Common Reality: ADHD & Addiction

What I discovered as part of my recovery

David Rich Sol

Nov 07, 2023

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Addiction is very common among ADHDers especially undiagnosed adults who are trying to self-medicate.¹ According to experts, the likelihood that an ADHDer will be addicted to substances such as alcohol, recreational drugs, or prescription medication sometime in their lifetime is 50% which is more than double the likelihood of someone who is neurotypical in the general public.²

Did you catch that?

Let me say that another way. According to research, about half of all ADHDers may develop a substance addiction sometime in their lifetimes. Additionally, over 40% of ADHDers tend to smoke cigarettes compared to about 26% of the non-ADHD public.³ When it comes to vaping, the estimated numbers are higher. In one study, over 46% of ADHD children started to vape before the age of 17.⁴ Another substance that ADHDers tend to use to self-medicate in high numbers is caffeine. In recent studies, it was found that ADHDers intuitively seek out caffeine to increase alertness and improve cognitive function including attention, learning, and memory.⁵ And, according to a 2023 study on the comorbidity of ADHD and opioid addiction, the study concludes that:

“Almost one out of five patients with [Opioid Use Disorder] OUD suffered from comorbid ADHD. In 83.3%, ADHD had not been diagnosed prior to participation in this study. Thus, patients with SUD [Substance Use Disorder] could benefit from being routinely screened for ADHD.”⁶

In fact, addiction doesn’t stop at chemical substances for ADHDers, they are more likely to suffer from all kinds of addictive behaviors including compulsively surfing the internet, gaming, gambling, shopping, pornography, sex, food, you name it.⁷

Dopamine & ADHD

Whether it’s self-medication, thrill-seeking, or novelty, the ADHD brain craves stimulus that increases dopamine production.⁸ Current research suggests that ADHD is linked to a dopamine system dysfunction which is essential to the brain’s reward system.

“Dopamine also impacts memory, attention, sleep, arousal, mood, and motivation, in addition to a range of basic bodily functions. A normal balance of dopamine and a properly functioning dopamine reward system allows someone to feel motivated, relaxed, alert, focused, and happy.”⁹

Low levels of dopamine can produce many unfavorable symptoms including mood swings, anxiety, depression, low sex drive, lack of motivation, loss of interest in many activities, difficulty concentrating or focusing, insomnia and sleep disturbances, restless leg syndrome, hand tremors, and gastrointestinal issues.¹⁰

Did you know that snacky foods, or comfort foods that contain sugar or starchy carbohydrates, help increase and regulate dopamine too?¹¹ This may be one reason that binge eating, food addiction, and obesity are also very common among ADHDers.¹²

So, is there any wonder why an ADHDer would seek out a chemical substance or behavioral activity that triggers a dopamine response to help them feel better–even if it’s temporary?

Shame & Addiction

As with all addictions and compulsions, there are negative consequences and side-effects whether it’s related to physical or mental health, relationship issues, job or school issues, or even involving the law and criminal justice system. To top this off, depending on the addictive substance or behavior, a person may have increased feelings of shame and embarrassment for engaging in the addiction.¹³

For many people, they may try to escape their already low self-esteem and ongoing shame whether from feelings of not measuring up to society’s standards or from complex traumas they experienced through different addictions or compulsions. I’ve discussed my own journey with shame and its consequences in a previous post, Exposing Toxic Shame. Unfortunately, the negative side-effects and consequences of the addiction itself may strengthen the feelings of shame and create a perpetuated shame-addiction-shame cycle that continues to feed itself. Specifically, the cycle of addiction and shame will continue until the root of toxic shame is exposed and directly addressed. Personally, I believe it is only then that the process of true healing will begin.

Beginning Stages of Recovery

In my own life, the shift began when I no longer could bear myself and the mountain of shame that I was experiencing from the addiction, the cover-up, and the unaddressed, unhealed trauma. Once I finally admitted to myself that I had a real problem and started to take action to address it, things started moving off the usual course and a shift toward health began. At first, it was gradual and small.

I won’t sugarcoat it.

I needed a tipping point, some call it hitting “rock bottom” to make significant changes in my life. The process of breaking the addiction, facing myself, working through the shame, and finding more healthy ways to cope with stress and negative emotions takes courage, a willingness to change, a desire for something better, an effort to make a different choice, and time. It also required continual support from others. Some people may say that the solution is simple, just don’t engage in the addiction. But, if you’ve created a habit and pattern of life, which for me started at the age of 11 with pornography and food, it can be complicated. Sure, stopping the behavior can be somewhat simple depending on the addiction. For example, I put parental controls on all electronic devices to block porn sites. That’s simple. But, that only addresses the substance, the thing that an addict uses; it doesn’t address the underlying root and cause of the addiction.

