genetics

ADHD and Addictions

How you can feel when you have ADHD   Our brains have a pathway called the Dopaminergic pathway, which controls how we feel pleasure, think, remember things, and move our bodies. When things go out of balance in this pathway, it can make us more likely to struggle with addictive behaviors like using substances excessively or engaging in risky activities. Did you know that up to 50% of individuals with continuing ADHD symptoms have a substance-use disorder?   If you have ADHD, you might have symptoms like feeling restless, having trouble controlling your mood, or feeling overwhelmed.  You are seeking the very thing that your brain struggle with: dopamine. You are on a constant quest for something that will help you feel normal, like you belong. That will quieten the constant noise in your head and give you peace. But for most of us with ADHD, peace often eludes us… Because of these feelings, you might try to find ways to calm down and get rid of the anxiety.   Why many with ADHD have addiction problems   ADHD can affect your ability to make decisions, use judgement and practice self- control, you might end up turning to substances that temporarily make you feel less restless or anxious, and more like everyone else. This feeling of relief can be addictive, leading to a cycle of substance abuse.   Research shows that people with ADHD often have genes that make them more likely to develop addictive behaviors. ADHD is a condition that affects the structure and function of the brain, as well as how certain chemicals in the brain, like dopamine, and other neurochemicals work.   Many people with ADHD don’t realize they’re seeking substances to help them feel “normal.” Even after being diagnosed, some still struggle with substance abuse. However, treatments like medication or supplements can help manage ADHD symptoms and reduce the risk of substance abuse. (substance abuse refers to alcohol, nicotine and possibly even other drugs)   It’s important to understand how ADHD affects your brain and why you might be more prone to addictive behaviors. Substance abuse can make ADHD symptoms worse and cause other health problems. If you’re struggling, it’s essential to seek help from medical and mental health professionals who can offer safer and healthier ways to cope.   How genetic testing can help The DNA Resilience test looks at 7 neurochemicals to see how well you can handle stress and difficulties. And the DNA Mind test looks at Neurodegenerative disorders, Mood regulation and Addictive behavior – Risk for alcohol, nicotine, cannabis and opioid dependence, psychosis response from cannabis use, eating disorders (binge eating), ‘adrenaline seeking’ or risk-taking behavior. These two tests together can help someone with ADHD to get personalized advice on diet, supplements, exercise, and lifestyle changes to optimize your resilience and improve your overall health. I also recommend my clients get a functional test to look at neurochemical metabolite levels, micronutrients, amino acids, fatty acids and proteins. Contact me for more info on these tests to orders yours and receive nutrigenetic feedback.     Sources: Sullivan MA, Rudnik-Levin F. Attention deficit/hyperactivity disorder and substance abuse. Diagnostic and therapeutic considerations. Ann N Y Acad Sci. 2001 Jun;931:251-70. doi: 10.1111/j.1749-6632.2001.tb05783.x. PMID: 11462745. Zulauf CA, Sprich SE, Safren SA, Wilens TE. The complicated relationship between attention deficit/hyperactivity disorder and substance use disorders. Curr Psychiatry Rep. 2014 Mar;16(3):436. doi: 10.1007/s11920-013-0436-6. PMID: 24526271; PMCID: PMC4414493. Anker E, Haavik J, Heir T. Alcohol and drug use disorders in adult attention-deficit/hyperactivity disorder: Prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation. World J Psychiatry. 2020 Sep 19;10(9):202-211. doi: 10.5498/wjp.v10.i9.202. PMID: 33014721; PMCID: PMC7515748.  

