Neuroscience of Pornography Addiction & Withdrawal

Hey there, everybody, and welcome to this video on the neurochemical process of pornography addiction. I'm your host, Dr. Donnelly Snipes. In this video, we're going to review the neurochemical process underlying the development of, guess what? Porn addiction and other compulsive sexual behavior disorders. This video is going to be very sciency, very dense with material. If you're looking for a higher level overview view of what's going on. I do have other videos on that on the YouTube channel. But if you're looking for a deep dive to try to better understand what's going on in there, stick with me. So let's start out by talking about the neurochemical basis of compulsive sexual behavior disorder. And yes, there's a lot of words there, but it's important to recognize that compulsive sexual behaviors have a behavioral component, but they are also driven by neurochemistry. It's important for people to recognize that we don't just think of a behavior and decide to do it. There are chemical processes at work that are driving our urges and our desires. So when exposed to a sexual stimulus, either in real life or in the media, or even in your own imagination, a sex cocktail of chemicals are released. Dopamine, glutamate, testosterone, oxytocin, endorphins and nitric oxide, among other things, are released when you start feeling sexually aroused. When this arousal sets in, or a craving for whatever the sexual stimulus is sets in the HPA axis, your stress response system also increases cortisol and other stress hormones to give you the energy to pursue it and make it happen. So now you're excited physically and sexually, and you're kind of ready to go. It's important to recognize the andro accelerator hypothesis, and we'll talk about that later. But the andro accelerator hypothesis tells us that when testosterone is added to the pleasure cocktail, it intensifies the strength of the reward. All of these hormones and neurotransmitters that I mentioned a minute ago are involved in multiple bodily processes and operate on the Goldilocks principle. Too little of any of them, you ain't going to feel good. Too much of any of them, you ain't going to feel good. It has to be just right. And they all impact each other. So altering levels of dopamine, for example, will also cause the levels and availability of things like testosterone and endorphins to change. You cannot change one without affecting all of the others. The dopamine fast, which is going around right now. Well, okay, yeah, you are avoiding things that cause intense surges of pleasure in, in theory. But you're not just reducing the amount of dopamine in your system. You're reducing a lot of these things. And that may be good. Your system may need a break, but it's important to recognize you can't just single out one neurotransmitter or hormone and think it's not going to affect everything else. So let's talk about what these hormones and neurotransmitters actually do. Well, we already talked about arousal. They're all involved in the arousal process, both motivation, both cognitive arousal as well as physiological arousal. Mood. Dopamine, glutamate, testosterone, oxytocin, endorphins and nitric oxide are all involved in mood regulation. Motivation. Dopamine, testosterone, oxytocin and endorphins, not so much. The nitric oxide are involved in the motivation process. The. These are chemicals that we need to feel like we want to get off the sofa and to pursue things that are of interest to us. Energy and insulin regulation. Who knew? Nitric oxide, testosterone and indirectly glutamate all impact our insulin levels and our energy, inflammation and immunity are impacted by oxytocin, nitric oxide and endorphins. And pain tolerance is impacted by dopamine, testosterone and endorphins. Now, ultimately, you don't need to know each one of these things. My point with this slide is that if you are having difficulties in your dopamine system, or what we call the dopaminergic system, it's not only going to impact your motivation, but it's going to impact your energy levels, it's going to impact your mood, it may impact your ability to regulate your insulin levels, it may impact your pain tolerance. So we need to recognize just because dopamine is not directly involved in insulin regulation, it impacts those other chemicals. And when those other chemicals are impacted, then it's going to have sort of a cascade effect. Now let's talk about excitotoxicity and we're going to put all this together. Just bear with me. Excitatory or stimulating hormones and neurotransmitters can be thought of as hot. Okay? When your system is over stimulated or things are running too hot, neurons die and that they're not actually hot, but just kind of envision them that way. It makes it easier to conceptualize calming and refractory or recovery hormones can be thought of as cool. When your system is too relaxed, too cool, it impairs blood flow and oxygenation. And guess what? Neurons die. So think about people who get go into a really cold pool and go into shock or. I don't like the example, but it's one everybody's familiar with. People who overdose on opioids, they get too relaxed and then the oxygen's not getting to the brain and neurons die. So we need the just right amount of excitotoxicity, not too much, not too little, and they balance each other out. We're going to have periods where we're really excited, no problem. The brain can handle that for a short period of time, but eventually it needs to cool down. It would be like going out into the Sahara desert in the middle of the summer. You can handle it for a short period of time when it's really, really hot. But very quickly you're going to get to the point where you need to cool down or your system is going to start to overheat. According to that andro accelerator hypothesis I mentioned, adding testosterone to