Mental Illness: Untouched Subject at AA


According to reports published in the Journal of the American Medical Association:

  • Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.
  • 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
  • Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.

Source: National Alliance on Mental Illness


Fifty-six percent of individuals with bipolar disorder meet lifetime criteria for drug or alcohol abuse or dependence. Individuals with bipolar I have higher rates of lifetime substance use disorder (61%) when compared to individuals with bipolar II disorder (44%).  Bipolar Illness and Alcohol Abuse: Course and Treatment

I have been attending Alcoholics Anonymous for nine months with 100% success.  It is a very good program, and I have experienced a tremendous amount of personal growth through it.  In AA, we share our stories, we read the Big Book, and we listen to speakers.  I’ve attended at least one meeting a week since July of 2015, and not once have I heard a word about mental illness other than from myself.

Think about that for a moment. More than a third of the people in any AA meeting should have at least one serious mental illness, and nobody talks about it.  Now, we also know that around half of people with mental illness are undiagnosed.  These are the ones self-medicating.  They know they have some problem, but they don’t know what, and they know that drugs and alcohol seem to help at least for a short period.

I was beginning to become concerned that there was some sort of anti-mental illness bent to AA, so I asked a long term member and he assured me that he was not aware of it.  One of the instructions for any discussion meeting is that we confine our remarks to those related to alcoholism.  Maybe that has something to do with it.  But it’s no accident that there are so many mentally ill folks who abuse alcohol and substances.

What I am afraid of is that my sobriety depends in part on my mental health.  I worry that if I have a big enough manic episode, I will fall of the wagon.  I will lose all sense of rationality and will no longer see the need for sobriety.  That seems like a pretty relevant topic to me.

I recently had a significant manic episode, and I let my sponsor in on it.  He had no experience with mental illness other than alcoholism, but he handled it so well.  He kept very close tabs on me.  He talked me through anger issues in particular.  He helped me examine the triggers which caused me to behave irrationally.  At first, I was skeptical.  I don’t like to take responsibility for my illness.  I don’t like to concede that there might be something I can do besides take my medicine.  It’s a medical issue after all.  But he was right, with practice, I could curb my impulses both with anger and hypersexuality as relates to women outside my marriage.

I haven’t read enough to understand why so many mental ill, especial bipolar, become addicted to alcohol and drugs.  I know self-medication has a lot to do with it, but my alcoholism didn’t really get out of control until I was medicated and level.  I went from drinking 2-3 drinks a few nights a week to 5-7 drinks every night.  I know drunks who drink/drank a lot more than that, but that’s all I could tolerate without puking.

That’s really the only thing from having prevented me from abusing alcohol through most of my adult life.  I got sick really easily, and I hate being nauseous and puking.  But I slowly built an immunity.  I would have built more and more immunity.

When I first started treatment for bipolar, I was forbidden from drinking.  I was mostly compliant.  It’s a progressive disease, so when they told me I could drink again, I drank even more than before.

I would really like to see more open discussion in AA about mental illness.  I might have to be the one to make that happen in my meetings.  I worry about stigma in a place that understands stigma very well.  I wonder if recovering alcoholics see all of their mental health issues as a symptom of their addiction and feel that they should address it that way.  I also wonder if those are the very same people who keep relapsing over and over again.





8 thoughts on “Mental Illness: Untouched Subject at AA

  1. Congratulations on your sobriety! That is not easy. I just celebrated 12 years clean and sober, which I am extremely grateful for. I too, noticed that mental health is not talked about in meetings or even among other group members. I was lucky to find a sponsor that was understanding and supporting of my mental health diagnoses. Not everyone will understand, but that’s their own problems. AA is supposed to be a place we can go where we are accepted and not judged. I always wanted to have more open discussions about mental health, but it didn’t work well for me. I’m sure you will have better luck, as long as you have someone there that understands your diagnosis. Again, congratulations!

    • I don’t hide it, but I find that I’m less likely to bring it up. I remember my very first meeting. I came too early and there was a real odd bird there. She did two things that almost caused me to turn right around. She quizzed me to try to find out if I were a “true” alcoholic, and when I mentioned my illness she told me that we only talk about alcoholism and that I should keep that to myself. I know now that that is complete bullshit. My illness and my alcoholism are all mixed up together.

      What I would like, is to be asked to be a speaker on the topic of mental illness. There are so many undiagnosed bipolars in AA. I can spot ’em a mile away.

      I do think the program has helped me deal better with my illness, but it’s no substitute for treatment.

  2. Pingback: AA, Mental Illness, and Changing Your Braining | Closer to the Middle

  3. Thank you for your post. I am 27 years sober in AA and had a break with my bipolar mania that was horrendous and landed me in jail. My AA sponsor of 16 years hung up on me when I reached out to her and told me that I was sick with my mental illness. I have been in search of support and place to belong every since. I know that with God’s help and people who have experienced what I have there is a place for sober people who are dually diagnosed. Blessings, Bipolar Anonymous

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