Psychological dependence is a term that describes the emotional or mental components of substance use disorder, such as strong cravings for the substance or behavior and difficulty thinking about anything else.
- Dependence refers to the process by which your mind and body come to depend on a substance so you keep feeling a certain way. This tends to result in withdrawal symptoms when you stop using the substance.
- Addiction is a brain disorder involving compulsive substance use despite negative outcomes. It’s a complex condition with both psychological and physical elements that are hard (if not impossible) to separate.
When people use the term psychological addiction, they’re often talking about psychological dependence, not addiction.
However, it’s important to note there are still wide variations in the way doctors use these terms.
In fact, the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
The symptoms of psychological dependence can vary from person to person, but they usually include a mix of the following:
- a belief that you need the substance to do certain things, whether that’s sleeping, socializing, or just generally functioning
- strong emotional cravings for the substance
- loss of interest in your usual activities
- spending a lot of time using or thinking about the substance
Physical dependence happens when your body starts to rely on a substance to function. When you stop using the substance, you experience physical symptoms of withdrawal. This can happen with or without psychological dependence.
This isn’t always a “negative” thing, though. For example, some people have a dependence on their blood pressure medication.
To better illustrate, here’s how the two might look on their own and together in the context of caffeine.
Physical dependence only
If you drink coffee every morning to wake yourself up, your body might come to rely on it to be alert and upright.
If you decide to skip the coffee one morning, you’ll probably have a pounding headache and feel generally crummy later in the day. That’s physical dependence at play.
Physical and psychological dependence
But maybe you also spend that entire morning thinking about the way coffee tastes and smells, or longing for your usual ritual of getting out the beans and grinding them while you wait for the water to heat up.
You’re probably dealing with both a physical and psychological dependence in this case.
Psychological dependence only
Or, maybe you prefer energy drinks, but only when you have a big day coming up. On the morning of one of those big days, you lose track of time and miss your chance to pick up a can on your way to the office.
You feel a sudden onset of panic because you’re about to give a huge presentation. You’re gripped with fear that you’ll fumble your words or screw up the slides because you didn’t get your caffeine boost.
When it comes to withdrawal, many people think of the classic symptoms associated with withdrawal from things like alcohol or opioids.
Left unmanaged, withdrawal from certain substances can be severe and even life threatening in some cases. Other withdrawal symptoms, like those mentioned in the coffee example, are just uncomfortable.
But you can experience psychological withdrawal as well. Think about the panic and fear in the third example above.
You can also experience both physical and psychological withdrawal symptoms.
Post-acute withdrawal syndrome (PAWS) is another example of psychological withdrawal. It’s a condition that sometimes pops up after the symptoms of physical withdrawal have subsided.
Some estimates suggest approximately 90 percent of people recovering from opioid addiction and 75 percent of people recovering from alcohol addiction or other substance addictions will have symptoms of PAWS.
Symptoms usually include:
- insomnia and other sleep problems
- mood swings
- trouble controlling emotions
- cognitive issues, including problems with memory, decision making, or concentration
- low energy or apathy
- difficulty managing stress
- trouble with personal relationships
This condition can last for weeks, even months, and symptoms can range from mild to severe.
Symptoms might also fluctuate, improving for a period of time and intensifying when you’re under a lot of stress.
Treating purely physical dependence is pretty straightforward. The best approach typically involves working with a professional to either gradually taper off use or stop use altogether while under supervision to manage withdrawal symptoms.
Treating psychological dependence is a bit more complex. For some folks dealing with both a physical and psychological dependence, the psychological side of things sometimes resolves on its own once the physical dependence is treated.
In most cases, though, working with a therapist is the best course for addressing psychological dependence, whether it occurs on its own or alongside physical dependence.
In therapy, you’ll typically explore patterns that trigger your use and work to create new patterns of thought and behavior.
Talking about substance use disorder can be tricky, and not just because it’s a sensitive topic. There are a lot of terms involved that, while related, mean different things.
Psychological dependence just refers to the way that some people come to emotionally or mentally rely on a substance.
Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.