Why You Need to Know About Dopamine and Autism

Our ability to engage in tasks is often motivated by reward. This article looks at how dopamine can play a role in motivating desire and perhaps assist autistic children in the long run.

“Whoever knocks persistently, ends by entering.” – Muhammad Ali

Several studies have sought to find a link between dopamine and autism but, so far, the results are inconclusive. And yet there is a reason that scientists keep on looking, it does seem this chemical messenger has something to teach us about the nature of autism. Read on to find out why.

Dopamine fuels desire

Like many people I believed that dopamine was a feel-good hormone which is released when we do something rewarding, but it turns out that is not the case. Dopamine is actually released in our quest for a reward and would be more aptly described as the desire hormone.

Dopamine fuels our cravings, and it has a big role to play in addiction. We have probably all had the experience of desiring something that is not good for us. That might be a cigarette, one too many glasses of wine, an extra slice of cake, or staying up late to watch one more episode of our favorite show. If we give in to these desires, as we are biologically wired to do, we may discover what we want is not all that rewarding and the consequences can be dire or even life threatening.

Whilst we may only suffer a bad night’s sleep or putting on a couple of pounds, some desire can lead to much darker consequences. In extreme cases we may neglect our basic self-care and relationships, make dangerous choices, and experience economic ruin.

So why do we continue to pursue such negative experiences? The answer is dopamine. Dopamine motivates us to repeat actions that have had positive outcomes in the past and is an important part of how we learn. The fact that the desire we experience when dopamine kicks in is so powerful is a sign of its significance to not only our personal development but to our very survival.

Dopamine can motivate us to get out of bed each morning, go to work and persist when the going gets tough. Even when the rewards are not obvious, dopamine reminds us that these behaviours have been successful in the past. Low levels of dopamine have been linked to depression. People experiencing depression will often find it difficult to motivate themselves to do even the simplest of tasks.

Dopamine and autism

You may be wondering what any of this has to do with autism? Well, dopamine might help us understand some autistic behaviors that can be damaging and that do not seem to lead to any obvious rewards. Autistic people are far more likely than their non-autistic peers to engage in strict rituals and routines. These practices will often be functional and help with feelings of safety and navigating in a confusing world, but this is not always the case. Sometimes rituals and routines can become so complex and inflexible that they become problematic.

For example, I recently read of one autistic child who would only drink a particular drink and even refused that after the label on the bottle was changed. I also used to work with a young man who had such complex routines associated with transitions that moving from one room to another could often take half an hour. Autistic people will also often have a strong desire for order within their environment. This can become dangerous as it may lead to darting across a busy road to remove a piece of litter, or physically removing someone who gets in the way of their goal.

Whilst these behaviors may appear unusual, they begin to make more sense when we remind ourselves that we’re all driven by desires (e.g. phoning our ex, eating our kids’ candy) that we know are not going to be rewarding in the long term. It is likely that behaviors of this type probably did lead to a reward at some point but that over time the behaviors became less rewarding and yet the desire remained.

Dopamine drives initiation of movement and speech

Parkinson’s is a disease which has a debilitating effect on movement and balance. Scientists believe it is caused by low dopamine levels in certain areas of the brain. A study by Silva et al suggests that dopamine is required for the initiation of voluntary movements but that it is not needed once a movement has gained momentum.

Difficulties in the initiation of movements and actions can often be a feature of autism and it is not uncommon for an autistic person to require an external prompt to begin an activity even when the activity is familiar. A prompt could be a verbal instruction, physical touch, or more tenuous such as a light turning on or hearing a sound.

A person’s reliance on prompts can cause problems. For example, when the prompt is unavailable, they may become stuck and unable to partake in essential activities such as eating or using the bathroom. Prompt dependency can also be frustrating for those witnessing these struggles who may not understand why they cannot just “snap out of it”. If we consider that abnormal levels of, or responses to, dopamine might be behind these behaviors, we begin to see prompt dependency as biologically driven and beyond one’s control.

Dopamine has also been implicated in the initiation of speech and disorders of speech such as those seen in Parkinson’s, schizophrenia, and Tourette’s syndrome. It is worth noting that it is the initiation of speech that is often challenging for autistic people rather than the ability to speak. Naoki Higashida in his book The Reason I Jump describes his experience as: “I couldn’t help envying all those people who speak without even trying. Our feelings are the same as everyone else’s, but we can’t find a way to express them.”

The “rat park”

We do not yet know what relationship dopamine has with autism and yet understanding how dopamine can influence behavior in the autistic and non-autistic population can help us to relate to each other with greater compassion and acceptance.

Let us consider an experiment carried out by Dr. Bruce Alexander in the 1970s that has recently had a revival in the addiction community. Dr. Alexander started by putting rats in isolation with two water bottles, one containing plain water and another containing drug laced water. He found that the rats preferred the drug laced water and would continue to drink the water to the point of overdose and death.

He then placed the rats in a “rat park” with other rats and stimulation such as bridges and wheels and found that even the addicted rats showed preference for the plain water and no rats drank the drug laced water to the point of overdose. The conclusion drawn was that a connection to others was the most effective cure for addiction.

Whilst Dr. Alexander’s methods have been questioned it is rare (if not unheard of) for successful recovery programmes to work without human connection. I would suggest the same can be said for autism therapy. Here is the thing, the most important factor in behavior change is to feel understood, seen and accepted. When we feel accepted, we feel safe and when we feel safe, we can experiment with new behaviors and new ways of being.

Positive interactions with others also cause our bodies to release a hormone called serotonin and there is some evidence that serotonin reduces the production of dopamine. This may be because, once a reward has been reached, we no longer need desire to drive us to keep searching or learning and so dopamine production is turned off.

It may be true that we only want what we can’t or don’t have. So next time you are considering the next great therapy or gadget, consider whether what you are searching for is just the next great person. A person who can make your child feel loved and accepted, to support them to grow and thrive.