Addicted Brains

A neuroscientist examines life on drugs.

When the Thrill is Gone: Reward Deficiency Syndrome

Different brains have different quantities of receptors -- such as receptors for neurotransmitters like dopamine. If you were born with, or acquired, a disappointing crop of dopamine receptors, then it might be harder to feel the thrill of being alive. That's where drugs, booze, gambling, and binge-eating come in handy. Read More

I'm wondering about adolecents

You said that adolescents may have Reward deficiency. Is that largely based on this study from 2004 - Adolescent Brains Show Reduced Reward Anticipation

However, many animal and human studies seem to show enhanced reward activity. Such as

What Motivates the Adolescent? Brain Regions Mediating Reward Sensitivity across Adolescence.

"Teen brains over-process rewards, suggesting root of risky behavior, mental ills." January 26th, 2011.

I suspect the earlier study could not capture waht teens found to be rewarding.

Dopamine re-balancing in adolescence

Hi. Good question. I had to go back to Steinberg for the answer. I'm copying the following excerpt from the paper that I linked in my post. I think this explains it pretty well, but check out the rest of the article if you want more detail. Steinberg is the world-renowned expert on this stuff.

The remodeling of the dopaminergic system within the socio-emotional network involves an initial post-natal rise and then, starting at around 9 or 10 years of age, a subsequent reduction of dopamine receptor density in the striatum and prefrontal cortex, a transformation that is much more pronounced among males than females (at least in rodents) (Sisk & Foster, 2004; Sisk & Zehr, 2005; Teicher, Andersen, & Hostetter, Jr., 1995). Importantly, however, the extent and timing of increases and decreases in dopamine receptors differ between these cortical and subcortical regions; there is some speculation that it is changes in the relative density of dopamine receptors in these two areas that underlies changes in reward processing in adolescence. As a result of this remodeling, dopaminergic activity in the prefrontal cortex increases significantly in early adolescence and is higher during this period than before or after. Because dopamine plays a critical role in the brain’s reward circuitry, the increase, reduction, and redistribution of dopamine receptor concentration around puberty, especially in projections from the limbic system to the prefrontal area, may have important implications for sensation-seeking.

Several hypotheses concerning the implications of these changes in neural activity have been offered. One hypothesis is that the temporary imbalance of dopamine receptors in the prefrontal cortex relative to the striatum creates a “reward deficiency syndrome,” producing behavior among young adolescents that is not unlike that seen among individuals with certain types of functional dopamine deficits.

I've wondered about reward

I've wondered about reward perception. Whatever other people get out of their various activities, I don't get it, and they get exasperated with me because I'm not all gung ho for their activities. Even things that I like to do, I either don't like them very much, or find that the annoyances around them overshadow the event itself. It makes me wonder, when I do X, do I not find X rewarding, or do I later not remember that X was rewarding? I like museums, for example, but the annoyance of finding parking will prevent me from going, so the "punishment" of parking is stronger than the reward of going, or else I later just can't remember how rewarding it was while doing it.

reward versus punishment

I had researched to some extent reward versus punishment with various hormones but the answer probably lies in something Daniel Kahneman figured out. Negative experience weighs way more than positive. The curve in fact--which I cannot draw here--can go infinitely negative on a small negative and just a tiny bit positive on a huge positive. This is why we tend to recall negative experiences (baggage) even in relationships more than any positive memories.

I hope it helps understand why you feel that the negative overshadows the positive.

you are an interesting study!

I wouldn't presume to diagnose in a blog forum, but you sure do present an interesting case. You many indeed have some version of reward deficiency syndrome. If this bothers you, then you might want to consider trying a course of Ritalin or some other dopamine-enhancer. Check with your doctor. Otherwise, you might have a condition called alexithymia. As usual, Wikipedia does a great job of describing it: I have a friend who is at least partially alexithymic, and we sometimes joke about it. It doesn't slow him down much. It seems unlikely that you'd have an emotional response and then forget about it, unless you were never consciously aware of that response to begin with.

Thanks for the interesting observations.

That was interesting, thanks!

That was interesting, thanks! I do relate to much of what was described; for example, I often can't tell the difference between hunger, thirst, nausea, and low grade tension because they all feel the same. I can tell if I'm angry, happy, or neutral, but can't identify and describe other emotions except as "unpleasant". Oddly, I can often identify what other people are feeling better than I can identify my own feelings, even when they are trying to hide it. The phony smiles of salespeople are so painfully obvious I don't see how anyone ever falls for them. I know that when I'm hiking, I really enjoy hiking, but when I'm at home thinking of hiking, it just seems like another chore, and I have to make significant effort to remember that I liked it while I was doing it. The result is that I mostly don't do anything, because my efforts are geared toward "avoiding the unpleasant" instead of "engaging the enjoyable", which is harder to identify.

so maybe you' ve got a diagnosis

I don't know a whole lot about alexithymia, but my impression is that it might be a good category for what's bothering you -- if you like categories. There are many different networks connecting "emotional" structures and structures related to "declarative" knowledge/memory.... Maybe those connections are structured a bit differently for people, like you, who can't identify or can't remember the details of emotional states.

Thanks, I just looked up a

Thanks, I just looked up a website about it. They had a questionnaire, and on the one hand it says I rate high for alexithymia, but on the other, I don't know if it's just the way the test is constructed. Just reading the questionnaire brought up a few issues. They wanted to know if I "have trouble describing my feelings to others", and I after some thought I have no idea; I've never in my life been asked how I feel about anything. I have little opportunity to interact with others closely, and when I do, they want me to SHUT UP and let them talk. They don't ask what I feel, and if they ask what I think, they usually cut me off in the first sentence and make it very clear that they don't care.

