
Why Dopamine Makes People More Impulsive - neurosphere
http://knowingneurons.com/2016/03/10/dopamine-makes-people-impulsive/
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y0y
This is really fascinating to me.

As someone with adhd, my psychiatrist has explained it to me in terms of
Dopamine. In his words, stimulant medications help to treat symptoms of adhd,
in part, by creating dopamine when we either lack it or have a weakened
response to it. This flood of dopamine keeps us from being impulsive, in his
explanation.

In other words, I am _more_ impulsive without stimulants and the explanation I
was given is that my brain is too busy seeking out dopamine and thus always
looking for excitement. By providing dopamine through medication, that seeking
behavior diminishes and I am more focused and less impulsive.

So, something doesn't add up. Either my psychiatrist has been misinformed or
there is a lot more going on here / my understanding is very off base.

~~~
chrischen
From what I understand your description is also experimentally validated.
People on ADHD medication become like zombies and no longer seek short term
excitements that cause distractions.

Perhaps there's something else in ADHD people wiring that cause a different
response, but even _normal_ college students took ADHD medication to help
focus.

~~~
Amezarak
Precisely. It's not that stimulants help people with ADHD focus. They help
everyone focus, regardless of whether they have ADHD. [1]

> Attention-deficit drugs increase concentration in the short term, which is
> why they work so well for college students cramming for exams.

> Versions of these drugs had been given to World War II radar operators to
> help them stay awake and focus on boring, repetitive tasks.

> And when we reviewed the literature on attention-deficit drugs again in 1990
> we found that all children, whether they had attention problems or not,
> responded to stimulant drugs the same way.

I've always been baffled how I didn't see this for myself years ago - after
all, that's exactly what caffeine does for millions of people.

Worse, though, people with ADHD are prescribed stimulants for long-term use,
and even after the medicine ceases to be effective - because your body adapts
to it over time - you can't just stop taking it, because withdrawal sucks.

[1]
[http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-a...](http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-
add-drugs-dont-work-long-term.html?hpw)

~~~
mickronome
So I have ADD, and I can't tell you if my brain is different or not. But I
have exactly zero withdrawal from methylphenidate after years of use. If I
don't take it, I simply don't get anything done. I have stopped taking it for
several week at one point, and then I start spiraling down to my pre-diagnosis
state since I forger to eat and sleep.

I get much less impulsive also, car rental managd my own mood much better. My
blood pressure add resting heartrate has also improved since I started with
the stimulants. A bit unusual according to my doctors.

YMMV - the medication is crude, but being without is not really an option -
it's really nice to start being able to plan, and actually decide what actions
to take instead of simply doing whatever feelt good at the time.

------
pizza
I summarized this video by K.C. Berridge about some of his research on
dopamine:
[https://www.youtube.com/watch?v=15TvKADY0QQ](https://www.youtube.com/watch?v=15TvKADY0QQ)

* animals that lose their dopamine learning mechanisms can still learn new things

* even when dopamine is there, sometimes the system will continue to respond to unconditioned responses that are learned and expected

* microinjections of amphetamine do not increase reward expectation - they increase peak of desire for reward - like when food is more tempting after not eating the whole day; sometimes a nasty salty taste is desirable in sodium deficiency, say

* system is computing value, rather than learning

* incentive-salience is a cue-trigged type of wanting; say someone else across the room lighting up a cig cueing your desire

* the cue becomes an attention magnet - the cue is very hard to not want to pay attention to

* the mesolimbic state of brain at a certain instant in time plays a huge role in amplifying responses to cues - hunger increases desire for food, repeated experience of drugs amplify the cue for drugs

* an addict is a person who will have a super strong dopamine response when provided opportunity, due to sensitization of cue-triggered want - even months after enduring withdrawals, acquired hypersensitivity may still exist

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carbocation
I often wonder why we refer to the neurotransmitters as making people
depressed/impulsive/etc rather than referring to specific groups of neurons
that presumably mediate those experiences or behaviors.

