lf11

It becomes a question to you of which is most important to you - your lifestyle or your future earning potential.

Gave this advice to a highschool kid struggling to find purpose and employment, with steel and tattoos all over his body.

He'd never heard it, and it hadn't occurred to him.

Didn't see him after that for two years. When I met him again, he was wearing one small earring in one ear, khakis, a polo shirt, cut hair, and was taking his car to get it washed during his lunch break.

Changed his life.

Generally speaking, yes. Also alcohol, and probably nicotine (if those substances are used).

It's an interesting question, because often times these substances can be just a part of a coping/compensation strategy. People use these drugs so they can be functional in society. If you try to take away their self-medication, you quickly need to address all the other things going on in their life or they fall apart.

Unfortunately, some of the tools for self-medication are addictive themselves and can precipitate further problems.

Even more unfortunately, many of these tools are illegal.

"Substance abuse" is a catch-all term relating to any of the above three definitions, none of which are particularly related. Some people use "substance abuse" to refer to addictive behavior. Some people use the term to refer to use of controlled substances. Some people use the term to refer to conscious or unconscious self-medication. It's a mess.

Not OP, not a doctor, and don't know your case, but with that said.....

Absolutely not. Modern medicine has this little fetish about the personality being fixed for life after some point in the teens or even childhood. However, the psychedelic research folks are showing that this is not at all the case. (Not to mention the many spiritual traditions that recognize a continual state of change in who we are moment to moment.)

Furthermore, there is now a fairly wide spread of research that shows physical changes in the brain subsequent to therapy of varying kinds. I know a lot of people somewhat discount "therapy" because "it's just talking" but the plain fact is that well-constructed words can change your life.

Here's an recent example of specific neurological changes in people with borderline personality disorder undergoing transference-focused psychotherapy.

Find another doctor. And if you do have an untreatable condition, then your doctor should be helping you to live the most productive and fulfilling life you can, regardless.

edit: bipolar != borderline, fat fingered mistake

Holy shit. What the fuck.