Open Your Mind Fighting Alcoholism Was A Losing Battle Until Depression Was Treated, Too

For his death, he usually chose the basement or the garage.

I’ve never had the courage to ask my brother why each time he tried to kill himself he selected these sites, but I can imagine a reason; both are quiet, with a kind of reverent silence.

My mother’s basement, and across town, my father’s garage, are disheveled museums, collections of family history.

In the basement are childhood toys packed in unmarked boxes. Once, they were the most precious tools my brother and I had to try to fix the chaotic adult world around us. In those days, our faith lay in Malibu Barbie and G.I. Joe.

In the garage are unrealized dreams. Big pieces of steel. Small, greasy engine parts. My dad’s elusive attempts at restoring a 1964 Ford Thunderbird. Two-door. Glossy red outside, black leather interior. The kind of car factory workers like my dad, living in a mid-sized industrial city on Lake Michigan, aren’t supposed to own.

My mother’s basement and my father’s garage are like tombs. In both, hope is frozen in time.

Of course on a practical note, suicide is less messy in the basement and the garage. I wonder if my brother thought of that, of how much easier it would be for us to physically erase his death if there were no recarpeting or repainting to be done as there inevitably would be in any other area of either parents’ house.

Joey, my brother, tried to hang himself twice before he reached his 30th birthday this past August.

Once, my mother found him dangling from the rafters in her basement. On his next attempt, my father found Joey suspended above the car parts in his cluttered garage.

It wasn’t always like that. Joey is a talented drummer. Before his suicide attempts, he played in bands at night and worked driving semi-trucks during the day. He was married and had a son, Eric. He served honorably in the U.S. Marine Corps for several years.

But like most of the men in my family, Joey is an alcoholic. We know now that he is also clinically depressed.

Why tell you his story?

Joey is alive today because he and I discovered one word: Comorbidity. Joey and I made the discovery by accident. I fear others may not be so lucky.

Comorbidity

Looking back, Joey had always seemed sad, even as a a child. Maybe that’s why when he tried to stop drinking by following the 12-step program of Alcoholics Anonymous, I had a feeling it wouldn’t be enough.

Oh, I believe in the AA program. It worked for the other alcoholic men in my family, and it works for millions of people around the world.

But with Joey, a piece, something visceral, seemed to be missing.

Then I stumbled across a brochure from the National Depressive and Manic-Depressive Association. I read these words: “A depressive illness may be masked if another disorder, such as substance abuse, is present. … Comorbidity can be very difficult to treat.”

I told Joey about it. He went to see a psychiatrist. He was diagnosed as clinically depressed.

Comorbidity is the presence of two or more illnesses in any part of the body at the same time. Examples include diabetes and glaucoma; depression and schizophrenia and, in the case of my brother, depression and alcoholism.

“In psychiatry, it’s a hot area right now because patients with more than one psychiatric problem are harder to treat,” said Dr. David Dunner, a psychiatrist and director of the Center for Anxiety and Depression at the University of Washington.

With comorbidity, diagnosis can be difficult. Symptoms of one condition can mask the presence of another, yet both must be treated for a person to get well.

In the case of alcoholism and depression, Dunner cites two staggering statistics:

Fifty percent of patients with alcoholism have a mood disorder.

The suicide rate is markedly higher in patients with comorbidity.

Why?

Alcohol can temporarily alleviate the anxiety associated with mood disorders like depression and manic-depression. But such self-medication is fleeting.

Alcohol, after all, is a depressant. And, Dunner said, alcohol can prompt impulsive acts.

Joey knows that. Both times he tried to kill himself he was drunk.

Opening the mind

The brain sits atop the rest of the body rather undramatically. There it is, lumpy folds of tissue and cells and arteries and veins coiled inside a hard bone called the skull. Like the kidneys or the liver or the heart, it’s an organ. Like any other organ, it is influenced by both disease and chemical imbalances.

But stigma surrounds the brain unlike any other organ. Pick a culture, pick a religion, pick a period in history - you will no doubt find everything from odd to stupid to downright cruel reactions to how the brain functions and, sometimes, malfunctions. Throughout time the mentally ill have had holes drilled into their heads, been shackled in warehouses, been tortured and killed.

My brother has a mental illness called clinical depression. He also has a disease called alcoholism.

