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Re:Rethinking Addiction as a Chronic Brain Disease by navjack27 on Wednesday September 04, 2024 @07:39AM (#41444482)
But everything a living creature does is chemical. Even the process of that young man who has suffered sexual and psychological abuse as a child, that brain that can't stop ruminating can't stop ruminating because of a chemical feedback loop that the brain is doing natively.

When my mom got diagnosed with pancreatic stage 4 cancer and I couldn't cope with it and I was already in a drug explorer mindset at the time and I started taking her opioids and I became quite addicted (no she wasn't deprived of any of her medications she was fine). This whole process absolutely was chemical imbalance. Years before in high school I stopped taking all of my ADHD medication and then started spiraling out of control dabbling in all sorts of disassociative and psychedelic drugs. If I didn't stop taking my Adderall in high school I wouldn't have gone down any of that path.

Re:Rethinking Addiction as a Chronic Brain Disease by threecheese on Wednesday September 04, 2024 @06:11PM (#41451415)
It has taken me many years to come to that same realization, which many of us must have learned in school bio class. I continually observe the value of attacking life-problems from this perspective -that behavior is a product of chemical signaling and continuous chemical-reinforcement learning, and our decisions are steered by it and not the reverse. I find that my level of empathy has increased, both for others (like the guy that cut me off in traffic) and for myself and my failures. A willpower-based explanation of the self only leads to resentment, “why can’t i just stop behaving this way it is killing me” or “if they loved me they would change”; knowing that we are all literally enslaved to our chemical neuro anatomy allows forgiveness and openness. I don’t mean to imply that will doesn’t exist and isn’t a powerful force, but it’s not the Layer One protocol like some parts of society claim.
Re:Rethinking Addiction as a Chronic Brain Disease by Spivak on Sunday September 08, 2024 @10:08AM (#41480491)
I don't think you have to deny that will or willpower exists, just that willing your brain is an action that requires mental energy and your average adult is mentally exhausted constantly.
Re:Rethinking Addiction as a Chronic Brain Disease by tsimionescu on Sunday September 08, 2024 @11:30AM (#41480973)
Willpower and mental energy are entirely pseudoscientific concepts. They co-opt sciencey language to sound smart, but they have no backing in experiment or observation. What exactly is this "mental energy" being expended on (converted to)? What is it's law of conservation, that we might call it "energy"? Is willpower defined as the consumption of mental energy per unit time, that we might call it "power"?

You could think that maybe willpower/mental energy is a resource you have to consume to suppress natural instincts like overeating or consuming a drug that triggers pleasure in order to achieve some long term goal. But then you find that some people routinely engage in behaviors that contradict basic natural instincts, and in fact find it very hard to stop doing those behaviors (e.g. cutting or other self-harm behaviors, suicidal tendencies). Are they just a font of mental energy?

Re:Rethinking Addiction as a Chronic Brain Disease by Spivak on Sunday September 08, 2024 @01:00PM (#41481502)
You can argue the explanation but it's hard to argue the observation— kids are tired after school even with no physical exertion, knowledge workers are tired after work. People need to "decompress" after mentally taxing work, burnout is a thing.

Name it what you like, but your theory does have to account for people's lived experience. Why does studying make you tired? Actively using certain parts of your brain is a limited resource in some respect no matter how you swing it. The rules are super weird so maybe energy is a bad name but it's the best we have right now.

Re:Rethinking Addiction as a Chronic Brain Disease by tsimionescu on Sunday September 08, 2024 @01:18PM (#41481638)
Oh, tiredness due to knowledge work is real, and relatively easily explained: you spend energy (real, physical energy - calories) on computation in your brain. Whether you're learning at school, designing bridges, driving, or what have you, there are measurable outcomes of your work.

But there is no obvious relationship between this and the concept of "expending mental energy" on combating your cravings. It's not at all clear that there is any measurable "effort" involved in not doing something like eating a sweet. Chess masters consume more calories during a tournament. People who avoid eating cake at a birthday party don't.

