Be yourself; Everyone else is already taken.
— Oscar Wilde.
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How Living With Mental Illness, Addiction, and Recovery Directly Impacts the Family
When considering someone who is suffering from addiction, more often than not people immediately think of the person in need of recovery. We begin to feel sympathy for them, or in certain gruesome cases, anger, especially after considering that children who have alcoholic family members are four times more likely to develop alcoholism than individuals who were not raised by alcoholics, they are more likely to have difficulty coping with life’s stressors, and are likely to marry an alcoholic or abusive spouse. Some people may even begin to look down on the person, and wonder: “Where are their families? Don’t they have someone to take care of them?” They absolutely might, but helping a loved one with a substance use disorder, which often co-occurs with a mental illness, presents unique and emotionally taxing challenges for family members. I will be examining how addiction co-occurring with mental illness can impact family members just as much as the person experiencing the addiction in this research report. My argument is that incorporating families into treatment for their loved ones may be the thing that helps the addict the most.
Introduction
According to “The Dual-Diagnosis Client: Substance Use Disorder and Mental Illness” in Concepts of Chemical Dependency, “If a patient has any form of mental illness, she or he is 270% more likely to have an SUD than the average person” (Doweiko 2015). This staggering statistic proves that there is an undeniable direct and complex relationship between mental illness and a SUD. Therefore, to examine the impact addiction has on families, mental health must be discussed. Mental health is the root of how we think, act, feel about ourselves and others, respond to stress, and make choices, thus, family members are directly impacted. An adolescents mental health influences their decision to switch their parents vodka with water; likewise, a father’s mental health directly influences their willingness to receive treatment for a substance use disorder that causes him to abuse his wife. An individual who suffers from a mental illness often seeks an escape from reality, which can be detrimental to his or her relationship with their family. The family may even begin to blame themselves, questioning whether or not it was something they did that pushed their loved one to alcohol or drugs. Despite the pain, a family members’ hope, coping, and readiness to change in family recovery is pivotal (Bradshaw, 2015). A dual-diagnosis client, someone who has a mental illness as well as a substance use disorder, may find it easier to deal with their unwanted feelings of anxiousness and sadness with a trip to the corner liquor store instead of one to a family member to talk about their feelings. The article, “Tug of War: The Mental Health/Addiction Connection,” explains that, “When someone is diagnosed with a co-occurring disorder — a mental health issue in tandem with substance addiction — an integrated, comprehensive treatment program for both disorders is essential. Why? Because left untreated, substance abuse will likely render any treatment for the mental illness ineffective, while untreated mental health issues will make sobriety increasingly difficult” (“Tug of War” n.d.).
The Toll on Family
The brutal cycle of mental illness and substance use disorders absolutely takes a toll on everyone involved, especially family members. It doesn’t end at getting and receiving treatment, because it falls in the hands of the loved ones to be able to think logically and help pick the proper program for the addict. Doctoral researchers Clark and Drake (1994) explicate this by stating, “Families are typically a major source of support for people with mental illness, but substance abuse places an additional burden on family relations and could reduce the amount of direct support they give. Data from families of 169 people with co-occurring mental illness and substance abuse indicate that they give a substantial amount of time and money to their relatives with dual disorders” (Clark & Drake 1994). The researchers also concluded with their data that the more severe cases of substance abuse co-occurring with mental illness resulted in families spending less money on helping their loved one, but direct caregiving did not decrease. This proves the resilience of families to provide help for the ones they love no matter what, but at a substantial cost, mentally and financially.