Dry Drunk

Have you heard of the term, “dry drunk”?¹⁴ Basically, the term refers to an alcoholic who stops drinking, but doesn’t address the root causes of their addiction. They still act as though nothing really changed. Let’s be clear. They may no longer be using their substance of choice; but, emotionally, mentally, and dare I say spiritually, they have not made any changes in their life. In many cases, they will substitute something else for alcohol as a poor coping strategy. This applies to all types of addicts, not just alcoholics. It’s common for addicts to substitute something else as a new compulsion or addiction whether it’s smoking, vaping, caffeine, excessive exercise, sugar, rigid and dogmatic rules, or basically anything else that seems to them to be less harmful while also increasing their dopamine levels.

The danger is that even things that can be helpful and healthy for someone who isn’t an addict can become a new obsession, compulsion, and addiction for those struggling with addiction-seeking tendencies and lower levels of dopamine. In many cases, we just substitute one thing for another whenever given a chance. For example, initially, I got very restrictive with food as a way to deal with my binge eating and created very complex rules around it. And, I expected others in my home to follow those same rules. And, I was very dogmatic and judgmental about anyone who didn’t follow those rules. In other words, I went extreme in the opposite direction from binge eating to restricted eating of only certain foods and at certain times. Suffice it to say, it didn’t last long nor did it work because the underlying issues and root causes of the binge eating and addiction were not addressed at that time.

Then, I got obsessed with buying books. I substituted pornography and binge eating with spending money and shopping for books and other things. The insatiable drive to spend money got so bad that I ended up needing to go through credit counseling and had my credit cards taken away. I tried justifying it; but, in reality, it was a dopamine fix and a way to distract myself from the internal hell that I was experiencing from the compounded shame, guilt, anger, grief, and rage. So, even if I wasn’t using pornography, I was still the same “dry drunk” or addict who was looking to cope and fill a void using something else.

Beginning Recovery

What I found for myself as a more comprehensive solution was first to begin addressing the underlying beliefs, thoughts, and emotions that were driving the addiction. Talk therapy, or counseling was a good place to start exploring all of these areas and to make logical connections. Counseling was also the place where I could feel safe sharing my story and processing my thoughts and emotions around it. Luckily, I had some good therapists who helped me. It was a good place to begin, but it wasn’t the whole solution. Starting at the age of eighteen, I spent probably close to 17 or more years in counseling and I was still struggling with shame issues that were driving my addictive tendencies.

Additionally, my lower levels of dopamine due to autism and ADHD were undiagnosed and unaddressed. In other words, I was still acting like a “dry drunk” especially when I’d get stressed out or overwhelmed. And, at the time, as an undiagnosed autistic ADHDer, I felt overwhelmed and stressed out all the time. So, I kept looking for and finding different ways to cope. Most of those were becoming new forms of compulsions. Definitely, for me, talk therapy by itself was not a real long-term solution to breaking my compulsive habits, or providing true freedom from the bondage of addiction.

Beyond Psychotherapy

In addition to traditional counseling, I found hypnosis to be very helpful. According to the Cleveland Clinic:

“[Hypnosis, or] Hypnotherapy is a heightened state of concentration and focused attention. Guided by a trained, certified hypnotist or hypnotherapist, hypnosis allows you to be more open to suggestions to making healthful changes in your perceptions, sensations, emotions, memories, thoughts, or behaviors.”¹⁵

Through hypnosis, I began to address and reprocess my underlying beliefs about myself and to re-write them. This was very helpful in shifting many of the self-limiting beliefs that I was holding onto. Truly, I found that I accomplished more value from the one year of hypnosis than I did from over a decade of regular talk therapy. I was very fortunate to work with Larry Garrett, a Chicago-based certified Hypnotist who began his career in 1968. Larry is internationally known and considered a legend in the field and he’s an amazing person too. Thank you, Larry, for all that you do. I am deeply grateful.

In fact, I had such a profound experience with hypnosis that I decided to go through the training myself and get certified in clinical hypnosis. Again, I was extremely fortunate to work with an amazing teacher and clinical hypnotist, William Mitchell. William not only helped me to gain the skills to provide hypnosis, but he also taught me tools that I could apply as self-hypnosis for myself as well. Thank you, William. You’re the best.

