Recovering from an addiction happens on multiple levels. Many people go through changes in their behaviors, mental health, and social life when attempting to quit a substance or a destructive habit. However, sometimes change is a lengthy and complex process, albeit a life-altering one.
In this article, I will address some questions that many people might ask themselves during a recovery process – does addiction recovery reflect in our biology? If it does, how long does it take for positive changes to occur?
Areas of the Brain Affected by Addiction
People engage in behaviors that lead to addiction, such as substance abuse or non-chemical addictions, to elevate their mood and experience new emotional states. However, repeated use of substances or behaviors can lead to tolerance and therefore result in addiction. Repeated exposure to these behaviors leads to an adaptive state, also known as dependence.
A state of dependence occurs when the brain undergoes changes in its biology according to the new addictive habits. In the case of chemical addiction, biological changes are elicited by the substance itself. In other types of addictions – such as gambling, video games, and addictions of intimate nature – dependence results from behaviors that are reinforced on a frequent basis.
Addiction and the Dopamine System
The effects of addiction on the biology of our brains are real. A major change that occurs as a result of engaging in addictive behaviours is related to a neurochemical called dopamine. This neurotransmitter is involved in learning and reward and is released every time someone associates a certain substance or behavior with a pleasant and uplifting emotion.
For example, the euphoric feeling experienced when consuming alcohol leads some individuals to repeat the experience in the pursuit of the same emotional reaction.
An addictive substance or habit activates the areas in the brain associated with reward, which causes a sharp increase in dopamine. This reward signal triggers associative learning or conditioning, paving the way for the association between a habit and a certain emotion.
Dopamine also regulates motivation and drive for everyday activities. Therefore, chronic addiction can lead to difficulties with sustaining motivation for a prolonged period of time. Some individuals who present addictive behaviors might find that they lose their interest in things they previously used to enjoy. Instead, they might feel unchallenged by the prospect of completing daily tasks, going to work or paying bills.
Changes in Other Key Brain Structures
Besides creating significant changes in the dopamine circuit, addiction also modifies other brain structures. One such brain region is called the basal ganglia. This cortical network plays a crucial role in the positive forms of motivation necessary for pleasurable activities such as eating, socializing, and sex. It also plays a function in the formation of new routines and habits.
Chronic addiction leads to an over-activation of the basal ganglia. Initially, this might result in a strong feeling of euphoria. In the long term, however, this brain circuit adapts to addiction, producing less and less of these pleasurable effects. For some people, this might mean that they are unable to obtain pleasure from other stimuli other than the source of their addiction. For others, it can also mean that they need more of the same drug or behavior to experience the same initial high.
Addiction also affects a brain area that plays a crucial role in emotional regulation called the amygdala. The irritability, mood swings, and poor emotional modulation that are seen in people with addiction are caused by a malfunctioning of this brain area. Over time, addicted individuals use a drug or behavior to get temporary relief from these symptoms, only to exacerbate them.
Finally, addiction also affects the proper functioning of the prefrontal cortex, a brain region located in the area of the forehead. The functions associated with this area are higher executive skills such as planning, thinking, reasoning, and regulating impulses. This is also the latest brain region to mature, making young people in particular most vulnerable to addiction.
Poor functioning of the prefrontal cortex results in impaired self-control over one’s impulses and a reduced capacity for decision-making and reasoning. This is why addiction is characterised by a long-lasting risk of relapse. Compulsively engaging in behaviors with an addictive potential can lead to reduced control over one’s actions.
What do Brain Scans of Affected People Show?
Changes resulting from addiction happen both at a biological and neurochemical level. The most significant changes in the brains of addicted individuals have been observed in the dopamine circuit. The reduction in the dopamine activity in the brain is also reinforced by neuroimaging studies.
An article published in the Journal Behavioral Brain Research has shown that repeated exposure to the same reward leads to a decreased production of dopamine. In other words, the initial feeling of ‘high’ or euphoria experienced in the initial stages of addiction wears off. As a result, a higher dose of the same substance or addictive mechanism is needed to achieve the same effect.