If a dually diagnosed client does not receive proper treatment, he or she becomes more susceptible to larger problems. For example, the increased risk of suicide in dual-diagnosis clients has been estimated 60- to 120- fold higher than for the general population (Howland et. al., 2009). Further, dual-diagnosis clients are at increased risk for incarceration, less able to handle personal finances, have a weaker support system, and are more prone to depression and feelings of hopelessness” (Doweiko 2015). Not only do clients face critical environmental consequences, but they also “Face a 300% higher chance of contracting the virus that causes AIDS, a 170% higher risk for contracting the Hepatitis B virus, and a 250% higher chance of contracting the Hepatitis C virus” (Doweiko 2015). Dual-diagnosis clients are in pressing need of treatment because of the grave repercussions of the combination of their mental illness and SUD. Their inability to make logical choices, think clearly, and desperate desire to get their next fix makes them more susceptible to make impulsive decisions than a substance abuser without a concurrent anxiety or depressive disorder. The responsibility falls in the hands of the person’s loved ones and this takes an immense toll on families. SAMHSA, the Substance Abuse and Mental Health Services Administration, explains that some individuals have a genetic predisposition for developing mental and substance use disorders, and may be at greater risk based on environmental factors such as having grown up in a home affected by a family member’s mental health or history of substance use. Again, the impact a family member, especially a parent of an addict, is significant and can lead to feeling as if they caused the addiction. As explained by Cohen in the The Family text, conflict theorists believe that opposition and conflict define a given society and are necessary for social evolution (Cohen 2015). A conflict as severe as addiction and successful recovery absolutely results in change, which can drive the family’s history forward. While the journey can take an immense toll on the wellbeing of family members, living a life knowing your loved one is safe can make it worthwhile. This directly relates exchange theory in regard to addiction and recovery within families. Cohen states that exchange theory focuses on groups with “different resources, strengths, and weaknesses entering into mutual relationships to maximize their own gains” and “as long as the relationship is rewarding, both sides stay engaged. If the exchange is not rewarding, and if the cost of leaving is not too great, either party may leave” (Cohen 2015). In a family where addiction is present, it is clear that the addict is not able to use their resources in order to avoid using alcohol or drug(s) of choice, and the other family members who do not suffer from addiction must find the strength to provide their loved one with resources, whether it be a support system or financial aid for a recovery service. The cost for the non-addict family member can be incredibly high in certain situations, but their reward of helping a loved one is priceless.
Recovery and Families
Thankfully, families do not have to go through facing recovery for a loved one alone. Throughout the globe, family intervention programs are being implemented by mental health services as well as substance abuse services. One program in particular provided clear successful results, as explained by Muser and Fox (2002). The two mental health professionals created a new program called Family Intervention for Dual Disorders, FIDD. Licensed clinicians were able to implement the program in their treatment centers and to successfully engage the clients families in treatment. The results concluded that the majority of the clients demonstrated significant improvements in substance abuse over one to two years of treatment. This may not sound like a lot, but the recovery process can often take years to show even slight positive results. A collaboration between family members and mental health professionals may be the thing that helps those in need most successfully (Muser & Fox 2002). Moreover, health care professionals view treatment for patients with a mental illness and SUD as a three phase process including the initial establishment of a healthy and positive therapeutic relationship, engagement or motivational enhancement/engagement, and rehabilitation where active treatment is presented (Doweiko 2015). With this being said, treatment must often be designed towards the individual in order for a true recovery to begin. Each patient has a different amount of willingness to change, motivation, varying levels of anxiety or depression, whether or not they have previously experienced different treatments, and interventions and what kind of environment they will enter into after being discharged. Making sure the families of these people are able to provide a stable environment at home is imperative but can also put a strain on the family members, especially those from lower socioeconomic environments. The amount of pressure families receive is overwhelming. These factors along with numerous other factors, must be taken into consideration for each individual dual-diagnosis client. However, it is important to remember that even though a long term commitment to abstinence is a possible goal to reach, “it is the endpoint of a long, difficult, process for both the client and treatment staff” (Doweiko 2015).
Global Comparison
In order to grasp how many families are being affected by mental illness, addiction, and recovery, one must understand how much of the world is impacted by addiction. The statistics are staggering and alarming.
