Conversations – Elle B.

Elle wants people to know they’re not alone. Even through the toughest times, there is hope that people can get well and thrive. Having a positive outlook can seem futile, but in Elle’s experience, keeping moving forward and staying connected with others who are going through similar situations is vital. She was able to find a supportive community and long-term guidance through Marijuana Anonymous (MA), and she encourages others to consider taking a chance on 12-step programs. MA meetings are available by phone and conference call daily through https://ma-phone.org/ .

The Conversation

Peter Forster:

Moodsurfing is focused on living creatively with moods and the non-pharmacological aspects of self-care and treatment. Recently it has evolved into a primary emphasis on bipolar disorder, but originally it was about all kinds of mood disorders.

Considering your own interest in moods and marijuana, maybe we could begin by getting a little bit of your background and how you got interested in this interview and bringing the issue into the light.

Elle B.:
Sure. How about if I give just a brief story of how my disorders developed and bring you to the present day. Would that be okay?

PF: More than okay, it would be wonderful. Our readers love stories.

EB: Good. Okay. Well, I have a story and hopefully some people will see themselves in it. So, from the time I was a kid I was anxious, controlling, a perfectionist, high achieving, and really put a lot of pressure on myself, and I think I had some disordered behaviors from a young age. I didn’t know about mood disorders yet or mood behaviors, whatever we want to call it. But I was a very disciplined goody two-shoes, and I didn’t do anything I thought was risky or would jeopardize my academics until the summer after my senior year of high school.

Then I thought, “Well, I just finished up as valedictorian, why not try to loosen up a bit?” So I tried drinking and smoking a little pot. Both of those things were sort of revolutionary for me because suddenly I felt like I belonged with a group of friends. I felt like I could loosen up. I could laugh. People seemed to like me more. I wasn’t as self-conscious about my appearance or how I sounded to other people. And it just helped me feel like I was fitting in.

Especially with weed, I felt that just as soon as I took a puff it would instantly evaporate my anxiety. I knew I had a powerful tool there to help me cope with my anxiety, which had been debilitating for me. I was still putting a lot of pressure on myself; I moved to the Bay Area to attend a university here and I still had high ambitions. I knew that I had these tools that I could use to make myself feel better and I started using marijuana fairly quickly. It was my anti-anxiety drug and also a way to control stress. In college, obviously, you have a lot of stressors, and a lot of them are totally new. In addition, I used it to be creative and to enhance my performance in certain classes, like art and music. I felt like it really helped me perform and write well, and I thought it was a good thing for me at first. It was like a medication that would instantly help me get better.

When I wasn’t using it, I went back to this more painful existence with more struggles. I knew it wasn’t perfect, but it was helping me in a way, and it was fun. And it might have been the first time in my life that I felt like I was having fun with other people. But, as time went on, I realized that I was relying on it more and started to notice that my anxiety was getting worse and I was starting to get some depression.

When I realized I was experiencing some more serious difficulties, I went to seek help from the University Health Services for therapy and psychiatry services.  Those interventions were helping. But I also started to notice that I was relying on weed and alcohol more heavily than I was comfortable with and I joined a harm reduction group, a therapy group at the health center, which did really help a lot. Through the group, I learned to start expressing my feelings about my life and my struggles with weed. We were encouraged to put in place strategies to use less or only use in situations that weren’t as harmful as what we were currently doing.

At the time, I was trying to reduce harm by lowering the amounts I was taking and only using during certain times of the day; for example, I tried to smoke after school instead of before attending or teaching a class. As I kept attending the harm reduction group and failing to stick to my goals, I knew for sure that I was starting to lose control of when I would smoke marijuana and that I was probably an addict.

I participated in that group for a while, and I thought it was really good. Then I graduated, and I continued to do very well, at least on the surface. Much later, I learned that 12-step programs say high-functioning addicts live under the “fantasy of functionality.” That fully describes where I was at. I was looking really good on paper and I was high achieving; everybody thought I was doing great (or so I thought). I continued that fantasy for years after that, but I was really struggling inside. I already knew I probably had addiction. I knew that I had some sort of mood disorder, probably depression. And I had other things going on in my life that were stressful. 

