*I can’t believe I actually have to write this but* Is addiction a disease?

Yes. Now we can all stop reading. Thanks very much, please read again.

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Photo by Pixabay on Pexels.com

OK fine I will go into more detail, but seriously? Why is this even a question?

The definition of a disease according to Wikipedia: “A disease is a particular abnormal condition that negatively affects the structure or function of part or all of an organism, and that is not due to any external injury” well yep, I’d say that covers addiction wouldn’t you? Wikipedia goes on “In humans, disease is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, or death to the person afflicted, or similar problems for those in contact with the person”, wow it’s almost as if the person who wrote this broader definition did so with addiction in mind!

Still doubtful? OK what does the National Institute of Health say? “Recent scientific advances have revolutionised our understanding of addiction as a chronic, relapsing disease and not a moral failure”. That really gets to the crux of it, don’t you think? Because what people are really saying, when they say that addiction is not a disease, is that it is a choice, a moral failing. They see it as the individual’s choice to pick up a drug or a drink, that they could stop at any time if they wanted to. OK so let’s unpack that a little. Is addiction really a choice? Luckily, my research speaks directly to this question.

It is well established, and without dispute, that addiction is accompanied by particular chances in the brain. Some of these I have talked about on this blog already: the alteration in phasic dopaminergic firing from responding to the drug itself to the stimuli that predict it, and the long-term plastic changes in glutamatergic receptors in the nucleus accumbens to name but two examples. There are many more.

However, it is also true that all learning and memory changes the brain, and some have used this as their reasoning to say that addiction is not a disease after all. In particular, that other ‘neuroscientist in recovery’ Marc Lewis is a strong proponent of the idea that addiction is a memory disorder that is formed by repeated experience. I don’t dispute this, but I would argue that it does not mean that it is not a disease.

*Sciencey bit*

In addition to the changes I have already described on this blog, there are alterations in the striatal “action-selection” centres of the brain during addiction. To be specific, there are two parts of our dorsal striatum that control action selection the middle ‘caudate’ and the more lateral ‘putamen’. When we are in control of our actions, or our actions are voluntary and conscious, there’s a lot of evidence from animal studies, neuroimaging studies in humans, and more, that it is the caudate that regulates action selection.

Huntingtons

On the other hand, when actions are repeated over and over, in the presence of the same stimuli, they no longer become consciously controlled, but are instead involuntary, automatic, and habitual. At this point action control is transferred to the putamen.

*End science bit*

There are a number of consequences of this switch in control from what we call ‘goal-directed’ to ‘habitual’ processes. One of the main ones is that actions will be elicited in the presence of particular stimuli much faster than they would if they were voluntary, and under normal circumstances this is efficient. For example, right now I am touch-typing this blog post without any thought as to where the letter ‘A’ actually is, and if I start to try and think about where the letters are, it slows me down. This habit is adaptive.

However, in the case of addiction, habits can be maladaptive. This is because another consequence of action selection becoming habitual is the fact that, once habitual, the ‘goal’ or the ‘outcome’ of the action itself becomes somewhat irrelevant to whether the action will be produced or not. So when you hear someone say that they went to X place and ended up drinking/drugging, without even really knowing why or how they ended up there, chances are that it was a simple reflex, a habitual response elicited in the presence of particular stimuli without any thought for the consequences. This often happens outside of addiction too: when we automatically take a wrong turn because we are so used to turning left at a particular intersection, for example. At these moments, it is our putamen and not our caudate that is in control.

There is lots and lots of evidence that, in addiction, goal-directed control is impaired. What this means is that addicts have less voluntary control over their actions, and are more reliant on habits. When those habits are tuned towards drinking and taking drugs, well you can imagine the consequences: more drinking/drug-taking. So no, sorry, addiction is not a choice. Absolutely not.

The other thing I’d like to point out, is there are plenty of brain disorders that involve an interaction between a genetic predisposition to a particular disorder and environmental circumstances, that no-one would question the nature of whether they are legitimately a ‘disease’ or ‘disorder’. Individuals with a genetic predisposition to schizophrenia, for example, who smoke a lot of weed in adolescence, might end up schizophrenic. If either of those components had been missing: the predisposition OR the smoking weed, the individual might not develop schizophrenia. Does that mean schizophrenia is not a disease? Of course not! To take a different disease: there is evidence that individuals who do not look after their health generally, do not exercise, and do not perform cognitively demanding tasks are at more risk of Alzheimer’s. So again, there is often an interaction between a genetic predisposition and environment for an individual to end up with Alzheimer’s. Do we then say it’s not a disease because there’s often (although not always) an environmental component? Of course not.

