Dopamine Nation

Review of the book Dopamine Nation by Anna Lembke.
2022-07-14 – ⁠2022-09-11 notes
⁠certainty: log ⁠importance: 1Source published on: 2021

When we enjoy an experience, the brain floods itself with dopamine. The more we enjoy the experience, the more dopamine is released and the more the brain is rewired to build a habit to seek to repeat that experience. And the more we repeat that habit, the more we want to repeat it and the harder it becomes to stop ourselves. And like that, an addictive habit is born.

Addiction is something you can’t stop yourself from doing that harms you or others.

We evolved this reward system for a world of scarcity where getting addictive to scarce sugary foods ensured that we passed our genes. In our modern world of abundance, this wreaks havoc.

Part 1: The Pursuit of Pleasure

70% of deaths are attributable to things in our control, and a big part of climate change (eventual destruction of humanity) is also caused by addictive behavior (chapter 1).

When we try to avoid pain, we are causing ourselves more pain because the more we experience pleasure, the weaker its effect (marginal pleasure of eating the first candy, vs the 100th) and the worse we feel afterward (chapters 2 and 3).

When you stop an addictive behavior, the brain recovers its pain-pleasure balance; it slowly lowers the threshold necessary for you to feel pleasure. However, at first the withdrawal strength as its peak and it will make relapses very likely. Anything associated with your addictive habit like people, places and objects, also increases the chances of relapses. Universal withdrawal symptoms: anxiety, irritability, insomnia, and dysphoria 1.

Events that cause dopamine releases:

  • Getting a reward
  • Anticipating a reward
  • Learning
  • Losing on 50/50 bets (loss chasing)

Part 2: Self-binding

Framework (mnemonic: DOPAMINE) to help deal with an addition problem (Chapter 4):

  • Data: Gather data: What are they using, how much, how often, etc.
  • Objectives: Why are they using (e.g. read romance to escape painful life transitions, physical pain, etc). There is nearly always a logical reason.
  • Problems: Ask, tell or show the negative consequences of their addiction.
  • Abstinence: your brain needs on average four weeks of abstinence to rebalance pleasure-pain thresholds. Younger people with shorter addiction periods and more neuroplasticity might need less, older people using stronger drugs for longer periods of time with less neuroplasticity might need more.
    • Swapping one drug for another rarely works.
    • About 20% of the time people don’t feel better after the initial fast because the drug wasn’t the main driver of their addictive behavior.
  • Mindfulness: develop the ability to observe sensations without judging them or reacting to them.
  • Insight: be open to insights about your behavior during or after the abstinence period.
  • Next steps: some people can engage in a habit in a moderate way and still benefit from something that they otherwise don’t get from life. Other people can’t do this and for them full abstinence is better.
  • Experiment: with your tentative Next Steps plan set, start experimenting and adapt as necessary.

If you want to make it harder to engage in an addictive behavior, you must deeply believe that when you feel compelled to engage in that habit, your self-control can’t help you. When you do, it becomes obvious that you must act in advance. “In the throes of desire, there’s no deciding.” (Chapter 5)

Types of restrictions you can use:

  • Physical: lock the cookie jar and give the key to someone else.
  • Chronological: play video games for only 2h.
  • Categorical: only eat vegan or vegetarian food.

Some people need drugs to fix dopamine and addiction issues, but it should be a last resort. Trying to medicate away every human suffering causes serious problems for the individual and for society. (Chapter 6)

Part 3: The Pursuit of Pain

A bit of stress makes living organisms better (hormesis.)

Expose yourself to pain and discomfort regularly to become less vulnerable to it and to lower your threshold to experience pleasure. Examples: cold showers, intermittent fasting. Food tastes better when you’re hungry. (Chapter 7)

Exposure therapy: the more you expose yourself to something, the less effect it has on you (pain, fear, etc). But remember the operating keyword “a bit”; pursue pain too hard and for too long and you can become addicted to it and end in a persistent dopamine deficit state.

