Category: Medical Research

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Rewiring Your Brain From Addiction: 7 Things You Need To Know

Illustration of a robotic arm manipulating a brain with circuit-like patterns, placed on a microchip, symbolizing artificial intelligence and neuroscience integration.

When you stop using drugs and alcohol, it takes time to rewire your brain. The exact timeframe depends on several factors. Certain drugs, for example, lengthen the brain rewiring process. Some practices can also help you recover faster.

Here’s what experts know about helping your brain rebuild after addiction:

1. Understanding How Addiction Changes Your Brain

Dopamine and the Brain’s Reward System

Your brain has a natural reward system1 that makes you feel good when you do things that help you survive and thrive. This system uses a neurotransmitter called dopamine, which creates feelings of pleasure and happiness. When you eat good food, exercise, or spend time with people you love, your brain releases small amounts of dopamine.

Alcohol and drug use release far more brain chemicals2 than natural activities do. This creates an unnaturally strong surge of pleasure signals in your brain. When this happens repeatedly, it can overwhelm your brain’s normal reward system.

Over time, your brain tries to adjust to these high levels of dopamine by becoming less sensitive to it. This means you need more and more of the substance to feel the same effects: a process we call tolerance.3 Regular stimuli that used to make you happy might not feel as good anymore, because your brain’s reward system isn’t working like it should.

Infographic titled top 6 triggers of substance abuse, featuring icons of flames to represent six key triggers: stress and anxiety, negative emotions, social pressure and environments, boredom or lack of fulfillment, mental health struggles or trauma, and chronic pain or medical issues. A lit fuse leading to a cartoon-style bomb symbolizes the risk of relapse.

Areas of the Brain Affected by Addiction

Addiction affects 3 main parts of your brain.4 Each plays a crucial role in helping you think, feel, and make decisions.

The basal ganglia is your brain’s pleasure center. It helps you feel good when you do healthy things like eating or exercising. With substance use disorders, this area becomes less sensitive to normal pleasures and more focused on substances.

The amygdala is your brain’s stress manager. When addiction develops, this area becomes more sensitive. This can make you feel anxious, irritable, or uncomfortable when you’re not using addictive substances.

The prefrontal cortex5 helps you make good decisions and control impulses. Addictive behaviors make this area weaker, which makes it harder to resist cravings or think about long-term consequences.

Rewiring your brain from addiction is real, and it works. Research suggests meaningful neural shifts can happen in weeks, but full recovery takes months or years of consistent effort involving identifying and replacing toxic thought patterns, creating new neural pathways, and reinforcing them with repetition, consistency, and community.

– W. Lee Warren, M.D. | Brain Surgeon and Author

How Habits and Triggers Form

Your brain is designed to help you repeat behaviors that make you feel good. During addiction, your brain creates strong connections between certain situations (called triggers) and substance abuse. These connections form through repeated use over time.

Triggers can be places, people, feelings, or times of day that your brain associates with drug abuse. When you encounter these triggers, your brain automatically generates cravings. Learning to understand and manage your triggers (and their associated coping mechanisms) is an important part of recovery.

Infographic titled how addiction rewires your brain, illustrating the cycle of dopamine and tolerance. A man runs in a hamster wheel surrounded by stages: substance consumed, dopamine surges, short-term pleasure, brain adapts, tolerance increases, dopamine crash, negative feelings, and cravings. Arrows show the repeating cycle of addiction.

2. The Timeline of Brain Recovery

The recovery process happens in stages, and everyone’s path is different. While your brain health starts to improve as soon as you stop using substances, the full process takes time. Knowing what to expect during each stage can help you see the progress you’re making, which helps you stay motivated.

What to Expect in the First Month

The first month of recovery usually involves the biggest changes as your body adjusts to being substance-free. During the first week, you might experience withdrawal symptoms as your brain chemistry starts to reset. These symptoms can be uncomfortable, but they usually peak within a few days.

After the first week, many people notice their thinking becomes clearer and their sleep starts to improve. You might have mood swings or strong cravings during this time, which is normal. Your brain is working hard to restore its natural chemical balance.

Some people also notice changes in their appetite and energy levels during this first month. These changes are signs that your brain and body are beginning to heal.

Changes During Months 2-12

During these months, your brain continues to heal and rebuild healthy pathways. A lot of people in this stage find their mood becomes more stable and they start enjoying regular activities again. Your sleep quality and energy levels will continue to improve during this time.

Your brain’s ability to think clearly and make decisions also typically gets better during these months. But you might still experience occasional cravings—especially during stressful times. If this is the case for you, you’re not doing anything wrong! It’s totally normal and tends to happen less often as time goes on.

Your dopamine reward system will gradually become more responsive to natural pleasures like food, exercise, and social connections. This is a great sign that your brain is returning to its normal way of functioning.

Infographic from Recovery.com titled “How Long Until Your Brain Recovers?” comparing recovery timelines for six addictive substances: alcohol, cocaine, meth, opioids, cannabis, and benzodiazepines. Categories include dopamine restoration, cognitive recovery, and cravings fading. Timelines vary by substance, ranging from months to several years for full brain recovery.

Long-Term Recovery: One Year and Beyond

After a year, many people find their brain function has significantly improved. While some people still experience occasional cravings, these are usually less frequent and easier to manage. Your brain continues to heal and strengthen new, healthy patterns throughout your recovery journey.

Factors That Affect Your Recovery Timeline

Several things can influence how quickly your brain heals. These include the type of substances used, how long you used them, your overall health, and whether you have other mental health conditions. Having good support and treatment can help speed up the healing process.

When someone actively works to rewire their brain in recovery, they experience several key benefits: regaining self control, restoring emotional balance, breaking destructive patterns, improved stress response , enhanced cognitive function and a greater sense of purpose and joy. Rewiring the brain in recovery isn’t just about breaking free from addiction—it’s about reclaiming your life, restoring your mind, and creating a future built on strength and resilience.

– Dr. Zoe Shaw | Psychotherapist and Author

3. Stages of Brain Rewiring

Just like healing from a physical injury, your brain goes through different stages as it recovers from drug addiction. While everyone’s journey is unique, knowing what to expect at each stage can help you feel more confident about the path ahead. Let’s look at how your brain heals over time.

Stage 1: Getting Through Withdrawal

The first stage of recovery starts when you stop using substances, and it’s often the most challenging part of the journey. During this time, your brain works hard to adjust to life without substances. You might feel physically and emotionally uncomfortable, which is completely normal.

Most people experience withdrawal symptoms for about a week, though this can vary depending on the substance. It’s very important to get medical support during this time, as some types of withdrawal can be dangerous. Remember, these difficult feelings are temporary and are signs that your brain is beginning to heal.

Stage 2: Early Recovery Changes

After withdrawal, you’ll enter a period where your brain is actively rebuilding healthy patterns. While you might still have cravings, they’ll likely feel less intense than before. This is the perfect time to start learning new ways to handle stress and challenging emotions.

During this stage, many people find it helpful to work with counselors or join support groups. These supports can teach you practical tools for managing cravings and building a healthy lifestyle. Your brain is becoming more receptive to new experiences and ways of coping.

Stage 3: Long-Term Healing

As you move into long-term recovery, your brain continues to strengthen its healthy pathways. While the journey doesn’t end here, many people find that cravings become less frequent and easier to handle. Each day of recovery helps your brain build and maintain these positive changes.

4. Supporting Your Brain’s Recovery

Fortunately, there are plenty of ways you can support your brain’s natural healing process. Think of recovery like tending a garden: The more care and attention you give it, the better it grows. Simple daily choices can make a big difference in how quickly and effectively your brain recovers.

Regular Exercise and Physical Activity

Moving your body is one of the best gifts you can give your healing brain. Exercise naturally boosts your mood6 by releasing feel-good chemicals, similar to the ones your brain is learning to produce again on its own. Even a 15-minute walk can help!

You don’t need to live at the gym or start running marathons. Start with activities you enjoy, whether that’s dancing, swimming, or taking an easy walk around your neighborhood. As your energy improves, you’ll gradually be able to do more.

Sleep and Nutrition

Your brain does much of its repair work while you sleep, making good rest essential for recovery. Try to go to bed and wake up at the same time each day, even if you don’t feel tired at first. Your sleep patterns will naturally improve over time.

Eating nutritious foods gives your brain the building blocks it needs to heal. Instead of worrying about perfect eating habits, focus on adding healthy foods like fruits, vegetables, and proteins to your meals. Even small improvements in your diet can help your brain recover.

Stress Management

Finding healthy ways to handle stress is essential to your recovery journey. Deep breathing, taking short walks, listening to music, or talking with supportive friends all help calm your mind. Remember that it’s okay to start small—working in small moments of relaxation throughout your day can go a long way in calming your nervous system.

Building New Routines

Creating new daily routines helps your brain build healthy patterns. Start with one or 2 simple habits, like having breakfast at the same time every day or taking a walk after dinner. As these become comfortable, you can gradually add more supportive activities to your day.

5. Treatment Options That Help Rewire the Brain

Recovery isn’t a journey you need to take alone—there’s no shame in asking for help. Professional addiction treatment and support can have a huge impact on how quickly your brain heals. These interventions are like tools in your recovery toolkit: you can choose the ones that work best for you.

Therapy and Counseling

Working with a counselor or therapist gives you empowering tools for addiction recovery. These professionals understand how addiction affects the brain and can teach you practical ways to handle cravings and stress. Many people find cognitive behavioral therapy (CBT)7 especially helpful, as it teaches you how to change thought patterns that lead to substance abuse.

Your therapist can act as a guide on your recovery journey, helping you understand your triggers and develop strategies that work for your specific situation. It’s a great idea to find a therapist you like and start building a relationship with them, so help is there when you need it.

Support Groups

Meeting others who understand what you’re going through can be incredibly motivating. Support groups are safe spaces to share your experiences, learn from others, and build connections with people who support your recovery goals.

Lifestyle Changes

Small changes in your daily life can support your brain’s healing process. Focus on one change at a time, like improving your sleep schedule or adding healthy activities you enjoy.

When you rewire your brain, you stop being a passive passenger in your own life and start taking control. Old, destructive circuits weaken, and new, healthier ones take over. This means fewer cravings, better decision-making, and a stronger sense of purpose. It’s not just about avoiding addiction—it’s about building a brain that works for you, not against you. The result? A life where you’re free to think clearly, choose wisely, and move forward with confidence and hope.

– W. Lee Warren, M.D. | Brain Surgeon and Author

6. The Science of Hope and Healing

Understanding Brain Plasticity

Your brain has the ability to change and heal throughout your life. Scientists call this “plasticity,” which means your brain can create new neural pathways as it adapts to changes. This incredible ability is what makes recovery possible, no matter how long you’ve struggled with addiction.

Evidence of Recovery

Brain scanning studies show that people’s brains do heal during addiction recovery.8 While everyone’s timeline is different, many people see improvements in their cognitive functions, including memory, impulse control, decision-making, and emotional regulation. These positive changes only continue as you move forward in your recovery.

Setting Realistic Expectations

Recovery is more like a marathon than a sprint, and that’s okay. Some days will be easier than others, and healing happens gradually. Being patient with yourself and celebrating small victories along the way can help you stay on track.

7. Getting Help and Support

Finding Treatment

Taking the first step toward addiction treatment takes some courage, but the rewards of a life in recovery are well worth it. There are plenty of different treatment programs available to meet your specific needs, from detox to outpatient treatment to residential care. To learn more about choosing the right program, see our guide to finding a treatment center.

