Hope Starts With Us

Co-Occurring Substance Use - Episode 5

September 21, 2022 National Alliance on Mental Illness (NAMI) Season 1 Episode 5
Hope Starts With Us
Co-Occurring Substance Use - Episode 5
Show Notes Transcript

In this episode of NAMI’s podcast, NAMI CEO Daniel H. Gillison Jr. highlights National Recovery Month and Hispanic Heritage Month by speaking with Odette Cressler about her experience living with depression and recovering from an eating disorder and alcohol use as a member of the Latinx community. 

I think there's a very important piece that we work in recovery, which is really confronting things that sometimes we're not ready to confront. It's going to take work. This is work. Recovery is work.

DAN:

Welcome to Hope Starts With Us, a podcast by NAMI, the National Alliance on Mental Illness. I'm your host, Daniel H. Gillison Jr., NAMI’s CEO. We started this podcast because we believe that hope starts with us. Hope starts with us talking about mental health. Hope starts with us making information accessible. Hope starts with us providing resources and practical advice. Hope starts with us sharing our stories. Hope starts with us breaking the stigma. If you or a loved one is struggling with a mental health condition and have been looking for hope, we made this podcast for you. Hope starts with all of us. Hope is a collective. We hope that each episode with each conversation brings you into that collective to know you are not alone. Today I'm joined by Odette Cressler, a NAMI supporter and mental health advocate living in recovery from depression, eating disorders and alcohol use. She was the host of the Recovery Elevator podcast for two seasons and remains involved in leading groups pursuing sobriety. Born and raised in Guadalajara, Mexico, Odette is acutely aware of the intersection between culture and mental health. She's been living in the U.S. for 12 years now and currently lives in San Diego, California, with her husband and two children. Odette, thank you so much for joining us today, especially doing Hispanic Heritage Month and National Recovery Month. For those who don't know, September is National Recovery Month, an important time to increase awareness and understanding of mental health and substance use disorders, to encourage individuals in need of treatment services to seek help and to celebrate individuals in recovery. We know that a number that the number of people struggling with substance use has increased significantly since the pandemic. And roughly 50% of people with a mental health condition also have a problem with substance abuse. Also, more than one in three people who die from suicide are under the influence of alcohol at the time of death. In the past, the mental health field hasn't always done a great job of treating substance use as an integrated issue alongside other mental health conditions. But thankfully, that's begun to change. Odette, you've spoken openly about your experience with having a formal diagnosis of depression, recovering from an eating disorder and pursuing sobriety. Can you tell us a little bit about your journey with that?

ODETTE:

