Tag Archives: co-occurring disorders

Winnie-the-Pooh’s Mental Illness: How to Treat Others (in spite of their “flaws”)

mental illness

All of us in recovery have a story. Our stories go back to before we began walking down the treacherous road of addiction. Many of us had, for the most part, decent childhoods. Growing up in houses full of love. Parents who bent over backwards to ensure we would be afforded every opportunity in life. After all, that is the role that parents are expected to take in a child’s life. Two people who teach you how to be a good person, to yourself and to others.

However, our guides in early life had no way of knowing that deep inside their children something was amiss. Rather than a philharmonic orchestra, a syncopated jazz ensemble was on stage. The music sounded great, but it was off-beat. While there is certainly beauty in organized chaos, left unchecked the lines of discord and harmony become blurred. Truly, the number of variables that lead one toward the grips of addiction are numerous. Each individual case with unique roots, but the trees that would grow up were similar in appearance. Everyone recovering from addiction has unique experiences, but what brought us to surrender looked the same.

The signs may not have been picked up on early on. But, it can’t be denied that a significant number of people living with addiction met the criteria for mental illness. In one form or another, early on. Such conditions, and a lack of treatment, likely played a part in many people's path to drugs and alcohol. Verily, those touched by mental illness, but don’t have tools to cope or even talk about it, turn to self-medication. It doesn’t have to be in the form of substances, it can be behaviors as well. Patterns of risk-taking behaviors, specifically, resulting in co-occurring disorders.

What Does Winnie the Pooh Have to Do With People In Recovery?

When you were a kid, your parents likely read you children stories. Regardless of which decade you spent your childhood, A.A. Milne’s stories were probably read to you. Winnie the Pooh and his pals of the Hundred Acre Forest danced through your mind before falling asleep. We couldn’t see it then, but Milne was trying to reach us—even if it was inadvertently. You see, Milne fought in both world wars, which scared him. At the time “experts” would have called it bullet wind, soldier's heart, battle fatigue, or operational exhaustion. But, most people called it “shell shock;” what we would call post-traumatic stress disorder.

A new biopic ‘Goodbye Christopher Robin,’ explores A. A. Milne’s battle with post-traumatic stress disorder (PTSD) and the creation of Pooh. Milne’s inspiration being his son and his toys, TIME reports. The Winnie the Pooh series has been dissected and has even been applied to schools of philosophy (i.e.The Tao of Pooh and The Te of Piglet) over the years. Helpful for those in recovery, to be sure. Perhaps even more relevant to the field of addiction is a study from 2000, published in The Canadian Medical Association Journal (CMAJ). Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne.

In the study, Dr. Sarah Shea Read and colleagues started out with the intention of having a bit of fun. They assigned a mental illness to each character, using criteria from the DSM, according to iNews. Dr Shea claims that she hadn’t any knowledge Milne’s struggle with PTSD, at the time of the research. Milne’s characters were likely the author’s way of processing his own struggle with mental illness. Untreated mental illness, that is.

Concept of Comorbidity (Co-Occurring Disorders)

For some of you, decades may have passed since you read or watched something with Winnie the Pooh. Still, there is good chance you remember the attributes of the characters. iNews compiled some of the researchers’ insights on the characters:

Winnie the Pooh: Attention Deficit Hyperactivity Disorder

This unfortunate bear embodies the concept of comorbidity [the presence of more than one disorder].
Most striking is his Attention Deficit Hyperactivity Disorder (ADHD). As clinicians, we had some debate about whether Pooh might also demonstrate significant impulsivity, as witnessed, for example, by his poorly thought out attempt to get honey by disguising himself as a rain cloud.”

Piglet: Generalized Anxiety Disorder

Had he been appropriately assessed and his condition diagnosed when he was young, he might have been placed on an anti-panic agent… and been saved from the emotional trauma he experienced while attempting to trap heffalumps.”

Eeyore: Dysthymia – or ‘Persistent Depressive Disorder’

We do not have sufficient history to diagnose this as an inherited, endogenous depression, or to know whether some early trauma contributed to his chronic negativism.”

Tigger: Recurring Pattern of Risk-Taking Behaviours

We acknowledge that Tigger is gregarious and affectionate, but he has a recurrent pattern of risk-taking behaviours. Look, for example, at his impulsive sampling of unknown substances when he first comes to the Hundred Acre Wood. With the mildest of provocation he tries honey, haycorns and even thistles. Tigger has no knowledge of the potential outcome of his experimentation.”

Rabbit: Possible Narcissism

We note his tendency to be extraordinarily self-important and his odd belief system that he has a great many relations and friends. He seems to have an overriding need to organize others, often against their will, into new groupings, with himself always at the top of the reporting structure.”

Do Unto Others… The Stigma of Mental Illness

People living with untreated mental illness are often treated poorly by society. What people can’t understand, often frightens them. Impelling them to treat people in ways that they would never wish to be treated. Perhaps all of us missed the most important aspect of Milne’s stories. That it is O.K. to be different. That things happen in life that are beyond any one person’s control. And rather than ostracize and exile others, compassion and love can be what helps them heal.

