How does one identify emotional issues related to substance abuse/ depression?
October 9, 2010 9:31 AM   Subscribe

Because: 1) of depression and 2) I got into relationship trouble (with my spouse) because of occasional binge drinking--- I've have had no alcohol for about 7 weeks. I've been on a mild dose of an antidepressant almost the whole time and feel a low-level, but constant, state of mild depression- kind of "zombie-like." I was hoping getting alcohol off the table would reveal "emotional issues" as to why I've enjoyed binging , but that really hasn't happened, even with therapy (about 7-8 sessions - we've just kicked around painful events that probably most people have encountered one way or another.) Soooooo, the question is: How does one define or identify "emotional issues" related to substance abuse and/or depression? (beyond therapy, eliminating substances)
posted by anonymous to Health & Fitness (13 answers total) 1 user marked this as a favorite
I am kind of confused about what your specific question is but I can say that antidepressants can take a while (4-12 weeks) to kick in full force. You might need a different one, or at least more time with your current one. Congrats on being sober for 7 weeks. Please let a doctor know if you relapse because mixing street drugs/alcohol with mental health meds can be messy and sometimes fatal.
posted by ShadePlant at 9:59 AM on October 9, 2010

Oops. What I meant with "might need a different one" is in regards to the "zombie" feeling. It could be the meds, it could be something else... IANAD but feeling like you want braaains all day can't be good.
posted by ShadePlant at 10:01 AM on October 9, 2010

There aren't always reasons for depression. You can look for them, but you might not find them. 7 weeks may not be long enough for anti-depressants to work, or you might be on one or a dose that doesn't work for you, but if you believe that if only you could recognize your "emotional issues" you could snap out of it is not always true. It really is a chemical imbalance, and it could be caused solely by chemicals.
posted by brainmouse at 10:07 AM on October 9, 2010

Identify and express all your feelings honestly, and don't think of them as "emotional issues," because then they seem like something dirty that you shouldn't have and need to get rid of. They're just feelings, and everybody has them, both good and bad ones.

In my opinion, it's the feelings like shame, anger, regret, anguish, guilt, and so on, that when we don't own up to them and express what they're about, start to haunt us, and that's when we start trying to push them out (through avoidance, or substances).

They won't go away though: they are usually trying to tell you something about the ugly parts of your life that you either need to face up to, get help on, or take responsibility for.
posted by Theloupgarou at 10:13 AM on October 9, 2010 [1 favorite]

I wish you'd given a throwaway email address.

For one thing, seven weeks sober isn't terribly long.

However, I'll say that I'm in a pretty similar boat to you (and actually don't really have an answer). I cut alcohol out of my life at the beginning of the year but it didn't fix or reveal the underlying issues (at least no more than I was already aware).

I'm back in therapy now (that had always been the idea but it took me a while) and my therapist's opinion is that talking issues to death can be pretty pointless as long as you don't get to the actual emotions. Personally I have tremendous problems articulating (and even feeling) emotions. I can rationalise it all perfectly well, but that's been pretty useless so far.

So I guess if I had to draw a conclusion from my rambling it would be to maybe try a different approach in therapy? Or a different therapist?
But also accept that it will take time.
posted by ClarissaWAM at 10:19 AM on October 9, 2010

Sometimes drinking isn't because of some Issue, but because of a desire to want to escape from a few minor issues. And it turns into a binge because it feels good to get good and disconnected from the real world.

That's the good news and bad news about stopping drinking- the highs and lows are gone, and in comparison sometimes even good normal seems monotonous. That's part of the recovery process, to realize that those highs and lows were artificial and that real life is better.
posted by gjc at 10:47 AM on October 9, 2010

The "zombie-like" feeling you're describing is something to talk to your doctor about. I think you might be experiencing "flat affect" which can happen to some people on an anti-depressant. Talk to your doctor. Also, if your GP is prescribing the meds for you, I'd recommend finding a psychiatrist because they can help you find the right medication.
posted by radioamy at 10:49 AM on October 9, 2010

Realistically, and this is tough, whatever emotional stuff you got going on was probably years in the making, it'll be probably 2-3 years of work to fix.

