There are good reasons that people refer to a substance use disorder as a disease of the mind, body, and spirit. The mental and physical tolls that addiction and alcohol and drug dependence can have are numerous and range from depression and anxiety to serious health issues like liver disease and seizures.
To help you better understand the wide net addiction can cast, and what you can do if you or a loved one needs help, Dr. Matthew Goldenberg, who is double board-certified in psychiatry and addiction psychiatry, reviews five common psychological effects of a substance use disorder.
The overlap between substance use disorders and major depressive disorders are extremely high, and the relationship is bidirectional. For example, one-third of people with major depression have an alcohol use disorder.
There are several reasons for this connection, including chemical changes in your brain due to addiction. This increases your risk of mood regulation disorders like depression.
Some people drink or use drugs to escape and cope, aka self-medicate, their depression. Others may find that they become more depressed the deeper they fall into their addiction. In many cases, it is unclear whether it is the “chicken or the egg.” Sometimes it is both underlying depression and addiction which are co-occurring. This is often the case, and because of this, a comprehensive treatment plan is required to address both the depression and the addiction.
Another common side effect of addiction is anxiety. According to the 2020 National Survey on Drug Use and Health, about 17 million people in the United States had both a substance use disorder and a mental illness. Anxiety is just about as common as depression.
The relationship between addiction and anxiety creates a vicious circle in which the symptoms of each are heightened by the other. As an example, when you try to quit using, your anxiety levels can skyrocket. This could be part of withdrawal, but it feels like anxiety and seems to be only relieved by alcohol or the drug of choice. This makes it even more difficult to quit.
Or, conversely, when your levels of anxiety are high, you’re more likely to turn to drugs or alcohol as a form of self-medication. Like depression, it is not uncommon to use drugs and alcohol to escape and cope with anxiety. This may provide temporary relief, but using or drinking only makes your anxiety worse in the long run.
It is not uncommon for heavy drinkers to find their anxiety worsens as the day goes on, which can be a sign of alcohol withdrawal. In extreme cases, drinking not only becomes daily but can be the first activity of the day as heavy drinkers wake in alcohol withdrawal, which feels like extreme anxiety and seems to only be relieved by a drink (or two).
Like depression, anxiety and addiction require a multifaceted and individualized treatment approach.
3. Behavioral changes
One of the insidious effects of a substance use disorder is that the chemical changes in your brain influence your behaviors. Acting on obsessions and cravings is a prime example of this.
For instance, the obsessive side of addiction causes you to focus on your drug of choice above all else, and figuring out how to get your next “fix” becomes your priority. As a result, you skip work, appointments- whatever it takes- to score your next hit or drink. Over time, addiction can cause you to behave in ways that are far from the true you.
To friends and family, this type of behavior can look “insane” or even “criminal.” However, we now understand that the normal reward systems in the brain are hijacked by drugs and alcohol and so an individual’s needs are being met by their substance of choice and they no longer need the dopamine release from normal activities (i.e. food, water, laughter, sex, education etc.) This can lead the person suffering from addiction to lie, cheat and steal if needed to get their substance of abuse.
4. Loss of self-esteem
Addiction can slowly erode your self-esteem as you become imprisoned by your substance use disorder. This loss of control not only affects your confidence, but it can also extend beyond low self-esteem and turn the corner into self-loathing. This has been referred to as “malignant shame.” This severe shame and intrapersonal conflict leads an individual to continue to drink or abuse their drug of choice to numb these dark and negative feelings. In an endless cycle, the addiction causes “malignant shame”, which leads to more alcohol and/or drug abuse.
Addiction treatment is not only about getting sober. Addressing the underlying guilt, shame, grief, and other internal conflicts is essential to enter into a strong and lasting recovery from drugs and alcohol.
Many people with substance use disorders become increasingly angry and irritable. Here again, biology plays a role as your natural feel-good hormones, such as dopamine and serotonin, are suppressed by your substance use disorder.
Over time, the prefrontal cortex, the part of our brain that helps us understand danger and when to say no, goes offline, and alcohol and drugs further control behavior. The normal neuro-transmitters that control our behavior, thoughts, and feelings are depleted. An individual goes from enjoying alcohol or their drug of choice, to needing it to feel normal. Then even that isn’t enough, and the substance is used over and over to not feel terrible.
In an ever-increasing cycle of use, the individual becomes dependent on a substance that no longer brings them positive feelings, but only temporary relief from terrible ones. It is easier now to understand why addiction can make you a little angry.
The bottom line is that a substance use disorder can hijack your mental well-being in many significant ways. If you want to get on the road to reclaiming your psychological health, you are invited to set up a no-obligation, 10-minute phone consultation with Dr. Goldenberg. To get started, click here. Dr. Goldenberg is licensed to provide care to patients in both California and Alaska.
Addiction does not just negatively impact the mental health and well-being of the person suffering from substance abuse. It can equally, or even in some cases more significantly, negatively impact the lives of the friends and family closest to them.
Dr. Goldenberg provides consultations and educational support to families who need assistance getting a better understanding of the options and types of support that they will benefit from when addiction is impacting the whole family. Dr. Goldenberg provides educational consultations to families no matter the location. To get started, click here.