Dependence refers to the inability to exist without something. The inability to go on without it. The inability to act without it. When you are dependent on something, you feel bound to it in a way that no physical bond can completely recreate. And that physical dependence can be terrifying.
For many who struggle with addiction, physical dependence is a daily reality, and a debilitating illness. However, like so many illnesses, it can be treated and overcome. But to do so, it is important to understand what it is, first.
Conventionally dependence in addiction refers to physical and emotional dependence, or physical and psychological dependence. Physical dependence describes the bond a drug forms with its user through changes in the brain. Pathways are “remapped”, and what used to be exciting or fulfilling fades away in the face of the next high.
Physical and psychological dependence both achieve the same thing: an addiction, one that often causes the user harm, and makes their lives miserable. Both are characterized by the fact that when someone is dependent, they cannot stop using even if it means hurting themselves or, potentially, those around them. Turning the situation around either takes a very sobering moment (a “rock bottom”, which is never necessary for recovery) or a realization that things are getting worse before they become terrible.
While physical dependence revolves around drugs and the brain, psychological dependence is different, but the two are tightly wound. In many ways, it is the difference between the mind and the brain.
The Mind and the Brain
The human brain is highly capable of adapting. Part of that means learning very quickly to get used to uncomfortable or strange situations, if they occur repeatedly. Even in times of distress, we can learn to eventually find our balance, and adapt. That ability to adapt – and thus, survive – is what helped us get to where we are today.
Of course, the system is not without its kinks and bugs. Sometimes, we misappropriate something bad for something good, and we feed a terrible habit. Psychological dependence is built on the basic idea that using a drug is beneficial, and our mind latches onto that benefit. A classic example is self-medication, where drugs become involved to drown out physical or emotional pain. In this case, drugs are the quickest and most effective coping mechanism – at the cost of being very short-term, with their own host of issues.
The mind latches onto the release, the fleeting moments without pain, and you begin to crave it. However, if you deny yourself the drug (and the origin of the pain has long since gone), then eventually that need will pass, and you will begin to feel again.
Physical addiction is somewhat more complicated, involving symptoms of withdrawal, and drug tolerance.
Your Brain on Drugs
Psychoactive substances – from coffee to much more illicit vices like cocaine – all function in a similar way. When consuming them, they enter the bloodstream and penetrate the blood brain barrier, feeding into your brain cells. There, these drugs mimic your natural neurotransmitters and latch onto receptors in the brain, thus causing you to feel a certain way.
Caffeine blocks melatonin, making you less sleepy. Melatonin naturally accumulates throughout the day and is meant to make you drowsy to maintain a healthy sleeping pattern. With the caffeine in coffee, you can block these effects for a short amount of time, elevate your heart rate, and perform without sleepiness. But it often comes with a crash after irresponsible use.
Illegal drugs and alcohol have stronger, more dangerous effects. But they all essentially hijack your brain cells and cause you to feel things you should not feel naturally. So, the brain tries to adjust. After a while, it begins to see these drugs as normal. And when you try to quit, your body reacts violently, and cravings kick in.
This reaction is called withdrawal. Overcoming withdrawal is the first and necessary step to detoxification and rehabilitation, but it can also be dangerous. Some drugs – especially depressants like barbiturates, benzodiazepines, and alcohol – can cause near-fatal, and sometimes fatal withdrawal symptoms. It is best to undergo withdrawal under medical supervision.
Tolerance is the after effect of the brain getting used to the drugs. As part of a natural effort to subdue the powerful effects of a high, the brain builds a resistance against a certain drug, metabolizing it faster. This often means dumping it through the liver at an accelerated pace. But that does not mean the side effects from taking too many drugs is also bypassed. Instead, tolerance often encourages people with an addiction to take more than usual, eventually leading to an overdose.
Breaking a physical dependence takes a proper addiction treatment program – and time.
Physical Dependence Takes Time to Heal
Some say time heals all wounds. It is arguable whether that is profound or simplistic, but in the case of addiction, time plays a very big role in physical and mental recovery. While you can get quite a lot done with proper treatment, good rest, and a healthy diet, ultimately the greatest healer for the wounds of an addiction is time. And lots of it.
Within the first few months of abstinence and total sobriety, you can expect a lot of changes in thinking, mood, and memory. As time passes on – within the first few years – the effects of the addiction will have faded as much as possible, and any remaining mental scars will either heal very slowly, or not at all. Just giving it time can reverse most of the damage to the brain, and even completely rewire it back to normal, so the cravings become rare if at all present.
Getting there, however, to the point where the brain has recovered from addiction, is the big challenge. While therapy, medication and treatment can get you far, it is very difficult if not impossible to go all the way without some help. Recovery is an individual thing, and every choice you make must be your own, full of conviction. However, that does not mean you do not need help, or cannot ask for it. It is important to surround yourself with people you love and care about, and anchor them in your mind as motivation for your continued sobriety.
Friends and family can also act as a much-needed safety net, a support system to rely on in your darkest hour. Having someone to call – or even someone who can come over when you desperately need them to – can help prevent disasters and keep you sober at times when staying sober alone feels impossible.
It is also important to seek out other people in recovery. Certain experiences and thoughts can only be completely understood by people who have gone through addiction themselves. Thankfully, through group meetings and the internet, finding other formerly addicted people to talk to is easier than ever. You could try and make some new friends or find group meetings to attend.
There is no shortage of ways in which you can bolster the recovery process – and it is a good idea to try as many as possible. If it is possible, consider travel, or even moving to a nearby neighborhood away from old memories. Pick up new hobbies, try out new experiences, and invest time in the things that interest you and make you happy. By pouring your heart and soul into the things in life that matter the most and bring you the most joy, you will be able to live life without worrying quite as much about addiction, and in time, close that chapter of physical dependence off completely.