“The problem with illicit substances is their efficiency.”
The goals of the substance user and athlete battling depression is the same – Both seek a shift in mood and/or mental state. The goal to, ‘feel better,’ is universal, regardless of the tool used. In fact, substance misuse is considered superior in that it is absolutely efficient at achieving its aims. Once we accept this universal intent, only then will we be able to address stigma and prejudice.
Defining, “Altered State”
Typically, the expression, ‘An altered state of consciousness,’ refers to any change, or shift, in mental state where the person is generally aware and wakeful. This includes mental states during hypnosis, meditation, or active hallucinations while using elicit substances (LSD), etc.
For purposes of this article, we are shifting the definition away from a focus on consciousness, towards mood and emotional wellbeing. An altered state of mood and/or emotional wellbeing, refers to a change of one mood/anxiety state, to another. Altered states in mood and emotional wellbeing come in both adaptive and maladaptive forms. Both are considered functional in that they achieve the goal to shift from one state to another.
The Runner (Adaptive Approach)
Using physical activity to alter mood is considered an adaptive approach to coping. The best example of using movement to achieve an altered emotional state is found in the long distance running community. There are numerous anecdotal accounts of runners entering the sport for the profound improvements experienced in mood and anxiety (an altered/shifted state, resulting from adaptive behaviour).
Rob Krar, an elite ultra runner originating from Canada, opened up about his struggles with clinical depression in 2014. He often speaks about the effects of running on his mood and the strength it gives him, knowing that any pain he experiences during an event is familiar to him; he understands that with persistence, he can push through to the other side of his pain.
Following is a video where Rob Krar describes his personal experience with depression, and the relationship he has with long distance running:
The Substance User (Maladaptive Approach)
Alcohol and drugs produce profound effects on one’s personal sense of wellbeing. From this perspective, substance misuse is considered effective and efficient in achieving the desired altered state, most notably a reduction in perceived anxiety and depression. While effective, the approach is also understood to be maladaptive in nature; the tool works, but is accompanied by profound long term biopsychosocial consequences.
Those struggling with the negative consequences of substance misuse talk, almost universally, about the intention to decrease anxiety and feel happier. There is no doubt that substance use of any kind achieves these aims, at least for the short-term.
Some individuals discover this connection after living many years with a pre-morbid diagnosis of Major Depressive Disorder. For others, ongoing substance misuse has caused regular states of dysphoria and anxiety between episodes of use. Both are equally affected by substance use behaviour – Things improve, at least temporarily.
An Honest Look at Maladaptive Outcomes
The desire to improve wellbeing through an altered state as described by both runners and substances abusers is no different. Each attempts to improve their overall experience of life.
Now that we have levelled the playing field on intent, it is important to highlight the consequences of maladaptive coping strategies.
- Adaptive approaches are less likely to have profound negative consequences on physical health over the the long run.
- Maladaptive approaches have shorter effect cycles. In other words, you must return to the method more often for repeated short-term gains.
- Adaptive approaches have positive effects across multiple areas in our lives. This includes positive outcomes on fitness, anxiety management, and relationships at home and work. We like to call this, ‘generalizability‘.
- Maladaptive approaches reinforce quick short-term reward, while adaptive approaches tend to reinforce the powerful effects when required to delay gratification. In other words, adaptive approaches teach us that working hard towards a long-term reward is difficult now, but has massive reward with persistence (finishing a race, completing education, etc.)
The Problem With Judgement
It is critical that each of us recognize the universal desire found in both adaptive and maladaptive strategies for achieving an altered state towards wellbeing. While there are different consequences for adaptive and maladaptive approaches, it is important to understand the universal desire to feel better.
When individuals exercise morality as a basis for judging behaviour, the end result is stigma and alienation. Harm reduction depends on viewing the consequences of behaviour through a public health and human rights lens. Whether you are a practitioner, or a family member living with someone misusing substances, in the end, we all are attempting the same thing – To feel better.
Acceptance Promotes Change
The first step in promoting change in individuals is understanding your own bias. The second step is accepting those around you, regardless of where they are at in life, or the choices they make.
Universal acceptance is the most powerful tool in being an effective care provider, partner, parent, or teacher. Others will experience your accepting approach and seek you out when ready. Your job is to simply be with them along the way, while recognizing that you both seek the same thing.