Some drugs are good
I won’t beat around the bush, I’ll get straight to the point. Every time I diagnose a patient with clinical anxiety or depression, I recommend medication as the first step of treatment after which I ask them if they have any questions regarding the medication. Invariably, I get asked if they will get ‘addicted’ to the medication.
Let us first understand what addiction is.
Addiction, or as we clinically like to call it, disorders of substance abuse is characterised by a number of behavioural, physical and thought disorders along with changes in the brain circuits and neurochemistry which occur on taking specific substances.
A specific neurochemical called dopamine is present in many areas of the brain. The release of dopamine in the midbrain is responsible for that feeling of happy high. Under normal circumstances, during any pleasurable activity, dopamine is released in pulses leading to a sense of joy and bliss.
Substances of abuse, release of large amounts of dopamine at a time giving a sense of high and then a sudden drop.
This extreme high followed by the extreme low is what leads to a craving for more drug. Also, with time, the receptors of dopamine become desensitised to the large amount of dopamine, no longer giving the same sense of high. So the amount of drug required to produce the same high goes on increasing.
Behaviourally, this is seen as-
- Craving for more and more drug.
- A progressive increase in the amount of drug consumed to produce the same effect.
- Physical / psychological withdrawal symptoms when the drug is not consumed.
- Denial that there is a drug problem.
- Unsuccessful attempts to cut down the drug use.
- A large amount of time is spent on obtaining the drug.
- Problems at work, in social relationships and overall functioning as a result of the drug.
- Continued use of the drug in spite of these problems.
As against this, symptoms of depression and anxiety are generally related to a deficiency in another neurochemical, serotonin, in certain areas of the brain. Drugs of abuse do not correct dopamine deficiency but instead release large amounts of it in a way that is not required.
But imbalance in serotonin produces symptoms like anxiety, panic, persistent sadness, loss of interests, changes in sleep, changes in appetite, negative ideas, suicidal thoughts, to name a few.
Antidepressant and anxiolytic medications act by producing and normalising serotonin in the brain so that the brain gets the amount it needs to function normally.
So, to answer the question, no, you won’t get ‘addicted’ to your medication.