Building a Support System

Recovery is stronger when you have people in your corner. Loved ones, family, friends, counselors, support groups, and others in recovery can all be part of your support network. Don’t be afraid to let people know what you need.

If you’re ready to start recovery, a comprehensive rehab program can be a great starting point for your journey. This immersive experience gives you a chance to focus entirely on healing in a substance-free environment. Search for an addiction treatment center that matches your criteria and reach out to their team directly today.

FAQ

Q: How long does it take to rewire your brain from addiction?

A: The brain’s rewiring process varies by individual, but significant changes often occur within 12 to 18 months. Early improvements can be seen within weeks, while full recovery may take years, depending on factors such as substance type, duration of use, and lifestyle changes.

Q: Can dopamine levels return to normal after addiction?


A: Yes, dopamine levels can return to normal over time. The brain gradually restores its natural dopamine balance through healthy activities like exercise, proper nutrition, and stress management. However, this process can take several months to years.

Q: How long does it take to rewire your brain from a bad habit?


A: Breaking and rewiring a habit can take anywhere from 21 days to several months, depending on the habit’s intensity and duration. Consistently practicing new behaviors and avoiding triggers helps establish long-term changes.

Q: Can brains recover from addiction?


A: Yes, the brain has the ability to heal itself through neuroplasticity. While addiction alters brain structure and function, recovery is possible with time, therapy, and healthy habits that support brain repair.

Q: How long does recovery from addiction take?


A: Recovery is an ongoing process that unfolds in stages. While withdrawal symptoms may last days to weeks, brain healing continues for months or even years. Long-term recovery depends on individual factors and continued support.

Q: How long does it take to rewire the brain from addiction?


A: The timeline varies, but research suggests that noticeable improvements occur within 3 to 12 months, with continued healing over several years. Factors like substance type, overall health, and treatment interventions influence recovery speed.

Q: What are the benefits of rewiring the brain from addiction?


A: Rewiring the brain from addiction improves mental clarity, emotional stability, impulse control, and overall well-being. It also restores natural pleasure responses, strengthens decision-making skills, and enhances quality of life.

Q: What are the benefits of brain rewiring?


A: Brain rewiring helps create healthier thought patterns, reduces cravings, improves emotional regulation, and supports better decision-making. It also aids in forming positive habits and strengthening coping mechanisms.

Q: What is brain rewiring in addiction recovery?


A: Brain rewiring in addiction recovery refers to the process of forming new neural pathways to replace substance-related behaviors with healthier alternatives. This involves breaking old habits, reducing cravings, and restoring normal brain function.

Q: How can you increase dopamine in your brain?


A: You can naturally increase dopamine through regular exercise, a healthy diet rich in protein and antioxidants, sufficient sleep, mindfulness practices, social interactions, and engaging in enjoyable activities.

Q: Are there any ways to speed up this process or aid in the brain’s recovery from addiction?


A: Yes, brain recovery can be supported through consistent sleep, regular exercise, balanced nutrition, therapy, mindfulness, and positive social connections. Professional treatment, such as cognitive behavioral therapy (CBT), can also accelerate healing.

Q: What is the timeline for brain recovery from addiction?


A: Brain recovery follows a general timeline:

  • First month: Initial withdrawal symptoms, mood swings, and sleep disturbances.
  • Months 2-12: Improved cognitive function, emotional stability, and reduced cravings.
  • One year and beyond: Strengthened neural pathways, increased natural pleasure responses, and long-term behavioral changes.

Q: What factors influence the time it takes to rewire the brain from addiction?


A: Several factors impact the brain’s recovery timeline, including the substance used, length of addiction, overall health, mental health conditions, treatment interventions, and the presence of a supportive environment.

Q: How long does it take for the brain to heal after quitting an addiction?


A: The brain begins healing immediately after quitting, with significant improvements seen within the first year. However, full recovery, including emotional regulation and cognitive function, can take multiple years, depending on individual circumstances.

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Can You Be Predisposed to Addiction?

Your genes affect your hair color, height, personality, and even your music taste. But can they go so far as predisposing you to a substance or behavioral addiction? Research says yes—but the reasons aren’t as cut-and-dried as having a certain gene or not. 

But in any case, it’s crucial to note that being predisposed to addiction doesn’t mean you’ll become addicted. Other factors contribute much more heavily to addiction, like your environment, life situation, past traumas, and more.

When The Apple Doesn’t Fall Far From The Tree

Certain genetic functions and traits can pass through families and predispose you to addiction, much like being predisposed to a condition like diabetes, depression, or heart diseases. The DNA you inherit can make you up to twice as likely to develop an addiction compared to someone with a different genetic makeup. 

So if your parents or grandparents have had an addiction, you’re more likely to develop one too. The likelihood varies slightly by substance, but hovers around 2x for most. 

This phenomenon has been meticulously studied and documented, mainly because it can seem so counterintuitive. If you see first-hand how an addiction has hurt a parent and affected your life, falling into the same patterns would seem like the last thing you’d expect to happen. But those genetic variables, plus your environment and life history, can turn casual substance use into an addiction right under your nose.

Genes Related to Addiction

Several genes code for different traits and predispositions that can lead to addiction. These genetic influences show a pattern of causation, but the exact reasons for those patterns isn’t as well-known or understood, yet. Here are a few examples of specific genes and genetic variants that can predispose someone to addiction:

  • One variation of the dopamine receptor gene can make you more susceptible to the addictive effects of substances because it changes how substances influence your brain’s reward pathway.
  • Variations in genes Per1 and Per2 can trigger someone (especially a teenager) to drink more alcohol than another, especially when stressed.  
  • People can be more likely to develop an alcohol or opioid addiction if they have a certain variation in their mu opioid receptor gene.
  • Dual copies of a gene called CHRNA5 makes people twice as likely to become addicted to nicotine, since the coding of that gene makes cells more sensitive to nicotine.

Is There an “Addiction Gene?”

In short, no. No one gene codes someone to become addicted to substances. And even for the genetic variations that can lead to addiction, it’s not a given that having those WILL make you addicted. That’s because addiction is the product of much more than your DNA. 

While there are “risk genes,” these aren’t the same as a gene that guarantees addiction. More often, genetic addiction risks relate to how your brain processes risk and reward, and if you’re more or less impulsive. How your brain regulates dopamine signaling also contributes to addiction risk, which is determined by your genes and various genetic variants.  

The Role of Epigenetics

Your behaviors and environment can activate or deactivate parts of your genes, a process called epigenetics. These changes aren’t to the DNA itself, but rather how your body reads and interprets genetic sequences. This can result in more or less proteins being made and when your body makes it, which can have cascading effects throughout your body. Epigenetic changes are reversible, unlike DNA mutations. They’re also what determines the function of your cells, like whether they become heart cells or nerve cells. 

A change in your behavior or environment could result in an epigenetic change that makes you more susceptible to addiction. For example, a highly stressful situation (like job loss) could vary how your body reads a sequence of DNA, triggering the small biochemical changes that make you more susceptible to addiction—like altering how your reward pathway handles dopamine. 

The epigenetic changes that make addiction more likely can happen with or without the inherited changes that can predispose you to addiction. 

Stress and Trauma as Triggers for Change

Trauma at any stage in your life can result in epigenetic changes, designed to help you survive in some way. These changes can also be passed down from a mother to her child. For example, mothers who experience greater stress and poor nutrition during pregnancy pass down epigenetically altered genes and the higher risk for diseases and addiction.

Chronic stress associated with trauma or other events can change how genes are expressed. The hormone released when we’re stressed, glucocorticoids, makes these changes through epigenetics. Other physiological changes related to hormones like adrenaline and cortisol also make epigenetic changes, altering how genes are read and expressed. When these changes affect your reward pathway, decision-making skills, and dopamine levels, you can become more predisposed to addiction.

Environment: The Other Side of The Coin

Your environment greatly affects if you do or don’t become addicted to substances or a behavior, like gambling. Did you grow up around others who used substances, or in a traumatic and chaotic home? Did your peers at school normalize substance use? Is instability and stress a daily norm for you?

Factors like these strongly contribute to both substance use and mental health conditions like depression, complex post-traumatic stress disorder (c-PTSD), and more. 

Social pressures make up your environment, too. If everyone around you uses substances, you’re more likely to as well. They might even encourage it as a bonding mechanism. Being genetically predisposed to addiction can make these environmental influences all the more impactful.

Would Knowing Risk Levels Lower Addiction Rates?

If you knew you had a higher risk of addiction based on your genes, would you be less likely to drink or take drugs? Some people might, but not everyone.

Studies found genetic risks don’t usually inspire changes in behavior. Risk doesn’t equal sureness, so people may not feel they need to make any changes. 

However, some people would find that information invaluable, much like discovering their genetic risks for cancer could help them navigate its prevention and treatment. It might inspire them to them take the appropriate steps to screen for it regularly and catch it early on. Depending on their risk levels, they may make changes to their lifestyle and diet to lower their risk of developing cancer. 

Similarly, someone who knows they’re at-risk to develop addiction can make lifestyle adjustments (like not drinking) and work on stress-management to lower their risk.

Knowing Your Risk Without Genetic Testing

You don’t need lab results to let you know if you’re predisposed to addiction or more likely to develop it. While that’s the most accurate route, you can also take a look into your past.

Did you have a parent or grandparent that struggled with addiction? You’ve likely inherited small genetic variations that make it more likely for yourself. And, that might also mean you’ve grown up in an environment that would contribute to addiction’s development. You may have PTSD, a mental health condition, or chronic stress from an unstable household or emotionally unavailable parenting, which can all heighten your chances of addiction.

Reflect on how drinking or taking drugs makes you feel—this can be another great indicator of your addiction risk, but it takes mindfulness and being willing to recognize issues. Ask yourself,

  • Do you feel markedly less afraid, anxious, or stressed after drinking or taking drugs? 
  • Do you like yourself better after you’ve drank or taken drugs?
  • Do you feel like you need it?

Recognizing these results early on and proceeding cautiously can prevent casual use from becoming an addiction. You may decide to abstain all together if the potential for addiction feels too great. The choice is yours. 

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Healing Trauma, Brain, and Body with Bessel van der Kolk

Dr. Bessel van der Kolk is a psychiatrist, researcher, educator, and author of The Body Keeps the Score. His book, published in 2014, explains how and why trauma stays within—and transforms—the body. Decades of experience and research, much of it outside treatment norms, led Bessel to write his best-selling book, now translated into 43 languages. 

Since publishing, clinicians and the general public alike have used his research and insight to develop new understandings of trauma and its effects on the whole body. We’ll dive into the themes and topics covered in van der Kolk’s momentous novel.

Author’s Background

Dr. Bessel van der Kolk began his career in trauma studies/treatment in one of the first-ever clinical research centers studying people with trauma. He began by studying post-traumatic stress disorder (PTSD) and how mental health medications could affect it. Van der Kolk worked directly with traumatized adults, many of them veterans, to study how trauma works and how people heal. 

Bessel van der Kolk’s research and treatment focuses on creating safe connections to the self and others and becoming aware of inner emotional states. He’s studied various treatments for trauma, including yoga, eye movement desensitization and reprocessing (EMDR), neurofeedback, and psychedelic therapy. 

His book encompasses his years of research, what he discovered about trauma (and narratives he found were false), and what he’s found can help people heal. 

Overview of The Body Keeps the Score

The Body Keeps the Score highlights the connection between trauma and the physical body, emotions, and the truth of certain behaviors (like avoidance, substance use, and rage). Bessel’s direct work and study with PTSD patients informed his conclusions, theories, and proven hypotheses. 

