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Join certified trauma professional Dr. Amy Hoyt and licensed therapist Leina Hoyt, MFT at https://www.mendingtrauma.com as they teach you how to recover from trauma and cPTSD. Trauma shows up in our everyday reactions and sensations and recovering requires a multi-prong approach that considers the mind, body and spirit. Dr. Amy and Leina will teach you the most emerging research and skills to empower you to overcome your past traumas. They address nervous system health, somatic therapy, trauma, cPTSD, EMDR, Neurofeedback, IFS (Internal Family Systems therapy), and many other modes of recovering from trauma. As mental health experts, sisters and trauma survivors, they teach you the tools that actually helped them recover, are backed by research and have helped thousands of their clients. Each episode is packed with clinically effective methods as well as scientific findings to guide you through your own trauma healing journey. Whether discussing cPTSD, PTSD, medical trauma, somatic therapy, nervous system regulation, EMDR or neurofeedback, Amy and Leina will help you recover from trauma so that you can reconnect to yourself and others.
Dr. Amy Hoyt (02:10)
Hi, welcome back to another episode. We are happy to be here with you again. And we are of course still in September, which is Suicide Prevention and Suicide Awareness Month. And so today we wanna talk about how addiction relates to suicide. So Lena, talk to us about addiction and suicide.
Leina (02:37)
Well, as we were preparing to do this podcast, I mean, I think anecdotally and from experience in our own family, we know that there's a link between addiction and suicide. But as I was doing some research about it, a few things really stood out. And one was that the risk is higher when you have an alcohol use disorder and or an opioid use disorder.
Dr. Amy Hoyt (03:06)
Interesting.
Leina (03:06)
And opioid use disorder increases suicide, risk of suicide exponentially.
Dr. Amy Hoyt (03:16)
Okay. And opioid, just for anyone who doesn't know, typically can include pill form. A lot of people get addicted through the pill form and then can move into injecting through heroin and synthetics that are similar.
Leina (03:29)
Correct.
Correct. Yeah, that's a good clarification. Thank you. Yeah. So one of the other things that came up as I was looking into this is that aside from depression, substance use is the highest risk factor. That's one of the articles that I read. And that suicide and addiction and depression are all interconnected.
Dr. Amy Hoyt (03:43)
Yeah.
For suicidality. Okay.
Okay, that makes so much sense to me based on my own experience of attempting suicide when I was 15. And then when that didn't work, I started using alcohol and drugs to self -medicate. But the reverse is also true that when we start self -medicating with alcohol and drugs, which
Leina (04:24)
Right.
Dr. Amy Hoyt (04:32)
a lot of us do because depression is so painful. Yes. Then once we start that addiction, what I see happening is that that depression doesn't go away so we're just, that self -medication doesn't take our risk factor away.
Leina (04:37)
Is painful. Oh gosh yes.
No, no, in fact it can increase it. Yeah, yes. And so the other thing that I think is really important to note is that behavioral addictions can be a contributor as well, can increase risk. And one of the reasons why any addiction can increase risk is because it's so disruptive
Dr. Amy Hoyt (04:56)
And in fact, exactly, exactly.
Leina (05:21)
primarily to our relationships. And it also induces addiction in general, induces negative emotional states. And this can be contributed or excuse me, attributed to the financial strain from an addiction, even if it's a behavioral addiction. mean, how many purses do you need to own? It can.
Dr. Amy Hoyt (05:47)
Right.
Leina (05:48)
It can also contain a social stigma. There's a lot of isolation in addiction and addictive behaviors.
Dr. Amy Hoyt (05:58)
Sure. Cause you have to hide your behaviors. So can we backtrack a second with what, what is a behavioral addiction?
Leina (06:02)
Well, and your print... Sure.
It's also called a process addiction. So it's anything that we can get addicted to that's behavioral that isn't a substance. So shopping, gambling, pornography, sex, yes. Yep. And the isolation is really profound in addiction as well. And, and
Dr. Amy Hoyt (06:15)
Okay, so shopping, sex, porn. Yep. Okay. Okay.
Leina (06:29)
when we are in the grips of an addiction, our primary relationship is with the addiction, either the substance or the process, behavior. And so we have less genuine connection with other people because our drive is to get more of whatever it is we're addicted to. Doesn't it?
Dr. Amy Hoyt (06:38)
Yes.
That makes so much sense. Which causes the relationship disruptions, which causes the negative spiraling of self and negative emotions. How does one know whether they are simply in love with shopping or whether they are addicted?
Leina (06:57)
Mm -hmm.
Right.
Sorry, go ahead.
Dr. Amy Hoyt (07:17)
Full full disclosure. I actually don't like shopping. So y 'all know my addictions are drinking, drugs. I don't mess with shopping I I go right for the substance abuse. Thank God I am sober and have found recovery. Going back though, I'm thinking of listeners who
Leina (07:32)
Hard stuff. Yeah.
