Dopamine Nation: Finding Balance in the Age of Indulgence

Addiction broadly defined is the continued and compulsive consumption of a substance or behavior (gambling, gaming, sex) despite its harm to self and/or others.

A nationwide study in Sweden analyzed rates of prescribing for different psychiatric drugs, based on indices of what they called “neighborhood deprivation” (index of education, income, unemployment, and welfare assistance). For each class of psychiatric medication, they found prescribing of psychiatric medications increased as the socioeconomic sta

When we experience pleasure, dopamine is released in our reward pathway and the balance tips to the side of pleasure. The more our balance tips, and the faster it tips, the more pleasure we feel. But here’s the important thing about the balance: It wants to remain level, that is, in equilibrium. It does not want to be tipped for very long to one si

Because we’ve transformed the world from a place of scarcity to a place of overwhelming abundance: Drugs, food, news, gambling, shopping, gaming, texting, sexting, Facebooking, Instagramming, YouTubing, tweeting . . . the increased numbers, variety, and potency of highly rewarding stimuli today is staggering. The smartphone is the modern-day hypode

According to the World Happiness Report, which ranks 156 countries by how happy their citizens perceive themselves to be, people living in the United States reported being less happy in 2018 than they were in 2008. Other countries with similar measures of wealth, social support, and life expectancy saw similar decreases in self-reported happiness s

As philosopher and theologian Kent Dunnington wrote, “Persons with severe addictions are among those contemporary prophets that we ignore to our own demise, for they show us who we truly are.”

More than 15 percent of North American households use gluten-free products. Some people are gluten-free because they have Celiac disease, an autoimmune disease wherein the ingestion of gluten leads to damage in the small intestine. But growing numbers of people are gluten-free because it helps them limit consumption of high-calorie, low-nutrition c

Gambling disorder highlights the subtle distinction between reward anticipation (dopamine release prior to reward) and reward response (dopamine release after or during reward). My patients with gambling addiction have told me that while playing, a part of them wants to lose. The more they lose, the stronger the urge to continue gambling, and the s

If others respond by rejecting, condemning, or shunning us, we enter the cycle of what I call destructive shame. Destructive shame deepens the emotional experience of shame and sets us up to perpetuate the behavior that led to feeling shame in the first place. If others respond by holding us closer and providing clear guidance for redemption/recove

With prolonged and repeated exposure to pleasurable stimuli, our capacity to tolerate pain decreases, and our threshold for experiencing pleasure increases.