Have you ever wondered why some addiction patients act with no thought of consequences? Like they run into a friend in town and accept a sudden invitation to get high when they have a job interview? Or they take part in pathological gambling despite the well-known risks of doing so? What really makes an addict so impulsive?
As it turns out, most people who are struggling with substance abuse act on impulse. So, this means many have trouble controlling their behaviors or emotions. Impulse disorder could be a sign of an underlying problem, like a mental health issue or other personality disorders.
In this article, we will look at the things that make addicts impulsive and the treatments that can help them. But first, let’s understand what an impulse disorder is.
An addict with impulsive behavior finds it hard to resist the sudden desire to do something that’s contrary to the societal norms. They may do so quickly, repeatedly, and with no consideration of the consequences.
Acting on impulse is not a bad thing. It can be a motivating force behind the artistic genius. For instance, some incredible music, books, and art come out of impulsive action. But most addiction patients are impulsive often, sometimes multiple times in a day.
While the cause of impulsiveness is not always evident, studies show that it may have something to do with the prefrontal lobe. According to this study, the prefrontal cortex is responsible for higher-order functions. These functions include conscious thought, spatial learning, decision-making, and judgment.
Addiction negatively affects this part of the brain and alters its functioning. So, someone who’s dependent on drugs or alcohol might be unable to make rational decisions or override impulsive urges. So, they end up acting on impulse without thinking, which is not usually in their best interest.
The ability to resist impulse urges allows us to function well in society. It keeps us from danger by enabling us to consider the outcomes of our actions. But when that part of the brain is no longer functioning well, we become susceptible to impulse actions.
Addiction causes changes that promoted impulsive behaviors. So, the addict desires to only live in the present moment with no regard for the future.
Impulse behavior is an immediate factor between ADHD and addictive disorders. According to one study, both impulsive acts and impulsive choices are observed in ADHD and addiction disorder. Experts believe that there’s a strong link between ADHD and addiction and that many individuals with ADHD often turn to alcohol and drugs.
Different studies have shown that people with ADHD have higher levels of impulsive and hyperactive behaviors. That’s why:
Again, those with ADHD usually turn to substances. While there isn’t a clear reason why that’s the case, experts believe that these patients have problems regulating neurotransmitters like norepinephrine and dopamine. But it could also be that they turn to alcohol or drugs as a way to cope with ADHD symptoms.
It is especially challenging for adults with undiagnosed or untreated ADHD. One expert matched the situation to playing with an invisible fire and wondering why the hands are burning.
Impulse behavior is a hallmark of BPD, a debilitating personality disorder that distorts a person’s self-perception. BPD patients are seen as highly dependent, manipulative, and dramatic. However, mental health experts say that these behaviors arise as a dysfunctional way to deal with emotional pain and overwhelming fear.
Patients with borderline personality disorder often suffer from insecurity, anxiety, and low self-esteem. They also have substance abuse issues. Alcohol, in particular, makes them comfortable when they are in the company of others.
Alcohol dependent individuals with BPD express a wide-range of impulsive behaviors. These include:
IED is an impulse-control disorder that’s characterized by the inability to resist impulses. This may lead to property destruction, serious assaults and frequent verbal aggression in the form of temper tantrums.
The condition results from a combination of environmental, biological, and genetic factors. Many IED patients grew up in families where verbal and physical abuse and explosive behaviors were common.
According to the National Institute of Mental Health, IED starts in adolescence and affects someone throughout their lives. It’s one of the many impulse control disorders where a person is unable to control aggressive behaviors that violate other people’s rights.
An episode of intermittent explosive disorder could manifest as:
In addition to substance use treatment, a patient needs treatment for the specific impulsive behavior condition. One general approach is behavioral therapy, where one learns to work through and better handle situations that trigger impulsivity.
Healthcare providers may use several medications to treat impulse-related severe conditions. They recommend a dopamine agonist, opioid antagonists, mood stabilizers, and antidepressants for treatment. Antidepressants like selective serotonin reuptake inhibitors can also help treat IED and other impulse-control disorders. Methylphenidate or amphetamine and dextroamphetamine treat ADHD.
Family therapy is also an effective treatment for impulse behavior. This is especially true since the roots of severe impulsive behaviors may stem from the family environment. And in some cases, the impulsive behavior also hurts other members of the family. Family therapy can help address both of these issues.
Addiction can be both psychological and physical. Treating the physical aspect alone won’t address the psychological triggers that compel an individual to keep abusing substances. Addiction needs personalized treatments that address the symptoms, triggers, and consequences that drug abuse has on different areas of an individual’s life. That’s why many treatment facilities use various types of therapy as part of a holistic approach to tackle addiction and its related issues to reduce the risk of relapse.
Treatment for mental health and substance use disorders has come a long way. Numerous studies and clinical trials have shown the effectiveness of different therapy techniques in addressing a range of issues, including stress, depression, schizophrenia, substance abuse, and so on. As an example, behavioral therapy is known to enhance the physical and psychological well-being and prevent relapse of substance use, mental illness, or both in dual diagnosis patients.
Kicking the addiction habit is a lifelong process that needs consistent application of coping mechanisms. Addiction relapse rates, according to NIDA, are similar to those of chronic illnesses like heart disease, diabetes and asthma. So, the risk of relapse, irrespective of how long one has been clean, is high. This is why the importance of therapy in treating addiction can never be overemphasized.
