> compulsive, physiological need to use rewarding stimuli despite adverse and negative consequences.
> stimulus drives pleasure – via agonists (alcohol, cocaine, nicotine, sugar), or environmental stimuli (smart devices, exercise).
> ‘healthy’ habits can also drive addiction, such as an obsession with eating ‘clean’ eating.
> involves neuroplasticity in the brain structures that regulate motivation, anticipation and reward. It involves a structural change in the associated neural pathways and neurotransmitters such as dopamine, serotonin, GABA and glutamate.
Dopamine-mediated positive reinforcement
> dopamine makes us feel pleasure, satisfaction and motivation.
> dopamine-craving is a large part of addictive behaviours.
> agonist stimulates dopaminergic pathway => brain increases dopamine signalling => pleasurable.
> repeated exposure => body adapts to higher dopamine levels=> craves more => addiction.
> anticipation of reward often drives higher dopamine than taking it - this leaves you unsatisfied=> crave more.
Genetics
> variations in genes that regulate neurotransmitter synthesis predispose people to addictive behaviours.
> OPRM1 gene stimulates dopamine production. Genetic variant can leave people unaffected by exercise endorphins=> look for dopamine stimulants such as nicotine.
> GABA reduces stress by inhibiting glutamate (excitatory). Individuals who don’t effectively convert glutamate to GABA are more anxious.
> The wild COMT genotype are fast dopamine recyclers=> lower levels => predisposed to addiction.
> MAO enzymes breakdown dopamine, serotonin, & adrenaline - genetic defects recycle dopamine quickly.
> MTHFR variants can drive addictive behaviours, and OCD and ADHD (associated with dopamine dysfunction).
Sex Hormones
> oestrogen (days 1-14 of period) increases the number of brain dopamine receptors => dopamine is higher.
> in menopause, oestrogen levels decline => drives dopamine & GABA seeking behaviour to relieve stress, tension and anxiety.
> fluctuations of oestrogen & progesterone (days 15-28 of period) => mood fluctuation - highlighted by depression, anxiety, and a tendency to addictive behaviour
Environmental Influences
> traumatic childhood events create anxiety or tension=> stimulate GABA receptors to relieve anxious feelings.
> parental addiction - inherited genes influence likelihood of addictive behaviours in later generations.
Lifestyle recommendations
1/ reduce use of smart devices (blue light interferes with melatonin and cortisol production) impacts energy and blood sugar levels, increasing the likelihood of addiction
2/ remove temptations to avoid feelings of cravings and withdrawal and ask for emotional and behavioural support such as counselling and CBT.
3/ daily exercise (walking, yoga, running or cold-water swimming) - releases endorphins, promotes GABA and serotonin, and puts body into a parasympathetic state of rest and digest.
4/ reduce toxic load by using natural, organic household and beauty products.
Dietary recommendations
1/ Blood sugar regulation=> good quality protein with each meal, wholegrain carbohydrates and colourful vegetables => reduce sugar, caffeine and refined carbohydrates => chromium or alpha lipoic acid supplements.
2/ Tyrosine for dopamine production => seafood, turkey, cottage cheese, kefir, nuts, and pulses.
3/ Vitamin B6 is required for dopamine and GABA synthesis.
4/ Zinc for DNA repair and regeneration.
5/ Magnesium reduces HPA overactivity, improves sleep patterns and is an agonist of GABA.
6/ Methylfolate is required in the synthesis of dopamine and serotonin.
7/ Vitamin C and glutathione for tissue repair caused by repeated acetaldehyde exposure and neurotoxic effects.
8/ Lemon balm contains rosmarinic acid and modulates the HPA axis through increasing levels of GABA.
Adapted from Hannah McMartin (Biocare)
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