Addicted mind May Edition 2020
Introduction Mental health problems and addictions are more connected that one might think. One can cause the other, potentiating each other in the most harmful way. Since EPSA is focusing on advocating for awareness about mental health, in this Science! Monthly we have focused on different aspects of how addictions influence mental health.
Josef Kunrt EPSA Science Coordinator 2019/2020
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Do smartphones and the internet make us unhappy? It is undoubtedly that we are spending more and more time on our smartphones. In a decade from 2008 to 2018, the time spent online per week has doubled to 24 hours. Even more, one in five of all adults spend as much as 40 hours weekly on the web. Over the same time, the use of smartphones in the population has risen from 17 % to 78 %. (1) But what are the consequences of the prolonged use of smartphones on our mental well-being? According to a study done at the University of California, San Francisco, U.S. longer average screen-time is associated with poor sleep quality and less sleep overall. This was especially prominent in people who used their smartphones near their bedtime. (2) As you may know, poor sleep is associated with various health disorders, such as obesity, cardiovascular diseases and certain mental illnesses. (See the Science Blog article The mystery of sleep to learn more). A survey of 300 students at the University of Illinois found out that people who self-described themselves as having really addictive style behaviour towards smartphone use scored much higher on depression and anxiety scales. However, there was no relationship between the use of smartphones and mental health problems in participants who used technologies to escape from boredom. Therefore the motivation behind the use of technologies plays a role in the outcomes of smartphone use. The subsequent study ascertained that people who had, but not used, their phones with them during stressful situations were able to resist or be less sensitive to the stress. (3) The outcomes from this work may suggest that smartphones are used as an escape mechanism from anxiety and unhealthy use of this way to cope with day-to-day mental problems may lead to developing an addiction. The same thing was proposed by other researchers who found out that college students addicted to the internet use “significantly higher amounts of depression and anxiety symptoms, problems with planning and time management, greater levels of attentional impulsivity as well as ADHD symptoms.” (4) Research conducted at Swansea University and the University of Milan focused on assessing the link between the use of digital technologies and their approach to the studies. The results showed that the students addicted to using the internet found it harder to gather motivation and will to study. As a result, the students felt lonelier and that made studying even harder for them. (5)
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Stress as a gateway to addiction It is undoubtedly that the levels of stress are rising. A survey done by Korn Ferry, a management consulting company, asked nearly 2 000 professionals and almost two-thirds of them said that they are experiencing higher levels of stress compared to five years ago. The majority also stated that work stress had a negative impact on their personal relationships and sleep schedule. (6) It was previously shown that stressful experience is making people more likely to fall into the pit of substance abuse. A survey done with almost 1 000 persons living in Manhattan, New York City, U.S. during the terrorist attacks on the World Trade Center in 2001, showed that about 25 % of people said that they were drinking more alcohol (at least one extra drink per day) in the weeks after the attacks. About 10 % reported an increase in smoking (at least an extra pack of cigarettes per week) and 3.2 % said they had increased their use of marijuana. Generally, the research team found out that people who reported an increase in substance abuse were more likely to suffer from post-traumatic stress disorder (PTSD) and depression. (7)
The susceptibility to reach for alcohol as a way to cope with stressful stimuli is connected to the way we perceive our ability to handle the negative emotions. A study done with firefighters struggling with PTSD symptoms showed that those who thought they cannot handle negative emotions are more likely to use alcohol as a way to cope with their traumatic experience. Previous research has shown that higher rates of alcohol use and related disorders have been documented among firefighters compared to the general population. Preliminary research based on these results showed that an increase in stress tolerance is connected to the improvement of PTSD symptoms and lowers the tendency to use alcohol as an escape from negative emotions. (8) But what is the underlying mechanism of such effects? Experiments done on rats found out that stress caused an imbalance in the part of the brain involved in the rewards system. This imbalance weakened alcohol-induced dopamine response and as a result, made the rats consume more alcohol in comparison with the control group. (9)
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How to overcome cravings? The desire to quit an addiction is often considered a requirement for enrolling in treatment programs. But the desire to abandon the habit alone is often not enough to break the addiction. Recent neuroimaging studies have shown that smokers have diminished activity in the brain regions associated with self-control. Review of addiction research suggests that exercises of self-control can decrease the unconscious motivation for lighting a cigarette. (10) One such approach employs mindfulness strategies. A study done by researchers from the Clinical Psychopharmacology Unit of University College London compared mindfulness techniques and relaxation techniques and their influence on the amount of alcohol consumed by heavy drinkers. There were 68 heavy drinkers recruited for the experiment. Half of them were presented with 11 minutes of mindfulness training first delivered through audio recordings. At the end of the training, participants were encouraged to continue practising the techniques for the next week. The other half was taught relaxation strategies. The results have shown that the group trained in mindfulness drank 9.3 fewer units of alcohol (the equivalent of approximately 1.5 litres of beer) in the following week after the experiment in comparison to the week preceding the experiment. (11) Another way to decrease cravings for chemical substances might be aerobic exercise. One study done on nicotinedependent mice at the St George’s University of London found out that even moderate-intensity exercise reduced the severity of nicotine withdrawal symptoms. (12) If there’s no time for full exercise but still craving cigarette, even a short brisk walk can reduce the cravings as well as the withdrawal symptoms as shown in multiple studies reviewed in an article done by researchers from the University of Exeter. (13) Another study done at the University of Plymouth suggested that even simple exposure to greenery from your window or in your neighbourhood lowers the strength and frequency of the cravings. (14)