According to the 2014 status report on “Global Statistics of Addictive Behaviors,” “people in Eastern Europe smoke and drink more than anyone else in the world, while Asians drink the least. One thing that stands out is countries that are predominantly Muslim have a much lower rate of alcohol consumption” and “Alcohol consumption is also lower in the least developed countries. In many countries the smoking rate is much higher among men. Drinking is more common among men in some countries, but not in Western nations,” (Gowing et al., 2015). The statistical analysis provided specific information that explains the details of global addiction: “An estimated 4.9% of the world’s adult population (240 million people) suffer from alcohol use disorder (7.8% of men and 1.5% of women), with alcohol causing an estimated 257 disability‐adjusted life years lost per 100 000 population. An estimated 22.5% of adults in the world (1 billion people) smoke tobacco products (32.0% of men and 7.0% of women). It is estimated that 11% of deaths in males and 6% of deaths in females each year are due to tobacco. Of ‘unsanctioned psychoactive drugs’, cannabis is the most prevalent at 3.5% globally, with each of the others at < 1%; 0.3% of the world’s adult population (15 million people) inject drugs” (Gowing et al., 2015). While these statistics are alarming and put things into perspective for those who have little knowledge on the influence of addiction internationally, research on how this has affected family members in these countries is unfortunately less frequent. However, one study titled, “Harm Experienced from the Heavy Drinking of Family and Friends in the General Population: A Comparative Study of Six Northern European Countries” does look at the impact addiction and recovery has on family members. The researchers used data from national general population surveys collected from Finland, Scotland, Iceland, Norway, Sweden, and Denmark. The surveys asked participants questions on experiencing the harms of the drinking of family and friends. The results concluded that the prevalent concern of harm by the drinking habits of family and friends was reported more frequently by women and young participants. Also, the highest prevalence of harm was reported Finland, Iceland, and Norway and lower estimates for Denmark, Sweden, and Scotland (Ramstetd et al., 2016).
Given the statistics and information above, addiction influences more families than we may think. In an attempt to see from the perspective of a dually diagnosed individual, the stigma of both a mental illness and SUD can prevent people from being honest about what they are going through. Individuals who are dual diagnosed might find it harder to get a job, participate in events with loved ones, and live their lives without constant fear of being judged, which impacts their family members greatly. It is vital that a proper and competent treatment plan that includes family be implemented in all mental health facilities that treat substance abuse and mental illness. Family can provide the protection and support needed for a suffering individual to live a life as healthy as possible. The role of the family in addiction may be the key to reducing the staggering statistics of addiction worldwide.
Discussion question: Can you think of any specific ways that involve family members into the recovery treatment process for addicts? Do you think incorporating family has any downsides? If so, what are they?
Key words: addiction, recovery, family impact, mental illness, mental health
References
Clark, R.E., Drake, R.E. Expenditures of time and money by families of people with severe mental illness and substance use disorders. Community Ment Health J 30, 145–163 (1994). https://doi.org/10.1007/BF02188626.
Cohen, Phillip. The Family. W.W. Norton, 2015.
Comer, J. R. (2014). Abnormal Psychology: Eighth Edition. New York, NY: Worth Publishers.
Doweiko, E. H. (2015). Concepts of Chemical Dependency: Ninth Edition. Stamford, CT: Cengage Learning.
Fadden, G., Bebbington, P., & Kuipers, L. (1987). Caring and its Burdens: A Study of the Spouses of Depressed Patients. British Journal of Psychiatry, 151(5), 660-667. doi:10.1192/bjp.151.5.660
Gowing, L. R., Ali, R. L., Allsop, S., Marsden, J., Turf, E. E., West, R., and Witton, J. ( 2015), Global statistics on addictive behaviours: 2014 status report. Addiction, 110, 904– 919. doi: 10.1111/add.12899.
Grant B.F, Stinson F.S, Dawson D.A. (2004). Prevalence and Co-occurrence of Substance Use Disorders and Independent Mood and Anxiety Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry, 61(8),807–816. doi:10.1001/archpsyc.61.8.807.