Addiction is a huge problem today. In 2014, about 20.2 million adults aged 18 and over had substance use disorder in the past year. Of these adults, 6.2 million had illicit drug use disorder, while 16.3 million had alcohol use disorder. What starts as a fun activity can escalate into a full-blown addiction problem.
Addiction changes the way human brain works. It alters the reward center to the extent where one craves for the substance, losses control, and ends up using despite the adverse consequences. As we mentioned earlier, addiction is complex and involves more than the physical aspect. Treating physical manifestations and ignoring the emotional part is not enough.
Even after detoxification, one is still at high risk for relapse. Sudden life stress, environmental cues, social networks, among other factors, can contribute to relapse. Therapy helps one escape the cravings and learn to handle whatever it is that life throws their way without turning to drugs.
Therapy plays a vital role in a successful addiction recovery plan. Many alcohol or drug addiction programs understand this and include different types of therapy into their patient’s treatment plans. There are various forms of therapy, but according to the Principles of Drug Addiction Treatment by the National Institute on Drug Abuse, behavioral therapies are the most effective in treating addiction.
Therapy is a linchpin of addiction treatment for many people. Family Counseling, Cognitive Behavioral Therapy, Contingency Management, and other forms of therapy can help a patient manage drug cravings and avoid relapse. It can also address mental health disorders that often contribute to substance use.
In one post, a TIME writer who almost lost his son to addiction said he sees hope in evidence-based treatments (EBTs) and treatment programs that emphasize research-based therapies like Motivational Interviewing and Cognitive Behavioral Therapy in addition to medication.
The National Institute on Drug Abuse indicates that behavioral approaches help individuals in substance abuse treatment in vast ways. It engages them and offers incentives for them to maintain sobriety. It also modifies their behaviors and attitudes towards drug use and increases their life skills to tackle environmental cues and stressful situations that may trigger intense cravings for use.
With that in mind, let’s look at why therapy is essential in treating addiction:
One of the main reasons people don’t treat addiction is because they are skeptical about quitting. Some of them are in denial, while others feel fear or shame, and so on. Therapies, like motivational interviewing, help such people resolve insecurities and ambivalent feelings to find internal motivation they need to change their addictive behavior. This therapy allows one to recognize the impact of drug use in their lives and that of their loved ones, and nudge them to take a step toward recovery.
Many individuals who are dependent on drugs or alcohol feel as though they’re deep into it and cannot stop. Cognitive Behavioral Therapy (CBT) can come in handy in such cases, as it modifies the behaviors and attitudes behind people’s difficulties, and change the way they feel. CBT helps individuals to understand why they crave substance and arms them with tools to cope with the cravings and feelings. It’s effective in addressing vast issues, including mental illnesses and substance use disorders.
Patients experience many mixed emotions during detox. Talk therapy during detox helps them to change unhealthy responses and live life positively. Counseling supports patients during their journey from addiction to developing a healthy and productive life.
Addiction is a family disease. In most cases, the drug-dependent individual strains relationships because of their habits. But again, some people abuse drugs because of underlying family problems. Family Behavior Therapy (FBT) treats substance use disorders along with coexisting issues like depression and family conflict. It also educates family members about addiction issues and how to help their loved one through their journey to sobriety.
Group therapies, like Alcoholics Anonymous or Narcotics Anonymous, are effective for drug and alcohol addiction. Being in a group setting allows individuals to get support from peers. It also is an excellent opportunity for one to see their problems in a new light and try out new ways of thinking in a safe environment without fear of judgment. Group therapies are not meant to be a substitute for professional help – but a complementary therapy.
Addiction is a complex disease. It is physical and psychological and may worsen depending on one’s emotional state, mental health, environment, and other aspects. Holistic approaches that include a simultaneous focus on mind and body for complete healing take care of the patient’s physical and psychological needs. So, in addition to detox, medical advice, and other forms of interventions, patients need therapy, meditation, massage, acupuncture, etc., to through to achieve life-long sobriety.
Addiction is sometimes referred to as a "family disease," and rightfully so. It affects the patient and his or her entire family's physical health, finances, and psychological well-being. At the same time, the family also has the power to make or break their loved one's recovery efforts as he or she goes through the journey to sobriety. That's why the importance of family therapy can never be overstated.
Family therapy is designed to address specific issues that affect the psychological health of the family, like substance abuse. It helps families work through challenges, struggles, and tough times in a manner that doesn't just address the problem but leaves the family stronger.
Addiction takes a toll on everyone. It forces family members to pick up the slack of the addict, make excuses for his/her behavior, and potentially endure physical, sexual, and emotional abuse. Extended family members and friends may also have to chip in financially (or in other ways) to cushion the ignored responsibilities. Unfortunately, this naturally leads to instability and conflict within any given family, irrespective of how close-knit it used to be. In the long run, family members end up feeling disappointed and even frustrated with the behavior.
Therapy is a means to help cope with alcohol or drug addiction – and that's not the same as making the problem disappear. Accepting the situation and letting go of things that are beyond control is part of family therapy. When families let go of expectations, they can heal and embrace their present reality while working to a better future. The opposite is also true.
