Addiction & Depression - Go Hand in Hand - Dual Diagnosis & Treatment
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Addiction & Depression - Go Hand in Hand - Dual Diagnosis & Treatment
We Are Having the Wrong Conversation About Robin Williams
By Richard Taite - founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also coauthor with Constance Scharff of the book Ending Addiction for Good
This week we are remembering Robin Williams. Rightly so; his unique genius had us laughing and crying, sometimes in the same performance. Through the mainstream media, across social media, and in person with friends, family and colleagues, this week we are all sharing the same conversation. How could he take his own life? Unfortunately, we're sharing the wrong conversation. We talk about Robin Williams' depression and his struggles with addiction -- which caused his suicide? Instead, for the sake of the many thousands of people like Robin Williams (and Philip Seymour Hoffman and Heath Ledger), it's time to start talking about addiction and depression as symptoms of one disorder, and one for which there is treatment and hope of recovery.
Substance abuse? Depression? No, it must have been Mr. Williams' recent diagnosis with Parkinson's that caused his suicidal actions! At least that's what the latest news reports suggest. We'd like to think that's true, because it would comfort us. It is easier for us to believe that someone with a disease or disability would find the future too much to handle rather than accept that one more shining light has gone out because he didn't get the right treatment for mental health issues that he needed. Yes, those who are diagnosed with serious diseases do often suffer a period of depression after the diagnosis, but they do not often kill themselves because of it.
Depression. Addiction. Those are the psychological disorders that bring on suicide. And we don't give those with those kinds of disorders the appropriate treatment.
Substance abuse and depression are the right and left hands of a heartbreaking condition that often includes both. For example, research suggests that nearly half of people in treatment for alcohol addiction have co-occurring depression; at my treatment center, we find the rate somewhat higher. Of people treated for major depressive disorder, nearly 40 percent will struggle with alcoholism at some point in their lives. Not only do these two challenges tend to happen together, there's strong evidence they may actually create each other. If you treat one without treating the other, the challenge that remains can cause relapse of the other.
This combination is especially dangerous in addicts who have been abstinent for many years and who may also have held their depression in check during that time. For them, it can be as if there's no way out. No way but suicide or overdose.
So why, in light of all this evidence, in light of all this death, do we continue to insist on talking about depression and addiction as if they were two different things?
Why do we continue to treat them separately?
We are talking about people in pain, and not only must we treat the symptoms of that pain, addiction/depression/suicidal ideation, but we must also treat the root of the pain -- and that's what few treatment programs ever manage to achieve.
It's time for the addiction treatment industry to get hip to mental illness and for the mental illness treatment industry to get hip to addiction treatment.
Every addiction treatment center in the nation should be qualified to treat dual-diagnosis clients, and if you aren't qualified to do that, for goodness sake, send the dual-diagnosis client to a facility that can help them.
If you are not using evidence-based methods to treat the underlying causes of addiction and depression, you're setting your client up for relapse. Expect overdose or suicide. That's what the research and our experience tells us.
Certainly our conversations this week should remember the genius of Robin Williams. But we should also be talking about how to help prevent yet another tragedy.
The way to help is to start seeing addiction as more than the craving for a substance relief. Addicts want what the substance promises. They want to feel better or nothing at all.
Those with depression often cannot feel, cannot see their value or experience joy. These are issues that go hand-in-glove.
We need to advocate for higher quality, more accessible treatment, concurrent treatment for mental health issues.
Even with all his resources, Robin Williams likely did not receive the proper care he needed. Yet it's out there, and we need to make it more widely available.
Only that will keep safe the next brilliant man or woman who knocks on a treatment center door, overwhelmed by addiction, depression, and suicidal ideation.
By Richard Taite - founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also coauthor with Constance Scharff of the book Ending Addiction for Good
This week we are remembering Robin Williams. Rightly so; his unique genius had us laughing and crying, sometimes in the same performance. Through the mainstream media, across social media, and in person with friends, family and colleagues, this week we are all sharing the same conversation. How could he take his own life? Unfortunately, we're sharing the wrong conversation. We talk about Robin Williams' depression and his struggles with addiction -- which caused his suicide? Instead, for the sake of the many thousands of people like Robin Williams (and Philip Seymour Hoffman and Heath Ledger), it's time to start talking about addiction and depression as symptoms of one disorder, and one for which there is treatment and hope of recovery.
