Dopamine, the good and the evil: the key neurotransmitter in addiction

Why do people become addicted to certain feelings, behaviors, and things? Such as gambling, alcoholism, food…

Why are teenagers more likely to become addicted to video games and pornography?

Today, a 19-year-old young patient with severe erectile dysfunction and long-term chronic prostatitis was admitted. Various urination symptoms had a severe impact on his life. An important reason for his symptoms is uncontrolled masturbation. Indiscriminate masturbation that makes him feel self-blame and pain, but still continues.

Before we talk about this young patient, we need to talk a little bit about addiction.

The good and the evil dopamine

To talk about addiction, you need to talk about a well-known neurotransmitter – dopamine.

Dopamine has always been considered a “happy molecule” that can make people feel good and full of energy. Therefore, many people spare no effort to find a way to increase the secretion of dopamine.

But with the deepening of research, scientists have found that when people are full of expectations for something, the dopaminergic circuit in the brain is greatly activated, making people feel enthusiastic, eager, and desire for something. This is actually a feeling of anticipation, a feeling of longing for the future, not a feeling of the present.

In other words, the role of the dopaminergic circuit can be understood to some extent as enthusiasm for something that has not yet happened. It’s a reward circuit, it’s a feeling of “wanting.” And for this feeling of “wanting”, people will put in a lot of effort and even forget about everything else.

The things that human beings desire the strongest are related to survival, which are deeply rivets at the genetic level for the survival of the individual and the continuation of the species.

Not just for survival, but for better living conditions. Related things include food, sex, safety, access to resources, feeling respected, higher social status, and more.

Just like the lion king in the lion group, in order to obtain more food, to obtain priority to mate, and to fight for the life and death of the challenger in order to defend his dominance.

Then things related to the factors mentioned above are more able to stimulate people’s desires, make people more full of expectations, and make people feel more satisfied and excited.

Therefore, the role of dopamine in the brain, in addition to making people full of vitality, energy, and hard work, may also make people addicted to something, and in severe cases, they can even fall into it and cannot extricate themselves.

"like" and "want"

Is what you want what you like? If your answer is yes, then see the example below.

Drug addicts know that drugs are harmful to the body and that drugs will destroy people, why do they still want them? Do they like drugs? do not like! But still desperate for it!

Don’t alcoholics know about the dangers of alcohol? Now the Internet is full of knowledge about the harm of alcohol to the human body, and there are many cases of liver failure caused by alcohol addiction. I have never seen it before. But still want to drink? Does he like to damage his own body? But still want to drink!

There are many people who lose everything because of gambling. These people, who have lost wealth and loved ones, are still addicted to gambling after countless assurances and remorse. Is this what they like? But still want to gamble!

The 19-year-old boy in the outpatient clinic suffered from severe erectile dysfunction and chronic prostatitis due to incontinent masturbation after being addicted to pornography. He even masturbated in remorse and remorse. I know it’s not good, I obviously don’t like my state, but I still want to do it!

Therefore, “want” and “like” are often not synonymous.

The dopamine-controlled desire-reward circuit is one of the important neurochemical underpinnings of wanting, preparing it for the future.

The study found that the brain activity of sex addiction, alcohol addiction and other factors that are addicted and unsatisfied is similar to the brain activity of craving for drugs when drug addiction is involved: the limbic pathway of the ventral tegmental area is activated, Dopamine is produced and desire arises.

So why do people always "want"? Why do you always feel unsatisfied?

Because after working hard to get the “wanted” thing full of expectations, the future becomes the present, “wanting” becomes “getting”, the circuit impulse of dopamine, the “future factor”, decreases, the secretion decreases, and the feeling of expectation is reduced. fading away. That’s why passion doesn’t last forever.

Just imagine if you are very excited every Friday afternoon, because tomorrow will be a holiday. But it really feels like that on Saturday weekend.

People like the feeling of anticipation and surprise, never tired and never satisfied.

In psychology, there are concepts of ego, id, and superego. When we know that sometimes dopamine is driving us to do something, it helps to control our behavior.

Imagine observing the actions of the id in a higher dimension with the attitude of the superego, and in my mind, “it turns out that dopamine is controlling me again”.

If you can always achieve the state of “when a thought arises, you know it rises, and when a thought falls, you know it falls”, then it will be more helpful for self-control.

The troubles of young people

The same is playing games, why minors are more addicted than adults.

Same goes for masturbation, why it’s harder for teens to control themselves.

From a neurophysiological point of view, one of the important reasons is the immature brain. The frontal lobe of the brain does not develop until about 20 years old and is basically the same as that of an adult, and the frontal lobe gives people good control. It’s like a brake that warns us to stop when we’re about to do something bad.

Take games, for example, the game world is full of surprises, challenges and rewards, just enough to let teenagers who lack control enjoy the excitement brought by dopamine.

The game designer has even calculated the probability of players getting needed and important props in random treasure chests through huge data resources, so as to prolong the game time of players. This probability is said to be 25%.

The brain is designed to allow us to obtain all the resources we need to survive while consuming less energy. That is to say, after lying flat and earning the same amount of money as a job, I believe that not many people will retain much interest in this job.

The availability of something is one of the key factors in whether it is addictive or not.

With the rapid development of the Internet and smart mobile devices, it is becoming easier and easier to obtain various related resources, and the cost and effort to be paid are less and less.

If the cost of acquisition can be appropriately increased, it may be helpful for addiction.

For example, when I worked out a medication plan and a lifestyle adjustment plan for this 19-year-old boy, I asked him to go back and cut the network cable and delete all the “teachers” on the computer. But I don’t know if he is reluctant.

Existence is reasonable, everything pays attention to degree

It is said that meditation is good, but meditating all the time is just fantasy; exercising is good, but excessive exercise can cause muscle damage and even rhabdomyolysis; moderate stress can help you be more motivated, but too much stress can crush you; moderate The game, the regular sex life is good for people’s body and mind.

Existence is reasonable, and there is demand before supply. Everything has two sides.

At this time, moderation is particularly important.

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