Addiction

Our brain is a complex arrangement of neural tissue, differentiated into functional units that are interconnected and interact in many ways. The chemical signaling system that transmits information between nerve cells to excite or inhibit nerve activity creates feedback loops that signal threat, relief or pleasure. Much of this activity occurs in the limbic system which regulates emotional meaning and context independent of higher cortical reasoning capacity. When we are anxious, fearful or otherwise distressed, chemicals or behaviors can alter the signaling system in these parts of the brain and relieve our suffering. Release of dopamine in the nucleus accumbens is particularly important in this reward system. We can become dependent on or even addicted to something when it provides relief from the distress that we are experiencing. When we are frequently in a state of emotional distress, either from fear, nervousness, anger, pain, or sadness we are more at risk for developing a problem. If there is a family history of addiction and if we are exposed to a pleasurable stimulus repeatedly we can become driven to seek this short term relief at the expense of long term happiness.

Sometimes simple boredom is a trigger for seeking the alteration of senses and pleasure that chemicals can bring. Often emotional distress can be beneath our conscious awareness. We can be feeling stress or depression based on events in our day that we have not fully considered intellectually or consciously. We may feel a nagging sense of need for relief without appreciating or considering its specific cause. This is because of the semi-independent functioning of some of these emotional centers in the brain. These systems evolved over millions of years, before the evolution of higher cortical brain functions. When we seek relief of emotional distress or boredom by chemical means, we risk becoming dependent on the feedback loop that is created by that chemical reward system. The feedback loop is created in our brain by behavioral stimuli that trigger the same neurotransmitters that are stimulated by the ingestion or inhalation of chemicals as well. Food, sex, gaming or gambling are examples of this situation. We can become excessively engaged in an activity that triggers a positive feedback loop in our brain, even when that activity is normal in other circumstances.

So what defines addiction? When does something that makes us feel better, relieves our emotional distress or boredom, or gives us pleasure become a problem? Addiction is defined as compulsive engagement in rewarding stimuli despite adverse consequences. So the key components are not the trigger (distress) or the behavior but rather the compulsion (uncontrolled) and the consequences (bad outcome). When you feel the need to do something to soothe your feelings, even though you know it is not good for you or it is creating problems in your life, you may have a problem with an addiction. This is an extremely common condition in the human experience. Why? Because emotional suffering is common to everybody and we don’t always cope well with our suffering. We don’t always know how to relieve our pain or boredom in ways that do not cause negative effects on us or our loved ones. Sometimes it is just that the addicting stimulus is very powerful and provides a much easier, faster and stronger sense of relief than other less potent means. Once we are exposed to this powerful effect, it can become extremely difficult to find a less harmful alternative to relieve distress or provide the same sense of pleasure that the addicting stimulus brings. This exposure also affects gene transcription in the brain so that protein expression is altered and the addiction becomes more powerful.

Why fight addiction? It depends on the outcomes mostly. The fact that the addiction is beyond ones control, that it becomes a compulsion is usually not enough to effect change in behavior. Some people are motivated to maintain emotional control over their lives, but many will surrender this control if it provides them with relief from suffering or even a sense of temporary pleasure. If it is causing harm for yourself and for others in your life it is a problem. Even this is usually not enough to get people to change their addictive behavior. They become willing to sacrifice their own health, economic success, even personal happiness for the temporary relief of distress or pleasure that the addiction provides. They become willing to negatively affect family, friends and others to pursue the relief they seek. The addiction simply becomes too powerful for them to control. They know it is causing problems, yet they continue despite the problems. This is usually hard for others to understand why someone would make these choices regardless of terrible consequences. Often it is not until the consequences become so bad there is no choice but to seek corrective action. Death, disability, destitution, incarceration. These are frequently the outcomes that prompt change.

Can these outcomes be avoided? Can we find a way to conquer addiction earlier or prevent it from occurring in the first place? Education about addiction and the power of addictive substances can help young people avoid exposure when coupled with adequate supervision and parenting. Understanding our emotional drivers is an important key as well. Discovering what causes our distress and how to manage it in positive ways is critical. Preventing emotional distress created by our response to the environment requires us to examine our responses and our expectations. Learning how to better regulate our emotions, to let go of certain stresses before they adversely affect us is an important skill to develop. We can learn to control how we let circumstances affect our emotional states. Building resilience to stress is possible and there are concrete actions and steps to take in order to do so. This can also lead to living a more satisfying, connected, self-directed and ultimately happier life.

Breaking free of the harmful feedback loop created by the addicting stimulus is necessary to overcome the addiction. This usually takes the form of abstinence or substitution. It requires intellectual and emotional analysis of the situation, the triggers, the responses, behaviors and rewards. Working with an experienced therapist can be helpful in this regard. When you are in the situation and feel the desire to smoke, drink, binge eat, gamble, take drugs or whatever addictive behavior captured you, you must analyze what caused the feelings that got you to that point. Break down the triggers into the situation as well as your response to it. Think mostly about how you react to certain situations that cause you distress. Is there something you can do differently to either alter the situation or change your response to it? We are more in control of our response than we are to the situation, but often our own words and actions can make a big difference in how a situation unfolds, especially when it involves other people. Realize that we can decide how much we choose to react to situations and how much we will let them bother us. We can take back some of the power we give to other people to control our emotional state. Sometimes this involves letting go of some of our own expectations for how other people should act or behave. This means allowing other people the freedom to speak and act as they will without our controlling expectations. Certainly we do not have to agree with them. We can also have significant objection to behavior that challenges our values or sense of morality, but often by tempering our expectations of others we can be free to not allow them to control our own emotional responses. This is certainly not easy to do. It takes practice repeatedly and still does not always work perfectly.

Breaking free also involves creating new feedback loops in our brain that bring us relief from distress or boredom in less destructive ways that do not harm our health or our relationships. Finding healthier habits that bring enjoyment without harm can be a challenge, especially when the addiction is powerful and pleasurable. Some of the successful means of accomplishing this include spiritual practices, exercise, meditation, participation in social activities and peer support groups, hobbies or creative pursuits, volunteering, helping other people, learning, counseling and cognitive behavioral therapy. Medication can be helpful in certain situations. Redefining your purpose for living can have a powerful impact on how you conduct yourself and the joy with which you live life on a daily basis. Finding the motivation to change involves acknowledging the power the addiction has over you and admitting the negative influence it is creating in your life. You must then decide to take charge and accept responsibility for making changes that will alter your course. You will have ups and downs along the way but you will enjoy the ride much more than before. Interestingly, the things that help overcome addiction are the same things that are associated with happiness and life satisfaction.