the pleasure cocktail greatly intensifies its pleasurable impact, which then causes the release of even more dopamine and even more glutamate. So adding testosterone makes people even more excited and more driven to get it, whatever it is, when motivated. The sex cock, the sex cocktail and increased levels of dopamine temporarily reduce a hormone called prolactin. The prolactin is one of those refractory hormones that is designed to say, you know what, we don't need to go again yet. This is our recovery period. And it stimulates something called dynorphin. Prolactin is responsible in part for the refractory period after orgasm. Some prolactin is necessary for the production of testosterone, Goldilocks, you need some of it. And regulation of reproductive, immune and inflammatory processes. So again, you've got another hormone that's involved in a bunch of stuff. Too much prolactin, however, can reduce testosterone levels and libido. One of the interesting things that they found is in new fathers, a lot of times their prolactin levels are higher when the new baby comes home. Dynorphin has two main effects. Reducing the motivating effects of dopamine. Dynorphin says, okay, stop, this is, it's time to stop. We're getting too hot. And it makes glutamate toxic, causing damage the dopamine to the dopamine receptors if the person does not reduce the levels of those chemicals in the system. So dynorphin is sort of like your enforcer, I guess. And if you don't pay attention, then it's going to do some damage. As dopamine increases, so does dynorphin, which eventually reduces the craving. As dopamine goes up, dynorphin goes up. And as dynorphin goes up, it reduces the motivating effects of dopamine. So it eventually dinorphin takes over and the effort doesn't seem worth it anymore. Additionally, and unique to sexual behaviors after orgasm, in addition to dinorphin, the body now increases prolactin, which also blunts the effectiveness of the sex cocktail. So we have another chemical in there going, we're not going to get excited again right now. It's just, it's not worth it. There's no motivation for it. And it's responsible for the refractory period and temporarily, temporarily reduced libido. Now, this temporary state may be five minutes, it may be five hours or more, but prolactin is involved here. They have also found that extended periods of celibacy are often associated with situationally increased levels of prolactin as well as so if somebody has gone an extended period, whatever extended is for them, prolactin levels may increase. When they start engaging in sexual activity again, the prolactin levels will drop and normalize. This feedback loop, the dopamine dinor dynorphin loop, as I call it, is designed to prevent extended exposure and overloading of the pleasure circuitry. The dinorphin and prolactin work together to basically tell the person in the desert, hey, you need to find some cool rock to go sit underneath for a little while and cool down and then you can start again. Basically the brain's saying, we're starting to overheat. Too much dopamine, too much glutamate, and you need to have an orgasm so we can cool down. When dopamine and glutamate levels stay too high for too long, then that hot state is sitting in the brain and neurons start dying. This contributes to what we are going to call hypofrontality. When neurons start dying, it's not just in the hippocampus, it's also in the frontal cortex. The frontal cortex is where we have all of our higher order thinking. And when your dopamine and glutamate levels stay too high for too long, some of that higher order thinking, some of those neurons start to die and it becomes more difficult to think clearly, if you will. Under conditions of prolonged or frequent ex or excessive exposure to stimulation, the body calls in protective reinforcements dynorphin still there, continues to try to cool the system by blunting the effectiveness of dopamine and causing glutamate to damage the dopamine receptors. It says, okay, I'm going to try to make this not rewarding to you and if you keep doing it, I'm going to start causing damage, okay? But the person doesn't listen and they keep doing it anyway. Prolactin builds up and and works with dopamine to blunt dopamine's effects and protect against that excitotoxicity. This is level two. So they called in dynorphin, calls in reinforcements and says, I'm breaking fingers here and ain't nobody stopping doing anything. So prolactin comes in and tries to help convince the brain, convince the person to stop engaging in that behavior to make it not motivating. Delta phos b. This is our third level response. These are the big guns. Delta phosp B is created to assist in protecting the neurocircuitry. Delta phosph B triggers an increase in the production of brain derived neutrophic factor or bdnf. So this is like when the governor recognizes that things have all broken loose and calls in the National Guard. These are the big guns. BDNF causes changes that lead to reduced signal strength and neurotransmitter release. It says, all right, I'm going to stop the flow of stuff, neurotransmitters and hormones from the beginning. I'm not even going to let them out right now. So the pleasure palace in the brain becomes fortified and harder to break into. The BDNF builds up some walls and so the signals can't get through. We've all been down in the basement of buildings and stuff where the signal couldn't get through. All right? To override the tolerance caused by delta phos b and bdnf, more intense or additional types of stimulation are needed to create a stronger activation of the neurocircuits. So the offenders, whatever is trying to break through, has to up their game or they have to increase the signal strength in order to get the message through the fortress. When the brain becomes addicted and delta phos b and prolactin build up, the body's response to