Harmful use of alcohol, according to the World Health Organisation (WHO)¹, is responsible for around 5% of the global burden of disease. Physical and psychological dependence is prominent in addiction, a key identifier of the disorder. Addiction affects people differently, although there are specific signs that help professionals and those with addiction issues recognise the issues. It is important, then, that we address the signs of physical and psychological dependence properly, for the sake of the people involved and the people it affects.
Addiction can be physical and psychological because it affects the body and mind in different ways and provides different rewards or senses of satisfaction. To summarise addiction, it occurs when something is taken or engaged in in excess, which activates the brain’s reward circuitry system, resulting in reliance on the substance and issues with tolerance and withdrawal.
- We are going to discuss the physical and psychological dependence signs in addiction.
- We will provide a physical and psychological dependence definition, exploring what each definition means and how it affects addiction.
- We will delve into the differences between physical and psychological dependence, discussing addiction in physical dependence and psychological dependence.
- Throughout, we will also provide psychological dependence examples and physical dependence examples.
- Finally, we will briefly touch upon the physical and psychological dependence of depressants.
Fig. 1 - There are physical and psychological differences in dependence.
Physical and Psychological Dependence Definition
We need to explore what we mean by physical and psychological dependence to understand how they connect to addiction. To understand the differences between the types of dependence, however, we must first define dependence.
Dependence is the state of reaching reliance on a substance or behaviour, and without it, withdrawal symptoms occur. It usually comes in the form of a scale: this can be from little to no dependence, to severe dependence.
Dependence becomes the body's new 'normal' state, and it relies on outside substances to achieve this new sense of normalcy.
What is Physical Dependence?
The body has a ‘normal’ state. When you take a drug or substance or even engage in a behaviour (such as gambling), it alters this state and gives you the pleasurable feeling associated with engaging in that behaviour. This is more apparent with substances such as alcohol, or more powerful drugs such as cocaine.
Physical dependence is where the body itself becomes dependent on a drug/substance or behaviour to achieve a sense of normality and also to achieve the initial high associated with taking the drug.
When a person stops taking the substance or engaging in the behaviour, they will experience withdrawal symptoms. It affects the body physically, down to the chemicals within the brain.
After drinking alcohol consistently and excessively for a set amount of time, the body needs the alcohol to feel ‘normal’, as it has adapted to this intake. It usually takes more alcohol to achieve the same effects, known as tolerance.
When you stop drinking alcohol after drinking it in excess for a set amount of time, you will experience withdrawal symptoms, such as shaky hands, headaches, nausea and vomiting.
Fig. 2 - Alcohol addiction can manifest in physical dependence.What is Psychological Dependence?
Just like the body has a normal state, the mind essentially has a normal ‘state’, too, although it’s a bit more complex than that. Psychological dependence mostly affects behaviour; once psychologically dependent on a substance of behaviour, the person involved is incapable of acting a certain way without the drugs or behaviour and may struggle to stop taking a drug or engage in behaviours despite the health issues associated with it.
People may also take a substance or engage in addicting behaviours to satisfy their emotional needs.
Psychological dependence focuses more on the mental state an addiction induces, in the sense that usually, an addiction to something allows the person to achieve a different mental state. Psychological dependence usually affects how somebody behaves, and withdrawal symptoms manifest as extreme emotional/motivational issues.
For example, a person may take a substance to feel a sense of relaxation in times of anxiety, which can eventually result in psychological dependence on this drug to feel relaxed.
Without it, they are anxious. Similarly, the behaviour of taking the drug is hard to stop. If they know they will feel anxious if they don’t take the drugs, it is hard to voluntarily submit yourself to uncomfortable feelings you could prevent by taking the drug.
Those with substance abuse issues and addiction may engage in drug use, alcohol, or addictive behaviours to self-medicate.
Khantzian (1997) discussed clinical observations of patients. They found that, in clinical observations, painful and distressing situations are significant psychological determiners in using and becoming addicted to drugs, and are involved in self-medicating.
What is the Difference Between Addiction in Physical and Psychological Dependence?
Addiction is a subtle or severe craving or dependence on something (such as alcohol or drugs) and can come in many forms.
