How often have we heard – or even said, “I need a drink! I’ve had a hard day. I need a nice big meal — or a cigarette!” In the face of stress, it can be tempting to “self-medicate” with alcohol, food and even drugs. Abuse of various substances can be a misguided way to relieve pain, anxiety, sleeplessness or other symptoms of (what might possibly be) an emotional disorder.

Self-medication becomes a real problem when it takes on a life of its own. Let's say you mix yourself a vodka and tonic to reduce anxiety over some difficulty in your life. But instead of doing something about that difficulty, you just continue to drink. This, of course, results in greater anxiety. So you drink more. The cycle continues until the drinking (or eating, or whatever) becomes a bigger part of life than problem-solving, and things quickly spiral into emotional paralysis. Legendary poet and author Edgar Allen Poe hit the nail on the head: “I became insane with long periods of horrible sanity. During these fits … I drank. As a matter of course, the enemies referred the insanity to the drink, rather than the drink to the insanity.”

The same applies to other self-medicating behaviors such as drug abuse, compulsive shopping, compulsive gambling, overeating, or just about any other unhealthy escape. But it’s not the escape that matters; it’s what you're escaping that matters. Once you identify that, you can resume thinking and problem solving on your own or with a trained counselor or therapist.

Thinking about your emotions can help resolve lots of issues, even when you’re self-medicating with something as nasty as nicotine. As any smoker or ex-smoker knows, “Nicotine dependence,” according to mayoclinic.com, “…produces physical and mood-altering effects … that are temporarily pleasing. These effects spur the continued use of tobacco and lead to dependence. Quitting tobacco use causes irritability and anxiety.”

Notice how self-defeating nicotine dependence is! People smoke because of the mood-altering effects. But any attempt to cut back results in greater anxiety. Leaving aside the sometimes fatal consequences, the psychology of smoking isn’t very effective even on its own terms.

Attempts to quit these various unhealthy escapes can easily fail. People conclude that they “just don’t have the willpower.” Willpower is defined as strength, determination and commitment to the value of something, such as one’s life or health. It emanates from the mind. If you don’t engage in personal introspection or even some counseling, it can be very difficult to figure out what motivates you to continue the problem behaviors. You need explanations, not excuses. “I don’t have the willpower to stop my habit” is an excuse. “I lack the motivation or the commitment to stop my bad habit” is an explanation. Armed with that, you can develop your commitment by thinking about what is, and isn’t, important to you. You can’t exercise willpower without first indulging in mind power.

Quiet reflection will probably reveal that you medicate yourself because you’re trying to lower anxiety and stress. You then have the opportunity to, (1) figure out how to reduce that stress, and then, (2) learn to better handle it by looking at things differently. People who self-medicate often skip these steps and just condemn themselves for their habits — all the while maintaining the habits. I’ve told many a recovering alcoholic or other addict, “You were not wrong to try and make your life happier and easier. It’s normal and natural to want to do that. The problem is that the way you went about it just didn’t work.”

Life is full of stress. If we didn’t have any, we’d probably create some. It’s normal and natural to want to be happy and feel good, but the challenge is to do it right, with balanced and rational decisions to eliminate the underlying causes.

Michael J. Hurd, Ph.D., LCSW is a psychotherapist and author practicing in Bethany Beach. He can be reached at 302-539-5986, by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or through his website at www.DrHurd.com.

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