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Old 03-22-13, 09:52 PM
mildadhd mildadhd is offline
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"Addictions And The ADD Brain", (chapter 30)

(Chapter 30)In Places of Tears And Sorrow: Addictions And The ADD Brain.

Quote:
(p 302-304) It has become evident that brain of people who are prone to addiction are biologically predisposed by some imbalance of brain chemicals.

Narcotic addicts, for example, are thought to suffer from a relative undersupply of endorphins,

the brain's indigenous narcotics.

People with ADD seem to be short on dopamine,

the reward chemical.

There probably exist, too, combinations of imbalances.

What causes the abnormal brain chemistry?

The scientifically simplistic answer would again put the onus on genetic inheritance,

although there are also compulsive moralizers who insist on seeing everything in terms of ethically flawed and weak-willed culpability.

The moralizers are chewing on a kernel of truth when they reject genetic determinism;

the genetic-minded are right to insist on the importance of biology and physiology.

And they both miss the point.
Quote:
The deficient neurochemistry of addiction,

like the deficient neurochemistry of ADD,

can be traced to events in the first year or two of life,

as we know, the brain's most crucial formative period. (*2)


Quote:
Notes (*2)

The role of natural opiates in infant attachment:

"Opiates play a unique role in socioemotional, imprinting,

and attachment developmental processes.

In face-to face affective interactions,

the emotionally expressive face of the imprinting object, the mother,

induces alterations in opioid peptides in the child's developing brain." -(Shore, 145)
We saw in chapter 12 that emotional stresses can affect the supply of brain chemicals-

-recall, for example, that infant monkeys suffer a drop in dopamine levels in their frontal lobes after only a few days' separation from their mothers.

"Social isolation, the early deprivation of emphatic care,

causes a permanent reduction of brain opiate receptors,"

writes the researcher and theorist Allan Shore. (*3)

The catastrophic incidence of substance abuse that afflicts oppressed minority populations in North America can,

in this light, be accounted for by the unbearable stresses society has imposed on family life among the poor and powerless.

Yet the media leap with alacrity anytime someone reports the latest rhubarb about the so-called alcoholism gene, for instance.


Quote:
We, see, then, that pain the substance abuser does not want to feel has as its original source the same experiences that deprived her of the chemical she is trying to replenish by means of her habit.

The emotions the behavioral addict is running to escape were imprinted in his implicit memory circuits at the same time as the dopamine circuits were stunted,

which now, by his trill-seeking behaviors, he is trying to stimulate.

The harder these people work to compensate for their deficient biochemistry through their respective addictions,

the more they perpetuate the emotional emptiness that only the ownership of their problem and the recognition of its causes in past and present will begin to fill.

Quote:
A significant proportion of the adults I see with ADD admit to substance addictions at some time in their lives,

and not a few continue to engage in them into the present.

When I find that parents who seek treatment for their child's ADD have a substance addiction,

say, alcoholism,

I tell them as gently as I can that little meaningful help can be given their son or daughter unless they,

the parents, confront their addiction.

A number of times such parents have declined to return.

Adults who hope to outgrow their ADD problems need to make a similar choice.

While they stick with their addiction,

they are being no kinder to themselves than the parents who are unable to give up theirs even to help their child.
Quote:
There are many potential sources of help for the addict wishing to heal,

although too many put the emphasis purely on addiction rather than the underlying causes.

"We so often become so preoccupied with the problem the drug use creates,"

writes Drs. Hallowell and Ratey in Driven to Distraction,

"that we fail to consider what purpose the drug must be serving for the user." (*4)

While attention deficit disorder cannot be successfully treated as long as the addiction continues to dominate,

neither can the addiction be given the appropriate attention if the ADD is ignored and if the common origins of both remain unexplored.
Gabor Mate M.D., Scattered, "Addictions And The ADD Brain", p 302-304.
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Old 03-23-13, 12:46 AM
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Re: "Addictions And The ADD Brain", (chapter 30)

I didn't read the whole thing but the part about not making enough endorphins hit me. I never get that 'endorphin high' when running. It ****** me off. I think I am double screwed. That said, I have infinitely less stress now that I am medicated so I don't feel a huge urge to binge drink like I used to. I don't even crave alcohol.

But my stupid pain pills are REALLY nice. Too nice.
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Old 03-23-13, 02:42 AM
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Re: "Addictions And The ADD Brain", (chapter 30)

Quote:
.. it would be more accurate to say:

addiction may not be a natural state,

but the brain regions in which its powers arise are central to our survival.


The force of the addiction process stems from that very fact.

Here's an analogy:

let's say the section of someone's brain that controls body movements-

-motor cortex-was damaged or did not develop properly.

That person would inevitably have some kind of physical impairment.

If the affected nerves managed nothing more than the motions of the little toe,

any loss would hardly be noticeable. If, however,

the damaged or undeveloped nerves governed the activity of a leg,

the person would have significant disability.

In other words, the impairment would be proportional to the size and importance of the malfunctioning brain center.

So it is with addiction.

Quote:
There is no addiction center in the brain,

no circuits designated strictly for addictive purposes.

The brain systems involved in addiction are among the key organizers and motivators of human emotional life and behavior;

hence, addiction's powerful hold on human beings.

Three major networks are involved...the opioid apparatus,

the dopamine system (which performs incentive-motivation functions)

and the self-regulation system in the cortex, or gray matter.

The defining molecules of the opioid apparatus are the brain's "natural narcotics"--endorphins.
Gabor Mate M.D., "In The Realm Of Hungry Ghosts", p 150.
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Old 03-23-13, 02:55 PM
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Re: "Addictions And The ADD Brain", (chapter 30)

Quote:
Opiates help make some pain bearable.

It has been suggested, for example.

that high levels of endorphins help toddlers endure the many bumps and minor bruises they sustain on their rambunctious adventures.

It's not that toddler's injuries don't cause pain; they do.

But partly because of endorphins,

pain isn't enough to discourage him.

Without a high level of endorphins he might even want to stop his explorations of the world,

so necessary for learning and development. (*10)

A child who complains bitterly of the slightest hurt and is often accused of being a "crybaby" is probably low on endorphins and is likely to be less adventurous than his peers.

Quote:
Anatomically, physical pain is registered in one part of the brain,

the thalamus,

but its subjective impact is experienced in another part,

the anterior cingulate cortex, or ACC.

The brain gets the pain message in the thalamus,

but "feels" it in the ACC.

This latter area "lights up", or is activated,

when we are reacting to the pain stimulus.

And it's in the cortex--the ACC and elsewhere-

-that opiates help us endure pain by reducing not its physical but emotional impact.
Quote:
A recent imaging study showed that the ACC also "lights up" when people feel the pain of social rejection. (*11)

The brains of healthy adult volunteers were scanned as they were mentally participating in a game and then suddenly "excluded".

Even this mild and obviously artificial "rejection" lit up the ACC and caused feelings of hurt.

In other words,

we "feel" physical and emotional pain in the same part of the brain--and that in turn,

is crucial to our bonding with others who are important to us.

In normal circumstances,

the emotional pain of separation keeps us close to each other when we most need that closeness.
Gabor Mate M.D., "In The Realm Of Hungry Ghosts", p154-155
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