The Disease Concept
Addiction is best understood and best treated if recognised as a disease. There is still widespread misunderstanding and stigma surrounding addiction where many believe it is a weakness of character, this could not be further from the truth.
Addiction is classified as a disease because it meets the criteria of all other terminal diseases:
- It has patterns of signs and symptoms which are similar across all types of substance abuse
- It is a chronic condition. It doesn’t go away. It only gets worse.
- It is progressive. Addiction only gets worse with continued use
- It KILLS thousands of people daily
Addiction is classified as a mid brain mental illness. It is considered chronic and incurable, but is treatable. Addiction does not have any one specific cause; it does not need to be caused by anything it is simply an existing disease of the reward system in one’s brain. There are usually symptoms which precede the use of any substance and often remain once the substance or problematic behaviour has ceased.
Bravura offers recovery support for wide range of substance and behavioural addiction, as well as assistance with common mental health diagnoses. Below you will find information on various addictive behaviours and substances abuse:
Around the world, alcohol abuse is a problem that either directly or indirectly causes two million deaths each year. Millions more lose their health, their families, their jobs or just the joy of living.
One of the difficulties with eliminating alcohol abuse is its legality. Drinking itself is legal in nearly all the countries of the world. Being a little or a lot drunk is acceptable or even normal in many cultures. In other cultures, there are specific times and places when moderate drunkenness is considered usual–for example, in Western cultures at sporting events, New Year’s Eve parties, college campus parties and 21st- birthday celebrations.
Signs and symptoms of a problem with alcohol abuse may be overlooked or condoned by friends and co-workers until the damage starts to become obvious. For family members and close friends, the damage is probably apparent far sooner.
If you are wondering if a person is abusing alcohol or if they have progressed to alcoholism, here is what you can look for.
- Alcohol consumption interferes with work, school or other activities because of being hung over or sick.
- The person will drink despite knowing he or she will be driving, boating or doing something else that would be risky when impaired.
- There are memory losses or blackouts.
- There are accidents or injuries after drinking.
- The person drinks even though there are physical conditions that would be worsened by drinking.
- The person can’t control how much or when he or she drinks.
- He needs to take in more alcohol to get the same buzz as before.
- Withdrawal symptoms set in when alcohol consumption is stopped, and the person may feel sick, sweaty, shaky and anxious.
- The person gives up other activities they used to enjoy, so they can drink
- A lot of time is spent either drinking or recovering from drinking.
- Even though there is harm to career, education, family or other relationships, the person still drinks.
- The person drinks early in the day, stays drunk for a long time, or drinks alone
- They try to conceal their drinking and make excuses.
- They consistently rely on alcohol to relieve stress or solve problems.
- The drinker would like to quit drinking but despite repeated attempts, still drinks.
- Alcohol becomes a focal point in life. The drinker must always make sure there is enough on hand, and social activities nearly always include drinking.
These symptoms of alcohol abuse and alcoholism are warning signs that damage is occurring, whether to health, mind, relationships, legal situations or life in general. Overlooking the signs of abuse can pave the road for addiction to follow. When a person loses control of their drinking, the dwindling spiral may end in illness, incarceration, destruction of the family or death.
Just as alcohol damages the liver, it also damages the brain. When the liver begins to deteriorate and so is unable to process all the toxins in alcohol, these toxins start to attack the brain.
As the brain begins to be damaged by these chemicals, the following effects may be experienced:
- Anxiety and depression
- Short concentration span
- Sleep disturbances
- Pronounced personality changes
Cocaine is a powerfully addictive stimulant drug made from the leaves of the coca plant native to South America. As a street drug, cocaine looks like a fine, white, crystal powder. Street dealers often mix it with things like cornstarch, talcum powder, or flour to increase profits. They may also mix it with other drugs such as the stimulant amphetamine.
People snort cocaine powder through the nose, or they rub it into their gums. Others dissolve the powder in water and inject it into the bloodstream. Some people inject a combination of cocaine and heroin, called a Speedball.
Another popular method of use is to smoke cocaine that has been processed to make a rock crystal (also called “freebase cocaine”). The crystal is heated to produce vapors that are inhaled into the lungs. This form of cocaine is called Crack, which refers to the crackling sound of the rock as it’s heated.
People who use cocaine often take it in binges—taking the drug repeatedly within a short time, at increasingly higher doses—to maintain their high.
Cocaine cause a flood of dopamine in the brain ultimately disrupts normal brain communication and cause cocaine’s high.
Repeated use of cocaine changes the brain structure which leads to a chemical dependency.
- increased appetite
- unpleasant dreams and insomnia
- slowed thinking
Short-term health effects of cocaine include:
- extreme happiness and energy
- mental alertness
- hypersensitivity to sight, sound, and touch
- paranoia—extreme and unreasonable distrust of others
Cocaine can lead to a number of adverse health effects.
Some long-term health effects of cocaine depend on the method of use and include the following:
- snorting:loss of sense of smell, nosebleeds, frequent runny nose, and problems with swallowing.
- consuming by mouth:severe bowel decay from reduced blood flow.
- needle injection:higher risk for contracting HIV, hepatitis C, and other blood borne diseases.
Other long-term effects of cocaine use include being malnourished, because cocaine decreases appetite, and movement disorders, including Parkinson’s disease, which may occur after many years of use. In addition, people report irritability and restlessness resulting from cocaine binges, and some also experience severe paranoia, in which they lose touch with reality and have auditory hallucinations—hearing noises that aren’t real.
It is possible to overdose on cocaine which can be fatal.
GHB or Gamma Hydroxybutyrate (C4H8O3) is a central nervous system (CNS) depressant that is commonly referred to as a “club drug” or “date rape” drug. GHB is abused by teens and young adults at bars, parties and is often placed in alcoholic beverages.
Euphoria, increased sex drive, and tranquillity are reported positive effects of GHB abuse. Negative effects may include sweating, loss of consciousness, nausea, hallucinations, amnesia, and coma, among other adverse effects.
GHB is available as an odourless, colourless drug that may be combined with alcohol and given to unsuspecting victims prior to sexual assaults. It may have a soapy or salty taste. Common user groups include high school and college students and rave party attendees who use GHB for its intoxicating effects.
GHB has also been postulated to have anabolic effects due to protein synthesis, and has been used by body-builders for muscle building and reducing fat.
GHB is bought on the streets or over the Internet in liquid form or as a white powdered material for illicit use. It is taken orally and is frequently combined with alcohol. Much of the GHB found on the streets or over the Internet is produced in illegal labs. It is often mixed with other chemicals making it toxic.
Euphoria, increased sex drive, and tranquillity are reported positive effects of GHB abuse. However, immediate negative effects of GHB use may include sweating and loss of consciousness (reported by 69 percent of users), nausea, auditory and visual hallucinations, headaches, vomiting, exhaustion, sluggishness, amnesia, confusion, and clumsiness.
GHB can have an addictive potential if used repeatedly. Withdrawal effects may include insomnia, anxiety, tremors, and sweating. Withdrawal can be severe and incapacitating.
Combined use with alcohol, other sedatives or hypnotics (such as barbiturates or benzodiazepines) and other drugs that possess CNS depressant activity may result in nausea, vomiting and aspiration, and dangerous CNS and respiratory depression.
High doses of GHB, even without other illicit substances or alcohol, may result in profound sedation, seizures, coma, severe respiratory depression and death.
Hallucinogens are a diverse group of drugs that alter perception (awareness of surrounding objects and conditions), thoughts, and feelings. They cause hallucinations, or sensations and images that seem real though they are not. Hallucinogens can be found in some plants and mushrooms (or their extracts) or can be human-made. People have used hallucinogens for centuries, mostly for religious rituals. Common hallucinogens include the following:
Blotter sheet of LSD-soaked paper squares that users take by mouth
- Ayahuascais a tea made from one of several Amazonian plants containing dimethyltryptamine (DMT), the primary mind-altering ingredient. Ayahuasca is also known as Hoasca, Aya, and Yagé.
