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Q&A: Addiction and Mental Illness
Drugs and alcohol don’t make life easier
Destiny Frasqueri

We spoke with Ira Moses, Ph.D., Director of Training at the William Alanson White Institute in New York City, about the connection between addiction and mental illness, the influence of the people around us, and how to seek help.

Q: What’s the first thing you check out when someone comes to you with a drug or alcohol problem?

A: Many people don’t just have an addiction problem—they may also have a mental illness or personality disorder. A psychiatrist, psychologist, or social worker can do something called a diagnostic evaluation by asking basic questions about the patient’s history. If there’s a history of alcoholism, the person doing the evaluation will want to see if the person also has major depression or bipolar illness. Lots of people self-medicate those two conditions with drugs or, most often, alcohol.

A lot of people don’t know they’re depressed. Sadness is a very normal feeling; we all have it sometimes. Everybody deals with issues in life, but being diagnosed with a clinical or a psychiatric depression means that feelings including hopelessness and low self-esteem haunt you most of your life. Being sad doesn’t mean you’re clinically depressed.

Q: If you feel depressed, where can you seek help instead of turning to drugs or alcohol?

image by Ismaili Torres

A: Start talking to a social worker or psychologist to see if therapy can help; sometimes that’s enough. But sometimes one may need to also try an anti-depressant after consulting with a physician. People sometimes fear they’ll get addicted to them, but anti-depressants (Prozac, Zoloft, Celexa, etc.), are not addictive or habit-forming. You don’t build up a tolerance to anti-depressants and you can’t abuse them either; they don’t get you high. Sometimes anti-depressants cause side effects, though, so if you have concerns, you should talk to the prescribing doctor and ask questions.

If you’ve been getting high because you’re depressed, you may need a mild dose of an anti-depressant before starting drug treatment. The key is that everybody’s different, and you and your doctor need to carefully monitor your prescription. Anti-depressants will affect different people differently.

Though many teens self-medicate with marijuana, it is not going to help your depression, and it may interfere with your living. Teenagers are setting in stone their coping functions. When you’re 17, life could look hard, but hard things will keep happening throughout your life. Do you always want to be dependent on marijuana as the way you cope?

Q: What makes drug treatment work best?

A: Successful drug treatment is treatment of the entire individual—not just the physical and biological self. An individual is not just her brain chemistry; she’s also the product of her relationships: her family, her support system, and how she interacts with others. Who you are is often dependent on the environment you come from.

image by Ismaili Torres

Recovering from an addiction often involves finding someone to help you stay off the drug. If your older brother’s a stoner, and your sister’s dating a drug dealer, and your neighbor’s in jail, those are tough environments. It’s good to have someone supportive who can help you avoid those negative influences when you’re struggling with addiction.

It’s extremely helpful to find a sponsor or someone you feel safe with, someone you can talk to about your problems and the anxieties of growing up. I think drugs are what people fall back on to deal with the loneliness and fear of living in this crappy world sometimes.

You need to manage how you feel about yourself and your emotions. How do these drugs help you? These drugs make you feel good, but are there alternative pleasures in the world?

A shy, anxious, inhibited person may feel fantastic on drugs and get in touch with pleasurable feelings. If the drug treatment counselor represents the side of denying that person pleasure, it’s not going to work. The person has to build up alternative senses of self to give up the drug.

If you’re part of a group of users, try to replace that group of users with another, more positive group. Find a group like a sports team or a club, where the focus is on something besides using drugs or alcohol.

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