Dopamine, Disability & The Hedonic Treadmill - OC87 Recovery Diaries

Dopamine, Disability & The Hedonic Treadmill


Listen to Executive Director Gabriel Nathan read this post aloud:

My mental health took a dive the summer I was thirty-two years old. The reaction was understandable. I had broken my neck in a car accident. My spinal cord injury was cervical and complete. My body had lost all motor and sensory function from the chest down.

Truth be told, I hadn’t been in the best place mentally prior to my injury either. Mental health wasn’t something I prioritized, and this affected my life and relationships negatively. I’d never been diagnosed with depression or anxiety but I had all the symptoms. I had covered up my pain by making self destructive decisions, and I was often focused on physical gratification and my own aesthetic attributes. I used alcohol frequently and drugs at times, and my intimate relationships with incompatible partners were often volatile and toxic.

My unhealthy outlets for stress were stripped from me along with the autonomy I took for granted in every other aspect of my life. Depression dominated my days after I broke my neck. I didn’t want to talk with anyone, connect with other people in my situation who might understand, or even get out of bed. Inside, I obsessed about the life I left behind and loathed my disabled body. I felt detached from who I used to be, and uninterested in any kind of future that didn’t involve restored motor function. I missed the grind of the career I left behind. I couldn’t use alcohol because of my medications so I used them in excess instead. For about a year I stayed medicated enough to sleep my life away.

I felt trapped in my broken body, limited by it, and irrelevant because of it. Long hours I wasted gazing out the window listless, longing for a time and a body I wasn’t going to get back. No amount of physical therapy would restore the function I’d lost. I couldn’t conceive of a future in which I would ever find peace. I felt robbed of my life, terrified about my future, and imagined I’d never be capable of a career again. I was fearful I wouldn’t be afforded the opportunity to care for my daughter and aging parents. I assumed I would never experience intimacy or find love again. I didn’t know if I wanted to live a life, stripped that bare.

Nearly a decade has passed now, since I stood on my feet and arrogantly asserted my place in the world. I’d have never imagined I could make a place for myself again, but I have. The mental health journey has been fraught with incredible challenges. Learning to exist in my paralyzed body was no easy feat, but being stuck with my messy mind presented perhaps even more of a challenge.

I lived in the past, more often than not. Closing my eyes I would return to the career I left behind, envisioning my agile, able body up on the steel. I had been a traveling tradeswoman. Working with the hands that now sat supine and stubborn at my sides was all I knew. Now I felt validated as a person only when reminding or informing other people of who I used to be.

A few years post paralysis I decided to stop taking psychiatric medication, and under the guidance of physicians I quit the drugs which had kept me trapped in a foggy haze mentally. I longed to become a productive person again and the groggy side effects didn’t afford me that opportunity. Kicking the medication cleared my head, after a time. I’d often become inspired and motivated with new ideas to write about, topics to study, social causes to advocate for. I was more present with my daughter, taking control of parenting her like I needed to long ago after inadvertently handing the reins to my brother, who was largely incapable in that department.

Taking agency of my life again was a grueling, gradual process. Self motivating to endure the stress and pain of transfers and transportation in an attempt to participate in life again was often difficult. Still, I began to drag my body to my daughter’s events, take my dog out to the lake, go to movies and shows with my brother. I felt more like myself for the first time in a long time. I let my eyes drink in the beauty of nature and my face soak up the sun. I lost my sedentary self in the live music.

I began reaching out to support groups online, finding strength in solidarity with other people with spinal cord injury and I got involved with disability advocacy. I started writing again, although I had to do it with my teeth. Because my injury is a complete crush of the C4 vertebrae, I have no use of my hands. Instead I type with a stylus pen in my mouth.

Five years post injury I published my first book. I spent many long days penning my memoir, hoping to create a real and raw picture of life after spinal cord injury, jumping back into my past every other chapter to recount the adventures of my life prior to paralysis. I reflected on growing up a church kid in rural Arizona, becoming a teen mom, experiencing addiction and incarceration before my injury.

Now, nine years in, I have a career as a writer, and I find myself relatively satisfied with day to day life; relative in comparison to my degree of satisfaction with life before I became disabled. I hadn’t been thrilled with my life even on my best days. I’d just learned to go to my happy places, chase my dopamine. Today I’m still chasing dopamine but now I don’t seek it in the adrenaline rushes and validation once provided by my career, or chased by making destructive decisions. I maintain my peace of mind and find my joy with alternative sources now, finding often that the satisfaction they bring is less fleeting.

Alright as Ever: the Hedonic Treadmill

Likely the hedonic treadmill is to blame. That’s the concept that people typically have this baseline level of happiness they don’t stray far from. Interestingly, a 1978 study of the phenomenon actually included my demographic: individuals who were paralyzed in catastrophic accidents. Researchers asked both this demographic alongside a very disparate group, lottery winners, about the happiness in their lives.


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Results found that the recent accident victims reported gaining more happiness from everyday pleasures than the lottery winners. Paraplegics and quadriplegics to be much less unhappy than expected.

I wasn’t one of the happy quadriplegics, not at first. But I’d never been happy.