Substance abuse? Depression? No, it must have been Mr. Williams' recent diagnosis with Parkinson's that caused his suicidal actions! At least that's what the latest news reports suggest. We'd like to think that's true, because it would comfort us. It is easier for us to believe that someone with a disease or disability would find the future too much to handle rather than accept that one more shining light has gone out because he didn't get the right treatment for mental health issues that he needed. Yes, those who are diagnosed with serious diseases do often suffer a period of depression after the diagnosis, but they do not often kill themselves because of it.
Depression. Addiction. Those are the psychological disorders that bring on suicide. And we don't give those with those kinds of disorders the appropriate treatment.
Substance abuse and depression are the right and left hands of a heartbreaking condition that often includes both. For example, research suggests that nearly half of people in treatment for alcohol addiction have co-occurring depression; at my treatment center, we find the rate somewhat higher. Of people treated for major depressive disorder, nearly 40 percent will struggle with alcoholism at some point in their lives. Not only do these two challenges tend to happen together, there's strong evidence they may actually create each other. If you treat one without treating the other, the challenge that remains can cause relapse of the other.
This combination is especially dangerous in addicts who have been abstinent for many years and who may also have held their depression in check during that time. For them, it can be as if there's no way out. No way but suicide or overdose.
So why, in light of all this evidence, in light of all this death, do we continue to insist on talking about depression and addiction as if they were two different things?
Why do we continue to treat them separately?
We are talking about people in pain, and not only must we treat the symptoms of that pain, addiction/depression/suicidal ideation, but we must also treat the root of the pain -- and that's what few treatment programs ever manage to achieve.
It's time for the addiction treatment industry to get hip to mental illness and for the mental illness treatment industry to get hip to addiction treatment.
Every addiction treatment center in the nation should be qualified to treat dual-diagnosis clients, and if you aren't qualified to do that, for goodness sake, send the dual-diagnosis client to a facility that can help them.
If you are not using evidence-based methods to treat the underlying causes of addiction and depression, you're setting your client up for relapse. Expect overdose or suicide. That's what the research and our experience tells us.
Certainly our conversations this week should remember the genius of Robin Williams. But we should also be talking about how to help prevent yet another tragedy.
The way to help is to start seeing addiction as more than the craving for a substance relief. Addicts want what the substance promises. They want to feel better or nothing at all.
Those with depression often cannot feel, cannot see their value or experience joy. These are issues that go hand-in-glove.
We need to advocate for higher quality, more accessible treatment, concurrent treatment for mental health issues.
Even with all his resources, Robin Williams likely did not receive the proper care he needed. Yet it's out there, and we need to make it more widely available.
Only that will keep safe the next brilliant man or woman who knocks on a treatment center door, overwhelmed by addiction, depression, and suicidal ideation.
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This is as much conjecture as anything else I've read about Robin Williams.
The alcoholics and addicts want to claim him as one of theirs, proponents of mental health, the same, and Parkinsons folks, too.
I understand that people are trying to find something good to take away from the tragedy, but frankly I find it all kind of sordid.
The truth is I doubt any of us will ever really know what led to his decision.
addiction and depression is a vital topic I agree...I don't think this article advanced the discussion very much tho, sorry.
D
The alcoholics and addicts want to claim him as one of theirs, proponents of mental health, the same, and Parkinsons folks, too.
I understand that people are trying to find something good to take away from the tragedy, but frankly I find it all kind of sordid.
The truth is I doubt any of us will ever really know what led to his decision.
addiction and depression is a vital topic I agree...I don't think this article advanced the discussion very much tho, sorry.
D
Last edited by Dee74; 09-30-2014 at 11:28 PM.
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In regard to Robin Williams I agree... we don't know enough because its private.. but I think the discussion can bring about great value...
I agree with the concepts presented.. they follow the protocol of my husbands rehab... I also think many people don't think about root causes, past traumas, and what kind of in depth care is needed for recovery BEFORE treatment is selected for a loved one. Scary as it is.. Ive even heard it said "it doesn't matter what caused the addiction" and I think this is what the article points to... it does matter for proper recovery.
