Patient Stories: Dual Diagnosis Services Aid Recovery from Depression and Alcohol Abuse

As a young girl in 1950, Kathy Leonard suffered a spinal cord injury in a car accident that has kept her in a wheelchair most of her life. But it was not the physical injuries that she says “sowed the seeds” of her depression and eventual alcoholism, but the psychological scars caused by many years of isolation in and out of hospitals.

“By the time I was 14 years old, I had spent half of my life in hospitals,” recalls Kathy. “It was a difficult way to live. I grew up with a large piece of me always feeling unsafe, scared, and insecure.”

In her 30s, Kathy also began experiencing bouts of depression.

In addition to taking antidepressants, she turned to alcohol. “This is a common scenario that we see repeatedly in many of our patients,” says Alan Gordon, MD, chief of Butler Hospital’s Alcohol and Drug Treatment Service (ADTS), which has been providing dual diagnosis care to people for over 30 years. “Confronted with anxiety, stress, or depression, people will often turn to alcohol or drugs to try to alleviate these feelings.”

The trauma early in Kathy’s life, coupled with the subsequent health problems had placed Kathy at risk for developing a serious psychiatric disorder as an adult. Despite getting help for depression, her drinking gradually increased.

Following the death of her mother in 2003, Kathy’s addiction escalated to the point that she could not start the day without a drink. “I was in great emotional pain, and my drinking increased. At this point, I was never sober.”

Kathy had been successful in keeping her addiction from her husband but that changed on Valentine’s Day, 2006. “I had taken a pain pill and my antidepressant medication before we went out to dinner,” she remembers. “Then I had several gin and tonics and wine at dinner. I don’t remember the drive home, or anything after that. I had blacked out for the first time in my life. The next morning, my husband was very angry, and I was very depressed. I thought about what a failure I had been and that my husband really deserved better.”

Without any previous thoughts of taking her life, Kathy wrote her husband a note saying how sorry she was for disappointing him and then took some tranquilizers and beer. As she began drifting off, something inside of her caused her to realize that what she was doing was a mistake. She called her husband and told him what she had done and that she needed to get to the hospital.

Kathy had reached the breaking point.

Her alcohol addiction coupled with depression and anxiety had pushed her over the edge. Dr. Gordon says he has seen these dual diagnosis situations many times before. “There are very few persons who have reached the point of a serious problem with alcohol or another substance who are not struggling with psychiatric issues.”

Kathy’s care at Butler Hospital began with a detoxification process that lasted for about 48 hours. Once a long and physically painful ordeal, the process today is far less difficult with the use of medications that help people come off their dependence gradually.

Within two days of her admission, her treatment had progressed to include activities centered on relaxation and dealing with problems related to poor self-esteem. At the end of a week, Kathy was discharged to Butler’s Alcohol and Drug Partial Hospital Program (ADP), which allows patients to combine their life at home in the evening with hospital care during the day.

In the ADP Kathy continued to learn about the physical and psychological effects of alcohol, and was taught skills for dealing with situations that might cause her to start drinking again. She also participated in cognitive behavioral therapy, which includes a functional analysis group that, Kathy says, was most informative and taught her how to deal with her alcoholism as well as how to cope with life and its many challenges and complexities. Kathy also credits Carlos Gomez, one of the ADP team members, for, among many things, teaching her that she did not have to let fear control her life.

Today, Kathy is well on the road to recovery.

She credits much of her success to the “extraordinary” staff in the inpatient program and the ADP at Butler Hospital. She continues to meet at the hospital every Friday with others who are recovering from their addictions or dual diagnosis issues. “I’ve adopted the first line of the Alcoholics Anonymous serenity prayer as my personal words to live by — God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” 

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