The Addicted Brain: Anatomy of Compulsion and Need

It is often said that between three and five people or forces live in the addicted brain.. There is one with a kidnapped will who only seeks the well-being that her addiction generates. Another, anticipates what this will generate in the short and long term: anxiety, depression, withdrawal syndrome… Their other “selves” have the silhouette of their loneliness, the weight of conscience, the shape of the family and the burden of fear. .

The presence of all these voices does not at all correspond to the classic profile of someone with a multiple personality. Because If there is something that is worth knowing about addictions, it is that they completely fragment one’s own identity, thinking and will.. Addiction is like a thief waiting patiently in a corner to invade one’s property and destroy every iota and fragment of our brain, mind and dignity.

Sometimes, not even the most refined techniques of cognitive-behavioral therapy can make that thief turn around and desist. Hence one more strategy to redirect an addicted brain is also the medical and pharmacological approach.

However, we must not be mistaken. Medications relieve withdrawal syndrome and many associated side effects, but those neural pathways that generate addiction, as well as certain habits of thought and behavior, do not always respond to these treatments the first time. It is a long and expensive process that requires a multidimensional approach.

This makes Many people with a chemical or behavioral addiction find themselves in real dead ends.. In those revolving doors where they leave and re-enter until they find, effectively, that strategy, approach or assistance that works for each person based on their characteristics and needs.

The addicted brain: the compulsion of emotional emptiness

When we talk about addiction, it is common to immediately visualize someone consuming opiates, hallucinogens or designer substances, such as amphetamines. We forget, perhaps, that Addiction has many faces, many forms and behaviors. There are the shopaholics, those who can’t separate themselves from their mobile phone. We have addicts to sex, sports, games, certain foods…

An addict is not just an alcoholic or someone who uses hard drugs or certain medications. These are, in essence, unadjusted behaviors where a person generates a physical and psychological dependence on a substance or a certain behavior.. From here on, a whole range of possibilities undoubtedly opens up where the result is always the same: inability to function normally in your life, loss of health and suffering.

What do all addiction processes have in common?

If we now ask ourselves if there is some common element in all addictions, it seems that there is. In the fourth International Conference on Behavioral Addictions held in Budapest last year and promoted by the medical journal Journal of Behavioral Addictions It was concluded that the common denominator in all cases is compulsion.

Naomi Fineberg, psychiatrist and neuropharmacology specialist at the University NHS Foundation Trust (HPFT) from Hertfordshire, England, explained that People with an addiction have obsessive-compulsive disorder, as well as low cognitive flexibility and limited or non-existent personal goals..

The addicted brain always shows certain alterations in the ventral regions of the prefrontal cortex, an area related to emotional meaning and our ability to control.

Thus, something that many neurologists and addiction specialists conclude is the following: People with a dependence on a substance or behavior meet an emotional need with their addictions. However, in their search to satisfy that void, they lead to compulsive behaviors, behaviors that the brain is unable to control and that also feed back over and over again.

The neurological mechanism of addiction

The addicted brain works differently. His only objective, his most priority need, is to find that well-being that he obtains with the use of that substance or with the activity of said behavior, which generates momentary and limited pleasure. Little by little, this external “stimulant” replaces the body’s own natural rewards, and the brain needs more.

The work of dopamine in any addiction process is key. The reason? It is it that generates craving and desire, it is what “turns on” the rest of the brain regions so that they are oriented towards that same cause and need. The striatum, for example, is the first to start and “recruits” structures such as the midbrain and the orbitofrontal cortex. The entire brain understands that that substance, that behavior is a priority and focuses on that single objective. Generally, All drugs of abuse generate serious alterations in the activity of the dopaminergic system. mesocorticolimbic. In this way, if consumption becomes chronic, neuroadaptive and neuroplastic changes will appear to the point of completely altering the structure of this system.The prefrontal cortex is one of the most affected. Drastic changes also occur in it as a result of addictions. Our emotions and their regulation are altered, as well as our cognitive processes. It is difficult to focus attention, reason clearly, control one’s own behavior and make decisions.

On the other hand, there is an aspect that we cannot neglect. When we talk about alcohol and drug consumption, the changes that are generated at the brain level are immense, sometimes devastating. The alterations generated in the prefrontal cortex, the amygdala and the striatum are immense and in many cases irreversible.

Is addiction a chronic disease?

As we have pointed out, the addicted brain can sometimes show chronic alterations. Intoxication by certain substances impairs short-term memory and the ability to record new information. Likewise, alcohol, for example, has a serious impact on the cerebellum, which can interfere with aspects such as motor coordination.

Thus, experts from National Institute on Drug Abuse They often make it clear that addiction is basically a chronic, recurrent brain disease. However, there are already many neurologists who question this statement. The key to such an assertion is in a concept that we all know and have heard on more than one occasion: cerebral neuroplasticity. The brain is not like the heart, the stomach or the pancreas. The brain has an exceptional virtue: It is designed to change, to produce new neural connections, to learn, train to create new tissues and nerve cells. Thus, if our brain had not changed throughout our lives we would be in a coma. We evolve, we change, we generate new capabilities…

What does this mean and how does it relate to the addicted brain? Basically there is hope. Just as many patients with brain damage are capable of improving certain aspects to have a better quality of life, it can also happen The same in people with an addiction.

It would be, in essence, generating new synaptic patterns based on new behaviors and thoughts. A door to change that is already being developed in many clinics and rehabilitation centers with good success rates. Science and knowledge about the human brain is constantly evolving, something that will make the task of providing better answers to all types of needs easier.

We will be waiting.

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