I stood on the corner of Prince and Mott in Manhattan on my lunch break, screaming and crying on the phone with my mother. About five minutes earlier, I’d bounced out of my office in a relatively neutral mood. Now, I had snot and tears drowning my cheeks and could barely manage to choke out that I couldn’t fucking take it anymore as strangers gave me the semi-concerned side eye.

Feeling like I couldn’t fucking take it anymore wasn’t an unfamiliar feeling to me. My mood would often swing from stable to intensely dark in a matter of minutes. But in the midst of this particular meltdown, I experienced a moment of clarity. I knew that I could no longer live under the tyranny of my unpredictable moods. I needed—and deserved—more help.

I say more help because I was about two and a half years sober at the time. I was active in a 12-Step recovery program and had undergone trauma therapy. The thought of needing even more support felt daunting, especially since I thought my life would improve through sobriety alone. I’d made strides in some areas, but the mood fluctuations I’d struggled with since childhood were still a constant battle.

Ultimately, I sought the advice of a psychiatrist, who diagnosed me with bipolar II, a mood disorder characterized by depression and hypomania (a mild form of mania), and recommended a regimen of medication along with dietary changes, amino acid therapy, and cognitive behavioral therapy to help me cope.

Some people see major improvements to their mental health in recovery without the need for medication or specialized treatment. For others, like me, the darkness doesn’t sustainably lift. Dallas-based clinical psychologist Dr. Kevin Gilliland, Psy.D shares that it’s always a good idea to seek professional support from the get-go as you get sober, which can make gaining clarity around your mental health an easier process.

“Our emotions and our thoughts in particular are impacted by drugs and alcohol, often slowing and stripping color from the world,” he says. “When we quit using, it takes time to rebuild our emotional life.” That’s a slow and frustrating process. But ultimately, it’s worth it.

3 Signs You May Be Dealing with an Underlying Condition

For me, my intense mood swings were the best barometer. I could feel just fine in the morning, then like I wanted to jump off of a bridge by lunch, or, all of a sudden, I’d be short-fused for no discernable reason. I was exhausted, I cried a lot, and my self-esteem was at all all-time low. The ups-and-downs alone tipped me off that something more was going on beyond my history of substance misuse.

I could feel just fine in the morning, then like I wanted to jump off of a bridge by lunch, or, all of a sudden, I’d be short-fused for no discernable reason.

But the signs can be different for everyone since the spectrum of mental health issues is wide and varied. Gilliland suggests keeping a close watch on your sleep, emotional patterns, and relationships. These facets of your life will give you insight into the state of your mental health.

Your Sleep

“Your sleep may be a little poor when you stop drinking or using because it takes time to get our sleep cycles healthy,” Gilliland writes. But if your mood or your mind constantly interrupts your sleep—falling asleep, staying asleep, getting up early, or never wanting to get out of bed—that’s often an indication or symptom of underlying issues.

Your Relationships

You may need to take time to build or repair ties to those closest to you when you’re in recovery. But if you’re struggling to maintain any healthy relationships, that’s another red flag. Plus, Gilliland writes, one of the most important things is to not become isolated, even if that’s your desire or instinct. Having a healthy support system, even if it’s small, is necessary.

“If you have family or friends that have been around your addiction, it is a slow and often emotional path back to healthy relationships,” he writes. Nevertheless, those friends and family are often the most honest sounding boards. If those close to you, or those in your current support system, think you’re still struggling, take heed.

Your Emotions

And pay attention to the “weather” of your emotions.

“When you’re in the midst of addictions, you don’t really learn and grow from the information that emotions provide,” writes Dr. Gilliland. “You rarely manage them or address them in a way that helps them improve.”  

In reality, if you’re at all feeling that your emotions are hard to manage, that’s enough of an indication that you might want the help of an expert.

Are Mental Health Issues Just the “Growing Pains” of Getting Sober?

Unfortunately, there’s no clear-cut answer to this question. Gilliland says that heavy substance use can sometimes mask underlying mood or anxiety disorders. Only after these substances are out of your system can you get a more accurate picture of what’s actually going on.

