Depression: The Enemy Within

By Deborah Bosley 03/17/15
Addicts and alcoholics often mistake their symptoms of depression as a sign that the program is not working for them and leave recovery altogether.

Depression is a complex illness. Subject to any number of variables, it can be impossible to understand and is torturous to live with. It is a topic awash in mythology, a magnet for opinions so strong that it can be difficult to discern the facts. Like snowflakes, no two experiences of depression are the same. It comes in a variety of forms, from sledgehammer hard to subtle and pernicious. It will leech joy and hope from the most advantageous circumstances and bring utter devastation to those without adequate support. Many of us lose years of our lives to this murky fiend, years which might otherwise have been spent productively, if not happily. Some of us, wearied by the unrelenting anguish, will end our lives altogether. Like addiction, mental illness is a killer, yet within recovery circles there is an often grotesque misunderstanding about its nature. 

Addicts and alcoholics often mistake their symptoms of depression as a sign that the program is not working for them

Depression had been a regular feature of the last 10 years of my drinking; I had been prescribed antidepressants by my doctor. In AA, I learned that in all likelihood it was the drink and drugs that had caused my depression in the first place. I was in thrall to the promise that I might fully expect this difficult cast of mind to right itself within the first few months of recovery. For me, this discovery was a thrilling one; I hungrily sought advice from old-timers. Two women I particularly admired assured me that taking antidepressants was not consistent with working a "proper" program of recovery. Against the advice of my doctor, I slowly withdrew from my medication with every hope of sailing serenely toward recovery and good mental health.  

Nobody was more surprised than me when I celebrated my first year sober by having a complete breakdown. The fall was swift and hard. For many months, my waking hours were dominated by a fear and despair so acute that I found it difficult to accomplish the smallest tasks, or even leave my bed. I kept "handing it over" to my higher power, but my higher power, it would seem, could not quite help me with this one. Unlike any depression I had experienced in the past, this one felt like falling off the edge of the world. I was beyond reach and could not see the point in staying alive—even for my young son. It was with a sense of irony that I came to see that devastating though my addiction had been, it had in some small sense provided a shield between me and the most acute symptoms of my depression. Miraculously, I managed not to drink during the 18 months it took me to climb out the well of despair, but at the time it seemed a small comfort.

During that period, I met the man who is still my psychiatrist today. Kind, clever and very patient, he spent many hours talking with me before arriving at his diagnosis; I had a mood disorder known as bipolar II. Bipolar II differs from the classic model of clinical depression in that there are likely to be repeated cycles of the illness punctuated by spells of agitation—this has been my experience. I have reluctantly accepted that I will never be free of my condition, but medication gives me a fighting chance, and without it, I do not function. I know because I have tried and the results were predictably disastrous. Seeking the help of therapists is also recommended and for those with mild-to-moderate depression it can be incredibly helpful, but it is debatable that therapy alone will pull a person through a deeply entrenched spell of clinical depression. These days, I take my medication, hang on to the good spells, work hard at my recovery and pray for the strength to endure the tough times. Without the help of medication, I doubt I would have reached the milestone of 10 years of sobriety this year.

There is, at the heart of the controversy over taking medication in recovery, a willful ignorance and damaging double standard. We are encouraged to view our addiction not as a moral weakness, but an illness. We are not bad people trying to be good, we are told, we are sick people trying to get well. This dignified common sense approach is sadly not always accorded to afflictions of the mind. All but the most fleeting depressions are incontrovertibly biological in origin and all the prayer, step work and reaching out to other alcoholics will not change its nature. Depression is a medical condition, which requires a medical solution. Is the brain not a physical organ like the others? Nobody would suggest that a person taking medication for heart disease or diabetes should aim to free themselves of this treatment so that they might enjoy a "proper" recovery. 

There is also a weird form of snobbery, which skewers the debate that somehow natural remedies including diet, exercise and meditation are superior to their chemical counterparts. From personal experience, I can attest that all these things are an essential part of an ongoing maintenance program to support optimum mental health. But it is very unlikely that somebody in the acute stages of clinical depression would have the wherewithal to even attempt these things without medication as a sound platform. 

This same skeptical attitude extends to the big drug companies, who, we are told, are cynically trying to turn the world onto anti-depressants to boost their revenues. Certainly the pharmaceutical giants are not profit-averse, but what of the scientists, the thousands of men and women whose lifework is committed to alleviating suffering around the world? The current medications available for depression and other mental illnesses are not perfect, some side effects are an indisputable fact, but they save lives and for the time being they are what we have to work with. 

The greatest tragedy of this specious debate is that unless a recovering addict has some degree of mental stability, he will not be able to latch onto a 12-step program and discover the miracles therein. Addicts and alcoholics often mistake their symptoms of depression as a sign that the program is not working for them and leave recovery altogether. People who might otherwise have discovered the riches of a contented sobriety are prevented from doing so by their untreated mental illness. We are urged in the Big Book to "seek outside help" for matters not related to alcoholism.

If you are suffering from depression or any other mental illness I strongly suggest that you do seek outside help. Any form of mental illness can be an isolating, terrifying condition and we should be encouraged to work with whatever is available to mitigate its effects and experience the best recovery possible.

Deborah Bosley is a writer and novelist based in the UK.

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