Why Some People Get Addicted While Others Have It Easy - Anna Lembke

We bombard our brains with so much dopamine that our brains have to compensate by way downregulating our own dopamine production and transmission, and we end up in this chronic dopamine deficit state where nothing else is enjoyable. We're only focused on our drug of choice. We need to keep using, not to feel good, but just to restore a level balance and feel normal. And when we're not using our drug, we're experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, irritability, insomnia, depression, and craving. (air whooshing)

I- it's like one of those buzzwords at the moment. I've seen dopamine fasting and dopamine detoxes thrown around YouTube a lot, and we're talking about imbalances in the brain, is it chemical, is it environmental? What's your favorite framework for explaining what dopamine is and how it affects us?

Well, my framework for communicating the role that dopamine has in our brain, um, it really has to do with the fact that pleasure and pain are processed in the same part of the brain. Um, it's a part of the brain called the reward pathway. And pleasure and pain effectively work like opposite sides of a balance. So when we do something pleasurable, that balance tips to the side of pleasure, and we get a little release of dopamine in our brain's reward pathway, which is reinforcing and, and feels good. But one of the overarching rules governing this balance is that it wants to remain level. It doesn't wanna be tipped for very long to the side of pleasure or pain, and the brain will work very hard to restore a level balance, or what's called homeostasis. But importantly, the way that the brain brings that balance back to a level resting state is first by tipping it an equal and opposite amount to the side of pain, and that's wha- when our brain downregulates our own dopamine production and our own dopamine transmission, not just back to baseline levels, but actually below baseline levels to this dopamine deficit state. Now if we wait long enough, you know, that's that feeling of wanting another piece of chocolate, just one more video game, another drink. If we wait, that passes, and our balance is restored. But if we continue to, um, repeatedly expose ourselves to highly reinforcing drugs and behaviors, then over time, that initial stimulus gets shorter and weaker, but that after-response gets stronger and longer, which is why typically, we need more of a drug or more potent forms over time to get the same effect. And furthermore, what can end up happening is our, our balances can kind of get stuck on the pain side, where we end up. I like to think of it as these neuroadaptation gremlins hopping on the pain side of our balance, kind of camping out there. If we bombard our brains with so much dopamine that our brains have to compensate by way downregulating our own dopamine production and transmission, then we end up in this chronic dopamine deficit state where nothing else is enjoyable. We're only focused on our drug of choice. We need to keep using, not to feel good, but just to restore a level balance and feel normal. And when we're not using our drug, we're experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, irritability, insomnia, depression, and craving.