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Information you need to live your best-recovered life. Join host Damon Frank as he brings you addiction recovery stories, news, expert perspectives, and features about life in sobriety and addiction recovery.
(Transcribed by TurboScribe.ai - Go Unlimited to remove this message) You're listening to The Recovered Life Show, the show that helps people in recovery live their best recovered lives.
And here is your host, Damon Frank.
Welcome back to The Recovered Life Show.
Today we're talking about bipolar disorder and sobriety.
My guest today is Rachel Dawkins.
So great to have you on The Recovered Life Show.
Excited about this topic.
A lot of questions in the recovery community about bipolar disorder, Rachel.
People are very confused about it.
Can we dive in real quick about what actually is bipolar disorder?
Okay, so bipolar disorder is a sometimes you're born with it.
Sometimes you can acquire it from trauma, stress, but basically the definition is where you have a distinct period of abnormally and persistent elevated mood, irritable mood.
It can come across as, well, it's manic.
So you could stay up all night, you could stay up for days, and you're cleaning the house super fast and everything has to be done right this second.
And then you have the downswing where you have the depressive side.
And so you're not getting out of bed.
You're not wanting to do anything.
You're crying.
And those things can happen within days of each other.
It's not usually a switch just like that.
It can be if you're rapid cycling.
But normally, based on what I have observed and the family members and the clients that I've talked to, you can most times tell it's coming.
So you can tell when the depressive mood is getting rated bottom out.
So you just become more talkative in the manic stage, you're distracted.
Some people may say, oh, no, you just have ADHD, which is not true.
So a lot of times ADHD will be the diagnosis when it's actually not, and vice versa.
So sometimes people think, well, I'm bipolar when it's not.
Just because you have mood swings doesn't mean that you have bipolar.
So it's just basically where it's a roller coaster ride.
Yeah, that's one of the things I wanted to talk with you about is these mood swings.
One of the reasons I wanted to do this episode, and when I was talking with you before we went on air here, I was saying, so many times in early recovery, people come into early recovery.
I've seen this in 12-step groups, in coaching Rachel, they'll come in, and of course they're anxious.
They're having mood swings because this is a huge thing.
They might have drank for decades, used drugs, and maybe something's happened.
A lot of times there's been some sort of traumatic event that has gotten them into recovery.
So they're dealing with that, they're having all of these kind of feelings and very big ups and downs, which you just described, which doesn't necessarily mean they're bipolar disorder.
But then after a period of time of recovery, several months, let's say six months to a year, still these extreme ups and downs, could that be a sign that something else is going on beyond maybe just dealing with an addiction issue?
So a lot of times people will start drinking or using drugs because they do have bipolar or trauma, and they don't know what's going on inside their mind.
They feel like they're going crazy.
And so they're like, well, the only thing I know is that when I drink alcohol, I feel calmer.
And so that's where that comes from.
So the thing that I've noticed as well is that bipolar people, more chances than not, will have issues with alcohol and drugs.
So the majority, if not all, of the clients that I have seen and family members that I have seen all have issues with some type of substance because nothing else works.
So especially marijuana, I mean, it's so readily available, especially in Illinois.
And so it's just easy to go down to the dispensary and chill out for a minute.
They have one that brings you up, they have one that brings you down.
So yeah, so it's really easy to get addicted.
So as a licensed clinical social worker, when you're out there dealing with, if you obviously deal with a lot of people who have both, maybe they have bipolar disorder, maybe they also have very big addiction problems.
How do you start to separate that out to say, well, I'm having, you know, mood changes because maybe I'm not working a program or not doing what I need to do in my sobriety, or I'm maybe doing everything I need to do, but I'm uncovering and going through a lot of stuff.
How do you start to separate that out?
And obviously people need to get diagnosed and all that.
Definitely saying that upfront, but, but what, how do you start to do that?
How do people start to recognize, Hey, you know what?
This might not be just totally anxiety from getting sober.
Right.
So I like at the very first session, before we get into anything, I do a, a full mental health assessment.
Um, and have you had any trauma?
Is there any family history of mental illness?
Um, that's where it usually comes out.
Like, yeah, my mom, she was just all over the place.
Okay.
So we'll talk about that in a minute.
And then, so, um, then I do a, um, a, oh my goodness, I can't believe it.
It's an ASAM.
So that is the, um, addictions, uh, assessment and, uh, that, uh, also like, okay, does mom have mom and dad.
Did they have problems with alcohol and drugs?
Yes.
Well, now on the mental health assessment, you told me that they also have mental illness.
Okay.
So, you know, a lot of times people will have that gene that, you know, the science that studies have shown that you have more of an addiction potential because, you know, you've had family history of that.
Um, and so one thing that I recommend is for clients to get a, what they call a gene site test.
So they get blood work and it will tell them all the different issues, like any abnormalities with their genes, uh, what medicines will work and what medicines don't work, um, how they will interact if you use alcohol and drugs, so all of that, you know, some kind of gene screen, uh, various places have those, um, that will tell you exactly.
