As was described earlier, we now know that virtually all chronic diseases evolve into being gradually over time and are mediated through two primary mechanisms: increased inflammation, and diminished circulation. This is true whether we are talking about diabetes, stroke, heart attack, Alzheimer’s, hypertension, arthritis or any number of other diseases and disorders. We also now know that mood disorders are affected by blood flow and inflammation. Studies are showing that chronic depression and anxiety, as well as certain psychiatric illnesses such as ADHD (Attention Deficit Hyperactivity Disorder), and bipolar disorder, are directly linked to blood flow. We do not generally see these mood disorders without associated diminished brain circulation, (especially to the limbic and prefrontal areas) and, perhaps even more impressively, when we restore the brain’s circulation to normal we generally see reduction or elimination of the mood disorders.
Chronic use of drugs, including alcohol, caffeine, nicotine, and many prescription medicines, lead to diminished circulation and increased inflammation throughout the body, including to the brain. These substances are themselves to greater and lesser degrees mood-altering. Specifically, they tend to mask to some degree symptoms of anxiety and depression. Withdrawal from the chronic use of any mood altering drug involves a sharp adjustment to reality, a sudden awareness of feelings of anxiety and/or depression that had previously been soothed, masked, or numbed during chronic substance use. This is one of the reasons that substance users of all kinds, from coffee to cocaine, tend to share a common anxiety over the issue of quitting their mood-altering substance(s). Breaking the habit not only means giving up something from which they derive pleasure or respite, it also involves a painful process of experiencing often intense feelings of anxiety, frustration, irritability, and depression. The process activates the limbic system, which in turn stimulates the sympathetic division of the ANS to create a generalized stress response, including increased heart and respiratory rates, perspiration, and constriction of blood vessels causing diminished blood flow throughout the body, including the brain.
Although in time (usually after about 3 weeks) the body adapts to the substance-free state, and physiology gravitates toward normal function again, there often remains a lowered sense of mood, a feeling of something missing. For many people who chronically use a mood-altering substance of some kind, coming off that substance not only deprives them of their “high,” but also of a kind of ritual, something to look forward to. Taking a smoking break, sipping coffee while reading the morning paper, having that cocktail before dinner, or smoking pot before bedtime can become a emotional management tool as much for the ceremony of the practice itself as for the high derived from the substance. If some other practice is not substituted in its place, breaking even a soft addiction like coffee can be very difficult.