He describes and explains the symptoms of PTSD, why they develop into risky behaviors, and why traumatic stress affects and dictates neuroscience. Bessel led the forefront of the notion that the mind and body connect—and he proved it on many accounts. His book explains his findings, reasons how and why trauma lives in the body, and how traumatized patients can find genuine healing. 

Van der Kolk’s proposed and proven treatments for PTSD veered from pharmacotherapy and traditional therapies, where patients were primarily suggested to talk about their experience until it no longer bothered them. As Bessel and his colleagues found, this could lead to retraumatization, avoidance, and treatment failure as a whole. Somatic approaches, EMDR, psychedelic therapy, and more became his new modes of healing. 

Clinicians, patients, and loved ones alike found Bessel van der Kolk’s delivery to be empowering and educational. Despite his book’s clinical complexities and neurological themes, Bessel makes the information easy to read, insightful, and moving for the general public.

Exploring Trauma and the Brain 

Trauma is more than just a feeling or a thing that happened. It has a definable and proven ability to change the brain, altering the way it works until the trauma is treated. 

In his studies and experiences with patients, Bessel found people would re-experience the sensations of trauma at a neurological level, which would then affect breathing, heart rate, and other physical responses (Van der Kolk, 2014).

This often begins in the amygdala, which signals fight-or-flight (producing adrenaline) and releases stress hormones. For many traumatized people, their bodies don’t stop secreting these hormones because they don’t often feel safe. Their brains and the many parts within it adapt to respond to perceived threats, which can affect physical health, mental health, and your wellness as a whole. 

Neurological Impacts of Trauma

Bessel van der Kolk and colleagues found multiple neurological impacts of trauma. In one instance, they found a traumatized person’s brain activated in the visual cortex, right limbic area, and deactivated in the Broca’s cortex (where language is produced) (Van der Kolk, 2014). Additionally, the “self-sensing” areas of the brain simply did not activate when PTSD patients were asked to sit still and think about nothing, which naturally triggers an awareness of self (Van der Kolk, 2014).

These findings meant patients neurologically responded to the intense emotions of relieving their trauma, as expected, but also went into a state of “speechless horror” (when the Broca’s cortex deactivated). Bessel found this to be the reason why many trauma victims are physically unable to relay what happened to them, and he could see it in real-time on the scan. Many also could not feel a sense of self, instead feeling separated from their body and unaware of sensations like touch.

As long as trauma sensations remain stored in the memory, any activation may trigger the same sensations and feelings; as if the trauma is happening again. Bessel saw this through brain imagery and observing his patients’ reactions to stimuli related to their trauma. 

Neuroplasticity for Recovery

Just as the brain can learn to live in a state of arousal, it can also learn to regulate. The areas of the brain, like the amygdala, can go back to healthy functioning. This ability is called neuroplasticity, or “a process that involves adaptive structural and functional changes2 to the brain.” 

Neuroplasticity offers hope to those with trauma. In the same way their brains adapted to survive, so they can adapt to live fully. 

Trauma’s Manifestation in The Body

Trauma does not go away without treatment. It lingers in sensations, memories, flashbacks, immune diseases, sleep problems, and asthma attacks. Mysterious illnesses without cause may point to the body simply trying to deal with the effects of being in survival mode long after you’ve survived the event. Such strain on the nervous system can eventually lead to mental and physical illness (Van der Kolk, 2014).

The Body Keeps The Score

Somatic symptoms without a clear physical cause commonly affect traumatized adults and children. Examples include:

  1. Autoimmune disorders
  2. Sleep disorders and insomnia
  3. Skeletal/muscular problems
  4. Asthma 
  5. Numbness
  6. Migraine headaches
  7. Fibromyalgia
  8. Chronic fatigue
  9. Irritable bowel syndrome
  10. Chronic back and neck pain

In one example from Van der Kolk’s book, a woman with asthma attacks requiring hospitalization eventually realized she was experiencing a physical manifestation of intense emotions (related to childhood trauma). By focusing on the connection between them and addressing the emotions, she stopped having the attacks and needing hospitalization. This highlights the powerful connection between mind and body. 

Therapeutic Approaches to Recovery

Dr. van der Kolk found and practiced multiple therapeutic approaches for trauma. He initially sought something other than the suggested mode of trauma healing: talking about it until it lost its effect. Bessel found avoidance, retraumatization, “speechless horror”, and other somatic effects of trauma often made this approach ineffective.

Though his patients sometimes reaped benefits from bringing their trauma to light, Bessel rightly thought they needed to do more than just become desensitized to verbalizing it. 

Mindfulness and Somatic Experiencing

To help his patients first feel what was going on in their bodies, as many traumatized people are unable to do, Bessel practiced mindfulness with them (Van der Kolk, 2014). This strengthens the body’s natural ability to notice what’s going on within it. 

You can practice mindfulness in many ways. One of the most simple ways is through breathing exercises—you can count the seconds you breathe in, hold the breath, and exhale. Becoming aware of basic functions like these can help ground you in the moment and experience the present. By connecting his patients into the present, Bessel aimed to tell their brains, “that [the trauma] was then, this is now.” (Van der Kolk, 2014, p. 181).

Similarly, somatic experiencing aims to help patients notice the physical sensations related to traumatic memories (Van der Kolk, 2014). They would then work on calming the body, mitigating hyperarousal, before ever wading into the trauma itself. Doing so offered a safe, stable baseline to begin parsing through memories. If done in a state of panic or arousal, attempting to relive the memories could cause retraumatization.

Eye Movement Desensitization and Reprocessing (EMDR)

Dr. van der Kolk soon adopted EMDR as one of his treatment modalities, though hesitantly at first. It seemed odd—tracking objects (like the therapist’s fingers) back and forth while recalling a traumatic memory allowed people to process it and heal? Bessel van der Kolk soon found that to be the case.

He found EMDR an effective way to orient trauma back to the past, rather than lugging it along into the present. Patients could radically improve in just a few sessions. 

In examples from the book, Bessel guided assault, rape, and other trauma victims through rapid back-and-forth eye movements as they recalled their trauma. Vivid memories and sensations arose almost immediately, but his patients didn’t need to describe them to process them; only notice it. In one example, his patient/fellow student didn’t have to say a word to feel profoundly healed. That’s what Bessel found to be such an intriguing and effective aspect of EMDR: even those plagued by speechless, intolerable horrors could truly heal (Van der Kolk, 2014).

Studies highlighted in The Body Keeps the Score showed EMDR could be a much more effective treatment for PTSD than medications, or therapies like cognitive behavioral therapy (CBT) (Van der Kolk, 2014).

Yoga

Van der Kolk found yoga to be another way his patients could reorient themselves in their present body. It served as a mindfulness tool, a gentle form of exercise, and something his patients could grow an affinity for. 

Poses and breathing techniques helped his patients reconnect to their bodies and feel comfortable being present. Bessel found yoga could be especially helpful for victims of rape and sexual assault as they began to grow more comfortable experiencing physical sensations (Van der Kolk, 2014).

Yoga also helped his patients become more attuned to their emotional states and passing sensations, ultimately helping them separate from past traumas and hold tight to the present.

Many other holistic and alternative therapies were found to alleviate trauma and help patients process it, including theater, psychedelic therapy, neurofeedback, and other forms of creative expression.

Impact on Mental Health Professionals

As one of the pioneers in trauma studies and healing, Bessel van der Kolk influenced many treatment providers and continues to do so. Many found success with their own patients after adopting a mind-body-connection ideology and focusing on helping trauma victims come into the present.  

The revelations found in The Body Keeps the Score ultimately proved what many treatment providers suspected: talking about trauma didn’t cure it; and while prescribed medications could help with symptoms, they weren’t a cure-all either. It also gave them concrete insights and tools into what was found and proven to work. 

Bessel effectively proved how and why traditional therapies didn’t always work for trauma, and how they could even do more harm than good (such as retraumatization). His accumulation of 30 year’s clinical work creates a manual, so to speak, for anyone wanting to deeply understand how people heal. Quotes from appreciative healthcare professionals include:

“With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. … This is a watershed book that will be remembered as tipping the scales within psychiatry and the culture at large towards the recognition of the toll traumatic events and our attempts to deny their impact take on us all.”

-Richard Schwartz, originator of internal family systems (IFS) therapy

“This outstanding volume is absolutely essential reading not only for therapists but for all who seek to understand, prevent, or treat the immense suffering caused by trauma.”

-Pat Ogden, PhD

“This book will provide traumatized individuals with a guide to healing and permanently change how psychologists and psychiatrists think about trauma and recovery.”

-Ruth A. Lanius, MD, PhD

Lighting The Path to a New Future

Books like The Body Keeps the Score effectively help change how society views trauma. As many reviews state, Dr. van der Kolk’s clinical findings have the power to change how the world sees trauma and trauma recovery.
To see rehabs treating trauma, you can browse our collection of trauma treatment providers with photos, reviews, pricing information, and more.

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Is Alcohol Bad for Your Brain? Understanding the Impact of Alcohol on Cognitive Health

Although drinking is commonly accepted in most cultures, alcohol can damage your brain more than you think. Alcohol affects brain function by interacting with neurotransmitter systems and altering the communication between nerve cells while  depressing your nervous system, causing a slew of side effects, wanted or unwanted. 

Short-Term Effects of Alcohol on the Brain

Alcohol impacts how your brain and body communicate soon after you take those first few sips. Short-term effects include:

Euphoria

Drinking alcohol causes euphoria, commonly referred to as a “buzz” or “high.” Alcohol activates the brain’s reward system1 and increases dopamine release. People may experience increased confidence and sociability, as well as decreased inhibition. They also feel less stressed and anxious. These feelings can be enjoyable and are why people choose to drink alcohol in the first place. However, it’s important to remember that alcohol can also cause feelings of depression, irritability, and aggression when consumed in excess.

Impaired Frontal Cortex

The frontal cortex is one of the most important areas of the brain, responsible for decision-making, planning, problem-solving, and regulating behavior. It’s no surprise that alcohol has a damaging effect on the communication between neurons in the frontal cortex2. This can lead to difficulty making decisions, planning, and focusing. It can also impair the ability to control emotions and behavior, leading to impulsive and reckless decisions.

Impacts on the Central Nervous System

Alcohol’s impact on the central nervous system leads to slurred speech and a lack of coordination. And alcohol can impair memory storage3, leading to difficulties remembering recent events or conversations. You could even experience a blackout, where you have no memory of the situation because the memories could not be stored in the hippocampus. 

Long-Term Effects of Alcohol on the Brain

Day to day, it may be hard to notice how your drinking is affecting your brain and body. Over time, however, persistent heavy drinking leaves you susceptible to structural changes and damage in certain areas of the brain4. Each drink can wreak havoc, physically and mentally. In a worst-case scenario, some of the destruction might not be reversible. 

Physical Health Complications

One of the most well-known effects of excessive and long-term alcohol use is liver damage. Unfortunately, it can lead to a range of other health complications, such as heart diseases and pancreatitis, which can have serious and potentially life-threatening consequences. It’s essential to be aware of these issues and take steps to reduce your risk of damage to your body.

Weakened Immune System

Chronic alcohol consumption can significantly impair the body’s immune system5, increasing the risk of developing illnesses and infections. When the immune system is weakened, it’s unable to function properly and fight off invading pathogens, leaving the body vulnerable to attack. Long-term alcohol use can also disrupt the body’s natural balance of hormones6, which can further weaken the immune system. Poor nutrition and dehydration resulting from heavy drinking also weakens the immune system.