I agree with the concepts presented.. they follow the protocol of my husbands rehab... I also think many people don't think about root causes, past traumas, and what kind of in depth care is needed for recovery BEFORE treatment is selected for a loved one. Scary as it is.. Ive even heard it said "it doesn't matter what caused the addiction" and I think this is what the article points to... it does matter for proper recovery.
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I've never been to rehab, so I'll not comment on that 
I have had a lifelong battle with depression tho, and it was vital for me to address both those problems to stay sober.
I choose to focus on my alcoholism first.
I'm glad I did it that way because I needed a clearer head than the one I had as a drinker in order for me to deal with my depression and all the associated baggage there.
Dealing with my depression first, but still drinking, would have been futile for me.
D
I have had a lifelong battle with depression tho, and it was vital for me to address both those problems to stay sober.
I choose to focus on my alcoholism first.
I'm glad I did it that way because I needed a clearer head than the one I had as a drinker in order for me to deal with my depression and all the associated baggage there.
Dealing with my depression first, but still drinking, would have been futile for me.
D
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I agree with this too.. for my husband treatment was mostly concurrent though.. once he stopped using, got past the initial WD and stabilized the rest of treatment was concurrent. Their view was once you stop, your stopped...then it was how do we keep you from starting again. So for him it was important the work started right away with CBT and other therapies.. they addressed both addiction and underlying causes while he was in rehab.
For me I also think when I hear about how rehab didn't work and the person failed.. didn't want recovery bad enough.. the real answer may be the rehab treatment wasn't sufficient for that individuals specific needs. Addiction is one of the only illness where if treatment doesn't work, we blame the patient. Often the rehab or program... isn't meeting the persons needs.. and for possible tens of thousands of dollars being spent in the case of a rehab.. IMO this is an issue.. patients and families need to be aware, and demand evidence based care.
For me I also think when I hear about how rehab didn't work and the person failed.. didn't want recovery bad enough.. the real answer may be the rehab treatment wasn't sufficient for that individuals specific needs. Addiction is one of the only illness where if treatment doesn't work, we blame the patient. Often the rehab or program... isn't meeting the persons needs.. and for possible tens of thousands of dollars being spent in the case of a rehab.. IMO this is an issue.. patients and families need to be aware, and demand evidence based care.
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I agree we don't know for sure what led to Robin Williams' death....What his state of mind was at the time......but if his tragic death helps to open up the dialogue and increase public awareness that the majority of people who suffer from addiction also suffer from mental illnesses I'm all for it. If it can lead people to make more informed choices when it comes to treatment. That's wonderful.
The program I attended specialized in dual diagnosis. Everyone in my group had an underlying mental illness. Mine was anxiety. But there were many who suffered depression, bipolar, PTSD, OCD etc. and used substances to self-medicate. Nowadays, the specialists in addiction medicine believe its essential to treat the underlying mental illness also, in order to prevent relapses. My Bio-father, a Vietnam Veteran died from chronic alcoholism...he suffered from severe anxiety and PTSD. Unfortunately back in the day...they did not have the knowledge and or facilities they have today or he might still be alive.
I think it makes a lot of sense to treat them concurrently because the treatment for mental illness is very similar to the treatment of addiction. They both use the same type of treatment plan.
-monthly visits with the psych Doctor / Meds when required.
- weekly one on one therapy sessions with a therapist.
-two -five group sessions per week with other patients
Below is a link I found helpful in understanding dual-diagnoses.
Substance Abuse & Mental Health: Substance Abuse and Co-Occurring Disorders
The program I attended specialized in dual diagnosis. Everyone in my group had an underlying mental illness. Mine was anxiety. But there were many who suffered depression, bipolar, PTSD, OCD etc. and used substances to self-medicate. Nowadays, the specialists in addiction medicine believe its essential to treat the underlying mental illness also, in order to prevent relapses. My Bio-father, a Vietnam Veteran died from chronic alcoholism...he suffered from severe anxiety and PTSD. Unfortunately back in the day...they did not have the knowledge and or facilities they have today or he might still be alive.
I think it makes a lot of sense to treat them concurrently because the treatment for mental illness is very similar to the treatment of addiction. They both use the same type of treatment plan.
-monthly visits with the psych Doctor / Meds when required.
- weekly one on one therapy sessions with a therapist.
-two -five group sessions per week with other patients
Below is a link I found helpful in understanding dual-diagnoses.
