In this chapter we investigate the stigma associated with dependence on addictive substances. Although this dependence is considered to be a psychiatric disorder, features of the disorder exist, and social factors are associated with it, that distinguish it from other mental illnesses. These features affect the nature of stigma associated with the disorder-how people with the disorder are viewed and treated and how they view themselves. Moreover, an investigation of these distinguishing features and their relationship to stigma may provide additional elements to the understanding of stigma and mental illness in general.One distinguishing feature of dependence on addictive substances is that it can occur in the absence or presence of other psychiatric disorders, such as major depression, schizophrenia, or bipolar disorder. In the absence of other disorders, substance dependence may be considered by the public as the most likely of the psychiatric disorders to be outside of the realm of a medical disorder and within the realm of individual choice. According to some theories of stigmatization, this would make the disorder especially likely to be stigmatized by the public (
Faced with pervasive loss, life threat, and moral conflict in the field of battle, the human body and brain adapt to extraordinary circumstances in extraordinary ways. These adaptations come at a high price, and many men and women returning from Iraq and Afghanistan are paying that price every day. For the clinician who seeks to help, an understanding of the physiology of war-zone stress and resilience is an essential foundation, both for recovery from post-traumatic stress disorder and other conditions, and for addressing the stigma and shame that keep many service members and veterans from seeking and accepting the help and support they need. This article explores ways in which the body and brain adapt to war-zone stress, resulting challenges, and implications for clinical services and ongoing recovery.
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