The Psychology Behind Dependence

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When people talk about struggles with drugs and alcohol, the terms dependence and addiction are often used in the same breath. While the concepts are difficult to separate from one another, there is a subtle yet critical difference between dependence and addiction. However, both can and often lead to physical, emotional, and behavioral challenges directly linked to chronic abuse of drugs or alcohol. Also, dependency and addiction are disease processes that, if left untreated, will worsen with time. Because of the potential severity of withdrawal symptoms often experienced when dependent on or addicted to drugs or alcohol, the safest and most effective way to get and stay sober is by seeking help at a luxury drug and alcohol treatment center like The Hills. 


What is Dependence?

Dependence is the term used to describe the point at which your brain and body have become accustomed to a certain level of a particular substance being present in your system at all times. When you are dependent on drugs or alcohol and try to stop or reduce the amount you use, you will experience side effects or “withdrawal symptoms.” These symptoms are signals from your brain and body indicating that your substance of choice levels are low and you need to use or drink again soon to return things to the way your system desires. In short, dependency is the need to operate at higher and more frequent levels to satisfy cravings for the high you once achieved when you first used. 


When people talk about dependence, they often combine the symptoms of physical and psychological dependence into the same conversation. Although physical and mental dependence is often discussed as though they are the same, the two concepts are different. Although it is difficult to point to a symptom of dependency and determine it to be purely psychological or entirely physical, there are specific symptoms that are reflective of one over the other. Also, dependency on some substances produces symptoms that are more physical in nature, whereas others may produce more psychological symptoms. 


What is Physical Dependence?

Physical dependence is all about how the body reacts when you are using and when you try to stop using. When an individual develops a dependency on drugs or alcohol, they will experience physical withdrawal symptoms if they stop providing their system with the substance or substances it craves. When you are dependent, you crave these substances, and your vital body systems cannot function in the way they have been without the drug’s presence. When you are physically dependent and stop using or drinking, it often results in painful withdrawal symptoms such as body aches, nausea, flu-like symptoms, gastric disturbances, and in some cases, tremors (DTs) or seizures.


As noted above, while most substances can lead to both physical and psychological dependence, there are some that lead to primarily one or the other. If you are concerned about a friend or loved one’s use of a substance and the symptoms they struggle with, consider reaching out to a professional rehab like The Hills so they can get the help they need to safely detox and begin working towards health and sobriety. Substances associated with developing a strong physical dependence often include those that result in the development of withdrawal symptoms should an individual stop using. Common examples of these include alcohol, opioid drugs (heroin, Vicodin, Morphine, etc.), benzodiazepines (Xanax, Valium, Ativan, etc.), and barbiturates (Seconal and phenobarbital).  


The withdrawal process from some of the drugs that are considered to be strongly associated with physical dependence, such as alcohol, opiates, and benzodiazepines, can result in the development of potentially fatal withdrawal symptoms, including deadly seizures, cardiac arrest, coma, and respiratory failure. These potentially life-threatening withdrawal side effects do not occur as often with substances more widely linked to psychological dependence. Due to the potential medical complications associated with withdrawal from these substances, detox should take place in a professional treatment environment where medically supported detox is available. Having the support and guidance of a trained team of medical and mental health professionals can ensure prompt intervention is possible should dangerous withdrawal effects occur. 


However, this is not to say that individuals detoxing and withdrawing from other substances do not require support or medical monitoring. Medically supported detox should always be considered during the initial recovery and detox from any substance, regardless of the potential withdrawal symptoms. There is always the possibility of significant emotional and physical distress that can lead to a host of potentially dangerous symptoms during detox. It is also important to mention that someone who chooses to “cold turkey” or detox on their own has an increased risk for relapse and fatal overdose should withdrawal symptoms become too complex or challenging to manage without assistance. 


What Is Psychological Dependence? 

Psychological dependence refers to the series of addictive behaviors associated with using. The term psychological dependence is generally meant to describe the emotional and mental processes related to the development of and recovery from a substance use disorder or addiction. This is not to imply that “psychological dependence” is not as severe as physical dependence; however, it helps to distinguish the emotions behind addiction from the actions involved in using or sustaining addiction. 


