May 27, 2020

Addiction and Relapse — Are Hormones to Blame?

By Dr. Mark Calarco
Hormones are powerful modulators of mood and behavior. Women intuitively understand this because their hormones fluctuate about every month, but the influence hormones have can be profound for both men and women alike. Having a healthy hormonal balance improves mood, memory, cognition, energy, focus, drive and motivation.
Conversely, when someone experiences hormonal imbalance, he or she can experience a decline in those areas. This might act as a trigger that makes a person more susceptible to relapse into addictive behavior, whether that addiction is to alcohol, substances of abuse, unhealthy eating habits, etc.
Disrupting Health, Behavior and Hormonal Harmony
A recent study indicates that 32 million adults in the U.S. have struggled with alcohol abuse in the past year. Binge eating disorder affects approximately 2.8 million people. And addiction to nonprescription and prescription drugs is in the millions as well. Many people express issues with their recovery that they believe are interpersonal and related to their jobs, home lives or other external factors.
But many times, the problem actually stems from tumultuous hormone imbalances within their own bodies. When hormones change, the stress on your body increases, and symptoms such as fatigue, anxiety, depression, low energy levels and more can trigger addictive behaviors and relapse.
Age is a common influence behind hormone changes, such as the significant decline in sex hormones as men and women age. But hormone imbalances affect people of all ages and for a wide variety of reasons. For instance, we are increasingly exposed to hormone disruptors in the environment, including water and air pollution and food and beverages.
In fact, according to the Endocrine Society, approximately 93 percent of people in the U.S. have detectable levels of bisphenol A in their systems — a chemical found in plastic consumer products that is known for its potential health risks. In addition to increased risks for cancer and cardiovascular disease, such influences also accelerate your chances for hormone disruption and your susceptibility to addiction.
Here are the four most common hormonal stressors that affect behavior:
  1. headache-1472830_640The hormonal decline in women: Menopause most commonly begins to affect women around the age of 50. But many women experience hormonal decline much younger due to early menopause, surgery, medications and environmental factors. Regardless of the cause, this hormonal decline can cause fatigue, depression and anxiety, as well as other physical and physiological symptoms. In fact, we know that menopause significantly increases the risk for depression and dementia in women. Such stressors can lead to a significantly increased risk of relapse for women recovering from addiction.
  2. Low testosterone in men: Like hormonal decline in women, low testosterone levels in men can result from age, legal and illegal substances, and environmental disruptors. For men, testosterone is like a natural antidepressant, and when levels decline, the results can include weight gain, fatigue, depressed moods, attitude changes, and lack of motivation and drive. These are triggers that can lead to issues like self-medication, substance abuse and harmful eating habits.
  3. S.A.D.: Seasonal affective disorder, or seasonal depression, is a mood disorder that affects people at the same time every year, usually in the fall and winter. The exact causes of S.A.D. are unknown, but experts believe that hormones generated deep within the brain trigger mood and attitude-related changes at certain times of the year. For people with pre-existing substance abuse or psychiatric disorders, S.A.D. can exacerbate stressors that could turn into a relapse.
  4. Stress: Although hormonal changes can be brought about by numerous factors, many of those factors increase your levels of stress, which also cause or exacerbate the underlying problem. Cortisol and DHEA, for instance, are key adrenal hormones that fluctuate under acute and chronic stress, throwing hormonal ratios completely out of balance.
When it comes to hormone imbalance, it is important to remember the following: If you do not look for it, you will likely not find it, and hormonal imbalance can occur at any age. If undiagnosed, people who frequently relapse or have trouble working their recovery might lack the energy to complete programs or experience depression and have trouble maintaining their motivation.
The truth, though, is that addiction and relapse often have underpinnings in physiological hormone responses. Determining your hormonal balance and taking it into account from the beginning will promote a faster, more successful recovery and improve your chances of remaining clean and sober with a lower chance of relapsing.
Dr. Mark Calarco is the national medical director of American Addiction Centers, a leader in drug and alcohol abuse treatment. He is a pioneer in treating hormone imbalances in recovering individuals and has served as a board member for the State of Tennessee Medical Laboratory Board and the American Academy of Anti-Aging Medicine. Calarco was also the first board-certified anti-aging and regenerative medicine specialist in Tennessee. 

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