Howland R.H., Rush J.A., Wisniewksi S.R., Trivedi M.H., Warden D., Maurizio F., Davis L.L., Balasubramani G.K., McGrath P.J., Berman S.R. (2009). Concurrent Anxiety and Substance Use Disorders Among Outpatients with Major Depression: Clinical Features and Effect on Treatment Outcome. Drug and Alcohol Dependence, 99(1-3), 248-260. doi.org/10.1016/j.drugalcdep.2008.08.010.
Mueser, K.T., Fox, L. A Family Intervention Program for Dual Disorders. Community Ment Health J 38, 253–270 (2002). https://doi.org/10.1023/A:1015271908765
Ramstedt, M., Sundin, E., Moan, I. S., Storvoll, E. E., Lund, I. O., Bloomfield, K., … Tigerstedt, C. (2015). Harm Experienced from the Heavy Drinking of Family and Friends in the General Population: A Comparative Study of Six Northern European Countries. Substance Abuse: Research and Treatment. https://doi.org/10.4137/SART.S23746
Spencer Bradshaw, Sterling T. Shumway, Eugene W. Wang, Kitty S. Harris, Douglas B. Smith & Heather Austin-Robillard (2015). Hope, Readiness, and Coping in Family Recovery From Addiction, Journal of Groups in Addiction & Recovery, 10:4, 313-336, DOI: 10.1080/1556035X.2015.1099125
“Tug of War: The Mental Health/Addiction Connection.” (n.d.). In. Co-Occurring Treatment Methods. Retrieved from Talbott Recovery website.
Sociology of the Family
Kayla Allbright
My name is Kayla Allbright and I am a senior Psychology major with a Writing and Communications minor at Siena College. I have worked at Siena’s Writing Center since my sophomore year, where I am a tutor and specialize in mentoring international students. Aside from working on Siena’s campus, I am an intern at New Paradigm Psychological Services, which is a psychology practice in Albany that deals with individuals who have committed sexual offenses or have faced sexual difficulties. Currently, I do not plan on working with this population in the future and want to confront a variety of topics and people suffering from different mental illnesses (Sociological Imagination, 21). At home in a small town, Floral Park on Long Island, I work at a clothing store called Lilly Pulitzer. When I’m not working or at my internship, I enjoy spending time with my friends, watching the New York Yankees, and taking pictures of my dog, Axl.
Leaving for college was an extremely hard thing to do coming from a close-knit family. My immediate family is small, consisting of my parents and older sister, Sam. Since my sister moved to Chicago three years ago, it is just my parents and I at home. Besides big Sunday pasta dinners and sharing a love for the Yankees, owning a business together is what made my family so close. For years, my parents, sister and I co-owned and operated an old fashioned candy store called Bliss on Tulip. According to the Conway Center for Family Business, over 60% of U.S. gross domestic product is accounted for by family businesses and they generate for almost 80% of all new job creation. Growing up my peers would ask me if it was weird having my parents also be my boss since they were already my authority figures by common practice and formally by the law (Cohen, 6). It never felt strange to me because my parents did a great job filling their roles appropriately both in the institutional arena and the family arena (Cohen, 11).
While co-owning and working at the candy shop for most of my adolescence kept me busy, it was not always sweet. All of our time was spent at the candy store and when we weren’t there, our conversations centered on things like what shipments were coming in or who has to handle the next social media posts. This is a common reason why family businesses struggle; a lack of separation between business time and family time, according to GrowWire, and explains why only about 30% of family businesses survive into the second generation. After I left for college and my sister moved to Chicago to be with her fiance, my parents had no choice but to sell the candy business because they both own their own businesses on top of Bliss on Tulip. Taking two out of the four family members out of the business unfortunately did not work, but I believe it made my family much healthier and happier overall.