And yes, I have of course experienced the difficulty with not giving in to a craving. But I'm not at all convinced that it is the same thing as the difficulty of taking a math exam. If anything, my experience is that it's easier to control my cravings after accomplishing a difficult mental task then it is if I've just idly been watching TV all day.

Re:Rethinking Addiction as a Chronic Brain Disease by ethanol-brain on Sunday September 08, 2024 @09:16AM (#41480214)
> I wouldn't have gone down any of that path

Yet, if you actually believe in biological determinism, there is no way you could have taken anything but that path.

Re:Rethinking Addiction as a Chronic Brain Disease by tsimionescu on Sunday September 08, 2024 @11:33AM (#41480991)
Biological determinism is not necessarily full determinism. External circumstances could have been other than they were, and then the biologically determined decision could have changed. Plus, for every deterministic model, the same arguments would also support a world that also includes pure randomness in addition to the deterministic laws.
Re:Rethinking Addiction as a Chronic Brain Disease by ethanol-brain on Sunday September 08, 2024 @08:30PM (#41484456)
Still, the author is making a deterministic leap by stating that they wouldn't have been X if Y.
Re:Rethinking Addiction as a Chronic Brain Disease by navjack27 on Friday September 20, 2024 @01:32PM (#41604033)
I'm not making a deterministic leap I'm leaving out vast amounts of information from my story that are way way more personal. Of course there are more things that I know that don't make this a deterministic leap but I don't care to share them.
Re:Rethinking Addiction as a Chronic Brain Disease by larodi on Sunday September 08, 2024 @09:33AM (#41480313)
Do you realize that this basically translates to "had I not stopped taking prescribed amphetamines, I'd never be exploring other drugs"... sounds a little hypocritical to me, and particularly when ADHD-diagnosed-on-prescription drugs fail to note that they been treating themselves with micro-dosing. So then how is Psilocybin or THC microdosing different?

If it's all about the dosage, then we need to focus on a different narrative. Besides, I'm sure a lot of very sane, and very performant people, met lots of these, actually enjoy the regular micro-dosing of alcohol or tobacco...

Re:Rethinking Addiction as a Chronic Brain Disease by from-nibly on Sunday September 08, 2024 @10:46AM (#41480717)
Prescribed amphetamines are very different than meth. Its not just about dosages.
Re:Rethinking Addiction as a Chronic Brain Disease by SkyPuncher on Sunday September 08, 2024 @10:53AM (#41480764)
"Very different" is a strong word. They're more similiar than different and both have similiar intermediaries within the body. Thankfully, that difference is largely the difference between long-term debilitating addiction and short-term focus.
Re:Rethinking Addiction as a Chronic Brain Disease by from-nibly on Monday September 09, 2024 @09:55AM (#41488616)
Ive taken two different amphetamines and 1 brings on panic attacks and the other doesn't. I call that very different. The molecule doesn't have to be that different in order to be vastly different in what it does to humans.
Re:Rethinking Addiction as a Chronic Brain Disease by larodi on Wednesday September 11, 2024 @01:52AM (#41508382)
Two street amphétamines or two prescribed? Sorry not trying to be rude, but you know there seem to be like 4 in Aderall, so how do you tell them apart?

Besides you can be absolutely sure there is very clean stuff out there on the streets.

All I’m saying is that bros are effectively micro-dosing to cater to condition and there are lots of people taking this in very regular manner.

Re:Rethinking Addiction as a Chronic Brain Disease by navjack27 on Friday September 20, 2024 @01:30PM (#41604026)
That is literally exactly the case. I'm not going to pull fake percentages out of my ass here but it's in the medical literature that a person with ADHD who is medicated and treated correctly has less likelihood by a significant factor of drug abuse.

It's not hypocritical. You seem to have a line of thought you couldn't escape from when writing these replies where the bad guy in this scenario is microdosing and tech Bros.

Re:Rethinking Addiction as a Chronic Brain Disease by marginalia_nu on Sunday September 08, 2024 @09:37AM (#41480336)
It's specifically because the brain is an electrochemical computer that the whole "brain chemistry imbalance" narrative isn't very useful. After all, every feeling you experience and every thought you think is brain chemicals in action.

