The ‘TRUTH’ About Dopamine - The Neuroscience Behind Your Brain's Reward System

[@Qurlir]

I am grateful for this channel. Your channels is the first time i've felt like the person speaking understands what ADHD is. Also, the approach in which you propose for which ADHD and other conditions should be approached really hits me, because you touch on the intersectionality of these conditions. And the exact phrase that you used in one other video has stuck with me. That it requires a "multi-pronged biopsychosocial, cultural, diet, lifestyle approach" that is so deep and factual, i feel like they should make that into a law on how diagnosis should be made. Thank for educating and sharing you field of knowledge, I really do appreciate it.

[@PsychiatrySimplified]

Thank you for your feedback. Really appreciate it 🙏🏻

[@DennisBolanos]

Dr. Rege-would you consider making a video about “predicting violence in persons with mental illness”? 🎭

[@WB-63]

Great video suggestion!

[@PsychiatrySimplified]

Yes great video suggestion. I’ll add to the list !

[@andrewconnor4429]

@@PsychiatrySimplified My suggestion is to talk about the LEAP method, how to speak to someone who is psychotic. Dr. Rege I'm asking you to explain to me, how do you talk to someone who has lost their mind and is psychotic and believes things that are obviously wrong, how do you handle them?

[@9me9a92]

So grateful to have found your channel

[@PsychiatrySimplified]

Appreciate the feedback 🙏🏻

[@Qurlir]

Ditto!

[@Cagsjdr5]

My father was diagnosed with Parkinson’s at 70, he passed just prior to his 80th. I have recently been diagnosed with ADHD at 54, I am now 57. Both my father and I wore/wear glasses for shortsightedness.

[@PsychiatrySimplified]

Thanks for sharing.

[@jerryholdcroft4607]

Dr. Rege, Thank you for another piece of jigsaw, in my understanding of the complex mechanisms of Dopamine, having SSRI induced EB and SD I was fully prepared to simply ask my GP for a dose of Dopamine, in my crude (at the time) understanding of depression I thought the simple release of Dopamine (the happy stuff) would be the answer. I now understand better, the real mechanisms and sequences of the processes involved, modulation is better than optimisation. I agree that the plethora of fixes and potions advertised for Dopamine is a dangerous thing, especially when there is no recognised scientific research to support them and no effective regulation.

[@Truerealism747]

Did you have physical symptoms

[@jerryholdcroft4607]

@@Truerealism747 Lethargy (lack of energy), constant tiredness and genital numbing

[@Jules-kp7rw]

As a person cumulating both the rigidity and perfectionnism associated with autism and the constant reward seeking state of ADHD, this resonates deeply. Finding the balance between 2 seemingly opposite traits is something I struggle tremendously with. Thank you for that video. I keep hoping to find the magic answer even though there isn't such a thing. I feel like a puppet.

[@PsychiatrySimplified]

I've done a few videos on ADHD treatment talking about this balance. I wonder if those may clarify a few things for you? Is the ADHD treated?

[@nickibanks5185]

@@Jules-kp7rw ooh you described perfectly how I experience life. I have been diagnosed three times with ADHD. The first in NZ, second when I relocated back to Western Australia as they don't or wouldn't accept a diagnosis from another state or country . Then again when returning to NZ I was referred to an actual ADHD specialist and he also confirmed ADHD. However...when I read , hear see anything on typical ADHD...I don't think I relate into many of the "said" profile traits of ADHD, less so now I am ...erm 🤔...much older 🤨. I think more along autism now that trauma & the self preferred social isolation, I believe,has become the result of it. I am boring in comparison to my younger years way more introverted & can spend days alone in my room( when not at work) Listening to podcasts thinking & just pottering. Rigidity yes!! I have to do I don't become to overwhelmed & dissregulated It usually involves habbits / rituals that involve rewards & anticipation of them to keep me grounded,food in particular certain types at certain times. Yet...I can hear the faint yelling & pounding of fists of the unruly ADHD child who has been locked away immobilised for some time. I'm too scared to let it out as there will be Armageddon going on between the quiet & rigid routine patterned self & the ...to hell with it let's go run amok self 😳

[@ayeshanabeel2095]

superb explanation of very complex dopaminergic mechanisms novelty, unexpected experiences, embracing change can enhance dopamine at D1 receptors its the essence of life thanks alot may God blesss you

[@PsychiatrySimplified]

Thank you for your feedback 🙏🏻

[@MarcelNeculae]

hey Dr. Rege, are you planning on doing a similar video on glutamate (and receptors) and the proposed mecanisms of actions as an antidepressant, as an alternative to SSRIs? 🤔 also, do you know if any such compounds exited human trials and have been proven more effective than SSRI/SNRI for specific conditions?

