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Issues with Medication for Mental Health

I frequently find that as an addictions expert in the field of mental health, many health professionals are not looking at addiction as the “primary disease”. This can result in issues with medication for mental health. They only see the mental health issue.

I understand it can be often confusing. In fact, people who are on drugs and alcohol often look exactly like someone with a bi-polar or psychotic episode. In some cases, the drug and/or alcohol misuse itself may precipitate the mental health episode permanently.


Some psychiatrists I have spoken with feel in their years of experience that the latent gene for mental illness may express itself with the use of alcohol and drugs. It is hard to know which came first…as they say “the chicken or the egg”.

Often clients who are disgruntled with mental health medication take themselves off (some without titrating that medication) and without any professional guidance.

They are in the delusion that somehow they need to “be themselves” and get back to someplace they think they remember (where the problem didn’t appear to exist at that point in time). The brain doesn’t work well with immediately being taken off that mental health medication. (This isn’t the same thing as addiction withdrawal.)


People that have bi-polar issues are especially vulnerable to these types of ideas. They need to be careful about medication for mental health. So, many of them “self-medicate” with drugs and alcohol, which, if they have the “X” factor of addiction, now end up having 2 diseases. The destruction that the drugs and alcohol will have on their brain physiology will do much damage.

Primary Disease

In some cases, it will take a 6 month period of sobriety and a re-introduction to the original medication, which may not be strong enough now, due to the brain damage. You cannot treat a mental illness while someone is doing drugs and alcohol. That is why they call addiction a “primary” disease.

People who are involved and care about the person who has the mental illness can have compassion about the range of problems that can occur due to the medication. However, the affected person needs to be responsible and talk with their treating psychiatrist and therapist to come up with a solution.

When someone decides on their own, to treat themselves and discontinue the medication, the repercussions can be deadly. If they are bi-polar, for example, they may have a manic episode that causes legal, emotional, financial and physical consequences.

If they add a drug such as alcohol or methamphetamine, their judgment is impaired and will only continue the impairment. They unknowingly are “self-medicating”.


This is where the Al-Anon family program can help. The insanity that develops over time with the people who care has been carefully demonstrated to the people who live with this illness. They too become angry, irrational, obsessed, anxious, worried and at times blame themselves. Al-Anon and Nar-Anon 12 step groups have many meetings and help heal the emotional trauma the loved ones have suffered by “helping”.

They can help where very few others can. Common sense with a regular illness does not work in the cases involving addiction or mood disorders. A good therapist or recovery coach can assist as well with the difficult situations that will come up in these relationships.

Most shocking of all, people suddenly realize that they have to protect themselves from the upsetting behavior that is now appearing in their formerly rational friend or family member. They do not realize that the “disease” has taken over. Rational discussions or emotional pleas, no longer work. These are the people I treat and work with.

I hope this article helps you understand medication for mental health.

Scott Silverman talks about Addiction and what we can do

Barbara C (Part 1) of Speaker with Don

The Heart Lady

 Barbara shares her early childhood as the daughter of alcoholic parents and her great ability to survive and ultimately thrive as she learned her tools in Al-Anon.

(The other Al-Anon speaker was of Don C, Barbara’s husband, sharing his experience, strength and hope of over 30 years of recovery.  Inspiring story of how it affected him.)

Both were asked to speak as a married couple at an Alanon Speakers meeting.