Whether you’ve been sober for a long time, or you’re beginning to contemplate embarking on a sobriety journey, you probably know that there are a lot of factors that can contribute to addiction. Genetics, psychology, and culture can all play a role when it comes to substance use. 

However, as a therapist, and a person in long-term sobriety, I find that there are a lot of misconceptions out there about substance use and mental health affect one another. Here are a few things I wish everyone knew about sobriety and mental health.

Drugs and Alcohol Can Worsen Mental Health Symptoms 

Did you know: 

• Alcohol is a depressant? 
• Marijuana can negatively interact with antidepressant medications like Prozac? 
• Drugs and alcohol can worsen mood swings associated with bipolar disorder?

Many drug and alcohol users use their substance of choice in order to cope with the effects of mental illness, but these substances can make your condition worse and interfere with the medications prescribed to help manage symptoms. 

When choosing a therapist (for talk therapy), or a psychiatrist (for medication), try to find someone who has experience working with people who struggle with addiction. If your clinician does not have a full understanding of the way addiction and mental illness interact, then they might not be the right person to help you manage your symptoms. 

Your Drug and Alcohol Use is Serving a Purpose

While it is true that our genetic makeup can play a factor in whether or not addiction becomes part of our story, this doesn’t occur in a vacuum. 

Beyond genetics, there is almost always a reason we are drinking or using. Maybe social situations cause great anxiety, and being drunk allows you to interact comfortably with others. Maybe the pain and shame caused by abuse you endured in a past relationship only subsides when you’re using your drug of choice. Maybe marijuana allows you to manage your anxiety and get through the workday. 

When I’m working with patients who struggle with addiction, I always point out that using, in a way, is adaptive. While drinking and drugging are not healthy ways of coping, they are still ways of coping. 

That said, those ways of coping come with damaging side effects. When we drink and drug, our physical and mental health suffers, we find ourselves in dangerous situations, we harm our relationships, and we may lose control of our professional lives or our finances. 

When we make the choice to pursue sobriety, we have to find new ways to manage the anxiety, the pain, or the fear that our substance of choice was helping us cope with. Removing the substance without a plan for managing what’s underneath won’t get you far. 

There is More Than One Way to Get Sober

The prevailing narrative about sobriety would have you believe that there is only one truth when it comes to sobriety. 

12-step programs have helped countless people to achieve sobriety, but for those of us who find we are misaligned with the philosophy of programs like NA and AA, it can be hard to find an alternative. 12-step meetings are free and widely available, and they can be a great resource for many people working toward sobriety. 

However, some folks may not be ready to stop using drugs or alcohol altogether, and in those cases, a therapist or psychiatrist might be a better alternative. With talk therapy and medication assisted treatment, you may not have to stop using right away in order to get help. No one should be denied mental health or medical treatment because they are still using. 

Further, it’s possible that you need a higher level of care to manage your addiction. Sometimes seeking inpatient treatment is necessary, especially if you’ve developed a physical dependency on a substance like alcohol or opioids. When this is the case, the first line of treatment should perhaps not be therapy or 12-step meetings. 

While substance abuse treatment has a long way to go in terms of combating stigma and becoming more tolerant of differing paths to sobriety, there are indeed a variety of options available if you’re ready to address your addiction. For more information, read our article on outpatient treatment options.