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Not everyone is in a bad place when they start using. Some people use drugs, gamble or engage in other behaviors recreationally.  As the “happy chemicals” in your brain got used up, and other coping skills became overwhelmed, the addictive behaviors were used to help you feel better.   It is easy to quickly get withdrawn into an addiction-focused world.  At that point, development of coping skills and healthy social supports stops.

Much like an infection in a wound that is not treated, whatever is causing the pain in your life, whether it be addiction, mental health issues or both, continues to fester.  This creates a vicious downward spiral.  You are overwhelmed and in pain, so you use to stop the pain.  Whatever is causing the pain continues to worsen.  When you sober up, the problem, and the pain is worse, so you use again.  Some of these issues may have existed before your use even started, or at least before the addiction took over; however, the addiction inevitably made them worse.

Now it is time to look at the consequences of your addiction and mental health issues, because it is the impact of these consequences that you face each time you sober up—-which usually compounds the depression and anxiety, and leads to crawling back into the bottle (or addiction).    The other reason to examine these consequences is because you may be holding yourself hostage for things you cannot (or could not) control.  Identifying the consequences of your behaviors and figuring out what you can and cannot control, you will have a clearer picture of the problem and can make a better recovery plan.  That is, you can figure out what crappy things happened because of your actions or choices, and which ones were simply out of your control.

Returning to the analogy of a physical illness, if you get sick, there are some symptoms that will likely happen regardless of what you do.  If you have a cold, you will likely get a runny nose and a cough.  You cannot control that.  It is simply how the bug behaves.  However, if you continue to workout at the gym and do not take your medicine, you could not only get other people sick, but also develop pneumonia (both potentially preventable and controllable outcomes).

For most people with addictions, something happens that pushes them from recreational use to abuse and addiction.  Sometimes, as in the case of a loss or a trauma or onset of mental health problems, this is an uncontrollable event.  Other times, as in a divorce, it may have been preventable, but these things happen.  They are awful, and there is usually some fallout.  Unlike getting a common cold, you may not  have realized the warning signs that something may be wrong—that your coping skills were failing.   It may seem like your world suddenly came crashing down.  You were left feeling hopeless and helpless, and just wanted to be happy and have some relief.

(Preview) Activity: Consequences of Co-Occurring Disorders

In the following activity, give examples of how addiction and mental health issues have impacted your life in each area.  If they have not impacted your life in that area, leave it blank for now—You may remember something later.  For each consequence, indicate how concerned you are about this particular issue.  1= not at all to 10= Very concerned.

My addiction and/or mental health issues have impacted me emotionally by increasing my:

Anger Level of Concern: _____
Example of how it has impacted you:

Anxiety Level of Concern: _____
Example of how it has impacted you:

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My addiction and/or mental health issues have impacted me mentally by causing:
Increased confusion, Inability to Concentrate Level of Concern: _____
Example of how it has impacted you:

Decreased ability to deal with stress Level of Concern: _____
Example of how it has impacted you:

Difficulty Making Decisions Level of Concern: _____
Example of how it has impacted you:

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My addiction and/or mental health issues have caused or worsened the following physical symptoms/issues:
Blackouts Level of Concern: _____
Example of how it has impacted you:

Changes in eating/weight Level of Concern: _____
Example of how it has impacted you:

Pain Level of Concern: _____
Example of how it has impacted you:

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The rest of this worksheet is included in the workbook.