When Self-Medication Stops Working

bethjmakar
Jun 28
2 min read

Post 5 in our daily series on the top concerns clients bring to Integrative Mind Body Psychiatry.

Drug-related fatalities in the United States have tripled over the last 15 years. Substance use disorders rarely travel alone — they almost always overlap with anxiety, depression, trauma, ADHD, or chronic pain. People do not become addicted because they are weak. They become addicted because something hurt and the substance helped — until it did not.

This post is not about shame. It is about honesty, biology, and hope.

Why Mental Health and Substance Use Are So Tightly Linked

Most substances work because they temporarily soothe a real biological problem:

Alcohol dampens an overactive anxiety circuit.
Cannabis quiets racing thoughts and helps with sleep.
Stimulants mask undiagnosed ADHD or depression-related fatigue.
Opioids numb both physical and emotional pain.
Nicotine and caffeine patch over poor sleep, undertreated ADHD, or low mood.

The substance was answering a question the body was asking. Real recovery means answering that question another way.

What I See Most Often in Practice

Adults using alcohol every night to 'take the edge off' — and waking up anxious at 3 a.m. as the body rebounds.
Young adults using cannabis daily for sleep or anxiety, and then unable to feel calm without it.
Professionals quietly leaning on stimulants to keep up.
Parents and caregivers numbing exhaustion they have not been allowed to name.
People in early recovery whose anxiety, depression, or ADHD suddenly becomes loud once the substance is removed — and who need real psychiatric care to stay sober.

Why a Whole-Person Approach Matters

Recovery is not just about stopping the substance. It is about giving the body and brain real tools for the job the substance was doing. That means treating the underlying mental health condition, rebuilding the gut and nervous system, restoring sleep, blood sugar, and movement, and tending the spirit.

Five Whole-Person Steps That Help

Tell the truth to someone safe — a sponsor, a clinician, a pastor, a trusted friend. Secrets feed the cycle.
Get a real psychiatric assessment. Untreated anxiety, depression, ADHD, or PTSD is the most common reason recovery does not stick.
Rebuild your nutrition. Protein, omega-3s, B vitamins, magnesium, and a healing gut profoundly support a recovering brain.
Anchor sleep. The healing brain needs sleep more than almost anything else.
Find your people. AA, Celebrate Recovery, SMART Recovery, a faith community — recovery is a team sport.

When It Is Time for Professional Care

If a substance is taking more from you than it is giving — relationships, sleep, work, peace, time, money — that is information. You do not have to wait until you have 'lost enough.' Psychiatric care can support recovery from day one.

If you or someone you love is in crisis, call or text 988. For substance use specifically, SAMHSA's National Helpline is 1-800-662-HELP (4357).

I see patients via telehealth in Utah at integrativemindbodypsychiatry.com.

Tomorrow: Our teenagers are not okay — and what we can do about it.

Respectfully, Beth Makar, RN, Dual-MSN, PMHNP-BC · Integrative Mind Body Psychiatry