"Much research today, funded by national organizations, is focusing on the neurobiology of addiction. The catch phrase is "addiction is a brain disease." This line of research has served to help "legitimize" the field of addiction. Research is showing that alcoholism, drug addiction and compulsive gambling-my particular area of focus-have genetic and biological bases. These addictions are not just self-centered, immoral, bad behavior.
If addiction is a brain disease, what is the brain? Basically, it is an organ like other organs in the body-heart, liver, kidneys.... The brain is made up of tissue, blood cells and nerve cells. This collection of nerve cells differentiates the brain from other organs. We can think of the brain as a bio-organic computer. Its nerve cells work through transmission of biochemical signals that create bio-electric impulses. The chemicals responsible for transmission of messages from one nerve cell to another are called neurotransmitters. Three of the neurotransmitters most significant in addictive disorders are dopamine, serotonin, and norepinephrine. Dopamine and a system of nerve cells responsive to it have been identified as the primary reward system in the brain. This system appears to manage feelings of pleasure and satisfaction and also controls how we respond to reward and punishment. The dopamine system also affects memory and learning, since we tend to remember what is pleasurable or satisfying. We can trigger the system's actions over and over, trying to learn from what is rewarding or punishing or painful. Many addictive substances and activities directly impact on this system by mimicking the action of dopamine or increasing the release of dopamine into the nervous system. Serotonin largely manages the emotional system. A lack of serotonin or of the ability of the nervous system to process this neurotransmitter contributes to depression, emotional instability and impulsive behavior. The third neurotransmitter discussed here works on the arousal system. Norepinephrine is the "fight or flight" agent, managing alertness, attention, and responses to potentially dangerous, stressful, anxiety-provoking situations.
Scientific studies increasingly demonstrate differences between these major brain systems in individuals who develop addictive disorders and those who do not. Such differences have been shown to be, not simply a result of using toxic substances that can damage the brain but, genetically mediated differences that existed prior to the addiction and contribute to a person's higher risk for addiction.
Individuals who are more biologically at risk for addiction are likely to have a neurobiological basis for deficits in experiencing pleasure, reward and satisfaction. Additionally, they are more likely to be emotionally unstable and impulsive, or experience either over- or under-arousal. Addictive substances and behaviors act in some ways to "fix" such neurobiological risk factors. However, the addictive "cure" only serves to intensify the problem, by further aggravating the underlying biological problems.
Taken alone, this discussion of addiction in relation to the biology of the brain probably seems disheartening. But the mind is a component of the addiction equation, as well, and next month I'll discuss tools for reducing our subservience to the brain's neurotransmitter systems.
***Lori Rugle, Ph.D. specializes in treating and understanding compulsive gambling at Trimeridian, Inc. in Indianapolis, IN
BRAIN, MIND AND ADDICTION (Part 2 of 2)
by Lori Rugle, Ph.D.
We learned that the brain may be somewhat of a 'villain' when it comes to addiction. The addiction equation also contains an element that can play the 'hero': the mind. Certainly our physical brains set the baseline for mind. However, mind seems to have a choice in how it responds to the physiological boundaries established by our brains.
In addition to the results I spoke of previously, research studies are making it clear that other risk factors contribute. While genetic, neurobiological factors exist, they are not the only- perhaps not even the most significant-factors that place some of us at risk for developing addictions. Biological factors may provide less than 25% of the explanation for why one person becomes addicted and another doesn't. Clearly, other critical factors demand attention in order to understand the cause of addictive behaviors.
The brain can be touched and measured. With modern neuro-imaging techniques, we can even see pictures of the brain as it works.
What, however, is the mind? Where is it located? Does the mind "exist" in the brain? Is it only the sum of the brain's neurochemical impulses, or is it something more? I recently asked participants in a workshop I was facilitating to define 'mind.'
After a significant silence, people talked about mind consisting of thoughts, ideas, memories, experiences, learning, images, feelings, beliefs. Then I asked, "If we took all of our thoughts, memories, experiences, feelings and just added them all up, would the sum of all these things equal 'mind,' or would there still be something more?" Everyone agreed that we would also have to include our spirit, something that makes us unique and at the same time ties us all together.
These questions about mind are questions that scientists, philosophers and clergy have been debating for centuries. Our minds do make choices. We can choose meditation or prayer to manage sadness, anger, fear and loneliness; or we can chose to drink, drug, shop, eat or gamble trying to numb out these feelings. We can choose to exercise to help reduce stress, focus our attention and manage our feelings. We can use our minds to learn to accept the limitations of our brains and our bodies, and to learn loving and compassionate ways to manage our impulses, express our feelings and cope with stress and problems.
For some, making such healthy choices is extremely difficult because the biology of their brains works against them. These individuals may suffer from severe depression, attention deficit disorder, manic-depression, or disorders of impulse control. Certainly, to reduce the risk of using addictive substances or behaviors to self-medicate, the compassionate choice for some individuals may be appropriate medication.
However, it is important to recognize that medication helps the brain to function. While this may assist an individual to better utilize the mind, medication does not necessarily "heal" the mind or, by itself, stop addictive behavior. Ideally, the mind will be used to make healthy choices, not choosing to seek escape, euphoria, or relief via the quick fix of addiction.
At the same workshop I mentioned earlier, we also talked about how we can change the chemistry of our brains through activities such as relaxation, prayer, meditation, eating mindfully, exercising and such. When you take a few minutes to breathe deeply and slowly, your brain chemistry automatically changes, your brain waves change.
One person suggested that when a compulsive gambler is gambling she or he changes the brain in the same way, since many gamblers report that gambling relaxes them. While this may seem true on the surface, gambling and other addictive behaviors only provide the illusion of providing this type of relief. If we took a brain image of someone who was gambling and compared it to someone who was meditating, we would have vastly different pictures.
Addiction is about mindlessness; conversely, meditation, prayer, and relaxation are about mindfulness. Addiction is about forgetting who we are, and meditation is about remembering who we really are. About remembering that, when our true minds are 'enabled,' the elements in the addiction equation are greater than the sum of their parts; each mind is a spark of a higher mind and a greater reality. If we accept our biology and use our minds to maintain this conscious contact, we can live mindfully, not turning to the illusory safety of addiction."
Courtesy: Lori Rugle, of Trimeridian, Inc. in Indianapolis, I.N.
Dr. Rugle specializes in treating and understanding compulsive gambling.
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