“Wait a minute,” I interrupted my daughter. “You mean he’s addicted to something?”
She was reading to me from her favorite story collection: Sherlock Holmes. The amazing detective had no cases to solve that day, so he turned to his usual diversion: cocaine, shot up.
I was mortified. My daughter’s hero was addicted to cocaine?
In Addiction and Grace, Gerald May notes that all of us deal with addictions of one kind or another. These addictions can come between us and others, us and our jobs, and even us and ourselves. They are almost impossible to kick, and some can be life-threatening; I know that firsthand, having lost an aunt to heroin addiction, a stepfather to cigarette addiction, a grandfather to alcohol addiction. My own grandmother claimed she stayed with my abusive grandfather because she was addicted to the sex; she bore the black-and-blues of his kicks and punches, and her children bore emotional scars from watching their mother beaten again and again.
Not all addictions are so tragic. Chocoholics, shopaholics, workaholics, and coffee fiends can tell you about their addictions, even joke about them, and none of it seems too terrible. Overeating, undereating, eating junk food. Self-cutting, shoplifting, video games, porn. The list goes on. We have our secret lists of what’s acceptable, what’s immoral, what’s stupid or what’s even perhaps a little avant garde.
But from the brain’s perspective, addictions are not particularly unique. Some carve deeper paths more quickly. It’s not about right and wrong. Smart or stupid. Young or old. It’s not even about pleasure, as we often mistake it to be. To the brain, addiction is about survival, even though some addictions will (ironically) kill us before our time.
Addictions are anything we helplessly engage in despite undesirable physical or social consequences. They are generally considered chronic because of the way the brain has “over-learned,” carving deep pathways and even causing dendrites to bloom and increase synaptic connections related to the addiction. These brain adaptations cause the addicted to go on autopilot, and the prefrontal cortex can’t override actions, even if a person “knows better.”
The main player is dopamine, which is known to be in short supply in those with ADHD tendencies (about half of those with ADHD also struggle with addiction). Dopamine helps a person have a sense of what is important, what is salient. The addiction provides relief because, in essence, it provides focus and a sense of motivation to survive. It’s pretty basic.
What is not basic is the way out of addiction. Memories work against us. A sense of emptiness or “hollowness,” as some describe it, works against us. Yet there is great hope in using exercise as part of a road towards health. At Odyssey House in New York City, an employee started a running program for the clients. Soon it was discovered that any client who engaged in the vigorous exercise was twice as likely to stay in treatment and to overcome (Ratey suggests a bare minimum of 30 minutes of vigorous aerobic exercise at least five days a week to root out addiction).
Exercise works from the top down and the bottom up, “rewiring the brain to circumvent the addictive pattern and curbing the craving [through a natural, healthy supply of dopamine].” In very few cases, exercise itself can become a dangerous addiction, but this is the exception and not the rule.
Addiction is obviously best handled before it begins, by offering those with “reward-deficiency syndrome” (low dopamine) the kinds of opportunities that encourage bold exploration, iconoclasm, or high-energy entrepreneurship (in other words, healthy excitement that would boost dopamine). Developing early habits around the natural high of exercise would also be critical. It is interesting to consider whether early moral pressure would be beneficial too (once an addiction is formed, Ratey cautions against calling it a moral failure since it appears to more likely be a neurological malfunction; also perhaps instructive is the information Lauren Winner shared in Real Sex— that students active in sports were less likely engage in premarital sex).
Thinking back on Sherlock Holmes, I wonder when his life with cocaine began—surely he would have been less susceptible if he’d been a risk-taking sleuth before the addiction. Getting off the couch when he felt emotionally low would have helped too. If he’d but known.
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