The Diary Of A CEO with Steven Bartlett
The Dopamine Expert: Doing This Once A Day Fixes Your Dopamine! What Alcohol Is Really Doing To Your Brain! Your Childhood Shapes Future Addictions!
Thu, 02 Jan 2025
From smartphones, to sugar, to exercising, the modern world is plagued by dopamine addictions, and Dr Anna Lembke holds the key to breaking free Dr Anna Lembke is Professor of Psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. She is the author of bestselling books such as, ‘Dopamine Nation: Finding Balance in the Age of Indulgence’. In this conversation, Dr Anna and Steven discuss topics such as, the link between addiction and childhood trauma, how exercise balances your dopamine system, the benefits of chasing pain, and the real effects of alcohol on the brain. 00:00 Intro 03:44 Why Does Dopamine Matter? 04:08 What Is Dopamine? 05:35 How Understanding Dopamine Can Improve Your Life 06:09 Biggest Misconceptions About Dopamine 07:30 Everyday Activities That Impact Dopamine 09:36 Dopamine and Its Relationship to Pleasure and Pain 18:26 Why Do Our Brains Overshoot? 20:31 How Our Brains Are Wired for Addiction 25:22 Finding Ways to Deal With Pain 31:51 Stories of Addiction 34:52 How Many People Have Addiction Disorders? 40:14 Hiding Away From Friends and Family 41:21 Distinguishing Between Good and Bad Behaviors 45:50 How Addiction Makes You Feel 47:50 Is Work an Addiction? 54:18 What Activities Provide the Biggest Dopamine Hits? 58:59 Can We Inject or Drink Dopamine? 01:01:00 Why We Must Do Hard Things 01:02:37 Can You Get an Exercise Comedown? 01:04:19 How to Optimize for a Better Life 01:05:17 How Should We Be Living? 01:09:29 Being Comfortable With the Uncomfortable 01:10:34 Causes of Anxiety Throughout Life 01:12:43 Living in a World Where It's Easy to Outrun Pain 01:13:09 Where Are You Now in Your Grieving Journey? 01:14:43 Youngest Child Seen With Addictions 01:15:37 Youngest Age When Addiction Can Have an Effect 01:16:50 Youngest Patient With Addiction 01:18:40 Has Society Gone Soft? 01:21:05 Victimhood and Responsibility 01:25:02 How to Help Someone Overcome a Victimhood Mentality 01:28:36 Connection Between Responsibility and Self-Esteem 01:30:13 Importance of Our Self-Narrative 01:37:24 Ads 01:38:22 How Helping a Loved One Too Much Can Hurt Them 01:44:49 Overcoming Pornography Addiction 01:48:35 Harms of Watching Porn 01:51:04 Is Dopamine Responsible for Sugar Cravings? 01:53:05 Turning Addictions Around 01:58:25 Why We Bounce Back to Cravings After Relapsing 02:02:49 Effects of Early Exposure to Addictive Substances on Children Follow Dr Anna: Website - https://g2ul0.app.link/f0HLrXUTqPb You can purchase Dr Anna’s books, here: ‘Dopamine Nation: Finding Balance in the Age of Indulgence’ - UK version: https://g2ul0.app.link/BWfeDh0TqPb ‘Dopamine Nation: Finding Balance in the Age of Indulgence’ - US version: https://g2ul0.app.link/jPIwbElUqPb ‘The Official Dopamine Nation Workbook’ - UK version: https://g2ul0.app.link/MbZZbHhUqPb The Official Dopamine Nation Workbook’ - US version: https://g2ul0.app.link/BEet3RnUqPb Watch the episodes on Youtube - https://g2ul0.app.link/DOACEpisodes Independent fact check: annalembke.tiiny.co My new book! 'The 33 Laws Of Business & Life' is out now - https://g2ul0.app.link/DOACBook You can purchase the The Diary Of A CEO Conversation Cards: Second Edition, here: https://g2ul0.app.link/f31dsUttKKb Follow me: https://g2ul0.app.link/gnGqL4IsKKb Sponsors: ZOE - http://joinzoe.com with code BARTLETT10 for 10% off Learn more about your ad choices. Visit megaphone.fm/adchoices
Chapter 1: Why does dopamine matter?
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There's a very famous experiment in which rats were engineered to have no dopamine. And the scientists discovered that if they put food in the rat's mouth, the rat would eat. But if you put the food even a body length away, the rat will starve to death. Which tells us that dopamine is fundamental to get the things that we need for our basic survival.
Now, every time we're doing something that's pleasurable, from sugar to video games, work, pornography, social media, that will affect dopamine. And the more dopamine that's released, the more likely that drug or behavior is to be addictive. But also, the genetic risk of addiction is about 50 to 60 percent.
