Balancing Our Neurotransmitters: Electrochemical Communication as the Biological Component of Mental Wellness
by: mike morse, 2/23/2021
Author’s Note 7/15/2021: My purpose for writing this essay was to try to explain neurotransmitters through the lens of psychiatric medications. I want to challenge readers to abandon any previous feelings or thoughts you may have that may lead you to believe that our mental health can be reduced to an entirely biological condition.
The language surrounding mental health has been the center of discussion for psychological scholars and researchers over the past few decades. Psychology as an academic discipline treads the line between medicine, physical science, and social science. Because of this, much of the field’s foundations reflect characteristics of the Western medical model orientation, under the belief that it has a sort of empirical superiority. For example, the Diagnostic and Statistical Manual for Mental Disorders (DSM), which was created by the American Psychological Association (APA), is used by psychiatrists, psychologists, medical professionals, researchers, lawmakers, and insurance companies throughout the country as the preferred method for classifying mental health diagnoses. For the most part, the DSM is used to help discuss treatment of mental health disorders in a medical model framework, rather than as a tool to guide individualized care. The history of the DSM reveals the ties of the psychiatric industrial complex with the military industrial complex. Preceding the first DSM, a document called the Statistical Manual for the Use of Institutions for the Insane was adopted as a guide in 1917 to formalize nomenclature for the psychiatric-medical industry. Thirty years later, United States military officials were seeking official labels to use for ‘disturbed’ soldiers, likely people suffering from what would now be labeled PTSD. They encouraged the development of a classification scheme called Medical 203, which was severely edited by United States Army officials. When the APA officially created the first edition of the DSM in 1951, the ideologies and conceptual framework were the same as those in the Medical 203, and even included some identical passages. This version included classifying homosexuality as a sociopathic personality disturbance, all of which resulted in public pushback and protests, eventually resulting in updates to the DSM, which is currently in its fifth edition.
Currently, advocates have established arguments both for and against the use of diagnoses for mental health disorders. DSM diagnostic labels provide strict boxes for people to fall into; these boxes can result in a variety of outcomes, from anywhere between the extremes of social control to community building. Each diagnosis is merely a particular combination of physical, behavioral, or emotional symptoms that need to be perceived as causing dysfunction to merit a consideration of a ‘disorder’. Additionally, these symptoms overlap and often result in misdiagnosis; different practitioners may even give the same individual entirely different DSM labels. The development of the DSM was entirely centered in a medical model approach to psychiatry, and even psychology, meaning it was initially focused on providing a strictly physiological explanation for behavioral differences, which at the time of its inception compared everyone to post-WWII productivity. More modern ideologies within psychological practice attempt to take a biopsychosocial approach to treatment, which include emotional, mental, and sociocultural influences to one’s mental processing and resulting behaviors. In order to be fully introspective and engage in psychological processing, understanding that biology alone cannot be the full blame for how we interact with ourselves and with others, however we can use it as a guide. Modern neuroscientists have been working to build a connectome, a neurological map showing all of our brain’s connections. Personally, I believe that the most helpful biological component to understanding our functioning and behavior is neurotransmitters; these electrochemical molecules act as intracellular communicators throughout our brain and body, connecting our conscious and unconscious minds with our physical brain and body.
In my last thought piece, I explained the process of neuron connections and communications and discussed what I believe are the 8 essential neurotransmitters: acetylcholine, histamine, GABA, glutamate, serotonin, dopamine, noradrenaline, and adrenaline. As a reminder, neurotransmitters can only act in one of two ways on their receiving cell: excitatory or inhibitory. While many of these molecules overlap in some of their functions, they all serve a unique purpose, which can help us comprehend how different pharmaceutical drugs interact with our body, brain, and mind. Acetylcholine in the brain is often associated with learning and memory, and issues with acetylcholine distribution have been associated with problems discriminating factual information (from fictional) and with forgetfulness. Many medicines affecting acetylcholine act as antagonists, and use techniques of blocking, hindering, or mimicking the neurotransmitter, such as drugs to help with nausea or relaxing skeletal muscles; nicotine, opposingly, acts as an agonist, encouraging acetylcholine action. Histamine is a neurotransmitter most known for its role in inflammatory responses throughout the body, however it also plays an important role in our brains. One of the primary roles of histamines in the brain is alertness (think of how some of the original antihistamine medications are known to make people drowsy); other associations have been made with sexual dysfunction. Issues with histamine processing can result in immune system disorders and allergies.
GABA, an amino acid, serves as the matured brain’s calming neurotransmitter (functionally replacing glutamate in the premature brain), including relieving anxiety and stress. Well-known drugs increasing GABA activity include barbiturates, benzodiazepines, and alcohol. Deficits in GABA signaling and communication have been associated with conditions including ADHD, depression, anxiety, and epilepsy. Glutamate is known for its excitatory behavior, accounting for 90% of the synaptic connections within the human brain, and is highly understood to play a role in plasticity, learning, and memory. It is an amino acid and is most widely recognized as the food additive MSG. As glutamate is defined by activating features (i.e. it acts as an excitatory molecule for our nervous systems), it has been associated with autism, schizophrenia, Parkinson’s disease, Alzheimer’s disease, stroke, ALS, MS, depression, and OCD.
