Voices From the Field: Walking In Daylight

by Steven Samra
February 27, 2014

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Homeless and Housing Resource contributing writer Steven Samra opens up about his mental health recovery journey and from his perspective what peers need to help into support others who are experiencing acute symptoms overcome ostracism, shame, and misinformation.

I “aged out” of the mental health system at 17, after having spent much of my adolescence under the influence and control of the amphetamine Dexedrine, which was used to treat Attention Deficit Disorder for “hyperactive” children in the days before Ritalin and Adderall. For the following 23 years, I wandered from job to job, relationship to relationship, and street drug to street drug, trying to calm the anxiety and the uncontrollable need to move, talk, think, and do something—anything. I suffered classic hypomania symptoms of bipolar disorder throughout my adult life, and eventually gravitated towards those drugs to help me slow down the noise and activity in my mind and body. 

Throughout those decades, the idea of experiencing a mental health condition never really occurred to me. After all, I had been “cured” back in the 70’s, and there was no way I was “crazy”; I was just “high energy,” which frankly served me quite well until I would “overamp” and make inappropriate decisions due to my inability to gauge and tailor/control my own behavior and responses effectively.

Worse, even if I would have been self-aware that I was experiencing a mental health condition, I would have never told anyone because being branded with a “mental illness” brought with it almost certain scorn, ridicule, ostracism, and blatant discrimination from those in my immediate circle and the larger community. It wasn’t until I entered counseling and a Methadone maintenance program in early 2000 that I began to understand there was something underlying my compulsion to use, a need to self-medicate symptoms of my mental health challenges away. 

Fast forward 15 years later and today I am in the final stages of a medically supervised withdrawal from Methadone, but more importantly, I am acutely aware that I suffer from some mental health challenges, exacerbated by trauma experienced as a youth and the repeated retraumatization—accompanied by “collateral” trauma—of decisions and behaviors related to a life spent in addiction. 

Today, I wear the scars of my addiction and underlying mental health conditions on my sleeve. I do so because when I was open to and seeking treatment, I didn’t ask the service deliverer I approached whether they were “addiction” or “mental health.”  I asked, “can you help me figure out what is going on inside?” Unfortunately, what I found was that very few were able to work with me on both fronts and that treatment delineation, to a large extent, continues in provider organizations today. Strides have been made, to be sure, but we as providers, as people in recovery, and as people needing the support of both groups, are still seemingly light years from effective and complimentary dual treatment options. Worse, the discrimination, ignorance, and fear of those experiencing a “mental illness” are still rampant in our communities and show little sign of abating anytime soon.

To help combat this, I and many others now talk openly, freely, and regularly about our “co-occurring” disorder and work daily to raise awareness, reduce discrimination, and promote mental health because with mental health comes not just recovery from the condition, but a liberating freedom, self-esteem, and genuine self-worth as well. We stand as a testament, along with millions of others—colleagues, friends, and peers—that recovery from both addiction and mental health challenges is not only possible, but to be expected. 

From my perspective, what my peers need to do to help support those who are both in recovery and experiencing acute symptoms is simple:

  • Provide easy to understand information that helps us identify and understand what’s happening to us as we endure our mental health challenges;
  • Offer real treatment and “return to life” options that are tailored to—and driven by—our complex needs and conditions; and
  • Suggest opportunities to join our larger community without fear of discrimination, verbal and/or physical abuse, and/or marginalization.

We are making progress every day, and the more we share about our lived experience and our journey into recovery, the more we raise awareness, smash stereotypes, and reduce the ignorance associated with mental health issues. Make no mistake; however, we still have a very long road to travel, and it will be up to us to walk in the daylight along this path so that others are unafraid—and in fact, empowered—to join us.

Interested in being a HRC Guest Blogger? Email us at generalinquiry@center4si.com.

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Category: General | Guest Entry

Rachel's Story

by Wayne Centrone
June 22, 2011

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Sometimes the most important lessons—the kinds of lessons that have lasting effect on one’s attitude or outlook—occur in the most unlikely of situations. I recently recalled a patient I had the good fortune of working with a number of years ago, while I was still in clinical practice.

I had a busy morning in clinic that day. The schedule did not leave a spare moment for reflection. After a working lunch, I planned to catch up on phone calls and e-mail correspondence. Around 2 p.m., a young woman came to the clinic. She really made me think twice about all the “business” in my life.

Rachel (not her real name) was a 16-year old suffering from a heroin addiction. She wanted help with her third attempt at drug detoxification. What made Rachel so unique to me (keep in mind that I worked for a number of years in very close proximity to a needle exchange program and thus saw many intravenous drug use patients) was the fact that she came to the clinic with her parents. Mr. and Mrs. Smith (again, not their real names) were anything but “typical” patrons at my clinic. They were both in professional careers, lived an upper-middle class lifestyle, and never thought they would find themselves sitting in a community healthcare center. However, they expressed their commitment to Rachel and wanted to help in any way possible.

It is important to mention that injection drug users do not fit a particular profile. Sure, we can stereotype them to the “skid row” image of Hollywood, but there really is no “one size fits all” addict. I saw injection drug users come into the clinic fresh off the streets, and I saw some come straight from their offices. The single caveat that holds them all together is their powerlessness over a drug that has the potential to destroy their lives.

Rachel started using drugs when she was a 13-year old. She never saw herself becoming an addict. It just seemed to happen. Previous attempts at detox and sobriety had all come to naught. Strung out as a 16-year old, her face held the sort of sorrow that one would expect to see on someone many years her senior. Rachel was the victim of a life that she never envisioned nor desired. She was angry and scared. Most of all, she needed help.

I now know that one does not need to be a great thinker or renowned scientist to make a difference in the world. Rachel did not need a marvel of modern medicine. She did not want someone to lecture her about the “deleterious” effects of injection drug use. She really only wanted to get well.

Acute early detox-related treatment for injection drug use is not standardized. Earlier that day, Rachel and her family tried to see their family doctor. That doctor told them not to come, because she would not treat Rachel. They tried going to a doctor recommended by a friend, but again the services they requested were not available. Finally, in desperation, Mrs. Smith phoned the needle exchange program at our clinic. She heard that we had limited resources. She said she wanted to come in anyway.

What Rachel and her family needed was someone who would listen to their concerns, and show them that they were not alone. What they wanted from me was a listening ear and a concerned advocate.

What I learned from this remarkably strong family was that I make a difference just by being present to the suffering of another person. I learned that the “little things” (a smile, the gentle touch of a caring hand, an open heart) comfort the biggest of worries and sorrows. I learned that taking time to care about another means that I need to be present to suffering. Most of all, I learned that life’s most significant lessons come in the most unlikely of ways.

Interested in being a HRC Guest Blogger? Email us at generalinquiry@center4si.com

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Category: HRC Insight