Do you find yourself addicted to social media? Do you constantly pick up your phone without even thinking about it? Or maybe you’re addicted to alcohol, drugs, sugar, shopping, video games, sex, or even pornography. If this is you, you are not alone. We are living in the age of overindulgence and instant gratification in which our bodies and minds have learned to crave “dopamine hits”, or feelings of intense reward and pleasure. It’s easy to feel trapped in a culture consumed by a yearning for the next best fix or maybe the same fix (and just more of it).

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It makes sense, right? If a behavior is making us feel good, wouldn’t you want to come back to it again and again? A "dopamine hit" gives us that rush of feeling good but it is often quickly followed by a comedown – this keeps us motivated to keep coming back for more despite the pain or discomfort that may follow. Dr. Anna Lembke, a Stanford Medical School psychiatrist, researcher, and author explains, "It's really an ingenious method to make sure that no matter what we do that's pleasurable, it doesn't last very long. And it's followed by pain so that immediately, we're searching again." This is the essential explanation behind how typical human behavior can easily turn into addictive behavior.  

What is dopamine and how does it actually work?

Dopamine is a neurotransmitter often referred to as one of our “feel-good hormones.” It’s principally known for its role in the brain’s reward system, experiences of pleasure, and motivation.

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Dopamine also plays a role in: mood, movement, learning and attention, heart rate, sleep, pain processing, kidney and blood vessel function, and even lactation.

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Dr. Huberman, from the Huberman Lab Podcast, argues that the term “dopamine hit” may be a bit misleading since we all have a baseline level of dopamine that is circulating in our body at all times (whether we are experiencing a pleasurable stimulus or not) that impacts things like our general mood and motivation on a daily basis. This baseline circulating level of dopamine is often referred to as the tonic release of dopamine. On the other hand, when we do something that is really exciting for us or extremely pleasurable we get a peak in our dopamine, referred to as phasic dopamine release.

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This is all well and good, but an issue arises when we engage in too many dopaminergic activities too frequently over time.

Consequences of dopamine blowout

It is not uncommon to think about dopamine and its connection to the disease of addiction. And, living in an age of overindulgence and more, more, more, many of us experience these addictive tendencies often and sometimes even daily.  

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When we experience something that we crave or desire and it’s super pleasurable to us, our baseline level of dopamine drops. These peaks of dopamine release directly influence how much circulating dopamine will be around once the pleasurable experience ends. Additionally, with the habitual intake of the same pleasurable stimulus – whether it be cocaine, social media or pornography – the dopamine receptors expressed in our brains become decreased, making activities that do not involve the pleasurable stimulus feel more boring. We become less interested and are unable to mount the same dopamine response as we once were because our baseline level of dopamine has now dropped.

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Once we reach this new level of low dopamine baseline, we can often feel burnout and what used to make us feel happy and motivated no longer works. Our brains adjust and, after repeated exposure to a pleasurable stimulus, we need more and more of it just to feel “normal.” This is referred to as a “dopamine deficit state” - our drug of choice no longer gives us that dopamine high we are looking for. Once in this depleted state, we can experience withdrawal symptoms when not engaging in the dopaminergic evoking activity or require more of it to prevent symptoms of depression, anxiety, insomnia, irritability, and more cravings.

A Moment for Stress & Hypothalamic-pituitary-adrenal (HPA) Axis

When we think about the reason or the root cause encouraging us to engage in addictive behaviors or consume things that we know may not be the healthiest for us, we must consider stress as a causative factor. In fact, many addictive behaviors– including overeating, undereating or eating unhealthful foods, drinking alcohol, smoking, and drug use – are often attempts to find stress relief.

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Research has shown that there are many conditions commonly associated with these types of addictive behaviors, including depression, anxiety, OCD, alcoholism, and obesity. These same conditions have been associated with a lack of resilience and metabolic reserve. In fact, evidence indicates that people who experience mental health conditions/addictive behavior may have hypothalamic-pituitary-adrenal (HPA) Axis dysfunction. This may be a key contributor to being unable to adapt to stress, leading to poor treatment retention and potential relapse.

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Stimulants such as ADHD medications (Adderall, Vyvanse, Ritalin), cocaine, nicotine, alcohol, and sugar all damage our adrenal glands, potentially leading to HPA Axis dysfunction and feelings of exhaustion and burnout. In fact, many of the same people who seek out these stimulants are already experiencing adrenal burnout and are looking for ways to increase their energy. However, by engaging in these addictive behaviors they end up further exacerbating the dysfunction of the HPA axis rather than increasing their energy. The same activities/behaviors that used to yield happiness, focus, or an energy boost now leave them feeling exhausted and wiped out. Again, this further encourages the cycle of addiction to want more of the chosen drug or more often.

Should we seek out things we enjoy?

Absolutely! It’s important that we continue to seek out things that bring us joy - that is part of life and overall well-being. But we must understand how dopamine peaks occur and, more importantly, how to maintain a healthy level of baseline dopamine so that we may achieve those dopamine peaks and maintain a sustained amount of baseline dopamine.

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If you often feel burnt out, unhappy and unmotivated, do not fret! There are many actionable lifestyle changes that can be made to help restore dopamine balance. Watch for action steps coming out soon.