Guest Article Share by Amy Dresner ~ Writer for The Fix. Getting Through Life Events ~ Taking Care of a Parent and Staying Sober Through It.

Guest Article Share by Amy Dresner ~ Writer for The Fix. Getting Through Life Events ~ Taking Care of a Parent and Staying Sober Through It.

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How to Stay Sober Through a Parent’s Illness – By Amy Dresner 08/05/19


I won’t lie, the urge to fix from the outside is constant. The helplessness is overwhelming, the grief indescribable.

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I think it was about a year a half ago when my mother became wheelchair-bound and was diagnosed with dementia. The two trips to visit her in Santa Fe were so stressful that my bestie, also a recovering addict, started vaping for the first time and she still hasn’t stopped. We had five days to clear out her apartment, find her a board and care, break her lease, put her stuff in storage, forward her mail, and much more. I cried most of that trip but it all got handled.

My life is different now. My mother can’t hear well and she’s confused. She can’t walk or use the computer anymore. People bathe her. She calls me multiple times a day about the same thing. On top of that, I was suddenly given the “power of attorney and appointed Social Security payee.” I was in charge of all her bills, speaking to her nurse, speaking to her chaplain, and speaking to her social worker.

Role Reversal

If there’s one thing addicts don’t seek out, it’s responsibility. As an only child, I alone had to handle all of it. Sure I was sober but mature? Hardly.

I recently had to sign a form to approve the use of Narcan should my mother overdose on her Oxycontin. When the nursing staff assistant tried to explain opiates and Narcan to me, I stopped her.

“I’m …um…well-versed in Narcan. I’m an ex-junkie.”

I heard her mutter an “Oh” followed by an uncomfortable silence.

I’ve never had children for a sundry of reasons: my genes, my fertility, my financial situation, my shitty relationships. Suddenly I had a child and it was my mother. The role reversal was sudden and jarring and I recall rocking and crying and whimpering, “I don’t want this.” But it was all mine, like it or not.

My relationship with my mother was always difficult. I was resentful for her physical absence during my childhood and her emotional absence always. But suddenly all that resentment melted away. Resentment is a luxury, I realized, and as her caretaker, there was no room for it anymore.

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Dispelling Common Myths About Depression (2)

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Almost 50, with Zero Life Skills

Having spent 30 years of my life mentally ill and struggling with addiction, having to “adult” suddenly felt premature and impossible. It was like coming out of a time warp. I was almost 50 but I had zero life skills: No idea how to pay taxes or when to rotate your tires or how to hold down a “real” job, let alone handle all my mother’s shit. Sure I had other life skills: making a crack bong out of a Mountain Dew bottle or how to hit a rolling vein or manipulating people into taking care of me. But these weren’t so helpful now.

I was a grown woman but I still felt and honestly acted like a child most of the time. I still needed my mom but now she wasn’t available. I’d never felt like she “heard” me and now she really couldn’t hear me. I never felt she “understood” me and now she really couldn’t grasp what I was saying. I hate to use the “t” word but yeah it was triggering.

We had grown closer during this sobriety but now, suddenly, she wasn’t somebody I could bring things to. She became somebody who brought things to me and they were all “emergency” needs: Afrin, salted nuts, Nars concealer. My mother had always been particular, snobby, and demanding. That didn’t change. I quickly accepted all of these things and began to lean much more heavily on my father.

Gutted

Then, about a week ago, my father was diagnosed with cancer. I was gutted. He and I are impossibly close; he is my mentor, my hero, my best friend.

“You can’t go. You’re my person,” I wept pathetically into the phone. Everything good about me comes from him: my humor, my intelligence, my writing ability. And now he’s ill. Really ill. My first reaction and I’m not proud of this at 6.5 years sober, was to kill myself or get loaded. My brain screamed, “GET OUT.”

We all have those things: if “this” happens, I’ll get loaded. My dad’s death was always that: my hold out, my exemption. When I told him that a few years ago he said, “Too fucking bad, Ames. It’s in my will if you get loaded, you get nothing.” Fuck.

It’s all so selfish. Fuck his cancer, I’m hurting and I need to attend to that. Suddenly I was making it about me. I try not to cry on every phone call but am rarely successful. I feel weak and small.

I started to spiral, lumping all the bad on top of each other as we do: I’m single, I’m broke, I’m getting old. My parents are dying. But if I know one thing, it’s that a relapse would kill both of them faster than the diseases they were battling. It just isn’t an option.

