Saturday, December 1, 2012

Brain Chemistry and Addictions

Today I want to explore the connection between bad brain chemistry and addiction.  In the past, I've pointed to various self-destructive behaviors as being the BBC sufferer's attempt to fix the problem caused by his or her bad brain chemistry.  It's a form of self-medicating to binge on alcohol, food, tobacco, drugs, shopping, gambling, sex, video games, channel surfing, texting, hand-washing, hoarding, or even violent behaviors such as beating or killing or destroying someone or something.  (People who kill animals obsessively, for instance, are self-medicating, I believe.)

People use these forms of medication because they work--they make the bad feelings go away.  Unfortunately, even the relatively harmless remedies don't work for very long, and people find they need more and more of the medicine more and more frequently to obtain the same result.  In other words, they develop a tolerance for it, and as their tolerance builds so do the medicine's costs and debilitating side-effects.

There are treatment programs for the more well-known obsessions, and people are becoming aware of how many ways there are to become addicted, thanks to a number of shows currently on TV that depict such maladies.  One of the things all the treatment programs seem to have in common is that the addiction is a medical problem, something that can't be helped.  The two methods used to treat addictions involve either swearing off the behavior completely or gradually decreasing the incidence until it's at a reasonable level.  Both seem very difficult for the addict to accomplish.

The same serotonin uptake inhibitor drugs used to treat depression are often recommended for addictions, with the idea that bad brain chemistry is causing the addictive behavior.  I wonder, though, if there's a way to using cognitive therapy to fix addiction. I'm guessing it would be very difficult, but maybe it would work better than what is being used currently.

Let's think about that for a minute.  The addictive behavior is in response to the feeling state produced by the brain.  The logic goes like this: I feel terrible.  Doing X will make me feel better, so I need to do X so I can feel better.  And I need to do it right away.

The urgency of the need is indicative of its being brain chemistry induced.  It's not simply a desire, but a powerful urge, a craving that is out of the normal realm of desire.  And what kind of need falls into that category?  A life-or-death urgency.  When one is in a fight-or-flight situation, time is of the essence.  If you're confronted by a mountain lion about to pounce, you can't afford to wait until a more convenient time.  You need to respond now!

Does the brain create that need?  I don't think the brain is particular about what the person uses to respond to the apparent emergency.  Whatever works is what the brain will be satisfied with.  The need is for the pain (that comes from the fear) to stop.

I know, I know--it doesn't feel like pain.  For example, I was at a luncheon today and even though I wasn't hungry after the first several bites, I ate everything on my plate in addition to the candy appetizer.  There are a lot of theories about why I did that, but I'm satisfied that it's an addiction.  The clean plate is the signal to stop, not the full stomach.  (Shirley Simon talks about this in her book, Learn to Be Thin.)  But I don't recall any pain associated with my behavior.

But what produces that desire to see the clean plate?  That's the question that most intrigues me.  In order to change my behavior, I would have to know the answer; otherwise, it's just a matter of doing what I'm told--to respond to the full stomach instead of the clean plate--a task that seems like it should be easy.  After all, it's just a matter of doing one thing instead of another.

So, what produces the urgency to eat until the plate is empty?  It must be providing me with the medication that I need to make the bad feeling go away.  But what is the bad feeling?  I don't recognize it when it sweeps over me.  But I do feel anxious when I see that there is food that is not being eaten, on my plate or someone else's.  Where does that feeling come from? 

Let's look at my original premise: the brain produces the bad feeling for no reason other than its own hyperalertness.  I feel hungry and that frightens me, so I try to feel less frightened by eating.  At that point, my mind is keenly focused on food.  I'm not paying attention to other things around me becaused I'm distracted by the desire to eat.

But what happens when I do eat and I'm no longer hungry?  Why do I keep eating?  How is my brain producing this desire?  Clearly it's not related to physical satiety.  What is it related to, then?  Well, maybe it's just what I've learned to do to make the bad feeling go away.

Like right now I feel bad, but the reason (I tell myself) is that my sister is unhappy.  I want my sister to be happy, so I try to do something right away to make my sister feel better so I can feel better.  Did I start out with the bad feeling that then fixes on my sister's problems?  If my sister no longer had problems would I still need something to be worried about?

Perhaps that's an addiction like any other.  I feel bad->I look for a reason to feel bad->Finding a reason creates the need to find a solution->act on that desire by carrying out the solution.

So, if I apply this reasoning to my eating behavior, I have this.  I feel bad (brain chemistry solar flare); one of the ways to make myself feel better is to eat; when I eat, I feel better.  I might even keep eating until I'm sure I won't feel bad again.

But the fact is, any number of actions will fix the brain chemistry.  And by the way, sometimes the brain chemistry produces euphoria instead of dysphoria.  It doesn't matter, really, the response is the same--do something to get my brain back in balance.

Some people would say: oh, come on! Is there no good reason to feel bad in your world?  Yes, there are good reasons to feel bad.  It's reasonable to think that I would feel bad because someone I love feels bad.  But then my desire to do something about it has more to do with me than with my loved one.  I want my sister to stop feeling bad so I can stop feeling bad.  That's about me, not her.  And even if I do solve this problem for her, she'll come up with another one, and another one after that.  And I'm going to keep feeling bad with her until she stops feeling bad (never, apparently).

So, what to do? More on that later.

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