ADDICTIONS

How does addiction work?

Addiction is classified as a “brain disease” because it impacts both brain structure and function.

Our brain registers pleasure regardless of whether it originated from a drug or a satisfying meal. When the brain’s reward center (the limbic system) is activated, dopamine is released into our bloodstream. Dopamine is a neurotransmitter that contributes to feelings of satisfaction and pleasure.

Certain substances, such as drugs and tobacco, as well as activities, such as gambling, cause a particularly intense surge in dopamine, causing a person to experience a “rush” or “high”. Since people often like the way they feel, they quickly learn to repeat the behaviour and are motivated to actively seek out the substance or activity out.

However, since the amount of dopamine that is released through addictive substances is abnormally high, the brain struggles to regain its chemical balance once the effects of the substance wears off. Oftentimes this results in a hangover, or feelings of withdrawal from a substance, which can manifest as physical pain, mood difficulties, and impulsive behaviour. Excessive and prolonged use of a substance can also lead the brain to stop producing dopamine naturally, causing further withdrawal and the development of physical dependency on a substance. During this time, liking often transitions to wanting, where a substance is used just to feel normal and a vicious cycle is created.

With this, the brain’s reward system is reorganised, where finding the substance (or a substance with similar effects) becomes an ongoing priority.

When do I seek help?

Having an intense craving for food or alcohol does not necessarily mean that a person is suffering from addiction or is an alcoholic. It is therefore important to understand and recognise symptoms of addiction, especially when considering whether to seek professional help. Although it can mean different things to different people, addiction is often chronic in nature and generally manifests in the following ways:

Ψ Lack of self-control
Ψ Dismissal of serious consequences
Ψ Preoccupation with substance or activity
Ψ Failed attempts to quit
Ψ Possible lack of emotional response

Addiction has been found to have serious consequences that can cause impairment and interfere with a person’s daily life. Individuals experiencing addiction are prone to cycles of relapse and remission and often fluctuate between intense and mild substance use. Nevertheless, addictions generally worsen over time, potentially leading to serious health complications and impact relationships with loved ones. Fortunately, addiction can be effectively prevented, addressed, or managed by healthcare professionals in conjunction with family or peer support. It is therefore important for anyone experiencing addiction to seek timely professional help.

Can psychotherapy help with my addiction?

Addressing addiction is a long and arduous process, and often involves several relapses after an initial success at managing it - but it can be done.

Because addiction is a learned process that is stored in the brain as memory, reducing the strength and influence of addiction is a process, and will take time.

It is easy for an individual managing addiction to become discouraged, but it is important to know that there are effective concurrent management options available: medication, rehabilitation, and psychotherapy.

As addiction is considered a “brain disease”, a brain-based intervention program that helps people adopt healthier coping strategies and unlearn their addictions is necessary.

Behavioural therapy is the most common evidence-based psychotherapeutic approach for addressing addictions.

Specific therapeutic methods include, Cognitive Behavioural Therapy (CBT) and Dialectical Behavioural Therapy (DBT). CBT teaches individuals specific techniques to recognise and change their maladaptive behaviours, while DBT equips individuals with the skills necessary to manage cravings and prevent relapse.

Time taken to successfully manage the addiction will ultimately depend on the nature of the addiction, as addiction affects each person differently. It is therefore important for therapy to be individualised. Working closely with a clinical psychologist will help to identify individual needs and establish a personalised therapy plan that will guide you through.