So if you have a biological parent or grandparent with addiction, you are more likely to develop that addiction. We have to keep it in balance in order to stay healthy.
Chapter 2: What is the link between dopamine and addiction?
Dr. Anna Lemke is professor of psychiatry at Stanford, chief of the Stanford Addiction Clinic, and a world-leading expert on the subject of dopamine.
She will tell you how this one powerful chemical is controlling your life and what to do about it.
One of the most important findings in neuroscience in the past 75 years is that the same parts of the brain that process pleasure also process pain, and the balance wants to remain level. The problem is that we automatically seek out pleasure and avoid pain, and we're exposed to all kinds of pleasures that we have in the modern world. And our brains are reeling in response to try to compensate.
Chapter 3: How can understanding dopamine improve your life?
Now I need more of my drug in more potent forms to get the same effect, which then leads to addiction. And that's what happened to me when I got addicted to romance novels.
Take me into that phase of your life.
I was out of control, and I needed to restore a level balance and take advice I give my patients.
And what is that advice?
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Quick one before we get back to this episode. Just give me 30 seconds of your time. Two things I wanted to say. The first thing is a huge thank you for listening and tuning into the show week after week. It means the world to all of us. And this really is a dream that we absolutely never had and couldn't have imagined getting to this place.
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Chapter 4: What are the misconceptions about dopamine?
But secondly, it's a dream where we feel like we're only just getting started. And if you enjoy what we do here, please join the 24% of people that listen to this podcast regularly and follow us on this app. Here's a promise I'm going to make to you. I'm going to do everything in my power to make this show as good as I can now and into the future.
We're going to deliver the guests that you want me to speak to and we're going to continue to keep doing all of the things you love about this show. Thank you. Thank you so much. Back to the episode. I've sat here for the last 20 minutes trying to figure out how to say this to you. So I'm just gonna say it how it comes out my mouth.
And I apologize if this is messy, but if there was ever an episode this year that you should listen to, it is this one. Since this episode was recorded about a month ago, All I've been thinking about is how on earth I get you to watch this. And I don't say this often. The last time I said this was the first time mogul.com came on this podcast.
This is the second time I've said this in almost four years of recording this podcast on YouTube.
And the reason for that is so many of the things that I know you're struggling with in your life that stand in the way of the person you want to become, that relationship you have with your phone, the procrastination, the cycles of behavior that make you feel embarrassed and full of shame that you've just never been able to crack.
All of them, all of them, I genuinely believe for many of you are going to be understood today if you listen to this episode. It has changed my life and it has changed much of the lives of my team. If I'm wrong here, you have the right to message me and tell me that I was wrong. Please listen to this episode. Really, really, I mean that from the bottom of my heart. Dr. Anna Lemke.
You wrote one of the most iconic, well-known books about dopamine, which propelled the subject matter of dopamine into the public consciousness. But I guess the most important question I should ask you is, why does dopamine matter?
Ah, good question. Good place to start. I mean, dopamine matters because it's fundamental to our survival, right? So it's the chemical that we make in our brain that tells us this is something we should approach, explore, investigate. So it's really almost the survival chemical.
So what is dopamine? If you had to explain it to a 10-year-old, how would you go about explaining it?
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Chapter 5: How does childhood trauma relate to addiction?
having a basic understanding of how dopamine works, how we process pleasure and pain, and also what happens with dopamine as we go from adaptive recreational use to maladaptive addictive use is something that is really useful, especially for those of us living in the modern world, where now we're exposed to so many reinforcing substances and behaviors that we've all become vulnerable to the problem of addiction.
And what are the biggest misconceptions on the subject of dopamine? Because it's kind of thrown around in society. I see it in my group chats, people saying, I need more dopamine or whatever, or that person just craves dopamine. What are the biggest misconceptions you've come across?
the main misconception is that somehow we can get addicted to dopamine. We're not getting addicted to dopamine itself. Dopamine is neither good nor bad. It's a signal to tell us whether or not something that we're doing is potentially useful for our survival. And also, it's related to what we predicted about how rewarding or pleasurable something would be.
And so it's really, you know, I sort of sometimes I joke it's like the reward theory of relativity, dopamine is, in the sense that pleasure and pain really are truly relative to one another. And so dopamine gives us information about where we are in that relativity scale between pleasure and pain.
And when you say relative, you mean, I mean, it's quite fitting for anyone that can't see, we have a set of scales on the table. And scales are relative to each other, because if you pour in one end, the other end goes up. And if you pour in the other end, the other end goes up and this end goes down. And when you say relative, that's what you're describing, right?
Yes, that's what I'm describing. Yes.
Okay. And what activities that I do every day have an impact on my dopamine?
