Guest Blog: Understanding Depression During Addiction Recovery

Note from Josh: While I take an extended break this summer, I wanted to provide some kind of content, so Patrick Bailey was once again nice enough to contribute several entries you’ll read over the next few weeks.

By Patrick Bailey

People who have gone through withdrawal or have witnessed someone suffer because of addiction understand how difficult it is. Besides the physical discomfort and pain, people in this process suffer from devastating depression that makes the recovery even more difficult.

Depression is a mental illness that can affect anyone and anywhere in the world, even those in rehabs. According to the report released by the Center for Disease Control, 10 percent of physician’s visit is because of depression. The World Health Organization reports that it is the leading cause of disability.

Depression is a mental illness that can happen anytime. In fact, it often strikes during recovery from alcohol or substance abuse and addiction. The symptoms often show during the first few weeks or months of the recovery phase. It is therefore essential that the treatment facility, be it a regular type or a luxury rehab in California, offers dual diagnosis treatment in order to effectively provide care should depression happen during recovery.

Causes of Depression During Recovery

There are many factors that could cause depression during the addiction recovery process. This includes the following:

Post-acute withdrawal syndrome

Post-Acute Withdrawal Syndrome or simply PAWS is the usual phenomenon related to recovery. Depression can function as PAWS and commonly happens in the days or weeks after symptoms of acute withdrawal died down. The symptoms of acute withdrawal often coincide with detoxification and linger until the first few weeks of recovery. On the other hand, depressive symptoms can last for months during the recovery stage.

Changes to the brain related to addiction

During addiction, the brain is affected by alcohol or drugs. When you go to a rehab or a treatment facility, you are treated. As a result, your brain adjusts to the effects of the substances by decreasing the production of neurotransmitters that give you the high or feel good sensation. This includes dopamine, GABA, and serotonin.

These neurotransmitters are responsible for modulating your mood or simply tell you how you should feel. When these chemicals are at their optimum levels they can be translated as a positive outlook or a good mood. When these neurotransmitters are at their lowest levels, this could manifest as depression.

During the early stage of recovery, when the brain is still adjusting to life without harmful substances like alcohol or drugs, depression can happen due to low levels of dopamine, GABA, and serotonin. This usually happens approximately 90 days without drugs or alcohol. A brain functioning lower than normal and producing lower levels of these neurotransmitters can show symptoms of depression ranging between mild and severe.

Dual Diagnosis

Dual Diagnosis has a higher chance of occurring to people with substance addiction. Although there are also other factors at play such as family history. Usually, an untreated dual diagnosis like bipolar disorder, major depression, and other depressive mental issues may be the reason for depression during recovery. After all, there is a strong link between alcoholism and dual diagnosis as well as depression and substance addiction. Several studies show that many cases of substance addiction are due to the patient’s effort to numb the pain he is feeling.

Feelings of despair

Most patients undergo the stage where they grieve for the loss of drugs or alcohol in their life. This usually happens at the start of the recovery process. Letting go of your old habits or addiction, however crucial to your well-being, can still cause you to feel a sense of loss. In addition, emotions that were once repressed by alcohol or drugs can suddenly arise causing sudden negative changes in your mood.

Symptoms

During the addiction recovery stage, it is important to be aware of the symptoms of depressions. Signs can include the following symptoms that could manifest alone, or all at the same time:

  • Persistent emotional numbness or being in a sad, empty, or low mood
  • Recurrence of negative thoughts
  • Irritability
  • Restlessness
  • Anxiety
  • Fatigue
  • Difficulty to focus or concentrate
  • Changes in appetite (eating remarkable more or significantly less)
  • Having trouble sleeping, oversleeping, or staying asleep
  • Lack of motivation for hobbies that you once loved
  • Feeling of worthlessness
  • Frequent feeling of being guilty

If you or your loved one is experiencing or manifesting any of the symptoms listed for a couple of weeks or more, consult a healthcare professional about this.

Risks of Untreated Depression

Clinical depression that goes untreated and allowed to progress can compromise your recovery in rehab centers, treatment facilities, or wherever you are admitted. This is applicable especially during the first few weeks of the recovery stage when cravings are at their strongest. Negative emotions like anger, grief, sadness, feeling of helplessness, can trigger anyone to go back to their old habit.

