Often, chemical dependence presents itself as anxiety or depression, so someone having trouble with alcohol or some other drug might think that, say, anxiety is the main problem, when in reality the addiction is generating the anxiety. Sometimes anxiety and addiction can co-exist, but many times addiction is creating an anxious state of mind that tends to get worse and worse as the addiction grows out of control. It’s generally thought among the public that chemically dependent people are driven to addiction by some underlying psychological disorder or condition – this is not true. Addiction can happen to anyone, regardless of their psychological condition. Once a person starts moving through the stages of addiction, psychological problems often develop, but this is usually due to the nature of addiction and behavioral consequences that are at odds with reality. Addiction causes much confusion and emotion/mental turmoil.
The same thing goes for depression. In fact, alcohol is a depressant drug that initially has a stimulative effect. Most social drinkers don’t drink enough for the alcohol to become a depressant, so they enjoy a few drinks for relaxation or stimulation. The alcoholic, though, is often depressed from the alcohol itself and the consequences that attend alcoholic drinking. When an alcoholic goes to seek counseling, they’ll often minimize the drinking and highlight the depression. The alcoholic’s brain is slowly being rewired and he/she believes alcohol is vital to existence. The alcoholic protects the alcohol, concentrates on the depression, along with the magical thinking that maybe if they deal with the depression they’ll be able to drink without dire consequences.
Counselors trained in anxiety, depression and addiction disorders will recognize chemical dependence as the primary problem, if, indeed, the person is chemically dependent. The trained addiction professional will determine if anxiety or depression are likely caused by the addiction, or if there’s a long history of anxiety or depression. If it’s determined that addiction co-exists with either an anxiety disorder or a depressive disorder, then both conditions require treatment.
From experience, I’ve found that most people who’re chemically dependent don’t have problems with anxiety or depression after they’ve been abstinent and in recovery for a while. Then, there’s another possibility — a person might have an anxiety disorder or a depressive disorder, and the person might be misusing alcohol or some other drug to self-medicate, thinking that their drug of choice will alleviate their disorder. In this case, anxiety or depression would be the primary disorder — there would be no addiction diagnosis. The person’s anxiety or depressive disorder would require treatment, and the person would receive counseling on the dangers of self-medication. In order to straighten all this out, an in-depth evaluation is necessary by a trained professional who understands anxiety, depression and addiction. The key it to get good information, which is never easy. It’s always good if a family member attends the evaluation — then maybe the perspective is a little clearer.