This therapy recognizes that the addiction problem affects the entire family as opposed to just one person. It aims to empower families with skills to help adults and adolescents communicate through conflict and understand any substance abuse or co-occurring disorders like mental health disorder, family conflict and communication, learning disorders, peer networks, work or school issues, and so on. Family involvement is especially critical when the addict is an adolescent because he or she is still under parental care and is subject to the parent's rules, control, and support.
Family therapy is based on the belief that every family member plays a part in the family system, and when one person is affected, the entire family takes the hit. Treating an individual alone is the same as addressing an illness's symptoms without treating the disease itself. And although this approach is often used to help solve a person's problem that's impacting the entire family, it also applies in family-wide issues like conflicts between spouses, siblings, children, or parents. Family therapists can help loved ones to identify ways to manage conflicts, struggles, and challenges.
Family-based interventions are often provided in conjunction with behavioral interventions and medications. The adult or adolescent substance abuser may attend individual or group therapy sessions with their peers and family therapy.
Family therapy is offered in outpatient, intensive outpatient, and residential rehab programs. According to the National Institute on Drug Abuse post, dubbed "Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide," here are some types of family-based approaches.
Family Behavioral Therapy is an evidence-based intervention that uses innovative, easy-to-learn, behavioral therapies to attain goal performance within a family context. It blends behavioral contracting and contingency management to address drug and alcohol abuse and other behavioral problems. FBT addresses vast areas, including family relationships, mental health, sobriety, and effective management of substances, sports performance, self-protection, employment, beautification, and home safety. Under this model, the patient and family member take part in treatment planning and select specific treatments from a list of evidence-based treatment options. FBT also rewards positive behavior during each session. And when behavioral goals are met, the therapist may use contingency management to reinforce the behavior.
MDFT protocols guide counselors in analyzing and intervening simultaneously in adolescents and their family's life. Cognitive processes, emotions, and behavior are linked and are all addressed under this family-based treatment model. Teen problems like substance abuse and delinquency are multidimensional, and therefore require multifaceted therapist behaviors and remedies. As a multisystem model, therapists work separately with the teen, the family and other systems (juvenile justice systems or school), and then together to forge new relationships.
BSFT diagnoses and corrects patterns of family interactions connected to distressing symptoms and experiences in children ages 6-10. It attempts to shift family interactions from habitual to proactive or conflictive to collaborative, to allow the trapped love to thrive. BSFT is a short-term, problem-focused model with an emphasis on adjusting maladaptive interaction patterns. It includes 12-16 sessions that run over three months.
The overriding goal of MST is to keep adolescents who display serious clinical issues like violence, drug use, or severe criminal behavior in school, at home, or out of trouble. Through intense contact and involvement with family, this treatment model tries to get to the bottom of the adolescent's behavioral issues. It works to change the patient's ecology to enhance prosocial conduct while minimizing problems and delinquent behavior.
FFT is an empirically grounded family therapy for dysfunctional and at-risk adolescents ages 11-18 and their families. It's a short-term (about 30 hours) program that helps the youth overcome conduct disorders, behavior problems, delinquency, and substance abuse. The counselor works with families to uncover family behaviors that contribute or lead to delinquent behavior. He or she then modifies the communication in the dysfunctional family, and trains members to set clear rules about responsibilities and privileges, negotiate effectively and generalize changes to community relationships and contexts
Family therapy in addiction treatment leverages the family's strength and resources to find ways for the addict to live without drugs or alcohol and to improve the effect of dependency on both the patient and their family. It can help families uncover their own needs and help to keep addiction from moving from generation to generation.
The idea that some foods may have the potential of causing addiction and that some forms of overeating may indicate an addictive behavior has been discussed for years. There has been a growing interest and research on the subject, leading to more definitions and assessment methods. While the diagnosis of food addiction isn’t formally recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), some studies show that DSM-5 criteria for substance use disorder (SUD) might be transferable to food addiction. Food addiction involves cravings, binge eating behaviors, and a lack of control around food.
Experiments in humans and animals reveal that foods (especially those highly palatable) activate the same areas of the brain as addictive drugs like heroin and cocaine. Highly palatable foods are foods rich in salt, fat, and sugar. Like cocaine, marijuana, heroin, or even alcohol, these foods trigger dopamine, a feel-good chemical in the brain. Note this; the brain registers all pleasures in the same way – whether they come from a sexual encounter, monetary reward, psychoactive drug, or a palatable meal. In the brain, pleasure is linked to the production of dopamine. Food, like addictive drugs, provides a shortcut to the brain’s reward system by triggering dopamine production.
Researchers from Connecticut College discovered that Oreos, a tasty cookie, excited some neurons in the rats’ brains’ pleasure center even more powerfully than cocaine. Surprisingly, these rats quickly identified the tastiest, fattiest, and sweetest part of the snack – the middle. So, they would break and eat that part first. If this study’s findings are anything to go by, then high-sugar, high-fat foods and substance of abuse trigger brain process to the same extent.
Dopamine doesn’t just contribute to the pleasure experience; it also plays a part in memory and learning – both of which are critical in the transition from “liking” eating to becoming addicted to it. Dopamine interacts with glutamate, another neurotransmitter, to assume control of the brain’s system reward-related learning. Repeated exposure to palatable food causes the reward center to want it, driving the vulnerable person to go after it.
