‘Stress’ refers to processes involving perception, appraisal, and response to harmful, threatening, or challenging events or stimuli (Sinha, 2008). No one is immune to stress; it is part of the experience of being alive. Life is full of opportunities and challenges, and we need to face the demands that life has for us. At times, we are overwhelmed by these demands. Stress, if not managed or relieved, can potentially result in distress and burnout. In the absence of early intervention, distress and burnout can lead to an anxiety disorder and depression.
There is a substantial literature on the significant association between acute and chronic stress and the motivation to abuse addictive substances or engage in compulsive behaviours such as problem gambling, internet use, gaming, pornography use, overspending, and binge eating, among others. Majority of people with addictive behaviours do not seek help. Without early intervention, addictive behaviours can potentially result in dependence i.e. an addiction.
To better understand the association between stress and addictive behaviours, we utilise the biopsychosocial model of health and illness to explain how stressors develop. The biopsychosocial model of health and illness is a framework developed by George L. Engel to explain the interactions between biological, psychological, and social factors that determine the aetiology, manifestation, and outcome of wellness and disease. This model argues that any one factor is insufficient; it is the interplay between individuals’ genetic makeup (biology), mental well-being and behaviour (psychology), and the socio-cultural context (sociology) that determines the course of their health-related outcomes.
Biologically, an individual may be genetically predisposed to substance use. One perspective looks at addiction as a brain disease and seek to explain the development of addiction using neurobiological evidence to show that “motivational brain pathways are key targets of brain stress chemicals and provide an important potential mechanism by which stress affects addiction vulnerability” (Sinha, 2008: 3). Studies have also reported that addicts often present themselves with poor physical and mental well-being. Psychologically, individuals who experience loneliness, chronic pain, anxiety and depression, among other mental disorders, may have a high risk of being vulnerable to addiction. Sociologically, stressful events, lack of social support, financial debts, poor health behaviours, among other reasons, can increase an individual’s vulnerability to addiction.
How do individuals recover from an addiction? Honestly speaking, recovery from any addiction is not a walk in the park. It involves relapse, failures, frustration, disappointment and a great deal of resilience. Let us consider substance (drugs, alcohol and inhalants) use as an example. Stopping substance use is possible and easy for some but staying stopped is often a big challenge. Many recovering addicts encounter relapse, which is a gradual process. Melemis (2015) argues that if people in recovery do not practice self-care, they eventually start to feel uncomfortable and look for ways to escape, relax, or reward themselves. This can be explained by thinking of relapse in terms of three stages: emotional, mental and physical.
During emotional relapse, individuals are not thinking about using substances but often recall their last relapse. Denial is a big part of emotional relapse and their emotions and behaviours set them up for relapse down the road. In mental relapse, individuals encounter a conflict of thoughts in their minds where part of them wants to use substances but part of them does not. The prolonged conflict of thoughts diminishes their cognitive resistance to relapse and their need for ways to escape, relax or reward themselves increases. Lastly, physical relapse occurs when individuals start using substances again. Once an individual uses drugs once or have one alcoholic drink, it may lead to a relapse of uncontrolled substance use (Melemis, 2015).
On the bright side, relapse prevention and recovery are possible. Cognitive therapy is one of the main tools used by practitioners to change an addict’s negative thinking and develop healthy coping skills in the process. Relapse prevention depends not on willpower but effective coping skills instead. Recovering individuals need to learn from setbacks, overcome a fear of recovery, and learning to becoming comfortable with being uncomfortable. In the recovery journey, individuals must be willing to change their lives and be comfortable with not using substances. Therapists will recommend that people in recovery be completely honest about his/her recovery and ask for help when needed.
In conclusion, stress, if unmanaged and unrelieved, may result in addictive behaviours for some individuals. By applying a Bio-Psycho-Social Model of health to understand stress, we seek to better understand the impacts of stress and explain why individuals respond differently to stress and utilise both positive and negative coping mechanisms to manage their stress. Early intervention for individuals afflicted with addictions is crucial for the recovery journey, which is about making life better for the recovering person and his/her loved ones.
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