Laura Zera

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Mental Health: Joyable App Delivers CBT to Treat Social Anxiety

By Laura Zera 8 Comments

Keep talking about mental healthWhen the team at Joyable kicked off development for its web app in 2013, its founders knew two things (well, they probably knew more things than that, but these are the two that are relevant here):

  1. According to the National Alliance on Mental Illness, approximately 85% of mental illnesses go untreated annually (my put: because of shame or time or money or access, or any combination thereof)
  2. Cognitive Behavioral Therapy (CBT) is the most effective treatment for anxiety disorders.

Founders Steve Marks and Peter Shalek decided to tackle this by making online CBT accessible, convenient and affordable, and to start with an app that targeted anxiety disorders. Launched in March 2015, Joyable’s early results–both number of people signed up and positive outcomes–are promising: They state that 90% of clients see a reduction in their anxiety.

The current set-up is slick. The app is salmon pink, probably because research says it’s a happy color or something (also, if you are trying to lose weight, put your food on a blue plate and you won’t eat so much. Crazy, hey?). So, yeah, salmon pink, and super easy to use. It steps you through the CBT process of identifying the situation that made you anxious, describing the thoughts you had around it, and then challenging those thoughts, all wrapped up in a series of self-paced, interactive exercises.

It seems pretty basic, right? But what happens after a CBT session at a therapist’s office, or when you read a self-help book, and then you go out into the world? You forget to practice what you’ve learned! And before you know it, you’re hightailing it out of that class or meeting or party, feeling like a total dweeb, and you don’t know who to call, or your next therapist appointment isn’t for another month.

CBT processTa-da! Joyable to the rescue. When you sign up, you are assigned a coach who is trained in CBT. They offer support and keep you engaged with the app, and, frankly, keep you accountable. In order to make a new thought process stick, you have to willfully invoke it for a while before it becomes an automatic deal. If you know someone is going to be asking about your week and if you practiced CBT techniques in an anxious situation, heck, you’re going to try harder.

I should mention that Joyable isn’t branding itself as a replacement for in-person talk therapy. Rather, it allows that it can be used to complement in-person therapy, or on its own. The recommended treatment period is three months, and while you can sign up for a month for $99, if you purchase three, the cost goes down to $239. Convert that to pounds sterling or euros and it’s almost free! (I mention that because last I heard, there was a two- to three-year wait to get in-person CBT in the UK.)

Last week, the company announced it had received another $8 million in funding to expand its offerings (it raised $2 million around the time of launch). They hope to one day have online solutions for obsessive compulsive disorder, post-traumatic stress disorder and depression, too. If you want to read more, here’s an excellent article in The Atlantic: The Startup That Wants to Cure Social Anxiety.

If I sound like a fan of Joyable, well, I guess I kind of am. I haven’t used it (way back in my days of harsh social anxiety, I leaned on benzodiazepines, because there was no Joyable). They’re not paying me for an endorsement. I just think it’s a fan-freaking-tastic idea. Technology for good. And offering a quiet, private, economical and easy way for people who are suffering to feel better seems quite a likeable thing. Or is it just me?

What do you think of Joyable, or just about the idea of online cognitive behavioral therapy? Yay or nay?

Images: cc.logo.large

The Third Act Is My Second Chance

By Laura Zera 36 Comments

IMG_5013 - CropIn screenwriting, the three-act structure can be broken down as exposition, rising action and resolution. In my relationship with my mother, the third act of “resolution” began in 2009, and followed the lengthy and excruciating first and second acts of “raised by crazy mom” and “estranged from crazy mom.”

The thing about our third act is that for many years, I had no idea if it would ever come. My mother could have passed away before I saw her again (and that dreadful scenario was ever-present in my imagination). We needed a transition between the second and third acts, which, mercifully, was facilitated by a social worker. Once the third act started, I didn’t know how long it would last, and still don’t, but now count every year as a bonus. And given the volatility of our first act, the nature of this final one is, well, quite bizarre.

