Kennedy Bobyck

“I was diagnosed with ADHD in my mid fifties and I was given Ritalin and Dexedrine. These are stimulant medications. They elevate the level of a chemical called dopamine in the brain. And dopamine is the motivation chemical, so when you are more motivated you pay attention. Your mind won't be all over the place. So we elevate dopamine levels with stimulant drugs like Ritalin, Aderall, Dexedrine and so on.

But what else elevates Dopamine levels? Well, all other stimulants do. What other stimulants? Cocaine, crystal meth, caffeine, nicotine, which is to say that a significant minority of people that use stimulants, illicit stimulants, you know what they are actually doing? They're self-medicating their ADHD or their depression or their anxiety. So on one level (and we have to go deeper that that), but on one level addictions are about self-medications.

If you look at alcoholics in one study, 40% of male adult alcoholics met the diagnostic criteria for ADHD? Why? Because alcohol soothes the hyperactive brain. Cannabis does the same thing. And in studies of stimulant addicts, about 30% had ADHD prior to their drug use. What else do people self-medicate? Someone mentioned depression. So, if you have been treated for depression, as I have been, and you were given a SSRI medication, these medications elevate the level of another brain chemical called serotonin, which is implicated in mood regulation. What else elevates serotonin levels temporarily in the brain? Cocaine does. People use cocaine to self-medicate depression. People use alcohol, cannabis and opiates to self-medicate anxiety.

Incidentally people also use gambling or shopping to self-medicate because these activities also elevate dopamine levels in the brain. There is no difference between one addiction and the other. They're just different targets, but the brain systems that are involved and the target chemicals are the same, no matter what the addiction. So people self-medicate anxiety, depression. People self-medicate bipolar disorder with alcohol. People self-medicate Post-Traumatic-Stress-Disorder.

So, one way to understand addictions is that they're self-medicating. And that's important to understand because if you are working with people who are addicted it is really important to know what's going on in their lives and why are they doing this. So apart from the level of comfort and pain relief, there's usually something diagnosible that's there at the same time. And you have to pay attention to that. At least you have to talk about it.”
― Gabor Maté