It was difficult at that time in my life, but I did stick to the more traditional medical interventions and they were sort of working for me. But I couldn’t imagine my life without drinking and smoking weed. Part of that was just because I built my whole social network around that stuff. I would throw parties and that’s what we would be doing at the parties. I was hanging out with people who were older than me and I kind of wanted to impress people, and that kind of stuff that I was trying to do as a kid I was still trying to do as a young adult. It was around that time when I started to really become addicted to weed with daily use and really become depressed. I think long-term weed smoking and mood issues went hand in hand for me. The chronic pot use really exacerbated my depression.

I tried the medical intervention route again, went back to the psychiatrist, and we got some antidepressants on board plus one-on-one therapy. I’m not sure if this is a common thing, but sometimes when a patient exhibits depression and you give them certain antidepressants, the medication can bump them up in to a hypomanic or manic state. That happened to me, and that’s how I was diagnosed with bipolar 2.

PF: In retrospect, was there any evidence to suggest that your moods followed cycles or were you just more or less depressed at different times?

EB: Not at that point, I didn’t really notice a cycle, I didn’t notice the pattern. I would say that I exhibited very spontaneous mood changes, and definitely problems with impulse control. I had high-energy moments along with the more depressive times when I was sleeping a lot and feeling bad. I know now that there are different types of bipolar like a rapid-cycling type. So maybe I just wasn’t aware, but I don’t think I’d ever really experienced hypomania before that as clearly as I did then.

PF: How old were you at the time?

EB: I was 22 when I really experienced that more serious depression and then was diagnosed with bipolar. The marijuana use was just always there and probably getting worse. I had some acute stressors in my life and I experienced some scary moments of rage. I had an accident where I hurt myself and it wasn’t intentional, but it was very uncharacteristic of me. I just felt things were kind of out of control. I saw the doctor again and they diagnosed me with bipolar 1.  At that time, I was on mood stabilizers, antidepressants, and anti-anxiety medications. It helped me quite a bit; I managed to avoid hospitalization and other serious consequences.

There are a lot of problems with marijuana use and medications, but one is compliance. I saw that when I would smoke or drink (or mainly smoke), I would forget to take my pills and maybe the effectiveness of the pills was also reduced because I was doing those things. So, that was pretty problematic for me. I had some stomach issues and side effects that I thought were from the pills, so I would use marijuana to quell those side effects. It was kind of a weird situation where the meds were on board, but I don’t think they were as effective as they could have been. You know what I mean?

PF: Yes, it’s hard for them to work when you don’t take them.

EB: Right. Even if you only miss a dose once or twice a week, that’s a big deal, and I hear they do not work as well if you drink or smoke while taking them. At that point, I was having serious problems with memory, with cognitive function. I was having a really hard time communicating with others. I wouldn’t know what to say. I couldn’t express myself. A lot of the times I was just quiet, and I was amongst these very smart people, I just felt like I couldn’t keep up. I couldn’t learn and remember, and I thought everybody else could. I felt like I was disabled in a way and I know it was the weed.

And still, I did just fine; I finished grad school. Some really awful things happened in my life that were very traumatic, but I got through them. The thing is, smoking pot really prevented me from feeling my emotions and accessing those things like grief and happiness and everything. I wasn’t able to express the full range of human emotions and that’s how I wanted it. It was too painful for me to get through the day without tamping down those emotions with weed. But what that meant is I sacrificed emotions like love, and it just kind of cuts everything to a narrow range of feeling. I thought I was okay and happy, but I really wasn’t. It wasn’t a human existence. It was limited.

