Stress and Addiction

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Studies show stress and addiction are linked. Stress impacts us all in some way. We live in a world that moves at a million miles a second. So, when it comes to the topic of ‘stress’, it is certainly something that everyone could relate to as it is unavoidable, whether it is financial, school, relationships, or internal stress/ conflict one is having with themselves. But what is stress and what happens to our bodies when we get stress?

‘Stress’ is an evolutionary process that happens when the body perceived threats being psychological, biological or social.  It demands the body prepares itself by pupils dilating, rising heart rate and blood sugar for the muscles to respond through ‘fight or flight’. Then after the stressor has passed the body can then bring itself back to its equilibrium state (back to normal). Sometimes we are unaware of what is causing us stress, therefore stressors can be categorized into three categories:

  1. Psychological stressors – anxiety, depression, emotion regulation, insomnia etc.
  2. Biological stressors – health-related issues, illnesses etc.
  3. Social stressors – workplace, relationships, family etc.

Is stress ever good?

It is important to point out that, the reason we humans undergo stress does have some benefits. Studies have shown that a certain amount of stress can boost our productivity and helps us perform better. It may give you an edge when cramming for a test, for example. It could even help you perform under pressure in a sporting event, or in a work environment.

However, the negatives of longterm stress outweigh the positives.

When we are exposed to stress for an extended amount of time it becomes more problematic to our health and psychological well-being. It can also make us more likely to form addictions and to relapse.

What happens to the body when we get stressed?

Now we will take a look further into the mechanics of stress on our bodies. The core anatomical structures of the stress system are the amygdala, the hypothalamus, and the prefrontal cortex, in which these structures activate the Hypothalamus-Pituitary-Adrenal (HPA) axis. The primary function of the HPA axis is to regulate stress responses. The process begins with the initial stressor activates the amygdala, which sends the message to neurons in the hypothalamus. Then the pituitary gland releases the corticotropic hormone (CRH) and activates the HPA. The CRH also stimulates the releasing of the adrenocorticotropic hormone (ACTH), which consequentially boosts the release of cortisol (stress hormones) from the adrenal cortex into the bloodstream (Chrousos & Gold, 1992). Aforementioned of the fight or flight, it is a result of the HPA axis on the sympathetic nervous system (fight or flight – rising heart rate).

Then after the stressor has passed the system calms itself down which is when the parasympathetic nervous system activates (calming heart rate and resting).

Additionally, stress can be divided into acute stress (short term) and chronic stress (long term). And as mentioned, the body releases stress hormones which are toxins and our body has to flush them out, but when we get stressed for an extended amount of time the body would not have enough time and resources to restore itself. Which over time can have a significant effect on our bodies and make us more prone to certain illnesses such as diabetes and coronary heart disease. 

Now that we know how stress functions, how does stress make addiction more complex?

Well, over the years many pieces of research suggested a link between stress and vulnerability to addiction, whether it be drugs or alcohol. For example a study by Gorders (2002), where they looked at the HPA axis and cocaine self-administration in the laboratory rats. The brain has a reward circuit, which allows us to feel pleasure and when we do the brain releases neurotransmitters. One of them is called ‘Dopamine’. Dopamine allows us to enjoy tasks that are rewarding such as food and sex.  When we take those actions, by the body releasing Dopamine, our body tells us they are good. That positively reinforces our behaviors.

What happens to our brains when we are on drugs?

Drugs change the way our brains react. For example during cocaine use, the brain is highjacked by the drug, as the drug blocks the normal process of neurotransmission, causing prolonged exposure of Dopamine in the brain which then produces a sense of euphoria. This can become a problem as the next time the brain tries to release dopamine on its own without drug administration, there would be less Dopamine and as a result, causing us to feel less happy, a low mood and even anxiety… This is not enjoyable and can increase our cravings for drugs.

Why would being stressed make me want to take drugs?

Linking this back to the aforementioned experiment by Goeders (2002): In this experiment, they compared normal rats and rats that were administered stress hormones: corticosterone (similar to cortisol). The purpose of this is to mimic the human body under stress.

The stress hormone appears to increase sensitivity to low doses of cocaine. This tells us that when we do use drugs while we are under stress, we become more prone to addiction as the body becomes more sensitive to drugs. Therefore, if an individual is sensitive to stress and feels inadequate to take control over stressors/ stressful situations; then it is suggested that they would be likely to engage in substance abuse. Further examples showed unhappy marriage, harassment, dissatisfaction at workplace or employment increases alcohol use (Jose et al., 2000, Vasse et al., 1998); also after traumatic life events to alleviate pain, anxiety and depression, studies reported higher substance abuse such as alcohol, cocaine, and opioids (Volpicelli et al., 1999).

Relapse risks: Stress and addiction

Research further suggested a link between stress and relapse in addiction. Being stressed can act as a trigger.  Whether it is a psychological, physical, social triggers. An experiment has shown that simply a presentation of stress-related imagery of potent events can provoke cravings and drug-seeking in humans which may result in relapse (Shinha et al., 2000). Therefore it is crucial to identify what events we have encountered in our lives that are affecting us to this day (e.g. trauma) and addressing those. If these are triggering us into cravings and substance seeking behaviors, being aware of them will help to avoid relapsing. The understanding of our addiction can act as a key to our own understanding of ourselves, which can make a difference to our own recovery.

Managing addiction through stress

At Dara Rehab Thailand, we offer a variety of tools and resources for our clients. These include psychoeducational classes, for example through Cognitive Behavioral Therapy (CBT) and classes on relapses prevention. This has been demonstrated to be very informative and proven to be effective. Furthermore, we also offer meditation, massage, mindfulness and yoga. These activities have shown to be beneficial as relaxation techniques and help in stress reduction. This combined approach, can help to pave your way to recovery.

References 

Goeders (2002) https://www.ncbi.nlm.nih.gov/pubmed/12023504

Withdrawals https://americanaddictioncenters.org/cocaine-treatment/withdrawal

Shinha et al. (2000) https://www.ncbi.nlm.nih.gov/pubmed/11057517

Cocaine and reward system in brain youtube.com/watch?v=yeAN26kJuTQ

https://www.psychologytoday.com/intl/blog/science-choice/201705/stress-and-addiction

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.325.8527&rep=rep1&type=pdf

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Monica Howells

Monica joined the DARA Rehab team in July, 2019, after interning the year prior. Her role entails supporting the clients between their therapy sessions. She first became interested in addiction after studying psychology at Bangor University in Wales. Being half Thai and half British gives Monica a unique appreciation for the international environment of diverse clients. She particularly enjoys learning about different cultures and how they impact addiction recovery. Ultimately she finds her work extremely rewarding. Her goal is to help people understand the psychological aspect of their addiction, to enable them to better understand their behavior to help them with their recovery.

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