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Clinically Reviewed by Linda Whiteside, LPCC

Medically Reviewed by: Dr. Ryan Peterson, MD

The Relationship Between Stress and Addiction

Table of Contents

Sadly, we live in a society that is really good at placing blame. Whether you are feeling shamed and blamed for your weight, your addiction, your relapse or simply feeling inadequate for not being able to “do it all,” you are not alone. In this article, we want to share why and how your addiction, likelihood of relapse along with other symptoms or challenges you might be facing have a real physiological root, and that root has a lot to do with stress.

How does Stress and Addiction Relate?

Good Stress, Bad Stress

You might be surprised to learn that stress is actually quite a complex topic, and there are “good” stressors and “bad” stressors, all which have a ripple effect on just about every system within the human body. Most people think of stress as the usual suspects such as work, relationships, finances and more. While these “perceived” forms of stress are key players, there are many others as well, some of which you likely aren’t even aware of and come in the form of toxins, food intolerances, environmental pollution and more. It could also be a positive stressor, like the birth of a child or planning a wedding.

Regardless of the type of stressor, first it’s important to understand something central called the HPA Axis and how it can play a key role in addiction and mood disorders.

What the Heck is the HPA Axis?

To sum it up the HPA axis is the central regulator or stress in your body. It forms a bidirectional feedback loop in your brain that sends signals back and forth. When you experience perceived stress, such as an argument, fight, or someone cutting you off in traffic it sends a signal to the HPA axis letting your body to prep you for battle or take off for the hills.

This axis communicates top-down: your brain talks to your hypothalamus, which sends a chemical signal to your pituitary (P), which releases adrenocorticotropic hormone (ACTH) to turn on the cortisol (and adrenaline) output from your adrenals so that your adrenals release stress hormones. When cortisol reaches high enough levels, it suppresses H and P to help regulate your fight or flight response.

Many people are familiar with the term, “adrenal fatigue” as the state of burnout. It’s not that your adrenals aren’t working, but rather that after chronic stimulation of stress hormones, the communication between the hypothalamus, pituitary, and adrenal glands breaks down.

Primitive Biology meets the Modern World

Keep in mind that your stress response has evolved to outwit predators and avoid starvation, not be always on-edge because of your boss or rush hour traffic. Modern living swells with sources of stress unrelated to life-or-death situations: sleep deprivation, poor nutrition, social interactions, anemia, and other health conditions, over-exercising, daily anxieties, job stresses, parental duties, financial concerns, political concerns, having a new baby, moving to a new home…the list goes on

While certain types of stress are totally normal, natural and needed (more on this in a moment), these chronic stressors can set up the body for dysfunction, and both addiction and relapse can be significantly impacted.

HPA Balance, Mental Health, and Addiction

First let’s review some nervous system basics. The nervous system has 2 modes it operates in: sympathetic and parasympathetic. Your sympathetic mode is known as “fight or flight” mode, and your body goes into this mode when it’s exposed to stress. You’ll feel reactions like an increase in heart-rate, a mobilization in energy and heightened brain function and sensory skills.

The parasympathetic state is just the opposite, and is often referred to as your “rest and digest” mode. While the sympathetic state inhibits rest digestion, tissue repair, immune health and production, the parasympathetic state enables your body to carry out these important functions.

Research is showing us that the HPA Axis dysregulation described above could have a major connection and impact on addictive behaviors, and this isn’t necessarily new information. One 2006 review in the International Journal of Psychophysiology asserts that:

This is pretty profound, as it lays out three key points:

  1. Substance abuse itself, particularly alcohol and nicotine, cause an increase in cortisol (the body’s main stress hormone).
  2. Abuse of alcohol in the long term impacts the body’s ongoing secretion of cortisol.
  3. Some people might have a genetic predisposition to altered cortisol production and release which could play a role in their likelihood of becoming and addict and/or relapsing.

