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

Drugs act as a form o 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.

What do you think?

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  1. 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.

  2. 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.

    • 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.

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