Dr. Anna Lembke
Appearances
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
They were excited. And from the moment we got into the car and started driving to Yosemite Valley, I felt excited. a distinct difference in the quality of the presence of all of us, even in the car. And it lasted through the whole three days. It's like we played board games. We had meals together. And the key thing there was like nobody was sort of
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
looking toward the end of the meal to go check their device. Because there was no device to check, we lingered, right? We extended these conversations. We moseyed along after dinner, you know, under the stars. It was so different. And I became even more convinced that we need internet-free communal spaces. We need places where we come together
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Not all of the time, but some part of the time we come together and nobody is connected to the Internet and they can't get connected. Because when the ability to choose is removed, it changes the state of craving.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Yeah, I think that's right. We are now turning to these devices and to the Internet to meet our physical, emotional, sexual, educational, every need we have. We don't really need other people anymore. We can get those needs met from the Internet. And I think that's a very scary prospect because I think it means that we will get more and more isolated.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
The Surgeon General issued an advisory on our loneliness epidemic. And the irony is that even though the Internet can connect people, you know, across oceans and borders in a way that's amazing, it also, I believe, engenders and creates more isolation because people aren't needing other people in the same way anymore. They're getting their needs met. through the internet.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And originally the concern was sort of like, oh, well, they're getting their needs met through other people in chat rooms or what have you for good and bad. But yeah, as you point out, now with AI and large language models, it's not even real people. It's like this amalgam of collected language creating a simulated person. I don't know. I just, it's really scary.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Right. So the data here is really preliminary, and we need a lot more research. But there is clearly a signal that the GLP-1 agonists can help with alcohol addiction. We have patients in our clinic who have failed all other treatments for whom we have prescribed GLP-1. Things like Ozempic and Munjara and seen benefit.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And these are people who literally have tried everything and struggled for years and years and now report sustained remission from alcohol in a way that's just so hopeful and wonderful. I think there are some studies showing its benefit in possible behavioral addictions like gambling disorder and sex addiction. So, yeah, I mean... I want to emphasize that they don't seem to work for everybody.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So it's not like some kind of miracle cure. I mean, we have patients for whom, as I just described, they seem like a miracle cure. And then we have other patients for whom they don't really seem to do much. And that's true across the board with our medication treatments for all kinds of addictions. They work for some people individually.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And not for others, which is why it's so important that every individual has access to all the different options so they can use what works best for them.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So I know that my work is often interpreted that I'm skeptical of medical interventions.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I guess I would nuance that a little bit and just say I have seen that our medical system overemphasizes prescribing pills and performing procedures because it's more lucrative and it's faster and because we have a system that's not well set up to deal with chronic relapsing and remitting disorders like addiction and and other mental health concerns.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
But I very much use all kinds of medical interventions. I prescribe psychotropics and other types of medications on every clinic day. So what I'm seeking is more balance here and the recognition that, first of all, that psychotropics are overprescribed and that many patients experience debilitating polypharmacy where they're on 13, 14, 15 different psychotropics
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
to the point where it becomes completely unclear what's working, what's not. Plus, you have drug interventions, which can be really dangerous. But getting back to GLP-1, I mean, you know, I don't have really a judgment one way or another about whether people should stay on them long term. I think it depends on the person.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
You know, it does appear that when people stop the GLP-1 agonists, they have, with food addiction, a resurgence in their appetite and they're at risk to gain the weight back. I've seen reports of individuals now kind of pulsing the GLP-1 agonists and
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I think the irony is that amazing research has been going on for a long time, but for whatever reason, the American public hasn't been particularly interested until very recently. And why that shift? I mean, I have my theories. I think that with the advent of smartphones and 24-7 access to the Internet online,
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So using them for a period of time and then going off of them and then going back on for brief periods in a kind of pulsing way if, you know, the weight starts to creep up again or the relationship with the food starts to get verklempt again.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I think those cultural shifts can have a huge impact. I think we are seeing that with alcohol. More people, especially in the last two to three years, seem to be interested in drinking less alcohol. This is, you know, outside of the temperance movement and prohibition, it's definitely a new trend. But I think like most things, it tends to be a pendulum swing.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
We typically go too far in one direction and then too far in another. I mean, in general, I think it's very good.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Obviously, given my profession and all the terrible harms I've seen associated with alcohol and drug use and other addictive substances and behaviors, you know, I'm glad that there's more awareness and that people are interested in finding out about how to have fun together without using substances.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I do have a fear, though, that progress in the arena of drugs and alcohol might be happening because people are turning to digital drugs. I don't know. I hope that's not the case, but I do have some concern in that regard.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Yeah, it's a really fair question, and I think on some level we really are, which then begs the question, what is it about human nature, or I would argue, what is it about modern life that makes us so vulnerable to these addiction problems? I have kind of a, you know, some theories on that, totally, you know, speculative. Hit me. All right. You know, I think that...