At that point, I tried to keep going. I got a job that I was pretty happy with but the weed use just kept getting worse, and it was a huge source of anxiety for me. I was doing things to get the weed that I never thought I would have done, crazy things. And it was really hurting my performance at work and in life. I was deteriorating physically because I didn’t have the desire or the ability to go out and go for walks or just do anything. I had a binge eating disorder that went rampant and I gained a lot of weight. So not only were things just crumbling physically, mentally, and cognitively, but I felt totally trapped. There was no way out, I was spiritually bankrupt, and I had nothing I could hold on to. I had no hope, really.

The craziest thing is that even then, I looked totally fine. Besides some of the physical aspects, on the outside I looked like I was achieving. But my social circle that I had in college, great people that I felt awesome being with, had shrunk down to two or three people who were all enabling each other. My world was very small at that point. I was really unhappy with that.

Basically, everything I’d had I had lost. I was still taking medication and seeing a therapist and everything, and then someone suggested that I go to the Chemical Dependency Recovery Program (CDRP) at Kaiser. I was very lucky to have access to that rehab program.

PF: Did you have trouble with that idea? I mean, that marijuana is actually a chemical?

EB: Well, I knew I had serious problems because of marijuana. Deep down, I knew that it was bringing me down. I had some shame about that because I knew other people who could use a good amount without feeling the things that I felt. I had gone to groups where I had met people who had issues with marijuana, and I just knew I had to do something. There was an intake session at Kaiser where we talked about marijuana and for me, to a lesser extent, alcohol use. The counselor I talked to had been a marijuana addict, but she was a recovering marijuana addict now, and she said, “This is real. Marijuana is a real issue for people, even me.” People get addicted to marijuana at a rate of 9%. I read that if you’re an adolescent, the rate goes up to 17%. Among those who are daily users, it’s up to 50%.

Although some people can totally use it without a problem in the world, just like some can with alcohol, there are those people who can’t. Being someone with bipolar, I thought that weed fit super naturally, super normally into my self-medication and prescribed medication regimen. I thought this because I could reliably control my moods just by taking a puff or X amount of weed of a certain strain or maybe take it as an edible or as a vapor, whatever. I thought I could control my moods on it. Whether that was going from a depressed mood to normal or from going from normal to hypomanic, I could kind of choose my own adventure. I think that was why it was particularly dangerous for me as someone who was very controlling, because it helped me instantly be able to think that I could control my moods, whereas with these other meds I was taking, I just had to take them every day and I couldn’t really feel them working. I have talked to other people who were addicted to marijuana and also had bipolar disorder. They totally agree with me that that was one of the draws of marijuana. They could control their moods better than if they were not using weed, which is sort of fascinating and scary.

So that’s kind of where things started to turn around. And I could talk about that or do you have any questions?

PF: Well, yeah, I’d like to get a little bit of a sense of how things changed after you went through the CDRP program and I think that might be useful for readers to get a sense of how things are different.

EB: Yeah, totally. Now it’s about three years since I joined the CDRP program. A lot has changed. In the early days, I was totally defeated. I was at the point where I had surrendered. I wanted to change, but I didn’t know how.

At the beginning, they started giving me information in a sort of framework for how to change. One of the things that they taught me was that addiction is a disease. It’s nothing to be ashamed of. And there are certain things you must do to recover and that you can heal from it. One of those things was they pretty much required you to go to outside 12-step program meetings for your drugs of choice. That’s when I learned about Marijuana Anonymous (MA).

Not only was I getting over a year of intensive support from Kaiser, but they also showed me this outside community that could help me during and beyond that time. The 12-step program, at first, mainly gave me a sense of community and the knowledge that other people were struggling with this problem, and that there were other people who seemed to be recovered and happy. And it gave me tremendous hope that I could do that as well if I followed what they had suggested.

They talk about the recommended 12 steps, which I think are really important to go through. There is sort of a transformation in the personality that happens once you’ve gone through that whole thing. It really cleans up your life and gives you a fresh start. Working with a sponsor to do those steps and to be supported in my life has been really important to me, as well as sponsoring other people to help them recover. I’ve always been into mentorship, so that fit really well into my life, and doing things like that really improve my self-esteem. There’s plenty of opportunities for service within each meeting, making sure each meeting happens. At a higher level of organization, called the District, you can also have service positions there to maintain the function of the organization.

