Addictive Disorders: Causes, Symptoms & Treatment

An addictive disorder is a disease characterized by an uncontrollable craving for a particular substance or activity. It may be alcohol, medications, drugs, or even sex or gambling, for example. Addictive disorders usually have severe psychological and/or physical consequences for the person affected.

What are addictive disorders?

Experts understand the term addictive disease as a dependence on a substance or even an activity that cannot be controlled by the affected person. Accordingly, physicians distinguish between a substance-related and a substance-unrelated addiction. The latter is also referred to as activity addiction. Substance-related addictions refer to a substance such as alcohol, drugs or medication. Activity addictions can include gambling, working, sex or even sports. The individual experiences a sense of elation or even relaxation by acting out their addiction. The experience represents a temporary escape from reality and must be repeated after the associated feeling subsides. For this, those affected sometimes also accept criminal acts. Some addictive disorders are socially accepted, while others are fundamentally rejected.

Causes

The causes of an addictive disorder have not yet been clearly clarified scientifically. Basically, however, it can be stated that social as well as biological and psychological factors are involved in the development of an addiction. Often, people are affected who have had to deal with a severe psychological trauma and are unable to cope with the experiences they have had. Socially disadvantaged people whose lives are difficult also tend to develop addiction quite often. On the other hand, affluent people can also be affected if, for example, they feel bored with life and therefore seek an escape from reality. Addictive disorders occur in all social classes and affect people with a wide variety of personality structures.

Symptoms, complaints, and signs

The first sign of an addictive disorder is often that the person uses the substance more often or for longer than originally planned – or spends more time on the slot machine or computer than intended. At this point, however, many addicts tell themselves they still have the drug use or behavior under control. When the addict finally tries to reduce or stop consumption, this does not succeed or involves considerable effort. Usually, the addict is aware that continued use has negative effects, even though he may deny this to others. In order to pursue addiction, sufferers often withdraw. They isolate themselves privately and often shut themselves off from their family as well. They may no longer fulfill their household, childcare or work duties as they used to. Addicts often give up their hobbies. Many addictions lead to financial problems as money is spent on drugs or gambling. A clear sign of substance addiction is the development of tolerance. The same dose of a drug produces a weaker effect than before. Addicts therefore often increase the dose. If the addiction cannot be lived out, withdrawal symptoms appear. The symptoms that withdrawal leads to depend on the addictive substance. In the case of behavioral addictions, withdrawal symptoms can consist of restlessness, anxiety, aggressiveness and mood swings.

Diagnosis and course

If an addictive disorder is present, diagnosis is often difficult, because those affected usually only admit their problem when they are already suffering from severe physical or mental impairments. The mere consumption of the addictive substance or its quantity does not provide any information about the presence of an addictive disease. The attending physician must therefore combine psychological and medical tests and thus, in addition to a detailed interview, conduct examinations of the blood and hair. Substance abuse in particular can be determined on the basis of the physical effects. Addictive disorders always require treatment, otherwise they will continue to intensify and affect the person concerned and his or her environment. Substance-related addictions in particular also damage the body and can be potentially fatal.

Complications

Addictive disorders can cause a variety of complications of a physical, psychological, and psychosocial nature. Drug or alcohol dependence often results in irreparable liver damage, and seizures and sensory disturbances caused by nerve damage are also possible. In many cases, memory declines, and severe alcoholics not infrequently suffer from a dementia known as Korsakow’s syndrome. Some drugs cause hallucinations that are extremely frightening for the person concerned or drive him to overestimation of his own abilities: The result can be fatal accidents or suicide. Perceptual disorders, delusions and motor disorders often occur during withdrawal, and many addicts suffer from depression during the drug-free period. If drugs are injected, there is a risk of infection with hepatitis or HIV through infected hypodermic needles. An overdose of drugs or alcohol can lead to multiple organ failure and thus death. Very often, addiction is accompanied by neglect of food intake, which is evident in weight loss and deficiency symptoms. Other complications can include heart damage, kidney failure, lung disease and weakening of the immune system. As life becomes all about the addiction, friends, family, work and hobbies are neglected until the social fabric eventually breaks down. Long-term consequences in many cases include job loss, separation from a partner, and a social and economic crash.

When should you see a doctor?

