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Psychological Addiction

Psychological Addiction can be difficult to understand as it is sometimes combined with a physical addiction and this can cause confusion as to whether the patient continues to use the situation, activity, substance or object because of a craving caused by their mind or by their body. Doctors are still debating this gray area. However, it is important to note that in some patients the Psychological Addiction is the sole disorder, and is not combined with a physical dependency to drugs or other alcohol. It is common to think of drugs and tobacco, or heroin and cocaine as addictive, but this addiction is not entirely due to physical dependence. Addiction also results from the relationship between a patient and the object or substance. Evidence suggests that ‘neuroadaptation’ results from addictive behaviors, thereby ‘training’ the brain to want and need the substance or object, so that addiction can occur even without an ingested substance. In these cases, the patient is addicted to the feeling they get from the activity, situation or object, and while the brain chemistry does change after intake, this change is because of the emotional and mental gratification, not because of a true physical dependency.

In all cases, the patient is unable to control his/her behavior because of an overwhelming craving. These addictions can include drug and alcohol abuse, or nicotine (to which there may also be a physical addiction), food addictions like caffeine, sugar or chocolate, gambling, love or sex, and more contemporary addictions like video games, computer games and internet chat rooms. Addiction is a quantitative change in behavior patterns whereby things that once had priority in the patient’s life become less important and those less frequent behaviors now dominate the patient’s life and thinking, causing adverse biological, social, or psychological consequences.

Even in the absence of substance use, symptoms of withdrawal can occur in Psychological Addiction. For example, pathological gamblers who do not use alcohol or drugs often exhibit physical symptoms of withdrawal when they try to stop or decrease gambling behavior. Those with Alcohol Addiction may stop drinking and experience physical withdrawal for a period of several weeks. These physical cravings will stop with time as their body adjusts, but their psychological craving for alcohol may continue long after the physical withdrawal has ended. There is conflicting research about the cause of these addictions. Some doctors believe that there is genetic predisposition to addiction. Others believe that there are many factors to influence the patient’s predisposition to addiction. Social circumstances, peer pressure and the existence of other mental disorders with symptoms of low self-esteem or low tolerance for stress are all possible causes.

What are the symptoms?

The symptoms of Psychological Addiction will vary with the particular situation, object or substance to which the patient is addicted.

The following summary of symptoms applies to all Psychological Addictions:

• Craving or compulsion for object, situation or substance
• Feeling out of control, unable to stop using the substance, or object or participating in the addictive activity
• Patient is preoccupied with thoughts of the addictive substance, activity or object
• Patient feels restless and irritable when not participating in addictive activity or using the substance
• Patient will spend beyond their limits to acquire the substance or participate in the activity
• Continued use in spite of adverse effects on life, work and family
• Substance, object or activity becomes the major focus of a patient’s life to the exclusion of other activities
• Patient increases time spent participating in the addictive activity or taking the substance
• Patient becomes secretive about the activity or use of substance and hides it from family and friends
• Feeling guilty or trying unsuccessfully to stop activity or use of substance

How is it diagnosed and treated?

Doctors will use varied diagnostic techniques including a full medical examination and mental evaluation to rule out other disorders and illnesses. Depending upon the specific perceived addiction, diagnostic techniques may vary.

The following are general signs doctors will look for to diagnose Psychological Addiction:

• Inability to stop behavior in spite of severe consequences
• Mood change or altered state of consciousness after using the substance or participating in activity
• Irritability, restlessness, depression or craving when the patient tries to stop using the substance or participating in the activity
• Hiding or denying behavior
• Persistent pursuit of behavior to the exclusion of other activities and values
• Using and needing more of the substance or activity to be satisfied
• Preoccupation and persistent thoughts of substance or activity

Treatment(s) will vary for Psychological Addictions depending on the specific patient, the severity and type of addiction. The following is a summary of general treatment modalities that may be applied to Psychological Addictions:

• 12-Step models, Self-Help Groups
• Cognitive Behavioral Therapy
• Psychotherapy
• Medication as appropriate for secondary conditions like depression, anxiety: antidepressants, anti-anxiety medication

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