Thursday, July 9, 2009

How many of us are self-medicating?


I sent an odd email to my father the other day. I was intoxicated when I sent it; actually I was high. I had been smoking weed for the past week almost daily and not entirely sure why I reached for my stash each night and proceeded to put myself into a stoned state. The experience was not always a good one. In fact, on some nights I descended into an extreme paranoia—even when there was nobody around to trigger it. The positive effects, I guess you could call them, were my racing thoughts and the hypo-mania my personality lends itself to while high. There were so many brilliant ideas shooting off like fireworks from my synapses, but translating these ideas into writing seemed increasingly difficult. To me, drugs have always been a way to make contact with another world, another dimension of myself.

The night I sent the email to my father I was researching the growing trend in self-medication. I rummaged through the top results on Google for “self-medicated” (it turns out this is also a movie) and “self-medication.” First I wanted to know the definition of self-medication so I turned to Wikipedia.

Self-medication is the use of drugs or self-soothing forms of behavior to treat a perceived or real malady. Self-medication is often referred to in the context of a person self-medicating, in order to alleviate their own distress or pain.

What originally drew me to the idea of self-medication was the broadness of the topic and the number of people (I knew) who seemed to self-medicate in one form or another. While “addiction” is a term usually reserved for a specific class of people enslaved by their substance of choice; “self-medication” sounded more ambiguous.

Surely, it doesn’t have to be ambiguous. There are plenty of people suffering from mental illnesses in which self-medication is a clinical fact. The correlation is so common that doctors have come to expect it in patients with depression, post-traumatic stress syndrome, and anxiety disorders.

These people have “real” maladies. But what about those of us who don’t? I’m pretty sure I don’t suffer from a real or perceived malady, and yet I self-medicate.

But my definition of "self-medication" is broad. For example, I drink coffee at least twice a day. This has become a sort of ritual, like a religious exercise. I have my coffee at a local Border’s. I always bring The New York Times with me; I find a comfortable chair in a spot where there are few distractions. Coffee is a powerful stimulant, but sometimes I think the ritual holds more sway over my body.

I’m also addicted to cigarettes, which I’ve tried to quit many times. My essay “The Divided Self” gives a psychological portrait of my struggle to quit smoking. I keep telling myself that my smoking is temporary, as if nicotine were a drug I’ve prescribed to myself to cope with reality for the time being.

And so we can expand “self-soothing forms of behavior” to include almost anything. My father has never taken illegal drugs and he rarely drinks more than a glass of wine. But he engages in many “self-soothing forms of behavior” from meditation to yoga to hiking.

What's the underlying malady my father self-medicates with his intensive yoga practice? Maybe it's stress, maybe over-activity or insomnia. I don't know, but it seems my father with his "healthy" practices and me with my "unhealthy" ones are attempting to treat some internal issue.

Does it sound like I'm validating my behaviors? I hope not. Self-medication is not always a bad thing, as I see it. But I'm curious about human behavior in general and why we medicate ourselves in the broadest sense of the term. After all, "self-medication" could simply be a metaphor for how we cope with reality.

The question posed in the title of this essay is not meant to be condescending. I seriously want to know, "How many of us are self-medicating?" Because I have a hunch that self-medication is pervasive, and I would like to know of how many people identify themselves in this way . . .

“Dysphoria” is a term sometimes associated with “self-medication.” The general idea is that we self-medicate to assuage, or lessen, the effects of an undesirable mood such as sadness or anxiety. I think this complicates the matter further. How many of us engage in behaviors to alter our mood? The American culture clings to the idea that shopping, eating, exercising, taking a pill, and (fill in the blank) will make us feel better. Because most of the time it's true; at least temporarily, like my cigarettes.

The growth of the pharmaceutical industry in the last two decades has led to many of us becoming connoisseurs of our own vague conditions, our own dysphorias. And this is especially true of teenagers and women between the ages of 18 and 44 in the United States. We take pills rather nonchalantly for every slight problem that arises. And you don’t need a prescription drug in order to self-medicate. The vast selection of over-the-counter drugs practically grants the consumer status as diagnostician.

But I digress.