Furthermore, changes at the structural level of the brain have been observed in the prefrontal cortex area. For example, a study published in the Journal of Clinical Investigation has shown MRI and PET scans of addictive individuals who also present a decreased functioning in the prefrontal cortex area. This is why some addicted individuals have a difficult time exerting self-control over their impulses when engaging in addictive behaviors.
The impaired functioning of the prefrontal cortex also explains why so many addicted individuals struggle with emotional regulation. They might feel unable to disengage from addictive behaviours and pursue healthier habits. The combination of motivation loss, decreased self-control and reward associated with addiction makes it significantly difficult to cease addiction.
Other brain areas that are affected by addictive behaviors of any nature are regions associated with memory and learning. Two main areas associated with these processes – the amygdala and the hippocampus – are shown by neuroimaging studies to have an impaired functioning in individuals with a history of addiction.
Can the Brain Help Itself after Addiction?
Since addiction is a learned behavior, recovery is possible by learning new habits and coping mechanisms. One principle involved in addiction is neuroplasticity – which refers to the brain’s ability to create new connections between neurons. This can happen by repeating the same habits over and over again. Changing the structures of the brain involved in addictive behaviors means undoing the effects that occurred as a result of repeated abuse.
While some people feel that they cannot undo the damage by years of engaging in destructive habits, it might be hopeful to know that we can all use neuroplasticity to create meaningful changes in our health. Sometimes change can feel incredibly hard and often impossible to achieve by individual means. However, it is important to consider that positive changes in our cognitive and emotional health are attainable, even despite a history of addiction.
A crucial aspect of addiction recovery is building new and adaptive habits. These can replace the former destructive ones related to compulsive behaviors. People who engage in recovery programs are supported to implement positive routines and behaviors that serve their long-term goals of recovery.
When a new habit is learned and fully integrated into someone’s routines, the brain develops a new pathway. This allows the individual to perform this new habit with less effort. This new pathway becomes stronger and more active when the habit is maintained over a longer period of time. We can also conceptualize the process of neuroplasticity in a similar fashion to growing a muscle – the more we exercise, the stronger it gets.
The Use of Psychotherapy-based Tools
There are also current psychotherapy approaches that can provide tremendous support in addiction recovery. Ultimately, they can lead to lasting changes in the structures of the brain. For example, Cognitive Behavioral Therapy (CBT) takes advantage of the principles of neuroplasticity. It also encourages those in recovery to learn about the relationship between their thoughts, feelings, and behaviors. Furthermore, it helps patients change their destructive behaviors and implement positive changes in their daily routines and choices.
Certain mental well-being tools such as mindfulness meditation also help promote neuroplasticity and behavioral change as part of addiction recovery. Studies have shown that regular meditation increases emotional regulation and leads to a higher gray matter density in the brain stem. In other words, this means that meditation aids recovery by increasing self-control and promoting new coping mechanisms.
Neuroplasticity shows that our brains can recover, even despite a long history of addiction. As long as there is a willingness to implement healthier, more adaptive behaviors, the brain will modify its structure to reflect the new habits. Because our behavior and biology are interlinked, the good news is that we can target our daily habits by implementing new practices to change our biology.
The Takeaway Message
Addictions of any kind are incredibly harmful for our health. It goes without saying that every choice resulting in chronic addictive behaviors will negatively impact our physiology and mental health. The detrimental effects of addiction on our brains cannot be denied. However, it is important for us to know that there are ways in which we can support ourselves to recover from this mental health condition.
A history of long-term addiction should not be a sentence to poor mental health. With the right support, resources, and interventions, even the most complex cases of addictions can be guided towards positive change. Surely, full brain recovery can be a slow and, in some cases, difficult process. However, this should not discourage people from believing that they can make better choices for their brain health.
As more and more research shows, our brains are malleable and can change according to our daily practices and behaviors. The principles of neuroplasticity make it possible for us to change our biology by introducing new and beneficial interventions, such as CBT, mindfulness-based practices, and by reinforcing new thoughts and behaviors.
