I learned the hard way that, ultimately, someone will only seek help—for addiction, mental health problems, or anything else—when they do. I am not sure they must be “ready.” What is ready, after all? What does it feel like?
It is, however, nearly impossible to force someone to quit a harmful habit or to go into therapy (or other treatment) before they themselves agree to quit or to go or to whatever it is. I absolutely think it is reasonable and can even be helpful for friends/family of someone who is practicing self-harmful behaviors or who needs specific help/treatment (therapy, for example) to express their concern and suggest healthier paths that the person they are worried about might take.
It is normal to feel frustrated, sad, and perhaps let down if someone you are worried about refuses help or does not change their behaviors. A few recommendations for people in such a position. First, remember to take care of yourself, and that you can provide support only when you yourself are sufficiently grounded and healthy (mentally and physically); it will be counter-productive if you strain and drain yourself in order to help someone. Second, do not take it personally if someone does not change their behavior or get help when you express worry or ask them to stop a harmful behavior (such as drinking too much, smoking) or recommend they seek psychological support. In my experience, such refusals are rarely personal. In fact, it can be meaningful and impactful to simply express concern, offer support, and gently provide helpful recommendations. That is not to say one should not be persistent. Just also be polite, gentle, and meta-communicate with the person you are worried about: express your concern, be honest that their self-harmful behavior worries/distresses/hurts you (however try not to make it about you), and check in with how they feel about you expressing this and about how you expressed it. Finally, as a close friend reminded me: it is ok to feel as though you are not doing enough.
Habits are helpful and comforting to many humans, and breaking ourselves of addictions and habits that do not serve us can be incredibly difficult.
I began my last set of articles observing just how minimal an emotional education most people receive as children—or adults. This affects not just our relationships and productivity, but our very experience of the world. When everything feels particularly bleak, too overwhelming, perhaps too boring, or when you feel low energy or high-energy-anxious, what do you do?
It is easy and common to turn to alcohol, drugs, and food (among other things). When these methods of dealing with difficult feelings or events becomes habit, and when such a coping mechanism involves some kind of self-“dosing” (without a doctor), it is called “self-medication.” Used regularly as coping mechanisms, these behaviors can be dangerous and counter-productive.
Often, such self-harmful habits, addictions, and coping mechanisms actually cause and/or increase anxiety, depression, and other unpleasant feelings. And on long-term, these behaviors can cause significant health problems. Self-medication (and other self-harmful coping mechanisms) can also produce conflict between an individual and their friends and relatives who are worried by their behavior, as I indicated above.
There are many health coping mechanisms for dealing with these states: taking a walk, talking to a friend, reading a book, eating a quality meal if you can, drinking herbal tea, meditating, drawing, singing, watching a relaxing show, etc.
I often see my friends self-medicate both (i) when they experience chronic mental health issues such as depression, or (ii) go through periods of depression, anxiety, or experience other forms of psychological discomfort and disquiet. Self-medicating is not the same as taking mental health medications such as might be prescribed by a psychiatrist. Further, even though various forms of self-medicating might temporarily relieve your feelings, this is not the same as finding a solution either to long-term, chronic mental health issues or to shorter term struggles you may be facing due to unique life events/stressors.
In fact, methods that many folks use to find respite can actually exacerbate the depression, anxiety or other feelings and issues they are attempting to banish. Several studies suggest that smoking cigarettes can actually cause depression, even as some people with depression also feel and claim that smoking makes them feel better. It may, in the short term, but usually only because it satisfies an addiction craving and because the action provides a quiet moment in which to ground oneself. Alcohol is a depressant, and therefore can increase “down” (sad, depressed) feelings. Ironically, people often turn to alcohol for distraction and relief when they are sad. Both alcohol and tobacco can also exacerbate long-term mood disorders.
We all use different coping mechanisms to help us keep chugging through life when we are feeling bad or when something stressful happens. I do not want to be in the business of judging other peoples’ coping mechanisms. However, I do urge everyone to consider what their go-to de-stressors and coping mechanisms are. How these affect you and others in the long and short term? You may find that some coping mechanisms have side effects that negatively impact you and others. For many people, coping techniques (smoking, drinking, taking prescription drugs without a prescription) can themselves become addictions and become both stressors and coping mechanisms simultaneously. This is a very negative feedback loop that can be hard to escape from.
It is difficult, and also absolutely possible, to quit self-harmful coping mechanism behaviors and to replace them with healthy and sustainable ways to relax and to ground oneself. Sometimes it is difficult to find these healthy coping/calming mechanisms, and can be even harder to make the change. Remember that there is nothing shameful in seeking help during this period, both from friends and from professionals. Therapists/counselors are particularly good resources for this.
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