hi i'm Dr Anna Lembke welcome to a special episode of After Skool today we're going to be talking about dopamine and how to find balance in the age of indulgence so without further ado let's dive in 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 scores including belgium canada denmark france japan new zealand and italy researchers interviewed nearly 150 000 people in 26 countries to determine the prevalence of generalized anxiety disorder defined as excessive and uncontrollable worry that adversely affected their lives they found that the richer countries had higher rates of anxiety than the poorer ones the authors wrote the disorder is significantly more prevalent and impairing in high income countries than low to middle income countries the number of new cases of depression worldwide increased 50 percent between 1990 and 2017. the highest increases in new cases were seen in regions with higher sociodemographic index especially in north america the question is why in a time of unprecedented wealth freedom technological progress and medical advancement do we appear to be unhappier than ever in this video i present five big ideas that outline how an increase in access to pleasure causes the degradation of mental health and how to find balance in an age of indulgence to understand the roots of this issue we must start in the brain big idea number one the pleasure pain balance one of the most important discoveries in the field of neuroscience in the past 100 years is that pleasure and pain are co-located by that i mean the same parts of the brain that process pleasure also process pain and pleasure and pain work like a balance when we feel pleasure the balance tips one way when we feel pain it tips the other one of the overarching rules governing this balance is that it wants to stay level after any deviation from neutrality our brains will work very hard to restore a level balance or what neuroscientists call homeostasis for example i like to watch videos of american idol when i watch my brain releases a little bit of the neurotransmitter dopamine in my brain's reward pathway and my balance tips slightly to the side of pleasure but no sooner has that happened then my brain adapts to the increased dopamine by down regulating my own dopamine receptors and dopamine transmission i like to imagine this as little gremlins hopping on the pain side of my balance to bring it level again not very scientific i know but here's the thing about those gremlins they like it on the balance so they don't hop off once it's level they stay on until it is tipped an equal and opposite amount to the side of pain this is the after effect the hangover the come down or in my case that moment of wanting to watch just one more video if i wait long enough the gremlins hop off the balance neutrality is restored and that feeling passes but what if i don't wait what if instead i watch another video and another and another pretty soon i'm no longer watching american idol videos i'm watching videos of people watching videos alternating with memes of dr pimple popper if i keep doing this for hours a day days to weeks weeks to month i end up with enough gremlins on the pain side of my balance to fill a whole room they are camped out for the long haul tents and barbecues in tow once that happens i've changed my hedonic set point now i need to keep watching videos not to feel pleasure but just to feel normal as soon as i stop watching i experience the universal symptoms of withdrawal from any addictive substance anxiety irritability insomnia dysphoria and mental preoccupation with using otherwise known as craving this is the hallmark of the addicted brain big idea number two dopamine overload this fine-tuned balance of ours has evolved over millions of years to help us approach pleasure and avoid pain it's what's kept us alive in a world of scarcity and ever-present danger but here's the problem we no longer live in that world we now live in a world of overwhelming abundance the access quantity variety and potency of highly reinforcing drugs and behaviors has never been greater including drugs that didn't exist before texting tweeting gaming gambling sugar shopping vaping voyeuring the list is endless online products with their flashing lights celebratory sounds laudatory likes bottomless bowls and the promise of ever greater rewards just a finger click away are engineered to be addictive the smartphone is the equivalent of the hypodermic syringe delivering digital dopamine for a wired generation if you haven't met your drug of choice yet it's coming soon to a website near you yet despite increased access to all these feel-good drugs or as i hypothesize because of it we're more miserable than ever rates of depression anxiety physical pain and suicide are increasing all over the world especially in rich nations our compulsive over consumption has led not just to increase psychological suffering we are literally consuming ourselves to death seventy percent of world global deaths are attributable to diseases caused by modifiable behavioral risk factors like smoking physical inactivity and diet the leading global risks for mortality are high blood pressure tobacco use high blood sugar physical inactivity and obesity in 2013 an estimated 2.
1 billion adults were overweight compared with 857 million in 1980.