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
We're essentially struggling with endemic narcissism, where our culture is demanding that we focus on ourselves so much that what it's creating is this deep need to escape ourselves. And I think that is what is driving much of our pursuit of intoxicants as a way to just not have to think about ourselves for a blessed hour or two.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Yeah, that's right. And it's not like the whole explanation, because obviously the whole point of dopamine nation is that we also live in this world of abundance with constant access and access alone is a risk factor. So I've already kind of made that point.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
But although I think access is important and supply is more important than we have given credit for, we do have to focus on the demand part of this equation. What is it about our lives now that make us so desperate to essentially be intoxicated in one form or another? And I do think it is this sort of obsessive self-focus.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I think that we can, like most things, take it too far and end up doing harm with all the time that we spend thinking about ourselves. Now, having said that. I think that good therapy gets us to a place where we can mindfully observe ourselves without being self-absorbed. But ultimately, I think the goal is to tune out.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
All of a sudden, people who saw addiction as a problem that somebody else had began wondering about their own compulsive consumption of digital media. And then I think COVID just really, like, you know, we just went off a cliff with COVID. Sure did. Yeah. And it was, I think, along the lines of, like, life is really weird.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
That is not to tune out as in not listen to ourselves, but to get out of our own heads ultimately. Yeah.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Yeah, I mean, it's a really sad, sad thing when people die of their, you know, mental disorder, addiction or otherwise. You know, there are lots of risk factors for addiction. There are genetic risk factors.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
If you have a biological parent or grandparent with alcohol addiction in particular, where the evidence is strongest, you're at increased risk for alcohol addiction, even if raised outside of that alcohol-consuming home. So we know there are genetic vulnerabilities. People don't come into the world. with equal risk.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Having said that, given all of the different drugs, including drugs that didn't exist before and the increased access, I think even without a genetic risk, we're now all more at risk than we were before. You know, there are social determinants of health that make a big difference in terms of people's ability to
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
To get into recovery, we know that poverty is a risk factor, multigenerational trauma, unemployment. These are all enormous risk factors that if we could target, we would improve people's chances of pulling out of the spiral of addiction. Gosh, I mean— There's a whole element, too, I would say, of just unpredictability.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Like, I used to think that I could predict when a patient came in whether or not they would be able to get into recovery, and I've long given up that idea. I've seen people with decades of severe and life-threatening addiction miraculously late in life get into recovery. And I've seen people who I thought for sure were helpable who ended up dying of their disease. So...