Um, exactly what medicines will work if you do have that genetic disposition to become and, you know, have addiction issues, um, all of that should be done probably within the first, uh, three to seven days after they come into counseling.
Yeah.
You know, one of the things I've noticed, especially in 12 step groups, how it's changed over the decades of, of being sober for me is that, um, you know, I think mental health is much more of a topic.
You know, I know in the nineties, when I got sober, Rachel, people weren't talking about mental health.
They didn't care about your mental health.
Like they did, you know, it was not, you didn't have sponsors or, uh, are people who worked even in addiction.
They were necessarily talking about that.
It was just, are you physically sober?
Are you not physically sober?
Right.
It was very, it was very, very black and white.
Now there's a much bigger conversation about this.
And I think just like you pointed out people use drugs and alcohol to self-medicate a bipolar disorder.
So obviously there's going to be much more people that are going to be in up and 12 step groups in addiction support groups that have bipolar disorder.
Um, you know, let's talk a little bit about the stigma of this because, you know, I know I have worked with people in the past where even after a year or two of them being sober, Rachel, I'm like, you know, there's something else going on here, you're doing everything that you're supposed to do, but you have so many ups and downs.
You can't hold a job.
You can't, you burn out your relationships very quickly with people.
Right.
That you have to go in and kind of explore maybe some other mental health issues beyond just your addiction treatment, uh, that you're dealing with.
And there's always a resistance with bipolar disorder because there's this stigma about it that one, I'm never going to be able to heal from this.
Right.
Uh, and that's it.
I'm doomed.
Is it that bad if you get diagnosed with a bipolar disorder, if you, if you're labeled bipolar disorder, there's hope, right?
And so that's one thing that, uh, is important for me.
I try not to label people, but if it's clear, you know, unfortunately, you know, insurance companies, if you're in, uh, you know, practice, they want some kind of diagnosis at the very beginning.
And so I try not to do that.
I just put, you know, we're here because of something, you know, and so, cause I don't, I will not diagnose bipolar or borderline personality or any personality disorder in the very first session because you can't get to know someone in 60 minutes.
Um, and so, but they do, they were like, well, my mom had something or my dad had something and, but I don't want to be like them.
I'm not like them, you know, please don't tell me that I have, you know, bipolar, uh, because then I'm crazy.
Um, and whereas bipolar doesn't go away, it can be treated.
So, and, but it needs both medication and psychotherapy.
Um, because what happens is people with bipolar will take medication.
I feel better.
So I'm not going to need that medication.
And then they wonder why they crash.
Um, and so it's, it's good for them to come in here and identify, well, do I actually need my medication or maybe I need to stay on it and then learn other things, you know, like the deep breathing and maybe there's been some trauma and that's where the bipolar came from.
Then we do separate like EMDR and things like that.
Yeah.
One of the great things about, about a recovery now, right.
In, in, in today's world is there's much more focus.
We were talking about mental health, but also trauma, you know, um, in the 12 step area, it was always considered a character defect.
And, and I think we're kind of growing out of that a little bit, that there are certain things that people hold onto.
Maybe it's not a character defect, right?
Maybe there's something deeper that's going on.
And you mentioned trauma and I think that's been one of the biggest aha moments for people that have been in addiction is that maybe all of this is kind of starting from some sort of trauma, right?
And obviously alcoholics.
I know I have a physical allergy.
Something happens to me, but when it's linked to a trauma or something else, that's what kicks it over to alcoholism, drug addiction, things like that.
Um, I guess, can we talk about the, can we talk about that trauma a little bit and some of the process because I'm sure there's people that are listening to this, they're like, you know what, this is me.
You know, they're like, Rachel, this is me.
I've been doing what I need to do with the therapy 12 step, have a sponsor, have every, you know, a coach, everything.
And I still really can't, I can't get my mood together, right?
I just can't get it together in recovery.
What is the steps forward to healing with somebody who has addiction and bipolar disorder?
What does that look like?
So one thing that used to happen is we would treat either the substance or the mental health.
They were not connected in any way.
Well, now we realize that, uh, you can't just treat one and not the other.
You can't treat just the substance and then the mental health.
They've got to be interconnected.
Um, and so when they come in here, that's what we talk about.
Like, especially if there's trauma, we, um, I love the EMDR, uh, therapy.
Um, and so since I've been trained in that, it's just people come in here and they go, Oh my, it's like a light bulb moment.
You know, like I had no idea that the trauma that I experienced when I was two years old has anything to do with the fact that I am one bipolar or have an addiction issue.
Um, and what I tell people is if you keep pressing things down, it's like filling a balloon with water.
You keep filling it and filling it one day, boom, it's going to burst.
And so if you don't deal with these issues and you say, I'm fine, I'm fine, then you're, and you're not fine, then you're going to explode.
You know, your mental health is just going to.
Why do you think EMDR is more effective, Rachel, than maybe a standard type of therapy that they, they have used for years?
What, what about EMDR specifically really works for people that have bipolar disorder?
Okay.