Premature Aging

Some studies emphasize the premature aging hypothesis, which states that heavy drinking accelerates natural chronological aging7, beginning with the onset of problem drinking. This idea highlights how alcohol’s damaging effects can cause permanent changes and complications, such as cognitive decline and memory problems.

Sleep and Alcohol’s Effects on the Brain

Sleep is the basic building block on which you build a healthy life. As a depressant, alcohol is a sedative that interacts with several neurotransmitter systems involved in sleep regulation8. Alcohol disrupts how your rapid eye movement (REM) cycle progresses throughout the night. Whenever your blood alcohol concentration (BAC) is highest, among other factors, determines how the cycle is disturbed. Without quality sleep, your mood and cognitive function can suffer. Chronic alcohol abuse can even spur sleep issues like insomnia.

Neurodegeneration 

Alcohol’s neurotoxic effect on the brain can cause neuron destruction9, also called neurodegeneration. Once your neurons and their pathways change, it’s difficult for your brain to properly communicate with itself and the body because neuron loss jeopardizes how neural networks function. Without healthy networks, your brain’s health can severely decline.

Alcohol Abuse and Brain Health

Research shows that people with alcoholism have smaller brain sizes compared to those who don’t10. Long-term alcohol consumption can also lead to a decrease in gray matter and white matter11 in the frontal cortex. This might be because alcohol has neurotoxic effects on nerve cells, which can contribute to neuronal damage and increased vulnerability to alcohol-related brain damage (ARBD) like dementia. 

While it is possible to develop a few different alcohol-related brain disorders, two of the most severe include Wernicke syndrome and Korsakoff syndrome. Both are associated with thiamine (vitamin B1) deficiency and alcohol abuse12. Thiamine helps the brain turn sugar into energy. With thiamine deficiency, brain cells cannot generate enough energy to function properly, which causes a myriad of physical and mental difficulties.

Wernicke syndrome 

Alcohol’s destruction to neurons and cell communication in the peripheral and central nervous systems can prompt the onset of ​​Wernicke syndrome. Wernicke’s encephalopathy can have a severe and sudden onset and involves ophthalmoplegia13, which is paralysis or weakness of eye muscles. It also includes ataxia, weakened muscle control in their arms and legs, and confusion. Wernicke’s encephalopathy usually precedes the onset of Korsakoff syndrome14. 

Korsakoff syndrome 

Alcohol abuse can inhibit learning new information, remembering recent events, and long-term memory processing. Over enough time, this can progress into Korsakoff syndrome. Korsakoff’s psychosis causes damage to the brain’s thalamus and hypothalamus14, which can lead to confusion, memory problems, coma, and irreversible brain damage. 

If you or someone you know is experiencing these symptoms, visit your primary care practitioner immediately. If the situation feels life-threatening, call 911 and/or take them to an emergency room and stay with them until they have medical help. If you live outside of the United States, you can find your country’s emergency number in this list15.

Neurotransmitter Disruptions

Alcohol primarily interacts with the reward and stress systems in the brain16, which includes dopaminergic, serotoninergic, glutamatergic and GABAergic neural circuits. A neural circuit has a series of neurons that send chemical signals to one another. 

As you drink, your brain releases more dopamine, endorphins, and serotonin and suppresses Gamma-Aminobutyric Acid (GABA) and glutamate release. These disruptions in normal functioning greatly affect your mood, behavior, and cognition. 

Alcohol’s impact on dopamine levels is a key factor in the formation of alcohol dependence17. Dopamine is not only the “feel good” hormone, but it’s also the motivation and incentive-based hormone. Your brain begins to reinforce unhealthy drinking habits because your dopamine levels rise when consuming alcohol, so, without alcohol, your brain will begin to crave that dopamine boost again. This spurs the dangerous cycle of chasing the high.

IJHG 20 20 g002

Image from the Indian Journal of Human Genetics16

Mental Health and Alcohol

Alcohol and mental health are closely intertwined, and the relationship between the two is complex. Some people are more vulnerable to alcohol abuse because of preexisting conditions. In contrast to those who drink responsibly or abstain, those who abuse alcohol—especially adolescents and those with long-term exposure—are more likely to develop depression or other psychological conditions. 

The prevalence of anxiety, depression, and other mental disorders is significantly higher among those with alcoholism18 compared to the general population. For many, this is due to using alcohol as self-medication for the uncomfortable emotions associated with these mental disorders. Chemical changes in the brain from alcohol, such as the disruption of neurotransmitters crucial in maintaining good mental health, also contribute to and worsen existing symptoms. 

If you have co-occurring disorders, finding specialized care for all conditions is essential because of their complicated relationship. You’re actually more likely to recover from each condition if the alcoholism and the co-occurring mental health disorder(s) are individually addressed and treated18. Explore professional treatment options with your doctor to get to the root cause of your co-occurring disorders. 

Adolescents’ Vulnerability to Alcohol’s Effects

According to the National Institute of Alcohol Abuse and Alcoholism, roughly 35% of adolescents (ages 12-20) have tried alcohol19. And this number likely doesn’t include the many teens who didn’t report their drinking. Alcohol use during these crucial years can disrupt normal brain maturation20 and increase the risk of cognitive impairments because of restricted blood flow in certain brain regions and electrical activity. 

Adolescents are also more prone to risk-taking behaviors21, which drinking only exacerbates. Alcohol greatly affects the prefrontal cortex, which is the decision-making area in the brain that is still developing for adolescents. They could be more likely to make bad decisions and get into trouble if they’re drinking, such as getting into a car crash while driving under the influence. 

If your child is in these pivotal years, have an open conversation with them. Being open-minded and honest with them, and actively listening to their experiences without judgment, will create trust. Your child may be more likely to listen to your advice if you approach these conversations with empathy and the desire to learn from each other.

Can the Brain Recover?

So, is it possible for your brain to recover from alcohol’s damage? In many cases, the answer is yes. It is a resilient organ that can heal. Your brain has something called neuroplasticity, which means your nervous system can change, positively or negatively, to stimuli22. So, while your neuroplasticity can negatively change from alcohol abuse, it can also positively adapt in recovery. 

Recovery from alcohol abuse is complex, and it can vary depending on factors like genetics, age, and overall health. The best way to recover is to stop drinking; however, this should be done over time with a tapering plan. Attempting to stop drinking “cold turkey” is dangerous and could cause serious implications. 

For this reason, recovering with professional guidance is essential. Medical professionals can ensure that the detoxing process goes as smoothly as possible. And tapering off alcohol will decrease the likelihood of withdrawal symptoms.
Alcohol shouldn’t be running your life. Your health matters. Begin your journey towards sobriety today by browsing rehabs that specialize in alcohol treatment.

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23 Essential Facts About Alcohol Addiction

It can be hard to trust what you hear about alcohol addiction. And when you’re planning for recovery, you need to know exactly what you’re facing. These alcohol facts can help you make important decisions about treatment. 

1. Alcohol Addiction Is a Chronic Disease

Alcohol addiction is a chronic disease1 with serious, long-term health effects. This condition is also known as alcohol use disorder (AUD) or alcoholism. AUD is highly treatable and can go into long-term remission.

2. Alcohol Use Disorder Can Affect Anyone

Anyone can develop AUD, regardless of age, gender, ethnicity, socioeconomic status, and so on. Because alcohol is socially acceptable in most parts of the world, it can be hard to tell when your drinking gets out of hand. 

3. Alcohol Addiction Affects Nearly 30 Million People

The National Institute on Alcohol Abuse and Alcoholism (NIAA) tracks alcohol facts and statistics in the U.S. According to their most recent data, 28.6 million adults had alcohol use disorder2 in 2021. That’s 11.3% of everyone in the country aged 18 or older. 

4. Your Genetics, Environment, and Other Factors Can Lead to Alcohol Addiction

Many factors can make you vulnerable to alcohol addiction.3 For example, alcohol addiction tends to run in families. On the surface, that implies AUD is genetic. But this could also be an environmental issue, because childhood trauma increases your risk of addiction. Studies show that mental health issues like post-traumatic stress disorder (PTSD) and depression can also play a role. 

5. Long-Term Alcohol Abuse Has Serious Health Impacts

Over time, excessive drinking can cause severe physical health problems:4

  • Stroke
  • High blood pressure
  • Liver problems
  • Weakened immune system
  • Pancreatitis
  • Cancer

Alcohol abuse also increases your risk of developing mental health problems.5

6. Alcohol Addiction Gets Worse Over Time

For most people, alcohol use disorder is progressive.6 In other words, it gets worse over time. Without proper treatment, your alcohol addiction will likely get more severe. 

7. Alcohol Withdrawal Can Be Physically Dangerous

When you first quit drinking, you may develop some or all of the following alcohol withdrawal symptoms:7

  • High blood pressure
  • Sleep problems
  • Headache
  • Digestive issues
  • Hallucinations
  • Seizures
  • Delirium tremens

Without proper treatment, withdrawing from alcohol can be fatal. When you first enter recovery for AUD, it’s extremely important to get the medical care you need.

8. There Are Many Treatments for Alcohol Addiction

There are countless ways to heal from addiction. Rehab for alcohol addiction can include a combination of medical treatments, talk therapy, support groups, and other activities. Different programs offer various types of therapy. Some even develop individualized care plans for each client.

9. Alcohol Addiction Often Co-Occurs With Other Mental Health Disorders

Alcohol addiction commonly co-occurs with other mental health issues. People with AUD have higher rates of depression,8 anxiety, PTSD, and other substance use disorders. If you’re healing from multiple conditions at once, you will likely need specialized treatment.

10. Alcohol Use Disorder Has a High Relapse Rate

Relapse is a common part of alcohol addiction recovery. In one study, at least 60% of people with AUD relapsed9 within the first year of recovery. Certain risk factors — like clinical depression — make relapse more likely. On the other hand, having a strong support network reduces your risk of relapse.10 That could include a therapist, support groups, family, and trusted friends. Building out your support system is an essential part of healing. You can start this process during rehab by making a specific plan for aftercare.

11. Alcohol Addiction Affects Relationships

Alcohol abuse can profoundly affect your closest relationships, in every stage of addiction and recovery. While untreated AUD can severely impact whole families,11 treatment has the opposite effect. Experts say it’s impossible to separate alcohol addiction from family dynamics. That’s why many rehabs offer family therapy as a central part of treatment.

12. Alcohol Addiction Can Impact Cognitive Function

Drinking alcohol, and especially alcohol abuse, can interfere with brain function.12 Specifically, it interferes with memory, motor function, and judgment. These effects are worse for teenagers and for people with chronic, long-term addiction. 

13. Early Intervention Can Make a Huge Difference

Early intervention and treatment for alcohol addiction can significantly improve the chances of successful recovery.

14. Social Support Can Help You Recover

Social support is essential during recovery13 from alcohol addiction. A wealth of data shows that people with stronger relationships recover more quickly and completely. Your support network could include family, friends, colleagues, your care team, and members of a support group. Given the high success rate of Alcoholics Anonymous (A.A.), it might be a good place to start building your community.

15. Alcohol Addiction Is a Diagnosable Medical Condition

Despite the stigma surrounding addiction, healthcare professionals agree that AUD is a serious medical issue. The American Psychiatric Association (APA), for example, explains that people with alcohol addiction “have lost reliable control of their alcohol use.14 It doesn’t matter what kind of alcohol someone drinks or even how much: Alcohol-dependent people are often unable to stop drinking once they start.” If you have a diagnosis of AUD, you’ll probably need professional treatment to recover. 