There is also a great chance that the patient will have the urge to escape the facility because of the painful situation he is undergoing. Patients usually report ebbing of suicidal thoughts. The worst thing that could happen when depression happens during recovery is drug or alcohol relapse. Going back to alcohol or substance at this stage could have fatal results because of the high risk of overdose and deadly health effects.

Patrick Bailey is a professional writer mainly in the fields of mental health, addiction, and living in recovery. He attempts to stay on top of the latest news in the addiction and the mental health world and enjoy writing about these topics to break the stigma associated with them.

Q&A Time: I failed to get better. How do I live with porn addiction?

 

QUESTION: I’ve read your site for a while, I’ve tried to follow your advice. I saw a therapist until I couldn’t afford it anymore, but porn is just part of my life and I don’t think I’m ever going to get better. What’s the best way to just live with the addiction?

ANSWER: If that’s your reality, I’d say don’t do anything illegal, but it’s impossible for me to accept giving up and succumbing to your addiction.

Here’s a truth that is sometimes hard for people like me who are trying to help others to face: There is nothing that rehab, a therapist, your partner, or I can do to change your addiction. We can offer help, encouragement, tips, support, punishment, boundaries, motivation, etc., but we can’t get you to stop. That’s on your shoulders.

You can do it. I’m proof of it and I’ve seen it happen with others. Some still struggle staying sober after 10 years, some lick this in a couple of months and never go back, but in every single case, they decided the most important thing in their life was doing what they needed to do to kick their habit. I believe you simply haven’t reached the point that defeating this addiction is your No. 1 priority.

I only reached that point after intervention from the law. It’s not how I would have wanted it to be, but more than five years later, I’m grateful it happened.

Back then, I was a magazine publisher and city councilor who worked 90 hours every week and ignored my family. I snuck a couple hours of porn watching and chat room trolling in the middle of the night. I was sick and didn’t see how to get out of it.

I now work about 30 hours per week and spend all my time with my family. I would have said my current lifestyle was impossible, but when forced into certain situations, you figure things out. Nothing is impossible, but excuses make it seem that way.

If you can quit, and do it on your terms, it will make your future much easier and you’ll have more control. I fear based on the brevity and tone of your question that you are in a critical phase of addiction and whether it be in 2 months or 2 years, it’s going to lead somewhere you don’t want it to go. Make it a priority — THE priority — to take care of it before that happens. I wish I would have.

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If you liked this Q&A, check out the others HERE

You can check out my Resources page if you need a place to start getting help. Click HERE

If you’d like somebody to talk to who has been there about porn addiction, be it yours or someone you love, but aren’t ready to make the leap to get help from the medical community, I can be a great resource. For more information, click HERE

DISCLAIMER: I have no formal training in counseling or medicine. My advice comes from experience as an addict and as someone in recovery for over four years. Please take my words only as suggestions and before doing anything drastic, always consult with a professional. If you’d like me to answer a question publicly, either post it in the comment section or visit the contact page. Questions may be edited for brevity and clarity.

My Pornography Addiction was About Power and Control, Not Sex

I probably should have recognized this early in my recovery, but I’ve come to realize that my addiction to pornography was just an extension of who I was at the time: Somebody struggling greatly with a lack of power and control to the point I’d fool myself into believing I had both by almost any means necessary.

I recognize that this comes from the faulty survival skills I developed as a child when I was being babysat everyday by a woman who was mentally unstable. Looking back, I can now recognize the severe obsessive-compulsive disorder she had, along with a handful of other issues that led to an environment of multiple forms of abuse and one where I didn’t feel safe.

My outlook on life then, as it was for most of the next 30 years, was to simply survive to the next day. It didn’t matter how you got there, as long as you made it until tomorrow. Along the way, I developed a variety of coping and escape mechanisms. I’ve only recently realized that they were my ways of maintaining control.