Dr. Amy Hoyt (07:42)
maybe they've started listening to this episode because they traditionally think of addiction as substance abuse. And how does one know if they have an addiction, a behavioral addiction, or if it's simply what sometimes we see in the literature as like problematic use of?
Leina (07:48)
Mmm.
Right. Generally, there are a few things that stand out in terms of evaluating whether or not you are engaged in some type of addictive behavior. One is if you've ever thought to yourself that you should cut back or cut down. One is if somebody who is close to you and cares about you has ever suggested that you slow down, cut back.
eliminate, etc. Another really hallmark sign is that you need more of it to get the same dopamine high, the same dopamine burst. And that is applicable whether it's a substance or a process addiction.
Dr. Amy Hoyt (08:45)
Yes.
Yes. And the other hallmark is secrecy.
Leina (08:54)
Yes, yes, yes, good.
Dr. Amy Hoyt (08:56)
So when we are using our behavior or a substance in secrecy and mind you, this can be food too, right? When we are being secretive about our behavior or our substance, that's another sign.
Leina (09:04)
Absolutely.
Yes, I'm so glad that you identified that because that can be another really big hallmark sign, the secrecy.
Dr. Amy Hoyt (09:21)
Yes. Cause there's shame associated with it because whether we're conscious or not, we are somehow realizing, I'm, I'm going over the line here.
Leina (09:32)
Yes, and a lot of times it can be subconscious. This, this, and that, leads to the secrecy. And we may not have this conscious awareness that our behavior or our usage is high or too much, but we do have this subconscious awareness that we don't want people to criticize or judge us because we're drinking too much or shopping too much or whatever.
Dr. Amy Hoyt (09:35)
Exactly.
Yeah. Yep. Yeah.
Yes.
Yes. And you know, I still fall in those tendencies sometimes with food. So for many, many years I was secretive about certain foods I was eating. If I was, you know, quote unquote, eating too much or, sweets or, and we grew up in a household that was pretty, focused on our physical appearance. And so that was, you know, I felt shame if I was eating too much ice cream or
Leina (10:06)
Mmm, me too.
Mm -hmm.
Dr. Amy Hoyt (10:32)
and so even now, every once in a while I'll think, I don't want anyone to see if I'm eating ice cream, which is so sad.
Leina (10:39)
Right. Yes. Well, and we grew up in a house where food was hidden from us. Do you remember?
Dr. Amy Hoyt (10:46)
Yeah, that's true. Yes. my gosh. I totally remember. Yes. Yes. Yes. my goodness. Yes. Mm hmm.
Leina (10:51)
Right, those brownies? Mommy still had those brownies.
Yeah, So there's a lot of like familial cultural stuff around that. And shame is another really big problem with addiction, regardless of what kind of addiction it is. And then the shame drives more usage because shame feels so terrible.
Dr. Amy Hoyt (11:05)
Yeah, sure.
Yes.
And these are all the negative emotions that we're talking about when we're talking about how addiction can actually increase our risk of suicide or suicidal ideation.
Leina (11:33)
Correct, yeah. Well, and the other thing that can happen is that when we're actively involved in an addiction, whether it's a substance or process addiction, it starts to distort our judgment and it greatly affects our impulse control.
Dr. Amy Hoyt (11:49)
It does.
Yes.
Leina (11:55)
And one of the articles I read talked about how it interrupts neurotransmitter pathways, which I don't know exactly how. I don't know the mechanism. But as much as we talk about new neural pathways and setting up new ways to behave, we don't want disruption in our neural pathways.
Dr. Amy Hoyt (12:19)
Exactly. Right. No, that's such a great point. So we're actually damp, you know, we're doing damage to the brain, which I think most people understand, you know, from those 1980s commercials, this is your brain, this is your brain on drugs. If y 'all are young, you got to Google the commercial, this is your brain, this is your brain on drugs.
Leina (12:27)
Right.
Hahaha
Seriously. Yes.
Dr. Amy Hoyt (12:45)
So most of us understand with a substance that it's going to affect our brain in a negative way, but the behavioral addictions have the same exact effect.
Leina (12:55)
Exactly. And it drives disconnection because of the shame. It drives disconnection because of the secrecy. It drives, yeah.
Dr. Amy Hoyt (12:59)
Yes.
Yes.
Yep. Okay, let's move on to talk about what do we do with this? I mean, obviously with the subject of addiction and suicide, our first line of defense is to work on the addiction. That's going to reduce our risk of suicidal ideation.
Leina (13:20)
Sure. Absolutely.
I wanna acknowledge how difficult it is to work on any addiction. It is exceptionally painful. And so that's one of the reasons why 12 -step recovery programs talk about one day at a time. Cause if you think I'm never gonna have a drink again, there's gonna be a part of you that's gonna be like, screw that.
Dr. Amy Hoyt (13:33)
It is.
is extremely difficult.
