Dual Diagnosed--Relief or Recovery?

by James Rist

I’ve had a little bout with gout, the past few days. In my mind, the pain ranks right up there with that of a toothache.

I knew I had the gout even before I saw my doc. How did I know? I knew because I’d had it before. I recognized the stinging pain, the ache, the inflammation, and the swelling in my foot. The doc knew I knew, and he prescribed Indomethacin without even the need to see me. He knew I knew, but, moreover, when I called him, he trusted me and my experience enough to write the prescription.

In a few short lines now, I have written about four very important things in my recovery from addiction and bipolar: PAIN calls attention to my problem; EXPERIENCE motivates me to seek help; SELF-DIAGNOSIS facilitates treatment; and TRUST makes treatment more effective.

The origin (etiology) of pain in mental illness and addiction is matter quite different from the etiology of other diseases. While the pain from most other diseases can be associated with a "physical" event or anomaly, the pain of mental illness is mostly emotional or perceived, if you will. While one might argue that pain relief is humane but not an essential first step in treating a physical disease, the treatment of pain in diagnosed mental illness IS a critical first step; because it is essential to relieve my mental anguish and restore my focus before attending to anything else.

You caught me on THAT one, didn’t you!? ...and you’re right! DIAGNOSIS, not pain relief, is the essential first step in treating disease!

While the clinician or doctor may see, touch, and describe my physical disease, he/she may NOT see or touch the mental disease, and must ironically rely on me to describe the disease, when it is mental illness. Now..., doesn’t that sound a lot like self-diagnosis!? You may say the same for the disease of addiction.

Bipolar disease and addiction do, in time, cause physical diseases, but the presence of the physical diseases does not confirm a diagnosis of bipolar or addiction. For example, liver disease does not confirm my addiction, and a shrunken hippocampus (region of the brain) does not confirm my bipolar disorder. The main indicators for bipolar disorder and addiction are behavioral, not physiological. How do diagnosticians confirm these diseases–that is, how do they connect the behavioral symptoms to the physiological effects of the diseases in order to diagnose the diseases?

The answer? ...I must ADMIT to the diagnostician that I have the disease. What’s the proof for this statement?

If I refuse to admit or if I deny having the disease, the disease CANNOT EFFECTIVELY BE TREATED! This leaves the doctor with only one recourse for treatment–pain relief without recovery or cure for the disease. Pain relief in this instance without my admission, I am sure you can see, becomes, rather than a remedy, a way to prolong and aggravate my disease--a way to postpone or avoid getting better.

In short, I have to admit to having bipolar disease or addiction, before anyone can give me effective help to recover.

I have made a pretty simple argument, in a small space, to support the idea that pain leads to discovery; and self-diagnosis is the only means of diagnosis for bipolar disease and addiction. The behavior changes and even the physiological damage done by these diseases, even though they are powerful indicators, are not enough for the doctor to diagnose the diseases, thus he must rely on my experience. So if your doc seems passive or indecisive toward your disease, perhaps he is only waiting for you to admit that you have it. Doctors generally avoid "spinning their wheels" until their patient is ready for help. Got it? TRUST it!

If you don’t "got it," please write a note or send an email, so we can talk more about it . It’s that easy.

Finally, I repeat–I am not an expert. I am not giving you NEW ideas here. I am not plagiarizing, either. I have based what I told you on my experience and the shared experience of others like me, and I have learned from experience to trust the information I share.

So, there it is–the magic "daisy chain" which opens the door to recovery–pain, experience, self-diagnosis, and trust.

Jim Rist

Taken from "The Lightbox Forum"

© 2006 www.cerebral-storm.com

i’ve been visiting mdjunction every couple of days for the past few months.

since you’ve joined the team i enjoy reading all of your posts (and your personal suicide story that touched me deeply). i admire the way you face life’s challenges and your total perspective of things.

good luck man. keep writing beautifully.

Sincerely,

Adam

It is a known fact that ( as "they" say): 50% of the recovery is admission. Without that self diagnosis, it's hard to make any progress in solving the "core" problem as I call it. All that can be done is to treat the sympotms - very poor replacement.

Enjoyed the reading-

David