The Dopamine Deficit Theory of Addiction
Updated: Jul 12, 2020
There are different types of addicts: (1) Those who are going through a difficult phase in their life who abuse substances as a coping mechanism to numb their pain; and (2) Those who experience chronic emptiness who are looking for something to fill that emptiness. The primary difference between these two groups of individuals is that the former is going through a phase and the latter has a chronic condition, typically a genetic predisposition (i.e., a chemical imbalance in their brain; a dopamine deficit).
What is Dopamine?
Dopamine is one of the brain’s neurotransmitters. It enables us not only to see rewards, but to take action and move towards them. It also helps with attention, learning, and emotional responses. Individuals who are genetically predisposed to addiction have less D2 dopamine receptors in their brain, which results in a dopamine deficit. Less dopamine means less reward, which means less motivation to accomplish daily goals and tasks.
Filling the Black Hole
Chronic addicts typically describe feeling like they have a black hole inside them that they need to fill with drugs and alcohol. The black hole they describe is probably the dopamine deficit in their brain. Drugs and alcohol deliver dopamine to the brain with instant gratification. Many addicts with this dopamine deficit will describe the first time they used drugs or alcohol as the first time in their life that they felt like the black hole was gone. The thought that follows is usually something like, “Wow, this is how I am supposed to feel. If I can feel like this all day every day, then I will be okay.” The problem is that the dopamine deficit is only temporarily corrected. As the drugs and alcohol ware off, there is a greater dopamine deficit than before; a bigger black hole that grows with each use. Thus, the addict gets stuck in a vicious cycle and needs more drugs and alcohol to continually fill the growing black hole. This is an unsustainable cycle that eventually results in catastrophic consequences. The good news is that there is a better way.
A Better Way
The key to managing the black hole is first accepting that it is there. As an addict with less dopamine, you will have to work harder than the average person to feel normal on a daily basis. You start most days with less dopamine than others, but you can fill your dopamine gauge by engaging in healthy activities. Yes, you can get dopamine from healthy activities and accomplishments, such as by exercising, socializing with others, completing tasks at work, taking a hot shower, drinking a cup of tea. Think of each healthy task in your day as dopamine gain. Each task you accomplish fills your dopamine meter. Each time you fill your dopamine meter with healthy activities, the black hole shrinks, but this time the black hole does not come back bigger when the effect wares us, such as the case with drugs and alcohol.
You may have to drag yourself through these activities in the earlier part of your day, but you will slowly start to correct the deficit. It may feel like you are walking through quicksand. You may feel like you have no motivation or desire to accomplish the goals that you have set for the day. The key is to put one foot in front of the other and slowly get through each task until the dopamine meter fills and you start to feel “normal” (i.e., your brain is not working from a deficit) again. Remember that some days will be worse than others, but that you have tools to correct the deficit, even on the worst days. Accept the crappy feelings and find comfort in knowing that you will feel better later as long as you take care of yourself.