Are Antidepressants Off-Limits For People In Recovery From Drug And Alcohol Addiction?
A lot of people recovering from drug or alcohol addiction are under the mistaken believe that antidepressants – also known as SSRIs – are a “no-no.” This is unfortunate. Many people who have made the commitment to abstain from drugs and alcohol could greatly benefit from taking SSRIs. Furthermore, an estimated one in three recovering people need them due to a co-occurring mental health disorder.
The reason why people in recovery shy away from antidepressants is because they have made a firm commitment to refrain from using all mood and mind-altering substances. Because antidepressants are considered by many to be mood or mind-altering, recovering addicts or alcoholics erroneously believe using these medications would be considered a relapse. To put it bluntly, this is wrong thinking.
In this blog, we will talk about SSRIs, explain what they are and what they do, tell you how they can actually enhance your sobriety, and talk about how you can successfully use antidepressants while enjoying a life in recovery.
What Are SSRIs? How Do They Work And What Do They Do To The Brain?
Most antidepressants prescribed by doctors today belong to a classification of medications known as Selective Serotonin Reuptake Inhibitors, or, as they are more commonly known – SSRIs.
SSRIs treat moderate to severe depression and other mental health disorders like anxiety and bipolar. They are generally considered very safe and produce far fewer side effects than antidepressants that belong to non-SSRI classifications.
SSRIs work to increase well-being by increasing serotonin levels. Serotonin is the famous “feel-good” chemical in the brain that creates feelings of contentment and happiness. To be more technical, serotonin is actually a neurotransmitter that communicates with other cells in the brain and the rest of the body.
People who experience depression and other mental health disorders have low levels of serotonin. SSRIs work to increase levels of serotonin by blocking the reabsorption of serotonin by the brain and gastrointestinal tract. This makes more serotonin available in the brain, which greatly increases feelings of pleasure and enjoyment.
SSRIs That Work To Treat Depression and Their Possible Side Effects
Here is a short list of some antidepressants approved by the Food and Drug Administration (FDA) to treat depression:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil, Pexeva)
- Sertraline (Zoloft)
- Vilazodone (Viibryd)
To keep you informed, we want to make sure you know that SSRIs come with potential side effects. Here are a few:
- Dry mouth
- Sexual problems (these include loss or reduced desire for sex, difficulty reaching orgasm, and erectile dysfunction)
- Blurred vision
Why Antidepressants Aren’t Recommended in Alcoholics Anonymous and Other 12-Step Programs
Depression is very common for people who quit taking alcohol or drugs, but so few people in their early days of recovery take advantage of antidepressants. When we did the research for this article, we wanted to know why.
Here’s what one member of a 12-Step Fellowship had to say:
“I take Zoloft now, but when I first got to the rooms of A.A., I was told not to drink no matter what, get a sponsor, go to meetings, and work the steps. I wasn’t told anything about taking medication,” said Lauren K., a recovering alcoholic from Boise, Idaho. “I was so depressed, and I just couldn’t stay sober. I kept drinking to combat the depression. Finally, after being in and out of the program for a year and returning to alcohol again and again, I went to my doctor and he recommended antidepressants. After getting on Zoloft, I was finally able to stay sober. Today, I have more than three years off the bottle.”
Lauren’s answer explains a lot. The answer to the problem of alcoholism in Alcoholics Anonymous is sobriety, sponsorship, meetings, and the 12 Steps. There is no room in the A.A. prescription (or any 12-Step program for that matter) for medication – and there shouldn’t be. A.A. literature specifically forbids members of A.A. from playing doctor, and rightfully so. Few members of 12-Step programs are qualified to speak on the topic of SSRIs.
However; medication can play a positive role in the recovery equation. But, it should be pursued outside 12-Step fellowships through appropriate medical channels.
How Antidepressants Can Greatly Benefit People Who Are Recovering From Substance Abuse
When you first get clean, there is hell to pay. After months or years of chemical abuse, the body and mind are depleted of the nutrients and chemicals it needs to feel a sense of well-being and contentment.
Although some people experience what is known as the “pink cloud” effect in the early days of sobriety, the majority of recovering addicts and alcoholics battle severe depression for at least the first year. This causes a great many an addict and alcoholic to relapse.
Antidepressants can help with this.
Although many hardcore recovering people will tell you all you need is a 12-Step program to get and stay clean – whatever program that may be – we argue that taking antidepressants can make the early days of recovery much more bearable.
Antidepressants help battle fatigue, depression, anxiety, loss of motivation, the inability to focus, insomnia, and a host of other issues that accompany early sobriety. If you can take a pill that will increase your chances of staying clean and help you to better enjoy your life, why wouldn’t you want to make this choice for yourself?
