Psychological dependence

Psychological dependence is a cognitive disorder and a form of dependence characterized by emotional and motivational withdrawal symptoms following the cessation of prolonged drug use or certain repetitive behaviors. It develops when repeated exposure to a substance or behavior produces an adaptive state in the brain, so that stopping the stimulus triggers withdrawal symptoms through a negative reinforcement mechanism that drives the person to resume the behavior. Withdrawal symptoms are primarily psychological rather than physical, including anxiety, low mood, an inability to feel pleasure, exhaustion, insomnia, irritability, appetite changes, cravings, panic attacks and stress. The condition involves neuronal counter-adaptation, changes in how brain neurotransmitters and receptors function after repeated exposure, including activation of the transcription factor CREB, which reduces reward sensitivity and produces the negative emotional state of withdrawal, and dysregulation of stress systems involving corticotropin-releasing factor. Some substances, such as the psychostimulants cocaine and amphetamine, are understood to produce only psychological dependence, while others, such as alcohol, produce both psychological and physical dependence together.