
Chronic adversity dampens dopamine production - AdrienLemaire
https://elifesciences.org/for-the-press/49f3ac1d/chronic-adversity-dampens-dopamine-production
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PragmaticPulp
Interesting finding, but the headline doesn’t quite match the study. They
didn’t find that chronic adversity dampens dopamine production in general, nor
did they find that the stressed individuals had less dopamine than their
unstressed peers per se. They only discovered that dopamine production
differed between the two groups in response to a specific stressful task.

In other words, the chronically stressed individuals had a different response
to stress, which involved less dopamine production than that of their less
stressed peers. It’s not clear how much of this is actually a negative
adaption, as opposed to just being a different way of responding.

It’s also important to consider the context provided by the researchers in the
article:

    
    
      “This study can’t prove that chronic psychosocial stress
      causes mental illness or substance abuse later in life by
      lowering dopamine levels,” Dr Bloomfield cautions. “But we
      have provided a plausible mechanism for how chronic stress
      may increase the risk of mental illnesses by altering the
      brain’s dopamine system.”
    

With studies like this, it’s important to avoid the knee-jerk reaction that
you might need “more dopamine”. More is not always better, and we have decades
of research demonstrating that dopaminergic drugs are not great
antidepressants. When considering your own treatment programs, it’s important
to focus on evidence-based medicine and proven, sustainable treatments and
therapies.

~~~
c3534l
Measuring dopamine is a bit like measuring a person's heart rate. It could
indicate fear, or it could indicate sexual arousal, too much coffee, or some
other medical condition. People like to say things like "seratonin is the drug
that makes you happy," or "oxytocin is the drug that makes you feel love," or
"dopamine is the brain's reward mechanism," but those statements are
simplified to the point of being wrong.

This study is still pretty cool though, because it does point us in a general
direction. It can help explain why some mental illnesses like schizophrenia
have strong genetic components, yet also environmental factors like childhood
abuse. As you said, the reduced dopamine could be a good thing. But maybe in a
genetic minority it creates a neuro-chemical downward spiral. Maybe we could
prevent the development of schizophrenia by prescribing medication following
trauma. Who knows. It opens a lot of doors.

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ianai
Meds and, you know, talking to them for longer, more often, at earlier stages.

~~~
apatters
Sure. But the issue that needs to be solved with talking therapies is, how do
you scale them? Talking to a psychologist starts at $200/hr and the farther
you go down the ladder in terms of qualifications the lower the success rate
of the therapy.

Not everyone can afford this, whereas pills can actually be covered by
insurance.

~~~
raxxorrax
In time of depression I often recommend to start drinking. But if anyone comes
up with a better drug, it would be completely irresponsible to deny them this
opportunity.

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apatters
I actually think we do a great disservice to people who are dealing with
trauma by using alcohol because we stigmatize it instead of treating it like
what it is: self-medication.

It is just another thing a lot of people do to cope with stress, pain,
unhappiness etc.

In some ways it's effective, unfortunately it can also come with a lot of
nasty side effects like hangovers, damaged relationships, etc.

When you view alcohol as a medication you can then compare it to other
medications. The pharmaceutical antidepressants, anxiolytics etc. are far from
perfect, but they almost universally have less dangerous side effects than
heavy alcohol usage. If someone's using alcohol to cope there's nothing
intrinsically immoral or shameful about that, but if the side effects are
manifesting there's probably a better medication out there.

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hirundo
The College Board recently added an "adversity score" to the SAT that "will
reportedly reflect students' family income, environment and educational
differences" and hence help level the playing field. Maybe all of that could
be replaced by a measure of dopamine production. Rather than measuring
external correlates of adversity it could be an objective measure of the
actual internal experience.

I wonder how people would game that in order to increase their chances of
admission.

The concept of intersectionality seems to be an attempt to measure chronic
adversity using oppressed identities as a proxy. It could theoretically be
replaced by a more direct, objective measure like this.

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brodouevencode
I am not a fan of the adversity score. There are a lot of things kids go
through that don't make it down on paper: abuse/bullying, non-parental
involvement or incompetent parents, living barely out of poverty, etc. You
don't have to be a lesbian African American living in the projects to have a
shit life.

