Disorders and Treatment
- Mental Illness
- Bipolar Disorder
- Mood Disorders
- Borderline Personality
- Mental Health Diagnosis
- Mental Health Treatments
- Alternative Meds
- Case Studies
One of the real tragedies of drug addiction is the corruption of our innate mechanisms to feel pleasure. These are co-opted by the addictive substance and our normal ability to feel enjoyment becomes inextricably linked to using. For many addicts, this is the long-term consequence, long after they no longer actively use, they still can’t seem to enjoy their own lives.
Because a loss of interest in what should be pleasurable activities is a hallmark of depression, it should be no surprise that depression is so strongly linked to addiction recovery. But there may be more to the picture. Some addictions are the result of trying to self-treat for depression in the first place. Users find they can escape the burdens and frustrations they feel by taking drugs. When they no longer use, they are right back where they started, but no have the additional element of rerouted pleasure pathways.
This rewiring of the brain is real. It shows up on fMRI and can last months or even years. The system we have for reward and pleasure is actually altered.
The first step is education. Drug and alcohol treatment centers will make this part of the process, but in the midst of the stress and turmoil of withdrawal, new information is hard to take in or accept. For this reason, it’s important not to stop learning and reviewing the condition. This won’t stop the feelings or lift the depression on its own, but it will help you understand the pathway through.
Becoming a student of depression is no different than understanding any disease which may afflict you. The more you know, the better you will be able to take useful action and the more tools you’ll have when you need them.
The second step is believing. Believing in this context means convincing yourself that what you are hearing is true. That the condition is 1) treatable and 2) doesn’t last forever. Depression as a result of withdrawal is common, expected, and eases over time. The primary message, the one worth having faith in, is: “It will get better.”
The third step is facing reality. This is critical. The temptation is to use the one thing you already know, for sure and certain, helps with the depression – the drug you were addicted to or a relative. The harsh truth is that this is no longer a possibility and you have to face up to who you were then and who you are now. This is the starting place. Ignoring the realities and refusing to deal with the shame, heartache and damaged relationships simply extends the healing process.
The next step is getting help. There’s a saying in Narcotics Anonymous, “Relying on your best judgment is what got you here.” They’re saying that addicts don’t have the best track record when it comes to good decisions. Getting help adds an outside view and support – two things you cannot do yourself.
Depression can be treated, not just by medication, but also by behavioral therapy and counseling. Many addicts fear that if they take a pill for depression, they are only replacing one addiction for another. This idea isn’t strange to doctors and you should bring it up with any therapist you see. The point of therapy isn’t to over medicate you, but to offer useful help. Whether it is informal or formal help, don’t try to go it alone.
Get out. Depression, and especially depression after drug addiction, tends to isolate those who suffer from it. But there is good evidence that not closeting yourself is much, much better. Exercise and getting out in the world is fine, but social engagement is even better. Learning to care about others will help you relearn to care about yourself.
Not using opens up time and feels like a hole in your life. That needs to be filled. Work and social engagement can help fill this hole. It also helps move your focus from “I am suffering” to more healthy areas. These also give you some control over your life, and the loss of control – a feeling of “this is happening to me and I can’t stop it” – only reinforces the depression.
Don’t forget. Always in the background is the temptation to use, “just one more time.” Addict after addict has fallen for that subtle trap. Why? Because their bodies remember the good and they have forgotten the bad. As much as hunger is a craving that takes will power to ignore, so too is the desire to slip back into old behavior patterns.
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