The Enridges - circa 1970 - cropWhen my mother was crazy with undiagnosed psychosis, it was difficult to be anywhere near her. She was often in a rage, and when she wasn’t, my sister and I would be waiting on tenterhooks for the next rage to start. My sister left home at age 17 and I was out by 15 (and lived with my sister, a benefit of being the younger sibling). As I turned into a late-years teenager and then young adult, my mother behaved toward me the same way she had always interacted with the “outside world,” her rage replaced by a carefully controlled mask. It was fragile and fake, and, in the moments when cracks appeared and her behavior faltered, completely unnerving.

I tried to keep up a relationship – who doesn’t want a mother? – but the anxiety that came from dancing with the devil (or “dancing with the crazy person who is acting sane”) impacted my own mental health so much that eventually I had to sever all ties. I hid from her. She didn’t know my phone number. She didn’t know my address. She didn’t know that I got married. From my end, I knew where she was at all times, but was painfully aware that there was nothing within the law that I could do to help her.

After all of that, Act Three opened with my mother’s diagnosis of dementia. It was already quite advanced when an aunt took Mum to the hospital. She stayed there for three months before going to a nursing home, and that is where my sister and I met her again for the first time in 17 years.

Most people don’t count dementia as a blessing, but my sister and I do. My mother is no longer paranoid, suspicious of everything that moves. She has no anger left. Her delusions are gone. So is her memory and her verbal recall, but she doesn’t miss them anyway. In a magic twist of fate, she is the happiest, most cheerful and easygoing resident in her nursing home ward. And because of this, I have my mother back in my life. She doesn’t know who I am, but boy, do we ever enjoy each other’s company.

IMG_5016Mum turned 80 last Friday. To celebrate, I joined my sister, her ex-husband and their two sons, and we all took Mum for lunch and a walk in the park. We visited the petting zoo, where Mum was greatly amused by the children and I was greatly amused by the goats. We ate strawberries at a picnic table, and hamburgers and French fries at a restaurant. Mum chattered and sang and laughed. My brother-in-law, who hadn’t been near her for decades, was a bit freaked out. He said, “It’s almost like she’s faking it. You know, the last time I saw her, she tried to kick me in the balls.”

“Nope,” I said. “This is real. This is her.”

Our third act has been playing without intermission for six years now. Mum is physically healthy, and her dementia has leveled off quite remarkably, with no major changes in her symptoms for the last few years. I visit her whenever I can (she is in B.C., I am in Seattle) and just keep adding scene after scene to the screenplay that is our lives, filling those long-empty pages and feeling blessed that we never seem any closer to having to write an ending.

Mental Health: Depression Linked to Inflammation, Gut Bacteria

By Laura Zera 21 Comments

BrainWhat is going on in our bellies may matter more than we knew to our brains. Two interesting depression-related studies were reported earlier this year: the first links depression to inflammation, the second researches depression in the context of the “gut-brain axis.”

A summary of the inflammation research is found in The Guardian, under the title “Is Depression a Kind of Allergic Reaction?” To me, the title is misleading. People can have allergies to all kinds of foods. Inflammation, however—and possibly the associated depression—is caused by crap food. You want to live on starchy carbs and processed foods? Then you are going to puff out like a condom-turned-balloon in the hands of a ten-year-old. Fill your face with things that are fresh, raw and unprocessed and you will fare much better, as I first wrote about in this post on brain food.

The Guardian article also suggests, rather hopefully, that a shift in the perception of depression from being a mental illness to a physical one could relieve the ongoing stigma that is attached to the illness. Author Caroline Williams writes, “This time, though, the target is not any kind of brain or mind-based weakness but a basic feature of everyone’s body that could strike anyone down given the right – or wrong – turn of events. And if that doesn’t inspire a greater sympathy and understanding, then nothing will.” I like the idea of our society arriving at a place where depression no longer carries stigma, but the mind vs. body debate does still seem to be infused with discrimination in that it categorizes a body illness as more acceptable than a brain illness in the first place. How about compassion for all?

VegetablesFirst things first, though: let’s focus on keeping our bodies and brains healthy through better diet. And possibly add in oral supplements of omega 3 oil and curcumin, both known to have anti-inflammatory effects. I’ve been working on diet improvement for two years now. Do I see a difference? Unequivocally, YES.