The truth is, addiction is just like these disorders in the sense that individuals who have a genetic predisposition to addiction who are exposed to alcohol or drugs will often become addicts. Again, if either of these elements are missing: the exposure or the predisposition, an individual will not become addicted. Indeed, most people who drink alcohol do not have a genetic predisposition, and therefore do not become problem drinkers. Yet they still make the same choices addicts do initially: to have a couple of drinks. No-one sets out to become an addict. Therefore, to characterise addiction as a disorder of low will-power is simply ludicrous.

To those who prefer not call addiction a disease because they find it empowering and believe that it gives them a choice not to drink in recovery, that’s fine by me. Do whatever you need to do for your recovery. But I choose to exercise a lot, partly because I know it is neuroprotective against Alzheimer’s -that’s my choice, but it doesn’t mean Alzheimer’s is not a disease.

Having said all of that however, whether you call addiction a disease or not, the really, really important thing to remember is that addiction is not a moral failing, it is not a choice, and most importantly of all: you can make choices every day that will help you recover.

Learning how to “sit in my feelings” in recovery

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Photo by Kat Jayne on Pexels.com

 

This morning briefly reminded me of those mornings I used to start dreaming about drinking Sauvingnon Blanc around breakfast time. First of all my daughter wasn’t sure if it was fancy dress day at school today, and couldn’t decide whether to go in normal clothes or fancy dress: cue gigantic meltdown. Then my computer-illiterate husband starts swearing and getting frustrated at the computer when it turned off in the middle of his paperwork, losing what he was working on. Right in the middle of it all the chaos the dog starts to barking to be let out so he can pee and poo in his favourite spot up the street where I have to go and pick up after him, and I was running late. It made me think: life isn’t easy! No wonder people look to alcohol or other crutches to get them through! I am just so happy that I had been to the gym before all of this craziness descended, and that put me in a good enough mood to get through the morning without having a meltdown myself and, for the most part, with a smile on my face. I am so grateful that I have begun to learn the coping skills in sobriety that mean I don’t turn to meltdown in stressful situations.

Hello Again

So I’ve been gone a little while. Last time I left you guys I promised to try and get a bit more raw and vulnerable on the blog. I can’t say I’ve had any epiphanies or deep amazing thoughts about where to go with this blog or how to reveal myself in a vulnerable manner. One thing I have decided, however, is that instead of aiming for weekly blog posts I need to aim for monthly posts instead. This is the only way it is going to be manageable for me as I just have too much work to do in my day job. As for my personal journey I do feel like I am still learning and progressing every day, although rather than it being epiphanies hitting me all the time, the progress is a little more incremental now. But that’s fine too. Slowly, slowly in sobriety I am starting to build self-esteem, starting to believe in myself more, and starting to get over my imposter syndrome, all of which is a welcome change from the stuck record that was previously in my head for so long, telling me I’m not good enough.

Online Commenters (Trolls)

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Yesterday one of my more controversial blog posts was shared around a few places online, getting a bit of attention. Now I have been trolled a fair bit in my life prior to writing this blog whilst trying to advocate for science online (some of those anti-vaxxers can be cray cray!), so I can handle a bit of criticism and don’t tend to take most of it on board. Generally I don’t bother giving trolls oxygen, or only engage with them in a way that amuses me, but as a ‘once only deal, I will reply to a couple of the comments I received here. The ones I will reply to were those saying that I am in love with my intellect, or that I have a huge ego. I can have a huge ego it’s true – the kind of ego that a person with low self-esteem has, where they are going to solve the world’s problems alone on the one hand, and are deserving of nothing on the other. An ‘insecure egomaniac’ as my recovery coach calls it. Nothing special or different about that, and I’m trying to become more balanced.

Am I in love with my intellect? Well at this point in my recovery, I look at it this way: I have battled with low self-esteem and imposter syndrome for many years, and this was one driving force behind my drinking. In sobriety I have begun to piece together some self-esteem and some belief in myself so that now I think I’m in a position to say “Fuck yeah I’m in love with my intellect”. It’s pretty good. It’s helped me get pretty far in life, so I’m not going to sit here and tell you that I’m stupid when I’m not. Sorry (#notsorry) if that pisses you off, but it’s the truth and I have finally reached a place where I am comfortable enough within myself not to apologise for that. It doesn’t mean I know everything about everything, and it doesn’t mean I’m never wrong. I have changed things on this blog when inaccuracies have been pointed out to me for example, but I  only engage in this manner with commenters who are respectful.

