Double Trouble: Bipolar Disorder and Alcoholism
Balancing mental illness and addiction requires caution and good information.
I am bipolar and I am a drunk. Through over 20 years of being in and out of recovery—and psych wards—and off and on various medications, I have come to realize that I must treat both illnesses in order to recover from either.
I experienced major depressions throughout my young adulthood, making it impossible to hold down a job, show up for friends and family, eat properly, or even bathe regularly. I stayed in bed for weeks at a time. I once took a razor blade and chopped all my hair off. I scratched myself so hard with bitten fingernails that my face was bloody and scabbed. Drinking was the only way to numb the pain.
It was not until seven years ago, when I stopped relapsing, got sober and stayed sober, that doctors were able to ascertain exactly what was going on with my brain and prescribe the medication that has saved my life.
But the manias were even worse, tornadoes racing through my life and the lives of everyone around me. I had multiple psychotic breaks, including a particularly disastrous episode in the south west 16 years ago.
At the time, miserable with a year sober, I concluded that New York was the problem so I moved to a small town in Northern New Mexico. At first it was idyllic—beautiful sun-swept canyons and desert, big crystal blue sky and breathtaking horizons. I was happier than I’d ever been. I drove along gorgeous desert highways with my dog in the back seat, feeling a sense of excitement and joy. I had no idea I was entering the realm of bipolar mania. I just thought I was finally in a good place, after so many episodes of depression.
It really started the afternoon I caught my boyfriend having sex with another girl in my own bed. I walked out of the house, got in my car, and burst into hysterical laughter. Doctors call this type of reaction “inappropriate affect.” I drove all the way to Santa Fe, laughing until my sides hurt, and sat in my car in the Walmart parking lot for several hours, unable to think clearly enough to come up with a plan. Finally, all I could come up with was to return to New York.
Over the next few days, I was torn between my insatiable appetite for sex with that boyfriend (the mania made me hypersexual) and my desperation to get away from him. I repeatedly forgave his indiscretion and then, when he left for his housepainting job in the morning, wrote dozens of goodbye letters to him. My little adobe farmhouse was a disaster: boxes half-filled with books and records as I tried to get up the courage to pack the car and leave. The chaos in the house was a physical manifestation of the chaos in my mind. Doctors call this “disorganized thinking.”
One morning I threw a haphazard collection of my stuff in the backseat of my car, along with my dog, my cat, and a puppy I had picked up off the side of the road. I left the house trashed and sped toward Colorado, alternately laughing and crying. I was pulled over near the border for weaving, and the police officer looked concerned when he saw the hodgepodge of junk and animals crammed in the car. I convinced him I was okay, and he let me go—a mistake. Within a few hours I was convinced that the other drivers on the highway were spying on me. I saw dead cows hanging from the telephone poles.
I pulled into a creepy little motel on the edge of a cornfield and locked myself into a room with all my animals milling about. I was convinced the motel desk attendant was spying on me, too. I was afraid to use the phone for fear she would record the conversation, but I knew I needed help so I called my sister in Virginia, who subsequently flew out to Denver to come get me. She later told me how horrible it was to see me huddling in that little room with piles of dog poop all over the place—I was too paranoid to take the animals outside. God bless her, my sister drove me all the way back to New York while I repeatedly threatened to grab the steering wheel and drive into a tree.
After this experience, I was finally put on antipsychotic medication. But I continued to have depressive—and manic—episodes, and I ultimately self-medicated my bipolar disorder with drugs and alcohol. It was not until seven years ago, when I stopped relapsing, got sober and stayed sober, that doctors were able to ascertain exactly what was going on with my brain and prescribe the medication that has saved my life.
As suggested in the AA pamphlet, Medications and Other Drugs, I consulted a doctor who specialized in treating addicts. He took me off the benzos other doctors had wrongly prescribed to me, because those drugs are addictive and I had found it impossible to take them as prescribed. He put me on the non-addictive drug Clozaril, which has kept me stable for seven years. After being hospitalized over a dozen times, I have now managed to stay out of psych wards this entire seven year stretch. The drug has caused me to gain weight, but I have decided I would rather be stable, sane and overweight than skinny, out of my mind, and hallucinating. Who cares if you are skinny when you are on a locked psych ward?
On the last psych ward I was on, an AA member brought in a meeting for the patients who were dually diagnosed. He proceeded to tell these bipolar and schizophrenic people to stop taking medication, that the steps were all we needed.
“If you are depressed, get a new Big Book sponsor and work the steps,” he said. I had been around the block in AA for 15 years, so I knew to ignore this ill advice, but some of the other patients were very confused, and some refused to take their medication that night. The next day, the ward was louder, crazier, and more scary than before, as the non-medicated patients started to spiral into psychosis.
That AA message was dangerous, irresponsible and uninformed, but that AA member was speaking contrary to AA's actual take on the issue. That same AA pamphlet states: “No AA member plays doctor.” It clarifies: “…some members have taken the position that no one in AA should take any medication. While this position has undoubtedly prevented relapses for some, it has meant disaster for others. It is…wrong to deprive any alcoholic of medication which can alleviate or control other disabling physical and/or emotional problems.”
The bottom line is, without sobriety, doctors can’t help me with my bipolar symptoms. But without treating the bipolar disorder, chances are I will drink to self-medicate. No amount of medication will keep me sober, but no amount of step work will keep me from hallucinating dead cows hanging from telephone poles. I must address both issues with equal commitment.
Sadie Long is a pseudonym