It's like saying a software bug is an electromagnetic imbalance in the hard drive. Well, technically yes, but there's also more to it than that.

Re:Rethinking Addiction as a Chronic Brain Disease by sickblastoise on Sunday September 08, 2024 @10:10AM (#41480510)
That’s a great analogy! The chemical imbalance thing has always sounded to me like there “are spirits in the system”
Re:Rethinking Addiction as a Chronic Brain Disease by marginalia_nu on Sunday September 08, 2024 @10:38AM (#41480667)
The brain imbalance narrative really is a double-edged sword.

On the one hand, it can help people understand that a condition is real and not imagined, especially other than the sufferer. "Look at this brain scan, it looks different from a healthy person's" is quite tangible and convincing.

On the other hand, it can lead to a sense of helplessness, and notions that because there's a physical element to the mental illness, it's a permanent disability, or to be exclusively treated with pills and injections. That just doesn't follow. Sometimes it's true, but in many cases, lifestyle interventions can help, talk therapy can help.

Re:Rethinking Addiction as a Chronic Brain Disease by soulofmischief on Sunday September 08, 2024 @12:45PM (#41481401)
That's just your projection. A proper neurological diagnosis can absolutely help a patient find a viable path to recovery, as well as enable them to find support groups.

And not every neurological disorder is fixable. And the question of whether this is "sometimes" or "in many cases" is still in the air, unless you can provide solid citations proving otherwise. So there is no need for this kind of judgement.

Re:Rethinking Addiction as a Chronic Brain Disease by marginalia_nu on Sunday September 08, 2024 @01:45PM (#41481838)
Yeah dude I think you're the one who is projecting. You're reading a lot into what I wrote that just isn't there.
Re:Rethinking Addiction as a Chronic Brain Disease by soulofmischief on Sunday September 08, 2024 @03:40PM (#41482603)
I'm addressing the words you wrote, mainly this idea that learned helplessness is a significant concern when diagnosing chemical imbalances. Learned helplessness is tangential to a proper diagnosis, there is still CBT and other techniques for developing coping mechanisms around mental health issues, but those cannot be utilized without first receiving a diagnosis.

For example, in the case of ADHD, it s clear that patients have a reduced dopamine receptor count. It's not just a chemical imbalance, it's structural. Medication is the only effective solution for severe cases, and the result is night and day. Knowing this helps me make better decisions around my diagnosis, and also alleviates the great shame and anxiety that come hand in hand with ADHD.

I don't wish to devolve into an argument and I apologize if my initial comment was too aggressive.

Re:Rethinking Addiction as a Chronic Brain Disease by wslh on Sunday September 08, 2024 @09:54AM (#41480420)
The danger from the article's perspective is, once again, viewing addiction solely as a disease rather than as a symptom of multiple underlying issues. This is similar to how anxiety and depression have been framed as single diseases, when in reality, they can be symptoms of various conditions. Even if we consider addiction a disease, there's often an oversimplified focus on a "single root cause" when, in fact, multiple, independent factors can contribute to addiction. One clear example is the physical dependence on certain drugs, which can be beyond a person's control. On the other hand, many young people start using marijuana under the old, now cliché, mantra that it doesn’t cause physical addiction, as if physical addiction were the only form of addiction possible.

My 2 cents, from someone with a [strong] non-addictive trait but having witnessed people with various addictions, including gambling.

Re:Rethinking Addiction as a Chronic Brain Disease by adamtaylor_13 on Sunday September 08, 2024 @02:10PM (#41482001)
Having experienced my fair share of awful life circumstances, I’ve came away with an opposite understanding.

You can’t boil everything down the chemicals.

Life boils down to choices. Some are easier and some are harder, but as soon as you take away the fact that it’s all a choice, you find yourself in a very dark place where you’re always a victim of your circumstances.

At the end of the day though, whether you believe me or not, your reality will reflect your beliefs. If you believe you can’t, you won’t. If you believe you can, you will.

It’s an unpopular and rather inconvenient truth that we have choice, but accepting that leads to a far better life than believing everything is just chemicals.