On to the gut-brain axis, which is decidedly less evil and more scientific than the axis between Iran, Iraq and North Korea that George W. Bush introduced in back in ’02. Phew. Good on it, I say.

Scientific American published Charles Schmidt’s article “Mental Health May Depend on Creatures in the Gut” in February, which points out that this idea goes back more than a hundred years. More recently, oodles of studies have been conducted using mice, with some pretty amazing results. For example, mice injected with the gut microbiomes of humans with mood disorders soon start to exhibit the same behaviors. Translated into mice-world stuff, this meant they began exhibiting anxiety over jumping down from one platform to another, which leaves me wondering: if humans with mood disorders were injected with healthy mice microbiomes, would they eventually become Olympic-level divers?

Gut-brain axisOne of my favorite parts of this article is delivered via the research of John Cryan, a neuroscientist at University College Cork in Ireland. He recently published a study in which two varieties of Bifidobacterium produced by his lab were more effective than escitalopram (the antidepressant Lexapro) at treating anxious and depressive behavior in a lab mouse strain known for pathological anxiety. Hurray, make way for the development of psychobiotics, live organisms comprised not only of probiotics but also other bacteria known to produce psychotropic signals such as serotonin and dopamine. The research has a ways to go yet, so in the meantime, a good quality brand of probiotics from your local vitamin shop could go a long way to making you feel better, in both body and brain.

Have you experimented with diet change and/or the use of supplements for the benefit of your mood? I’d love to hear from you!

Tips and Tools for the Sensory Defensive, Part II

By Laura Zera 8 Comments

Going to sling one final post at you with information on the condition known as “sensory defensiveness.” If you haven’t heard about this condition, you can find the basics in my introductory post on what it means to be sensory defensive. The first batch of tips and tools are in this Part I post.

too loud book coverToday, I’m covering the last part of Dr. Sharon Heller’s book Too Loud, Too Bright, Too Fast, Too Tight. The reason I’ve devoted three posts to sensory defensiveness is because I suspect there are more of us walking around with it than we realize. I hadn’t heard of it until recently, but boy, do some of the triggers resonate! And as I mentioned in Part I, even if you’re not sensory defensive, Dr. Heller’s tools are helpful all the way around for living well, and living well means living healthy and living long.

These points are taken from the section titled “Removing Treatment Obstacles.”

  • Your GI tract is highly sensitive (over 30 gut hormones!), and certain foods can exacerbate sensory defensiveness: caffeine, simple sugars, starches and high glycemic foods, to name the biggest culprits. Food allergies may also be lurking. To test for this, start by eliminating all sugar, alcohol, wheat, dairy and corn from your diet for three weeks, then slowly reintroduce them, one at a time. You might be surprised by what you find; I was.
  • Sensory defensives often suffer from leaky gut syndrome, candida overgrowth, and acidity. Maintaining balance in the gut is vital for modulating your nervous system and managing sensory defensiveness. Remember the song that goes “hip bone is connected to the thigh bone,” and then take it even further.
  • In the chronically tense body that is the bane of most sensory defensives, breathing tends toward fast and shallow. Practice breathing from the diaphragm instead of the chest. To go a bit deeper (pun intended), look into special exercise that use alternate nostrils, Pranayama or Ujjayi breathing. There are lots of techniques to try, and all will lead to a more relaxed mind and body.
  • Tense body often means poor posture. Does your neck hurt? Tight shoulders? Do you feel frozen in your current posture? Heller recommends a variety of bodywork: craniosacral therapy (especially good for TMJ), neurocranial restructuring, Tragerwork and Rolfing. (She also mentions massage, but I’ll tell you from firsthand experience, massage rarely results in permanent structural change the way these other modalities can.)
  • After bodywork, how about retraining your movement to match your new posture so the results stay with you forevah? Some to check into are Feldenkrais, Hanna Somatic Education, the Alexander Technique, yoga, Qi Gong, and bioenergetics. Spoiler: somewhere along the way, you might be told to ditch those four-inch stilettos. Consider yourself forewarned.
  • Meditating ManAnother avenue for deep relaxation is mind-body practices. Progressive relaxation, where you start at your head or feet and then clench and release each major muscle group one at a time is a good one. Another is meditation, where you move your focus away from thoughts and onto sensations. Both have major medical results: lower blood pressure, a slower heart rate, relaxed muscles, and slower brain waves. Bonus: you can practice them at your desk, on the subway, or during the Annual General Meeting of <insert organization of your choice here.>
  • Hypnotherapy, where you are deeply relaxed and open to suggestion, can be effective in desensitizing a sensory defensive to fear, phobias and pain. Look for someone trained in analytical hypnotherapy; this approach regresses you so you can tap into buried memories or emotions that might be playing a role in your stimuli responses.

