I have been noticing a growing trend in my practice where a lot of patients who are suffering from depression, anxiety, complicated grief or unresolved trauma use addiction as a way of coping. Addiction can be defined as a state of feeling stuck to something, whether it be a substance, a thought or behaviour, regardless of its negative impact on the relevant person’s life or the life of others.
Addiction does not exist in a void; biological, psychological, emotional, social, and even spiritual factors play a key role in the development of addictive patterns. However, the potential of drugs to be addictive is deeply rooted in an inability to deal with emotions, feelings of emptiness/meaninglessness and is increased by pre-existing vulnerability and stress.
Even the type of substances/object that a person was addicted to was usually telling of the type of issues they were dealing with for example I noticed that many of my patients who highly valued materials success and have hoarding disorders report having challenges in relating to people around them and had parents that were not nurturing. They appeared to adopt materialistic values to cope with loneliness.
Anxiety was associated both with alcohol consumption and drug use to cope with stress. Marijuana was commonly used to feel calmer and reduce the self-doubting. Patients who were unconformable with confrontation and prone to feeling overwhelmed attempted to detach themselves from psychological distress by using hallucinogens as a means of avoiding painful emotions and self-awareness.
Anxiety, fear of not feeling good enough and a desire for perfection also contributed to eating disorders. A critical mother was usually part of that story as well. Weight related concerns appeared to be a defensive method to compensate for feelings of helplessness, insignificance, and vulnerability.
People who cannot find or receive love and have lost meaning in their lives, need to find substitutes and that’s where addictions come in. Usually, as patient’s moods lift and they reconnect with people around them, find meaning in their lives and feel understood, the desire for substances reduces and they find healthier ways to cope. Johann Hari aptly summarises this observation and said that the opposite of addiction was not sobriety but connection.