When the brain’s reward center keeps getting flooded with dopamine, it will, at some point, adapt to the trigger and eliminate the dopamine receptors. As a result, dopamine becomes less effective. So, the individual may realize that the food no longer gives them as much pleasure. They have to eat more to feel good because the brain is now tolerant. The pleasure linked to the food diminishes, but the memory of the pleasure and desire to remake it persists. So, compulsion takes over.
Does this mean that someone is a food addict if they have too many unhealthy foods like ice cream or burgers, or knowingly eat calorie-packed meals that are potentially harmful to their body and overall health? The short answer is annoying: “it depends.”
According to some scientists, too much fast food or junk food changes the brain’s wiring to an extent where one loses the ability to resist eating certain foods – despite the potential undesired effects. However, some experts question the validity of comparing any overeating habits with those of addiction to alcohol or drugs. They suggest that the uncontrolled or binge eating disorder may be connected to biological triggers that vary from one person to another. And that the intense cravings cannot be equated to those of someone struggling with substance abuse disorder.
The debate about whether food addiction is a real addiction lies in the term “addiction,” and the way one defines it. If an individual cannot control their urge to indulge in unhealthy food even when it is causing psychological or physical harm, then the phrase, “food addiction” matches the bill. The inability to stop doing something when you want to is the heart of addiction.
Although food addiction is often associated with obesity, it can take many forms. A food addict can be thin or normal, someone who overeats at regularly scheduled meals or grazes on snacks the entire day, etc. So, someone can have healthy body weight and still be addicted to food. It’s just that their bodies may be genetically programed to take care of the extra calories consumed. In some cases, they do lots of physical activity to compensate for overeating. Unfortunately, those addicted to food will keep on eating despite the adverse outcomes.
Researchers at Rudd Center for Food and Science & Policy at Yale University designed a questionnaire to identify patients with food addiction problems. The questions seek to find whether one:
Unlike drug or alcohol addiction, food addicts cannot abstain from eating. That’s why food is perhaps more insidious than drugs. Food addiction can be all-consuming and interfere with different aspects of a patient’s life. In addition to causing or worsening medical problems like heart disease, diabetes, malnutrition, or acid reflux, food addiction can also cause obesity and accelerate conditions like sleep disorders, obesity, chronic pain, chronic fatigue, arthritis, and osteoporosis. Not to mention psychological problems such as anxiety, stress, depression, and low self-esteem.
Although food addiction may not be a recognized diagnosis or treatment, advances in the medicinal world make it possible to manage and resolve it. A medical expert may recommend one or more of the following treatments after conducting a medical review:
Addiction treatment is usually personalized and needs individual, family and community support.
The internet has changed the way we do things, including addressing addiction problems. Today, people turn to the internet for all kinds of addiction-related issues, whether it’s to self-diagnose, find professional help, or to browse through endless online addiction resources to gain more insights about what they are dealing with. And in the face of the social distancing measures needed in the coronavirus pandemic, many in-person rehabilitations are becoming online out of necessity.
Currently, enrolling in a telnet drug rehab may no longer be an option but a necessity for many patients. Countries across the globe are moving fast against COVID-19 to avoid disaster. Most of them have canceled international flights, closed borders, banned all social gatherings, and enforced lockdowns to flatten the curve. So, it might be impossible to travel from one city or state to another to access a physical rehab center. The social distancing guideline also means that patients can no longer access Narcotics Anonymous (NA) or Alcoholics Anonymous (AA) meetings, pushing them to switch to digital technologies like Skype or Zoom for continued support.
If you are planning to start your journey to sobriety during the crisis (or even afterward), you are probably wondering about whether remote alcohol or drug rehab works. In this article, we will dive deeper into what remote drug rehabs do, and why they are the best option for many individuals. But before we do that, let’s address your concerns about whether a remote drug rehab can help with your addiction problem.
As substance abuse continues to challenge traditional treatment programs, activists and advocates are exploring ways to reach patients who might not respond adequately to standard models. Most of them incline towards remote treatments, which are outpatient programs designed to address an individual’s specific needs using digital technologies. Remote substance abuse treatment is perhaps the most advanced way to reach patients who live on the margins (or those who cannot access treatment due to COVID-19 pandemic and government restrictions).
A group of researchers performed a systemic survey on interventions delivering substance use disorders (SUD) treatment by video calling that looked at clinical effects of drug abuse, treatment retention, and feasibility, and acceptability. Interventions were divided according to substances, including opioids and alcohol. Most of the reviews suggest that remote treatment could be associated with enhanced treatment retention than traditional treatment that involves travel. These researchers concluded that telnet rehabs are a promising alternative, particularly when evidence-based treatment isn’t readily available.
For specific substance use and treatment categories, especially when treatment retention is a significant outcome, it’s also possible that telnet care could lead to higher treatment retention because of increased accessibility for patients.
In another systemic review of 20+ articles performed in the US, Australia, and the European Union, remote rehabilitation lowered alcohol consumption to a great extent. It also had incredible outcomes reducing depression, increasing accessibility, increasing patient satisfaction, reducing cost, and enhancing the quality of life.