For addictions, a doctor should be consulted for substance-related as well as non-substance-related addictions. Regardless of what need is being repeatedly satisfied by the individual, help should be sought. In the case of a strong excessive consumption of alcohol, nicotine or the immense consumption of food, a doctor can help to bring about changes. Insofar as the person has the feeling of suffering, medical help is indicated. The consumption of drugs, the urge to spend money in large amounts every day or the indispensable consumption of sweets are signs of an existing health irregularity. As soon as the thoughts keep circling around the fulfillment of the one need, a doctor can be consulted. If attention disorders, an inner restlessness or aggressiveness occur as soon as the addiction is not satisfied, a visit to the doctor is necessary. If several hours a day are spent almost compulsively satisfying a need, the person concerned needs medical support. Excessive computer gaming, use of medications, or the compulsive need to receive compliments and recognition should be discussed with a physician. If vegetative problems, sleep disorders, headaches or loss of social environment occur, consultation with a physician is necessary. An internal stress experience as well as compulsive behavior are alarm signals of the organism.

Treatment and therapy

If an addictive disorder has been diagnosed, the attending physician must initiate appropriate therapy. This consists of medical and psychological components. If physical damage is already present, it must be treated with medication or even surgical intervention. The main focus, however, is on psychological therapy. Treatment begins with withdrawal, during which the person concerned is detoxified under medical supervision and is no longer allowed to consume the respective substance or perform the respective activity. This is followed by detoxification, which is designed to help achieve permanent abstinence from the individual addictive substance. This includes talking therapies and working through personal problems that may have led to the development of the addiction. Often, the patient’s family or partner is also involved here. Resocialization measures support the affected person in returning to everyday life. Such therapy can last several months or even years in total. Addicts generally have a very high risk of relapse, which is why it is not uncommon for those affected to have to undergo therapy more than once before the desired abstinence can be achieved. In principle, there is a lifelong risk of relapse.

Prevention

Addictive disorders can only be prevented to a limited extent, for example when an affected person notices the first signs of addiction in themselves. Relatives and friends can also visit a counseling center if they suspect that an addictive disorder may be present. Counseling centers are located throughout Germany and can also be contacted anonymously.

Aftercare

Aftercare is a necessity in the case of addiction, because addicts are considered to be psychologically unstable. Even if a sufferer has regained inner stability after successful treatment, a worsening of the condition can never be ruled out. Aftercare treatments for addictive disorders take place in both psychotherapeutic and behavioral forms. There are substance-related and non-substance-related addictions. The first category includes alcohol addiction or addiction to illegal drugs. The second group includes eating disorders, shopping or gambling addictions. A substance-related addiction is usually treated in a rehab clinic. For non-substance-related addictions, the doctor applies behavioral therapy. Aftercare, on the other hand, aims to prepare those affected for an addiction-free future in both forms of addiction. In the process, they learn to consciously refrain from using drugs and to better control their own behavior. Despite successfully completed therapies, an addict may relapse. In such situations, the aftercare program identifies points of contact to which the affected person should turn. Parallel to the therapeutic approaches, self-help groups have a positive effect on the development of the addict. The exchange with other addicts takes place in a more informal atmosphere than in therapy sessions with a psychologist. Addicts can derive additional benefit from this.

Typical and common disorders

  • Nicotine addiction (nicotine dependence)
  • Alcohol addiction
  • Drug addiction
  • Gambling addiction
  • Sex addiction
  • Computer game addiction
  • Internet addiction

What you can do yourself

People suffering from addiction mostly need professional help from a psychologist or therapist. Depending on the type and severity of the addiction, drug treatment or even inpatient treatment may be needed. In the case of addictions to stimulants such as caffeine, nicotine, alcohol or food, a change in diet and general lifestyle may be appropriate. If an alcohol or nicotine addiction is detected early, intervention is often successful without professional support. It is important to recognize the warning signs of addiction and take the necessary measures, such as contacting a therapist or a self-help group or making a lifestyle change. Which measure is appropriate depends on the individual case. In the case of drug addiction, controlled withdrawal must be carried out. People with severe alcoholism should also go to a clinic for withdrawal, as complications such as delirium tremens can occur. In the case of anorexia or binge eating, a diet plan must be created with professional help. Depending on the cause of the eating disorder, medical professionals and therapists must also be involved here, for example to determine organic causes or to work through internal conflicts.