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When the words matter Addicted people often struggle with the sense of shame and struggle with feelings of anxiety, anger, frustration and other negative emotions. Such feelings are often aggravated by the public stigma that an addicted person experience. As a result, people may not seek the treatment they need. Right communication about addictions is crucial to address this problem. One way to decrease the stigma and encourage treatment is to talk about addictions as a disease rather than a personality flaw. An unforeseen by product of this approach is that some people experiencing addiction felt like they had less control over it. This was the starting point for a study done by scientists at North Carolina State University. The researchers divided the people enrolled in this study into two groups. One half received a growth mindset article which described various factors that can contribute to substance abuse, and stressed that there are multiple ways for people to address their addiction. The other half got an article stating the addiction is a disease and describing the changes in the brain that take place during addiction. The results showed that people receiving growth mindset messages reported more confidence in their ability to handle their addiction and had stronger intentions to seek counselling or cognitivebehavioural therapy compared to participants who got the disease message. (15)
In the case of smoking, its stigmatisation may make it harder for people to quit because they become angry and defensive and the negative messages lead to a drop in self-esteem. A review of almost 600 articles relating to smoking self-stigma. It found out that stereotypes connected to smoking are almost exclusively negative. Many smokers have to deal with high levels of family disapproval and social unacceptability. In multiple studies, smokers used words such as "leper," "outcast," "bad person," "low-life" and "pathetic" to describe their own behaviour. Certain vulnerable groups with few coping mechanisms would benefit from anti-smoking programs that do not stigmatize smoking but focus instead on the benefits of giving up. (16) The words used to describe someone struggling with substance abuse can significantly alter the attitudes of health care professionals. A survey distributed to mental health professionals presented them with a paragraph describing the current situation of "Mr Williams," who is having trouble adhering to a courtordered treatment program requiring abstinence from alcohol and other drugs. On half of the surveys, he is referred to as a "substance abuser;" on the others, he is described as having "a substance use disorder," with the rest of the narrative being exactly the same. Participants who received the paragraph describing him as a "substance abuser" were significantly more likely to agree that he should be punished for not following his required treatment plan. They were also more likely to agree with statements implying that he was more to blame for his difficulty adhering to the court requirements. (17)These studies show that it is important to communicate properly with people battling an addiction to ensure that they will reach the help they need.
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References: 1. https://www.telegraph.co.uk/news/2018/08/01/decade-smartphones-now-spend-entireday-every-week-online/ 2. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0165331&type=printab le 3. https://www.sciencedirect.com/science/article/pii/S0747563215303332?via%3Dihub 4. https://www.sciencedaily.com/releases/2016/09/160918180002.htm 5. https://onlinelibrary.wiley.com/doi/abs/10.1111/jcal.12414 6. https://www.kornferry.com/insights/articles/workplace-stress-motivation 7. https://www.sciencedaily.com/releases/2002/05/020529071330.htm 8. https://www.sciencedirect.com/science/article/abs/pii/S0165178119315860?via%3Dihub 9. https://www.cell.com/neuron/fulltext/S0896-6273(16)306183?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0896627 316306183%3Fshowall%3Dtrue 10. https://www.cell.com/trends/cognitive-sciences/fulltext/S1364-6613(15)001448?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1364661 315001448%3Fshowall%3Dtrue 11. https://academic.oup.com/ijnp/article/20/11/936/4060517 12. https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bph.14068 13. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2006.01739.x 14. https://www.sciencedirect.com/science/article/abs/pii/S1353829218308451 15. https://guilfordjournals.com/doi/10.1521/jscp.2019.38.5.367 16. https://www.sciencedirect.com/science/article/abs/pii/S0277953615301283?via%3Dihub 17. https://www.sciencedirect.com/science/article/abs/pii/S0955395909001546?via%3Dihub
Picture sources: 1. https://aviaryrecoverycenter.com/addiction-affects-brain-life-family/ 2. https://pxhere.com/en/photo/1554977 3. https://www.wallpaperflare.com/woman-holding-beer-while-holding-her-head-femalealcoholism-wallpaper-wzbnl 4. https://p1.pxfuel.com/preview/375/768/1/yoga-by-the-bay-yoga-outdoor-yoga.jpg 5. https://cdn.pixabay.com/photo/2017/01/19/09/31/communication-1991849_960_720.png
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Further reading 1. Why screen time can disrupt sleep Source:
https://www.cell.com/cell-reports/fulltext/S2211-1247(18)317546?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS221112471 8317546%3Fshowall%3Dtrue
2. A combination of personality traits might make you more addicted to social networks Source:
https://www.sciencedaily.com/releases/2018/03/180312084911.htm
3. Chronic Stress, Drug Use, and Vulnerability to Addiction Source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732004/
4. Stigma and Self-Stigma in Addiction Sources:
https://link.springer.com/article/10.1007/s11673-017-9784-y
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