Although traditional treatment is still an essential component of addiction treatments, it is certainly not the be-all-end-all. Many caregivers attest that in-person care makes patients dependent on them when what they need is to face their addiction recovery process with brevity. Besides, we live in an on-demand world. Unlike years back, when people had to wait for days or weeks to get appointments and even enroll in their rehab of choice, they are now leaning towards immediate care. People want what they want when they want, and that’s where online rehabs come handy. Here’s why more patients are embracing remote treatments:
One of the primary duties of substance abuse treatment centers is to educate their patients. The internet offers an excellent opportunity for these facilities to provide vast resources through videos, audios, articles, blog posts, whitepapers, e-books, and so on. So patients can access these educative materials irrespective of their location or circumstances.
Online rehab is especially valuable in the remote areas – where people might not have access to any other form of alcohol or drug addiction treatment programs because of limited or no treatment facilities in their geographic area. Having to travel long distances and spare hours out of a busy schedule to get help can be a burden on many patients. But with a steady internet connection, and an internet-powered device, remote rehab provides quick and easy access to care that wouldn’t otherwise be available.
The fact that one can access addiction treatment in the comfort of their own home (or place of choice) makes digital learning an appealing option. This learning model allows patients to schedule their rehab sessions at the most convenient time – whether it’s early in the morning or late at night.
Not every person who is struggling with addiction wants others to know that they are getting professional help. And while traditional rehab systems go to a greater extent to ensure privacy, one can’t hide the fact that they are getting help from their loved ones. Telnet rehabs give patients the discretion they need throughout their recovery journey.
One of the main benefits of online rehab is affordability. The boarding costs and the traveling costs associated with traditional rehab make it less appealing for many patients who don’t have financial resources at their disposal. Online programs offer quality solutions at a fraction of the cost, making it an excellent option for many patients. Most health insurance plans will also cover remote treatment options.
The internet makes mental health treatment more accessible. Rehabilitation centers are always up and running 24/7, and have on-call professionals who can be accessed on an immediate basis (though this might vary from one facility to the next). Most centers provide a “please call” number that patients can dial, should there be an emergency.
Remote treatments allow patients with substance use disorder to stay in treatment and get remote drug counseling to help in their journey. Through reduced travel time, enhanced convenience, and cost-saving, telnet rehab provides additional benefits for physicians, patients, and the greater healthcare system.
Several studies have shown a strong correlation between substance abuse and mental illness. According to the National Institute on Drug Abuse, many people with mental health conditions develop substance use disorders (SUD), and vice versa. The incidences tend to co-occur (also called comorbidity or dual diagnosis) more often than what could be attributed to chance.
While mental health issues don’t cause drug addiction or vice versa; they can exacerbate the symptoms. It is not uncommon for individuals to self-medicate a mental illness with alcohol or drugs. Conversely, alcohol and drugs can lead to psychological issues like paranoia, delusions, anxiety, and depression or worsen existing psychiatric conditions. So, individuals diagnosed with anxiety or mood disorders are highly likely to suffer from drug abuse disorder compared with respondents in general. The same holds for those diagnosed with drug disorders as they are likely to suffer from mental disorders like anxiety or mood disorders, etc.
Please don’t take our word for it
A past NIH study showed that certain protective factors don’t exist among those with severe mental illness. Individuals with bipolar disorder or schizophrenia, for instance, have a higher risk for drug use. Multiple national population surveys suggest that about 50% of those who experience substance use disorder will also experience mental illness at some point in their lives, and vice versa.
Other reports not only support that these two disorders are connected, but also emphasize that drug use in itself is a mental illness. This is because drug use changes the brain in ways that affect the person’s hierarchy of desires and needs. The resulting compulsive behavior that overpowers one’s ability to control impulses despite the negative outcome is similar to other mental illnesses.
With that in mind, let’s now look at types of mental disorders that increase drug use.
Anxiety disorder is one of the most common mental illnesses in the United States, affecting 40 million (or 18.1%) adults age 18 and over annually. But anxiety doesn’t affect adults alone. According to the Anxiety and Depression Association of America (ADAA), these disorders affect 25.1% of children aged 13-18. When the anxiety goes untreated, these children may perform poorly, become distant socially, and abuse substances.
Comorbidity is common with substance abuse and anxiety. About 20% of individuals with mood disorders or anxiety have substance use problems. The same number of people with drug problems suffer from anxiety and mood disorders. A mental health professional told ADAA that anxiety disorder often travels in the company of drug or alcohol abuse, as those with a social anxiety disorder might abuse substances to feel comfortable and less restricted in social settings. But it robs them of knowing when to stop or accepting that they have an underlying problem that needs therapy and treatment and not substance to overcome the fear. Eventually, the drugs that serve as temporary solace (whether illicit drugs, prescription drugs, or simply stimulants) can also trigger anxiety.
Individuals with bipolar disorder experience radical mood swings that can last for days or weeks in a row. Depending on the severity, these episodes may occur as little as a few times in a year or as often as several times in a week. In one study of people with bipolar disorders, about 60% had some history of substance misuse. And while it’s not clear why this disorder makes people more prone to alcohol and drug abuse, different studies try to connect the dots.
