If you haven’t met your drug of choice yet, it’s coming soon to a website near you. Yet despite this increased access to all these feel-good drugs and behaviors—or as Anna Lembke hypothesizes, because of it—we are more miserable than ever. Rates of depression, anxiety, physical pain, and suicide are increasing worldwide, especially in wealthy nations.
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One of the most important discoveries in neuroscience in the past 100 years is that pleasure and pain are co-located. The same parts of the brain that process pleasure also process pain. And pleasure and pain work like a balance. When we feel pleasure, the balance tips on...
When we feel pleasure, our brain releases a little bit of the neurotransmitter dopamine in our brain’s reward pathway, and our balance tips slightly to the side of pleasure. But no sooner has that happened than our brain adapts to the increased dopamine by down-regulating my dopamine receptors an...
“Throughout my 20-year career, I have seen more and more patients, including otherwise healthy young people with loving families, elite education, and relative wealth, presenting with depression, anxiety, and full-body pain. We are titillating ourselves to death.”
Whatever your drug of choice, give it up for a month, a week, or even a single day. When you do, notice how, at first, your pleasure–pain balance tilts to the side of pain, and you feel restless, cranky, and most of all preoccupied with using your drug. Your brain is screaming out all the reasons...
Anna Lembke put a patient of hers that was suffering from debilitating anxiety and depression on a dopamine fast: instead of prescribing antidepressants, she suggested he abstain from all screens, including video games for one month.
The patient returned a month later and reported feeling ...
In the late 1960s, scientists conducted a series of experiments on dogs. Due to their obvious cruelty, these experiments would not be allowed today. Nonetheless, they provide important information on brain homeostasis, or leveling the balance.
If and when you decide to go back to using your drug of choice, remember to create literal and metacognitive barriers between yourself and it. The bottom line is this: To reset your dopamine brain, first abstain.
If we wait long enough, neutrality is restored, and the hangover and the comedown pass. But what if we don’t wait? What if, instead, we go after pleasure and then again after pleasure?
Once that happens, we’ve changed out joy set point. We need to keep doing what gives us p...
The access, quantity, variety, and potency of highly reinforcing drugs and behaviors has never been greater, including drugs that didn’t exist before—texting, tweeting, gaming, gambling, sugar, shopping, vaping, voyeuring. The list is endless. Online products with their f...
This fine-tuned pleasure–pain balance of ours has evolved over millions of years to help us approach pleasure and avoid pain. It’s what has kept us alive in a world of scarcity and ever-present danger. But here’s the problem: We no longer live in that world. We now live in a world of over...
With repeated exposure to a painful stimulus, the dog’s mood and heart rate adapted in kind. The initial response (pain) got shorter and weaker. The after response (pleasure) got longer and stronger. Pain morphed into hypervigilance, which morphed into a fit of joy. It’s impossible to read this e...
Anna Lembke, medical director of Stanford Addiction Medicine, program director for the Stanford Addiction Medicine Fellowship, and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic, shares key insights from her new book, Dopamine Nation: Finding Balance i...
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