Etowah County has both a mental health court and a drug court - and some people need both.
According to the National Alliance on Mental Illness, about a third of all people experiencing mental illness and about half of people living with severe mental illnesses also experience substance abuse.
Teresa Dawson, clinical director of C.E.D. Mental Health, said her center treats several patients with dual diagnosis locally, though she doesn't see it as a huge problem here. "Of course, it's a problem if there were just two," she said.
While common thinking is that mental health patients develop an addiction through self-medicating, Dawson said, it's not that simple.
"Sometimes it just happens," she said. "We don't know that it's caused by the mental health issue."
NAMI.org points out that self-medicating can be a cause, though drugs and alcohol make the symptoms of mental illness worse.
Also, substance abuse can actually cause mental health issues because of the drug's effects on moods, thoughts, brain chemistry and behavior. Treatment of both disorders is key.
"I don't really see it as being harder, just different," Dawson said, adding that they've treated the illness and addiction both independently and together. "We've had a lot of good success."
NAMI says the most common treatment is integrated intervention, starting with inpatient detoxification and possibly inpatient rehabilitation.
After that, medication is used to treat a variety of mental illnesses, as is psychotherapy, and self-help and support groups.
Sometimes, Dawson said, a therapist will discover a patient with dual diagnosis has begun using again, and that is a threat to treatment.
"A lot of times, it just cancels out what the medication does," she said. "We do monitor patients with dual diagnosis intensely."
Dawson said sometimes people end up at C.E.D. Mental Health through court referrals, family referrals or they seek help themselves, but nothing is going to work until they're ready.
"They have to be willing to come in if it's a family referral," she said.
By Melanie Jones Times Correspondent
Any mom can tell you that raising kids is a challenging role, but Harmony Hobbs was seemingly able to do it very well and with ease.
As she wrote in an essay for Refinery 29, this mom of three kept an immaculate home. Everything was preplanned, down to how she unloads the dishwasher. Her kids always looked neat. Hobbs herself never left the house without makeup on her face and her blond hair blown out. She described herself as “the mom you love to hate”; she seemed like the perfect mom.
And Hobbs can tell you that outwardly, she was that perfect mom. But there was an inner turmoil and a secret she kept from everyone, even her husband. This secret helped her keep up with her structured life but, ultimately, sent her world spiraling down; Hobbs was an alcoholic.
In her freshman year of college, Hobbs would experience a trauma that first led to her alcohol dependence. She also became addicted to prescription diet pills to regain focus after going out drinking with her friends.
Jennifer Kaufman, who is a Ph.D. candidate at George Washington University, is a mental health counselor specializing in crisis, trauma, and substance abuse. She spoke to Dearly about the connection between trauma and alcohol.
“Trauma is one of the major predictors of substance use disorders in people. The reason being — coping. Many individuals who have experienced trauma look for something, anything, to help them cope with the residual pain; to help numb the intrusive thoughts and flood of emotions. The issue with this is while alcohol may assist with an individual's anxieties, pain, depression, insomnia, nightmares, etc., in the long run, alcohol has the opposite effect.”
Hobbs learned this the hard way when she became a mother and her stress worsened. In turn, she felt an even greater need to depend on substances to get her through. The substances she bought were expensive; the diet pills alone cost her $120 a bottle. To distract her husband from taking notice of these expenses, she would have frequent, scheduled sex with him.
I began drinking at 5 p.m. every evening to get me through the difficult hours of homework and bath time, and by the time my husband got home around 9, I’d made one bottle of wine disappear and was making eyes at the next.
Hobbs described herself as having a Type A personality, a “control freak” who felt the need to always be in control of her environment. In retrospect, she noted that this is impossible, especially when it comes to children.
I had wanted to be The Best Mother with The Best Children, and any time something threw a wrench in my grand plans of being outstanding, I became upset. And I drank. A lot. The harder I worked to make real my idealized life, the unhappier I felt, and the more I drank. The more I drank, the more chaotic our household became.
