I woke up to several missed calls and text messages from my

younger brother Richie, my other brother Pat and my dad, Come

home Pam, mom is sick, she has to go to the hospital. I had slept
over my girlfriends house like any normal high school teenager, and I
had taken my families calls lightly. I figured my mom must have fell
from falling asleep just as she had so many times before, not really
thinking it was anything serious. When I pulled into my driveway, I
noticed a strange amount of black birds that were all squealing from a
tree. It gave me the chills and made me think of death. What if this
is the day that my mom finally stopped breathing? I thought to
myself. It had become a routine to make sure my mom still had a
pulse, while she laid unconscious on the kitchen floor for hours at a
time. But, I did not think that it would actually ever become a reality,
nothing like that could ever happen to me. I walked inside, and saw a
few of my moms clothes scattered across the foyer floor. Confused, I
continued to walk and thats when I saw my father, and my brothers all
sitting in silence on our living room couch. My youngest brother,
Richie, sat there dazed and stiff. My brother, Nick, had bright red,
swollen eyes and a trembling cry. My third brother, Pat, had tears
slowly crawling down his face as he stared at me emotionless. My dad,
stood up and walked over to me, Pamela he said. Your mother is
gone. He barely made that sentence out before he started
hysterically crying as he went to hold me.

My mother passed away from a drug overdose my senior year of

high school, on January 29, 2012. She was clearly addicted to narcotic
drugs like Oxycodone, Percocet, and Vicodin; but never admitted it to
herself. My dad and I were the only ones who really knew she had a
drug problem; while, my three younger brothers grew up believing that
she had a sleeping disorder. Aside, from having a drug addiction, we
believe my mother was also bipolar. Many people on her side of the
family suffered from the disease, and she showed many symptoms that
led us to think she did also.
Correspondingly, the topic of this paper is a dual diagnosis of
bipolar disorder and substance abuse. Bipolar disorder can be defined
as a serious mental illness that includes extreme mood swings from
mania to depression. The bipolar disorder is usually caused by a
combination of factors including: biologic, genetic and environmental.
People who suffer from bipolar disorder have higher risk of relationship
problems, economic instability, accidental injuries and suicide. Which
also directly coincides with people who suffer from substance abuse.
People with a bipolar disorder are more likely to develop an addiction
to drugs or alcohol. The American Journal of Managed Care said,
About 56 percent of individuals with bipolar who participated in a
national study had experienced drug or alcohol addiction in their
lifetime. They also claimed that about forty-one percent of that group
had abused or had an addiction to drugs. Dual diagnosed individuals,

such as my mom, have a harder time with recovery because of their

heightened emotional instability; making it difficult for them to abide
by certain guidelines.
A main question that might be asked is, how are bipolar and
addiction related? Well, it is believed that a large number of bipolar
individuals try to self medicate with drugs and alcohol. They do this to
numb the painful symptoms that they are feeling from the bipolar
disorder, which is mainly involved with the fanatic mood swings. The
mood swings vary from mania, hypomania, depression and mixed
episodes. Mania symptoms are excessive happiness, restlessness,
increased energy and less need from sleep. Hypomania symptoms can
be a little less intense. These periods might make it seem like the
person does not have a problem, it just makes them seem really
productive. Next, is depression, which includes sadness, anger,
anxiety, change in appetite, and thoughts of death or suicide. Then,
there are also be mixed episodes, which can be a combination of any
of the above symptoms.

There were times that I could place my

mom in all of these categories. I could tell when she was in mania
because she would become extremely energized, and would do things
like going on a cleaning spree around the house for days. This mood
would vary with how long it lasted, sometimes a week, and other times
more than a week. It was obvious when her energy decreased
because she would then begin to do things like fall asleep and have

slurred speech. A lot of the time, we would catch her sitting on a chair
in the kitchen mumbling things, when all of a sudden, she would doze
off and fall off the chair onto the floor. So that could clearly be
categorized under her depression state, which could run as long as two
weeks at a time.
People with bipolar disorder have abnormal levels of chemicals
like serotonin, dopamine, and norepinephrine; which have vital
functions such as: appetite, metabolism, sleep, response to stress and
can affect a persons mood and emotions. Thus, any heavy alcohol or
drug use can interfere with the way their brain processes these
chemicals causing emotional instability, erratic energy levels and
depression. Moreover, when people with this disorder turn to drugs or
alcohol thinking it will level out their mood and make them feel
normal, the drug or alcohol abuse is actually having the opposite
effect, making their symptoms from bipolar disorder worse.
Individuals who suffer from bipolar disorder have been shown to
have at least one close relative with the disorder. Children of a parent
with this disorder have a ten to twenty-five percent chance of
developing it themselves; while, children of two parents with this
disorder have a ten to fifty percent chance of developing it. So,
experts do believe that bipolar disorder runs in families and that there
is some sort of role that genetics play in it. It is also said that the

environment and lifestyle of a person with the disorder causes the

disorder to be less or more severe.
There is no prevention for bipolar disorder; however, there are
medications and diets that are suggested to help manage the lifestyle
of a bipolar individual. Some recent findings have said that people
with bipolar disorder may have a greater risk of being overweight, so it
is important to exercise and watch caloric intake. The American Heart
Association also recommends eating fatty fish two times a week
whether its albacore tuna, herring, mackerel, salmon or trout. Some
vitamins and minerals that are suggested are calcium, magnesium,
zinc, and vitamin B. These are all said to help alleviate some of the
symptoms of the bipolar disorder.
Doctors use many different classes and brands of drugs to treat
bipolar disorder, like lithium, anticonvulsants, antipsychotics, and
benzodiazepines. These medications help people with bipolar to see
things clearly again; however, its usually recommended that they have
ongoing psychotherapy. This can include: behavioral therapy, which
focuses on ways to relieve stress; cognitive therapy, learning to
identify and modify the patterns of thinking that come with mood
shifts; interpersonal therapy, dealing with relationships and the
problems that the disorder can put on them; and social rhythm
therapy, helping a person develop and maintain daily routines.

For people like my mom who suffer from dual diagnosis; a

different process is done, called integrated treatment. It includes one
on one psychotherapy with a mental health professional, counseling
sessions with an addiction therapist, dual diagnosis support groups and
family counseling. This all usually takes place in a single rehabilitation
facility that provides collaborative treatment teams: psychologists,
addiction counselors, and other professionals that were trained
specifically with dual diagnosis care. There is psychiatric medication
that helps the people handle their ups and downs, plus peer group
support from others that are battling both addiction and mood disorder.
Growing up, watching my mom go threw this took a toll on my
entire family. Not only was my mother living with the disorder and the
addiction, but my entire family was too. It can be extremely frustrating
to suffer from one disease, but it is even more exhausting when you
suffer from two, where one is enhancing the pain that the person was
already feeling. It is important to get help for yourself or anyone you
know living with this disorder, there might not be a cure, but there are
ways to manage it.

References

http://www.webmd.com/bipolar-disorder/guide/medications-bipolardisorder
http://www.livestrong.com/article/392036-is-bipolar-disorder-caused-bynutritional-deficiencies/
http://www.webmd.com/bipolar-disorder/guide/bipolar-diet-foods-toavoid
http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-causes
http://www.bipolargenes.org/
http://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-whosat-risk
http://www.webmd.com/bipolar-disorder/guide/bipolar-disordersymptoms-types
http://www.clearviewtreatment.com/drug-abuse-bipolar-disorder.html
http://www.dualdiagnosis.org/bipolar-disorder-and-addiction/