Science

What we all can learn from National Recovery Month.

National recovery month is a great opportunity to reflect on healthy change.
Live less out of habit and more out of intent.

- Amy Rubin Flett


It’s national recovery month, which is “a national observance held every September to educate Americans that substance use treatment and mental health services can enable those with a mental and/or substance use disorder to live a healthy and rewarding life.”

As America faces an unprecedented trend of overdose deaths and mental health struggles, it’s more important than ever to understand addiction, mental health, and how to care for ourselves and others.

Neuroscience

We know much more about the brain today than we did in 1933 when Bill W. and others began AA in the living room of a small home in Akron, Ohio. And yet, we’ll soon see why the tenets of AA and the 12 steps were amazingly effective at helping those suffering from addiction.

We now better understand how the brain works through advanced brain imaging techniques and extensive studies. Neuroscientists have deciphered the roles of dopamine, serotonin, oxytocin, and other chemicals in the brain and how they impact our behaviors.

As intelligent beings, it’s easy to believe we are always in control of our decisions, and those who are addicted or struggling with mental health issues need to use more willpower to choose better. However, this misguided belief significantly undermines our ability to help those in need and prevent ourselves from struggling with mental health and substance abuse.

Our Predicting Brains

Possibly the most remarkable breakthrough in neuroscience is better understanding our predicting brains. In the simplest sense, our brain spends most of its time on autopilot to conserve energy. From one moment to the next, our brain processes information from all our senses and uses our past experiences to predict what will happen next and how to act. This happens automatically until something unexpected happens and our brain “wakes up” to process the new lesson.

Throughout our journey from one moment to the next, our brain is releasing chemicals to guide our drive, learning, and choices. We have dopamine, our “more” chemical, and serotonin, oxytocin, and others which are our here-and-now chemicals.

What’s even more fascinating is how our brains are not prewired with what we think of as good or bad choices. Instead, our brains have a simple purpose of ensuring we have sufficient energy for survival. To that end, we are each continuously learning how to maximize the attainment and use of energy. For example, sugar (glucose) is pure energy, so our brain rewards our consumption of sugar without consideration for obesity, tooth decay, or diabetes.

Our brains are not prewired with what we think of as good or bad choices

Homeostasis

Let’s continue with the sugar example. We have dopamine driving us and rewarding our brains when we consume sugar. And yet, if glucose is such a good energy source, why don’t we all carry around a bottle of sugar water? That’s where the other chemicals come in. Serotonin and other here-and-now chemicals help us maintain balance and see the bigger picture and the long-term consequences of overeating sugar. 

Okay, but what is balance? Our brain and body seek to maintain "homeostasis" or equilibrium and use pain and pleasure to guide our behavior. When we don't have enough glucose, we feel uncomfortable cravings - pain. When we have too much glucose, we also feel uncomfortable - jittery, headaches, irritability. Conversely, when we are in balance, we feel good. These feelings are all happening within our brain from the release of different chemicals. All this is happening behind the scenes guiding our daily actions. 

At the same time, homeostasis is subjective. Our routines, experiences, and choices determine our unique equilibrium. For example, if we are constantly stressed, our brain creates a new daily balance of additional energy needs because we burn more energy when stressed. However, because our body will be uncomfortable with too much sugar in our blood, as we consume more energy throughout the day we store it as fat to ensure we have the energy we need later.

Understanding Addiction

Our brains are living a reality that exists solely within our imagination. We have all our experiences and billions of sensory inputs that our brains continuously process to interpret events and guide us in making choices that maximize pleasure and minimize pain. Everyone's interpretations are unique to them. No two individuals are living the exact same experience or reality.

However, we also know that pain and pleasure are subjective. Consider the elite athlete who has a much higher threshold for muscle pain. In their continuous training, they’ve tuned their homeostasis to a different balance than non-athletes. Moreover, unlike those who don’t exercise regularly, the elite athlete will feel discomfort when they don’t exercise because they are not maintaining the balance their brain has come to expect.

Addiction and mental disorders work the same way. The brain creates a new balance - based on one's experiences, substance use, genes, etc. - that is painful when not maintained. 

  • The gamer addict has an increase in dopamine levels that require more stimulation to maintain
  • The alcoholic brain craves the euphoric dopamine release and continues to need more alcohol to experience the same feelings
  • Someone abused as a child often experiences more anxiety from higher levels of norepinephrine as their brain interprets more events as threats

Recovery

The reality for us all is the brain does not unlearn past experiences. The brain can learn new information and practice new choices; however, the brain’s "wiring" retains the old dopamine-encoded pathways that can lead to prior interpretations and choices. 

For this reason, someone who has overcome addiction or mental disorders will say they are always in recovery. They understand how the past learning is always there to trip them up if they don’t continue to practice better choices, which now explains why Bill W. and his friends at AA have had so much success in helping millions overcome addiction. Through their personal experiences, the early AA founders didn’t have the science of why their approach worked, but they knew the addict was never fully cured and needed to continually practice making better choices every day if they wanted to stay sober. 

In fact, all successful recovery programs provide a lifetime of continuous reflection and practice on living a better life. Every day, those in recovery make a conscious choice to choose better. They reflect on triggers and behaviors that may take them back to their “prior wiring.” They continue learning and practicing new skills to get them further and further from those past choices.  

Wrap Up

The lesson for us all in national recovery month is how everyone learns behaviors and makes choices that are not in our best interests. We all have things that are holding us back from living the life we want most, and the only way to overcome those challenges is to continuously learn and practice new skills that align better with what we want more.

We all have things that are holding us back from living the life we want most, and the only way to overcome those challenges is to continuously learn and practice new skills that align better with what we want more.

Instead of waiting until we reach rock bottom or face severe consequences from our behaviors, we can learn from those brave individuals who chose healthy change and live each day as though we are in recovery. We don’t need to wait until we have panic attacks to address our stress and anxiety. We don’t need to wait until we are arrested for battery to overcome our anger issues. We don’t need to wait until divorce to face our relationship challenges. We begin to learn and practice new choices today.

There is a lot to learn from those brave individuals who have faced their most significant challenges and learned to make better choices. They admitted they needed to make changes and took action to be better. They envisioned the life they wanted more, and one step at a time, they consciously choose - every single day - to take action to live it.

Today is a good day for us all to get started in recovery.