I’m breaking the royal “we” on the site again to speak about something that’s near and dear to my heart: self-medication. Because so many of us do it — whether we’re aware of it or not — and it puts us all that much further behind a brighter, better life.
The clinical definition of verb “self-medicate” is, “choose and take medicines oneself, rather than by prescription or on expert advice” and “take addictive or habituating drugs to relieve stress or other conditions.” Sometimes, this definition is quite literal, and the self-soothing occurs with legal, illegal, prescribed, and not prescribed drugs. However, self-medication can also manifest itself as food, sex, gambling, shopping, smoking, and/or alcohol addiction. Some might even say gossip is a form of self-medication. Not all soothing mechanisms come in a pill, and not every means of soothing the wounds that lie deep within us are prescribed by doctors.
The interesting link behind most self-medication behaviors is Post-Traumatic Stress Disorder. Psychology Today has a fascinating article that cites a famous Centers for Disease Control study that looked at Adverse Childhood Experiences (ACEs) as it relates to the development of subsequent physical and mental illnesses. The results are astounding, and the graphics quite proving: the higher the number of adverse experiences from childhood reported among the 17,000 participants, the more likely they were to end up addicted to alcohol, food, drugs, cigarettes, and many other things. If you’re like me and suffer from PTSD, chances are you might self-medicate with any number of substances or circumstances, and while there’s nothing wrong with feeling better, there is a better way to go about it.
In order to talk about solutions, you need to know how it works. For that, we’ll refer back to the Psychology Today article:
“So how does self-medication work? There must be something about PTSD, depression, and anxiety that gets soothed by drugs, booze, binge-eating, and other addictive hobbies. Again, it’s not complicated. PTSD, depression, and anxiety disorders all hinge on an overactive amygdala—one that is not controlled or “re-oriented” by more sophisticated (and realistic) appraisals coming from the prefrontal cortex and anterior cingulate cortex (ACC). That traumatized amygdala keeps signaling the likelihood of harm, threat, rejection, or disapproval, even when there is nothing in the environment of immediate concern. In fact, this gyrating amygdala lassos the prefrontal cortex, foisting its interpretation on the orbitofrontal cortex (and ventral ACC) rather than the other way around (which we might loosely call emotion regulation). The whole brain is dominated by limbic imperialism—making it a less-than-optimal neighborhood in which to reside.”
This author, neuroscientist Marc Lewis, Ph. D., has written a whole series of articles I’ve been reading recently. All my life, my PTSD has called out for me to calm the fears and scars that lie just behind my eyes. You can’t see the wounds that I carry, but know that they are deep, and sometimes they demand that I deal with them. It’s almost like a ghost limb; I know that the trauma isn’t going to happen again, but I can feel it, and sometimes it’s very painful.
I’ve had to treat the self-medication issue step by step, which meant involvement in a few twelve-step programs that taught me how to release my ego; deal with the trauma in a calm, methodical way; and adopt some mechanisms that stop me from harming myself. These programs aren’t for everyone, but coupled with regular therapy, meditation, yoga, a daily exercise practice, and surrounding myself with good people who are kind, understanding, and non-harming themselves, I’ve seen a good amount of improvement. I’ve been sober for almost five years, and it feels amazing. I don’t have the daily desire to drink or take drugs.
But that doesn’t mean self-medication doesn’t pop up in other places.
For most of my life, food has also been a constant battle. My body weight is a good measure of how well I’m dealing with my trauma. For me, that bloated feeling that comes from mindlessly throwing down too many sweets (and by too many, I mean a pint of ice cream in under ten minutes) because I’m grappling with a bout of chronic depression can be crippling. In the end, staying alive is the most important thing, so in the beginning you do what you have to do to get through a depressive or manic episode. Moving forward, the spiral of frustration that comes from not being able to fit into my clothes starts the cycle of self-harm again.
Excessive dieting is the other side of that condition, and I’ve gone to that side as well, where deprivation and excessive exercise become the way I deal with my anger, frustration, and pain. I’ve recently come to a major decision that has helped me manage the cycle altogether: I’m opting out of the whole bad food/good food cycle. Most of the time, I try to eat really healthy, and sometimes I eat something that’s just super fun and decadent, but I no longer try to use food as a reward system, punishment, or soothing mechanism. I don’t weigh myself, I don’t work out more than once a day, and I try to talk about how I feel instead of stuffing my words down my throat. I’ve realized I can’t drink or drug the pain away, and slowly but surely I’ve realized that silencing my feelings with food isn’t helping, either. I’m not commenting on weight or body image. That’s not what this is about. This is how I have chosen to deal with my personal issues around self-medicating with food. Your doctor can help you find the right solution if you have a problem. I know mine has been super helpful.
There are other things that many of us use in place of a proper diagnosis, prescribed medication, and talk therapy that count as self-medication: cigarette smoking, shopping, gambling, and sex can all fill that wounded void for brief moments as we attempt to self-soothe. But something I’ve learned is that I can throw all the food, booze, pills, clothes, smokes, fitness classes, and people I want at my diagnosis, but unless I’m in treatment and following the protocol prescribed, I’m never going to get better. The pain will never go away. The void will just get bigger and bigger. I can’t get creative with my meds, I can’t “forget” to take them and opt for yoga and talks with my mom instead. In order for my diagnoses not to destroy my life — and they most certainly did until I was properly diagnosed and treated — I have to ask for help from the people who know my conditions best and follow their advice. I don’t know best, and I’m quite frankly tired of the dread and dismay that comes moments after I’ve been using self-medication practices. I don’t want to live that way anymore, and thankfully, I don’t have to live that way.
Neither do you.
Call your doctor, find a doctor, go to a clinic, ask for help. Find a trusted friend or confidant to go with you if you want, but there’s no shame in hiding the fact that you need help. I needed help, and I’m so grateful to every single person who has been there for me as I’ve had to figure it out. I have four separate diagnoses, and they’re the company I keep every single day. I nod at them in the morning when I take my medication, and they get to stay quietly to the side as long as I follow the advice of professionals. I get to be in the driver’s seat. But the minute I think I know better, all Hell breaks loose and then they get to run the show. Is my self-medicating completely over? I’d be lying if I said that I didn’t make mistakes now and then. I’m human. But I let it go, forgive myself, and get right back on track. Because in the end, the only path to true healing and happiness is through the guidance of people who know these illnesses best. I’ve been through enough self-medication to know that my way isn’t the best, and I’ve let them handle it.
Best decision I’ve ever made. Make a new choice for yourself. You can start your life over at any time. Today seems like a good day. Reach out to someone who can help you now.