DUAL DIAGNOSES ARE NOT DOUBLE TROUBLE FOR ME BECAUSE

Jim Wallace’s Story

September 1984:   My seventh admission to South Carolina State Hospital, and my fourth since becoming sober.  As a matter of fact, I celebrated my sixth year of sobriety from alcohol during this one month stay.  I had hoped that the Twelve Steps of my sobriety program would restore me to sanity from my mental illness, but they had always only promised to relieve me from my alcoholism.  So I decided to approach my mental illness separately.  I promised myself that I would exert every effort to comply with the professionals’ treatment plan, take the medications that were recommended to me, structure my life, limit it where necessary and be consistent in my effort.  Maintaining recovery from the two illnesses has to be separate, but in duality.  Each day I must remind myself that I am recovering from alcoholism and mental illness.  There must be no reservations or exceptions in dealing with either illness.

I tried alcohol, cigarettes, and cussing in high school as part of my growing process.  College allowed alcohol to be a social tool to overcome shyness with the girls.  I danced better, my conversation was more lively, and I was more relaxed (or so I thought).  Unknowing at the time, depression brought on by the stress and shock of my new college life almost got the best of me, but youthful will brought me through it.  I graduated four years later in Textile Manufacturing (in 1956), but I dodged stress along the way wherever possible.

After college, I had a six-month military (U.S. Army) obligation at Fort Bliss, Texas (El Paso).  While most young officers were taking advantage of the opportunity to tour the scenic west, I spent my off-time in the local bars.  Locating the nearest bar became my pattern during my drinking career.

After the military, I began my career in textile manufacturing.  Soon after starting to work, I broke up with the young lady I had dated throughout college and had planned to marry.  I immediately went into a debilitating depression which rendered me bedridden.  My mother, a nurse, and my understanding plant manager saw me through it.  I advanced quickly in my vocation mainly by long, hard work and a reasonable mind.  Not being able to handle stress, I could not advance beyond middle management, and left after five years.

Satan must have been answering prayers when I was afforded my next opportunity.  I became sales engineer for a prestigious textile machinery corporation.  Big job, big money, big auto, and I was expected to golf with, drink with, and entertain clients.  Had I died and gone to Heaven?  No, Hell, it turned out.  Progressively, I drank with clients, then heavy drinking clients, then alone because no client drank like I did.  I began to drink alone in my motel room or in bars in client cities, but not with clients.

Business trips became drinking sprees exclusively.  When I did make client contact, they told me of my inappropriate behavior (during a blackout) in a previous visit. Of course, my sales reports and expense accounts were false.  I began to have to drink my way home to combat the tremors and anxiety attacks.  DT’s, seizures, emergency rooms, ninety miles from home.  Wife, three children, big beautiful home, two country club memberships, responsibility, obligations, two DUI’s, overnight jail stays.

Out of control can’t last forever.  I awoke in my first psychiatric hospital.  I don’t remember the days leading up to the admission.  Being there, and eventually being discharged is still a haze, but I do remember that I hoped the psychiatrist would not somehow learn how much I drank.  Ten years earlier, my mother had Electro Convulsive Therapy (ECT) at the National Institute of Mental Health in Bethesda, Maryland for very severe depression, and never had any more psychiatric admissions or problems, living the next fifteen years in relatively good mental health until her death.  My hospital in Greensboro, North Carolina also recommended ECT, but my family had me flown to NIMH for a second opinion.  NIMH concurred, and I was flown back and had ETC.  Vitamins, diet, thorazine, and ECT were the only recommenced treatments for mental illness in 1970.  Lithium was in trials, but most psychiatrists considered it too toxic and dangerous, and a risk.  After discharge from the hospital, my employer, and subsequently, my family and psychiatrist decided I could not handle the stress of my job, so they agreed that I resign with a fair severance benefit after eight years with the company.  The few months of relaxation that I had during my inactivity, recuperation, and rehabilitation were replaced with varying degrees of spiritual, psychological, emotional, mental, and physical upheaval and problems with anger, resentments, betrayal, ego, esteem, confidence, coping, hopelessness, helplessness, finances --the gamut.

I spent the next few years, and really the rest of my life underemployed because I lacked the confidence to apply for the better jobs.  I feared the stress, and my resume had become questionable.  Less than two years after this first hospital admission, my marriage was gone.  My ex-wife and children moved 150 miles away to her hometown.  The house was sold.  Finances had dictated that from the outset.  I never could accept being an occasional father, even though I was faithful with the legal child support and visitation rights.  I was not comfortable with my friends and withdrew from them.  Also, social occasions consisted of me entertaining myself only.  My self-esteem, finances, quality of life all suffered and declined.

