Thoughts on Addiction and ADD
A recent cover story in Time Magazine, “How We Get Addicted” from their July 16, 2007 publication, got me thinking about addictions again. Specifically, those with ADHD and addictions. Addictions are common in adults who have ADD, and near-addictions and intermittent substance abuse are more the rule than the exception. This may be because of an inborn physiological problem that makes finding pleasure in ordinary ways much more difficult for the person who has ADD than for the person who doesn’t have it.
It is interesting that brains scans of addicts suggest that they have reduced activity in the prefrontal cortex. People with ADHD also show reduced activity in the prefrontal cortex.
This is the part of the brain that controls rational thoughts that can override impulses. It is unclear whether addiction causes this reduced activity or whether reduced activity, such as you see with ADHD, helps lead to addiction due to low impulse control. In any event, we do know that rates of addiction are significantly higher for those with ADHD than for those without.
Though addiction commonly refers to substance abuse or behavioral addictions like sex and gambling, there are other kinds of non-traditional pseudo-addictions that you might consider “treating” if you have ADD.
- Some adults with ADD cannot let go of their sense of unworthiness, behaving as if they were addicted to feeling shame, guilt and unworthiness.
- Some adults with ADD are addicted to conflict. Wherever they go, they instigate an argument. They have insight into the problem, but they can’t stop doing it – as if they are addicted to the negative feelings associated with interpersonal conflict.
- Some adults with ADD can’t stop procrastinating. No matter how many systems they put into place, they find themselves getting into a frenzy to do things at the last minute. They seem addicted to the pain of the last minute crisis.
For all of these addictions, I ask you to consider these ideas. The first is the power of connection. Human connection, in the form of friendships, memberships, involvement in relationships and groups where you are deeply valued and understood are critical for the person who is trying to overcome an addiction of any kind. Fellowship is the best and safest “drug” we have.
Medications can also help. We have come a long way in our ability to prescribe medications that treat the subtle kinds of desperation, depression and anxiety that can lead to self-medication.
Exercise can help a great deal – it’s one of the best tonics we have for the mind and soul. Aerobic exercise stimulates the production of various chemicals in the brain providing both sensations of pleasure in the brain and increasing focus. Nutritional interventions, such as omega-3 fatty acids help stabilize moods.
I have seen 12-step programs, such as the one used by Alcoholics Anonymous, used with great effect, even for those who are dealing with the less-traditional ADD behaviors that seem like addictions. These programs are not for everybody, but I urge people to think twice before they dismiss a 12-step program. Whether a person suffers from a true addiction – to alcohol, other drugs, food, sex, gambling, shopping, work, exercise or whatever – or behaves as if he were addicted to some of the negative feelings created by symptoms of ADD, he may find that a 12-step program allows him to let go of whatever it is he has been unable to let go of so far.