- DMTis a powerful chemical found in some Amazonian plants. Manufacturers can also make DMT in a lab. The drug is usually a white crystalline powder. A popular name for DMT is Dimitri.
- D-lysergic acid diethylamide (LSD)is one of the most powerful mood-changing chemicals. It is a clear or white odorless material made from lysergic acid, which is found in a fungus that grows on rye and other grains. LSD has many other names, including Acid, Blotter, Dots, and Yellow Sunshine.
- Peyote (mescaline)is a small, spineless cactus with mescaline as its main ingredient. Peyote can also be synthetic. Buttons, Cactus, and Mesc are common names for peyote.
- 4-phosphoryloxy-N,N-dimethyltryptamine (psilocybin)comes from certain types of mushrooms found in tropical and subtropical regions of South America, Mexico, and the United States. Other names for psilocybin include Little Smoke, Magic Mushrooms, Purple Passion, and Shrooms.
Some hallucinogens also cause users to feel out of control or disconnected from their body and environment.
- Dextromethorphan (DXM)is a cough suppressant and mucus-clearing ingredient in some over-the-counter cold and cough medicines (syrups, tablets, and gel capsules). Robo is another popular name for DXM.
- Ketamineis used as a surgery anesthetic for humans and animals. Much of the ketamine sold on the streets comes from veterinary offices. While available as an injectable liquid, manufacturers mostly sell it as a powder or as pills. Other names for ketamine include K, Special K, or Cat Valium.
- Phencyclidine (PCP)was developed in the 1950s as a general anesthetic for surgery. It’s no longer used for this purpose due to serious side effects. While PCP can be found in a variety of forms, including tablets or capsules, liquid and white crystal powder are the most common forms. PCP has various other names, such as Angel Dust, Hog, Love Boat, and Peace Pill.
- Salvia divinorum (salvia)is a plant common to southern Mexico and Central and South America. Other names for salvia are Diviner’s Sage, Maria Pastora, Sally-D, and Magic Mint.
Research suggests that hallucinogens work at least partially by temporarily disrupting communication between brain chemical systems throughout the brain and spinal cord. Some hallucinogens interfere with the action of the brain chemical serotonin, which regulates:
- sensory perception
- body temperature
- sexual behavior
- muscle control
Other hallucinogens interfere with the action of the brain chemical glutamate, which regulates:
- pain perception
- responses to the environment
- learning and memory
The effects of hallucinogens can begin within 20 to 90 minutes and can last as long as 6 to 12 hours. Salvia’s effects are more short-lived, appearing in less than 1 minute and lasting less than 30 minutes. Hallucinogen users refer to the experiences brought on by these drugs as “trips,” calling the unpleasant experiences “bad trips.”
Along with hallucinations, other short-term general effects include:
- increased heart rate
- intensified feelings and sensory experiences
- changes in sense of time (for example, time passing by slowly)
Specific short-term effects of some hallucinogens include:
- increased blood pressure, breathing rate, or body temperature
- loss of appetite
- dry mouth
- sleep problems
- mixed senses (such as “seeing” sounds or “hearing” colors)
- spiritual experiences
- feelings of relaxation or detachment from self/environment
- uncoordinated movements
- excessive sweating
- paranoia—extreme and unreasonable distrust of others
- psychosis—disordered thinking detached from reality
Little is known about the long-term effects of hallucinogens. Researchers do know that ketamine users may develop symptoms that include ulcers in the bladder, kidney problems, and poor memory. Repeated use of PCP can result in long-term effects that may continue for a year or more after use stops, such as:
- speech problems
- memory loss
- weight loss
- depression and suicidal thoughts
Hallucinogens can cause severe visual disturbances.
Though rare, long-term effects of some hallucinogens include the following:
- Persistent psychosis—a series of continuing mental problems, including:
- visual disturbances
- disorganized thinking
- mood changes
- Flashbacks—recurrences of certain drug experiences. They often happen without warning and may occur within a few days or more than a year after drug use. In some users, flashbacks can persist and affect daily functioning, a condition known as hallucinogen persisting perceptual disorder(HPPD). These people continue to have hallucinations and other visual disturbances, such as seeing trails attached to moving objects.
- Symptoms that are sometimes mistaken for other disorders, such as stroke or a brain tumor
Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the Asian opium poppy plant. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin. Other common names for heroin include dope, horse, junk, and smack.
People inject, snort, or smoke heroin. Some people mix heroin with crack cocaine, called a speedball.
Heroin enters the brain rapidly and changes back into morphine. It binds to opioid receptors on cells located in many areas of the brain, especially those involved in feelings of pain and pleasure. Opioid receptors are also located in the brain stem, which controls important processes, such as blood pressure, arousal, and breathing.
Prescription opioid pain medicines such as OxyContin® and Vicodin® have effects similar to heroin. Research suggests that misuse of these drugs may open the door to heroin use. While prescription opioid misuse is a risk factor for starting heroin use, only a small fraction of people who misuse pain relievers switch to heroin.
Heroine leads to a number of potentially lethal health conditions which can be fatal.
People who use heroin report feeling a “rush” (euphoria) accompanied by effects that include:
- dry mouth
- flushing of the skin
- heavy feelings in the hands and feet
- clouded mental functioning
- going “on the nod,” a back-and-forth state of being conscious and semi-conscious
Researchers are studying the long-term effects of opioid addiction on the brain. Studies have shown some loss of the brain’s white matter associated with heroin addiction, which may affect decision-making, behaviour control, and responses to stressful situations.
An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death.
When people overdose on heroin, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage.
If Heroine use does not lead to overdose and a person stop using the drug abruptly may have severe withdrawal. Withdrawal symptoms—which can begin as early as a few hours after the drug was last taken—include:
- muscle and bone pain
- sleep problems
- diarrhea and vomiting
- cold flashes with goose bumps (“cold turkey”)
- uncontrollable leg movements (“kicking the habit”)
- severe heroin cravings
Marijuana refers to the dried leaves, flowers, stems, and seeds from the hemp plant, Cannabis sativa. The plant contains the mind-altering chemical delta-9-tetrahydrocannabinol (THC) and other related compounds. Extracts can also be made from the cannabis plant.
People smoke marijuana in hand-rolled cigarettes (joints) or in pipes or water pipes (bongs). They also smoke it in blunts—emptied cigars that have been partly or completely refilled with marijuana. To avoid inhaling smoke, some people are using vaporizers. These devices pull the active ingredients (including THC) from the marijuana and collect their vapor in a storage unit. A person then inhales the vapor, not the smoke. Some vaporizers use a marijuana liquid extract.
People can mix marijuana in food (edibles), such as brownies, cookies, or candy, or brew it as a tea. A newly popular method of use is smoking or eating different forms of THC-rich resins.
When a person smokes marijuana, THC quickly passes from the lungs into the bloodstream. The blood carries the chemical to the brain and other organs throughout the body. The body absorbs THC more slowly when the person eats or drinks it. In that case, he or she generally feels the effects after 30 minutes to 1 hour.
THC acts on specific brain cell receptors that ordinarily react to natural THC-like chemicals. These natural chemicals play a role in normal brain development and function.
Marijuana overactivates parts of the brain that contain the highest number of these receptors. This causes the “high” that people feel. Other effects include:
- altered senses (for example, seeing brighter colors)
- altered sense of time
- changes in mood
- impaired body movement
- difficulty with thinking and problem-solving
- impaired memory
Marijuana also affects brain development. When people begin using marijuana as teenagers, the drug may reduce thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions. Marijuana’s effects on these abilities may last a long time or even be permanent.
A Rise in Marijuana’s THC Levels
The amount of THC in marijuana has been increasing steadily over the past few decades. For a person who is new to marijuana use, this may mean exposure to higher THC levels with a greater chance of a harmful reaction. Higher THC levels may explain the rise in emergency room visits involving marijuana use.
The popularity of edibles also increases the chance of harmful reactions. Edibles take longer to digest and produce a high.