I have been diagnosed with a detachment disorder. I think that developed, along with a lack of empathy, because it was easier to not care about things. Instead of being hurt, if I didn’t have any vested interest in most things or people, it wouldn’t have an effect on me when bad things happened. Detaching was control and control equaled power.

For several years in my late teens and early 20s, I had a daily marijuana habit. I can now see it was my way of taking control of my mind, emotions and thoughts. Yes, it was a dulling of the senses, but it was my choice. For the hours of the day I couldn’t control my natural reaction to things, there were those hours that I could check out – on my terms – with the marijuana.

The two constants for so long were alcohol and pornography. I think the alcohol was like a more socially acceptable form of marijuana at the time. Alcohol was my way of taking control and deadening my nerve endings temporarily so I didn’t have to feel.

When it comes to the pornography addiction, I believe that was more akin to the rest of the way I lived my life. I owned a business so nobody could boss me around. I was on the City Council because I wanted to decide what happened in my town. No matter the political or social issue, I’d be on Facebook advocating for my side and talking down to those who disagreed. I tried to create a world where I was in complete control, but the only person I fooled into thinking that was true was myself.

Pornography wasn’t about naked people doing sexy things so I could relieve myself. It was about controlling the people on the page of the magazine, in the videos, or the film clips on my computer screen. If they weren’t doing exactly what I wanted, I could just skip to the next picture or clip and eventually I’d find someone doing what I wanted. Since I couldn’t really control people in my real life (despite trying) I was able to use porn as surrogate.

When that stopped being enough, I made the transition to chat rooms. A lot of the time, things never even got sexual. I simply enjoyed steering the conversations and getting women to admit things they probably wouldn’t otherwise. If I couldn’t get the woman to acquiesce to my sexual requests, I’d get her to try on clothes, or rearrange furniture in her room…whatever I could do to gain power in my mind. Power equaled control.

I haven’t had much in the way of triggers or cravings with pornography in a long time and I was asking myself exactly what that was the other day. I was wondering if I reached a point of being “recovered” as you can read about in my most recent blog. I think that the relative ease that I am having being away from both porn and alcohol has to do with the fact that I don’t feel the need for power and control the way I once did.

I think my ordeal of getting arrested, going through the court system, spending six months in jail and being on probation for the past three years – not to mention the radical changes in my lifestyle and daily routines – have put me in a place where I know that there is just so much control I can exert over my life, and a lot of it is just out of my hands and none of my concern.

Truth is, I don’t care who the President is. I know they’re making decisions that may or may not affect my life, but whether I like it or not, I have no control, regardless of what I used to write in Facebook diatribes. My opinion about a border wall means nothing, so why fool myself into thinking it does? That’s a waste of energy I can use on healthier things. I can’t control who my daughter dates now that she is a legal adult and trying to force my will on her probably will do more harm than good. If my wife doesn’t cook me dinner, it’s up to me to get it for myself. I can’t control the people and happenings around me, especially when they don’t go the way I wish.

Those people who were depicted in the pornography I consumed were there because they were either making money or because they had deep-seeded issues…probably both. But they were not there with the sole intention of being used by me. That was a fantasy I concocted in my head.

Ironically, now that I’ve admitted my lack of control and power, I feel more in control and powerful than ever because it’s grounded in reality, not fantasy. And with reality, I don’t need the escape hatch of addiction to fool myself.

 

Is it Possible for an Addict to Go From “Recovering” to “Recovered?”

If you’re reading this on the day I wrote it, April 2, 2019, today marks five years of sobriety from alcohol. I also count this as my sobriety date from pornography, although it technically was a few days earlier. If you would have ever told me I’d go five years without either of my nearly life-long addictions, I’d have said it could only happen once I was put in the ground.

I won’t be attending AA to pick up my five-year chip. I believe I took from the program what I could in about six months of attending meetings. One of the things that I questioned at the time, and question even further now with so much sober time behind me, is if their belief that alcoholism is an ongoing disease and people never truly “heal” or completely “recover” is accurate for every addict.

I have no question in my mind that I was addicted to pornography and alcohol. They were my go-to vices when I needed to curb anxiety and stress for two decades. Despite negative consequences and a desire to stop, I didn’t until the law intervened. For me, being told I’d be thrown in jail (first on bail, then on probation) was the incentive I needed to quit.

