Dopamine and me: thoughts on autism, dyslexia, social deficits

Note: I’m reading a lot today. I didn’t cite anything on this blog post but any fact that wasn’t personal came from reading a scientific article with some definitional support from Wikipedia.

What interests me today: dopamine and memory recall. I’m listening to this Alec Baldwin conversation with psychiatrist Julie Holland. Amphetamines like Adderall increase dopamine levels in brains. Dopamine can improve performance in the hippocampus but there may be time windows when dopamine can have a positive effect.

What does dopamine feel like? It can make things feel pleasurable such that you want to do them again. Good when it means you feel motivated to work out. Bad when it leads to addictive behaviors like gambling.

How does it help with memory? I’m not clear on that part, but hippocampus function is related to associative memory. Our brains recall things by creating unique circuits that light up to bring a memory to the forefront. The stronger those pathways become, the better your recall is.

Your strongest memories might include sights, sounds, smells, and other physical associations because of the way your hippocampus performed.

I have very strong recall for most events in my life. This is good when I need to write but also not great when I get overwhelmed by the intensity of memory. When I started experiencing PTSD after a summer in New Jersey in 2000, EMDR therapy helped me to disassociate the memories from the traumatic response I had. I stopped reliving the trauma in everyday settings.

My memory superpowers go out the window when I perform live or during certain intense conversations. For someone who can remember things almost verbatim, I suffer what I can only describe as amnesia. I remember the feelings but not what was said. Something blocks the memories from forming. It could have been anxiety.

My memory has also failed me in times when I’ve been depressed. I once visited Montreal on vacation. I was very depressed (and heavily medicated) during this time. I remember that certain events transpired, but only very few and without much specificity.

Psychopharmacologists have been studying the effects of MDMA and psilocybin on PTSD, anxiety and depression. These drugs (street names: Molly and shrooms) can be abused. They release serotonin and have positive increase effects on dopamine. I’ve seen people use and abuse them in pursuit of a good time, mental health, creativity and spiritual enlightenment to good and bad ends. As anecdotes, they fascinate me. But when someone prescribes them to others recklessly, it gets annoying fast. These people are quick to distinguish these drugs from pharmaceutical drugs as “natural” My response is usually, “Yeah, well so is cyanide.”

Drugs can do amazing things when done in the right amounts at the right time in the right circumstances.

Adderall has helped me immensely and immediately with focus but not with recall. I take it on days I want to devote to studying. It lowers my impulsivity. Off Adderall, I can focus for short bursts but I can be careless and lose interest quickly. I get bored quickly when something is predictable. And when I’m reading, a train of thought might arise that derails my ability to complete a passage that is difficult for me to process. On Adderall, I read better. My brain is less likely to misinterpret individual words and more likely to stick through to the end of a paragraph in order to contextualize everything.

I’m self-diagnosed dyslexic, which has a high co-morbidity with autism. It’s similar to my auditory processing issues (also self-diagnosed). I take in more stimuli than neurotypical people and my brain has to work overtime to process everything that’s coming it. When I’m in new environments, it means that I burn out faster from the overload. This is why routine and familiarity are so important to me.

I cope in my own ways. I am slightly myopic (it returned after 10 years of LASIK corrected vision). I don’t wear my glasses in public unless I need to read street signs or license plates. Having my glasses off means less visual stimuli. I wear noise cancelling headphones while walking or on the train for the same reasons. It allows my brain to have a syphoned amount of new information to manage so I can devote my prefrontal cortex to whatever problem solving I’ll have to do in the course of that day. What that means is I’m less anxious and less prone to meltdowns.

From what I’ve read about dyslexia, it’s a product of an underdeveloped left-hemisphere arcuate fasciculus. Neurologists believe that this part of the brain processes language syntax. The right hemisphere processes non-individual phonetic segments (vowels and consonants) but are properties of syllables and larger units of speech, including linguistic functions such as intonation, tone, stress, and rhythm. Such elements are known as suprasegmentals. It also interprets facial expressions and emotions.

If your brain, as I suspect mine does, relies on the right hemisphere to process visual and aural input, it takes longer to process because the right-hemisphere has to process stimuli conceptually. The whole picture gets scanned in and only becomes clear when it’s filled out. There’s a lag time. If you impulsively disrupt this process, the picture doesn’t fill out and the concept doesn’t have time to form. But with Adderall, I can pay attention long enough to get to that point.