Overall, I guess what I’d like to say to those people who feel negatively about the things that I write in the blog is that all I am doing here is trying to help people. When I got into recovery I couldn’t find many voices like mine – atheist with a strong adherence to science and evidence – so I thought why not put my voice out there for the others in recovery who feel like me? You don’t have to like it and you don’t have to agree.

I would also like to address some of the comments on my atheism for a second, as people seem to have plenty of thoughts about that. To the trolls on this issue: I am not you, and my reasons for my atheism are not necessarily the same as yours were before you got into recovery etc. Mine have a lot to do with believing in the big bang, evolution, the vastness of the universe (and if there’s an omnipotent power ruling over such vastness then what is the meaning of their life?), the fact that coincidences are statistically more likely to happen than not, and the fact that our brains are wired to detect patterns when they are not present (hence inferring the hand of God).

Working through Trauma

Finally, something I share in common with so many of you who are in recovery is some of the traumatic events I have been through in my past that had led me to drink. I talked about many of these today for the first time in a very long time to my wonderful recovery coach and this has left me feeling very emotional. But for the first time in recent memory, not only have I been able to ‘sit’ in my emotions, but I have actually wanted to. I haven’t wanted to run away and escape from them, but rather have just let them wash over me in a way that wasn’t necessarily effortful or effortless. Mainly I have known that I am just processing them in both a conscious and unconscious manner. Most importantly, until writing this blog right now, the thought of drinking didn’t even enter my mind, and this is real progress.

So overall, between the crazy morning, the trolls, and the trauma, I experienced a lot of triggers today. But I didn’t drink, and I didn’t even want to drink. This is real progress, and I think I might finally be growing up – not actually to the point of being a proper adult yet, but maybe 15 or 16 instead of 13 😀

 

Getting Personal in a Time when #timesup

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Photo by Alex Tim on Pexels.com

 

I watched ‘Nanette’ by Hannah Gadbsy on Netflix last night, and WOW WOW WOW! What a show (if you haven’t seen it I have tried to keep spoilers out of this post). I have to be honest, I was a little apprehensive about watching it beforehand, based on a couple of reviews I had read. I mean, I like to think I’m pretty ‘woke’ an all, but sometimes I’m just… tired (ironically so it turns out, so is Hannah). I had heard that Nanette was bang on message for many current ‘woke’ issues, and sometimes I just get a bit of fatigue with it all (‘woke fatigue’?). I know that it is part of my privilege that I am able to get fatigue about these issues, and as a middle class white woman I’ve certainly had my fair share of privilege. Nevertheless, I just wasn’t sure if that’s how I wanted to entertain myself after a long, hard day at work then being a mum etc. But damnnnnn, Nanette was worth it.

One area in which the odds have been stacked against me somewhat, and I can relate to being an underrepresented minority, is in my career. Neuroscience, and behavioural neuroscience in particular, is very top heavy with white men. That is, although most of the graduate students and people in the early phases of their career are female (I’m not sure of the exact numbers, but I’d estimate at around 70-80% female), the further you get up the career ladder, the more those numbers switch around completely. By the time you reach Professor level, the numbers are approximately 80%+ male. Representation of other minority groups is even worse, and those of us working in science have a lot to do to make things fairer and more equal.

What does this all have to do with drinking or addiction I hear you ask? Well a number of things. Before we go on, I would like to say that I know these are first world problems, but they are still problems, and did feed into my addiction nevertheless. One of the reasons I drank was because I think that as a female striving to make it in this field, I felt highly visible in the sense that each time I go to give a talk, I feel the weight of various expectations on me based on how I look (i.e. that I won’t be that smart). I have also experienced things like giving a talk and having all questions about my research being directed to my (white male) supervisor. I have been overlooked a number of times in favour of males when trying to ask questions at conferences, something I see happen to other females all the time. I have been told that people think I don’t understand my own research. I have had grant reviewers pull me up on ‘gaps’ in my track record, that they extended to 3 x as long as they actually were and having completely overlooked the fact that I had given birth to a WHOLE FRIGGING HUMAN BEING the year before and had been on maternity leave. I have had other grant reviewers question the contributions I made to my first author publications relative to my (white male) senior author. I have been told that I need to have a thicker skin and get over all of this. Put the pressure of dealing with all of this on top of all the other immense pressures brought on by such an intensely competitive career choice and it’s a potent mix, ripe for self-esteem issues and you guessed it… drinking.

As I said, I know these are first world problems. They are far from the worst problems I have ever had to deal with in my life, but that doesn’t mean that they don’t matter and that they are not important. They do and they are.

