Hiding Addiction Behind Depression

By Temma Ehrenfeld 03/03/16

Alcoholism cost him his life, after professionals said my partner was just depressed.

Hiding Addiction Behind Depression

Everyone in the psychology field knows that it's common to be depressed and alcoholic. My partner (call him Mark) took antidepressants, confided in me and others, and none of it helped. Still, for years, neither our couples therapist nor either of his two psychiatrists, or any of our friends labeled him an “alcoholic.” The real problem was depression, even after he died in a binge at 55.

To me, his death is a tale of medical professionals failing. Maybe I'm the innocent one and there is a shadow story I don't know—help they offered and he rebuffed. But my guess is that they all just circled around his scary problem. 

When I met Mark, he drank a bottle or two of wine every Saturday night. We lived in New York City and didn’t need to drive. I also didn’t know drinkers. I left my one glass half-full and he’d finish it off for me.

We were so very much in love.

He was the funniest man I’d ever met, and the sweetest.

Six years later, we still read poetry and talked for hours every weekend. But we didn’t live together and I didn’t want to marry him—yet. I wanted him to be stronger, able to knock off a list of problems. Every so often, he’d decide to “cut out the wine,” and he’d drink less for a few months. Then he was drinking more, slipping at work and staying in bed until noon on Sunday mornings. I’d ask, “Are you hungover?” He’d say, “I’m depressed. Work.”

I was thinking about having a child—I was 36—but Mark didn’t want to. So we went to a couples counselor. When I raised the wine as “an issue,” the therapist said Mark was “just depressed” and sent him to a psychiatrist, who agreed. Mark went on antidepressants. 

I read that people weren’t supposed to drink while taking antidepressants; he reassured me that wine didn’t count. He also told me the medication was working.

More time went by and I was approaching my 40th birthday. I’d given up on having children. I’d stopped asking him about his work. Now I was taking antidepressants. 

One day, a friend of mine who worked as a parole officer called me when I was stuck late in the office. I told her that I loved Mark and he loved me, that we would have long talks and fierce fights and make-ups, but somehow things just kept feeling more difficult and hopeless. ”I can’t get any traction. I feel like he’ll agree to anything one day and then the next, we’re starting all over again. It’s like I’m not with one person, there’s no ‘there there.’”

She said, “Doesn’t he drink a lot?”

I gave her the details.

“You sound like someone in love with an alcoholic,” she said.

“An alcoholic? He’s depressed.” 

She explained that alcoholics are often depressed and that they have to treat their alcoholism too. Parole officers see lots of this. 

Soon after that, I received an alarming phone call from Mark after an office party. He was slurring his words and making no sense. I thought he might be sick. I’d never heard him like that.  

I called his psychiatrist, thinking he was having some kind of drug reaction. When I described his condition, the psychiatrist paused. “He’s drinking,” he said. “Will you recommend alcoholism treatment?,” I asked. The psychiatrist said, “I really should be talking to Mark here. I’m treating him for depression.”  

The next thing I knew, Mark told me the psychiatrist had dropped him as a patient. 

I picked the second psychiatrist—call him “Dr. K.” He had treated a friend of mine for a painkiller habit and specialized in addictions. Mark agreed and received a different set of antidepressants. I also scheduled a visit on my own, with his permission, and told Dr. K that Mark might hide how much he drank, and I really didn’t know how much drinking was going on. 

I figured an addiction expert could handle Mark, who after all, just drank wine.  

Mark said he felt better. 

The next event I recall was when he got sloshed at a retirement party hosted by an older couple I was close to. He walked into a mirror. Other people were slightly tipsy, and I not at all. I dragged him out and considered leaving him on the street. Instead, I put him in a cab, gave the cabbie money and told him to take Mark home, and went to my own apartment alone.  

In the morning, he called and said, “Why aren’t I with you?”

I explained. I said, “You have to stop drinking.” He laughed. “It was a party, pumpkin.” “You’re an alcoholic,” I said. “I’m just depressed,” he answered. 

My friend the parole officer told me that if I left him, he might get better. She also said that alcoholics who recover are “beautiful people.” I remember the enthusiasm in her voice. She explained that conquering weakness teaches compassion. She gave me hope. I needed to believe I would be helping him. 

When I did break things off, he confessed a couple of days later, on the phone: “I am an alcoholic.” It may sound strange to you, but I was devastated. I realized he had known all along and had been lying to me.  

He also told me that he would stop drinking—go sober, forever. 

Mark had always been slender, more delicately boned than I, and graceful. Over the next few months, he seemed solid, as if he’d gained muscle. In my memory it’s as if an image on a grainy TV screen had resolved and then walked out of the screen and became a person. The collection of dots I couldn’t see was connected. 

I hadn’t known a composed, clean Mark.     

I told him that I wanted to be with him again—if he didn’t drink for year. He turned down my offer. Later I blamed myself for that hedge, thinking if I had just trusted him, he might have survived. I had a couple of other boyfriends, and Mark had a couple of girlfriends. He would comfort me when I was unhappy with my boyfriend, and I would comfort him and laugh at his jokes. 

Pretty soon, we were both single again, but he looked shaky. Then he went on medical leave from his job.

Mark barely left his apartment for a year. He wouldn't let me see him. We spoke on the phone every day. He was still seeing Dr. K, who I regularly called with my reports. He didn’t ask me whether Mark was drinking and I wouldn’t have known the answer. 

It was springtime when I felt a shift; Mark seemed detached when we spoke and made the calls shorter. One day he didn’t answer the phone at all. 

Dr. K and I agreed that I should go see Mark, a subway ride away, even though he had asked me not to. I brought a doctor with me, a friend, in case Mark was sick. Mark wouldn’t answer his buzzer. My friend and I decided to leave a note and see what happened. 

That night he called and told me he had been sleeping. I said, “You’re going to die if you go on like this.” “I know,” he answered. “Goodbye,” and hung up. I called Dr. K and left a voicemail, “I think he just said goodbye to me. He needs to be in the hospital."  

That was on Monday. On Tuesday, I called Mark and Dr. K. No one answered. I called again. I thought Mark must be in the hospital. I called Wednesday.

On Friday, Dr. K called to say Mark was dead. When I asked him what had happened between Monday and Friday, his answer was, "I know you are feeling very guilty, Ms. Ehrenfeld." 

After that, people still didn’t want to talk about alcohol. The official cause of death was liver damage. The floor of his apartment was covered in diarrhea. His horrified parents and sister and ex-wife chose not to have a service. In the office newsletter, mourners were asked to donate money for cancer research. People said it was so sad he was so depressed. 

It could have been different. His doctors could have pushed the alcohol issue, and I could have caught on years earlier. So could others. A friend I’ll call Nick did talk therapy, journaled his life and feelings, and lots more—all while drinking to excess. “I think overcoming depression requires a level of mental and emotional clarity that is simply unavailable to an active alcoholic—at least that has been my experience,” he says. He joined Alcoholics Anonymous and now, after more than a decade of sobriety, he’s happier. He’s also here. 

Temma Ehrenfeld is a ghostwriter and journalist in New York. Her journalism has appeared in The New York Times, Newsweek, Reuters and Fortune and her literary work in Michigan Quarterly Review, The Hudson Review, Chicago Literary Quarterly, Catamaran Literary Reader and Prism International. She blogs at Psychology Today and is shopping her first novel, The Wizard of Kew Gardens.

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