Are you or your employees using alcohol or drugs to cope with stress?

Mood disorders such as depression or anxiety can cause distressing symptoms including sleep problems, nervousness, and lack of interest in pleasurable activities. So it is not surprising that people with these common disorders sometimes medicate themselves with drugs or alcohol in an attempt to get some relief.

Unfortunately, this relief is nearly always short-lived, and drugs or alcohol are likely to make the problems worse. All mood-altering chemicals have a rebound effect, so even if they give relief initially, they usually cause the symptoms to worsen afterward. There is also the risk of developing a substance-abuse disorder in addition to the mental health disorder, known as a “dual disorder.”

People with a dual disorder need to treat both the alcohol or drug dependency and the mood disorder to fully recover. If you suspect that you may be relying too heavily on alcohol or drugs to cope with sadness or anxiety or to help you sleep or stay awake, it’s important to seek professional help as soon as possible. Once the line to addiction has been crossed, the substance dependence persists even after the emotional issue has been resolved.

What is “self-medication” for depression or anxiety?

Self-medication for depression or anxiety refers to the use of substances to relieve symptoms such as racing thoughts, low energy, sleeplessness, or sadness. Substances commonly used to cope with these conditions include alcohol, cocaine, marijuana, and prescription drugs such as tranquilizers and painkillers. For example, someone who has been feeling very anxious may use alcohol or marijuana to experience a calming effect. Likewise, someone who is depressed may use cocaine or other stimulants to “make it through” the day or an event. It is particularly problematic when an individual uses one substance to “get up” and then another to “come back down,” which is a common pattern for those who use substances to deal with the symptoms of a mental health disorder. This can lead to feeling dependent on the drugs or alcohol for daily living. Substance abuse can ultimately worsen the emotional symptoms it is being used to manage. This is particularly true when the cycle of addiction and withdrawal begins, creating a chemical imbalance when the substance is removed.

Depression and anxiety are the two most common mental health issues. About 18 percent of Americans have an anxiety disorder, and nearly 7 percent have depression. People with chronic depression or anxiety are at increased risk for developing an addiction. Research indicates that more than half of the people with mental health concerns also abuse drugs or alcohol.

Signs of a problem: 

Here are some of the common symptoms of depression and anxiety:

• irritability
• poor concentration
• trembling or sweating
• irrational fear of relatively safe settings (for example, movie theatres)
• suicidal thoughts
• excessive discomfort in social situations (for example, going to a party or a new place)
• insomnia
• feeling blue
• isolation
• dizziness or lightheadedness
• decreased energy

Here are some warning signs of a substance-abuse problem:

• blackouts or memory lapses
• inability to stop or control use of drugs and alcohol (for example, being unable to just have one drink or needing to use cocaine every weekend)
• interference with work responsibilities (for example, frequently arriving late to work because of hangovers)
• feelings of remorse after using drugs or alcohol
• preoccupation with either drugs or alcohol
• continued use of drugs or alcohol despite negative consequences

However, not everyone who self-medicates has a substance-abuse problem or experiences the symptoms listed above. To determine whether you are self-medicating, you might think about your particular pattern of drug or alcohol use and whether you have any of the symptoms of depression or anxiety. For example, perhaps you have an intense fear of meeting new people and find yourself needing to drink heavily in order to enjoy yourself at a social function. Or, perhaps you feel sad and have low energy in the evenings unless you use cocaine before coming home from work.

How to get help

It can be difficult to acknowledge that there may be a problem. It is normal for people to think, “I am just going through a bad time right now, but it will go away.” Sometimes looking at the length of time you’ve been using drugs or alcohol can be helpful in realizing that it is time to deal with the issue. If you identify with any of the symptoms or behaviours associated with substance abuse or addiction, taking action and getting an assessment can help remove any lingering doubts. Depression and anxiety can sometimes be situational, triggered by major life events, such as job loss or a child going off to college. Whatever your experience is, it’s important to remember that treatment is available to support you.

Stopping certain behaviours, even when you recognize that they are not helpful, can be challenging. By seeking help, you are not making the decision to stop self-medicating immediately; rather, you are giving yourself the opportunity to find out what assistance is available to you. Multiple treatment options are available, including psychotherapy, support groups, and sometimes appropriate medications, to alleviate the underlying problems for which you were using alcohol and/or drugs to cope. Overcoming substance abuse can open the door to developing healthy, long-term coping strategies.

But each person in recovery has different needs depending on the nature and severity of his or her problems. That’s why it is critical to get an evaluation by a doctor or mental health professional before deciding on a course of treatment.

As a first step, you might try the following options:

Contact your employee assistance program (EAP). Your EAP or other confidential counselling service can give you information about resources in your community and elsewhere that can help you decide what steps to take next.

Make an appointment with your primary care physician or family doctor. Your health care provider may be able to evaluate your situation and make referrals for treatment options. In fact, in many managed care plans, your primary care physician will need to authorize these services. Contacting your health care provider is very important because he or she can conduct a thorough medical exam to rule out any underlying medical problems. This can be critical because the symptoms of anxiety and depression can sometimes be caused by medical problems.

Get an evaluation at a substance-abuse treatment facility. To find out about treatment facilities in your area, you might contact the Mental Health Commission of Canada or call its helpline, 833-456-4566, text 45645 or click http://www.crisisservicescanada.ca/.

Go to a local community mental health centre. These clinics typically provide mental health care for little or no cost.

Resources

Alcoholics or Narcotics Anonymous
12-step programs designed to help people suffering from a particular form of substance abuse. Alcoholics Anonymous: http://www.alcoholics-anonymous.org, Canadian Assembly of Narcotics Anonymous: http://www.cana-acna.org, or Cocaine Anonymous: http://www.ca.org.

Anxiety Disorders Association of Canada
http://www.anxietycanada.ca/
This website provides resources and information about anxiety disorders.

Canadian Centre on Substance Abuse
http://www.ccsa.ca/
CCSA changes lives by bringing people and knowledge together to reduce the harm of alcohol and other drugs on society.

Canadian Mental Health Association
http://www.cmha.ca/
As a nation-wide, voluntary organization, the Canadian Mental Health Association promotes the mental health of all and supports the resilience and recovery of people experiencing mental illness.

Double Trouble in Recovery (DTR)
http://www.bhevolution.org
Double Trouble in Recovery is a 12-step program for people with dual disorders. Once you’ve connected to the website listed above, search “Double Trouble in Recovery.”

Mood Disorders Society of Canada
http://www.mooddisorderscanada.ca
Mood Disorders Society of Canada (MDSC) is committed to ensuring that the voices of consumers, family members and caregivers are heard on issues relating to depression, bipolar illness, and other associated mood disorders.