Beware, though, if you pursue pain too much and for too long you can also become addicted to it and lead you to a persistent dopamine deficit state.

You need to be honest with yourself and with others about your addictions to recover. It makes you aware of your addiction, it strengthens intimate human connections that you may need for emotional support, and it holds you accountable. (Chapter 8)

Shaming people who relapse in a support group setting may help or it may backfire, it depends on the person and the group; for example, in Alcoholics Anonymous social shaming generally works. (Chapter 9)

Conclusion: Lessons of the Balance

We need dopamine, without it we lose the motivation to live and we die.

  1. Seeking pleasure through addictive behaviors leads to pain, unbalances the brain reward pathway and reduces the pleasure we get from other less-harmful behaviors.
  2. To recover from addictive behaviors, first abstain from doing them.
  3. Abstinence resets the brain’s reward system which lets you then find pleasure in other things.
  4. Modern life and the way the brain works make it hard to stop addictive behaviors, so plan ahead to make it as impossible as possible for your future self to relapse.
  5. Medications are dangerous; use them only if absolutely necessary.
  6. Seek pain to balance your brain.
  7. Don’t seek pain too much or it will become another addiction.
  8. You won’t change unless you believe that you’re addicted.
  9. Use accountability buddies and organizations, they work.
  10. Don’t try to escape the world, instead find flow activities.


In the approximately two years in which I compulsively consumed romance novels, I eventually reached a place where I could not find a book I enjoyed. It was as if I had burned out my novel-reading pleasure center, and no book could revive it.

The brain changes that occur in response to a stimulating and novel environment are similar to those seen with high-dopamine (addictive) drugs.

Our sensory perception of pain (and pleasure) is heavily influenced by the meaning we ascribe to it. ~ C3

This is powerful. What does it mean if we learn to feel pleasure when we feel pain? May be pain is then manifested in other ways?

Science teaches us that every pleasure exacts a price, and the pain that follows is longer lasting and more intense than the pleasure that gave rise to it. ~ C3

The Yoga Sutras say something similar, but in my experience that’s not always true. When I eat pizza or I have an orgasm I experience pleasure, but afterwards I don’t experience pain.

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

I see so many people around me unconsciously experiencing this. People who avoid physical exercise, doing chores, etc, become increasingly weak in several dimensions.

ISBN: 9781524746735


  • Vipassana / physical sensations: I can see how vipassana meditation is so powerful. By observing every sensation without reacting to it, you’re really undoing so much automated pleasure-seeking, aversion-avoiding behaviors. And I can also see why Goenka recommends 2h/day of continuous practice, to undo the effect of People, places, things and the about 14h of extra exposure…
  • Homeostasis
  • Learned helplessness (you must agree that you don’t have self-control). What is self-control and willpower?
  • Don’t medicate away every human suffering: This connects with Taleb in Antifragile: the emphasis on removing stressors (pain) is making humanity more fragile.
  • Antifragility (hormesis)
  • Dopamine makes you want things. Yoga teaches you to stop wanting things. What exactly happens to your dopamine levels then?
  • Austerity / tapah niyama in yoga: intensely pleasant sensations increase your threshold for experiencing pleasure in the feature. Besides seeking pain to counter-balance, what if you reduced the amount of pleasure you experience on a normal day? It would also lower your threshold for what is considered pleasurable without the negative consequences of feeling pain, right? This might be why monks of many spiritual and religious disciplines practice austerity. At first sight it seems like you deprive yourself of a life worth living, but perhaps it’s not like that and instead you become able to experience the same amount of pleasure (body hormones) as a normal person but at a lower cost, e.g. once you’re used to it, someone eating once a day may end up experiencing the same or more pleasure from that meal than someone who eats six times a day. The person eating six times a day will experience pleasure more times, but the austere person may be experiencing pleasure from other things during those times.


  1. State of unease or generalized dissatisfaction with life. ↩︎