The email I sent to my father was odd because I sought to convince him of the connection between my mother’s degenerative disease and her incessant painting with toxins and solvents. You see, there was a section of the Wikipedia definition that stood out from the rest—even as I was stoned, or perhaps because I was stoned.
Exposure To Organic Solvents

Chronic exposure to organic solvents in the work environment can produce a range of adverse neuropsychiatric effects. Occupational exposure to organic solvents can lead to alcoholism with higher numbers of painters for example suffering from alcoholism. It is possible that a small number of alcoholics are self medicating the toxic effects of organic solvents albeit with another toxic substance alcohol.
I wondered if my mother was self-medicating because, as an oil painter, she was exposed to many toxins. But my father sent me a curt reply: “No, your mother was not self-medicating.”

My mother never drank a sip of alcohol. But she did plenty of other things excessively, and obsessive-compulsively, creating for herself an abundance of self-soothing behaviors. Gradually her nervous system broke down until she lost her ability to draw a straight line on the canvas.

I’ve decided to put the pot away. I’m not smoking weed, or drinking, at the moment. Two roommates have just moved into my house and the new experience of living with other people has motivated me to go to sleep at a normal hour and avoid the temptation to self-medicate.

I still drink coffee twice a day and smoke a pack of cigarettes. But maybe those things are not considered “self-medication”.

ARTWORK BY LUI FERREYRA

Visit Escape into Life for more essays by the author

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39 comments:

warren said...

Hmm. The occasional beer/whiskey/whatever, or coffee or tea, or cigarettes or pot -- these don't strike me as being self-medicating, just recreational substance use.

Sort of like exercise, yoga, meditation, etc. are recreational body use.

Seems to me that terms such as "self-medicating" seek to categorize or possibly attempt to validate things that we're all prone to do from time to time, no matter what we call it.

Why we seem to feel we need to validate that behavior is, to me, a more interesting question than why many of us like to get buzzed from time to time.

Lethe said...

Warren,

I think a key distinction is the "regularity" of the practice. Meaning, when you take medication, you have to keep taking it.

"Getting buzzed from time to time" is not what I'm talking about here. I'm talking about needing to get buzzed every time, every night, for example.

Self-medication thus implies regularity, a regular practice.

And medication is not necessarily bad. Neither would self-medication. Yoga and meditation could easily be perceived as "healthy" forms of self-medication.

Chris

GreatBigBadger said...

I'm not happy with the term 'self-medication'. Perhaps it's a cultural thing, but in the UK, I believe most people presented with the term would think of taking a paracetamol for a headache or rubbing liniment into a bruised knee.

From what you write, there seems to be an element of self-abuse in the term. Isn't it a good thing that people treat themselves, as for one thing, it helps keep numbers down in doctors' surgeries.

Perhaps more importantly, it stops us handing more and more of our treatment choices to medical professionals. Educated self-medication, in the sense I would use the term, is surely empowering.

serena3495 said...

I agree with the comment above -- self medicating refers to the use of drugs, herbs, etc. to treat a physical symptom, like pain or sinus congestion or a skin rash. It does not refer to drinking coffee or practicing yoga, as you claim. Any healthcare practitioner can define the term for you unambiguously.

And it does NOT refer to regularity, either. People can self-medicate an occasional headache without having to take medicine every day.

Your essay is flawed because you don't understand the definition of the term you seek to write about.

Lethe said...

GreatBigBadger,

Well, I did say in the essay that I don't necessarily consider self-medication a bad thing. And I point to healthy examples of self-medication.

But you bring us a good point. Educated self-medication is definitely positive and empowering. Maybe because of the way the healthcare system is set up in the US, we are encouraged not to self-medicate; rather let doctors do this work. And yet, ironically, we see examples in our culture that suggest self-medication is pervasive.

But the question of educated self-medication almost veers into another topic area--that relating more specifically to prescription drugs or over-the-counter drugs.

Thank you for bring this to the discussion.

Lethe

Lethe said...

Serena,

I'm willing to concede that regularity is not a necessary characteristic of self-medication.

However, the Self-Medication Hypothesis, from which the term derived, was originally formulated based on studies of heroin users. And you can bet the original theorists had regularity in mind.

Second, I chose this topic because it's controversial and interesting. The controversy may stem from how we choose to perceive ourselves in regards to this concept. But there also may be varying cultural connotations to the term. For example, the comment from GreatBigBadger, who is from the UK, adds another perspective.

I don't believe this term is as unambiguous and clearly demarcated as you seem to hold.

Chris

Mary Jane said...