[@imperfekt7905]

Excellent presentation. In addition to the neurological explanation, I thought the philosophical comments near the end were well chosen.

[@PsychiatrySimplified]

Thank you for your feedback

[@KonstantinShepard]

By dopamine detox, fasting I understand one abstaining from alcohol, smoking, drugs, porn, etc. How do I miss the mark, as you put it?

[@PsychiatrySimplified]

Because there is no such thing as dopamine detox. One is simply making a behavioural change which may involve a range of neurotransmitter changes but this is not direct causality. Detox indicates removing a toxin- so the detox is about behaviours that may be harmful. Not removing Dopamine

[@loulouloulou5977]

Hello, I wondered if you had any thoughts on why I'm so angry after quitting smoking (I'm in my 30's and been nicotine fee for 4 months now). Things are not improving and its really effecting my life. Is it because I have less dopamine now. Many thanks

[@PsychiatrySimplified]

It’s not uncommon- nicotine has psychoactive properties and nicotine and dopamine are linked. While I don’t want to reduce it to low dopamine as that is too simplistic - it’s helpful to evaluate it medically if it is problematic. We know smoking often is used as self medication and to regulate affect ( mood etc )

[@loulouloulou5977]

Thanks very much for getting back to me! Yes its def problematic. I'm on zoloft for severe anxiety for many years. Is there anything that could help this? I am trying to see a psychiatrist, but we seem to have a massive shortage in nz

[@BobvanH]

Great presentation! Mind bogglingly complex. Modulating the different states of mind pharmacological must be a very delicate enterprise.

[@PsychiatrySimplified]

Thank you for your feedback 🙏🏻

[@studentaccount4354]

Thank you, Dr. Rege. I am curious about excess dopamine and schizophrenia hypothesis I read about. I also read some other articles on scizophrenia and ph imbalance in the blood (1930) the blood was slightly acidic. Another, correlation or association was around half of patients with schizophrenia haf toxoplasmosis ghondi. Finally, I found another clue the calcium channel gateways in the cells. Clearly, there is something biochemical going on in this illness that is so complex. Can you discuss this? Elyn Saks, an attorney and Ph.D. wrote a book and did a Ted Talk about her turning point and diagnosis. I would love to hear about the scizophrenic illness and if it can go into remission etc.

[@PsychiatrySimplified]

Here I’ve written about the hypothesis. Yes it can go into remission and a certain percentage follows a relapsing remitting course - psychscenehub.com/psychinsights/the-dopamine-hypothesis-of-schizophrenia/

[@LucidSteve]

Incredible video as all of your others. I cherish every video you post. Kudos.

[@PsychiatrySimplified]

Thank you. Appreciate the feedback 🙏🏼

[@wetelectronics238]

Did you see the recent paper that found normal peripheral norepinephrine and dopamine in CFS but reduced spinal fluid NE and DO metabolites? Was interesting.

[@PsychiatrySimplified]

Not surprised but this is known and inflammation reduces this. I’ve covered it in the videos on CFS / Long Covid . Consequences of neuroinflammation in general .

[@RajGupta-z5i]

Sir will taking 50 MG amitriptylline increase both serotonin and norepinephrine

[@PsychiatrySimplified]

At this dose there is a minimal effect on both neurotrasnmitters

[@RajGupta-z5i]

@@PsychiatrySimplified ok thank you so much sir

[@func99]

Dude your videos are great and awesome, exactly what we need, but i would recommend maybe a different microphone set up thats less agitating since people will unfortunately probably dismiss you with a reflexive reaction to the discordant sound. You say things bluntly and truthfully its precious. Everything else in the production is pretty great.

