People of all ages and life circumstances are consulting more and more counselors about being depressed and worst, committing suicide. Counseling practitioners in diverse settings are becoming aware of this problem. The growing incidence of depression is often attributed to many factors among which are detachment, depersonalization, loss of the capacity to trust, interpersonal destructiveness and a loss of control over one’s destiny. The theme of depression which is a sense of loss, a pessimistic view of self, world and future, are now topics of conversation and healing session dialogues.
Treating and preventing suicides as a result of depression is a challenging counseling problem. There are other behavioral malfunctions that arise because of drug use and this paper looks into those factors. This paper shall examine the different ways by which drug use can affect behavior putting particular emphasis on the use of drugs to alleviate depression. It fact, it will examine how these drugs affect one’s behavior so dramatically. The Drug Society Since nearly 100 percent of the American adult population uses drugs in some form, ours must be labeled a drug society.
If you think your exempt from membership, consider the following. First, the definition: a drug is any substance, other than food, that, when consumed, alters the functioning of the body. Chemicals that reduce pain, make you sleep, kill germs inside your body, lower blood pressure, stimulate your brain or health, or both, are all drugs. Some perform only one function, but almost all affect many parts of the body. And few drugs have no unwanted side effects. When a doctor prescribes drugs, we tend to think of them as medicine.
But millions of people take drugs without a doctor’s prescription. They swallow aspirin, cough syrups, cold pills, sleep tablets, laxatives, stay-awake pills, and antacids, just to mention a few kinds of the estimated 250,000 products you can buy over the counter without a slip of paper from physician. Recently, the word drug has come to have a special, pejorative meaning. When people speak of the “drug problem,” they usually mean mood-changing chemicals, particularly drugs like heroin, cocaine, and morphine.
The drug idea usually also includes a large variety of other, milder mood-changing substances: marijuana, amphetamines, barbiturates, LSD, mescaline, and tranquilizers; all are being taken regularly by millions of people in both legal and illegal ways. It has been proven that there are mood-changing substances in cigarettes, coffee, tea, and cocoa. Cigarettes contain nicotine, a powerful stimulant. Coffee and tea contain caffeine, also a stimulant, and cocoa has a chemical cousin of caffeine. None of this can be classified as a food, because without cream and sugar they, like cigarettes, have a food value of zero.
Finally, there is the most dangerous drug in America: alcohol, the mood-changing drug excellence. Indeed, if alcohol were cot centuries old thoroughly entrenched in our social mores, the Food and Drug Administration would probably make it available by prescription only. Use of drugs to study behavior Different institutions use different procedures in analyzing abuse of drugs. One of these is the Behavior Pharmacology Program that uses operant behavioral procedures where the goal is to determine how drug self-administration is modified both by manipulation of behavioral contingencies and administration of putative treatment agents.
Other programs include the interactions between abused drugs and the neuroendocrine system. There are ways in which the abused drugs modulate the hormonal milieu spurring the reproductive dysfunction. More recent studies on the drug-induce alterations in hypothalamic-pituitary adrenal and hypothalamic-pituitary-gonadal hormones contribute to the reinforcing effects of cocaine (Alcohol and Drug Abuse Research Center). Meanwhile, it has been found out that frustration and hopelessness about life- is the most common psychological problem of adolescence.
About 15-20% of teenagers have had major depressive episodes, a rate comparable to adults. Depression occurs twice as often in girls as boys. Adolescent depression is associated with drug abuse, lawbreaking, and car accidents, and it predicts future problems in school performance, employment, and marriage. Because of the stereotype of adolescence as a period of storm and stress, many adults misinterpret adolescents’ depressive symptoms. This condition is actually difficult to recognize in adolescents because they manifest it in a variety of ways.
Adolescents are almost always able to cover up what they are feeling. In males, the depression can also be expressed as rage. Depressed teens usually display a learned-helpless attributional style in which they view positive outcomes in school performance and peer relations as beyond their control. The challenges of adolescence combined with gender-typed coping styles contribute to making girls more prone to depression. Coping with new experiences and responsibilities of adolescence is hard.