Substance Abuse & Mental Health: Substance Abuse and Co-Occurring Disorders
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Thank you for linking the page here Cleanin… I looked through it and its representative of my feelings.. I posted the article, and even though it highlights Robin Williams I think the most important thing is that he represents a person who was dealing with “dual diagnosis” or “comorbidity” as its sometimes defined. The fact that he is a celebrity draws attention to the particulars of his situation, and allows for discussion and hopefully an increase in awareness.
This is a common question from family and friends… recited from national Institute of Drug Abuse:
For family and friends who may be involved in trying to aid their loved one in seeking proper treatment for dual diagnosis there are also important factors to consider. Sadly Ive heard it stated many times in “the type of treatment doesn’t matter”… this may be an opinion but its not supported by organizations such as National Institute of Drug Abuse, National Institute of Health… Type of treatment is critical to recovery..
Another myth debunked by medical professionals is the concept that a person has to hit rock bottom before treatment will be successful… unfortunately this belief is still spread among family members, and often halts them from trying to intervene and encourage treatment:
We also know….
From national Alliance on Mental Illness
But treatment is available for dual diagnosis… even when still in active use…..
This is why I find the topic interesting to discuss on a family forum… its important as family members and friends to realize the bulk of the work in recovering from substance abuse, dual diagnosis, falls on the patient… same as it would for heart surgery, diabetes diagnosis, or asthma… BUT family can play, and is often encouraged to play an active role in helping their loved one… especially if they have dual diagnosis and cannot efficiently advocate for themselves... and this is ok… its up to each family member to define their own role in the process, making their own life as healthy and happy as possible.
Dual diagnosis is highly prevalent in our loved ones and friends… do we share this information, do we share the importance of the need for early intervention, for proper treatment of these conditions?
Or do we say it doesn’t matter why they use… they use just because they are addicts.
References from these two sites:
Letter From the Director | National Institute on Drug Abuse (NIDA)
NAMI | Dual Diagnosis: Substance Abuse and Mental Illness
This is a common question from family and friends… recited from national Institute of Drug Abuse:
I think my loved one takes drugs because he feels depressed—but he’s depressed because drugs are overtaking his life. How do we know which problem came first?
It is very possible your friend needs to find treatment for both depression and addiction. This is very common—it’s called “comorbidity,” “co-occurrence” or “dual diagnosis” when you have more than one health problem at the same time. Encourage your friend to discuss all symptoms and behaviors with the doctor. There are many non-addictive drugs that can help with depression or other mental health issues. Sometimes health care providers do not communicate with each other as well as they should, so you can be your friend’s advocate (with his permission) and make sure all of his health care providers know about all of the health issues that concern you. People who have co-occuring issues should be treated for all of them at the same time.
It is very possible your friend needs to find treatment for both depression and addiction. This is very common—it’s called “comorbidity,” “co-occurrence” or “dual diagnosis” when you have more than one health problem at the same time. Encourage your friend to discuss all symptoms and behaviors with the doctor. There are many non-addictive drugs that can help with depression or other mental health issues. Sometimes health care providers do not communicate with each other as well as they should, so you can be your friend’s advocate (with his permission) and make sure all of his health care providers know about all of the health issues that concern you. People who have co-occuring issues should be treated for all of them at the same time.
Barriers to Comprehensive Treatment of Comorbidity
Although research supports the need for comprehensive treatment to address comorbidity, provision of such treatment can be problematic for a number of reasons:
In the United States, different treatment systems address drug use disorders and other mental illnesses separately. Physicians are most often the front line of treatment for mental disorders, whereas drug abuse treatment is provided in assorted venues by a mix of health care professionals with different backgrounds. Thus, neither system may have sufficiently broad expertise to address the full range of problems presented by patients. People also use these health care systems differently, depending on insurance coverage and social factors. For example, when suffering from substance abuse and mental illness comorbidities, women more often seek help from mental health practitioners, whereas men tend to seek help through substance abuse treatment channels.
A lingering bias remains in some substance abuse treatment centers against using any medications, including those necessary to treat serious mental disorders such as depression. Additionally, many substance abuse treatment programs do not employ professionals qualified to prescribe, dispense, and monitor medications.
