Everyone Has Opinions. Everyone Has Research. Does Anyone Have THE Answer?

Readers have been sending me all kinds of articles lately about where addiction and mental illness come from and how best to recover. It’s useful and appreciated. But there’s a missing piece. A big missing piece.

Mood music:

Here’s the thing about addicts: We know all the things you’re supposed to do to get well. We know full well what is good for us and what is bad.

And when the itch takes over our brain, all that stuff doesn’t matter. We want the thing that’ll make us comfortable. In that mode, we avoid all the good stuff at all costs.

Yoga is fantastic for you and helps you learn to live in the moment. But when my head is in that other zone, there’s just no way I’m going to try it. A big fat cigar is what I REALLY want. (I just quit tobacco, which is why I’m prickly as I write this).

Fruit and veggies are terrific for you. But when the binge eater wants to binge, only the bad stuff will do. Forty dollars of McDonalds. That’s what I go for.

These are the things people just don’t understand when they try to help people like us with advice. When the addictive impulse strikes, the overriding craving is for something that’s very bad for us. Sure, gluten is bad for you. But if my binge-eating compulsion were active and I had gluten intolerance, I’d swallow all of it anyway.

Because I want that momentary feeling of rapture more than anything, regardless of the pain I know will come minutes and hours later.

That, my friends, is what escapes you when you’re trying to help me.

Now, let’s stop here for a reality check: I AM NOT going on a binge right now. I’ve been clean of that for more than two years now. Fundamentally, I am doing well. I’m going to my 12-Step meetings. I’m writing. True, I am edgy right now because I quit smoking cold turkey Friday night. But that will pass. I’m holding steady on that front, despite the constant twitching.

But I am feeling vulnerable. My disease is doing push ups in the parking lot and it’s just dying to kick my ass.

I’ve written much about how my addictive behavior is a byproduct of mental illness (OCD). But addiction itself IS the mental illness. My friend Alan Shimel sent me an article from the AP that states the case pretty well:

Addiction isn’t just about willpower. It’s a chronic brain disease, says a new definition aimed at helping families and their doctors better understand the challenges of treating it.

“Addiction is about a lot more than people behaving badly,” says Dr. Michael M. Miller of the American Society for Addiction Medicine.

That’s true whether it involves drugs and alcohol or gambling and compulsive eating, the doctors group said Monday. And like other chronic conditions such as heart disease or diabetes, treating addiction and preventing relapse is a long-term endeavor, the specialists concluded.

Addiction generally is described by its behavioral symptoms — the highs, the cravings, and the things people will do to achieve one and avoid the other. The new definition doesn’t disagree with the standard guide for diagnosis based on those symptoms.

But two decades of neuroscience have uncovered how addiction hijacks different parts of the brain, to explain what prompts those behaviors and why they can be so hard to overcome. The society’s policy statement, published on its website, isn’t a new direction as much as part of an effort to translate those findings to primary care doctors and the general public.

“The behavioral problem is a result of brain dysfunction,” agrees Dr. Nora Volkow, director of the National Institute on Drug Abuse.

That’s some very enlightening stuff, and it will be helpful to people going forward. But THE answer to the problem will remain elusive.

I get a lot of dietary advice lately. People read about how I don’t eat flour or sugar as part of my recovery from binge eating. And that leads to questions like this: “Have you tried a gluten-free diet?”

It’s a fair question, and the person who asked about it just wants me to be well. I suppose a diet devoid of flour and sugar is gluten free. Mostly gluten free, anyway.

But in the end, the gluten itself was not my problem. The problem was my overwhelming instinct to eat all the gluten.

The problem is about control. I have none. The sensor in the brain that tells people when they’ve had enough doesn’t work in my head. It broke long ago. So I need a set of coping tools and the 12 Steps to keep my head in the game.

That’s not THE answer, either. But it helps a lot.

Thanks for sending me the articles, friends. I might balk at some of the information, but I appreciate the spirit in which it’s delivered.