~~~
bsanr2
Would it surprise you to know that, looking back at my own life, my being a
gay black male had a lot to do with being subject to the things "that don't
make it on paper?" It's not too hard to imagine that I was bullied or put down
for not fitting the ideal straight male parameters, but the lack of parental
involvement is a fun one, which has been experienced by many seemingly stable
middle-class black families. The story is thus: academically high-achieving
black Boomers/Xers must take out loans to fund their education, without the
benefit of access to familial wealth or well-paying work during college (re:
hiring discrimination in the 70s, 80s, and 90s). This delays their entry into
the housing market until, say, the early-mid 2000s. Additionally, their career
advancement is stymied by the various forces that tend to hit black workers
harder - being the first to get laid off and last to be hired during and after
recessions; having more difficulty finding employers and mentors interested in
their growth; wage discrimination curtailing opportunity that may require
investment, like professional certifications or moving to a better job; having
to take less ideal, more stressful positions in order to prove worth within an
organization - meaning that there is less cash outside of the real estate
investment to cushion a fall.

I suspect that all this had something to do with how little support I was able
to get from them when I was applying for colleges in 2007. The stresses they
were experiencing - stresses which were, in their intensity, in that moment in
history, largely the domain of people of color - had material effects on my
ability to make my case to America's higher education system. They had too
much on their plate to help me, and no one knew anything was the matter
because we were a middle class family headed by parents with professional or
advanced degrees. None of the colleges knew that I was dealing with that - and
my sexuality, and the divorce, and depression, and body dysphoria - as I
groped my way blindly through the process, alone, high SAT score and decent
GPA from a STEM magnet program in hand.

My final choice and subsequent experience were resultingly lackluster, in
hindsight, and if someone involved in the process had known, maybe I could
have made better decisions. All this is, is acknowledging the subtractive and
deleterious effects some circumstances can have on this most important of
tasks, and taking action; in America, the simple experiencing of racial animus
is one of those circumstances, no matter how much portions of the country
harrumph about level playing fields and the past being the past. Here,
friends: look up, and see how the light of 30, 40, 50, 60 years ago glints off
the present.

~~~
brodouevencode
I hate that you had to deal with those types of trials, and really wish things
had been a lot smoother for you.

But, I'm not exactly sure what your point is.

~~~
bsanr2
Marginalized identity is directly related to the kinds of hardships that
parent claimed were not directly associated with marginalized identity (see
the first sentence). You generally have to go pretty far up the income/class
scale to find black lesbian who's better off than a given poor white man.

To put it a way most guys here will understand: how much more money does a
5'4" man have to make to get the same social and professional consideration as
a 6'2" man? Identity is not destiny, but at the same time, you'd be forgiven
for getting that impression from a glance at American society.

~~~
brodouevencode
> You generally have to go pretty far up the income/class scale to find black
> lesbian who's better off than a given poor white man.

In certain countries, I'm sure this is the case. In western countries I don't
think so.

~~~
bsanr2
It is very much so, especially in Western countries, where members of the
black diaspora tend to be found and are able to express LGBT identity without
fear of facing full and immediate ostracization (though violence is still a
risk). If you consider, for example, suicide risk a crude measure for (lack
of) life satisfaction, being LGBT reverses the black-white disparity (wherein
white people are more likely to commit suicide, considering the general
population).

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Apocryphon
On the subject of dopamine, we’ve all heard new colloquialisms that speak of
dopamine hits from webpages updating, notifications of likes. But has anyone
done research into it? To formulate some sort of biochemical model of internet
addiction?

~~~
PragmaticPulp
The colloquial use of “dopamine” is more metaphorical than scientific. Your
brain and body use dopamine in many different pathways for many different
reasons. For example, the tremors in Parkinson’s disease are related to the
degradation of certain movement-related dopaminergic pathways in your brain.

When most people self-diagnose as “low dopamine” or refer to addictive
behaviors as a “dopamine hit”, they’re not exactly referring to hard science.
Yes, dopamine is involved in motivational reward and anticipatory behavior and
dopamine is also key to the rewarding aspects of certain drugs, but the reward
system is much more complicated than a single chemical messenger. For example,
the opioid system plays an important role in reward as well.

In terms of treating addiction disorders, understanding the fine details of
neurotransmitters and reward pathways in the brain isn’t as relevant to
therapy as you might hope. The high level concepts and therapeutic methods for
changing people’s behavior don’t really depend on understanding how dopamine
or serotonin operate in the brain.

For example, with internet addiction it’s important to enable people to
understand why they are spending so much time on the internet. You need to
give them the tools to recognize their behavior, perform some introspection,
and intentionally take action to make different choices about how they spend
their time. Relating this back to dopamine or reward systems is only really
useful as a tool to make these mental models stick with the patients. If they
feel a sense of understanding, they’re more likely to feel a sense of control
over their actions, and in turn more likely to take action to change that
behavior.

