“Beautiful Boy” & Mental Illness

*I’m talking about the afterword of the book “Beautiful Boy” by David Sheff, so… yes, that would be a spoiler.*



Odd enough, one of the things that will stick with me most from “Beautiful Boy” is a part of the story that isn’t even mentioned until the afterword.


Through years of addiction, treatment, and relapse…

Through years of therapy, ER visits, and doctor appointments…

Through years of pain, tears, and heartbreak…




The doctor was incredulous. “Do you mean to tell me that Nic has been in a dozen treatment programs, and he’s seen all those therapists”- about a dozen of those, too- “and no one had him tested?”


No one had.


He identified a major problem in the addiction-treatment field: the majority of those who become addicted have co-occuring psychological disorders and have experienced some form of trauma. If those issues aren’t addressed, continued relapse is likely.


The doctor ordered tests, and the results were definitive: Nic has severe bipolar disorder… –Beautiful Boy, David Sheff (p. 322)






If Nic had been diagnosed years ago, who knows how his life would have been. Maybe he wouldn’t have gone down a lethal path of addiction. Sometimes, those with mental illness, unfortunately, turn to drugs to cope with their symptoms or episodes. For example, Nic used drugs to self-medicate, trying to alleviate his symptoms of bipolar disorder and anxiety.


Since getting treatment for his mental illnesses, he has stayed sober. The end of the book says he has been sober for 8 years.


I think that highlights the significance of treating BOTH addiction and underlying issues or comorbidity (e.g. bipolar disorder). The conditions can feed off one another, so success depends upon the treatment of both!


It would be great to see treatment programs effectively work to treat addiction AND mental illnesses!

2 thoughts on ““Beautiful Boy” & Mental Illness

  1. Definitely. The old way of thinking was to treat sequentially, focusing on the more severe disorder first. Now research has shown it’s more effective to do treatment for both disorders concurrently, especially if it’s done in an integrated way.

    Liked by 1 person

    1. The book highlighted SO many issues with seeking treatment for addiction… but the fact that he went through the system/programs/therapy for years without even being evaluated for mental illness is bizarre to me.

      Liked by 1 person

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