You can’t help the unwilling?

 

I thought I’d write something for families and friends today. I want to address the idea that you can’t help someone who is unwilling to get help. There is an age old myth that you need to hit “rock bottom” before you are willing and ready to receive treatment. I will tell you though, that one of the first things people in treatment learn is that there is always a lower bottom and that everyone has a different level of “rock bottom”. So let’s start by questioning this myth. In most states, there is an ability to apply for involuntary treatment for the individual needing treatment. While I’m not suggesting this will work every time, the idea is that if you get someone to begin to change their behavior, even if it is forcibly, then they will see the positive results even if originally, they were supposedly not interested in making the change.  While I’m not necessarily advocating this approach for everyone, why would involuntary treatment exist if “treatment only works if you hit rock bottom” were true? 

Not the strongest argument, but possibly valid, you might be thinking. What about if we accept the premise that addiction is a disease and not just a choice. Also, let’s treat it like all other diseases (I’m not just being coy here, please treat addiction like all other medical conditions, it will really help). Would you say that someone with diabetes will only accept treatment if they get their foot amputated, or need dialysis? Surely, that would be the “diabetic rock bottom” or perhaps the depressed person who attempts suicide, again “rock bottom”. I know that sounds silly…A lot of people get warnings from their doctors about weight and blood pressure and do absolutely nothing. They definitely aren’t ready for treatment. In fact, we should stop offering it! Did I go too far? Too absurd perhaps? I know I can be a bit ostentatious sometimes. I do think it makes sense though. Or we can just scrap the whole “rock bottom” myth. 

 

Now I’m not completely oblivious to the fact that some people aren’t ready for treatment. Yes, I get it; however, most people aren’t pleased with having a monkey on their back. Most individuals want help, even if they are too scared, ashamed, or proud to admit it. Most people feel they will be judged or found to be weak. Many will feel it is a question of their character and morals. Addiction isn’t these things. It is a disease. Like most diseases, addiction is a disease that is easier to treat when caught early. It will help improve prognosis, chances of successful recovery and the likelihood that worse things won’t happen. 

 

Finally, while we are on the topic; addiction is a deadly illness. Tens of thousands a year die from it in the US alone. Do we really want to wait for “rock bottom”? Unfortunately, for so many, rock bottom is a casket.  

 

As always, if you or a loved one is struggling with substance use, or any other mental health issue, please seek treatment. There are a lot of good and effective ways to get treatment, so please contact myself (or someone else local to you) and get help. If you need treatment from a psychiatrist, please contact me at 954-755-2885. My office is located at 5551 North University Drive, Suite 202, Coral Springs, Florida 33067, part of Kimmel Psychology. I have evening hours available. 

 

Also, I now have YouTube videos. Find me at KimmelPsychology or search “A minute with Dr. Daum”. Please like and subscribe.

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Akiva Daum, MD FAPA can be found at Kimmel Psychology 5551 North University Drive, Suite 202, Coral Springs, FL 33067

Phone: 954-755-2885

**Telepsychiatry Available**

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