Balancing Biochemistry for Addiction Recovery
By Hyla Cass, M.D.
The Biochemical Roots of Addiction
The biochemical roots of addiction lie in the same part of the brain that governs passion, love, and mental energy. In addition to whatever psychological factors are present, addiction also reflects imbalance of neurotransmitters — the chemical messengers in the brain that are the molecules of thought and emotion.
The ones that we’re most familiar with are dopamine, norepinephrine, serotonin, endorphins, and adrenalin. Imbalances in any of these can lead to low energy, depression, and burnout, which then drive you to look for ways to wake yourself up using whatever is on hand. Or they can lead to irritability, hyperactivity, and hypersensitivity that pull you toward the easiest downer available. Often, it’s all of these.
Your Brain: Getting the Message Across
Trillions of nerve cells, called neurons, are scattered throughout the body, but are most highly concentrated in the brain. Connecting to one another via branches called dendrites, they link together like interconnecting highways. Neurotransmitters deliver messages from one neuron to the next.
The “sending” neuron produces the neurotransmitter, propelling it toward the “receiving” neuron, across a small gap called a synapse. There it attaches to its specific receptor site, just like a key fitting into a lock. When it fits, the message is delivered — that is, the receptor is activated. An electrical signal then travels along the dendrites until it reaches the next synapse or road junction, where it triggers the release of more neurotransmitters.
Once a neurotransmitter has delivered its message, it is released from the receptor site and returns to the synapse. It might then be taken up once again into the neuron that sent it, where it can be used again, or it might be broken down and destroyed. Now that’s recycling!
Each neuron, on average, makes more than 1,000 synaptic connections with other neurons. In total, there may be between 100 trillion and quadrillion synapses in the brain. Moreover, these synapses are not random, but form patterns that give rise to what are called circuits in the brain. These form the basis of behavior and of mental life. How you think and feel – your mood, alertness, level of relaxation, and the state of your memory – is affected by the fine-tuned activity of these circuits, which are controlled by the interplay of the various neurotransmitters.
One of the most awe-inspiring mysteries of brain science is how activity of neurons within circuits gives rise to behavior and, even, consciousness. There is a delicately balanced system in place involving our genetic makeup, environmental influences, memories, and neuronal health. We can, however, influence brain cell activity by supplying the right nutrients that include the raw materials to produce these neurotransmitters.
While there are hundreds of neurotransmitters, the following are the main players (that we know of, at least) and their actions:
· Dopamine energizes the brain, makes you motivated, focused, and on track. Not enough dopamine? You feel lethargic, apathetic and depressed, unable to focus or get moving. Caffeine, cocaine, certain addictive behaviors, and dangerous activities such as reckless driving can raise dopamine levels in the brain, so if your levels are low, you may just be drawn to these activities. How do we get low in dopamine? Some of the factors here are:
o Your genes: Some people are just born that way, with less dopamine or fewer receptors for it.
o Poor nutrition
o Lack of emotional connection to others
· Too much dopamine and you’re manic, losing normal inhibition and good judgment. You may turn to alcohol to chill you out. Or a doctor might prescribe tranquilizers, which have their own dangers. We have better ways.
· Serotonin is another major neurotransmitter in the brain, though surprisingly, 95 percent of it is made in the gut, a fact than may help to explain the term “gut feeling”. Serotonin regulates mood, appetite, sleep, muscle contraction, and mental functions such as memory and learning. If you have low serotonin, you don\'t feel so well: depressed, anxious, tense, unable to sleep, more sensitive to pain, and craving carbs.
o Stress is one factor that causes serotonin to go south; low estrogen in women is another. Most of the newer mood-enhancing drugs, such as Prozac, Zoloft, Paxil, Lexapro and Celexa are SSRIs – selective serotonin reuptake inhibitors. They prevent the drug from being taken back up, so it makes more ‘hits’ on the receiving cell, making it believe there is more serotonin available than there really is until those molecules are used up and the drug stops working. Sound familiar? Ever experience SSRI poop-out, where the doc has to raise the dose or add another drug? That’s why.
· Adrenalin is the fight-or-flight neurotransmitter produced by the adrenal glands, which are working overtime in our modern-day, 24/7 lifestyles. This overdrive, along with cortisol imbalances leads to adrenal fatigue, which presents with low energy, especially in the mid- to late-afternoon or on mornings when simply can’t wake up, even though you think you’ve had enough hours of sleep. That’s where Starbucks comes in (not a great idea, though).
· Endorphins are the feel-good hormones. Activities such as running or even stress can release an abundance of endorphins, boosting the feelings of pleasure and satisfaction, so we can actually become addicted to both. Running is obviously healthier. With a lack of endorphins, we feel apathetic, unmotivated, and tired. Life feels not worth living and you may be drawn to either stimulants or opiates. I don’t recommend them.
· GABA is the chill factor that helps us calm down. Without adequate levels of it, we are nervous, hyperactive, and most often, have trouble sleeping. We may turn to alcohol to chill us out, though this can end up backfiring, with all the usual bad consequences.
o When levels of these neurotransmitters are low, we feel bad: anxious, depressed, tired, and just generally uncomfortable. Wanting to feel better, we reach for what’s handy and for what works: sugar, caffeine, alcohol, cocaine – whatever. Or we shop ‘til we drop, all in an attempt to restore mental, physical, or emotional energy. We’ll even gamble away our family’s means of support for the momentary thrill of the pursuit of a win – a fool’s journey, for sure.
We have seen how the origins of addiction arise from the complex workings of the brain. The substances that give us pleasure – such as alcohol, coffee, sugar, cocaine, and tobacco – all cause stimulation through the release of feel-good neurotransmitters.
Over time these substances can lose their kick, requiring higher doses to maintain the feel-good effect. This occurs when the receptors for the neurotransmitters close down (called down-regulation) in response to the heavy bombardment of a given substance. And to complicate matters further, when you decide to stop using your substance, you have fewer spots to receive the chemical message. Down-regulation wins every time.
The trick to overcoming addiction is to restore and regulate normal neurotransmitter balance, and maybe even have it for the first time. Many turn to addiction in the first place to try to self-treat a long-time imbalance in mood. However, the solution is not necessarily “white-knuckling it” or taking medication, in addition to any therapy or 12-step program. Rather there are specific nutrients that will help restore balance as you will soon see.
Excerpted from Dr. Cass’ book, “The Addicted Brain and How to Break Free”.