Psychological Dependence

Psychological dependence refers to a state where you feel a strong emotional or psychological need to keep using a substance, despite any physical symptoms. It is distinct from physical dependence, which involves experiencing withdrawal symptoms when the substance is discontinued. Psychological dependence, on the other hand, is more about the mental cravings and urges to use drugs or engage in certain behaviors. The concept of psychological dependence refers to the emotional and mental aspects involved in the development and recovery of a substance use disorder or process addiction. It highlights that emotions and thoughts are closely linked to physiological processes, emphasising that there is an interconnectedness between our psychological state and physical body in the context of addiction.

Psychological addiction is often mistakenly thought to be the same as physical addiction but they are distinct. Psychological addiction is characterised by altered thinking and behaviour patterns, unlike physical addiction which involves the body’s reliance on a substance. Effective addiction treatment must address the psychological aspect to fully support a person’s recovery from the substance or process addiction.

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Psychological and Physical Dependence

Physical dependence is when the body relies on a substance to function, leading to physical withdrawal symptoms if the substance is stopped. This can occur even with necessary medications like blood pressure drugs. In contrast, psychological dependence involves emotional and mental preoccupation with a substance. For instance, if you regularly drink coffee, physical dependence is evident if skipping it causes a headache. However, if you also crave the taste, smell and routine of coffee-making, it indicates both physical and psychological dependence.

Psychological dependence alone might occur in situations where a substance like an energy drink, is used occasionally for specific purposes (e.g., a big presentation). Missing it may cause panic or fear due to reliance on its effects for performance, which is a sign of psychological withdrawal.

Withdrawal can be both physical and psychological.

While physical withdrawal from substances like alcohol or opioids can be severe, psychological withdrawal can include symptoms like anxiety or mood swings. Post-acute withdrawal syndrome (PAWS) is an example of prolonged psychological withdrawal, potentially lasting weeks or months with symptoms like insomnia, mood swings, cognitive issues and difficulties in personal relationships. These symptoms can fluctuate in intensity, often worsening during stressful periods.

The roots of psychological dependence can be traced back to researchers’ efforts to better understand addiction. They recognised that in some cases, individuals would continue using substances long after physical withdrawal symptoms had subsided. Through extensive studies, it became clear that the powerful hold of addiction often goes beyond mere physical effects.

Psychological dependence is often associated with patterns of compulsive drug seeking and drug use. Addiction can hijack the brain’s reward system, reinforcing the desire for the substance by releasing chemicals that generate pleasurable feelings. This reward-seeking behaviour becomes deeply ingrained making it difficult to break free from the psychological grip of addiction.

Recognising psychological dependence is essential for effective addiction treatment. Addressing the underlying emotional and psychological factors that contribute to addiction is fundamental for obtaining a sustainable recovery. Therapies such as cognitive-behavioural therapy (CBT) and motivational interviewing can help individuals understand their triggers, develop coping mechanisms and build resilience against cravings.

Causes of Psychological Dependence

Psychological addiction can arise from various causes including trauma, mental health disorders, peer pressure and an unhealthy environment. Trauma, particularly PTSD, is a major factor, often leading individuals to self-medicate with addictive substances. Studies, such as those by Professor Wim Van den Brink and others, highlight the high prevalence of trauma, including sexual abuse, among those with substance addictions. Mental health disorders like depression, ADHD and anxiety are also significant contributors to psychological addiction. Peer pressure and environmental factors play a important role, especially in contexts where substance use is a learned behaviour, such as in families with a history of addiction or in social circles where drug use is common. These factors collectively contribute to the development of psychological addiction.

Crossover Between Behavioural and Substance Addictions

Psychological addiction is marked by several distinct characteristics:

  • Cravings and Obsessive Thinking
    Individuals with this addiction frequently face intense cravings and are often preoccupied with thoughts about their addictive behaviour or activity. These cravings can be triggered by various external or emotional cues.
  • Loss of Control
    Those suffering from psychological addiction typically struggle to control or limit their involvement in the addictive behavior. Despite efforts to reduce or stop, they tend to repeatedly succumb to their urges.
  • Escalation of Behavior
    Over
    time, a tolerance may develop, necessitating more frequent or intense participation in the addictive behaviour for the same level of satisfaction or pleasure. This often leads to an increase in the addictive behaviour, reinforcing the addiction further.
  • Negative Impact on Life
    Psychological addiction can severely affect different areas of one’s life, including personal relationships, work or academic performance and overall mental health. It often results in social withdrawal, financial problems and deteriorating mental health.
  • Withdrawal Symptoms
    Although less intense than physical addiction, individuals withdrawing from a psychological addiction may experience emotional or psychological discomfort, such as restlessness, irritability, anxiety or depression.

Behavioural and substance addictions, while different in their specific nature, share several critical similarities in brain function and psychological impact. Both trigger the brain’s pleasure centers, leading to intense cravings and emotional needs that overshadow rational thought. These addictions can evolve into physical dependencies with individuals experiencing similar psychological effects such as lying, cheating, anger, depression and anxiety. Treatment approaches for both types of addiction often align, encompassing detoxification, therapy and support groups, aimed at restoring balance and teaching new coping mechanisms. It’s also common for individuals to suffer from both behavioural and substance addictions simultaneously, necessitating comprehensive treatment that addresses both issues.

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    Founded in 2008, WeDoRecover has evolved from an advisory service for addiction treatment into a comprehensive provider of care, following its 2019 merger with Changes Addiction Rehab in Johannesburg. Specialising in connecting patients to top-tier addiction treatment centers in the UK, South Africa and Thailand, WeDoRecover supports individuals globally, including those from the United Arab Emirates and Europe. Accepting both South African medical aid and international health insurance our organisation facilitates access to high-quality treatment for substance and alcohol use disorders, offering individualised care that addresses the physical, mental and social needs of patients.



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    Rehab care is a good option if you are at risk of experiencing strong withdrawal symptoms when you try stop a substance. This option would also be recommended if you have experienced recurrent relapses or if you have tried a less-intensive treatment without success.

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