Therefore, people may consume more to feel the effects faster, leading to dangerous results.
Higher THC levels may mean a greater risk for addiction if people are regularly exposing themselves to high doses.
Marijuana use may have a wide range of effects, both physical and mental.
- Breathing problems. Marijuana smoke irritates the lungs, and people who smoke marijuana frequently can have the same breathing problems as those who smoke tobacco. These problems include daily cough and phlegm, more frequent lung illness, and a higher risk of lung infections. Researchers still don’t know whether people who smoke marijuana have a higher risk for lung cancer.
- Increased heart rate. Marijuana raises heart rate for up to 3 hours after smoking. This effect may increase the chance of heart attack. Older people and those with heart problems may be at higher risk.
- Problems with child development during and after pregnancy. Marijuana use during pregnancy is linked to lower birth weight and increased risk of both brain and behavioral problems in babies. If a pregnant woman uses marijuana, the drug may affect certain developing parts of the fetus’s brain. Resulting challenges for the child may include problems with attention, memory, and problem-solving. Some research also suggests that moderate amounts of THC are excreted into the breast milk of nursing mothers. With regular use, THC can reach amounts in breast milk that could affect the baby’s developing brain. More research is needed.
Long-term marijuana use has been linked to mental illness in some users, such as:
- temporary hallucinations—sensations and images that seem real though they are not
- temporary paranoia—extreme and unreasonable distrust of others
- worsening symptoms in patients with schizophrenia(a severe mental disorder with symptoms such as hallucinations, paranoia, and disorganized thinking)
Marijuana use has also been linked to other mental health problems, such as depression, anxiety, and suicidal thoughts among teens. However, study findings have been mixed.
Methylenedioxy-methamphetamine (MDMA) is a synthetic drug that alters mood and perception (awareness of surrounding objects and conditions). It is chemically similar to both stimulants and hallucinogens, producing feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception.
MDMA was initially popular in the nightclub scene and at all-night dance parties (“raves”), but the drug now affects a broader range of people who more commonly call the drug Ecstasy or Molly.
People who use MDMA usually take it as a capsule or tablet, though some swallow it in liquid form or snort the powder. The popular nickname Molly (slang for “molecular”) often refers to the supposedly “pure” crystalline powder form of MDMA, usually sold in capsules. However, people who purchase powder or capsules sold as Molly often actually get other drugs such as synthetic cathinone’s (“bath salts”) instead.
Some people take MDMA in combination with other drugs such as alcohol or marijuana.
MDMA increases the activity of three brain chemicals:
- Dopamine—causes a surge in euphoria and increased energy/activity
- Norepinephrine—increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems
- Serotonin—affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust. The release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.
Other health effects include:
- muscle cramping
- involuntary teeth clenching
- blurred vision
MDMA’s effects last about 3 to 6 hours, although many users take a second dose as the effects of the first dose begin to fade. Over the course of the week following moderate use of the drug, a person may experience:
- impulsiveness and aggression
- sleep problems
- memory and attention problems
- decreased appetite
- decreased interest in and pleasure from sex
It’s possible that some of these effects may be due to the combined use of MDMA with other drugs, especially marijuana.
High doses of MDMA can affect the body’s ability to regulate temperature. This can lead to a spike in body temperature that can occasionally result in liver, kidney, or heart failure or even death.
Methamphetamine is a stimulant drug usually used as a white, bitter-tasting powder or a pill. Crystal methamphetamine is a form of the drug that looks like glass fragments or shiny, bluish-white rocks.
Other common names for methamphetamine include chalk, crank, crystal, ice, meth, speed and Tik.
People can take methamphetamine by:
- swallowing (pill)
- injecting the powder that has been dissolved in water/alcohol
Because the “high” from the drug both starts and fades quickly, people often take repeated doses in a “binge and crash” pattern. In some cases, people take methamphetamine in a form of binging known as a “run,” giving up food and sleep while continuing to take the drug every few hours for up to several days.
Methamphetamine increases the amount of the natural chemical dopamine in the brain. Dopamine is involved in body movement, motivation, pleasure, and reward (pleasure from natural behaviors such as eating). The drug’s ability to release high levels of dopamine rapidly in reward areas of the brain produces the “rush” (euphoria) or “flash” that many people experience.
Taking even small amounts of methamphetamine can result in many of the same health effects as those of other stimulants, such as cocaine or amphetamines. These include:
- increased wakefulness and physical activity
- decreased appetite
- faster breathing
- rapid and/or irregular heartbeat
- increased blood pressure and body temperature
People who inject methamphetamine are at increased risk of contracting infectious diseases such as HIV and hepatitis B and C. These diseases are transmitted through contact with blood or other bodily fluids. Methamphetamine use can also alter judgment and decision-making leading to risky behaviors, such as unprotected sex, which also increases risk for infection.
Methamphetamine use may worsen the progression of HIV/AIDS and its consequences. Studies indicate that HIV causes more injury to nerve cells and more cognitive problems in people who have HIV and use methamphetamine than it does in people who have HIV and don’t use the drug. Cognitive problems are those involved with thinking, understanding, learning, and remembering.
Long-term methamphetamine use has many other negative consequences, including:
- extreme weight loss
- severe dental problems (“meth mouth”)
- intense itching, leading to skin sores from scratching
- sleeping problems
- violent behavior
- paranoia—extreme and unreasonable distrust of others
- hallucinations—sensations and images that seem real though they aren’t
Yes, a person can overdose on methamphetamine. Methamphetamine overdose can lead to stroke, heart attack, or organ problems—such as kidney failure—caused by overheating. These conditions can result in death.
Yes, methamphetamine is highly addictive. When people stop taking it, withdrawal symptoms can include:
- severe depression
- intense drug cravings
Misuse of prescription opioids, central nervous system (CNS) depressants, and stimulants is a serious public health problem.
The reasons for the high prevalence of prescription drug misuse vary by age, gender, and other factors, but likely include ease of access. The number of prescriptions for some of these medications has increased dramatically. Moreover, misinformation about the addictive properties of prescription opioids and the perception that prescription drugs are less harmful than illicit drugs are other possible contributors to the problem.
Although misuse of prescription drugs affects certain populations such as youth, older adults, and women may be at particular risk. In addition, while more men than women currently misuse prescription drugs, the rates of misuse and overdose among women are increasing faster than among men.
Prescription drugs that are commonly misused are:
- CNS Depressants
Opioids are medications that act on opioid receptors in both the spinal cord and brain to reduce the intensity of pain-signal perception. They also affect brain areas that control emotion, which can further diminish the effects of painful stimuli. They have been used for centuries to treat pain, cough, and diarrhea. The most common modern use of opioids is to treat acute pain. However, since the 1990s, they have been increasingly used to treat chronic pain, despite sparse evidence for their effectiveness when used long term. Indeed, some patients experience a worsening of their pain or increased sensitivity to pain as a result of treatment with opioids, a phenomenon known as hyperalgesia. Importantly, in addition to relieving pain, opioids also activate reward regions in the brain causing the euphoria—or high—that underlies the potential for misuse and addiction. Chemically, these medications are very similar to heroin, which was originally synthesized from morphine as a pharmaceutical. These properties confer an increased risk of addiction and overdose even in patients who take their medication as prescribed.
Prescription opioid medications include hydrocodone (e.g., Vicodin®), oxycodone (e.g., OxyContin®, Percocet®), oxymorphone (e.g., Opana®), morphine (e.g., Kadian®, Avinza®), codeine, fentanyl, and others
Opioids act by attaching to and activating opioid receptor proteins, which are found on nerve cells in the brain, spinal cord, gastrointestinal tract, and other organs in the body. When these drugs attach to their receptors, they inhibit the transmission of pain signals. Opioids can also produce drowsiness, mental confusion, nausea, constipation, and respiratory depression, and since these drugs also act on brain regions involved in reward, they can induce euphoria, particularly when they are taken at a higher-than-prescribed dose or administered in other ways than intended.
