Getting sober requires that we attend to the various deficits that long-term chemical use caused in various parts of our life. I've met many clients who told me that they never get sick nor did they have any injuries. The reality is that many people engaged in active addiction have masked illness by using alcohol and drugs, much like long-term use of Opiates can mask the pain of injuries. I don't think this is much different than chemical use masking emotional problems or mental health issues. The National Institute of Drug Abuse suggests that at least 50% of clients with a history of disordered chemical use also have a co-occurring disorder, with one of the most prominent issues being depression. In this article I would like to discuss the manifestations of major depressive disorder and offer a few suggestions to manage your illness.
According to the National Institute of Mental Health Major Depressive Disorder exists when five of the following symptoms are present nearly every day: "very low mood, which pervades all aspects of life, and an inability to experience pleasure in activities that were formerly enjoyed. Depressed people may be preoccupied with, or ruminate over, thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness, hopelessness, self-hatred, thoughts of death or suicide, or have a suicide plan. Depressed individuals have a shorter life expectancy than people who do not suffer from depression, in part because of greater susceptibility to medical illnesses and suicide".
The primary focus of dealing with depression is the management of symptoms to decrease the effect it has on a patient's life. Effectively dealing with depression requires the need to take into consideration lifestyle, history of alcohol and drug use, family history, other medications a patient has used or is using, as well as diet. Previous mental health history is also a significant indicator of a current or future depressive episode.
The first line approach for many providers is to consider pharmacology in conjunction with therapy. Medication is helpful in that it can help support deficient brain chemistry that lends itself toward depression. Medication can also create new neural pathways that have been depleted by lifestyle choices, trauma, and physical problems such as illness and other blood disorders. Using therapy or counseling to augment medication has proven to be very helpful. Therapy can be helpful in addressing thinking errors or talking about issues that give rise to depressive thoughts. There are various kinds of talk therapy so before you pick a therapist be sure to ask them for a free consult to see if you connect. It is important to note that the relationship you have with a provider, not their orientation or education, is the key determining factor in the success of your therapy.
Exercise has been shown to be effective for people who do not want to take meds or for folks who have a religious or spiritual opposition to healthcare. I am quite fond of martial arts.
Medical approaches have been helpful for people who have treatment resistant depression. These can include Electroconvulsive therapy, deep brain stimulation, Repetitive transcranial magnetic stimulation, Vagus nerve stimulation, and Cranial electrotherapy stimulation. Be sure to do your research as there is some evidence that some of these approaches can have an effect on memory.
Bibliotherapy is helpful for people who want to try self-study. This can include books, movies, assignments, articles, poetry and books on tape. Blogging or contributing comments to various sites can be very helpful. Listening to podcasts could also be another option to consider.
Pet therapy has been shown to be quite valuable. The therapeutic connection between pets and animals has been well-established in reducing stress and eliminating depressive thoughts.
I would be remiss if I didn't include volunteering or service work. My grandmother used to say that if you want to feel better, try doing something for someone else. I think that recommendation is spot on.
Spending time with friends, support groups, and engaging in hobbies can have a very positive outcome for people who feel stuck. Remember, more of something doesn't work, trying something different is the key.
Addressing your alcohol and drug use needs to be a priority if you want to weed out your chemical use as a factor for your emotional distress. Addictions affect various neurotransmitters and can alter brain chemistry to the point that it impacts functioning in several important life areas. Various chemicals act as central nervous system depressants and cause depression. Long-term use of stimulants is known to cause depression. If people drink or use to change how they feel, it is important to address what may be a motivator for your chemical consumption. In the moment using alcohol or drugs tends to feel like it solves problems, but the reality is that the problems you solve only creates problem you can't see at the time.
Be sure to talk to your medical provider before try any approach as your situation is different and your background and lifestyle choices need to me taken into consideration before you start on a path to deal with your mental health issues.
Good luck on your path.