Reznor interpreted "The Downward Spiral" as an extension of himself that "became the truth fulfilling itself," as he experienced personal and social issues presented in the album after its release. He had already struggled with social anxiety disorder and depression and started his abuse of narcotics including cocaine while he went on an alcohol binge. Around this time, his studio perfectionism, struggles with addiction, and bouts of writer's block prolonged the production of "The Fragile", and Reznor completed rehabilitation from drugs in 2001.