You Simply Cannot Relapse on SSRIs Because They Don’t Get You High
As we mentioned in the beginning of this blog, many people do not take antidepressants because they want to avoid all mood and mind-altering substances. So many people in recovery are simply not educated about SSRIs and they think taking antidepressants equals a relapse. Like we said, this is simply not true.
SSRIs do not get you intoxicated. There is no feel-good buzz, no experience of euphoria, no trippy hallucinations, and no thrilling high. This is why you can’t relapse on antidepressants. If you take them to catch a buzz, you will be terribly disappointed.
Antidepressants do not work on the brain the same way that drugs like marijuana, cocaine, heroin, or methamphetamines do. They just don’t get you high – plain and simple. Furthermore, it can take weeks for antidepressants to begin to work, and when they do, the change is slow and subtle.
Although it can be argued that antidepressants alter your mood and mental state, we argue that they do this in a way that is conducive to your health and well-being. They are a help, not a hindrance. Antidepressants are medications used to treat depression and mental health disorders. They are not narcotic painkillers like Oxycodone, stimulants like Adderall, or tranquilizers like Xanax and they are not addictive.
Co-Occurring Disorders Require The Use Of Antidepressants And Other Psychiatric Medications
“My sponsor joked with me that anyone getting off crack would be diagnosed with bipolar in their first year of recovery,” said Brittany L., a recovering addict who faithfully works the Narcotics Anonymous program. “But two years into my sobriety, we stopped joking about the roller-coaster I was on and began to talk seriously about the possibility that I might actually have bi-polar disorder. I started using drugs when I was thirteen, so I was never diagnosed because my symptoms always seemed to be related to the drugs. Turns out, I do have bipolar. Today, I am medicated, and I am able to enjoy a balanced, productive life.”
This is the story of so many people in recovery from alcohol and drug addiction. Not only do they suffer from the disease of addiction, but they also have a mental health disorder of some kind. When someone has been diagnosed with a substance abuse problem AND a mental disorder like bipolar, clinical depression, schizophrenia, generalized anxiety disorder, PTSD, or a personality disorder, they are said to have a co-occurring disorder or dual-diagnosis.
It is estimated that approximately one in three people who have a substance abuse problem also have a dual-diagnosis. When this is the case, medication is needed to treat the mental health problem separately from the substance abuse issue. Quite often, the medication prescribed is an anti-depressant. Mood stabilizers and anti-anxiety medications are also commonly prescribed by a mental health professional to treat mental conditions.
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How You Can Successfully Use Antidepressants While Enjoying A Life In Recovery
According to the 2011 A.A. Pamphlet “The A.A. Member – Medications and Other Drugs,” which was comprised by a group of physicians who attend A.A., here are some helpful tips that should be followed when taking antidepressants in recovery:
- “Be completely honest with your doctor and yourself about the way you take your medicine.”
- “Let your doctor know if you skip doses or take more medicine than prescribed.”
- “Explain to your doctor that you no longer drink alcohol” (or take drugs) “and you are trying a new way of life in recovery.”
- “Let your doctor know at once if you have a desire to take more medicine or if you have side effects that make you feel worse.”
- “Be sensitive to warnings about changes in your behavior when you start a new medication or when your dose is changed.”
- “If you feel that your doctor does not understand your problems, consider making an appointment with a physician who has experience in the treatment of alcoholism” (or addiction).
If you follow these simple suggestions, you will be actively participating in your recovery and taking your medication responsibly. You should always tell any doctor you visit that you are in recovery from drug or alcohol addiction. This will help your physician make responsible, recovery-oriented choices when it comes to your healthcare.
If You’re Struggling With Sobriety, You May Want To Consider Talking To Your Doctor About Antidepressants
We want to be clear – we are not offering you medical advice here. However; in our experience, people who have a sincere desire to say sober, but continue to relapse repeatedly, may need a chemical solution. This can often be found in the form of antidepressants. SSRIs not only help with uplifting the mood, they can also help curb cravings for drugs and alcohol.
Maybe you are staying sober and relapse isn’t your problem. Perhaps you have been clean for a continued period of time, but you are miserable and cannot seem to attain any level of contentment or lasting joy. If this is the case, antidepressants may be a solution for your down-and-out mental state.
Remember, you can’t relapse on SSRIs, but what they can do for you is enhance your recovery and help you stay sober. You don’t have to stay on antidepressants forever. You can take them for the first year or two of your sobriety and then stop taking them once you have a firm foundation in recovery.
If you think antidepressants might be a solution to your current situation – or if you think you might have a dual diagnosis – talk to your doctor and see if an SSRI might be right for you.