Still, every day I have the urge to escape my body, numb the pain, check out. Not because I don’t have a strong program or I’m not connected to my higher power or any of that bullshit, but because I’m an addict and we don’t like feelings and we get high to avoid them. Six and a half years of sobriety doesn’t negate a lifetime of drugs and suicide attempts as my top and most successful coping mechanisms.

But if I’ve finally learned anything, it’s that it doesn’t matter what I feel like doing, it matters what I do. I can’t control my feelings or thoughts but I can control my actions.

When I’m Not Crying, I’m Angry

When I’m not crying, I’m angry. I’m so fucking angry. Fuck you, God. God never gives you more than you can handle?! Well, this feels like more than I can handle. And fuck me. Fuck me for having been a complete wreck for most of my adult life.

And then in between the tears and the rage, there’s numbness, where I feel nothing because it’s all just too much. I catch myself just staring into space, zoning out on the multitude of Pyrex dishes at Target. Not lost in thought, lost in nothingness.

I don’t think anything prepares you for the death of your parents. I don’t care how old you are or spiritually fit (insert eye roll). Sure, they’re in their 80’s; it’s bound to happen, it’s part of life, blah, blah, blah.

But you still never think it will happen. And when it does, you are suddenly faced with an aloneness that is inconceivable, an unending void that will never be filled.

I look back now at me mourning a break-up for over two years. What a fucking joke. You can get a new boyfriend. You can’t get a new mother or father.

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I've been through a lot of tough times, more than my fair share and these words are very true.

How I’m Staying Clean

I won’t lie, the urge to fix from the outside is constant. The helplessness is overwhelming, the grief indescribable. So how am I staying clean? Well, I started vaping again (judge away, fuckers). I’m talking to my sponsor every single day, I’m talking to my friends, I’m working with my sponsees.

I’m crying. I’m trying to be kind to myself. I’m trying to be of service to my parents and process my grief elsewhere. I’m calling friends and asking for support. Sure I don’t always answer the phone, but don’t take it personally. Sometimes I’m just too shut down to talk. I sleep and nap …a lot. Depression or escape? Does it really matter? It beats the alternatives.

When I asked other people in recovery how they made it through a parent’s illness and death, almost all of them said the same thing: They didn’t. They drank and used during the whole process to escape the pain and it was the biggest regret of their lives.

Whether the parent had known or not was immaterial. They were haunted by the guilt they felt and if they could do it all over again, they’d stay sober, give their parent the gift of being completely present, and not run from the feelings. I can and will do that, as ungraceful as it might be.

I said to one of my sponsees: “You are about to witness a magic trick. You are about to watch your sponsor go through one of the most painful times ever and not get loaded.” I think I was telling myself as much as her.

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Amy Dresner
is a recovering drug addict and all-around fuck up. She’s been regularly writing for The Fix since 2012.

When she isn’t humorously chronicling her epic ups and downs for us, she’s freelancing for Refinery 29AlternetAfter Party ChatSalonThe FriskyCosmo LatinaUnbound BoxAddiction.com and Psychology Today.

Her first book, My Fair Junkie: A Memoir of Getting Dirty and Staying Clean was published in September 2017 by Hachette Books. Follow her on Twitter @amydresner.

 

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Important Guest Article Reshare By Amy Dresner, Author of ‘My Fair Junkie,’ A Memoir. This Post Is About Recovery & Depression…

Important Guest Article Reshare By Amy Dresner, Author of ‘My Fair Junkie,’ A Memoir. This Post Is About Recovery & Depression…

Welcome Recovery Friends, Warrior Advocates, and New Visitors,

I am so happy and blessed that Amy agreed to let me reshare her article which comes by way of The Fix Magazine. She is an amazing “in your face –let it hang out” writer and blogger for them. The Fix share news about addiction and recovery from drugs and alcohol and is one of the top resource magazines around!

I happen to have signed up for there newsletter a while back and seen Amy’s article. Being dual-diagnosed myself and still have bouts of depression at times, I felt this article of hers really needed to be shared with all my friends here.

It is very informative and I just love Amy’s views on a variety of issues and her writing style! I hope you enjoy reading it and learn some from it as I did! Don’t forget to grab of copy of her book (link listed in her bio) if you have not read it.

It is truly a great read and her life memoirs are “one of kind!”  ~Cat 

Depression in Recovery: Do You Have Low Dopamine Tone?

By Amy Dresner 09/10/18 ~ Courtesy of The Fix Magazine
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Mature Woman Depression Looking Away
((The Fix does not provide medical advice, diagnosis, or treatment, nor does anything on this website create a physician/patient relationship.  If you require medical advice, diagnosis, or treatment, please consult your physician.)

