How The 12 Steps Help With Depression For Alcoholics
The founders of Alcoholics Anonymous (AA) established the 12 steps for anyone to use as a guide for overcoming an addiction to alcohol and to deal with mental health issues like depression. One of the founding members, Bill Wilson, struggled with depression for years. It became apparent to him that there is a connection between addiction and mental health.1
In this article:
- Applying the 12 Steps of AA to Depression
- Starting the 12 Steps of AA
- Treating Dual Diagnosis Depression and Alcohol Use Disorder
Applying the 12 Steps of AA to Depression
Each of the 12 Steps of AA can apply to a dual diagnosis of depression and alcohol use disorder (AUD).2,3
Step 1: We admitted we were powerless over alcohol—that our lives had become unmanageable.
In Step 1, admitting you are powerless over alcohol (or depression) is about recognizing you cannot achieve recovery from alcoholism or depression on your own. This step is about opening yourself up to accepting help in overcoming alcohol misuse and mental health symptoms.
Step 2: We came to believe that a Power greater than ourselves could restore us to sanity.
Step 2 is believing that something more powerful than you exists. Not only that, but that your higher power sees the good in you and wants to help you heal your mind and body so that you no longer suffer from the effects of AUD and depression.
This “Power”—also referred to as a “Higher Power” and “God”—is referenced in several steps. However, your higher power does not need to be a religious deity. Your higher power can be any concept, being, or energy with which you feel a strong connection that makes you feel hopeful, loved, and empowered.
Step 3: We decided to turn our will and our lives over to the care of God as we understood Him.
You have likely tried to overcome depression and to achieve and maintain sobriety on your own. Often, people turn to the 12 Steps of AA because the things they have tried on their own to take control of their lives have not worked. If you are in this situation, you may feel fatigued, ashamed, or hopeless about your recovery.
Step 3 is about surrender. This step takes courage to accept the powerlessness you admitted in Step 1 and to give control to the higher power you connected with in Step 2.
Once you achieve Step 3, you are more capable of reflecting on yourself, your life, and the thought patterns and choices you have made that have contributed to your depression and alcohol use disorder.
Step 4: We made a searching and fearless moral inventory of ourselves.
Step 4 begins your journey of analyzing yourself and your actions. It helps you identify thought patterns and emotional reactions you have to situations that lead to negative behaviors. This step is not about blaming yourself for external factors that may have contributed to the development of your dual diagnosis, but rather to identify how you can take responsibility for what you do control and how your choices affect your life and others around you.
Step 4 teaches you to be honest about your mental health and addiction, even when the relationship between your depression and alcohol use disorder is complicated.
Step 5: Admitted to God, ourselves, and another human being the exact nature of our wrongs.
Step 5 helps you confront mistakes you have made in the past that may have harmed you or people you love. This step is where you can recognize the root causes of your depression and alcohol misuse that you have control over. You can admit to the character defects and poor choices that may have kept you from healing.
Admitting “your wrongs” to another person can be freeing, allowing you to move on and believe that you can become better physically and mentally with the help of your higher power.
Step 6: We were entirely ready to have God remove all these defects of character.
Reaching Step 6 means you are ready to do what it takes to stay sober and fight depression. You have reached the point where you are ready to stop struggling with the same issues. You know you need help and you are ready to ask for and accept it.
Step 7: Humbly asked Him to remove our shortcomings.
In working the steps, you have found the humility to recognize when you are wrong and when you need help. Step 7 involves gratitude for your higher power and conviction that you are worthy of help without expectations, demands, or entitlement. You can now ask for your needs to be met and for the removal of any shortcomings.
Step 8: Made a list of all persons we had harmed and became willing to make amends to them all.
Step 8 increases your humility and begins to break down the isolation may people with depression and alcohol misuse experience. By identifying the people who may have been harmed when you were in the darkest days of your substance use disorder and mental illness and thinking about how you may be able to make amends, you can begin to see the path forward toward healthier relationships.
Step 9: Made direct amends to such people wherever possible, except when to do so would injure them or others.
Moving forward with Step 9 means focusing on forgiveness, especially the forgiveness of yourself. As you start to make amends, you may better understand how your mental health or addiction played a role in how you have treated people in your life. Then you can let go of the guilt, shame, resentment, and other negative emotions associated with those actions and begin healing your relationships.
