After My Stint With Drugs, Will I Ever Be “Normal” Again?

Reader’s Question

I’ve been suffering from intrusive, obsessive thoughts for about 5 months now. Some of the thoughts involve images of stabbing and thoughts such as turning into oncoming traffic when driving. I’m 100% sure that I do not want to act on these thoughts, yet they still occur almost 24/7. As you can imagine, these thoughts are really starting to get me down, and it is affecting my performance at work, not to mention bringing on a horrible depression.

I am now 23 but between the ages of 15 and 22 I did drugs regularly, including taking ecstasy pills, smoking cannabis regularly, and using cocaine on several occasions. I’m fairly convinced that my drug use caused these obsessive intrusions, as ecstasy use in particular depletes the serotonin levels in the brain which is a big factor in obsessive thoughts. I wish I had known this before taking those drugs but of course now cannot turn back the clock.

I have started a course of CBT and have also been taking 50 mg of Sertraline for about 4 weeks now. Both of these have helped muffle the thoughts, but they are still occurring quite frequently. I really would love to eradicate them completely from my mind and just get back to normal. I’d like to know if you’ve heard of similar cases like this involving drug use and obsessions and whether patients have recovered. I’d also like to know if my brain will be able to repair itself at least to some extent and serotonin levels increase again. Lastly, I’d like to know is there anything else I should be doing treatment-wise that you would recommend in order for me to get better?

Any advice would be most appreciated!

Psychologist’s Reply

There is no doubt that polydrug abuse can affect the brain’s chemistry and functioning, and it will be some time before science fully understands all the possible substance-brain interactions and kinds of problems that can ensue. It’s also not unusual for there to be more than one underlying “cause” of mental conditions. And sometimes, drug use complicates, “triggers,” or exacerbates problems in the nervous systems of individuals who are otherwise predisposed to types of dysfunction. While it’s not possible to be definitive in appraising your situation, there are some things you might consider.

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Individuals who have the kinds of problems you describe (especially those who irresponsibly use substances) tend to have personalities characterized by “the 3 ives.” That is, they tend to be excessive, impulsive, and compulsive. Their impulsivity is evident in the way they tend to behave recklessly and without forethought. Their excessiveness is reflected in the degree to which they persist in behaviors — even self-destructive behaviors — until circumstances finally force them to modify their conduct. Their compulsivity is reflected in their relative lack of ability to moderate, step back, or be patient when there’s something they want or something they’e worrying (obsessing) about.

The likelihood is that in time you will heal or, at the very least, learn to cope well enough to function “normally.” Your story is not all that uncommon, and many folks who have struggled with issues similar to yours have experienced sound recoveries. What might be hard for you is to accept where you are now, to remain faithful to your therapy regimen, and to have patience with the process. Anxiety can only exacerbate problems, and worrying about the future will only increase your anxiety. It’s possible that some other medications might be necessary to assist your recovery. It’s also likely that your therapy will eventually need to address “issues” other than your symptoms.

The most important things to remember are to be patient and to remain committed to your therapy. As mentioned before, it’s rare that there is simply one “cause” and a simple cure for such problems. Take heart and remain hopeful, but above all, be patient.