Some experts believe that inherited traits play a role in linking bipolar disorder to alcoholism or drug abuse. In a Mayo Clinic post, one doctor suggests that the genetic differences affect brain chemistry linked to bipolar disorder. He further noted that the same traits might also influence how the brain responds to drugs and alcohol, exacerbating the risk of substance use disorders. But there’s also the aspect of mania – where the upswing from depression lowers judgment, leading to increased substance abuse.
Other experts suggest that addiction arises when the patient uses drugs or alcohol to ease anxiety, depression, and other bipolar-related symptoms. As discussed above, abusing substances in the name of relieving the symptoms only worsens the situation. Frequent drug use can change the brain’s reward system. Over time, this mind-altering changes lead to compulsive drug-seeking behavior. Drug use can also cause brain changes that lead to bipolar disorder.
Depression is another mental disorder that frequently co-occurs with drug use. Like other mental illnesses, the relationship between drug use and depression disorders is bi-directional. Depressed individuals may abuse substances to uplift their mood or escape from feelings of despair or guilt. However, substances like alcohol (which is a depressant) can increase the feelings of fatigue, lethargy, hopelessness, or sadness. On the other hand, people can feel depressed once the effects of alcohol or drugs wear off, or when they struggle to deal with the way addiction has affected their lives.
Depression is like a gateway to substance abuse. Approximately one-third of those with major depression go on to have alcoholism problems. People struggling with depression often have a hard time giving up drugs or alcohol because it can worsen depression. Some who quit cold turkey are bombarded with withdrawal symptoms that are difficult to bear, causing them to relapse.
Schizophrenia is a severe mental illness in which people interpret reality abnormally. This brain disorder makes it hard for people to distinguish the imaginary from reality, affecting about 1% of all Americans, approximately two million adults. Patients often are unable to respond to different social situations in an appropriate emotional way. This leads to strained relationships with family and friends.
An estimated 50% of those suffering from the condition have a history of substance misuse. Often, these people engage in alcohol or drug abuse to self-medicate or relieve feelings of depression and anxiety. Drug and alcohol are environmental triggers for schizophrenia. A person with existing genetic risk factors for the condition can activate it after prolonged substance abuse. Using illicit drugs like cocaine, amphetamines, or marijuana heightens schizophrenia symptoms or make them worse.
Schizophrenia and substance abuse disorders have similar symptoms, which explain why people often confuse one for the other. Unfortunately, this only makes it even harder to diagnose the condition or co-occurring illnesses.
It suffices to say that mental disorders and drug use are two sides of the same coin – you cannot address one and ignore the other and expect a successful outcome. That’s why dual diagnosis patients enroll in integrated treatment programs that address both problems simultaneously. Otherwise, untreated mental disorder symptoms can cause the patient to be unable to remain sober and clean. Untreated drug use, on the other hand, can make mental disorder treatment ineffective.
While there are a great many resources to help and aid you in your recovery journey, the ultimate decision rests with you. A Scientific American article points out the following:
"But some in the field point out that many if not most addicts successfully recover without professional help. A survey by Gene Heyman, a research psychologist at McLean Hospital in Massachusetts, found that between 60 to 80 percent of people who were addicted in their teens and 20s were substance-free by their 30s, and they avoided addiction in subsequent decades. Other studies on Vietnam War veterans suggest that the majority of soldiers who became addicted to narcotics overseas later stopped using them without therapy."
Again, there is no shame in seeking professional help or looking to other avenues for assistance in your recovery process. Below are some helpful concepts to keep in mind at this stage in your sobriety journey.
Drug and alcohol, as well as other types of addiction, are always rooted in some behavioral causes. This can be anything from a past trauma or experience, stress, the need for escapism because of environmental factors, depression, an addictive personality, or nearly any other variable you can think of. Identifying the source of your addiction is the first step to sobriety. Therapists can often assist with this process.
There are many possible side effects of withdrawal, and some of them can be seriously dangerous or even deadly. Check with your physician or another expert about whether or not your recovery journey needs professional supervision.
It is essential when kicking an addiction to make value judgments about the positives and negatives of the behavior you are trying to avoid. Part of those value judgments can involve creating two lists: “reasons to use” and “reasons not to use”.
Fill out the first column with everything positive about using or engaging in the negative behavior - “It makes me feel good”, “it helps me sleep”, “it makes me productive”.
Fill out the second column with everything negative: “my addiction is hurting my family and I”, “my addiction is making me a different person”, “my addiction is killing me”. This is vital for the next step.
After preparing your lists, it is time to do some soul-searching. If you have been honest with yourself, you will quickly see that the benefits of substance abuse do not come close to outweighing the negatives. You will have to fall back on this value judgment daily during your path to recovery.
Friends, family, and even colleagues can all play an essential role in your recovery journey. Talk to your social group and tell them what you are going through (and if appropriate, what they can do to help you along the way). Try to find several contacts who you can call for support at any time if you need - group therapy programs will often assign “sponsors” who can be there at any time to help and support you.
This may not seem important to your recovery process, but it is. Wake up at a specific time. Go to sleep at one particular time, and take your meals at a specific time. The order and structure of your life can provide a powerful counteraction to the chaos that addiction brings.
