The face of addiction: Differentiating between abuse and dependence.

 

 

 

 
Most people know the textbook example of addiction as the vicious, consuming black hole that can ultimately destroy one’s family, career, mental and physical health, and severely compromise the quality of life. Indeed, many of us have struggled with addiction or have encountered someone who has. Because of all the attention this disorder generates, it is easy to make sound judgment, to assume that a heavy drinker is an alcoholic or a cocaine user is a drug addict. Yet, as we will see, the criteria for diagnosing true substance dependence (addiction) is complex. 
addicthelp.org
 
First of all, not everyone who indulges in their vices, whether it be smoking, drinking, drugs, gambling, shopping, etc. is considered dependent. People who repeatedly continue their self-destructing behavior, despite recognizing how the habit is negatively affecting their quality of life, are engaging in substance abuse. They may face serious ramifications, such as legal trouble, financial struggles, problems at home, etc. However, unlike those with substance dependence, they do not exhibit substance tolerance or withdrawal symptoms.
 
Substance abuse however can transcend into substance dependence. The theories about this spiral into addiction are both controversial and plentiful: neurological disruptions regarding levels of serotonin and dopamine, genetics, environmental cues, etc. Still, it should be noted that abuse does not always lead to dependence. Many people go through an “experimental stage,” especially during their teenage and young adulthood years, and they do not suffer from addiction later on.
 
For people with substance dependence, however, the user acquires tolerance to the substance, therefore requiring a dosage increase to achieve the same intoxication or altered state. Likewise, the individual is deemed unsuccessful in reducing or quitting from the substance, despite his or her willpower or desire to do so. Withdrawal symptoms, such as hangovers, headaches, tremors, nausea, and shakes, occur during periods of abstinence. When the individual engages in the substance, he or she often often intakes more than intended and a “loss of control” feeling is common. Individuals may go to extreme measures (theft, lying, spending inordinate amounts of money or time) to find the substance when experiencing strong cravings for it.
 
 
It is critical to understand that the two mental illnesses are not interchangeable. In other words, a person cannot have both diagnoses at the same time. For users to be considered substance dependent, they must have already surpassed the stage of substance abuse. Furthermore, the necessary course of treatment action is different. Treatment plans for substance abuse often promote learning the appropriate strategies and techniques to reduce environmental and social triggers for cutting back intake. Some, but certainly not all, individuals choose a path of sobriety at this point. While people may seek professional help at this point, others are able to quit or cut back and improve their quality of life on their own. However, for people who are substance dependent, the treatment tends to be more aggressive. Recovery programs, such as the popular Twelve Steps and rehabilitation centers, usually advocate full sobriety. Most individuals must seek professional help in order to achieve this.
 
It should also be noted that the amount and frequency of abuse does not necessarily determine dependence. In fact, the face of addiction is difficult to detect, simply because some people engage in their substances secretly or do not fit the “addict” stereotype. Others may go through stages of heavy use followed by stages of abstinence or steady use. For instance, a college student who goes out to the bars and staggers home drunk every night for one week cannot automatically be deemed an alcoholic. For one, dependence patterns must have been evident for at least twelve months. This rules out most situational factors and variables that can lead to substance abuse. Also, we must consider the context. Is this drinking binge an isolated event? Did an emotional event, whether happy or sad, just happen?  Let’s examine an elderly woman who drinks a glass of wine a night to calm her nerves. A few months, noticing she is feeling more stressed, she starts drinking two glasses. Sometimes, on particularly bad nights, she finishes the bottle. Is she substance dependent? If she finds that she cannot curtail her habit, despite a longing to quit and the withdrawals provoke a sense of anxiety and relentlessness, she may be developing a problem.
 
To conclude, we are quick to throw around the terms like addiction and addict, but automatic labeling can be harsh, false, and detrimental to a person who is not actually suffering from dependence. While there is a plethora of research discussing the proposed models of addiction, it is important to continue studying why most people engage in substance abuse at some point and why only some of them transcend into substance dependence. This knowledge can help prevent and raise awareness about the addiction epidemic.
 
References:
All information can be retrieved from the DSM-IV-TR or behavenet.com; substance abuse and substance dependence.

 

 

 

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Why are we so good at failing?

 

 

 

 
Failure is a necessary component of life, a circumstance that can only be avoided when humans remain stagnant. Since life is constantly changing and we are constantly evolving, everyone encounters failure. It happens when we struggle, when we cannot understand, when we exhibit weak performance. Failure, in many senses, is healthy, as we grow and learn from it. The negative feelings that stem from failure are imperative in motivating us to continue seeking progress.
 
