Can Sobriety Cause Depression?
One of the best descriptions I’ve ever encountered of early sobriety is relevant here: “a steady low-level depression and a persistent gut-wrenching impending-doomism.”
Sobriety and depression are undeniably connected, particularly in early sobriety.
Runs contrary to the pink cloud version often erroneously held, doesn’t it?
The truth is depression, alcoholism, anxiety, these things are meshed and interrelated in a variety of ways.
For starters, an exact definition of depression, alcoholism, anxiety, and addiction is out of reach.
These disorders are largely subjective.
Yes, we can pinpoint precisely what’s occurring in the brain (objective) but we cannot explain what the person is experiencing (subjective).
These types of problems are heterogeneous, both in their objective and subjective sense.
Therefore, these words must be used rather broadly and loosely.
To illustrate, for some people depression causes alcoholism. For others, depression is caused by alcoholism.
In particular fashion, some folks just have depression and alcoholism simultaneously; for others, the depression strikes upon giving up the drink.
This article is specifically about this latter form and is focused on answering the question: Can Sobriety Cause Depression & Anxiety?
YES, IT CAN AND LIKELY WILL.
What a terrible feeling to finally give up the sauce and wake every morning with barely enough energy to eat let alone brush your teeth, hit a meeting, see your therapist, and follow whatever means you’ve been employing to reach sober ends.
You might eventually want to throw in the towel and say “to hell with it all.”
But seriously, why get sober to only feel worse, right? It seems counterintuitive.
Therapist: Why did you drink?
Alcoholic: I drink because I feel like shit when sober.
Is this you?
Sounds like you have a sobriety problem, not a drinking problem.
Well, you’re not only in good company but in the right place.
The Biological Reasons
First let’s delve into some of the biological culprits behind sober depression.
Acute Withdrawal
One Psychiatric Journal reported the following:
- The prevalence of depression among alcohol-dependent persons is high.
- There is recovery from depression after alcohol detoxification and rehabilitation, and majority of the cases do not necessarily require treatment for the depression.
- In addition persons that are depressed have a significantly higher craving for alcohol after detoxification and rehabilitation.
Undoubtedly, acute withdrawal can cause depression. This is of course temporary but no less real.
Additionally, early recovery is a stressful time. Here’s the kicker: stress can cause depression. Particularly in the brain of an early recovering alcoholic.
The Addicted Brain
John Dupuy comments, “Stress elevates the corticotropin-releasing factor (CRF) and cortisol in the blood, the natural ‘feel okay’ dopamine system is repressed, he anhedonic individual encounters a drug, which powerfully (if temporarily) relieves this condition, and the brain interprets this relief as the key to survival itself. We are then off to the races.”
Early recovery stress will inevitably depress the individual, which causes the brain to demand an extra dopamine surge to carry relief.
This is the nature of craving. So this is expected and completely normal.
Patrick Carnes, in The Gentle Path Through The Twelve Steps, notes
Ninety days can feel like an eternity. This is why it’s paramount to rely on strong support and accountability. Moreover, to what does “addictive behavior” refer? Drinking? Or the host of behaviors that accompany that lifestyle? I’d argue the latter.
Fortunately, Carnes clarifies, “Addicts and coaddicts typically have a problem feeling safe. Many were sexually, physically, or emotionally abused; others lived for years in an environment of fear, trauma, or continual stress (emphasis mine)”
Now recall that “Stress elevates the corticotropin-releasing factor (CRF) and cortisol in the blood, the natural ‘feel okay’ dopamine system is repressed,” and a litany of behaviors can relieve the condition, not simply a drink or a drug.
He continues, “Such an environment (high levels of stress) causes the brain to produce powerful neuro-chemicals known as cortisol and endorphins. When creating these chemicals repeatedly over time, the brain can become addicted to them. This is why addicts and codependents are often drawn to drama, intensity, stress, and fear: they cause the brain to generate cortisol and endorphins. The sex addict visiting a prostitute, the gambling addict betting the rent money, the codependent husband trying to control his wife’s drinking—these situations all create cortisol and endorphins in the brain. These chemicals then become two of the main drivers of addiction (emphasis mine)”
At any rate, I just wanted to stress that the very system that drove you to drink won’t suddenly be inoperative now that you decided to be sober.
