When we’re repeatedly exposed to pleasure-producing stimuli – social media, sugar, alcohol or any number of readily-available substances – our bodies adjust. Then we need more on repeated use, just to feel a the marginal pleasure boost – and, eventually, just to feel “normal.”

Meredith Miotke for NPR


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Meredith Miotke for NPR


When we’re repeatedly exposed to pleasure-producing stimuli – social media, sugar, alcohol or any number of readily-available substances – our bodies adjust. Then we need more on repeated use, just to feel a the marginal pleasure boost – and, eventually, just to feel “normal.”

Meredith Miotke for NPR

Be it sugar, social media or sex, the response in our brain is the same: It produces the “feel-good” neurochemical called dopamine, which brings on feelings of pleasure and motivation. “It may be even more important for motivation than for actual pleasure,” says Dr. Anna Lembke, a Stanford Medical School psychiatrist, researcher and author of the new book, Dopamine Nation: Finding Balance in the Age of Indulgence.

A dopamine hit brings about pleasure, and then is quickly followed by pain, or a come-down, in order to keep us motivated. Lembke says this balancing see-saw of pleasure and pain made sense in the time of early humans, when we had to constantly search for our basic needs – food, water, shelter. “It’s really an ingenious method to make sure that no matter what we do, that’s pleasurable. It doesn’t last very long and it’s followed by pain so that immediately we’re searching again,” she explains.


Cover of the book Dopamine Nation: Finding Balance in the Age of Indulgence

But, in modern life, we live in a world of abundance rather than scarcity, and Lembke says our brains weren’t evolved for the “firehouse of dopamine” of sugar, social media, TV, sex, drugs or any number of dopamine- triggering stimuli so easily available. In short, Lembke says, almost every behavior has become “drugified.”

When we’re repeatedly exposed to our pleasure-producing stimuli, our brains adjust and, eventually, we need more and more just to feel “normal,” or not in pain. That’s called a “dopamine deficit state,” and the cycle that leads us there can actually lead to depression, anxiety, irritability and insomnia.

“We’re not able to take joy in more modest rewards,” Lembke says. “Now, our drug of choice doesn’t even get us high. It just makes us feel normal. And when we’re not using, we’re experiencing the universal symptoms of withdrawal from any addictive substance, which are anxiety, irritability, insomnia, dysphoria and craving. ”

Ultimately, Lembke says, this is a universal problem – not one limited to those of us struggling with the disease of addiction – that has come with living in modern life. And to restore our sanity, collectively we must rethink how to navigate a dopamine overloaded world.


A dopamine hit brings about pleasure and is then quickly followed by pain, or a come-down, in order to keep us motivated, says psychiatrist Dr. Anna Lembke.

Meredith Miotke for NPR


hide caption

toggle caption

Meredith Miotke for NPR


A dopamine hit brings about pleasure and is then quickly followed by pain, or a come-down, in order to keep us motivated, says psychiatrist Dr. Anna Lembke.

Meredith Miotke for NPR

Break the cycle and restore balance

Start with a dopamine fast. Take a 30-day break from whatever it is that you rely on for pleasure: social media, sugar, video games, sex, pot, booze – anything, really. This doesn’t mean going cold turkey forever, but this first month is key to getting your pleasure-pain balance back in check. It’s a lot easier to cut out an addictive behavior entirely at first, and then re-introduce it in moderation.

Lembke warns that you’ll probably feel a lot worse before you start feeling better. But she says to stick with it – after about two weeks, the pleasure-pain see-saw in your brain will start to restore to its natural balance and you’ll be able to enjoy more modest rewards, like just one scoop of ice cream or just one episode of a TV show.

There is one caveat: this is not the approach one should take for highly addictive substances like drugs and alcohol. Going cold turkey can actually cause life-threatening withdrawal, and should be done under the care of a professional.

Place obstacles between you and your addictive behaviors

There are three ways to “bind” yourself from – or place limits on – the behavior to which you’re addicted. Employing these strategies can help you enjoy some version of that behavior without letting it take over.

  • Physical self-binding: Create actual distance between you and your addiction. That could mean just removing the addictive substance from your home and spaces. For someone who’s addicted to video games, that could mean a separate laptop for work and one for play.
  • Chronological or time-related binding: The 30-day fast from your addictive behaviors counts as chronological or time-related binding. This could also look like intermittent fasting for someone who has a food addiction, or a time limit control on social media apps.
  • Categorical binding: This means limiting yourself from certain types of “substances” – maybe reality TV sucks you in beyond your control, but you can consume a sitcom in moderation. Cutting out reality TV from your life would be categorical binding.

For long-term change, radical honesty and community are key

In her work treating addicts, Lembke says she sees the most success in long-term recovery when people can’t lie. She that even though we’re often terrified of being radically honest with others because we think they’ll go running, the opposite actually happens: radical honesty promotes intimacy. “And intimacy is an incredibly valuable and potent source of dopamine,” she says. “We know that when we make intimate human connections, oxytocin binds dopamine, releasing neurons in the reward pathway and dopamine is released and it feels really good.”

Another level of this involves being radically honest with ourselves. Lembke explains that if we tell ourselves stories that aren’t true, we’ll repeat our mistakes. But if we’re ruthlessly honest about how we’re flawed and how we’ve contributed to our own problems – we can work on those mistakes and navigate the future differently.

“People in recovery are modern-day prophets,” Lembke says. To maintain balance and whole-heartedness, we have to strike a pleasure-pain balance, which, in a time of abundance and over-consumption, means intentionally avoiding pleasure and seeking the kind of purposeful pain that keeps us healthy, such as exercise or resisting certain temptations.

“By doing that,” Lembke says, “We will reset reward pathways and ultimately be a lot happier. It’s simple but not easy, but it’s well worth doing.”

Elise Hu is also the host of the TED Talks Daily podcast.

The podcast portion of this story was produced by Audrey Nguyen.

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