I’ll admit, the cravings for porn were strong that first year and the cravings for alcohol were just as strong for around three years. Today though, unless I’m writing for this blog or giving an interview on a podcast, thoughts about using are not there. It’s just not a part of my everyday thinking anymore.

I think it’s healthier for me not to attend multiple meetings per week where discussions of alcohol and pornography are the focus. I appreciate the newcomers who are on the verge of falling back into that world of addiction, but I’ve met so many people with long-term sobriety who didn’t take the 12-Step route to know it can be another road to success.

I spent years (and continue to attend) in therapy, learning what happened in my life to contribute to the addictions starting. I have also spent years carefully crafting a new life where my routines are different, my motivations are different and I dutifully pay attention to my mental health.

So, am I still a recovering addict? According to most of the messaging, yes. I’ll never actually “recover”. Can one be an addict yet not actively participate in their addiction, nor having cravings? I’m not sure. Someone who played professional baseball from 1970 to 1984 is not still a baseball player. Someone who stopped smoking in 1997 is not still a smoker. Someone who spent their single life as a womanizer, but remains devoted in marriage is not still a philanderer. So why am I still an alcoholic and a porn addict?

I think the answer for most is, “It’s safer to consider my addiction as an active, living thing instead of a behavior of the past. I’m just one bad choice away from being back there.”

I understand that line of thinking, but aren’t I just one bad choice away from being a heroin user or starting a gambling addiction? We’re all just one bad choice away from ruining our lives, addict or not.

I believe addiction is a disease. It’s been proven by science. But science has also proven there are many diseases that people recover fully from. Is it possible addiction is one of those diseases?

I’m not completely there yet, but I have a feeling at some point, there is going to be an evolution in my mindset from “recovering” to “recovered” and I’m not worried about it being the slippery slope that returns me to the addictions. While I hopefully will always educate and inform about the dangers of addiction, I think the personal danger can dissipate to nearly nothing over time for many people.

Maybe this is just a matter of semantics. We love to label things in our society and we also tend to catastrophize for the worst-case scenario. When I was in rehab, the program was geared the same toward me, who needed only one trip each for alcohol and porn, as it was the person who had been 12 times and never been successful. I realistically probably didn’t need the same level of care that they did.

If constant self-monitoring and keeping your addiction top-of-mind, even after a decade, is what you need to stay sober, then please, fight the daily fight. I don’t want anything I say to dissuade you from continuing on with a program that works for you. I’ll never say that I wasn’t “really” addicted because I don’t need to white-knuckle it day-to-day anymore.

I also think it’s OK if you’re not struggling day-to-day. I don’t think it minimizes your battle and I don’t think you have to apologize for a recovery that the mainstream doesn’t acknowledge. I think it’s actually the place that most addicts strive to arrive at. I’m here, and I’m grateful.

Yes, Recovery Does Get Easier

While porn addiction isn’t exactly a happy topic, I feel like I sometimes tend to be about doom-and-gloom, often specifically looking for negative statistics to show what a problem the addiction is, and will become in our society.

I rarely talk about what it’s like for me today, nearly five years into recovery. For those wondering the big question “Does it ever get easier?” I’m here to tell you that yes, it does, but you have to find the way to make it easier.

I cannot say enough wonderful things about cognitive behavioral therapy. If you have a behavior, even one that reaches an addictive level, I urge you to seek out a therapist who specializes in CBT.

When I was at both of my rehabs, there were the naysayers and people who didn’t want to be there. I remember one time, there was an especially mouth drug addict. He was young and it was clear his parents forced him to be there or he’d get cut off. There are always a few those at every rehab.

“You’re just here to brainwash us!” he once blurted out to a clinician who was running one of our group activities.

He stopped, walked over to the guy, looked him straight in the eye and said one of the most truthful things I’ve ever heard.

“If you’re not here to get your brain washed, you’re in the wrong place. Don’t you think you all need a little bit of brainwashing?” he asked the addict.