Additionally, the safety factor is one reason why the community here at SOBERTOSTAY is crucial.
You’ve likely heard people in recovery claim sobriety is the best thing that’s ever happened to them – that they’re living a life beyond their wildest dreams.
However, I’d argue damn near all of them went through the wringer early on.
Sobriety and depression are simply too closely connected for this gamut to be bypassed.
Post Acute Withdrawal
Post Acute Withdrawal (PAWS) is simply inescapable for most and with it a string of mood swings from pink cloud to consummate darkness.
“In a recent study of a large number of patients it was discovered that between 70% and 90% of people experience symptoms of PAWS. The number affected depended upon what the substance of abuse was: about 70% of former alcohol users and as high as 90% for former opiate users. These numbers are very high!”
PAWS is the name and depression is the game. “Post-acute withdrawal is a consequence of the significant changes to brain anatomy and chemistry that take place during active addiction. The brain’s reward system is turned on its head, and its natural ability to cope with stress is undermined.”
Therefore, we have a brain that amplifies even the tiniest of stressors to unmanageable proportions. The stress causes depression; this signals via cravings the desire to drink again to deal with the stress. It’s a vicious cycle.
But how long does this last?
Mager states that,
This is basically the same amount of time Carnes provided.
That’s the good news. The bad news is “Depending on the intensity and duration of alcohol or other drug use, post-acute withdrawal is known to last many months. Post-acute withdrawal symptoms typically last between one to two years; however, the severity and frequency of symptoms tend to dissipate as time goes by without the use of addictive substances.”
Nonetheless, despite the difficulties, you can recover and maintain your sobriety.
Depression doesn’t need to lead to a relapse.
It’s best to be evaluated by a professional to rule out clinical depression and other diagnoses
The Psychological Reasons
Unfortunately, the biological barrier isn’t the only one. Early sobriety has a host of other psychological reasons for depression.
The Loss Is Significant
Do you remember your first love? What an amazing feeling, right?
Do you remember losing your first break-up? What an awful feeling, right?
The former feels like life and the latter feels like death.
Oddly, this is what early sobriety feels like. It’s eerily similar to a horrible break up.
For some of us the drink became our last friend, all the others had since left; we pushed them away.
Sure, the relationship was abusive but at least we had something to come home to – granted we still had the home.
To be frank, it’s far worse than a break up because it’s a loss of identity.
However, said identity, likely associated with certain types of people and places, most of which will no longer be compatible with your new lifestyle.
It’s a lot of loss and it seemingly happens all at once. This can be excruciating!
This can be psychologically devastating, which makes it so much more important to establish new relationships.
However, if you struggle with relationships this only adds to the horror.
It’s not easy, but 100% doable granted you can follow instructions, put in the work, and rely on the help of others.
Where’d The Fun Go?
Let’s get real, our culture is alcohol-saturated. The conception and birth of which alcohol was seemingly the center and circumference.
When most of us ponder a social life we cannot picture it without some form of alcohol.
What about weddings? Promotions? Or just an exciting evening with peers?
Would anyone even want to hang out with me once I’m sober? Won’t I be labeled the weird and boring sober one? Birthday parties must be an exception, no?
These types of thought tend to fuel alcoholic speculation and cause immense often nonsensical rumination.
You’ll likely start to believe the garbage you’re peddling yourself. This is how depression often rears its ugly head.
Though you are likely abstaining from all non-sober social events for the time being, this doesn’t have to be a permanent sentence.
Living alcohol-free is becoming increasingly popular. This is evident by the growing number of mocktail beverages at bars.
Additionally, as your life evolves and changes you may rarely associate with people that are big drinkers.
Plenty of people live very social and happy lives while sober. It’s crucial to remain rational about this. (Check out SMART Recovery’s ABC’s).
Re-Learning To Cope
The truth is that most of us with alcoholism (click here to understand the various types), use booze to treat something that ails us.
Perhaps it’s depression. Maybe trauma, anxiety, or inability to socialize and connect with others; it could even be codependency.
All these things still exist once we sober up.
This compounds the already heavy burden of stress, which I noted above is dangerous for the newly sober individual.
For starters, we need to be proactive in combating this.
For insight into launching an attack on this click here, here, and here.
You may not be able to control everything that happens to you, the thoughts that run through your cranium, nor how you feel but you can control your response.