I just tried to get involved as much as possible. Now, I have a huge community of friends that I honestly never thought I would be friends with: a bunch of addicts. But these are recovering addicts and they’re not all perfect. And I’m not perfect, but I think we all have a growth mindset. We have a really great time together and we support each other. It’s been tremendously valuable in my life, these days going to meetings a couple of times a week, where I get to share what’s going on with me in my life. I get to share my knowledge of how I recovered, give some encouragement to people who are new, and engage with those people and help them out. So really it just makes you feel so good to be a part of that community. I think those are some reasons why it works for people. Things are really turned around.

PF: So back to the changes that took place, what did you notice in terms of the symptoms of anxiety and depression?

EB: Yeah, great question. At first, I knew it was going to take on the order of several months to a year to start feeling better. That’s what they told me to expect. Because I was being active and I started imposing structure on my life, I did begin feeling better. I was doing something about my problem, taking action. I would say that my brain still felt very foggy. It was just a continuation of the cognitive problems that I was having with processing and working memory. That started to get a little bit better at six months, and I think by maybe a year and a half, I felt almost fully better. And that was huge for me because that was one of my biggest concerns. I’d been scared that I was just losing my mind and my capacity to think, and just have a healthy brain, and now I’m feeling totally recovered. There’s a huge capacity for the brain to heal from addiction.

In terms of mood, I had to work with my psychiatrist on the medication situation – what meds to take and what doses – and I soon became fully compliant (taking my meds exactly as prescribed) because I knew how important that was. It was kind of weird. I’m not sure if this happened when I quit using marijuana or if this was how it was happening towards the end of my using, but my bipolar exhibited a yearly cycle, where in the late summer, autumn, and early winter, I had a very obviously elevated mood: cleaning the house, making sure everything was tidy, things I normally wouldn’t do, being more active. And then starting mid-winter, I would crash and get depressed. So, there was something going on there that my meds were not able to address. They were effective, but they were not fully effective because of the weed and alcohol use. But, since I became compliant with the medications and the substances went away, and I had vastly improved my life, I had one more mood cycle that year and then the cycling stopped. I have no symptoms. I take my meds religiously and I have no symptoms of bipolar disorder. Yeah. I’m thrilled.

PF: And what about the anxiety, which I guess was really the reason that you got started in the first place?

EB: It was pretty obvious to me toward the end that weed did not help with anxiety anymore. It would only heighten my anxiety and paranoia and worrying. So, I started taking a medication called propranolol on a daily basis, which seemed to help my anxiety, along with deep breathing techniques. I still struggled with anxiety for a while after quitting marijuana. I had an abrupt change in my whole life and had to learn new ways to deal with anxiety without weed. The anxiety gradually subsided and I’m not sure I could put a time on it, in terms of a number of months. But definitely as I started gaining confidence and my life started to get put back together, I didn’t have as many things to worry about, like getting weed all the time, and all my worries just lessened.

One of the interesting things I’ve noticed is my resilience is very strong. I’ve been able to cope very well with pretty difficult things that have popped up in my life; I just do what I have to do (guided by advice from the 12-step program and my therapist) and I get through it.  I don’t have a lot of anxiety. I use my 12-step program to help me cope. It’s been really interesting to me to see how I can deal with things now.  Because I thought, things are still going to happen in my life, and they’re still going to be really hard, and it’s just going to be like it used to be – but no, it just isn’t. I have so many more tools to deal with things now.

PF:  What I wondered is how you would respond to some of the questions that people have shared with me. There’s the whole 12-step program issue of not feeling like you fit in a group, that people are different from you. I think historically, with marijuana addiction, a lot of those folks got referred to Narcotics Anonymous but that was not always a perfect fit. And I guess the first question is whether you have any advice for people who say, “Yeah, I know I have this issue, but I really am not comfortable with this group or that group.”

