GABA: Mania and Seizures to Relaxation and Impulse Control

by Joseph M. Carver, Ph.D.

Gamma-Aminobutyric Acid (GABA) is a neurotransmitter that is inhibitory, that is, it decreases the ability of other neurotransmitters to work. GABA is involved in our level of excitability. Rather than encouraging communication between cells such as Dopamine, Serotonin or Norepinephrine - GABA reduces, discourages, and blocks communication. This neurotransmitter is important in brain areas involving emotion and anxiety.

When GABA is in the normal range in the brain, we are not overly aroused or anxious. At the same time, we have appropriate reactions to situations in our environment. GABA is the communication speed controller, making sure all brain communications are operating at the right speed and with the correct intensity. Too little GABA in the brain, the communication becomes out of control, overstimulated, and chemically unstable. Too much GABA and we are overly relaxed and sedated, often to the point that normal reactions are impaired.

Low levels of GABA are associated with Bipolar Disorder, Mania. With GABA levels below average, the brain is too stimulated. We begin talking rapidly, staying up for days at a time, and develop wild and grandiose ideas. In a Manic state, we are so “high” and out of control that social problems are quick to develop, often due to hypersexuality, excessive spending, reckless decisions, risk-taking behavior, and grandiose ideas. We may feel so good that we think we are a heavenly spirit, an intellectual genius, or possessing extraordinary powers. I personally had one patient who locked himself in his mobile home and spent one week rewriting the New Testament in “hillbilly”. Another, with limited education, began purchasing books on the Theory of Relativity by Albert Einstein, sensing he may be able to use the information to invent “warp drive”.

Low levels of GABA are also associated with problems of poor impulse control, including clinical conditions such as gambling, temper tantrums, and stealing. When GABA is low in the brain, impulsive behaviors are not inhibited (stopped) by logical or reasonable thinking.

Low levels of GABA are also associated with epilepsy or seizure disorders. If we imagine a seizure as a type of electrical storm, the seizure begins at one location in the brain then rushes across and through the brain like a sudden storm. Low levels of GABA make it easy for the brain to develop seizures which is why seizures are part of the withdrawal syndrome for many substances that work with GABA such as alcohol and tranquilizers (benzodiazepines – Xanax, Ativan, Librium, Valium, etc.). Substances that artificially maintain a high level of GABA, when stopped, create a dramatic drop in GABA levels, thus creating the risk for withdrawal seizures due to the chemical instability that is created.

High levels of GABA produce more control, relaxation, and even sedation. Alcohol works by increasing GABA levels, which is why all body systems are relaxed at first – then sedated to the point of slurred speech, unsteady gait, and foggy thinking. Alcohol withdrawal, or the sudden severe drop of high GABA levels, produce a low GABA level and the possibility of seizures. Withdrawal from benzodiazepines is known to follow the same pattern. Taking forty milligrams of Valium for two years, suddenly stopping all medication, will likely produce a seizure.

Medications for anxiety create relaxation and a decrease in anxiety by increasing GABA levels in the brain. Alcoholic beverages work in the same manner; the alcohol increasing GABA levels to produce mild euphoria, loss of social anxiety, and other symptoms of intoxication. Excessive intake of benzodiazepines and/or alcohol is extremely dangerous as the high GABA level actually smothers the communication between brain neurons – sometimes to the point of a total lack of communication between neurons – also known as death.

Medications for seizures, impulse control problems, and Bipolar Disorder, Mania all work by increasing the GABA levels without accompanying euphoria. Lithium and anti-seizure medications all increase GABA into the normal range, thus lowering the possibility of seizures and producing brain chemical stability. As GABA is the neurotransmitter policeman, changes in GABA can influence all neurotransmitters but especially norepinephrine.

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