When people think of dependence, they often think of physical dependence on something.
For instance, when someone is dependent on drugs or alcohol, their body often reacts violently and painfully to the lack of their substance of choice. This person has grown physically dependent on substances. Without a continual intake, they will begin to experience withdrawal symptoms, which often spur them to resume drinking or using. This is a vicious circle which, in most cases, requires intensive treatment at an addiction treatment center to break.
Psychological dependence is another form of dependency that doesn’t receive as much consideration as physical dependence. Psychological dependence is a conditioned response. These responses are triggered by events or feelings that compel an individual to use a substance such as drugs or alcohol. Triggers, an event, person, or location commonly spoken of during addiction treatment, can be anything that a person associates with using their drug of choice. Triggers can also cause strong emotions that influence or provoke addictive behavior.
Physical vs. Psychological Dependence
When it comes to addiction, psychological and physical dependence are two terms that are often used interchangeably. However, it is essential to note that there are many critical differences between the two. While it is difficult to designate something as being “purely physical” or “purely psychological,” there are specific symptoms that reflect more of one form of dependence than the other.
Physical dependence is all about how the body reacts. When individuals develop an addiction to drugs or alcohol, they can and do experience physical withdrawal symptoms if they stop feeding their body the substance they’ve regularly been using. Dependence refers to the body’s craving for alcohol, drugs, or another addictive substance. When dependent, the body cells cannot function in the way they have been without the drug’s presence. With the individual stops using the drug, it often results in painful withdrawal symptoms such as body aches, nausea, flu-like symptoms, gastric disturbances, and in some cases, tremors (DTs) or seizures.
Psychological dependence refers to the series of addictive behaviors associated with using. The term psychological dependence is generally meant to describe the emotional and mental processes related to the development of and recovery from a substance use disorder or addiction. This is not to imply that “psychological dependence” is not as severe as physical dependence; however, it helps to distinguish the emotions behind addiction from the actions that sustain addiction.
Symptoms of Psychological Addiction
Psychological addiction, like physical addiction, also has common and noticeable symptoms. An individual struggling with psychological addiction will often experience a host of symptoms related to using and attempting to quit. For example, an individual with a psychological addiction may experience irritability and restlessness when they’re not using their drug of choice, or they try to stop using. They may also exhibit signs of anxiety, depression, or lash out in anger when someone tries to stop their addictive behavior or encourages them to seek treatment. In addition, someone with a psychological dependence may experience other physical or mental health conditions related to their addiction. It is not uncommon for addicts to experience changes in appetite and sleep disturbances while using. They may also obsess over obtaining or using the drug of choice or appear to be in denial that they have a substance use issue at all. Long term and chronic addiction can also result in cognitive problems such as issues with concentration, memory, and other aspects of judgment, especially pertaining to obtaining or using drugs or alcohol. Because the presentation of symptoms related to physical dependence is much more measurable, it can sometimes be challenging to weigh the severity of the symptoms of psychological dependence. In many cases, these symptoms are much more variable in their intensity. Also, there is no objective way to measure an individual perceived level of distress, either emotionally or psychologically, so psychological dependence can be complicated to assess.
Psychological Dependence vs. Addiction
Understanding the difference between addiction and psychological dependence can be a valuable tool throughout the treatment and recovery process. Substance dependencies – whether physical or psychological- commonly lead to substance use disorders and addiction. Addiction refers to the combination of both psychological dependence and physical dependence on a substance, object, or behavior. In other words, when an individual has developed an addiction, they exhibit an ongoing psychological need for a specific substance, along with experiencing the physical effects of dependence on that substance.
Addiction can cause changes in the brain, including those areas critical for judgment, behavior control, and learning. Addiction also influences the parts of the brain that control pleasurable feelings. Consequently, this can create a learned response or psychological dependence on the substance or activity as those pleasure centers are triggered when the substance is used. When the addictive substance is not supplied, the individual who has already formed a psychological dependence will experience physical withdrawal symptoms in the absence of reward center stimulation.