I had known for many years (even in my teens) that alcohol was not my friend, but I rationalized that it was.  It offered me a few hours, or a few minutes of normalcy, confidence, socialization, relief, respite, euphoria, or oblivion from the pain of hopelessness and helplessness (that it actually prolonged and increased).  I even sought to relieve the symptoms of alcoholism with internal medicine, ophthalmology, plastic surgery, and psychiatry.  All that accomplished was to introduce me to medications that only offered temporary relief.  All along the way, I tried alternative medicine, diet, vitamins, self-help books, and religion (not spirituality).

My first job after my first hospitalization ended in only three months, because my control drinking got out of control.  The next one I tried to abstain from alcohol, and was pretty successful.  The job was successful also.  I stayed on it for two years and thought I was ready for the big time again.  I interviewed for (on Valium) and was hired, and stayed on the next job for nine months.  Most of this time I didn’t drink, but alcoholism took its toll, and I was fired.  It was a very good opportunity, too.  The interim allowed a spree, bringing two DUI’s in three weeks, and more hospitalization.  Eventually, I gained control, stopped drinking, edited my resume, and asked my references to make a good report.  To my surprise, the communist country of Czechoslovakia (now the Czech Republic and Slovakia - two countries) hired me to sell their weaving machinery in the United States.  I had been with the company seven months, and alcohol - free seven months when my mother died.  This shock brought on delusions and psychosis, and my primary care physician had to come to my home and give me an injection to bring me back to sanity.  I missed my mother’s funeral.  The next week I went to Czechoslovakia for a month, and drank the first day out, continuing to drink each day that I was there.

Thirty-two days in this beautiful and quaint section of Eastern Europe with all its history, museums, castles, churches, thousand-year-old buildings and landmarks, World War II remains, and picturesque landscapes, and all I saw were textile mills by day and taverns by night.  Custom allows Eastern Europeans to drink wine, beer, and vodka on the job during the day-- and my addiction dictated it at night-- so I was in my element full-time!

Early in my four years with this company, I met and married a beautiful, sweet and  talented artist with two children still living in the home.  This was during one of those rare periods when I was in temporary control of my addiction.  (I had lost other such opportunities when fate was not smiling at me so favorably).  Our marriage lasted nine years, attesting to her tolerant, patient, and compassionate character.  During this time I made her life, and that of her children, a living hell.  Alcoholism, mental illness, tantrums, jail, public drunkenness, finances, shame, embarrassment, grief --they and I experienced the lowest depth of existence.  My wife took respite in the same private hospital that my mother checked me into in her later years.  Fortunately for my wife, my priest who was also a psychologist introduced her to the public system, which was less enabling, and probably saved her sanity as well.

Even my employer had to hospitalize me during one spree, and eventually had to terminate me due to habitual drunkenness.  Over the years, many good and experienced people attempted to intervene on my behalf, but my addiction and mental illness manipulated and took every advantage, allowing me to continue my destructive downhill direction.  Another period of unemployment, uncontrollableness, home evictions, judicial commitments, another DUI, jail, DTs, seizures, excruciating withdrawals and control. –Abstinence again.

Another job, seven months not drinking, another excuse to drink, threat to kill my wife (danger to self and others), judicial commitment for five months at South Carolina State Hospital, she changed the locks on her doors, told the judge “the end”, five more months in Rehab., two months in community care homes, kicked out for drinking, back in the valley, the valley so low.

Nowhere to go, I went to the woods, to a state park that my wife and I had enjoyed in happier times.  I remembered it had two beer bars and a bootlegger within walking distance if I became too incapacitated to drive.  For five weeks, I drank, passed out, came to, drank, passed out, ad infinitum, ad nauseam, no sermons, no nagging, no fussing and no glares or rejection.  I showered to get my clothes off, due to aggravated hemorrhoids, uncontrolled  bladder and bowels, and refusal of the  joints to allow me service because of my odor and unkept appearance.  In my element again, planning to extend my wasted but self-imposed life style.

