The obituary for Coleen Sheran Singer gave me a lot to think about. She was a young woman who died last year of a heroin overdose, and her ex-husband recently printed an obituary in the Bangor Daily News. In it, he discusses the MaineCare expansion debate and gives a graphic description of Singer’s life.
I’ve written about how expanding MaineCare would help alleviate the addiction epidemic in Maine. And I’ve written extensively about the drug epidemic itself. So in that regard, I appreciate the writer’s sentiments. I also appreciate and share his desire to raise awareness about the impacts of heroin addiction in Maine. I am also very sorry for his grief. He obviously cared deeply for Singer.
But what he hoped to gain by exposing her most personal information around her mental illness and her life path, I’m not sure.
Honestly, I’d be haunting him if it were me, but no one can say how Singer feels about it because she’s not here. There is science behind the information he disclosed, however, and a tell-all look at her life should have included it. Inclusion of such information would have not only been informative for whatever audience the author was seeking, but it also would have helped preserve this young woman’s inherent dignity.
Impulsiveness, struggles with addiction, and things like a solicitation charge or issues around sexual behavior are intertwined in the symptoms of borderline personality disorder. Is there some degree of choice involved? Yes.
But it is choice in the context of abnormal brain biology and chemistry that is most likely related to childhood trauma. Some studies have estimated that as many as 78 percent of patients with personality disorders experienced some form of childhood trauma.
The science behind the nexus where mental illness meets trauma has been evolving over the last couple decades, but I’d argue it’s still understudied and under-reported. Personally I’ve long been fascinated by the slowly emerging science around the impact of trauma on the amygdala — the part of the brain that deals with emotions.
There’s also ample science around treating co-occurring disorders. Co-occurring refers to having a dual diagnosis of mental illness and addiction. Best practice recommends treating both the mental illness and the addiction through integrated care, which often lowers costs and results in better outcomes. The obituary refers to Singer’s borderline personality disorder as untreated, even when she sought addiction treatment and recovery.
Best practice for co-occurring disorders would suggest that just treating the addiction isn’t enough to ensure the likelihood of recovery from both mental illness and addiction. “Unless treatment for addiction is combined with treatment for the co-occurring disorder, a complete recovery is not likely to take place,” reads dualdiagnosis.org. Further, a lack of treatment for the co-occurring disorder can contribute to an increased likelihood of relapse with addiction.
Access to addiction treatment through MaineCare may very well have helped Singer. Understanding her own mental illness and its relationship to her addiction and having access to effective treatment for both, however, probably would have helped more.