Wednesday, February 20, 2008

Can I bum a neurotransmitter?

I recently read a mean-spirited and narrow- minded post which blamed chemical imbalances in Hollywood, mental disorders if you prefer, on substance abuse. I agree that there is a strong link between the two; in the case of bipolar disorder, the correlation is astounding. Nearly 70% of those afflicted use drugs or alcohol as self-medication. But which came first, the disorder or the substance abuse? The chicken or the egg?

Lots of research shows a connection between bipolar disorder and creativity. Beethoven, Van Gogh, Oscar Wilde, even Kurt Cobain, suffered from the condition. Doesn’t it make some sense that, because Hollywood is full of creatives, there might be a greater population of bipolars? That said, the incessant partying and easy access to drugs by Hollywood’s young elites may both trigger the manifestation of bipolar disorder, and then provide some relief from it.

Because bipolar disorder is complicated, let me talk about a simpler and more widespread addiction–nicotine. Not only are the Hollywoods abusers of drugs and alcohol, they smoke like chimneys and slurp energy drinks like camels at a watering hole. Aniston, Pitt, Jolie, Hilton, Richie, Spears, Affleck, Damon, even Julia Roberts, are chain smokers. We know that nicotine is highly addictive. But why? And why is it not true for social smokers, who have a couple cigarettes, maybe even daily, but don’t get addicted? The addictive sorts likely possessed a different brain chemistry from the get-go.

Our brains are a tangled mess of neurons that make connections, fire impulses and respond to neurotransmitters at all times. What we perceive as emotion is largely chemical in nature. Dopamine, adrenaline, serotonin, epinephrine, norepinephrine, and melatonin regulate mood, emotion, concentration and creativity. Dopamine is one of the feel-good neurotransmitters. Certain situations trigger a dopamine response–a belly laugh, a big hug, or great sex to name a few. But because the brain likes to keep itself in a nice steady state, pretty soon the kill-joy neurotransmitter, monoamine oxidase b (MAOb), enters the mix to step on (re-uptake) the happy buzz.

Look at these brain scans. The top scan shows the amount of MAOb in the brain a few seconds after a happy dopamine moment. The brain is positively flooded with this stingy little chemical, racing in to mop up the dopamine and jealously guard it until another thrill wrests it from its greedy grasp.

The bottom scan shows the brain of a smoker in the aftermath of a happy moment. The dopamine lift stretches on and on, like an elastic ribbon of elation, not only allowing the positive feelings to continue, but also allowing the brain greater connectivity, thus, more focus, more creativity, greater sensitivity to the world at hand. To go one step further, if the brain’s steady state is unbalanced to begin with–as in a depressed person who has a paucity of key neurotransmitters–a morning cigarette and cup of caffeine positively impacts brain chemistry, and helps them feel like most of us do naturally.

This is self-medication. And self-medication is often counterintuitive. Do you know what they give hyperactive children to calm them down and help them focus? Speed! Alcohol is a known depressant. But to a depressed person, it has the opposite effect. It elevates mood and improves brain connectivity.

I agree that Big Pharma does not care a whit about Britney Spear’s mental state. Their main goal is profit, and many of the drugs that they push are over-prescribed, too expensive, and downright detrimental. But don’t dismiss the need to balance brain chemistry in the war on substance abuse–caffeine, nicotine, and Red Bull included. Without addressing root causes, it’s a war doomed to continued failure.

Some of the information in this post came through my friend, Jacques, at BlaBlaBlawBlawg: A Mysteriously Enchanted Evening with Dopamine-Soaked Truffles.



Tony said...

I think that all this talk about drug and alcohol use being a form of ’self medicating’ has a lot of truth to it, but can often be carried a little too far, too. No where is that more true than with talking about people suffering from bipolar disorder, since instead of ’self-medicating’ many people with this disorder simply lose ability to make good judgments regarding the options around them.

For example, many with bipolar disorder spend a lot when they are hyper. We could call shopping a form of ’self medication’ for depression, which it is for some people, but in this case it is more like the bipolar person simply loses contact with reality while in ‘hyper-active’ form, losing contact with the sense of reality which is necessary to balance the checkbook and credit cards. He/she is not ’self medicating’ by shopping wildly, rather he/she is merely just out of control and exercising the poorest of judgments.

As to Hollywood? I’m not so sure that Hollywood actually has more than its fair share of creative people? I rather think that it might actually be the other way around, since this is bureaucratically formed creativity at best.

As a whole, we live in a rather uncreative society, yet more and more of us are becoming more and more imbalanced in multiple ways as our society continues to deteriorate. Too much emphasis is spent on analyzing chemicals and foods as supposed cause to all of this.