No addiction, from sugar to heroin and everything in between, is managed without defeating cravings. Cravings are not voluntary. A craving is caused by your brain seeking to acquire more of something provided by the habit you’re kicking.
Cravings can be triggered by stress, a lack of sleep, unhappiness, pain (emotional or physical), an association with a person, place or thing, a smell, a memory, or any other number of stimuli. They can often be very intense, but the intensity fades quickly. Your cravings will be strongest at the very beginning of your abstinence and become weaker with time.
How do we deal with cravings?
This is perhaps the most challenging part of recovery for many people. When the seemingly uncontrollable urge to use again arises, we must open our toolbox to fight it.
One such tool is “self-talk”. Remember the lists we made and the value judgment? Go over those again in your mind. Think about how much better your life will be clean. Think about how your addiction harms your friends and family, and even yourself. Think about the ground lost if you relapse and stay strong.
Another way to deal with cravings is to keep yourself busy. Clean your home, go for a jog, take out the trash. Occupy yourself mentally and physically, and you won’t have the time to focus and obsess over the substance of your desire.
Cognitive Behavioral Therapy is a potent tool to use in your journey. Cognitive Behavioral Therapy (referred to as CBT) allows you to identify and interrupt the patterns that lead to using and view things objectively and dispassionately. You can read more about CBT and addiction in one of our previous posts.
If your cravings become too intense to manage, call on your support group and talk it out with them. Friends and family may be able to pull you out of a negative mental state, and a sponsor from a group therapy class may be able to empathize and help you pull through your temptation.
As you continue down the path to recovery, you may relapse. You have not failed. You have only delayed success. Climb back onto that proverbial horse and try again. Identify factors that led to your relapse so that you may avoid them in the future. Expand your support network. Avoid people or places that lead to urges or cravings. Find professional help, if necessary. Your mental and physical health is worth it! While the decision to get clean is yours to make, you don’t have to fight that battle alone.
You may be wondering what a typical day in a drug rehab program looks like. Today we’re going to detail every aspect of a drug rehab program, from the minute you arrive to the minute you leave, we’ll cover it all!
One of the biggest reasons people struggle with addiction is a lack of support. Many people are too embarrassed to admit they have a problem, or simply don’t know who to turn to for help.
They are non-judgmental, qualified to help, and have experience treating people with similar addictions.
You may be surprised to find out that many people go to rehab for non-drug related reasons. Some examples are serious gambling and binge eating. While these are rarer, it should help you realize that there’s no reason to be embarrassed, since addiction comes in many forms.
One of the most powerful ways to beat addiction is to keep yourself busy, and they definitely adhere to that in rehab.
In rehab, you will generally follow the same schedule every day. This often includes waking up early and eating breakfast, group and personal therapy, exercise and chatting, and more.
The main goal of therapy is to get you over that initial first hill during your recovery process. The hardest part of fighting an addiction is the first few days, as this is when most relapses happen.
Once your body has detoxed of whatever substance you are addicted to, you will be able to think more clearly and function better. At this point, it really comes down to having a support group and knowing how to fight off the cravings you will experience.
On the plus side, once you have rehabbed from your withdrawal symptoms, you will be better equipped to fight through your cravings without the physical effects - which can feel impossible to overcome at times.
Up until this point, you may have thought of rehab as a type of “jail” with therapy, but it’s important to note that this is not the case at all.
There are many types of therapy offered, and it’s probably not what you think.
As you can see, there are a wide variety of ways you can empower yourself to fight through your addiction. Each of these types of therapies is intended to help increase your mindfulness and develop more control over your own mind and impulses.
In addition to the above therapies, there is often a “traditional” therapy, where you sit down and have a one-on-one chat with a therapist.
These sessions may sound intimidating, but they are incredibly helpful if you can let yourself be open to them.
Your therapist will listen to your history, feelings, thoughts, and more, and then help devise a treatment program tailored to your needs.
These therapy sessions are often extremely helpful, as they can help get to the bottom of why you feel the urge to use.
For example, many people who become addicted to drugs use them to forget or cope with previous unhealed trauma or stresses. Your therapist can help you work through these past traumas and provide feedback and tips to start the healing process. Drugs may seem to dull the pain, but unfortunately, they are not actually fixing anything, only delaying your healing.
Another practice you may find helpful is the group therapy sessions that most rehab centers offer. These are often very different than group therapy sessions outside of rehab centers because everyone in the rehab center is strongly fighting at that moment to overcome addiction.
It can feel comforting to know that no one is there judging you, since you are all in the same place at the same time, going through the same struggles - no matter what your addiction may be.
One concern that many people have prior to checking into rehab is the fear of going through horrible physical effects when they stop taking the drug they are addicted to.
This is especially true with narcotics and benzodiazepines, as they can have serious life-threatening effects when stopping. The good news is that most rehab centers are equipped to deal with these issues, and know exactly how to help.
Many rehab centers employ medical doctors that are very familiar with the detox and withdrawal process from common drugs. The doctor will be able to prescribe certain medications that will slowly wean your body off of the substances you are addicted to.
This means that you won’t have to experience some of the painful side effects of withdrawal that could happen if you try to quit cold turkey.
It’s important to note that serious substance addictions should not try to be treated by yourself. A serious addiction to dangerous drugs can be life-threatening if you try to quit cold turkey without the supervision of a doctor.