When taken as prescribed, patients can often use opioids to manage pain safely and effectively. However, it is possible to develop a substance use disorder when taking opioid medications as prescribed. This risk and the risk for overdose increase when these medications are misused. Even a single large dose of an opioid can cause severe respiratory depression (slowing or stopping of breathing), which can be fatal; taking opioids with alcohol or sedatives increases this risk. With both dependence and addiction, withdrawal symptoms may occur if drug use is suddenly reduced or stopped. These symptoms may include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps, and involuntary leg movements..
Central nervous system (CNS) depressants, a category that includes tranquilizers, sedatives, and hypnotics, are substances that can slow brain activity. This property makes them useful for treating anxiety and sleep disorders. The following are among the medications commonly prescribed for these purposes:
- Benzodiazepines,such as diazepam (Valium®), clonazepam (Klonopin®), and alprazolam (Xanax®), are sometimes prescribed to treat anxiety, acute stress reactions, and panic attacks. Clonazepam may also be prescribed to treat seizure disorders. The more sedating benzodiazepines, such as triazolam (Halcion®) and estazolam (Prosom®) are prescribed for short-term treatment of sleep disorders. Usually, benzodiazepines are not prescribed for long-term use because of the high risk for developing tolerance, dependence, or addiction.
- Non-benzodiazepine sleep medications,such as zolpidem (Ambien®), eszopiclone (Lunesta®), and zaleplon (Sonata®), known as z-drugs, have a different chemical structure but act on the same GABA type A receptors in the brain as benzodiazepines. They are thought to have fewer side effects and less risk of dependence than benzodiazepines.
- Barbiturates,such as mephobarbital (Mebaral®), phenobarbital (Luminal®), and pentobarbital sodium (Nembutal®), are used less frequently to reduce anxiety or to help with sleep problems because of their higher risk of overdose compared to benzodiazepines. However, they are still used in surgical procedures and to treat seizure disorders.
Most CNS depressants act on the brain by increasing activity at receptors for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Although the different classes of depressants work in unique ways, it is through their ability to increase GABA signaling—thereby increasing inhibition of brain activity—that they produce a drowsy or calming effect that is medically beneficial to those suffering from anxiety or sleep disorders.
Despite their beneficial therapeutic effects, benzodiazepines and barbiturates have the potential for misuse and should be used only as prescribed. The use of non-benzodiazepine sleep aids, or z-drugs, is less well-studied, but certain indicators have raised concern about their psychoactive properties as well.
During the first few days of taking a depressant, a person usually feels sleepy and uncoordinated, but as the body becomes accustomed to the effects of the drug and tolerance develops, these side effects begin to disappear. If one uses these drugs long term, he or she may need larger doses to achieve the therapeutic effects. Continued use can also lead to dependence and withdrawal when use is abruptly reduced or stopped. Because all sedatives work by slowing the brain’s activity, when an individual stops taking them, there can be a rebound effect, resulting in seizures or other harmful consequences.
Although withdrawal from benzodiazepines can be problematic, it is rarely life threatening, whereas withdrawal from prolonged use of barbiturates can have life-threatening complications.
Stimulants increase alertness, attention, and energy, as well as elevate blood pressure, heart rate, and respiration. Historically, stimulants were used to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments. But as their potential for misuse and addiction became apparent, the number of conditions treated with stimulants has decreased. Now, stimulants are prescribed for the treatment of only a few health conditions, including attention-deficit hyperactivity disorder (ADHD), narcolepsy, and occasionally treatment-resistant depression.
Stimulants, such as dextroamphetamine (Dexedrine®, Adderall®) and methylphenidate (Ritalin®, Concerta®), act in the brain on the family of monoamine neurotransmitter systems, which include norepinephrine and dopamine. Stimulants enhance the effects of these chemicals. An increase in dopamine signaling from nonmedical use of stimulants can induce a feeling of euphoria, and these medications’ effects on norepinephrine increase blood pressure and heart rate, constrict blood vessels, increase blood glucose, and open up breathing passages.
As with other drugs in the stimulant category, such as cocaine, it is possible for people to become dependent on or addicted to prescription stimulants. Withdrawal symptoms associated with discontinuing stimulant use include fatigue, depression, and disturbed sleep patterns. Repeated misuse of some stimulants (sometimes within a short period) can lead to feelings of hostility or paranoia, or even psychosis. Further, taking high doses of a stimulant may result in dangerously high body temperature and an irregular heartbeat. There is also the potential for cardiovascular failure or seizures.
Sex addiction, also known as hypersexual disorder, is characterized by persistent and escalating sexual thoughts and acts that have a negative impact on the individual’s life. Sex addicts struggle to control or postpone sexual feelings and actions. Most sex addicts do not know how to achieve genuine intimacy, forming little or no attachment to their sexual partners.
Eventually, the pursuit of sex becomes more important than family, career and even personal health and safety. As sexual preoccupation increases in terms of energy and time, the sex addict follows a routine or ritual leading to acting out on desires, which is then followed by feelings of denial then shame, despair and confusion.
Effective treatment for sexual addiction requires a multifaceted approach that addresses both the compulsive behavior and the underlying issues and co-occurring disorders that may contribute to it.
- Sex Addiction's Similarities with other Addictions
- Sex Addiction Dependence / Withdrawal
- Types of Sex Addiction
Like people who abuse drugs and alcohol, sex addicts can experience a “high” through compulsive sexual behaviors, develop a dependence on this feeling, and suffer withdrawal symptoms without sex. Sexual addiction is like most other compulsive behaviors: a potentially destructive twist on a normal life-enhancing activity. Similar to drugs and alcohol, sexual activities produce chemical changes in the brain. When a sexual behavior is engaged in compulsively over time, the brain adapts to the flood of neurotransmitters and craves more intense or more frequent stimuli to feel the initial rush.
Like other addictions, sex addiction is characterized by repetitive compulsive seeking or use of an activity despite adverse social, psychological, and/or physical consequences. Addiction is often accompanied by physical dependence, withdrawal and tolerance. Physical dependence is defined as a physiologic state of adaptation to a substance or chemical change in the brain, the absence of which produces symptoms of withdrawal.
Withdrawal syndrome consists of a predictable group of symptoms resulting from abrupt removal of, or a rapid decrease in, the regular dosage of a psychoactive substance or activity; the syndrome is often characterized by overactivity of the physiologic functions that were suppressed by the drug and/or depression of the functions that were stimulated by the object of addiction.
Tolerance is a state in which a drug or activity produces a diminishing biologic or behavioral response; in other words, higher doses — or in the case of sex addicts, riskier or more intense behavior — is needed to produce the same initial effect.
A common misconception is that someone with a strong libido or who has a number of sexual partners must have a sexual addiction. In reality, most sex addicts crave the pursuit of sex and may gain little pleasure from a sexual act itself. Whereas most people stop engaging in a behavior that harms their health, relationships, finances or careers, sex addicts are unable to stop seeking out sexual experiences despite these consequences. They achieve a “high” when engaging in compulsive sexual behaviors, and as the brain chemistry changes, they must engage in more and more sexual acts to prevent a “crash” or withdrawal. Sex addiction withdrawal can include symptoms such as depression, anxiety, emotional instability, anger, fatigue, agitation, hypersensitivity and physical discomfort.