Thank you so much for having me, Dan. And I'm really honored and I agree what a better time than Recovery Month to continue to shred the shame and continue to share resources and support. So thank you. And yes, my name is Odette and I have been in the recovery world for--for many years. Um... My father is an alcoholic in recovery. He is 13 years sober. Super proud of him. And I like saying and honoring that, thanks to him, the whole trajectory of our family has been able to tilt into, you know, now I can say recovery runs in my family versus we hear, you know, addiction runs in my family. That's what we hear and we hear. So anyway, my story starts with him having the courage to get clean and get sober. You know, I'm a very high-functioning individual. So while my dad was really struggling, I started developing some coping mechanisms around food to deal with the hardship that we were going through as a family. And my eating disorder developed. I’m gonna try to keep this brief, but developed kind of in the shadows when he was in the spotlight. And that happens to a lot of people and dysfunctional families. So I was able to sustain my disorder in a secret for--for a long time. And it's just a slow progression with eating disorders similar than with alcohol use. You know, it takes a lot of time and repetition and I'm just grateful for my body because I certainly wasn't treating it well. Um... Once it was time for me to get help with my eating disorder, I was already living in the States and I went to a treatment center. I'm super grateful for all of the therapists that I've worked with. You know, once I was able to tackle that, um, I developed, you know, a different kind of attachment to cope with hardships of life. I noticed that I was starting to latch onto alcohol, and I didn't really drink a lot in my teen years. I was very controlling of my caloric intake because of the eating disorder. And in my mind, alcohol was calories. So I was not going to-- not going to go there. Once that was healed, I just feel like if you're not addressing the root cause of the issue, your--your mind, your body, you still need a comfort blanket. You still need a way to deal with the pain, a way to deal with what is internally going on. So I did feel that shift. It's also known that people who recover from an eating disorder tend to have a co-occurring disorder later. So I felt like I was quickly going into a terrain that I thought that I had left behind with my eating disorder. You know, I started to actually get scared because I was already in the recovery field. So it felt to me almost like a deja vu, like, I've done this, I've walked this path that I know to be dangerous and I have a choice to continue to go or to redirect. You know, I'm one of those “yet” people. I didn't get a DUI. I luckily didn't have any external huge consequences, but it was more of an internal wakeup call, an emotional rock bottom, where I knew exactly what would happen if I kept going in the opposite direction of recovery, and I knew that I was drinking to cope. It's really easy to recognize, once you're in this arena, why you do the things that you're doing. Am I doing it to celebrate or am I doing it because my kids drove me crazy today and I just need to, quote-unquote, “relax”? So I'm grateful because I feel like I've learned so much to where I developed awareness to recognize those behaviors in myself and be able to reach out for help. And just real quick, my depression has been diagnosed since I was 15, and I feel like that one's my hardest beast to tame. I feel very out of control when I'm having a dip season, as I call it, or a dip day. It's like I almost don't recognize myself and it gets very scary and very dark in a way that feels completely out of control. Grasping control is something that I've, you know, held through my eating disorder. You know, that's just-- I'm a control freak in recovery. And when I feel like I'm in the throes of depression, everything feels so out of control and overwhelming that it's--it's scary. And I know that a lot of people experience that. And because I've always been pretty high functioning, I fall into that category of, “Oh, we would never know that Odette’s internal world is so different than what you see when you meet her.” You know, I am very, you know, extroverted. Talk to people, smiling, love-sharing. So I've had to really validate myself internally, because sometimes I feel like what people see is nothing to do with what is going on inside.

DAN:

You know, Odette, what you just said, it's--it's so incredible. It's--it's like we judge the book by its cover versus actually looking at the table of contents. And as you've indicated, first of all, thank you for sharing your story and being so authentic and so open. And congratulations to both you and your dad. So let me start there. And the next thing I want to say is some of the phrases you've used are so critical and there's so many that are feeling the same way: out of control, overwhelmed or overwhelming, high-functioning, people would never know. There's so many people that we see and we ask that social question, “How are you doing?” And inside they know they're not doing well, but they answer back, “Oh, I'm doing great.” But if you ever peeled it back, they're not. So thank you for being so, so strong. There’s strength in vulnerability, and you sharing your story and sharing it so authentically is going to help so many. So about 8 million American adults have both a mental health condition and a substance use condition. It's incredibly common for people struggling with a mental health condition to also struggle with substance use. Why do you think that is? Can you tell us more about how these were related, in your experience?

ODETTE:

I know I tiptoed around, you know, co-occurring disorders, which I think is a conversation that is another biggie, important one. One of the people that I really learned from is Dr. Gabor Maté, and he has spent many years researching addiction. And I--there's a phrase that he says, and he says, “We shouldn't ask ourselves why the drinking. We should ask ourselves why the pain.” He's specifically talking about alcoholism, but I think that is the reason why co-occurring diseases exist and happen, because there's many books out there now on behavioral change, you know, “Atomic Habits” and all of this personal development world. It's easy to think, you know, I just need to change what I'm doing and everything will change. And to a certain degree, that's 100% true. But I think there's a very important piece that we work in recovery, which is looking within and really confronting things that sometimes we're not ready to confront, sometimes that we're not ready to--to feel the pain. We know it's there. We just don't want to go there yet because we know it's going to take work. This is work. Recovery is work. So I think sometimes we're not ready and our brain is just on survivor mode and wants us to help latch on to anything that will make us feel better. I really remember one time that I had a relapse and I shared with one friend in recovery and I told her that I was devastated. And she just looked at me and said, “I'm really not surprised that you--that you relapsed. “Like, why are you surprised?” I was going through a lot of personal hardship. And she said, “Of course, your brain thought it was a great idea because your brain knows that that would 100% “make you feel better. Your brains are so smart, so don't...” She was trying to prevent me from going into that shame spiral of why, you know, I thought I healed this and now this is popping up. And it--it's true. You know, these mechanisms help us until they don't. And we all know recovery isn't linear. But I think that until we have the courage and the safe container and the right relationships to heal what really has caused the pain in us, our brains will continue to find something to numb the pain or to escape it for a minute or for the day. And I think that's why these things go hand in hand, because when the root issue isn't addressed, it's hard.

