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Addiction Denial: Signs, Stages, and Causes – Verywell Health

Geralyn is a Licensed Mental Health counselor and wellness content writer. She has experience providing evidence-based therapy in various settings and creating content focused on helping others cultivate well-being.
Elizabeth I. Molina Ortiz, MD, is board-certified in family medicine. She is a primary care provider with Atrius Health in Boston and was the medical director of Charles River Community Health.
Addiction is a brain disease characterized by compulsive behaviors that continue despite harmful or negative consequences. Usually, people envision drug or alcohol use when they think about addiction. However, addiction can include a variety of behaviors, including other forms of substance use, gambling, and sexual fantasies, urges, and actions.
People living with addiction may deny their behavior. This article explores the signs of addiction denial and when to seek help.

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Denial is a defense mechanism. It is a means of coping with anxiety-provoking or distressing thoughts or emotions. When it's difficult to accept information about oneself or the world, denial can serve as a way to distort or downplay the truth, keeping a person from facing reality. 
Denial can persist for short or long periods and looks different for everyone. However, as addictive behaviors become more disruptive to a person’s life, it can be harder to deceive oneself and others and ignore what is happening.

There are several theories on denial, but one of the ways healthcare providers view it is through the stages of change model. These include:
In the pre-contemplation stage, someone may not view themselves as having an addiction or be willing to evaluate their actions (denial). As the behavior continues, a person may begin to reckon with the idea that there may be a problem (contemplation).
Finally, a person moves from denial to accepting their addiction when they recognize the issue and are mobilized to change it.

Illustration by JR Bee / Verywell
Signs of denial may include but are not limited to:
People experiencing addiction denial may try to justify or downplay their actions. For example, a loved one may hear things like:
The following factors can lead to the development of addictive behaviors:
Genetics also increase the chances of developing addiction. Heritability rates can be 50% or more in family members with alcohol or opioid use.
Environmental factors such as access, social pressure, and lack of coping can also increase the likelihood of addiction.
Depression can fuel addiction denial by causing low emotions, unhelpful thoughts, avoidance, or escape mechanisms. These can perpetuate feelings of denial by prohibiting someone from examining their addictive behavior and addressing the issue head-on.
This can become a vicious cycle in the sense that depression and addiction can exacerbate each other.

Initiating a conversation with your healthcare provider can be the first step to getting support for addiction. Signs that it may be time to reach out include:
Withdrawal symptoms can be dangerous. For those dependent on a substance, talking to a healthcare provider is the best way to develop a plan for detoxing safely.

If you or a loved one are struggling with addiction or addiction denial, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
 If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
A person may consciously or unconsciously engage in addiction denial because they are struggling to accept the reality of their behavior. It is possible to move past denial. Recognizing signs in yourself or loved ones can initiate the process of recovery. Help is available through various sources, including talking to a healthcare provider, mental health or substance use professional, and support groups.

While addiction denial may seem like a method of protecting yourself from hard truths about your behavior, continued denial can be harmful. If you’re struggling with addiction or addiction denial, reflecting on your behavior and approaching yourself with honesty and compassion can help you begin the process of recovery. Acknowledgment and acceptance are essential to that process.

With addiction, a person continues to engage in the use of a substance or compulsive behavior despite consequences for themselves and others. An individual often craves the substance or behavior and may spend great amounts of time planning to or participating in the behaviors. There may also be unsuccessful attempts to reduce or control the behaviors.
Healthcare professionals widely consider addiction to be a brain disease. When a person uses a substance or engages in other addictive behavior, dopamine is released in the brain. Over time, the brain becomes increasingly responsive to cues. Additionally, dopamine circuits undergo changes, which lead to cravings and behavior changes.
Everyone is different, and so is their experience with addiction. While some may achieve their recovery goals quickly, it may take others more time and professional support to find success in recovery. Factors that may help people tackle their addiction include:
Addiction is challenging to talk about and navigate. The pain of addiction also extends beyond the person with the addictive behaviors. You can help someone who has an addiction by being empathetic and understanding of addiction as a disease. Offer your support to them as they seek and engage in care, as well as when they set boundaries to avoid triggers and potential relapse. If it feels healthy for you, be a genuine part of their support system and encourage them to take care of themselves, while doing the same for yourself.
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National Institute on Drug Abuse. The connection between substance use disorders and mental illness.
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