understanding addiction

I made some notes straight out of a mental health class I’m taking. This session focused on the brain science aspect of addiction, and I found it really interesting! I’m also endeavoring to synthesize some of my learning from other sources, and thought I’d take a bit to share this very brain science-y information, because I’ve not only found it interesting, but also instructive! I also tend to remember more when I write it out. So… here goes!

In normal, every day brain activity, pleasurable activities stimulate the VTA (Ventral Tegmental Areas) to develop dopamine, to stimulate the Nucleus Accumbens, which lights up and says “this is a great experience!” These regions are connected by what is called the pleasure or reward bundle. In neuroanatomical terms, this bundle is part of the Medial Forebrain Bundle (MFB), whose activation leads to the repetition of the gratifying action to strengthen the associated pathways in the brain. The Amygdala and Hippocampus give color and shape to the experience, helping us remember what made this so great – so we can do it again later.

These are all considered healthy adaptive functionings.

Then, the Prefrontal Cortex (the executive function area of the brain) says “okay that was fun, but enough is enough, you can’t do this every day, all the time – you have a job and a life!”

The greater the pleasure, the stronger the memory, the more pull to repeat it.

Then we have drug mediated pleasure. With drug mediated pleasure, the whole system is hijacked, overwhelmed – stimulated to death! This is also known as excital toxicity.

At the point of addiction or excitable toxicity, we’ve created a monster, some refer to this as Acquired Drive.

The Locus Coerulius, which transmits noradrenaline / norepinephrine has the responsibility to establish whether we need to fight, flight or freeze. In other words, it’s our warning system. Pretty important! But at the point of acquired drive, the Locus Coerulius starts to think the drug of choice is needed – like water, air, sleep, food. It’s no longer a “want to”, it’s a “have to”. Because it’s now considered a need, eventually the need overtakes the desire not to use – no matter how strong that desire may be or how determined we may be to break cycle. Physical pain, anxiety, sleeplessness, and other real symptoms will appear. These may be considered psychosomatic (all in the head), but it doesn’t really matter. In essence, the crave takes over!

We also have GABA (γ-Aminobutyric acid) which is the primary inhibitory neurotransmitter of the brain and Serotonin, which is a chemical that carries messages from one part of the brain to another. In Acquired Drive, these important chemicals are essentially turned off. In other words, all braking systems are lost! The frontal lobe has lost control, the gremlins are now running the show!

The brain is screaming like an out-of-control 2 year old “Where’s my dopamine? I want it now!”

Drugs of abuse mimic naturally occurring substances in the brain, hijack the system, and change the hardwiring (neuroplasticity) of the brain. Some of them bypass the VTA altogether, providing higher and higher doses of dopamine-like chemicals to flood the brain. This is why some drugs require a replacement drug in order to safely detox. Without that, the brain will short circuit and the body will die.

Sexual addiction, and to some extent food addiction, uses our own highly designed, highly functional brain chemistry against us! No exterior chemical required. The hijacking ends up with the same results as any other addictive substance.

THIS is why approaching addiction as a “character flaw” or simply a spiritual problem is ineffective. Regardless of why someone becomes addicted, it is a chronic health condition, not “just” a character or spiritual condition – even if we bring it upon ourselves through our own poor choices. We cannot spiritualize our way out of it. And we can’t just do better or try harder. A lot of people are carrying around loads of shame because someone told them they are defective in character, they need to just stop it, or some other possibly well-meaning but incredibly harmful statement.

Dr. Anna Lembke’s research has shown that it takes about 30 days for the brain to balance itself out when addiction is the issue – regardless of what type of addiction. Her book, Dopamine Nation is quite eye opening! In it, she recommends self-binding (doing whatever it takes to keep clear of your drug of choice). Literally, she says do whatever it takes! Making it past that first 30 days is crucial to recovery! She also has research showing the importance connecting with others and radical honesty. That is right in line with what we can read in scripture: confess to one another and pray for each other that we may be healed (James 5:16). But again, just being more spiritual is ineffective, on its own. Other effective coping mechanisms – and by coping mechanisms I mean sources that lead to dopamine production – are also vital to recovery. Without healthy sources that lead to dopamine production, we WILL, sooner or later, take the path of least resistance.

There are plenty of healthy sources that lead to dopamine production. These vary from person to person. The first question in discovering these sources is to ask: what do I do for fun? Some sources of dopamine may be surprising. Pain can also be a source. Meditation – prolonged meditation will result in some of the highest levels of dopamine production. Exercise, music, mindfulness, and yoga are all great sources. There are others. We just have to seek them!

Something else I learned, and this fully tracks with what Dr. Jay Stringer teaches in his book, Unwanted: dopamine is also produced by… shame! This is why we often include shame in telling our stories – almost as if we can’t not. So becoming aware of our own shame language and surgical extrication of it is a vital part of healthy recovery.

There’s more. A lot more! How neurons fire and wire. Myelination. How trauma impacts brain development. And the list goes on! But this is a basic explanation for how something adaptive (pleasurable activity) becomes maladaptive in the brain.

If you made it all the way to the end of this, I congratulate you! And I hope this was in some way helpful!

If are a neuroscientist or someone who has more knowledge about this than me, and I’ve made any errors, please do let me know!

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