Well I am emboldened by Hannah Gadbsy, and I am sober now, and I’m not gonna take this shit any more.  Because I have advanced in my career somewhat now, I don’t tend to get overlooked when trying to ask questions at conferences so much anymore, and I don’t get people making as many inaccurate comments on my grant reviews. But that doesn’t mean the unfairness isn’t there any more for other, younger females. I also really hope that I can help the young female scientists navigate their way through it the way that some of the badass female neuroscientists I know have helped me. I know there are also some fantastic men in my field who are also well aware of these issues and are fighting to make things fairer and more equal, and I totally support that too. And if someone tells me to grow a thicker skin then they might be told which improvements society could make to be more supportive of female scientists.

I am so glad I sobered up at this point in my career. I think I had a lot of shame, I certainly had low self-esteem, and I took these negative things people said and did personally or thought that I had done something wrong. But my head is clear now, and I can see clearly.

I can see clearly now

What does this have to do with Nanette? Well the reason I found this show to be SO incredible, was not anything to do with it being so zeitgeisty, but rather because it was so raw and honest and vulnerable. Damn Hannah, your emotions were real and you made me feel. I didn’t agree with everything she said, but that’s OK. We’re adults and we can still be friends (can we Hannah? Please?).

It also made me think about this blog and what I am doing here. I wanted to start this blog so that I could start a dialogue with the recovery community, and I sat back and thought for a moment about how well I have been doing at that. I start thinking about whether I was really connecting. Have I been my most vulnerable and honest self? I certainly haven’t been dishonest, and the topics that I have covered have been interesting and important to me, but something was niggling at me.

Then I came across a podcast interview with Prof. Alan Jasanoff, author of the “The Biological Mind: How Brain, Body, and Environment Collaborate to Make Us Who We Are”. Very interesting interview, give it a listen if you have time. Again I didn’t agree with everything he said (I guess I can be quite disagreeable sometimes!) but one point that he did make got to the core of something that was niggling at me. It was this concept of ‘cerebral mystique’. This is the idea that the brain is not some distinct, unknowable entity, but although complex, is essentially a part of the body it is attached to as well as the environment it experiences.

It was exactly this mystique that I wanted to tackle in my blog. I wanted people to realise that the brain can be knowable and although it is unimaginably complex, we also do know a lot about how it works. I wanted people to know that it is not just drugs that change the brain, but our experiences, learning and memories all change the brain as well. I wanted people to know that even though the names of particular parts of the brain sound big and scary, in the end they are just names – names like ‘arm’ or ‘leg’ or any other part of the body. When you know the names of the brain parts this mystique recedes a little bit. And if we realise that experiences can change the brain, just as drugs can, then I think this can feel very empowering.

Other than that, I also want to figure out how to be vulnerable and how to put the ‘real me’ on the page. I really struggle with this, as I know many other people do, but, as the famous Australian saying goes “I ain’t here to fuck spiders”. In other words, I’m not writing this to half-ass it, I want to be vulnerable and I want to give you all of me. But I need to figure out how to do that, so after this post I’m gonna take a little break and re-assess. Thank you all for reading so far.

Should I Smoke Marijuana in Recovery?

 

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Using Marijuana in Recovery

I don’t really like smoking weed. Those who know me might be surprised to hear that, because I have given it a really good nudge in the past. I think sometimes I would smoke it just to feel something other than sober, or because I was hungover, but I never really like the high. I certainly never liked it as much as alcohol.

In my younger days I would smoke weed in cars or parks and stuff, and I would always have to be the last person out of my friends to smoke because as soon as I did I was immediately convinced the police were going to come and arrest us – much to the amusement of my friends. As I got older my paranoia would move on to believing that people were talking about me, or laughing at me, or other paranoid thoughts. One time I may or may not have even been a little bit scared that aliens were coming to get me from outer space (sadly not even joking). I have smoked weed a couple of times since I quit drinking, just to make sure that I reeeeaaalllly don’t like it. However, I finally admitted to myself that I don’t like it several months ago and stopped for good.

But other people do like it. It doesn’t make them feel paranoid, it makes them feel relaxed. Some people believe that it is not as addictive as alcohol and other drugs, and not as damaging, so some people substitute it for their drug of choice. Well I have no judgement on people who choose to do that – I can’t tell you what’s right for you. But I can tell you the facts, and they do seem to suggest that it isn’t quite as harmless as many would like to believe.