Step 10: Continued to take personal inventory and, when we were wrong, promptly admitted it.
In the past, your depression and alcoholism may have kept you from admitting what was true. As you grow in your recovery, you will get better at recognizing damaging thoughts and behaviors and change them immediately rather than suppressing them.
In Step 10, you become willing to continually analyze yourself with honesty and eagerness to make changes that contribute to your recovery.
Step 11: Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
Step 11 guides you to focus on nurturing your relationship with your higher power by spending time in practices that strengthen that connection. You may feel more connected to your higher power through prayer, meditation, journaling, listening to or performing music, or another mindful practice.
You open yourself to guidance on how to continue to improve your mental, physical, emotional, and social health. You seek knowledge on how to continue in your recovery.
Step 12: Having had a spiritual awakening due to these Steps, we tried to carry this message to alcoholics and practice these principles in all our affairs.
With Step 12, you become clear-minded and awakened to what is needed and expected of you from now on to maintain your sobriety and continue to recover from depression. If you see someone struggling with alcoholism and depression, you are ready to offer help and to pay it forward.
It also suggests that you try to implement the 12 Steps of AA in all areas of your life to heal other challenges you may be experiencing.
Starting the 12 Steps of AA
If alcohol, depression, or a combination of the two are interfering with your life, help is available. There are things you can do today to start your journey of healing, including:4,5
- Finding a 12-step meeting to attend locally. Meetings typically start with a prayer and introductions. The meeting’s core involves a speaker giving testimony, reading from 12-step literature, or sharing successes and challenges among group members. You are not required to share during a meeting
- Continuing your research about 12-step programs
- Watching videos, reading personal stories, and reviewing the steps
- Developing a spiritual or mindfulness practice that is meaningful to you, such as daily affirmations
Extra support, especially early in recovery, is important for co-occurring disorders like depression and alcoholism. There are dual diagnosis treatments that incorporate the 12 Steps throughout every stage of recovery for your dual diagnosis.6
Treating Dual Diagnosis Depression and Alcohol Use Disorder
Depression is the most common dual diagnosis disorder among those with alcohol use disorder (AUD).6 Having AUD or depression alone can be challenging. Having them at the same time can be more difficult. Effective dual diagnosis disorder treatment addresses all areas of a person’s life. Through integrated care, both alcohol use and depression can be treated successfully at the same time.6
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Dual-diagnosis treatments include:
- Medication-assisted detox—Depending on the severity of your alcohol withdrawal symptoms, doctors may use medication assistance to make the detox process more manageable. Medications can help keep cravings and physical symptoms under control so you can participate in other types of treatments that focus on recovery from mental health issues.8
- Psychotherapy—In psychotherapy, you meet one-on-one with a psychologist, psychiatrist, or other licensed mental health professional to learn how to make changes to your thought processes and emotional reactions to events, so you can also change your actions. 9
- Family counseling—Treatment that includes your family is an important part of recovery for many individuals. Your alcohol use and depression can significantly affect your loved ones. Your family members also need to learn how they can help and support you in recovery. 9
Treatment approaches like these help with goal setting, building your support network, and finding community-based support to enhance life skills and relapse prevention skills.10
Get started by reaching out to a treatment specialist at 800-839-1686Who Answers?. Let us help you join the millions of others who have used the 12 Steps of AA in their recovery from struggles with depression and alcohol.
- Alcoholics Anonymous World Services, Inc. (2021). What is A.A.?
- Substance Abuse and Mental Health Services Administration. (1999). Chapter 4—Twelve-Step-Based Programs. Treatment Improvement Protocol (TIP) Series, No. 32.
- Sterling, S., Chi, F., & Hinman, A. (2011). Integrating care for people with co-occurring alcohol and other drugs, medical, and mental health conditions. Alcohol Research and Health. 33(4), 338–349.
- McHugh, R.K., & Weiss, R.D. (2019). Alcohol use disorder and depressive disorders. Alcohol Research: Current Reviews. 40(1).
- 12 Step.Org. (2021). Newcomers Guide for the 12 Step Program.
- Lesser, B. (2021, March 30). Treatment for Dual Diagnosis. org.
- Winslow, B.T., Onysko, M., & Hebert, M. (2016). Medications for alcohol use disorder. American Family Physician. 93(6), 457-465.
- McGreevey, S. (2011). A new study points to social contacts as crucial to successful recovery. The Harvard Gazette.