TYPES OF SEX ADDICTION
A wide range of behaviors can be symptoms of sex addiction, including:
- Compulsive masturbation
- Multiple affairs
- Anonymous sex
- Obsessive dating
- Compulsive use of pornography
- Risky or unsafe sex
- Prostitution or use of prostitutes
Porn addiction occurs when the person viewing pornography, with or without masturbating, loses control over whether or not he/she will engage in that behavior. Porn addicts look at and use porn compulsively, despite consequences that include:
- An inability to form lasting social and intimate romantic relationships
- Intense feelings of depression, shame and isolation
- Disintegration of relationships with family, friends and romantic partners
- Loss of many hours, sometimes entire days, to porn use
- Loss of interest in non-porn activities such as work, school, socializing, family and exercise
- Trouble at work or in school (including reprimands and/or dismissal) related to poor performance, misuse of company/school equipment and/or public use of porn
In the same way that a sex addict doesn’t have sex primarily for the pleasure of the act, the porn addict doesn’t look at pornography primarily for sexual enjoyment. Instead, his/her addiction is a way to escape from stress and other forms of emotional discomfort, including the pain of psychological issues like depression, anxiety, low self-esteem and unresolved trauma such as abuse or neglect. Alcoholics drink and drug addicts use for exactly the same reasons. So, as with other addictions, porn addicts are not looking to feel good, they want to feel less, or at least to control what they’re feeling.
As with drugs of abuse, pornography triggers a chemical response in the brain that feels pleasurable. This is fueled mostly by the release of the neurotransmitter dopamine, but also by other biochemicals, such as oxytocin, adrenaline, serotonin and endorphins. Over time, porn addicts learn to abuse this naturally occurring reaction in the same way that alcoholics and drug addicts learn to abuse alcohol and drugs, intentionally triggering the pleasure response with pornography and sexual fantasy. In this way, the addict creates and uses that high as a way to avoid experiencing depression, anxiety and other stressors.
Like other addicts, porn addicts like to stay high for prolonged periods. For that reason, they’re typically much more interested in using porn to sustain their intense sexual fantasies than in reaching orgasm. In fact, for porn addicts an orgasm ends the high and catapults them back to real life, which is what they’re trying to avoid. As such, porn addicts often spends hours, sometimes even entire days, in a trance-like, zoned-out neurochemical bubble, looking at and fantasizing about porn and sexual activity without actually masturbating or having sex.
Both men and women can become addicted to pornography. The kind of porn that each prefers tends to differ, though. Where men tend to look at purely sexualized imagery (hardcore porn), women typically prefer erotica with at least a hint of an emotional connection (such as the book Fifty Shades of Grey). Either way, the core signs of pornography addiction are similar for both men and women, typically including some combination of the following:
- Escalating amounts of time spent on porn use, with hours and sometimes even days lost to pornography
- Viewing progressively more intense or bizarre sexual content
- Continued porn use despite negative consequences and/or promises made to self or others to stop using porn
- Lying about, keeping secrets about and covering up the nature and extent of porn use
- Anger or irritability if confronted about the nature or extent of porn use
- Escalation from two-dimensional porn viewing to use of technology for casual, anonymous or paid-for sexual encounters, whether in-person or via Webcams
The factors that raise someone’s odds of developing an addiction to porn are the same as with other forms of sexual addiction (and addiction in general, for that matter). Since there’s been comparatively little research into the causes of sex and porn addiction, most health care professionals who treat sex and porn addicts tend to rely on studies looking at other types of addiction. Generally speaking, these studies show that genetic factors can increase or decrease the risk for addiction, usually by altering the ways in which a particular substance or activity is experienced in the body and brain. Genetic makeup also plays into many psychiatric disorders, including depression, anxiety and bipolar disorder, among others. And it’s well-known that individuals dealing with these emotionally painful issues often choose to compulsively “self-medicate” with an addictive substance or behavior.
Nevertheless, genetics are not entirely to blame. In fact, research indicates that environmental factors are equally at play. For instance, if someone was neglected or abused in childhood their risk of addiction jumps, just as it does if they were exposed to addictive substances or behaviors early in life. (The younger a person is when he or she first uses an addictive substance or starts an addictive behavior, the greater the risk of developing an addiction.) So it appears that most porn addicts become addicted thanks to a convergence of risk factors — typically a mixture of genetic predisposition, poor parenting and early and often inappropriate exposure to pornography and/or sexual activity.
Eating Disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about body weight or shape.
Eating disturbances may include inadequate or excessive food intake which can ultimately damage an individual’s well-being. The most common forms of eating disorders include Anorexia Nervosa,
Bulimia Nervosa, and Binge Eating Disorder and affect both females and males.
Eating disturbances may include inadequate or excessive food intake which can ultimately damage an individual’s well-being. The most common forms of eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder and affect both females and males.
Eating disorders can develop during any stage in life but typically appear during the teen years or young adulthood. Classified as a medical illness, appropriate treatment can be highly effectual for many of the specific types of eating disorders.
Although these conditions are treatable, the symptoms and consequences can be detrimental and deadly if not addressed. Eating disorders commonly coexist with other conditions, such as anxiety disorders, substance abuse, or depression.
The three most common types of Eating Disorders are as follows:
Anorexia Nervosa-The male or female suffering from anorexia nervosa will typically have an obsessive fear of gaining weight, refusal to maintain a healthy body weight and an unrealistic perception of body image. Many people with anorexia nervosa will fiercely limit the quantity of food they consume and view themselves as overweight, even when they are clearly underweight. Anorexia can have damaging health effects, such as brain damage, multi-organ failure, bone loss, heart difficulties, and infertility. The risk of death is highest in individuals with this disease.
Bulimia Nervosa-This eating disorder is characterized by repeated binge eating followed by behaviors that compensate for the overeating, such as forced vomiting, excessive exercise, or extreme use of laxatives or diuretics. Men and women who suffer from Bulimia may fear weight gain and feel severely unhappy with their body size and shape. The binge-eating and purging cycle is typically done in secret, creating feelings of shame, guilt, and lack of control. Bulimia can have injuring effects, such as gastrointestinal problems, severe hydration, and heart difficulties resulting from an electrolyte imbalance.
Binge Eating Disorder– Individuals who suffer from Binge Eating Disorder will frequently lose control over his or her eating. Different from bulimia nervosa however, episodes of binge-eating are not followed by compensatory behaviors, such as purging, fasting, or excessive exercise. Because of this, many people suffering from BED may be obese and at an increased risk of developing other conditions, such as cardiovascular disease. Men and women who struggle with this disorder may also experience intense feelings of guilt, distress, and embarrassment related to their binge-eating, which could influence the further progression of the eating disorder.
Eating Disorders are complex disorders, influenced by a facet of factors. Though the exact cause of eating disorders is unknown, it is generally believed that a combination of biological, psychological, and/or environmental abnormalities contribute to the development of these illnesses.
Examples of biological factors include:
- Irregular hormone functions
- Genetics (the tie between eating disorders and one’s genes is still being heavily researched, but we know that genetics is a part of the story).
- Nutritional deficiencies
Examples of psychological factors include:
Negative body image
- Poor self-esteem
Examples of environmental factors:
- Dysfunctional family dynamic
- Professions and careers that promote being thin and weight loss, such as ballet and modeling
- Aesthetically oriented sports, where an emphasis is placed on maintaining a lean body for enhanced performance like:
- Long distance running
- Family and childhood traumas: childhood sexual abuse, severe trauma
- Cultural and/or peer pressure among friends and co-workers
- Stressful transitions or life changes
A man or woman suffering from an eating disorder may reveal several signs and symptoms, some which are:
- Chronic dieting despite being hazardously underweight
- Constant weight fluctuations
- Obsession with calories and fat contents of food
- Engaging in ritualistic eating patterns, such as cutting food into tiny pieces, eating alone, and/or hiding food
- Continued fixation with food, recipes, or cooking; the individual may cook intricate meals for others but refrain from partaking
- Depression or lethargic stage
- Avoidance of social functions, family, and friends. May become isolated and withdrawn
- Switching between periods of overeating and fasting
Codependency is a type of dysfunctional helping relationship where one person supports or enables another person’s drug addiction, alcoholism, gambling addiction, poor mental health, immaturity, irresponsibility, or under-achievement. Among the core characteristics of codependency, the most common theme is an excessive reliance on other people for approval and a sense of identity. Given its grassroots origin, the precise definition of codependency varies based on the source but can be generally characterized as a subclinical and situational or episodic behavior similar to that of dependent personality disorder. In its broadest definition, a codependent is someone who cannot function from their innate self and whose thinking and behavior is instead organized around another person, or even a process, or substance. In this context, people who are addicted to a substance, like drugs, or a process, like gambling or sex, can also be considered codependent. In its most narrow definition, it requires one person to be physically or psychologically addicted, such as to heroin, and the second person to be psychologically dependent on that behavior. Some users of the codependency concept use the word as an alternative to using the concept of dysfunctional families, without statements that classify it as a disease.
