The Reward Pathway

 Amygadala

• The NA connects to the Amygadala.
• This part of the brain stores our memories and plays a major part in fear.
• This section is responsible for flight or fight.
• Those who suffer from PTSD or Anxiety Disorders have abnormal activity in this section of the brain.
• The pleasurable memories of drug use are stored in this part of the brain.
• It causes the addict to forget the negative consequences associated with chemical use which results in relapse.

Addiction is driven by pleasure and not by the relief of withdrawal. When I discovered this concept, I was really surprised especially with those addicted to opiates. I always thought it was about avoiding the painful effects of withdrawal.

• Pleasure is due to the release of dopamine.
• Seeking of pleasure in order to feel well vs. unwell.
• Those in rehab tend to increase cigarette smoking and eating because dopamine levels have dropped once the person stops the use of drugs and alcohol. Smoking and eating increase the dopamine levels.
• If addiction was all about the relief of withdrawal than detox would be enough treatment.
• 95% of those who leave treatment after detox and do not stay for rehab will relapse in the first year.

This is an important fact, I teach in the Addictive Brain class on Tuesday mornings. Many of the patients, I encounter think detox is enough only to discharge and return a short time later. My greatest challenge is getting insurance companies to recognize this fact. Most insurance companies want to fund detox and have the patient discharge to IOP (Intensive Outpatient). This sets a patient up for failure. Only after the patient fails in IOP will the insurance company consider rehab. This is a dangerous game to play when the life of a person is in the balance. The next drug run could be their last.

The Reward Pathway

• Most addicting drugs bind to receptors on the neurons of the Ventral Regmental Area (VTA).
• The axons of the VTA connect with the nucleus accumbens (NA), the pleasure center.
• Drug or alcohol use results in a release of dopamine into the NA resulting in euphoria.
• The NA has neurons that extend to the frontal lobes and the amygdala.

Some interesting facts that I now consider when working with my younger patients.

• The frontal lobe does not fully develop until the age of 25, therefore relapse rates increase in this age populations.
• Addicting drugs over ride the pleasure center creating tremendous release of dopamine in the NA.
• Normal survival behaviors occur in the NA such as sex, eating and drinking to sustain life.
• When drugs or alcohol are introduced into the NA, they become more important to essential living than sex, eating or drinking.
• The amount of dopamine in one's brain is genetically mediated.
• This results in a greater amount of dopamine released when an addict uses alcohol or opiates compared to the non-addict who uses alcohol or opiates.
• It is important to realize that gambling, porn addiction overlaps with substance addiction. Over 50% of those with one addiction have a second addiction. 

The Brain as an Obstacle for Recovery

Neuron Communication

• The neuron sends an electrical signal down its axon.
• At the end of the axon, a chemical messenger is released in the synapse.
• The chemical messenger then binds to a specific receptor on the receiving neuron.
• These chemical messengers are known as neurotransmitters.

There are seven neurotransmitters which I will review today.

Gaba (Gamma-Aminobutyric Acid)

• Binds to Gaba receptors.
• Receptors are the same receptors Benzodiazepines and alcohol binds to.
• Is a naturally occurring sedative neurotransmitter.
• Low levels of Gaba is believed to be part of the cause for anxiety disorders.

Glutamate

• Binds to Glutamate receptors.
• Naturally occurring stimulatory neurotransmitter..
• It is also an amino acid.

The imbalance between Gaba and Glutamate results in dysphoria and drug cravings. Medications may help to restore this imbalance.

Endorphins and Enkephalins

• These are our natural opiates or pain killers.
• Binds to opiate receptors the same way heroin, morphine and oxycodone binds to.
• The chronic use of opiates results in the suppression of endorphins leading to the symptoms of opiate withdrawal including poor pain tolerance and a lack of the sense of well being.

Serotonin and Norephinephrine

• Low levels of either of these neurotransmitters results in the symptoms of depression.
• Depression is the result of a defect in the genetic code responsible for the production of these neurotransmitters.
• Chronic drug and alcohol use lowers the levels of these neurotransmitters resulting in the depression like symptoms of early recovery known as PAWS (Post Acute Withdrawal Symptoms).
• Ecstasy can cause cell death and destroy serotonin levels after just one use.
• Genetic vulnerability to mental health diagnosis and addiction problems.

Dopamine

• Is a neurotransmitter as well as a hormone.
• Plays many different roles in different areas of the brain.
• When there are low levels can result in Parkinson's Disease.
• When there is high levels can result in hallucinations and Schizophrenia.
• Called the "feel good" chemical in the reward pathway that is released when drugs are taken.

Endocannabinoids

• Recently discovered neurotransmitter.
• Binds to the same receptors as THC.
• Plays a role in hunger.
• Being researched to see if they can benefit weight loss and quit cigarette smoking.

I hope you enjoyed Part I of the series by Dr. Christopher Davis. Part II coming soon known as The Reward Pathway.

Holistic Approach To Anxiety & Depression

Overview
The holistic approach to treating anxiety and depression recognizes that mental health is influenced by diet, exercise, spirituality and lifestyle. Allopathic approaches to mental health focus on treating symptoms, whereas holistic approaches address underlying causes of anxiety and depression and seek to restore the natural balance of your body and mind. According to Merriam-Webster, holistic medicine is interested in treating your whole system rather than separately analyzing its parts.

