Q: Tell me more about "your brain is a pot of stew" metaphor.

A: Think of your brain as a pot of chemical stew. That's really what it is. In the physical world you can have three pots on the stove with identical basic ingredients in each pot, and dramatically impact the way each tastes just by the seasonings you add (e.g., Minestrone, Curry, Asian).

All human beings continually self-medicate so that their brain's chemical stew feels comfortable (or at least familiar to them). Sometimes the self-medication runs away with itself and becomes addictive behavior.

Direct self-medication: human being can achieve direct self-medication by ingesting any substance that binds to receptor molecules on surface of cells. With direct self- medication there may be a period of physical discomfort when the person abruptly stops self-medicating with the substance (withdrawal).

Many drugs used for self-medication (especially street drugs) can disrupt functions of the brain's frontal cortex where risks and benefits are analyzed, decisions are made, and conscience and willpower are activated.

Examples of substances often used to achieve direct self-medication include:

  • Nicotine and alcohol
  • Prescription medications
  • Over-the-counter medications
  • Inhalants (legal or illegal)
  • Illegal drugs
  • Simple carbohydrates such as sugar

Drug use can actually alter blood flow patterns in the brain during the initial drug exposure, triggers pleasure, and creates a desire to repeat the behavior that produces the reward (reinforcement). The drug may disrupt frontal lobe function (thinking layer) directly and/or damage crucial dopamine pathways in the midbrain (action layer), information from which is transferred to the frontal cortex through altered neurochemical pathways.

Drug use can also alter the distribution and density of dopamine receptors in the frontal cortex. Prolonged drug use can result in the disruption of frontal lobe capacity related to reason and control (e.g., appears to influence the individual to overvalue the reward, undervalue the risk, and fail to learn from repeated errors. A similar pattern can be seen in other disorders not classically associated with drug use (e.g., obsessive/compulsive disorder, poor choices).

Indirect self-medication: human beings can self-medicate indirection through a variety of behaviors or actions that trigger changes in the brain's neurochemistry (e.g., exercise, sexual compulsions, eating disorders, gambling). The addiction is really to the person's own internal substances that are released in the process of the behavior or action.

The individual can experience some level of anxiety if he/she ceases to exhibit the behavior or action, but this is not usually the same type of physical discomfort experienced during withdrawal from a direct substance.

Examples of internal substances released during specific behaviors/actions that are engage in to trigger indirect self-medication include:

  • Adrenalin that can be released during episodes of anger or fear, competition, and high-risk activities
  • Endorphins and enkephalins that are released through: extreme exercise, bingeing/purging (e.g., released during starvation, overeating, or vomiting), high-risk behaviors and activities; excessive hand washing, religious obsessions including flagellation, sexual activity (estimates are that 80% of sexual compulsions are accompanied by another concurrent addictive behavior such as alcohol, work, or gambling).
  • Serotonin that can be released by eating specific types of foods, dopamine that can be released when an unexpected reward or a larger-than-anticipated level of an expected reward is received, oxytocin and vasopressin that can be released during sexual activity and/or by a feeling of being in love.