Although Dr. Patrick Mbaya’s illness caused a lot distress and nearly took his life, the emotional symptoms of the depression he developed helped him understand and empathize with patients and how they feel when they become ill. In My Brain is Out of Control, Mbaya, fifty-five and at the peak of his career, shares a personal story of how he suffered from a brain infection in 2010 that caused loss of speech, right-sided weakness, and subsequent depression. He tells how he also dealt with the antibiotics complications of low white cell count and hepatitis. He narrates his experiences as a patient, the neurological and psychiatric complications he encountered, how he coped, and his journey to recovery. Presenting a personal perspective of Mbaya’s illness from the other side of the bed, My Brain is Out of Control, offers profound insight into battling a serious illness.
CHASING DOPAMINE: NATURAL HIGHS
Following my mystery illness, I developed strategies in order to get my body and brain strength back. I used natural ways to induce (chase) dopamine in the reward centre. Press-ups is one way to keep fit, and at the same time, chase dopamine. This can be done at home in secret, especially at the beginning, like when I first started doing press-ups, after doing one, I couldn’t lift my body off the floor! After two years of practice, I was able to do 60 in 60 seconds! Not bad. As they say, “practice makes perfect.”
Whatever exercise one designs, that’s fine. You will know it’s working when you sweat, muscles start to ache and maybe in time muscles start to show? For those people who are courageous enough to go the gym or jog, that’s even better. I have continued with my exercise regime at home. Although before you start it might be a struggle, when you are in the flow, you actually feel good, solutions to complex problems are found, especially when done first thing in the morning?
Another way of chasing dopamine, is listening to good music. I used this strategy when I was recovering. I tried to lift my mood by visiting the “Mandela Garden” while listening to good music. The sort of music which can make dopamine flow even in “aliens” brains.
In addition to “chasing dopamine,” exercise will also improve blood flow to different parts of the body, which may have been injured. As outlined in, “My Brain is Out of Control,” I was advised by my orthopaedic doctor, following my knee injury while doing my “moon walk”, at a club in Washington, that I will need a knee replacement, but I have not had any problems, I think I have completely recovered? That’s this form physiotherapy, has been beneficial to me.
There are user friendly ways of chasing dopamine, where one does not get in any form of bother or arguments with any one. Thus, although you might not chase as much dopamine, compared to naughty or illegal ways, this can be done at any time, and anywhere?
The brain is involved in processing reward. The brain connection called the, “mesolimbic” dopamine pathway, is involved in reward, and pleasure. This is described as the “pleasure centre.” The chemical dopamine is the pleasure chemical that transmits this information for both natural highs (chasing dopamine), and drugs of addiction (naughty ways of chasing dopamine), like stimulants (cocaine and amphetamines), which are powerful inducers of dopamine.
In natural highs (chasing dopamine), natural occurring chemicals from different parts of the brain carry messages to influence the mesolimbic pathway for reinforcement, and reward. Some behaviours as described above, including exercise, sex (orgasm), food, and listening to good music, can trigger the mesolimbic pathway.
The brain makes its own chemicals like endorphins (brain morphine like substance), endocannabinoids (brain cannabis like substance) etc, can act on the reward system, triggering dopamine, causing pleasure in the reward system.
Drugs of addiction, including alcohol, cannabis, opiates, amphetamines, cocaine, bypass natural occurring chemicals (neurotransmitters), and directly stimulate brain receptors, causing dopamine release. Artificial highs may be achieved on demand rather than naturally. Using more of a particular drug, will release more dopamine, inducing my more pleasure, than naturally chasing dopamine. Drugs of addiction release much more pleasure than natural highs, although at an expense of likelihood addiction. However, with time, the drug stops working, or when the individual decides to stop using the drug, dopamine receptors crave for dopamine. The individual becomes pre-occupied with the drug, and will try to avoid the horrible withdrawal symptoms by using the drug, and not for enjoyment. Thus, addiction has occurred.
Some of the current drugs used to treat addiction, work by interacting with this system. Drugs which work by reducing consumption, promote abstinence or reduce craving of a particular psychoactive drug (like Acamprosate, and the opiate blocker Nalmefene for alcohol, or topiramate for cocaine).
Dr Patrick Mbaya MD FRCPsych.
Essential Psychopharmacology, Neuroscientific Basis, and Practical Applications. Stephen M. Stahl. Second Edition, Cambridge University Press, 2000.
Essential Psychopharmacology, Neuroscientific Basis, and Practical Applications. Stephen M. Stahl. Fourth Edition, Cambridge University Press, 2013.
Lowinson and Ruiz’s Substance Abuse: A Comprehensive Textbook, Fifth Edition (Williams & Wilkens, 2011).
My Brain Is Out of Control. Patrick Mbaya. Author House. September 2016.
Dr. Patrick Mbaya is a medical doctor specializing in psychiatry. He is a consultant psychiatrist and honorary clinical lecturer in psychiatry at the University of Manchester, United Kingdom. He has a special interest in mood and addiction disorders.