DAN:

Yeah, and that root issue in terms of, you know, we--we look at the surface and we address the--what we think is the symptom and we don't get to that root cause where that pain is coming from. So thank you. This is excellent. So NAMI actually just came out with a new book yesterday, September the 20th, titled

“You Are Not Alone:

The NAMI Guide to Navigating Mental Health.” The book is written by our chief medical officer, Dr. Ken Duckworth. It offers advice from experts as well as firsthand accounts from real people and real families living with mental health conditions. And we have an entire chapter based on this very subject. Chapter five is all about co-occurring substance use conditions. In the chapter, Ken talks a lot about how culture, racism and stigma all affect the type of care people have historically been able to get or not been able to get for substance use. He explains that it used to be best practice to tell people to get sober first before treating other mental health conditions. But now, with a medical model of addiction, the best practice is to actually treat both at the same time. He writes that addiction was long considered a moral failing, not a treatable brain disorder. He also explains how this attitude toward substance use has really begun to shift into being seen as a public health issue rather than simply a criminal problem since the opioid crisis began to heavily affect primarily white communities. Still, people of color remain disproportionately targeted by police for drug-related crimes and face additional barriers in receiving the treatment they need. We can't ignore the role culture, race and identity plays in how we perceive, experience, diagnose and treat mental health conditions. So with that said, it's Heritage-- It's Hispanic Heritage Month. I know you come from a Mexican family, and you've also mentioned that you've had other family members who have struggled with substance use. In your experience, are there any extra barriers or stigmas that exist in addressing issues with substance use in Hispanic/Latinx communities?

ODETTE:

Yes, that's a great question and I'm really grateful that NAMI's addressing wider subjects in terms of access and racism and how all of these communities, you know, it's easy to just say access the root of things, but you need a community and help and you need so much to get from point A, from point B. And accessibility, I think, is a big, big part of a problem that we all need to address collectively, specifically your--to your question, in Mexico, just having access, having the money, the means to do it. You know, it's a completely different economy down there. There is no middle class. I am extremely privileged because I was able to go to therapy in Mexico. I was able to go to rehab. You know, how many people want to, would love to go to rehab. And they--they can't-- they don't have the means. So I think in Latin America, not only are the systems not in place yet, but also what makes it trickier is I really do think that even if we did have the systems in place, the stigma and the culture and the people aren't ready. Like, I think, you know, I know of friends of my father who have been struggling, who know that they could go here to get help and know that they need it, but won't out of that shame and stigma. Right? So I think the normalizing, which is what we're trying to do here in America, too--normalizing mental health, is where we're very behind. Because even if, like I said, we have the means, the economic means, the systemic means, it won't happen if the shame is bigger than that normalization. So I do think in Latin cultures it's very much about, you know, you need to be strong. We are, you know, Mexicans are strong people who have made it here and we're immigrants and we work hard and, like, we almost need to prove a point because of where we came from. And I think a lot of the times our mental health gets put to the sidelines because of of that because of our culture and our roles within the families, you know, the machismo, the-- the woman taking care of the man, all of that, the man not being able to cry or show feelings or have vulnerability. All of these roles that are ingrained in the Latin cultures are--make it difficult. Make it hard.