Interesting article. Hmmm, I have never done any 'fun' drugs, other than some alcoholic drinks. I do drink coffee though. I only allow myself 2 cups at the start of the day, because it makes me shaky. I do love it. I feel that I can't really 'wake up' without it. I do believe that I am self-medicating with the coffee. It's okay though, no worries. My parents used to drink it all day and it was very strong coffee.
I do take several homeopathics medicinals every day. I have done research about them and feel that I really need them as prevention against disease.
Thanks for sharing your article and I do hope you can be happy without the happy plant and hopefully you can also give up the cigarettes. You know you really want to. ;-) As for the coffee...well we NEED it!

serena3495 said...

The comment from the gentleman in the UK is not a different cultural perspective -- that's the exact same perspective on self-medicating that's held by healthcare workers here in the U.S. He's exactly right in his definition of self-medicating.

Lori said...

I self-medicate. A lot. I require coffee in ample amounts. I require cigarettes in equally large numbers. While I don't think of this as self medication on a daily basis, I know that it is.

I don't take drugs, nor do I drink all that often. My form of self medication is - outside of the aforementioned coffee and cigs - behavioural, rather than chemical.

I can name any number of things that I do to alleviate pain that no doctor could prescribe, and no street drug could purchase. And yet, they are far more effective to me than anything else.

These are not things that alleviate the mere symptoms of the pain, as a lot of medications do. They are things that heal the cause of the pain, and bring peace to my body and soul.

So, while these behaviours might not be something derived from the medical community, there is no chance that anyone in that particular community could know better than I do how to medicate me.

At least not when it comes to that particular kind of pain.

I embrace my self medication. Without it, there wouldn't be anything to bother medicating.

Carlos said...

I smoke everyday and have been doing so (almost everyday) for the last 15 years.

Why?

I don't like alcohol and I really don't like cigarettes. But it's also more than that.

I like who I am when I am high. I like the mellowness I express and the love I can connect with.

When I'm not high I remember who I want to be, how I want to treat others and I work towards being exactly who I am when I am high even when I am not.

Getting stoned opens the doors of perception, I can detach from the problem and receive the solution.

Natural forms of self medication are far better than the pills and medicines BIG PHARM offers us in exchange for our wealth and health.

I am proud of the fact I smoke herb. I think it is one of the greatest crops on Earth. As we search for ways to cope, heal and understand I think we need to look away from industrial solutions and search the natural.

Perhaps we all medicate in one way or another to restore the imbalances we feel, so may be if we put some natural balance into our lives we would not feel the urge to medicate as much or at all.

Have a wonderful day. Thank you for such a fantastic article.

All the Best,
~Carlos Duran

VinaMist said...

From experience myself, "self-medicating" is a way to deal with stress from society weather good, or bad. Also to alter mood or state of mind. It has been a social way to escape from reality.There are healthy and unhealthy ways.

I often worried about my father whom smoked cigs and pot daily. Not because of the substance use, but the unhealthy effects on his lungs. Around age 40 he quit and became addicted to exercise. Some people become "addicted" to exercise with a chemical release in the brain (BDNF).

My mother with her COD, is obsessed with painting and refinishing. She has admitted to "getting high" off of the chemical fumes from the paint. So in theory you may be right about your mom.

As for Coffee, caffeine has proven to be the most popular psychotrophic drug, and healthy in moderation as Wine.
I think most everyone has a way of "self-medicating" in one way or another to deal with the stressful society we live in.

This is just my view and nothing against your essay.

Cheers!

Lethe said...

Serena: It is easy to fall back on clinical definitions in textbooks; but much harder to look inside yourself and ask, "Could I be self-medicating with X?"

We will have to agree to disagree on this topic.

Mary Jane: I must say that it was good to hear you write, "I do believe that I am self-medicating with the coffee." Because according to Serena's definition of self-medication, this would not be possible.

Maybe I'm not alone in my thoughts, which gives me hope.

Lori: I really appreciate your honesty and openness on this blog.

You write, "While I don't think of this as self medication on a daily basis, I know that it is."

I think this is true for many people. We don't think of our coffee addictions as "self-medication" but they are.

I also like how you break down self-medication into chemical and behavioral. This is an illuminating distinction.

Lastly, you give the perspective I am most closely aligned with. We know what makes us feel better. We may not know exactly what's wrong with us, ie the "pain" you mention. But we have our treatments.

