Mental Health - I Self-Medicate With Cigarettes

This is a sample from our ‘Quit Cigarettes’ mission, which is currently live in the UK. Our goal is to increase the amount of people in the UK who quit cigarettes. Read more about our first mission here.

Writer Zoe Beaty explains how depression and anxiety have been intertwined with her cigarette habit - and why it's time to finally quit

I like to roll the tobacco through my fingers for slightly too long. 

It’s become a nightly ritual, rolling well into the early hours, an essential process that helps me forget, for a few minutes, by way of reflexive familiarity: a filter between the lips instead of food, rhythmic strokes over the paper until this little thing in my hands is perfectly shaped. Then, a shocking flame against the cool air and the first, decisive drag. 

Smoking matched my depression well. For the macabre among us, there’s something very, very funny about reading a threat, that “smoking kills”, when you think that you want to die.

The first sign of what was to come, in Summer 2017, was the sharp onset of insomnia and I marked each hour with a fag. Soon my stomach was sewn up with anxiety and eating was difficult too, so I smoked instead. Sometimes I drew too hard on the rollie on purpose so that it caught in my throat and burned. We all want to feel something, don’t we?

I first smoked at age 15 when it was cool. When I left home for university, I sought solace in the momentary distraction of cigarettes from unknowns – unknown people and cities and music I found foreign. During my first real heartbreak I smoked 20 a day, sitting outside grim cafés and murky pub gardens, feeling like a lovelorn French heroine. I flicked ash into the sink – inexplicably right next to my shitty, single bed – in halls at 4am, deep in self-absorption and the conviction that I was “dealing” with stuff. 

It wasn’t until I moved to London aged 23 and felt the first pangs of anxiety that I really considered my toxic relationship with something that was now not just natural, but part of my perceived identity.

Cigarettes took on a new role – an escape route out of conversations

For the first time, I began to find social situations overwhelming, just a little at first, and then soon after, quite paralysing. I stopped speaking freely, convinced that I would reveal my “real” inners: boring, unintelligent, achingly uncool. Cigarettes took on a new role – an escape route out of conversations and a way of avoiding people who intimidated me. 

An ex-boyfriend convinced me to seek help after I stopped going to work – as a journalist, being afraid of new conversations is a bit of an issue. I was diagnosed with social anxiety and started a 12 week course of CBT, during which smoke breaks were identified as “safety behaviours”. “What do you think people think of you when you suddenly exit conversations and march outside?” my therapist asked. “That I’m going to smoke,” I said. “Or,” she replied, “that you’re rude.” 

I believed that smoking eased my anxiety and depression. I would become defensive about my addiction, repeating untruths like “it helps me clear my head” and “it forces me to take a break” and “there’s something relaxing about inhaling and exhaling very consciously”. Actually, this is pretty much bullshit. Studies on this subject are conflicting. While a 2017 review of studies found evidence to suggest that many people experiencing depression or anxiety used smoking as a type of self-medication, smoking to alleviate psychiatric symptoms – evidence shows that smokers are generally more likely to develop depression than non-smokers

Furthermore, the physical effects of smoking – how nicotine releases adrenaline, for example, the same hormone the body releases in its ‘fight, flight or freeze’ response to fear – can invoke anxiety, at least partially. Many studies have suggested that early exposure to cigarette smoke during gestation or childhood may “exert neurodevelopmental influences capable of changing anxiety trajectories” – or can potentially make it more difficult in later years to control our response to anxiety. While smokers tend to associate having a cigarette with stress-relieving qualities, this is a temporary fix to a withdrawal symptom, a falsehood of sorts. 

 

Some analysis by the British Medical Journal has gone as far to say that stopping smoking could be as useful as taking antidepressants – a 2014 experiment involving 26 people found that people who quit experienced reductions in stress, anxiety and depression as well as showing an improvement in mood and quality of life with regards to mental health, compared to people who continued to smoke. The benefits of smoking cessation, they found, were the same in people with psychiatric disorders as in the general population. 

For years I have willingly (forcefully) turned a blind eye to this type of research. I’ve often toyed with the idea of quitting and pursuing the body and mind of someone in control, devoid of this unattractive, unfashionable addiction; of being clean in a very literal sense. Still, there has always been one more thing to get through before the idea of quitting could be considered – after the heartbreak, after graduation, the job interview, the redundancy, after this birthday or that one, after the depression. In the malaise of melancholy, there is a sense of “what’s the point” of quitting – the anti-self-care infliction of a mind that just won’t give a shit. It doesn’t seem to go away, even when the depression lifts slightly. 

While it has been a constant, I am beginning to realise it has been the wrong kind of familiarity and misrepresentative comfort. It is hard to take steps when your mind is not your own, but I am hopeful that I might. Maybe sometime soon I can stop rolling well into the night-time and maybe I’ll sleep instead.