16. Excessive Drinking Can Weaken Your Immune System

Heavy drinking can interfere with immune function.15 As a result, chronic alcohol abuse increases your risk of pneumonia, respiratory problems, liver disease, and certain types of cancer. People with AUD have a higher rate of complications after surgery and may heal from injuries more slowly.

17. Alcohol Addiction Harms Marginalized Communities

Anyone can abuse alcohol. However, some data shows that AUD disproportionally affects marginalized communities. For example, having less education and lower socioeconomic status greatly increases your risk of alcohol addiction.16 This is true regardless of genetics or family history. Other studies report that race also plays a role in AUD,17 and that Black communities are at greater risk. 

18. Binge Drinking May Increase Your Risk of Addiction

Recent studies show a link between binge drinking and alcohol addiction.18 We still need more information about how they relate. It could be true that binge drinking raises your risk of developing an addiction in the future. On the other hand, some say that binge drinking itself is a sign of addiction. If that’s the case, the act itself wouldn’t increase your risk of AUD. But either way, it can still qualify as alcohol abuse. If you binge drink regularly, you might consider getting treatment for alcohol addiction.

19. Relapse Is Not Failure

Relapse is a common part of recovery from alcohol addiction. It is not a sign of failure. When you think of AUD as a disease, it’s easier to make sense of this pattern. The National Institute of Health (NIH) compares addiction to other chronic conditions,19 like asthma and high blood pressure: “Relapse is common and similar across these illnesses. Therefore, substance use disorders should be treated like any other chronic illness. Relapse serves as a sign for resumed, modified, or new treatment.”

20. Underage Drinking Can Lead to Alcohol Addiction

Drinking as a teenager20 increases your risk of developing AUD as an adult. One study found that people who drank alcohol before age 15 were 3.5 times more likely to abuse alcohol. Underage drinking can also change or interfere with the way your brain develops. For teenagers with alcohol addiction, family therapy is usually an important part of treatment.

21. Integrated Treatment Can Help

If you have a mental health diagnosis in addition to AUD, it’s called dual diagnosis. Recovering from co-occurring disorders can be complex. Studies show that it’s most effective to treat mental health issues and addiction21 at the same time. By integrating different types of therapy, you can address the root cause of both issues simultaneously. Many residential rehabs use this holistic approach to treatment.

22. Chronic Alcohol Abuse Can Cause Brain Damage

Long-term alcohol addiction can lead to brain damage.22 This can occur in several different ways:

  • Wernicke-Korsakoff syndrome: This condition is a rare type of dementia. It affects people who drink so heavily, for such a long time, that they develop severe vitamin B-1 deficiencies. Symptoms include confusion, memory issues, poor judgment, hallucinations, and cognitive decline.
  • Traumatic Brain Injury (TBI): Alcohol increases your risk of TBI, either due to accidents or aggressive behavior. Up to 81% of people with TBIs are intoxicated when they first sustain their injuries.
  • Alcohol-related brain damage (ARBD):23 While ARBD mimics dementia, it has some key differences. For one thing, it usually doesn’t worse over time. This condition usually affects people in their 40s or 50s. With proper treatment, many patients can completely recover.

23. Different People Need Different Types of Treatment

There are many factors to consider when you’re planning recovery. For example, do you need to detox from alcohol before starting rehab? While you’re in treatment, will you need ongoing medical care? Are you interested in attending a faith-based program that follows the 12 Steps? There’s no right or wrong way to approach treatment, but it’s important to find a center that can meet your unique needs. 

Compare rehabs that treat alcohol addiction to find the right program for you.

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A Guide to the Biopsychosocial Model of Mental Health

According to the biopsychosocial model of mental health, there are 3 different dimensions of health and illness. Clinicians believe biological, psychological, and social factors can all affect your well-being.

Within this model, you’ll receive holistic treatment. Your care plan will include various therapies that focus on each aspect of your life. This comprehensive approach addresses your needs as a whole person, instead of just treating isolated symptoms. 

Understanding the Biopsychosocial Model

George L. Engel introduced the biopsychosocial model of mental health1—sometimes called the BPS model—in 1977. Since then, it’s gained widespread support among mental health professionals. 

According to Engel, health problems don’t happen in a vacuum. He defined 3 areas that contribute to any diagnosis: 

  • Biological
  • Psychological
  • Social

These 3 dimensions of wellness have a complex relationship. Having symptoms in any one of these areas can cause problems in the other two. 

For example, seasonal allergies are a biological issue. If you work outside, severe symptoms might force you to take a sick day. That could affect your income and your family, which are social issues. Sneezing all day can also put you in a bad mood, affecting your psychological state. What starts as a simple immune response can impact every aspect of your life. 

When you understand how your symptoms support each other, it’s easier to find the right types of treatment. For example, data shows that anger makes chronic pain more severe.2 If you have both of these issues, going to talk therapy for anger management could help you physically heal. 

The BPS model draws clear distinctions between its 3 areas of focus: 

Biological Factors

There’s a strong link between mental and physical health.3 On one level, this may seem intuitive. If you’re sick, you’ll probably have to rest instead of doing things you enjoy. But the connection goes much deeper. Having a heart attack, for example, raises your risk of depression. And some mental health issues, like PTSD, can have physical symptoms.4

Mental Health and Genetics

Many mental illnesses run in families,5 suggesting they might be genetic. However, until researchers can isolate the relevant genes, this will remain a theory. Today, experts believe that bipolar disorder, major depression, and schizophrenia, among other diagnoses, are likely hereditary. 

The Neurochemistry of Addiction

Behavioral health problems can also have biological components. For example, the neurotransmitter dopamine plays a role in addiction.6 This naturally occurring chemical makes you feel a sense of reward. 

When you have an addiction, the act of taking drugs stimulates the release of dopamine. That’s true no matter which drugs you’re using. Your brain can come to depend on substance use as the trigger to produce this essential neurochemical. In other words, you’ll only feel a sense of achievement when you drink or take drugs. 

This chemical balance can get worse over time, making it harder and harder to quit. While that cycle is a biological process, it also has serious emotional consequences. 

Psychological Factors

Psychological factors, like self-esteem, can affect your mental health.7 On its own, low self-esteem isn’t technically a symptom of mental illness. But it can lead to more severe issues. For example, one study found that people with less self-esteem had a higher risk of anxiety, depression, and attention problems.

Cognitive Processes

A cognitive process is the way your brain performs a task.8 Learning, decision-making, and paying attention are all examples of cognitive processes. 

Mental illness affects your cognitive processes. For example, data shows that depression interferes with memory formation.9 And ongoing memory problems can affect your work, social life, and overall well-being.

This connection goes both ways. Poor cognitive processing10 increases your risk of developing a new mental illness. Without proper treatment, this can lead to a spiral of worsening symptoms. 

Social Factors

Interpersonal relationships have a major impact on mental health.11 Social support lowers your risk of developing mental illness and addiction. And if you do have mental health issues, strong relationships improve your chance of recovery. 

Cultural Norms

There’s more to your social life than relationships. Your cultural background also influences your mental health.12 That’s because your values affect the way you think about your behavior. In some cultures, for example, it’s okay to have a beer with friends after work. In others, drinking is strictly taboo. Either way, your beliefs may affect how you define alcohol abuse. 

It’s important to find treatment that supports your values. With the biopsychosocial approach, clinicians may design a clinical care plan just for you. They may employ a variety of treatment methods, depending on your unique recovery goals. 

Socioeconomic Status

Your economic status matters, too. Researchers correlate lower socioeconomic status with higher rates of mental illness.13 This is probably due to the chronic stress of financial insecurity. That stress can also damage relationships, cutting you off from valuable social support. And what’s more, a lack of resources makes it harder to afford mental health treatment.

Application of the Biopsychosocial Model in Assessment

Under the biopsychosocial model, treatment starts with a comprehensive assessment.14 This approach to diagnosis is the standard of care. In other words, experts agree that it’s an effective way to start planning your long-term recovery. 

During the assessment, your care team will ask a series of questions15 about your physical, mental, and social well-being. These interviews are extremely detailed and may vary between providers. However, most assessments will include certain basic questions:

  • Do you have any past or present medical diagnoses?
  • Do you have any past or present mental health diagnoses?
  • Do you have a family history of any physical or mental illnesses?
  • What symptoms are you currently experiencing?
  • Do you now, or have you ever taken illicit drugs?
  • What is your living situation?
  • How much sleep do you normally get in a night?
  • Who is part of your support network? Does it include family, friends, healthcare providers, etc?
  • What is your highest level of education?
  • Are you currently employed?

Clinicians use this information to understand how your symptoms fit together. If you don’t already have a diagnosis, they may give you one before discussing treatment. Either way, the next step is to develop your plan of care. 

Treatment and Interventions

Despite the evidence that supports it, biopsychosocial treatment is not widely available.16 One study found that in hospital settings, few doctors perform comprehensive assessments. Instead, most providers focus on physical symptoms. If you’d like to receive treatment under the BPS model, you may need to seek out a specialized program.

By definition, biopsychosocial care includes multiple types of treatment.17 Each one addresses a different aspect of your health. For example, your care plan might include some or all of these therapies:

  • Biological: Medical care, nutrition counseling, physical therapy
  • Psychological: Talk therapy, behavioral therapy
  • Social: Family therapy, support groups

In many programs, your clinicians will work together18 to provide integrated treatment. You may meet with your care team as a group, and they may meet privately to discuss your case. This close communication allows them to track your progress and make adjustments to your care plan if necessary.

Limitations and Criticisms

While biopsychosocial assessment is the standard of care, this model has some limitations.19 Specifically, it focuses more on diagnosis than treatment. Without formal guidance on how to design a care plan, every provider takes a slightly different approach. This makes it hard for patients to know what they can expect during recovery. 

Some experts argue that the biopsychosocial approach is outdated.20 Critics say that scientific breakthroughs “have changed the very face of psychiatry in the last few decades,” leaving Engel’s theory behind. This new research suggests that some mental health issues have purely biological causes. However, we need much more data before we can confirm these theories.

The BPS model is more holistic21 than other approaches—maybe to a fault. S. Nassir Ghaemi, Director of the Mood Disorder Program at Tufts Medical Center, explains that “its boundaries are unclear.” In the effort to include so many dimensions of health, Engel left room for practitioners to interpret information as they see fit. As a result, their personal biases may affect treatment. Biopsychosocial treatment “gives permission to do everything, but no specific guidance to do anything,” Ghaemi writes. 

Future Directions and Implications

Despite these critiques, other experts say we can keep learning from this approach. For example, experts posit that focusing on the biopsychosocial model might reduce burnout among medical students.22 This could have far-reaching implications for the future of treatment. By setting an example for the next generation of healthcare providers, we might be able to reduce the stigma around mental illness. 

Biopsychosocial care also offers unique opportunities during recovery. Because treatment is so personalized,23 you and your care team may develop a closer bond. That connection can help you commit to treatment more fully. 

For a complete assessment of your physical, mental, and social needs, reach out to a treatment center and inquire with their admissions team. From there, you can begin planning the next phase of your recovery journey—and the rest of your life. 

Frequently Asked Questions About the Biopsychosocial Model of Mental Health

What is the biopsychosocial model of mental health?

The biopsychosocial model of mental health recognizes that biological, psychological, and social factors all contribute to a person’s well-being and the development of mental health issues. It emphasizes holistic treatment that addresses each aspect of a patient’s life to provide comprehensive care.

What are the 3 dimensions of the biopsychosocial model?

The biopsychosocial model consists of 3 dimensions: biological, psychological, and social. These dimensions interact with each other, and symptoms in one area can impact the other two. By understanding these connections, healthcare providers can develop tailored treatment plans.

