Stress and Addiction: The Vicious Cycle

By Jessica Peyton, Jen Hames, Rebecca Llontop, and Mike Many

Meeting deadlines. A family crisis. Juggling social obligations. We all have responsibilities that demand effort. Given all this, who isn’t stressed?

While most people are aware that stress can be a factor in how much and how often you choose to drink, the term “stress related drinking” remains ambiguous. Here we use it to discuss the consumption of alcohol or drugs in response to environmental stressors. For example, a college student is overwhelmed with needing to finish two papers by the end of the week, upcoming exams, and a fight she had with her roommate. Then her mother calls to let her know that her grandfather is sick. This student, extra anxious come Friday, might agree to go out with her friends to forget about her problems for a while. Once out, the alcohol flows – a temporary release from what feels like continual stress.

But what happens when someone habitually uses alcohol or drugs as a means of coping with stressful situations? Studies show that the substance abuse itself becomes a stressor, triggering a cycle of use that can ultimately result in the development of an addiction. As Enoch Gordis, M.S. states in his commentary Drinking and Stress, “Why people should engage in an activity that produces effects similar to those that they are trying to relieve is a paradox we do not yet understand.”

Today, new research offers some insights regarding the cyclical nature of stress and addiction. Returning to the example of a college student, stress related drinking is primarily social in origin. According to Wesley H. Perkins (1999) students are constantly bombarded by academic, social, and family stressors. Particularly at the nation’s top institutions, the student body is characterized by perfectionist personalities, people who are acutely aware of the expectations for them to be straight-A scholars, winning athletes, and socially popular. Substance use, particularly alcohol, is one potent option to relieve anxieties and forget disappointments. Moreover, you are also being social by getting out and commiserating with people experiencing the same stressors.

The same Perkins study speaks to the differences in gender and how each sex uses alcohol in response to stress. Men in college tend to use drinking more for social purposes, rather than stress relief. However, men who continue to drink heavily after graduation, away from college’s social atmosphere, began to do so in response to stress. A new job, all those bills, being lonely, it can all up the number of beers drained and the nights out.

Unlike the guys, women use drinking for social purposes and stress relief while still in college. However, the two sexes are similar in that women who continue to drink frequently after college do so in response to perceived stress in their lives. Interestingly, stress-related drinking’s negative effects are more pronounced and begin sooner in post-collegiate women than men.

While college students may not appreciate being compared to monkeys, the Morgan et al. (2002) study offers another stressor typically experienced by young adults: the drive for social dominance. In this research, monkeys were housed individually for one and a half years and then placed in social cages of four monkeys each. Researchers then observed the patterns of aggression among the monkeys, and concluded that being low in social dominance is stressful. Dopamine levels dropped for these animals. When self-administered cocaine was made available to the monkeys, the subordinate animals got hooked on the dopamine boost from the cocaine. This suggests that “alterations in the environment can produce profound biological changes that have important behavioral association, including vulnerability to cocaine addiction” (see the Addiction and Our Faultlines post for further discussion).

So what do monkeys have to do with college students? In a way, students are also placed in a cage, the university setting of dorms, sports teams, and groups of friends, sparking the struggle for achieving and maintaining social popularity (see more here on social hierarchies and stress). And while it does not follow that all geeks will become coke addicts, the Morgan study does infer that people who feel socially ostracized and use substances to cope with feelings of inferiority are at a higher risk for developing an addiction. Ironically, their substance dependence can then cause more intense social rejection, and cycle back to increase stress. The addiction itself becomes a motivation for using.

The question remains as to why people continue to abuse substances as a means of stress relief even after the use itself becomes a stressor. Such individuals are paradoxically putting themselves in more stressful situations in order to deal with present stress. This seems, frankly, a no-brainer – stop!

But then let’s consider the case of adrenaline junkies. You can skydive, climb a mountain, or ride a rollercoaster, effectively voluntarily placing yourself in duress in order to experience release from other pressures. Robert M. Sapolsky’s Why Zebras Don’t Get Ulcers discusses the science behind such habits, explaining that the dopamine levels in these risk-takers return to a lower baseline after each adrenaline-inducing activity. Consequently, they are always searching for a greater rush.

A thrill-seeker is constantly searching for a faster rollercoaster or bigger mountain to conquer. In the same way, an addict becomes entangled in the quest for a better fix. And while a work promotion might raise one’s dopamine levels by 10-15%, drugs can cause up to a 1000% increase (Why Zebras Don’t Get Ulcers). An overworked tax attorney might stop at the bar after work, perhaps even with a group of his colleagues, in search of relief after a stressful day. Yet, studies show that using alcohol and drugs actually induces stress by constantly activating the brain’s stress systems, rendering individuals extremely susceptible to the pharmacological impact (Enoch Gordis, M.S.). Aha! – here lies the point of transition where a substance can go from a stress-reliever to a stressor.

So if we understand stress to be socially motivated by academic, professional, and inequality demands, compounded by the search for a better fix, there a few questions left to address.

• Does stress promote substance use or does substance use promote stress?

The point is not the origin of stress, but rather, the measures that can be taken besides alcohol and drugs to reduce it. Those of us experiencing social pressures can learn to differentiate between healthy and unhealthy ways of alleviating stress.

• So if stress and addiction are linked, will a drink or two cause me to fall victim to this vicious cycle?

Probably not. The stress-addiction cycle should not make you feel powerless. In fact, it’s quite the opposite. You have control over how you choose to cope with daily stressors. Granted, it’s hardly fair to expect an alcoholic, the next time he reaches for a beer, to close his refrigerator door, and announce, “Nevermind, I think I’ll go for a nice walk instead!” However, it is reasonable to focus the prevention of addiction on alternate forms of stress relief, outside of substance use. After all, Alcoholics Anonymous preaches HALT: Don’t get hungry, angry, lonely, or tired. These are stressful states, and can lead to relapse.

For those already trapped in the cycle, Caroline Knapp offers her own take on dealing with the stress of addiction. In her memoir, Drinking: A Love Story, she acknowledges, that “like vigorous exercise, sobriety can also be tiring, wearying” (Knapp 266). For Knapp, being sober forced her to confront her insecurities and frustrations she had previously drowned in alcohol. Yet her AA meetings kept her from using, providing inspiring examples to remain sober: “I heard a guy named Bill talk about living with fear, and he had to keep reminding himself that there’s a big difference between walking through fears, which you do in sobriety, and escaping them, which you do through drink” (Knapp 280).

Whether you are a college student or a monkey, life is stressful. Thus, the prevention and treatment of substance dependence should take the cyclical nature of stress into greater consideration, and particularly its dual cause and effect roles in addiction. Like Knapp mentions, it is crucial not to ignore stress, but rather, confront it head on. Substance use only masks the problem, and over time, causes it to grow even larger. By reducing stress-related substance use, we decrease our likelihood of continuing to return to it every time we experience life’s uncomfortable and weighty pressures. The cycle of stress is a difficulty we all must inevitably confront. However, addiction is one stress that can be avoided, provided we use healthy ways to manage the stress that accompanies or lives.