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xhan's picture

In order to describe the deeper issues involved with depression, I think it’s important to define what addiction really is. Addiction is a chronic, often relapsing brain disease that causes compulsive substance seeking and use despite harmful consequences to the individual who is addicted and to those around them. Addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain. It is a behavioral syndrome in which substances impede one’s ability to exert control over the impulse to use drugs despite adverse consequences. This is the defining characteristic of addiction. There is a slight difference between substance abuse and addiction. Substance abuse means using a substance in the wrong way. Addiction begins as abuse, but can abuse a substance without having an addiction.
People can become addicted to all types of substances-some are more addictive than others. For example, drugs like crack or heroin are so addictive that individuals may become addicted after using it once or twice. People who suffer from addiction may experience psychological or emotional cravings. They may feel overcome by the desire to have a drug and may even lie or steal to get it. This leads me to question the extent to which these people are truly themselves, and the extent to which they are someone else: someone whose brain is controlled by an external stimulus.
It is also interesting for me to realize that people can get addicted to virtually anything-from riding a bicycle, eating, sleeping, to more “harmful” substances such as drugs and alcohol. However, I now realize that individuals who are addicted to conventionally harmless activities such as eating and sleeping, may feel the end to succumb to the uncontrollable urge to sleep and eat and thus be at risk for addiction. I realize that, it is not so much the substance that poses a threat, but rather our perception, level of dependency of and on that particular substance. So for example, although eating is not considered a life-threatening activity(rather it is a substance that is essential for survival)an habitual over-consumption of food over a long stretch of time can be very well be a sign of addiction.
Research has shown that pleasure, a “competence or function of the reward and motivation circuitries that are imbedded in the central nervous system(CNS) is strongly correlated to addiction. Neurobiologists have known for a long time that the euphoria induced by substance abuse, sex or other things we enjoy arises because al these factors boost the activity of the brain’s pleasure and award systems.
It is not that “feeling good’ is a bad thing, but the things we do inorder to “feel good”, can be bad. Although this may be an over-simplification to a very complex problem, I think this is a habit hat addicts are prone to. According to researchers Esch and Stefano, “Immediately after substance usage, feelings of pleasure euphoria, and rush predominate. This is followed by induction of craving with accentuated amygdala and nucleus accumbens activity. The craving grows even as the euphoria wears off. Moreover, the initial drug exposure triggers tolerance, and in the drug’s absence, discomfort that only more drug can cure. Tolerance and dependence are related to a suppression of the brain’s reward circuitry that, ironically, is a key feature of frequent and continued drug abuse. Thus, the reward system fails to give rewards in the end.”
To me, this poses a great deal of discomfort and distress. First of all this implies that addicts seek immediate gratification and do so above all means. Instead of facing the underlying problem, individuals continually mask problems by resorting to drugs. Perhaps for some individuals, the anxiety, depression, loneliness, unhappiness are so severe that they cannot immediately face these issues, and must look for an external stimulus to distract themselves. In the process of exploring these substances however, one might become addicted.
Although treatment for addiction is difficult, researchers find that belief in a doctor or therapist may be an incentive for the patient to be treated. Since belief has an emotional component in that the brain’s motivation and reward circuitry(linked to limbic system and emotional memory) will be reinforced with a positive emotional valence attached to the person, idea, or thing one believes in. This emotionalized memory, potentially accompanied by pleasant emotions(‘somatic markers’) strongly influences an individual. Personally, I believe that this would be a great way for individuals to go about treatment, but I have come to learn that what works in theory-isn’t always very practical. First of all it may be difficult for individuals to find someone or something they care about if they are already feeling lonely and depressed, secondly, sometimes that “loved” someone can cause greater pressure for the individual, and the individual may want to escape that pressure by using substances and persist in using these substances t the onset of guilt. This guilt can trigger substance use in which the cycle repeats itself, and this repeated substance-use can turn into an addiction.
Although researching this topic has made me more aware of the symptoms and causes of addiction, I’m still every bit as uncertain as I was initially on how to treat addiction.











Works Cited




Paul Grobstein's picture

addiction and therapy

"it is not so much the substance that poses a threat, but rather our perception of and level of dependency  on that particular substance"

This seems to me a useful way to think about addiction.  And, perhaps, a useful way to think about treating it as well?  If the problem is people coming to see a single aspect of their lives as all important, maybe what is needed is to help them discover alternatives, so they don't put all their eggs in one basket?  I wonder what either this characterization of addiction or of therapy corresponds to in brain activity?