hold on. My son suffered so, but he has found that the Lord is faithful and will always provide – He knows what your body needs to feel well again so you can live the life He gave you and wants you to live.

My son Peter is 19 and has had manic dysphoria and depression for years. He abused prescription pain medications in high school (while on lexapro) and got kicked out. He did 90 days rehab, stayed clean & sober for a year, but when his girl friend dropped him two months ago he went on heroin and is now returned to detox. He told me when he is on heroin he doesn’t worry about his acne, which he obsesses over normally. He has never taken a mood stabilizer. I feel educated & encouraged by these posts that we will find the right mood med combination for him. Thanks to all of you.

I’m a heroin addict. An alcoholic. A smoker. A former pothead. A former cokehead, and tweaker. The only drugs I never got on with were MDMA and hallucinogens.

I was diagnosed with mental illness at a very young age, twelve or thirteen, and have been abusing drugs for nearly as long, and physically addicted, on and off, since I was fifteen or sixteen, and constantly since I was seventeen or eighteen.

No doctor, or series of doctors, has ever been able to nail down a specific psychiatric disorder – it seems to be mutable in my case, to change with time, and be very uniquely un-diagnosable even in a “constant” episode or era – beyond blanket “severe anxiety and panic attacks” and “likely PTSD” as relative constants; medications for all of the common suspects (and then some: epilepsy, schizoaffective, MDD, BD, cyclothymia, BPD, APD, CD, OCD, GAD, PD, PTSD, schizophrenia, HPPD, HFA, AD, etc., etc.) have been trialled with various results – usually not good, with the sole exception of the epilepsy, which was brought under control relatively rapidly (although the medications used to treat it didn’t do anything for whatever else was going on in my brain).

In my case, treating the mental illness didn’t work well, if at all.

Sixteen years after first being diagnosed with a mental illness – I believe it was MDD, in the age where Prozac was new and Pamelor seemed to be the standard – and fifteen years after first getting in to heavy drug abuse, without more than a stretch of two or three sober days for not more than two months’ total sober time in 15 years (although a few years of this time was spent addicted to non-physical-dependence-engendering substances instead of heroin), and after dropping out of the psychiatric establishment for about the fifth time due to lack of, or lack of enduring, results…

I met a doctor who reverted to treating the symptoms alone – from what I gather in my amateur research, considered suboptimal – with unconventional (medicinal/psychopharmaceutical, not quackery/”alternative medicine”) treatments, I am faring better – much better than ever before – though still not well (as everything that I’ve ever come close to being diagnosed with has “refractory” tagged on the front of it), insofar as being rendered utterly unemployable (after a doctoral degree – in pharmacy(!), which was obviously a doomed endeavour due to my chemical dependency issues) and on the low end of GAF.

(Although insofar as raw action/kinetic potential/quantifiable intellect, I’m off the chart – in the upwards direction: when it comes to the actual kinetic energy, I’m also off the chart – in the downwards direction.)

This seems to be the exception, as do I, rather than the rule, but:

Treating the symptoms of my addiction with Suboxone worked – I’ve been clean now for 3 years – where everything else (traditional, “get at the underlying cause”) had failed multiple times over the course of half a score years and as many residential rehabs and thousands of meetings and sessions. Treating the symptoms of anxiety and PTSD worked, whereas attempts to treat the causes (twenty years’ worth of weekly or more psychotherapy and the common medications) had failed multiple times, so on and so forth.

At least it worked enough to make me less of a nutter, and in remission from active addiction, in the first time in my adult (or adolescent) life, if not exactly employable or self-sufficient, yet.

Maybe I should try my hand at freelance journalism or something.

A (Recovering) Mental Health Consumer; A (Recovering) Addict;

KFbY (D.G. Imp. Rex Insanitas)