Opinion: Is it OK to take antidepressants in sobriety?
Within the culture of the 12 Step program, you will hear this often said: Nomood or mind-altering drug. I can see how some might say antidepressants qualify as mood-altering; confusing these mood-stabilizing drugs as somehow mood-altering. But that is an important distinction.
I do not consider antidepressants breaking sobriety. And this, of course, comes from personal experience. I am a little over a year clean and sober, and I take an antidepressant. At about 7 months clean, I attempted to get off this medication, to see how I felt without it or any other substance in my system. It was no good. I started feeling “the old way” – wanting to escape how I felt, my thoughts; obsessing about taking something, anything to avoid myself. It wasn’t that I wanted to get high, I just didn’t want to be me. In order to preserve my sobriety, I made the decision to go back on my medication.
My depression began at a rather early age, around 11 or 12 years old. This was before I ever drank or used drugs. In fact, my drug use began quite late – all of my friends had been experimenting with alcohol, pot, and acid for years before I finally decided to try it. And as I’ve heard it said in the rooms, drugs became my solution. I no longer had to try so hard to numb myself; I had drugs to do it for me.
What is Depression?
Depression is at least partly linked to a lack of the brain chemical serotonin—and the activity of the two neurotransmitters is interconnected. There are two main types of depression: episodic or chronic. And depending upon this, some people may only need medication on a short term basis, such as a matter of months, while others may need to take medication for years or for their whole lifetime. Depression or paranoia is not necessarily directly linked to the drug abuse; it can be biological. Another scenario for many in recovery is that, as a result of their drug abuse and addiction, they have experienced significant life changes – and those, too, can result in depression.
Antidepressants in Sobriety: What Do the Professionals Think?
There are many studies that show that the incidence of mental health problems is vastly more common among addicts, so denying them safe and effective treatment seems dangerous, to say the least. A medical doctor who denies treatment to a patient is generally viewed as unfit to practice.
According to Dr. Adi Jaffe, an addiction specialist at UCLA and an expert for The Fix, there is a mountain of evidence that links depression and substance abuse, although the chicken-and-egg aspect remains unresolved. Says Jaffe, “Depression rates are 2.5 to four times higher among substance abusers than the general population, but it is hard to nail that fact down to one specific cause. For some people, the depression was there first and they use the alcohol or drugs to alleviate it—what we call self-medication. For others, the drugs actually induced brain changes that ended up causing depression.”
Treat the alcoholism and drug abuse, and you can lift the depression, he says. “But many addicts have real chemical-imbalance problems, and they get sober, do the 12-step program, and are still really depressed. They need either cognitive or experiential therapy—and they may well benefit from medication as well.”
Antidepressants in Sobriety: What Does AA Say?
Alcoholics Anonymous actually has literature to address this very question. In the pamphlet titled “The AA Member: Medications and Other Drugs,” AA states its policy that “no AA Member Plays Doctor.” And when it comes to requiring medication, “it becomes clear that just as it is wrong to enable or support any alcoholic to become re-addicted to any drug, it’s equally wrong to deprive any alcoholic of medication which can alleviate or control other disabling physical and/or emotional problems.”
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