What types of treatment are involved in the biopsychosocial model of mental health?

In the biopsychosocial model, biological treatments may include medical care, physical therapy, and nutrition counseling. Psychological treatments may involve talk therapy and behavioral therapy. Social treatments may include family therapy and support groups. Integrated care, where different treatment providers collaborate, is common in this model.

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The Link Between Substance Abuse and Domestic Violence: Understanding and Breaking the Cycle

There’s a strong relationship between substance abuse and domestic violence. Abuse is traumatic, and its effects can follow you even after you end the relationship. Many people use drugs or alcohol to cope with that trauma, which can quickly lead to addiction. But addiction is traumatic, too. What starts as a coping mechanism might eventually compound the problem. When you’re ready to end this cycle, a rehab that treats trauma and addiction can help you move forward.

If you or someone in your life is experiencing domestic violence, you can call the National Domestic Violence Hotline at 1-800-799-SAFE (7233) to get immediate support. 

What Is Domestic Violence?

Domestic violence is the intentional use of force by a family member, romantic partner, roommate, close friend, or other loved one. There’s a common myth that all abuse is physical assault. In reality, domestic violence can be much more subtle and complex. You don’t have to wait for it to escalate. Instead, you can get help as soon as you notice any of these types of abuse, no matter how minor they may seem:

  • Intimidation
  • Destroying property 
  • Physical assault
  • Verbal insults
  • Social isolation
  • Forced sex
  • Harming pets
  • Financial, physical, or emotional control
  • Coercion to have sex, drink, or take drugs

Domestic violence can happen to anyone, regardless of their age, gender, or social standing. There’s also a complex relationship between substance use and domestic violence.1 These 2 issues often go hand in hand, and each one makes the other more likely. 

Both perpetrators and survivors of abuse have high rates of addiction.2

The Impact of Addiction on Domestic Violence

Addiction is common among perpetrators of domestic violence.3 25-50% of intimate partner abusers have substance use disorders. And as an abuser’s addiction grows more severe, both the frequency and severity of their abuse increases.4 

It’s important to note that most people experiencing addiction are not violent5 towards others. However, the influence of drugs or alcohol can make people with violent tendencies more likely to act on them.

By definition, being drunk or high changes your brain chemistry.6 As a result, drinking or using drugs can change the way you think, feel, and react to stress. You might be less capable of controlling your anger, making violence more likely. Ongoing drug use increases your risk of violent behavior7 over time. 

Social norms can also contribute to higher rates of violence. In some cultures, “I was drunk” is an acceptable excuse for a wide range of negative behavior, from telling secrets to picking fights. When people feel like they can blame their actions on substances, they may drink or use drugs to justify ongoing violence.8 This mindset can also prevent them from getting the help they need.

Women experiencing alcohol or drug addiction are also more likely to become victims of domestic violence.9 However, studies show that this often relates to their partners’ substance abuse issues even more than their own.

Substance use doesn’t cause domestic violence. And blaming violence on a person’s addiction—whether they’re the survivor or the perpetrator—removes the abuser’s responsibility.

Facts on Substance Abuse and Domestic Violence

Data shows a strong connection between correlate substance use and domestic violence: 

  • Domestic violence survivors are nearly 6 times more likely to develop alcohol addiction. 
  • Nearly 50% of women who enter addiction treatment are domestic violence survivors. The rates are much higher for women in opioid addiction treatment. 
  • When both people in a relationship use substances, their risk of interpersonal violence goes up.
  • 39% of incarcerated abusers have a history of alcohol addiction.
  • 22% of incarcerated abusers have a history of drug addiction.
  • Substance use is involved in up to 80% of child abuse cases.
  • Teens and young adults who were abused in childhood have a higher risk of addiction.
  • Serious physical violence occurs in 8-13% of all marriages.
  • Women who abuse substances are at a higher risk of domestic violence.

How Domestic Violence Can Lead to Addiction

Domestic violence survivors are at a high risk of addiction.12 That’s partly because it’s so common for survivors to self-medicate13 the symptoms of trauma. Survivors are also more likely to experience mental health issues.14 So they may use drugs or alcohol to cope with the symptoms of another diagnosis, like post-traumatic stress disorder (PTSD).

Addiction in Survivors of Intimate Partner Violence

Many people cope with the trauma of intimate partner violence (IPV) by using drugs or alcohol.19 For many survivors, this occasional coping method quickly turns into addiction—especially if you lack other coping strategies. Survivors of IPV also tend to have more severe addiction symptoms. 

Physical injuries from IPV can also lead to addiction. For example, it’s common for IPV to result in chronic pain or traumatic brain injury. Both of these conditions increase your risk of addiction. But developing an addiction also increases your risk of experiencing IPV again, and this can quickly become a cycle. Seeking treatment can keep you safe from further violence. 

Special Considerations for Men Who Have Survived Domestic Violence 

Although most research focuses on women survivors, 25-50% of people who survive IPV each year are men.20 And like women, studies show that male survivors of domestic violence are more likely to develop addiction. But the cultural stigma that male survivors face can be a barrier to treatment and recovery. 

Treatment for Addiction and Domestic Violence-Related Trauma

When you’re recovering from abuse and addiction, it’s ideal to find treatment that addresses both at the same time. Studies show that comprehensive treatment is more effective21 than seeking help for trauma and addiction separately. 

How Does Comprehensive Treatment Work?

Most rehabs that address both addiction and domestic violence offer trauma-informed care. Trauma affects everyone differently, and its impacts can be surprising. A trauma-informed approach accounts for your unique needs during recovery, even as those needs change.

Recognizing your triggers and respecting your boundaries is a huge part of this. For example, you’ll be able to say “stop” at any point in therapy, and take a break or change the subject. The physical environment will also be conducive to healing with well-lit common areas, no loud noises, and safety features like security personnel at entrances and exits. 

Integrated treatment also accounts for the role of trauma in addiction.22 For example, if you’re in cognitive behavioral therapy (CBT), you might learn how to cope with trauma triggers without using drugs or alcohol. These skills can help you navigate long-term recovery from both conditions. 

Aftercare Planning for Survivors of Domestic Violence

For survivors, aftercare includes more than ongoing mental health support. While that’s important, it’s just one part of your safety. In most programs, you can start planning for aftercare as soon as you enter treatment.

When you start rehab, your therapist may ask you to sign a no-contact contract,23 where you’ll agree not to communicate with your abuser during treatment. But after rehab, it’s not always that simple. If you have children with them or share assets like a house, the legal system may require some amount of contact. 

It’s also common for survivors to be socially isolated24 and have fewer financial resources immediately after an abusive relationship. So as you approach the end of treatment, you’ll work with your therapist to create a concrete safety plan25 for after you leave. That plan might include: 

  • Intentions around if, when and how you’ll be in contact with your abuser, including information about your legal rights
  • A safe place to live
  • A new phone number, email address or other contact information your abuser won’t have access to
  • A local therapist
  • In-person support groups
  • Relevant hotlines for social services
  • Other community resources

Healing from abuse is a deeply personal process, and every survivor has unique needs. Your provider can help you find the resources you need to achieve your recovery goals.

You can start healing from abuse and addiction in treatment centers around the world. Rehabs that treat trauma will help you plan for a safer, brighter future. 

Frequently Asked Questions About Domestic Violence and Addiction

How does substance use affect domestic violence?

Substance use is common among both perpetrators and survivors of domestic violence, and it can increase the risk and severity of violent behavior. Alcohol and drugs change brain chemistry, making it harder to control anger and increasing the likelihood of violence.

How can rehab help with domestic violence and addiction?

Rehabs that specialize in treating both addiction and trauma offer a safe, supportive space where survivors can heal from the trauma of abuse while also addressing their addiction. Treatment often includes individual and group therapy, medical care, and complementary therapies. Rehab can also provide survivors with the skills and tools they need to build a healthy, substance-free life after leaving the program. It’s important to choose a rehab that’s equipped to handle both issues and has experience working with survivors of domestic violence.

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Exploring the Link Between ADHD and Addiction

Attention-deficit/hyperactivity disorder (ADHD) is a serious mental health issue. From the name, it’s easy to think this condition is a set of behavioral problems. But those are just the symptoms. In reality, ADHD comes from a neurochemical imbalance—and it’s remarkably similar to the brain chemistry of addiction.

If you’re considering treatment for ADHD and addiction, you can start by learning how they relate to each other.

The Brain Chemistry of Addiction and ADHD

People with ADHD have much a higher risk of addiction. ((Davis, Caroline, et al. “Attention-Deficit/Hyperactivity Disorder in Relation to Addictive Behaviors: A Moderated-Mediation Analysis of Personality-Risk Factors and Sex.” Frontiers in Psychiatry, vol. 6, Apr. 2015, p. 47. PubMed Central, https://doi.org/10.3389/fpsyt.2015.00047.)) This is true across age groups, affecting both adults and teens with ADHD. ((Schellekens, Arnt F. A., et al. “Often Overlooked and Ignored, but Do Not Underestimate Its Relevance: ADHD in Addiction – Addiction in ADHD.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 169–72. www.karger.com, https://doi.org/10.1159/000509267.)) Experts agree that the 2 conditions have “a shared biological background.” Specifically, both addiction and ADHD have an impact on dopamine, which is a neurotransmitter.

Dopamine relates to the brain’s reward system. ((Watson, Stephanie. “Dopamine: The Pathway to Pleasure.” Harvard Health, 20 July 2021, https://www.health.harvard.edu/mind-and-mood/dopamine-the-pathway-to-pleasure.)) This naturally occurring chemical is released when you do something pleasurable. The brain defines “pleasure” broadly: your dopamine might increase when you buy a new pair of shoes, get a job, or eat a cookie. And when an activity feels good, you’re more likely to do it again.

That can be very healthy. For example, you can get dopamine from exercise. ((“Five Surprising Ways Exercise Changes Your Brain.” Greater Good, https://greatergood.berkeley.edu/article/item/five_surprising_ways_exercise_changes_your_brain. Accessed 14 Dec. 2022.)) Your brain is quite literally wired to make you want to work out. But there’s a downside to dopamine. Plenty of activities—like substance use—feel good while doing serious damage to your health. And for people with ADHD, dopamine might already be hard to come by.

The Biology of ADHD

If you have ADHD, it may take extra effort to concentrate, sit still, or complete important tasks. This often interferes with relationships, schoolwork and career. In severe cases, people with ADHD can qualify for disability benefits. ((Is ADHD A Disability? https://www.disability-benefits-help.org/disabling-conditions/adhd-and-social-security-disability. Accessed 14 Dec. 2022.)) But it also comes with some advantages. Like any other type of neurodivergence, this condition changes the way you see the world. And your unique insight can be a strength.

Biologically, people with ADHD can’t regulate dopamine levels. ((Blum, Kenneth, et al. “Attention-Deficit-Hyperactivity Disorder and Reward Deficiency Syndrome.” Neuropsychiatric Disease and Treatment, vol. 4, no. 5, Oct. 2008, pp. 893–918. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2626918/.)) This condition affects at least one of the genes responsible for that process. And that, experts say, “makes it difficult for neurons to respond to dopamine.”

In other words, even if you have healthy dopamine levels, it may not feel that way. So things that “should” be pleasurable might not always feel as good as you want them to.

If nothing feels good enough, it makes sense to go looking for new types of stimulation. This may explain the link between ADHD and risk-taking. ((Shoham, Rachel, et al. “ADHD-Associated Risk Taking Is Linked to Exaggerated Views of the Benefits of Positive Outcomes.” Scientific Reports, vol. 6, no. 1, Oct. 2016, p. 34833. www.nature.com, https://doi.org/10.1038/srep34833.))

