September is National Recovery Month, and let’s be honest; addiction and recovery are taboo topics. We don’t know what to say when we suspect someone we love may be struggling with repetitive behaviors and the last thing we want for ourselves is a negative label. Throughout the month, we’re going to address questions such as:
Before we dive in, there’s at least one thing counselors, psychologists, psychiatrists, social workers, treatment centers, and courts agree upon: we struggle to define addiction and related terms. The American Society of Addiction Medicine and the National Institute of Health helps us put some more words to each of these fields of thought. Here is a brief breakdown on some of the semantics.
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.” (ASAM.org). If a person is experiencing negative consequences from using a substance or participating in an addictive behavior, and is unable to stop the behavior and/or use, he or she may be addicted. Addiction may also be called Substance Use Disorder.
When someone no longer responds to a substance in the same way they initially responded, they may be experiencing tolerance. Higher doses of the substance are needed to achieve the desired “high.”
When an individual stops or tries to abstain from using a substance or participating in a compulsive behavior, they experience withdrawal symptoms. Withdrawal symptoms may be physical and/or emotional and vary in severity depending on the length and frequency of use, as well as other factors. *A person who is dependent may not be addicted.
When an individual stops using a particular substance or stops engaging in an undesirable behavior, and then begins again, they may be experiencing a relapse Not everyone will relapse, and relapse occurrence often depends on external factors such as family support, recovery program, and commitment.
Recovery is a word often associated with 12-step programs. Sometimes recovery means an individual has stopped using a substance and is sober. Other times, recovery is synonymous with working toward sobriety. Even further, someone may consider them self in recovery as long as they are working to lessen their unwanted, repetitive behavior.
Regardless of the many terms that get thrown around, addiction actually does have a foundation in science. In our brain lies a complex reward system. At the front of our brain is the prefrontal cortex which helps us make decisions and regulate our impulses. Our reward circuits lie in another part of our brain called the limbic system, also referred to as the “emotional” part of our brain. When the prefrontal cortex is underdeveloped, we may struggle with responsible decision making or impulse control. Therefore, when a person drinks alcohol, uses drugs (prescribed or otherwise) and/or participates in an addictive behavior such as video gaming, shopping, or eating, the limbic system becomes the primary decision-maker of that person’s brain.
The addictive substance or behavior itself does not cause someone to be addicted; there is a pleasurable neurotransmitter which communicates with the limbic system called dopamine. Dopamine is released when the brain gets a signal that something is pleasurable or rewarding. The more dependent the brain becomes on that specific drug or behavior to release dopamine, the more a person needs to engage with a substance or repetitive behavior in order to achieve pleasure.
“So, Lauren, I don’t drink beer during the week, but I drink a 6-pack every weekend. Am I an addict?” When I hear this question, I hear, “Please don’t label me.” And I get that! None of us likes to be put in a category that has a negative, cultural connotation. If we’re struggling to get a hold of a negative pattern in our lives, nothing about being labeled is going to be helpful. More appropriate, less shame-based questions I may ask include:
Most of us who enjoy activities such as casino slots, shopping, smoking, eating, or drinking alcohol don’t plan to let those activities take over our lives. We don’t set out to drink a beer a day and then increase to a 12-pack a day. We don’t plan on losing thousands of dollars to gambling or staying up till 3:00 a.m. playing Clash of Clans. But, our brain really likes the way these things make us feel. And the more we engage, the more at-risk we may be for addiction. When we realize our life is changing in order to accommodate the behavior, we may try to revert back to “normal life” and find it’s harder than we thought. In fact, we may try so hard and realize it’s impossible to do on our own. That’s when shame sets in.
Shame fuels addiction more than any other emotion and perhaps, even more than the substance or behavior itself. Our brain is already working hard to maintain a baseline of pleasure and on top of that, it begins working to keep our newfound pattern(s) a secret. The more we hide, the more shame we feel, the more we want to make that shame go away, the more we engage in our secret behaviors. Before long, we’re feeling worse more often than we’re feeling better. It’s a vicious cycle that is very powerful and very difficult to escape on our own.
Let’s revisit the “Am I an addict?” question. Instead of focusing on trying to figure that out, let’s focus on what is motivating that question. Let’s work together so you don’t have to be alone in your struggle.
In the coming weeks, we’re going to discuss some local resources that are very helpful to individuals and families struggling with challenging, repetitive behaviors. We’ll also dive into one of the newest and incredibly challenging impulse behaviors, technology and social media. Follow along with us on Instagram and Facebook.