Why is it important to treat both the mood disorder and the alcohol/drug use? When neither illness is treated, one illness can make the other worse. When only one illness is treated, treatment is less likely to be effective. When both illnesses are treated, the chances for a full and lasting recovery are greatly improved, and it is easier to return to a full and productive life. Why is it important to stay clean and sober when getting treatment? Mixing alcohol or drugs with medication can have serious and dangerous effects. Many medications, including over-the-counter medications, interact with alcohol or drugs in harmful ways. It is also unlikely that you will benefit from talk therapy if you are under the influence.
What should I expect from treatment?
You may need to go to more than one doctor and attend more than one support group. All of your treatment providers should be aware that you have a dual diagnosis. Treatment for your mood disorder may include counselling or psychotherapy, medication and DBSA support groups where you can share your experience living with depression or bipolar disorder. Treatment for your alcohol and/or drug use may include some type of recovery group. If you are drinking or using every day, you and your doctor may decide that you need to check into a hospital or treatment center so you can be treated for physical withdrawal symptoms. After treating the withdrawal, you will need to treat the addiction. This may include a residential or outpatient alcohol/drug treatment center, a 12-step group or another group that focuses on living without substances. In these groups, you will learn how others stopped drinking or using, how to cope with cravings and urges to drink or use, and how to live comfortably without the use of alcohol or drugs.
Talk therapy (psychotherapy) can help you learn to cope with symptoms of depression and/or mania, and change the patterns of thinking that may be making them worse. Therapy can also help you look at your drinking/using habits and work on staying clean and sober. You may get therapy from a psychiatrist, a psychologist, a social worker, a therapist, a counsellor, a nurse or another health professional.
Medication to help with symptoms of depression and mania may be prescribed by a physician or psychiatrist. You and your doctor will work together to find the right medication(s) for you. Different people have different responses to medication, and many people need to try several before they find the best one(s). Though it may not be easy, be patient when starting new medications and wait for them to work. Don’t lose hope. Some can take four to eight weeks before you feel their full effects.
Keep your own records of treatment—how you feel each day, what medications and dosages you take and how they affect you, and any alcohol or drug use.
Medications that affect the brain may also affect other systems of the body, and cause side effects such as dry mouth, constipation, sleepiness, blurred vision, weight gain, weight loss, dizziness or sexual problems. You might feel the side effects before you feel the helpful effects of your medication. Many times, these side effects will go away in a few weeks. If they don’t go away immediately, don’t be discouraged. There are ways to reduce or get rid of them.
Change the time you take your medication to help with sleepiness or sleeplessness.
Take it with food to help with nausea.
Your doctor may change your dosage or prescribe another medication.
Tell your doctor about any side effects you are having. You and your doctor should work together to make decisions about medication.
Never stop taking your medication or change your dosage without talking to your doctor first.
Am I still clean and sober if I take medication?
Absolutely. Taking medication as prescribed by a doctor is not the same as using alcohol or street drugs to feel better. Medications affect the same brain chemicals that alcohol and street drugs do. But medication balances the levels of these chemicals instead of making them rise and fall. Medications help keep your brain chemicals, and your moods, more predictable and stable. They can help you to be yourself.
Medications do not impair your judgment. They do not give you a false sense of courage. They do not cause you to crave another pill soon after you’ve taken the first. They are not mixed or “cut” with other dangerous chemicals. They have been tested and found to be safe and effective.
The goal of medication treatment is to help you become stable and healthy. Medications manage your symptoms, rather than masking them. They help you take control and work toward positive changes in your life. Your doctor also monitors your medications, and if you have any problems, s/he can help you decide what changes need to be made. Some drug and alcohol recovery groups may believe that you can’t be clean and sober if you take medications prescribed by a doctor. This belief is just plain wrong. Medication for your mood disorder is no different than medication for another illness such as asthma, high blood pressure or diabetes. If your recovery group challenges your use of medication, it is probably best for you to become part of another group that understands the concept of dual diagnosis. The good news is there are many different recovery groups to choose from. Don’t give up hope. If you keep looking, you will find other people who are dually diagnosed and receive treatment for both illnesses.