Neurobiology of Addiction

Addiction is a psychological and physical inability to stop consuming any substance or stop an activity even though it is causing one psychological and physical harm. It is important we understand the neurobiological processes that lead to addiction as they are the same ones involved in recovery.

Here, I will write on how different parts of the brain are responsible for self-regulation, reward, learning, and memory change and become rewired during repeated substance use. Neurobiology of addiction is basically how these parts of the brain interact with each other as an addiction develops.

The most important neural pathway involved in substance use disorders is the mesolimbic pathway, often called the reward pathway. This pathway controls our response to natural rewards like food, sex, and social interactions. This is the primal or primitive part of our brain in charge of survival.There are a variety of brain chemicals involved in Substance use which include both neurotransmitters and hormones but the one common is a neurotransmitter called dopamine. Dopamine is responsible for supercharging reward-seeking via the ventral tegmental area and the nucleus accumbens. The euphoric feeling one gets when they use a substance is rewarding, right? Dopamine is the neurotransmitter that urges such act to be repeated as the consequences (euphoria) was rewarding.The ventral tegmental area (VTA) releases dopamine based on whether or not environmental stimulants such as drugs, stress, sex, food, or winning a race were rewarding or aversive.

The nucleus accumbens receives the dopamine released by the VTA and mediates the rewarding effects of drugs and stimuli. This is where the fun lives. The pathway from the nucleus accumbens and the amygdala is involved in learning.

Now grab the gist……The brain says this feels good. The pathway from the amygdala to the ventral tegmental area is involved in memory. So the brain says, this felt good last time, and the pathway from the amygdala to the nucleus accumbens is involved in emotional cues from both internal and external triggers.

The brain says these are the conditions that lead to good feelings. The pathways from the prefrontal cortex to many of these areas are involved with higher-order thinking and self-regulation and are referred to as executive functioning.

So the brain might say, I know that this felt really good but it gets in the way of my goals so I won’t do it again. The activation of the mesolimbic pathway tells the individual to repeat what it did to get that reward (euphoria). It also tells the memory centers in the brains to pay attention to all features of that rewarding experience so it can be repeated in the future. So that is how the brain processes, remember, and desires rewarding things, and simply put, drugs are rewarding.

While intoxicating substances including stimulants such as cocaine, and methamphetamine, opioids, and alcohol act in different ways on the mesolimbic system, they all have a lot in common.

Most drugs bind to receptors on neurons within the mesolimbic system either by reducing inhibitory signaling or actively causing dopamine release. Alcohol may be an exception here.

Drugs are dangerous because they cause dopamine release far in excess of what is produced by normal pleasurable stimuli like food, sex, etc., and sends the reward pathway into overdrive. For instance, cocaine increases dopamine release with the burst by a factor of 10! Yeah. That’s crazy, right?

Most brain activity is affected by an individual’s specific genetic makeup and this is certainly true for substance use. Additionally when an individual started using impacts the risk of addiction.

When younger ones start using substances, unfortunately, the more efficient intracellular (communication within a cell) and neuronal communication (communication within a neuron using electrical and chemical signals) work.

This is due to the fact that myelin, a fatty substance like insulation around a battery wire, helps to signal work fast and efficiently and it is produced during several periods in younger life. So what happens with repeated substance use? In short, brain habituation (decrease in response to a stimulus after repeated intake). Overtime, pathways used repetitively become more efficient, require less and less of a stimulus of thought, and create habits, and also are impacted by one’s genetics and age of use. The time it takes to achieve this varies with the kind of drug. Ultimately, the distribution of neurotransmitters gets all out of kilter (out of balance). A person that chronically uses a substance now requires a greater amount of neurotransmitters to activate the reward system. This is what is termed tolerance. Simply put, tolerance occurs when there’s a diminished response to a drug, which occurs when the drug is used repeatedly and the body adapts to the continued presence of the drug.

Studies on animals and humans showed that repeated habitual use changes the number and density of receptors for addictive drugs which is why tolerance develops and changes intracellular signaling molecules and protein expression that are long-term which explains the persistent craving that follows withdrawal.

So what are the consequences of long term drug use? The brain becomes altered chemically and anatomically. The emotional systems of the brain run rapidly and feel out of control. The physical sensation, sensation part of the brain gets badly distorted. The thinking part of the brain, the prefrontal cortex shuts down as the reward system takes over. Everything gets oriented around just trying to feel normal.

But is all hope lost? Obviously not!

The good news is that just as new pathways formed during addiction, the brain can generate new pathways during recovery.

There are evidence-based, cognitive, behavioral, and pharmacotherapies available to help re-calibrate the neural pathways to strengthen pathways to the prefrontal cortex and to weaken pathways to the reward system. In a nutshell, you can remember that during addictions, the reward system, the system that says go, overpowers the prefrontal cortex, the part of the brain that says stop.

Thank you.

Suicide

What is suicide?

Suicide is a ‘cry’ that was not heard.

Three years ago, we lost a patient who was struggling with SUD to suicide. He felt defeated because of relapse and decided to end it, painful!

