This monthly series is dedicated to increasing community understanding about brain disorders, treatment options, and recovery.

Dax Nicola, addictions counselor at Willapa Counseling Center, is the source for this column. Members of the WCC staff will contribute future articles. Barbara Bate of the WCC Board is interviewer for the series.

You work in the area of dual disorders. What does that term mean?

People who seek counseling for problems related to their minds, emotions, or behavior very often are using alcohol or other drugs when they come to us.

As many as 80 percent of the people we see are dealing with both a brain illness and a substance abuse issue. We call this a "dual disorder" situation because both parts affect each other. A person with a family history of mood swings, depression, or hearing voices may be drinking or using marijuana to deal with the brain problem.

It's double trouble when the person comes to us under the influence of both the illness and the substance. My job is to try to discover what's going on so we can treat the whole person.

What led you to become involved in the mental health field?

I grew up in the Southwest. My first employment was in Child Protective Services in the Rio Grand Valley. After getting out of the Navy I started working with people with mental illnesses and addiction problems. It was hard to see progress when the two problems were treated separately; people would be bumped around a lot between agencies and services.

While raising my four sons, I took graduate work in psychology and went to law school. For 10 years I directed a mental health agency outside Houston, Texas. I've also worked on nursing home compliance and in other mental health facilities on the West Coast.

There's a lot of heartbreak in this work. It's hard for people to get help for both the brain problem and the addiction. And it is tough just to get the money to print out educational fliers. But this is what I chose to do, and the need for services in Pacific County is growing.

What are particular issues that you see in Pacific County?

There's a large segment of the population in this area that is unaware and naive about the range and severity of drug problems here. Some believe that marijuana grows around here but is not an issue when it is used privately. Many people think "you can't have fun without a beer or two" and that the capacity to hold their liquor is a sign that someone is a real man.

Each drug has its own features. Alcohol kills more brain cells than any other drug. Marijuana has unpredictable effects, and it is likely to be followed by other drugs bringing bigger highs. Methamphetamine is popular because it is cheap to buy and possible to make at home. Meth is extremely dangerous because it is highly addictive and changes the structure of the brain after just a few uses. I've seen it destroy a person's mind, and the whole family.

What are some positive directions you see in your work?

There's now a group called the Acutely Intoxicated Committee that deals with situations in which a person is at risk of dying in jail without intervention. There is also increasing teamwork between the Pacific County Sheriff's office and the Counseling Center. They get together to evaluate people who commit crimes without weapons and need both detox and mental health assessment. Both are essential. Public information is also increasing; more citizens are beginning to see connections among family genetic illnesses, codependency, and community uses of alcohol and other drugs.

Any further suggestions for someone who reading this interview?

The biggest thing you can do is to educate yourself about these illnesses. Learn about the symptoms of bipolar disorder, post traumatic stress disorder, panic attacks, and depression. Ask about any family history of unusual behavior, mood swings, isolated individuals, or suicide. Pay attention to someone's use of alcohol and other drugs in relation to major stresses. Don't hang back from asking questions of people you care about!

Willapa Counseling Center has informational pamphlets about all of the topics mentioned above. For this or other information about the Center, dual disorders, or mental illnesses and treatments, phone 642-3787 in Long Beach or 875-9426 in South Bend.

You can also e-mail the executive director, Christine Hearth, at ( The emergency 24-hour number for Willapa Counseling Center is (800) 884-2298.

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