No Dopamine No Dice

Have you ever had the urge to just slap somebody? Like maybe the jackass driver in the lifted diesel pickup truck who “rolls coal” all over your just-washed-by-hand white car. Or more likely here in open-carry-stand-your-ground South Carolina, you might be able to chase the truck down, pull out your pistol, and shoot the jackass driver . . . if he doesn’t shoot you first. (A similar incident happened down state in Horry County where these two recently enacted laws collided leaving one driver dead, another driver and his sidekick under suspicion, and two trucks full of bullet holes.)¹ Anyway, that urge you feel, that desire to engage another person in anger, that sense of anticipation comes from dopamine. Anger can be an addictive vice too.

I write a lot about dopamine. You might think that I am obsessed with it, but I am not. Well, not really. I am one of the more fortunate survivors. My progression from having a dopamine deficiency disorder (i.e. Parkinson’s Disease) has been a shallow descent over the past 20 years.

While each Parkinson’s patient has their own unique symptoms and progression, the overall experience is much different for those diagnosed while still young (say, in their 30’s) as compared to those who are diagnosed later in life. My Parkinson’s progression reminds me of the hunger stones found in the rivers of Germany back during their drought with the stones being my symptoms and the subsiding water my dopamine levels.

Many people think that dopamine fuels feelings of satisfaction. The much discussed dopamine hit that we get from scrolling on our smartphones. If dopamine gives satisfaction then why do we keep scrolling?

Instead of satisfaction, dopamine fuels desire. I can still remember how if felt to be in my late 20’s, the anticipation, the possibilities, the wanting of it . . . whatever it was. I also remember being intensely angry about the state of things, but now not so much.

Researchers had long considered dopamine to be the brain’s pleasure chemical but further studies suggest that a more accurate description is that dopamine is the brain’s chief desire chemical.

The Molecule of More: How Your Brain Drives Love, Sex, and Creativity — and Will Determine the Fate of the Human Race.

Despite what many believe, dopamine isn’t the molecule of pleasure. It’s the molecule of desire, of anticipation. It doesn’t seek contentment. It doesn’t reward satisfaction, and it doesn’t care about happiness. It only cares about the next step, the next reward, the next best version of you.

An article from Scientific American entitled Dopamine: The Currency of Desire better reveals the dark side of dopamine and its imitators.

The article begins with a discussion about Mirapex, a sort of artificial dopamine developed back in the late 1990’s, and the side effects that it had on Stephanie, a 29 year old Parkinson’s patient. While her movement improved from taking the drug, her non-motor side effects were terrible. They included compulsive gambling, compulsive eating, compulsive shopping, along with sex addictions. Granted, these side effects weren’t initially known but were revealed as patients and their caregivers began noticing the compulsion problems. Still, you would have thought that the FDA could have picked up on that.

I was prescribed Mirapex early on in my diagnosis but escaped the compulsive addictions. I was one of the fortunate ones. However, I remember being more impulsive than my normally reticent self ever allowed me to be. Mirapex may be the reason I jumped into politics with little warning. I changed neurologists and she prescribed proper levodopa to me at much lower dosages. In any event, excess or erratic dopamine surges can cause patients to do the wrong thing even when it feels right.

While taking dopamine agonists, Stephanie was certainly aware that her priorities had shifted in uncomfortable ways—but at the time she accepted this because her addictive behavior seemed, as she put it, like “the right thing to do.” Our feelings, in a sense, are decision-making algorithms that evolved to guide behavior toward what was historically most likely to promote survival and reproduction. Pleasure can cue us to repeat activities such as eating and sex; fear drives us away from potential harm. But if the brain regions that determine what you value go askew, it can be extremely difficult to change your behavior because these areas will make you “want” to continue and will also make the addictive behavior “feel” right.

Can we always trust our feelings? Apparently not even though Stephanie was aware that her behavior had shifted. With awareness comes responsibility.

When Stephanie stopped taking Mirapex, all her addictive desires and behavior vanished overnight. In fact, not only did she no longer find her iPhone or buying lottery tickets attractive, they seemed at best of little interest or even actively repellent. She also lost the weight she had gained without much effort. Indeed, Daniel Weintraub, a psychiatrist at the University of Pennsylvania, says that her experience is typical of Parkinson’s patients who develop impulse-control disorders while taking dopamine agonists, which is roughly 8 to 17 percent of people taking such drugs. The fact that stopping these drugs can end addictive behavior so abruptly and decisively shows how critical dopamine is in driving it.

So, no dopamine, no dice? It appears so.

If dopamine driven desire leads to temptation, does the lack of dopamine lead to virtue? Remember the seven deadly sins and their curative virtues? We will review those and the impact of desire in posts to follow.

As Alexander Pope might have said: To have dopamine is human; to not have dopamine is . . . Divine?

1. Further proof that when alcohol, guns, standing your ground, pick-up trucks, and the Southern male ego collide, death and stupidity ensue. Now where is my old copy of the SC Code Duello?

https://wpde.com/news/local/south-carolina-stand-your-ground-castle-doctrine-law-explained-scott-spivey-murder-deadly-force-self-defense