Suicidal people are only trying to end some form of pain or escape bad reality.

How can we prevent suicide?

1) understand that they are looking for a way (thou not the best way) to end pain then proffer alternatives, that are attainable by:
a) kind words of encouragement
b)meeting immediate needs that trigger suicide (food, job, money, loneliness….)
c) Referral them to treatment
d) follow up on the fellow
e) Demand good policies and hold government accountable. This may not have an immediate effect, however most new suicide cases are links to economic hardship which good governance can ameliorate.

Therapy techniques (for mental health professionals only)

DBT: use it to help patients regulate and tolerate emotions eg loss or relationship breakup.

CBT: use to help patients correct negative thought patterns that may lead to suicide.
Motivational interviewing (my fav):
Find people, things, memory that pt cherishes, motivate them with these, and keep hope alive.

Support Group.

Finally, plan prevention with client Center approach, work with pt to indicate red-flags & quickly implement an ur prevention plan❤

Mindfulness


As you go about your day to day life, how often are you really paying attention to just exactly what is in front of you?
For example, when you’re having a conversation, are you really listening to what the other person is saying?

Or is your mind drifting off, worrying about something totally unrelated? When you’re walking down the street, are you paying attention to the scenery and sounds around you? Or is your mind elsewhere?

And are your eyes glued to your mobile phone? Are you constantly engaging in disturbing thoughts that are unrelated to what’s in front of you?

When you are in the car are youu paying attention to the roads? Or are you angry at the traffic?
Agonising that you’re late?

These constant chattering of worries in our minds makes it hard to concentrate or be fully present in what we’re doing, they also contribute to feelings of stress.

What is mindfulness?

Mindfulness is being Here and Now.

Mindfulness is paying attention to the present moment without judgement.

It is being aware of how we are feeling, what’s happening in our mind, body & around us at any given moment.

Mindfulness is not allowing ourselves to get caught up in our thoughts.

The goal of mindfulness practice is training our attention through regular practice to become more aware of and less reactive and judgemental towards our thoughts, emotions, and bodily sensations in day to day life.

Practice

Time: 5 minutes

And the best part is, anyone can practice mindfulness anywhere, at any time. And it costs nothing to bring your attention back to the present moment. So why don’t we give it a go?
Because the best way to understand mindfulness is to experience it.

No matter where you are, just start paying attention to your body.

Are you lying down? Or sitting up?

Start to notice how you are breathing. Is it short and shallow, being held in the chest?

Gently adjust your posture either to be lying down on your back or sitting up comfortably in a chair, legs uncrossed with both feet resting on the floor.

Close ur eyes.

Start by bringing awareness to your breathing.
Our breath is a fundamental anchor to the here and now.

Notice the rising of ur abdomen with each breath in &how it falls with each breath out.

Stay connected to ur breath and in doing so, bring ur awareness to the rest of your body.

Feel the points of contact between your body, and a chair, or the floor.

Bring awareness to ur feet.

Then slowly shift your attention up through your body.

The front of your legs, the back of your legs. Your belly, around your back, Your chest and your shoulders, are you holding tension there?

Now, Relax the shoulders down and let it go.

Then finally, move your awareness up to your face, letting go of any unnecessary tension in your jaw and relaxing the muscles around your eyes, and in your forehead.

If you notice your attention wandering or if you become caught up in a stream of thought, that’s okay.
Simply bring your attention back to the next breath and continue.

As you come towards the end of the practice, start to reactivate your body by moving your fingers and toes.

And when you are ready, slowly open your eyes.

How are you feeling now?
How many times did your thoughts travel the universe and back?

Mindfulness is a way of training our attention towards opening ourselves up to whatever life puts in front of us.
It is simple but not easy and takes practice.
So don’t feel bad if u found it difficult the first time.

Keep Practicing…..10 minutes without losing concentration 🤩🤩

Covid-19 and how it may affect young people.

Covid-19 anxiety, it is normal and expected. However, We try to remind people with severe version of it that their object of fear (getting infected, isolation, death) is irrational and may not even happen.

  • Lockdown, restrictions, unemployment, isolation has led to Anxiety, loneliness, patients being unable to access health care and this may worsen their health conditions
  • Bereavement due to Covid-19 complications. Many people lost their loved ones and are griefing.
  • Increased domestic violence as couples who are having a hard time staying together are forced to share and remain in the same space due quarantine. Children are not speared too.
  • Ab/use of substance as coping mechanism for anxiety, depression or loneliness.
  • Addiction to or over use phone, game or social media.
  • Sleep pattern altered (this is worse for people with bipolar or schizophrenia).
  • Worsened OCD,those with compulsive hand washing and other hygiene related OCD are at risk.
  • Isolation, unemployment and bereavement will increase depression which is the chief cause of SUICIDE

Finally, our government and their policies are not youth friendly…..this group (youth) that makes up the bulk of the population will bear the brunt💔

Anger

Anger can be defined as a feeling of annoyance, displeasure or antagonism towards someone or thing you feel has offended you.

