The work of our brains is beyond incredible. And its design, and how it evolved, continues to be hard for me to wrap my arms around. Just one example is our reward system. Without it, we don’t exist. With it, we have to remain aware of the trap potential. Let’s open the door….
This disconnection is a set-up for addiction as we search for other sources of dopamine. The ‘other sources’ look shockingly similar to the list of common cultural complaints – overeating and obesity, drug and alcohol abuse, consumerism, chronic hooking up. Amy Banks, MD
It’s pretty common knowledge that our reward system is a huge factor in substance use disorders. But what escapes the headlines is its role in any impulse control situation: overeating, problem gambling, excessive internet use, hypersexual behavior, explosive rage, and more.
And, of course, it can be a player in the generation of mood and anxiety misery.
I find the reward system fascinating and relevant to what we do here on Chipur. And I think you will too.
What say we get busy…
What Is the Reward System?
The reward system is a gathering of brain structures and neural pathways that are responsible for major cognitive functions such as behavior learning through association (classical conditioning), behavior learning through reward and punishment (operant conditioning), motivation and craving for a reward, and positive emotions – especially those involved with pleasure.
By design, the reward system is about survival behaviors – reproduction, eating, socializing, physical defense.
The Reward System: Anatomy
There are numerous pieces of anatomy that make the reward system roll. You can see some of them in the image. However, the heavy-hitters are the nucleus accumbens (NA) and the ventral tegmental area (VTA).
Now, the power-line, if you will, of our reward system is the medial forebrain bundle (MFB). It’s the MFB, a neural pathway, that transmits signals from the VTA to the NA.
Makes sense that the MFB is frequently referred to as the “hedonic highway.” And when it’s blocked the longing for, we’ll use drugs of abuse (DOA) for our discussion, is greatly reduced or downright ceases.
The signals that pass through the MFB are supported by dopaminergic (dopamine releasing) neurons. Generally speaking, drugs that are not abused have no effect on dopaminergic concentrations.
The Reward System: Physiology
Getting into all of the reward system’s physiology would exhaust the both of us. So we’re going to fast-forward to the appearance of the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA).
DOA act upon GABA receptors, which leads to neurons being inhibited from firing. And that results in the release of less GABA onto dopaminergic neurons. When that happens, a disinhibition of dopaminergic neurons occurs, which makes them fire more rapidly – releasing more dopamine into our reward system.
And wouldn’t you know it, higher dopamine concentrations result in feelings of well-being, even euphoria. So the “buzz” is on.
Interestingly enough, it’s through GABAs interaction with limbic system structures – the amygdala, hippocampus, hypothalamus, thalamus, cingulate gyrus, etc. – that we experience anxiety reduction, sedation, and behavioral disinhibition.
So, in fact, the components of the brain that generate anxiety-reducing effects are, let’s say, an extension of the reward system.
Bottom-line, outside “substances” (DOA, food, the internet, and more) gain entry into our bodies and use our reward system to fulfill their mission. And it quickly becomes a reciprocating relationship. Our reward system ends up needing the substance, just as the substance needs our reward system.
And as it so often goes, the substance commandeers the reward system. And addiction is accomplished.
Input from Amy Banks, MD
In prep for this piece I came upon a great article on Psychology Today’s site by Dr. Amy Banks, co-author of Four Ways to Click: Rewire Your Brain for Stronger, More Rewarding Relationships. I’ll slip you a link to her piece at the end.
Let’s add Dr. Banks’ input to our discussion…
Banks opens by observing that dopamine is trending as the most popular neurotransmitter. Why? It’s responsible for…
The craving many of us experience when smelling the morning coffee brewing
The elation we deeply feel when we fall in love
The thrill of a shopping spree
The desire for that second or third glass of wine at dinner
Banks asks, “So what’s the harm? It’s a natural, biologically based chemical that provides energy and motivation.”
She answers the question by recalling B.F. Skinner’s operant conditioning work in the 1950s. Scientists put electrodes into the limbic system (emotional center) of rat’s brains and gave them a small zap when the rat entered a specific corner of a box.
Everyone thought if the shock was unpleasant enough it would cause the rat to keep away from the corner. Hmmm, but something unexpected occurred. When the electrode was placed in the nucleus accumbens (NA), instead of avoiding the corner, the rats went back to get the shock time and again. As in 700 times in an hour. They even chose a shock over food.
Banks points-out the behavior was something the rats absolutely “needed” to do.
The take-away, according to Banks…
The increase in motivation and energy that dopamine provides can be a good thing, but when your brain gets wired to compulsive behaviors that stimulate the dopamine reward pathway (addictions) then your life can be as out of control as the poor rat in Skinner’s Box.
Banks believes dopamine, nor the reward system, are the problems. No, the problem is how we stimulate the dopamine pathway.
She summarizes…
This disconnection is a set-up for addiction as we search for other sources of dopamine. The ‘other sources’ look shockingly similar to the list of common cultural complaints – overeating and obesity, drug and alcohol abuse, consumerism, chronic hooking up.
Not only do these addictive, destructive behaviors get paired to the dopamine reward system but they create a feedback loop of isolation that pushes people towards more addictions.
Without healthy relationships we each become like the rats in Skinner’s Box – seeking dopamine from all the wrong places. It is time to rewire our brains for the healthy relationships and connections that reward us with positive energy and motivation.
And there you have it.
Let’s Wrap It Up
Our reward system and dopamine: absolutely stunning design and work. But as incredible and life-sustaining as they are, can you see the trap potential?
I’ve always needed to know the anatomy and physiology behind my emotional and mental challenges. Understanding has always provided me with healing direction, and that’s a huge component of hope.
If you’re struggling with impulsive behaviors, even with a mood or anxiety situation, what you just read had to have hit home.