~~~
refurb
Agree completely.

We already know what happens when you don’t have enough dopamine (Parkinson’s
disease - dopamine analogues are used to treat it) and too much dopamine
(schizophrenia - dopamine blockers are used to treat it). Saying more is
better is a major over simplification.

Dopamine is involved in a number of different neural structures that all have
different effects. Not to mention there are several dopamine receptors
subtypes that all have different actions.

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crb002
I can attest to this. ADHD (low dopamine) caused by chronic stress. On
Adderall XR 10mg to counteract it.

Symptoms that suck which adderall doesn’t fix is OCD (brain looping on stuff),
amphetamine caused anxiety (rarely but it sucks), and depression.

Steam room at my gym and hard exercise helps a lot. Need 8 hours of sleep.
Intermittent fasting in the AM. Caffeine is a hard dial to set right.

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taneq
Are you saying that chronic stress causes ADHD?

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chemeng
I should hope not. Chronic stress and PTSD do have shared symptoms with ADHD,
but do not cause it. ADHD is genetic and neurodevelopmental in origin.
Functioning and symptoms do vary with stress though.

Of interest though is that the causality does run the other direction, with
those who have ADHD at a higher risk of incidence for psychosocial trauma and
development of PTSD subsequent to traumatic events.

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helge9210
Prolonged stress exposure dampens response to stress?

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thedudeabides5
"The researchers found that other physiological responses to stress were also
dampened in this group. For example, their blood pressure and cortisol levels
did not increase as much as in the low-adversity group in response to stress."

Focusing on dopamine to try to predict negative outcomes seems weird here.
Sounds like a just as viable title could be "people who have been through real
adversity don't get stressed in trivial situations where someone calls them
names"

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HNLurker2
Farewell but I can cope in other ways like: smoking. Point invalid

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purplezooey
"Chronic adversity" is how I would describe a couple of the workplaces I've
been in

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xrd
It's always interesting when things are upvoted to the front page but no
comments. It makes to you think that this kind of article is resonating with
people who are fearful of commenting because the conclusions would contradict
a really powerful dogma in the community.

~~~
braythwayt
No, it makes YOU think this, because you have some fairly evident set of
biases around dogma in the community.

I find THAT more interesting than why an article could get upvotes but the
discussion might be delayed.

We all have biases. For example, when I read people who talk a lot about being
fearful of contradicting community dogma, I tend to anticipate that they will
be... Men who lean towards conspiracy theories involving women, minorities,
and "the left" being in control of society and forming "witch hunts" and "mob
justice," not to mention "cancelling people for wrongthink."

Of course, that has absolutely no bearing on who you may be and what you may
believe. Recognizing my biases is the first step towards banishing them.

~~~
xrd
I'm getting known as having biases, that's important to think about (that's
what I interpret what you are saying). I'm a fan of your writing on Twitter
and will definitely consider all you said here. For the record, I think my
biases lean the exact opposite of what you say you would assume they are.

~~~
chillwaves
It's interesting to me because I also thought the exact opposite in terms of
biases when I reacted to the parent's comment on your post.

I believe you were speaking to the dogma of the privileged SV coder elite,
which you were fearful of.

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zzzeek
all I am hearing about this week is dopamine. We did brain scan A on
population B (kids on screens, alcoholics, schizophrenics, ADHDs, you name it)
and saw their DOPAMINE WENT TO C!! It just seems quite odd that we can reduce
the well-being of the human spirit to just one single neurotransmitter. This
week I'm feeling like "we did an fMRI / PET scan on population X" is like the
new phrenology since I don't get the impression the structure of the brain is
so well understood that these scans point to some irrefutable facts about the
subjects being scanned.

~~~
BayesStreet
Absolutely, not only a single neurotransmitter but can have completely
different effects in different regions of the brain and most articles are
extremely reductive.

This study in particular though is very well done, just publishing striatal
dopamine and hopefully we'll see more studies like this in the future to piece
it together.