Humans have a long history of treating those with mental illness as broken. Moral weakness, and a lack of constitution, drove them to insanity and vice. That has never been the reality, but if people are treated that way they will never find the courage to recover. Recovery is possible, so long is people are given the opportunity to do so—without fear of repercussion.

More than anything, the key to the books are their tone of love and acceptance and unspoken forgiveness in the Hundred Acre Wood,” said Dr. Read. “The stories provide lovely examples of how humans should behave.”

Many of us, upon finding recovery, were unaware that our addiction was inextricably linked to a co-occurring mental health disorder. We found that when our depression or anxiety was treated, achieving lasting addiction recovery was exponentially more likely to come to fruition. If you are a young male battling addiction, please contact PACE Recovery Center. We can help.

You can watch the ‘Goodbye Christopher Robin’ trailer below:


If you are having trouble watching, please click here.

Addiction Family Work: A Two-Sided Problem

Addiction is a Family Disease

An addict’s net cast wide…” HBO Mini Series A Night Of, August 28, 2016
Family Work Two-sided ProblemIn five simple words, the above quote manages to capture the essence of the disease of addiction. It is a family disease, not unlike any other chronic disorder. It requires family work. It is a two-sided problem. But for some reason, an addiction diagnosis, like many mental health disorders, often carries with it elements of shame and guilt. With any health diagnosis one can experience an array of emotions: shock, terror, fear, resentment, confusion...and so the story goes. How we learn of a family member’s addiction diagnosis will vary. One might be standing in a hospital emergency department, one could receive the phone call in the middle of the night from a jail, one may find himself at a parent-teacher conference listening to someone describe their child’s unexplained behavior. Every parent has their own story. But most parents won’t share their story after receiving a final diagnosis of addiction. They will pull inward, feeling guilt, shame and fear of the unknown.

So, what steps should parents pursue to start the family’s recovery?

First and foremost, the family must understand and accept they are not alone. An estimated 21 to 25 million Americans struggle with substance abuse. Indeed, last month the U.S. Surgeon General reported that one in seven Americans struggle with substance abuse. To put that number in perspective, if you live in a neighborhood of 100 people, then 14-15 could be dealing with addiction. And each of those 15 have a story they are afraid to share. Secondly, get the facts. If you have a family primary care physician, seek their advice. If your employer offers an Employee Assistance Program (EAP), then determine what programs might be available for your loved one. Third, take a deep breath, have a family meeting and make a plan. If planning doesn’t come easy, then perhaps you need an interventionist to guide you in this process. Fourth, if an intensive primary care substance abuse treatment program or intensive outpatient treatment program are in order, then review your health insurance policy and move forward. Finally, take the first step and start to care for yourself; learn to set your boundaries. Seek out an Al-Anon meeting and understand the three “C’s”: You didn’t cause it, you can’t control it, and you can’t cure it. Work your own program of recovery and allow your loved one to work their program.

Dr. Phil helps one young man take his first step

Dr. Phil logo This past November Dr. Phil viewers were allowed to meet one young man and his parents. If you happened to tune-in, you may have been shocked to hear their story. But if you have a family member with an addiction diagnosis...then you may have been empathetic and hopeful that this family will find recovery. Here is how Dr. Phil guided the family to consider PACE Recovery Center’s multi-pronged approach to addiction and co-occurring disorders. In his own words, Dr. Phil explained:
There is an organization called PACE Recovery Center and it is a gender specific, extended care program for young men struggling with chemical dependency and behavioral health issues, such as immaturity, the inability to modulate, regulate,  predict their behavior. Whether it is neurological, psychological, or whatever. The  PACE approach utilizes a model of integrating philosophies and research and clinical practices from medical, psychiatric, psychological, social, familial and self-help communities. I mean this is a very integrated model."
If you are having trouble viewing the video, you can see it here.

Family recovery is possible…

PACE Recovery Center specializes in treating young men. We have a core philosophy to offer a place where men can delve into their underlying issues, which have caused them to resort to substance use and self-defeating behaviors. We understand that a positive attitude changes everything. Parents are encouraged to attend family therapy with their loved ones at PACE to address how addiction has impacted family members. This therapy allows family members to leave behind the guilt and shame; they are encouraged to share their story. Working with PACE Therapists and counselors, family members can learn about the disease of addiction, acquire tools to end enabling or co-dependency, and develop new healthy communication patterns in sobriety. Yes, the story goes on...

