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.