 

I just felt like shit and slept as much as I could. I showed up to work. I kept my commitments. I spoke when asked to, but I felt more than unhappy. I felt like I just didn’t care.

I just came out of a six-week depression. That might not sound very long, but when you’re in hell it feels like forever. Good news: I didn’t bone any 25-year-old strangers; I didn’t cut myself; I didn’t get loaded; I didn’t smoke or vape although I really, really wanted to. I didn’t even eat pints of Ben and Jerry’s while binge-watching I Am A Killer. I just felt like shit and slept as much as I could. I showed up to work. I kept my commitments.

I spoke when asked to, but I felt more than unhappy. I felt like I just didn’t care. I didn’t return phone calls. I didn’t wash my hair. Suicidal thoughts bounced around my head, but I ignored them like I do those annoying dudes with clipboards outside Whole Foods.

I’ve suffered from symptoms of depression since I was 19, so it’s an old, old friend. What really annoys me was that some (dare I say many?) people think at five and a half years of sobriety, you shouldn’t feel depressed. What I kept hearing from AA fundamentalists was:

“It’s your untreated alcoholism.”

“Listen to these tapes about prayer and meditation.”

“You’re not connected enough to your Higher Power.”

“You’re not going to enough meetings.”

“You need to do more service.”

Thankfully my sponsor, who has a foot in the medical world, did not say something along those lines.  One of my big problems with AA is that it looks at every mental problem through the paradigm of your “alcoholism.” If you’re suffering, you should look to the program for relief.

Nobody would tell you to “drive around newcomers!” more if you had diabetes or kidney failure, but if you’re feeling down, that’s what you’re told to do. As it turns out, AA is not completely off the mark: “Addiction is a not a spiritually caused malady but a chemically based malady with spiritual symptoms,” addictionologist and psychiatrist Dr. Howard Wetsman told me.

“When some people start working a 12-step program, they perceive a spiritual event but their midbrain is experiencing an anatomical event. When they’re working a program, they’re no longer isolated and they no longer feel ‘less than,’ so their dopamine receptor density goes back up [and they experience contentment],” he explained. But what if your program hasn’t changed or feels sufficient and you still feel depressed?

What if you’re working your ass off in your steps and helping others and you still feel like shit?
“Well, low dopamine tone experienced as low mood can be brought on by fear and low self-esteem (the untreated spiritual malady part of alcoholism/addiction) but it can also be brought on by biochemical issues,” Wetsman added.

Huh?

So was I experiencing the chemical part of my “addiction” or was I having a depressive episode? Perhaps my whole life I’d been confusing the two. Of course, all I wanted, like a typical addict, was a pill to fix it. But as I’ve done the medication merry-go-round (and around and around) with mild to moderate success, I was hesitant to start messing with meds again. I didn’t have a terrific psychiatrist, and SSRI’s can really screw with my epilepsy. And Wetsman was talking about dopamine here, not serotonin. Hmmm…

Dr. Wetsman has some interesting stuff about brain chemistry and addiction on his vlog. He mentions something called “dopamine tone” which is a combination of how much dopamine your VTA (Ventral Tegmental Area) releases, how many dopamine receptors you have on your NA (Nucleus Accumbens), and how long your dopamine is there and available to those receptors.

Stress can cause you to have fewer dopamine receptors and fewer receptors equal lower dopamine tone. He’d explained to me in previous conversations how almost all of the people with addiction he’d treated had what he described as “low dopamine tone.”

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When you have low dopamine tone, you don’t care about anything, have no motivation, can’t feel pleasure, can’t connect to others. In addition, low dopamine tone can affect how much serotonin is being released in the cortex. Low midbrain dopamine tone can lead to low serotonin which means, in addition to not giving a shit about anything, you also have no sense of well-being. Well, that certainly sounded familiar.

Dr. Wetsman has a very convincing but still somewhat controversial theory that addiction is completely a brain disease and that using drugs is the result, not the cause. I really suggest you get his book, Questions and Answers on Addiction.

It’s 90 pages — you could read half of it on the john and half of it while waiting at the carwash. It explains in detail why most of us addicts felt weird and off before we picked up and why we finally felt normal when we used. Again, it’s all about dopamine, and it’s fucking fascinating. No joke.

