Mental Health

Depression is not uncommon in the first year or so of recovery. Some people manage to avoid it entirely, but many of us experience it to one degree or another. That’s because sometimes the ability of our brains to produce the chemicals that make us feel good has been damaged by the alcohol and other drugs, and it takes time for the necessary repairs to take place.

Unfortunately for many of us, the drugs that we used masked underlying problems.  For example, roughly 65% of alcoholics are known to suffer from pre-existing emotional problems, most of them brought about by imbalances in brain chemistry.  Those folks usually find that the removal of the drugs brings out the underlying conditions, often severely so.  Thus, the idea that all we have to do is stop drinking and straighten up is often — sometimes tragically — not the case at all.

Whatever the case, if we end up feeling that we’re worthless, that life is not worth living, and that it’s just not worth the effort, that’s bad. Depression kills people every day — far more than it should, because in most cases it’s treatable.  The problem is that, in some cases, it worsens so rapidly that the time to begin effective treatment can be quite short, so it doesn’t pay to wait around.  If you’re feeling depressed to the point of not caring about your life, see a doctor.  Right now!  If you’re having thoughts — even casual — of self-harm, then you’re already in crisis.

Many folks have been on antidepressants, felt that they didn’t work, and stopped taking them. Most antidepressants take from three to eight weeks to have their full effect, and sometimes in the early treatment period they seem to have no effect at all. Combine that with an addict’s conviction that taking a pill should make us feel good right now, and you have a good chance that the patient is going off the meds before they have a chance to help.  Others have found relief, and stop because they believe they’re cured.  AD’s are not like antibiotics.  They cure nothing, they simply reduce the effects of the depression and allow us to function.

Not all antidepressants work for all patients, and if we toss one before it has a chance to work, we run the risk of missing the one that was right for us. Second, and perhaps more important, is the fact that sometimes the medication was beginning to work and we just didn’t notice. In that case, if we quit suddenly, we can experience a rebound effect that throws us straight into deep depression.

This brings us to the big point we’d like to make here. Depression is nothing to fool with! There is an unfortunate attitude among some of the laypeople in the recovering community that antidepressant medications are just another drug. That is emphatically not true!

Antidepressants (ADs) are not the sorts of drugs that most recovering people mean when they say drugs. They are not addictive, in the sense of creating tolerance and cravings for more. They will not interfere with recovery by preventing our bodies and brains from repairing themselves — in fact, they assist in the process. They do not alter our mood, except for the better, and they do not interfere with our judgement. They do not trigger the addictive process, and they do not make our lives unmanageable.  Quite the opposite: antidepressants in recovery can lift the weight of the world off our shoulders, and contribute to our recovery by giving us the ability to be enthusiastic about it and enjoy its rewards.

The greatest danger of antidepressants is the danger of not taking them when we need to. Depression can not only lead to self-harm in its more severe forms, it can keep us from seeing the gains we are making in recovery, putting us at increased risk of relapse.

That said, there are some downsides. In some people, ADs affect the ability to feel and express emotion. Some have other side effects that can vary with the particular medication. However, none of these are as dangerous as suicidal thoughts or acting out, or as harmful to recovery as a relapse because “Life sucks, so I might as well just use.” And, as mentioned earlier, going off an antidepressant without a physician’s guidance can have devastating results. Any undesirable side effects should be discussed with a physician.  It may be necessary to change a dosage, or switch drugs, but do not stop on your own!

We’re not recommending that recovering folks run out and look for a doctor who will prescribe antidepressants, nor are we offering them up as some sort of magic pill. What we are trying to get across is that we need to listen to the experts, and we need to be careful about making medical decisions that we aren’t qualified to make.

For some of us, antidepressants in recovery can be a tool, but they are not the whole answer. The answer, as always, comes from remaining abstinent and learning how to live without addictive drugs through therapy, support groups, and an organized program of recovery, but it makes sense to utilize all the tools if we need them, especially if failure to do so can kill us.

Important Note: This article should not be taken as, nor is it offered as medical advice. You should consult with your personal physician or a specialist, as appropriate, before considering the use of, or ceasing the use of, any medication.