Suddenly, young people need to cope in a variety of settings, including school, home, peer group, and the workplace, with a range of life problems, from examinations to divorce. Frydenberg addresses the relationships between coping and age, gender, and ethnicity, and between family functioning and coping. She also states that there is a correlation between the measurement of coping, how we learn to cope, and such areas as social support and depression (Frydenberg, E. 1997). Hormonal changes Are the behaviors we see in adolescents simply a result of “raging hormones”?
Certainly that’s not the complete answer, but changes in reproductive and stress hormones can also influence behavior. Hormonal changes during adolescence can also trigger depression during this time (Cameron, J. 2005). Reproductive, adrenal, and growth hormones all change during puberty, Judy Cameron noted. Stress can cause hormone changes, too, by increasing cortisol levels. Moreover, hormone levels can fluctuate by the hour and differ among individuals. In the light of analyzing this issue, there are more recent studies and materials that explain a variation in this.
For example, the book by Ian Goodyer on The Depressed Child and Adolescent published by Cambridge University Press maintains his volume bears witness to the rapid advances taking place in our understanding of depression in children and adolescents, specifically, in the realms of psychopharmacology, psychotherapies, and genetics. Our understanding of the interplay between the bio-psycho-sexual-social factors is crystallizing: we are gaining better understanding of the way in which each component impacts on the other. Gone are the days of polarized camps of dynamic vs behaviorist vs biologic theorists.
This is based on the most recent conceptual, clinical, theoretical, and research data in the field of child and adolescent depression. The editor is internationally well known in child and adolescent psychiatry for his scholarly book on the study of life experiences and their impact on the development of child psychopathology. He has collaborated with several contributors in this volume, choosing well-established and proven experts to contribute chapters on their particular area of clinical and academic research (Goodyer, I. (ed). 2001). Risks to a Person’s Mind and Body You must first learn about the risk to your mind and body.
No drug is without risk, in either the short or long run, although, of course, some drugs, like heroin and alcohol, carry greater risk than others, like aspirin and tea. For still others, like marijuana, the risk is unknown. But with all drugs you must decide if the risks are worth the immediate benefits. A physician makes a similar judgment when he writes a prescription. He knows that no drug is completely safe; in fact, if a chemical is not in some way harmful, it is probably completely ineffective medicine. An effective drug must produce bodily changes, and for some people the changes are undesirable.
Aspirin, for example, causes stomach bleeding in considerable number of individuals, and in some even hemorrhaging. Thus, a physician will warn ulcer patients about using aspirin. On the other hand, in dealing with a cancer patient, he will suggest the most dangerous substances – some that bring the patient to the outer edge of life – in an effort to stem the disease. For example, it was revealed that the long-term use of inhaled steroids can increase the risk of cataracts. This was revealed by scientists at the London School of Hygiene and Tropical Medicine from data of around 31,000 people.
Inhaled steroids was used by 11. 5% of those with cataracts and only 7. 5% without the eye condition, confirming beliefs that this is one major source of the ailment. This was also published in the British Journal of Ophthalmology which confirmed that doses of inhaled steroids must be minimized (Asthma drug ‘raises cataract risk’). Is the familiar problem of estimating risk versus benefit. Unfortunately, too often people cannot face that problem, consciously or rationally. Those who have formed habits with certain drugs tend to underestimate the risk and overestimate the benefits.
Furthermore, since the harm people suffer usually lies at some remote time and pleasure potential is imminent, the decision at any moment is heavily weighted for use of a drug. Even when its harmfulness has been established incontrovertibly, we still tend to make exceptions of ourselves, as in the case of cigarettes, for instance. The habitual taking of drugs – the morning coffee, the drink at lunchtime, the cigarette, the pep pill – also makes any action on a rational risk-versus-benefit basis extremely difficult. The time to make a decision is before habits are formed. But even that may be difficult.
In our social environment drug-taking appears to be as natural as eating. Almost all of us have been urged by friends at one time or another to take aspirin, to have a drink, to smoke a cigarette, to sip some coffee of tea; and today increasing numbers of us have been offered marijuana, LSD, heroin, cocaine, and other drugs that are not legal. Such offers are hard to turn down, so strong is our gregarious nature. Getting into Drugs There are principles of reinforcement in habit formation in order to understand how many people get so involved with drugs that they cannot let go.