Many of those needing treatment are in the criminal justice system. It is estimated that about 45 percent of offenders in state and local prisons and jails have a mental health problem comorbid with substance abuse or addiction. However, adequate treatment services for both drug use disorders and other mental illnesses are greatly lacking within these settings. While treatment provision may be burdensome for the criminal justice system, it offers an opportunity to positively affect the public's health and safety. Treatment of comorbid disorders can reduce not only associated medical complications, but also negative social outcomes by mitigating against a return to criminal behavior and reincarceration.
Although research supports the need for comprehensive treatment to address comorbidity, provision of such treatment can be problematic for a number of reasons:
In the United States, different treatment systems address drug use disorders and other mental illnesses separately. Physicians are most often the front line of treatment for mental disorders, whereas drug abuse treatment is provided in assorted venues by a mix of health care professionals with different backgrounds. Thus, neither system may have sufficiently broad expertise to address the full range of problems presented by patients. People also use these health care systems differently, depending on insurance coverage and social factors. For example, when suffering from substance abuse and mental illness comorbidities, women more often seek help from mental health practitioners, whereas men tend to seek help through substance abuse treatment channels.
A lingering bias remains in some substance abuse treatment centers against using any medications, including those necessary to treat serious mental disorders such as depression. Additionally, many substance abuse treatment programs do not employ professionals qualified to prescribe, dispense, and monitor medications.
Many of those needing treatment are in the criminal justice system. It is estimated that about 45 percent of offenders in state and local prisons and jails have a mental health problem comorbid with substance abuse or addiction. However, adequate treatment services for both drug use disorders and other mental illnesses are greatly lacking within these settings. While treatment provision may be burdensome for the criminal justice system, it offers an opportunity to positively affect the public's health and safety. Treatment of comorbid disorders can reduce not only associated medical complications, but also negative social outcomes by mitigating against a return to criminal behavior and reincarceration.
When is the best time to get someone into treatment?
It is a myth that an addict must hit "rock bottom" to be ready for treatment. The reality is, treatment works regardless of whether a person has hit rock bottom; and catching a person earlier in the addiction cycle, may mean fewer accompanying problems and a better overall prognosis for long-term recovery. Further, "rock bottom" is a dangerous place to be, and for many addicts, that point is when a near-fatal overdose or other serious health or criminal justice consequence has occurred. If you think a loved one is in need of treatment, it is advisable to do everything in your power to help them find the courage, determination, and means to seek treatment as early as possible
It is a myth that an addict must hit "rock bottom" to be ready for treatment. The reality is, treatment works regardless of whether a person has hit rock bottom; and catching a person earlier in the addiction cycle, may mean fewer accompanying problems and a better overall prognosis for long-term recovery. Further, "rock bottom" is a dangerous place to be, and for many addicts, that point is when a near-fatal overdose or other serious health or criminal justice consequence has occurred. If you think a loved one is in need of treatment, it is advisable to do everything in your power to help them find the courage, determination, and means to seek treatment as early as possible
From national Alliance on Mental Illness
more than one-third of all alcohol abusers and more than one-half of all drug abusers are also battling mental illness.
Abuse of drugs and alcohol always results in a worse prognosis for a person with mental illness. People who are actively using are less likely to follow through with the treatment plans they created with their treaters: they are less likely to adhere to their medication regimens and more likely to miss appointments which leads to more psychiatric hospitalizations and other adverse outcomes. Active users are also less likely to receive adequate medical care for similar reasons and are more likely to experience severe medical complications and early death. People with mental illness who abuse substances are also at increased risk of impulsive and potentially violent acts. Perhaps most concerning is that people who abuse drugs and alcohol are more likely to both attempt suicide and to die from their suicide attempts.
Individuals with mental illness and active substance or alcohol abuse are less likely to achieve lasting sobriety. They may be more likely to experience severe complications of their substance abuse, to end up in legal trouble from their substance use and to become physically dependent on their substance of choice.
Abuse of drugs and alcohol always results in a worse prognosis for a person with mental illness. People who are actively using are less likely to follow through with the treatment plans they created with their treaters: they are less likely to adhere to their medication regimens and more likely to miss appointments which leads to more psychiatric hospitalizations and other adverse outcomes. Active users are also less likely to receive adequate medical care for similar reasons and are more likely to experience severe medical complications and early death. People with mental illness who abuse substances are also at increased risk of impulsive and potentially violent acts. Perhaps most concerning is that people who abuse drugs and alcohol are more likely to both attempt suicide and to die from their suicide attempts.
