Practicing Self-Care with Dual Diagnosis

Early sobriety is like a fragile bird. It must be nurtured, protected, and handled with care in order to gain strength and thrive. But early sobriety paired with a genetic mood disorder like depression, bipolar, or anxiety is more like an injured bird. It can be nurtured to health as well, but this bird requires more attention and care to take flight. Practicing self-care with dual diagnosis adds a layer of complexity to recovery. Not only are you dealing with cravings, triggers, and all the other unpleasant things that come with getting clean and sober, but you are working a program at a slant. It’s not so easy to do the things you know you need to do when it’s difficult to even get out of bed in the morning with major depression. Or when you are experiencing a panic attack from an anxiety disorder. So how do people with dual diagnosis set themselves up for success?

Chemical Imbalances in the Brain

Mood disorders are the result of chemical imbalances in the brain. There are several chemicals the brain used for mood regulation: serotonin, dopamine, and oxytocin are a few of them. When these chemicals are not being regulated as they should be, the results are chaotic. They create physiological symptoms like lethargy, apathy, and constant anxiety. But it doesn’t always have to be this way: just as a diabetic needs insulin to process sugar properly, people with mood disorders need the correct medication to rebalance the chemical functions in the brain.

The stigma attached to mental illness often obscures the simple truth that many mood disorders can be treated with the right medications prescribed by a psychiatrist. It is recommended that people in recovery seek referrals to a psychiatrist with a background in addiction (treatment programs will do this through appropriate counselors or therapists). This last part is important because there are narcotic prescription medications used to treat some mood disorders that should be avoided by people with substance abuse disorder (for example, the tranquilizer Xanax is often overprescribed to treat anxiety and has incredibly high potential for abuse). But there are many safe prescription medications that are not narcotic and can help regulate the symptoms of mood disorders that contribute to relapse.

Self Care for Self Esteem

Proper medication is only the first step in managing a mood disorder. Although these medications relieve many symptoms that make life difficult, they do not act as a be-all and end-all solution. Self care with dual diagnosis goes beyond that in several ways.

The first is building and maintaining a positive self image and emotional wellbeing in relation to self. Addiction can take a heavy toll on self esteem as the disease is so stigmatized and conflated with personality. As the midbrain slashes any control over an addict’s decision making, recovering addicts are often left wondering how they could be brought to some of the lows experienced in during their disease. But the behaviors associated with addiction are just that: symptoms of a disease, not a moral failing. Restoring a sense of self worth requires an understanding of that difference, as well as enough time sober to rewire the brain back to normal thought processes to stop those behaviors going forward.

Building self esteem takes time. Though getting sober is a big step in this process, it is only the first step. There is still a lot of work to be done moving forward. Daily self care goes a long way in this process. Making sure that you’re getting enough sleep, eating well, maintaining good personal hygiene, and exercising will help rebalance the chemicals that regulate mood. An outpatient program will help establish these healthy routines because counselors understand the importance of self care.

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