Some of the practices listed above might be foreign and freaky sounding to you, as they were to me. I felt it was important to list them because each one works differently, although sometimes the differences are subtle. But because they are different, they also work well together, as part of an integrated approach. Just trust me on this. The more you play in this sandbox, the more you’ll find yourself dipping your toes into multiple pools (and yes, I freaking LOVE mixing my metaphors).

If your mind and body are suffering a little or a lot, these practices are worth exploring. And don’t be discouraged if sometimes it feels like the changes are too big to handle. Bite off a bit at a time, and course correct as needed. Wellness is a continual journey, because your body is always changing.

Are any of these tools your personal faves, or on your to-do list? What has your experience with them been?

Depression as a Dinner Table Topic

By Laura Zera 2 Comments

Mental health This week, I’m using my airplane-exit-row hands to direct you over to Matthew Peter’s blog. A fellow mental health services consumer and wellness advocate, Matt has been an important voice in the conversation and education around dual diagnosis (which he wrote about on my website back in June). I’m grateful that he’s created space for me to highlight something I feel quite passionate about, and that is the need to extend the “depression conversation” to include your kids if you’ve got a case of it in your home. It may not sound like a good idea initially, but I explain my rationale here: Depression as a Dinner Table Topic.

Thank you for reading and sharing!

Tips and Tools for the Sensory Defensive, Part I

By Laura Zera 11 Comments

Stress - image courtesy MicrosoftA few weeks ago, I wrote about what it means to be sensory defensive. The basic definition, as provided by Dr. Sharon Heller in Too Loud, Too Bright, Too Fast, Too Tight, is this: “sensory defensiveness is a condition that encompasses a constellation of symptoms, including tension, anxiety, avoidance, stress, anger, and even violence, that result from aversive or defensive reactions to what most people consider nonirritating stimuli.”

As promised, this post is a summary of Dr. Heller’s recommendations for living well in an overstimulating world. Whether sensory defensive or not (I am in some areas, not in others), her tools are helpful for everybody, and I highly recommend the book. Dr. Heller has covered all the bases, and created a timeless guide for a healthy life.

Your Sensory Diet

The last part of the book is divided into two sections, “Your Sensory Diet,” and “Removing Treatment Obstacles.” These bullet points will highlight information from the first section. I’ll save the latter section for a future post.

  • Jot down (and rate from 1-3) the objects, people and/or situations that stress your senses and which you find yourself avoiding. Heller provides a list, but you could do just fine if you aim to be specific when you create this inventory.
  • Get used to body scanning for tension throughout the day. Start at the feet or head, and go up or down. Where do you feel tight, clenched, compressed, etc.? Are you frequently tense? Once you’ve found the tension, part of the exercise is to let go of it by allowing that part of your body soften.
  • If you have severe sensory defensiveness, seeing an occupational therapist (OT) could help. Seek one who is a specialist in sensory integration.
  • Engage in proprioceptive activities (“priming the pump,” as Heller calls it). Deep pressure on your body and heavy work that engages your body helps you feel grounded. This can be done in many ways, such as house work, exercise, standing in front of a wall and pushing into it with straight arms, or pushing your hands together in prayer position. What you are doing is stimulating the brain’s cerebellum, which communicates with the reticular activating system to inhibit arousal to a normal level. Our bodies were designed for movement and exercise. Heller points out how active our early ancestors were, and that exercise purges stress chemicals and helps organize the brain to do its job effectively.
  • Slow down the music and turn down the volume. Music that is fast and loud creates internal chaos for the sensory defensive. Perhaps even try baroque or New Age music, which shift brain consciousness toward alpha waves, enhancing overall well-being (I’ve been listening to alpha wave music for six months and it has made a giant difference for me!).
  • Lightbulb - image courtesy MicrosoftChant, hum or sing. It creates vibration in the upper body that leads to deeper breathing, a more relaxed jaw and throat, and released tension.
  • Replace your lightbulbs with the full-spectrum variety. They’re available for fluorescents, too. (Heller includes a fascinating section on light therapy, e.g., the work of optometrist John Downing and the Lumatron phototherapy device.)
  • Carpets, paints, cleaning products, self-care products, etc. should all be as chemically free as possible. Besides the fact that chemicals are far from harmless, they can set off olfactory alarms for the sensory defensive which others are able to ignore. (I adore the smell of essential-oil-based stuff, but can’t tolerate perfume at all).
  • Pay attention to your physical environment. Feng shui your home to allow natural flow of energy (de-clutter!), and choose paint colors based on mood impacts (this information can be easily found online; green has the most restful effect). Also, escape to nature as often as you can, and bring nature into your home.