Thanks again.

Carlos: I am so glad you found this blog. Your perspective is very important here.

You're a regular cannabis user who feels that pot helps you to achieve balance. This sounds like an empowering form of self-medication. Pot may not work for me, but it does for you.

It's important, I believe, not to stigmatize any medication, the medications are neutral--each person will have a different response.

"Perhaps we all medicate in one way or another to restore the imbalances we feel."

This is a beautiful statement. Thank you.

VinaMist: Thank you for sharing that about your parents. We're influenced by our parents in terms of substance use and abuse and how we choose to cope with reality.

From what you say, it seems like we're in agreement. You write: "I think most everyone has a way of 'self-medicating' in one way or another to deal with the stressful society we live in."


Everyone: I must say after the first couple comments, I became discouraged. With every essay I write, I put a lot of thought and energy into it. After the first comment, I actually revised the essay to embrace a more holistic idea of self-medication.

Future readers, tell me, do you think there are flaws in my essay?

This is not a black and white issue. Human subjective experience is what I'm exploring here; not medical definitions.

I like a diversity of opinions. But I can't help myself from stating my original intentions, and how I experience reality myself.

Chris/Lethe

Lisa said...

I think the problem you've run into with the various comments is directly tied to the term "self-medicating". Without providing a narrower context, I don't think you can zero in on an answer to the question you've posed.

Within addiction recovery circles the term, "self-medicating" is pretty generally accepted as self-destructive behavior linked to the intentional ingestion of something, which could be alcohol or drugs or even food for people with eating disorders.

Although there are other compulsions that serve to address the kinds of issues addictive personalities have (like cutting, shoplifting, sexual addiction, etc.) I wouldn't include them under the umbrella of "self-medicating".

I also don't think non-compulsive drug or alcohol use would generally be considered "self-medicating".

So if you accept my very narrow definition of "self-medicating", the next hurdle you'd have to jump would be in determining whether or not a person is in fact, "self-medicating". I would hazard a guess that a large percentage of people would deny engaging in "self-medication". Many people will claim that they do what they do because they enjoy it or they abuse prescription drugs because they're convinced that they're treating a legitimate ailment. Maybe some do enjoy it (although if that's true, the use couldn't be tied to an overwhelming compulsion), but others don't actually recognize why they're doing it or may not accept that they're self-medicating a problem they can't define.

As for a literal answer to your question -- it would be impossible to find an answer -- if by "us" you mean society, in general.

Lethe said...

Lisa: Now that is an intelligent response. Thank you.

Lori said...

Lethe, I don't think your essay is flawed. Why would you think so?

The only statement that I would have to say I disagreed with at first was that self medication is something that needs to occur with regularity.

However, after some thought, I have to say that I have revised my opinion, based on my own personal experience. The key is not in the regularity, but in the personal definition of 'regularity'.

Some of my personal behaviours fall into the more accepted definition of regular. Morning coffee, for example.

That being said, the behaviours that I would never have considered to be regular, in actual fact, are.

They might only crop up when required by whatever I'm going through at the time, but they are as regular as taking an aspirin would be to a person who gets an occasional headache.

Not daily, but certainly regular.

As well, I think that there are people who get hung up on the terminology. Medicating is generally accepted as meaning with some form of chemical addition to the system.

Loads of people would not want to admit to medicating because it infers that there is something wrong with them that requires treatment.

As well, just from personal experience, I would have to say that with the possible exception of smoking, there are few self medicating behaviours that I practice that are self-destructive.

Healing, yes.

Perhaps what is really need is a phrase that one can use that would strip away the negative connotations and leave something that would allow us to embrace our practices, both chemical and behavioural.

Self-balancing?

Lethe said...

Lori: You're right. The term "self-medication" has so many medical, psychological, and addiction-based connotations.

We need a new term to define what we're doing here. "Self-balancing" is getting closer to that holistic idea of "self-care".

But I do believe there is a negative side to self-medication. Only in the sense of "We need it". There is a dependency.

I would like a term which embraces both sides. But it seems we fall into either a positive or a negative view of self-medication.

Thanks for your extensive comments.

Chris

Lisa said...

Wow, you've really made me think now. It's hard to believe there isn't a term that encompasses all activities that lead to an altered state of some kind, whether the activities or motivations are healthy or not. I suppose there would be several categories of -- just for the purpose of this discussion -- what we could call SM.

