Thursday, January 28, 2016

Dopamine: “The Anticipation Molecule”

by Peter R. Coleman, MD

For a long time, it has been known that dopamine is the pleasure molecule. After all, it is common knowledge that a large amount of dopamine is released in the nucleus accumbens area of the brain when we do pleasurable things - like eat food and have sex.  When the dopamine is released, we experience a strong sensation of pleasure and, of course, we are likely to want to repeat that experience.  We also know that all addictive drugs release massive amounts of dopamine in the nucleus accumbens - way more dopamine than we humans were ever meant to experience.  This heightened pleasure sensation is the biggest reason why people use addictive drugs.
But now, more light is being shed on just how complex are our brains and how different parts of the brain interact. Scientists are now also calling dopamine “the anticipation molecule” because it has been shown that dopamine is also released in large amounts when we anticipate a pleasurable experience.  We actually release dopamine in the nucleus accumbens and get a sensation of pleasure by just thinking about having one of these experiences. Actually, just thinking about having a pleasurable experience is not quite enough to release a lot of dopamine. The large amount of dopamine is released when two things happen - we both think about the pleasurable experience and there is a realistic opportunity that we will be able to have the pleasurable experience - true anticipation.
We can all relate to this and know that this is true. I’ll stick with the food example.  Let’s say we are quite hungry and someone brings out a plate of warm chocolate chip cookies.  We are suddenly presented with the opportunity to eat one of our favorite comfort foods.  In this situation our brains will actually release a small amount of dopamine and we will experience a thought - “maybe I should have one cookie”.  We start to process this situation and think about the different possibilities. We could refuse the temptation and not have the cookie, or maybe we think that we could have just one.   Our thoughts about the cookies begin to become a little more like a desire.  We analyze the pros and the cons.   Our thoughts are becoming more like a craving.   Our mind starts to swing towards making the decision that one cookie wouldn’t be so bad, and “What the heck - I deserve it”, or “Why not - I can go to the gym later”. As we allow these thoughts to build, we start to imagine what the cookie will taste like and how it will be amazingly delicious.  Our old memories kick in.  At this point, our pleasure center is releasing so much dopamine, we are getting very excited and we can’t wait to eat that cookie. We know how good it is going to be! We feel great!
And then, we bite into the cookie, and it happens - the cookie wasn’t that good.  It was an okay cookie, but it was not nearly as good as we had imagined. “The cookie lied to me!”  “Now I am going to get fat, and for what - a lousy cookie that didn’t even taste that good”.  It is amazing to know we actually got more dopamine from anticipating the cookie than we received from the cookie itself.
Drug addiction is just the same.  Even patients who are physically addicted to opiates have to go through all sorts of mind games each time they decide whether to use or not. They all know using drugs is bad, horrible, and they should stop.  But, once they have the opportunity to use, the dopamine kicks in so strongly that not using becomes almost impossible. And, frequently, it is just like the unsatisfying cookie - it wasn’t that satisfying.  Addiction is cruel for both the addicts and everyone around them.

Monday, January 4, 2016

6 Ways to Keep your Resolution for Sobriety

by Gabriella Pinto-Coelho

For those struggling with an addiction to alcohol or another substance, the end of the year can be a challenging time. Thanksgiving, Christmas, and New Year’s can bring up old temptations and triggers that can make your goal for sobriety seem out of reach. But now that the overindulgent holidays are past us, we can focus on the possibilities of the New Year that lies ahead.

Approximately 40% of Americans make resolutions, viewing the New Year as a fresh start, a symbolic transition. While setting resolutions can be a great way to get clear and motivated about your goals, only 40% of those who make resolutions actually go on to keep them. This 60% failure to keep a resolution can stem from a variety of things - unrealistic expectations, lack of discipline, loss of motivation, or something else. I personally think that some of the trouble with keeping resolutions lies in our cultural “all-or-nothing” attitude when it comes to resolutions. For example, say you have a friend who has made a resolution to eat healthier. But on a snow day in February, she eats 10 cookies. 

Sadly, many people would throw in the towel at this point, thinking, “Today I went completely against my resolution, so I guess it’s over now.” In reality, keeping a resolution involves a less-than-perfect path. You might have days when you slip-up and others when you feel on top of the world. Doesn’t that sound a lot like the road to recovery? The point is, don’t give up on your resolutions when the going gets tough or when you take a few steps back. That’s life.

There are some other excellent ways to help yourself keep your resolution for sobriety in the New Year.

1.      Focus on what you are gaining from sobriety. When you frame your resolution as simply “not drinking,” you are making a negative statement. Instead, think and talk about your resolution as something like “freeing yourself from addiction.” Reframing your decision in a positive statement allows you to focus on the benefits that you get out of keeping your resolution.
2.      Forgive yourself for past mistakes and focus on making decisions you are proud of. Beating yourself up over what you did in the past will only create more pain and suffering in the present. Offering yourself some compassion and forgiveness will go a long way toward creating the life that you deserve.
3.      Let your friends and family know about your decision so you can develop a strong support system. Gathering the support of trusted loved ones allows you to get the encouragement that that you need as you navigate the road to recovery. It also holds you accountable to your resolution because the force of positive peer pressure can help keep you in check when you feel your motivation waning. Invest in relationships with the people that can be the helping hands you need.
4.      Do something altruistic. Volunteering not only helps those in need, but it can also give you a boost of self-esteem. When you feel good about yourself, you are more likely to take the necessary steps to take care of yourself.
5.      Face your demons in a healthy way. Many people start using alcohol and drugs as a way to escape their troubles. Whether it’s depression, anxiety, past trauma, insecurity, or something else, everyone has their demons.  Rather than self-medicating, make an appointment with a therapist and work through your issues. While therapy can be emotionally challenging, if you can attack the root cause of your addiction, you will set yourself up for long-term sobriety.

6.      Find clarity and meaning. Without drugs and alcohol clouding your outlook on life, you can start focusing on things that give you joy and meaning. Whether you decide to explore your faith, take up a hobby, learn a new language, travel, or something else, find something that gives you a sense of purpose. Living with intention will give you the attitude that you need to accomplish your resolution for sobriety.