Dr. Anna Lembke

So for example, Parkinson's disease, which is a disease related to stiffness and tremor, is caused by a depletion of dopamine in a part of the brain called the substantia nigra. And as dopamine gets depleted in that part of the brain, people lose the ability to move their bodies.

So for example, Parkinson's disease, which is a disease related to stiffness and tremor, is caused by a depletion of dopamine in a part of the brain called the substantia nigra. And as dopamine gets depleted in that part of the brain, people lose the ability to move their bodies.

And it's probably no coincidence that the same neurotransmitter that is so important for pleasure, reward, motivation is also really important for movement because most organisms have to locomote toward the object of their desire. We want that thing. We have to exert effort, right? We have to put in the work to go get it. But in the world today, we really don't have to do that, right?

And it's probably no coincidence that the same neurotransmitter that is so important for pleasure, reward, motivation is also really important for movement because most organisms have to locomote toward the object of their desire. We want that thing. We have to exert effort, right? We have to put in the work to go get it. But in the world today, we really don't have to do that, right?

We can swipe right, we can swipe left, and all of a sudden it magically appears at the touch of a finger. And that's very confusing for our brains because that's not how we evolved. We really evolved for having to do quite a bit of upfront work for a tiny little bit of reward.

We can swipe right, we can swipe left, and all of a sudden it magically appears at the touch of a finger. And that's very confusing for our brains because that's not how we evolved. We really evolved for having to do quite a bit of upfront work for a tiny little bit of reward.

Sure.

Sure.

Oh, okay. So one of the most exciting findings in neuroscience in the past 75 years is that pleasure and pain are co-located in the brain. So the same parts of the brain that process pleasure also process pain. And in a very simple reductionist kind of way, they work like opposite sides of a balance.

Oh, okay. So one of the most exciting findings in neuroscience in the past 75 years is that pleasure and pain are co-located in the brain. So the same parts of the brain that process pleasure also process pain. And in a very simple reductionist kind of way, they work like opposite sides of a balance.

So imagine that deep in your brain's reward pathway, which is another exciting discovery, right, that there's this dedicated reward pathway of the brain that consists, broadly speaking, of the prefrontal cortex, which is this large gray matter area right behind our foreheads that's so important for future planning, for delayed gratification, for appreciating future consequences.

So imagine that deep in your brain's reward pathway, which is another exciting discovery, right, that there's this dedicated reward pathway of the brain that consists, broadly speaking, of the prefrontal cortex, which is this large gray matter area right behind our foreheads that's so important for future planning, for delayed gratification, for appreciating future consequences.

You might think of it as like the brakes on the car if we're going to analogize to an engine. And then deep, you know, in the brain, we've got what we call the limbic areas or the emotion brain. And there you have the nucleus accumbens and the ventral tegmental area that are rich in dopamine-releasing neurons, right? And they act like the accelerator on the car.

You might think of it as like the brakes on the car if we're going to analogize to an engine. And then deep, you know, in the brain, we've got what we call the limbic areas or the emotion brain. And there you have the nucleus accumbens and the ventral tegmental area that are rich in dopamine-releasing neurons, right? And they act like the accelerator on the car.

So when you've got a healthy functioning brain, you've got enough accelerator but not too much, right? So enough dopamine being released but not too much. And you've got a healthy prefrontal cortex putting the brakes on that dopamine release.

So when you've got a healthy functioning brain, you've got enough accelerator but not too much, right? So enough dopamine being released but not too much. And you've got a healthy prefrontal cortex putting the brakes on that dopamine release.

When people become addicted, there's either a problem with the brakes, the prefrontal cortex, or the accelerator, the nucleus accumbens and ventral tegmental area, or both, right? What we're finding is that there's actually a disconnect.

When people become addicted, there's either a problem with the brakes, the prefrontal cortex, or the accelerator, the nucleus accumbens and ventral tegmental area, or both, right? What we're finding is that there's actually a disconnect.

So there are large neuronal circuits and pathways between those deep limbic structures and the prefrontal cortex that literally get severed or disconnected when people become addicted. As we think about pleasure and pain being co-located in the same parts of the brain, working like opposite sides of the balance,

So there are large neuronal circuits and pathways between those deep limbic structures and the prefrontal cortex that literally get severed or disconnected when people become addicted. As we think about pleasure and pain being co-located in the same parts of the brain, working like opposite sides of the balance,