Drug use falls neatly into this category.

Dopamine and Addiction

Over time, addiction makes the brain less sensitive to dopamine. ((The Neurobiology of Substance Use, Misuse, and Addiction | Surgeon General’s Report on Alcohol, Drugs, and Health. https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-use-misuse-and-addiction. Accessed 14 Dec. 2022.)) At first, your brain starts associating drugs with a sense of reward. The act of taking drugs triggers a release of dopamine, whether or not the drug itself does.

As you get used to this repeated flood of dopamine, you’ll feel less satisfaction from taking drugs. This effectively increases your tolerance to the drug, so you need to take more of it to achieve the same result. At the same time, you start feeling less pleasure from other activities. So even if you no longer enjoy the sensation of being high, you might still feel driven to take drugs.

These behaviors quickly become a vicious cycle. Psychiatrist and dopamine expert Dr. Anna Lembke explains that for people in this state, joy is often out of reach. “Now, our drug of choice doesn’t even get us high,” she says. “It just makes us feel normal.” ((Hu, Elise, and Audrey Nguyen. “Too Much Pleasure Can Lead to Addiction. How to Break the Cycle and Find Balance.” NPR, 4 Apr. 2022. NPR, https://www.npr.org/2022/03/31/1090009509/addiction-how-to-break-the-cycle-and-find-balance.))

But if you have ADHD, addiction recovery might not be enough to break the cycle. You might stop taking drugs, but still feel unsatisfied with your life. In order to heal from these co-occurring disorders, it’s important to find treatment for both of them.

Treatment for ADHD and Addiction

ADHD is often diagnosed in children ((Braaten, Ellen. “5 Things Parents and Teachers Need to Know about ADHD.” Harvard Health, 27 Oct. 2017, https://www.health.harvard.edu/blog/5-things-parents-and-teachers-need-to-know-about-adhd-2017102712643. and teens, and some people grow out of their symptoms. But that’s not true for everyone. And recent data shows that you can develop ADHD as an adult, ((“‘Late-Onset’ ADHD May Emerge in Young Adults.” Psychiatric Times, https://www.psychiatrictimes.com/view/late-onset-adhd-may-emerge-young-adults. Accessed 14 Dec. 2022.)) even if you showed no signs of it in childhood.

Because of these complexities, you might need different types of treatment in different stages of recovery. And after you complete rehab, you may benefit from ongoing care for addiction, ADHD, or both. Certain therapies are especially helpful for people with these diagnoses.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a popular treatment for many mental health conditions. And a wealth of data supports CBT as a therapy for ADHD and addiction. ((Zulauf, Courtney A., et al. “The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders.” Current Psychiatry Reports, vol. 16, no. 3, Mar. 2014, p. 436. PubMed Central, https://doi.org/10.1007/s11920-013-0436-6.)) This framework focuses more on practical skills than it does on emotional processing. Your therapist will teach you coping strategies for dealing with difficult thoughts, urges, social situations, and more. In between sessions, you’ll try them out in your daily life.

Integrated Cognitive Behavioral Therapy

As the name implies, integrated cognitive behavioral therapy (ICBT) integrates components of CBT ((Capone, Christy, et al. “Integrated Cognitive Behavioral Therapy (ICBT) For PTSD and Substance Use in Iraq and Afghanistan Veterans: A Feasibility Study.” Journal of Traumatic Stress Disorders & Treatment, vol. 3, no. 4, 2014, p. 1000134. PubMed Central, https://doi.org/10.4172/2324-8947.1000134.)) and other treatment methods. Patients learn about their condition, practice mindfulness, and learn flexible thinking skills. You’ll use a workbook, and your therapist will give you homework assignments to complete between sessions. This format empowers clients to develop practical skills and put them to use in real-life situations.

ICBT is a highly effective treatment for co-occurring ADHD and addiction. ((van Emmerik-van Oortmerssen, Katelijne, et al. “Integrated Cognitive Behavioral Therapy for ADHD in Adult Substance Use Disorder Patients: Results of a Randomized Clinical Trial.” Drug and Alcohol Dependence, vol. 197, Apr. 2019, pp. 28–36. PubMed, https://doi.org/10.1016/j.drugalcdep.2018.12.023.)) One study even found it to be more effective than other forms of CBT. ICBT can also treat post-traumatic stress disorder (PTSD). ((McGovern, Mark. Integrated Cognitive Behavioral Therapy for Co-Occurring PTSD and Substance Use Disorders. Clinical trial registration, NCT01457404, clinicaltrials.gov, 23 Oct. 2015. clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT01457404.)) However, like most types of talk therapy, ICBT focuses on mental, emotional, and behavioral issues. Since ADHD is also a neurochemical issue, many people need medical treatment as well.

Medication for ADHD

Prescribing medication to treat co-occurring ADHD and addiction ((Mariani, John J., and Frances R. Levin. “Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders.” The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, vol. 16, no. Suppl 1, 2007, pp. 45–56. PubMed Central, https://doi.org/10.1080/10550490601082783.)) is a controversial issue. If a patient has ADHD without addiction, prescription stimulants are the standard treatment. But stimulants are highly addictive. Because of this, experts disagree about the best course of action.

This controversy even affects people with ADHD who have no history of drug abuse. Some sources caution against treating ADHD with stimulants ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) because of the risk of future addiction. Others say prescribed stimulants protect against addiction, ((APA PsycNet. https://psycnet.apa.org/record/2013-43688-006. Accessed 14 Dec. 2022.)) because they empower patients to manage symptoms in a healthy way.

During addiction recovery, taking medication of any kind can be complicated. Tell your doctor about your history before you start a new prescription. Together, you can make a plan to keep yourself safe. For example, they might only prescribe you a few pills at a time, and ask you to come back into their office before you can get more.

Whatever treatments you pursue, it’s essential for you to get an official diagnosis first. That can be surprisingly difficult, especially for people of certain demographics.

Getting an Accurate Diagnosis

Because of the overlapping symptoms of ADHD and addiction, ((Chardée A. Galán, M. S., and PhD Kathryn L. Humphreys. “ADHD and Substance Use: Current Evidence and Treatment Considerations.” Psychiatric Times, vol. 34, no. 8, Aug. 2017. www.psychiatrictimes.com, https://www.psychiatrictimes.com/view/adhd-and-substance-use-current-evidence-and-treatment-considerations.)) doctors can’t always distinguish between them. This means that if you already have an ADHD diagnosis, you might need to start addiction treatment before you can get one. Most rehabs start their program with thorough assessments, so it’s relatively easy to get assessed for ADHD while you’re in residential treatment. Some doctors even recommend screening everyone in addiction treatment for ADHD. ((Matthys, Frieda, et al. “[Summary of the practice guideline for the diagnosis and treatment of ADHD in adolescents and adults with addictions].” Nederlands tijdschrift voor geneeskunde, vol. 157, no. 24, Jan. 2013, p. A6025.))

In some populations, though, ADHD is harder to diagnose. There are several possible reasons for this. Many clinicians have a preconceived image of what ADHD patients look like. This makes it easy to miss the symptoms when they present in a different way. It can also be hard to differentiate between ADHD and other mental health issues.

ADHD in Teens

For children and teens with ADHD, ((“Severity of ADHD in Children Increases Risk of Drug Use in Adolescence, Says Longitudinal Study.” Https://Www.Apa.Org, https://www.apa.org/news/press/releases/2003/08/adhd-drugs. Accessed 14 Dec. 2022.)) early diagnosis is key. That’s because children with more severe ADHD symptoms are at a greater risk of developing addiction later on. However, ADHD symptoms may not appear before puberty. ((Ostojic, Dragana, and Carlin J. Miller. “Association Between Pubertal Onset and Symptoms of ADHD in Female University Students.” Journal of Attention Disorders, vol. 20, no. 9, Sept. 2016, pp. 782–91. DOI.org (Crossref), https://doi.org/10.1177/1087054714535249.)) And because even healthy teenagers go through behavioral changes, that timing can make it difficult for parents to notice a problem. While this can be an issue for teens of any gender, it’s most common among young women.

Women With ADHD

Data suggests that up to 75% of women with ADHD may be undiagnosed. ((Walters, Anne. “Girls with ADHD: Underdiagnosed and Untreated.” The Brown University Child and Adolescent Behavior Letter, vol. 34, no. 11, Nov. 2018, pp. 8–8. DOI.org (Crossref), https://doi.org/10.1002/cbl.30337.)) That might be because women with ADHD often show different symptoms ((Quinn, Patricia O., and Manisha Madhoo. “A Review of Attention-Deficit/Hyperactivity Disorder in Women and Girls: Uncovering This Hidden Diagnosis.” The Primary Care Companion for CNS Disorders, vol. 16, no. 3, 2014. www.ncbi.nlm.nih.gov, https://doi.org/10.4088/PCC.13r01596.)) than clinicians expect.

For example, one study found that women were more likely to be inattentive than hyperactive. Inattention primarily affects the person feeling it. Your inability to focus on your book won’t distract a stranger at a bus stop. But hyperactivity, which is common in men with ADHD, can be disruptive in a group setting. Both clinicians and patients’ loved ones commonly miss “internalizing” symptoms like inattentiveness. Instead, women with ADHD are often misdiagnosed with bipolar disorder, anxiety, or depression.

Differentiating Between ADHD and Anxiety

ADHD and anxiety ((Pliszka, Steven R. “ADHD and Anxiety: Clinical Implications.” Journal of Attention Disorders, vol. 23, no. 3, Feb. 2019, pp. 203–05. DOI.org (Crossref), https://doi.org/10.1177/1087054718817365.)) often go hand in hand. While ADHD is not an anxiety disorder, ((ADHD and Anxiety: What’s the Connection? 15 May 2017, https://www.medicalnewstoday.com/articles/315303.
)) they can present with similar symptoms. For instance, either condition might get in the way of finishing your homework. In people with ADHD, that’s probably because you just can’t focus. On the other hand, people with anxiety might be able to focus, but afraid of getting it wrong.

ADHD can also cause anxiety. That’s because its symptoms make it harder to achieve your goals. Some people get anxious about the impact ADHD has on their lives. Without proper treatment, it’s all too easy to get stuck in this loop.

If you have both of these conditions, it’s important to get the right diagnosis before taking medication. Otherwise, you’ll risk making your symptoms worse. ADHD patients commonly take stimulants, which can increase anxiety. ((Stimulants – Alcohol and Drug Foundation. https://adf.org.au/drug-facts/stimulants/. Accessed 14 Dec. 2022.)) Stimulants may still be a good fit for some people with anxiety disorders—it all depends on your specific health history. You can work closely with your doctor to design a care plan that meets your needs.

ADHD May Be a Risk Factor for Depression

There’s less of an overlap between the symptoms of ADHD and depression, but they have a strong correlation. People with ADHD often develop depression ((Riglin, Lucy, et al. “ADHD and Depression: Investigating a Causal Explanation.” Psychological Medicine, vol. 51, no. 11, Aug. 2021, pp. 1890–97. Cambridge University Press, https://doi.org/10.1017/S0033291720000665.)) later in life, even if they grow out of childhood ADHD symptoms.

There may be a genetic link between these conditions. And people with ADHD and depression often have other mental health issues, like addiction or trauma. Recovering from these co-occurring disorders is complex. You may require specialized care, and ongoing treatment even after rehab.

