Dr. Goschi's Blog

Stress, Pot and Addiction

Stress, Pot and Addiction

New research in the journal of Abnormal Psychology (May, 2018) highlights how heavy marijuana users deal with stress. Chronic pot smoking leads to an overreaction to stressful situations. Research found that these individuals easily became stressed and unable to problem solve versus moderate consumers. Most pot smokers say they smoke pot to “relax” or escape a stressful job. Perhaps recreational marijuana consumption leads to relaxation but not habitual heavy use.

Researchers Hefner et al from University of Wisconsin in Madison found heightened startle responses to even the anticipation of stress among heavy marijuana users. Heavy pot usage involved daily use sometimes as much as twice a day. This finding contradicts self-reports from fifty percent of pot users that claim marijuana reduces their stress. Why is this important? Because, addiction relapse for many addicts can be traced to the person’s inability to manage stress.

Hefner et al reported physiological responses in abusers. They claim “heavy and chronic (marijuana) use contributes to heightened behavioral and affective response(s) to stressors via central nervous system…” Indeed, these “stress neuroadaptations” result in poor emotional reactions to stress. Maladaptive responses escalate even more when the individual stops using the drug. Heavy marijuana abuse leads to long term changes in the users central nervous system. This implies that the addict won’t cope well with stress going forward until they make some serious and lasting changes to their lives.

The research supports using the word addict to describe the heavy marijuana abuser as they show signs of addiction. Many debates insist that marijuana does not possess addictive properties. Yet, withdrawal from pot shares many similarities to other addictions, “marijuana withdrawal syndrome … involves increased affective symptoms (irritability, anger or aggression, nervousness or anxiety)…” It becomes a viscous cycle for the abuser, one of an inability to cope with stress leading to mounting stress resulting in increased drug usage. Minimal indulgence in marijuana (only occasional use), did not show greater reactivity to stress.

How can individual therapy help the marijuana abuser/addict? Therapists should help the individual identify personal stressors. These events may involve finances, housing and/or relationships. Therapy should target these stressors by teaching better coping skills to minimize the impact of the stressor. Individual addiction therapy helps individuals “reshape” their environment while maximizing lifes predictability. Attending NA meetings and working the 12 steps is enormously beneficial in maintaining sobriety. Individual therapy assists the individual work through fears and anxiety which trigger the addictive response.

If you are struggling with addiction Dr. Goschi can help. Call today to set up your individual appointment at (312)595-1787 or email at barbara@drgoschi.com.

Suicide

Suicide

The focus moves to depression and suicide after Kate Spade and Anthony Bourdain took their lives.  But, the suicide rate has been going up steeply since 2008 and no one really talks about it. The British Journal of Psychiatry posted an article on January 2, 2018  written by Reeves, McKee and Stuckler talking about the 10,000 suicides related to the job losses and overall bad economy during the recession between 2008 and 2010. Somehow this disturbing information was mostly ignored.  Stuckler also discussed an alarming trend that talked about all mental health issues rising.

People don’t like to talk about mental health very much until some tragedy occurs.  I’ve seen this avoidant pattern for the 30 years that I’ve been treating couples and individuals.  Seeking individual therapy for depression, anxiety or some other issues can result in the individual feeling ashamed.  Individual’s worry about the stigma of seeking individual psychotherapy.

In this age of eating healthy and working out it still seems like people at large don’t focus as much on mental health.  We should speak more openly and encourage our friends struggling with depression to seek individual treatment. However, it can be awkward to speak with a friend about their mental health issues.  It feels like a boundary intrusion. We might even hope that the pain goes away once the person gains some distance from the seeming catalyst, such as a death or loss of job.

Some people experience unrelenting depression unrelated to a specific catalyst.  Despite the individual’s life seeming wonderful they still cannot experience joy.  Even a bad hamburger in an airport could trigger a relentless depressive episode for Anthony Buordain.  Peter Splendorio quoted Bourdain in his June 8, 2018 Daily news article as saying “It’s a hamburger but not a good one.  Suddenly, I look at the hamburger and I find myself in a spiral of depression that lasts for days.” Clinicians understand this symptom as anhedonia.  Anhedonia is the inability to feel joy over life events which would usually bring one pleasure.

In these instances, family and friends find it hard to be around their loved one who cannot experience joy.  It can be exhausting and stressful to always worry about your family member. If the person tries to put on a happy face in front of everyone it will cause further stress.  The person’s moods come crashing down when they get home. Couples and family therapy help the family members and spouses of such individual’s develop empathy and understanding for toward their loved one.

Our culture demands quick fixes.  Just take a pill and it will alleviate your woes.  Depressive symptoms respond well to medication. However, meds should never be prescribed without the therapeutic relationship to back them up.  Individual counseling augments the beneficial effects of psychotropic meds. If you take antidepressants, for example, you should also see a therapist in individual therapy weekly.  Seriously, no less! Your therapist develops an intimate relationship with you. They have eyes on their patients. The therapist often sees when things start going wrong.

Bottom line is that individual therapy should be encouraged for those struggling with some kind of mental illness, especially depression.  Let’s destigmatize therapy so more individuals reach out for help when needed. Please, if you know someone who needs help or if you are struggling don’t hesitate to seek individual treatment.  If it’s an emergency and you feel like taking your life call 911 or go to the nearest emergency room. I’m here to help. Call today at (312)595-1787 or email me at barbara@drgoschi.com