A few days later, the anti-brainwasher was kicked out for hooking up with one of the young women he shared his drug of choice with at the facility. It’s funny how it’s never the sex or porn addicts that hook up at these places.

In a nutshell, CBT is self-brainwashing.

The other idea this clinician introduced me to was the concept of the “pre-lapse.” His contention was that once you’re at the stage of relapse, you’re going to engage in your addiction, but if you can nip it in the bud in advance, you’ll never reach relapse stage. There are a series of almost ritualistic thoughts and behaviors most addicts, regardless of the specific addiction, go through prior to using. Once that chain of events begins, it’s hard to derail it.

I learned how to derail the pre-lapse with cognitive behavioral therapy. I used it to tackle both my alcohol and porn problems and although muscle memory has made coping with the addictions easier, I still have CBT in back pocket.

As long as I live and I see an ad for beer on television, I’m going to have the Pavlovian response of thinking it looks tasty. That’s because the first beer or two is tasty. It’s when I feel this way that I pause and remind myself that I’ve never stopped at one or two and can’t stop at one or two, so I can’t have any. That works now. When the pull was harder years ago, I’d start thinking about all of the horrible things I’d done or said when I was drunk and how I never wanted to go down that route again. Eventually, maybe the commercials won’t trigger any response.

With porn, if I see a beautiful woman on TV or in the movies, I’ll sometimes have the immediate thought, “I wonder if she’s done a nude scene.” In years past, that would lead me to one of those celebrity porn websites. Today though, I’m able to pause and ask myself, “What does it matter if she’s done a nude scene? What will I see that I’ve never seen before?” I find that when I boil porn down to its essence, naked people being objectified, I want nothing to do with it.

And whether it’s alcohol or porn, I’m able to look back at the last six years: First, my worst year of addiction, then getting in legal trouble, attending two rehabs and hundreds of hours of therapy, a six-month jail sentence, hurting so many people close to me, almost bankrupting myself all leading to what is today a very isolated, often lonely life. My choices with alcohol and porn led me here and having spent time with addicts, I know I’m actually one of the lucky ones. Reflecting back on these last six years is a quick trick to put any porn or alcohol triggers to rest.

Yes, it’s easier now going into Year 5 of recovery than it was Year 3 and certainly Year 1. For those of you who are in the early stages, don’t fret. Just stick with it. You have control over your actions, even if you need someone to teach you how. Seek out a CBT therapist and make the recovery journey a successful one.

Getting Trivial Things Off My Chest – January Edition

I haven’t written a trivial thoughts entry yet for January and since we’re both at the end and I have no thoughts worthy of a long-form entry, it’s the perfect intersection of deadline and laziness.

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I had a fascinating conversation with a friend the other day. I have been engaging in a little more anti-porn talk on the podcasts I appear on and presentations I make lately. I’ve tried not to come off as anti-porn because I believe the people who need the most help are pro-porn. Being anti-porn is passing judgment and addicts generally don’t respond well to being judged. That said, I also fully subscribe to the idea that all porn is objectification. There is no other reason to look at pornography than to objectify the person in the images being looked at or watched. Pornhub doesn’t exist to play “Guess this person’s IQ!”

I mentioned that porn is never a good thing because of the objectification, my friend asked the question if all objectification is wrong. I said that I thought it was, even when it’s a simple as seeing a pretty girl on the street. I’m not saying it can be helped necessarily, but I did say it was wrong. He brought up the idea of people making themselves look good, especially for a blind date. Aren’t those people specifically trying to appeal to the other person on nothing more than a visual level? He also brought up the fact that most people don’t want to be in a relationship with somebody unless they find their partner physically attractive. He said that’s just part of how evolution works.

I thought it was a fascinating point to make and one that I’m still wrestling with. I’d be curious to hear your opinions if there is such a thing as acceptable, or perhaps even necessary, self-objectification.

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I was going through the list of bloggers that I follow and saw the number had exceeded 100. It doesn’t feel that way when I look through the Reader section of WordPress, so I checked into the blogs I follow and it was amazing how many people haven’t kept up with their blogs. I went through and deleted every blog that hadn’t updated in at least four months. By the time I was done, I only had 56 blogs left. Some of them were amazing and I wonder what happened to those people. Others, often about addiction, just abruptly stopped and I worry what happened to those people.