Kaufman described perfectionism and the need to always be in control as a slippery slope.
“For no one is perfect and no one is always in control. When we set our sights higher than humanly possible, we are guaranteed to not achieve them. And, when these standards or goals or expectations are not met, the feelings of failure, inadequacy, embarrassment, etc. follow. Those feelings are overwhelming for many, which leads them to alcohol — a way to numb the feelings and put our inner critic on mute — and it actually works until it doesn't.”
In an interview with Dearly, Hobbs said:
“I seemed very on top of everything, but the truth is, I wasn't. I got up every morning and faked my way through my life ... so no one around me really knew how much of a mess I was under the surface ... I knew I had a problem, but I wasn't willing to name it or face it. I couldn't fathom a life without my lifeline: alcohol.”
Kaufman described why individuals such as Hobbs turn to alcohol when dealing with feelings of inadequacy and a lack of control.
“Alcohol becomes a crutch, a way to handle constant failure (and it would be constant when one's expectations are not attainable), dull the feelings of being out of control and the anxiety which surrounds it. This is also why the Serenity Prayer is often heard at the end of AA [Alcoholics Anonymous] and NA [Narcotics Anonymous] meetings: 'Grant me the serenity to accept the things I can not change, the courage to change the things I can, and the wisdom to know the difference.'”
A few events led Hobbs to get the help she needed. On a Christmas outing two years ago, Hobbs, her husband, and her kids went caroling and drove around to look at the lights. Before they left, Hobbs made sure to spike her hot chocolate with bourbon. In the car, she was intoxicated, irritable, and lost her temper with her kids:
I snapped, screaming “SHUT UP!” I was drunk and agitated, and they were loud and little. I had ruined the holiday for all of us.
The next event that played a role in her sobriety was when her best friend confronted her.
“My best friend ... asked me a question: If drinking was my way of coping with stress, what was I going to do if my life became even more stressful? My immediate response was 'drink more.' That is when I realized I needed help.”
Hobbs reached out for help and was forced to face her problems. Her therapist described her as a perfectionist, but the term does not sit right with her; she would prefer to be labeled an alcoholic.
In her interview with Dearly, Hobbs explained:
“Most of the perfectionists I've known in my life are so damn uptight that I don't want to be lumped into a category with them. The alcoholism is something that actually makes sense to me. Like oh — this is why I feel this way, act this way, obsess over drinking, salivate when I see liquor, and why it was so hard for me to stay sober each time I got pregnant.”
She said that today, her life looks the same externally, but the way she experiences life has drastically changed for the better.
“I'm calmer. I'm a much, much better mom. I'm a better wife, except that my clothes don't fall off the way they did before I got sober, which is unfortunate for my husband. They tell me that will get better, though. The thing that has changed the most is my mental clarity. I feel like I see things so much more clearly now ... when I was drinking and taking pills (which I did for a very, very long time), I viewed myself and my life in an extremely distorted way.”
Hobbs no longer has scheduled sex with her husband. She said their relationship improved after she quit drinking, and her husband stood by her through it all:
“It's weird. It's almost like we're dating again, except with three kids. We laugh more. My view of our marriage and my perceptions of him were all out of whack and I'm slowly straightening it out, which means that we argue a lot less. There's something to be said for having a spouse who loves and accepts me, even when all of my worst flaws are on display in a very public way.”
Hobbs decided to share her story in an effort to help women who may be struggling with alcoholism.
“I loved wine more than almost anything else in this world. It was my secret elixir. I miss it. I'll always miss it, because life can be really, really scary in sobriety. But I'm telling my story because I want other women like me to know that there is a way out. My children deserve better and theirs do, too.”
This week, Hobbs reached nine months of sobriety. On her Facebook account, she wrote:
Today marks nine months sober; the same amount of time that it takes to grow a baby. There’s a lot of symbolism there.
You can continue to read about Hobbs' inspiring journey on her blog, “Modern Mommy Madness.”
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