Understanding Psychological Dependence

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People addicted to substances like drugs or alcohol have trouble refraining from substance use. A lot of this difficulty is from physical, biological changes. After all, addiction is a brain disorder. It can take time for the body to regain the ability to function well without substances. However, psychological dependence also plays a major role.

Psychological Dependence on Substance Use

It can take time for individuals to understand the impacts their substance use or abuse is having on their well-being. Often, individuals with substance use disorder (SUD) and addiction will engage in recurrent alcohol and drug use for months, if not years or longer, before the consequences of their substance use become undeniable. This is a lot of time that has reinforced the habit of substance use.

If you have ever tried to break a habit, you know how challenging it can be. When a habit is also a coping mechanism for stress or other negative emotions, it can be even more difficult to break. Unfortunately, this usually applies to substance use habits. It is no wonder that people's psychological dependence on substance use is particularly strong.

At Pathways Recovery Center, we understand psychological dependence and its associated compulsions. These often cause individuals to remain stuck in the cycle of recurrent substance use. To break this cycle, we offer a wide range of treatment programs and services for addiction recovery.

What Is Physical Dependence?

According to the National Cancer Insitute (NCI), physical dependence is defined as “a condition in which a person takes a drug over time, and unpleasant physical symptoms occur if the drug is suddenly stopped or taken in smaller doses.” Another term for physical dependence is chemical dependency.

When a person develops a physical dependence on drugs or alcohol, their brain and body begin to rely on that substance to function normally in their daily lives. Therefore, when they attempt to cease or slow their substance use, they experience physical withdrawal symptoms. That is why medically supervised detox is usually the first step toward recovery.

Signs and Symptoms

Many withdrawal symptoms indicate a physical dependence has developed. These vary based on the substance but may include:

  • Nausea
  • Headaches
  • Vomiting
  • Diarrhea
  • Seizures
  • Hallucinations

Factors That Lead to Physical Dependence

Many factors influence whether or not a person will develop a physical dependence.

One significant factor is the type of drug(s) a person uses. For example, alcohol, methamphetamines, opiates, and cocaine are several substances that are well-known to contribute to physical dependence and potentially severe withdrawal symptoms.

Other factors that may influence the development of physical dependence include a person's:

  • Genes
  • Duration of substance use
  • Frequency of substance use
  • Intensity of substance use
  • Polysubstance use

What Is Psychological Dependence?

Simply put, psychological dependence develops from the associations that one's brain makes with the people, places, and things linked to recurrent drug use. Rather than one's brain and body relying on substances to function, psychological dependence causes a person's mind to rely on substances to function.

Signs and Symptoms

Another way Pathways Recovery Center recommends understanding psychological dependence is by recognizing it as the emotional and mental processes that occur during and after drug withdrawal. The signs and symptoms associated with this include:

  • Denial of personal problems with alcohol and drug use
  • Tendency to romanticize substance use
  • Compulsion to spend a great deal of time using or obtaining substances
  • Ambivalence and uncertainty about sobriety
  • Inability to handle emotions without substances
  • Cravings
  • Anxiety
  • Irritability
  • Restlessness
  • Depression
  • Mood swings

Can Psychological Dependence Alone Constitute Addiction?

Many individuals believe that physical dependence constitutes addiction, and vice versa. However, that is a misconception. People do not have to be physically dependent on a substance to struggle with addiction. This is because psychological dependence is behind a lot of the power of addiction.

People don't even have to experience withdrawal to be addicted. An article by the Annals of Medicine explains, “[P]eople can suffer withdrawal without having addiction and have addiction without suffering withdrawal.”

Furthermore, the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) lists 11 criteria for SUD. When six or more of these criteria are filled, it indicates the presence of addiction. Drug withdrawal is recognized as only one of these 11 criteria. The DSM-5 recognizes that although many people with SUD and addiction experience physical dependence, not everyone does.

This is bad news for individuals who believe they are safe from addiction because the substances they use are not known to cause chemical dependence. Substances like marijuana, hallucinogens, and other psychedelics show little evidence of triggering physical dependence. However, they can certainly trigger psychological dependence and addiction.

The Link Between Physical and Psychological Dependence

It is important to understand that physical dependence and psychological dependence are not mutually exclusive. When a person experiences physical drug cravings and withdrawal symptoms, they will also experience psychological cravings that attempt to motivate recurrent substance use.

A person who experiences psychological dependency may not necessarily experience physical dependency at first. However, over time and through repeated substance use, they increase their risk of developing a physical dependency. This may be truer for certain substances than others, though.

There is not one type of dependence that is more serious or worse than the other. However, psychological dependence may be longer lasting. While the physical symptoms of withdrawal can be treated and tend to resolve over time, the psychological symptoms can continue years after a person has become sober. Psychological dependency, and associated emotions and discomfort, are what often trigger relapse for those in short-term or long-term recovery. 

Physical and psychological dependence are not mutually exclusive. In fact, they often occur together. The psychological withdrawal symptoms that you may experience when you cease alcohol and drug use – such as anxiety, irritability, and paranoia – occur as your mind struggles to adapt to your changing habits. Neither type of dependence is necessarily “worse” than the other, as they both carry immense harm to your ability to achieve and sustain lasting sobriety. However, psychological dependence can be longer lasting. Pathways Recovery Center offers mental health and addiction treatment for individuals seeking healing, regardless of where they are in their recovery journey. To learn more about our programs and therapeutic options, give us a call today at (888) 771-0966.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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