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When I first went to rehab for alcoholism in 2014, I was told by a recovered heroin user that people who are heavy addicts will often dream for years about their addiction, and using. I have to admit, that’s never happened with me and pornography. I have never had a dream about it. I did however, go through a long stretch of having dreams about alcohol and over the last few weeks, they have returned.

Almost all of the dreams are the same. I am usually at a bar or a party and somebody offers me a pint of beer. I say no. Then, the dream jumps forward and I’m sitting with a couple of empty pint glasses in front of me and I immediately recoil in disgust. I can’t understand how I could have drank those beers since I haven’t had alcohol going back to April 1, 2014. I am thoroughly disturbed in the dream at the idea that I “just forgot” I had years of sobriety.

There was a wrinkle in the latest dream. I was faced with drinking and I said to myself, “Well, since I already slipped up, I guess I could” and for the first time in years, I recall drinking beer in one of my dreams. I think it’s fascinating that in my dream world, I relapsed in one dream and used it as an excuse to continue drinking in another dream. This is just another reminder that for all the energy I put toward pornography addiction awareness, I personally have to keep just as strong a watch over the alcohol.

Reflecting on the Third Anniversary of My Time in Jail

It feels a little strange to recognize the anniversary of something that was so life-altering, but tomorrow, January 22, 2019, marks the three-year anniversary of the day I went to jail. I ended up serving 27 weeks which were among the most definitive of my life.

I ended up there because in late 2013, I made the heinous, reprehensible mistake of engaging a teenage girl online in a chat room. It doesn’t matter that I was an alcoholic, off my bipolar meds and generally watching my professional and personal worlds crumble. I made an error in judgment that I would never have made for 99.8% of my life.

The irony is that by the time I was sentenced, I’d spent the better part of two years in intense rehabilitation including two inpatient rehab stints, participation in 12-step groups and frequent one-on-one therapy sessions. The version of me that was sentenced by that judge in 2016 was the healthiest version I’d ever been.

I’m glad that I was healthy when I went to jail. If I had gone before my recovery truly had time to take root, I’m not sure I could have been so reflective with my time there. For me, jail was not hard time because I learned how to keep myself continually occupied. It was however, long time…and I think that’s the point. You get plenty of time to think.

In jail, nobody expects much out of you. You follow a few basic rules and that’s it. For some people, it drives them crazy. They literally pace the pod, taking 25 steps in one direction, turning around, taking 25 more and doing this for hours at a time. Others play cards, wagering their dinnertime desserts just to make things interesting. Meanwhile, others will veg out in front of the television, ironically watching marathons of Cops.

I did a lot of reading and wrote several books, including the one that a publisher picked up last year. I probably averaged 10 hours a day of reading or writing. While it was nice to have the time to get done two things I’d been neglecting for years, I felt a little like Burgess Meredith on that one episode of The Twilight Zone where all he ever wanted to do was be left alone to read, and when his end-of-the-world wish came true, he accidentally stepped on his glasses.

There were many occasions where I would just stop and look around at the other nine or ten men sharing this small space with me and say the words to myself, “I am currently in jail.” It remains as surreal now as it was then. The script my parents wrote for my life and tried to have me internalize at a young age did not include incarceration.

I said earlier I don’t make excuses and try not to minimize nor rationalize my crime. The one caveat I do make is that I know if I had been aware of pornography addiction or had someone called my growing use of pornography in those final years to my attention, I may not have ended up where I did. My addiction – one I never tried to control – led to my going to jail.

For those reading this who think to themselves, “There’s nothing wrong with looking at pornography a couple times a week or a few times a month,” just please recognize, I once held that belief as well. I couldn’t see the evolution from an ongoing addiction to a critical-phase addiction.

I got a lot of time to think about my poor choices and poor health management while I was in jail. You may think it’s impossible that you’ll ever end up there, but I am proof anything is possible when it comes to an insidious addiction. You’ve been warned.