8/18/2023 0 Comments Dopamine pain and pleasure![]() ![]() “The smartphone is the equivalent of the hypodermic needle, delivering digital dopamine 24/7 for a wired generation.”Īccording to the World Happiness Report, which ranks 156 countries by how happy their citizens perceive themselves to be, people living in the United States reported being less happy in 2018 than they were in 2008. Rates of depression, anxiety, physical pain, and suicide are increasing worldwide, especially in wealthy nations. Yet despite this increased access to all these feel-good drugs and behaviors-or as I hypothesize, because of it-we are more miserable than ever. If you haven’t met your drug of choice yet, it’s coming soon to a website near you. The smartphone is the equivalent of the hypodermic needle, delivering digital dopamine 24/7 for a wired generation. Online products with their flashing lights, celebratory sounds, laudatory likes, and bottomless bowls promise ever-greater rewards just a finger click away. The access, quantity, variety, and potency of highly reinforcing drugs and behaviors has never been greater, including drugs that didn’t exist before-texting, tweeting, gaming, gambling, sugar, shopping, vaping, voyeuring. We now live in a world of overwhelming abundance. But here’s the problem: We no longer live in that world. It’s what has kept us alive in a world of scarcity and ever-present danger. This fine-tuned pleasure–pain balance of ours has evolved over millions of years to help us approach pleasure and avoid pain. This is the hallmark of the addicted brain. And as soon as I stop watching, I experience the universal symptoms of withdrawal from any addictive substance-anxiety, irritability, insomnia, dysphoria, and mental preoccupation with using, otherwise known as craving. I need to keep watching YouTube videos-not to feel pleasure, but just to feel normal. Once that happens, I’ve changed my joy set point. They’re camped out for the long haul-tents and barbecues in tow. Now, if I keep doing this, I end up with enough gremlins on the pain side of my balance to fill a whole room. I’m watching YouTube videos of people watching YouTube videos, alternating with memes of Dr. But what if I don’t wait? What if, instead, I watch another video and another and another? Pretty soon, I’m no longer watching American Idol YouTube videos. If I wait long enough, the gremlins hop off the balance, neutrality is restored, and that feeling passes. “After any deviation from neutrality, our brains will work very hard to restore a level balance, or what neuroscientists call homeostasis.” This is the aftereffect, the hangover, the comedown-or in my case, that moment of wanting to watch just one more video. They like it on the balance, so they don’t hop off once it’s level they stay on until it has tipped an equal and opposite amount to the side of pain. Not very scientific, I know-but here’s the thing about those gremlins. I like to imagine this as little gremlins hopping on the pain side of my balance to bring it level again. But no sooner has that happened than my brain adapts to the increased dopamine by down-regulating my dopamine receptors and dopamine transmission. And when I watch, my brain releases a little bit of the neurotransmitter dopamine in my brain’s reward pathway, and my balance tips slightly to the side of pleasure. After any deviation from neutrality, our brains will work very hard to restore a level balance, or what neuroscientists call homeostasis.įor example, I like to watch YouTube videos of American Idol. ![]() One of the overarching rules governing this balance is that it wants to stay level. When we feel pleasure, the balance tips one way when we feel pain, it tips the other. ![]() And pleasure and pain work like a balance. The same parts of the brain that process pleasure also process pain. One of the most important discoveries in neuroscience in the past 100 years is that pleasure and pain are co-located. Listen to the audio version-read by Anna herself-in the Next Big Idea App. ![]() She is the recipient of numerous awards for outstanding research in mental illness, for excellence in teaching, and for clinical innovation in treatment.īelow, Anna shares 5 key insights from her new book, Dopamine Nation: Finding Balance in the Age of Indulgence. Anna Lembke is the medical director of Stanford Addiction Medicine, program director for the Stanford Addiction Medicine Fellowship, and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. ![]()
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