What are addictions and how neuroscience treats them

[Tomcat]

Not every addiction is destructive. Gambling, drinking too much, and an unhealthy love of sugar - definitely. As well as a painful attraction to any person, despite the toxicity of the relationship. And addiction is the habit of spending 20 minutes before bed, unconsciously flipping through the Facebook feed: the consequences, of course, are unpleasant, but not fatal.

Traditional addiction treatments, which we call "addictions," offer a cure for cravings for alcohol, tobacco, and even heroin. This is good news. The bad news is that even after treatment there may be breakdowns, and not at all because the person has not once pumped willpower.

Science no longer believes that an irresistible craving for something that pushes us to self-destruction is a manifestation of weakness of character or a chemical and biological "attachment"

The problem lies much deeper - in the stable neural connections that are formed in the brain when a person performs an action. Addiction uses the plasticity of our brains (the very quality that allows us to learn dozens of great and useful skills!) To form new synapses - the points of contact between neurons - and directly affect memory. By repeating the harmful action over and over again, we are engaged in "negative learning" - we encourage and transform minute weaknesses into habits, which then develop into addiction. Gradually, addiction becomes an absolute value, and everything else against its background - work, home, family, friends - fades away.

You can get rid of such a simple "since Monday doing differently" only if the addiction is quite recent. But if we are talking about destructive behavior that we have adhered to for years, the principle of "just stop" will not work.

About mice and people​

One of the most serious human addictions, drug addiction, has been studied in mice in laboratories for many years. Scientists have found that cocaine-addicted rodents have weakened areas of the brain responsible for self-control. By acting on these areas with the help of optogenetics, scientists were able to stimulate their "awakening" and seriously reduce the craving of mice for the drug. What does this mean for people? That with the help of a similar effect on the brain, addiction can be treated in representatives of our species - for example, using TMS, or transcranial magnetic stimulation. A non-invasive method of stimulating the cerebral cortex using short magnetic impulses .. Moreover, brain stimulation has already been tested in the treatment of depression and migraine.

To test the hypothesis that regular exposure to TMS can "reset" and repair damaged synapses, a team of scientists selected 29 volunteers suffering from cocaine addiction. 16 people were treated with stimulation, 13 - with the traditional method, including drugs for anxiety. As a result of the experiment, 11 people in the first group were cured of addiction, and 3 in the second.

Slaves of desires​

Experiments like these have led to a whole new perspective on the nature of addiction. Even 30 years ago, its definition was approximately as follows: the regular need for a certain chemical (for example, nicotine), with the need to gradually increase the concentration of the substance to achieve the desired effect.

But then what about the painful and uncontrollable craving for fast food or shopping?

After all, in this case, it seems that there is no talk of dependence on substances? Yes and no. On the one hand, in the case of shopping or hanging out on social networks, a person receives dependence not on a physical need for some substance, but on an obsessive desire to perform a certain action again and again. On the other hand, this desire itself arises for a reason. Like Pavlov's dogs, we develop a reflex: do you want to have fun? Click the application icon / swipe the credit card, and the release of dopamine into the brain is ensured. So there is a dependence on the substance in the case of gambling addiction, and in the case of shopaholism - the brain, and we, after it, simply adore the neurotransmitter dopamine, the "pleasure substance".

The more often we encourage dopamine madness, the faster our brain learns to produce it in response to any stimulus that even remotely resembles our guilty pleasure . And now the smell of fresh baked goods in the store leads to a breakdown of the diet, semi-automatic eating of buns and a carbohydrate coma, and the message notification signal makes you throw everything and run into the room for the phone.

Everything's under control!​

Our brain - a structure that is undoubtedly complex and not stupid - at the same time receiving pleasure, realizes all the harm that addictions inflict on ourselves. But why, then, is it difficult for some to pull themselves together, while others are able to eat lettuce leaves for years without falling into sugar bombs? How do habits prevail over reason, logic and common sense?

Perhaps it's all about disorders of the prefrontal cortex - the area that is responsible for self-control. MRI scans of people who are addicted to drugs show a serious lack of gray matter in these areas: the more severe and longer a person is addicted, the more difficult it is for him to quit the addiction. People suffering from behavioral addictions like the already mentioned shopaholism also have similar disorders, but less pronounced.

Unfortunately, science has not yet been able to give an answer about "chicken and egg" and say that it is primary: a person gets addiction, since he has disorders of the prefrontal cortex, or disorders appear due to heredity, trauma, stress and over time increase the likelihood of acquiring an addiction?

Only one thing can be said for sure: while behavioral addictions like gambling addiction are not comparable in harm to smoking or alcoholism, they also alter the functioning of the brain, deprive willpower and reduce the ability for general self-control.

But where is the line between adequate behavior to please some of your desires and heavy addiction? Can you get hooked on any activity that brings pleasure? Eating three cakes a day is overkill. And if the same three cakes, but every Saturday?

Alas, there is no unequivocal answer to this question either, but there are some kind of warnings. First, anything that gives you a sense of euphoria and pleasure is a potential trigger for addiction. Secondly, it is important to pay attention to the classic signs. If you noticed an obsessive craving for some product or action, if you realized the unhealthy nature of what was happening, tried to fight, but nothing came of it - this is certainly a wake-up call. It is worth living in pleasure, but pleasure should not become the meaning of life.