“The use of substances or compulsive behaviors is not the cause of addiction. These are, simply, unsustainable attempts at symptom suppression. Managing the underlying symptoms is the key to recovery.”

Now that we know how addiction works in the midbrain, let’s explore the symptoms of untreated addiction. When people have untreated addiction, they experience some or all of the following symptoms:

  • Inability to focus or concentrate
  • Poor memory
  • Low energy
  • Low motivation
  • High frustration and irritability
  • Intense boredom
  • Inability to enjoy things, people, or experiences as fully as those without addiction
  • Feelings of being lesser or inadequate when around others
  • The “little pleasures” in life give no enjoyment
  • Difficulty making connections with others
  • An unreasonable fear or phobia of people or situations
  • Impulsiveness and risk-taking

People with addiction typically do not suffer from all of these symptoms at once. Characteristically, clients report experiencing several of these symptoms at different times. Clients may also report never experiencing some of these symptoms at any time. Everyone is different, but clients with addiction will relate experiences and feelings that reflect struggling with at least some of these symptoms while in the “Untreated Addiction” phase.


The above is the graphic representation of how addiction works in the midbrain that was cited in an earlier post with the main elements of the disease included.

Without a complete addiction assessment, some of these indicators may possibly be present as the result of other mental health diagnoses including depression, anxiety and PTSD. Addiction shares some common symptoms with other illnesses, which is one of the reasons that it has, historically, been misdiagnosed.

You may be saying to yourself, “I’ve experienced some of these symptoms in the past and it never caused me to use substances or engage in compulsive behaviors to the point of addiction.” You’re right; everyone experiences some of these indicators at points in their lives. The difference is degree and persistence. When someone with untreated addiction experiences these symptoms, it is not a short-term experience. These symptoms are ongoing, and they progressively worsen. Normal solutions such as rest, engaging in other activities, or waiting it out, don’t work. People with addiction see their symptoms intensify to the point of being unbearable. Remember, this is a result of a breakdown in the survival/reward center of the midbrain. These symptoms are sending the false message that something is happening that is affecting one’s safety and survival. The unconscious message is, “If I continue to feel this way, I am going to die.”

The feedback I receive when discussing symptoms of addiction, with a group of clients is often profound. Rarely, in the past, have treatment professionals mentioned that how someone feels and thinks before using substances or engaging in behaviors is the true reason for those behaviors in the first place. This component of the disease explains why people feel compelled to engage in self-defeating actions repeatedly without regard for the consequences.

I’ll share an example used by a mentor of mine, Dr. Howard Wetsman, a nationally recognized authority in the addiction treatment field. Imagine yourself standing next to a busy interstate highway, with cars and trucks speeding past, and your favorite food is on the other side of the highway. Would you try to cross the highway to get that food? Of course not, attempting that would almost certainly result in injury or death. Now, let’s imagine that you have not eaten in three weeks and the food across the highway is the only source available to you. That changes things, doesn’t it? The survival/reward circuitry is fully activated and you are quite symptomatic. The focus on sating your hunger to survive overrides the possible consequences of getting hit by the speeding traffic. Whether you realize it or not, you are completely focused on symptom elimination that will stop the mid brain signal that says, “If I don’t eat that food I will die.” That is the same state that people with addiction experience as they go from untreated addiction into active addiction.

These are the forces at work in the brain when someone is suffering from untreated addiction. Past experience has taught them that certain substances or behaviors will give them quick relief from the false signal that their survival is in danger. By using those substances or behaviors they will become asymptomatic, even if only for a short period of time.

For some people, this malfunction in the brain, attributed largely by experts in the field to a genetic predisposition, is enough to develop these symptoms that result in active addiction. These are folks who report no stress, trauma or abuse in their environment. Many report they discovered substances or behaviors that made them feel “normal’ and that resulted in an ongoing compulsion to recreate that feeling.

Others, however, do report stress, trauma, or abuse in their environment and that has significantly contributed to the same compulsion for relief. This is the role that epigenetics, defined as “changes in the way genes are expressed that occur without changes in the sequence of nucleic acids,” (themedicaldictionary.com 2009) plays in addiction. Why do twins who are separated at birth and raised in very different homes sometimes display different health outcomes? That’s because a chaotic, stressful and/or abusive environment can increase the chances that predisposed individuals will see their genetic “destiny” made reality. Of course, the opposite is also true. A safe, structured, and healthy environment can decrease the chances that an individual will develop the symptoms of addiction that cause self-destructive behaviors, in spite of their genetic makeup.

So, if you look at this basket of symptoms as the initial cause of addictive behaviors, then the goal of recovery is not abstinence, but the successful management of these symptoms. It stands to reason that if we lower the intensity and frequency of the problematic symptoms, we lower the overriding compulsion to engage in self-destructive behaviors. As a treatment professional, it is my goal to educate the client as to how addiction is working in the midbrain, and then help develop and implement a treatment plan that will reduce or eliminate these symptoms.

How do we reduce or eliminate these symptoms of untreated addiction? First, there is no one-size-fits-all plan. People respond to interventions and lifestyle changes with varying degrees of success. A cursory examination of any group of people in recovery reveals that there are many different successful paths to recovery. There are also many elements to symptom management, and just to make things even more interesting, our symptomatic management needs evolve over time. That description of what is involved may seem overwhelming and daunting. Part of my job in working with clients is to help them reframe that belief, and to help them begin to look at this ongoing process as an exciting and enriching journey to a better, more fulfilling life.

In future posts, we will examine what those interventions are, and how they can be effective in building an enhanced, healthier life. These interventions and lifestyle changes can be placed into one of the following categories: medication, change in thinking, and change in behavior.

Works Cited

(2009). “Epigenetics,” Retrieved March 6, 2017, from the freedictionary.com.medical-                         dictionary.thefreedictionary.com/epigenetics




































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