Codependency does not refer to all caring behavior or feelings, but only those that are excessive to an unhealthy degree. One of the distinctions is that healthy empathy and caregiving is motivated by conscious choice; whereas for codependents, their actions are compulsive, and they usually aren’t able to weigh in the consequences of them or their own needs that they’re sacrificing. Some scholars and treatment providers feel that codependency is an overresponsibility and that overresponsibility needs to be understood as a positive impulse gone awry. Responsibility for relationships with others needs to coexist with responsibility to self.
Codependency has been referred to as the disease of a lost self. Codependent relationships are marked by intimacy problems, dependency, control (including caretaking) denial, dysfunctional communication and boundaries, and high reactivity. Often, there is imbalance, so one person is abusive or in control or supports or enables another person’s addiction, poor mental health, immaturity, irresponsibility, or under-achievement. Some codependents often find themselves in relationships where their primary role is that of rescuer, supporter, and confidante. These helper types are often dependent on the other person’s poor functioning to satisfy their own emotional needs. Many codependents place a lower priority on their own needs, while being excessively preoccupied with the needs of others. Codependency can occur in any type of relationship, including family, work, friendship, and also romantic, peer or community relationships.
- intense and unstable interpersonal relationships
- inability to tolerate being alone, accompanied by frantic efforts to avoid being alone
- chronic feelings of boredomand emptiness
- subordinating one’s own needs to those of the person with whom one is involved
- overwhelming desire for acceptance and affection
- external referencing
- dishonesty and denial
- lack of trust
- low self-worth.
Internet addiction is described as an impulse control disorder, which does not involve use of an intoxicating drug and is very similar to pathological gambling. Some Internet users may develop an emotional attachment to on-line friends and activities they create on their computer screens. Internet users may enjoy aspects of the Internet that allow them to meet, socialize, and exchange ideas through the use of chat rooms, social networking websites, or “virtual communities.” Other Internet users spend endless hours researching topics of interest Online or “blogging”. Blogging is a contraction of the term “Web log”, in which an individual will post commentaries and keep regular chronicle of events. It can be viewed as journaling and the entries are primarily textual.
Similar to other addictions, those suffering from Internet addiction use the virtual fantasy world to connect with real people through the Internet, as a substitution for real-life human connection, which they are unable to achieve normally.
- Preoccupation with the Internet. (Thoughts about previous on-line activity or anticipation of the next on-line session.)
- Use of the Internet in increasing amounts of time in order to achieve satisfaction.
- Repeated, unsuccessful efforts to control, cut back or stop Internet use.
- Feelings of restlessness, moodiness, depression, or irritability when attempting to cut down use of the Internet.
- On-line longer than originally intended.
- Jeopardized or risked loss of significant relationships, job, educational or career opportunities because of Internet use.
- Lies to family members, therapists, or others to conceal the extent of involvement with the Internet.
- Use of the Internet is a way to escape from problems or to relieve a dysphoric mood. (e.g. Feelings of hopelessness, guilt, anxiety, depression.)
Internet addiction results in personal, family, academic, financial, and occupational problems that are characteristic of other addictions. Impairments of real life relationships are disrupted as a result of excessive use of the Internet. Individuals suffering from Internet addiction spend more time in solitary seclusion, spend less time with real people in their lives, and are often viewed as socially awkward. Arguments may result due to the volume of time spent on-line. Those suffering from Internet addiction may attempt to conceal the amount of time spent on-line, which results in distrust and the disturbance of quality in once stable relationships.
Some suffering from Internet addiction may create on-line personas or profiles where they are able to alter their identities and pretend to be someone other than himself or herself. Those at highest risk for creation of a secret life are those who suffer from low-self esteem feelings of inadequacy, and fear of disapproval. Such negative self-concepts lead to clinical problems of depression and anxiety.
Many persons who attempt to quit their Internet use experience withdrawal including: anger, depression, relief, mood swings, anxiety, fear, irritability, sadness, loneliness, boredom, restlessness, procrastination, and upset stomach. Being addicted to the Internet can also cause physical discomfort or medical problems such as: Carpal Tunnel Syndrome, dry eyes, backaches, severe headaches, eating irregularities, (such as skipping meals), failure to attend to personal hygiene, and sleep disturbance.
Strength doesn’t come from
what you can do.
It comes from overcoming
the things you thought
Video game addiction is described as an impulse control disorder, which does not involve use of an intoxicating drug and is very similar to pathological gambling. Video game addiction has also been referred to as video game overuse, pathological or compulsive/excessive use of computer games and/or video games.
Those suffering from video game addiction may use the Internet to access massively multi-player online role-playing games (MMORPGs) and multi-user domain games (MUDs). MMORPGs are networks of people, all interacting with one another to play a game to achieve goals, accomplish missions, and reach high scores in a fantasy world. MUDs combine elements of role-playing games, fighting, and killing in a social chat channel with limited graphics. Some of the most popular on-line games include EverQuest, Asheron Call, Ultima Online, World of Warcraft, Final Fantasy, Vanguard, and City of Heroes. Most MMORPGs charge monthly subscription fee.
Similar to other addictions, individuals suffering from video game addiction use the virtual fantasy world to connect with real people through the Internet, as a substitution for real-life human connection, which they are unable to achieve normally. Some suffering from video game addiction may develop an emotional attachment to on-line friends and activities they create on their computer screens. Those suffering from video game addiction may enjoy aspects of the on-line games that allow them to meet, socialize, and exchange ideas through games. Because some games requires a large number of players to log on simultaneously, for long durations of time, to accomplish a game’s task, players may feel an obligation and loyalty to other players. This may further the individual’s justification of his/her use and sense of relationship with other players, that are otherwise strangers.
Statistics show that men and boys are more likely to become addicted to video games versus women and girls. Recent research has found that nearly one in 10 youth gamers (ages 8-18) can be classified as pathological gamers or addicted to video-gaming.
- Preoccupation with the Game. (Thoughts about previous on-line activity or anticipation of the next on-line session.)
- Use of the Game in increasing amounts of time in order to achieve satisfaction.
- Repeated, unsuccessful efforts to control, cut back or stop Game use.
- Feelings of restlessness, moodiness, depression, or irritability when attempting to cut down use of the Game.
- Gaming longer than originally intended.
- Jeopardized or risked loss of significant relationships, job, educational or career opportunities because of Game use.
- Lies to family members, friends, therapists, or others to conceal the extent of involvement with the Game.
- Use of the Game is a way to escape from problems or to relieve a dysphoric mood. (e.g. feelings of hopelessness, guilt, anxiety, depression.)
- Fatigue, tendency to fall asleep during school
- Not completing homework or assignments on time
- Declining grades, or failing classes
- Dropping out of school activities, clubs, sports, etc.
- Isolating from family and friends to play video games
Gaming addictions result in personal, family, academic, financial, and occupational problems that are characteristic of other addictions. Impairments of real life relationships are disrupted as a result of excessive use of the Game. Those suffering from video game addiction spend more time in solitary seclusion, spend less time with real people in their lives, and are often viewed as socially awkward. Arguments may result due to the volume of time spent playing. They may attempt to conceal the amount of time spent playing, which results in distrust and the disturbance of quality in once stable relationships. Additionally, gaming can become very costly, resorting in financial consequences. Much of the equipment needed to play video games designed for prolonged use can be quite costly and many MMORPGs charge monthly subscription fees.
