mental illness and addiction

Why Is Addiction A Physical, Mental and Spiritual Condition?

Why do they say that alcoholism and other addictions are a physical, mental and spiritual condition? 

Not to seem like a wise guy, but it's because they are.  Addiction affects us in many ways.  Let's look at some.

Most of us can understand the physical part.  We get sick, we feel shaky when we need our drugs.  We suffer withdrawal when we stop after using too much.  A hangover is simply short-term withdrawal, for example, and the fun increases the longer we use.  After prolonged use of alcohol and/or other drugs our health may start to deteriorate.  We may lose or gain weight, develop digestive problems, the shakes, liver problems, and a variety of other symptoms of physical decline.  Clearly the disease of addiction affects us physically.

It's not too hard to discern some mental effects, either.  When we're using, our minds obviously don't work in the same fashion as when we're straight, and over time the dysfunction begins to predominate.  As we reach the point of chronic use and addiction we may develop mental issues that can range from paranoia to mania, depression, and just about anything in between.

Even the various forms of denial that allow us to continue to fool ourselves that we're okay are a form of mental aberration.  As we progress in our addiction, our thinking and reasoning ability may begin to deteriorate.  In some cases, this can lead to various forms of dementia that are usually permanent.

However, spiritual deterioration is sneaky. 

Before I get into just how sneaky, I need to explain that by “spirituality” I mean the qualities of the human spirit that relate to the people and things around us.  No metaphysical or religious connection need be involved, although the qualities of spirituality are certainly necessary for those things to flower.

One of the first things to go is honesty. 

We begin to lie to ourselves and others about matters related to our drug use.  We tell ourselves that we can stop whenever we like — we just don't want to. 

We lie to our families about when and how much we have used. 

We call in to work with the “stomach flu,” when in fact we have a bad hangover. 

We steal time and services from our families and employers, and lie about our reasons.  When we've done that long enough, it becomes habitual. 

We are no longer the honest people we once were, even though we may console ourselves that we haven't stolen anything or harmed anyone by our neglect of the facts.

Compassion goes out the window.  We armor ourselves against the concerns, needs and pain of others, because to acknowledge them would be to admit our own part.  As our lives center more and more around getting and using our drugs, we reach a point where we're immune to any feelings but our own.  Those, we try to squash with drugs, because the reality is too painful to consider.  Relationships and family ties deteriorate.

We are quick to create resentments that justify our actions, and to forget what we may have known about forgiveness.  If I can hold your behavior against you, then I don't need to worry about how you feel, or about your opinions.  You're the bad guy, and forgettable, even though you may be right.

Love and the idea of joy either disappear, or become so distorted that we have no idea what they used to mean.

And so on, and so on.

Most of us draw away from our religious beliefs as well.  It becomes apparent to us that we are falling short of our convictions, and so we change those to accommodate our current lifestyle.  Morality may be an issue, if we have been promiscuous or dishonest.  We fear the consequences of those things predicted by our religion, and thus we can't afford to believe any longer.  We may cling to some beliefs that fit our situation, reject religion altogether, or become convinced that we are terrible people who are doomed.

So addictive disease is, indeed, a physical, mental and spiritual issue.  If we don't address all three equally in our attempts at recovery, we will almost certainly fail to gain the true benefits of a sober life, even though we may fool ourselves that we're okay, simply because we aren't using drugs.

But are we really okay?  Think about it.

Help or enable — what if the person is mentally ill?

A reader writes:

My adult son plays me like a fiddle, but I am confused as to where do I draw the line because he is mentally ill. I am so stressed about this that I can barely function and I am going broke and he isn't getting better. Can you provide any advice? Thanks.

Mental illness and addiction seem to go together.  Some people learn that they can self-medicate by using alcohol or other drugs, thereby moderating their symptoms.  Others may be less mentally-ill than simply suffering from messed-up brain chemistry due to the drugs.

In any case, the presence of chemicals always complicates treatment for other disorders. In fact, it's nearly impossible to treat mentally-ill people effectively if they are still using.  How, for example, is a physician to treat depression in a person who is addicted to alcohol or opiates, both of which cause depression?

Would that I had an easy answer, but there are none when it comes to addiction and other mental disorders.  So let's approach this problem from a different direction.  You write, “I am so stressed about this that I can barely function and I am going broke and he isn't getting better,” so let me ask you a question.  If you are going nuts and broke, how are you ever going to be able to help your son?  Would it not be better to get your own situation under control, keep your sanity and whatever resources you have left, and stop banging your head against the wall?

The fact is, your son is quite aware that he can “play you like a fiddle,” and he has no reason to try to get better.  It gets back to the simple fact that when you make his life easier, you remove any incentive to change.  You did not state what his mental problems may be, but one thing is sure.  You can't help him if you're losing your own ability to function.

So I suggest you start taking care of yourself.  Begin by attending some support groups — I suggest Al-Anon, and perhaps one for people dealing with mentally disabled dependents.  Your local mental health association should be able to direct you to some of the latter.  As for Al-Anon, there are meetings all over the world, and I strongly urge you to avail yourself of the understanding and companionship of people who know where you're coming from.  Only by dealing with your own confusion and coping problems will you reach a state where you are able to help your son when — and if — he decides to accept effective assistance.

In the meantime, I would suggest that you minimize any “helping” that in any way facilitates his drug use.  If he is unable to care for himself, then perhaps throwing him out is not the kind of tough love that would be helpful.  If, however, he is capable of fending for himself, even at a low level, let him know that he has a choice: give up the cushy life at your house and take over his own life, or go get some treatment.

In any case, you need to take care of yourself first.