Cannabis and the Brain

*Warning sciencey bit*
There’s actually still a lot we don’t know about the effects of cannabis on the brain. This is one of the reasons I tend to be sceptical when I hear claims that it is ‘harmless’ and not linked to mental health disorders etc. The latter claim in particular, is demonstrably untrue, because cannabis use is strongly linked to schizophrenia, as well as several other mental health disorders, particularly amongst those who smoke heavily during adolescence. However, it’s not entirely clear if the evidence is causal or correlational (in other words, does smoking weed cause schizophrenia, or does schizophrenia cause smoking weed? Perhaps those affected are more likely to smoke to get relief from their symptoms. I don’t think science has answered this – but happy to hear about it if I am wrong). One thing that is pretty clear, however, is that smoking weed is not good for the developing/adolescent brain. So if you’re a teenager, then you probably just shouldn’t smoke weed.

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As for what we do know about marijuana’s effects on the brain; well the active ingredient in cannabis is THC, and it is this that binds to cannabinoid receptors (specifically CB1 receptors). This has been linked to increasing ‘magical thinking’ and ‘imagination’, but I think at a fundamental level it really just magnifies your thoughts. So whatever the basis is there for already gets exaggerated. It also releases dopamine and norepinephrine, which can lead make you feel good or anxious, depending on several factors.

At a circuit level, marijuana can affect CB1 receptors in your hypothalamus, messing with satiety signals and hence giving you the munchies. It can affect your amygdala that regulates emotions and basal ganglia linked to decision-making. We’re not really sure why it has different effects on different people, but my assumption is that it builds upon the foundation that is already there. For me, because I am already quite prone to anxiety, smoking weed can amplify these thoughts and feelings and lead to paranoid thoughts. Of course it also affects your cerebellum which regulates movement and coordination.

Smoking marijuana also affects the hippocampus, although this possibly occurs primarily through neurotransmitters other than cannabinoids. This brain region is central to learning and memory. In particular, it is important for those memories of the things that you experience, rather than memories that have to do with learning facts about the world or learning skills. This is why if you smoke weed often, your memory can tend to be quite hazy (alcohol also affects this part of the brain, so if you drink and smoke, you might be particularly forgetful!).
*End Sciencey bit*

Should I Stay Away from Marijuana in Recovery?

I just don’t think that there is a ‘one fits all’ answer to that question. If you smoking weed sparingly (not every day), whereas you used to shoot dope every day, and your life is all the better for smoking, then I don’t think I should be the one to tell you to stop. Especially if you do stop and your life goes to shit again, that’s not going to do anyone any good.

I should also make it clear that I am not referring to medicinal marijuana for anything other than addiction here. The science is really very preliminary with regards to medicinal marijuana, despite what a few loud voices over the internet might have you believe. Therefore it is totally possible that smoking weed might be helpful in overcoming nausea for cancer patients undergoing chemotherapy, for example. There’s also cannabidiol that does not contain THC, which might be particularly helpful in treating a range of conditions. I am not speaking to those uses of marijuana here, I believe with regards to those we should go with what the science says. I am only speaking to the addict in recovery who is thinking about substituting their drug of choice for marijuana.

In these instances, my worry is that the person who substitutes one drug for another will not adequately address the underlying issues that led to their addiction in the first place, and then end up addicted to a whole new drug all over again. I have heard of this happening to a number of people in recovery. And yes I do think marijuana is addictive, psychologically at least. It might not induce tolerance and physical dependence in the same way as alcohol and heroin etc, but it certainly contains perceived value that can be imbued in its use and everything associated with it. That alone can produce a physical reaction in the brain and, over many learning episodes, a psychological need for the drug. It’s also a little worrying that if you are smoking weed you are still partaking in a mind-altering drug that could lead back to your drug of choice. Also if we take what we know about marijuana’s effects on the brain into account, then it just doesn’t seem to be as harmless as advocates would have you believe. Several lines of evidence now suggest that the damage from smoking heavilly over a long period of time can be long term.

So in short, my answer is that you probably shouldn’t smoke weed whilst recovering from other addictions. But as I said, I never liked it much anyway so the decision may have been easier to make for me than for others.

I’m sure there are bound to be those who disagree with me on this one, so feel free to let me know what you think. I am here as much to learn as I am to impart the knowledge that I have.

Big Pharma, Industry, and the Study of Alcohol: A Scientist’s Perspective

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Oh Frigging hell.

A $100 million study titled “The Moderate Alcohol and Cardiovascular Health Trial” was recently pulled because of corruption and credibility issues, resulting from collusion between Alcohol industry executives, scientists, and government officials.

Frigging hell.

But before I get to that…

Big Pharma Tangent and Sticking up for Scientists

I started this blog for many reasons, one of which was to try and give a different perspective to the way that scientists and scientific research is portrayed on social media and certain other circles on the internet. What I mean is that there is a general distrust of big corporations, of ‘Big Pharma’ and so on and so forth, and sometimes scientists get lumped in with that. We can be seen as pawns working for pharmaceutical companies, exploiting people for profit, or altering findings in order to earn money for shareholders.

