When I went to my first 12 Step meeting, decades ago, a speaker mentioned that she didn’t need therapy or medication anymore. All she needed was the steps, her higher power and her sponsor. She no longer needed extra help in recovery.

I was on meds and in therapy at the time, and after the meeting, I asked the old-timer who had greeted me whether it was true that in recovery, you didn’t need or shouldn’t rely on outside help like therapy or meds. The old-timer smiled: “A lot of us need all the help we can get. Don’t let anyone tell you to give up therapy.”

When You’re Fighting More Than One Battle

Like many people in recovery, I have what’s called a “dual diagnosis,” or, more casually, I’m a “double trudger.” I have bipolar disorder to go along with my addiction. I need medication to keep me stable, and I’ve found therapy to be vital to my ongoing recovery. It’s not an either/or for me, it’s a both/and.

But not everyone in recovery has a psychiatric diagnosis as I do. For people who don’t have a recognized medical condition, what role does mental health care play in recovery? Are 12-step programs enough, or is more needed?

The Ground Rules

Here are some basic ground rules regarding extra help in recovery.

First, if you’re already in therapy, or on medication, or receiving some other form of mental health care, don’t stop just because you’ve entered a 12-step program. The old adage of “no major changes your first year of recovery” holds true here. Time will tell whether working a recovery program alone is sufficient, or if you should continue to receive outside mental health treatment.

Second, you should know that recovery from an addiction may bring up previously suppressed issues. One thing that almost every addiction has in common is that it functions to self-medicate. When we take away the addictive behavior, feelings and issues that have been buried can suddenly appear. Some of those can and should be dealt with through a recovery program—but others are better brought to a mental health professional.

How to Determine if You Need Extra Help in Recovery

So how best to know what will work for you? How best to take care of your mental health in the early stages of a recovery program? Make sure you pick a sponsor who is open to therapy and medication if needed, and not someone hostile on principle to mental health care. Be willing to ask for extra help in recovery if needed, and have a friend close enough to you who can suggest that the time for extra help is now.

You are not a failure—and neither is your recovery program—if you find you need additional support.