The important thing to remember is that there is science behind these tips. Brain waves, pulse, breath, etc. have been measured and compared when exposed to different sensory inputs, such as fast, drum-based music versus music with a slower (or no) beat, and different types of light. And while some of us might be painfully aware of our adverse reactions to some stimuli, others may have been living with the discomfort for so long that we have accepted it as “normal.” I invite you to play with this information: take a baseline of your body’s stimuli responses, incorporate some changes into your sensory diet, and see what happens.

Have you incorporated any of these types of changes into your daily life? What effects have you felt?

Mental Health: What Is Sensory Defensiveness?

By Laura Zera 25 Comments

too loud book coverI’m currently reading a book called Too Loud, Too Bright, Too Fast, Too Tight by Sharon Heller. Sounds like erotica, I know, but it’s actually about what it’s like to be a sensory defensive person in the world, and how to cope. My coach recommended it a few weeks ago after I told her how spending a half day in a noisy, busy hair academy (chosen because it was cheap), getting my gray colored over AND foils AND a haircut, left me completely shattered. My plan had been to go to my office afterward and work for the rest of the day, but when I got there, I lay curled in fetal position on my beanbag chair for 30 minutes before I could even attempt to look at words on a page. I considered shaving my head and getting a nice wig, rather than ever go through that kind of torture again (I have way too much hair; the foils pushed me over the edge).

A surge of books and articles have been written recently about what it means to be an introvert; as it turns out, the concept has historically been rather misunderstood, so the material filled an information need. It helped a lot of people, me included, understand why we have no problem engaging with groups of people—leading meetings, facilitating workshops, public speaking, etc.—but then require anywhere between hours and days of quiet time to restore our energy balance. Many of us have also heard of highly sensitive people (HSPs), a term introduced by Dr. Elaine Aron in 1996. But sensory defensive? That’s a term we don’t see kicked around as much, even though it has been around since the 1960s (although called “tactile defensive” until the 1980s).

As defined by Dr. Heller, “sensory defensiveness is a condition that encompasses a constellation of symptoms, including tension, anxiety, avoidance, stress, anger, and even violence, that result from aversive or defensive reactions to what most people consider nonirritating stimuli.” The stimuli can include anything from irritation to tags in clothing, to touching dirt, to an aversion to cutting your nails, to getting carsick.

There’s some science behind why some people can find themselves with this condition. Three particularly important senses are involved, and those are the “proximal,” which tell you what’s going on inside your own body: 1) the tactile system, responsible for information on touch, pain, temperature and pressure, 2) the vestibular system, which involves inner ear structures and is used to detect movement and changes in the position of your head and 3) the proprioceptive system, which provides feedback from your muscles, joints, and tendons that enables you to know your body’s position in space. Then, these three sensory systems send messages to the three parts of your brain: 1) the brain stem, or primitive brain, 2) the limbic system, or emotional brain, and 3) the neocortex, or thinking brain.