[@PsychiatrySimplified]

Thanks for the feedback. Could you be a bit more descriptive re the agitating part? Is it the entire video sound or something specific? I'm trying to understand to get it right. This video is filmed in a make shift ‘studio’ with no extra audio input so if i understand it better I can improve on it. I appreciate your feedback

[@func99]

​​@@PsychiatrySimplified hey sure, I just mean the vocal recording part after the into. It's like the ambience in the room is picked up on... So when you speak, or change the cadence/speed/vocal rigour it's reflected too much, and kind of results in an explosive sound element, it also 'clips' the high end I think, as certain vocal frequencies duplicate and overlap each other. It's just the vocal recording device which is probably incompatible with the spacey room you're in. I think a different or maybe directional mic that picks up more like a podcast would be better/solve the issue. They represents things with a pretty steady E.Q. It would then allow you to speak with any pace and all kinds of sounds recorded would be brought to a pretty close level. (And sound professional). It could also be the acoustics of the room itself if a mic swap test doesn't work. I'm not an expert on mics but I assume it's cheap and easy since almost all podcasts/explanatory videos have this quality and tone to them. I hope this helps answer things; your mixing and edits are good for makeshift, I think it's just the mic. I think that's all it is, and you could give it a test run and see if that's all it is, if it still seems too unclean , unpolished you could then attempt to experiment varying your speaking slightly. If you'd like I could even let you know next time you upload a video. Just message me or I can check your station, or you comment on any of my videos. -jonsat

[@func99]

Yeah it's through the whole video btw except perhaps a little of the intro(where you go through 6 points), but just the talking being recorded, there's a lot of high dynamics, which is like you're shouting sometimes. Some of the music is really well selected too, and some of it isn't, like the more repetitive ones at 2min30 and 25mins, but the one at 15 minutes is a great choice. Damn, great video again by the way.

[@anuullannur]

Can you send me the diagram of the different neurotransmitters that ends in the dopamine production and if possible the inhibitory dopamanergic pathway (the VMPFC, DLPFC, and Insula-amygdala pathways if I am not wrong)!

[@9me9a92]

Hi, what about unpredictable parents, does it decrease dopamine levels in children?

[@9me9a92]

Like lashing out on a child and then being kind to them BCs feeling guilty. Is it considered an award?

[@PsychiatrySimplified]

You raise some very important points and it’s a theme for a further video. But in short yes it does result in a reward deficit state. I’ve covered this aspect more in the video on how Trauma ‘rewires’ the brain. Inconsistencies in parenting result in what is know as reward prediction processing duration which results in Dopamine dysregualtion. This can present with affective instability, mood swings, procrastination , self doubt and a range of ‘inconsistencies’ in self

[@9me9a92]

@@PsychiatrySimplified thank you so much. Since ever watching your videos, some new areas of my mind have been unlocked. Thank you for sharing the professional content all for free.

[@PsychiatrySimplified]

Pleasure. Thanks for the feedback. 🙏🏻

[@Yasen1791]

Dr Sanil. When will we have new medications for Depression in Australia?

[@PsychiatrySimplified]

We have a lot in Australia - it’s just that not all on PBS. The treatment of depression in relation to successful outcomes is about using what we have appropriately which does make a difference. Depression consists of domains and deconstructing these domains and using medication / psychotherapy/ lifestyle changes etc to target these is necessary for optimal outcomes

[@ShadowMan66]

Dr Rege off topic here sorry but wanted to ask you as I am trying to come off Tramadol 100mgs twice daily due to Australian Drs only being able to prescribe it once a month as of 2020 and you have to go to the GP for this in person. Is Cymbalta a good neuropathic pain killer? My Dr has put me on it at 30mgs going up to 60mgs in a month. Have you heard of people being able to come off Tramadol opioid type drugs by reducing and substituting it with Cymbalta for this sort of pain? Having to go to the Dr once a month every month for a 30 day supply of Tramadol is getting tiresome.

[@PsychiatrySimplified]

Can’t speak specially in your case but yes Duloxetine is effectively used for pain and can help. However in the transition duloxetine plus tramadol poses a risk of serotonin syndrome hence has to be done properly. Also Duloxetine pain benefits occur above 60 mg. Ps not advice

[@ShadowMan66]

@@PsychiatrySimplified Thanks for the reply, my Dr has assessed the risk of serotonin syndrome and decided that the Duloxetine may benefit my neuropathic nerve pain and help me come off the opioids they kept me on for 31 years. What dose is considered effective to dull this kind of pain as I thought it was 60mgs?

[@Yasen1791]

Dr Sanil, Is there a role for thyroid hormone therapy in depressive disorders?