The primary association of serotonin within mental health is related to mood; however, it also plays many other roles, such as in cognition, appetite, sleep, memory, learning, reward, and various physiological processes (including vomiting and vasoconstriction). Most antidepressants work directly with serotonin, as do psychedelic drugs. Low levels of serotonin are associated with depression, anxiety, irritability, aggression, impulsive behavior, fatigue, IBS, poor memory, and poor appetite; too much serotonin can result in serotonin syndrome. Dopamine plays a role in regulating mood, motivation, pleasure, reward, arousal, and reinforcement. Many medications for ADHD (including Adderall and Ritalin), cocaine, and methamphetamine are all recognized for their direct interaction with dopaminergic systems in our brain; in fact, most drugs classified as stimulants are recognized for the role of dopamine in their addictive elements. Dopamine is also known for its role in pain modulation, as often noted in its role in painful symptoms of Parkinson’s disease.
Norepinephrine is a molecule that directly evolved from dopamine; it is associated with wakefulness, alertness, and fight-or-flight biological responses. Because of its relation to dopamine, norepinephrine is often increased in the brain when interacting with other drugs (such as amphetamines or antidepressants); this increase is associated with general nervous system hyperarousal. Conditions associated with norepinephrine dysfunction include chronic stress, ADHD, heart failure, high blood pressure, and other sympathetic nervous system hyperactivity issues. Finally, epinephrine, aka adrenaline, is also closely related to dopamine and norepinephrine; most highly associated with autonomic fight-or-flight responses, epinephrine primarily works to help neurons within the brain communicate with each other. Adrenaline is used as a drug for anaphylaxis, asthma attacks, and cardiac arrest.
Most neurotransmitters are synthesized directly within neural cells, depending on the type of molecule. Synthesis and distribution occurs throughout the body, as neurotransmitters are not only activating brain cells; the majority of serotonin production, however, occurs in the gastrointestinal tract and gut. Like any multicellular organism (plants, animals, etc), molecules (i.e. neurotransmitters) also undergo evolution. Many preceding molecules to modern neurotransmitters can even be traced back to differentiated bacteria and other unicellular organisms, highlighting yet another connection between humans and other life forms. Our brain’s current electrochemical building blocks can be found in other forms of life as well, such as certain plants and animals, which can provide sources of energy. For example, large amounts of dopamine have been found in bananas, suggesting adding bananas to your diet may be helpful for people who tend to have naturally lower levels of dopamine (which is associated with a variety of anxiety disorders, mood disorders, and features of psychosis). I have compiled a list of natural food sources of different neurotransmitters that I have linked here; it is important to note that dietary supplements will not ‘cure’ any disorders, however experimenting with different foods may help provide a safer and healthier solution for some symptom relief than chemical alternatives. As we become aware of the energy sources related to the food we eat, this is one of many parts of an activity known as mindful eating. I believe that understanding these basic building blocks of our body can help bring us to further processing our overall functioning and being as well.
Many biological approaches to mental health try to take either a genetic or structural approach. By focusing on the actions of neurotransmitters instead, we center molecular communication as the primary biological aspects of mental wellness. Most psychiatric medicines work in this way- often targeting the reuptake of neurotransmitters within the synapse, which in turn encourages them to work more efficiently. Since these neurotransmitters are not worked on in an isolated location (there is not a vacuum separating the neurotransmitters in the brain), they are also affected in neural connections throughout the body. As a result, many people who take psychiatric medicines experience numerous side effects, and often need to decide whether their improved symptoms outweigh these effects. If our neurobiology was instead understood as differences in neurotransmitter communication, whether in the synthesis, activation, or mere amount, it may be easier to integrate the biological components impacting people’s mental health with psychological and social ones. SSRIs, for example, are medications taken for depression that work by decreasing serotonin reabsorption in the synapse, therefore activating serotonin activation in the receiving neuron (see here for my recent explanation of neural activity at synapses). People with naturally low levels of serotonin absorption tend to experience symptoms of depression, low energy, fatigue, and anxiety, but too much serotonin can lead to a toxicity known as serotonin syndrome. Rather than targeting neurotransmitter dysfunction as something that needs to be fixed, it should be instead viewed as something to be balanced. By recognizing mental and behavioral differences as merely being dysfunctional through the eyes of capitalism (many neurodivergent people may find their symptoms as their mind and body’s way of setting boundaries, not closing doors), we can work towards a more person-focused approach to our personal and communal mental health care.
To gain self-awareness into our psyche, and to be truly self-reflective of our own mental and emotional wellness, it’s essential to remember not only the interconnectedness of our mind and body, but also of our personal behaviors, our lives, and the spider web of connections we have with others. As social beings, humans rely on each other, and in modern society very few people are able to live entirely self-sufficiently. To be able to embrace our role within the interconnected web of humanity, we need to first be able to calm and balance ourselves. Understanding the role our neurotransmitters play in keeping our minds and bodies alive, and how they are connected with other life forms, can be a stepping stone to this process. Mindfulness, meditation, prayer, and self-reflection are all examples of ways to practice centering and balancing oneself. The therapeutic technique of dialectic behavioral therapy, a derivative of cognitive behavioral therapy, uses the concept of mindfulness to reach its main goals of mental health management. All five major religions of Buddhism, Christianity, Hinduism, Islam, and Judaism practice some form of meditation; the most obvious differences lie in whether the purpose is for the individual’s connection with their God or that of the greater society. By practicing what are known as grounding techniques, people can practice cognitive tasks and behaviors in an attempt to counteract unwanted negative thoughts and feelings. One exercise I learned during my undergraduate years is known as the 5–4–3–2–1 technique for coping with anxiety in the moment: name five things you can see, four things you can feel, three things you can hear, two things you can smell, and one thing you can taste. Engaging in regular meditation or self-reflection, regardless of its frequency, can help us re-center and refresh ourselves as well as open ourselves up to feeling our connections with the greater life and world around us.
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