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.