This post was originally published on March 22, 2016.
Almost 12 years ago, when I walked out the door of the detox unit after five days, I felt relief. In addition to alcoholism and cocaine addiction, I had been diagnosed with “Major Depressive Disorder” and put on an antidepressant. The detox doctor explained that my round-the-clock use of drugs and alcohol likely began as an attempt to self-medicate. When I really thought about it, I realized that even when I was a kid with a gloomy brain, I found relief in the form of a half-gallon of vanilla fudge ice cream and a spoon.
Freshly detoxed and armed with my diagnosis, medication and a commitment to How to Deal With Depression in Sobriety attend outpatient rehab, I was released back into the wilds of New York City to navigate life as a sober person. Theoretically, my depression would be alleviated, allowing me to feel peace in my head without resorting to drugs and alcohol. For the most part, it worked. It would have been helpful, though, if someone had warned me that despite my consistent practice of the new regime, I could (and would) have periodic depression relapses. I learned the hard way that even when life was going great, depression, much like addiction, could raise its ugly head. Despite doing everything right, sometimes I sink back into the mental cesspool. In the past it led me to reach for a liter of Absolut vodka and gram of cocaine.
Depression feels different to each sufferer, but for me, it tends to announce its arrival in the form of overwhelming exhaustion. I feel as if I’m moving underwater—an unseen force seems to resist every effort to lift my arm or move my feet. When I start to get out of bed, it’s as if there is a giant squid under my mattress and it has wrapped its tentacles around me, dragging me downward. Next, the tears start, not because something happened, but because everything happened. There’s no point in being here. Little blackout scrims fall behind my eyeballs, making it impossible to see the world as anything but dark. I can barely get through the day.
So what is a sober girl to do when she goes to 12-step meetings and takes her antidepressants religiously, yet still gets sucked into the black hole of depression? Having gone through these episodes of depression in sobriety more times than I can count, I have learned a few helpful approaches that don’t involve the dive bar across the street from my apartment.
The first thing I have to do is accept it, just like I accept my addiction. When I see and feel the signs of a depression relapse coming on, the best thing I can do is acknowledge its arrival, not try to swim upstream against it. Willing myself not to be depressed and trying to act like it’s not happening does not make it go away. When I’m feeling hopeless, I remind myself that like every other time I’ve had this kind of relapse—this too shall pass. I just don’t know exactly when.
Living with a depressive episode when it has stolen space in my head is tricky. I have to remember that feelings are not facts. Just because my brain keeps telling me that I suck and life is pointless, doesn’t mean it’s true. I have to trust that the hard work I’ve done in sobriety means perhaps I’m not as terrible and the world is not as awful as it seems in the moment. Easier said than done, but if I can convince myself of this, even a little bit, it can slow the downward spiral.
In a depression relapse, interactions with (seemingly) not depressed humans around me are challenging. When someone says, “Are you okay? You seem out of sorts,” I typically tell them I’m a little under the weather, which is true. The few times I’ve said, “I’m just feeling really down right now,” I have received a response along the lines of, “Cheer up! You have nothing to be sad about!” Which, naturally, makes me want to chug a liter of tequila and then break the bottle over the person’s head. So, I’ve learned there’s no need to offer details to other people.
Avoiding them is tough, though, when I have to be in the office all day. So when the end of the day rolls around, I allow myself to do exactly what I need to keep myself out of the liquor store. It may mean breaking dinner plans because I can’t be social, skipping the gym because I feel wiped out, eating a pint of frozen yogurt for dinner, and yes, sometimes blowing off my 12-step meeting to climb into bed. I know a professional would probably advise me to make better choices for three of these actions. Eating well, exercising and going to meetings are all things that would probably help my depressive episode to pass. But, screw that, if I’m depressed, I want Ben & Jerry’s Half Baked Frozen Yogurt. As long as it’s not Stoli, I’m feel like I’m ahead. It’s a good time to remember that any day I don’t drink is a perfect day.
When I fall back into depression, it’s usually lasts about a week. I slowly start to feel myself coming around and getting back to normal. But I pay close attention and if it’s more than a week, I call my doctor. An adjustment to my medication may not be necessary, but I don’t feel equipped to make that call either way. My doctor does, so I leave it to him. When the dark feelings start to lift, I still err on the side of caution for a week or two, not overloading my schedule or putting myself in uncomfortable situations that I can avoid.
I’ve learned to accept that, like alcoholism and drug addiction, depression is a chronic condition and I have to be vigilant about watching for relapses and taking care of myself through them. There’s nothing noble in trying to “power through” depression. My inclination would be closer to staying in bed for a week, but that’s not possible for me and my guess is that seven days in the sack would make me even more miserable.
Now when I see the black clouds forming, I take a deep breath and brace for the oncoming storm. I clear anything unnecessary off my calendar to give myself maximum flexibility. I skip the social phone calls, but I do talk to sober folks. I let myself sleep when I’m tired. And I pity anyone standing between my friends Ben & Jerry and me.
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