In a world where people are searching for their next dopamine high—getting likes on social media, shopping, gaming, etc.—it’s important to find a balance. Learn from psychiatrist and author Dr. Anna Lembke about how to keep your dopamine in check in her new book, Dopamine Nation: Finding Balance in the Age of Indulgence


Read an excerpt from Dopamine Nation below. 


We all desire a respite from the world—a break from the impossible standards we often set for ourselves and others. It’s natural that we would seek a reprieve from our own relentless ruminations: Why did I do that? Why can’t I do this? Look what they did to me. How could I do that to them?

So we’re drawn to any of the pleasurable forms of escape that are now available to us: trendy cocktails, the echo chamber of social media, binge-watching reality shows, an evening of Internet porn, potato chips and fast food, immersive video games, second-rate vampire novels… The list really is endless. Addictive drugs and behaviors provide that respite but add to our problems in the long run.

What if, instead of seeking oblivion by escaping from the world, we turn toward it? What if instead of leaving the world behind, we immerse ourselves in it?

Muhammad, you’ll remember, was my patient who tried various forms of self-binding to limit his cannabis consumption, only to find himself right back where he started, progressing from moderation to excessive consumption to addiction at an ever-faster cadence.

He went hiking at Point Reyes, a nature trail just north of San Francisco, in hopes of finding refuge in an activity that had previously given him pleasure, as he once again tried to get control of his cannabis consumption.

But every turn in the bend brought fresh memories of smoking weed—hiking trips in the past had almost always occurred in a state of semi-intoxication—and so, instead of being an escape, the hike turned into an agony of craving and a painful reminder of loss. He despaired of ever being able to wrestle his cannabis problem into submission.

Then he had his aha moment. At one particular vista point where he had explicit memories of smoking a joint with friends, he brought the camera up to his eye and pointed it to a nearby plant. He saw a bug on a leaf and focused the camera further, zooming in on the beetle’s bright red carapace, striated antennae, and ferociously hairy legs. He was mesmerized.

His attention was snared by the creature in his crosshairs. He took a series of pictures, then changed his angle and took more. For the rest of the hiking trip, he stopped to take extremely close-up pictures of beetles. As soon as he did so, his cravings for cannabis decreased.

“I had to force myself to be very still,” he told me at one of our sessions in 2017. “I had to achieve a perfect stillness to take a good in-focus picture. That process grounded me, literally, and centered me. I discovered a strange, surreal, and compelling world at the end of my camera that rivaled the world I escaped to with drugs. But this was better because no drugs were needed.”

Many months later, I realized Muhammad’s path to recovery was similar to my own.

I made a conscious decision to reimmerse myself in patient care, focusing on the aspects of my work that had always been rewarding: relationships with my patients over time, and immersion in narrative as a way to bring order to the world. In doing so, I was able to emerge from compulsive romance reading into a more rewarding and meaningful career. I was also more successful in my work, but my success was an unexpected byproduct, not the thing I was seeking.

I urge you to find a way to immerse yourself fully in the life that you’ve been given. To stop running from whatever you’re trying to escape, and instead to stop, and turn, and face whatever it is.

Then I dare you to walk toward it. In this way, the world may reveal itself to you as something magical and aweinspiring that does not require escape. Instead, the world may become something worth paying attention to.

The rewards of finding and maintaining balance are neither immediate nor permanent. They require patience and maintenance. We must be willing to move forward despite being uncertain of what lies ahead. We must have faith that actions today that seem to have no impact in the present moment are in fact accumulating in a positive direction, which will be revealed to us only at some unknown time in the future. Healthy practices happen day by day.

My patient Maria said to me, “Recovery is like that scene in Harry Potter when Dumbledore walks down a darkened alley lighting lampposts along the way. Only when he gets to the end of the alley and stops to look back does he see the whole alley illuminated, the light of his progress.”

Here we are at the end, but it could be just the beginning of a new way of approaching the hypermedicated, overstimulated, pleasure-saturated world of today. Practice the lessons of the balance, so that you too can look back at the light of your progress.

Lessons of the Balance

1. The relentless pursuit of pleasure (and avoidance of pain) leads to pain.

2. Recovery begins with abstinence.

3. Abstinence resets the brain’s reward pathway and with it our capacity to take joy in simpler pleasures.

4. Self-binding creates literal and metacognitive space between desire and consumption, a modern necessity in our dopamine-overloaded world.

5. Medications can restore homeostasis, but consider what we lose by medicating away our pain.

6. Pressing on the pain side resets our balance to the side of pleasure.

7. Beware of getting addicted to pain.

8. Radical honesty promotes awareness, enhances intimacy, and fosters a plenty mindset.

9. Prosocial shame affirms that we belong to the human tribe.

10. Instead of running away from the world, we can find escape by immersing ourselves in it.



From DOPAMINE NATION by Anna Lembke M.D., published by Dutton, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright (c) 2021 by Anna Lembke M.D.