I get it! I really do. I look upon the role of drug companies in the US in the current opiate crisis with as much horror and disgust as anyone else. It is awful that people are dying and lives are being ruined every day, all because of greed.

But to speak for myself for a second, and for my colleagues, and for the vast, vast majority of scientists I know, I would like to say that most scientists I know are good people, who got into this biz because they want to help others. I know I did. Like myself, most of the scientists I know don’t work for pharmaceutical companies (although plenty of good scientists do), they work for Universities and Institutes. Most scientists I know work on their own ideas funded by competitive grants with no vested interest in particular outcomes. We are just trying to find out what the brain does, and we don’t argue with the data. Most scientists I know have never had anyone tell them what to study, ever, or had anyone put pressure on them to produce results in a certain direction. Most scientists I know have never knowingly been compromised or misrepresented data. I certainly haven’t.

A Lack of Trust

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Despite all of that, however, there is still a general distrust of the scientific community, and the recovery community is particularly vulnerable to this. Although this makes me a little sad, it makes sense. Those in recovery are those who have lost so much because of drugs and alcohol, and their addictions may have started with a prescription, or succumbing to societal and advertising pressures to drink, and when these things are seen as being linked to scientists, it is understandable that we would be looked upon with distrust.

But scientists and industry/big Pharma are not one and the same, and they’re not all bad. There are so many of us out there, working hard to try and make things better for people.

A Setback (back to Frigging hell)

With all of that in mind then, it was more than disappointing to read about a recent $100 million study involving over 7,000 participants examining the possible health benefits of drinking alcohol being shut down because of corrupted interactions between individuals in the alcohol industry, scientists, and government officials. Disappointing on so many levels. It is events like this that make it difficult for the general public to trust scientists, and make it tempting for people to tarnish us all with the same brush.

I must be clear for a minute, however, that when it comes to science and the study of the effects of alcohol or drugs, scientists MUST approach that the data for what it is. As much as my life has unimaginably changed for the better since I have quit drinking, that doesn’t mean that this is the same for everyone, and it doesn’t mean that moderate drinking is bad. If the data shows that moderate drinking is healthy, then we have to go with what the data says, whatever our personal feelings are on the matter. We have to be unbiased.

Of course, as it turns out, there are plenty of studies showing that even moderate drinking can actually be bad for us, especially in terms of raising the risk of cancer (alcohol is a group 1 carcinogen), and more recently dementia for example. This information was produced from good studies conducted by good, uncorrupted scientists, in the aim of trying to help us become a healthier society.

Therefore, I am as disgusted and as horrified as anyone else that this large study has been corrupted, that people’s trust has been betrayed, and so many people’s time and money has been wasted. I can’t imagine how it must feel for the scientists involved with the study who were innocent – and there were many because they were the ones who worked diligently to expose those that were colluding with industry. I would also like to note was scientists at the National Institute of Health and the National Institute of Alcohol Abuse and Alcoholism that shut down enrolments into the study and eventually investigated and exposed the corruption.

So we’re clearly not all bad.

But we have to do better.

Scientists Have to do Better

As scientists we are privy to a certain way of thinking. For example, if we see reports in the media of a study showing that ‘drinking red wine is as good as going to the gym’, for example, we would usually know to take this with a large grain of salt. Specifically, because of our extensive years of training in how to critically evaluate information, we know that things like a) the findings of the study are likely to be much more nuanced and complicated than have been reported (in the linked study, for example, participants were fed resveratol, an ingredient in red wine, not red wine itself), b) one study alone generally doesn’t prove very much, rather what is important is the convergence of evidence from many studies, and c) we can make informed assessments about the likely quality of the study based on the journal it is in, and how likely it was to have involved conflicts of interest (such as industry funding from a partner that has an interest in seeing certain results). We can know all this information quite quickly upon reading an article. But the general public don’t study science for around a decade like we do, and then go on to live and breathe science every day in their jobs like we to. So we have to do better.

As scientists, we need to ensure our results are being reported accurately, and to ensure that hyped up results are put into their correct context in a way that is jargon free, and easily accessible. Hopefully this way, we can start to install trust in our profession again. We also need to talk to people, to start a dialogue. Not to sit in our labs and talk to other scientists all day, but talk to the real people that are living the issues (e.g. addiction, dementia, mental health disorders) that we are studying. I should note that there are plenty of scientists already doing this – the conversation is a good example. But there’s always room for improvement, and in the words of the great Michael Jackson “I’m starting with the (wo)man in the mirror“, starting with this blog. Even in the short time I have been writing here I have learned so much about the opinions of non-scientists, how to communicate my ideas more effectively, and so on. But I still have much to learn.

