Thursday, November 12, 2009

Dopamine, Methamphetamine and You

This is another guest blog by Lori Pate explaining how meth affects the brain, and why it's so addictive.

Thank you, again, Lori.

First things first -- What does dopamine do anyway?
1) Dopamine is critical to the way the brain controls our movements. Not enough dopamine -- can't move, or control our movements well. Too much dopamine? Uncontrollable/subconscious movements (like picking, tapping, repetitive moments, jerking, twitching). Remember that the heart is a muscle, too, and too much dopamine will result in increased pulse and blood pressure.

2) Dopamine controls the flow of information from other areas of the brain, especially memory, attention and problem-solving tasks. This becomes important when we talk about amphetamine-induced psychosis that is common in meth abusers.

3) When dopamine is released it provides feelings of enjoyment and reinforcement to motivate us to do, or continue doing, certain activities. Dopamine is released by naturally rewarding experiences such as food and sex. This pre-programmed reward system makes sure that people do eat, do desire to procreate, and basically survive. Without enough dopamine, people feel the opposite of enjoyment and motivation -- they feel fatigued and depressed, and experience a lack of drive and motivation.

How do brain chemicals like Dopamine work?
Brain chemicals, including Dopamine, are stored in cells, which you can think of like barrels full of that chemical. When something occurs like a good meal or great sex the brain pours out some dopamine from the dopamine barrels into an open space in the brain called a synapse. It floats around there. Think of the synapse like a street, and dopamine is like little cars driving around aimlessly on the street.

Across the street (not far) from the barrels of dopamine are Dopamine receptors. These receptors have little parking spaces on them that only fit Dopamine (or a substance VERY similar in chemical shape to Dopamine) into them, like a lock and key. As the Dopamine floats around in the synapse, it finds parking spaces at Dopamine receptors, and "plugs in" to the receptors. THIS is the point where we feel good, when the Dopamine is parked in a receptor's parking space. There are, however, a limited number of receptors with "Dopamine only parking" available, and each receptor has a limited number of parking spaces. So some of the dopamine may not be able to find a place to park.

When all the parking spaces are taken, the remaining dopamine that didn't find a place to park is normally recycled. There are "reuptake molecules" that do this -- think of them like tow trucks. They find the extra dopamine, and tow it back to the barrels of Dopamine so that it can be re-used the next time. After some time has passed, the receptors release the Dopamine that was parked in their parking spaces, and the tow trucks take those Dopamine molecules back to the barrel too.

The brain has a safety-check system that will destroy any excess Dopamine that isn't in a parking space, and didn't get picked up by the tow truck. There are special chemicals in our brains that will break down this extra dopamine. Think of this like the toxic waste crew coming in and sweeping up the street.

As a last resort, after repeated long-term over-stimulation, the brain will shut down Dopamine receptors so that nothing can park there ever again. Think of this like the demolition team coming in and permanently barricading off the driveways.

This is your brain on Meth!
So now that we have a basic understanding of how things work normally, I'll try to explain how things work when meth is ingested.

When someone eats, snorts, injects, or otherwise gets meth into their system, meth stimulates those barrels of Dopamine to pour out Dopamine. Meth continues to tell the cells to pour out dopamine until the body can break down the meth, which is typically 12 hours or so.

So Dopamine is poured out into the synapse (street) and finds parking spaces at dopamine receptors and makes the user feel high.

But meth is a tricky little chemical. It is shaped closely enough to Dopamine that the tow trucks get confused, and pick up meth thinking that it is dopamine. So the tow trucks are busy driving around hijacked by meth molecules leaving the extra Dopamine molecules floating around in the street (synapse). Well... that means the toxic waste crew comes in and destroys that dopamine that did not get recycled. So for the 12 hours or so it takes for the body to break down the meth, it is also spending that time destroying dopamine.

As long as the user keeps ingesting more meth, this process continues until there is not enough dopamine left to feel high from. When the user finally stops using, and the brain breaks down the meth molecules, the recycle trucks try to salvage what dopamine there is left, while the user crashes.

The end result of a "run" or "binge" on meth is a marked decrease in the amount of dopamine left in the brain. This leaves the user feeling exhausted, hungry, depressed, possibly suicidal and definitely unmotivated. They are literally suffering from a brain chemical imbalance. Self-inflicted mental illness.

How can the brain ever be normal again?
Well, luckily, the human body is pretty resilient. We do have the ability to make replacement dopamine. However, the body was not designed to need to do this in large quantities or in quick supplies. So we don't have a mass-production plant making dopamine. It's a 3 to 4 step process, too.

