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I for one suffer from clinical major depression, a bipolar disorder. I’ve been sober and in recovery for many years. There are some of us who are recovering alcoholics and who also have psychiatric illnesses.

We must keep in mind that few recovering alcoholics and addicts in these groups are mental health and treatment professionals. Almost all are certainly well-meaning. Many don’t fully understand the difference between the usual depressions and anxieties most recovering folks go through in early sobriety and psychiatric illnesses–nor should they be expected to. These are understandable misconceptions, but can lead to poor advice even from some of the “old-timers”.

It is clear that no one should play the role of doctor but a licensed physician or psychiatrist. Sponsors and other well-meaning Twelfth Steppers should not give medical advice. Those of you who seek sponsors in 12 Step groups must weigh carefully the potential sponsor’s attitude and understanding concerning medications and psychiatric illnesses. We can not expect them to fully understand, but an attitude of acceptance toward the the nature of a dual disorder in our recovery is key. Experience has shown us that honesty is the basis for successful sponsorships.

On page 133 of the Big Book of A.A. it says in part:

“Now about health: A body badly burned by alcohol does not often recover overnight nor do twisted thinking and depression vanish in a twinkling. We are convinced that a spiritual mode of living is a most powerful health restorative. We, who have recovered from serious drinking, are miracles of mental health. But we have seen remarkable transformations in our bodies. Hardly one of our crowd now shows any dissipation.

But this does not mean that we disregard human health measures. God has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitated to take your health problems to such persons. Most of them give freely of themselves, that their fellows may enjoy sound minds and bodies. Try to remember that though God has wrought miracles among us, we should never belittle a good doctor or psychiatrist. Their services are often indispensable in treating a newcomer and in following his case afterward.”

Some have been told in AA by well meaningful and good intention people that they do not have an emotional or psychiatric illness, and that they are experiencing merely self-pity or some other character defect “You don’t need those pills; they’ll cause you more problems” and “If you’re taking pills, then you’re in relapse and not really sober”. Individuals who have followed such advice have experienced relapse: some have been hospitalized; some have returned to alcohol or drug use; some have attempted or even completed suicide. To say the least, it can be very confusing. Alcoholics Anonymous and Narcotics Anonymous makes clear that these types of statements are not the official position of A.A., N.A., or in fact any other Twelve Step recovery groups.

There is also an important piece of A.A. conference approved literature called “The A.A. Member – Medications & Other Drugs” Here are a few excerpts:

“…A.A. members and many of their physicians have described situations in which depressed patients have been told by A.A.s to throw away the pills, only to have depression return with all its difficulties, sometimes resulting in suicide. We have heard, too, from schizophrenics, manic depressives, epileptics, and others requiring medication that well-meaning A.A. friends often discourage them from taking prescribed medication, Unfortunately, by following a layman’s advice, the sufferers find that their conditions can return with all their previous intensity…”

“It becomes clear that just as it is wrong to enable or support any alcoholic to become re-addicted to any drug, it’s equally wrong to deprive any alcoholic of medication which can alleviate or control other disabling physical and/or emotional problems.”

Bill only moved away from religious conversion for a while and in fact did not experience an end to his depresiion until he learned to apply the steps in a deeper way, following Dr. Bob’s rejection of psychological principles. This deeper spiritual surrender is outlined in Emotional Sobriety (see the article of the same title).
I am a professional addiction and mental health counsellor. I don’t discount the power of psychology for most people, except those like Bill, of whom I am one. Of course I wish that the program was psychological in nature. It certainly would be more accessible, especially with my training. It wouldn’t have taken me 14 yrs of depression in the program if psychological applications could work. I don’t begrudge those in the program who found benefit from seeing it as a psychological program. But by definition, on p. 19, they would be problem drinkers not people like Bill and Dr. Bob. My depression ended when I realized that my life depended on conforming to our literature, not because alcohol was going to kill me. Depression was going to kill me. I haven’t had a depressive episode in 15 yrs now.
Once i learned the literature based program like my life depended on it, I realized how many people had only given it a cursory look over, like I had those first years. I went to many Big Book studies but didn’t read them to save my life. Depression was the motivation I needed to surrender at the level necessary to change my entire self.