Dr. David Fawcett

Addictions create consequences that are beyond the imagination of most users when they first experiment with an addictive substance or behavior. Users are initially attracted to these substances or behaviors by the powerful and immediate psychological rewards (including both feelings of pleasure and relief/distraction from emotional discomfort). But when addiction sets in (and even before that), things can rather quickly fall apart. Users eventually and inevitably experience physical, psychological, interpersonal, and spiritual consequences. A few weeks ago, we discussed the physical impacts. This week, we are focused on the psychological impacts. 

Sex addiction, drug addiction, and substance/sex addiction all result in serious psychological consequences. For starters, all addictions impact the reward center of the brain – the portion of the brain that gives us bursts of ‘feel good’ neurotransmitters when we behave in ways that help us sustain ourselves as individuals and as a species. These behaviors include cooperating, eating good food, loving and being loved, and, most of all, having an orgasm.

Unfortunately, addictions commandeer this part of the brain. As addictive processes take hold, neural pathways connecting the reward center with the frontal cortex grow thin. The frontal cortex is the thinking/reasoning part of the brain – responsible for controlling our behavior, predicting bad outcomes, resisting impulsive choices, and other essential executive functions. As a result of the diminishing role played by the frontal cortex, addictive processes gradually gather strength in the brain.

Moreover, drug addiction, sex addiction, and paired substance/sex addiction increase levels of the neurochemicals that create feelings of pleasure and excitement far above the levels created by any source in nature. Over time, this creates a new baseline for stimulation that must be reached in order to experience pleasure from any activity.

Basically, the brain adjusts to excessive inputs in an attempt to maintain homeostasis. One of the ways the brain compensates for heightened levels of stimulation is shedding dopamine receptors. This adaptation ‘turns down the volume’ on the heightened inputs of addictive substances and behaviors. This creates the phenomenon of tolerance, where addicts continually need more of or a more intense version of the substances and/or behaviors that get them high.

Unfortunately, when addicts enter recovery and stop their addictive behaviors, thereby reducing the continual input and intensity, the brain is still accustomed to high levels of stimulation. This may result in a period of anhedonia (the inability to experience pleasure) in the early months of recovery. This can lead to hopelessness and depression. The good news is that the brain can and will re-adjust to normal levels, and the ability to feel pleasure will return – provided the recovering addict can stay sober long enough for that process to occur.

Another psychological impact of drug addiction, sex addiction, and sexualized drug use, particularly when amphetamines are involved, is a dramatic increase in psychotic episodes, especially paranoia. In fact, it is common for stimulant users, especially those who have used too much methamphetamine, to scan air vents for microphones and cameras and to sincerely believe that there are vast law enforcement efforts dedicated to following their every move. The psychotic features caused by meth can be quite profound and, in a small fraction of meth users, will persist even into recovery.

Perhaps the most profound psychological consequence of these addictions is the sense of hopelessness that begins to overwhelm the user. This is due not only to changes in the brain and the inability to experience pleasure but also to the sense of defeat that comes with trying to control addictive behavior. It is at this point that many people become open to discovering the relief of treatment and recovery.

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If you or someone you care about is struggling with substance/sex addiction, help is available. Seeking Integrity offers therapy for substance/sex addiction. We also offer low-cost online workgroups for addicts new to recovery.