Ask an Expert: What Can I Do To Avoid Self-Medicating?

By Janice Dorn 01/29/15
Today's question is on what to do when you need to take the edge off without using drugs or alcohol.
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I am a 43 year old woman who has been struggling financially and gotten into debt as my industry is going through transformations. I am drinking a lot more now to help with the anxiety. I don’t seem to relate well to AA though I have a spiritual side to me. I am thinking of some anxiety and sleep meds but I know I am an addictive personality and am afraid to go on one of those. I read about the horrors of Ambien, for example. What kind of help you would suggest? - Natalie

Janice Dorn: Thank you so much for reaching out to us for help. You have shown great courage in doing this, as well as some excellent insight. It may or may not be of comfort for you to know that you are not alone in your worries about financial issues. It is estimated that 75% of the American population lists money worries as Number 1 on the list of situations that are causing them stress. Number 2 on the list of stressors - coming in at about 70% of the population - is concern about work. You have a double dose, since you are struggling with both financial and work issues.

You are under a huge amount of stress. This is manifested as anxiety and you are drinking to try to calm the anxiety. To the best of my knowledge there is not a definitive study on the incidence of alcoholism resulting from stress, or on the relationship between drinking behavior under stress and the development of alcoholism in human beings. However, the fact that you admit that you have an “addictive personality” puts you at high risk for development of alcoholism and other addictions. Perhaps you have some family history of alcohol or substance abuse that adds further risk factors? I don’t know this from your question, but I suspect this may be the case.

I have written and spoken a lot about what stress is doing to our society. I have labeled this the Dorn Dart Board. Take a medical book with just about every illness known to human beings and put all of the illnesses on a dart board. Now throw a dart. That dart will land on an illness that is either: 

(1) Caused by stress

(2) Made worse by stress

(3) If you get it, you are going to have stress

In my opinion, stress and the inflammation associated with stress are intimately related to the majority of illnesses of our time. You have stress that may well be causing or manifesting as anxiety and insomnia. The first thing to do is to go to a really good Family Practitioner and have a complete physical workup to rule out that the anxiety and insomnia are not secondary to another illness such as a thyroid, diabetes or a cardiac condition. If any physical cause is ruled out, the physician is like to recommend an anti-anxiety medication (such as a benzodiazepine) or a sleeping pill (such as Ambien).

At that point, just say “No” and ask the doctor if he or she can recommend any complementary or alternative treatments for your anxiety and insomnia. If the physician says “No” or “Nothing like that really works,” I suggest you politely thank him or her and leave (quickly!) before you are given a prescription for an additive drug.  Taking prescription drugs for anxiety or insomnia is the worst thing you can do in your present situation. You may want to seek out a homeopathic or naturopathic physician who can possibly offer you more natural and non-addictive alternatives to classical (allopathic) remedies.

In terms of support, get as much as you can. I don’t know anything about your life, but I suspect you may be presently unmarried and have no children or a child who may not be completely supportive to you. You are intelligent and resourceful enough to research your current challenge. If you have a trusted friend who is not an addict, reach out to him or her. Join a support group. There are many alternatives to 12-Step Programs. You can find these out by doing a search in your area for addiction recovery that is not 12-Step. Depending on where you live, you should also be able to find a therapist who treats addiction without the use of the 12-Steps. You will likely be well-served by exploring more deeply the spiritual side of you, as this may lead you to stress-reducing activities such as meditation, yoga, or Chi-gong (Qigong)

In terms of your financial issues, the most important thing is to begin to get out of debt. There are a number of ways to do this that are beyond the scope of this answer. You may want to start by making an appointment with a certified financial adviser (CFA). Make sure the person is licensed and reputable. If you pick the right one (many will give you a free initial consultation), you will be helped greatly. You will have to make some significant changes in the way you look at money and the way you spend money. A good financial adviser can be a great help to you in getting started. I caution you about employing so called debt counseling agencies or services. There are some that are reputable, but, as a general rule, you have to be very careful with these. There are few life situations that are as burdensome and troubling as being in debt. Having a plan to get out of debt is likely to reduce your anxiety and allow you to get some decent sleep. 

I really would like to hear back from you about what I have suggested.   Your question is a great one that affects so many people. I have really only scratched the surface in terms of an attempt to help you. If you wish to write more, please do so.

There is hope!

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Janice Dorn, MD, PhD, specializes in psychiatry, addiction psychiatry and addiction medicine. She holds a PhD in Anatomy and has done extensive research and teaching in brain anatomy and physiology. She is also an expert on addiction to stock trading and on stock trading itself. Her second book, Mind, Money and Markets, with co-author Dave Harder, is scheduled for publication in the fall.   Full Bio.

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