Progress not perfection eh?

Sunsets in Recovery: Something I can’t explain with science

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It has been a massive week. HUGE! Usually I would have written this post a few days ago and then spent a couple of days editing it. This week I am late and there will be no time for editing. Straight from my brain to the page.

It has been a massive week because of work, but also because we went away for the weekend. One thing I appreciate very much since getting sober, and something that seems to be pretty common among those in recovery, is an appreciation of nature. So I was really looking forward to going away for the weekend, getting away from the traffic and busyness of the city, and spending some time in nature. Unfortunately it rained pretty much the whole weekend.

Today was sunny though, and as I was hanging out the washing I turned around to see the most beautiful sunset, and took a few moments to appreciate it. This is something I don’t remember ever doing when I was drinking – back then it was as if I just didn’t notice the world around me. Possibly I simply wouldn’t have been out hanging washing at that time because I would have been inside drinking, so I just didn’t have the same opportunities to appreciate nature. Now if I’m angry, or frustrated, or just feeling waaaaay too many emotions (y’all in recovery know what I’m talking about!), taking a walk and getting among nature is right up there as one of the best things I can do to work out those stresses, along with exercise and writing about it.

Going for a walk has saved me from drinking a number of times. I remember the first BBQ I went to after I got sober, and I found myself getting really agitated. Everyone was fine (my friends actually accept the fact that I don’t drink anymore – they are far more grown up than I ever used to be) but I was getting antsy. Then I thought, why not just go for a walk? So I did. I walked and walked and walked until I stopped on a bridge, and saw the most spectacular sunset I had ever seen. It was mesmerising. It even made me understand for a second why people could feel that there was a higher power guiding them, sending them messages and so on.

When I saw that spectacular sunset in early recovery, I certainly felt a sense of connection with nature, but for me this was not necessarily spiritual. I am sure there is a scientific reason out there for this feeling, and that it is discoverable, but I haven’t come across it myself. Indeed at the time, I tried to think of scientific ways I could make sense of this connection. For example, I reasoned that everything in nature is connected in a sense, as everything living shares a certain amount of DNA. But the sun doesn’t have DNA. And even for things that do, what is the mechanism by which shared DNA might make us feel connected?

At the end of the day though (see what I did there? The end of the day! That is when we see the sunset!!! Ah ha ha ha ha ha ha. Just me? OK just me), it doesn’t matter why. It doesn’t matter what the mechanism is, the most important thing is that we feel that awe of nature, or some type of connection when we need to. And that we don’t pick up, of course.

So that’s it for this week. No ‘sciencey bits’ as I really have no knowledge of any science that speaks to the fact that we didn’t notice nature in addiction but do in recovery, and I haven’t had time to research any. Happy to hear about it if anyone knows of any studies? Or your personal theories! I’m super busy so I can’t promise extremely detailed responses, but I will read I promise.

Have a great week 😀

 

Overthinking and Drinking

 

overthinking

If you’re anything like me, then there are times when you start thinking about something…. then something else… then that same thing you first started thinking about again… around and around in circles without getting anywhere and you wish your brain would just shut the hell up! Especially at night when I’m done with work and chores for the day, and all I can think about is what I have to do at work over the next few weeks, all the chores I haven’t gotten around to yet, that bill I haven’t paid, and the fact that it’s library day at my daughter’s school tomorrow so I must remember to put her library book in her school bag. Fun.

Then there’s the longer-term and more serious kind of rumination (basically a fancy term for overthinking) that my brain appears to involuntarily indulge in. I am definitely a ruminator. I can have conversations with people and still be thinking about something stupid I’ve said hours later and what I should have said instead. I also ruminate about work. A scientific career is one ripe for rumination: about how I’m not good enough, how I should have X many publications and grants by now, how people are going to rip me apart next time I give a talk, how people don’t take me seriously because I’m female in a still relatively male dominated field, how if they do take me seriously then they end up finding me pushy or arrogant or resting bitch facey.

If you like being happy (because so many people love being sad), then rumination is a problem. In fact, it can lead to quite serious anxiety and depression. Or maybe it’s caused by anxiety or depression, or maybe its both caused by it and causes it. Regardless, it is highly correlated with anxiety and depression.

This is why alcohol can be so appealing for people who like to overthink. Just a few sips of alcohol and suddenly, all those unnecessary extra thoughts go away. You get to be present in the moment and stop worrying about tomorrow, as put so elegantly by Sia in her song Chandelier: “IIIIIII’m gonnna swing from the chandelier…. I’m gonna live like tomorrow doesn’t exist”. A kind of alcohol-induced mindfulness.