DAN:

You know, that-- that's such an incredible point. I want to build on that and ask you another--another question. And that--that question really builds on, how do you think we can break the stigma around people struggling with substance use in general and in Hispanic/Latinx communities?

ODETTE:

I just think that “normalization” is the key word here. I think a lot about mental health on the same track as comparing it to when veganism came to be, you know, the first-ever vegans. And people were like, “What's veganism? “What's that? You mean, you don't eat...” And like, it was so weird, almost like an alien community. Until every restaurant had vegan options and until it became normal. It was weird if that's the, for lack of a better term, until it was normalized. And I feel like with mental health, thanks to organizations like NAMI and other people that are really talking about it, we’re on that track of, it's weird until it isn't. It's not normalized. I do think that we need to normalize where this is where the--the power of individually sharing stories becomes a collective of that movement until we don't have more of these conversations at home with our families, with our friends, you know, it's all a bigger part of, I think, this global issue. And I do think that it's tipping. I do think that younger generations are talking about things more than, for example, my parents or even myself, that I think sometimes we feel helpless because we see the problem and we think it's so big and we think there's nothing we can do about it.

DAN:

Mm hmm. ODETTE: And I do think it's one of those huge boulders. “boulders”--sorry, English is my second language-- that we can move through our individual decisions of talking about it, of getting informed, of sharing and being a part of this collective solution. I want to go into our next question. In the chapter of our book I was talking about earlier, Ken shares a story of a woman named Margaret, whose father died from alcoholism. Margaret says she had been trained and conditioned to be embarrassed about her dad's struggle with alcohol, that they didn't even write it in his eulogy. But a big part of her healing has come from coming to terms with sharing those experiences, which is why she began teaching middle school presentations about mental health and substance use conditions. Ken attended one of these presentations before the pandemic. And after one middle schooler asked a question about how to deal with an overdose in his family, he says a presenter then asked the other students to raise their hand if they knew someone who had overdosed. Almost half of the hands went up. Ken describes this experience as a wake-up call, but more than that, as a message of the healing power of openness. That day, every student who raised their hand learned that they were not alone. Odette, do you have any other reflections on the types of stories in this chapter?

ODETTE:

Yes. You know, I love that story because the community that one builds when we get open about these things is, in my opinion, one of the greatest gifts of--of being in this world. I don't think I would have some of my bestest friends if it wasn't for something that in the past or for some people can bring us so much shame. Something that's really a silent killer, but we don't talk about enough and it's part of the mental health bucket, is secrets. Like, how do you think all of these students felt knowing that they didn't have this big, bad secret on them, weighing on them in their backpack? You know, I think for me, when I felt at my worst, it's when not only do I feel alone, but I know that I'm alone because I haven't shared with anyone, because I haven't connected with anyone who could hold my hand and say, it's okay. You know, when I'm withholding information, it-- I'm starting to really detect that that can really be something that affects my physical and mental health. The secrets, that--that self-shame that we carry. And sometimes we carry our family secrets, like you said, with the--with the father. And--and it's--it's really toxic for us. So I think for me, it's been wonderful to gather in rooms in recovery where instead of my shares scaring people, my shares kind of making heads nod and being like, “I hear you, I see you, we all need that.” And I think you do need to be in the right room for that to happen because there are definitely some people that even though they don't intend to do so, when we give these scary shares out, they don't know what to do. I mean, we in in our disease don't know what to do. Our loved ones don't know what to do with the people in the disease. That's a whole other story. We want people to react the way that we need them to, but there's not enough information, either, for loved ones--what to say, the right thing to say, the right words to deliver. So I do think that we specifically find that with other people on the same journey and we need that.

DAN:

You just mentioned a key word, “secrets.” And how do we minimize those secrets and how do we celebrate recovery and and how do we minimize self-shame? So thank you for sharing that. (inspiring music) You know, the world can be a difficult place and sometimes it can be hard to hold on to hope. That's why each week we dedicate the last couple of minutes of our podcast to a special section called “Hold On To Hope.” Odette, can you tell us when you feel like giving up in your journey towards recovery, what helps you hold on to hope?

