Dr. Anna Lembke

But built into the algorithm is this novelty or this mystery where we are intentionally fed the occasional video that's not something that we've watched before, right?

But that's something that, oh, I never thought I would be interested in X. We are wired for uncertainty.

We're wired for friction and for challenge, again, because that is what has kept us alive in a world of uncertainty.

We live in a world of certainty that in many ways is incredibly boring because there aren't these challenges for us to resolve beyond what we make up for ourselves.

That's where this third piece comes in, where we crave that uncertainty because

Again, there's enormous uncertainty still in our lives, but what we want is the controlled digital uncertainty where we have this very short perception action loop of resolving it, kind of the drugified uncertainty.

Can you talk a little bit about dopamine and ADHD?

Yeah.

So we do know that people with ADHD are at higher risk for developing addiction, and the mechanism is not well understood.

But there are some interesting studies suggesting that people with ADHD might have baseline lower levels of dopamine transmission in the reward pathway.

Yeah, so these are brain imaging studies where you measure dopamine transmission in the nucleus accumbens in healthy control subjects.

You compare that to people with ADHD and you find, lo and behold, in that reward pathway, people with ADHD appear to have lower baseline levels just at rest of dopamine transmission and even fewer postsynaptic dopamine receptors.

which is, again, related to dopamine transmission.

Yeah, because remember, that's what we see in addiction.

So the pathophysiology of addiction is this downregulation of dopamine transmission in the reward pathway.

So folks with ADHD might at

baseline have some reward insensitivity, which might contribute to their impulsivity, their stimulus seeking, their vulnerability to overconsume, intoxicants, their vulnerability to addiction.

Oh, yeah.

I absolutely love this.

And this is why I think we're sisters from another mother, because that's essentially my drug of choice is attachment.