Food doesn’t make me feel better, it
just temporarily stops me from feeling what I’m feeling.
More about the stress thing. And eating because I’m stressed. And
returning in my mind to the event that caused the stress… an abnormal amount of
time and energy spent in imaginary conversations. Too much dopamine forces my brain to perseverate on the
cause of the stress until it is dealt with. But when the problem is people who don’t act like grown-ups,
there is no ‘dealing with it’.
Those people are so much better at being aggressive, illogical and just
plain mean.
Here is a not-so-quick lesson in the neurobiology of
behaviour:
Everything you know to be
true is learned via your body and brain. The environment is perceived by the
five “far” senses (sight, smell, taste, touch, sound) and travels through the
body into your brain, specifically the cerebellum. The vermis (or lining of the
cerebellum) “gates” information into the cerebellum much as the gates in a
horse race ensure everyone is off to a good start. Information travels through
specific ventricles (areas) of the vermis en route to the cerebellum. People
with autism may have insults (injuries) to the 7th and 8th
ventricles (known to be responsible for language) which can be seen on an MRI
[Courchesne & al [1988]. Those “language horses” can’t get out of the gates
efficiently. In Joubert Syndrome, Dandy Walker and several other cerebellar
disorders, many gates are damaged or completely missing. Just imagine a horse
race where the gun goes off and some of the horses are not even facing the
right way!
Behaviour is dictated by
many different reasons: some behaviour is learned, some is due to reasoning and
some is “instinct”. Imagine sitting at a computer and your little brother comes
in and yells “BOO!” Your brain is flooded with a biogenic amine (or
neurochemical) called dopamine and one of three things will happen: a fright
response (Freeze with eyes wide open); a flight response (duck or veer to away
from the sound) or a fight response (punch the little rugrat). This response
happens immediately: you don’t even think about it. This is dopamine at it’s
best. Its job is to get you out of danger immediately.
Now, if your little brother
makes a habit of scaring you at the computer and after a day or two you are
typing away and waiting for him to come in: punching him as soon as he comes up
behind you is not a dopamine-driven response. You have cognitively learned that
it feels good to punish him for his joke and the line “My dopamine made me do
it!” is not going to stand up in a “sensory-court” of law. That last punch was
definitely a learned response!
Another important neurochemical
is norepinephrine. Its main job is to figure out why there is so much dopamine
and keep you focused on the problem. This is a very useful tool when walking
across the road to the doughnut shop and a big red truck comes barreling down
on you. The dopamine will cause you to have a fright response
(deer-in-the-headlights) a fight response (yell at the driver) or a flight
response (Run away!). The norepinephrine keeps you alert to the dopamine-driven
response – rather than planning your next shopping trip for shoes the same
colour as the truck!
The fact that
norepinephrine keeps your brain focused on the reason for the influx of
dopamine is very important when the problem is an obvious, solvable problem.
After you realize it was your little brother scaring you, your body releases a
third neurochemical called serotonin. Its job is to bring all the dopamine back
down to a normal level. As that happens, the norepinephrine also is reabsorbed.
After you get out of the path of the truck, it may take several hours for your
body to produce enough serotonin to match the dopamine and bring it “back
down”. Sometimes, after a particularly devastating situation (accident, death
of loved one, etc.) it may take months for you to feel “equal” again. You may
even experience “flashbacks” as your body tries to compensate for the large
influx of dopamine. Eventually, however, all things go back to normal.
In some cases, the dopamine
is elevated for no one observable reason. Perhaps a child’s parents are not
acting like grown-ups at home. This child goes home, not knowing if she might
get yelled at or hit.... or when.... or why. The dopamine level is always high
in order to run or duck as soon as necessary.
Common
Problems
Some children have brains
that do not work the same as other’s. If the vermis is missing or compromised,
as in many cerebellar disorders, the world is not processed in the same way.
This is very confusing for the child. Confusion and stress increase the amount
of dopamine. Signals come crashing into the brain in an unorganized way and the
brain struggles to make sense of it all. Quite often, “normal” sensory
information is perceived as a war-zone of lights, sounds, textures, and smells.
As a result of this
constant “dopamine-high”, the child often feels anxious or angry for no
apparent reason. If you ask them why they feel angry, they honestly cannot tell
you. They just feel it. They may have a heart-wrenching sob at the slightest
upset. It may appear that they are overreacting, but in essence, that event was
the “last straw” for them to withstand.
The norephinephrine is
still there, of course, trying to figure out why there is all that dopamine. It
may arbitrarily focus on someone or something. The child may suddenly become
angry at the pizza you have served for lunch... the same pizza you serve most
days... the same pizza served with exactly four pepperoni, one per slice... at
the same temperature as always (routine is very important for kids with sensory
processing problems :) But today, the pizza triggers a screaming fit. One
reason could be that the norephinephrine has decided that the pizza is the
reason for the increase in dopamine and therefore, a fight response is in
order. When you try to explain that the pizza is what is for lunch, the
dopamine may decide on a flight response... and fling the pizza across the
room!
