Category Archives: Co-occurring

The Keto Roller Coaster

anxiety, Co-occurring, job, keto, Medication, mental health, mental illness, peer support, psychosis, schizophrenia, support, Weight gain, Weight loss, , , , , , , , , ,
Image of roller coaster

I have been on a ketogenic diet for about 5 months to help treat type 2 diabetes. I was taking 2 medications. Metformin and Januvia. I am monitored through a program called Virta. I have a coach and a physician through Virta, it is all done virtually. There is also an online community for people on the program. It is covered by my insurance.

At the beginning of this month I had labs that my endocrinologist had ordered. The results were really good. A1C of 4.8 and fasting glucose 98. Everything else was normal, too. For some reason my endocrinologist office cancelled my appointment so I had to reschedule for August. The Virta dr said that I could try going off Januvia since my labs are so good.

So, I go off Januvia and everything goes screwy. I get ravenous at night and have to eat after dinner. I had been slowly losing, now I am gaining weight. My fasting glucose is higher than before I started keto. I test my ketones and they are low. I chatted with people in the community and they tell me to stick it out, that my body will adapt. I am not so sure. I put in a message to the Virta dr to ask for his opinion but I won’t hear until at least Monday. I did not even know if the Januvia was doing anything but I now notice a difference without it.

I rarely talk about work, but here I go. My opinions do not represent my employer.

I work in peer support in a 20 bed mental health crisis stabilization unit (CSU). I have worked in peer support at an activity center for people with mental health issues and in a residential program. The people we see are much more symptomatic than I had worked with in the past. I am available to talk and offer groups but I don’t get much interaction because people want to sleep, are too symptomatic, want to be left alone etc.

It is a new facility and peer support is a new position for my employer. I have been there about 5 months and still have not found my footing. My boss is aware of the issues of people not wanting to interact and told me to keep being available and offering groups. She is going to give me some additional duties once they are approved.

It also can be anxiety provoking when patients are loud or aggressive. I am not involved with dealing with those situations but I feel tense. I help out where I can. I like the place and what we do.

Taking a Break From AA

12 step, AA, alcoholism, career, Co-occurring, keto, mental health, mental illness, peer support, sobriety, , , , , , , ,
Virta supplies

I have had problems with the spirituality part of AA.  I am not religious and don’t feel comfortable praying.  I am okay with the Serenity Prayer at meetings, but don’t usually pray on my own.  I also started getting busier in my life. 

I started a new job this month and am also starting the ketogenic diet. It is fewer days, but 8 hr shifts so I have to plan lunch. I have been bringing nuts and cheese and making it more of a break. So far that is working well. But, I do have to think more about meals and planning until I get keto down.

I have lost 10 lbs in a month, which is great for me, but the main reason I am doing the diet is for type 2 diabetes. When I stick to the plan, 30 g total carbs moderate protein and fats to satiate I am good, but the store bought “keto” products that go by net carbs, not counting sugar alcohols and fiber, still raise my blood sugar a little. It is still better than when I started.

I am in a program through my insurance called Virta.  They provide me with supplies, a health coach, a dr and a forum.  I report weight, glucose and blood ketones daily.  At first the additional fat in my diet upset my stomach, but I think I have adjusted.  My sister started when I told her how well it worked for my blood sugar, so I have someone to talk about keto.  It is a huge change for me. I am a big fruit and sweets eater but I don’t get many cravings and rarely feel hungry.

The job is going well. I am a peer advocate in mental health crisis stabilization unit. Basically, a mental health urgent care.  We just opened and it has been quiet,  sometimes they send me home early because I have nothing to do,  I have been making a binder of resources,  I will be providing therapeutic communication when we have patients,  so far, I have only been there with one patient who was not very talkative.

As far as AA, I had cut way back in going to meetings because of things going on in my life. My sponsor suggested I go to more meetings and pray every morning and evening. I thought about it and decided to take a break from it all. I can meditate but I don’t want to pray every day and I felt pressured about going to meetings, I have not been drinking. I just don’t know if it is the right program for me.

What did I sign up for?

alcoholism, anxiety, Co-occurring, Dual diagnosis, mental health, mental illness, peer support, politics, Recovery, , , , , , , ,

I volunteered to lead one day in my AA group. It is not very complicated. They have a format and I pick a passage from AA literature to read, talk about 5 minutes and then open for discussion. But, I have social anxiety. It is much better than in the past but I am still nervous. On top of that, I told my friend I would speak on her podcast in January. That I am a bit terrified about.

I picked a chapter from the Big Book, More about Alcoholism, and will talk about doubting we are alcoholics. I think it will be good for me to hear others experiences. I just finished step 1- We admitted we were powerless over alcohol and that our lives had become unmanageable.

In my youth my life truly was unmanageable. I had rules for myself about when and where I could drink, by the time I stopped, to keep my drinking from getting out of hand. It is hard for me to see my life as unmanageable. I made a list and will continue to add to it, about being powerless and my life being unmanageable. I will refer to it when I have doubts.

As far as the podcast, I am going to be talking about myself, my experience with mental illness. I had an older brother who has passed away, who had a psychotic break in the 1970s. I am going to talk about his story, too.

My friend called to discuss the podcast with me. I froze on the first question. She asked me about being a mental health advocate. I think of myself more as my job title, a peer support specialist, or someone with lived experience. I have written letters for certain bills but am not very politically involved. We are going to talk again and hopefully I can relax. She can talk enough for the both of us. I just want it to go well.