~~~
marxidad
Neuronal pathways are based on a specific neurotransmitters. Dopamine usually
means limbic system and seratonin usually means the cortex.

~~~
moments
The parent here makes a good point, and your comment appears to represent a
common misconception about neurotransmitters. Both dopamine and serotonin can
do different things depending on the system and the receptors that are
actively present. Serotonin, for example, is mostly in your gut, not cortex!
From wikipedia:

"Approximately 90% of the human body's total serotonin is located in the
enterochromaffin cells in the GI tract, where it is used to regulate
intestinal movements."

Dopamine is more specific, playing an important role in the limbic system, but
is not limited to it. Its functions are not completely understood, and again
depend on the receptor.

Better to think of the function of neurotransmitters as dependent on both
system AND receptor. The function of neurotransmitters, like dopamine, can be
simplified, but others, like glutamate, are extremely complicated.

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utefan001
Just got diagnosed with ADHD at 42 years old. Strattera has been a HUGE help.

Of course there are varying degrees of ADHD. But if some of these descriptions
fit you. You might have ADHD.

"Everyone encounters some task he doesn't particularly enjoy, but most people
are able to find a way to complete the boring aspects of their job, says de
Marneffe. People with ADHD, however, have a hard time doing that."

"If you (sometimes) fly off the handle in a fit of anger or frustration one
moment but are completely over it in the next, it might be a sign of ADHD."

-you have a hard time sitting for multiple hours

[http://www.health.com/health/gallery/0,,20490145,00.html](http://www.health.com/health/gallery/0,,20490145,00.html)
\--15 Signs You May Have Adult ADHD--

~~~
Reedx
Doesn't everyone have a hard time completing boring jobs and sitting for
hours?

~~~
utefan001
My Dad didn't.

As for me, for some tasks, such as writing documentation for something I knew
nobody would ever read, my brain would refuse to focus. I would look for more
important things to do and never get a page of documentation done.

~~~
miguelrochefort
How is writing documentation that nobody will ever read a thing anyone should
be motivated for?

Do people without ADHD agree to do useless things because they're told to?

~~~
cstrahan
If it's that or be fired, I think most people would do what they're told.

There are some people, however, that will, in sheer determination to do what
is expected of them, stare anxiously at their screen, hoping to focus their
attention to the task at hand. No distractions, just a text editor waiting for
some text. The problem is, the thoughts just don't surface. They try to psych
themselves up, remember that their lively hood depends on it, that they don't
want to let their coworkers down, etc. Sure, their gut tells them that they're
working on the wrong solution to the wrong problem, but they remind themselves
to keep a good attitude, remembering that this is what their employer deems
both valuable and necessary. The hours tick by. It's 6pm, but they're
convinced that they'll be able to turn it around. A couple more hours pass by.
"If I just get this done, I get to spend time with my family, or go see my
friends, or have some semblance of balance." It's 10pm. They cry for a bit,
manage to get a bit of work done, and shortly after 1am, they hop in bed and
call it a day. As they doze off, they lament their inability to power through
uninspiring work (particularly work that they know could be obviated by better
practices/tools/business-sense/etc.)

If you've _never_ experienced something like that, then I suppose you either
don't have ADHD, or you've only had phenomenal working experiences.

~~~
miguelrochefort
I usually find a way not to do what I consider not worth doing.

I usually ask why the task is worth doing. If they can't come up with a valid
response, I try to show them why it's not worth doing. If I can think of a
better thing to do, I let them know. If this doesn't work, I will delegate or
trade the task with someone else. If that doesn't work, I will often just
ignore it. Usually, nobody realizes the job wasn't done, mainly because it
wasn't important in the first place. Rarely will I go through the pain of
doing something that I realize is not important.