Leina (13:51)
Yes, because one of the reasons we become addicted to things is because it gives us a dopamine dump and that feels really good.
Dr. Amy Hoyt (14:02)
It does. And the other reason we become addicted, and this is in the research, and this is really the work of Gabor Mate, is that addiction and trauma are linked. You will not find an addiction without trauma. Now, what that means is that not only are we self -medicating for maybe
Leina (14:18)
Correct.
Dr. Amy Hoyt (14:26)
depression, but separately we are trying at all costs to avoid the feelings associated with the trauma.
Leina (14:33)
Yes.
Dr. Amy Hoyt (14:35)
And the trauma doesn't have to be some big capital T trauma as we've talked about. can be a series of smaller things. It can be just anything that overwhelmed your nervous system that you are trying to re -feel.
Leina (14:51)
Yes, yeah, Gabor Mate. I'm so glad you mentioned him. He's a Canadian doctor that has really specialized in addiction for decades. And in recent years, maybe the last, well, as far as I'm aware, the last eight to 12 years, he's really focused on trauma and addiction. And his work is really fascinating if you're considering that maybe you do have some addictive behaviors.
His approach is so compassionate and understanding and it helps reduce shame when you're trying to address some of the behaviors or the substance use.
Dr. Amy Hoyt (15:35)
Absolutely. What other tools can we give our listeners if they're listening thinking, huh, I wonder if this applies to myself or a loved one. What else can we give them to take away?
Leina (15:50)
I think that it's easier to ask ourselves if it applies to a loved one. That's kind of just human nature. And, you know, if only my sister were listening to this, or if only my husband could hear this, right? That's just human nature. But I think when we're trying to consider whether or not we might be struggling with some kind of addiction, it's really important that we notice
Dr. Amy Hoyt (15:57)
It's safer.
Leina (16:19)
without judgment. Because as soon as we go into, only bad people use drugs. No, people in pain use drugs. If we go into this place of, I'm a good person, so I can't have an addiction, that's nonsense. Calling people good people and bad people is a huge problem because our behavior depends on the state of our nervous system in that moment.
Dr. Amy Hoyt (16:26)
Yes.
Yeah, and we're all, we all have equal parts of what we would call adaptive and maladaptive behaviors. And I mean, I think I'm a pretty good person and I'm an alcohol and drug addict. So, so there you go. Come join my camp. You can be a good person and have a full blown addiction that you are working on every day.
Leina (16:55)
Correct, yeah.
Yeah, think that's right. Yep. And another thing that can be helpful is the reason we use, whether it's process or substance, is because it relieves us. It makes sense in that context. Absolutely. Because
Dr. Amy Hoyt (17:27)
It's a survival skill. We are trying to survive because it's better to, for me at least, was better to drink every day than attempt suicide again.
Leina (17:39)
Yes. Yep. Well, that makes perfect sense to me. And in our family, the rule is you keep people alive and you deal with everything else later.
Dr. Amy Hoyt (17:41)
Oddly enough.
Yes, that is definitely the rule in our family.
Leina (17:52)
Yeah. So, so being able to be lovingly curious, being able to stay out of that black and white all or nothing thinking about, well, you know, if I think about myself as a good person, then surely this can't be part of who I am. That just is going to make things worse and it will trigger more shame for you. So you're a person and
when you're in a certain nervous system state, when you're really aroused or depressed in your nervous system, you're going to behave differently than when you're in a regulated state.
Dr. Amy Hoyt (18:26)
Yes, absolutely. So becoming curious about ourselves, suspending judgment of ourselves. And if you do notice that you have some problematic behaviors that you're hiding or you're trying to stop and you can't stop them, there is so much help. There are 12 step groups for pretty much anything you can think of. There are also, I mean, we
Leina (18:30)
Mm -hmm.
Dr. Amy Hoyt (18:57)
see people that are working on addiction as well. We've walked a lot of people through addiction by using a multi -prong approach, you 12 step programs plus trauma interventions that we work on through our programs. There's so, so much that you can do and we want to let you know that there's so much hope. So much hope.
Leina (19:22)
Mm -hmm. Yeah. Absolutely.
Dr. Amy Hoyt (19:26)
Even if you've tried quitting a million times, it could be the million and first time that sticks.
Leina (19:34)
I like that you're pointing that out.
Dr. Amy Hoyt (19:37)
Yeah, and that hope is hard to grasp onto at times when you're in the throes of addiction. It's very, very difficult and it's still accurate. There is still hope. It is never, ever, ever over.
Leina (19:45)
Right.
Yes.
Yeah, I like that. Thank you for making that explicit.
Dr. Amy Hoyt (20:01)
Absolutely. Well, thank you so much for joining us for another episode and we look forward to being with you next week. Again, we are so appreciative of our listeners and the people that we work with and are grateful for your courage to get help.
Leina (20:20)
Have a great week everybody and take good care of yourselves.