Simply put, There are other much larger factors involved than genes, chemicals, hormones, and DNA. We simply do not live in a very well adjusted and emotionally connected society much any more, and all suffer from that whether bipolar or not.

Marie said...

Tony, I agree with all you’ve said. I didn’t really want to take on Bipolar Disorder because it is so varied among people–-BP I and BP II with sublevels for each. In the manic phase, or even the gentler hypomanic phase, the ability to make sound judgments is compromised, sometimes to a huge degree, sometimes just by being reckless with money or driving too fast or, in Britney’s case, shaving your head in a salon while the paparazzi shoot photos.

As for the ills of society contributing to our disconnectedness, lack of creativity and general malaise–-absolutely right.

Jacques Poirier said...

I just need to interject that we pin 'pathological' labels too easily, even on purely natural phenomenons. Most of what people call 'bi-polar' is actually an unrecognized problem-solving mechanism. The depressed state is the creative half of the process, as depression occurs when huge internal shufflings of ideas occur, most of it unconscious. Most non-creative people do not easily accept this regressive-analytic state where the person appears to be incapable of taking pleasure or making decisions. The autonomous nervous system is in a state of "Rest & Digest" with a high preponderance of parasympathetic activity, with NO "Fight & Flight" capacity. When it is given a chance to develop fully (i.e. not smothered by Zolofs or Prozacs), these depressions always mutate into a narcissistic phase where a few of the solutions that were bred unconsciously start to emerge. At that point the person leaves the dependent (regressive) state to slowly turn into the so-called pre-manic phase, one in which they display an aggressive-synthetic outlook, make snappy decisions and become sociable again. If that person spent an inordinate amount of time in the 'dumps', chances are that it had had the time to stockpile the proteins necessary for the synaptic bulbs to manufacture the 'happy' neurotransmitters (dopamine etc...). So if the lady starts shopping at Neiman-Marcus...she can go on for a long time before these are depleted, possibly longer than her credit cards would allow. And then the 'manic' phase pops up, sociability taking a back seat and the person becoming aggressive, mistakes committed, people being hurt etc...At that stage of the game, according to the psychosomatic medecine, the body rides on the sympathetic system (red smooth muscles), the heart rate is up and one can become a fabulous used car salesman. But the "Fight and Flight" regime tires the heart and depletes valuable brain chemistry that was stockpile earlier. Guilt is one way for the brain to slow down the process. The person withdraws sociably with the notion of having been bad. Soon another depressive, infantile, regressive, thumb-sucking and cookie eating phase will happen, another "rest & Digest" period with full parasympatetic nervous system dominance.
I have described the cartoon version that enriches big Pharma and light up the tabloids. I just want to say that quite a few creators have come to love their so-called 'depressions' for they know that these always announce a period of flow and renewal. They will use this opportunity to read, study, daydream or walk by a brook, so as to better welcome their next 'coming out', synthesis with colors, words, numbers or notes. OK so a few will go overboard and scream, at the height of their process" "I am the greatest artist in the world (actor, painter, whatever!)". So what!? Harold Town once said of artists that they need to feel a God-like invincibility once in a while to be great artists. And you know what? Beethoven and quite a few others have proven that repeatedly.
If only people learned to accept ride out their depressions, think of how much less pathology we would have. It is well known that a depression that is welcomed is usually short and productive. One that is blocked is long and terribly dangerous since it will turn into the grotesque cartoon called 'bi-polar' disorder. Think of the steering corrections when you drive. If you prevent them, chances are you will go too far to the left, then overcorrect to the right, then swerve left again and tumble down the freeway. You'd make it to FoxNews along with Britney Spears, poor kid!

Marie Walden said...

Jacques, I hate the term depression because it connotes lying in a dark room with a tear-stained face, loaded gun ever at the ready. This is not my experience. I am usually happy as a lark, just as you described--reading, doing yoga, cooking, writing--but certainly not answering the phone or going to lunch with the girls.

Instead of depression I call it cocooning--waiting for the lovely butterfly to emerge, as it invariably does.

Jacques Poirier said...

Woooh! Butterflies, coccooning, rich imagery. Nothing like the coccoon cracking with new discoveries, the old shell dropping off and a light breeze drying our new wings with the promise of flight.

art of the north said...

Re Ritalin, I loved Richard Bandler's story where he went to a school board for an ADHD kid's class and suggested that rather than put the 30 kids on the drug to slow down their hyper-activity, they let them be themselves, and make the teacher take the drug to speed up to the kids' level!! Much more to be accomplished at a faster rate with many side benefits!