Problems, One Innovative Solution
Dr. Richard Frances and Nancy Helle
disorders affect more than 5 million Americans and about 60 percent
of the patients with these psychiatric problems or mood disorders
also have alcohol or drug problems. Silver Hill continually studies
how these disorders interact.
The outlook for treatment of these problems is encouraging. Educational
programs are gradually creating public awareness that mental disorders
and substance abuse are not signs of character weakness, but of
diseases that can be treated. As a result, more people are seeking
treatment. Also, new psychopharmaceutical drugs, such as depakote,
are effective mood stabilizers for treating the bipolar disorders
most likely to occur with substance abuse problems. At the same
time, they are good agents to treat alcohol withdrawal symptoms.
Seventy percent of the time, people develop alcohol problems before
they are diagnosed with bipolar disorder. The substance abuse
may bring about the disorder, or it may be that bipolar people
tend to self-medicate with alcohol or drugs. It’s the combination
of both disorders that often leads them to need hospitalization.
Early diagnosis and treatment of either disorder might prevent
complications of the other problem. When both are present, alcohol
problems must be treated first or “in synch” with the other disorder,
because if the person is drinking, he or she will fail to respond
to the treatment.
Patients who have bipolar disorders should consider that they
may also have an alcohol problem when they find themselves drinking
to relieve depression, drinking during a manic episode, encountering
medical, work or legal problems related to drinking, or if there
is a family history of alcoholism. Alcoholics in recovery might
suspect a bipolar disorder if they find themselves skipping their
12 step meetings, having frequent mood swings or suicidal thoughts
or if there is a family history of bipolar disorder.
Both of these problems are brain diseases and we need to get away
from any moral stigmas. We should have compassion and understanding
for these people who have two illnesses and need treatment. #
Frances is President and Medical Director of Silver Hill Hospital
in New Canaan, CT, one of the top programs for treating substance
abuse and bipolar disorder. For more information, call 1-800-899-4455
Education Update, Inc., P.O. Box 20005, New York, NY 10001. Tel:
(212) 481-5519. Fax: (212) 481-3919. Email: firstname.lastname@example.org.
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