Stopping the Stigma of Mental Health - Part 1: Addiction

Posted on July 30 2018

In light of the tragic overdose of singer, actress, and mental health advocate, Demi Lovato, we have decided to write this piece about addiction in hopes to bring forth awareness about mental health, and the stigma that sadly still encompasses mental illnesses today. We hope to be a part of the community that helps to heal and educate, and not discriminate those who have struggled, or currently struggle. If you or someone you know is struggling with substance abuse, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357).

Addiction

The world is trying to tell us that people are hurting. People are in pain, and there is an immense amount of suffering happening silently across the world. What we are learning here is that accolades, money, fame, success, power - they are not what will make us happy. Achieving more, doing more, or being more, will not fill our happiness bucket.

We cannot measure anyone's life by what we observe on the outside. When we see the glamorous lifestyle of celebrities, such as Demi Lovato, Anthony Bourdain, or Kate Spade - we wonder why? Why would people who are leading by example, being a role model to others, traveling the world, or building connections - harm themselves or want to leave this world and their talents behind?

The truth of the matter is, mental illness does not discriminate. It doesn't care who you are, what you do, or how public your life is. It is real. It is there. It is the biggest bully one could ever face, and there are several forms of it - addiction being one of them.

There has been much misconception about Demi's recent overdose all over the internet in the last week. The biggest misconception is that she chose this life. She chose this struggle with addiction. Reality is, she, just as 25.5 million other Americans ages 12 and older, did not choose this.

Throughout this post, we hope you will read with an open mind, open heart, and with compassion. Remember, we cannot treat brokenness, addiction, or mental illness without education, compassion, and vulnerability. 

 

What is Addiction?

Addiction is a condition in which a person engages in use of a substance, or in a behavior, for which the rewarding effects provide an incentive to repeatedly purse the behavior - despite detrimental consequences. Addiction may involve the use of substances, such as: alcohol, opioids, cocaine, inhalants, and nicotine, or behaviors, such as gambling or most recently, social media addiction. 

According to Psychology Today, there is scientific evidence that the addictive substances and behaviors share a key neurobiological feature - meaning, they intensely activate brain pathways of reward and reinforcement, which involve the neurotransmitter called Dopamine. 

Both substance and behavioral addictions have an increased likelihood of accompanying mental health conditions, such as depression, anxiety, bipolar disorder, and others. Substance and behavioral addictions engage many of the same brain mechanisms of compulsivity, and respond to many of the same approaches to treatment. 

Addiction affects the brain's executive functions, which means that individuals who develop an addiction may not be aware that their behavior is disrupting and causing harm to themselves, and those around them. Continuing use of substances or behavioral addictions not only disrupt every day activities and relationships, but they also include craving the substance or behavior. Typically, as the substance use increases, so does the tolerance in the body, thus leading individuals into an accidental, or purposeful overdose

What Causes Addiction?

There is no one cause of addiction. As mentioned above, addiction usually goes hand in hand with mental illness. Some suggest genetic and biological factors contribute to vulnerability to the condition, as well as social, psychological, and environmental factors - which have an extremely powerful influence on substance use. 

As mentioned earlier, it is rare for one thing to drive a person to addiction. Instead, it is a combination of nature - or genetics, mixed with nurture - or, environment. Here's how they can work together to encourage or discourage addiction:

Genetics

Dopamine Processing: Some people are genetically predisposed to addiction. Usually it is caused from a certain genetic mutation in their dopamine receptors. Those receptors crave and enjoy potentially addictive substances or behaviors, more so than people without the mutation. Thus, increasing the risk for addiction.

Psychological Disorders: By now we know that genetics can directly play a role in addiction, but they can also indirectly affect the risk for addiction as well. For example, genetics factor into many psychiatric disorders, such as anxiety, depression, bipolar disorder, post traumatic stress disorder, obsessive-compulsive disorder, etc. People who suffer with mental health issues often self-medicate with an addictive substance or behavior.

