Co-Occurring Disorders

We live in a society of excess, where street drugs are readily available, so it is not surprising that many teens experiment with drugs. However, more is known now about teenagers who are not only experimenting, but who are self-medicating because they have other disorders, such as depression or anxiety. Dealing with a child who has co-occurring disorders is of course even more difficult. If you are reading this blog, this already means your eyes are open and you’re taking steps to be fully informed.

For me the most challenging part of parenting has been that in my family, substance abuse has been intensified by co-occurring mental illness and a family history of genetic vulnerability. So much more is known now about the brain and chemical imbalances than when my husband and I and our children first began to experience the ravages of both in the early 1960s. Truly, we hadn’t a clue.

Months before my wedding, the man I was to marry, the star athlete and class president I had fallen in love with five years earlier in high school, climbed out onto the ledge of my mother’s fifth-floor New York City apartment, and in a state of drunken bravado, threatened to jump.

Off and on over our fourteen years together and the parenting of two children, he continued to go through episodic periods of binge drinking accompanied by wild behavior and threats of suicide. In 1977, when my children were eleven and thirteen, he did kill himself.

All through these episodes, we always thought of it as a problem with alcohol. It was not until his death, and when I finally sought professional help, that I realized that of course he had a mental illness, most likely a bipolar disorder.

And even though I was now much better informed, I still did not fully understand how vulnerable my children were. It was not until they reached their 20s that one of my children became willing to see his problems in terms of co-occurring disorders. The other son never sought help and ended his life at the age of 28.

When mental illness and suicide are part of a family’s history, the whole question of when to hang on and when to let go becomes much more complicated. Drawing the line when someone is in the midst of a psychotic break is more than a tough call.

Though it is important not to rush into labeling a difficult teenager, not to rush into medication as the answer, parents are wise to become informed about symptoms and seek counsel with highly qualified professionals who can keep an eye on what’s going on, especially if there is some family history of depression or manic behavior.

My husband’s father, a man who majored in psychology in college and was the director of a children’s home in a large city for many years — and who himself carefully monitored bouts of acute anxiety — revealed to me after my husband’s death that when he himself was a boy, he would come home from school hoping his mother had not stuck her head in the oven, as she had threatened to do before he and his sister had set out that morning.

I do not want to end on such a bleak note. Though I am reluctant to steal any more secrets from family members, I do want to say that my son has gone through a long period of recovery and is now, day by day, leading a productive, creative life.

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    Susan Lea

    March 12, 2011 at 12:46 AM

    Does anyone have information on the connection between Borderline Personality Disorder and Heroin addiction?

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    Carol

    July 1, 2010 at 6:49 PM

    I am working on my MLADC in the state of NH but am currently a child & adolescent counselor and mother of a 22 year old son with bi-polar disorder and a long history of substance use. As we put him on drug after drug for his bi-polar disorder and ADHD I did not realize I was teaching him that drugs were the answer. He also had learning differences so that is what he learned. He is still drug seeking and self medicating. I learned my lesson the hard way. How can we teach this to other in the medical model?

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    Susan Lea

    March 11, 2010 at 1:59 AM

    Your story is very painful to read. But I’m glad I read it because you bring up an important issue; mental illness combined with drug use. Many well-meaning counselors have told me over the years that my daughter has to “hit bottom” before she will seek help. But my daughter has repeatedly sought help and has hit bottom numerous times. People who use drugs don’t fit into a “drug addict mold.” They are all different people with all different reasons why they have problems with drugs.

    It’s so sad that you have had these losses in your family due to mental health issues like bi-polar disorder and anxiety. This makes it so hard for people to heal.

    My daughter suffers from anxiety. She began having problems at a very young age. I tried to help her but, without health insurance, our options were limited. By the time she was 15 years old she began using marijuana. And then when she was 17 she began using Oxycontin. Then at 20 she became addicted to heroin. Her closest friends recognize that being treated for just drug addiction isn’t going to solve the problem. She needs mental health care.

    Her father suffers from anxiety and is addicted to pain medication. My father suffers from anxiety and has used prescription medication for over 40 years.

    I wish the very best for your family and I look forward to our family finding answers for these multiple disorders that are tearing apart my daughter’s life.

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