How Stress Makes Us More Vulnerable to Addiction – Interview with Shahram Heshmat

Drugs act as a form of self-medication to dispel unwanted distress.

       

        We see how at the moment addiction is  one of the most discussed topics in the media. Looking at how drug overdose is currently the 9th leading cause of death in the US, it seems reasonable that people are so concerned. Some stereotypes about people who had been through some hard times or that work all day and use drugs/alcohol to get over the stress might seem stupid and irrelevant but studies tell us once again that there might be a connection between stress and addiction. I talked to Shahram Heshmat (Ph.D), specialized in the Health Economics of addiction and obesity, in order to understand how stress and addiction are linked and how we can help ourselves when we realise we may be in a position of vulnerability.


1. In your article  ‘Stress and Addiction’ you talk about the link between emotional stress and the initiation and maintenance of an addiction. How do you think high levels of stress impact teenagers and young adults considering the already difficult period they go through?

Chronic stress is often goes together with anxiety, depression, anger, and indifference. So drugs act as a form of self-medication to dispel unwanted distress.


2.You talk about how stress in combination with poor coping skills lead to this increasing risk factor of initiating an addiction. Can you please describe what would be a healthy set of coping skills?

The key skill is to learn self-control. Self-control refers to the exertion of control over the self by the self, which involves altering the way an individual feels, thinks, or behaves (i.e., the self is seen as an active agent). For example, when people are experiencing negative emotions, they may distract themselves by shifting their attention to something else.  The power to disengage our attention from one thing and move it to another is essential for well-being. The point is to reduce the power of transient feelings (see https://www.psychologytoday.com/blog/science-choice/201703/10-strategies-developing-self-control).





3.You said that trauma in early childhood alters our genetics, making us feel as if we live in a constant state of emergency. Can you explain a little bit more about this state, how it develops and how we can get better?

Excessive or chronic stress can distort our stress response system. Excessive stress to the body is termed allostatic load (the impact of lifelong experiences of “wear and tear”). High levels of uncontrollable stress and chronic stress promote sustained allostatic load resulting in unhealthy and inappropriate stress reaction. This person might be unable to terminate a stress response. Helping young adults with the ability for engaging in self-reflection, and identifying alternative ways to manage difficult emotions could be quite helpful.


4.Why do you think that drugs and other substances are  the ‘self-medication’ people use when stressed?

Drugs of abuse (e.g., cocaine or amphetamines) are addictive because they directly enhance the effects of dopamine providing pleasurable experience Depressive feelings emerges when the dopamine system is underactive, for instance during withdrawal from addiction. In short, the reward center in the brain is where all drugs of abuse, directly or indirectly, have their effect.

5.Why aren’t people generally getting help when they are stressed? Do you consider there’s stigma around this topic?

That is a very important question. Perhaps lack of education.

6. In this fast world, where stress has become the trait we all share, what advice would you give to the person that realizes they might have chronic stress?

This first step is the understanding of the how stress system influence their behavior.

Exercise and social connectedness and close, personal relationships are perhaps the world’s greatest stress reducer. It is also shown that that physical activity is associated with the release of so-called “feel-good” endorphins.

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  1. I have first hand experience with addiction, as a few of my close friends struggle with it. Addiction is very real, it can happen to all of us, and you better be careful because it’s easier than you think. I am personally not an addictive substance user, but I find that coping mechanisms, and ways to fog stress, mentioned in the article, IS self-control. It is really all about how we perceive the situation, and healthy brains can usually figure out several ways to combat it. I’m not against relaxing, or indulging, but seeing friends deal with this enemy, really balances my perspective. Ultimately it is up to the person, in my opinion. You have control, unless there are other leading causes of mental illness, everybody is capable of doing whatever that put their mind to.

    1. Thanks for sharing your perspective Daniel!

      If anyone else have thoughts on this, feel free to share! It’s a pleasure to be able to interview Dr. Heshmat, learning about how stress links to addiction.

  2. I consider myself addicted to stress because of the type of society in which I grew up. The lack of productivity is related to mediocrity. At the same time, we are programmed to be in constant competition with everyone else… that requires us to “endure”. Fortunately, I have never felt the need to use “drugs” stronger than coffee or the occasional energy drink to lead a competitive lifestyle, however, I agree very much with the doctor’s perspective on “lack of education” in this regard.

