Thoughts On Self-Medicating Anxiety

Self-medication is a way people deal with unwanted, unpleasant emotions like anxiety, sadness, and anger. This article will talk about it in the context of anxiety, but the points apply to other distressing feelings.

Strict and broad definitions

People use the term self-medication in regards to mental health issues in a strict and broader sense. The formal, tighter definition is when someone uses a non-prescribed psychoactive substance to manage their mood. For example:

People mostly use drugs to numb their nervousness. Some will also use psychedelics, like magic mushrooms, to try to actively explore their minds and heal themselves. Aside from using substances that aren't ever prescribed as anxiety medication, they might also illegally obtain anti-anxiety drugs, like benzodiazepines and beta blockers, and use them without a doctor's permission or supervision.

A looser, less-literal use of self-medication is when someone isn't misusing an actual drug, but doing any kind of behavior that changes their mood and keeps their anxiety at bay. That is, aside from healthy, recommended coping skills like relaxation exercises. Like someone might casually say, "My wife works long hours to self-medicate" or "He self-medicates with food".

The behavior may distract them, or temporarily replace the anxiety with another emotion. That new feeling may be pleasurable, but it doesn't have to be. The point is to feel non-anxious, not necessarily good. Eating too much and feeling uncomfortably full may be preferable to wanting to crawl out of your skin from worry.

Here are some examples, in no particular order. It's not that every behavior below is inherently bad when done in moderation, but can become a problem if taken to an extreme as a way to deal with unwanted feelings.

Is all self-medication harmful?

I think when we hear the term self-medication our minds can jump to an image of someone who abuses street drugs for years in a futile attempt to quell their severe mental illness. That happens, but not all self-medicating is severe or chronic. Like it's very common for people to have a drink or two to calm their nerves at a party. Ideally they could relax in other ways, but it doesn't always mean they have an alcohol problem. It's also not unheard of for someone to be anxious before a presentation and be given half a Xanax by a co-worker who has a prescription for them. That's not in line with what doctors would advise, but they may never use anxiety medication aside from that.

Awareness of self-medication

Some people are well aware that they self-medicate, even if they don't use that phrase. They may know they can't talk to strangers at a nightclub unless they're buzzed, or that they can't fall asleep quickly without smoking up to turn off their brain, or that they have an unglamorous habit of picking fights with their friends to give themselves a problem to occupy all their attention.

Others haven't made a conscious connection that they use a substance or behavior to manage their anxiety. They may see their self-medicating actions as neutral - "Yeah, I play video games during most of my free time, but that's just my hobby." They may view them as a mysterious, stubborn problem - "I can't figure out why I keep spending money I don't have." Or they might look at what they do positively - "I'm building a better life for my family by working really hard at my career."

Long-term effects of self-medication

Like I said, some people self-medicate here and there as needed. Others rely on substances or coping mechanisms more regularly. If they do, they may be able to use them for years, or decades. The fact is they don't all backfire right away. The bill often comes due though. Someone's go-to method may stop working as well, and their anxiety starts hitting them at full force. Or negative side effects start adding up, like damaged relationships, health problems, money trouble, or legal issues.

People who can't self-medicate

Other people never stumble on a self-medication strategy that works. They may not be deliberately looking for one, but they try various things over the years and nothing makes their anxiety any better. They try weed a few times in high school and it just makes them tired and paranoid. They randomly go to a casino with friends, and learn risking their money makes them more nervous. When they overeat it makes them feel pukey, not pleasantly satiated and comforted. They hate their job too much to ever become a workaholic.

In the short and medium-term they feel worse, because they don't have a coping method to fall back on. If their anxiety starts getting extra-bad they have nowhere to run. They experience it at full force. It sucks, and can really limit their lives. They may even half-joke that they're envious of people who can rein in their nerves for years by being high-functioning alcoholics or stoners.

Another perspective is that not being able to self-medicate is actually a blessing in disguise. With no crutch to lean on, it forces you to learn how to manage your anxiety properly. It's not a quick or easy task, but it can be done. You can learn to think of your anxiety in more empowered, accepting ways. You can learn to reduce it in the moment with healthy calming techniques. You can learn to tolerate it and let it pass, rather than impulsively doing something, anything, to try to get rid of it right this second. You can take on the longer-term project of healing the wounds from your past that may be at its source.

Like I said, it takes some time to get a handle on your anxiety, but once you've got those skills they'll serve you for life. It's better to go through the struggle now and be better going forward than to put off the bill for years, and then still have to learn to manage your anxiety anyway, while also cleaning up the damaging side effects of your self-medication.