Recovery from Dual Diagnosis: Addiction, PTSD & OCD

My life was a constant cycle of continuous self-destruction and self-pity. For years I was aware that something was wrong with me, but I could never vocalize exactly what I was feeling or why I behaved the way I did. All I knew was that when I used substances the noise in my head quieted, the people around me didn’t bother me anymore, and I hated reality a little bit less. Eventually, the substances stopped working. My high would fade and my life would become unbearable again. My unresolved trauma would begin to show up in strange ways and I couldn’t figure out how to ignore it anymore. 

This led me to seek help for the first time in my life. I was so desperate to feel anything other than the grueling psychological pain I was in. So, I told my mom that I needed help. I explained to her that I had been using drugs as a way to cope with my reality and that I had no idea how to go on living without being under the influence. She sent me to a dual-diagnosis treatment center where I could begin my journey of recovery in a safe and supportive environment. 

Treating My Substance Abuse Disorder 

Upon arriving at treatment, I was extremely skeptical. I truly didn’t believe that sobriety was possible for me, but I begrudgingly agreed to stay. In the initial phase of my treatment, my days consisted of individual and group therapy, followed by free-time and then an AA meeting later on. At first, I absolutely despised going to therapy. I had the delusion set into my mind that therapy meant I was weak. 

It wasn’t until I finally opened up in group therapy that I began to give my treatment a real shot. In the group, there was a girl around my age sharing about trauma. I’m not sure what it was about her, but after she shared I felt comfortable enough to word-vomit all of the trauma I had been keeping secret for my whole life. This allowed our therapist to finally understand what was going on with me, gave him some insight on how to move forward in gaining my trust, and allowed me to breathe just a tiny bit easier. 

During my next individual session, I still felt a bit uncomfortable opening up with my therapist. He suggested to me that Dialectical Behavioral Therapy (DBT) would be the best form of therapy for my treatment. 

What is DBT?

Dialectical Behavioral Therapy is helpful when treating addiction, trauma-related issues, and many different mental illnesses. 

DBT consists of a two-pronged approach:

1. The therapist talks and connects with the patient in order to form a bond and trust. This way the patient begins to feel comfortable opening up and discussing their issues so treatment can resume. 

2. The second part of DBT involves group therapy sessions where multiple patients work together with the help of one therapist. Patients learn skills involving regulating their emotions, communication, intimacy/connection, mindfulness, tolerance of distress, and acceptance of reality. 

My therapist found this form of therapy useful for me, especially when considering my trust issues coupled with my unresolved trauma. When someone has unresolved trauma, they have a hard time connecting with others, expressing their feelings effectively, and regulating their emotions. This held true in my case. I definitely needed help in almost every single area that DBT treats, so the thought of practicing DBT began to excite me. 

It wasn’t until about a month into treatment that we discovered I was a dual-diagnosis patient. Throughout the course of my therapy, it was discovered that I have major Post-Traumatic Stress Disorder (PTSD) from my trauma coupled with Obsessive-Compulsive Disorder (OCD). My therapist found this out by having me keep a journal where I would write down events throughout the day that made me angry, anxious, or fearful. Luckily, we had already begun DBT therapy, which was helping me learn how to regulate and cope with my emotions so they didn’t turn into negative behaviors. This just meant that we needed to be extra diligent throughout the remainder of my treatment and consider utilizing a non-narcotic anxiety medication for my OCD if need be. 

Applying Learned Skills Outside of Treatment

When I left treatment, I wasn’t sure if I was ready to be a responsible member of society. I was terrified that the stress of being an adult would lead me back to using drugs. However, I found that when I kept up with all of the skills and coping mechanisms I learned in treatment, everything seemed so much more manageable. Of course, I had my off days where I felt as if I couldn’t do anything right and sometimes I would begin to feel myself romanticizing the use of drugs again. When these kinds of situations would arise, I would make sure to promptly redirect my thoughts before they turned into action. 

Vital Coping Mechanisms I Apply Daily

• Meditation:

 When I feel stressed or overwhelmed, utilizing breathing techniques and meditation allows me to slow my obsessive and compulsive thoughts down. 

• Support groups: 

Going to support groups help me stay centered in my sobriety. When I feel centered and sober, the side-effects of my OCD and PTSD also decrease. 

• Journaling:

Writing my thoughts, feelings, and actions for the day on paper allows me to see if there are any patterns of negative behaviors and thoughts that I need to take a look at. If I notice such patterns, I tell my sober support and my therapist so that they can offer me advice on how to correct them.

• Continued therapy: 

Therapy should never end right after leaving a residential treatment center. In my experience, I still had a lot to work on emotionally. With new responsibilities and commitments, I needed a therapist to keep me in check and provide helpful tools when problems arise.