1. SM via medication to alleviate a physical or chemical ailment. Prescription and OTC drugs to heal, alleviate pain or balance mental illness might fall into this category. Holistic remedies could too.

2. SM via alcohol & illegal drugs (including prescription drugs that aren't prescribed) to alter a person's sense of well being. This would break down into two categories: occasional/social use and compulsive/addictive use.

3. SM via self-harm, sexual-addiction, overwork, shoplifting and other aberrant behaviors that people indulge in because it provide a sense of relief from something.

4. SM via running, yoga, meditation and other healthy activities that provide a heightened sense of well-being through endorphins or other healthy chemicals the body produces. This one is interesting because some people use these methods to relieve unpleasant states, like stress and others use them to enhance an already healthy lifestyle and sense of being.

There has to be an umbrella term for this stuff.

Interesting question.

Lethe said...

Lisa: An excellent classification "system" which can lead to many more insights. I don't think in scientific terms or definitions. I think based on my experience and observations of the experiences of others. But you can only go so far with this logic. Your semantic distinctions open up the discussion to a whole new level. Thank you.

leica said...

I disagree, to an extent, than to self medicate suggests a degree of regularity.

I do agree with the original assertion self medication involves using chemicals to assuage negative feelings including physical pain and discomfort.

I heard a program on BBC Radio 4 a few years ago that stated that scientists identified poor endorphin production (remember endorphin means endogenous morphine, a natural pain killer) as having a genetic origin. So, people are born with it, and tend to be the ones who get addicted to behaviours (taking drugs, sex addiction, exercise addiction, food, etc) that increase endorphin production. It's the endorphins we get addicted to as much as the behaviours themselves.

People who fail to produce enough endorphins do tend to suffer much more emotional and physical pain than people who do not lack the gene.

So, in order to not get addicted but suffer less we do need the self medication. But we can choose the form, and vary it enough to avoid addiction to any one substance.

So eat healthy, get plenty of exercise, take hot baths (yes they do help), have the odd drink, social cigarette, bong, chat with friends, sneak in a bit of chocolate now and again, coffee, whatever works. Just remember moderation is the key - well not just key but vital to maintaining a balance of feeling positive and staying free from common addictions.

Lethe said...

Leica: Thank you for this well-rounded, clear-sighted advice. Endorphins or lack thereof definitely play a big part in one's need to self-medicate.

Billy said...

powerful essay. you do what you can to get through the mundane. actually everyone self medicates. is that a bad thing? existence is a form or self medication.

Bookmarked said...

According to a model known as the Symptom Iceberg, it's approximately assumed that when confronted with a particular symptom 1/3 of people will do nothing, another 1/3 will seek professional attention and the remaining people will self medicate.

I agree with your essay, and some of the comments above, that virtually any activity can be a form of self-medication. From a purely biomedical aspect, one would probably only consider the physiologic effects of whatever activity chosen i.e the effects of drugs, the endorphins of excercise.

However, in a more balanced biopsychosocial approach, one must consider the underlying reasons people self-medicate, and why they choose the substances they do. Clearly, someone that chooses coffee for dealing with stress had different motivation/circumstances than someone who chooses to self-medicate with alcohol. In fact, a study I recall reading suggested the effects of alcohol and some other inhibitors was largely cognitive; you get the effect you expect because you expect it.

We all self medicate, but I suspect we do it for very different reasons.

Lethe said...

Bookmarked: I really like the new data/information you're bringing to the table. The Symptom Iceberg is something I haven't heard about before.

dujh said...

This is a fascinating yet somewhat morose category. I am impressed that you through in the word diagnostician, a la Capote. Sex is also a way to self medicate. I personally choose to self medicate when my rx runs out. I am struggling to take it as persceibed, helps me in so many ways and. It's legal, unlike other ways to seek comfort. Great article, I would love to see u work in some experiences of others, or expound on your father a bit. Tie it up in a bow I always like that don't we all... Thanks. Tweets2thetweet

autom said...

how many of us are self-medicating? i reckon a lot, and the 'self-medication' is done through different means and for various reasons, indeed, as you pointed out.

do correct me if i've misinterpreted this, but i'm somehow getting the sense that this piece also seeks to strongly disassociate "self-medication" from "addiction".

if so, i do believe the two are slightly different. although it is likely psychology's tendency to infer that self-medication may lead to addictive modes of behaviour. and this is quite simply a fact that more and more (in my mind) is losing its once stigmatized connotation.

the majority of addictive behaviours stem from powerful environmental conditions from which an individual is unable (or unwilling) to completely detach. i read a study that was done on lab rats to determine if the nature of the addiction can be pinpointed to the drug itself or the environment in which the addicted lives, functions, reacts, etc. the study proves that it points to the latter (environment).

there are parallels of those findings in this piece. nicely explored Chris. kudos.