Substances Associated with Psychological (and Physical) Dependence
Most addictions, be it to substances or behaviors, are commonly associated with both elements of physical and psychological dependence. However, it is not uncommon to separate the development of a substance use disorder and the withdrawal process into separate categories. It is also common to separate the development of dependence into categories that define substances, which lead to primarily psychological and primarily physical dependence.
Substances Associated with Psychological Dependence
Substances that often lead to primarily psychological dependence include a combination of prescription medications and “street drugs.” For example, many psychotropic medications, such as antidepressant medications, as well as stimulant medications, including Ritalin, are commonly thought to lead to psychological dependence. Nonprescription stimulants, including cocaine and hallucinogenic drugs such as LSD, also fall into this category. Other substances associated with the development of a strong psychological dependence include cannabis and many inhalant products.
Substances Associated with Physical Dependence
Substances associated with developing a strong physical dependence often include those that result in the development of withdrawal symptoms should an individual stop using. Common examples of these include alcohol, opioid drugs (heroin, Vicodin, Morphine, etc.), benzodiazepines (Xanax, Valium, Ativan, etc.), and barbiturates (Seconal and phenobarbital).
Again, it is essential to note that numerous drugs or substances of abuse can often be described as having both physical and psychological withdrawal symptoms, which foster both forms of dependence. One crucial distinction that must be made regarding the differences between drugs that are considered to result in physical dependence versus those that lead to psychological dependence focuses on withdrawal. The withdrawal process from some of the drugs that are considered to be strongly associated with physical dependence, such as alcohol, opiates, and benzodiazepines, can result in the development of potentially fatal withdrawal symptoms, including deadly seizures, cardiac arrest, and respiratory failure.
These potentially life-threatening withdrawal side effects do not occur as commonly with substances more widely linked to psychological dependence. As a result, the treatment and recovery process for individuals who have developed substance use disorders to substances strongly linked to physical dependence should be medically monitored by a physician who specializes in addiction treatment medicine.
Such monitoring can help to identify any potential emergencies that may arrive during the early stages of treatment, ensuring the individual receives any medical care that they might need. However, this is not to say that individuals detoxing and withdrawing from other substances do not require intervention or medical monitoring. Medically supported detox should always be considered during the initial recovery and detox from any substance. There is always the possibility of significant emotional and physical distress that can lead to a host of potentially dangerous situations for the individual. For example, an individual who chooses to detox on their own has an increased probability of overdose during relapse should withdrawal symptoms become too difficult to manage. In other cases, individuals had become suicidal due to the emotional and psychological effects associated with withdrawal.
Treating Psychological Dependence
The best course of action for an individual recovering from a psychological dependence on any substance is an individualized addiction treatment program at a residential treatment center such as The Hills Treatment Center. In reality, these treatment programs should not differ significantly from a treatment program one might complete should they have a physical addiction to substances. Whether physical or psychological, addiction and dependence require a comprehensive, thorough treatment program for the individual to successfully attain sobriety and long-term recovery.
Upon deciding to enter treatment, an individual with a psychological dependence on substances should still be thoroughly assessed, and an individualized treatment program created that suits their specific treatment needs. Throughout treatment, their progress and medical needs should be monitored by a physician and therapeutic treatment providers. During their stay at The Hills, any co-occurring issues will be addressed and treated.
Psychological dependence is associated with various emotional and cognitive symptoms. In contrast, physical dependence is typically related to the development of tolerance and withdrawal symptoms, which are not primarily emotional or cognitive in nature. However, understanding how psychological dependence, physical dependence, and addiction fit together is essential for successful treatment. The treatment of any addictive behavior should center around individualized treatment programs that are evidence-based and holistic. The treatment program should also be appropriate for the individual in recovery instead of the addiction being treated as all addictions affect each person differently.
If you or a loved one struggles with psychological dependence, remember that there are many treatment options available to you. At The Hills in Los Angeles, we offer a full range of rehabilitation services, including medically supervised detox, followed by a wide range of comprehensive traditional and alternative therapies meant to target psychological dependence and its associated symptoms. These therapies help our patients plan for a life free from addiction, rebuild healthy relationships, and thrive in their substance-free lives. Don’t let psychological dependence continue to control your life. Contact The Hills today to learn more about our treatment programs.