ODETTE:

I like really going back to my reason for wanting recovery. My “why.” I know that's something that's been talked about a lot these years in business. You know, find your why and what motivates you for me, you know, having my family, having almost like the responsibility of continuing what I shared at the beginning, continuing to change the trajectory of my family, for myself, for my kids, kind of, it's part of this family tree and I do feel a responsibility for that. I also--that was a little bit more like internal. In terms of external, you know, my friends reaching out to my friends in recovery. Sometimes I forget the things that I'm talking about and they remind me. I need people that remind me of the things that I need to hear when I can't remind them to myself. And also just a quick little thing that I do a lot when I'm feeling alone is, there's this play called “Dear Evan Hansen,” and it's about mental health. It's about this kid in school who struggles with depression, and there's a song that's called “You Will Be Found.” It's by Ben Platt, and the lyrics are just beautiful. I actually pull it up there, I'll just share a couple of sentences, but it says, “Even when the dark comes crashing through, when you need a friend “to carry you, and when you're broken on the ground, you will be found.” So it's a song that's probably my most-played song, and I cry all the time when I hear it and it's just so easy to forget that we're not alone, even though we hear “you're not alone” so often. But the feeling can be so overwhelming that we do forget. So I just--I'm a big advocate of just repeating, “You are not alone, “you are not alone” to myself and to other people, because we forget. We do forget.

DAN:

We absolutely forget. And one of the vehicles we have is, uh, in addition to our support groups for folks not to be alone, is our NAMIWalks. So we want to make sure that our audience knows about our NAMIWalks. And if you go to NAMI.org, you can find walks in your community. And we want to make sure you know you're not alone. So with that said, because it's Hispanic Heritage Month, we also just wanted to ask if you'd like to share any words of encouragement or hope in Spanish for any of our bilingual listeners out there.

ODETTE: Of course, you know, “you are not alone” in Spanish:

“No estas solo. No estas sola. “Y estamos aquí contigo de la mano, no te rindas. “Siempre hay esperanza “y siempre hay personas que estan listas para ayudar. “Entonces, si en algun momento quieren conectar conmigo, “estoy aquí para ustedes y estamos en esto juntos.”

DAN:

Odette, do you have any closing thoughts that you'd like to share that we may not have gotten to that you said, “Oh, I wanted to say this”?

ODETTE:

I think it's very important for us to remember that even though, like I said, we feel like we're behind on the resources, on the help, on... I feel like at least we're behind on the mental health issue. There's so much work to do. But I also--”and”--the power of “and,” I also believe there's already so much out there, and we have to be an advocate for yourselves. So sometimes we don't have the energy, especially if you're struggling with depression. But whenever you do, I highly recommend you just find organizations like NAMI and you find your resources and you make your toolbox because we do need it. And there are so many available resources out there. So gathering those as much as you can when you have the energy to do so and using them because we need to be our own advocates. You know, I like the saying, “It's not our fault, but it's our responsibility.” I highly believe that. So when you have the energy, connect. When you have the energy, build resources. When you have the energy, add tools to your toolbelt, and don't give up on yourself. (inspiring music) DAN: I want this audience to remember that last-- um, that last quote from Odette. It's... “Remember, it's not our fault, but it is our responsibility. “And advocate for yourself and create that tool kit and those resources.” This has been Hope Starts With Us, a podcast by NAMI, the National Alliance on Mental Illness. If you are looking for mental health resources, you are not alone. Visit NAMI.org/help to get in contact with the NAMI HelpLine and find local resources. Or if you are experiencing an immediate suicide, substance use or mental health crisis, please call or text 988 to speak with a trained support specialist. You can also find NAMI's first-ever book,

“You Are Not Alone:

The NAMI Guide to Navigating Mental Health,” written by our Chief Medical Officer, Dr. Ken Duckworth, at NAMI.org/NotAloneBook. I'm NAMI CEO Dan Gillison. We wish you the very best and be well. (music fades out)