With the extra time my family had thanks to the closing of the candy shop, my parents got to focus on something they truly love – animals. According to the APPA, the American Pet Products Association, almost 70% of US households include at least one pet. In regards to what kind of pets, the APPA’s 2017-2018 National Pet Owners Survey states that 89.7 million dogs have owners in the U.S. My family falls right into this statistic with our teacup yorkie, Axl.
Along with Axl, my family has had a few dogs throughout the years, two cats, hundreds of exotic fish that lived in a tank that covered the entire span of a wall in my dining room including a baby shark, several dozen chickens, one goat, bunnies, a few snakes, numerous tortoises, etc. The list goes on, but many of these lived in my home when I was very young so I do not remember them all. Currently, Axl shares our backyard with a chicken coop, chicken run, and a fenced off area for the tortoises. Other reptiles live in a separate area of my house in order to prevent any of the other animals from touching them or getting sick.
My sister, Axl, and I 
Axl and Sky 
Sky and Sunny 
Axl and chicken
In the past few years, the amount of people who consider their pets to be family has increased dramatically, according to a survey from the Harris Poll for Petfood Forum. The PetFood Forum explains that as of 2016, 95% of pet owners in the U.S. consider their pets to be part of the family. Pets are absolutely part of the family in my household and they have been my entire life. I wouldn’t have it any other way because as a Psychology major, I fully believe in the biophilia hypothesis and the therapeutic effect pets can directly have on people, and in my case, my entire family.
My family is my greatest support system. Even after my sister moved to Chicago to put an end to her long distance relationship, we prioritize our FaceTime calls and I will always consider her to be my best friend. I would consider my family to be in the middle-class but unlike the elite discussed in the “Who is Elite” excerpt, I do not fall subject to “upward comparisons and feelings of relative deprivation” because economic status means little when thinking about what my family has an abundance of, which is trust, clear communication, and love (Rivera, 288). In my future, I hope to have a family just as supportive as mine is, and I also hope it is filled with as many animals as possible. Professionally, my goal is to work in the mental health field and to make other people’s lives as happy as possible.
References
Cohen , Philip N. The Family: Diversity, Inequality, and Social Change. 1st ed., W.W. Norton & Company Inc. , 2015.
Mills, C. Wright. Sociological Imagination. Oxford University Press, 2001.
Rivera, Lauren. Pedigree: How Elite Students Get Elite Jobs, 2016.
Introduce Yourself (Example Post)
This is an example post, originally published as part of Blogging University. Enroll in one of our ten programs, and start your blog right.
You’re going to publish a post today. Don’t worry about how your blog looks. Don’t worry if you haven’t given it a name yet, or you’re feeling overwhelmed. Just click the “New Post” button, and tell us why you’re here.
Why do this?
- Because it gives new readers context. What are you about? Why should they read your blog?
- Because it will help you focus you own ideas about your blog and what you’d like to do with it.
The post can be short or long, a personal intro to your life or a bloggy mission statement, a manifesto for the future or a simple outline of your the types of things you hope to publish.
To help you get started, here are a few questions:
- Why are you blogging publicly, rather than keeping a personal journal?
- What topics do you think you’ll write about?
- Who would you love to connect with via your blog?
- If you blog successfully throughout the next year, what would you hope to have accomplished?
You’re not locked into any of this; one of the wonderful things about blogs is how they constantly evolve as we learn, grow, and interact with one another — but it’s good to know where and why you started, and articulating your goals may just give you a few other post ideas.
Can’t think how to get started? Just write the first thing that pops into your head. Anne Lamott, author of a book on writing we love, says that you need to give yourself permission to write a “crappy first draft”. Anne makes a great point — just start writing, and worry about editing it later.
When you’re ready to publish, give your post three to five tags that describe your blog’s focus — writing, photography, fiction, parenting, food, cars, movies, sports, whatever. These tags will help others who care about your topics find you in the Reader. Make sure one of the tags is “zerotohero,” so other new bloggers can find you, too.
kaylaallbrightblog 