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
You know, there is still a lot we don't know.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So my father's alcoholism was a major factor in my childhood. He was a surgeon, but he would go long periods without drinking, and then he would have long periods where he was drinking large amounts every day.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I remember coming home from elementary school with my best friend Laura and finding him not on the hammock but under the hammock passed out and just looking at her and saying, let's go to your house. So, you know, that was sort of a specter in my childhood.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Like, I am at home all day long in my pajamas consuming more alcohol, more cannabis, more YouTube shorts. And I think all of a sudden people were like, wow, this addiction thing is real. And I do think that that's been a big cultural shift. And so I think it's more that the spotlight has turned toward this problem.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
What I first did with that in medical school and residency was to not want to have anything to do with addicted patients, just because that's kind of what we call negative countertransference, but also hadn't really learned very much in medical school or even residency. So I didn't have the tools, didn't know what to do.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And then very early in my career, I was specializing in treating mood disorders. And I had a young woman in my clinic I was treating for depression. Her parents were paying for the care. And I saw her weekly and we had in-depth discussions about her childhood. I talked about every conversation she'd ever had with her mother. I was prescribing an antidepressant.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And I noted that she would often nod off in the sessions. And I thought, huh. That's funny. I wonder why she's so sleepy. Maybe she's a slow metabolizer. You know, I was like, I was trying to draw on, you know, what I had learned in medical school. And then one day her brother calls me out of the blue and he says, she's been in a rollover car accident. I said, oh my goodness, that's terrible.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
What happened? And he said, well, she's been using again. And I literally did not understand anything. the structure of that sentence. As using, I said, using what? He said, well, using heroin. Isn't that what you've been treating her for? Oh, wow. Yeah.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And that was the moment that I realized I'm a bad psychiatrist because the kind of don't ask, don't tell policy, because I never once did ask her about drugs and alcohol, and she never once volunteered the information, but that's not really her job, right? It's my job to get that information.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So I was really doing harm to patients out of my ignorance, and that was a huge turning point in my career. I realized, oh my goodness, I need to figure out something about addiction or I'm going to be a menace. And the irony is that... As soon as I started asking patients about drugs and alcohol, they were eager to talk about it.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And the majority of my patients had problems with drugs and alcohol. And when I started treating that problem alongside their other psychiatric disorders, they got better in ways I had never seen prior to that. And the work was fun. It was so enjoyable. People got into recovery. They were amazing people. Their recovery impacted their spouses and their children and their parents and their workers.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
It's like the most rewarding work. So a lot of times people say, well, how can you do this work? I say, are you kidding? It's the best work. It's the best population.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Yeah, there is something trivializing about doing that. And I don't mean to do that. You know, I don't mean to compare my relatively modest compulsive overconsumption of romance novels with people who are struggling with life-threatening addictions.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
On the other hand, by drawing a comparison between what they're struggling with and what I struggled with, I'm also attempting to humanize the behavior and to acknowledge the ways in which we're all vulnerable to compulsive overconsumption given enough access to our drug of choice. So, you know, again, just looking at my own life here,
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
As I mentioned, you know, father with severe alcoholism, alcohol does nothing for me. Absolutely. It's not reinforcing. And so therefore, I've never been vulnerable to alcohol addiction. And so thought I just wasn't vulnerable to addiction, period. But the truth was, I hadn't just hadn't yet met my drug of choice.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And my drug of choice turned out to be this behavior I've done as an escape behavior since childhood, which is read. But then once, you know, kind of discovered a certain type of romance, vampire novel at a certain critical period in my life, plus the applied technology of a Kindle, which meant I had immediate access 24-7, I was off and running.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And yeah, it never got to the point where it was life-threatening, but it did get to the point where I was staying up till three in the morning every night reading. I was bringing romance novels to work and reading in the 10 minutes between patients.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I was taking romance novels to neighborhood parties and going and finding a room during the party and reading romance novels rather than... You mean that's not normal?
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
You know, what I argue for is a combination of trying to avoid using intoxicants in high volume too often. So it's not that I imagine that, you know, we're never going to use intoxicants. We wouldn't be human, and it's a deep part of our culture, and it can be neutral or even beneficial. But we have to really be careful about over-consuming intoxicants or consuming them too often.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And I do think given this world of abundance that we have to now intentionally seek out things that are hard. Because our lives have become so easy, so convenient, so sedentary, the default is a state of consumption that's ultimately not good for our bodies or our minds.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So I do think that we have to kind of simulate hardship and intentionally create inconvenience and create struggle for ourselves.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Well, I've never heard the amoeba analogy, which is kind of funny. Yeah. Yeah, I mean, right. There's the risk here that it all starts to sound too schoolmarm-y, right, or kind of scolding or judgy. And that's a real danger, and I wouldn't want—I'm sure I probably do come off that way, and that's not at all my intention. I sometimes feel like that. Yeah, right, right, exactly.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I mean, I've got kids, so you can imagine how they feel. I mean, you know, again, I can certainly appreciate a criticism of my including things like that, like, oh, that lady doesn't want us to do anything. We're just going to be bumps on a log and not just... But I think what I'm advocating for is something like a reframe. You know, when we decide not to indulge in these pleasures...