The process: Phenylalanine --> Tyrosine -->L-dopa --> Dopamine

Phenylalanine is the first "pre-cursor". It can be found in the following foods: soybean protein, frozen tofu, dried and salted cod, shellfish, lean meat, organ meat, skin-free chicken, cheese, milk, eggs, many seeds (watermelon, fenugreek, roasted soybean nuts), and chocolate. Equal artificial sweetener also contains Phenylalanine. The body can turn Phenylalanine into Tyrosine.

Tyrosine can also be found in food. This would eliminate the need for the body to synthesize it from Phenylalanine. One step closer to dopamine! Meat, dairy, eggs as well as almonds, avocados and bananas are good sources of Tyrosine.

From there, the body will convert Tyrosine into L-Dopa, and then on to Dopamine (and other neurotransmitters like norepinephrine).

So... to replace dopamine destroyed while high on meth, the recovering user must eat sources of Phenylalanine or Tyrosine.

To aid the body in making Dopamine, the person can use what dopamine they DO have left as often as possible. This tells the body that they need more of it. While you sleep, you use very little dopamine. Exercising, even just a walk around the block will use dopamine (remember, it controls movement). So setting a reasonable sleep schedule, and trying to get some exercise will help speed up recovery from Self-inflicted Dopamine Destruction (aka meth addiction)!

Be patient -- remember, we weren't designed to waste dopamine, we were supposed to be recycling it. The process of replenishing dopamine takes months. Studies show that recovering meth addicts who have abstained from meth use have about 80% of normal dopamine levels after 18 months of abstinence. This WILL be a long battle. It CAN be won.

What about the receptors that were destroyed?
Well, good news again. Even though those receptors can never heal or recover, the brain is able to use existing receptors and find new pathways to accomplish the same results. Some receptors will even get a home equity loan and build on extra parking spaces!

Are there any medicines that can help?
A doctor should always be consulted and included on any medication treatment for a recovering user. Many recovering addicts have found Wellbutrin (Bupropion) to be helpful after a few months of clean time. What Wellbutrin does is block some (not all) of the tow trucks for a little while so that the dopamine the person has left can be more effective. It does not, however, stimulate the barrels to pour out dopamine. The person has to have enough dopamine in their brain before Wellbutrin can help.

Health stores do carry supplements of Phenylalanine and Tyrosine. A recovering addict who finds it difficult to eat enough protein may benefit from a supplement. Again -- consult your doctor first.

Lori Pate
B.A Psychology
University of Texas at Austin
Disclaimer: I am not a medical doctor and this page was not intended to provide medical advice.

Wednesday, November 11, 2009

Men and Women - It's destiny

I promise a serious post next time.

Finally, the long time debate over nature vs. nurture has come to an end. Result? The differences are present from the beginning.

(Just ignore the titles. You'll get it.)

Thanks, Mom, for sending me these!

Thursday, November 5, 2009

This is my new inspiration

I turned my television off two weeks after 9/11. (the original one) I can't deal with it.

But if I turned it on and saw this, (which I totally lifted from Janet Reid's blog) I'd probably leave it on forever.

Monday, November 2, 2009

The Brain Chemistry of Being a Loved One (of an addict)

Guest blogger
Lori Pate

B.A. Psychology
University of Texas at Austin
Disclaimer: I am not a medical doctor and this page was not intended to provide medical advice.

The Brain Chemistry of Being a Loved One

Many people who have loved an addict have felt like they were going insane from all the chaos, worry, regret, fear, anger, confusion and more that comes with caring for someone who is in active drug addiction.

It seems reasonable that if the addict would just stop using, everything would return to normal and a happy life would resume. There is usually more going on though. There are chemical changes happening not just in the brain of the addict, but also in the brain of the loved one.

"What? I'm not the crazy one! The addict in my life is the only one going crazy, not me!"

That isn't always true. The chemical changes in the brain of a loved one should be understood to help speed recovery. Chemical changes in the brain of someone who is constantly in a state of stress, fear, anxiety and anger are not insignificant and are accompanied by withdrawal symptoms just like an addict who stops using.

The brain uses chemical messengers, called neurotransmitters, to allow us to feel feelings. Hunger, thirst, desire, satisfaction, frustration, fear and every human emotion are felt by the activity of chemical messengers in the brain. The most important messenger in this situation is norepinephrine (also knows as adrenaline).

Norepinephrine is known as the "fight or flight" chemical messenger. This chemical is what causes us to feel a rush of energy when faced with a dangerous situation. Proper activity and levels of this messenger help humans get and keep themselves safe from harm. This chemical gives us the super-human abilities to outrun an attacker or think quickly in an emergency.

