Gays, Substance Abuse, and Depression

Rob H., a 29 year-old freelance artist, took his first drink at the age of 8 and started experimenting with drugs by 14. Moving to New York City as a young adult, he got swept up in the hard-partying gay social scene.

"I was just a full-blown addict and alcoholic," says Rob, who, now two years sober, preferring not to use his last name in order to observe Alcoholic Anonymous's guidelines that members should maintain their anonymity in any discussions with the press.

Now that he has the clarity of hindsight not encumbered by substances, he can see how his drinking and using was causing a host of emotional problems, which, he says, "I tried to fix in any way I could, outside of stopping the drinking and doing drugs."

"I had a shrink who diagnosed me with depression and general anxiety disorder," he says. "I had a doctor who tried to give me antidepressants left and right. And I went to yoga, and I saw an acupuncturist, and I saw herbal healers and psychics and spiritual gurus and shamans."

Studies over the past decade have found that while gays may abuse alcohol at rates similar to straight men, the level at which they abuse drugs is significantly higher. Thanks so a social atmosphere that often revolves around substances, gays are far much more likely to experiment with drugs. They are also less likely to grow out of drug or alcohol abuse as they move into middle age.

Benoit Denizet-Lewis, the author of America Anonymous: Eight Addicts in Search of a Life, who is himself a recovering sex addict, says a culture of homophobia causes lifelong struggles with depression and substance abuse in the gay community.

"Gay men grow up traumatized," he says, "often not realizing it and then acting out that trauma through substance abuse or other addictions."

Evan Senreich, Ph.D,, an assistant professor of social work at Lehman College in the Bronx, N.Y., who has written several research papers on LBGT experiences in drug treatment programs, says the chicken-or-egg conundrum of mental health problems and substance abuse confounds many addicts and serves as a road block to recovery.

"There is a large overlap between many mental health diagnoses and substance abuse," he says.

"A lot of substances--not immediately, but afterwards--cause depression," says David McDowell, MD, a psychiatrist in private practice in Manhattan who studies drug abuse among gay men. "Somebody who's been drinking all the time can have low energy, bad sleeping, feel panicked--a full symptoms of depression and you can't tell the difference."

That said, getting sober almost invariably improves mental health. Provided, of course, that addicts can successfully cope with any withdrawal symptoms.

"Your brain has been depleted of chemicals," Senreich says of those who are coming down off of stimulants like coke or meth in particular, "so you will feel depressed and not think clearly for weeks or months."

Rob H. said he was lucky enough to escape such a purgatorial transition period. Acknowledging he was an addict and getting sober caused a Lazarus effect in his overall well-being.

"The depression, the anxiety, the mood swings, the insomnia all just completely ceased. It was pretty immediate," he says.

In his quest to stay sober, Rob says, he's tried not to romanticize the idea of drinking or using drugs: "Like sipping wine in Paris or on the side of a mountain in Capri."

He adds, "It was really just trying to figure out how to live my life again without drugs or alcohol."