Outpatient rehab programs are perfect for someone who is mildly or moderately addicted to drugs. These are also an option for someone who is being discharged from a rehab center and feels they are strong enough to overcome their addiction.
These programs focus on getting you through the detox period safely and empowering you to continue the fight against your addiction.
These will generally involve a 30-minute visit with a doctor for the first week as they monitor your progress and symptoms. This is the recommended way to quit if you don’t feel like checking in to rehab, yet feel you need some help quitting drugs, or are afraid of withdrawal symptoms.
Overall, there are thousands of excellent rehab centers across the world. It’s important for you to know that you’re not alone in your fight against addiction. Keep pressing forward and use every resource available to you!
No matter what the details of your addiction recovery journey, experts agree - the use of CBT (or Cognitive Behavioral Therapy, as it is known) is a powerful tool to prevent relapse and fight off temptation. One study of cocaine-dependent patients even showed 60% of patients subjected to Cognitive Behavioral Therapy remained clean upon a 52-week toxicology screen!
The DrugAbuse.Gov website says the following about CBT:
Cognitive-behavioral strategies are based on the theory that in the development of maladaptive behavioral patterns like substance abuse, learning processes play a critical role. Individuals in CBT learn to identify and correct problematic behaviors by applying a range of different skills that can be used to stop drug abuse and to address a range of other problems that often co-occur with it.
Cognitive Behavioral Therapy teaches you to stop and think about what you are doing and why you are doing it. This is important to interrupt the pattern that keeps you trapped in your addiction. Cognitive Behavioral Therapists can utilize a wide array of tools to help you to identify your problem behavior’s triggers, your responses, and then give you a methodology to interrupt the behavior before it leads to a relapse - see below.
A central element of CBT is anticipating likely problems and enhancing patients’ self-control by helping them develop effective coping strategies. Specific techniques include exploring the positive and negative consequences of continued drug use, self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations.
One of the cruxes of Cognitive Behavioral Therapy is understanding what triggers your addiction. Let’s break down a few of the most common triggers below.
HALT is an acronym that stands for Hungry, Angry, Lonely, Tired. If you feel the need to relapse during your recovery journey, stop and ask yourself: Am I experiencing HALT?
When we think of hunger, we immediately think of physical hunger, a need for food. The signals your body sends to the brain can push you towards substance use as a coping mechanism. Learn about your body’s needs and find a snack or food that meets them. Perhaps this will cause your impulse to relapse to disappear.
Hunger can also refer to a psychological need, such as affection or intimacy. The lack of these things can also encourage us to relapse - so work out what you are missing in life with your therapist.
Anger causes a spike in the so-called “stress hormone”, Cortisol. If you are feeling anger, the urge to relapse may become very strong, as you attempt to counteract the elevated Cortisol with dopamine. There are a great many therapeutic techniques to help you deal with anger. Speak to your therapist about the subject.
The terrible feeling of loneliness - isolation, separation, being apart from others - is a powerful one. If you are feeling the need to use, consider seeing a friend or reconnecting with a family member.
A lack of sleep, or physical exhaustion, will wear down even the most stalwart individual. Sleep is tied to a great many physiological processes, and not getting enough of it will impair your ability to reason and your ability to cope. As a result, your tolerance for irritations in your life will be low - possibly feeding into anger - and substance use will seem increasingly more valid.
Any mental state wherein you are feeling down or hopeless can easily lead to apathy, which leads back to substance use. Speak to your therapist and other care providers about any depression, anxiety, or erratic behavior you observe in yourself. Keep a journal to watch for negative patterns in yourself mentally, and be on the lookout for any unwanted behaviors.
Likewise, physical illness and its various symptoms can make the allure of relapse seem very attractive. It is of the utmost importance to inform all your care providers that you are an addict in recovery. They need to know this information in order to make the best possible decisions regarding your care.
Nearly anyone could tell you that negative emotions and events can lead you to relapse, but the opposite is also true. Many people overlook positive or happy events as being a potential trigger for substance use. The allure of “one little drink” (or your substance of choice) as a celebration is a dangerous pitfall that can lead you to a full-blown relapse. Be mindful of your cravings in the context of a joyous occasion and head off trouble.
Some of these can be obvious, and some can be very subtle. A certain coworker or friend could remind you of the “good old days”, or even actively encourage you to relapse. Walking past a favorite bar. Talking to an ex, or a family member that gives you strong negative emotions. Interacting with former friends or associates who used drugs with you. A fast-food parking lot where substance transactions took place. Reminders of a wedding or other event you drank at. Eating specific foods or listening to a certain genre of music. The scope of potential triggers of this type is astounding - work with your therapist to identify and avoid them.
Thinking about your “good old days” and ignoring the negative consequences is an easy path to returning to them. Do not dwell on the “good times” you may have had; any recollection of those should be paired with remembering the downsides of your behavior. Avoid being around any paraphernalia, or even media glamorizing or glorifying substance use.
This was but a brief list of common triggers that can lead you to relapse. Your CBT care professional will cover more, and help narrow down your specific triggers, as well as the tools he or she believes will work best for you to interrupt any unwanted behaviors. CBT can be a powerful methodology in your recovery process.