“The fact is most obits are mixed reviews. Life is a lottery; a lot of people lose.” – Paul Simon
“What’s my drug of choice? Well what have you got?” – Layne Staley
Maladaptive coping mechanisms for dealing with mental illness, like substance abuse, self-destructive behavior, and self-harm are not moral failings. They are just ways people try to get by. Most of us who live with mental illness were symptomatic for years prior to receiving an accurate diagnosis and effective treatment plan. Often by the time we have proper medical care these maladaptive coping mechanisms have become so habitual that they are difficult to stop employing.
What needs to be understood is this: Maladaptive coping mechanisms are coping mechanisms. They work. There may be significant issues associated with them, but they help you deal with symptoms of mental illness in the short term. Self-medication is still medication. It works. Again, the long term effects may not be good but the “medication” works in the short term.
If you have racing thoughts, for instance, alcohol can slow them down. Alcohol can lower the volume of the voices in your head. Alcohol can take the edge off. Alcohol has also helped me to cope with the existential angst that seems to always accompany my mood episodes.
Some people assert that marijuana is quite effective, too. Really any depressant, anything that pushes you down can be beneficial in the short term. The problem with self-medication is that it is difficult to control the dose. It is also difficult to always predict how alcohol or recreational drugs can affect you. In my experience alcohol always worked well, except when it made things exponentially worse.
Alcohol abuse can also lead to psychosis, which is obviously not ideal when treating bipolar. Marijuana can also increase anxiety and panic and lead to mood episodes. As far as medications go, both alcohol and marijuana have their limitations.
Self-harm is also a way to deal with stress and bipolar symptoms. It can focus you. It can quiet your mind and have a similar effect as meditation. It can help you release extra energy and to let go of interpersonal issues or self-loathing that may be eating up at you. It can release endorphins and make you, perversely, feel good. The problem with self-harm is that is it, by definition, harmful. I have landed in the Emergency Room several times for various self-inflicted injuries.
Being bipolar and going to the Emergency Room for self-inflicted injuries can be a very unpleasant experience. You don’t get much sympathy. In fact, often you get condescension. Generally speaking you are treated as though you have become non-adherent with your treatment and may need what they euphemistically refer to as “assistance” to become adherent; “assistance” being inpatient treatment. Of course being completely adherent to your treatment plan does not get rid of all of the symptoms of bipolar; nothing does. Treatment just makes the symptoms easier to manage and easier for you to cope with.
Instead of judging stigmatized maladaptive coping mechanisms wouldn’t it be great if we could create a culture in which stigma doesn’t prevent early detection and intervention? We could work to create a culture in which mental illness was seen as an illness like any other and early detection and intervention could be the norm.
If stigma did not prevent early detection and intervention for me then I might not have developed maladaptive coping mechanisms. I could have been given better tools to deal with my symptoms. If I had been given better tools earlier I would likely not have done nearly as much harm to my brain and my body than I have.
At least I am thankful that I have better tools now. And I am optimistic that we can create a future in which less people like me slip through the cracks for so long and have to deal with their illness on their own, trying anything that makes things seem, at least temporarily, less unbearable.