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COMT, MAOA, DRD2

COMT, MAO-A and DRD2 Phenotypes at your worst and best

The combination of COMT and MAO-A variants can affect mood regulation and neurotransmitter balance. Add in a DRD2 variant and you have very different phenotypes. Definition of phenotype: the expression (set of symptoms) of your genes as influenced by your epigenetic factors such as your diet, lifestyle and environment. You can change your phenotype by changing your epigenetics as this will in turn change the expression of your genes. Here is a quick breakdown of these different phenotypes. I have also included a fictional character for each one to help you see how this could play out, especially with regards to risks, predispositions , mental and physical symptoms that might present. Keep in mind, though, that the effects of these enzyme activities are also influenced by other genetic factors and environmental stressors. Personal history, stress, diet, sleep, and overall health can influence how these enzymes  impact mood and behavior. So while someone with a specific genotype could tend to lean towards a certain phenotype, it would ultimately depend on a combination of their genetic make-up, and other internal and external epigenetic factors.   When I am doing a feedback report for a genetic test, I take a look at this in connection with the client. This can be of benefit when it comes to making recommendations in how they can adjust their diet, certain lifestyle choices and habits and clean these up to help their genes express better. This also will determine what supplements will and won’t work for them. Sometimes we are not even aware of how the small choices we make each day impact our physical and mental health.   Slow COMT / Fast MAO-A / DRD2 (Wired but tired phenotype) With this phenotype, you’re likely to experience higher dopamine levels especially in the prefrontal cortex due to slow COMT. You will likely be quite good at problem solving and have better attention and focus and memory (slow COMT) but on the other hand you will probably struggle with mood stability due to low serotonin (Fast MAO-A)  The Reward factor is low, and there may be an increased risk of addictive behaviors and mood swings due to DRD2.   Fast COMT / Slow MAO-A / DRD2: ( ) You may struggle with cognitive issues like poor focus, attention and lack of motivation due to rapid dopamine depletion (fast COMT) but may find that you have greater emotional stability thanks to higher serotonin (slow MAO-A) which means you are able to cope better when under stressful situations. The Reward factor remains low, and the addiction tendency remains the same due to the DRD2.   Let’s break it down a bit further.   COMT -fast or slow The slow COMT variant (Met/Met, AA) leads to a slower breakdown of the neurotransmitters dopamine, norepinephrine and epinephrine. This can lead to higher levels in the brain, particularly the prefrontal cortex and basal ganglia,  that stick around for longer than what they should. When this happens it can lead to increased anxiety, mood swings and irritability. The fast COMT variant (val/val, GG) leads to an accelerated breakdown of the neurotransmitters dopamine, norepinephrine and epinephrine, which can lead to lower levels in the brain. This affects executive functioning like working memory, focus and attention. (also seen in inattentive ADHD)   MAO-A- fast or slow A fast MAO-A variant leads to an accelerated breakdown of the neurotransmitters serotonin, metatonin, dopamine,epinephrine and norepinephrine in the brain. Which results in lower levels of these affecting  mood, and potentially leading to anxiety, and reduced motivation and impacting sleep. A slow MAO-A variants leads to a reduced breakdown of the neurotransmitters serotonin, dopamine, and norepinephrine in the brain. Which results in higher serotonin availability. This can provide a buffer against emotional volatility and protect against anxiety or depression.   DRD2 DRD2 is a dopamine receptor located in the stratum, hippocampus, amygdala and cerebral cortex. The DRD2 gene codes the dopamine receptor DRD2.  The variant causes a reduced number of dopamine binding sites in the brain, resulting in reduced dopamine signaling which means that individuals with mutations are less sensitive to the activation of dopamine- based reward system and this makes them more likely to be predisposed to addictive behaviour. A simple example would be while some people may feel satisfied after one block of chocolate, it may require a whole slab for someone with a variant in DRD2 to feel the same sense of satisfaction which is why they often are led to overeating. They need stronger stimuli to experience the same level of reward as individuals with a normal receptor density, which is what often leads to addictive behaviors or seeking out more intense experiences.  Shopping, gaming, spending money, seeking out new experiences, trying new hobbies, or over eating are often part of the reward seeking. The DRD2 receptors play an important role in addiction and eating behaviour as they are involved in the dopamine based reward circuitry. This receptor has been associated with Parkinson’s Disease, alcohol addiction, opioid addiction, ADHD with hyperactivity and impulsivity, and binge-eating, affecting working memory.     Slow COMT / Fast MAO-A / DRD2 (Wired but tired phenotype) Greg (fictional character) has this combination. He works really hard and loves his job. In fact, he finds it hard to stop working! Greg is quite meticulous when it comes to detail and work ethic, paying close attention to small details. He can sit for long periods of time, focusing on his work without any problems. He likes things to be “just right”, perhaps even bordering on some perfectionist tendencies. However, when things don’t go his way, he finds himself reacting with annoyance and anger. Small things often annoy him, like spelling and grammatical errors. Greg finds it hard to switch off and relax. He feels the constant need to keep going. Others would describe him as a workaholic. When he isn’t working, he likes to participate in sports, go to the gym or do fun and exciting activities on the weekend like go-cart

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