Now, the dopamine and
norephinephrine are not sentient beings living inside the child’s head. They
are very powerful neurochemicals that drive behaviour and it is extremely
difficult to ignore the impulse to act on their commands. Just as it would be
almost impossible to stand still while the truck was coming at you or not to
duck when someone startles you, to ask a child on a “dopamine-high” to be reasonable
is UN-reasonable: they are reacting to a message that is not coming from a
learned response.
A sensory processing
therapist works under the philosophy that some behaviour is driven by a
person’s neurochemicals and these can be manipulated to change behaviour.
Bonnie Hanschu spoke of people with special needs as a rose within an onion. A
sweet, beautiful person in there, glimpses are caught, but the vision is
blurred and opaque. The layers of need can be peeled away with different
therapies (sensory processing, cognitive, medication, etc.) until only the
person remains. This is the goal of any advocate: ensure that all the child’s
needs are addressed.
How to
Increase Serotonin
There are a variety of ways
to increase serotonin in the system. There are many different types of drugs
which alter the amount to serotonin: Zoloft, Celexa; Paxil are some names of
commonly prescribed SSRIs (selective serotonin reuptake inhibitors). Also some
natural plants such as St. John’s Wort may elevate serotonin. Everyone will
have a time in their life when there is a strain on the dopamine/serotonin
balancing act: a death; divorce; new child; etc. These events are all very
emotional and disrupt your body's normal routine.
Diabetics constantly need
to monitor their sugar levels in order to be able to stay healthy. People with
brains which work differently need to have their dopamine “monitored” in order
to interact positively with their environment. Just as a diabetic uses insulin
to keep their body’s chemistry at an optimum, some people require boosts of
serotonin before, during and/or after a stressful event to help their
neurochemisty remain efficient.
In a normally functioning
brain, a difficult day is usually soothed by a walk in the sun, perhaps sitting
in a green field, listening to music, eating chocolate or having a warm bath.
All of these coping strategies utilize your far senses to increase serotonin.
The effect of the serotonin on your system would be a “few drops” (although
it’s not really drops, that is just a convenient visual analogy :)
If you have been
experiencing a larger amount of stress over the past few days, you may choose
to get a massage or wrap up tightly in a warm, heavy blanket. This strategy
uses deep pressure to stimulate the receptors under your skin and serotonin
increases. The analogy would be a “full beaker”.
An incredibly difficult
period in your life may cause you to go for a run or begin an exercise program.
These activities stimulate the proprioceptive sense of where your body is in
space and it has a latency effect of one to two hours. The proprioceptive
system has its receptors in muscles, tendons and joints. (Hanschu, 1997) Each
time you activate the deep tendons at the joints, your brain makes a better
connection to where that part of your body is. Serotonin is also created in
this process. There are other aspects of your body chemistry at work here:
endorphins, etc. but for this discussion, we will stick to the biogenic amines.
The amount in our visual analogy would be a “full teacup”. Because of the
latency effect, the running or weight lifting will keep your serotonin elevated
for an hour or so after the activity has ended.
The most stimulating sense
is your vestibular sense of where your head is in space. It is sensed in your
inner ear and has a latency effect of four to eight hours. If you have ever
spent a few hours on a boat then closed your eyes on land and still FELT like
you were on a boat, you have experienced the latency effect of your vestibular
sense. The analogy of the amount of serotonin enhanced by the vestibular sense
is a “full bucket”. It is the most alerting and focusing of the seven senses
and is particularly beneficial for the special needs population that we are
discussing.
Practical
Ideas
In order to meet elevated
amounts of dopamine in the brains of people with sensory processing spectrum
disorders, there needs to be “buckets” of serotonin available at regular
intervals. A physiotherapist or occupational therapist that has sensory
integration or sensory processing training can assist the person’s caregivers
in setting up a series of activities (also called a sensory diet) that are
designed to provide the boosts of serotonin needed.
A child who screams every
time they are put into the family car, may need to bounce on a trampoline for
ten minutes before being told it is time to go. A person who refuses to eat may
need to spend ten minutes on a vestibular swing followed by some time with an
electric toothbrush before going to the supper table. A student who becomes
restless in math class may need to carry some textbooks to the book room,
preferable one upstairs.
References
Courchesne E,
Yeung-Courchesne R, Press G, Hesselink JR, Jernigan TL (1988) Hypoplasia of
cerebellar vermal lobules VI and VII in autism, New England Journal of Medicine
318:21:1349-1354
Hanschu, Bonnie, OTR (1997)
Evaluation & Treatment of Sensory Processing Disorders Phoenix, AZ: Developmental Concepts
p100
Ministry of Ontario:
Curriculum Expectations. Math Grade 1-8
Going out of my head over you.
Out of my head, over you.
Out of my head, day and night, night and day and night. Wrong or right.
-----Little Anthony and the Imperials "Going out of my Head"
https://www.youtube.com/watch?v=Kq204wG8UfA