Individuals with mental illness and active substance or alcohol abuse are less likely to achieve lasting sobriety. They may be more likely to experience severe complications of their substance abuse, to end up in legal trouble from their substance use and to become physically dependent on their substance of choice.
Multiple scientific studies have shown that psychiatric treatments are more effective in people who are not actively abusing drugs and alcohol. Once individuals are safely “detoxed” from drugs or alcohol—or stop abusing drugs that they may not necessarily be “addicted” to—treatment of underlying mental illness may be more successful. This is not to say that people with mental illness cannot be treated while they are still using, rather that treatment of mental illness is generally more effective once one is sober and more able to actively participate in treatment.
Many options exist for people who are newly sober or who are trying to avoid relapse on drugs and alcohol. These can include inpatient rehabilitation centers or supportive housing (e.g., sober houses, group homes or residential treatment facilities). Other people may choose to return home to their friends and family who can be helpful in encouraging newly-sober individuals to continue their efforts. This can be critically important as a significant majority of people will relapse into drug and alcohol abuse at some point in their lives, even if they are eventually able to achieve long-lasting sobriety.
Many options exist for people who are newly sober or who are trying to avoid relapse on drugs and alcohol. These can include inpatient rehabilitation centers or supportive housing (e.g., sober houses, group homes or residential treatment facilities). Other people may choose to return home to their friends and family who can be helpful in encouraging newly-sober individuals to continue their efforts. This can be critically important as a significant majority of people will relapse into drug and alcohol abuse at some point in their lives, even if they are eventually able to achieve long-lasting sobriety.
This is why I find the topic interesting to discuss on a family forum… its important as family members and friends to realize the bulk of the work in recovering from substance abuse, dual diagnosis, falls on the patient… same as it would for heart surgery, diabetes diagnosis, or asthma… BUT family can play, and is often encouraged to play an active role in helping their loved one… especially if they have dual diagnosis and cannot efficiently advocate for themselves... and this is ok… its up to each family member to define their own role in the process, making their own life as healthy and happy as possible.
Dual diagnosis is highly prevalent in our loved ones and friends… do we share this information, do we share the importance of the need for early intervention, for proper treatment of these conditions?
Or do we say it doesn’t matter why they use… they use just because they are addicts.
References from these two sites:
Letter From the Director | National Institute on Drug Abuse (NIDA)
NAMI | Dual Diagnosis: Substance Abuse and Mental Illness
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My boyfriend suffers from depression. He feels abandoned and - in a way - he sort of is.
For some time he's focused on his alcoholism. But the more he focuses on that, the more depressed he gets. I feel like the only way to help combat his alcoholism is by sorting his depression out.
He just got insurance! So hopefully things will work out.
Last night he called a hotline for help. While I wish it could have been me that he called, the fact that he called in general is the most amazing thing ever. For the first time he's willing to take someone else's help. It may be a small step, but it's a step. And I'm so proud of him.
For some time he's focused on his alcoholism. But the more he focuses on that, the more depressed he gets. I feel like the only way to help combat his alcoholism is by sorting his depression out.
He just got insurance! So hopefully things will work out.
Last night he called a hotline for help. While I wish it could have been me that he called, the fact that he called in general is the most amazing thing ever. For the first time he's willing to take someone else's help. It may be a small step, but it's a step. And I'm so proud of him.
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Dreamer - it is huge that he called a hotline, and likely he called them instead of you because he realized it was more advanced and needed clinical help vs a supportive loved one. Hang in there, it's all a journey .
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While depression or other mental illness can be treated while someone is still using substances, I do not believe they can be effectively treated. While using, the brain is being flooded chemically and that will (obviously) effect any course of treatment.
It is not always a poor approach to say that it doesn't matter why someone uses. In my case, I experienced childhood trauma and depression. I continued drinking, using, and other self-destructive behaviors "because of my underlying issues ". The thing about that is that I could use that as an excuse to keep drinking/using. I'd say, "I will never be able to completely quit until I get my mental issues straightened out". That was music to my addiction's ears. A perfect, unending excuse for my addiction to live on!