    I love that more and more studies are being done on this type of problem, however, I fear that it will take a long time to reach the Latino community (despite being a group with a lot of stress and a tendency towards addictions) Mental health is not a priority.

  3. Overall the article provided interesting information. However, I was expecting a bit more of a biological explanation as to how stress levels influences our response to certain substances and behaviors that can form into an addiction (psychologically and physiologically). Maybe it was the title that set that expectation “How…” Although, the article did provide a psychological stand point. I also think it would be beneficial if the article Stress and Addiction by Shahram Heshmat was provided. I would love to read it!

  4. I think it is great that we are constantly trying to look for the cause of unhealthy and self-harmful behavior. It seems logic that anything causing us displeasure could somehow lead to self-medicating, unhealthy ways of trying to feel better. However, the content of this article goes a little further and talks not only about cause, effect, but also about healthy ways of treatment. I found really interesting the connection with the fact that ‘trauma in early childhood alters our genetics’. It shows just how complex and deeply rooted our sensitivity to addiction can be. Also, I totally agree with the fact that ‘lack of education’ is a problem concerning this matter. That is why I would have enjoyed a little more deepening on that subject, maybe ways we can teach children or young adults in school or through campaigns to deal with stress.

  5. It’s important to raise awareness to stress and I appreciate this article for doing so. While it may be an uncomfortable topic it makes sense that it would be linked to addictions of alcohol and drugs. Many points briefly covered in this article should be contemplated or applied to your daily life. When we feel the stress of the world weighing down on us. It’s reasonable to turn to a form of relief that we have control of. Make sure to find a healthy way to manage stress in your life and do not be silent about it. Whether it be retrieving aid from friends or family or simply forming new habits, stress plays a powerful role on an individual health.

  6. I really liked this interview in particular because as a college student, I can empathize with stress and addiction. My initial response though, was “but what if you don’t have an addictive personality, and not all people handle stress with addiction”, and I think this should’ve been discussed a bit more because older generations tend to stigmatize millennials in that we are the “stoners and screw ups of the world.” I wish the interviewer was more raw and in a sense uncomfortable with their questions because those are the most honest, and easily relatable types of conversations. I do appreciate the awareness this article brings to light, however I wish it touched more of a social and psychological aspect of addiction and stress.

  7. I found the article to be well prepared and introduced within that first paragraph, however, I wish there was more information on the person being interviewed to reassure his qualifications to be discussing it. I did appreciate having a face to put the information to. I noticed one or two minor typing errors, these can definitely be overlooked, I just wanted to mention them. The topic is an important one, and the questions were really well chosen for this article. I also liked how they were ordered numerically, as it helped the article to flow and made it easy to follow. The fact that the source information for some answers provided an actual link to references helped cement the information as facts. Overall it’s a very informal interview, and I appreciated the discussion. Hopefully, more can read this and be educated in a very necessary topic.

    1. Thank you very much for the constructive feedback. I’m very glad that you enjoyed the article.

  8. This article was very relatable to some circumstances I have seen with issues of how stress can stem addiction in people. Many people want to find ways to cope with stress and to not feel the tension it creates by having it fester. With giving into drugs or drinking or more people can find ways to temporarily give up the stress and to feel a since of euphoria for a short period of time. Then once it’s gone they come back to the reality they wish not to face and turn back to those things known to be addictive because it’s easy to get to and not had to give the effects that person needs to get away from stress. I really like how Shahram Heshmat talked about trauma in early childhood alters our genetics. Which hits me on a personal level because for generations above me to my own, there have been childhood traumas. A lot of people in my family are abusive alcoholic or have dealt with the traumas of certain events surrounding that. But I can see how the reactions can become explosive due to the distortion of our stress response systems. Which I never knew before and I am glad I could learn this source of information. I also agree that a lot of people don’t get help because they feel that there is no way of getting better. Some people don’t believe what they are doing is wrong or can have tunnel visions to the initial problems that are underlying.

  9. I can relate to this topic. I’ve had my experience with addiction and still do. Anyone can be a target. Especially students and teens because they’re very stressed out with everything. Fitting in is not very easy. So, some people try to fit in by doing drugs or smoking cigarettes and just partying. That’s the sad truth. And having self-control is the best cure to addiction. It’s not the easiest cure but it gets easier after a while.

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