Psychological addiction, like physical addiction, also has common and noticeable symptoms. An individual struggling with psychological addiction will often experience a range of symptoms related to using and attempting to get sober. For example, if you or a loved one struggles with a psychological addiction you may experience irritability and restlessness when you are not using your drug of choice, or you try to reduce or stop using altogether. You may also exhibit signs and symptoms of anxiety, depression, or lash out in anger if a friend or loved one tries to stop your addictive behavior or suggests seeking addiction treatment intervention. 


In addition, someone with a psychological dependence may experience other behavioral or mental health conditions related to their addiction. It is not uncommon for addicts to experience changes in appetite and sleep disturbances while using. They may also obsess over obtaining or using the drug of choice or appear to be in denial that they have a substance use issue at all. Long-term and chronic addiction can also result in cognitive problems such as problems with concentration, memory, judgment, or decision-making skills, especially pertaining to obtaining or using drugs or alcohol.


Because the presentation of symptoms related to physical dependence is much more measurable, it can sometimes be challenging to weigh the severity of the symptoms of psychological dependence. In many cases, these symptoms vary in their intensity. Also, there is no objective way to measure an individual’s perceived level of distress, either emotionally or psychologically, so psychological dependence can be complicated to assess.


Substances that often lead to primarily psychological dependence include a combination of prescription medications and “street drugs.” For example, many psychotropic medications, such as antidepressant medications, as well as stimulant medications, including Ritalin, are commonly thought to lead to psychological dependence. Nonprescription stimulants, including cocaine and hallucinogenic drugs such as LSD, also fall into this category. Other substances associated with the development of a strong psychological dependence include cannabis and many inhalant products. 


Dependency vs. Addiction

Understanding the difference between addiction and dependence can be a valuable tool throughout the treatment and recovery process. It is also a vital part of ensuring you or a loved one receive early and comprehensive treatment to help overcome addiction. 


Drug or alcohol dependence – whether physical or psychological- can and often do lead to addiction. But, it is possible to be dependent on a substance and not be addicted.  Because the symptoms for both conditions overlap considerably and there is a significant gray area associated with pinpointing whether a condition is a dependence or an addiction, in today’s mental health and addiction treatment communities, addiction and dependency are typically referred to as substance use disorders. 


If one is looking to separate the terms, addiction refers to the combination of both psychological dependence and physical dependence on a substance, object, or behavior. In other words, when an individual has developed an addiction, they exhibit an ongoing psychological need for a specific substance, along with experiencing the physical effects of dependence on that substance. 


Addiction can cause physical and functional changes in the brain, including those areas critical for judgment, behavior control, and learning. Addiction also influences the parts of the brain that control pleasurable feelings. Consequently, this can create a learned response or psychological dependence on the substance or activity as those pleasure centers are triggered when the substance is used. When the addictive substance is not supplied, the individual who has already formed a psychological dependence will experience physical withdrawal symptoms in the absence of reward center stimulation. 


Treating Substance Use Disorders

Whether physical or psychological, addiction and dependence require a comprehensive, thorough treatment program for the individual to successfully attain sobriety and long-term recovery. Understanding how psychological dependence, physical dependence, and addiction fit together is essential for successful treatment. The treatment of any addictive behavior should center around individualized treatment programs that are evidence-based and holistic. The treatment program should also be appropriate for the individual in recovery instead of the addiction being treated, as all addictions affect each person differently.


If you or a loved one struggles with psychological dependence, remember that there are many treatment options available to you. At The Hills, we offer a full range of rehabilitation services, including medically supervised detox, followed by a wide range of comprehensive traditional and alternative therapies meant to target psychological dependence and its associated symptoms. These therapies help our patients plan for a life free from addiction, rebuild healthy relationships, and thrive in their substance-free lives. Don’t let psychological dependence continue to control your life. Contact The Hills today to learn more about how our treatment programs at our Los Angeles area rehab can help you achieve lasting sobriety.

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