Megaphone manWhen integration is lacking between the proximal systems, and/or connectivity blips in the three brain parts make it difficult for the brain to organize the inputs from the proximal systems, you find people who are sensory defensive. This isn’t to say that the other senses – touch, vision, hearing, smell and taste – aren’t also involved. Oh yes, throw them all into the sensory defensive stew!

From the reading I’ve done about introverts, HSPs, empaths, people with anxiety disorder, and the sensory defensive condition, there is an unsurprising amount of overlap in symptoms and traits. In fact, sensory defensiveness is often misdiagnosed as anxiety, Heller writes. And, it largely boils down to one core concept: our brains receive and process signals differently, then tell our bodies how to respond. For whatever reason—biological, environmental, psychological—some people’s brains and bodies respond in a more dramatic way than others. That could range from having physiological reactions of nausea, headaches, etc. to stimuli such as light, smells, and touch, all the way to a fight-or-flight cortisol spree, which, while unpleasant at the moment of occurrence, also has long-term health implications.

Having read about a third of the book so far, I’m not convinced either way yet as to whether I’m sensory defensive or not, and while I may be, I’d certainly fall in the “mild” category in terms of symptoms (some with this condition find things such as the sound of a bag of potato chips being opened excruciating!). However, I’m about to get into the tips and tricks section for how to cope as a sensory defensive in a stimulating world, and given that I do know I’m an introverted empath who has had anxiety disorder, something tells me the information will be useful in some capacity or another! I will be sure to share the highlights in a future blog post.

Have you had experience with sensory defensiveness, or any of the other conditions I’ve listed? Whether diagnosis-driven or anecdotal, I’m interested to hear stories of your experience in a world that can feel too loud, too bright, too fast, too tight.

Mental Health: Dual Diagnosis and Effective Treatment

By Laura Zera 22 Comments

Image courtesy MicrosoftThe comorbid existence of a mental illness and a substance abuse problem is called “dual diagnosis.” Until recently, I hadn’t read or heard too much about it, beyond its basic definition, but was interested to learn that the condition brings about its own set of treatment considerations. Today, Matthew Peters is here to share his personal experience and insights with regard to dual diagnosis. I’m grateful for both his courage and willingness, because sharing our stories is the fastest path to reducing stigma and shame. I hope you’ll join in the conversation by leaving a comment below.

Dual Diagnosis Guest Post by Matthew Peters

My deepest thanks to Laura Zera for having me as a guest on her blog to share my experience with dual diagnosis. It is truly an honor to be here.

There are some variations in definitions of dual diagnosis, but the term generally describes a person who has a mood disorder and some form of chemical dependency.  For example, I have depression (Major Depressive Disorder) and I’m an alcoholic. There are genetic links associated with each disorder. My mom was an alcoholic and suffered from depression and generalized anxiety disorder.  There was a long line of depression and alcoholism on her side of the family: her father was an alcoholic and committed suicide when she was ten.

I drank regularly by the time I was thirteen. I sought help at a local substance abuse clinic when I was fifteen.  Despite being dual diagnosed from an early age, the diagnosis didn’t stick. Over the years, as I made my way through countless detoxes and rehabs, and a few psychiatric wards, the standard course of treatment was to deal with one disorder without addressing the other, or the combined effect of both. It was more than twenty years before I received the help I needed.

The most effective treatment program I’ve found is the cognitive behavioral therapy approach used by places such as ASAP (Alcohol and Substance Abuse Program) in Chapel Hill, North Carolina. ASAP takes a comprehensive approach to substance abuse that involves education and group therapy as well as one-on-one sessions with therapists. Crucially, there is a strong psychiatric component built into the program because of the recognition that mental illness and substance abuse are often comorbid. I feel that recovery is limited for the dual-diagnosed unless both conditions are treated concurrently.

Image courtesy MicrosoftIn terms of recovery, having a dual diagnosis differs from a single diagnosis in that it is not just about refraining from alcohol, or taking anti-depressants. It is a synergistic condition where one illness exacerbates the other. For example, major bouts of depression are often accompanied by the desire to self-medicate. It might sound counter-intuitive to want to drink alcohol, which is a depressant, when you are depressed, but the mind and brain chemistry of the alcoholic differ from that of the non-alcoholic. Drinking may actually alleviate depression in the short-term, lifting your spirits, so to speak, and quickly, too. That makes drinking very enticing to a person going through a depressive episode; the solution to feeling bad seems just an arm’s length away. Of course, what happens is that you might feel better after taking a few drinks, but when the effect wears off you are at a lower mood baseline than before you drank.