What happens, however, when an individual continuously fails? When he or she has the right tools and awareness in knowing how to succeed, yet disregards them time and time again? We coin this action as sabotage, and we see it  frequently in all walks of human behavior. Sabotage is what dieters do when they keep eating extra helpings of dessert, despite knowing the importance of exercise and proper nutrition. Sabotage is what students who decide to party the week during final exams do instead of study.
 
 
The self-fulfilling prophecy theorizes that one’s actions tend to correspond with their beliefs. What does that mean? Let’s say, after a bitter divorce, a newly-single woman experiences an unsuccessful dating streak. Disappointed with the quality of her suitors, she concludes men are selfish assholes. What happens, then, when she goes out on her next date? The woman’s guard will be strong, her suspicions high, and her faith? Well, naturally, that will be at an all-time low. This new man hardly stands a chance against her powerful opinion, seeing as she is already expecting him to disappoint her. Therefore, in order to avoid another letdown, she will likely fit and adapt her criteria to confirm her beliefs. In reality, the woman may be blaming external variables for her dating struggles (low self-esteem, meeting men in the wrong places, an inability to commit, pining over an ex, etc.).
 
Still, the question remains: why do we fail at the very things we try to avoid failing the most?
 
Surely, it cannot just be attributed to a mere absence of willpower. Ask anyone who fails at an important task, and he or she will often delve into a lengthy explanation about how hard they are trying and how much they seek success.
What’s more likely? We fail because we fear the absence of failure.
 
How does that make sense? When we set goals and fail to achieve them, we become habituated to the adverse emotion. The failure keeps us contained, keeps us square in place. And many times, we cannot actually visualize what the success will feel like. Moreover, we mistake what the success will feel like.  For instance, take someone who has sunk into the dark abyss of financial debt. Despite a strong desire to save money, he spends his paychecks frivolously, draining his bank accounts and racking up insurmountable credit card bills. Why?
 
Reason #1: Behavioral addiction model (in a very simple manner)
 
Debt (creates anxiety)–> which causes heightened feelings of stress and more anxiety –> which leads to a need to relieve the anxiety and feel better (spend money)  –> which leads to heightened feelings of guilt, shame, anger
Addiction is a vicious, complicated cycle, and this is just a simplified  theory of its manifestation.. With addiction, the things that make us the unhappiest are consequently the same things that make us the happiest. Thus, the cycle repeats, and eventually, the habituated behavior may filter into other aspects of life (relationships, work, family).
 
 
2. Avoidance: The debt (or any other evidence of “failure”) is actually masking a much larger issue. In this case, finance trouble can indicate an insatiable need to fit in with others, career dissatisfaction, or underlying depression. The surface problem (debt) shields the more painful, rooted issues. This theory is popular, because it is so applicable. For instance, those who struggle with weight problems may blame their body size for appearance dissatisfaction or loneliness. They may falsely conclude that if they just shed the extra weight, these “other problems” would diminish. Yet, these problems are much more complex (self-esteem issues, shyness, difficulty in making relationships, etc.). These individuals may subconsciously sabotage their diets as a means of avoiding the real problems at hand. Therefore, they can blame these issues on their weights, rather than on their core personalities.
 
3. Mistaken priorities: Yes, repeated failure can stem from a lack of motivation, but in doing so, the person often does not even recognize this. Often seen in high-pressure situations, such as academic or athletic performance, people may subconsciously “mess up.” This is usually an unconscious mechanism, but it is most likely to happen when the individual knows he or she is expected to succeed at a given task. This expectation stems from societal and internal internal cues. For example, while nobody wants to fail an exam, a person may subconsciously pair success with greater pressure to study harder, spend more time focusing on school, or take more advanced courses in that subject. While the individual knows failure is not desirable, it may actually be more so than those other options.
 
 
4. Unachievable goals: Failure, of course, can happen when the expectations are too high. For instance, someone who has never held a job is unlikely to find a full-time career in a week, just as a longtime couch potato should not be disappointed when he cannot sculpt six-pack abs after one workout. Yet, we humans naturally seek short-term gratification, hence our uncanny ability to seek out the most convenient shortcut available. We want instant results and we stubbornly hold out on the belief that “once-in-a-lifetime” opportunities will  come our way and bring us success. This, of course, is an open invitation for continuous failure. A rushed, all-or-nothing mantra tends to result in higher levels of quitting, frustration, and endless restarting. Therefore, an individual will probably take much longer to succeed compared to someone who approaches their goals in a gradual but reasonable fashion.