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Mental Health

The Tragedy of Self-Medicating: Personal and workplace loss

Rafe Mair

Reprinted from "Men" issue of Visions Journal, 2004, 2 (5), pp. 28-29

One in five people will have mental health problems in their lifetime. Many now say it’s closer to one in four.

What the statistics don’t tell us, however, is how many people who are depressed actually get help. I have a hunch that the percentage is small. And of those who do get help, many will not get much relief.

For people who have depression, there is the dimension of stigma, which makes it extremely difficult to seek help. Men are more affected by stigma, because they believe that more is expected of them. They’ve been taught not to cry. Stiff upper lip and all that. I as diagnosed with anxiety and depression 15 years ago and was fortunate enough to have a doctor who knew something about the subject. That’s rare enough today, but it was damned new unheard of back then.

So how does the undiagnosed depressed person cope?

We get into the area of speculation here, but I suspect that a great many people ‘self-medicate.’ That’s a normal response; most of us do that with other ailments.

In 1966, at 59 years of age, my father died of cirrhosis of the liver caused by drinking a bottle of Seagrams 83 Canadian whisky every day of his later adult life. Looking back, it’s clear to me that this was self-medication. He was depressed. There was no one who would help then. If your problems were serious enough, you had a ‘nervous breakdown’ and went, most likely, to an institution.

Most evidence we have of the association between depression and self-medicating is anecdotal and not scientifically proved. Not all people abuse substances because of depression or allied maladies. Unless credible studies investigate the causes of addiction, we may, indeed, never know the actual extent.

Back in 2001, I started to look around me and to think about life experiences in the workplace. I began to wonder about many of the failed careers—and workplace accidents, for that matter. Many appeared, on the surface, to have been alcohol or drug related. And I wondered if they might have had a deeper meaning. Why did so many males of my acquaintance slip from showing great promise to losing their jobs?

In 2002 I began to do a bit of research. ‘Research’ may be too lofty a term, but I did start to ask questions of doctors, nurses, social workers and employers. I was convinced I was onto something: I was certain there was a relationship between substance abuse and depression. If I was right—and many much more learned than I were thinking along the same lines—what a tragedy! It was also a tragedy for friends and family.

But frankly, there was another factor. Employers were losing money on big investments. I started to read about safety on the job and talked to a number of union officials. Substance abuse was a major cause of industrial accidents. Labour had a stake in this too.

In 2002, I also became involved with the first-ever Bottom Line Conference, spearheaded by the Canadian Mental Health Association. Representatives of unions, employers, mental health professionals and the government were brought together in the same room to discuss these issues. The conference was a resounding success and continues to be held annually.

It was tough sledding at first, thought, New concepts often have a problem overcoming inertia. And there were some pretty prickly relations here. The provincial Premier was a politician, and so, in every sense, were the labour leaders. We all came into the room with some pretty deeply rooted prejudices. At times, some of the participants were at each others’ throats.

But it did come together. The common, uniting element was tragedy—tragedy that all had seen; tragedy that could be avoided.

We’ve come a ways, but there is still a long way to go. It’s tough as hell for a depressed person to admit it—especially for a man who has been taught to face problems with a stiff upper lip to admit to his boss or co-worker that he has a drinking problem (the drug of choice is irrelevant0. But a start has been made, and that’s important. Trust is being built. I think I can say that jobs and marriages are being saved. Indeed, people’s lives are being saved.

What can the ordinary person do to help someone in trouble? Understand. Don’t be, or appear to be, judgmental. If your relationship is close enough, try to get the person to see a helping professional.

There is now awareness that there’s a very direct line between substance abuse and depression. That awareness is a sign that, as a society, we’re less afraid of the subject and more willing to understand and be compassionate. But, as I said, we’ve got a long way to go. Often the help needed is hard to come by. But we have at least made a beginning.

About the author
Rafe was a lawyer and provincial cabinet minister before turning to broadcasting and writing on public affairs. He has written several books and innumerable columns in addition to his morning hotline show on CKBD 600 AM radio in Vancouver. For more on Rafe’s opinions, hobbies and books see

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