Crazy? Suicidal? Or Just Addicted?

Reader’s Question

I’m an almost 18-year-old male. I’m terribly depressed and have been for a few years, and I also have a lot of anxiety problems. I’ve been smoking marijuana and drinking since I was fifteen. I recreationally tried Xanax for the first time when I was 16 with some friends, and I’ve been through heroin binges, cocaine binges, and all types of drugs. I use drugs out of boredom mostly and to forget about my problems in school and relationships and friendships and parents, I guess. I do Xanax every few weekends or so, maybe even during the week for a few days to deal with school, even though I get severe panic attacks after binges, and wake up with cuts and bruises on my wrists and face sometimes, not knowing where they came from. I often don’t remember most days, whether or not I’ve done any drugs. My life is mostly a daze. I don’t talk, I barely sleep, and I’m confined to a dark room most weekdays. I sometimes walk up to past friends and talk as if we were currently best friends, not remembering that we haven’t spoken in a year. I sometimes see my ex-girlfriend and think we’re dating, when we haven’t dated for 8 months. People tell me things that I’ve done while on drugs that sound insane, like walking up to people’s faces and yelling at them and even starting fights, jumping in front of cars, and calling girls in the middle of the night and expressing my undying love for them. I think about my life when I was 15 and cry — because my life isn’t normal anymore, and I’m only 17 and I feel like an old man who’s already tired of the world.

My behavior seems random and crazy, emotionally confusing, and even self destructive. Am I insane or suicidal or is something else wrong with me?

Our Clinical Psychologist’s Reply

Polysusbstance abuse is a serious problem in its own right. Although it can often get started because of other underlying problems which the person attempts to “self-medicate,” it also creates problems of its own, including personality changes and changes to brain chemistry. Substance dependence is also a likely consequence, leading to withdrawal symptoms when the person is not using.

Unfortunately, far too many individuals don’t seek treatment for their substance abuse until they “hit bottom” physically, mentally, and emotionally. Still, help is available through appropriate counseling and treatment. Until your pattern of substance abuse is addressed directly, it would be difficult to assess accurately what other psychological issues might be present and in need of attention. Further, there is a variety of reasons why a person might repetitively engage in behaviors they ultimately know are self-destructive. It would probably be a good idea to seek the counsel of a professional with specialty training in the area of substance abuse and undergo a thorough assessment, or to explore participating in a program that employs a multiple-disciplinary team of professionals.