Who in the room has heard of self-medication?

In my last blog, I talked a little about instant gratification and how it related to grief, loss, and everything else that detonated in my life. Looking back now, I realize my grieving actually started at least a year — maybe more — before the major events ever happened.

My life had already radically changed long before the final collapse. I was already experiencing loss before the “big event” ever arrived.

To understand self-medication, we first have to understand why the need for it exists in the first place.

So yes, if you can already tell, this is going to become a multipart series about the effects of living in a narcissistic relationship.

As with any situation, there are both physiological and psychological consequences. A quick lesson that nobody asked for but that I’m going to give anyway because that’s apparently who I am now.

Any psychological symptom can eventually become a physiological symptom.

To begin with, living in a narcissistic relationship is very different from casually interacting with a narcissist. If you are not cohabitating with the person, the symptoms tend to be more subtle and insidious. Living with one, especially as the relationship progresses, keeps the body in a near-constant fight-or-flight response.

That means relentless stress and a constant flood of cortisol and adrenaline.

Through anecdotal observation — and no, I’m not pretending this is hardcore research data — it often feels like the body produces enough cortisol for four or five grown adults every single day.

So what exactly is cortisol?

Cortisol is a steroid hormone produced by the adrenal glands. It’s the body’s primary stress hormone and plays a major role in regulating blood pressure, heart rate, inflammation, metabolism, and energy usage.

You don’t need to be a physiologist to understand that constantly hammering the body with stress hormones is probably not a great long-term survival strategy.

There are a lot of fascinating studies on cortisol out there. If you’re the inquisitive type, I highly recommend reading reputable medical journals instead of listening to whatever Aunt Sally reposted on Facebook next to a Minion meme.

Right now, we’re focusing on chronically elevated cortisol levels.

Prolonged high cortisol can contribute to disrupted sleep, anxiety, weight gain, hypertension, weakened immunity, muscle weakness, and a laundry list of other issues. In my case, I had two separate factors feeding the machine.

The first was chronic PTSD. PTSD itself can produce periods of chronically elevated stress hormones, though there are often temporary moments of relief.

Living with a narcissist, however, creates a completely different type of stress. It becomes constant. Worse, it escalates over time. There is a gradient to it. The longer you stay, the more normalized the chaos becomes.

When you combine PTSD with an increasingly toxic home environment, the result is stress completely off the charts.

Am I boring the shit out of you yet?

I’m honestly not trying to. I’m trying to explain the physiological effects of a psychological environment that slowly wears a person down.

When I started writing this, it occurred to me that I spent twenty-seven years dealing with this reality. Twenty-seven years is a lot of cortisol. A lot of adrenaline. A lot of survival mode.

According to information from the Cleveland Clinic, prolonged high cortisol levels can contribute to:

Nervous System & Brain Fog:
Your brain becomes trapped in survival mode, making it difficult to differentiate between immediate danger and ordinary life. This leads to brain fog, memory problems, emotional exhaustion, and hypervigilance.

Pain & Tension:
Muscles remain perpetually braced, causing chronic neck pain, back pain, headaches, and joint discomfort.

Gastrointestinal Issues:
Stress disrupts digestion and overworks the adrenal system, leading to nausea, bloating, IBS symptoms, and appetite disturbances.

Exhaustion & Insomnia:
Living in a constant high-alert state destroys restorative sleep and creates a level of fatigue that coffee can’t even pretend to fix.

Weakened Immunity:
Chronic stress suppresses immune function, increasing vulnerability to infections, illness, and inflammatory flare-ups.

Cardiovascular & Metabolic Strain:
The body working overtime eventually impacts blood pressure, heart rate, blood sugar regulation, and overall cardiovascular health.

Now take all of those physical symptoms and pile them on top of the psychological damage already occurring.

In my case, I became a walking roadmap of these symptoms. Some were mild. Some were severe. Some came and went. Others simply became part of daily existence.

Eventually, I was wearing down, and something had to change.

I still don’t fully understand why I held on as long as I did. That isn’t really regret as much as it is self-examination. If I understand why it happened, maybe I can prevent it from happening again.

When you add aging into the equation, it becomes very obvious that compounded stress can physiologically kill you.

I remember reading years ago during undergraduate studies that many military personnel, first responders, and people from chronically high-stress professions often die relatively early after leaving those careers because their bodies have adapted to living under constant stress.

Honestly, if you had seen my lab work at the time, it’s no wonder I was headed toward a heart attack or another stroke.

The long-term effects of my living situation were destroying me.

And yes, while there were external factors, I also have to accept responsibility for my own role in remaining there. As my therapist likes to remind me, you can only control yourself. Trying to control another person is simply another source of anxiety.

When I finally realized my life was never going to change unless I changed it, I began grieving.

The problem was that I didn’t really have an outlet for that grief.

Which brings us back to self-medication.

Therapy is difficult because there’s rarely a short-term solution. It’s slow. It’s uncomfortable. It requires sitting with things you desperately want relief from.

And remember, we live in the age of instant gratification.

So self-medication becomes attractive.

Self-medication often leads to substance use, but it doesn’t have to involve illicit drugs or alcohol. It can be food, gambling, compulsive exercise, shopping, excessive religiosity — yes, that’s a real word and it makes me sound very scholarly — or anything else that provides temporary relief and distraction.

Essentially, self-medication is anything that becomes overutilized in an attempt to escape emotional pain.

The more severe the symptoms become, the stronger the pull toward relief.

And unfortunately, relief and healing are not always the same thing.

I hate cliffhangers, but I want to spend some real time talking about the pitfalls of self-medication in the next part of this series. I also try to keep these posts short enough that you aren’t unconscious by the end of them.

No matter how much I prattle on, my dog and my mom always listened — even if half of it went in one ear and out the other.

Find someone like that.

It helps more than you realize.