Addiction is a neurobiological phenomenon that often leads to people feeling powerless over their own decisions. As addiction can form out of behavioural habits, as well as a chemical dependence to a substance, the issue itself is incredibly complex. Luckily, our understanding of addiction and how it affects our brains is actually very well researched. Unfortunately, due to the extremely complex nature of addiction issues and the imprecision of neuroscience, there is still a lot that we don’t know about how our brains form addictions and mental health disorders.
Neuroscience, Addiction, and Mental Health
Humans have been trying to comprehend how our brains work for thousands of years. The human brain is made up of around 86 billion neurons, which all communicate to form circuits and share information with each other1. The brain serves as the control centre of the entire body, sending and receiving signals throughout the body and organs.
In all of the signals that are sent and received throughout our body and in our brains, somehow we are able to form addictions and mental health disorders. The understanding of how our brains cause addiction and mental health disorders is heavily debated among the scientific community, due to the complicated nature of neuroscience.2 Although our understanding of how our brains work has vastly improved in the last century, all things considered, it is still in its infancy.
Developing an addiction can be attributed to a variety of factors, and is also thought to be hereditary in some instances.3 There is not one known gene that is passed down which is attributed to mental illness and addiction, but rather a combination of genes and other factors. This highlights the need for a personalised approach to treatment that can be altered on a case by case basis. Remaining dynamic in treatment allows us to compensate for new information and treat patients with their personal circumstances in mind.
Effects of Drugs on the Brain
Drugs and alcohol have the ability to shift the levels of neurotransmitters like dopamine, serotonin, and norepinephrine in our brains, which effectively causes a chemical imbalance. Popular illicit substances like heroin, methamphetamine, and cocaine are known to release large amounts of dopamine into the brain.4 Through this massive influx of neurotransmitters, our brains can become less receptive to the substances that we ingest, in essence building up a chemical tolerance in our brains. It’s generally accepted that drugs have the ability to interfere with our dopamine receptors to a point where they become so insensitive to dopamine, that drug users need to consume a larger amount in order to achieve the same effect.5 When former users abstain from substance use, it is possible for their brains to recover, though the progress is believed to be incremental. Positive changes in the brain related to neurotransmitters have been shown to occur in those who have previously suffered from alcohol use disorder when they abstain from alcohol, even in the short term.6
Treatment Modalities and Neurological Changes
Many different treatment methods are used in a clinical setting to help combat the adverse effects of substance use disorders on mental health, as well as mental health disorders themselves. While significant progress has been made in many cases, due to the incredible differences in individual circumstances, there is no one treatment method that is known to work in every instance.
Cognitive behavioural therapy, also widely known as CBT, has been shown to benefit the brain in a recovery setting. For those who have experienced trauma, cognitive behavioural therapy is known to help them to address and process those instances.7 In the case of substance use disorder and other addictions, cognitive behavioural therapy has also been shown to help people recover from addictive behaviours.8
To combat the effects of substances on our neurotransmitters, sometimes antidepressants can be used for recovery purposes. The role of certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) have been shown to be effective in some instances.9 The goal of these medications is to restore chemical balance in the brain, but ideally, this should take place under medical supervision due to potential side-effects.
Where We Are Now
With modern breakthroughs in neuroscience, scientists have been able to map out and analyse areas of our brain in a precise manner, showing greater detail than ever before.10 Even as our understanding of our brains grows, we must continue in the pursuit of greater accuracy, in order to effectively treat a wide range of patients. Due to the extremely complex nature of our brains, as well as the unique circumstances of each individual suffering from a mental health disorder or addiction, we owe it to those seeking treatment to provide them with a highly personalised approach.
1 Ncbi.nlm.nih.gov. 2020. How Does The Brain Work?. [online] Available at: <https://www.ncbi.nlm.nih.gov/books/NBK279302/#:~:text=The%20brain%20works%20like%20a,the%20root%20of%20human%20intelligence.> [Accessed 15 October 2020].
2 Deacon, B. and Baird, G., 2009. The Chemical Imbalance Explanation Of Depression: Reducing Blame At What Cost?. [online] Pdfs.semanticscholar.org. Available at: <https://pdfs.semanticscholar.org/eb9f/6fd2aa8abed9dc48517c5edf9cd2452e74ea.pdf> [Accessed 15 October 2020].
3 Bloomfield, M., McCutcheon, R., Kempton, M., Freeman, T. and Howes, O., 2019. The Effects Of Psychosocial Stress On Dopaminergic Function And The Acute Stress Response. [online] eLife. Available at: <https://elifesciences.org/articles/46797> [Accessed 15 October 2020].
4 Di Chiara, G., Acquas, E. and Carboni, E., 1992. Drug Motivation And Abuse: A Neurobiological Perspective.. [online] Psycnet.apa.org. Available at: <https://psycnet.apa.org/record/1992-98781-015> [Accessed 15 October 2020].
5 Volkow, N. and Fowler, J., 2000. Addiction, A Disease Of Compulsion And Drive: Involvement Of The Orbitofrontal Cortex. [online] Oxford Academic. Available at: <https://academic.oup.com/cercor/article/10/3/318/449603> [Accessed 15 October 2020].
6 Sinha, R. and Seo, D., 2015. Neuroplasticity And Predictors Of Alcohol Recovery. [online] PubMed Central (PMC). Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476600/> [Accessed 15 October 2020].
7 Cohen, J., Murray, L., Mannarino, A. and Kliethermes, M., 2013. Trauma-Focused CBT For Youth With Complex Trauma. US National Library of Medicine National Institutes of Health.
8 Young, K., 2011. CBT-IA: The First Treatment Model For Internet Addiction. [online] Springer Publishing Company. Available at: <https://connect.springerpub.com/content/sgrjcp/25/4/304> [Accessed 15 October 2020].
9 Thase, M. E., Salloum, I. M., & Cornelius, J. D. (2001). Comorbid alcoholism and depression: Treatment issues. The Journal of Clinical Psychiatry, 62(Suppl20), 32–41.
10 Bandettini, P., 2009. What’s New In Neuroimaging Methods?. [online] US National Library of Medicine National Institutes of Health Search database PMC Search term Search. Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716071/> [Accessed 15 October 2020].