A highlight from Dopamine Nation

Mentally Yours


Podcast. And I'm Ellen, and today we're talking to doctor Ana lemke. She's the author of dopamine nation, and we're going to be talking to her about addiction, how our brains work and how to deal with an age of overconsumption. Well, my name is Anna lemke. I'm a psychiatrist and I am on the faculty here at Stanford University school of medicine. I see patients, I teach, and I do research. You've got a new book out called dopamine nation. For the non experts among us, what exactly is dopamine and what does it do? What's the kind of like beginner's guide to dopamine? Dopamine is a chemical in the brain that's very important to the experience of reward motivation and pleasure. We all secrete a tonic level of dopamine and when we do something that's rewarding or reinforcing, we release more dopamine, so it goes above tonic baseline levels. But one of the key aspects of our brains is that it wants to always restore homeostasis or a level balance. So as soon as we have an increase in dopamine, our brains will actually downregulate our own dopamine production and dopamine transmission, not just back to baseline levels, but actually below baseline levels and put us in a dopamine deficit state. And this is essentially how our brain uses dopamine to regulate the reward experience. And it's also the same part of the brain that is involved in the disease of addiction. So how can this plan to long-term mental health issues like depression and also struggles like addiction? Well, the fundamental difference between things that are addictive in those that aren't is that things that are addictive release a whole lot of dopamine all at once in the brain's reward pathway. And it's essentially more than our primitive brains were evolved to deal with. So that in response, again, what our brains will do is immediately down regulate our dopamine and dopamine receptors, not just to baseline levels, but below baseline will be put into it into a dopamine deficit state. And will remain there for a while until our brains are able to kind of recovery recover essentially from the insults of so much dopamine and restore normal baseline levels or what scientists call homeostasis. And that dopamine deficit state is akin to depression. People feel anxious, irritable, depressed, they can't sleep. They have intrusive thoughts of wanting to use their drug. And for people who engage in heavy drug use for long periods of time, that dopamine deficit state can endure and essentially become the new normal such that people need to continue to use their drug of choice not to feel high anymore, but just to feel normal and restore baseline levels. And when they're not using they feel the universal symptoms of withdrawal from any addictive substance which are again anxiety irritability insomnia and dysphoria. So the bottom line is that using addictive substances and behaviors actually drives initial dopamine elevation, but then a plummeting dopamine deficit state. And that state can look like a psychiatric disorder. I have many patients who come in and believe that their primary problem is depression or anxiety or what have you.

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