Dopamine Detox: How To Regain Control Of Your Life In 30 Days | Dr. Anna Lembke

if you could explain to the best of your ability like like what dopamine is uh when is it released and why it's important okay so dopamine is a chemical that that in our brain it has different functions in the brain for example it's very important for movement and it's also essential for the experience of pleasure reward and motivation but I think at its broadest level dopamine is a way that our brains signal to us that we need to pay more attention to the environment and that we potentially need to either approach the stimulus in the

environment or back away from it and the reason I think that that's a better broader way of understanding dopamine is because we can have a release of dopamine in response to things that are negative stimuli as well as to things that we typically associate with a positive or rewarding experience I think sometimes dopamine is mistakenly identified as the pleasure neurotransmitter and it is important to the experience of pleasure but not just pleasure novelty in and of itself so anything new in the environment even if it's potentially negative will get our brains to release dopamine in

response and of course it's no coincidence that dopamine is important not just for these stimuli in the environment but also for movement because those things are intertwined you know from an evolutionary perspective because most organisms will have to either move toward or move away from whatever the stimulus is and if you think about the purpose of like hormones and neurotransmitters in our brains the fundamental purpose at its most basic level is to trigger some kind of physical movement or physical action or physical response I sometimes think that reducing it down to that fundamental can be

very helpful because so much of our Modern Life life is sedentary we are not moving right we are having these interactions on the internet of the tip of a finger and yet our bodies really want to move in response to those so I think reconceptualizing dopamine as a signal for some kind of movement toward the stimulus can be a kind of a helpful broader way to think about it that's so well said and and very well explained and I learned something new like every time I talk to you and that definitely put things in a

different perspective for me because you're right like dopamine often gets associated with just being like the molecule that's associated with pleasure but it's also associated with pain and that's why things like drugs alcohol and other addictions are closely related to our relationship with dopamine as far as like like what happens in a like a real-time situation with dopamine the way I understand it and feel free to correct me if I'm wrong is that like say that I am going to do something like this let's just say that I'm I'm addicted to drugs and I am

super excited to go score some drugs like dopamine as I understand it is what's getting me excited and moving towards seeking that Rush that high that chase and then once I get the drug and do it and come down off the high it almost feels like there's no more dopamine you don't feel good anymore like you see that a lot like if somebody goes and cheats on their partner like they'll have the same kind of response or they spend a bunch of money that they didn't like want to spend like it's always like the chase

feels good and then once you once you've got it you feel like crap so like what's going on like in the brain and why do people feel like that right so let's break it apart in a couple different pieces so there first there's the piece about anticipating our reward and we can only anticipate our reward if we've learned that it is reinforcing or rewarding for us because we've done it in the past and this gets to the heart of what people talk about when they talk about addiction as a learned behavior because that that is

the element of learning we our brain remembers our reaction in the past to that stimulus unfortunately what our brain tends to remember is some of the earliest exposures to that drug we're very bad at remembering the sort of negative Downstream consequences which in and of itself is really interesting right that we have this Vivid acute memory of the early reinforcing effects of our early drug use but are almost amnestic for the sort of negative consequences of drug use but importantly once we've learned to associate that behavior or that substance with feeling good or feeling some

kind of reinforcing uh you know feeling then when we think about that drug or when we anticipate using that drug we're already getting an increase in dopamine firing so remember that dopamine we're always firing dopamine at a kind of Baseline tonic level and when we are reminded of our drug a trigger or we're anticipating using drug that drug we get an increase the point being that we're already a little bit High anticipating that drug now we have to do you know the work of going to get it but here's a key piece right after we

have that increase in dopamine firing as we're anticipating the drug immediately that's followed by a decrease in dopamine firing not just to Baseline levels but actually low Baseline levels so our anticipation or our recall of drug use alone triggers this dopamine deficit state which then drives the craving so once we've anticipated the drug use or been reminded the drug use we get a little bit High then we get that dopamine deficit State and now we're sort of caught in the clutches of the incredibly strong physiologic urge to get dopamine firing at least back to Baseline

so very hard once we've put ourselves in that state or been put in that state accidentally to resist the compelling drive to restore Baseline dopamine firing so that's the first piece of it now we're craving we go get it like there's no slowing down that train right we go and we get it we only remember like the euphoric recall of using we use it and if we're in the early stages of our addiction when we use we will get an even bigger increase in dopamine release with ingestion of our drug right but what happens over

time is that we develop tolerance over time with repeated use we develop tolerance meaning that we need more potent forms of our drug to get the same effect and if we are using enough for long enough essentially our brain learn turns that drug to the extent that we get zero bump with actual ingestion so again we anticipate the drug we get a little bit of dopamine release above Baseline followed by a dopamine deficit State that's craving that drives the work to do it now we're expecting a big dopamine increase with drug ingestion but because our

