Our easy access to drugs, food, alcohol — and yes, even social media — is changing our brains.
The world has transformed “from a place of scarcity to a place of overwhelming abundance,” Stanford psychiatry professor Anna Lembke, MD, writes in the opening pages of her new book Dopamine Nation. Food, alcohol, shopping, Facebook, Instagram, Netflix, and more can now all be summoned at a moment’s notice. This transformation has led many of us to spend a bit too much time scrolling through social media or binge-watching TV — but more critically it’s changing our brain chemistry, Dr. Lembke tells us.
We’re now awash in dopamine, the molecule responsible for that feeling of euphoria you get while eating a pint of Ben & Jerry’s. And we’ve built a tolerance for it that leaves us wanting more, Dr. Lembke writes. But it’s also robbing us of our ability to enjoy life’s simple pleasures, like dinner with friends or watching the sunset, and Dr. Lembke argues it’s behind the rising rates of depression, anxiety, and suicide in the U.S.
“We’re essentially titillating ourselves to death,” she says.
Dr. Lembke breaks down the science behind this phenomenon, provides some steps we can take to dopamine detox and break our patterns of compulsive overconsumption, and shares the surprising benefits of introducing a little pain into our everyday lives.
Katie Couric Media: You write that we’re now surrounded by potentially addictive substances and that’s leading many of us to compulsively overconsume. What types of products or behaviors are you talking about?
Lembke: Probably one really obvious thing is smartphones. The amount of time and intensity that we’re putting into our smartphones and digital devices really does speak to the problem of compulsive overconsumption and, in some cases, outright addiction. There’s also food and shopping. I’m seeing more and more sex addiction — especially as mediated by the internet — gambling, video gaming. Really all behaviors have become druggified and have made us vulnerable to addiction — from watching the news to engaging in social media.
Can you break down why even something as innocuous as checking your smartphone or your own habit of reading romance novels, which you discuss in the book, can affect our brain chemistry and our sense of wellbeing?
The part of our brain that processes pleasure also processes pain. Pleasure and pain work like opposite sides of a balance. So, when we do something that’s rewarding that balance swings to the side of pleasure, but our brain will recalibrate to try to bring that down to level again — or reassert what neuroscientists call homeostasis. Our brain does that typically by downregulating our own dopamine and the production of our own dopamine transmission.
The way I explain this to my medical students is to have them imagine these little gremlins hopping on the pain side of the seesaw to bring it level again. But they don’t hop off right away, they stay on until it’s tilted down to the side of pain — that’s the comedown or the after effect. If we wait long enough, the gremlins hop off and homeostasis is restored. But if we continue to stimulate that dopamine reward pathway with that substance or behavior, then our brains again adapt. We get more and more gremlins on the pain side of the balance and we ultimately change our joy set point, so we need to continue to use that substance or behavior, not to feel good but just to feel normal.
So when we’re not using that substance or behavior or are in a dopamine-deficit state, it leads to the universal symptoms of withdrawal — anxiety, irritability, insomnia, dysphoria, intrusive thoughts, and wanting to use.
The main premise of the book is that the reason we’re seeing increased rates of depression, anxiety, and suicide all over the world (and especially in rich nations) is primarily because we’re constantly stimulating our dopamine reward pathway triggering our own compensatory mechanisms so that we’re in a dopamine-deficit state. We’re essentially titillating ourselves to death.
What are some small, actionable ways we can start to reset this balance?
You can start with a period of abstinence, long enough to allow the brain to restore baseline homeostasis and give you some time to really look in a clear-eyed way at the true consequences of your overconsumption. After that dopamine fast, you can start to put barriers in place, so that if you do go back to using your drug of choice, you use it differently and in moderation. For instance, limiting yourself to only consuming during set periods of time or in certain settings — maybe you only consume alcohol when you’re with friends or when you’re celebrating.
I also recommend intentionally inviting physical and mental challenges into our lives. By pressing on the pain side of the balance and engaging in mildly noxious behavior, like ice-cold water baths or exercise in moderate doses, we can stimulate our own production of dopamine, instead of getting it from some external stimulus. And that’s a more enduring source of dopamine.
So would you suggest a social-media fast for those of us who may spend a bit too much time on our smartphones?
I would. I think for people who are really hooked, a period of a month is necessary to restore homeostasis. If the fast is too short, people just experience withdrawal without getting to the point where they experience the benefits.
And during this period, be prepared to be in withdrawal for the first two weeks and to feel worse before you feel better. Hopefully, by a month, dopamine levels have been restored and then they can think more about if or how they want to reintroduce it into their lives.
Can you tell us a little more about how exposing ourselves to pain in moderation can be beneficial, and how we can practice this in our everyday lives?
It’s the science of hormesis. The idea is that by using small to moderate doses of noxious stimuli — heat, cold, radiation, gravitational forces, food restriction — we can actually set in motion our own innate production of neurotransmitters. That can be a way to make us more resilient and build up mental calluses to withstand noxious stimuli and also to enhance our well-being by tipping the pleasure-pain balance.
When it comes to pain, everybody’s different. For my patients recovering from drug and alcohol addiction, they often need more extreme exercise or ice water baths, or more painful versions of stimuli than the average person in order to set in motion this upregulation and get some relief from their suffering. For some people, just walking for 30 minutes a day around their neighborhood would be sufficient. So it’s really just a matter of trial and error. But the main thing is to not be afraid of pain and to get out there and see what we can tolerate and what works.