Carlos said...

Really wonderful comments here and exchange of ideas.

Chris I agree with you, we should not stigmatize and we do need to realize what works for one person may not work for another. We need to be accepting of each other, if anything this will lead to healing. =)

Again, thank you for a brilliant piece which for me, lets me know I am not alone in my human experience.

We all have pains, ailments and our own way of dealing with it. I think your essay helps (at least it does me) to break out of my own "little office" and reach to others with similar challenges. Discussing it and working together I think it the BEST form of self-medication.

You Rock!

Time to roll a J. =)

All the Best,
~Carlos

Gretta said...

Chris, To me self-medication is no more than creating distractions for ourselves, some of us needing greater distractions than others. At times, I have needed great distractions from the angst and pain in my world, and at these times, I am looking for anything to block it out. Some times I seak out healthy distractions;sometimes not so healthy. We are all inadequate, and unempowered in this world (even though we sometimes delude ourselves to the contrary which is where "self-medicaton comes in) but ultimatly, I think that the challenge for all of us is to make some peace with this state of our being. Not an easy task, but what we all have to come to.

Showeda said...

This essay not only breaks new ground by problematizing some of the vocabulary used in managing our own health and well-being, it seeks to expand the debate around the growing inefficacy of squeezing these current notions into the more traditional dualistic health paradigms of the past..Lethe's inimitable style of judgement-free self disclosure, I think has encouraged the quality of responses and comments formed.

Its clearly an uncomfortable topic for some, but surely Lethe is asking us to at least recognise, if not analyse that discomfort, the very space between points of view,ways of living...What we do to get by, feel better.

We live in such bewildering times, when taken for granted knowledge/received wisdom has not only been seriously questioned but found wanting for so many of our worlds..This essay offers a welcome and much needed refreshing perspective.

As for the 'need' and 'regularity' issues raised..I think that maybe it can be determined by how close or far an individual feels to their authentic/intuitive selves and how important/ necessary it is to maintain that relationship..Lastly, I think a good umbrella term could be social or indivdual panaceas?

Lori said...

Showeda, thank you. Thank you for your whole comment, but particularly for the final part.

"...maybe it can be determined by how close or far an individual feels to their authentic/intuitive selves and how important/ necessary it is to maintain that relationship..."

In one thought you have managed to communicate very succinctly my feelings. The utilization of my 'medications' are almost entirely tied to this concept.

The connection that you speak of is imperative to my well being, and when that connection is weakened (or worse, broken) anything I can do to bring it back will be done.

My own panacea, indeed.

Absolutely brilliant. :)

Showeda said...

Ah Thanks Lori, and Lethe for original article :)

5affy said...

A term I would have used here instead of self-medication would have been escapism - this is a behavioural pattern I have noted in humans including myself.

It can be grasped in many ways - drugs, excersise, writing, painting, loud music, maths - anything that pervents the brain from focusing on those stresses of life.

Avoidance that isn't nessacerally a bad thing but can lead to detramental behaviour.

I would say from your essay that everyone would count as self-medicating as it encompases all the coping stratages humans have for stress.

OCD (I think but don't know) would have an appeal of escapism as the body and mind could be in a 'groove' a comfort zone created by the repeating pattern or obessession.

From an English point of view I had noticed a tendency at least with american television to push quick fixes and excesses with no thought of cuasality - ie advert for all you can eat buffet followed by one for indegestion tablets. To wit: eat crap and don't worry about the natural consequences as there is a pill to fix it.

Britain has been steadily following down this same path of consumerism cures all which alarms me to be quiet honest.

Artists becoming high and fixated on painting is I think two fold - there is the natural focus on what you are creating where you go into an altered state - this I could see as addictive which is why you are advised to have other people set you an external time limit. Secondly there are as you mentioned the solvents and the like - I has been known for artists to become unconcous from their paints or pens.

