A Poet’s Perspective on Mental Health and Substance Abuse

Alicia Cook, multi-award-winning writer and mental health and addiction awareness advocate, has found poetry to be a vital tool for healing. The poet behind Stuff I’ve Been Feeling Lately, I Hope My Voice Doesn’t Skip, Sorry I Haven’t Texted You Back, and The Music Was Just Getting Good, her writing focuses on addiction, mental health, and grief.

“I have always been a storyteller, or a documenter might be more accurate, since most of what I write is rooted in reality and based on my life experiences,” Cook shared. “In 2006, my cousin Jessica died from a heroin overdose. After years of dealing privately and struggling to find a voice I could relate to on the topic, I started shedding light on it. As an essayist and speaker, my activism to fight the opioid epidemic is far-reaching.”

Alicia Cook, writer and activist, is passionately fighting the opioid epidemic.

Source: John Romano/Used with permission

Research shows that from 2000 to 2018, the rate of drug overdose deaths more than tripled in the United States (Singh GK, et al, 2019). In fact, the U.S. Department of Health and Human Services reports that 1.6 million people had an opioid use disorder in the last year (U.S. Department of Health and Human Services, 2022).

While headlines of the opioid crisis are common, understanding its connection to a lack of mental health care is not. One large, nationally representative study showed that people with mental, personality, and substance use disorders (SUD) were at increased risk for nonmedical use of prescription opioids, and that 43 percent of people in SUD treatment for nonmedical use of prescription painkillers have a diagnosis or symptoms of mental health disorders, particularly depression and anxiety (NIDA, 2022).

Despite the need for mental health treatment to prevent self-medicating with substances, over 56 percent of adults with mental health struggles do not receive treatment—that’s over 27 million people suffering alone (Mental Health America, 2022). Whether it’s due to social stigma, lack of financial accessibility, or a shortage of providers, many people with mental health concerns are left to cope without support.

For Cook, poetry has offered a valuable pathway to raise awareness about these issues, process her own pain, and connect with others who are suffering. “Poetry and writing have always been integral to who I am. They serve as a release valve for my pain in many ways,” she described. “Translating my thoughts onto paper helps alleviate anxious tension, pain, sadness… and prevents all that from building up inside my brain.”

In an exclusive interview, Alicia Cook shared the heart behind her poetry.

Q: Each of your poems is paired with a song—what role has music played in your mental health journey?

A: I listen to music to work through my thoughts, much like others find solace in reading my poetry. There is a song for every emotion.

Growing up, my father was always listening to music, and his love for music influenced me deeply. He always explained the meaning behind the song. Bright Eyes has a lyric that goes, "I could have been a famous singer if I had someone else's voice." I truly believe that if I could sing, I would have pursued a career as a songwriter or musician. Since I can't, poetry allows me to create that same magic for others. Ultimately, we're all storytellers.

Q: Your poems dance between the dark days of depression and the hope for a brighter future. How did you embrace the "mosaicked" beauty in the broken pieces? In what ways can others hold onto hope in the midst of their own battles with grief and mental health issues?

A: My mother used to tell me, “We have bad days, and good days, but never normal days.” The first step was acceptance, at least for me.

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We didn’t ask for this. We didn’t deserve it. But it was happening, and nothing was going to change the fact that it was happening.

And then, I had to reckon with the fact that though some of my life was shattered at my feet, another part of my life was still experiencing moments of joy. And I told myself I shouldn’t feel guilty for smiling or laughing in those moments, because it didn’t negate the pain—it was existing simultaneously. I learned how to balance my life in this way. Like I say in Stuff I’ve Been Feeling Lately, “We need both. We need the good and the bad to be who we are,” (Track 78).

Q: Some of your work explores the relational impacts of living with anxiety and depression. How does this present a challenge when it comes to maintaining relationships? How can friends, significant others, and family members better understand and support their loved ones who are struggling with their mental health?

A: My second poetry mixtape, Sorry I Haven’t Texted You Back, really explores the challenges of maintaining relationships when living with depression and/or anxiety. These mental health conditions can create blocks to effective communication, trust, and emotional intimacy, making it difficult to maintain healthy relationships. Difficult, but not impossible.

Most people in my life have experienced these feelings themselves too, so they are in a place where they understand and also know me well enough to know what I need in that moment (ex: space, or connection). I am also vocal about how I am feeling, so they don’t have to guess.

Supporting a loved one with anxiety or depression requires understanding, patience, and compassion. But there is usually an educational or informational gap too.

Like, for years some people closest to me thought I was “lazy” because I slept so much, when it was likely depression. I was called “too sensitive” a lot too. By educating yourself and fostering an environment of open communication and support, friends, significant others, and family members can play a crucial role in helping their loved ones navigate what they are going through.

Source: Brian Erickson/Used with permission

Q: What do you hope readers take away from reading your poetry?

A: I hope my writing reaches those who find themselves just a few steps behind me on this journey. My wish is for them to feel less alone, knowing that someone else has faced similar struggles and emotions. When you’re in a mental health decline, or similar, it’s very easy to believe you’re on a deserted island.

Ultimately, the arts—whether it be poetry or visual art or music or dance—hold magical healing properties and have this uncanny ability to bring people together.