Illness or Character Defect?

A reader asks:  Lydia, I’m new to your site and much of it makes sense. How ever with the defect issue I have one thing that bothers me. That would be the influence of anyone with a mental illness. To be clear I’m talking about a diagnosis from Mental Health professional and not one of self diagnosis. I struggle with this. Depression for one is an illness and not a defect in character. I struggle with the concept of defect in relationship to mental illness. Where is the line between a defect and an illness? Maybe you addressed it in another post regardless I would be interested in your take on this.
Thanks Doug

******Extremely important disclaimer:  All that’s written here is my opinion only.  I have no special training or credentials.  I have lots of opinions, and when someone asks, I usually will give it.*******

I gave this question a lot of thought, for many reasons.  Critics of AA find fertile ground here.  AA members span the spectrum on what they think about these things.  As I hope we all know, AA is not an inherently safe place, and people can find someone to say just about anything there.

And that’s part of the problem.  Mental illnesses (including alcoholism), physical illnesses, terrible life situations, bad luck.  Alcoholics can and do use all of these to manipulate people including doctors and therapists.  They can and do use all of these things to manipulate the people in their lives.  They can and do use these things to avoid sobriety, to avoid work, to obtain drugs, to get or avoid attention.

I have personally been pregnant and given birth, I’ve had teeth removed and a dental implant, I’ve gone through bad emotional crises in sobriety and I’ve been offered drugs that I didn’t need and that are dangerous to me by doctors who I’ve specifically asked not to do that.

For me, it is incredibly dangerous.  Once the drug enters my system, my ability to think clearly is compromised.  My brain reacts in a way that does not care if my tooth actually hurts beyond my ability to bear it.  It craves the sensation of those drugs and once it has some it wants more.

Sitting here now, sober, I can recognize and avoid all that.  But “what if” I actually need the drug and have to take it?

What if I don’t actually need it and want to take it?

I know people who have gone out and died because of needed pain killers.  I know people who have not been able to bear the psychic pain of depression and who have killed themselves.

Is “depression” a character defect?  I think so, yes, for just about everyone.  Depression as a mental illness is something else that only some people experience.  Personally I absolutely cannot judge what someone else is going through, and this troubles me very much when I’m asked to counsel or sponsor someone who needs to take psychoactive drugs.  I know that they can be easily abused and misused and cause death.  I know that a lack of effective treatment for some mental disorders can cause death.  What I don’t know is the mind of the person I’m talking to, or thinking about.

People who have serious mental illnesses, including depression, or serious physical disorders, in my opinion, may face a much more difficult time achieving and maintaining sobriety than people who do not have those things in addition to alcoholism.  I try to move very very cautiously when I listen to those people.  I’m afraid I usually end up on the side of not being tough enough in my questions about, “Do you really need this drug?”

The thing is it’s just so, so dangerous to take them.  If there’s any way to avoid it, I’m for that.  But of course I realize there is more danger, for some people, to not take them.  Problem is, all of us alcoholics in some way want to be the person who has to take the drug.

So, to answer the question, is there a line between the illness and the character defect?  I think there is, but it’s a dotted line, not a solid line.  A person who has the mental illness can still suffer from the character defect, and probably does, as we all do to some degree.  It may be harder for that person to deal with the character defect.  That said, in my real life I do know some people who have mental illnesses including depression who are successfully sober for long periods of time in AA.  I can’t pretend to know what they go through, but from my staunchly pro-AA standpoint it seems to me they have lives that are so much richer because they work the steps and participate in the fellowship of the program that was in large part designed, by the way, by a famous depressive, Bill W.


5 thoughts on “Illness or Character Defect?

  1. Pingback: depression: six of one, half-dozen of the other? | club east: indianapolis

  2. Why do you believe it is do, so dangerous to take antidepressants? For many people they are the difference between a life not worth living and being functional?

    Why is this even a matter for a sponsor/sponsee relationship?
    Medical decisions should be left to doctors and all a sponsor should do is encourage full honesty with ones doctor.

  3. I disagree with about 50% of this, but admire your honesty. One – you were asked. If I’m asked, they’re going to get my honest opinion. Two – you placed a disclaimer – good for you. I wrote about Depression/Addiction – dual-diagnosis recently and essentially think meds are over-prescribed and too many jump on them in early sobriety before giving the brain half a chance to heal on it’s own. Besides, we’re wet noodles when we quit that first year – you aren’t supposed to feel great all the time. Stuffed emotions and memories start surfacing like someone threw a firecracker in a pond! That being said, I’m on meds for bi-polar, just one for 8 years now and found I was able to lower the dose through exercise.

    I think it’s absolutely necessary to talk to other members and a sponsor for opinions – in the end it’s my decision. But, I can’t make an informed decision in the vacuum of my therapist, or doctor’s office because everyone is coming from a valid construct. I need as many opinions as possible!

  4. I have been to AA for forty one years and sober for thirty seven. That’s right there is no magic wand at the door of any of the meetings I’ve gone to. It took me a few years to get over the fact that I would never be a social drinker. I still go to five yes I said five meetings a week. I enjoy the fellowship of people that come to my meeting so I go to there meeting. I’m on my third sponsor because when they stopped going to meeting they can’t be any help to you if there not going to meetings themselves. Taking advise from someone about what medications worked for them, is not right unless they have a MD after there named and there your doctor. BOB H

  5. I really appreciate you candid opinion on this issue – one that most AA’s are afraid to touch (especially in a public forum). I agree with your sentiments completely, and my own personal experiences support every point you’ve made. It is very difficult for an alcoholic – even a sober one – to determine where the line between illness/defect actually is without seeking counsel from other AA’s and their HP.

    I’ve had two surgeries and ultimately elected not to take any pain medication because at the end of the day, the physical pain after surgery pales in comparison to the physical/emotional/spiritual pain of active alcoholism. I feel like the introduction of mind-altering substances only threatens to “wake up the monster” in my head that I have worked very hard to put (and keep) asleep for the past 12 years. This decision was in direct contradiction to both doctors performing the surgeries. In fact, they argued with me at great length about why I should at least “take the prescription home in case I needed them.” The sad fact is that most medical professionals have very little knowledge/understanding of addiction and alcoholism (a fact that became clear to me from working with AA’s CPC Committees). I don’t blame the doctors. They have an innate desire to ease suffering and were only trying to keep me from being in pain. However, I cannot, as a recovering alcoholic, implicitly trust the opinion of doctors who have no experience being an alcoholic.

    The same has been true for my experience with mental health professionals. Without a spiritual solution, they only have chemical (and in some cases, behavior modification) techniques to attack depression and other mental health issues. I have been diagnosed by more than one psychiatrist of being bipolar, when I was actually just experiencing the highs/lows of active alcoholism. Not once did they suggest AA. It was always this drug or that – all of which continued to keep me from hitting the bottom I desperately needed to find in order to be willing to do the hard work of getting sober. I have been sober now for 12 years and have not needed Rx drugs to treat any mental illness. Sometimes I will go through spells of depression and can easily slip into feeling sorry for myself, thinking no one in AA understands how bad this actually feels, thinking my HP fostered in the medical technology that gives us Rx drugs to help, etc. But in my heart of hearts, I know this is my alcoholic thinking just looking for an excuse to take and easier, softer way. It’s in my nature to fantasize about a magical pill that will make life a little easier to handle. That’s exactly what makes me an alcoholic. And exactly why I have to rely on AA (not the medical community) in treating these “outside issues.”

    Thanks for allowing me to rant on about this. I’ve really enjoyed reading your blog.

    Mary P.

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