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Can’t Quit Smoking? Try a Wholistic Approach.

By on March 26, 2014
Screen shot 2014 03 26 at 9.50.47 PM 300x336 - Can't Quit Smoking? Try a Wholistic Approach.

   Nicotine is the principal addictive component that drives continued tobacco use, despite the users knowledge of the harmful consequences. The initiation of addiction involves the mesocorticolimbic dopamine system, considered the most important reward pathway in the brain.

   This circuit is a key detector of a rewarding stimulus such as the nicotine in cigarettes. Under normal conditions, the circuit controls our responses to natural rewards, such as food, sex, and love, and is therefore an important determinant of our motivation and desires. It also tells the memory centers in our brain to pay particular attention to all features of that rewarding experience, so we can recognize and repeat it once again. This is a very old pathway from an evolutionary point of view and is found in all mammals. The neurotransmitter dopamine even mediates reward behavioral responses in worms and flies, which evolved as far back as 2 billion years ago.
    Let’s take a look at what this looks like in a theoretical clinical session. When I ask someone who smokes, “What do you feel when I tell you that you cannot have another cigarette?” I often receive a response that they feel “anxious.” When I ask “Where do you feel that in your body?” They will often describe a heaviness in their chest and stomach or a tightness in their throat.  I will then request that they just sit with the anxiety and be curious about what may be underneath that particular feeling. Many find that feelings of sadness, emptiness, anger and fear come to the surface.  I then ask the client to go ahead and imagine allowing themselves the cigarette. How do you feel now, I ask? “Relief!” This experience, played out in the reward center of the brain is what makes cigarettes very difficult to quit. 
    Research indicates that nicotine causes the release of dopamine, serotonin and norepinephrine. As the nervous system adapts to nicotine, tobacco users develop tolerance, and need to increase the amount of tobacco they use. The effects of nicotine last for about 150 minutes before the levels drop and cause the following withdrawal symptoms:

    •    Dizziness 
    •    Depression
    •    Feelings of frustration, impatience, and anger
    •    Anxiety
    •    Irritability
    •    Trouble sleeping
    •    Trouble concentrating
    •    Restlessness or boredom
    •    Headaches
    •    Tiredness
    •    Increased appetite
    •    Slower heart rate

    These symptoms can lead a person to start using tobacco again to boost blood levels of nicotine and stop symptoms.

    To help my clients stop smoking I support the neurotransmitters serotonin, dopamine and norepinephrine with the use of supplements during the withdrawal process. Though everyone is unique in the reasons why they start smoking, I have found that many people start smoking to treat an underlying neurotransmitter imbalance. For example, it is thought that up to 70% of the population may have suboptimal serotonin levels; this can cause feelings of irritability, depression and anxiety.  Often, smokers tell me they feel calm and settled after a cigarette. Hence, unless the underlying neurotransmitter imbalance is treated, relapse will most likely occur. Case in point is the use of  antidepressants, which increase levels of norepinephrine and dopamine commonly prescribed to help people stop smoking.

    In a clinical session I will begin to explore the client’s feelings of sadness, loss and emptiness. I ask the client to remember the very first time they experienced that particular set of feelings. Often some trauma is remembered such as a time when they had felt lost, sick or alone. I ask the client, “If you could have anything you want, what would make you feel better?” Upon reflection, almost everyone will know exactly what they need, such as being comforted or to feel safe. I ask the client to imagine that happening, and to sit with the feeling. I then ask the client to go back to the craving for a cigarette, and see if they still want one. Most people reply with a surprised expression that they no longer crave the cigarette, and that it actually feels distasteful. The root of the addiction in this case was the desire to feel loved, safe and comforted. The cigarette was a poor substitute for the real emotional fulfillment. Setting up new neural networks based on healthy emotional life choices is essential to the healing process.  To aid in recovery, I recommend that clients support their neurochemistry with supplements, develop healthy eating patterns, exercise, seek counselling or psychological care and continue to practice setting up new comfort neural pathways with healthier choices.
    There are always underlying reasons such as; genetics, lifestyle, upbringing, support systems, stress, and nutrition as to why people take up and continue to smoke. In all cases, it is essential to look at the total picture; and the root cause, in order to realistically counteract this difficult addiction. 

Susan Janssens is naturopathic doctor who has been practicing for over 10 years. She provides a safe, effective, integrative and natural approach to health. For more information please go to www.IHConline.ca or phone 403-288-4880.

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