Now run with it. Do your due diligence and work toward healing…
Trichotillomania: Well, it’s not exactly a household word, but given millions are struggling with it right now, it may well be a part of your household. And that means we need to give it our attention. So let’s learn about it, one strand at a time…
Generally speaking, this condition can be experienced by anyone. Children as young as four have developed hair pulling, as well as adults in their sixties. The most common starting point for trich seems to be ages nine to sixteen.
Ariel from TrichStop dropped me a line not long ago asking if she could submit a guest post. I said fine, she did, I read it and hit the site – and here we are.
TrichStop is a unique online resource for those struggling with compulsive hair pulling – trichotillomania – as well as family and friends. Immediately available are tons of info, a blog and forum, and an online treatment program featuring experienced and passionate professionals who deeply understand body-focused repetitive behaviors (BFRB) treatment.
All very impressive, actually. I’ll slip you a link at the end.
Okay, ’nuff said from my side of the fence. Let’s welcome Ariel and learn about trichotillomania…
Trichotillomania: What Is It?
Have you ever had a day when you got so frustrated you wanted to pull your hair out? In essence, that is what people who suffer from trichotillomania (trich) experience on a daily basis. One real difference between your frustration and theirs is they literally pull their hair out. Hair from their eyebrows, eye lashes, or scalp – anywhere they have hair.
They feel frustrated, stressed, anxious maybe most of the time and respond to this by hair pulling. Somehow, the pulling of their hair relieves their anxiety temporarily. But the stress and anxiety often come back and so does the hair pulling.
Trich can result in so much hair being pulled from the head that it leaves bald spots. Because of this clear evidence of something being wrong, people who suffer from this condition often also suffer from low self-esteem and have a difficult time with relationships. They may also face ridicule from others who don’t understand why they have this compulsion.
Trich seems to run in families. That is, if you have trich, there is a good chance someone else in your family also has or had the condition.
Trichotillomania: Signs & Symptoms
In addition to hair pulling that may result from anxiety and stress, there are other symptoms that people with trich may experience. One of these is very significant tension just before the hair pulling behavior. This same kind of tension can be felt if the person tries to stop the hair pulling.
There may be specific kinds of rituals related to the hair pulling. Also, specific kinds of hair may be preferred. Once the hair is pulled, the person may play with it, rub it across their lips or face, or even consume it. If the hair is eaten, the person may literally develop hair balls, just like cats do.
There may be associated compulsive behaviors, as well. These may include picking at the skin, chewing on fingernails, or chewing the lips. Some people with trich also will pull hair from dolls or pets, or pull at blankets or clothes.
Trichotillomania: Types
Some people will engage in the automatic type of this condition. That is, they may not even be aware they’re pulling their hair when doing other things, such as watching TV.
Other people with trich have the focused type. This is a deliberate behavior designed to relieve tension. They may develop rituals around the actual hair pulling, possibly going as far as selecting specific hairs to pull.
Some people engage in both types of hair pulling behavior.
People with trich may also engage in the behavior because of negative or positive feelings. In the former case, they pull hair to relieve feelings of stress, tension, or anxiety. In the latter, the relief of tension following hair pulling is so positive they pull more hair to prolong the good feelings.
Trichotillomania: Causes
Earlier, anxiety and stress were said to be causes of trich. It was also said that the condition may be related to genetics. While that is true, they aren’t necessarily the only causes. Experts have not yet found an exact cause, but have found several possible reasons for the condition to begin.
Some professionals think trich may be the result of an imbalance in brain chemicals and pathways in the brain that control impulses, influence habit formation, and regulate emotions. Even abnormal brain structures may be involved.
Some believe the condition may be a habit that developed from what started out as a benign event, such as an itchy eye lash. Others believe the behavior may have grown out of another childhood habit, like thumb sucking.
Trichotillomania: Who Gets It?
Generally speaking, this condition can be experienced by anyone. Children as young as four have developed hair pulling, as well as adults in their sixties. The most common starting point for trich seems to be ages nine to sixteen.
While both males and females can have the condition, females have been diagnosed with it more often. This may be misleading, however, because males tend not to seek treatment, which may distort the numbers.
Trichotillomania: Treatment
Whatever the age when the condition is first seen, it is considered a chronic condition. Those suffering from it can’t stop the hair pulling through willpower, so there’s an obvious need for professional intervention.
A combination of medication to help alleviate any underlying anxiety and psychotherapy appears to be the best approach to dealing with trich.
Cognitive behavioral therapy (CBT) may be the best psychotherapy to use. Habit reversal training (HRT) seems to work especially well. In this approach, the hair pulling is said to be a learned response to certain triggers. The person may not even be aware of them. So the first order of business is to pay attention to and discover the triggers in their lives. Then they learn to substitute behaviors that are incompatible with hair pulling when the triggers present.
Another variation of CBT, mindfulness-based cognitive therapy (MBCT), has also shown to be effective in dealing with trich. In this approach, people learn how to accept the situations and feelings that trigger hair pulling without being judgmental about them. This allows the person to learn to tolerate the discomfort associated with the triggers instead of giving in to the desire to pull hair.
That’ll Do It
So there you have it, people. My thanks to Ariel for getting in touch and providing some great info on trichotillomania – a disorder that doesn’t get a lot of press. And that’s a shame, given millions worldwide are struggling with it.
If you’re one of those millions, a family member or friend, or someone who wants to learn more about trichotillomania, head-over to TrichStop.
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There are numerous pieces of anatomy that make the reward system roll. You can see some of them in the image. However, the heavy-hitters are the nucleus accumbens (NA) and the ventral tegmental area (VTA).
Some people will engage in the automatic type of this condition. That is, they may not even be aware they’re pulling their hair when doing other things, such as watching TV.
