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Written by Karen Doll, PhD

Addiction Defined

Addiction is commonly considered a disease of brain dysfunction, resulting in biological, psychological, emotional and interpersonal impairments. Addicts become obsessive and pathological in their pursuit of substance and behavior addiction.

Key Components of Addiction

Addicts cannot control their use, depend on it for daily coping, and have repeated, failed attempts of quitting the substance or the behavior. Addiction can be characterized by the following symptoms/behaviors:

  • Increased tolerance
  • Unsuccessful attempts at quitting
  • Impulsive, high risk behavior, despite consequence
  • Continued dysfunctional behaviors despite consequences
  • Craving for positive experience, escape from negative emotional state
  • Needs additional amounts to maintain "normal" state
  • Experiences withdrawal symptoms without drug/substance
Identifying addiction is not about the frequency of use or amount consumed. The negative impact and consequences in the addicts' life is what determines addiction.

Types of Addiction

Substance Addictions

Behavioral Addictions

What Causes Addiction?

There are a range of factors that contribute to the development of an addiction and there is no magic equation to predict addiction.

Research supports that genetic factors will account for roughly half of all addicts. Both family history and biological mechanisms contribute to the predisposition that some individuals have toward addiction. Situational influences can impact if and when one develops an addiction.

Overall, causes of addiction can be various combinations of family history, emotional, cognitive, biochemical, environmental and physical factors.

Biological Factors

Substance use can increase the neuropathways in the brain, particularly in the pleasure center. As positive experiences and patterns are created with more frequency, the brain becomes trained to repeat it. This pattern can reinforce the pathway and increase tolerance from repeated use. Eventually, the user no longer experiences pleasure from the substance and takes it simply to prevent withdrawal symptoms. They develop a need to take the substance or engage in the addictive behavior just to feel "normal."

Research suggests that dopamine plays a role in addiction. Increased dopamine levels can lead to more positive feelings of pleasure and well-being. Many substances that will increase the dopamine in the brain. There are studies to support that individuals with lower dopamine levels may be more at risk for addictive behaviors.

The Emotional Process of Addiction

People with addictions are typically seeking additional pleasure experiences or some sort of escape from emotional stress. Addictions can develop based on individuals seeking "euphoria." They are creating a positive emotional state that they eventually want more of. Also, it is common for individuals to begin their use with "self soothing" or "self medicating" other symptoms, particularly related to depression and anxiety. Others pursue substance use addictive behaviors for perceived relief from negative emotional states ("dysphoria").

Obsessive-Compulsive Cycles

Addicts develop obsessive thoughts and much of their time becomes devoted to thinking about their drug/behavior of choice. They persistently think about when and how they will use next. The compulsion is the actual addictive behavior or substance use. The use can provide temporary relief from the obsessive thoughts and emotional distress. The obsessive thoughts can lead to the compulsion as a desire to escape or create distance from the distress. The temporary relief fades quickly and the obsessive-compulsion cycle tends to move more quickly and frequently, leading only to self-destruction.

Those in recovery recognize that the compulsive behavior leads to more distress and problems, which is what they were trying to get away from. The following is quoted in recovery programs: "A thousand drinks is never enough and one is too many."

Additional Risk Factors

  • Dual Diagnosis: anxiety or depression
  • History of impulsive or reckless behaviors
  • Limited support system
  • Early exposure
  • Abuse or traumatic experiences
  • PTSD
  • Mental health challenges
  • Multiple life stressors
  • Crises faced beyond the realm of normal human experience

Criteria For Addiction Must Include Three of the Following:

  • Tolerance - the substance has less effect on the individual because their body has developed tolerance. They need more and more of it to get the same pleasure.
  • There are physical/psychological withdrawal symptoms, or the individual takes the substance to avoid experiencing withdrawal, or the individual takes a similar substance to avoid experiencing withdrawal.
  • The individual frequently takes higher-than-intended doses of the substance.
  • The individual often tries to quit or cut down.
  • More and more time is spent getting hold of the substance, using it, or recovering from its effects.
  • The individual’s drug use causes him/her to give up social, occupational or recreational activities.
  • Even though individuals know it causes psychological/physical problems, they continue taking it.

What Does Addiction Look Like?

Some still think of addicts in stereotypical and extreme terms. Facts and research support that there are addicts in every demographic, gender, age, walk of life, socioeconomic status, and ethnicity. There is a continuum of the level of severity and type of addict and it does not always present clearly. Additionally, comparing one addict to another is a pointless exercise, because one will always find greater or lesser problems experienced by other addicts.

Addicts who are confronted tend to immediately become defensive, believing that they aren't one of "them." Interventions are common in these situations. Family members can no longer accept or deal with the addict’s behavior and the addict may strongly deny there is a problem. The loved ones responses and behaviors can often be more indicative of the level of addiction to those evaluating from the outside.

