- Includes the Ventral tegmental area (VTA) and Nucleus accumbens (NAc).
- Central reward pathway reinforcing pleasurable and addictive behaviors.
- Highly active in habit formation, craving, and relapse.
- Governs decision making, impulse control, and long-term planning.
- Often underactive or dysregulated during addiction, especially under stress.
- Strengthens as individuals engage in preparation, action, and maintenance.
- Detects threats and triggers fear-based emotional responses.
- Overactive in trauma histories, fueling hypervigilance and reactivity.
- Can sabotage change by activating fight, flight, or freeze responses.
- Encodes memory and contextual associations.
- Links environmental cues with cravings and emotional responses.
- Heightens relapse risk by triggering old behavior patterns when familiar.
- Monitors errors, self-awareness, and emotional conflict.
- Integrates logic and emotion during decision-making under stress.
- Supports insight/motivation during contemplation and preparation stages.
- Limbic system dominates; reward circuitry overrides logic.
- Prefrontal cortex (PFC) activity reduced under stress.
- Denial and minimization protect from threat of change.
- Anterior cingulate cortex (ACC) and hippocampus weigh pros and cons.
- Conflict grows between dopamine-driven reward system and PFC goals.
- Anxiety and ambivalence emerge as old neural pathways resist change.
- PFC strengthens as goal-directed thinking increases.
- New synaptic pathways form through repeated planning and visualization.
- Dopamine release shifts toward anticipation of healthy behaviors.
- Neural plasticity expands as new behaviors are reinforced.
- Old reward pathways weaken through nonuse (synaptic pruning).
- PFC-amygdala regulation improves with stress management practice.
- PFC dominance supports long-term planning and self-regulation.
- New habit circuits solidify through repetition and myelination.
- Reward system recalibrates to reinforce adaptive behaviors.
- Triggers activate hippocampus and amygdala, hijacking reward pathways.
- Cravings spike as the PFC goes temporarily offline.
- Effective coping strategies are needed to regain control/prevent regression.
