Dopamine in Addiction and Other Mental Health Conditions

September 2nd, 2024

By P. Casey Arrillaga, LCSW, LCDC

Dopamine is a chemical in our brains that has been the
subject of much attention when it comes to addiction and other mental health
conditions. The reason for this is that dopamine is vital to our impulses
around motivation and reward, and also whether we take action on those impulses.
Since these all play a major role in many mental health conditions, especially
addiction, this post will explore what dopamine is, what role it plays in
mental health, and how we can use this knowledge to help people.

What We Know So Far

Dopamine is a chemical central to our conscious and
subconscious thinking. Because it is involved in the process of our neurons
communicating with each other, it is known as a neurotransmitter. Dopamine is
also involved in making our muscles move, so you might say that it helps
translate thoughts into action. It is thus involved in almost any decision we
make and how those decisions play out in what we actually do.

For years, dopamine was known as “the pleasure chemical,”
because it was such a major part of the brain’s reward system. Whenever
something feels good to us, dopamine is involved, whether it is food, sex,
love, spirituality, music, exercise, power, money, our pets, or any of the
countless other things people enjoy in life. One might say that “if it feels
good, dopamine is involved.”

This is part of our built-in survival system. When we
encounter something that seems to enhance our survival, dopamine kicks in to
help us recognize and remember the thing that seems to help us. Because humans
are a tribal animal and thus rely on connection to others for life itself, many
of the things that we find pleasurable also involve others. This probably why a
sense of connection and bonding is associated with dopamine, and secure connection
itself feels pleasurable.

However, more recent findings have shown that dopamine isn’t
just about feeling pleasure. It more accurately can be said to cause
anticipation of that pleasure. When talking about mental health, this makes all
the difference. People suffering from mental health issues often do things that
seem obviously destructive to themselves and others from the outside. If we can
understand what motivates them to do such things even when they know they will
cause pain, then we may be able to do more to help. As it turns out, it’s the
often-subconscious anticipation of reward that drives people to take actions that
are against their best interests. Dopamine is central to that anticipation.
Sadly, long after a given action no longer produces the expected reward, and
even after it causes harm, the brain may release dopamine in hopes that this
time things will work out. This is how such destructive actions and even habits
are cemented into place despite the person knowing rationally that what they
are doing is a bad idea.

There are many mental health conditions that are based in
chasing and responding to dopamine surges in the brain. The most obvious of
these is addiction. Whether a person is addicted to alcohol, sex, gambling,
heroin, work, methamphetamine, painkillers, shopping, or anything else, it
could be argued that they are really addicted to manipulating their dopamine
system beyond its natural limits. This may explain why there are so many forms
of addiction, with self-help groups seeming to spring up all the time to
address one addiction or another. It could also help explain how the methods
that help someone recover from addiction to alcohol are also effective for
other drugs, gambling, self-harm, compulsive work, or any form of addiction.

Dopamine is also central to other mental health conditions. Dopamine
levels that are too high can lead to impulsivity, aggression, increased sex
drive, feelings of unwarranted euphoria, and trouble sleeping. Low dopamine
levels leave people feeling anxious, off balance, subject to mood swings,
hallucinations, and various forms of problems in the digestive system. Problems
in dopamine levels have thus been found to be involved in mental health issues
including acute anxiety disorder, major depressive disorder, ADDD/ADHD, bipolar
disorder, and schizophrenia, among others.

How Can We Use This Knowledge to Help People?

At Windmill, we know that mental health has no quick and
easy fix. This is why we work with our clients on many levels and never stop
working to find what will help each individual the most. While the things we do
are not usually prefaced with “this will help your dopamine levels balance
out,” in reality, this is what so much of it boils down to. Our expert
therapeutic team helps clients remove internal barriers to their natural
happiness and sense of reward in life, getting their brains back to a functional
emotional state of self-regulation. Since dopamine is involved in human
connection, we stress the importance of connecting with recovery groups, and we
help our clients get through their difficulties with becoming part of such
fellowships. We work with each client to find what role medication may play in
helping their reward system find a more natural balance. We teach our clients
how to find pleasure and contentment in life again without constantly chasing
the next “dopamine hit.” We monitor mood, motivation, and optimism regularly to
spot trends and measure progress scientifically. This shows us, our clients,
and their families how their brains are healing and when they are ready for the
next steps. All of these things involve helping the dopamine system come back
into balance and be able to stay that way.

The Bottom Line

Dopamine is involved in everything we do and every choice we
make. It is thus central to understanding mental health and improving it. When
this is properly taken into account, we can use this knowledge to help people
in all aspects of their recovery from addiction or any other mental health
condition.

About The Author

P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.