Well, probably almost everything in some ways. I mean, every time we are doing something that's pleasurable, reinforcing, rewarding, that will affect dopamine. It's really the primary signal that lets us know that this thing is potentially important for our survival, as I mentioned. But even aversive stimuli can trigger dopamine. What's aversive? Something that's painful or not pleasurable.
Dopamine gets involved in that equation. Anything that's novel or new is something that triggers our dopamine in our reward pathway more. Dopamine is fundamental for movement, so not just pleasure and reward, but also movement.
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Chapter 6: What activities provide the biggest dopamine hits?
We can swipe right, we can swipe left, and all of a sudden it magically appears at the touch of a finger. And that's very confusing for our brains because that's not how we evolved. We really evolved for having to do quite a bit of upfront work for a tiny little bit of reward.
I just want to, before we move on, talk about this point you said, because I think it's quite foundational to everything we're going to talk about, about dopamine being relative to pain. And I have this set of scales in front of me. And here I have some chemicals that are likely to produce dopamine in my brain, I believe. Right, so alcohol.
Yes.
I have some rum, I have some whiskey, I have some vodka. And can you explain to me, using this rum, whiskey, and vodka, how dopamine is relative to pain and what's going on in my brain?
Sure.
Okay, I'll slide this over to you.
Oh, okay. So one of the most exciting findings in neuroscience in the past 75 years is that pleasure and pain are co-located in the brain. So the same parts of the brain that process pleasure also process pain. And in a very simple reductionist kind of way, they work like opposite sides of a balance.
So imagine that deep in your brain's reward pathway, which is another exciting discovery, right, that there's this dedicated reward pathway of the brain that consists, broadly speaking, of the prefrontal cortex, which is this large gray matter area right behind our foreheads that's so important for future planning, for delayed gratification, for appreciating future consequences.
You might think of it as like the brakes on the car if we're going to analogize to an engine. And then deep, you know, in the brain, we've got what we call the limbic areas or the emotion brain. And there you have the nucleus accumbens and the ventral tegmental area that are rich in dopamine-releasing neurons, right? And they act like the accelerator on the car.
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Chapter 7: Why is exercise important for dopamine balance?
So there are large neuronal circuits and pathways between those deep limbic structures and the prefrontal cortex that literally get severed or disconnected when people become addicted. As we think about pleasure and pain being co-located in the same parts of the brain, working like opposite sides of the balance,
In order to understand what happens in the addicted brain is to appreciate that there are fundamental rules governing this balance. And one of the most important rules is that the balance wants to remain level. It does not want to be tilted very long to the side of either pleasure or pain.
And in fact, what our brain does is first tilt an equal and opposite amount to whatever the initial stimulus is. So I'm going to try to illustrate that here. So let's say our initial stimulus is alcohol. Now, alcohol works through its own chemical pathway. It works on our endogenous opioid system, the opioids that we make. We have receptors for opioids in our brains.
It works on our endogenous GABA system, which is our calming neurotransmitter. And at the end of the day, it releases dopamine in the reward pathway. So any potentially addictive substance will release dopamine in the reward pathway. The more that's released and the faster that's released in a given individual, the more likely that substance is to be addictive.
Now, another important concept here is what we call drug of choice, which is to say what releases a lot of dopamine in your brain may not release a lot of dopamine in my brain and vice versa, right? Which is this idea that people have predilections to different kinds of drugs. And by the way, people can get addicted to behaviors too. I should emphasize that.
When you say drug of choice, you mean the brain has a particular sensitivity to that drug in terms of dopamine? Yeah.
Yes. The more dopamine that's released, the faster that it's released, the more likely that drug is to be addictive for a given individual.
So you're holding some whiskey there.
I'm holding some whiskey.
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Chapter 8: What practical solutions can help manage addiction?
Sort of baseline level...
That's right. Yeah, baseline level. And by the way, we're always releasing dopamine at a kind of tonic baseline level in our brains. I sometimes think of it as the heartbeat of the brain.
So what's happened here for people that can't see is you've poured a little bit of whiskey into one end of the scale, the pleasure side of the scale, and the other side of the scale has risen because now there's whiskey in the pleasure side, which I guess has released dopamine.
Exactly. So now we've released dopamine in the reward pathway.
Because the pain side went up, does that mean there's now less pain in the brain?
Well, I think, you know, again, this is a metaphor. It's an oversimplification. The idea here is just when we press on the pleasure side, we're releasing dopamine in the reward pathway and experiencing pleasure.
Okay.
Okay. But no sooner has that happened than our brain will try to compensate or adapt to increased dopamine firing by downregulating dopamine transmission, for example, by involuting postsynaptic dopamine receptors.
What does that mean?
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