The Chicken or the Egg?

“There’s something inside me that pulls beneath the surface.  Consuming me, confusing…Crawling in my skin.  These wounds they will not heal.  Fear is how I fall.” – Linkin Park

What comes first. Is addiction a symptom, a byproduct of an underlying mental condition or is addiction something that is there and then creates underlying mental health issues. I think it varies and can be both. This is my experience and how I self-medicated for years my own mental health issues that far preceded my first drink or drug. Ever since I can remember, before I found recovery, I felt different. It didn’t matter if I would be around a group of friends or family that I had known all my life. I had this distinct feeling of disconnect from people. In part I believe it was the shame I carried with me from an early age. I would later be diagnosed in my late teens with Obsessive Compulsive Disorder. A component of OCD is having intrusive thoughts that plague those who suffer with the diagnosis; and to create some relief to the anxiety, fear and paranoia that accompany these thoughts is for the individual to engage in some form of ritualistic behavior that in turn cause a disruption in the individual’s life. The onset of this can be in early adolescence, which was the case for me. I had always felt some anxiety throughout my childhood, but at the age of ten when the components of OCD began to rear its ugly head it magnified any initial feelings of anxiety which led me to come up with tools to distract me from my thoughts and get me through the next 24 hours. As a therapist I would later recognize that I was applying DBT skills to just get by, utilizing different forms of distress tolerance. I would often rewrite portions of encyclopedias on paper to distract myself or obsessively listen to music over and over writing down the lyrics of my favorite songs and memorizing every word. This was so if any intrusive thoughts came up for me during the day I would often just start singing a song I had memorized the night before. These were often daily skills I would apply to stay distracted from the intrusive thoughts that plagued me every hour of the day. For most with OCD intrusive thoughts can be so distressing and disturbing they often directly challenge the core values and morals of the individual. For a 10 year old boy I was absolutely a prisoner of my own mind and feared going to my mother or father as I was sure they would believe I was crazy and surely they would not want me. So I did the best I could to establish coping mechanisms and appear as normal as I could externally by doing well in school and playing sports; meanwhile as each year past I sunk deeper into what seemed like a dark abyss of the mind and spirit. I had never felt so alone and abandoned in spirit then at this time in my life. This created a significant amount of anxiety and dread about each day I awoke to. I’ve heard some people describe mental illness as if a black cloud were following them wherever they would go. I could have only wished for that analogy to be true in comparison for myself. I would have welcomed a dark cloud I could have at least quietly observed it from below and recognized I was separate from the cloud and that it was not who or what I was. However, for me it was as if a thin dark sludge covered every inch of my being it encased me and no matter what I did it was just there; suffocating me. Constantly reminding me of its presence. It didn’t just let me know it was there daily, but eventually it convinced me of the lie that it was me; and by the age of 12 I began to obsess about the idea of taking my own life. I wanted so badly for Gods approval and for Him to show me I was ok. So, I would constantly read the bible as a child. My mother bless her heart, thought I was being a good catholic boy when in actuality I was searching for redemption, because I thought I needed it. I was like, “Hey God look at me, see I can’t be evil. I’m reading your book, see.” It was around this time in my life 11 or 12 I began to develop a prayer ritual to dispute the intrusive thoughts in my mind. For I believed if I could not dispel them they would eventually overtake me and consume me, compelling me to become the very evil that plagued my mind. I would at time kneel in prayer in the early morning hours, not able to sleep from the crippling paranoia and anxiety I felt, night always seemed the worst. I began to take a rosary I had had since I was a young boy and begin to weave it between my fingers counting out loud the number of times it weaved in and out of my fingers hoping it would end on an even number in the middle of my hand so the crucifix could lay in the middle of my palm; if this did not happen I would unweave the rosary from my hand and start again. Once I would accomplish this I would continually pray out my penance and I would not stop until I either just passed out or I felt the paranoia subside and peace would come and allow me to sleep. Sleep became a struggle for me and often this ritual at night would take me into the early hours of the morning to which I would get incremental relief and sleep. Often going into school tired and irritable, to which I believe this may have contributed to my defiance in class at times. I felt as if I was a time bomb, I was a human pressure cooker and I felt as if I was running out of time on figuring out what I could do. The charade I often upheld with my family and friends was beginning to where me down and I was considering more and more the very real option of taking my life; until on a mild winter night I was introduced to alcohol with a group of friends. That moment was life altering for me on so many levels and to some degree created a lasting confusion in me for over a decade. You see, when I drank my first drink, I immediately began to feel the warmth and comfort I had been longing for my whole life, but it had always eluded me without alcohol. The more I drank I noticed the absence of fear and anxiety and my intrusive thoughts were easily dismissed and I was able to socialize and think about other things. I had found the answer, I had found not only a solution to my problem I had found something that took away my pain, restored a hope in me for a normal life. Due to that; I embarked on an intimately loyal relationship with alcohol that would later break every promise it had made to me that wintery night. Alcohol was efficient, effective and fun for about 3 years and by the time I was 18 it had run its course and everything it had taken from me, the pain, the fear, the suicidal thoughts, the intrusive thoughts, it gave back to me 100 fold leaving me confused, depressed, and full of fear. I supplemented with other drugs all the while trying to make alcohol work again to no avail. It wasn’t until I found heroin at 19 that I felt as if I recreated that first experience with alcohol but at a level 1,000x more intense. I had found Nirvana, heaven inside me or so I thought. It appeared to take away my pain and promise me far more then alcohol and I took the bait. I believed I could endure and sustain this relationship, but to my disappointment it crashed and burned in apocalyptic fashion a lot quicker then the time it took alcohol to destroy me. So here I was, I had been self-medicating and treating a mental illness for over a decade with one substance or another. For me I was lucky to find a solution to the drink and the drug dilemma but continued even in my recovery to battle with my mental illness to which was not entirely remedied effectively until about 5 years sober, that’s another blog for another time. Struggling in recovery with mental illness is a real thing. Often times one illness triggers the other and without proper tools individuals often find themselves in this vicious cycle of self-medicating to manage the symptoms of their mental illness. According to SAMSHA and a 2016 National Survey; In 2016, an estimated 9.8 million adults aged 18 or older reported they had thought seriously about trying to kill themselves. An estimated 8.2 million adults aged 18 or older (3.4 percent of all adults) had both a mental illness and a substance use disorder in the past year.   Yet 1 – 3 adults do not receive any care for either type of illness.

I often think if teachers or even my own family were educated about mental illness if they would have been able to pickup on some signs or if schools put into place mental health education as well as preventive classes in schools teaching young adults how to manage stress, anxiety and depression in a healthier manner with healthier tools if my path would have been different. Luckily for me I was able to eventually get the help I needed and continued well into my recovery to work on the underlying causes and conditions that contributed to my addiction. I only hope myself as someone in recovery not only from alcohol and heroin addiction but also mental illness as well as a professional in the field of mental & behavioral health will continue to educate and break the stigma of both. The more we as people get comfortable getting uncomfortable talking about mental illness and addiction with our children, family and friends; then maybe just then we will begin to see a dramatic shift away from the toxic shame we all hold and then the healing of a society in crisis can begin.