I don't know if your mother would have been seeking this particular high but probably at least some sort of escape from the real world by the sounds of things.

I'm not really sure where I'm going with this comment I realise but it was a very interesting read with allusions to conitations that more people need to be assessing within themselves. People really examine their own behaviour or if they do they don't do it impartially taking into account that a) they are human and b) there are going to be culteral factors and the like mixed in.

Thanks for the food for thought and sorry about my spellings

Sarah

windspirit_girl said...

I haven't read all the comments (wow-31 already!), but dealing w/ some of the original questions and some of what I read in the early comments, I would go back again to the issue of how we define self-medication to begin with. People were hearing the term different ways and responding based on their definition. Coming from a therapy background, I have its definition of "self-medicating, which is a pejorative terms for self-destructive behavior used to deal with things that seem overwhelming existentially (emotionally or whatever) to the self. It's already a pejorative term in its reference to the self-destructiveness aspect. (However, it's also morally neutral at times-trauma survivors may only be able to deal with aftereffects by "self-medicating" without enough support and resources elsewhere. There is no blame, a description of the phenomenon.) In this definition, it is imperative that the behavior be self-destructive in some way. That is, leading to more illness (however understood) and emotional problems--not to more health long-term. Things such as yoga and exercise, b/c they (seem to) lead to health would not necessarily qualify unless it took on an addictive quality and led to illness/destruction in some way (golden mean--haha). In traditional terms, then, what defines self-medicating is the destructive quality.

However, there are larger questions. How to define what is "healthy"-so much defined by society and its needs which may or may not be good for us. There is a question of widening the definition of self-medication, which it seems you want to Q here--how is our supposedly "good" behaviors also a way to escape. And, self-medicating, if we take it simply by definition, would seem to be neutral-it depends on context. Medicines heal. Medicines destroy. Poison. It is how they are employed. Self-medication could be a declaration of autonomy to a certain extent in some contexts, in a larger understanding of the definition.

Your essay excels in provoking thought, as you see--and that is precisely what essays are for. A good example of the original idea of the form. :-)

Shannon said...

My husband has just completed 3 months of Drug and Alcohol Rehab. The term self-medication has been thrown around a lot these past few months by his doctors and therapists.

I'm on the outside of the treatment looking in, and I am confused as to why he used and why he self-medicated. I can only imagine his confusion must be double.

I have learned however, that even after the patient is sober and the drug and alcohol use stops, the emotional issues that caused the addict to use are still there.

So I wonder, nobody's emotional issues are healed within 3 months of rehabilitation, so-how will he self-medicate now sober?

And as your essay explores, even if it's a healthy form of self-medication, isn't that just replacing one band aid with another? The emotional issues are still there. Our sadness, our anxiety, our vulnerabilities are still there.

Is the answer to not self-medicate at all? Maybe we are supposed to sit still and actually feel our feelings? -Feel our anxiety, feel our sadness, feel our anger, and watch these feelings come through us, resonate with us, and then pass through us?

We can all self-medicate as much as we want, but our pain waits for us. Is there ever really an escape?

Showeda said...

Hi Shannon, read your comments yesterday and again today...And felt the need to offer some words of very little comfort, I'm sure,but they're heartfelt all the same...Your words and situation touched me ...Particularly 'our pain waits for us'...Absolutely...As I'm sure you were experiencing even as you wrote...The bewilderment, the disappointment, the sadness all very effectively transposed from thought to pen/blog...But above all for me, was your strength...You searched out articles that might make you understand better...WOW...Please don't belittle or dismiss it...If ever a time called for consolidation of such feelings...Building fortitude without a destructive, pervading anger,seems nigh impossible...Yet you seem to be there already...Good luck and all positivity to you and your husband.

MrsWhich said...