In his vlog, he explains that dopamine production requires folic acid which you can get from green leafy veggies (which I admittedly don’t eat enough of) but it also requires an enzyme (called methylenetetrahydrofolate reductase or MTHFR for short) to convert folate into l-methyl folate. Certain people have a mutation in the gene that makes MTHFR, so they can’t turn folate into l-methyl folate as effectively, and those people are kind of fucked no matter how many kale smoothies they drink.

But it’s not hopeless. If people with this genetic mutation take a supplement of l-methyl folate, their brain can make enough dopamine naturally. Of course, once you have enough dopamine, you’ve got to make sure you release enough (but there’s medication for that) and that you have enough receptors and that it sits in the receptors long enough (and there are meds for that too).

So this all got me wondering if maybe my MTHFR enzyme was wonky or completely AWOL. Dr. Wetsman urged me to find a good psychiatrist (since I’m on Prozac and two epileptic medications) or a local addictionologist in addition to taking a genetic test for this mutation. In his experience, patients who had a strong reaction to taking the l-methyl folate supplement were frequently also on SSRIs. They either felt much better right away or really really shitty. But if they felt even shittier (because the higher serotonin levels work on a receptor on the VTA which then lowers dopamine), he would just lower their SSRI or sometimes even titrate them off it completely. And voila. Success.

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It’s all very complicated, and this whole brain reward system is a feedback loop and interconnected with all kinds of stuff like Gaba and Enkephalins (the brain’s opioids) and Glutamate. But you guys don’t need me for a neuroscience lesson so I’m trying to keep it simple. The basics: how do you know if you have too little dopamine?

You have urges to use whatever you can to spike your dopamine: sex, food, gambling, drugs, smoking, and so on. What about too much dopamine? OCD, tics, stuttering, mental obsession and eventually psychosis. Too little serotonin? Anxiety and the symptoms of too high dopamine tone. Too much serotonin? The same thing as too little dopamine tone. Everything is intricately connected, not to mention confusing as all hell.

Being broke and lazy and having had decades of shitty psychiatrists, I decided to go rogue on this whole mission (not recommended). I mean I used to shoot stuff into my arm that some stranger would hand me through the window of their 87 Honda Accord so why be uber careful now? This l-methyl folate supplement didn’t require a prescription anymore anyway. What did I have to lose? I did, however, run it by my sponsor whose response was: “I’m no doctor, honey, but it sounds benign. Go ahead.”

I ordered a bottle. A few days later I heard the UPS guy drop the packet into my mail slot. I got out of bed, tore open the envelope and popped one of these bad boys. A few hours later I started to feel that dark cloud lift a little. Gotta be a placebo effect, right? The next day I felt even better. And the next day better still. I didn’t feel high or manic. I just felt “normal.” Whoa. It’s been weeks now and the change has been noticeable to friends and family.

Normal. That’s all I ever really wanted to feel. And the first time I felt normal was when I tried methamphetamine at 24. It did what I wanted all those anti-depressants to do. It made me feel like I knew other people felt: not starting every day already 20 feet underwater. I found out later that my mother and uncle were also addicted to amphetamines which further corroborates my belief that there is some genetic anomaly in my inherited reward system.

When I emailed Dr. Wetsman to tell him how miraculously better I felt, his first response was “Great. I’m glad. The key thing is to take the energy and put it into recovery. People go two ways when they feel amazingly better. One: ‘Oh, this is all I ever needed. I can stop all this recovery stuff.’ Or two: ‘Wow, I feel better. Who can I help?’ Helping others in recovery will actually increase your dopamine receptors and make this last. Not helping people will lead to shame, lowered dopamine receptors and it stops being so great.”

So no, I’m not going to stop going to meetings or doing my steps or working with my sponsor and sponsees. Being part of a group, feeling included and accepted, even those things can create more dopamine receptors. But sadly I’m still an addict at heart and I want all the dopamine and dopamine receptors I can get. However, I also know that enough dopamine alone isn’t going to keep me from being a selfish asshole…

But maybe, just maybe, having sufficient dopamine tone and working a program will.

 

 

Amy Dresner

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Amy Dresner is a recovering drug addict and all around fuck up.

She’s been regularly writing for The Fix since 2012. When she isn’t humorously chronicling her epic ups and downs for us, she’s freelancing for Refinery 29, Alternet, After Party Chat, Salon, The Frisky, Cosmo Latina, Unbound Box, Addiction.com and Psychology Today.

Her first book, My Fair Junkie: A Memoir of Getting Dirty and Staying Clean was published in September 2017 by Hachette Books.  Follow her on Twitter @amydresner.