Sadly, emotional work isn't like building a house- it's not like if you spend 80 hours this week you get "ahead", it's more like farming- you have to work, then you got to be patient for things to grow, and come back and do more work.

Getting the substance off the table is a big step. Be patient, it sucks, but it will pass and with you being active about things, you'll be amazed at how much life can improve, it's just going to take time and work.
posted by yeloson at 12:04 PM on October 9, 2010

For one thing, seven weeks sober isn't terribly long.

Seconded. Give it a while, if not for anything else but to get used to a lack of self-medicating oneself. The time varies for everyone, but 7 weeks is just the start to feeling well, especially if you are taking prescription medication.

How does one define or identify "emotional issues" related to substance abuse and/or depression? (beyond therapy, eliminating substances)

To answer this question, you really need the perspective that time will give you. There is no magic pill, but patience along with therapy and a treatment plan will yield results. Just be patient.
posted by lampshade at 12:27 PM on October 9, 2010

Nthing changing the med if it makes you feel like a zombie. Lower dose, higher dose or different med. See doctor. This itself could be covering up hidden feelings if there are some. Some antidepressants make you feel numb in wrong dose or wrong drug for person.

And there are lots of reasons for binge drinking that don't involve deep emotional problems being covered up. You might be lonely, you might drink that way because that's the way your social group drinks, you might enjoy the high, you might want to escape from the everyday world like everyone does sometimes, you might have a gene that makes binging particularly enjoyable.

Not all binge drinking is addiction. Not all addiction is driven by "deep emotional issues" and not all psychological problems involve something hidden or unusual or deep being covered up. Many problems are exactly what they seem like on the surface. Sometimes depression is just chemical. Sometimes binging is just fun.
posted by Maias at 3:33 PM on October 9, 2010

Good on you for quitting drinking. Now that you are on anti-depressants, it's even more important to stay sober.

It's gonna take a while, maybe a couple of months, for the new medications to become fully titrated, this is also dependent on what you are taking as well.
posted by TheBones at 7:01 PM on October 9, 2010

If the depression meds are new, it's definitely something to talk with your doc about.

In a bigger, existential sense:

Drinking is about disconnecting from life.

Depression often manifests itself as a feeling of disconnection.

Lots of things we do that aren't good for us -- drinking, drugs, too much tv, too much ask metafilter (I tease guys!) -- we do in an attempt to escape from being in the moment.

So a simple thing you can try at any moment is really being present. Take a deep breath and then just take a good look around you. Whatever your surroundings are, try to see them as if it was the first time you'd ever done it. Then take a couple more deep breaths and go back to whatever you were doing.

It's not a world-changing thing, but as someone who struggles with similar things, it gives me a moment of grounding, which I usually need more than I realize.
posted by missjenny at 5:35 AM on October 10, 2010

As a recovering thing I learned about myself is that it wasn't any circumstance or thing that caused me to drink. It's not one thing I could point to or something that happened to me as a child. Sure I had some things rough as a child, but many people had it way way worse than I did and did not become alcoholic. The reason I drank is because I am an addict/alcoholic. Drinking is the way I responded to stress/emotion etc. I had to relearn new coping skills for life and truly change the way I think about everything. It is a process and I learn more and more as each day goes by how to live sober. I thought the hardest thing would be not drinking. It hasn't been. The hardest thing for me has been actually living life every day and applying the new coping skills, or as its called, living life on life's terms. I had been so disconnected from my feelings for so long when I was drinking that I had trouble identifying many of my feelings when I became sober. So my emotional issues, as you call them, come up as I live sober and life's situations arise. In the beginning, because I was still so new at using my new coping skills, little situations seemed very big to me and I needed help with everything. Now as I get better at applying my tools, it is much easier. So my suggestion is to take it easy, build a great support group, so that when the issues and emotions arise, you are well prepared and just realize that this is a lifelong journey that takes one day and sometimes one moment at a time.
posted by heatherly at 11:33 AM on October 11, 2010

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