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On the face of it, you might think that the philosophy behind Alcoholics Anonymous would only deepen a depression: the notion of admitting powerlessness doesn’t exactly sound like the kind of pep talk that would lift a bleak mood. But the central concept of taking recovery "one day at a time," surviving the hardest times by using the support of a kindred community, and "keeping it in the day" rather than projecting into the future or ruminating upon the past all can be transposed from the arena of addiction to other arenas with surprisingly positive results.

Components of Depression

Looking at depression and alcoholism more carefully, though, some parallels between the two become apparent. To start with, the cognitive impairments that often accompany depression bear an uncanny resemblance to an alcoholic’s malady known as stinkin’ thinkin’. These are what therapists often refer to as thinking errors. When using Cognitive Behavioral Therapy (CBT), these are the types of thoughts that are targeted. Some specific examples of thinking errors or stinkin’ thinkin’ that both alcoholics and people with depression use are

  • Black and white thinking, also known as all or nothing thinking.
  • Refusing or being unable to see or acknowledge positives (the glass is half empty).
  • Exaggerating or magnifying unfortunate or unpleasant events or incidences
  • Getting stuck, or perseverating, on negative things. Ruminating or stewing in your own juices are often phrases used to describe this type of thought error.
  • Jumping to conclusions. This means making assumptions prior to collecting all the necessary information.
  • Always and never statements that lead to discounting the positives and over-focusing on the negatives.
  • Shoulds. Piling responsibility or blame upon yourself, and then feeling resentful and guilty about it.

In treatment for depression, a therapist skilled in CBT techniques would help you identify the thinking errors and then use CBT techniques to overcome these errors and create new habits. In AA, people in recovery use conversations with their sponsor to identify stinkin’ thinkin’ and then use either readings or slogans to help stop sinking into these habits and start new ways of approaching situations.

Helpless and Hopeless

Frequently depression inventories and suicide assessment tools ask about feeling helpless and/or hopeless. A serious symptom of depression, thoughts of suicide often occur as a corollary to feelings of helplessness and hopelessness. Similarly in the progression of alcoholism, the experience of hitting bottom or bottoming out involves these same feelings of helplessness and hopelessness. In the case of depression, if feelings of helplessness and hopelessness are admitted to a therapist, this may lead to medication adjustments or the discussion of hospitalization, especially if suicidal thoughts or wishes are also present. Suicidal thoughts are also present in advanced stages of alcoholism, and these intense feelings may be the precursor to seeking detox or rehab.

Once the intensity of these thoughts and feelings has subsided and the emergency nature of these feelings has been managed, the AA approach can be positive and helpful for people struggling with depression. One key component to the AA approach is the combined notion of faith and hope.

Central to the AA approach is the following of the twelve steps – a recipe or map for becoming first abstinent and then ultimately sober. These steps offer concrete tasks to undertake as well as solace and hope when things seem impossible. The first step has to do with what’s often referred to as "turning it over" to your higher power: you admit that you are powerless over the substance and that your life has become unmanageable. While there is no direct corollary for depression, the feelings of powerlessness and concomitant hopelessness, as the sense that life has become unmanageable is certainly a shared experience. The purpose of this first step is to surrender and stop trying to manage something that is unmanageable. This can be tremendously freeing for both people entering recovery and people struggling with depression – it is the idea that you can stop fighting, stop struggling, admit that your way isn’t leading to success, and then be provided with the "open space" for healing and hope.

Faith and Hope

Turning it over can be helpful for those struggling with depression if it occurs within a context of faith. This doesn’t necessarily mean that becoming religious will alleviate depression or alcoholism, but it does mean that being willing to trust in something in AA this something is called a higher power can be an important aspect of healing. It may not be "scientific" the way in which pharmaceutical interventions are, and faith and hope may not be replacements for medication, but it is well documented that a positive attitude "helps" the medication be effective.

AA slogans, such as "Let Go and Let God" or "One Day at a Time," help remind people in recovery that faith, hope, and a willingness to live in the moment can help keep you away from that first drink. Similarly, these slogans can help people struggling with depression to keep their focus in the day, have faith, and be positive.

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