MindfulMan

I was at a lecture discussing this last Wednesday by a well respected addiction doctor and recovering heroin addict.

His take is that trauma causes shame, which leads to depression and anxiety, and in both cases the technique for dealing with all of it is avoidance. The easiest shortcut to feeling better is to use. This works incredibly well in the short term, but the consequences from addiction grow increasingly severe so that the using strategy eventually, sometimes quickly, sometimes over years, becomes unusable. When the addiction is stopped, the depression and anxiety return with a vengeance (explaining the frighteningly high relapse levels in early sobriety).

I think that the spiritual malady described in the Big Book describes this phenomenon in the language available at the time.

That depression can be blunted by medication, cognitive behavioral therapy and 12 step programs can give one the tools to stop drinking and remain sober, but I think in the vast majority of cases until the underlying causes of trauma and shame are addressed and processed, we're all living in some kind of limbo, not so sick, but not quite healed either.

A huge number of people get and stay sober without 12 step programs, and a huge number of people in 12 step programs relapse, even after years of sobriety. AA as a monotherapy is not the most effective course of long term treatment, neither is medication and therapy. Personally, I need all three to arrive at a life worth living, and in such cases medication is no longer needed. In my case I'm on it for life, as bipolar disorder is clearly a chemical imbalance that responds to specific medications and returns eventually if the medication is discontinued. Depression is a bit more of a slippery beast. Cognitive behavioral therapy works very well for anxiety, which is good because most anti-anxiety meds hit the same receptors as alcohol and are fiercely addictive in the long term. PTSD is responsive to therapy, ADHD is responsive to medication and life coaching. Again, a combination is the best answer.

Bunny211

I have both.
Two years of no medication or treatment of my depression, attending bible studies, prayer and meditation, helping others etc. could not get me out of my funk. I wanted to die every day. It wasn't working. I need AA, a sponsor, a higher power and antidepressants and a good therapist.

AA people are not physicians. Never let anyone tell you you cannot do something to take care of yourself. You deserve to be happy.

Pathwaytofree

Paul, thank you so much for an exceptional explanation. Seriously I'm printing this out and putting it in my big book by The Doctor's Opinion.

Yes the doctors opinion even says alcoholism is not about being moral. However I think I recall if the word "moral" was used, they meant "truth". Truth as in we were lying to ourselves when we said "I can control my drinking, I just need to try harder or have more willpower."

But weren't these what caused our character defects?
How do we explain to outsiders that once we mastered resentments and our character defects we stopped drinking? Or is that that's just a piece of the puzzle?

Pathwaytofree

Bunny, Thank you so much for posting this. You are strong for doing so. I wonder how many of us feel like failures when we do all that but are still in a funk.

I just wish we all could better understand the difference between the type of depression that goes away once recovered, vs the type of depression that is still there even though recovered.

I wish you all the very best.

Pathwaytofree

What's his name? I'd be curious to read his work.

Yes this is exactly my experience.

The Doctor's Opinion gets it. And others in AA explain it well. How a real alcoholic gets worse when we stop drinking, without taking action toward a spiritual awakening. How alcohol was our solution. But then why are some people still depressed/anxious after their spiritual awakening?

Hmm that's an interesting way of looking at it. I think in my case I may just need deeper work in therapy or something. My 5th step helped with the "this person was spiritually sick, it wasn't personal or your fault, forgive them and let go of the anger" but I still am dealing with the after affects.
That's an interesting perspective but I wonder if there's a difference in the type of AA the person was attending, and the effort being put into it.
I think many of us might.

I've also known many to get off meds after a spiritual awakening.

But what about the point that most people with depression also have anxiety?

I didn't know that the anti anxiety meds hit the same recepters as alcohol. That makes sense though.

That makes sense.

Thanks MindfulMan for sharing what you learned.

DayTrader

Knowing in advance - I doubt it's possible to distinguish.

The easiest way I know is to do 1-11, experience that guaranteed spiritual awakening and then make the determination if the depression is still there or not and whether or not additional treatment is necessary.

And let's be clear, depression is a normal part of anyone's life. There will be times when we're just depressed....and that's OK. Sometimes I (we) get caught up in thinking everything has to be perfect all the time for us to be OK.