Nurses must recognize that substance abusing women with a comorbid depression are likely to view the present, past, and future negatively, hold distorted views of the world, hold irrational false beliefs, and have a low self-esteem. Assisting women to recognize and own their feelings and accept responsibility for controlling them are crucial to changing their thoughts, feelings, and behaviors that contribute to low self-esteem and depression. Affirmations can be used to increase one's self-esteem through changing one's view of self and the world, and behavioral strategies can be used to change behavior and subsequently one's feelings.