It's possible that I just never developed the vocabulary because no one ever cared anyway.

Narcissism wins again

Don't take it too personally! Most people engage in conversation for the purpose of hearing themselves talk. Others' comments and feelings are merely triggers or at best rationales for what they are about to say. It is a bit discouraging, isn't it?!

Hello, Marc! I did my own

Hello, Marc!
I did my own little experiment. :-)
I got this idea that when people say, "Hi! How are you!?", they don't want to know how I am, they want me to say, "fine, thanks how are you?", then stand there and listen attentively while they dump their entire life on me. I decided to test it by only answering "Fine, thanks", without the "how are you?". It was hilarious to watch the "hurry up and shut up so I can talk" prompt, followed by them opening their mouths to start the flood, then realizing I didn't ask. Some of them just pour it on anyway, and others get all embarrassed and trip over themselves.

Doesn't matter if I'm at work or the grocery store, the result is pretty much the same! I am actually willing to listen attentively to those who will extend the same to me. That mostly means I don't need to listen.

testing others' capacity to listen

That's almost exactly what I do myself. There's a guy I used to think well of....I met him for the first time in months last weekend. As usual, he started to go on and on about the details of his business....I interjected something relevant, but concerning my own life, and he ignored it. I said to myself: I'll try that one more time: same thing happened. It was enough. He's just off my list now as a potential friend.

So....this kind of experiment is indeed revealing....and depressing! I felt angry at myself for having given him the time of day to begin with.

I think your conclusion is an

I think your conclusion is an error. We should probably run these tests sooner, before we invest much in the other person, but being the one to extend the benefit of the doubt, and give the other person a chance (they may just be nervous at first), is not a bad thing. It sounds like you gave him plenty of opportunity to not be self-centered, so the loss is his, not yours. You attempted mutual communication, and did your part to meet him half way. Nothing wrong with that, and it keeps your more desirable skills from getting rusty.

RDS is Real and rooted in genetics

If the epigenetic basis of Reward Deficiency Syndrome conditions was still a theory, it probably would not have caused the American Society of Addiction Medicine to redefine addiction as a primary chronic disease caused by an imbalance in the biochemistry of the reward sites in the brain and having a 50% genetic basis (ASAM Public Policy Statement on August 15, 2011). However, Dr. Blum's research finds greater than a 75% genetic basis in his 1990 JAMA paper publishing the discovery of the DRD2 A1 gene and its prominent expression in alcoholics. It went from being a software problem (mostly psychological basis) to a hardware problem (biochemical imbalance w genetic basis). It only took 21 years (1990 to 2011) and many hundreds of studies (mostly trying to refute that premise) to confirm Dr. Blum's findings. The evidence appears soundly in favor of the existence of RDS and its genetic basis. Importantly, while we can't change our genes, we can change/improve gene expression (epigenetics/nutrigenomics).

But of course it's still a theory

Theories don't stop being theories when they find some supporting evidence. But my impression of the literature is very different from yours. My impression was that researchers were not able to replicate Blum's results easily at all....which I think is why the concept has lost prominence. One important question is whether the reduced number or sensitivity of D1 or D2 receptors is due to drug use or is an initial condition due to a particular allele of a particular gene.

Can you please give me a lead to a positive replication or two...or ideally a meta-analysis of research in this area? That will help us to sort this out.

Thanks for keeping the discussion alive and interesting.

My personal experience with (probably) RDS

As a 21 year old with around 3 years of drug use, the article accurately reflects my own self diagnosis. I have experimented with over 20 different drugs spanning from hallucinogens to stimulants to downers, always looking for new experiences and perpectives. My drugs of choice are marijuana and psychedelics and I find most downers quite boring (though they still trigger my reward system). The most addicted I have been is to synthetic cannabinoids and cannabis (I believe as a result of cross-addiction to synthetic cannabinoids). Never had much of a problem with anything else. What I have derived from my drug use in regards to the topic is best described by a few quotes:
- "When you compare the sorrows of real life to the pleasures of the imaginary one, you will never want to live again, only to dream forever."
- "In my dreams the world would come alive, becoming so captivatingly majestic, free and ethereal, that afterwards it would be oppressive to breathe the dust of this painted life."

Don't get me wrong, I have learned a lot about human nature and psychology from psychedelic use, and they have a lot to offer when used sparingly and with respect (which I wrongly thought to have). Psychedelics in general have been quite rewarding long-term and have helped me appreciate certain aspects of the world in new ways. Things like nature and relationships. Now I find it that I often feel detached from the world and tend to indulge in activities that require little effort but still reward me to some extent. (Dissociatives and synthetic cannabinoids in particular made me feel detached and it may have had residual effects on me.) Activities like drug use, video games, and films are usually my go-to's. Though I do enjoy reading and learning as well, but it requires a lot of effort on my part. It seems that activities I actually put in effort to do are the ones that feel the most rewarding. I feel the most rewarded for new experiences of any nature. "New" seems to be what triggers my own reward system the most, but requires the most effort. But the "old" familiar routines are always the most comfortable, and thus more addicting and hard to break.

I apologize to have written so much, but I believe it is all relevant and I hope it's somewhat helpful to you in understanding the topic. I am wondering if anyone knows something that could help me become motivated. I know for a fact that Adderall (and probably Ritalin) would help, but I don't trust myself to take those as directed. Other than lifestyle changes (which I'm slowly but surely making), are there any other things that would help my reward system become more balanced? Maybe diet changes?

Thanks in advance and hope this shines some light on the topic.

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Marc Lewis, PhD has been a professor of developmental psychology and neuroscience for over 20 years and is the author of Memoirs of an Addicted Brain. 


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