In the last five years of my practice, about 90% of my patients had problems with alcohol, drugs or other compulsivities. Almost invariably, those who were clean, be it for 3 months or 30 years, were suffering from depression. These patients did not have a design for living.
"I'm in the program", "How often do you call your sponsor?", "I call him once every three days", "What did you do a year ago?", "Every day", "Why did you change?". "I'm going to meetings", "How many meetings are you going to?", "I'm going to three a week", "How many meetings did you go to a year ago?", "I went to five". "How do you start your day?" "How do you live your day?" "How do you end your day?" "What are your tools?"
Nobody was following the program. I'd give them a copy of Joe and Charlie's tapes and say, "Spend two weeks listening to these tapes, then bring your sponsor here and we'll talk about your program". In two weeks they'd come back in with their sponsor and say, "I feel 100% better!" They were following their program.
Situational or exogenous depression has to do with recovery. 100% of people coming into treatment are depressed. Of those coming off drugs and alcohol, 60% will be clear of depression within 4-5 months, just from getting off their toxin. 30% of them will become clear by learning a new way to live. That leaves 5-20% who may need medicine.