By coincidence, my wife ran into me when I was in Gaffney (twenty-five miles  from my campsite) withdrawing some drinking money from my bank account.  She wanted details of my last weeks since she had lost touch with me, and she asked if she could camp with me for the weekend, and the next.  The second weekend she asked if I would consent to going to a self-help group for alcoholics with a neighbor of hers.  Out of respect for her, I indicated I would come into town the following Monday, attend the meeting, and then of course, I would get back to my drinking.  The member told her I was not to drink the day of the meeting, and somehow my shoe leather held out.  That was on September 18, 1978, and I haven’t had a drink since.

The people at the meeting really made an impression on me. I could tell they were sincere and serious about what they were doing, and they said they used to be like me until they started working this honest program.  They were practical and realistic, yet had uncommon sense, They were humble and unselfish, and I wanted to be as much like them as possible.  I sensed this was my last way out, the only way out for me, and I wanted what they had.  I went back to my tent for another week, attending meetings everyday, and my wife invited me back into the home for the first time in over a year.  I became totally committed to this spiritual, sobriety program and was willing to go to any length and sacrifice that they suggested.

I was not compliant with good mental health practices, and the added stress of staying sober, and trying to sober up the world put me back in the State Hospital, but sober.  I refused psychiatric medication, assuring myself that increased effort to work the 12 Steps would restore me to sanity, as suggested.  Later I would learn that my sobriety program would restore me to sanity from addiction and not my total mental health, but it went a long way in improving my quality of life.

Hills and valleys became a way of life, whereas before it was all downhill.  Living with my wife didn’t work out, there were more periods of unemployment, missions, and fellowship homes, but no drinking.  It had been so long since I had lived life and coped with daily rigors that I had to get used to facing life as other normal people do, without the drink of oblivion.  Almost immediately, though, I begin to experience an inner peace which I had not known before, no matter what the early days and circumstances offered.  Guilt-free, the days and nights became better.  People complimented me on character traits which I used to admire in others, but never expected to develop in my own personality: less thoughts of self and more of others.  Early in my sobriety, I made a conscience pledge to God that if he would keep me humble and worthy, I would dedicate the rest of my life carrying the message of recovery to substance abusers.  Later when I decided to be compliant with good mental health practices, I promised God I would combine the duality of my recovery programs.

I still experience peaks and valleys, but now the cycles aren’t so great or frequent, and they are more manageable.  I know that experience teaches expertise, help and hope replace helplessness and hopelessness, and weaknesses turn around to become strengths.  My story illustrates the depth of addiction and mental illness, but also that recovery is possible for those of us honestly open to the opportunity.

Almost immediately upon quitting drinking with a sobriety program, I was named executive director of a thirteen bed residential rehabilitative program for the North Carolina Department of Mental Health.  However, I was not compliant with good mental health practices and became highly manic within a year. Denial or whatever, I still thought it was the residual effects of so many years of active alcoholism; but it set me to thinking that I was manic-depressive as indicated.  Soon, I made the decision that if I wanted to fully comply with a strict regimen of good mental health practices, I would have to move to Columbia, South Carolina, where all the good mental health models were located.  That was in September 1984, and I haven’t had a psychiatric admission since.  My cycles have decreased in amplitude and frequency, and my overall function has become a model for working with and within the system.  I have consistently been employed during the more than seventeen years I have been in Columbia.  I worked a Vocational Rehabilitation job for about three years, then three Transitional Employment Program jobs (TEPs) when they were just getting started in the state.  Next, I was the first consumer assistant case manager working for a clinical program, Psychiatric Services for the Homeless.  This innovative program involving consumers was named the number one grant awarded by NIMH in 1989.  Next, I became the first and only consumer client advocate for Protection and Advocacy for Individuals with Mental Illness (PAIMI).  While there, I wrote a comprehensive discharge manual that was distributed to every DMH social worker in the state, and for which I was given an Achievement Award by the Mental Health Commission.  Next, I became the first, and only consumer client advocate for DMH.  I than became a community support person for South Carolina National Alliance for the Mentally Ill (NAMI-SC), as part of an AmeriCorps VISTA grant.  Presently, I am with the Mental Health Association in South Carolina (MHASC).  Here, I developed a work program for advanced degree consumers, called the Mentor Program.  Now, I work as the first and only client advocate for MHASC.  All of my positions have been mental health related in some way.  In each case, I have been approached for hiring, and have never had to seek employment.  Dedication and effort have their rewards.