The thing I would change about the way dual diagnose is treated today is that in the presence of one of these conditions, an aggressive effort be made to determine whether the other is present. I would also often make it so that in regard to treating substance use disorder, Twelve Step Programs (TSPs) such as Alcoholics Anonymous are not the sole recourse. There needs to be a much more comprehensive method of treating dual diagnosis, one that allows a large role for education and cognitive behavioral therapy, and is inclusive with regard to people with little or no faith in a higher power. TSPs, in their Higher Power-based philosophy, often deter the latter. Also, when it comes to the dual-diagnosed, especially those who need medication to treat their condition, I would proceed with great caution when it comes to Twelve Step Programs (TSPs). Some  groups tend to be anti-medication, and some people really need to be on medicine to help control their mental health symptoms.

Fortunately, dual diagnosis has not gotten in the way of achieving my goals, though it did play a large part in how things have played out in my life. But right now I couldn’t be happier. Though I dropped out of high school, I went on to get my B.A., M.A., and Ph.D. I taught college for a while, and now I write full-time. The point is that there is treatment out there if you are willing. You need to be your own best advocate when it comes to getting well and keeping the symptoms of dual diagnosis from taking control of your life. My journey has not been a linear progression, where over time I have gotten better and better. At times it has been a “one step forward, two steps back” process, and I think acknowledging that is crucial in going forward and getting on with your life.

My website, www.matthewpetersbooks.com, includes resources for helping those dealing with dual diagnosis and related issues. My blog also discusses my own experiences with dual diagnosis. Since writing has been a crucial part of my recovery, I also talk a lot about writing. I encourage you to come by and check it out. Always remember that however low you feel, there is help out there.

_____________________________________________________________________________________

Here are some interesting facts about dual diagnosis and related issues from a book called Addiction and Mood Disorders: A Guide for Clients and Families, by Dennis C. Daley, with Antoine Douaihy (Oxford University Press, 2006). I highly recommend the book for anyone interested in the subject of dual diagnosis.

  • “Mood disorders are higher among people with alcohol and drug dependence than among the general population. For example, the risk of having a substance abuse disorder is four times higher if you have depression and up to 14 times higher if you have a bipolar disorder.” (pp. 8-9)
  • “Over 16% of adults in the United States will have a problem with alcohol or drug abuse or dependence at some point in their lives.” (p. 18)
  • “Depressive disorders affect about 20% of women and 12% of men at some time in their lives, and bipolar disorders affect a little more than 1% of the population, with men and women being affected equally.” (p. 40)
  • “Almost 1 out of 3 people with depressive disorders will also have problems with alcohol or drug abuse or dependence. About 1 in 10 people with major depression will also experience a bipolar disorder. Others will have an anxiety, eating, or personality disorder. Hence, people with clinical depression often have other psychiatric or substance abuse disorders as well.” (pp. 42-43)
  • “Up to 60% of people with bipolar illness also have a problem with alcohol and drug abuse or dependency.” (p. 47)

About Matthew Peters

Matthew Peters, AuthorDual diagnosed from an early age, Matthew Peters dropped out of high school at sixteen. He went on to obtain a B.A. from Vassar College, and an M.A. and Ph.D. from Duke University. He has taught various courses in a variety of disciplines throughout North Carolina. 

Matthew is committed to increasing the awareness and understanding of the dual-diagnosed. Conversations Among Ruins (forthcoming through All Things That Matter Press) is his first novel, and includes a dual-diagnosed character. His second novel, The Brothers’ Keepers (forthcoming through MuseItUp Publishing in summer/fall 2014), is a political-religious thriller that capitalizes on his love for history and research. Currently, he is working on a sequel to The Brothers’ Keepers. Learn more at http://matthewpetersbooks, or follow Matt on Twitter.

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