Phase Shift: Which people are more prone to addiction
People become addicted not only to alcohol, gambling and strong substances. Pathological cravings are sometimes inexplicable from the point of view of a normotypic person. In which cases addiction requires serious treatment, which types of addictions are considered the most difficult, whether a teetotaler can grow up in a family of alcoholics, and which genes are responsible for the unrestrained desire to take risks — in the Izvestia material.
Complete nonsense
In modern psychology and psychiatry, addictions are usually divided into chemical and non-chemical ones, recalls Daria Serebryakova, a clinical psychologist and deputy head of the rehabilitation program at Dr. Isaeva's Clinic. Alcohol, drug, and drug addictions are in the first group. The second category includes various forms of addictive behavior: obsession with games, sports, extreme sensations, certain types of activities and products. Eating disorders occupy a separate place. Strictly speaking, this problem is not classified as an addiction and is considered as an intermediate link between chemical and non-chemical addictions.
At the same time, the key importance for specialists, according to the editorial interlocutor, is not even the type of addiction, but the characteristics of a person's personality and the presence of concomitant mental disorders.
— Sometimes we are faced with a situation where serious mental illnesses are behind the addictive behavior. Dependent behavior is very often associated with personality disorders and impaired emotional self—regulation, the expert emphasizes.
It happens that a person with a relatively mild degree of addiction to alcohol or even drugs is able to cope with his problem much more easily than a person with an apparently harmless hobby that has developed on pathological grounds, says the psychologist. For example, excessive passion for sports or the pursuit of an ideal body can develop into severe forms of dysmorphic phobia (obsessive fear of non-existent or minor flaws in appearance) and dysmorphic disorder (delusional disorder, complete conviction of one's ugliness). There are also cases when the need to build muscle mass turned into a painful fixation on one's own body and led to serious consequences, explains Serebryakova. A person begins to commit actions that are dangerous to the body and health: to "reshape" his appearance, to exhaust himself for hours in the gym, abandoning other joys of life. In the future, according to the expert, chemical dependencies may also join this.
"Schizophrenia, as it was said"
There are worse things than "normal" addiction. Sometimes what looks like an addiction from the outside can actually turn out to be a super-valuable idea or even a delusional disorder, which is much more dangerous, warns Daria Serebryakova. At the same time, a person is not able to regulate his emotions and behavior, and the activity on which he is fixated becomes the only content of life.
— For example, from the outside it may seem that someone is very passionate about invention, but in fact this is nonsense of invention within the framework of schizophrenia. Formally, we see dependent behavior, but its nature is completely different. Such cases require a thorough differential diagnosis," the expert comments.
Some forms of dependence on spiritual practices are also dangerous, including involvement in destructive religious groups and sects, the clinical psychologist emphasizes. If such an activity gradually destroys all areas of a person's life, deprives him of social connections, leads to financial losses and loss of critical thinking, then we can talk about dependent behavior.
The main criterion for making a diagnosis is the so-called loss analysis, the Izvestia interlocutor points out. Experts assess how problematic behavior affects work, finances, personal relationships, mental and physical health, as well as possible problems with the law. The scale of these consequences makes it possible to understand that we are no longer just talking about a hobby or interest, but about the formed dependent behavior.
Adele's syndrome
Among the unusual (against the background of widespread alcoholism and drug addiction) addictions, experts single out the so—called Adele Hugo syndrome - love that has turned into addiction. The name was given to him by the sad fate of the daughter of the French writer Victor Hugo — her life was destroyed by hopeless love for officer Albert Pinson. Adele pursued the object of her adoration, paid his gambling debts, interfered with personal relationships with other girls, and eventually lost her mind due to pathological passion.
— In clinical practice, we often see that pathological passion is based not just on strong feelings, but on serious mental disorders. This condition is most common in women and usually develops either as part of a severe personality disorder or against the background of an endogenous process, such as a manic episode in bipolar disorder or some forms of schizophrenia," says Daria Serebryakova.
Dependence is evident if feelings for the object of love turn into obsession. In this case, we are often talking about a person with whom there is no real relationship and has never been.
— Harassment begins, constant attempts to achieve contact, blackmail, obsessive behavior is evident. A person can sell property in order to win the object of his affection, completely rebuild his life according to passion. In severe cases, suicidal attempts occur," explains the clinical psychologist.
Similar conditions occur in men, manifesting themselves precisely in the form of harassment of the object of attraction, the expert adds. Although women are also able to pursue the object of their love, despite the lack of a real relationship or even a hint of it. This happens in the case of fans of stars.
— In its extreme form, Adele's syndrome is not just an addiction to feelings, but a severe mental disorder that requires serious treatment of the underlying disease. In some cases, such patients need to be hospitalized, including involuntary ones," the specialist emphasizes.
External defect and internal problem
Obsession with one's appearance is characteristic of our time, but what is called dependence on body image changes is more often considered in psychiatry as part of the syndrome of dysmorphic phobia or dysmorphic mania. According to Daria Serebryakova, in this state, a person forms an overestimated idea of the shortcomings of appearance. It doesn't matter if it's an imaginary flaw or a real one. In any case, a person fixes on it and gradually spends his life eliminating it.
