How to Find Balance in the Age of Indulgence - Dr. Anna Lembke

hi i'm Dr Anna Lembke welcome to a special  episode of After Skool today we're going to be talking about dopamine and how to find balance  in the age of indulgence so without further ado let's dive in according 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.  other countries with similar measures of wealth social support and life expectancy  saw similar decreases in self-reported happiness scores including belgium canada  denmark france japan new zealand and italy researchers interviewed nearly 150 000 people  in 26 countries to determine the prevalence of generalized anxiety disorder defined as excessive  and uncontrollable worry that adversely affected their lives they found that the richer countries  had higher rates of anxiety than the poorer ones the authors wrote the disorder is  significantly more prevalent and impairing in high income countries than low to middle  income countries the number of new cases of depression worldwide increased 50 percent  between 1990 and 2017. the highest increases in new cases were seen in regions with higher  sociodemographic index especially in north america the question is why in a time of unprecedented  wealth freedom technological progress and medical advancement do we appear to be unhappier than  ever in this video i present five big ideas that outline how an increase in access to pleasure  causes the degradation of mental health and how to find balance in an age of indulgence to understand  the roots of this issue we must start in the brain big idea number one the pleasure pain balance one  of the most important discoveries in the field of neuroscience in the past 100 years is that  pleasure and pain are co-located by that i mean the same parts of the brain that process pleasure  also process pain and pleasure and pain work like a balance when we feel pleasure the balance  tips one way when we feel pain it tips the other one of the overarching rules governing  this balance is that it wants to stay level after any deviation from neutrality our  brains will work very hard to restore a level balance or what neuroscientists call homeostasis  for example i like to watch videos of american idol 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 but no sooner has that happened then my brain adapts to the increased dopamine  by down regulating my own dopamine receptors and dopamine transmission i like to imagine  this as little gremlins hopping on the pain side of my balance to bring it level again not  very scientific i know but here's the thing about those gremlins they like it on the balance so  they don't hop off once it's level they stay on until it is tipped an equal and opposite amount  to the side of pain this is the after effect the hangover the come down or in my case that moment  of wanting to watch just one more video if i wait long enough the gremlins hop off the balance  neutrality is restored and that feeling passes 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  videos i'm watching videos of people watching videos alternating with memes of dr pimple popper  if i keep doing this for hours a day days to weeks weeks to month i end up with enough gremlins on  the pain side of my balance to fill a whole room they are camped out for the long  haul tents and barbecues in tow once that happens i've changed my hedonic set  point now i need to keep watching videos not to feel pleasure but just to feel normal 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 this is the hallmark of the addicted brain big idea number two dopamine overload this  fine-tuned balance of ours has evolved over millions of years to help us approach pleasure and  avoid pain it's what's kept us alive in a world of scarcity and ever-present danger but here's the  problem we no longer live in that world we now live in a world of overwhelming abundance  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 the list is endless online products with their flashing lights  celebratory sounds laudatory likes bottomless bowls and the promise of ever greater rewards  just a finger click away are engineered to be addictive the smartphone is the equivalent of the  hypodermic syringe delivering digital dopamine for a wired generation if you haven't met your drug of  choice yet it's coming soon to a website near you yet despite increased access to all these  feel-good drugs or as i hypothesize because of it we're more miserable than ever rates of  depression anxiety physical pain and suicide are increasing all over the world especially in  rich nations our compulsive over consumption has led not just to increase psychological suffering  we are literally consuming ourselves to death seventy percent of world global deaths are  attributable to diseases caused by modifiable behavioral risk factors like smoking physical  inactivity and diet the leading global risks for mortality are high blood pressure tobacco use  high blood sugar physical inactivity and obesity in 2013 an estimated 2.

1 billion adults were  overweight compared with 857 million in 1980.