I quit drinking four years, one month, and twenty-five days ago. In my first few weeks sober, I never expected to make it this long. Sobriety felt nearly impossible, and I couldn’t comprehend how I’d maintain it long-term.

One of the hardest parts of going without alcohol was the overwhelming depression that I felt. It was such a debilitating experience that I seriously doubted my ability to function if I remained my sober.

My depression has long been intertwined with my alcoholism, and the key to my long-term sobriety has been to finally address my mental health.

Addiction as a Symptom

Addiction used to be widely thought of as a moral failure on the part of the addict. Alcoholics were nothing more than degenerates who didn’t have the self-respect to manage their drinking.

In the twentieth century, that misconception began to disappear, largely thanks to the popularity of Alcoholics Anonymous. In its place, the disease model of addiction arose.

This disease model says that alcoholism and other addictions act just like physical diseases. There is no morality attached to addiction, and it’s instead treated like any other medical problem. This model helped to reduce the stigma of addiction and lead countless addicts to a better life.

Although the disease model of addiction has now become the most popular, many modern psychiatrists have presented alternative explanations for addictive behavior. Dr. Ed Khantzian proposed the self-medication model, which suggests that addicts are using their substances of choice to address other mental and physical health problems.

Similarly, psychiatrist and former Harvard professor Lance Dodes argues that addiction isn’t a disease, but a symptom. He believes that addictions are a type of compulsion that people turn to when they feel hopeless.

My Addiction

When I think about my own addiction, each of these models makes some sense to me. I’ve long believed in the disease model, which seems to match the chronic nature of my addictions to alcohol and nicotine, as well as my personal struggles with relapses.

However, I also certainly recognize that my history with depression seems to have contributed to my drinking and smoking habits. I was first diagnosed with depression in high school. After initially treating it with SSRIs, I went off medication before starting college.

I started drinking and smoking cigarettes regularly in college, developing daily habits by the time I graduated. At the time, I didn’t make the connection between these addictions and my depression, but it seems obvious in retrospect.

It feels reductive to me to say that depression was the only reason that I developed an alcohol addiction, but I can’t deny that I was — at least in part — using alcohol as a form of self-medication.

For roughly a decade, I used alcohol and nicotine as a way to mask my depression. They didn’t cure the underlying mental illness, but they did a great job of letting me ignore it.

Once I quit drinking, however, the depression came back in full force.

Staying Sober Long-Term

I would never have been able to stay sober long-term if my depression had remained as bad as it was during my first year alcohol-free. I was miserable all day and completely overwhelmed by my poor mental health.

When I first quit drinking, I mostly ignored this depression, assuming that it was a symptom of alcohol withdrawal. Now, I realize that I actually had cause and effect reversed.

The depression had helped cause my addiction in the first place. Removing my form of self-medication didn’t create the depression — it just stopped hiding it.

When it became clear to me that my mental health wasn’t going to improve on its own, I started addressing it head on. I had two main strategies for fighting depression: therapy and exercise.

As my depression got under control, my desire for alcohol decreased as well. If I hadn’t ever taken the time to tackle my depression, I truly believe I would have gone back to drinking by now.

Regardless of what model of addiction one subscribes to, I believe that it’s important to think about the underlying issues driving substance abuse. Addiction might not always have a clear cause, but by trying our best to understand why we drank, we set ourselves up for the best chance at a full recovery.