*Warning sciencey bit*

Like most things (everything) in life, there’s good reason why alcohol helps us quiet our thoughts. This is because it is a GABA A receptor agonist, meaning that it activates GABA receptors, and GABA is the primary inhibitory neurotransmitter in the brain. Activation of these receptors therefore causes hyperpolarisation of the neuron. In lay terms, it means that alcohol makes the neuron less likely to fire and therefore slows or reduces its communication with other neurons. This is similar to what anxiety medications such as Xanax or valium (or other benzodiazepines) do. (As an aside – some neurons that release GABA are known as “chandelier cells”. I wonder if Sia knew this when she wrote her song?)

Ethanol_and_GABA_Receptor.png

These effects of alcohol on GABA are further compounded by the fact that it seems to suppress glutamate, the main excitatory neurotransmitter of the brain. This is another way in which alcohol depresses neural transmission. Thus when people say that alcohol is a depressant, and they don’t mean that it makes you feel depressed, they actually mean is that it slows neural transmission. In fact, because it can cause your brain to shut the hell up for a second, it can make you feel happier, especially for those prone to rumination.
*End sciencey bit*

It is this reduction of neuronal excitability that makes alcohol particularly appealing for overthinkers like me. All those thoughts, worries about what you said yesterday, about what you have to do tomorrow etc, get dampened down and all that neural noise just shuts down for a little while. Want to sleep? Just lay your head down on the pillow…. And voila. Sleep. Aaaaaah bliss.

But there’s one more piece of this puzzle that I haven’t explained yet, but that is really key. Alcohol only shuts your brain up for a little while.

What happens when the drunk feeling goes away? The overthinking and anxiety and depression come back stronger than before. The thing is, the body and brain don’t like being artificially ‘thrown out’ of their normal state of equilibrium by alcohol or any other drug, and it will fight to get back to where it was when the alcohol wears off. This means that although when you are drinking all that neural noise shuts up for a minute, the next day it comes back harder, stronger, and more forceful. Not only that, but you are now possibly also dealing with a hangover so you are overthinking whilst your body feels like shit. Not only that but you also have to deal with the very possibly stupid things you did last night that you regret, or have the vague feeling that you might have done something stupid but you can’t remember. I certainly spent many ‘next days’ trying to piece together what I said to whom, or did the night before (getting in bed with my parents naked anyone? Nope just me).
Of course, because alcohol can make your brain shut up for a little while, many people who suffer rumination in anxiety and depression are drawn to drinking it. But then when the effects of it wear off the next day, you feel more anxious, and if you’re like me, you drink again to get over it. Before you know it BOOM you have both anxiety and a drinking problem. FUN FUN FUN!!

When I got into recovery, I was very pleasantly surprised to find that many of my anxieties just went away by themselves. At social events I stopped forgetting what I said to people, and was more sure of what I did say because it was under my control. Therefore I didn’t need to ruminate over it later. I also just learnt to put the thought out of my mind before giving into rumination. If I start thinking about the stupid thing I said to someone, I just immediately counteract that thought with “that person will not still be thinking about it, so you don’t need to”. Sometimes this works better than others of course, but ya know. Progress not perfection. At work too, I’ve found that I believe in myself a lot more. I also work harder and my thoughts are clearer, so that helps a lot. Plus I have been more successful at work in sobriety (who knew right?) so I have received positive reinforcement from my successes.
The one final thing I will say with regards to overthinking is that, in sobriety, I do think it is very important to find some kind of mindfulness in life so that you have a certain amount of time each day when you are completely absorbed in a task and not thinking about what you have to do tomorrow or what you did yesterday. Science has shown that we are happiest when we are totally absorbed in a task. I have never been particularly good at meditation or tried particularly hard to get good at it, but that’s one avenue that a lot of people swear by. The science about meditation in particular is overall a little mixed but certainly there’s some positive studies and plenty of anecdotal evidence out there suggesting it works. What works best for me, however, is exercise, particularly vigorous exercise at the gym with other people. When I am working out, my mind is completely focused on how many reps I’m doing/what weight I’m doing/how gassed I am etc. Working out with other people also provides a social aspect, and lots of people who aren’t that into drinking go to the gym. Exercise is also amazingly good for your brain and general fitness etc. I really couldn’t have gotten sober without it.

So whatever you do in sobriety, my advice is find something to do that helps you shut your brain up for a second in a healthy way. Exercise, meditation, singing at the top of your lungs, or even watching a scary movie. All great things to do with the added bonus of not producing a hangover tomorrow.