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
It's not like all of a sudden things shifted in 2020. I think what happened was COVID just accelerated the trends that were already happening. So to put it in perspective, just from my clinical front row seat, such as it is, in the early thousands, what we were seeing is a sudden increase in people addicted to the very same pills their doctors were prescribing to them.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
The culture has us telling ourselves that we are denying ourselves. And I think a potent reframe here is, no, I'm actually going towards something that's good for me and that in the long run makes my life better. So, you know, I mean, that's just what I see clinically. That's what I've experienced in my own life.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And I think people are unhappier than they'd like to be and kind of can't figure out why.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
foremost opioids for chronic and minor pain conditions leading to our current day opioid epidemic, but also a signal early on in the early 2000s, middle-aged men coming in with severe internet pornography addiction and compulsive masturbation, primarily men who had been able to consume pornography in reasonable moderation without a lot of harm to their lives until the advent of the internet.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And then especially, you know, in the first decade of the 2000s, the smartphone. And that was probably our earliest signal for behavioral addictions. And then around 2012, 2013, we were seeing a bunch of teenage boys brought in by their parents primarily for Internet gaming disorders.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And then sort of roughly 2015, 2016, we start to see the earliest signal of social media addiction, online shopping, a huge increase in online gambling addiction. And then what I would say I've seen primarily in the past five years is a sort of diffuse addiction to the Internet, right?
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So people will have their drug of choice, whether it's shopping or social media or video games or pornography or what have you. But if that's not available, they'll switch to something else.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So addiction is the continued compulsive use of a substance or a behavior despite harm to self and or others. Importantly, there is no brain scan or blood test to diagnose addiction, and there won't be for a very long time, if ever.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
We still base our diagnosis on what we call phenomenology, which is patterns of behavior that repeat themselves across individuals, temperaments, cultures, time periods, etc.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Oh, interesting.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Well, I mean, I think these issues are debatable, and the use of language is important. When I use the term addiction, I am talking about a form of psychopathology, which is a spectrum disorder. So there is mild, moderate, and severe addiction. When we see severe addiction, we all recognize it. Like, it's obvious, right?
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
They're struggling, they're suffering, there's incredible consequences as a result of their use, and yet they can't stop using without significant help. On the less severe end, you know, it's much harder to tell when we might cross over from healthy, recreational, and adaptive use of a substance or a behavior into unhealthy, maladaptive use.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And often that's a judgment call, and it's also culturally informed. So, for example, when we think about something like work addiction, right, we live in a culture that absolutely celebrates workaholism. So we're not really going to identify that as a problem, typically.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
It is both, right? So sometimes... an outside observer might say, hey, this is clearly a problem. But, you know, a part of the addiction process is that we ourselves don't necessarily recognize a problem, even when it's obvious to others. This is why people talk about denial as an important part of the addictive process. People end up with this kind of double life phenomenon where
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
They have this secret life where they're engaging in their addictive behaviors, and then they have this other life that other people see. And the lives are so separated and the addictive life is so covert that we can actually convince ourselves that it's not really happening or it's not happening to the extent that it is or that it's not causing problems, even if it is happening.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
I agree 100%. This is a collective problem. I see it as part of the Anthropocene, which is a term that's been coined to describe the age we live in now, when human action is changing the face of the planet for the first time in history. You know, climate change is often included in this idea of the Anthropocene.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