It doesn’t really matter whether Joey sought solace in alcohol from the unrelenting hopelessness that persists in clinical depression, or whether the fact that he is physically addicted to alcohol made him depressed.

What matters is he received a correct diagnosis.

For alcoholics such as Joey, a 12-step program like Alcoholics Anonymous is crucial but not the only solution. To survive, comorbid alcoholics must take medication for their mental illness, follow the creed of an organization like AA and seek counseling to sort through all the ensuing emotional issues.

I’d like to be able to end here by telling you that Joey is doing just fine, that his life is on track.

For the past year, the first time in more than a decade, it was.

He finally started college, using the veteran’s benefits he earned while in the Marines.

He wants to earn a bachelor’s degree in alcohol and drug studies, with the goal of helping others like himself.

He was working two part-time jobs, one helping other veterans find jobs and another at a shelter for runaway kids. Both were good experience for his chosen career and helped him pay child support for his son - something that is important to him.

But about a month ago Joey relapsed. He stopped going to classes. He quit one of his jobs. He stopped taking his antidepressant. He stopped going to AA meetings.

He started drinking, and he gave away the AA medallion he earned for being sober for one year.

Why? Recovering alcoholics tell me relapses are common.

Psychiatrist and people diagnosed with depression and manicdepression tell me the urge to “go off meds” is also common.

All tell me that just when life is good, just when the insurmountable seems to have been overcome, there is an urge to believe that addiction or mental illness is only temporary, that neither requires treatment if one is to live a happy, “normal” life.

Where does that urge come from? Some say it’s human nature. Some say it’s our society, with its unsympathetic version of Christianity and its pull-yourself-up-by-your-bootstraps, black-and-white solution to every problem, no matter how complex.

As I write this, Joey is struggling through alcohol withdrawal. He is getting back on his medication. He has reconnected with his local AA chapter.

He hopes to keep at least one class this semester and get back on track academically in the spring.

One Spokane psychiatrist said mental health is a delicate balance between the physical, the emotional and the spiritual - a wise statement.

This week is National Mental Health Awareness Week. The Spokane Alliance for the Mentally Ill is hosting a series of events to educate all of us about the brain. The week’s slogan couldn’t be more perfect:

“Open your mind.”

, DataTimes ILLUSTRATION: Staff illustration by Molly Quinn

MEMO: These 2 sidebars appeared with the story:

1. COMING UP Here is a calendar of local events for National Mental Health Awareness Week: Today - The Silent Revolution - An Historical Look at Treating Mental Illness. 3-6 p.m. Eastern State Hospital Museum. Information: 299-4280. Wednesday - Consumer Dinner. 5:30-8 p.m. Central United Methodist Church, 518 W. 3rd Ave. Dinner and entertainment for people with mental illness. Information: 299-4280. Thursday - Free Depression Screening. Two locations: (1) Gonzaga University, Crosby Student Union, 10 a.m. - 4 p.m. Information: 328-4220, extension 4254, or 838-4661; (2) Eastern Washington University Counseling and Psychological Services, Martin Hall room 225. 8 a.m. - 5 p.m. Information: 359-2366. Saturday - Second Annual Walk for Mental Illness Awareness. Three miles along the Centennial Trail. Walk begins at 10 a.m. Park at Upriver Dan. Information: 924-1696.

2. RESOURCES FOR HELP A sampling of local and national mental health and substance abuse organizations: Spokane Alliance for the Mentally Ill 838-5515. 10 N. Post, Room 638, Spokane, WA 99201. Spokane Mental Health 838-4651. 107 S. Division, Spokane, WA 99202. Alcoholics Anonymous - 624-1442. 1614 W. Riverside, Lower Level 55, Spokane, WA 99201. National Depressive and Manic-Depressive Association - 1-800-826-3632. 730 N. Franklin St., Suite 501, Chicago, IL 60610-3526. National Institute on Alcohol Abuse and Alcoholism - (301) 443-3860. U.S. Department of Health and Human Services, 6000 Executive Blvd., Bethesda, MD 20892-7003. National Alliance for the Mentally Ill - 1-800-950-NAMI. 200 N. Glebe Rd., Suite 1015, Arlington, VA 22203-3754. Check with your personal physician, or in the Yellow Pages under topics including counseling, psychiatrists, psychologists, drug abuse, and alcohol for mental health and substance abuse professionals available in your area.