Mental Distress and Substance Disorders: The Substance Abuse and Mental Health Services Administration (SAMHSA) has designated September as National Recovery Month to celebrate the people who are in recovery, while increasing awareness and understanding of mental and substance use disorders.

This is no easy task and I applaud you if you are in recovery. Twelve-step programs work well for many, but there are plenty of paths to recovery. If you’d like to, please let us know what helped you and drop the length of your sobriety. You deserve kudos for every day!

If you follow me, you know my Choice Theory® background provides a different lens through which I view issues like mental and substance use disorders. In fact, let’s begin with the label “disorder.” I think of mental distress and substance abuse not as disorders. I believe they are perfectly ordered when you can get into the minds of the people who suffer from them.

People don’t just “catch” mental distress and substance abuse. These are behaviors people develop as coping mechanisms for whatever is happening in their lives, their minds or both. When you have the privilege of working with people who fall into these categories and you are able to connect with them in a deep and meaningful way, they might take the risk to trust you. When they do, and you begin to hear and understand what has happened to them in their life, their so-called disorders or symptoms may begin to make sense to you.

The problem is that our models for mental health and substance abuse come from a medical rather than a psychological model. Quite frankly, neither of these problems are medical. I know many people list substance abuse as a disease. As explained to me, it is considered a disease because it causes cellular changes in the body. You become addicted when your body grows accustomed to the substance; your brain thinks it’s normal and you need it. At that point, you can be considered to have a disease. However, you can be guaranteed never to contract such a disease if you don’t use. I don’t know any other disease that acts that way, except maybe SDTs, but abstinence won’t cure those diseases. Besides, it really doesn’t matter to me whether you have a disease. There is only one cure for this and that’s abstinence, and you have 100-percent control over that.

Mental health has somehow become a synonym for mental illness. Mental distress is not a disease. There is no empirical evidence to support the notion of chemical imbalances or structural changes to one’s brain when diagnosed with mental health “disorders.” Everyone lies somewhere on the mental health continuum, just like they do on the physical health continuum. When a person lives a life of mental and emotional distress and experiences trauma, the brain is looking for something the person can do to protect itself, and the symptoms of mental distress are born: depression, anxiety, post-traumatic stress, schizophrenia, bipolar disorder, dissociative identity disorder and every other diagnosis found in the Diagnostic and Statistical Manual of Psychiatric Disorders 5. They are all versions of compensatory behaviors designed to help the person get what they want and need in a situation where they generally feel powerless.

The problem is that, while these behaviors may help in some way—providing attention, support, sympathy, avoidance of responsibility, keeping others at arms’ length and a host of other benefits—they also bring a great deal of pain and dysfunction.

The same can be said of addiction. It can start as fun or a way to fit in. It can help the user feel more important and powerful than they feel without the substance. It can serve to numb pain or provide freedom from daily routines or the freedom to do something against socially accepted norms. There are many reasons addiction begins, but it always meets one or more of the person’s needs for Safety & Security, Connection, Significance, Freedom or Joy. After some time, the substance robs the person of any other things that used to make them feel good since the substance is the only thing to accomplish that in active addiction.

When a person goes into recovery from either addiction or mental distress, it means they have prioritized their own wellbeing and found ways to get their needs met in healthier ways. The addiction or the mental health behaviors may have been the best way to do that during the time of their trauma and distress, but once they decide they want to learn different ways, they have the hard work of rebuilding—sometimes building for the very first time—a life where they have healthy and responsible ways of meeting all their needs without relying on the substances or the mental health behaviors they were using.

The behaviors they chose when in the middle of their changes is not to be judged or punished. The individual was doing the best they knew to do under their circumstances and they found something that worked, even though it came with a high cost. Living a life of recovery means they are making even better choices now that are made challenging because of their former habits.

If you’ve ever broken a habit, you know how hard that can be. Imagine how difficult it is to break the habit of poor mental health or addiction when the pull to their former lives is quite rewarding, strong and persistent.

If you know anyone living in recovery, I hope you give them your utmost respect. There was nothing wrong with them. They were dealing with a lot of things that perhaps no one knew about or even still doesn’t know about. They may have repressed the memories themselves. You can know for sure: They are survivors! They found something that allowed them to stay alive. What they are doing now is incredibly brave. They are making better choices not only for themselves but also for the people around them and the people who care about them. I salute them. Carpe diem.

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