Some individuals may create on-line personas or “Avatars” where he/she are able to alter his/her identities and pretend to be someone other than himself or herself. Those at highest risk for creation of a secret life are those who suffer from low-self esteem feelings of inadequacy, and fear of disapproval. Such negative self-concepts lead to clinical problems of depression and anxiety.
Many persons who attempt to quit their Game use experience withdrawal including: anger, depression, relief, fantasies about the game, mood swings, anxiety, fear, irritability, sadness, loneliness, boredom, restlessness, procrastination, and upset stomach. Being addicted to video-gaming can also cause physical discomfort or medical problems such as: Carpal Tunnel Syndrome, dry eyes, backaches, severe headaches, eating irregularities, such as skipping meals, failure to attend to personal hygiene, and sleep disturbance.
Everyone experiences anxiety. Speaking in front of a group makes most of us anxious, but that motivates us to prepare and do well. Driving in heavy traffic is a common source of anxiety, but it keeps us alert and cautious to better avoid accidents. However, when feelings of intense fear and distress are overwhelming and prevent us from doing everyday things, an anxiety disorder may be the cause.
Anxiety disorders are a group of related conditions, and each with unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening. People can experience one or more of the following symptoms:
- Feelings of apprehension or dread
- Feeling tense and jumpy
- Restlessness or irritability
- Anticipating the worst and being watchful for signs of danger
- Pounding or racing heart and shortness of breath
- Upset stomach
- Sweating, tremors and twitches
- Headaches, fatigue and insomnia
- Upset stomach, frequent urination or diarrhea
Different anxiety disorders have various symptoms. This means that each type of anxiety disorder has its own treatment plan. The most common anxiety disorders include:
- Panic Disorder
Characterized by panic attacks—sudden feelings of terror—sometimes striking repeatedly and without warning. Often mistaken for a heart attack, a panic attack causes powerful, physical symptoms including chest pain, heart palpitations, dizziness, shortness of breath and stomach upset. Many people will go to desperate measures to avoid having an attack, including social isolation or avoiding going to specific places.
Everyone tries to avoid certain things or situations that make them uncomfortable or even fearful. However, for someone with a phobia, certain places, events or objects create powerful reactions of strong, irrational fear. Most people with specific phobias have several triggers. To avoid panicking, someone with specific phobias will work hard to avoid their triggers. Depending on the type and number of triggers, this fear and the attempt to control it can seem to take over a person’s life.
Generalized Anxiety Disorder (GAD)
GAD produces chronic, exaggerated worrying about everyday life. This can consume hours each day, making it hard to concentrate or finish routine daily tasks. A person with GAD may become exhausted by worry and experience headaches, tension or nausea.
- Social Anxiety Disorder
Unlike shyness, this disorder causes intense fear, often driven by irrational worries about social humiliation–“saying something stupid,” or “not knowing what to say.” Someone with social anxiety disorder may not take part in conversations, contribute to class discussions, or offer their ideas, and may become isolated. Panic attack symptoms are a common reaction.
Other anxiety disorders include: agoraphobia, separation anxiety disorder and substance/medication-induced anxiety disorder involving intoxication or withdrawal or medication treatment.
Scientists believe that many factors combine to cause anxiety disorders:
- Some families will have a higher than average numbers of members experiencing anxiety issues, and studies support the evidence that anxiety disorders run in families. This can be a factor in someone developing an anxiety disorder.
- A stressful or traumatic event such as abuse, death of a loved one, violence or prolonged illness is often linked to the development of an anxiety disorder.
Compulsive gambling is a progressive illness, which starts out as a recreational activity and ends up being destructive to both the gambler and his/her families. Compulsive gambling has mental, physical and spiritual consequences. The main symptom of this addiction is denial and the major characteristic is loss of control. There is also a tendency to take bigger and bigger risks as time goes by.
Like alcoholism, it is an illness, which cannot be cured, but which can definitely be arrested. One of the main symptoms of gambling addiction is that it becomes an overriding passion that permeates all aspects of the gambler’s life. Inability to stop gambling and continuing to gamble despite negative consequences are also characteristics of gambling addiction.
Winning, losing and desperation are the three phases of compulsive gambling. There are both social and economic costs involved when someone is addicted to gambling. These include poverty, starvation, family disintegration and criminal behaviour. People who gamble to excess often suffer from feelings of depression and anxiety, as well as muscular tension, fatigue, headaches and high blood pressure.
Employees who have a gambling addiction also do not perform well at work as they are preoccupied with the next bet, money problems, where to get money, etc. Engaging in criminal activities in order to fund the gambling habit becomes a reality for many gambling addicts.
There is no single cause of gambling addiction – one is either predisposed to it or not. However, there appears to be a genetic component as people with any addiction history in their families are at increased risk of developing this problem.
Gamblers Anonymous provides some insight, in that three qualities are isolated that seem to be inherently present in gambling addicts: an inability and unwillingness to accept reality, emotional insecurity and immaturity, which translates into an unwillingness to grow up and accept responsibility. There is also evidence to support the fact that many gamblers subconsciously want to lose because they want to punish themselves.
Compulsive gambling usually begins in early adolescence in males and at a later age for females. Some people are fascinated from the time of their initial exposure, but for others the process is more gradual, until they suddenly have a big win, or there is some other stressor bringing on a period of compulsive gambling. Usually, people who go on to become gambling addicts, have a big win early on in their gambling experiences.
Gamblers Anonymous defines gambling as follows: Any betting or wagering, for self or others, whether for money or not, no matter how slight or insignificant, where the outcome is uncertain or depends upon chance or ‘skill’ constitutes gambling.
Social gambling and professional gambling should not be confused with gambling addiction. In the former, gambling usually takes place as a social activity for a brief period of time and losses are predetermined and within certain limits. Professional gamblers tend not to take big risks and are often very disciplined. Risks are often also split between a number of people as are winnings. Gambling addicts have a tendency to gamble by themselves and to gamble until they have nothing left.
As time goes by, gambling addicts tend to bet larger and larger amounts, take greater and greater chances, gamble more frequently and become progressively more and more obsessed with gambling and getting money with which to gamble. Periods of stress or depression tend to exacerbate gambling activity. The process of winning, then losing, followed by desperation, is a known cycle in the world of the gambling addict.
Depression, and a deterioration of physical and emotional health are general signs and symptoms of a gambling addiction.
The gambler becomes moody, withdrawn and irritable and preoccupied with gambling, winnings of the past and getting hold of more money with which to gamble.
Gambling addicts may start to borrow or steal money, either from family members, employers or both, with which to gamble and will often carry on gambling until they have nothing left at all. They will let bills go unpaid while spending available money on their gambling pursuits. They will try, unsuccessfully, to put a stop to their gambling. Larger and larger amounts will be needed to produce the same sense of excitement – a state of escapist euphoria, which is used to counteract feelings of anxiety and depression. A gambler will often lie to others about the extent of the money at stake or the risks taken.
The bank accounts of family members will sometimes be accessed, jewellery and household goods pawned, money taken from employers or money accessed on credit cards or overdrafts – all for the purposes of gambling.
Significant relationships start suffering severely, with marriages often ending in divorce and relationships breaking up. Jobs are often lost and studies interrupted or ended. Often others are relied on to help the gambling addict out of a desperate financial situation.
Family relationships suffer greatly when the breadwinner is a gambling addict. There is loss of trust, worry, despair and fear. Characteristically there is also a lack of funds for family activities and a general atmosphere of tension and anxiety in the family home.
The gambling addict often has fantasies about the great life of luxury easy and quick money will buy for him or herself, family and friends. Sadly, this is seldom realised as most winnings are gambled away again.
BORDERLINE PERSONALITY DISORDER
Borderline personality disorder (BPD) is a condition characterized by difficulties in regulating emotion. This difficulty leads to severe, unstable mood swings, impulsivity and instability, poor self-image and stormy personal relationships. People may make repeated attempts to avoid real or imagined situations of abandonment. The combined result of living with BPD can manifest into destructive behavior, such as self-harm (cutting) or suicide attempts.
