I just read an article that suggested teens with mental illnesses should be screened for substance abuse.
The article also suggested that treatment for SUD and MI in teens should be integrated and not on parallel tracks.
I can’t believe that articles like this still are written. Did we learn nothing from Curt Cobain?
Apparently, treating both illnesses as inexplicably intertwined is a lot harder than simply treating substance abuse or mental illness alone. I know some clinicians get hung up on the “chicken or egg” conundrum: Which came first – the depression or the substance abuse?
Does it matter? Not to the kid being strangled by both. That kid could care less. Cause and effect doesn’t mean much when you are in the throws of depression and you’re stealing vodka from your parents’ bar and replacing it with water. Or you are hollowing out pens to fill with pulverized oxy so you can get high between classes.
When I was a teen I had depression. I drank and drank and drank. I smoked non-addictive marijuana …every…single…day. I hadn’t made the connection between my drug and alcohol use and my depression. I didn’t even know I had depression – it wasn’t really an illness back in the 70’s. We were just “troubled youth.”
I finally figured this out when I was diagnosed with depression seven years into my sobriety. Luckily, I had a therapist and nurse practitioner who understood the connection and importance of treating both. Two diagnoses. One treatment plan.
I look at my depression and alcoholism like this. They are twins. They don’t want to be split up. When one goes out to play – the other wants to go along for the ride. They are inseparable. I have to treat them both, all the time. Even when they are behaving themselves, I have to keep an eye on them and continue treating both.
How do I treat them? I visit my psych nurse every three months and take the meds she prescribes for me – religiously. I don’t blow off appointments. Lucky for me, she used to work in a drug-treatment center and knows which medications can safely be prescribed to dual-diagnosed addicts and alcoholics.
There were also years of therapy – with a therapist who introduced me to the notion that the illnesses were linked. She had me compose a timeline of my life. The clouds parted and I could clearly see how my depression and alcoholism are linked.
I treat my alcoholism with 12-Step meetings and working with other addicts and alcoholics. That’s my medicine.
I was lucky. I happened upon a psych nurse and therapist who understood the connection between the illnesses and treated them together. I gave permission for my psych nurse to talk to my therapist and my therapist to talk to my psych nurse.
Just because I feel good, I don’t stop taking my meds. Just because I’ve been sober 17 years, I don’t stop going to meetings. I treat them both. Everyday.
Teenage boy image available from Shutterstock.