Dopamine

[Nick799]

I am coming to realize that I am suffering from anxiety, and I think it may run in the family. I don't have attacks, rather, I find every one-in-a-million danger out there weighs on my mind far more than is warranted. If I call a friend or family member and it goes to voicemail, I worry that something terrible has happened to them. I know full well that the odds of that are one in a million, and it is almost certain that nothing bad has happened, but the thought keep gnawing at me. Something interesting happened recently that both illustrates this and makes me think dopamine may have something to do with it.

First, let me make it clear that I am not a druggie. I've never taken an illegal, recreational drug in my life, not even pot (and I was in high school in the 1980s!) On a couple of occasions, however, I have taken peyote with Native Americans. The reasons for that are another story. The peyote church I attended was in Arizona, several hundred miles from my home. Before the trip I heard a story on the news about Mexican drug gangs operating in Arizona. The story made it clear that the crime was taking place in cities and mostly involved people with connections to the drug trade. And yet, I kept worrying about it, even though the church was far from a city and far from the border. On the way we passed a state prison. Now, I knew the odds of someone escaping that day AND showing up precisely where I was going were almost zero, but I kept worrying (the church has been there for decades and no prison escapee has ever wandered into it). I had replaced a lamp shade a few days before leaving, and found myself worrying that the bulb might be too close and could start a fire (that might be a rational concern in some cases, but there was no real reason to be worried in this case). Further, my wife (who'd stayed behind) was having dinner one night with some friends in a neighborhood that, while not bad itself, bordered some bad parts of town. She knows to stay with her friends and wouldn't walk down a dark alley or do anything else stupid, but I was still worrying about her. The day I took the peyote, I found myself worrying incessantly that the law concerning the ritual use of peyote might change and the feds would show up that day. And, of course, I was worried that I would be the first person to die from peyote (peyote is not a toy and can be very dangerous when used recreationally, but there has been only death in the Native American Church, and that wasn't entirely related to peyote).

But when the effects came on, everything changed. My worries subsided. They didn't disappear, but they subsided to what was warranted by the odds. Yes, I knew it was possible that someone could escape from the state prison, but I wasn't any more worried that was warranted by the odds, which of course are less than one in a million. I started thinking about all the other things I worry about, and found that, while not totally numb to all worries, I was no longer any more concerned about them than I should be. I spent about 8 hours in this blissfully non-worried state. Later, after the effects of the peyote had passed, I called my wife and got her voice mail. My first thought was, "I hope nothing's happened to her, I couldn't do anything way out here!" That's when I knew for certain the effects of the peyote were over.

I've read that the active ingredient in peyote is a dopamine agonist. That fits with something else: I had severe ADD, and have had it for as long as I can remember. I was diagnosed at the age of 7, (when doctors were much more through in diagnosing the condition than some are today). I took Dexedrine for several years. That improved the ADD but caused a bad case of depression that went away as soon as I quit taking the it and hasn't come back since. I understand that ADD appears to have something to do with the dopamine system. That makes me wonder if the anxiety is somehow coupled with the ADD and is caused by some problem with dopamine system.

My grandmother was the same way, but much, much worse. She was in her 60s when I could remember her and she was 90 when she died. She was at the point where she didn't even realize how unlikely the subjects of her anxieties were. If someone was late coming home, there was no question they had been mugged, hit by a car, or something dreadful. Lately, family members have been telling me "You're getting to be just like your Grandmother!" I wish we could have done something for her, but it's too late. Now I'd like to make sure I don't get to be like her as I get older.

So what does this sound like? Am I on the right track thinking dopamine might be the culprit? What should I tell the doctor about this? And is it possible that there might be a medicine that, in fixing whatever problem the dopamine may be causing, might help both the anxiety and ADD at the same time? I can't begin to tell you how that would improve my quality of life.

By the way, for anyone reading this, peyote is not something to play around with. Native Americans are extremely careful in how they use it. Don't take this as an endorsement of recreational peyote use. In fact, consider it a warning against it. Believe me, I know of what I speak.

Thanks in advance.

[ILADVOCATE]

I'd more worry about the problem itself than the biochemistry. If anything brings up dopamine it can potentially cause psychosis that's correct. That's the basis of the current generation of antipsychotics (for the future generation you can read through my posts). But rather than analyzing yourself clinically which can be fruitless tell a psychiatrist what is going on. Yes aspects of it do sound psychotic but if it was caused by something you took (even as part of what you described which is legal under U.S. law and not done for recreational purposes under specific laws for religious exemptions) you need to let the psychiatrist know that as well as your history of ADHD and what you took for it. Then they can determine better what medication you need and what your diagnosis is.

[Nick799]

Thank you for the speedy reply. Let me be absolutly clear that I did not take peyote for self-diagnosis. I agree that taking peyote or any other substance for the purpose of self-diagnosis would be a terrible, terrible idea and I don't want anyone to think that I am advocating that. I took peyote for reasons that had nothing to do with anxeity.

The thing is, I used to think of my anexity as a personality trait, not a medical condition. I used to think I was a worry-wort, but not someone afflected with a disorder. It was not until I took peyote and spent 8 hours free of excessive worry that I realized just how much I was worrying, and that it really is a disorder. When I got home I asked my wife if she thinks I worry too much. She looked at me and said, "You mean you just realized that?" Well, actually yes, I guess I've grown used to it and didn't know anything else.

Please, let me make clear to anyone reading this that it was just an accident that peyote led me to realize that I have an anexity disorder. I would discourage, in the strongest possible terms, anyone from intentionally using any substance for self-diagnosis.

[Paxiled]

My only question for you here is, just how much does this problem interfere with your life?  If not that much, you might want to see a psychologist, or if you're into holistic medicine, which the peyote experience suggests, someone in that field.  Psychiatrists are basically middlemen between the pharmaceutical industry and the drug stores.  We know a lot about how peyote affects people because it's a natural substance that has been used for thousands of years (but for spiritual purposes -- only modern peoples use drugs all the time instead of occasionally for spiritual purposes), whereas we know very little about the these new medications and how they affect people.  So I've always seen them as a last resort, not the first.

What peyote taught you is what it's supposed to, about yourself and the world around you.  Now you know there's nothing really to worry about.  Work with that, don't rush off for more drugs.