You may want to spend time on a hobby or spend time with friends, but nothing is as exciting and engaging as before. It’s just a waste of an extra hour on social media.
Your problem may be related to your dopamine levels.
In many parts of the world, people are fed media, activities and food, and may be experiencing a surge in dopamine and causing an unbalanced outcome, which can affect mental health.
Lembke spoke with CNN about what dopamine is, what it does, and how you can better find the balance.
The conversation is clearly edited and condensed.
CNN: What exactly is dopamine?
Dr. Anna Remke: Dopamine is a chemical that we make in our brains. Specifically, it is a neurotransmitter. Neurotransmitters allow for fine-tuned adjustments to electrical circuits. Essentially, our brains are bundles of electrical circuits, a bundle of wires in the form of electrical signals that allow information processing, that is, neurons that do the work of the brain.
Dopamine has many functions, but over the past 75 years or so, it has been identified as a key player in joy, reward and motivation. Though it is not the only neurotransmitter involved in that process, it is a kind of common currency for neuroscientists to measure the potential for reinforcement of different substances and behaviors.
CNN: How does dopamine affect our mental health?
Lembke: It plays a central role in the phenomenology of addiction. Addiction is a brain disease in which certain reward pathways are dysregulated, specific circuits within the brain, and dopamine plays an important role in the brain’s reward pathways.
When we do what we are strengthening, we release dopamine in the reward pathway and turn our brains to say, “Oh, that’s what you need to do more. That’s important for survival.”
The highly enhanced material and behavior we design and currently have access to dominate the system. By downregulating dopamine propagation (them) the brain releases a great deal of dopamine at once in reward pathways that must be adapted or compensated.
As a result, over time, you can enter a chronic dopamine deficiency state. There, we essentially changed the setpoint of pleasure or pleasure. Now we need more rewards and stronger forms to stop feeling unwell and feeling bad. And when we are not “using”, we are experiencing the universal symptoms of withdrawal from addictive substances and behaviors such as anxiety, irritability, insomnia, discomfort, cravings, etc.
CNN: Does this affect people who are dependent on drugs and alcohol?
Lembke: We are all moving towards addiction about the spectrum of compulsive overconsumption, which is resetting our pleasure threshold – or moving to the joy setpoint. We need to be more and more delighted with these reinforcements. And when we are not using, we are uncomfortable, we are frustrated and unable to sleep.
CNN: What is the risk of falling into a dopamine deficit?
Lembke: Many different things release dopamine in reward pathways, such as learning and spending time with friends, something good for us.
It’s not that dopamine is the villain here, it’s that it releases dopamine badly. The problem is that they designed traditional drugs to be more powerful than ever, creating drugs that never existed before, like digital media like “drugized” foods. We took healthy behaviors like exercise, (tracked) ourselves, ranked ourselves, and drugged them by adding social media and social comparisons.
Nowadays, more and more people are obsessed with social media, online porn, online gambling, video games, and all sorts of addictive digital media. There is new evidence that these digital media activate the same reward pathways as drugs and alcohol, causing the same kind of dysregulation as seen in other addictions.
It’s the same as sugar. Ultra-positive foods cause dopamine release, and reward pathways lead to the same type of behavior as people become addicted to drugs and alcohol. It is essentially the same disease process, with a growing consensus with different subjects of desire and reward.
CNN: How can you determine whether material or behavior is a problem?
Lembke: When you look at what makes something addictive, there are a number of factors. One is effective. This refers to the amount of dopamine released in the reward pathway and how quickly it is released. However, other factors are simple things such as access.
We know that the easier access to reinforcing substances and behaviors, the more likely people are to use it and therefore become engrossed in it. We now live in this world like a very easy and frictionless access to many rewarding substances and actions.
Digital media in particular is 24/7 mobile access to almost endless sources anytime, anywhere.
Another thing that makes something addictive is the amount and frequency of exposure. The more dopamine acquires the brain, the more likely it is to change and adapt in ways that can cause addictive illnesses. (Social media algorithms) are designed to actually overcome tolerance, create novelty and encourage people to continue looking for the same or similar rewards they have already seen, but hopefully it gets a little better.
The criteria for diagnosing addiction are roughly the same with different definitions. Four Cs are looking for. Physiological criteria indicating out-of-control use, obsessive use, craving, consequences, and, in particular, continued use – and biological dependence despite outcomes. These are tolerant, and require more (or stronger forms) over time to achieve the same effect, and they withdraw if they try to stop using it.
CNN: What can you do to deal with dopamine deficiency?
Lembke: My recommendation is a 30-day abstinence trial called “dopamine fast” from the drugs of your choice. Not from all rewards, but from problematic substances and actions to see how difficult it is to stop, and to see if you feel better in 4 weeks.
Why 4 weeks? That is, on average, the amount of time it takes to reset the reward path, at least phenomenologically. I always warn people, they will feel sick before they feel good. But if they get through the first 10-14 days, they often feel much better.
After an abstinence trial, when people want to return to use, they need to be very specific about what they use, how often, how often, in what circumstances, how to track them, and how to make their red flags go back to old habits.
They can then reassess whether they can actually be used in moderation. When it comes to food, obviously people cannot and should not attempt to abstain. But they can withhold sugar. They can refrain from ultra-highly processed foods.
How do we engage in something fun, but stop before we reach the dopamine deficit?
Lembke: That doesn’t mean that you don’t have joy in life. It’s about resetting your balance, and simple joy rewards once more. That doesn’t happen when people constantly indulge in these frictionless, sophisticated rewards.
I talk a lot about “self-constraint” and make sure we don’t continually surround ourselves so that we can easily access these sophisticated and inexpensive pleasures, so it doesn’t become that problem in the first place.
But we live in a world where we are constantly invited to consume, so intentionality is necessary. Therefore, creating a barrier between yourself and the many drugs there requires planning and intentionality.
Self-connection refers to a physical barrier. If the problem is food, you don’t have super positive or sweet foods in your home. In the case of cannabis, there is no pot at home and no alcohol. Now, if it is some form of digital media, time can be used as a self-constraining strategy.
Others are a very important form of self-restraint. We tend to do what the people around us do, so hang out with people who use substances and behaviors in the way you want to use them.
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