Powerless and Unmanageable

12 step, AA, alcoholism, anxiety, Co-occurring, Uncategorized, , ,

I am starting to work on the first step of Alcoholics Anonymous. My sponsor has me writing down how I am powerless over alcohol and that my life has become unmanageable.

It is hard. I like to think that with enough willpower I can do anything, but I have tried quitting on my own and that did not work. I have gotten sick, saying “never again” to go out the next night and drink again. I am endangering my physical and mental health, but I did not stop until very recently.

I considered the bottle to be a friend. It was always there, never let me down. I think I was developing a tolerance. I was having trouble getting a buzz. I was letting daily activities go to the wayside. I am terribly shy and needed a drink to socialize.

I was talking with a friend who is very involved in aa. She started telling me rules. You aren’t supposed to make changes the first year and I should be journaling were a couple. She was scaring me. I wondered what I was getting into. I called my sponsor and she said those things can be good but not required.

The meetings I have been going to are over Zoom. I can’t wait to meet people in person. I have just been going to women’s meetings. The ladies have been nice. I have 25 days sober. I am still a newcomer.

Stages of Change in Recovery From Alcohol Addiction

alcoholism, Co-occurring, contemplation, relapse, stages, Uncategorized, , , , ,

Originally published in Psych Central

https://blogs.psychcentral.com/triple-winner/2017/04/stages-of-change-in-recovery-from-alcohol-addiction/

stages of change

(Photo from SmartRecovery.org)

There are a number of stages one goes through when recovering from an addictive behavior.

1. Pre-contemplation — at this stage one is unaware of any problems. Others may point them out, but you have no interest in changing.

2. Contemplation– At this stage one is aware of the problem, but not sure how to change. You may be thinking about changing but ambivalent.

3. Preparation– You develop a plan to change behavior.

4. Action– Modify behavior to put plan into action

5. Maintenance-Able to stick with new behavior with minimum effort and strong commitment

6. (Termination)– In some recovery programs they have a step where you have completed and no longer have the addictive behavior.

(Relapse)-relapse may happen at any time. It is common, but not everyone has a relapse. A relapse is when you revert to the addictive behaviorI was in the pre-contemplation stage with my drinking for years. If people would suggest I had a problem, I thought it was their problem. I started having certain rules. I wouldn’t drink if I had to drive or if I had responsibilities.

When I contemplated changing, I was ambivalent. Not sure I wanted to abstain forever. Not sure it was a problem. I prepared and even started going into action and would stop drinking for a bit, but then I would relapsebecause I had not really made the decision to quit.

I had done cost/benefits (pros/cons) and knew it was beneficial to quit. I knew drinking wasn’t one of my priorities. I knew I would drink more than I wanted to and had trouble abstaining. But, there was a part of me that still said “you’ll miss out on the fun”. And, I may. I will also miss out on any consequences.

I am in active recovery right now. I have been going to meetings and sticking with a plan. I have worked on motivation and controlling urges. I am using cognitive behavioral therapy and other techniques to control my distorted thinking.

I can resist temptations. I have been sober for 5 months straight. Another month of consistency and I believe I will be in the maintenance stage. At my work, they are training a couple of people, including me, to facilitate a SMART Recovery group. Facilitating should help keep me focused.

The end goal of these stages, is to live a life that is complete without alcohol.

The Stigma of Co-Occurring Disorders

alcoholism, anxiety, Co-occurring, Dual diagnosis, mental illness, Recovery, schizoaffective, stigma, Uncategorized, , , , , ,

In my opinion, this is my best yet 🙂

Originally published on Psych Central
https://blogs.psychcentral.com/triple-winner/2017/03/the-stigma-of-co-occurring-disorders/

There is a great deal of stigma attached with both mental illnesses and addictions. That is one reason I talk about my experiences. So, others won’t feel alone, and, to put a face to these conditions. It is scary to get a diagnosis of a life-long mental health condition that all you have heard are extreme negatives. People can lose hope. And, people fear what they don’t know.

I also have shame, or self-stigma. I have worked on accepting the schizoaffective diagnosis and at this point am okay. There was a time when I felt, less than, because of the severe symptoms. Now, I know I could not control what happened in the past, and just work on staying stable.

Social anxiety is something I contend with daily, and I cannot seem to prepare enough. I don’t know if I can ever accept how limiting it is for me. There are some things, like volunteering at my children’s school events, that are just too busy for me. I cannot enjoy shopping or parties, I just want an exit. I have worked very hard on this and work with people now and even do public speaking, but it is difficult.

The alcohol addiction label is new to me. In the program I am doing, SMART Recovery, they don’t give labels. But, I need to call it something. The drinking is not new, just the acknowledgement.

There are choices of programs for changing addictive behaviors. Some people work more than one at a time. This was just one that seems to fit my philosophy. It uses cognitive behavioral therapy (CBT) principles and I already learned some of those for my anxiety.

I haven’t had serious consequences from drinking. No DUIs or jail time, No relationship problems. But, I drink more than I would like to and it is hard for me to abstain completely.

When I started this blog, I decided I would like to write about the alcohol component along with the mental illness. So many of us have co-occurring disorders. I was excited, and then, I paused. What will people I know think when they see ‘alcoholic’?

Then I giggled. First, because I can’t decide which is the lesser of 2 stigmas (it doesn’t matter). And then, because they all have seen me drink. It isn’t really a surprise.

The secret is that I am working on it.

Info on SMART Recovery
http://www.smartrecovery.org/

Info on Alcoholics Anonymous (AA)
http://www.aa.org/