Although I have never been diagnosed with ADHD, I feel like I can relate to
some of the symptoms.

~~~
ktsmith
The above example isn't the only case where this is relevant. In this case
it's something the author doesn't want to do and is pretty boring and
pointless and any sane person isn't going to want to do it. Some people can
power through it and others won't be able to. You can rewrite the text where
the work to be done is maybe not "boring" but tedious and rather than
"pointless" it's actually critical that it be done. I've changed the
descriptive text above a bit.

> There are some people, that will, in sheer determination to do what needs to
> be done, stare anxiously at their screen, hoping to focus their attention to
> the task at hand. No distractions, just a text editor waiting for some text.
> The problem is, the thoughts just don't surface. They try to psych
> themselves up, remember that their lively hood depends on it, that they
> don't want to let their coworkers down, etc. The hours tick by. It's 6pm,
> but they're convinced that they'll be able to turn it around. A couple more
> hours pass by. " This is such a critical project I just have to get it done.
> If I just can just get started, I get to spend time with my family, or go
> see my friends, or have some semblance of balance." they tell themselves.
> It's 10pm. They cry for a bit, manage to get a bit of work done, and shortly
> after 1am, they hop in bed and call it a day. As they doze off, they lament
> their inability to power through their work and lament their repeated
> failures.

This was me. I'd have some project to work on, interesting or not and I would
have the hardest time getting started. Just getting the first bits and pieces
done. Or I'd have a clear picture in my head of how I wanted to do it, what
needed to be done, and how I needed to attack it to accomplish it. Then I'd
try to get started and fumble about not being able to get that mental picture
out into real productive work. I'd spend hours breaking tasks down into
smaller bits but not get any of the bits done. I'd think to myself, I'm
focused too much on this and I can't think straight any more I'll just take
care of another task for a bit and come back to this. Six hours later I've
forgotten about it completely and then panic when I realize it. Once it was
crunch time, or it was so late the only way to finish was to pull an all
nighter I'd some how miraculously get things done well enough to stay out of
trouble. I powered through these problems in my 20's by pouring in 15+ hour
days regularly. I nearly destroyed my relationship with my wife. I had friends
and colleagues that knew I'd get things done but couldn't count on it always
being the best quality or on time. I couldn't do that any more when I hit my
30s, started a family, and the toll of the hours and lack of sleep really hit
harder. Speaking to my Dr and getting an ADHD diagnosis, some medication and
some tools to approach my issues from different angles have been life
changing.

------
graeme
If this is accurate, is there any research on activities that can regulate
dopamine activity and reduce impulsivity?

~~~
nibs
Dopamine regulates "seeking" behavior. One can direct their "seeking" to good
things (achievement of something that benefits your family or community) or
bad things (drug induced highs, money at all costs).

Probably educating people on how they are wired to seek things (a good drive
when you are talking about going out and securing food/resources) and how to
direct that towards healthy pursuits instead of unhealthy ones would go a long
way.

Lots of pharmaceuticals can regulate dopamine in various ways too. The issue
as it relates to impulsivity seems to be caused by a combination of dopamine
driven seeking behavior and more primal parts of the brain hijacking decision
making.

It is the combination of primal parts of the brain doing decision making with
the brain's propensity for seeking that causes negative impulsivity, so that
could be aided by increasing gray matter (meditation) and regulating dopamine
(healthy seeking) but you can only do so much.

It seems like so much "crime" is really impulsivity, and so I often have
thought about ways you can reduce impulsivity, but it always seems to come at
the cost of considerably altering how someone's brain works, which not
everyone is open to.

------
caycep
the weird part - impulse control disorders is a well described side effect of
the "synthetic" and selective dopamine agonists (pramipexole, ropinirole,
rotigotine) developed in the 80's and 90's for PD. It doesn't happen to
everyone but seems to affect patients who have some sort of pre-existing
obsession or compulsion that was more or less under control prior to the
medicine. The odd part is that levodopa (basically good ol' dopamine) does not
have this issue...

~~~
meowface
I'm confused by what you're trying to say. The article repeatedly stated that
levodopa has been observed to create higher impulsivity.

I imagine any pure dopamine agonist can be prone to creating an impulse
disorder if you take a sufficiently high dose.

~~~
caycep
The impulsivity seen in patients only happens in the synthetic, and possible
more "selective" dopamine agonists that work more with certain dopamine
receptor subtypes. Whereas, levodopa, which is a dopamine precursor and
presumable not selective at all (ie. works on all receptors) do not have the
impulsivity effect, or at least as dramatic, on these same or similar
patients.

