Paying attention

IMPORTANT. READ THIS FIRST.

In this post, I’m going to be looking at biological stuff. After I finished writing, I realised that this could be easily read as advocating for a “cure” for autism. Nothing could be further from what I want to say. I don’t want to be fixed or cured. “Cure” thinking has done and is still doing so much harm to autistic people, that it almost stopped me from publishing this post.

However, I think the link between depression, ADHD, and autism could still do with some examining. Maybe we’re all part of a really broad spectrum. Maybe we’re all differently wired in a similar way. Maybe we can be who we are without feeling horrible or being made to feel horrible about it.

Maybe we aren’t alone.

© fotovika - Fotolia.com

© fotovika – Fotolia.com

In an earlier post, I wrote about how important it is for me to do things that activate my reward centre. I speculated that the lack of achievement in housekeeping was the reason my reward centre wasn’t lighting up with nice juicy dopamine, and so I didn’t have enough motivation to do any regular housekeeping. This is how recreational drugs work, and sex, and food, and any other pleasurable activity: they increase dopamine levels which in turn activate your reward centre.

The reason why I was thinking about rewards and dopamine is because since about the beginning of June, I have been really struggling in several areas of my life. I started a new job after being unemployed for 10 months, I decided to quit smoking, and I got referred to a mental health clinic for an autism diagnosis. Maybe a bit too much to cope with all at once.

But was that all?

Normally I feel pretty damn good whenever I manage to actually do something, even in my bleakest moments. Look, I did the dishes! The rest of the house is still a mess and I haven’t paid the bills in over two months, but screw that, I did the dishes! I’m awesome! Now, that sense of pride seemed oddly muted. Was this depression? It didn’t seem to be, I was feeling very overloaded with work and smoking and autism but not necessarily sad or down. Overwhelmed, unable to deal with sensory stuff, pretty normal for me in that kind of situation. The muted feeling was new.

And then I made a brain leap. That’s how it felt. My brain jumped up and landed in a different spot. A spot labeled “dopamine”.

You see, I was a very heavy smoker. Think 45-50 cigarettes a day. So when I decided to quit, I asked my GP for varenicline because I’d heard good things about it and figured it would be the support I needed in overcoming my dependency. It worked like a charm, the first day I used it I was down to 23 cigarettes and after 5 days I smoked about 8 a day. Instead of 50. And it didn’t cost me ANY effort. I just didn’t feel the need.

How does this work? Well, nicotine, like other addictive drugs, makes your dopamine levels peak. So there’s an instant reward when your nicotine receptor gets activated. Varenicline prevents this reward by making the nicotine receptor less sensitive, and at the same time mimics a low level of dopamine so you don’t go cold turkey.

So I was weaning myself off my dopamine addiction. And lowering my overall dopamine levels.

And suddenly I didn’t like alcohol as much. I didn’t pay my bills. I couldn’t keep my house clean. I hid in my bedroom. I bought things I normally never eat, like crisps and chocolate and cakes. I had a very low threshold for loud noises and bright light. I nearly broke down at the thought of having to take the train to work. I couldn’t focus on my work as easily as I used to do. I began compulsively refreshing my Facebook feed and email and rapidly switching from one browser tab to the next. I started stimming heavily (whereas I could have sworn I didn’t ever stim. Nope. Not me. Not stimmy at all).

I started thinking that maybe there was a blog post in this. So I looked up dopamine on Wikipedia, googled some stuff. And then I stumbled onto this.

We usually think of dopamine as a chemical messenger that is related to things like reward or drug addiction. But more properly, dopamine signaling has to do with salience, how important something should be to you at any given time. Dopamine spikes are associated with the pleasure of drugs or good food or sex, but they also say “PAY ATTENTION TO THIS”.

This is from an article called The Dopamine Side(s) of Depression and it looks at several behavioral studies done with mice to look at how dopamine works. Go read it. It blew my mind.

Because besides the “Pay attention to this” effect – which I’m starting to think could be part of why sensory processing disorders, for example difficulty to filter out background noise, occur so often in autistic people – the research also looked at the role of dopamine in social defeat stress.

You take a normal mouse, and put him into a cage with a bigger mouse. The bigger mouse “owns” that cage. He’s a retired breeder and very aggressive. He will usually launch himself right at the poor intruder mouse, beat him pretty badly, resulting in a “social defeat”. The mice are usually separated very quickly so the larger mouse doesn’t injure the intruder, but the defeated mouse is partitioned off in the case, where the aggressive resident can still threaten and bully the poor guy.

The mice that were given high level dopamine stimulation showed signs commonly seen in 10 day social defeat (less social interaction with other mice, less inclination to engage in pleasurable activities)… after only 2 days.

Let me repeat that for you. The mice that were bullied and beaten up showed signs of depression MUCH FASTER after giving them high levels of dopamine.

Are we on to something here?

Depression. Hyperfocus or the lack of focus. Unable to filter sensory input. Decision making (assigning priorities). Even motor skills are commonly linked to dopamine.

But social behaviour is a new one for me.

Can autistic people simply be part of the large group of people who are differently dopamine-wired?

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4 thoughts on “Paying attention

  1. This is pretty cool stuff to consider. I’ve primarily studied dopamine in relation to Parkinson’s disease, where dopamine generators fail and transmission is inhibited. The biggest problem with that in PD is the movement disorder: tremor, gait problems, rigidity, etc. From there it spreads to problems with mood (depression), personality (decreased executive function, so like problems with goal setting and paying attention), and memory. No good. And then of course there is the fact that it can be extremely painful, since your body just forgets how to process pain effectively. And really all of it is just screwy dopamine.

    I think the really interesting thing to keep in mind is that dopamine can go screwy in both directions, and neither is what you want. L-DOPA uptake is inhibited in Parkinson’s (or more accurately there just isn’t as much of it to go around), but there can also be big problems from increases, like you see in addiction to cocaine, speed, or even nicotine. A huge problem is the desensitization to dopamine, making withdrawal miserable like you’re describing. It can make you look a lot like a PD patient, or like your dopamine levels are way lower than they really are. But if there isn’t an addiction involved, and increased dopamine levels aren’t a response to a repeated stimulus, your body won’t necessarily desensitize, and crazy high levels can lead to things like photophobia and sensory overload (since essentially the dopamine isn’t saying “pay attention to this here important thing,” it’s saying “OMG everything you perceive right now is important!!”), and instead of nothing captivating your attention you start assigning equal importance to everything you see and hear, you lose the ability to “gate” or not encode every single detail as a long term memory (so it is as important to remember what color your professor’s belt is as it is to remember his lecture on the main facts of dopamine), and you can become paranoid or delusional (or both) because you can’t separate things that are relevant and true from random irrational ideas that pop into your head.

    This is not all necessarily super relevant, but I think it’s super interesting, and I just think it’s crazy how significant this one particular neurotransmitter is for defining a person’s personality and cognition, especially since very few neurons actually deal with it at all.

    /dissertation on weirdo obsession with neuro stuff

    • Thank you! I have no background in this stuff at all, so I’m really glad you’ve added some more information!

      It just seems odd to me that depressions are usually seen as serotonin-related, ADHD as dopamine-related, and autism as neither. Especially when you factor in the influence of dopamine in “social” settings like that behavioral study, it just seems to me there’s a lot of overlap.

    • Still working on that but it wouldn’t surpriseme if special interests trigger a dopamine hit as well. That would explain why it feels so awesome and relaxing to indulge in them, and why it’s so hard to stop doing them.

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