Post-traumatic Stress Disorder

Everyone experiences trauma differently. Something that feels like just a bad day to you might be deeply traumatizing for someone else. And your personal history can make you more or less likely to develop post-traumatic stress disorder (PTSD).

ADHD increases your risk of developing PTSD ((Biederman, Joseph, et al. “Is ADHD a Risk for Posttraumatic Stress Disorder (PTSD)? Results from a Large Longitudinal Study of Referred Children with and without ADHD.” The World Journal of Biological Psychiatry, vol. 15, no. 1, Jan. 2014, pp. 49–55. DOI.org (Crossref), https://doi.org/10.3109/15622975.2012.756585.
)) in response to trauma. That’s especially true for people with both ADHD and alcohol addiction. ((Luderer, Mathias, et al. “ADHD Is Associated with a Higher Risk for Traumatic Events, Self-Reported PTSD, and a Higher Severity of PTSD Symptoms in Alcohol-Dependent Patients.” European Addiction Research, vol. 26, no. 4–5, 2020, pp. 245–53. www.karger.com, https://doi.org/10.1159/000508918.)) And data shows that people with ADHD experience a higher number of traumatic events, whether or not they develop PTSD.

If you have trauma symptoms, you might benefit from trauma-informed care (TIC). TIC is a general approach to treatment, not a specific type of therapy. This means you can get trauma-informed care for ADHD, addiction, PTSD, and any other concerns you’re seeking help for.

Many Roads to Recovery

Everyone’s recovery is unique, and that’s doubly true for people with co-occurring disorders. Your provider will help you design a care plan that accounts for your various goals.

The act of healing can empower you to understand the depth of your emotional experience. That’s how it happened for Peach Perkins.

Peach is in recovery from ADHD, alcohol and drug addiction, ((ADHD and Substance Abuse: ADHD Aha! Podcast. https://www.understood.org/en/podcasts/adhd-aha/adhd-and-substance-abuse-peachs-story. Accessed 14 Dec. 2022.)) as they explained on the podcast ADHD Aha! But it took them almost a year of sobriety to understand how those conditions worked together. At first, they thought addiction was “the thing preventing me from doing a good job at work. Now I can really go all in. And I was still at work, just my eyes were crossed and I still couldn’t do what I needed to do. That wasn’t what was in my way.” After that realization, they were able to get an official ADHD diagnosis. With the right diagnosis, they finally got the treatment they needed—and you can too.

Find Balance in Treatment for ADHD and Addiction

ADHD is often, but not always, a life-long condition. Recovery usually doesn’t mean getting rid of your symptoms entirely. Instead, you’ll learn to manage them in a healthier way. And those coping skills can make it easier to heal from co-occurring diagnoses like addiction.

Learn more about rehab programs for ADHD, including their locations, pricing, insurance coverage, and more.

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Dopamine and Addiction: What’s the Connection?

Addiction changes how the brain functions. It especially impacts the brain’s “reward system,” which is largely based on dopamine. This hormone is responsible for our pleasure response, along with other important functions like memory, attention, and mood.

Understanding addiction is an important part of recovery. Knowing there’s a physiological reason for your addiction can relieve some of the shame around it, so you can move forward in your healing journey. And gaining perspective on what’s driving your behavior can help you make lasting change.

A Peek Inside the Brain’s Reward System

We can experience pleasure from all kinds of activities, whether it’s exercise or scrolling social media. Our brain’s reward system is responsible for that feeling, and the desire to seek more of it.

How It Works

Your brain produces a chemical called dopamine. Dopamine is both a hormone and a neurotransmitter, meaning it’s used to send messages between your nerve cells. It’s tied to many functions, from mood regulation and memory to learning. It’s known as the “feel-good” chemical for the large role it plays in pleasure and motivation.

Dopamine is released along different neural pathways when we anticipate and experience something pleasurable. ((Trevor Haynes. (2018, May 1). Dopamine, Smartphones & You: A battle for your time. Science in the News. https://sitn.hms.harvard.edu/flash/2018/dopamine-smartphones-battle-time/ )) As it’s released, it affects dopamine receptors that live along these pathways, resulting in feelings of euphoria or happiness. This is known as the reward circuit.

The reward circuit activates areas of the brain that relate to focus, learning, taking action, and motivation.

The brain builds connections between a stimulus and pleasure that follows. ((Martinez, J. L., & Derrick, B. E. (1996). Long-term potentiation and learning. Annual Review of Psychology, 47, 173–203. https://doi.org/10.1146/annurev.psych.47.1.173)) Your reward circuit strengthens each time this process occurs. The more frequently it happens, the stronger your response is. Also called a reinforcing effect, it’s involved in how we form habits. ((Volkow, N. D., Fowler, J. S., Wang, G.-J., Swanson, J. M., & Telang, F. (2007). Dopamine in drug abuse and addiction: Results of imaging studies and treatment implications. Archives of Neurology, 64(11), 1575–1579. https://doi.org/10.1001/archneur.64.11.1575))

Cues leading up to pleasure are important. Dopamine makes us pay attention to markers that lead to a reward. This means dopamine activates before you even engage in a pleasurable activity.

This system helped early humans survive by rewarding beneficial behaviors, like eating. When it’s in balance, it allows us to stay focused, motivated, and happy. Dopamine imbalance is linked to mental health issues, like depression, and substance use disorders.

The Reward System at Different Stages of Addiction Recovery

Substances bypass the body’s natural dopamine production by directly flooding the reward system with it. Some substances do this more intensely than others:

Stimulants like cocaine can release up to 10 times the amount of dopamine your body would naturally produce. ((The brain in recovery. (2017, January 28). Recovery Research Institute. https://www.recoveryanswers.org/recovery-101/brain-in-recovery/ ))

The Early Stages of Substance Use

The first time a substance is used, it creates a direct dopamine response. This intensity of this varies from person to person. According to neurotheology specialist Dr. Cyrus H. McCandless, “you can never accurately predict how much reward you’re going to get.” ((Misunderstanding dopamine: Why the language of addiction matters | Cyrus McCandless | TEDxPortsmouth. (n.d.). Retrieved September 30, 2022, from https://www.youtube.com/watch?v=aqXmOb_fuN4 ))

Your brain remembers everything leading up to a reward, so it can repeat the experience. This drives the desire to use more of a substance. As dopamine levels go up, serotonin, which helps us feel satisfied, goes down. This creates a cycle of wanting more while feeling less satiated.

This cycle doesn’t just apply to substance use. Altered dopamine pathways are seen in behavioral addictions, ((Grant, J. E., Potenza, M. N., Weinstein, A., & Gorelick, D. A. (2010). Introduction to behavioral addictions. The American Journal of Drug and Alcohol Abuse, 36(5), 233–241. https://doi.org/10.3109/00952990.2010.491884 )) including gambling, shopping, and sex.

Building Tolerance

Usually, brain chemistry returns to normal after a dopamine release. But continued substance use surges the brain with dopamine until it becomes overstimulated. Over time, the body wants to balance out, so it shuts down dopamine receptors. As a result, we won’t feel the same high from using the same amount of substances as before. This is how the brain builds tolerance. ((Volkow, N. D., Wang, G.-J., Fowler, J. S., Tomasi, D., Telang, F., & Baler, R. (2010). Addiction: Decreased reward sensitivity and increased expectation sensitivity conspire to overwhelm the brain’s control circuit. BioEssays : News and Reviews in Molecular, Cellular and Developmental Biology, 32(9), 748–755. https://doi.org/10.1002/bies.201000042 ))

Addiction

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has 4 criteria for classifying and diagnosing substance use disorders: ((McNeely, J., & Adam, A. (2020, October). Table 3, dsm-5 diagnostic criteria for diagnosing and classifying substance use disorders [abc] [Text]. https://www.ncbi.nlm.nih.gov/books/NBK565474/table/nycgsubuse.tab9/ ))

  • impaired control
  • social impairment
  • risky use
  • pharmacologic traits

The reward system plays a significant role in these.

Substances artificially change dopamine production. This can signal to the brain that substances are more important than other natural rewards. Eventually, natural rewards become less exciting and the brain learns to value substances ((MIT scientists discover fundamental rule of brain plasticity. (n.d.). MIT News | Massachusetts Institute of Technology. Retrieved September 30, 2022, from https://news.mit.edu/2018/mit-scientists-discover-fundamental-rule-of-brain-plasticity-0622 )) above all else.

Neuroplasticity, or the brain’s flexibility, ((Castrellon, J. J., Seaman, K. L., Crawford, J. L., Young, J. S., Smith, C. T., Dang, L. C., Hsu, M., Cowan, R. L., Zald, D. H., & Samanez-Larkin, G. R. (2019). Individual differences in dopamine are associated with reward discounting in clinical groups but not in healthy adults. Journal of Neuroscience, 39(2), 321–332. https://doi.org/10.1523/JNEUROSCI.1984-18.2018 )) also plays a part in addiction. We can get used to higher levels of dopamine following prolonged substance use. But an overstimulated brain no longer produces as much of it. Instead, it relies on substances.

Withdrawal

It’s not possible to keep up substance-induced levels of dopamine at all times. Drops in dopamine levels can contribute to withdrawal symptoms:

  • depression
  • anxiety
  • cold sweats
  • headaches
  • and others

For many people, detox is the first step in the recovery journey. As substances leave your system, your body and brain recalibrate. Low dopamine levels during withdrawal can make this process difficult. But thanks to neuroplasticity, we can nurture our brain chemistry back to normal over time.

Note: Depending on the substance, detox can be life-threatening and shouldn’t be attempted alone.

How Long Does It Take for the Reward System to Recover?

Each person has different levels of dopamine and dopamine receptors. ((J R Beveridge, T., R Smith, H., Nader, M., & Porrino, L. (2008). Abstinence from Chronic Cocaine Self-Administration Alters Striatal Dopamine Systems in Rhesus Monkeys. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 34(5). https://doi.org/10.1038/npp.2008.135))  The time it takes for the reward system to return to normal after prolonged substance use varies. Factors like the type of substance and level of use will impact recovery time. In general, it takes the brain up to 14 months to recover.

brain recovery timeline

30 days of abstinence

Brain scans show significant improvement and more dopamine receptors in just one month of abstinence from methamphetamine. ((National Institute on Drug Abuse. “Treatment and Recovery.” National Institute on Drug Abuse, –, https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery.))

90 days of abstinence

Brain scans in one study showed no significant difference in dopamine receptors following 90 days of abstinence compared to 30 days. ((J R Beveridge, T., R Smith, H., Nader, M., & Porrino, L. (2008). Abstinence from Chronic Cocaine Self-Administration Alters Striatal Dopamine Systems in Rhesus Monkeys. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 34(5). https://www.researchgate.net/figure/Representative-autoradiograms-of-3H-SCH-23390-binding-to-D1-receptors-top-panel-and_fig1_23234006 )) This indicates that recovery is possible, but it takes time.

14 months of abstinence

The brain’s reward circuit, including dopamine receptor levels, returns to nearly normal after 14 months of abstinence. ((“The Brain in Recovery.” Recovery Research Institute, 28 Jan. 2017, https://www.recoveryanswers.org/recovery-101/brain-in-recovery/.))

Repairing Your Brain in Recovery

The human brain is capable of amazing things, including the ability to modify and change throughout your lifetime. For many, it’s comforting to know that changes to the brain caused by substance use disorder are reversible. Your brain can repair and heal, if you facilitate its healing.

Rehab can help you do just that. Learn more about RehabPath and its latest announcements, and compare your options in our directory of treatment centers.

Reviewed by Rajnandini Rathod