Why we get Addicted with Dr Anna Lembke

My guest today is Dr Anna Lembke who is a professor of psychiatry at Stanford – she’s also the author of a best selling book called Dopamine Nation.

In this episode:-

Anna began by defining Dopamine for us: - it’s a neurotransmitter which is central to pleasure, reward, and motivation, and plays a crucial role in addiction.
One of the most exciting findings in neuroscience is that the same parts of the brain that process pleasure also process pain, and they work like opposite sides of a seesaw or a balance.
In Anna’s book Dopamine Nation you’ll find some great illustrations which demonstrate the pleasure-pain balance and which feature little pain gremlins hopping on and off the see saw!
There are 3 rules governing this balance
Rule no 1.  The brain will always seek homeostasis as the neutral position
Rule no 2.  Repeated exposure to alcohol can result in a chronic dopamine deficit - which is in fact the definition of addiction 
Rule no 3.  The brain remembers addictive behaviours which means that a single exposure can result in relapse –that’s why moderation never works once we’ve crossed the line into dependence
To quit drinking Anna recommends beginning with a dopamine fast, a 30-day period of abstaining which will allow the brain to restore homeostasis.
The first 10-14 days will be spent in withdrawal so will be difficult but that difficult stage is going to pass so
The key is to keep going – rather than stopping and starting which just means doings that really difficult bit again and again!
Genetic vulnerability plays a role in addiction, - An alcoholic parent means you’re 4 times as likely to develop a dependence 
But remember that "genetics may be the gun but your lifestyle is the trigger" – you can break the generational pattern
Our brains were wired for survival in a world of scarcity but they don’t fit quite so well in this modern world of abundance… and that’s why so many people become addicted
Anna recommends engaging in what she calls hard things, like exercise or cold water immersion, which can indirectly increase dopamine levels and provide a sense of reward.
For example regular gym sessions will trigger the feel-good neurotransmitters
 I asked Anna why support groups work so well and she explained that the genuine connections in recovery communities release both dopamine and oxytocin so
If you’re looking for a recovery community to keep your dopamine flowing as you tackle this journey then just go to ts.com and click on join our tribe
We also discussed the early sobriety blues – that low mood that can strike a few months into sobriety
I certainly went through a period of feeling very low and uninspired in early sobriety – plenty of time on my hands but no idea what to do with it - a period I referred to as the void
Anna says that tolerating the void is an important part of the human experience which can lead to bursts of creativity – that certainly happened in my case but certainly it took a while
We now advise Tribe Members to get a project if they get the early sobriety blues – something to keep the mind busy and engaged - rather than sitting around waiting for happiness to strike!
In fact we discussed the unrealistic societal expections to be happy all the time – these expectations can lead to people to believe that they are sick if they’re not happy
This reminded me of my conversation with neuroscientist Staci Danford who believes that unhappiness is our default and that happiness is a learned skill –  a link to that podcast is here
As Anna said we have to recognise that life is full of pain and to be alive means sometimes we have to suffer 
I explained that at Tribe Sober we try to focus on what we gain in recovery, rather than what we lose – a reframe that Anna agreed is essential for success
One of her tips for managing cravings was to intentionally engage in activities that press on the pain side of the balance.  -  that made me think of one of our members who used to take a cold shower every time she got a craving – I used to think that was a bit strange but in fact she was doing exactly the right thing!
Those of us who have drunk heavily for decades may have damaged parts of our brains but in recovery we are rewiring the brain so new neural pathways are developing around those areas
We agreed that a relapse is not the end of the world as so much learning will have taken place during our recovery – the key of course is to get right back on track as quickly as possible
To learn more about Dr. Anna Lembke, you can read her book "Dopamine Nation" and explore her other publications, including "The Drug Dealer M. D."

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