Replace the Stigma of Mental Illness With Hope

mental-illnessWith our nation’s eyes fixed on the television screen and other major media outlets following the primaries, there are a number of other important events happening that are being overlooked—such as Mental Health Month (MHM). Last month, events were held across the country to raise awareness about alcohol, with the goal of educating Americans about how alcohol can impact one’s life which would hopefully prevent people from traveling down a dangerous path towards alcoholism. In May, everyone is being called upon to do their part in ending the stigma of mental illness and advocate for equal care. Mental health disorder is an umbrella term that covers a number of different conditions, including addiction. The disease is recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). There are 20.2 million adults in America who have experienced a substance use disorder, a staggering number which begs everyone’s attention, according to the National Alliance on Mental Illness (NAMI). On top of that, more than half (50.5 percent or 10.2 million adults) had a co-occurring disorder; this is when someone living with addiction also suffers from another form of mental illness, such as: anxiety, bipolar disorder, depression and posttraumatic stress disorder. Mental health awareness is an extremely important topic, especially when you consider that the majority of people living with any form of mental illness do not receive mental health services. In the past year, only 41 percent of people with a mental health condition were able to get assistance, NAMI reports. Mental illness is unlike a number of other health issues, brain diseases currently do not have a cure, which means it is paramount for not only the patient, but society that those who are afflicted get the help they so desperately need. Expanding access to mental health services will only come to fruition if we, as a nation, work together to break the stigma that has for too long accompanied treatable conditions. We all have a vested interest in bringing mental illness out of the darkness, practically every American is close to someone who battles with a mental health issue 365-days a year. Every year, 43.8 million adults in America experience mental illness, approximately 1 in 5. May is Mental Health Month (MHM), and there are a number of things you can do to help break the stigma of mental illness. NAMI is asking people to harness the power of social media platforms to share mental health related information, images and graphics with #StigmaFree or #MentalHealthMonth. You can also take your efforts one step forward by taking a pledge to be ‪#‎StigmaFree‬. It’s quick, easy and could reach the millions of people who are too afraid to seek help due to societal shame. Just follow the steps below:
  1. Take the pledge.
  2. Record your video.
  3. Upload to your YouTube channel and other social media accounts.
  4. Be sure to include #StigmaFree in the title of your video.
If you’d like, take a moment to watch The Big Bang Theory’s Mayim Bialik take the pledge to be #StigmaFree: If you can’t see the video, please click here.

Back Pain, Anxiety, and Depression – Opioid Abuse

A large percentage of people who seek treatment for substance or alcohol use disorder also have other mental health disorders on board, such as depression or anxiety. When this is the case, it is referred to as having a co-occurring disorder, and successful recovery hinges on treating both. What’s more, people’s depression or anxiety may play a part in people forming an addiction. In fact, new research suggests that people living with high levels of depression or anxiety, and experience chronic lower back pain, are significantly more prone to developing a problem with prescription opioids, Medical News Today reports. People with chronic lower back pain and high levels of depression or anxiety were 75 percent more likely to abuse opioids than people with low levels, and their back pain was less likely to improve. The researchers involved in the study examined 55 patients with chronic lower back, as well as major or minor levels of anxiety or depression, according to the article. Over the course of 6-months, the patients were given oral forms of morphine, oxycodone or a placebo. The patient's pain levels and the amount of drugs taken were recorded daily. There was 50 percent less improvement and 75 percent more opioid abuse among patients who had high levels of depression or anxiety, compared with patients with low levels. The findings suggest that doctors treating patients with lower back pain, who show symptoms of mental illness, should make sure that the mental illness is being treated rather than "refusing to prescribe opioids," according to lead researcher Prof. Ajay Wasan, at the University of Pittsburgh School of Medicine. This may reduce the likelihood of opioid abuse and reduce pain. “High levels of depression and anxiety are common in patients with chronic lower back pain,” Wasan said in a news release. “Learning that we are able to better predict treatment success or failure by identifying patients with these conditions is significant. This is particularly important for controlled substances such as opioids, where if not prescribed judiciously, patients are exposed to unnecessary risks and a real chance of harm, including addiction or serious side effects.” The study is published in Anesthesiology. ___________________________________________________________________________ If you or a loved one is struggling with opioid addiction and depression or anxiety, please contact Pace Recovery Center.

Bipolar Disorder and Marijuana Use

cannabisBipolar disorder, also known as manic-depressive illness, is one of the more common co-occurring disorders that people living with addiction experience. Those in the field of addiction are acutely aware that those with co-occurring disorders are some of the most difficult to treat, due to the fact that both the substance abuse and the co-occurring disorder need to be addressed, if a successful recovery is to be achieved. Failure to properly diagnose and medicate co-occurring disorders accordingly usually results in relapse. Many living with mental health disorders, such as depression and bipolar disorder, often use illicit drugs to cope with their illness. Unlike prescription psychotropic medications, illicit drugs often exacerbate the mental illness, and often times lead to substance dependence and/ or addiction. New research has found that those living with bipolar disorder who use marijuana experience increased manic and depressive symptoms, Medical News Today reports. Symptoms including:
  • Shifts in Mood
  • Energy
  • Activity Levels
  • The Ability to Carry Out Day-to-Day Tasks
Researchers involved in the study found that around 2% of the UK population has Bipolar Disorder, and 60% of them have used marijuana at some point in their lives, according to the article. "One theory that is used to explain high levels of drug use is that people use cannabis to self-medicate their symptoms of bipolar disorder," said lead researcher Dr Elizabeth Tyler of the Spectrum Centre for Mental Health Research at Lancaster University. "The findings suggest that cannabis is not being used to self-medicate small changes in symptoms within the context of daily life. However, cannabis use itself may be associated with both positive and negative emotional states. We need to find out whether these relationships play out in the longer term as this may have an impact on a person's course of bipolar disorder." The findings were published in PLOS ONE.