Psychological Factors

Remember that it is common for a person to self-medicate to cope with her problems. If someone seeks to find relief from emotional difficulties through substances or compulsive behaviors, she may develop addictions. This is a popular perspective on the cause of addictions. Addictive substances and/or behaviors may be used to relieve one's stress, to improve one's mood, and to relieve one's emotional pain and discomfort.

It is currently well known that addictions frequently go hand in hand with mood disorders and other psychological problems. Mental health problems that are frequently seen coexisting with addictions can include anxiety disorders, bipolar disorder, depression, obsessive-compulsive disorder, and personality disorders.

What is a dual diagnosis?

When addictions to alcohol, substances, and/or compulsive behaviors are diagnosed simultaneously with a mental disorder or psychiatric problem, this is known as a dual diagnosis. According to the 2002 National Survey on Drug Use and Health, 17.5 million adults were diagnosed with a serious mental illness in the United States. Four million of those adults met the criteria for both a serious mental illness and addiction.

Certain psychiatric disorders may particularly increase your risk for addictions. Those disorders associated with an increased risk for addictions include attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), antisocial personality disorder, bipolar disorder, schizophrenia, and major depressive disorder. If someone has both a psychiatric disorder and an addiction, both must be effectively treated if that person is to successfully recover from both.

As with addictions, psychiatric disorders also have multiple causes, including genetics, environmental factors, physiological components, and social influences. If this is the situation, it will be important to understand and appreciate the complexity of treating both psychiatric disorders and addictions simultaneously.

At times, the symptoms of addiction can mask the symptoms of a psychiatric disorder, and vice versa. A professional with specialized training is necessary in order to treat a dually diagnosed person effectively. This is not something that a person can manage successfully on her own or even with the help of friends and family.


Two common myths about addictions are that addicts are bad, crazy, or stupid, and that, since addictions are often treated with behavioral approaches, the addictions must be caused by behavioral problems. Myths fail to take into account the fact that addictions are now known to involve changes in the brain and many other causative factors.

Another psychological theory to be aware of is that illogical thinking may lead to addictions. This explanation assumes that an addict is controlled by distorted and unreasonable thoughts. An example of a distorted thought would be when a person who was addicted to gambling believed that she could win every time she entered a casino.

If someone were addicted to alcohol, it would be an unreasonable thought to expect other family members to go without adequate food and clothing so the addict could afford to buy his substance. The foundation of treatment based on this theory is that a person's thinking needs to be challenged for accuracy.

Negative self-talk also puts a susceptible individual at risk for addictions. Examples of negative self-talk include catastrophizing, minimizing, blaming, perfectionism, magnifying, and so forth. Catastrophizing is always expecting the worst to happen. Minimizing makes less of something than what is actually there. Perfectionists tend to set impossible standards for themselves and others. If someone magnifies an event, she makes more of it than is warranted by the situation. Negative self-talk can provide rationalizations for substance use and addictive behaviors. The treatment for negative self-talk is to rewrite the message to reflect an accurate perspective.

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