brains have changed our hedonic or Joy set point we no longer get that big increase instead we get a tiny little bump or maybe no bump at all we actually go into the dopamine deficit State immediately or get the opposite so that's really important because if there's one thing that will send our brains into a dopamine nosedive it's anticipating a reward that doesn't come right so we thought that using would bring about a certain feeling we don't get that feeling we were anticipating so we use more and more more potent forms we add something else

to it just trying to recapture that feeling but we're not going to be able to recapture it because our brains have already adjusted our hedonic set point and we're in this kind of chronic dopamine deficit State and what will really recapture good feelings is to abstain from our drug for long enough for our brains to start to upregulate and make our own dopamine and dopamine receptors again so that's why abstinence you know sustained abstinence is so important probably not even just from our drug of choice but also from drugs generally right because all drugs end

up triggering the same dopamine reward pathway I hope that I explained it was a little convoluted but it's hard to do it without images no it was very well explained and I think people are really going to be able to gain a better understanding of of why like the chase in itself of going after something not just substances but anything in life that we regret it could be like I said like it could be like watching porn that you didn't want to watch it could be cheating on your spouse it could be like eating a

whole pizza like it could be like a variety of things and I guess to bring it back to what you were talking about like let's let's just say that that there's somebody who's listening to this that they just are caught up in these addictive patterns where no matter what they're constantly going after like the quick fixes and it doesn't have to be necessarily A drugs maybe it's with food or maybe it's with sex or what's with money like do you recommend somebody just going on a complete fast from like all things like dopamine because I

would say it's like it's kind of hard not to eat right so like what would you recommend to somebody who's looking to just break out of that toxic pattern and begin to learn to retrain their brain to help have a healthy relationship with dopamine for most of my patients I will recommend that they identify their drug of choice what is that substance or behavior that they continue to get caught in the addiction Vortex and to abstain from that for 30 days it's not that 30 days is you know gonna solve all their problems but it's

like the amount of time our brains can sort of conceptualize and we can anticipate it we can plan for it we can set a specific quick day we can put our self-binding strategies in place now if your drug of choice is something like food or sex obviously you can't not eat and we do consider sex to be a healthy part of you know a flourishing life but with food what you can do is you can not eat processed food for a month or not eat sugar you know and so you stick to certain categories of

eatings or you can stick to certain times of eatings whatever you can do to help bring back or moderate your use for something like sex I actually recommend that people have no orgasms with themselves or others for that period of time all in the pursuit of resetting reward Pathways and the idea is that when you get to 30 days it's not as if all your problems will be solved but at least you will have you know changed your brain chemistry enough that then you can make data informed decisions about how you want to use going

forward and if it's a drug like sex or food that we ultimately need to we need to ingest or you know we consider eating and sexual behavior a part of a you know a healthy lifestyle then we need to be very specific about the plan what are we going to use what are we going to eat what are we going to do sexually you know how much how often who with so that we can really begin to Define find what that healthy use looks like right that makes a lot of sense because I've had friends

who have had like issues when it comes to like pornography or or sex and food like things that are like maybe like non-drug related and one of the things that they've that is often like worked for them is obviously you can't cut all that stuff out like permanently but it's like learning how to re-establish healthy relationships with them and then getting your dopamine receptors like recalibrated to a point where when you introduce like certain parts of those things back into your life like this like you know sex and then also like maybe like having sugar

processed foods you're able to hopefully like like manage them in a healthier way because now your dopamine receptors are kind of brought back to some baseline yeah I think that was really well sad you know it's this acknowledgment that we are animals and that our ancient wiring you know has evolved to have us consume as much of the good things that come our way as humanly possible because in a world of scarcity you could never predict when you might not have more of that but now of course we have an infinite supply of almost every

reinforcing substance and behavior and so it's a really hard world to live in especially if we have that kind of innate vulnerability to be over consumers or to do things at you know the maximum volume so to speak so I think acknowledging you know the physiologic imperative or Loop that we can get into and then recognizing that it's not hopeless and that truly by abstaining for long enough we can reset reward Pathways such that we're then re-entering engagement with that substance from a new place from a healthier baseline from a place of more resilience and

ability to manage our consumption not that it's easy going forward from that again we have to be very disciplined we also have to be aware of what are the things that are like stepping stones to our drug of choice you know so for example you know for me you know as you know I write about in the book how I got addicted to erotic novels and it was interesting to begin to observe after I did a you know a dopamine fast from them and then went back to using them had the abstinence violation in fact

we're like a binged all weekend long you know went showed up at work like with no sleep feeling horrible and then I actually had to give up those erotic novels for a year to really kind of feel like I could manage it again then discovered going back to trying erotic novels that it like didn't do the trick you know that I was going to need a so much more potent drug to get recapture that original that I just sort of said you know what it's I'm not going to use that substance anymore because I don't

want to go to the place that I would have to go uh you know to recapture it but of course so people with the disease of addiction I mean that's part of their disease that they would be willing you know that they have that nature they would be willing to go very very far so I mean I think these are such things that can really present themselves in so many aspects of our life so we always have to kind of be aware and monitor it's a balancing act right it's a it's a delicate Balancing Act

but it is it is possible