By Patrick Callan
A few months ago I received the kind of phone call I’d been waiting years to get. I’d just been offered a job at CAMH – an organization I felt very passionately about long before I ever stepped foot on the grounds.
One of the first people I called to share the good news with was my longtime friend James. I knew he’d been coming to CAMH recently for help with anxiety and I was hoping we could work together on a feel-good piece about how he received treatment and was doing better than ever. But once we got talking, I quickly realized that wasn’t the story.
I first met James more than 10 years ago and we immediately became close friends. He was always someone I looked up to and admired – kind of a like an older brother. He was creative, funny, popular, and always had time for everyone. After years of hearing about his exciting sojourns to Thailand, I packed my own bags and took off for six months.
Half way through my trip, I found out he was coming to meet me. I was really looking forward to seeing a familiar face and since he knows Thailand like the back of his hand, I knew the stereotypical backpacking trip I was on was about to hit the next level.
We visited Buddhist temples in the mountains, cooked dinner in the jungle, volunteered at an orphanage, and took part in Songkran – a three-day water festival in April to celebrate the Thai New Year. The memories we made that month will last a lifetime.
When we returned to Canada, I began pursuing my journalism career across the country and we drifted apart. After a three-year hiatus, I returned to Toronto and was hoping to pick up our friendship we’re we left off. However, I started to notice James wasn’t his usual happy-go-lucky self. I didn’t know it at the time, but he’d just been in a serious car accident which had kicked his longstanding anxiety problems into overdrive.
“We were on our way to Ikea in stop-and-go traffic when someone hit us from behind and then all of a sudden my neck was hurting. I ended up going home that night. I went to sleep and woke up with a stiff neck and then that’s when I knew that the anxiety had come back And it came back tenfold,” James says. “I have trouble driving now. I can’t drive in traffic or I feel trapped. I avoid the highways at all costs. Not because of the high speeds, but because of the stop-and-go traffic I get the fear of getting in an accident.”
Shortly after the accident, James started to withdraw from social events and then stopped contacting friends completely. Instead, he would wander the streets, drink heavily by himself to cope with his anxiety, and frequently check into the emergency room.
“I hid it from everyone. I thought I was going to die,” he said. “I’d tell everyone that I was going home to do some artwork, but I really was just going home to the bottle. So I went to my doctor and she said the drinking has to stop and referred me to CAMH.”
When James first came to CAMH for help with his alcohol addiction in 2014, he joined the Integrated Care Pathways treatment program where he met with a physician, nurse and pharmacist on a weekly basis. He’s since gone to group sessions for anxiety and PTSD.
Dr. Tony George, Chief of CAMH’s Addictions Division, says about 50 to 60 per cent of psychiatric patients have concurrent substance use disorders. “There are no pure psychiatric patients anymore and there’s no pure substance misusing patients anymore,” he says.
CAMH’s Stephanie Carter, Clinical Director, Ambulatory Services Acute Care Program, adds that concurrent disorders can present themselves in many different ways. “Every situation is going to be different, and the support people need would also likely be different,” she says.
James says the coping mechanisms he learned at CAMH, such as breathing techniques and distraction methods, helped him get through his wedding last December and the birth of his son two months ago, but his anxiety levels remain high. And while he’s taking medication to deal with it, he occasionally still feels the urge to reach for the bottle.
“I don’t think any treatment is going to fix me. Not a lot of people understand. I was ignorant to it until I was in it. My whole life revolves around what I’m going through right now,” he says. “I have a wife and a child now, so I need to try to pretend to be strong for them, but inside I’m weak. I feel like I’m on the edge of breaking – like losing it.”
When I pitched this story idea to James, I had no idea what he was going through every day. As I got down to writing, I realized that when it comes to concurrent disorders, everyone is different and there’s no silver bullet. It can be a lifelong struggle. I just wish I’d known sooner so I could have stepped in to help.
“There are no telltale signs. Concurrent disorders are complex kinds of behaviors with multiple problems and usually trying to detect them is really tough,” said Dr. George.
He adds that if you suspect someone you know has turned to substance use to cope with another disorder, the best way to approach them is honestly and transparently.
“Get them into treatment as soon as possible so they can be assessed properly and started on the appropriate medication and talk therapy,” he said. “If they’re in trouble they will probably be a bit upset but they will thank you later.”
I know it wasn’t easy for James to open up and share his story, but I’m thankful he did. In fact, I have a whole new level of respect for him now.
Published on November 10, 2017