These principles are gaining ascendancy as the major theory of addiction to drugs like heroin and cocaine. But what are the major reinforcement factors? The drug taker – the cigarette smoker, alcohol drinker, tea sipper – is usually part of a social milieu in which the taking of a particular drug is common and approved. He may be born into that environment, as the Irish are born into a drinking culture. Or, for a new experience, he may seek out a society or group where drug-taking is common. Experience-seeking is not necessarily related to drugs, however. Among the young, experimentation is as old as civilization.
It has created a constant disturbance in society as, generation after generation, young people – particularly bright young people – attempted to break with the mores of their elders. With each generation, the fashion changes. For some it has been social revolution, for others religious innovation; more recently it is sex and drugs, although neither of these was unknown in past generations. The creation of a particular fashion is not a well-understood phenomenon. We know that styles in clothing can be relatively easily manipulated by the trendsetters of Paris and New York.
Something like may happen in behavior. The role of men like Dr. Timothy Leary, the apostle of LSD, in setting a trend among young intellectuals should not at all be underestimated. For a time, Leary, a Harvard professor, seemed to have projected the authority in drug fashion of a Dior in clothes. An easy and popular generalization about drug-taking behavior is that it is a symptom of a “sick” society, a society that was until recently involved in a immoral war in Southeast Asia, is too affluent and materialistic while at the same time grinding down its minorities, particularly the blacks.
In the absence of data, of course, any sort of theory seems plausible; for some people the mere assertion of a connection between drugs and a sick society proves the case. They make an appealingly simple conclusion: if our society were not sick, there would be no drug problem. Consider the fact that, whatever the morality of the war in Southeast Asia, there has been a world-wide increase in the use of mood-changing drugs even in countries that were not involved in the war. England is an example. In my opinion, the war, for the theory to be plausible, should be a basic factor in most cases of increased national drug use.
This is not the case though. The Reinforcement Idea If you find yourself in a social group in which drug-taking is common and approved, the chances are that you will try the drug of fashion that is offered to you – cigarettes, alcohol, pot, et cetera. Accordingly, close to 100 percent of Americans have tried at least one cigarette and 85 percent have had al least one drink of alcohol. Of course, on drink or smoke does not make a habitual user (just as one shot of morphine does not create a morphine addict – although I do not advocate even one).
To form a drug habit, you must use the drug repeatedly and obtain some reward for doing so. At first, the reward is social – approval by one’s peers or self-approval for having undertaken a popularly accepted or adult activity. For a boy, puffing a cigarette or taking a drink may be governed as much by t eh insistence of his friends as by his own manly view of himself; for girls, smoking provides a self-image of sophistication or sexiness. Those social rewards and supports must be fairly powerful, because the first few with almost any drug produce physical effects that are downright uncomfortable.
Cigarettes produce coughing and choking; cigars, nausea; alcohol, stomach upset and dizziness; heroin, overwhelming fear and nausea; LSD, terror. Marijuana, for may people, creates no physical or mental effect the first time, making it easy for social reinforcement to cause continuation of its use. As the drug experimenter repeats his experience, his body begins to tolerate the adverse effects. Out of the multiple responses of mind and body he learns to distinguish the pleasurable from the unpleasurable. With some drugs, the distinctions are made more rapidly than for others.
Drugs like heroin, morphine, and cocaine are powerfully rewarding; others, like cigarettes, coffee, and tea, less so. At the beginning of this period, the drug user is in a position to form a drug habit. As he takes the drug, he is immediately rewarded by the pleasure response: the lift of the cigarette inhalation; the calming effect of alcohol; the sexual throb of heroin injection; the delusions and illusions generated by LSD; the dream state created by marijuana; the intense stimulation of cocaine. Of course, the more frequently the drug is taken, the more strongly the habit is confirmed.
