Rebalancing Dopamine (Without “Dopamine Fasting”)

This is Dr. Anna Lembke, a professor of psychiatry at Stanford. Today we’ll explore her work on managing dopamine levels and getting off the hedonic treadmill.
Rebalancing dopamine without dopamine fasting.

Rebalancing Dopamine (Without “Dopamine Fasting”)

Listen to Dr. Anna Lembke's podcast focusing on rebalancing the brain's dopamine levels through fasting.
Credit Steve Fisch

This is Dr. Anna Lembke. She’s a professor of psychiatry at Stanford, and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic—as well as running her own clinical practice, and serving on the board of an array of state and national addiction-focused organizations.

Today we’re going to look at her work on dopamine management…

Getting off the hedonic treadmill

For any unfamiliar with the term, the “hedonic treadmill” is what happens when we seek pleasure, enjoy the pleasure, the pleasure becomes normalized, and now we need to seek a stronger pleasure to get above our new baseline.

In other words, much like running on a reciprocal treadmill that just gets faster the faster we run.

What Dr. Lembke wants us to know here: pleasure invariably leads to pain

This is not because of some sort of extrinsic moral mandate, nor even in the Buddhist sense. Rather, it is biology.

Pleasure and pain are processed by the same part of the brain, and if we up one, the other will be upped accordingly, to try to keep a balance.

Consequently, if we recklessly seek “highs”, we’re going to hit “lows” soon enough. Whether that’s by drugs, sex, or just dopaminergic habits like social media overuse.

Dr. Lembke’s own poison of choice was trashy romance novels, by the way. But she soon found she needed more, and more, and the same level wasn’t “doing it” for her anymore.

So, should we just give up our pleasures, and do a “dopamine fast”?

Not so fast!

It depends on what they are. Dopamine fasting, per se, does not work. We wrote about this previously:

Short On Dopamine? Science Has The Answer

However, when it comes to our dopaminergic habits, a short period (say, a couple of weeks) of absence of that particular thing can help us re-find our balance, and also, find insight.

Lest that latter sound wishy-washy: this is about realizing how bad an overuse of some dopaminergic activity had become, the better to appreciate it responsibly, going forwards.

So in other words, if your poison is, as in Dr. Lembke’s case, trashy romance novels, you would abstain from them for a couple of weeks, while continuing to enjoy the other pleasures in life uninterrupted.

Substances that create a dependency are a special case

There’s often a popular differentiation between physical addictions (e.g. alcohol) and behavioral addictions (e.g. video games). And that’s fair; physiologically speaking, those may both involve dopamine responses, but are otherwise quite different.

However, there are some substances that are physical addictions that do not create a physical dependence (e.g. sugar), and there are substances that create a physical dependence without being addictive (e.g. many antidepressants)

See also: Addiction and physical dependence are not the same thing

In the case of anything that has created a physical dependence, Dr. Lembke does not recommend trying to go “cold turkey” on that without medical advice and supervision.

Going on the counterattack

Remember what we said about pleasure and pain being processed in the same part of the brain, and each rising to meet the other?

While this mean that seeking pleasure will bring us pain, the inverse is also true.

Don’t worry, she’s not advising us to take up masochism (unless that’s your thing!). But there are very safe healthy ways that we can tip the scales towards pain, ultimately leading to greater happiness.

Cold showers are an example she cites as particularly meritorious.

As a quick aside, we wrote about the other health benefits of these, too:

A Cold Shower A Day Keeps The Doctor Away?

Further reading

Want to know more? You might like her book:

Dopamine Nation: Finding Balance in the Age of Indulgence

Enjoy!

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    Get Abreast And Keep Abreast

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    What does she want us to know?

    Start now

    If you have breast cancer, the best time to start adjusting your lifestyle might be 20 years ago, but the second-best time is now. We realize our readers with breast cancer (or a history thereof) probably have indeed started already—all strength to you.

    What this means for those of us without breast cancer (or a history therof) is: start now

    Even if you don’t have a genetic risk factor, even if there’s no history of it in your family, there’s just no reason not to start now.

    Start what, you ask? Taking away its roots. And how?

    Inflammation as the root of cancer

    To oversimplify: cancer occurs because an accidentally immortal cell replicates and replicates and replicates and takes any nearby resources to keep on going. While science doesn’t know all the details of how this happens, it is a factor of genetic mutation (itself a normal process, without which evolution would be impossible), something which in turn is accelerated by damage to the DNA. The damage to the DNA? That occurs (often as not) as a result of cellular oxidation. Cellular oxidation is far from the only genotoxic thing out there, and a lot of non-food “this thing causes cancer” warnings are usually about other kinds of genotoxicity. But cellular oxidation is a big one, and it’s one that we can fight vigorously with our lifestyle.

    Because cellular oxidation and inflammation go hand-in-hand, reducing one tends to reduce the other. That’s why so often you’ll see in our Research Review Monday features, a line that goes something like:

    “and now for those things that usually come together: antioxidant, anti-inflammatory, anticancer, and anti-aging”

    So, fight inflammation now, and have a reduced risk of a lot of other woes later.

    See: How to Prevent (or Reduce) Inflammation

    Don’t settle for “normal”

    People are told, correctly but not always helpfully, such things as:

    • It’s normal to have less energy at your age
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    • It’s normal to be at a higher risk of diabetes, heart disease, etc

    …and many more. And these things are true! But that doesn’t mean we have to settle for them.

    We can be all the way over on the healthy end of the distribution curve. We can do that!

    (so can everyone else, given sufficient opportunity and resources, because health is not a zero-sum game)

    If we’re going to get a cancer diagnosis, then our 60s are the decade where we’re most likely to get it. Earlier than that and the risk is extant but lower; later than that and technically the risk increases, but we probably got it already in our 60s.

    So, if we be younger than 60, then now’s a good time to prepare to hit the ground running when we get there. And if we missed that chance, then again, the second-best time is now:

    See: Focusing On Health In Our Sixties

    Fast to live

    Of course, anything can happen to anyone at any age (alas), but this is about the benefits of living a fasting lifestyle—that is to say, not just fasting for a 4-week health kick or something, but making it one’s “new normal” and just continuing it for life.

    This doesn’t mean “never eat”, of course, but it does mean “practice intermittent fasting, if you can”—something that Dr. Simmons strongly advocates.

    See: Intermittent Fasting: We Sort The Science From The Hype

    While this calls back to the previous “fight inflammation”, it deserves its own mention here as a very specific way of fighting it.

    It’s never too late

    All of the advices that go before a cancer diagnosis, continue to stand afterwards too. There is no point of “well, I already have cancer, so what’s the harm in…?”

    The harm in it after a diagnosis will be the same as the harm before. When it comes to lifestyle, preventing a cancer and preventing it from spreading are very much the same thing, which is also the same as shrinking it. Basically, if it’s anticancer, it’s anticancer, no matter whether it’s before, during, or after.

    Dr. Simmons has seen too many patients get a diagnosis, and place their lives squarely in the hands of doctors, when doctors can only do so much.

    Instead, Dr. Simmons recommends taking charge of your health as best you are able, today and onwards, no matter what. And that means two things:

    1. Knowing stuff
    2. Doing stuff

    So it becomes our responsibility (and our lifeline) to educate ourselves, and take action accordingly.

    Want to know more?

    We recently reviewed her book, and heartily recommend it:

    The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons

    Enjoy!