Only after these substances are out of your system can you get a more accurate picture of what’s actually going on.

But the bottom line is this, according to Dr. Gilliland: If you feel anxiety, depression, or other mental health issues are keeping you from enjoying life in sobriety, go talk with someone who can help you navigate a path to greater recovery.  

Taking Steps to Get the Professional Help You Need

There are a few options in terms of getting mental health help in recovery. Counselors and physicians are qualified to help you understand whether what you’re experiencing is normal, or if you should receive treatment. Medical practitioners aren’t the only people who can help, but Gilliland says that seeing a healthcare professional—particularly one who specializes in addiction—can be especially fruitful.

The best way to get started is with some basic, initial research. Credible websites, like the National Institute of Mental Health, can help you gain a better understanding of the symptoms of mental health disorders. However, it’s important to resist the temptation self-diagnose. Instead, use sites like this as a starting point to guide you toward helpful resources and professionals. There are screening tools on sites like Mental Health America, and more in-depth information about particular diagnosis can be invaluable in the process of gaining a better personal understanding of your mental health.

What’s Next If You Get a Diagnosis

Mental illness is still a thorny subject, much like addiction and recovery itself. Even the language used to describe mental and emotional patterns as being “off” or somehow abnormal can be distressing. When I’ve told people about my bipolar II diagnosis, most of them are baffled by it. I had a friend tell me I wasn’t bipolar II, because I’ve never thought I was Jesus Christ or gone on a spending spree. As a result, I don’t often talk about my diagnosis. Instead, I like to think I simply work differently than other people do.

So, I require some tailored, artful care. You might as well.

I’d be lying if I said that getting diagnosed in sobriety was an easy process. I haven’t found a cure-all for my well-being, even now that I’ve been at it for a while. Addressing your mental health—especially in sobriety—can be frustrating, and expensive. Plus, you may have to try several strategies before you find what works for you. But a diagnosis is a great place to start. Knowing that my feelings had a name ultimately made it easier to know how to care for myself. It’s also felt validating. What I feel may be in my head—but it’s not just in my head, so to speak.

So, I continue to explore the best, most fruitful, and even most enjoyable treatments for my mental and emotional health. I persevere even when doing so is rough on the bank account, or the approach seems kind of “out there.” I’ve kept a really open mind toward more traditional remedies, like talk therapy. While my therapist and I certainly continue to wade through the trauma of my childhood and young adulthood, she focuses on teaching me actionable tools through cognitive behavioral therapy.

I require some tailored, artful care. You might as well.

She also does nutricetal amino acid therapy and nutritional guidance, which was was something I wanted to try before I went the pharmaceutical route. But when my moods continued to cause me a great deal of suffering after a year of work together, she encouraged me to find a psychiatrist. After seeing a few that didn’t quite fit for me, I now work with one I like a lot, who works out of my therapist’s practice, and takes a very holistic approach to using medication.

Additionally, I do a lot of energy healing and body work. I’ve had really powerful experiences working with reiki practitioners on things like negative self-talk, feelings of self-loathing, and anxiety. I even started a reiki certification process myself. I also exercise a lot. My favorite is a dance-based workout because, in addition to the endorphin kick, the expressive element adds an appreciated element of catharsis for me. And keeping a regular sleep routine is pretty paramount, and I notice a real shift in my moods and ability to cope when I’ve had a few late nights in a row.

On top of all that, I also make a lot of art. I go to recovery meetings. I get massages. I work on my relationships with friends and family. Some days, I just rest. I go home when I need to go home, even if I’m supposed to be somewhere. I can’t say I make choices with my mental health in mind all the time, by any means. I do little things like drink enormous amounts of caffeine, eat plenty of sugar, stay up really late some nights, speak cruelly to myself, and forget to pick up my med. Among a variety of other things.

I do not feel good everyday. Or full of life. But taking care of myself is a practice, and I’m becoming more adept at it as time goes on. I feel grateful I have access to care that a lot of people don’t get. And I also feel a lot less shame about needing it.