Anger is a normal, a healthy emotion but it’s important to deal with it in a positive way.

Anger is a secondary emotion.
So what’s underneath it?

Disappointment, frustration, sadness, dismissal, loneliness, fear….

Explore the root emotion under the “anger”.
Once you know that root emotion, Good resolution comes.

ALCOHOL USE DISORDER(AUD)

ALCOHOL USE DISORDER(AUD)

Also called:
Alcoholism,
Alcohol dependence,
Alcohol addiction,
Is a chronic disease characterised by uncontrolled drinking & preoccupation with alcohol.
It is also an inability to control drinking due to both physical and emotional dependence on alcohol.

There are 11 symptoms currently in use for diagnosing an alcohol use disorder culled from DSM5

1)Have there been times when you ended up drinking more, or longer, than you intended?

2)More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

3)Spent a lot of time drinking? Or being sick or getting over other after effects?

4)Wanted a drink so badly you couldn’t think of anything else?

5)Found that drinking or being sick from drinking often interfered with taking care of ur home or family, school or job?

6) Continued to drink even though it was causing trouble with your family or friends?

7) Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?

8) More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?

9)Continued to drink even though it makes you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?

10)Had to drink much more than you once did to get the effect u want? Or found that your usual number of drinks had much less effect than before?

11)Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

Answering to the affirmative (yes) to at least two (2) of these symptoms indicates an Alcohol Use Disorder (AUD).

The severity of an AUD is defined as follows:

Mild: The presence of 2 to 3 symptoms from the list.
Moderate: The presence of 4 to 5 symptoms from the list.
Severe: The presence of 6 or more symptoms from the list.

Treatment:
Treatment involves counselling & therapy by a healthcare professional,
A medical detoxification programme are offered in a hospital or clinic.
Medications are available that reduce the desire to drink.

Seek help today…….

Regards❤️

The Church and Psychiatry

*THE CHURCH AND PSYCHIATRY*

Many people have one or more beefs with the church.
Some don’t agree with paying tithe, some baptism, order of worship or other stuffs. Whatever be the case, let me tell you roles church play in psychiatry.

The church has tuned people up psychologically, for instance, you see and hear a sick person repeating or claiming ‘I am strong’ or ‘I am well’ (there’s this saying, you are what you say) after the Priest or Pastor. Study shows that repeating these phrase over time has a way of turning the neurotransmitters in a correct direction- cognitive reversal.

The Church has done greatly in helping people fulfill their need to belong, thereby promoting self esteem or self actualization (Maslow, 1971).
The Church gave people something to believe in, instead of believing in Nothing.

Morals that church teaches, to a very large extent has helped people leave/avoid some health risky behaviours.

Confession is psychoanalysis which is without absolution of sin. Many slide out of depression after asking for forgiveness of sins. Many obtain faith to do things that dared them, things that gave them phobia.

Some non medical or not responsive to medical treatment cases, the Church has cured some successfully. That does not mean you should not seek medical interventions when need be.

Church is a psychosocial construct, if you are confused about its practices or beliefs, seek clarification. Do not mock it.

Suicide

Every 40 seconds, someone loses their lives to suicide. Almost 800,000 people die yearly from suicide.
Like addiction, suicide is a symptom of an underlying problem. Those who attempt suicide do so to escape from painful reality. Most people who commit suicide do not really want to die. They just want to end the pain. People who commit suicide are not in the right frame of mind to think logically or rationally.Suicide is a symptom of mental health challenges or a result of untreated mental illness. Mental health challenges varies, from bipolar disorder, depression, anxiety, post traumatic stress disorder, schizophrenia, conversion disorder and a host of others………people suffering from MH disorder may want to take their life. Studies has shown that clinical depression is a chief cause of suicide. History of prolonged medical ailment can also result to MH disorder that may push one to commit suicide. For instance, there’s been reported cases of people attempting suicide for being HIV positive.
No one is immune against MD disorder but some factors like biological (genetic), environmental and social factors can trigger it.
I defined suicide as a cry that was not heard. Even when life seems worthless, no one really want to end it. Suicide is highly preventable.
Here are some Tips
1. Do not worry excessively about things you can not change. Remember you can not control how people act towards you but you can control how you respond to them.
2. Don’t create unrealistic or unreasonable expectations. “Expectations not met weakens the heart”.
3. Think positively, use positive affirmations like “yes I can”, “I am fine”, “I can do it”, “All will be well”.
4. Do not seek validation from other people. This is a major threat to Mental health, excepting commendations, appreciation, love, empathy (which is ideal) from people you meet may not always be obtainable. People disappoint, learn to manage disappointment well.
5. Self care is very important…take care of yourself, take a break when need be, eat well, sleep well and exercise.

If your mental health is disturbed, all the dimensions of your health will suffer.
#HappyMentalHealthday.
Suicide is not an option
Do you feel life is worthless?
Let’s talk. 08027182805
At #SoundMindRepublic We Care!