Nutrition
What you eat influences the balance of chemicals produced and released in your brain. According to Kathleen DeMaisons in "Potatoes Not Prozac," irregular eating habits and unbalanced meals cause depression and anxiety. DeMaisons recommends eating three regular meals a day with a significant source of protein at each meal. Protein contains enzymes that are used in the production of serotonin, dopamine and norepinephrine. Without sufficient protein, the brain can become deficient in these chemicals, resulting in depression and anxiety. DeMaisons also recommends eating whole grains and vegetables with each meal to prevent mood swings and provide healthy nutrients for your brain.

Symptoms Of Depression Do You Have Symptoms Of Depression? Find The 3 Most Common Causes Now. www.healthyweb.com/Depression
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Exercise
According to Dr. Henry Emmons in "The Chemistry of Joy," regular vigorous exercise is the best, free way to improve your mood. Studies looked at in Dr. Emmons' book show that regular exercise has been proved just as effective, and sometimes more effective, than psychotherapy and medication. According to the U.S. Department of Health's "Physical Activity Guidelines for Americans," moderate exercise three to five times a week for 30 to 60 minutes is enough to provide mental health benefits. Changes in brain chemistry levels can take place in as few as two to four weeks of an exercise program.

Emotional Acceptance
Repressing emotions leads to depression and anxiety. Emotions are a practical guidance system that helps you to learn and grow. Usually, when you acknowledge and accept your emotions in a non-judgmental manner, they dissipate and fade. If embracing an emotion does not alleviate it, you may need to examine the source of the emotion more closely. Working with a qualified therapist helps you to understand your emotions.

Supplements
Vitamins, herbs, enzymes and oils are common supplements used to improve mental health. Common supplements used for holistic mental health care are vitamin D, fish oil, St. Johns wort and amino acid precursors Sam-E, 5-HTP, DL-Phenylalanine, L-Tyrosine and L-Tryptophan. Caution should be exercised in the use of supplements as many can have adverse affects and interact with other medications. Consult with your doctor before taking supplements.

Potential
Every person is different, so there is no specific formula for holistic healing. If one holistic treatment does not work, then try another. Frequently, several treatments, such as nutritional therapy, exercise and counseling, must be used together to result in recovery. Mind-body exercises such as yoga and tai chi have the potential to enhance fitness and improve emotional balance at the same time. Holistic approaches to mental health have the potential to greatly improve your quality of life and possibly reduce your reliance on psychiatric medications. Do not change your medications without consulting your doctor.



Read more: http://www.livestrong.com/article/185318-holistic-approach-to-treating-anxiety-depression/#ixzz1Z49s4o9F

What a Cute Face

Tough Life Being A Cat

Shark Shark aka Casper aka Mr. White

Awarded The Service Excellence Reward

For keeping a patient on the phone until help arrived who wanted to commit suicide. It was a very intense 45 mins. See original post. http://ajourneyintothepast.blogspot.com/2011/07/wow.html

Oh Brother

Tired but Happy Bunch of Brothers

                                       
                                                  

Remember

I stood in the waiting room at the lab where I worked watching the news's report on the North Tower being hit. At the time no one seemed to know what hit the tower. Some were saying a small plane. As I continued to watch the North Tower burning, I could not believe what I was seeing, a plane crashing into the South Tower. By that point there were several of us standing in shock just watching the towers burn. It was Joe's first day at Temple and I tried desperately to contact him but the phone lines were overwhelmed. I could not get a hold of anyone and watched as they evacuated the city in Philadelphia. Driving home that day seemed so eerie. 95 had no traffic and it was so quiet except for the fighter jets that flew up and down the area. I was unsure what to do so I stopped at Sam's club and loaded up on supplies. Are we at war? My grandson Shaun was just born a month earlier and I remember calling my son to make sure they were alright.

As the days went on and our country began fighting back, my youngest son paced back and forth then informed me and his father he was joining the military. He joined the Navy. I remember that cold early morning hour when he was picked up outside the house. I cried as I said "goodbye" and after he left I placed a statue of the Blessed Mother on my kitchen window. We all flew to the Great Lakes and watched him graduate. When we left for the airport to fly home, I cried because I was leaving my baby and I knew we were at war. That spring I planted a Victory Garden on the side of the house. It was the first garden I ever planted. It was the first time I realized that by digging my hands in dirt in order to create something beautiful was a great way to relieve stress. Joe was sent to Florida then Texas and then to Norfolk on the carrier Theodore Roosevelt. They would go out to sea for months at a time with no contact. His carrier went out to the Mediterranean Sea pass the Strait of Gibraltar and planted itself on the coast of the Middle East. Joe received a medal for joining the military during war time. He followed in the foot steps of my brother, my father and all the ancestors dating back to the Civil War. Today marks the 10th anniversary of a horror that changed the world. God Bless America.

NIDA

National Institute on Drug Abuse (NIDA)


September is Recovery Month for the Substance Abuse and Mental Health Services Administration. Check out http://recoverymonth.gov/ for more info on events, resources, and how to participate.

http://www.recoverymonth.gov/

Cousins

Nothing is so beautiful than a rose in bloom

Just Know That You May Be Watching Me

I am also watching you.

Welcome

To another Keller relative who found me via ancestry. Linda is from the Frederick and Mary Keller line. Frederick was my great great grandfather's younger brother, John Gottlieb Keller. I hope you enjoy the research.

Gardens

Some of my Favorites