When a dangerous situation is perceived, norepinephrine is released in the brain. Receptors in the brain have "parking spaces" for the chemical to "park" in, which deliver the message. Once the chemical is plugged in, we feel a burst of energy, and a drive to get ourselves safe, take action, run or fight.

After the event is over, the messenger is released from the parking spot, and recycled to use again later. We begin to feel calmer and safer. The rush subsides. Heart rates return to normal. The feelings of fear and anxiety subside.

This happens all the time in all healthy humans.

But the human brain does not like constant stimulation. As soon as we are excited from a chemical message, the brain goes to work to return levels to normal. There are several mechanisms that work to do this. First, the chemicals are picked up by "reuptake" chemicals. Think of them like a tow truck. They are constantly floating around, looking for a chemical to tow back home. Recycling the chemicals restores levels to normal.

If constant stimulation occurs, causing constant chemical messages, recycling isn't enough. So the brain, in its effort to regain a normal balance, will begin destroying the chemicals permanently. If we are constantly in fight or flight mode, the brain determines that we have too many "fight or flight" messengers, so destroys them.

For someone who actually has too much adrenaline in their brain, this is helpful. But for someone who is constantly in a situation where they really are put under stress, and are triggered to respond to fear over and over, the destruction of their chemical messengers begins to cause a brain chemistry imbalance.

There is a third mechanism that the brain uses to restore balance. After recycling and destroying the messenger chemicals, if the brain is still being over-stimulated, it will destroy the parking spaces that the chemicals plug into. These are called dendrites. Once a dendrite is destroyed, it can not be repaired. It will never again receive the chemical message it was designed to receive. It is like yanking out the phone cord of a phone that won't stop ringing. It will never ring again.

When a loved one is in a constant state of worry and fear, the brain first experiences stimulation. It feels imperative for the loved one to take action, sometimes desperate action, in an attempt to remedy the fearful situation. If this stimulation continues day after day, the brain can not tolerate the constant stimulation and starts taking action to regain balance. Adrenaline is destroyed. Receptors are destroyed.

This is when the insanity of being a loved one really takes off. The loved one is no longer chemically balanced. Several things happen at this point:

Things that used to signal danger no longer feel so dangerous. There simply aren't enough "danger" chemicals or receptors to accurately convey the appropriate feelings. At this point loved ones may begin accepting very dangerous situations as OK. For example they may feel it is a good idea to track down a loved one at a dealer's house, or accept a loved one who is violent and abusive in their home. They may make a choice to allow a dangerous person to be around their children. This is not because the loved one just isn't making good choices. More accurately it is because their brain chemistry has been altered by the constant chaos, and they no longer have the right feelings that would initiate safe choices. Unacceptable behavior doesn't feel as truly dangerous as it is.

Still, some loved ones are aware enough to know they should stop being in a dangerous situation. When the loved one stops contact with the addict in their life, that is when withdrawal sets in.

Withdrawal occurs when the brain is accustomed to a particular level of chemical activity, and that level is suddenly reduced.

A loved one who has become accustomed to constant stimulation from fear and concern, who then suddenly finds themselves in a safe, calm environment, will feel withdrawal because their brains have adjusted to a high level of adrenaline.

Withdrawal symptoms cause the loved one to feel quite uncomfortable. They will feel sad, have sleep problems, and feel that something is missing or just not quite right. This will cause the loved one to feel a desire to reach back out to the chaos they were accustomed to. The chaos will cause a hit of adrenaline to occur. This is the exact same cycle that an active drug addict goes through: stimulation followed by withdrawal. Withdrawal feelings cause a desire to be stimulated again, because the brain does not like extremes.

Because the loved one who has undergone chemical changes has lower than normal adrenaline activity in the brain, they will crave stimulation. They will feel an overwhelming desire to "check on" the addict, or to take a phone call even though they know it will not have the end result of a pleasant conversation. They will engage in arguments that they know have no possibility of being resolved while the addict in their life is still in active addiction. The will feel drawn back to the fear and worry they just escaped.

An extreme example of this is seen when a battered spouse continues to return to their abuser despite having other options.

This is the brain chemistry side of the chaos cycle of being a loved one.

So does it ever get better?

Yes! It absolutely can get better.

The human body can make more adrenaline, to replace what was destroyed when under constant stress. Not quickly, but slowly, it can replenish the levels of adrenaline so that the person feels normal, without needing chaos in their life to achieve a balance.

The human body makes neurochemicals from our food intake. A healthy, protein rich diet gives the body the building blocks it needs to make more adrenaline. Regular light exercise, a normal sleep pattern, a safe environment, and a healthy diet will help the brain recover.