I'd like to weigh in, but I found my comment getting too long so I've put it in a blog post. http://mrs-which.blogspot.com/2009/08/self-medicating.html

I hope you'll check it out, I'm really interested in discussion on this topic.

pamela said...

i'm reading this after searching in google 'what to do when someone is self medicating'.

my husband has been self medicating for as long as i've known him. he has genetic related anxiety issues (which i did not know for a long time). he has been perscribed a form of paxil but takes it sporadically. saying he only takes it when he "needs it".

most of the time (meaning everyday) he either drinks or smokes weed or sometimes both. it has caused so many problems in our relationship, i'm at a loss as to where to go from here.
sometimes i feel like he's abusing drugs, but i can't tell the difference. all i know is that i can see it in him when he needs it. he gets anxious and irritable and can't focus on anything. he starts lots of projects and never finishes them.
we have a 15month old daughter. he loves her i know. but spends very little time with her. when he gets home from work he immediately gets high. and sometimes gets so messed up that by 530 he's asleep. there are other days when he's out till late in the evening and doesn't even see his daughter...
i guess what i'm getting at is that he doesn't see what he is doing as a problem. he denies he is escaping or self medicating, yet he's constantly using.
what do the people suffering from this do? we went to a session of counseling, but he refused to go back. how can i make him see that his constant drug use may be making himself feel better, but his family relationships worse?

Lethe said...

@Pamela

I'm not psychiatric counselor or therapist, but I am a recovering drug addict.

The first thing that jumps out at me is that you say your husband sporadically takes antidepressants. Having been on some form of antidepressants since college, I know that these medications are not meant to be taken "as needed".

Paxil, Lexapro, Prozac, these are medications you get on and you stay on; or you get off.

On top of that you say he's drinking and smoking weed--and you're not supposed to mix alcohol with antidepressants.

During the time of this post, I was mixing weed on a daily basis with my medication, which is Lexapro. The medication already causes me to be a little hypomanic, which is not a usual symptom of pot, but when I smoked pot on Lexapro, I became manicky and one night I even had a seizure.

So these are issues that I faced.

Now the bigger question is what to do. Knowing addict behavior (I went to NA for three years), and knowing my own addict behavior, all I can say is that it gets worse, not better.

In some cases, a user may be able to self-medicate with certain substances and remain on a plateau, without getting worse. But overall, addicts tend to need more of their substance of choice, more often.

If you're already beginning to notice some anti social behavior, I would recommend:

A.) Talking to him. See where his is at with admitting his addiction. Don't push him, but show him you care. One of the things that bothered me was when people would threaten me--so don't do that. Let him smoke and drink until it puts you or your daughter's life in jeopardy.

B.) Try to get him to take some action. This can mean a healthy activity, a group such as NA or AA, or a sport/club. Try to get him to open up his world. The addict's world is very narrow.

C.) Lastly I would suggest you have him talk to a doctor. Because if he's taking Paxil on and off, then he is not taking it the proper way. He needs to know that these medications can actually be worse, if they're not taken properly.

I hope that helps,
Lethe

Philip Yana said...

Interesting article, but by applying the label "self-medication" to activities like hiking, you are stretching it beyond a useful point.

To chill on your own after a busy day spent interacting with people, or to go play a sport after a day in front of a computer is not "medication". Not in any form, even if it might be relaxing or invogaring or whatever.

No more than if after going for a run you take a shower, or after a day of hiking you rest up.

Those things are not "medicating" a "problem" they're just living life. Life in a physcial body that naturally gets depleted in various ways, and needs recovery periods.

Jaliya said...

First thought: that my cats could be said to self-medicate by eating grass (the ordinary kind!) and munching on catnip leaves. The grass, in particular, is a digestive aid -- that's what the cats are instinctively going for.

I've come to think of self-medication as whatever we do -- in or out of awareness; consciously or not -- to soften pain, suffering, stress, a mind that won't slow down ... All in all, to bring some balance to a process that's gone awry (i.e., sensation has become pain; stress has become overwhelming; the mind is racing). We tend to self-medicate for either a stimulant or a softening effect ... trying to shift an extreme into a more moderate place. Ergo (in a most common example), coffee in the morning; wine or weed at night.

With more excessive, chronic distress / pain (of any kind) ... I imagine this is where a person would reach for more extreme substances or behaviours (i.e., heroin or opiates; desperate gambling; drinking on the sly).

There are so many ways to self-medicate, aren't there? ... everything from comfort food to a good cry to a hot bath ... and all the ways listed above.

One thing I know for sure: it's a universal behaviour and shared amongst many species. I began to see occasional humour in what I was learning ... like how bears prefer to eat certain berries when they're overripe -- 'cause the bears get a buzz! ;-D

Wonderful post ... amazing responses! Thank you :-)