People with BPD experience wide mood swings and can display a great sense of instability and insecurity. Signs and symptoms may include:
- Frantic efforts to avoid being abandoned by friends and family.
- Unstable personal relationships that alternate between idealization—“I’m so in love!”—and devaluation—“I hate her.” This is also sometimes known as “splitting.”
- Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships.
- Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, substance abuse or reckless driving.
- Suicidal and self-harming behavior.
- Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.
- Chronic feelings of boredom or emptiness.
- Inappropriate, intense or uncontrollable anger—often followed by shame and guilt.
- Dissociative feelings—disconnecting from your thoughts or sense of identity, or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.
Borderline personality disorder is ultimately characterized by the emotional turmoil it causes. People who have it feel emotions intensely and for long periods of time, and it is harder for them to return to a stable baseline after an emotionally intense event. Suicide threats and attempts are very common for people with BPD. Self-harming acts, such as cutting and burning, are also common.
The causes of borderline personality disorder are not fully understood, but scientists agree that it is the result of a combination of factors:
- While no specific gene has been shown to directly cause BPD, studies in twins suggest this illness has strong hereditary links. BPD is about five times more common among people who have a first-degree relative with the disorder.
- Environmental factors.People who experience traumatic life events, such as physical or sexual abuse during childhood or neglect and separation from parents, are at increased risk of developing BPD.
- Brain function.The way the brain works is often different in people with BPD, suggesting that there is a neurological basis for some of the symptoms. Specifically, the portions of the brain that control emotions and decision-making/judgment may not communicate well with one another.
Bipolar disorder is a chronic mental illness that causes dramatic shifts in a person’s mood, energy and ability to think clearly. People with bipolar have high and low moods, known as mania and depression, which differ from the typical ups and downs most people experience. If left untreated, the symptoms usually get worse. However, with a strong lifestyle that includes self-management and a good treatment plan, many people live well with the condition.
With mania, people may feel extremely irritable or euphoric. People living with bipolar may experience several extremes in the shape of agitation, sleeplessness and talkativeness or sadness and hopelessness. They may also have extreme pleasure-seeking or risk-taking behaviors.
People’s symptoms and the severity of their mania or depression vary widely
A person with bipolar disorder may have distinct manic or depressed states. A person with mixed episodes experiences both extremes simultaneously or in rapid sequence. Severe bipolar episodes of mania or depression may also include psychotic symptoms such as hallucinations or delusions. Usually, these psychotic symptoms mirror a person’s extreme mood. Someone who is manic might believe he has special powers and may display risky behavior. Someone who is depressed might feel hopeless, helpless and be unable to perform normal tasks. People with bipolar disorder who have psychotic symptoms may be wrongly diagnosed as having schizophrenia.
- To be diagnosed with bipolar disorder, a person must have experienced mania or hypomania. Hypomania is a milder form of mania that doesn’t include psychotic episodes. People with hypomania can often function normally in social situations or at work. Some people with bipolar disorder will have episodes of mania or hypomania many times; others may experience them only rarely. To determine what type of bipolar disorder people have, doctors test how impaired they are during their most severe episode of mania or hypomania.
Although someone with bipolar may find an elevated mood appealing—especially if it occurs after depression—the “high” does not stop at a comfortable or controllable level. Moods can rapidly become more irritable, behavior more unpredictable and judgment more impaired. During periods of mania, people frequently behave impulsively, make reckless decisions and take unusual risks. Most of the time, people in manic states are unaware of the negative consequences of their actions. It’s key to learn from prior episodes the kinds of behavior that signal “red flags” to help manage the illness.
- Depression produces a combination of physical and emotional symptoms that inhibit a person’s ability to function nearly every day for a period of at least two weeks. The level of depression can range from severe to moderate to mild low mood, which is called dysthymia when it is chronic.
The lows of bipolar depression are often so debilitating that people may be unable to get out of bed. Typically, depressed people have difficulty falling and staying asleep, but some sleep far more than usual. When people are depressed, even minor decisions such as what to have for dinner can be overwhelming. They may become obsessed with feelings of loss, personal failure, guilt or helplessness. This negative thinking can lead to thoughts of suicide. In bipolar disorder, suicide is an ever-present danger, as some people become suicidal in manic or mixed states. Depression associated with bipolar disorder may be more difficult to treat.
- The chances of developing bipolar disorder are increased if a child’s parents or siblings have the disorder. But the role of genetics is not absolute. A child from a family with a history of bipolar disorder may never develop the disorder. And studies of identical twins have found that even if one twin develops the disorder the other may not.
- A stressful event such as a death in the family, an illness, a difficult relationship or financial problems can trigger the first bipolar episode. Thus, an individual’s style of handling stress may also play a role in the development of the illness. In some cases, drug abuse can trigger bipolar disorder.
- Brain structure. Brain scans cannot diagnose bipolar disorder in an individual. Yet, researchers have identified subtle differences in the average size or activation of some brain structures in people with bipolar disorder. While brain structure alone may not cause it, there are some conditions in which damaged brain tissue can predispose a person. In some cases, concussions and traumatic head injuries can increase the risk of developing bipolar disorder.
Dual diagnosis is a term for when someone experiences a mental illness and a substance abuse problem simultaneously. Dual diagnosis is a very broad category. It can range from someone developing mild depression because of binge drinking, to someone’s symptoms of bipolar disorder becoming more severe when that person abuses heroin during periods of mania.
Either substance abuse or mental illness can develop first. A person experiencing a mental health condition may turn to drugs and alcohol as a form of self-medication to improve the troubling mental health symptoms they experience. Research shows though that drugs and alcohol only make the symptoms of mental health conditions worse.
Abusing substances can also lead to mental health problems because of the effects drugs have on a person’s moods, thoughts, brain chemistry and behaviour.
About a third of all people experiencing mental illnesses and about half of people living with severe mental illnesses also experience substance abuse. These statistics are mirrored in the substance abuse community, where about a third of all alcohol abusers and more than half of all drug abusers report experiencing a mental illness.
Men are more likely to develop a co-occurring disorder than women. Other people who have a particularly high risk of dual diagnosis include individuals of lower socioeconomic status, military veterans and people with more general medical illnesses.
The defining characteristic of dual diagnosis is that both a mental health and substance abuse disorder occur simultaneously. Because there are many combinations of disorders that can occur, the symptoms of dual diagnosis vary widely. The symptoms of substance abuse may include:
- Withdrawal from friends and family.
- Sudden changes in behaviour.
- Using substances under dangerous conditions.
- Engaging in risky behaviours when drunk or high.
- Loss of control over use of substances.
- Doing things you wouldn’t normally do to maintain your habit.
- Developing tolerance and withdrawal symptoms.
- Feeling like you need the drug to be able to function.
The symptoms of a mental health condition also can vary greatly. Knowing the warnings signs, such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide, can help identify if there is a reason to seek help.
Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and healthy lifestyle choices, many people can and do get better.
Some will only experience one depressive episode in a lifetime, but for most, depressive disorder recurs. Without treatment, episodes may last a few months to several years.
Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day, and typically for more than two weeks. Common symptoms include:
- Changes in sleep
- Changes in appetite
- Lack of concentration
- Loss of energy
- Lack of interest in activities
- Hopelessness or guilty thoughts
- Changes in movement (less activity or agitation)
- Physical aches and pains
- Suicidal thoughts
Depression does not have a single cause. It can be triggered by a life crisis, physical illness or something else—but it can also occur spontaneously. Scientists believe several factors can contribute to depression:
- Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These changes may lead to depression.
- Genetics. Mood disorders, such as depression, tend to run in families.
- Life circumstances. Marital status, relationship changes, financial standing and where a person lives influence whether a person develops depression.
- Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
- Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) can mimic depressive disorder. Some medications can also cause symptoms of depression.
- Drug and alcohol abuse. Approximately 30% of people with substance abuse problems also have depression. This requires coordinated treatment for both conditions, as alcohol can worsen symptoms.