Essentially the cycle of stress, HPA dysfunction and addiction can become a vicious one, especially if we don’t understand their connection. For recovering addicts, this could mean that the body’s response to stress is fundamentally altered in the sense that your cortisol production is higher and the body spends more time than it should in its sympathetic state, a term referred to as sympathetic dominance.

Don’t worry, the story isn’t all doom and gloom because once you understand this, you can work to manage stress and rebuild proper HPA axis function, which can make a world of difference.

Good Stress vs Bad Stress: What’s the Difference?

Let’s take a step back for a moment and consider: “what is stress, exactly?” We’ve talked about on a biochemical level in terms of hormones, but we think it helps to understand that stress is really anything that disrupts your body’s natural homeostasis (balance) and your body’s response to that disruption.

Chronic and acute stressors are two very different things. Acute stressors are perfectly normal and healthy, such as a brief increase in the body’s stress hormones in response to an event. In Paleolithic times, this stress was typically escaping from a predator. In modern-day society might be the birth of a child, a marriage, death of a loved one or smaller, daily events like public speaking. 

You experience a rush of stress hormones (cortisol and adrenaline, in particular), and then these hormones levels drop back to normal. Unfortunately, many people in today’s fast-paced world are living with chronic levels of stress, meaning that stress hormones are constantly elevated. Studies solidly confirm the many negative health impacts of this reality (weight gain, addiction, metabolic syndrome, depression, anxiety and much more), not to mention that cortisol is catabolic, meaning it will break down healthy muscle tissue.

Keeping Stress in Check: Stress Management and Self-Care

Stress management has become kind of a buzzword, and you might roll your eyes when you hear it. Many people look at stress management and self-care as something else to check off of the to-do list, but understanding the physiological importance of managing stress will hopefully encourage you to take some important steps in preventing potential relapse.

3 types of stress:

1. Mental and Emotional Stress

These are the types of stressors we most often think of, and could be a wide range of factors such as a birth or death, wedding, a dysfunctional relationship, work-related stress that causes insomnia or anxiety, etc.

2. Physical Stress

These stressors could include a recent or past surgery or injury, over-exercise, over or under-eating, lack of sleep or dehydration.

3. Toxic Stress

This category involves the toxins our bodies are exposed to on a daily basis, including those found in foods, beverages, the environment (air and water), and personal hygiene and home care products.

Top 10 Stress Management Strategies

1. Diet

Inflammatory and toxic foods can be a major stressor, and you largely have the power to control what you eat. The act of cutting out inflammatory, processed foods and replacing them with organic, whole foods in the form of vegetables, fruit, high quality meat, fish and eggs, and whole grains can decrease stress in and of itself. Also key is to eliminate foods you are sensitive or allergic to, which can be done working with a practitioner to undergo an elimination and/or do food allergy testing.

Certain superfoods for supporting a healthy HPA axis include wild salmon, fermented foods like raw sauerkraut, kimchi, unsweetened kefir or plain yogurt (if you handle dairy well), green tea and chia seeds.

2. Meditation

Developing a regular meditation practice has been shown to actually change your brain chemistry to become more present, mindful and relaxed. It can even help to reduce symptoms of chronic pain and prevent disease. Talking specifically about addiction, studies show that mindfulness meditation can be used as part of a comprehensive treatment plan for addiction and relapse prevention.

3. Deep Breathing

When the body is stressed and in the sympathetic nervous state, we tend to take shallow breaths, which you’ll feel in your chest rather than in your belly. Studies show that deep, belly (diaphragmatic) breathing can physiologically work to improve mood and stress.

It can as simple as taking 5-10 deep belly breaths in the morning and at night, and also a few before meals to get you into digest-mode. Breathe in slowly through the nose, feel your belly rise, then slowly exhale through the mouth. Your belly should rise on the inhale and fall on the exhale, followed by your chest (instead of the other way around).