Relatedly, I’ll just point out that I don’t have problems understanding people’s emotions or facial features anymore (a common diagnostic point for autism). It used to be a problem for me until I decoded and hacked beings through trial and error. Once I figured those things out, I became too empathic and got just as easily overwhelmed with emotional stimuli as I get with visual and aural stimuli. Then I built up strong boundaries and the issue mostly took care of itself.

It might not even be a problem with the left side. It might be that my corpus callosum is less developed. There’s a theory that autism is really a genetic mutation that governs how protein structures form from a very early embryonic state. A less developed neural highway between the hemispheres results in more localized brain development and less global processing. Not just stuff coming in, but stuff going out as well.

Maybe this is why I, and so many autistics, are mistakenly considered emotional mutes. We can feel others emotions. Just not how everyone else does. It might be a function of overstimulation and communicating things in ways that neurotypicals can’t interpret. We register our emotions and those of others very deeply, even through direct eye contact and touch. So small talk doesn’t appeal to us because it is a neurotypical tool to gauge emotional states and ease into heavier conversation. And our body language is different. Autistics are not inherently disabled because our communication is different. We are disabled by the outside world’s structure.

How have I dealt with this? Masking. It takes a huge toll and increases anxiety but it makes life amongst other people easier. It also means that they make assumptions about me that are inaccurate. They overestimate my ability to function in society. I came to grasp this after my diagnosis little by little and then very quickly when I started observing other autistics who don’t mask as well. Sometimes I understand autistics so much better because I intuit their language. But it’s not like we speak the same language. It’s highly individual and takes time to learn. That’s another place Adderall helps me.

J has atypical body language and tonal expression. J also has issues with conversation. He listens extremely well but can get agitated if talked over or interrupted. I understand and it’s a challenge for me to accommodate this because 1. it takes time to learn his particular for of expression and associate it with what’s actually going on inside; 2. I’m used to predicting what people will say; and (relatedly) 3. I’m impatient and impulsive with speech. I finish people’s sentences. I’m working on that.

With Maddie, Mikey and Tyler, I tune into what they’re saying even before they’ve said it. It’s kind of beautiful to intuit that stuff and have conversations at light speed. I’m working on letting them say it anyway because there’s a benefit to hearing your own thoughts allowed. I don’t jump in because I don’t care. I jump in because I picked up on the entire concept and am ready to add insight. But the process of communicating can be just as important as what is being communicated.

When I’m on Adderall my conversation slows down. Mikey called me “stoic.” Maddie and Tyler noticed a new calm. It slows everything down: I parse words better, the global concepts get filled in with more detail, I don’t impulsively interrupt. On the whole, it’s a behavioral modifier.

Autism in general is associated with limited hippocampal ability to remember social information but a superability to remember facts. I have this crazy memory that now registers the social stuff as well as the random trivia. Could my progress within the past five years (think the good parts of Flowers For Algernon) be the result of increased dopamine? Dopamine might be not just the answer to my ability to remember things but how to slow everything down so that my social interactions are more fruitful.

I’ve already experienced major benefits from taking Quentiapine. It was initially prescribed to deal with misdiagnosed bipolar disorder. I only kept taking it because nothing else helps me fall and stay alseep.

It’s an atypical antipsychotic. In part it prevents the re-uptake of dopamine by binding with dopamine receptors. The result is more free dopamine in the brain, specifically within the pre-frontal cortex.

Maybe the properly titrated doses of Quentiapine and Adderall are what will help me continue to gain strides with autism deficits without negative side effects. I don’t know.

I love having an autistic mind. I don’t feel broken. I feel different and special. Autism is the reason for a lot of my superpowers. If I can manage the impulsivity, the anxiety and the depression that come along with autism, then maybe I can find a way to ameliorate my perceived autistic shortcomings enough to manage life in a neurotypical world.

These are just thoughts. But they come from an autistic genius who has been through the ringer and learned a lot of valuable lessons. Sure I’m unemployable and in serious need of someone discovering a use for my talents so I can exploit my strengths and keep a roof over my head. But just being able to manage friendships, intellectual pursuits and artistic endeavors is way more than I ever thought I was capable of five years ago. There was a magical coming together of getting off a lot of medications, being on the right ones, and having the right therapists in my life to help me work things out. It was serendipity.

If it could work for others, wouldn’t that be awesome? I don’t want to end autism. I want to end autistic suffering.

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