Addiction: What’s stress got to do with it? by Dr. Susanne Fogger

Fogger_Suzanne_webOn the surface, stress, distress and addiction might not seem related, yet for some people, stress/distress/pain are the underlying motivation for substance use.

It is important to identify and raise concern around certain stressors. Awareness and learning or practicing stress management skills can deter overuse/misuse of substances such as alcohol, tobacco, caffeine and opioids.

It’s important to remember that no one chooses to develop an addiction. The initial use of a chemical may be related to managing stress, often the person was attempting to cope with the stressors of a modern world in the quickest way possible.

Stress as a force in our lives is neither good nor bad. It is a fact of life. Han Selye, back in the 1950s, was the first scientist to focus on stress and its consequences, studying good stress and the more toxic and physiologically changing negative stressors or distress. Our bodies respond to stress as part of our survival mechanism, pumping adrenalin so we may either fight or run away. This stimulation creates a biologic cascade where anxiety is the primary emotion. While anxiety is a useful emotion when it is harnessed to prepare for battle or run away, modern life seldom presents an occasion where these are an option. Instead, we stay and deal with the day-to-day pressures. Such stress over a prolonged period diminishes the body’s ability to respond, and it starts to show signs of exhaustion through muscle tension, upset stomach, diarrhea or constipation, increased heart rate, palpitations, chest pain as well as other symptoms of distress.

Drugs work quickly. For someone seeking quick escape from their stress or anxiety, substances such as tobacco, caffeine, alcohol, cannabis and opioids can produce near instant relief. The tension and stress seem to melt away, and the pleasure of not feeling the stress, negative emotions or anxiety is the reward of use. Sometimes this can be as simple as choosing to have a drink after a long week. And while occasional use of any substance is not an addiction, and even heavy use is not an addiction, the line between casual use and addiction is crossed when the person’s brain becomes dependent on use. It begins to repeatedly believe “I need to get XX to help me relax, I have to have XX, only XX will make me feel better.”

This feeling comes from how a body’s natural neurochemicals respond after substance use. The substance use provides quick relief, making use more appealing. Eventually, the body is less attuned to natural neurochemical response. The brain seeks the artificial, neurochemical response from a substance. In turn, activities that used to be pleasurable such as attending a ball game, are not as attractive as the drug. Eventually, the person may find they need the substance more and more just to feel normal — not to get high, not to relax, but just to feel normal.

This leads to the hallmark symptoms, or “4 C’s” of addiction: Craving, compulsive use, loss of control and continued use despite consequences.

How is recognizing distress useful in recognizing addiction? Recognition of stressors and their effect is necessary to consciously alter outcomes. By recognizing stress, we can utilize other available forms of relief — ones that do not involve substance use. Meditation and exercise are two methods that can decrease stress, reduce muscle tension and help the person feel more in control of their environment. While they do not change the stressor, they change how the individual experiences and perceives the stressor. By experiencing some relaxation and calming, they become refreshed and ultimately more equipped to handle the stressor.

Exercise of any type has been shown to produce these positive effects in the face of stress. It can be as simple as walking in a park or safe area, participating in a gentle yoga practice or going on a run. Exercise helps to encourage the brain to produce natural endorphins (similar to what an opioid does), making the person feel better and less stressed. Conscious choice to manage how one copes with stress can go a long way in reducing the chronic effect of distress, and lessen the potential for harmful coping mechanisms.

What about breaking the habit? If someone is trying to cease substance use as a stress reliever, it is noteworthy that stopping use requires the individual to make a commitment to themselves to stop. It is the self-commitment that, with support, can help people get free of their addiction. Living without the substance can be complicated because it is an adjustment to learn healthier ways to manage stress, especially as those methods can seem less immediately gratifying. Life does not stop being stressful, just how one handles the stress changes.

Managing daily stress is just that. One must manage life and stress on a one-day-at-a-time basis. Plan how you are going to de-stress daily. Consciously choose to take care of yourself daily.  A change in thinking can change how one perceives stress. With support, people can recognize thinking that is not serving them. Stress management skills require a conscious decision to change how one faces the daily grind.

This is just a brief introduction to the relationship of stress to addictions. When it comes to substance use, it is important to note what happens when using a substance. An ongoing dependence of any kind on a drug or alcohol to change one’s mood is a red flag. It is important to seek out other options in addition to or instead of a substance to feel better, chill out and be social. Seek friends who want to do activities without substances. It may take a bit of practice, but it is worth the effort and can help prepare you to be more resilient in the face of stressors in the future.

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