Ep 172: The Link Between Indulgence, Addiction, and Depression

Dr Anna Lembke, author of Dopamine Nation, shares insight into
the pain-pleasure circuitry in the brain and how it affects our
ability to become addicted to painful things and numb to
pleasurable ones—and how we can do a ‘reset’ to get back a
sensitivity for both.


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Full show notes


What do you do when your teen suddenly seems to be in a rut? It
might be that they barely eat, lock themselves in their room, or
stop talking to their friends…whatever it is, they won’t clue you
in to what’s wrong. The truth is, they may not even know! These
days, more and more people are finding themselves feeling down
without an obvious reason—and this week, we’re going to find out
why.





In recent years, the number of prescriptions for antidepressants
has gone up all across the globe…but so have rates of depression
and anxiety. How could this be possible? It might just be that
relying on medicine is actually making us feel worse in the long
run–and the same goes for other substances, or even unexpected
comforts like social media and video gaming. To help us
understand further, we’re talking to a brilliant psychologist who
knows a thing or two about addiction and the mind’s ability to
process feel-good chemicals. 





Dr. Anna Lembke is the Medical Director of Stanford Addiction
Medicine and has been a leading researcher on addiction for over
25 years! Her new book, Dopamine Nation: Finding Balance in the
Age of Indulgence, highlights just how easy it is to partake into
too much pleasure when we’re constantly oversaturated with media
influence and convenient dopamine hits like fast food and vaping.
Beyond just substance abuse, many teens are finding themselves
addicted to digital stimulation, pornography or social media, but
may not exactly why they’re feeling so blue all the time.


To help us understand this mental health crisis, Dr. Lembke and I
are discussing the neurological and evolutionary reasons behind
why teens get into depressive episodes from too much indulgent
behavior. Plus, we’re talking about what we can do to make our
teens less vulnerable to addictive forces, and how to get them to
open up about their bad habits.



Why Your Teen Might Be in a Slump


There are a lot of reasons why teens can end up in a bad mood,
but if they seem like they’re in a hole they just can’t get out
of, an addictive behavior might be behind it. Anna explains that
in our modern world, with access to endless entertainment and
substances, we have a tendency to bombard ourselves with
pleasure…but it has a price. When we experience a rush of
happiness, our minds react by releasing dopamine, a feel-good
chemical. Then, in order to restore our mind's balance, our brain
brings in different chemicals that make us feel, well, not so
good.





Usually, this system works efficiently and effectively to keep
our moods stable. But when we’re constantly filling up our brain
with dopamine by reaching for alcohol or even the TV remote, we
set our brain’s balance off, says Anna. To try and restore the
balance, our brain pumps out  chemicals to lower our
moods…but it doesn’t really know when it’s reached the right
threshold. This leads us to feel chronically depressed and
anxious as a result of our addictive behavior, Anna explains.





This search for pleasure developed as humans tried to survive
bleak conditions, and needed that dopamine to go on, she tells us
in the episode. But as we became pleasure-seeking creatures, we
started to get a little too good at it! Now, instead of wandering
through the forest, scavenging for food with enough sugar and fat
to keep us alive, we can drive through McDonalds and get burgers
in sodas in less than ten minutes. Instead of waiting for the
sparkle of the stars to stimulate our minds, we can flip on a
screen at any moment and watch whatever we want. 





We are programmed to search for pleasure as though we are still
in a place of scarcity, even though we live in abundance. Dr.
Lembke describes us as cactuses in the rainforest! This leads our
whole mental balance to fall out of place, especially for
teenagers whose minds are still developing. So how can we fix it?
Dr. Lembke and I discuss solutions in the episode.



Treating a Depressed Teen


Nowadays, when teens are feeling blue, we tend to prescribe them
an antidepressant or anti-anxiety medication. But this may not be
the answer, says Dr. Lembke. In the episode, she explains that
while these medicines can be helpful and even life changing, they
really only work in the short term. There is almost no reliable
evidence to support the idea that these medications are helpful
when taken for months or even years, she says. The problem is
that users of these drugs begin to build a tolerance to them,
making them ineffective, or even harmful if they set off the
brian’s natural balance.





A lot of times, teens who are dependent on an addictive substance
or behavior might not be open to letting that behavior go, Anna
explains. They might believe that the behavior is helping them
feel less depressed or anxious, when really it’s the cause of the
problem! Anna explains how humans are born with brilliant
storytelling abilities, and we often harness that ability to
create elaborate and convincing rationales for our own
destructive behavior. For teens who aren’t yet seeing the
physical effects of their addictive behavior, it’s even harder to
see a reason to stop indulging.





Anna usually advises most of her patients to do one single
thing–lay off their destructive habit for 30 days. This allows
their brain to restore its natural chemical balance, free from
the dopamine overload caused by that addictive behavior. If your
teen has been spending too much time playing Fortnite or
scrolling through Instagram, it might help to suggest that they
delete it for a month, and see if their mood improves! 





Obviously, it’s not super likely that your teen will be
incredibly receptive to this suggestion. In the episode, Anna and
I discuss how you can get teens to open up to the idea of
dropping their addictive behavior.





Helping Teens Improve Their Habits


It’s not easy to talk to a teen out of a bad habit. Half the
time, they just shut the door in your face, or throw some hurtful
words at you to get you to go away. If we're going to figure out
how to get through to them, we’ll have to talk to someone who’s
an expert at talking to avoidant addicts and helping those who
don’t want to help themselves! Luckily, Anna is here to give us
some expert tips so we can have productive discussions with teens
instead of scaring them off.





To get kids to think critically, Anna recommends invoking the
idea of the future. Teenagers who are behaving impulsively might
benefit from thinking about where they’re at and where they want
to be. Young people are especially likely to search for immediate
gratification without thinking about future consequences. Dr.
Lembke suggests asking them questions like: do you want to keep
vaping like that for the rest of your life? Or, do you want to
play video games this much when you’re twenty five? This might
prompt them to shift their perspective by causing them to think
about their life’s direction.





Anna also emphasizes the importance of keeping your own pare...