Antidepressants In Recovery — Just Another Drug?

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.

Chaz Shares About “Outside Help” in Recovery

Alcoholics and other drug addicts in recovery sometimes run into problems beyond the ability of the recovery fellowships. There's a comment about this over on “Putting The Pieces Together”, left by Chaz, of Chaz Recovering.  It's worth a read.

I have often heard said by many 12 step members that “The Program” is all we need. To them I would suggest, “speak for yourself”.  Read more…

There Are Bad Drugs and Good Drugs, And You Probably Aren’t Qualified To Decide Which Is Which

This Memorial Day and all those following will have a special meaning for us.  The 29th of May marked the one-year anniversary of our granddaughter's suicide.

The death of a beautiful 19-year-old is always tragic.  Cadi's was especially so, because it almost certainly didn't have to happen.  She suffered from profound depression, had gone off her medication (which had been working well), and had been drinking.  The details don't matter.  She's gone, along with a piece of the hearts of everyone who knew and loved her.

The point here is that there are definitely good drugs and bad drugs.  I bring it up because in my correspondence and other contacts with people in recovery I often run across their expressed desires to get off all drugs, not just their drugs of abuse.  This unfortunate impulse is often supported by people who consider themselves to be well-versed in recovery issues but who, in actuality, are just people with opinions, not facts.

We have to keep a couple of points in mind here — important facts about addiction, depression and recovery.

  • Addiction causes changes in our brains that take from one to two years to return to “normal,” (if they ever do).
  • Depression is part of withdrawal, and “post acute” withdrawal can last for many months.
  • Antidepressant drugs can help, but they have their withdrawal issues as well.

As all addicts and many other folks know all-too-well, withdrawal symptoms are, generally speaking, the opposite of whatever pleasurable effects the drug may have had.  To put it another way, we took drugs or drank to feel good, then we did it to feel normal, then we did it because we had to — but in all cases, when we stopped taking them we felt discomfort ranging from icky to “Oh My God!”  If we used uppers, we were depressed when we stopped.  Quitting downers made us feel agitated, have blood pressure spikes, etc.; and our digestive systems' reaction to the removal of opiates, which cause constipation, made us throw up along with all the other withdrawal symptoms that we know and appreciate.

Well, folks, antidepressant drugs cause withdrawal too, and the major one is — you guessed it — depression.  The return is often sudden and profound.  It can also be fatal, especially if we combine it with a depressant like alcohol.  That's what Arcadia did, not too long before she jumped from a 200-foot bridge.

If you are on antidepressants, for heaven's sake don't stop taking them without careful detox by medical people who know what they are doing.  This is especially true if you are in early recovery, or if you are actively using other drugs.

It can stop your recovery.  Dead.

What A Perfect Excuse To Get Wasted!

A young woman I knew killed herself last year. The details don't matter, but for the sake of anyone dealing with depression in themselves or a family member, I will mention that she had gone off her meds and was drinking.

That's not why I'm writing, though. The anniversary is coming up two weeks from Saturday, and I was just thinking about how easy it would be to use that as an excuse to pick up.

Let me hasten to add that I feel no desire to use. I haven't felt those little monkey feet on my back for several years now, but the point is, it would be such a great excuse! What an opportunity for Angst! Self-pity! Posturing! Seeking sympathy! The “poor me's!” Screwing up my own head! Justifying! And finally, for using, and then making excuses for using, and using some more.

That's the way we addicts operate. Relapse comes before we pick up, and then we look for ways to justify what we already wanted to do anyway. Grief is a wonderful excuse. People “understand.” “Oh, he was under such stress! You know, this time last year…”

We're folks who will try almost anything to keep from feeling bad, whether emotionally, physically or spiritually — until we finally learn that it's impossible. For many years we kept that wolf at bay with drugs, including alcohol. Fact is, there is nothing about the death of a loved one that requires the use of drugs.  People have been grieving successfully, cold turkey, for thousands of years.  That is, unless we're looking for an excuse.

On the 29th I'll cry, and I'll hold the people close to me, and I'll grieve the way humans were meant to deal with sorrow, loss, and anger. I'll probably hit a meeting. Maybe a couple. One thing's for sure: I won't insult my granddaughter's memory by trying to forget.