I remember waking early on a weekend, out on the road. The loud beep of the hotel elevator, fog in the sky on the freeway, driving alone to the beach. The winter sunrise, salt in the air, coffee with too much cream, my French manicure and salon-bought-tan, knit sweater that fell off a shoulder. Joint burning between my fingers, toes in the sand. Wasn’t it heaven?

But my mind wasn’t present in that place of peace. I had looked out into the waves and thought how nice it would be to just walk in and let those waves take me away. There were no anxieties, no self loathing, no general inadequacy at the bottom of the sea.

I remember and I want to drag that girl into the ocean and plunge her head under the water and watch her fight with all she’s got because of course she doesn’t want this to be it, a life of little contribution to anyone, eulogy a testament to her own self indulgence!

I want to tell her that in short months she will lose the ability to control her arms and legs. She will feel like a burden to the one she loves the most. All her pride will be sacrificed.

I would tell that shallow girl to enjoy her life while she could because she had a really good life.

It’s still a good life. It’s better than a cold black abyss and lungs full of saltwater.

I can’t blame her for coveting that dark nothingness but I crave only the light now.

A Path to Healing

My place on the hedonic treadmill isn’t always the position of suffering and sorrow I know so well, especially as I take action toward cultivating a healthier perspective. Real healing though, came when I began to use the cognitive behavioral therapy techniques I was learning from Buddhism and Stoic philosophy. I found an affinity with the Stoics of Imperial Rome, meditating on the works of Marcus Aurelius, Epictetus, and Seneca the Younger.

Buddhism taught me to let go of the past with grace, and to give myself grace. Stoics taught me how to accept my own lack of control, and find peace deep inside. More than a matter of reading a couple books, putting this philosophy into practice is a daily challenge. I’m getting better at staying in the present and finding peace and strength deep within. I challenge myself to avoid excuses (yes, even disability) and to utilize the function I have not lost to contribute good things to the world. In my most anxious moments, it can be hard to recall the affirmations that sustain me and I instead stream Stoic content, focusing on the fortitude the words insist I possess within me. Sometimes concentration is hard and I still fall apart. That’s why it’s important to practice the meditations even in times of peace. They are easier to conjure through the storms.

Among the cognitive behavioral tools provided by the stoics were methods for accepting the dichotomy of control, becoming ambivalent toward negative people, dedicating my time to worthy work. These traits are so important when one relies on other people to meet every physiological need. My spinal cord injury puts my health in danger, but I no longer waste time worrying about hospitalization or death. The Stoics assure me I will meet those challenges with wit, death with a smile. I focus instead on my work; stay busy. I work for a nonprofit which provides resources to people with spinal cord injury. I do advocacy blogging. I just finished grad school to become an educator and I wrote two more self-help books.

Looking back I wish I’d worked on my mind rather than just my body. I would have been a better parent for it, and the years would have been kinder to me. I’m just glad I started working on myself out of absolute necessity post spinal cord injury. I have developed all these new anxieties about my health and care.

When the thought arises I have trained my mind to pause it, ask myself if the worry is even valid, or within my control at all. If the answer is no, and I’m suffering before it’s even necessary: Choose another thought. Yes; it’s possible.

I attend therapy now and I’m seeing a really knowledgeable psychologist. She’s taught me some techniques for coping with anxiety and experiencing peace.

Mostly though, I turn to philosophy.

As a 21st Century American woman with a disability my connection to these emperors and orators of ancient times might not seem obvious, but the tools for mental fortitude found in Stoic philosophy are largely universal.

Sure, I could have found the tools elsewhere. Many people do. But I enjoy imaging Marcus Aurelius standing firm in full armor, mediating the message to motivate me. I especially value the words of Epictetus, who lived with a physical disability, and wrote “Lameness is an impediment to the leg but not to the will.”

I don’t allow this disability to impede my will. I won’t let it steal my joy or my future. I roll the hedonic treadmill and seek my joy: creative endeavors, literature projects, advocacy articles, self help books. My work validates me and provides daily dopamine for my spirit. Within it I’ve found so much healing.

​EXECUTIVE DIRECTOR: Gabriel Nathan | EDITOR: Laura Farrell | DESIGN: Leah Alexandra Goldstein | SITE ORIGINATOR: Bud Clayman



Cassandra Brandt is an author and advocate for people with disabilities who has been living with spinal cord injury for 8 years. Formerly a tradeswoman, Cassandra is a C4 complete quadriplegic following a 2015 car accident. Post accident she went on to publish three books including a memoir, Iron Girl: Tomboy, Tradeswoman, Tetraplegic (2020) and Seven Secrets of a Sedentary Stoic: Pursuing a Path to Post Paralysis Peace (2023). Passionate about paying forward newfound peace, sharing her personal story in solidarity, and educating the spinal cord injury community about resources and tips for living with SCI, Cassandra has written for multiple disability publications, and has published work about disability rights on human rights platforms. Earning a Master’s Degree in Educational Studies in 2023, Cassandra is also passionate about sharing her love for the language arts, writing and literature. She lives in rural Arizona near her family.