Self-Medication: This is where we begin to see the transition from genetics to environment. Many times, due to their psychological disorders, individuals begin using substances or certain behaviors as a method to escape. Escapist self-medication can quickly lead to addiction. In this case, the genetic factor is not the main cause of the addiction, but rather fuels the fire of vulnerability that can lead to addiction.

Environment

Genetics aren't always entirely to blame for addiction. Environmental factors play just as much of a role too. 

Childhood Trauma: Neglect, emotional, physical, sexual abuse, etc., dramatically increase the risk for addictions, regardless of genes. The more times a child is traumatized, the greater the likelihood of addiction and other problems later in life. Psychiatric studies have shown that survivors of childhood trauma are:

- 1.8 times as likely to smoke cigarettes or tobacco

- 1.9 times as likely to experience significant weight increase, or become obese

- 2.4 times as likely to experience ongoing anxiety or panic attacks

- 3.6 times as likely to experience depression and suicidal behaviors

- 3.6 times as likely to engage in destructive and risky behavior

- 7.2 times as likely to become an alcoholic

- 11.1 times as likely to become an intravenous drug user

Adulthood Trauma: Whether you're a child, adolescent, or adult, any type of neglect, post traumatic stress, or abusive situation dramatically increases the risk factor for addiction. This is also when escapism comes into play, as many teens, and even adults, turn to substances or unhealthy behaviors from these types of situations. For example, bullying is a sign of emotional (and sometimes, physical) abuse for a teenager. He or she may develop psychological issues that can lead to the use of substances and behaviors.

Early Exposure: Unfortunately, many people are exposed to addictive substances and/or behaviors at an early age. Most likely, they have seen family members or friends use a substance or behavior around them - exposing them to the pursuit of pleasurable effects.  

The Road to Recovery

The road to recovery is very seldom straight. There are plenty of ups and downs, high and lows, and relapses or recurrences. One thing that everyone needs to know though, is that, that is okay.

No one's path or recovery journey is meant to be the same, and there are several ways that an individual can seek recovery. There is no right or wrong way, there is just the best way for the patient.

Addictions, while can induce pleasure for a short time, also have the capacity to induce a sense of hopelessness, feelings of failure, shame, and guilt. When individuals begin feeling this way, more often than not, they will begin to seek a route to recovery - whether that is from family or friends providing an intervention, or a self-discovery of not wanting to continue that lifestyle.

Sobriety is not an act of willpower alone. While it is very much dependent on the person's will to seek and receive treatment, it is also dependent on their brain and body's abilities to find reasons to become sober and find healthy coping mechanisms to replace the destructive ones. 

It is extremely important to know that individuals can receive help and treatment. Individuals with addictions as well as those around that individual, need to know that there is hope. Individuals can achieve improved physical, psychological, and social functioning on their own, which is called natural recovery.

Others prefer community support, or peer based networks, and still even more individuals opt for clinical based recovery through the services of credentialed professionals. All of these methods are perfectly acceptable.

One method that is not acceptable is to "just stop using." Abruptly stopping the use of a substance can be just as life-threatening as overdosing. An individual's body and mind becomes vey dependent on that specific substance, and the withdrawals can be a struggle.

The physical recovery is just as real as the mental and emotional recovery. It is not an easy road, it is not black and white, and it does not "go away" overnight. Relapse, or recurrence of substance use is common, but that does not mean it is the end of the road. In fact, Scientists have reported that the likelihood of relapse from those who achieve remission of the disorder for five years, is no greater than that among the general population.

As with any disease or disorder, addiction needs to be treated with tender care, gentleness, and compassion. It is not something to take lightly, and it is not something that anyone should shame. It is time to bring this taboo subject into the light. Support, encouragement, and help is what an individual struggling with addiction needs. Be there. Let's let everyone know that it is okay to have a mental illness and addiction problem. 

mental health Part 1 Addiction from Mountainside Medical Equipment on Vimeo.