[@PsychiatrySimplified]

psychscenehub.com/psychinsights/thyroid-gland-and-psychiatry/

[@nickibanks5185]

So grateful for your content.🤯 The amount of time & variety of ADHD questions I have searched for over the years, I would have expected KZbins algorithm to have introduced me to you ages ago.🤔

[@PsychiatrySimplified]

Thanks for the feedback. 🙏🏻

[@Qurlir]

Honestly!

[@anuullannur]

I mean the diagrams of the topics from 7:02 - 7:32 and 10:24 - 10:20 - 10:40 !!!

[@nivlakhera9]

Love it my upcoming book is in alignment with this ❤

[@anuullannur]

I I think artha and karma are explained nicely. But the golal of these aspects is gaing kama. . And the peace that can be attained by controlling "kama" (which may have a nice translation of getting pleasure) and the perseverance to achieve the pleasure slowly convert (this seeking or/and achieving of pleasure) to the state that reduces the immense importance of the kama, which is vairgya. From here, one can choose either the path of self-realization (considered as eternal happiness or moksha ) or using "vairaagya" to get the continuum of peace in this "laugika jeevita" . If we can translate these aspects into neuroscitific language, it may give some idea of the total activity of a yogi or a gruhasta. I feel so. Since the peace, the consistency of all happiness has the balance of kama and vairagya for a laugikaperson.

[@PsychiatrySimplified]

Thanks for those insights. I touched on yoga / kama in the video on Ikigai. Have a listen to that as well. Your insights are very nice. Thanks

[@anuullannur]

@@PsychiatrySimplified drive.google.com/drive/folders/1XtcxAMgYL1-R-nOF8z7xwJxcbHV0PmHc

[@gpslayer]

Hi Dr sanil rege. This is first video i have seen from you, i have read something about dopamine in scholar literature. And I had a feeling that these dopamine detox and other advices are wrong. So i was searching for videos like yours. But it did not answered all questions, I would like to know if dopamine can be just depleted by repeated spikes from playing games for example, or it is just some other thing that is depleted. In context of ADHD i would like to know why there is a lack of motivation or why there is a state when it is very hard to work and if in this states has something to do with dopamine and if some strategy from "dopaminic videos" would work though increased ability to produce dopamine or to conserve dopamine.

[@PsychiatrySimplified]

I’ve covered a number of these aspects across a range of videos. Partly in this video I’ve touched on the impact of repeated D1 stimulation. D1 receptor requires high levels of DA to be stimulated. They are stimulated via unexpected rewards. But the unexpected becomes expected - that’s the way we have evolved - so we aren’t exposed to multiple stimuli that create surprise ( D1 ) - associated with euphoria, surprise, curiosity etc . Repeated D1 stimulation can lead to desensitisation - so the response to DA dampens down- which can express itself with reduced hedonic drive and or decreased motivation. See the videos on ADHD - why ADHD is more than just stimulants or when stimulants stop working etc. also the impact of Meth use - hope that helps

[@joecaz]

Learning this, nirvana came to mind. Thank you!

[@PsychiatrySimplified]

Pleasure

[@Truerealism747]

Is this why nicotine patches help some with cfs etc as new evidence comes up as it helps dopamine

[@PsychiatrySimplified]

Yes that's right.

[@MonsoondelitewithDrSinsila]

Awesome

[@tsu525]

amazing, thanks a lot

[@PsychiatrySimplified]

Glad you liked it

[@ryansanders2009]

It’s my understanding Dopamine also plays a role in thyroid function

[@PsychiatrySimplified]

Yes that’s right. dopamine stimulates the production of thyrotropin-releasing hormone (TRH) and inhibits the production of thyroid-stimulating hormone (TSH). The HPT axis also regulates dopamine release.

[@Truerealism747]

​@@PsychiatrySimplifiedthis is why ADHD causes low thyroid

[@josep511]

why people become deeply addicted to opioids?

[@PsychiatrySimplified]

Releasing a video soon on this. Recorded it a few days ago

[@josep511]

@@PsychiatrySimplified Nice

[@bunnyoncloud]

Music was annoying tbh

[@PsychiatrySimplified]

Apologies! for the whole video or certain parts?

[@Qurlir]

@@PsychiatrySimplified It was great. It had some seriousness feel to it. The volume was okay too.

[@raymac1293]

I'm a cocaine addict

[@temotemo6939]

So interesting 👍💪