Mind-Body Connection

Both counseling and hypnosis were tremendous tools to help me with many of the mental and emotional aspects of healing from complex trauma, low self-esteem, and shame that was fueling my compulsions and addictive behaviors. However, they weren’t the only tools I needed. As discussed in the bestselling book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, trauma has a significant impact on the brain, mind, and body. Each of these areas including the brain and body need to be more fully addressed for complete recovery and healing.

A therapeutic tool that I found to be extremely helpful in simultaneously addressing the body, mind, and emotions is Eye Movement Desensitization and Reprocessing (commonly known as EMDR). This therapy has been found to be extremely successful in working with trauma, stress, and anxiety. In fact, I completed 30 days of daily virtual EMDR sessions from the comfort of my home. I found this therapy to be especially helpful in lowering my anxiety and stress response to specific memories, thoughts, and triggers. Not only was I able to lower my anxiety and other unpleasant sensations related to the past, but I was also able to replace those feelings with a state of increased relaxation and calm as well. After I completed this therapy, I no longer had the same heightened emotional response pattern to many of my old triggers and memories. Instead, their burden was lifted and I felt a sense of calm and peace.

EMDR has been profound in breaking and reprocessing specific, situational triggers and emotional patterns related to memories and emotional states. In my experience, however, I found that I also required additional tools to address some, more global themes such as shame and feelings of general nervous system overwhelm.

Body-Based Therapy

There are many body-based therapies that have helped different people from around the world to manage and heal from complex trauma including acupuncture, shiatsu, and therapeutic massage therapy. Even though I have received all of these therapies and modalities and have enjoyed them, I have not found them to be as long-lasting and profound as craniosacral therapy.

In fact, the work with this gentle body-centered therapy has been so profound that both my wife and I have received extensive advanced training in it, and have both provided it to others, each other, and ourselves. In fact, we have been training others in this approach for many years now. In a future post, I will discuss my experience with this holistic and non-invasive approach.

For now, I just want to share that body-based therapy is one of the quickest ways to address both the physical and mental-emotional aspects of trauma without causing a triggering or re-traumatization when done appropriately and from a completely neutral space. And, most importantly, based on my experience and others’ reports, the changes that occur through this work are long-lasting and life-transforming.

Dopamine, Recovery Support, & Self-Care

As I went through my internal shifts from living in a hypervigilant and traumatized state to a more centered, calm, and relaxed state, I found that I experienced less overall overwhelm and tension on a daily basis. However, I’m still a neurodivergent person who has sensory processing challenges and can get easily emotionally dysregulated. Not to mention, with my ADHD and autism, I do have a level of dopamine deficiency that I need to remember to address on a daily basis.

This is where discovering more about myself and what my body needs has been crucial. Learning to slow down, be more mindful in my daily life, and begin to listen to my body sensations has been profound. This has primarily come from practicing yoga, breathing exercises, and mindfulness meditation. These practices have helped me notice and distinguish my feelings and body-felt sensations. In turn, I can better sense when I’m beginning to feel overwhelmed or stressed out. It feels like I now have a choice on how to respond instead of reacting to everything after it happens. I can more consciously and practically address these feelings before they escalate and lead to old patterned unhealthy responses.

Additionally, knowing that my body needs more movement and proprioceptive input based on my ADHD and sensory processing challenges, I find time and ways to add that to my daily routine. I’ll admit that I’m not always up to exercising or moving more; but, when I do it, I feel a significant difference, especially in terms of lower levels of tension, stress, and overwhelm. In fact, people who interact with me notice and make positive comments too.

Finally, in order to help with balancing levels of dopamine, I try to get enough sleep, watch what I eat, take my daily nutritional supplements, laugh, and do something that brings me joy each day. This can be as simple as listening to music, dancing, or singing along to one of my favorite songs, watching a funny video, or playing with our dogs. The key is that I do something that brings me a sense of joy and lightheartedness.

Takeaways

As an ADHDer and complex trauma survivor, I recognize that I’m at a greater risk of developing an addiction or unhealthy coping strategy. This is why it’s essential that I focus on self-care and have an ongoing recovery mentality. For me, it means being kind to myself, knowing my limitations, understanding how my brain and body work, respecting my needs including time alone, need for physical activity, and practicing mindfulness as best I can. In a future post, I will go deeper into how I balance out my dopamine levels through evidence-based practices.

What about you, how does your life story intersect with mine?

If you're struggling with an addiction or unhealthy compulsive behavior, I encourage you to consider seeking help from a medical professional, or trusted friend or family member. Check out some of the resources I discuss in this post, I hope they help you as much as they’ve assisted me on my recovery journey.

Thanks for engaging in this post with me. Please leave me a comment, share this message, and remember to be kind to yourself and others. Until next time, cheers!