So we talk about what I usually do is when I'm doing the mental health assessment, I listen for trigger words, like I've never felt good enough or I can't trust anybody or, you know, just trigger phrases that I, you know, I have a list of them.
And so if I hear them, I'm like, okay, you're a good candidate for EMDR because we've got to get, we get to the core of the problem, not necessarily the trauma itself, but how did it make you feel in that moment?
Um, and so what I'll do is I'll say, when's the first time that in the whole entire of your, entirety of your life that you have felt like I'm not good enough.
Well, I remember when I was three years old.
Okay.
So then we process that with, you know, like either eye movements or tapping.
Um, and then we talk about, you know, when's recently the worst time you felt that and, you know, when might you feel that in the future?
And so if we can regulate that and it's connected to trauma, then they can learn to regulate their emotions.
Like, oh, okay.
The reason I act that way is because of something that happened to me in the past that I had no idea even about, we can have trauma in utero, um, whenever, you know, our parents, like say our parents smoked or drank, or maybe there was physical violence, that's still trauma to the baby.
And so, um, that stuff that they carry with, well, I never feel safe.
That's a big one.
I never feel safe.
So, and that's how we can basically break it down and realize, you know, what, you're not in that spot.
You're safe right now.
So what can we do?
And there's different types of, um, techniques, resources like deep breathing, uh, counted breathing, um, acupressure, you know, on your hand.
Um, we do all of that.
And I have noticed that the clients that I've done that with, they use that out in the community and they'll come and tell me, yeah, I was in my happy place today and I was doing the acupressure cause we do identify a, um, a happy place like, okay.
So we've dealt with all the crap basically, and we, uh, are going to put it in the safe container where we lock it up and, you know, and then we don't think about it.
Then we go over to our happy place, which may be a beach or a place out in the woods, and it's all about visualization, uh, which helps regulate blood pressure and, um, all kinds of things, breathing, everything.
So highly recommend EMDR, but of course, you know, it's great.
Yeah, it is amazing.
And I had my doubts at first, which most people do, like how can the, you know, following fingers cause you to be, you know, be less emotional, um, or deal with your emotions properly.
And, but it does, it's, it's amazing to see people go, wow.
I'm, you know, and I've seen progress in one session.
Yeah, that, you know, that's a, you know, it's interesting that you're talking about some of this because when you're talking about the process of this being safe, it, what came up is a lot of living your best recovered life is being able to let go.
Right.
And that's what this whole recovered life is all about, is about living your best recovered life, not just being recovered.
Like if you're sober, that's great.
That's the start, but you want to live your best life that you possibly could live sober.
And so much of addiction recovery, great addiction recovery is being able to let go of old ideas, old ways that you've done things, ways that you've looked at things, trying new things, being open to suggestions about life.
And I could see how hard that would be now, uh, with somebody that has bipolar disorder.
And, you know, looking back and having sat through a lot of fist steps and, you know, uh, with people in 12 step groups, also seeing them go through their own mental health journeys and finding the ones that ended up, I could see that now, how hard it was for them to be able to let go of it.
They just really couldn't let go of it because it's really rooted in trauma, right?
It's rooted in trauma.
They can't, there is no process for them to let go of it.
And so, you know, one thing about it is that's who I am.
So it's really hard to let go of who you are, your identity was in, I'm the partier, I'm the one who is the person who goes out and, um, is the life of the party.
Uh, or, you know, and that's really, you know, you hear a lot about comedians who are the saddest people on earth.
Um, and it's because they're trying so hard to make everybody else happy because I don't want you to feel like I do.
Um, and so if I can make other people happy, happy, then I am more fulfilled as a person.
Um, so yeah, definitely letting go in that.
And one thing I've seen too, is a lot of family members don't want people to get better or they say they do, but they don't, they enable them because then guess what, they're not who they used to be.
They won't be the same person.
So familiarity, I'd rather have something familiar than to help this person change.
And then they sabotage that person's recovery.
Let's talk about that.
If you were to, if, if somebody goes in and says, wow, you
know what, Rachel Damon, this sounds like me, they go in,
they get a diagnosis, they start doing the therapy that you
suggest and start doing this with a licensed professional and
everything, let's talk about the people around them, because
I've even seen people that are codependent, which is another,
we always say another addiction, addicted to changing
people, right?
Like everybody, every drug addict that I know, every alcoholic that I know is surrounded by codependent that moth to a flame.
Like we attract each other, right?
Like let's talk about how important it is.
If you maybe have this diagnosis, I know it is in recovery.
First thing I always tell people is you got to stop hanging around the people who the other alcoholics, the people that you can't, you're not going to be able to do that, at least right now.
Like that's just not an option for you, right?
So how important is it to make sure as you go through this bipolar journey of recovery, to make sure not to have those people around you who are not supporting you in this?
Right.
So yeah, it's, I tell the people I'm like, you have to basically change, if you're changing your whole self, your friend group is a part of yourself.
And so you've got to, and you don't have to be rude and say, you know, I don't want to be around you anymore.
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