Dr. Anna Lembke

But in about one in four Parkinson's patients, they will develop a de novo addictive disorder. Shopping addiction, sex addiction, other types of addiction. Because we have the same problem. We are stimulating... the reward pathway with dopamine that is ingested exogenously from the outside.

And our brain reads that as, oh boy, got to compensate by down-regulating dopamine transmission to below baseline, which then puts us in that addiction vortex. Does that make sense?

And our brain reads that as, oh boy, got to compensate by down-regulating dopamine transmission to below baseline, which then puts us in that addiction vortex. Does that make sense?

Right. Even more than having to try to live within this sort of narrow range of homeostasis, in the world we live in today, we probably have to intentionally do things that are painful, right? do things that are hard. Pleasure-pain balance, right?

Right. Even more than having to try to live within this sort of narrow range of homeostasis, in the world we live in today, we probably have to intentionally do things that are painful, right? do things that are hard. Pleasure-pain balance, right?

We learned that when we press on the pleasure side of the balance, like with alcohol or pornography or romance novels or cannabis or whatever it is, right? No sooner does that happen that our brain adapts by those neuroadaptation gremlins hopping on the pain side of the balance to bring it level again, but they like it on the balance, so they don't get off right when it's level.

We learned that when we press on the pleasure side of the balance, like with alcohol or pornography or romance novels or cannabis or whatever it is, right? No sooner does that happen that our brain adapts by those neuroadaptation gremlins hopping on the pain side of the balance to bring it level again, but they like it on the balance, so they don't get off right when it's level.

They stay on until we're tilted. An equal and opposite amount to the side of pain, that's the come down, the hangover, et cetera. But it turns out the opposite is also true. If we intentionally press on the pain side of the balance,

They stay on until we're tilted. An equal and opposite amount to the side of pain, that's the come down, the hangover, et cetera. But it turns out the opposite is also true. If we intentionally press on the pain side of the balance,

for example, with exercise or an ice-cold water bath or intermittent fasting, those gremlins will hop on the pleasure side of the balance, and we will get our dopamine indirectly by paying for it up front. And there are studies in humans showing that when humans expose themselves to exercise, for example, Dopamine levels gradually rise over the latter half of the exercise.

for example, with exercise or an ice-cold water bath or intermittent fasting, those gremlins will hop on the pleasure side of the balance, and we will get our dopamine indirectly by paying for it up front. And there are studies in humans showing that when humans expose themselves to exercise, for example, Dopamine levels gradually rise over the latter half of the exercise.

And then when the exercise stops, dopamine levels will remain elevated for hours afterwards before going back down to the baseline level position without ever going into that dopamine deficit state. So it's a great way to get our dopamine indirectly because it's much less vulnerable to that compulsive craving phenomenon of overuse.

And then when the exercise stops, dopamine levels will remain elevated for hours afterwards before going back down to the baseline level position without ever going into that dopamine deficit state. So it's a great way to get our dopamine indirectly because it's much less vulnerable to that compulsive craving phenomenon of overuse.

You can, but – and people can get addicted to exercise, right? But typically it's very unusual because the upfront cost to do the work and endure the pain of exercise in the first place – mitigates our vulnerability to an exercise addiction.

You can, but – and people can get addicted to exercise, right? But typically it's very unusual because the upfront cost to do the work and endure the pain of exercise in the first place – mitigates our vulnerability to an exercise addiction.

Yeah, those are amazing. I didn't know that. Those are amazing numbers. You know, in general, there's a part of me that wants to say, well, that's a good thing. But there's another part of me that's wary also because we're so good at drugifying everything that we do that there's a way in which these types of behaviors can also be drugified, right?

Yeah, those are amazing. I didn't know that. Those are amazing numbers. You know, in general, there's a part of me that wants to say, well, that's a good thing. But there's another part of me that's wary also because we're so good at drugifying everything that we do that there's a way in which these types of behaviors can also be drugified, right?

Made more potent with all of the technology, the way that we count ourselves, the leaderboards, the social comparisons. All of that takes this thing, which is, really in its natural state, kind of impervious to addiction. Like, you just typically wouldn't get addicted to these types of painful physical activities. You would do what you needed to do for survival.

Made more potent with all of the technology, the way that we count ourselves, the leaderboards, the social comparisons. All of that takes this thing, which is, really in its natural state, kind of impervious to addiction. Like, you just typically wouldn't get addicted to these types of painful physical activities. You would do what you needed to do for survival.

But we've managed to make them addictive in all these different ways. I still think it's a better way to get your dopamine. Like I really encourage exercise. We always talk about movement as medicine. And in general, our life is so convenient, so easy, so passive, so sedentary that I'm telling patients all the time, you know, get up off the couch, move your body, walk around the block.