Understanding Our Brain, Addiction How To Live A Healthy Life
Every day we make a range of choices. We do things that make us feel good or work a specific job because it's fulfilling or pays well. These experiences help shape our perspectives on life and define who we are.
However, problems with our ability to manage or maintain our pursuit of pleasure often lie at the root of many neuropsychiatric disorders such as addiction and even depression.
Dopamine - Friend and Foe
Pleasure is driven by the release of a range of neurotransmitters (chemical messengers) in many parts of the brain. But dopamine release in the brain's reward system is particularly important as it tells the brain when to expect something rewarding, modulates how rewarding it will be and drives us to seek rewarding things.
Dopamine is also important for a range of other functions such as voluntary movement and cognition. Disorders such as schizophrenia have too much dopamine release, which causes psychotic symptoms. In neurodegenerative disorders such as Parkinson's disease, the dopamine cells responsible for motor coordination die prematurely.
The reality also is all drugs of abuse release dopamine in this system. Other rewarding experiences — sex, food and gambling — are also associated with increases in dopamine release. On the other hand, decreases in dopamine within reward systems are associated with depression, a lack of pleasure or motivation, and also withdrawal.
We all experience pleasure differently as a result of individual differences in biology or neurochemistry, but also as a result of past experiences and differing social and cultural factors.
So while some may get a greater hit of dopamine from buying new clothes, others may get it from placing a bet on a sports match. As humans we make decisions, some are habitual and less reliant on pleasure and others are more goal-directed.
The cognitive processes behind goal-directed behaviour involve determining the value of the potential outcomes and forming a strategy that maximises our ability to achieve the best outcome. If we make the same decision enough times and the outcomes stay the same, our decisions become less goal-directed and become more habitual in nature.
But we are all well aware that certain choices do not always lead to a positive outcome. In these cases, over time we learn which outcome provides the best overall reward. We then guide our decisions towards this outcome, even if occasionally it does not result in a positive outcome.
Gambling is a good example of how this process can become problematic. Poker machines provide a positive outcome just often enough to keep you playing, even though they are programmed so that you lose money in the long run.
When you loose the power over your decisions
Having issues at any point in the decision-making process can lead to pathological behaviour.
Addiction is categorised by a single-minded focus on obtaining the next exposure or "hit". So much so the individual makes bad decisions in order to attain this particular outcome, even if they no longer find it that pleasurable.
This is why multiple approaches are required to treat addictive behaviours.
There is a quest to develop medications that adjust the neurochemical balance to weaken these habitual behaviours. Inevitably, these will require other interventions such as cognitive behavioural therapy and social support networks to help retrain the brain and improve decision-making capabilities.