Disconnects Between Addict and Their Loved Ones

  • There can be significant discrepancy in the self report of the addict and information provided from that given by the loved ones.
  • Addicts can be quick to point out others' behavior, suggesting what is "wrong" with them.
  • An alcoholic who is resisting treatment will often bring up how much others drink, particularly those who are referring them for treatment.
  • Addicts may or may not recognize the impact of their behavior on their loved ones or problems in their life with work, school, relationships, etc.
  • Addicts typically haven’t emotionally matured. From the age that the addiction started, emotional maturity may have been stunted or even stopped.

Is My Loved One an Addict?

If you are researching this topic, chances are you have experienced negative consequences due to the addictive behavior of someone in your life. This can indicate that your loved one is somewhere on the addiction spectrum.

Loved ones are often the first to recognize an addiction, commonly before the addict acknowledges it. One place to start when evaluating addiction is to recognize if the addict’s relationships are impacted by their addiction, not per their self-report.

Whether or not one has an addiction may or not be indicated by the level of distress they report. Those in denial can avoid recognizing the depth of destruction and strain they may be causing in their lives and others.

Several defense mechanisms are typically in play with addicts, denial and defensiveness being most common. Addicts will often justify their behaviors and compare themselves to others who they believe are "worse" than they are. Providing excuses, explanations, or lies are defensive strategies used to self protect. It is not uncommon for confronted addicts to turn the focus and blame on others to reduce their accountability. It can be very difficult to "pin down" an addict in denial.

What Can I Do To Help?

  • Be understanding but do not enable. Enabling only empowers addiction.
  • Help them be responsible and accountable for choices, don’t save them
  • Allow them to experience consequences from their addiction
  • Do not make excuses for them
  • Learn the process of healthy detachment from their moods, action, behaviors
  • Provide Options of rehab/treatment/support
  • Evaluate intervention options

How Do I Tell if I Am An Addict?

  • Has my substance use or pattern of behaviors impacted my relationships, school, work, life responsibilities, or family in a negative way?
  • Do I hide my habits?
  • Have I lied to cover up my use or behavior?
  • Has my tolerance increased?
  • Have I experienced failed attempts of quitting?
  • If I quit, would I experience withdrawal symptoms?
  • Do I need the substance to feel "normal"?
  • Have loved ones complained or confronted me about my use?
  • Do I have feelings of isolation?
  • Is my use/behavior causing problems in my life?

Reasons Why Addicts Don’t Seek Help

  • Think they can kick addiction on their own
  • Don’t think it’s a problem
  • Haven’t hit rock bottom – rock bottom is different for every addict
  • Embarrassed, shameful
  • Facing feelings is hard
  • Emotional Immaturity – emotional age diff than physical age
  • Cost of treatment and/or counseling
  • Time required for treatment
  • Energy required to kick addiction

Shame in Addiction: Does Being an Addict Mean I’m a Weak or Horrible Person?

Addicts can develop lies, secret and shameful behaviors in their lives, and in what they will do to cover their addiction. Most addicts experience a significant level of shame for their dishonesty and actions. Beneath the shame is also commonly a feeling of inadequacy.

Finding humility and facing dysfunctional patterns and behaviors with honesty is an imperative step, and will likely come at various times for people in acknowledgement of an addiction, addiction treatment, and recovery.

Humility is a key component to recovery and is not related to downplaying one's strengths or being self-deprecating. Humility is gaining self insight to understand where one fits in, without being too high or too low as compared to others.

What Next If You Are the Addict?

We encourage you to humble yourself and truly evaluate your life. Take some time to strip away the shame, the guilt, and the pride that has ruled your past and acknowledge that you can feel better about your future; those prideful emotions that accompany addiction don’t have to stay with you or control you any longer. You have the ability and opportunity to make some wonderful and amazing changes.

Your life is far too important and valuable to allow an addiction to regulate the positive impacts and outcomes that are possible. You can acknowledge and face your addiction, you can accept help from your loved ones and from addiction professionals and counselors, you can learn healthy coping mechanisms and thought processes that will help you let go of and even beat your addiction. Start accepting help today by calling (800) 260-2109 and speak to a treatment center representative.

What Next If Your Loved One is the Addict?

If you are researching addiction on behalf of a loved one, we encourage you to have a sincere and honest conversation with them about their addictive behaviors and their consequences. This conversation may happen in stages and may happen with multiple people. Remember that you are not there to accuse them, make them feel additional shame or guilt, and you aren’t there to treat their addiction; you are there because you love them. Take their personality into consideration as you choose the time and place where you have this conversation. Also, consider the tone and method in which you choose to talk with them. The more tenderness, sincerity, concern, honesty, and love they feel from you, the more open and possibly accepting they will be of what you have to tell them.

When you talk with your loved one about their addiction, they may become angry or defensive, or may not be completely honest, but have patience with them and do your best to separate their reaction from how they feel about you. This conversation and other conversations you will have with your loved one about their addiction are not about you, they are about focusing on loving the other person enough and in the right way, to support them as they acknowledge that they need help.

Get help for a loved one. Call someone who can help you understand your treatment options. Dial (800) 260-2109 .