dopamine is reduced not only for pleasurable activities, but also for all the other functions. So the person starts having more pain, they start having less energy, they start feeling very unmotivated for anything. The person may start have also having sleep problems, irritability, mood Swings, depression and brain fog. Even when they are doing things that used to help them feel good or motivate them so they're starting to get to this depression disaster. Blah, flat. I've heard colorless phase. I've heard it described a lot of different ways. The body recognizes the neurotransmitters are out of balance and sends out an alert. This triggers the brain's survival or stress response. That HPA axis, the brain goes, okay, we need more dopamine. I know this. We need more of these neurochemicals. We're low on some and too high on others and it's just a mess. So the managers, if you will, in the brain start getting freaked out and trigger the stress response to alert the brain, hey, we need to motivate this person to do something so we can balance out our inventory. The HPA axis releases chemicals including glutamate and dopamine, which cause the release of energy to seek out the resource. So the person starts craving. The body knows that if it gets a sexual stimulation and or release that it will increase the the levels of those chemicals so it can feel normal again. So that the resources can be balanced. But the person, so the person starts craving. Unfortunately, it becomes increasingly difficult to restore the balance. Since porn is a super normal stimulus and the brain has become accustomed to it and desensitized to regular stimuli. Supernormal stimuli are things that are more available to the person than they really should be in reality. For example, porn is never ending. Just click, click, click, click, click, all day, all night, never ending. In real life, you don't have access to that much sex. It's just not the way it works. So it's super normal. Porn is super normal because it's curated, it's edited, it looks perfect. Real life. You look at a person in real life and you may be like, ah, you know, they don't look perfect. Well, yeah, they're not airbrushed. So what do you think? But as a result, the brain responds more strongly to the perfect curated, edited version and the never ending access to it. As the dopamine system becomes even more out of balance, cravings become stronger. So the person is needing more dopamine and it's, they're just not getting it. So the brain becomes, if you will, the managers in the brain become increasingly stressed out and saying, we really, really, really, really need to balance out this inventory. Unfortunately, it's a downward spiral. Future exposure to the pleasurable stimuli triggers the release of the dopamine. So, okay, it's like oh, finally got a dose. And at the same time, delta phos B, who is now hanging around because the National Guard hasn't been sent home yet. Delta phos b promotes greater increases in dinorphin release and effectiveness of dopamine and increases in the toxicity of glutamate. So we've got the big guns that are working against the person. But remember, dynorphin not only blunts the effectiveness of dopamine, but it also makes glutamate more excitotoxic. It makes glutamate hotter. So by doing this, Delta phos b is actually promoting the destruction, if you will, of neurons. So how do we recover? Healing the brain and nervous system is possible, but it requires reducing the levels of excitatory hormones and neurotransmitters. It requires healing that stress response system or the HPA axis. Now I want you to think before you go. Well, that's not possible to heal the brain it is. Think about people who have had a stroke and lost the use of part of their body. They can learn to use it again, but it takes time. The brain has to remodel and create new infrastructure to support their behaviors. Withdrawal will involve a period of craving, irritability and sensitization or hyper awareness that peaks after about two weeks. Now hyper awareness is when you become more sensitive, which is why they call it sensitization of stimuli in the environment. Everything seems to make you think about porn or sex. Recovery will require healing the nervous system and reconditioning the reward pathways and sex related schema. Neurons that fire together wire together. So if the brain has learned that porn produces pleasure with very little risk and very high reward, it fires together a lot. Risk, the reward and the pleasure and the behavior. So that connects. And if the person is engaging in real life sex with people and it's not as rewarding or it's not as available or it requires more effort, that's going to be a weaker connection. The brain goes for the path of least resistance. So we're going to have to recondition the reward pathways to actually appreciate IRL stimuli. You can find more resources including worksheets, other videos and Recovery support@docsnipes.com Tolerance develops due to changes in the brain's reward and stress systems, specifically the dopamine system. Withdrawal symptoms occur when the brain has become dependent on increased levels of hormones and neurotransmitters caused by use to function normally. So when you are abusing substances, the body adjusts to it. When you are flooding the system with these hormones and neurotransmitters. The brain starts building its infrastructure on stilts to keep from getting flooded. But then it makes it harder for it to get its resources if it's all the way up there on stilts, if it's not regularly experiencing those floods. Without the hormones and neurotransmitters, the body struggles to maintain normal function. Changes in the effectiveness of dopamine impacts nearly all other hormones and neurotransmitters and causes withdrawal symptoms. Recovery requires creating a physical, mental and emotional environment that supports healing.