Withdrawal: Symptoms & Definition

Instructor: Devin Kowalczyk

Devin has taught psychology and has a master's degree in clinical forensic psychology. He is working on his PhD.

Using psychological diagnostic criteria and simple examples, this text explores the steps involved in what withdrawal is and takes a brief look into the neurochemistry of why it occurs.

Why do many people continue using drugs despite the horrific consequences? How is a morning cup of coffee, your morning 'pick me up,' similar to a drug user who cannot survive without their drug?

Definition

Psychological texts define withdrawal as the onset of symptoms, both physical and mental, when a substance is reduced or not given to the body. The substances we are talking about could be any chemical, but in psychology when discussing withdrawal you tend to deal with some kind of drug. This includes both prescription and illegal drugs as they both affect the body, but other substances could also lead to withdrawal like symptoms, which we will see in the first example.

To complete this broad definition, the symptoms must also cause significant distress, impairment, or problems in a social, occupational, or other area that the person functions in. Lastly, the symptoms cannot be caused by a medical condition ('He's having withdrawal!' said the bad psychologist. 'No, he has not eaten in three days' says the good psychologist).

Example

You most likely enjoy coffee, tea, carbonated soft drinks, or energy drinks. A common substance found in all of these is caffeine. Caffeine is a substance that your body can become accustomed to with a regular drinking. However, if you have ever missed a day's caffeine intake, you will have noticed some symptoms, and that is Step 1 for withdrawal: the substance has been reduced or not provided.

Step 2 follows swiftly and hits harder depending on how much you regularly use. If you typically drink a little coffee, and maybe a soda with lunch, then you might feel tired, a little irritated by others, and have a headache. If you are a pot-of-coffee and a 44-oz.-soft-drink-with-lunch type of person and you miss both of these, then you will be physically and mentally exhausted, the irritability might turn to rage, and the headache could be a migraine. A general rule is: the more used, the more often used, the more powerful the substances used all make the symptoms of withdrawal more severe.

Step 3, the significant distress and impairment due to a lack of caffeine is where this example fails as a good example. Caffeine withdrawal is typically not severe enough to stop someone from enjoying their day, going to work, or being a functional member of society. So while you did not feel great missing your coffee and soda, you were not lying in a puddle of drool and maybe vomit, moaning in agony, because your symptoms were so severe. This means that caffeine withdrawal is not a diagnosable disorder for psychologists. But we will examine another substance that does meet Step 3 after examining…

The Reasoning

A little bio-chemistry reveals why the body has these symptoms. Your brain naturally produces chemicals, called neurotransmitters, which help the neurons of your brain communicate. Many substances that change the way people function, such as alcohol, cocaine, etc, mimic these naturally produced chemicals/neurotransmitters or affect the production or effectiveness of these chemicals/neurotransmitters. Your brain does not want too many or too few chemicals, so it will change the amount produced to make sure that the balance is kept; basically so you function at your normal level. Another example would help.

Dopamine (Neurotransmitter)
Dopamine (Neurotransmitter)

Amphetamine (Chemically similar to Dopamine)
Amphetamine (Chemically similar to Dopamine)

Example II

An individual uses methamphetamine (also called meth, crank, crystal, speed, and ice), which is an artificial and powerful drug like cocaine, several times. When this individual began using meth, his brain released massive amounts of a specific neurotransmitter that makes a person feel good called dopamine. Your brain has a certain level of dopamine it likes to keep itself at, so when the drug is taken, the brain will be flooded with this neurotransmitter, making the user feel good. After a few hours, the excess dopamine goes away and the person is left with a hangover. To feel good again, this individual does more meth, but this time the brain is ready for the flooding and does not release as much, meaning the high is not as powerful. Again and again the individual takes meth, but over time the brain has stopped releasing the excess dopamine. Now the only time it releases dopamine is when the individual takes the meth. This means the individual is no longer getting high off of using, but is functioning at a normal level with the drug. The stage is set for withdrawal.

Step 1, the individual stops taking or does not take enough meth, resulting in a brain without enough dopamine. Step 2 can occur within a few hours or days of not using, depending on the heaviness of use.

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