This week we’re partnering with Riley’s Wish, a foundation started by Margaret Sisson after her son Riley– who struggled with OCD and a substance use disorder– passed away in September 2014, at age 25, after an accidental overdose. One of our team members saw Riley speak at the 2014 IOCDF Conference, and he was still on our minds when our CEO Stephen saw Margaret a few weeks ago. They hatched a great plan: to join forces and spread awareness with a week for Riley, in the spirit of his devotion to helping other people whenever and wherever possible.
We’re covering Riley’s story this week, and sharing content from the Riley’s Wish Foundation, because of how important it is that we all start doing a better job of caring for one another the way Riley cared for everyone in his life. But we’re also doing so because Riley’s story highlights an extremely important aspect of mental health: the fact that multiple types of symptoms are often overlapping, making things more confusing and, of course, more difficult for someone to confront.
When Riley Sisson was 25 years old, he died of an accidental overdose. Recently enrolled in a Masters of Social Work program, Riley had struggled for years with symptoms of obsessive-compulsive disorder and a substance use disorder. His friends say he was clearly struggling in the weeks before he passed away, but they also insist he never lost his characteristic empathy. Riley’s main concern was always for other people, whether they were his closest friends or strangers he’d never see again.
His sensitivity helped make Riley a crowd favorite at the International OCD Foundation Conference, where he gave speeches that helped people feel understood while making them laugh. But it also manifested in more destructive ways, as his OCD constantly latched on to the possibility that he might have inadvertently harmed someone else. According to Tim Blue, one of Riley’s friends and mentors, Riley was an hour late the last time he came over because he had been unable to leave his apartment.
One big part of Riley’s story isn’t unique. Up to 40% of people with OCD also meet criteria for a substance use disorder– meaning their use of a substance has either started to get out of their control or has entirely escaped their ability to control it. In the past few years there has increasingly been awareness of the ways that conditions like PTSD can intersect with substance use, but for some reason we haven’t also recognized the intersection between OCD and addiction. The takeaway: like with those other conditions, there’s a very strong link between OCD and substance use.
Although we don’t know all the details, remarks from Riley’s family and friends suggest he might have followed a familiar pattern: substance use can wax and wane over time, giving observers the impression that someone is doing better or worse, depending how heavy their use is at a given time. But a period of not using as heavily doesn’t equate to recovery, and it’s important that treatment is seen as a long journey, probably with plenty of ups and downs, not as a linear path ending in clear remission of symptoms.
There’s often no clear causal link between one set of symptoms and the other. Although we might be tempted to say that someone’s pain from OCD must be causing their substance use, and this might be true to some extent, the two conditions interact in more complicated ways too. For example, maybe the obsessionality gets worse every time someone sobers up, which leads to further use, and so on.
But it might be true that one condition came first, and in Riley’s case it seems like his OCD symptoms had him convinced that he needed a way out of the daily pain that this condition usually brings– not suicide, as Tim emphasizes in a heartfelt blog post, but just relief. This should remind us not only that there are vast individual differences in the ways people experience and deal with OCD symptoms, but also that those symptoms often become so painful and frightening that the risk of addiction to psychoactive substances (or really anything else) can greatly increase.
It’s hard to resist the urge to draw simple lessons from Riley’s very complex story, of which all this was only one small part. This much is clear: substance use disorders, like OCD, have no simple solution. As such, we all have a responsibility to make sure that addiction research and treatment are major priorities in our social agenda– especially given the opioid epidemic we now have on our hands.
But what’s also clear is that many people do benefit tremendously from the treatment options available today. Riley’s mother, Margaret, was kind enough to share these resources on the treatment of substance use disorders. Please share these with anyone who might benefit:
Special thanks to:
Margaret Sisson, Riley’s mother and Executive Director of the Riley’s Wish Foundation, who gave us everything we needed to tell this very small piece of her son’s story. Margaret also directed us toward the following writers. . .
Shannon Shy, whose blog post provides much-needed context for our attempts to grasp even a few of the many complexities of Riley’s life.
Tim Blue, whose aforementioned blog post offers tragic details about how difficult things often were for Riley, and how caring he remained despite all that difficulty.