— People stop seeing themselves objectively. This can include some forms of eating disorders, including anorexia, as well as various unhealthy body modifications, when changing one's appearance becomes an end in itself," the clinical psychologist comments.
This behavior is usually based not just on a love of tattoos, piercings, or plastic surgery, but on a deep mental disorder. The task of a plastic surgeon is not only to evaluate the technical feasibility of the operation, but also to pay attention to the patient's mental state. The boundary between the desire to improve one's appearance and pathology runs where a person begins to fixate on his disadvantage, and all his activities are subordinated to the fight against it, the Izvestia interlocutor notes. Practice shows that when undergoing medical examinations, some of these patients develop severe mental disorders, and the problem lies not so much in rejection of their own bodies as in a deeper violation of identity.
The specialist also draws attention to the extreme forms, when it is no longer just about dissatisfaction with appearance, but about severe delusional disorders in which a person seeks to cripple himself. According to the expert, such conditions are often combined with alcoholism, drug addiction and the use of heavy psychoactive substances. These people require serious psychiatric treatment and often involuntary hospitalization.
At your own risk
You can also become addicted to risky hobbies. Psychiatry even distinguishes dependence on adrenaline, risky behavior and extreme sports. To a certain extent, behaviors associated with risk-taking can be considered as a form of self-harm, emphasizes Daria Serebryakova.
— However, as in many other cases, the problem lies not so much in the passion for speed or extreme sports, but rather in the mental disorders that underlie it, — says the clinical psychologist. — Most often, this behavior develops within the framework of severe personality disorders. Therefore, treatment in such cases is not aimed at combating the love of speed as such, but at correcting the underlying personality disorder, which is behind the need to constantly look for risk, danger and strong emotional experiences.
And psychiatrists refer hyalophagia, an obsessive desire to chew and swallow glass objects, to the so—called gross drive disorders. This condition occurs in clinical practice, however, according to the specialist, it is a rare exception.
— Most often, this behavior is observed in patients with severe organic brain pathology, severe dementia, and some congenital mental disorders. This also includes other severe forms of pathological eating behavior, such as eating inedible objects or excrement," says the editorial interlocutor.
Congenital hyalophagia is rare. But this condition can occur against the background of severe anesthesia, when prolonged use of psychoactive substances leads to such a pronounced destruction of the psyche and brain functions that dementia forms and self-harming, suicidal behaviors appear.
Genetic predisposition
Addiction is a moderately heritable trait that depends on dozens of genes, says Valery Polunovsky, a molecular biologist, head of the development department at the National Center for Genetic Research (MyGenetics), and a trusted HealthNet NTI expert.
— The total contribution of genetics to the development of addiction is usually in the range of 40 to 60%. There is no single gene that determines the presence or absence of addiction — rather, it is the result of the interaction of multiple genes with environmental factors and a person's lifestyle. For example, the risk of alcohol dependence is significantly related to the form of the DRD2 gene, and the risk of nicotine addiction is related to the CHRNA5 gene, but other genetic markers also influence these processes," he explains.
As for love addictions or cravings for extreme sports, in these cases, according to the expert, genetic variations exist in a similar way to chemical ones.
"This is due, in addition to the features of the dopamine reward system, to the activity of the serotonin and oxytocin systems, which cause a stronger emotional dependence on certain people or hobbies," the expert comments. — Moreover, the specific form of addiction primarily depends on the environment, but the general tendency to form addiction has a pronounced genetic component.
Addiction is not gender-specific and is transmitted from both parents, Polunovsky warns. And if both had a tendency to addiction, then the child gets a unique combination of their genes.
"The final risk will be a combination of the risks of the mother and father with small variations around the average value," the molecular biologist continues. — Therefore, the presence of addiction in parents inevitably increases the likelihood of its development in a child. Genetics really plays a huge role here.
According to the source, this is clearly illustrated by large-scale studies of foster families. It happens that a child born to biological parents with alcoholism is accepted into a prosperous family where alcohol consumption is not practiced at all. But his personal risk of encountering alcohol addiction in the future still remains significantly higher than that of the native children of these adoptive parents.
The genetic lottery is won by those who are programmed by nature to completely reject addictions.
— In this case, a person has a very high specificity. For example, there are people who have fast-acting alcohol dehydrogenase enzyme encoded by the ADH1B gene, or slow-acting aldehyde dehydrogenase encoded by the ALDH2 gene. In both cases, a toxic metabolite, acetaldehyde, accumulates in the body in high concentrations, which leads to severe negative reactions to alcohol, followed by rejection of repeated doses. Such people will not drink alcoholic beverages, even if they have a general high propensity for other addictions," Polunovsky explains.
However, even if the father and mother drink, the person has a chance to go the other way.
— In this case, two factors are combined: the offspring inherits the genetic risks of developing dependence on both parents, and the environment observed in the family also creates conditions for increasing the risk of excessive alcohol consumption. But, as we have already said, there is no rigid determinism in the formation of addiction: genetics contributes only at the level of 40-60%, and a person can choose the environment himself as he grows up," the specialist clarifies.
Thus, much depends on the right choice of environment, lifestyle and profession at a conscious age.
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