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smiling doctor
June 18, 2018

Dopamine in Early Recovery – What Every Family Member Needs to Know

smiling doctorIn the 1950’s, scientists made a fascinating discovery when they implanted electrodes in the brains of rats and electrically stimulated the ventral tegmental area (VTA) of the brain. They found that another region of the brain known as the nucleus accumbens responded by triggering the release of the “feel good” chemical dopamine. That discovery eventually led to this one: that just like rats, humans have a “pleasure center” in their brain that turns on in the presence of an experience that is rewarding or pleasurable, stimulating dopamine and creating joyful sensations; and, that when we perform certain activities that are good for the body, those activities trigger the release of dopamine.

But a brain that has been hijacked by drugs of abuse readjusts its natural levels of dopamine to a baseline that can be significantly lower than the normal 80-120 units of dopamine in the nucleus accumbens (of a non-addicted brain). And what many families with a loved one in early recovery don’t know is that this deficit in dopamine can make their loved one more susceptible to cravings and relapse. On that note, here are some things to keep in mind and practice as you support a loved one in early recovery:

  • Encourage your loved one to stay in rehab for as long as possible. Rehabilitation is critical and takes time. For example, 90 days is the minimum amount of time required to build dopamine back up to near-normal levels. This may be one reason for the finding that 90 days or more of treatment correlates with better recovery outcomes. A longer treatment program will give your loved one the best prospect of successfully adopting healthy new habits and self-care strategies that will boost their natural dopamine levels without drugs.
  • Prepare yourself for the reality of low dopamine during life after rehab. It’s safe to assume that your loved one will still come home from rehab with lower levels of dopamine in their brain, a condition that is sometimes described as “anhedonia.” Symptoms can include: a flat or depressed mood; apathy (a general lack of motivation or energy); restlessness; irritability or disenchantment; and an inability to feel joy from more ordinary life pleasures. Recognize these symptoms for what they are.
  • Encourage your loved one to engage daily in what we know to be rewarding behaviors that increase dopamine. These can run the gamut. Sex and eating may be no brainers. (For example, an orgasm produces 200 units of dopamine in the brain.) But more surprisingly, research has also revealed that drinking water and escaping from the cold and from pain also stimulate dopamine. When you engage in an activity that you enjoy, such as fishing or another form of recreation, your brain is producing roughly 20-40 units of dopamine.
  • Encourage your loved one to get off the couch and get moving. If after rehab your loved one spends their time watching TV and playing video games, they are actually decreasing their dopamine levels. (Research has shown, for example, that binge watching TV shows is linked with higher rates of depression and anxiety.) This is the last thing your loved one needs, given they are already suffering from a dopamine deficit. Instead, encourage your loved one to turn off technology, get off the couch and start moving.
  • Reward positive behaviors that boost dopamine. Parents, say your son or daughter comes home from rehab listless and apathetic. Tell them you’ll give them $10 to go around the neighborhood, by taking a walk, run or bike ride. If they do it, time them. Then give them $10. That builds a positive association and gets their dopamine levels up. The fact that they earned a reward that required them to work also gives them something to be proud of, increasing their self-esteem.

Now let’s just say that their first time around the neighborhood took three minutes. Consider giving them another challenge. This time tell them that you’ll give them $10 if they can get their time lower than three minutes. The idea is that you’re giving them a positive incentive that increases their motivation, energy and dopamine reserves.

Got an experience or insight to share regarding the reality of low dopamine in early recovery and how to cope with it? Share it with the rest of us!

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