Take cigarettes as an example. The average smoker takes ten puffs on a single cigarette before he uses it up. Each inhalation is rewarded by the lift effect of nicotine and the taste of the tars. A smoker who takes in two packs a puffs and is rewarded 400 times a day, or about 150,000 times a year! Even if the cigarette reward is mild, 150,000 reinforcements a year is enough to make any habit rock-firm. Remember, too, that the more immediate the reinforcement the more powerful it is in confirming behavior. With cigarettes and with most other drugs, the reward follows within seconds after the drug is taken.
Each drug has its own reinforcing power, and the more powerful the reward, the fewer the trials needed for habitualization. Although, for almost people, heroin, morphine, and cocaine do not require many trials to create a habit, they do not induce habit formation after one or even few trials. Addiction, Habit, Dependency There has been much confusion over the concept of addiction, habit, and dependency. Even drug experts have problems with clear definitions. To me, the word are interchangeable because they simply describe repetitious behavior in the presence of a signal for starting that behavior.
Somebody lights a cigarette near a smoker and that signals the train of behavior to start smoking. A heroin addict is offered some heroin and he takes it. The strength of the habit, addiction, or dependency depends on how often the person involved responds to the stimulus when it is presented. A man who cannot refuse a drink has a strong drinking habit. Another who drinks regularly but can easily refuse a drink has a weaker drinking habit. The confusion arises when for some people there seems to be no external signal for the start of the drug-taking behavior. The person merely reports a craving for the drug.
In such cases, the drug-taking has been so prolonged that the slightest external signal or internal bodily change can trigger the train of activity for seeking the drug. Some drugs – heroin, alcohol, and barbiturates – produce profound bodily changes; withdrawal of the drugs creates physical symptoms, among them nausea, trembling, and chills. The onset of such changes, or even the presumed onset, is enough to signal the start of drug-taking for people who have used these a long time. When one observes a person who has been termed an addict one sees an individual who returns again to his drug.
If you take it away, he seeks it out. There is nothing different in this from the behavior of a person with a “drug habit” or a person who is “dependent” on a drug. It is the behavior that counts. The greater his addiction, habit, or dependency – pick your own word – the more persistently does he return to the drug, even in the face of increasing psychological, social, and physical punishment or threat punishment. Many people believe that physical dependency is the only sign of addiction; that is, believe only drugs like heroin are truly addicting because upon withdrawal there are physical symptoms.
However, amphetamines and cocaine, for which there are no physical symptoms when the drug is removed, create the same sort of strong habit heroin can. Indeed, some believe that cocaine is far more addicting than heroin because for many the rewarding nature of the stimulation is more powerful in inducing repetition of the drug-taking behavior. Physical dependency on drugs like heroin, morphine, alcohol, and barbiturates is real enough, however. But the theory of reinforcement suggests that it is only a negative reinforcement of an already established habit.
For example, imagine a rat in a cage in which there is a pedal bar that the animal has learned to press with its paw. At various intervals of time a bell rings within five seconds after the ring an electronic shock is delivered to the rat’s feet unless he presses the bar. After a few experiences with the bell and the shock, that will press the bar every time the bell rings. In the case of addiction, the “bell” is the first vague sense of discomfort that the addict feels when he has not had his drug for a few hours or days.
The electric shock is analogous to the nausea, the trembling, the delirium he will feel if he continues to withhold the drug. To avoid the shock of these withdrawal symptoms, the addict takes the drug. Heroin addicts say they take heroin to “feel normal. ” However, the origin of the habit and whether or not to continue it depend more on the rewarding features of the drug than on the anticipated punishment that accompanies withdrawal. One of the more persistent theories of addiction holds that a drug creates a biochemical change in the body that, in turn, produces the irresistible desire for it.
In the case of alcohol, where the chemical problem has been most studied, the search for such a change has proved vain, although there are physical changes that occur over a long period of time. One is tolerance: drug users find that they must increase their drug intake with time in order to maintain the level of rewarding effects. After a period of tolerance, long-time alcohol drinkers find that less alcohol will produce the desired effect – but that’s only because the liver has become inefficient in destroying the alcohol, allowing more of it to stay in the blood and reach the brain.