EB: I understand that when you’re at the point where you’re really struggling and you’re ready to seek help, you may not be ready to just dive into a new group of people. I was very isolated and I didn’t really know how to do that anymore. I didn’t really trust people and groups, but it is worth trying and keep coming back even if you don’t want to. It’s a good idea to test out a handful of meetings within the same fellowship and even try meetings in different fellowships (like AA, NA, and MA), if you’re not sure whether they’re going to be a good fit. The thing about marijuana is that it does have unique effects on people, and I thought there might be a certain type of person who is drawn to weed. After hearing people’s stories, I can say that a lot of us go through the same things and we have the same behaviors in our addiction. This holds true for people addicted to different substances and things.

It can be really comforting to hear those stories and know that the people you’re surrounded by know exactly what you’ve gone through. They can even joke around about those things and identify with those things. It made me feel a lot less alone and in my behaviors. Before, I didn’t know that other people were doing the same crazy things that I was doing. I thought I was a freak. But I shared what things I would do and people would be like, “Yeah, I did that too, and here’s what else I did!” It took a lot of the shame out of it. I also go to AA and I feel like I get a lot out of it. I read the big book of Alcoholics Anonymous, and I get things out of that too. But I really feel like my home is with Marijuana Anonymous because those are just my people.

I did have to hang around that group for about six months before I felt fully comfortable sharing my story. When I did, people came up to me with words of support and their own stories of what they went through. It really made me feel like I belonged there.

PF:  So thinking back on that experience that you had with the harm reduction group in college, was that kind of a mistake, or an experience that was useful at the time but not adequate? How do you feel about that now?

EB: Right. That’s a great question. I have thought about that a lot. I think it was a necessary step along my path towards choosing abstinence. It was the only thing that I could see myself doing at the time because I needed help, but I couldn’t see myself stopping my addictive behaviors. So at that time, it was perfect. I got the support I needed. I’m not sure it was totally effective because I don’t recall really reducing my harm because of it. But it gave me a place to talk about my struggles and hear about other people’s struggles. Since it was a process group, people were giving advice and responding to what I was saying, unlike the 12-step programs where you just share and nobody is supposed to comment on what you say.  They do that for safety reasons and to make sure everybody gets a chance to share. But, I think having a harm reduction process group was really helpful to me at the time. It helped me self-identify that I had a problem. It confirmed to me that I had an issue.

I did also go to a rehab little later on, an outpatient rehab that I didn’t take seriously. Obviously, I went because I knew I had a big problem and it was scaring me. But they asked me to quit all substances, and I didn’t stop drinking alcohol. I didn’t think that that was necessary. So there was some disconnect there. I wanted to abstain from all substances, but I couldn’t – further evidence that I had a problem. It had to get to a point where it was really messing up my life before I would actually do something and really want to do it, and then commit. I do think harm reduction is important for people and it just depends on where someone’s at in their journey.

PF: Anything else that you think would be really useful or important to mention?

EB: Yeah. I’d say that if someone feels like they’re having a problem or they’re struggling with a substance, it is worth getting the opinion of a doctor. For me, having that medical team really helped when I was eventually ready to let go of my using and start to move my life forward. I discovered I had multiple medical problems that I wasn’t addressing – serious medical problems that I felt were being masked by my marijuana use – that I was then able to address after I started treatment for substance use disorder and that fully changed my life when I started treatment for the other medical problems.

And I guess another thing is just to be open minded and willing to try something if you’re really struggling and to realize that you CAN heal from this disorder. If you’re in the middle of it, if you’re two weeks into sobriety, it may feel like this pain is never going to go away, but if you stick with it, your brain will heal. That’s a promise. I think that’s really encouraging.

PF: Thank you very much for taking the time to reach out and for following up. I really appreciate you doing that.

EB: Well, that’s great. And I really appreciate your interest in this and helping get the word out about this type of addiction. I’m very grateful that you’re out there trying to spread the word.