The term self-medicating simply means using a substance or engaging in a behavior to satisfy a physical or psychological need.
Quite often, though, self-medicating means relying heavily on legal or illicit substances, like alcohol or drugs. As a manifestation of addiction, such self-medication is especially problematic for patients with depression.
Those who battle depression, and especially those who are predisposed to addiction, may try self-medicating before or instead of seeking professional help, which can make their underlying problems even worse.
But like depression, the need to self-medicate is often triggered. If we can spot these triggers (especially the less obvious ones), we can more successfully battle depression, addiction, and the need to self-medicate that often overshadows both diseases.
Self-Medicating for Depression
For many people, depression is a temporary state. I’ve seen many patients who have undergone significant hormone changes, like menopause, who then become depressed and begin relying on antidepressants to lift their moods. In such cases, correcting the hormonal balance can alleviate the depression and their need for medication.
For many others, depression is a genetic trait they’ve inherited but may not fully understand. The extent to which they are depressed is less a matter of hormones or circumstance and more a matter of genetic makeup and environmental factors. While self-medicating to a degree is common for everyone, patients with pre-existing depression are more likely to do so more frequently.
But it’s vital to realize that just because someone is depressed doesn’t mean he or she struggles with addiction, even if that person is self-medicating. Like depression, addiction is a genetic illness that affects brain chemistry, and contrary to popular belief, it isn’t just restricted to drugs and alcohol.
People with depression and addiction need to self-medicate to feel normal. What they choose is usually determined by what they’re exposed to, but the need remains the same and can be triggered at any moment.
From Self-Medication to Addiction
Despite the increasing concern over addiction and addiction treatment in the U.S., a surprisingly modest portion of the population is affected by the disease (roughly 15 percent). If you’ve ever heard someone talk about trying drugs a few times, but never becoming hooked, it’s because that person is part of the other 85 percent who aren’t predisposed to addictive behaviors.
The truth is, people with addiction already have addiction long before they ever try a substance. They might become addicted to playing video games as children, or they might become addicted to smoking cigarettes and drinking — perhaps worse.
The drive to self-medicate is the same for people with depression; the difference, though, is people with addiction become physiologically and psychologically dependent on their self-medication. Without help, their need can progress into stronger and potentially deadly substances. If depression is also a factor, the consequences can be even more destructive.
3 Ways to Avoid the Triggers
If depression or addiction runs in your family, you should know you’re automatically more likely to be prone to self-medication. However, if you aren’t sure, there are other ways to know if self-medication is problematic.
- Genetics: Again, addiction and depression are largely genetic issues, and those who struggle with them have family members who struggled similarly. Know your family history, and if depression and addiction are in it, then be especially cautious about self-medicating. You can also find out your predisposition through pharmacogenetic testing, which is becoming more popular in addiction medicine.
- Dependence: There’s a big difference between enjoying a glass of wine at the end of the day and being unable to wait until the day’s over so you can get to that glass. If you wake up in the morning and need a cigarette or coffee or another drug of choice before you can face the day, then your addiction is so strong that simply waking up is a trigger. People with addiction can’t wait to self-medicate and will plan their entire day around it.
- Reflection: Remember the first time you drank or smoked a cigarette or used any other substance that you still engage with? Many patients who self-medicate due to depression or addiction begin doing so earlier than most. Many of my own patients recall smoking their first cigarettes and joints or drinking their first beers as early as 12 years old. They started earlier and continued longer than most of their peers.
The estimated 15 percent of the population who are in the grips of addiction learn early that self-medicating can make them feel better. This exacerbates the problem because they compound their issues through years of substance abuse before seeking professional treatment.
It’s important to remember that, by itself, self-medication isn’t a worrisome concept. It mainly becomes worrisome when someone with pre-existing depression or risk factors for addiction begins to self-medicate regularly. That’s when you know it can all go downhill fast help should be sought as soon as possible.