title: The neurobiology of pleasure, reward processes, addiction and their health implications.
abstract: Modern science begins to understand pleasure as a potential component of salutogenesis. Thereby, pleasure is described as a state or feeling of happiness and satisfaction resulting from an experience that one enjoys. We examine the neurobiological factors underlying reward processes and pleasure phenomena. Further, health implications related to pleasurable activities are analyzed. With regard to possible negative effects of pleasure, we focus on addiction and motivational toxicity. Pleasure can serve cognition, productivity and health, but simultaneously promotes addiction and other negative behaviors, i.e., motivational toxicity. It is a complex neurobiological phenomenon, relying on reward circuitry or limbic activity. These processes involve dopaminergic signaling. Moreover, endorphin and endogenous morphinergic mechanisms may play a role. Natural rewarding activities are necessary for survival and appetitive motivation, usually governing beneficial biological behaviors like eating, sex and reproduction. Social contacts can further facilitate the positive effects exerted by pleasurable experiences. However, artificial stimulants can be detrimental, since flexibility and normal control of behavior are deteriorated. Additionally, addictive drugs are capable of directly acting on reward pathways. Thus, the concrete outcome of pleasant experiences may be a question of dose. Moderate pleasurable experiences are able to enhance biological flexibility and health. Hence, pleasure can be a resistance resource or may serve salutogenesis. Natural rewards are mediated by sensory organ stimulation, thereby exhibiting a potential association with complementary medical approaches. Trust and belief can be part of a self-healing potential connected with rewarding stimuli. Further, the placebo response physiologically resembles pleasure phenomena, since both involve brain's reward circuitry stimulation and subjective feelings of well-being. Pleasurable activities can stimulate personal growth and may help to induce healthy behavioral changes, including stress management. However, more research is needed to better understand the nature, neurobiology and maybe dangerous aspects of pleasure. Also, a possible involvement of endogenous morphinergic signaling has to be studied further.
authors.affiliation: Charité - University Medicine Berlin, Institute for General Practice and Family Medicine, Schumannstrasse 20/21, 10117 Berlin, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Esch
authors.forename: George B
authors.initials: GB
authors.lastname: Stefano
mesh_terms: D016739:Behavior, Addictive / Q000503:physiopathology*; D003469:Culture; D004298:Dopamine / Q000502:physiology*; D004723:Endorphins / Q000502:physiology; D006801:Humans; D008032:Limbic System / Q000502:physiology*; D009042:Motivation; D009446:Neurobiology; D010990:Pleasure-Pain Principle; D012201:Reward
chemical_list: D004723:Endorphins; D004298:Dopamine