In a previous post, Addiction is Not a Choice | a Mom and Dad Share Their Daughter’s Story, we learned a great deal of what happened to Athena Kay, a pseudonym Cindy and Nick K’s daughter adopted following her rape at age 15 and subsequent PTSD, rape trauma syndrome, dissociative behaviors, depression, flashbacks, panic attacks and anxiety and eventual slide into heroin addiction. Today, I share the profound essay Athena wrote for a college scholarship application. In it, she shares the many systems that failed her as “a victim, an addict and a criminal,” not the least of which was access to effective dual diagnosis treatment. Athena’s courage and her strength come through – not only for what she’s survived and conquered – but for what she advocates society do in order to fix a series of very broken systems.

[A dual diagnosis is also known as having co-occurring disorders. It is a term to describe people with mental illness who have coexisting problems with drugs and/or alcohol. (National Alliance on Mental Illness, NAMI)]

Dual Diagnosis Treatment – A System Broken by Athena Kay

Athena K shares her essay on a broken system – dual diagnosis treatment.

I am a statistic.  As a sexual assault victim, a recovering drug addict, and a criminal, I have prosecuted, and I have been prosecuted.  Because of this experience with the criminal justice system and my diagnoses of Rape Trauma Syndrome and Post Traumatic Stress Disorder, I have powerful suggestions.  Change is necessary not only to improve our justice system but also to help other individuals who are suffering from a trauma-born addiction are being charged with non-violent crimes to support that habit.

A significant proportion of incarcerated women have a dual diagnosis; chemical dependency and mental health problems that are usually caused by interpersonal victimization.  At present, no treatment has been made that addresses dual diagnosis for these imprisoned women.  The jail is piling up with drug related offenses that are burdening the state and its taxpayers when the convicted should instead be treated.  Correctional mental health services are currently inadequate, because specified treatment does not exist and the needed funding is lacking.

Instead of prisons functioning as the defunct mental hospitals, early diagnosis and treatment for those at risk for committing crimes is necessary.  Alternatives to incarceration for dually-diagnosed non-violent offenders should be implemented.  Diversion to alternative programs would allow dually diagnosed offenders to receive appropriate treatment in therapeutic settings, decrease overcrowding in correctional settings, lessen recidivism, and would be cost-effective compared to incarceration in jails and prisons.

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I (Lisa Frederiksen) wanted to add this next section to Athena Kay’s post, for as you read in Athena’s essay and in some of the comments on her parents’ post, Addiction is Not a Choice | a Mom and Dad Share Their Daughter’s Story, dual diagnosis treatment is a broken system, and yet without effective co-occurring treatment for co-occurring disorders (aka a dual diagnosis), the person will, in all likelihood, relapse. And here’s why…

Information, Help and Resources on Effective Dual Diagnosis Treatment

It wasn’t that long ago that the prevailing treatment for someone who had a mental illness and an addiction was to “get rid of the substance and then treat the mental illness.” But if the substance had been the “medicine” to self-medicate the symptoms of the mental illness, for example, then taking away a person’s “medicine” without treating the source that demands it (the mental illness) can trigger the person’s embedded brain maps to seek and find the “medicine” (the substance) in order to relieve the symptoms of their untreated mental illness. Talk about a Catch 22!

Co-Occurring Disorders required Co-Occurring Treatments

Thus it’s imperative we understand co-occurring disorders – aka dual diagnosis – and what constitutes effective treatment, and then we must demand it.

Quoting from my May 27, 2014, post, Co-Occurring Disorders Require Co-Occurring Disorders Treatment, 

Co-occurring Mental Illness and Addiction – A Complex Dynamic

Thanks to advancements in imaging technologies (fMRI, SPECT, as examples), research funding opportunities and the collaborative efforts of brilliant minds – especially in the recent 10-15 years – the way co-occurring disorders are identified and treated is finally, ever-so-slowly starting to change.

It Comes Down to Neural Networks
It is now understood the brain controls everything we think, feel, say and do through neural networks. Neural networks are the way brain cells (neurons) “talk” to one another. They, in turn, exchange information with other neurons (cells) throughout the body via the nervous system. This “talking” is done through an electro-chemical signaling process, which is easier to understand if you think of neural networks as strands of holiday lights. Anything that happens along a strand of holiday lights – a loose bulb, frayed wire, power surge – changes how that strand works. This in turn changes how all other strands connected to it work.

Changes or Differences in Neural Networks Can Cause a Person to Think, Feel and Behave Differently
Thus if any of the “things” that make this electro-chemical signaling process possible are changed or “different” (inherited), it changes the way neural networks perform. These “things” include cues, neurons, axons, dendrites, neurotransmitters, receptors and synapses, as examples. Both mental illness and addiction change several of these “things,” which is why both disorders must be treated individually and simultaneously.

Causes of Co-occurring Disorders (aka Causes of Neural Network Changes or Differences)
Not surprisingly, addiction and mental illnesses can have similar contributing causes. These include:

• genetics
• brain chemistry imbalances
• brain injury
• childhood trauma
• environmental stressors
• presence of the other
• stage of brain development at onset – especially ages 12-25.

Having similar contributing causes, however, does not mean you fix one and the other is automatically fixed. This is because of the complex dynamic that exists with co-occurring disorders.

The Complex Dynamic
The National Alliance on Mental Illness (NAMI) explains the co-occurring disorders’ dynamic this way:

• Drugs and alcohol can be a form of self-medication [for the mental illness]– the drug or alcohol chemicals work on the brain’s pleasure-reward pathways, the ones that make a person feel good.
• Drugs and alcohol can worsen underlying mental illnesses – alcohol is a depressant, for example, which can worsen the depression mental illness symptoms.
• Drugs and alcohol can cause a person without mental illness to experience the onset of symptoms for the first time.

Because of this complex dynamic, it is imperative both disorders be treated simultaneously or else one can be the trigger for the other and/or the person still won’t feel “normal,” even though one of this disorders has been treated.

Bottom Line

Addiction and mental illnesses are brain changers. Given the brain controls everything a person thinks, feels, says and does, treating any and all brain changers is necessary in order to improve one’s thoughts, feelings and behaviors. To find out more about co-occurring disorders and what effective dual diagnosis (co-occurring disorders) treatment is, please read the remainder of my post, Co-Occurring Disorders Require Co-Occurring Disorders Treatment.

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