But I do think that this, the stressors of overabundance should also be included in that. In the richest countries in the world, we have more leisure time, more disposable income, more access to leisure goods than ever before. And I think that, you know, as a result, we are all struggling to know what to do with all that extra time and money.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And one would hope and think that we would be like engaging in deep philosophical discussions, helping each other, cleaning up the garbage. Sorry, I'm laughing, of course. Yeah. But instead, what we're doing is spending a whole lot of time masturbating, shopping and, you know, watching other people do things online.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And essentially what's happened is we're spending more and more time of our energy and creativity investing in this online world. which means that we are actually leeching our real-life existence of our energy and creativity. So when we try to get off out of the metaverse and reenter the real world, it actually is more boring, right? Because there's less going on because there's nobody there.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Yes, exactly. And it seems to me we've kind of crossed over some kind of abundance set point where we went beyond meeting our basic survival needs and now have so much access to so many pleasure-inducing substances and behaviors. that we may actually be changing our brain chemistry such that we're in a dopamine deficit state.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Now we need to keep using these highly stimulating drugs and behaviors not to get high and feel good, but just to level the balance and feel normal. And, you know, interestingly, even more recently, I'm part of a state of the nation project.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And some of the findings that we're seeing for the United States are that despite the fact that a lot of parameters would suggest the nation is doing better, from a mental health perspective, we're doing worse. And that's true around the world. Rates of depression, anxiety and suicide are going up in countries all over the world. And they're going up fastest in the richest nations of the world.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So there's some kind of phenomenon where this overwhelming overabundance has reached a tipping point such that now we're actually dealing with the stress of overabundance, which our ancient reward pathways were not really evolved for.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
No, I don't. I mean, I think we all struggle with appetitive control in the modern world. But I do think it's important to use this term addiction, or as the DSM defines it, a use disorder, as when we've crossed that threshold into self and other harm that is on some level out of our control.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So I don't want to just say like everybody's addicted, but I do think that the problem of compulsive overconsumption has become something that all of us are probably struggling with in one form or another.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And, you know, although I've been treating addiction for, gosh, going on 30 years and thought that I personally was somewhat immune to the problem of addiction, it wasn't until I got addicted to romance novels that I was like, oh, wait a minute, like, even I can get addicted to something. Right.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Yeah, I'm always a little reluctant to talk about sort of, you know, what we as a family did, because I don't want people to feel like, oh, you know, we should have done that or we should do that. I really think every family has to kind of find their own way. And I will say up front, I mean, my family struggles with this as much as the next family.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
But one thing that we did as a family that I am very grateful for and my kids are grateful for is that We did not have any devices in the home environment until our eldest started high school. Now, when our daughter started high school, she came home and said, I actually can't function as a student in high school unless we get a connection to the internet.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
You know, we're in the heart of Silicon Valley. So we realized that that was true. With the constantly changing high school schedules, all of the assignments in line, like there was no way to participate in high school life without without connecting to the internet. And this was already some eight years ago when she started high school.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
So we got internet connection, and really it was downhill from there. I just want to pause here.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
We did not have internet in our home, and I did not own a smartphone, if you can believe it, until about 2019 when I was forced through work to get one in order to be able to prescribe controlled substances using Duo Security. Again, I want to emphasize, like, I'm not judging other people because... I get it. Most people... I'm just at awe.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Yeah, well, and, you know, I have the kind of work that allows me to do that. Most people do not have that.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
Exactly, exactly. But, you know... What can I tell you? My kids are now between ages 18 and 23. They have struggled to various degrees with their time online. But what I'm really grateful for is that they have at baseline this notion that too much time on the Internet is not a good thing. It's not a good thing for relationships. It's not a good thing for mental health.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
It's not a good thing for physical health. So even if they intermittently struggle with spending occasionally too much time online, they have this very strong idea rooted in, let's be present. Let's be present together. Let's not be distracted. To the point where this past winter holiday, we decided to go to Yosemite Valley together as a family.
The Daily
'The Interview': Digital Drugs Have Us Hooked. Dr. Anna Lembke Sees a Way Out.
And we had done tons of vacations with the kids, always device-free, which, by the way, is like being a blind person now when you're traveling. It's literally like you cannot see because everything is—you need the QR code. But we've done it. And I said, are you guys still game for device-free? Because it had been a couple years since we'd gone on that kind of trip together. And they were.