QUESTION:
Dear Dr. Heller,
I have had several problems with depression. I am 31 years old and have several neurological dysfunctions it seems. I have seen doctors and psychiatrists but most either prescribe antidepressants or believe there is no problem at all. I have had a history of drug use so most seem to think I am just another user trying to get what I want. Recently, I have been convicted of felony possession of meth and cocaine (63 mg of meth and the coke was residue in a pipe). I am on 5 years probation and have 2 years on the shelf. You would think that would be enough to stop someone from using but all I can abstain for is about 2 to 3 weeks before the depression is so bad I feel I would rather be dead than feel the way I get so I use.
I have been in three treatment programs and they all say it is denial that all users suffer from depression when they try to quit and dismiss any "buts" as denial. However, I have had depression all my life, before any drug use started. I suffer from symptoms of ADHD and bi-polar as well as anxiety disorders. For instance, I have considered quitting my job when I was paged for fear they may be upset with me, even if there is no reason to be. I have panic disorders in stores and feel I'm being watched and that they think I may be shoplifting, and think they're going to stop me as I leave the store. I never finish any thing I start, and things I have always wanted to do I lose interest in .
I have went through all the chemicals one can and nothing hardly works. Cocaine I hate. I use it and suddenly become paranoid. I hide and almost lose the ability to speak for a short time. I lay down to wait out the high and promise never to use again but when I awake I feel great. For about a week I am in a great mood.. Then all of a sudden it ends and within moments I feel If I can't feel good I'm not gonna work, I'm not going home, all I can think of is ending it all. Alcohol also ends this feeling for a short time, however it isn't followed by the euphoria for days after. Percosets work for as long as I've had them but after they run out I'm back to the same problem. The only thing that I have used with any regularity that works is "crank". When I'm on it my family, my boss, and my friends say how well I've gotten it together. I have my motivation, I play with the kids, I finish what I start. I'm completely happy.
An 8 ball lasts me about two weeks. I don't stay up for days. I use a little before I leave for work and ration it (a lot because of the cost). I guess my question is from all the "brain" disorders you have studied does it sound like I'm chemically dependent , or do I fit into one of the other mental illnesses. Please help!!!!!!
ANSWER:
You likely have multiple diagnoses and have had them for a very long time, including in
childhood. My
screening test may be of help to you.
Having problems with substance abuse doesn't mean your other diagnoses shouldn't
be treated. Having chronic depression, ADHD, bipolar, etc. means you have many things that
need attention. You've likely been "self-medicating" your problems for a
long time with the wrong medications. You need to get some additional medical or
psychiatric opinions on the subject.