• Lynne Macaluso

Reframing Depression and Substance Use

Updated: Jul 31, 2019

There is no disputing the epidemic of depression, anxiety, and substance use in our society. What if we were to admit that the traditional approach to mental health and substance use treatment isn't working? What if we dared to change it?

When pharmaceutical companies first discovered a way to capitalize on emotional distress, many people in society stopped seeking practical solutions for personal pain. There was a pill for that. We no longer had to be the detective in our own story. We lost the motivation to examine our circumstances and become creative problem solvers. It was simple. We had a disorder or deficiency that needed to be corrected with medication. End of story.

What we failed to acknowledge is that emotional distress is not a malfunction. It is by design. It is our natural defense. Emotional distress is an indication that something is wrong and needs to change; even if it is only our perception that needs altering. Chronic depression and substance use are the results of grief, loss, and trauma. When people experience traumatic events, they often become frozen in time. Traumatic memories are stored in the body and will wreak havoc if left untreated. They will continue to interfere with a person's ability to function until they are released. 

For example, when a person has a serious physical condition, the body responds by creating a signal of extreme discomfort correct? Now imagine the long term damage if we only chose to mask the symptoms instead of addressing the cause? That would be ridiculous. What then is different about emotional pain? Why would we merely try to hide it? We need to take the same approach for both. We must determine what is causing the pain and treat it in order to heal the mind, body, and spirit.

Let’s follow this train of thought one step further. Say for example that same person goes to the hospital for treatment and he/she ends up having surgery. Most likely treatment doesn’t stop there. Chances are the individual will need some form of rehabilitation and physical therapy. The protocol in aftercare for a medical procedure is based on the assumption that the person will make a full recovery. The treatment plan focuses on healing and the patient is encouraged to resume normal and independent function as quickly as possible.

Why do we treat mental health and substance use any different? Why do we stay mired in the pathology instead of operating on the assumption of a full recovery? 

A healthy emotional state, similar to a healthy physical state, requires nurturing. When an individual is in recovery from surgery or illness they are encouraged to push through the pain and out of their comfort zone almost immediately. Once the medical intervention is complete, people are not instructed to lie there and ruminate over the trauma; they are encouraged to get up and move around. They begin to put the illness behind them and MOVE ON. Why don’t we take the same approach with mental health and substance use? What if inpatient treatment consisted of evidence-based, trauma-informed, holistic therapies such as Somatic Experiencing, Yoga, Interactive Journaling, Self-Care and Life Skills Education? What if clinicians were able to devote their time to the delivery of these desperately needed services instead of having to complete hours of documentation?

I have spent a great deal of time working in substance use treatment facilities and I believe that idle time is extremely detrimental to patients in early recovery. It is counter-productive for individuals to remain in a facility with nothing to do except sit with their negative thoughts and reminisce about their substance use with the other patients.

Does anyone else see the flaw in this plan??

We need to direct our energy and resources toward a structured curriculum that is motivational, educational, and goal-oriented. At the same time, we must incorporate holistic therapies and sensory interventions to heal trauma. We need to provide our clients with the tools to manage the overwhelming stress and anxiety that so often leads to relapse. 



Life Coaching is based on a cooperative partnership between the client and the facilitator to create positive change.  Lynne Macaluso at OneLife Personal Coaching is a Certified Coach and Licensed Addiction Counselor. Life Coaching services are not intended to take the place of professional counseling or primary treatment for mental health, addiction, or medical care. Coaching should not be used as a substitute for diagnosis or treatment of any condition. Lynne does not work with any individual with a diagnosed mental/physical condition without consent from a licensed practitioner. If you are under the care of a medical professional for any condition for which you are seeking additional coaching, please obtain a signed written referral from your provider.

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