It wasn't until I realized that it was not necessary for me to have all the answers to my screwed up mind in order to quit drinking and taking pills, that I could stop and get enough distance from daily use to finally end the cycle of addiction. After that, I worked on things at my own pace. The only way to start to work on both addiction and depression is to quit the use of substances first and foremost. Trying to do it the other way around just leads to the vicious cycle, because the effect of alcohol and drugs on brain functioning will forever interfere with any real and significant relief from depression and/or anxiety.
I think it is greatly underestimated the role drugs and alcohol play in depression. Substance use always exacerbates those conditions. In some cases, substance use is the sole cause.
So, for some of us, saying "it doesn't matter why I drink, I can still quit and recover" is life-saving.
It is not always a poor approach to say that it doesn't matter why someone uses. In my case, I experienced childhood trauma and depression. I continued drinking, using, and other self-destructive behaviors "because of my underlying issues ". The thing about that is that I could use that as an excuse to keep drinking/using. I'd say, "I will never be able to completely quit until I get my mental issues straightened out". That was music to my addiction's ears. A perfect, unending excuse for my addiction to live on!
It wasn't until I realized that it was not necessary for me to have all the answers to my screwed up mind in order to quit drinking and taking pills, that I could stop and get enough distance from daily use to finally end the cycle of addiction. After that, I worked on things at my own pace. The only way to start to work on both addiction and depression is to quit the use of substances first and foremost. Trying to do it the other way around just leads to the vicious cycle, because the effect of alcohol and drugs on brain functioning will forever interfere with any real and significant relief from depression and/or anxiety.
I think it is greatly underestimated the role drugs and alcohol play in depression. Substance use always exacerbates those conditions. In some cases, substance use is the sole cause.
So, for some of us, saying "it doesn't matter why I drink, I can still quit and recover" is life-saving.
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Originally Posted by soberlicious 
While depression or other mental illness can be treated while someone is still using substances, I do not believe they can be effectively treated. While using, the brain is being flooded chemically and that will (obviously) effect any course of treatment.
It is not always a poor approach to say that it doesn't matter why someone uses. In my case, I experienced childhood trauma and depression. I continued drinking, using, and other self-destructive behaviors "because of my underlying issues ". The thing about that is that I could use that as an excuse to keep drinking/using. I'd say, "I will never be able to completely quit until I get my mental issues straightened out". That was music to my addiction's ears. A perfect, unending excuse for my addiction to live on!
It wasn't until I realized that it was not necessary for me to have all the answers to my screwed up mind in order to quit drinking and taking pills, that I could stop and get enough distance from daily use to finally end the cycle of addiction. After that, I worked on things at my own pace. The only way to start to work on both addiction and depression is to quit the use of substances first and foremost. Trying to do it the other way around just leads to the vicious cycle, because the effect of alcohol and drugs on brain functioning will forever interfere with any real and significant relief from depression and/or anxiety.
I think it is greatly underestimated the role drugs and alcohol play in depression. Substance use always exacerbates those conditions. In some cases, substance use is the sole cause.
So, for some of us, saying "it doesn't matter why I drink, I can still quit and recover" is life-saving.
It is not always a poor approach to say that it doesn't matter why someone uses. In my case, I experienced childhood trauma and depression. I continued drinking, using, and other self-destructive behaviors "because of my underlying issues ". The thing about that is that I could use that as an excuse to keep drinking/using. I'd say, "I will never be able to completely quit until I get my mental issues straightened out". That was music to my addiction's ears. A perfect, unending excuse for my addiction to live on!
It wasn't until I realized that it was not necessary for me to have all the answers to my screwed up mind in order to quit drinking and taking pills, that I could stop and get enough distance from daily use to finally end the cycle of addiction. After that, I worked on things at my own pace. The only way to start to work on both addiction and depression is to quit the use of substances first and foremost. Trying to do it the other way around just leads to the vicious cycle, because the effect of alcohol and drugs on brain functioning will forever interfere with any real and significant relief from depression and/or anxiety.
I think it is greatly underestimated the role drugs and alcohol play in depression. Substance use always exacerbates those conditions. In some cases, substance use is the sole cause.
So, for some of us, saying "it doesn't matter why I drink, I can still quit and recover" is life-saving.
Thank you so much for your informative post. I appreciate your honesty and how you hold yourself accountable for your choices. We may not be able to control what happens to us, especially when we are growing up, but we can control how we choose to deal with it. It sounds like you are dealing with it in a mature and responsible way and I wish you the very best!
Thank you again for sharing your insight.
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