I want to reemphasize that since I made a commitment and decision to comply with good mental health practices in 1984, I have had no psychiatric admission to the hospital, a strong argument for compliance.  I have tried to carry a message of encouragement, experience, expertise, faith, hope, strength, and love to persons with substance problems and/or mental illness for almost twenty-five years.  I have presented to over 1000 audiences as diverse as the Governor’s School, Public Academic Consortium, universities, high schools, maximum security prisons, conferences/seminars/workshops, in-services, mental health centers, and many other different groups. Also for the past few years, I present weekly to the substance abuse lodge at Bryan Psychiatric Hospital.

In coalition with professionals in abuse treatment and self-help (SCSH, Morris Village, LRADAC, SCCADA, Bryan, psycho-social clubhouses, social centers, and others), I started the first (as far as I know) consumer-run Double Trouble group in the U.S.  I prefer to call it Dual Diagnosis Group because it is no trouble for me to be alcoholic because I don’t drink, and it is no trouble to be mentally ill because I take Depakote, and it keeps me out of the hospital.  I had the group approved by the oldest, largest, and most successful self-help organization from substances in the world.  I formed groups in churches, three clubhouses, and for almost ten years, SCSH.  Support from clinical services, is at best minimal since they can not bill for consumer-run services, and it takes away from their regular work, even though consumer-run groups are much more exciting, effective, and successful.  Consumers are more understanding when interest is not high, motivation is low, there’s over-medication/under-medication/no medication, and judgement and insight are lacking.  You have to walk the walk in order to talk the talk, and this honest respect for each other is very visible.  Recovery is different since both illnesses must be kept in remission to maintain health.  Even though the consumer may be unable to control his/her illnesses in a reasonable time, the groups are valuable as a model, for observation, information, and socialization, breaking down denial, implanting positive attitudes and healthy habits, and teaching how to get help, if and when ready.  Importantly, the groups act as a monitor to minimize out-of-control behavior of the consumer not in compliance with treatment for substance abuse and/or mental illness.

I was co-founder of the still active and successful consumer movement, S. C. SHARE, and I have been a client advocate for every advocacy organization in the state, but my greatest satisfaction has been in the area of dual diagnosis.  Dual Diagnosis is a relatively new approach, and has been neglected by the clinicians until recently (--and the emphasis is still not what it should be).  DMH plans to be more proactive, and it’s about time.  I have presented all over the state to mental health centers, medical directors, and others.  Hopefully with DMH becoming more active, the voice of the dually diagnosed consumer will finally be heard.

I was forty-four when I at last became sober, and was age fifty when I decided to become compliant with good mental health practices.  It was late in my life when I became a consistently positive person who contributed to the well being of society.  “Bottom”, “negative”, “cynical”, “failure”...... these are a few of the words used to describe me twenty-five years ago.  Today I have esteem, confidence, opportunities, choices, and a quality of life that includes contentment.

Probably the most important thing I have learned about myself is
“Life is a Journey.
Circumstances beyond our control enter our lives daily,
and the choices we make, or are made for us by God and other interested parties,
strengthen our resolve.”

In February 2000, I was discovered in my apartment to be in a coma.  My neurosurgeon did not think I was going to make it and he asked my case manager to notify my children, who had no contact with me for many years due to my dysfunctional fatherhood, thanks to my alcoholism and mental illness. I don’t remember it, but the two younger children who gave up on me more than ten years ago, visited me once.  The older child, who was shamed and hurt the most by me, and who had not had any contact for more than twenty years, now calls and visits with me on a regular basis.  Who says that a coma is all bad?

I stayed in a medical hospital for two months and a rehabilitation hospital for two months, where I had to relearn to talk and walk.  It was determined that dehydration had caused my lithium level to become toxic, hence the coma.  But, unrelated, the neurosurgeon found I had a life-threatening aneurism in my brain, which had to be taken care of as soon as the effects of the coma subsided enough to allow the brain operation.  I was readmitted to the medical hospital for two more weeks, followed by another two weeks in the rehab hospital.  The brain operation was a complete success.  Today, my medical condition is the best in years, and Depakote has given me the best mental health ever.  I have not had a manic nor a depressed condition that I can not handle without further psychiatric medication.  Also another benefit for laying on my back so much that year, I have quit my five pack a day smoking habit.  The best part by far has been the interaction with friends, who, I knew all along, cared for me, but who were given an opportunity to show it in so many ways.

I don’t speak much of my spirituality or about the God of my understanding, but my neurosurgeon and others have said that God saved me from death twice for some reason.  I believe it, too, and it may be to continue my work in dual diagnoses, and to expand this short book to a greater audience.

 

 

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