In this sense you are response-able.
It’s within the realm of your control and thus your responsibility.
Start with SMART Goals:
- Specific
- Measurable
- Attainable
- Relevant
- Time-based
If you set up daily SMART goals you’ll develop a sense of security as your confidence skyrockets.
This is the biggest issue I see with newly sober folks, they often play it by ear.
However, they end up using the same playbook that got them in trouble to begin with.
If you get a coach, or a sponsor, pastor, therapist, whoever, that can continue to provide positive feedback as well, you’ll start to believe in yourself to handle much bigger tasks as you intentionally conquer the smaller challenges.
You need to be intentional about changing your playbook. This is why a coach can be such a powerhouse for your personal development.
This new playbook is a host of new coping skills. Not easy to acquire, but you can do it!
Is Relapse A Part Of Recovery?
It’s vital to redefine failure.
Why?
There is no such thing.
In Neuro-Linguistic Programming, they have a saying: “no failure, only feedback.”
If a relapse does happen; statistically the odds are high, which is why I loathe statistics, but if it does it’s crucial to avoid feeling like a failure but deciphering the message the relapse brings.
Heck, even failing to accomplish your goals for the day. Recall, it’s not a failure, it’s just feedback.
The feedback is that something is off, something needs work.
If you have a flat tire you don’t give up driving because you’ve failed.
Instead, you realize the car is giving you feedback: fix my tire, bud!
So, you saunter to the truck, get out the spare and the jack, and get to work.
In a moment’s time you’re off driving again! No failure, only feedback!
What You Can Do About It?
Be mindful of your basic needs. In recovery circles we refer to this as HALT
- Hungry
- Angry
- Lonely
- Tired
Making sure you eat and sleep right, that you surround yourself with sober friends, and that you deal with your resentments.
It’s absolutely essential that you take care of yourself. It’s not always rigorous psychotherapy delving into the dark recesses of your past.
Most of the time, it’s merely taking care of yourself in the present. If you are not in fit condition you’ll simply lack the capacity to yield fruit from psychotherapy.
Reawaken Passion
Alcoholics and addicts are some of the most talented, resourceful, and brilliant people I’ve ever known.
Most have a history of music, art, carpentry, athleticism, fishing, hiking, etc.
However, these things have fallen by the wayside and booze has taken their place.
Well, it’s time to re-ignite the fire; it’s time to push the acceleration to the floor and burn some rubber.
Get back out there doing what you love.
There are only 24 hours in a day. That means that if you live to 80 years old you’ll only have lived
645,120 hours.
If you’re not doing what you love, then it’s logic that you’re depressed.
Sure you might retort, “but I love to trick.”
But that’s a negative ghost rider, you like what the drink enables you to do and to be.
Get out there and do it alcohol free.
I have one question: are you going to let shame win or life win?
Go live.
Keep A Schedule
Be very diligent about what you do.
Create a schedule and follow it religiously.
Pencil in outpatient, counseling, meditation, a meeting, time with your coach or sponsor, etc.
Involvement is HUGE.
Volunteer somewhere, soup kitchen, clothing closet, a homeless shelter. Get busy contributing to your community, I can assure you that there is nothing more rewarding.
Set the time and get it done.
The schedule helps keep you accountable.
Accountability affirms true identity so you can live to your maximum potential.
Additionally, the schedule keeps you busy. Not avoidance busy like some folks do, they work 80 hours a week so they don’t drink.
Unfortunately, that will end is disaster. You cannot avoid your problems.
Instead, you become very intentional about what you are trying to accomplish and set those SMART goals to achieve them.
We aren’t avoiding life, rather we are challenging it head on.
Begin With The End In Mind
Vision is the keyword here.
I’ve heard it said that where there is vision there is provision.
Mentally rehearse what your day will look like. Play it over and over.
You’re trying to build a new life.
The vision will inspire you, motivate you, and help you endure.
I suggest you create a mission statement and put it somewhere that you read it daily – an index card in the pocket works!
Above are just a few tips to help you wade through that muck and mire of early sobriety depression. However, if you think you may have clinical depression, it’s responsible to be evaluated by a professional psychotherapist and psychiatrist.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658562/
https://www.smartrecovery.org/am-i-going-crazy/
https://www.addictioncenter.com/treatment/post-acute-withdrawal-syndrome-paws/