Schizophrenia and Dopamine: Happiness's Dark Side

The "Happiness Hormone" Hype

People want, crave, and anticipate pleasure. To that end, dopamine is an excellent ingredient in a complex reward system.

An article from Harvard Medical School illustrates a well-struck balance of dopamine: "Dopamine is most notably involved in helping us feel pleasure as part of the brain's reward system. Sex, shopping, smelling cookies baking in the oven — all these things can trigger dopamine release, or a 'dopamine rush.'"

But dopamine as a "happiness hormone" is cutting the story short. Depending on dopamine receptors and the pathways followed in the brain, the neurotransmitter can act in a hellish world of delusion, hallucination, or permanent conditions that cause tremors or psychomotor dysfunction.

Not Too Much. Not Too Little.

Even though the brain's reward systems can naturally transmit delicate happiness chemicals around our brains, too much or too little can result in pathology.

Schizophrenia and Parkinson's disease are two diametric outcomes of an imbalance of the hormone dopamine. It's the "dopamine paradox," as established in the medical industry. And its dual effects on the mind and body are alarming.

The Dopamine Paradox

Side effects of antipsychotics used to treat schizophrenia cause dysfunction related to tremors and muscle control, fitting into the bucket "extrapyramidal syndrome" (EPS).

A partial set of the related effects in EPS is termed "Parkinsonism," although antipsychotics are not known to cause Parkinson's disease.

Research has shown the tremors caused by antipsychotics and those experienced in Parkinson's share a common factor: Decreased availability of dopamine.

The National Institute of Health remarks on the damaged neuronal cells in Parkinson's:

"Estimates of the loss of striatal dopamine terminals markers… support the statement that there is an 80% reduction at the time of disease onset."

In Parkinson's disease itself, a reduction in dopamine occurs due to the loss of dopamine transmitting cells in the brain instead of as a byproduct of antipsychotic medications, as happens in schizophrenia.

Adverse Effects of Parkinson's and Schizophrenia Medications

The Annals of Pharmacology and Pharmaceutics reinforces the link between the pushing and pulling forces of a dopamine imbalance in schizophrenia and Parkinson's disease:

"These pharmacological interventions in either of the two disease states result in over-shooting the optimum dopamine levels therapy, resulting in drug-induced extrapyramidal symptoms in schizophrenia and hallucinations in Parkinson's disease."

The resulting symptoms of dystonia, rigidity, and tremor disorder after the loss of dopamine terminals in Parkinson's parallel the loss of availability of dopamine due to antipsychotic use in treatment-controlled schizophrenia. And the occurrence of hallucinations and delusions with Parkinson's drug therapies demonstrates the link to dopamine elevation in schizophrenia.

The balance of symptoms and side effects can be a narrow path for these two conditions. And this shows how far dopamine can break down and stray from a positive actor in a natural pleasure and reward system to one that excites hallucinations, paranoia, and tremors.

The Role of Stimulants in Psychotic Episodes

Medications like Adderall and Vyvanse work wonders for people who have ADHD, but these advanced drugs greatly increase dopamine and have a fair risk of dependency with misuse.

The Journal of Neuropsychiatry and Clinical Neurosciences relates why caution is necessary: "It has been proposed that drugs-of-abuse induce larger and more prolonged activations than natural stimuli, promoting habit-formation that is quite robust and resistant to change."

As dopamine-promoting agents, there is great potential for added motivation and improved mood. However, the balance of dopamine here is of particular importance due to the potential for stimulants to overdrive the senses and induce psychosis as a side effect of misuse.

Guidance from Professionals on Addiction

Courtesy of The National Alliance on Mental Illness (NAMI), the American Association of Psychiatric Pharmacists (AAPP) has produced drug guides for many stimulants that are available on the market to help those who live with ADHD and disorders that benefit from these mental acuity aids.

As mentioned, the risk of psychosis is a potential in the misuse of stimulants. However, working with your doctor and following the advice of your pharmacists will greatly mitigate the chances of experiencing adverse events.

Metabolic Dysregulation: More Side-effects VS Symptom Relief

The apparent risks of manipulating dopamine levels (to a fair degree) can drastically change a person's life. In addition, the challenges of balancing effective treatments for schizophrenia are the risks of core metabolic dysregulation.

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Dopamine-inhibiting antipsychotics are lifesaving but also potentially perilous drugs. Metabolic syndrome (caused by antipsychotics) is a collision of dysregulated metabolism, and the result of the troubling side effects include high cholesterol, high blood sugar, high blood pressure, increased appetite, and weight gain.

The Bottom Line of Health and Happiness

Even with the sensitivity of the brain, dopamine is, in fact, an essential means of remaining healthy and happy. The pitfalls of the excess or scarce availability of dopamine do not sum up the total value of what dopamine does for us. And the benefits of experiencing the positive effects of dopamine cannot be understated.

Many healthy behaviors ping the happiness center in the primitive parts of our brain, including meditation, healthy eating, and exercise, as reported by Harvard.

The drugs used to treat schizophrenia, Parkinson's, and ADHD are also safe when used as prescribed, although close supervision is often required to avoid the potential of serious side effects.

A Personal Note on Schizophrenia and Dopamine

As someone who has taken antipsychotics for most of my life, I feel incredibly confident saying I would not be alive if not for these marvels of mental health.

As bad as some of the side effects of antipsychotics have been, I welcome them compared to the distinct hell of psychosis, hallucinations, delusions, and the general havoc of having schizophrenia.

Dopamine and happiness aren't simple, but by degrees, it's an easy choice for me to take the medications that keep the disorder in check and a brighter future on the horizon.

*Disclaimer: This blog has not been reviewed by a medical professional. Its content is intended solely for informational and entertainment purposes only. Nothing in this blog should replace, substitute, or inform the advice of or from any healthcare providers or any medical caretakers. Please consult a qualified medical professional to verify the information provided here.