Addiction, primarily, is defined as a physical and/or psychological dependence on substances (such as drugs or alcohol) and/or behaviours (such as gambling).
Physical and psychological dependence differ in how they affect the body and mind. Smoking cigarettes affects the body and mind in the feelings it induces and the dependence symptoms it causes.
Physical dependence is the way the substances or behaviours affect the body, whereas psychological dependence is the emotional state and needs the substance or behaviour abuse induces.
Psychological and Physical Dependence Example
We can see how smoking has both physical and psychological dependence issues.
Cigarretes contain nicotine. Nicotine aids and stimulates the release of dopamine, the feel-good neurotransmitter, and it also stimulates the neuron receptors that respond to dopamine. Smoking induces a feeling of pleasure and general relaxation through this stimulation of dopamine, so we can see why the act of smoking and taking in nicotine can become addictive.
People seek to smoke to reduce feelings of withdrawal and potential emotional issues. They seek the relaxation it offers (psychological) and may feel like they are anxious without it, and also seek the nicotine (physical), and may suffer withdrawal symptoms without it, such as restlessness, tiredness, hunger, and insomnia.
Fig. 3 - Physical and psychological dependence affect the body in different ways.
Addiction itself can be physical and/or psychological. Addiction can be physical and psychological because it affects the body and mind in different ways and provides different rewards or senses of satisfaction. This occurs specifically when something is taken or engaged in excess, which activates the brain’s reward circuitry system.
What is the Difference Between Substance-related Addiction and Behavioural Addiction?
Substance-related addiction is where the person is taking or consuming something that alters their body and the brain’s chemical state and gives the person a rewarding feeling (usually described as a ‘high’). As seen in our example with dopamine and nicotine, the stimulation of certain neurotransmitters and pathways within the brain typically causes addiction if not taken carefully and within reason.
Substances can be physically consumed or taken through other means, entering the body as a substance that has a physical effect on the body and alters its chemical state.
Drugs such as heroin, cocaine, and even chocolate fall under the substance-related addiction category.
Behavioural addiction differs in that the act of engaging in a particular behaviour induces a pleasurable or relaxing feeling. Certain behavioural scientists believe, especially those involved in addiction research, that any behaviour that stimulates a person has the opportunity to become addictive, as it is directly influencing a person’s feelings.
Gambling is arguably the best example of behavioural addictions, and it was recently added to the DSM-5.
Physical and Psychological Dependence of Depressants
Depressants are a type of substance that induce feelings of relaxation and tiredness, and generally reduce arousal and stimulation.
Alcohol is a good example of a depressant. Alcohol reduces inhibitions, slows down your cognitive faculties, reduces feelings of anxiety and stress, and overall tends to induce feelings of relaxation, as we discussed thoroughly above.
Problems occur when addiction becomes apparent. To achieve the same sense of relaxation and lowered feelings of arousal, such as when stressed or anxious, a person becomes physically dependent on the depressant, as they are experiencing withdrawal symptoms without it, and psychologically dependent. They struggle to feel relaxed without alcohol anymore and, to reduce their anxiety levels and feel 'normal', they have to drink.
Physical and Psychological Dependence - Key takeaways
- Addiction, primarily, is defined as a physical and/or psychological dependence on substances (such as drugs or alcohol) and/or behaviours (such as gambling).
- Dependence is the state of reaching reliance on a substance or behaviour, and without it, withdrawal symptoms occur. It usually comes in the form of a scale: this can be from little to no dependence, to severe dependence.
- Physical dependence is where the body itself becomes dependent on the drug/substance you’re taking to achieve a sense of normality or achieve the initial high associated with taking the drug. It alters the internal body state, such as neurotransmitter levels within the brain.
- Psychological dependence focuses more on the mental state that addiction induces, in the sense that usually, an addiction to something allows the person to achieve a different mental state. They may suffer emotionally without the substance, such as feeling anxious or upset.
- Substance-related addiction is where the person is taking or consuming something that alters their body and the brain’s chemical state, and behavioural addiction differs in that the act of engaging in a particular behaviour induces a pleasurable or relaxing feeling.
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