Addiction is a health condition that makes a person unable to stop the use of a substance or engagement in a particular behavior. The causes can vary by individual, but the desire is the body craving a behavior or substance, especially if it brings about an obsessive or compulsive pursuit of “reward”, with no concern for accompanying consequences.
Based on the standards of the World Health Organization (ICD-10) and the American Psychiatric Association (DSM-IV), an addiction must meet a minimum of 3 of the symptoms listed below:
- Limited control
- Negative consequences
- Neglected or postponed activities
- Significant time or energy spent
- Desire to cut down
Addiction is separated into different stages. The early stage is when the individual with addiction is still functioning correctly. They still have jobs, and their relationships are still intact, but their lives suffer subtly because of their habit. This scenario is the most common. Significant losses do not have to be involved before you are said to have an addiction. The late stage of addiction is when the addict becomes non-functional. They’ve probably lost their job and had to use every day, they’ve fallen into dependency and need help fast. This late stage is what many imagine to be an addiction, but this very stereotype is rare. Addiction is a progressive disease, and never easy to quit; with its consequences getting worse over time.
The reactions of your body and brain are far different at the early stage of addiction from responses at the later stages. The four stages of addiction are:
- Experimentation: engages or uses out of curiosity
- Regular or social: engages or uses for social reasons or during social situations
- Risk or problem: engages or uses in an out-of-proportion way without regard for consequences
- Dependency: participates in the behavior or uses daily, or multiple times in a day, despite the associated negative consequences
The Brain and Addiction
The brain is a complex organ in the human body and it’s affected by substance use in 3 main areas:
- The Brain stem. This controls basic body functions like breathing, heart rate, sleeping, etc.
- Cerebral cortex. This is responsible for thinking, planning, decision making, and sensory information processing.
- The Limbic system. This is where the subcortical structure meets the cerebral cortex. It’s responsible for motivation, emotion, learning, and memory.
Drugs of abuse with very similar chemical structures to natural neurotransmitters disturb normal neuronal processes. Excessive amounts of neurotransmitters get released which will make a person feel greater pleasures than naturally pleasure deriving activities (Such as sex, eating, etc) can produce, at the same time preventing normal chemical reuptake. What this means is that excessive amounts of neurotransmitters are left in the synapse, which will affect the behavior of other communicating neurons and consequently alter our mood.
Addictive behaviors and substances can create a pleasurable “high” that is psychological and physical. These highs can cause addicts to engage and re-engage in the act more often, using more and more of the substance for extended periods to achieve the same highs over and over again. Some people may try a behavior or a substance and never approach it again, while others keep doing it repeatedly to the point of addiction, and this is partially due to the frontal lobes of the brain. The brain’s frontal lobes allow people to delay the feelings of gratification or reward, but when it comes to addiction, the frontal lobes malfunction and the feeling of gratification is immediate.
Additional areas of the brain play a major part in addiction. The biological processes that lead to addiction involve the reward pathways in the brain. The brain registers pleasure the exact same way, regardless of the activity or events that led to them; whether it’s from a nice meal, a sexual encounter, monetary reward, psychoactive drugs or alcohol, or anything else that’s pleasurable. The pleasure signature in the brain is distinct and involves the release of the neurotransmitter dopamine in the nucleus accumbens. The nucleus accumbens and the anterior cingulate cortex, which is associated with the sensations of pleasure, can increase the response of a person when exposed to addictive behaviors and substances.
Addictive drugs or behaviors provide a shortcut to the reward system of the brain by bombarding the nucleus accumbens with dopamine. Memories of this rapid sense of satisfaction are then laid down by the hippocampus, and a conditioned response to certain stimulus is created by the amygdala. The tendency of addiction occurring is proportional to the rate at which the use of a substance or activity promotes dopamine release, the intensity of the release, and also the reliability of that release. Dopamine does not only contribute to the feeling of pleasure but it also helps with learning and memory – two important phases in the transition from liking a thing or activity to becoming addicted to that thing or activity. Other possible causes of addiction include mental disorders like bipolar disorders or schizophrenia, and also chemical imbalances in the brain. These disorders can bring about coping strategies that can result in addictions.
There are different theories on what causes addiction. Some argue that it is determined by genetics; while others argue that it is purely as a result of environmental factors, like a rough childhood. The “Disease Model” is the dominant model of the causes of addiction in the United States. The disease model sees addiction as a biological “disease” whereby the brain is essentially hijacked by the drug, leading to biological changes that are enduring, consequently making addiction inevitable. Other competing theories propose that addiction is based on conditioned behaviors and dysfunctional thoughts; that addiction is as a result of the lack of social connections, or that addiction is a spiritual or moral problem. Today many psychologists also accept that addiction is a result of complex interactions of many factors including psychological, biological, social, and even (for some) spiritual elements, and this is termed as Bio-Psycho-Social-Spiritual Model (BPSS Model).
The Causes of Addiction:
- Negative thinking, such as all or nothing approach to life
- Family history.
- Underlying anxiety or depression
- Poor coping skills for dealing with stress
Negative thinking makes you feel stressed, discontent, irritable, and uncomfortable. When you have an all-or-nothing manner of thinking, you see your life as either perfect or horrible. You also see the options you make as good or terrible. That sort of feeling makes you crave an escape, to relax or reward yourself, which can result in the use of drugs or alcohol.
Genetics accounts for 50% of whether an individual will develop an addiction or not. Twin studies have proven this claim. When an identical twin has an addiction to alcohol, the other twin has a high tendency of also being addicted. But when one non-identical twin is addicted, the other twin is not necessarily addicted to the alcohol. With the differences between the non-identical and identical twins as the basis, studies have shown that 50 – 60% of addictions are caused by genetic factors.
Underlying Anxiety or Depression
Statistically, approximately 15 – 30% of people with addiction problems also suffer from cases of underlying depression. The combination is sometimes termed a dual diagnosis. Depression and anxiety can result in addiction. Addiction can also bring about anxiety and depression. People who have dual diagnosis often use alcohol and drugs to escape the feelings of depression and anxiety. Those people have a recurring pattern; staying sober for a while and then relapsing when they become overwhelmed with the feelings and try to escape them.
Poor Coping Skills for Dealing with Stress
Lastly, stress is a very important risk factor in any addiction situation. Stress management is especially important in the transition from moderate drug use to addictive drug abuse. The more stressed you are, the harder you try to look for an escape route to regain some sanity, and that escape route, for most people is to suppress the effects of stress with the consumption of alcohol or drugs.
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