4. Epsom Salt Baths

Not only can soaking in an epsom salt bath work wonders in relieving sore muscles, but it can also be extremely helpful for managing stress. Epsom salt can be purchased at any local drug store and many grocery stores, and is also known as magnesium sulfate. When combined with water it dissolves and releases magnesium and sulfate ions, which are then absorbed by your skin.

Adequate levels of the mineral magnesium are crucial for high quality sleep and stress management, as magnesium carries out over 600 functions in the human body, one being the function of helping the brain produce neurotransmitters that reduce stress. To prepare your bath, dissolve 4-5 cups of epsom salt in a warm-hot bath and soak for 20-30 minutes.

5. Journaling

Keeping a journal can be very therapeutic, in whatever way makes most sense to you. Some people find it helpful to write at the end of every day as a simple reflection of happenings, thoughts and feelings experienced, while others like to create poetry, short stories, or maybe a daily list of things you felt grateful for.

6. Meditative Movement Techniques (MMTs)

Research shows that MMTs that promote syncing movement with breath can be incredibly helpful in reducing symptoms of depression and anxiety. Common and accessible examples are yoga, Tai Chi and Qigong. Try a local class or even an online video to get started if you are new to these types of practices

7. Botanicals and Nutritional Supplements

It’s always best to work with a functional medicine practitioner to determine your ideal and individualized supplement and/or herbal protocol, but common options that can be helpful for stress management and restoring HPA axis function are the following:

Ashwaganda: A powerful herb used as a nerve tonic and adaptogen, 1 capsule, 2 times per day (morning and night).

Buffered Vitamin C: Excellent for adrenal support, take 1,000 mg daily in 2 divided doses, with food.

Magnesium Glycinate: You can safely take up to 800 mg daily in 2-3 divided doses.

B6: This vitamin helps to produce brain neurotransmitters like serotonin, along with many other functions. Averages dosages vary from about 100mg-250mg per day with 25-50mg coming from P5P the active form of B6.

8. Optimize Sleep

Studies confirm that sleep deprivation profoundly impacts HPA axis function, as it hugely raises the output of cortisol. Practicing good sleep hygiene and working with a practitioner if you suffer from insomnia is key for healthy self-care, stress management, and mental health. Getting early morning and afternoon sunlight exposure can help set circadian rhythms.

Turning off computer and TV screens an hour before bed can also allow your body to produce the sleep hormone melatonin, which can be shunted by blue light exposure at night. Making sure your room is cool and dark is also important. The ideals temperature for sleep is 60-67 degrees. Making sure to get 7-9 hours per sleep at night is one of the best ways to improve your ability to handle stress and is restorative for the mind and body.

9. Exercise

The key to exercising for self-care is hitting that sweet spot of not too much but not too little. While a sedentary lifestyle is definitely linked with many chronic diseases and mental health disorders, too much exercise can also further stress and deregulate your HPA axis. Less truly is more when it comes to exercise, so finding a healthy combination of low-level aerobic activity (walking, hiking, swimming, dancing, etc) along with some amount of resistance training and (if your HPA axis is in decent shape) some high intensity interval training can be an approach that works to add just enough stress to the body, without overdoing it.

Exercise is a type of stressor, so listening to your body and really tuning in to what it needs in terms of movement is important.

10. Power Down

Last but certainly not least, try to disconnect as often as you can. If possible, set aside one full 24-hour period per week where you don’t pick up your phone, computer or any other device. If this isn’t possible, set aside 12 hours, or commit to powering down after 5pm (for example) every day. Moderate and severe depression have been associated with higher amounts of screen time, so by making time to practice mindfulness and stay present without distractions, the happier you’ll be.

Chronic stress, HPA axis dysfunction, mental health disorders and addiction all go hand in hand. The good news is that you hold the power to take self-care seriously and examine the ways you can implement powerful, research-backed strategies to reset your hormones and live a healthy life.

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Written By: Linda Whiteside

Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson

Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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