Dopamine starvation: new trend or cure

Are you attracted to social media, video games and gambling, or perhaps you find it difficult to give up alcohol, cigarettes, junk food and drugs? Dopamine fasting can help you reboot your brain's reward system and emerge victorious in the fight against bad habits and addictions - experts are confident. However, there are those who consider the new concept as just a fashion trend. How to practice dopamine detoxification and is it really possible to get rid of addiction through abstinence?

Dopamine starvation as a new concept

We think we control our habits, but often they control us," experts say. To get a grip on your reality, you have to give up the things that bring you joy but ultimately bring you suffering. Dopamine starvation is the new trend not only among TikTok bloggers and Silicon Valley executives, but more recently among doctors.

Anna Lembke, M.D., professor of psychiatry at Stanford University School of Medicine and author of Dopamine Nation, uses dopamine fasting with her patients:

"After about 4 weeks, we have seen patients experience decreased anxiety and food cravings, improved mood and sleep, and other parameters and markers of good mental health," notes Dr. Lembke.

Any physician, regardless of specialty, can adopt this concept, notes the author of Dopamine Nation. "There is an idea in medicine that we should leave addiction to the Betty Ford Clinic or addiction psychiatrist, but there is so much we can do, regardless of our training or treatment setting!" says Lembke.

The brain and dopamine: the evolution of happiness

The neurotransmitter dopamine is produced in the brain, delivering important messages about pleasure, joy, and motivation. We all have a baseline level of dopamine. Substances and behaviors we enjoy, from chocolate and coffee, to interacting with pleasurable people, sex, alcohol, and drugs, increase the release of dopamine.

"When we seek healthy rewards for ourselves, such as a good meal at a restaurant or a pleasant conversation with friends, dopaminergic neurons are triggered, causing dopamine to be released. This makes us feel good!" says Birgitta Dresp, PhD, a cognitive psychologist.

Over time, however, with chronic exposure to pleasurable stimuli, our brains begin to adapt. Dopamine receptors are suppressed and reduced, and the so-called "hedonic attitude," or baseline level of happiness, drops.

Now you need more of your favorite stimuli to feel as good as you used to. This primitive brain structure served an evolutionary purpose in helping our ancestors get food. But in today's world, with an overabundance of easily accessible and stimulating activities, our brains are constantly trying to compensate.

"As paradoxical as it may sound, this constant 'self-indulgence', the search for a sense of happiness and reward, may be leading to a global mental health crisis," experts say.

"Human activity has changed the world we live in, and now this ancient mechanistic structure has become something of a liability," Lembke notes.

Dopamine starvation: freedom from habits in perspective

To reset this pattern, Lembke recommends a 4-week fast from a person's "drug of choice." However, this is not a trendy quick cure-all where you have to abstain from everything that brings you joy. It's a targeted intervention aimed at one habit at a time.

According to Lembke, this abstinence allows a person to understand "the nature of the hijacked brain," and the release motivates them to change their habits for the long term.

Although the first two weeks are difficult, she finds that many patients feel better and more motivated after 4 weeks. Before prescribing dopamine fasting to patients, Lembke explores why they have a particular addiction.

Often, patients say they self-medicate or that the substance helps them cope with anxiety or depression. When people compulsively continue to use drugs despite negative consequences, Dr. Lembke recommends a 4-week reboot.

The expert does not recommend dopamine fasting for those who have tried repeatedly and unsuccessfully to quit drugs on their own, nor for those for whom abstinence is life-threatening.

For people who can safely try dopamine fasting, she recommends "self-bonding" strategies to help them stay on track. Think about the people, places and things that encourage you to use and try to avoid them:

• for example, delete social media apps if you are trying to kick this addiction;

• put physical distance between you and gadgets;
• as for "forbidden" foods and substances, keep them out of the house.

Lembke also recommends "hormesis" - any productive activity that requires consistency and effort, such as learning languages or exercising. Your brain's systems responsible for pleasure and pain are closely linked, so these activities affect your reward circuitry.

"You intentionally do challenging things that don't initially release dopamine, but you get a gradual increase in the neurotransmitter that remains elevated even after you stop that activity," Lembke states.

Why might dopamine abstinence not work?

Dopamine fasting is not suitable for everyone, and there are quite a few experts who consider this method to be ineffective and even dangerous. "It's too simplistic," says Peter Grinspoon, MD, a primary care physician and Harvard Medical School faculty member.

According to the expert, dopamine starvation is not really starvation because we don't have a limited supply of dopamine that can be stored or depleted over a period of time.

Even if you abstain from some pleasures, your brain will still produce some amount of dopamine. Grinspoon believes that "re-targeting dopamine" to seek rewards from healthy and pleasurable activities makes more sense than just abstaining.

Plus, the dopamine system isn't the only part of our brain that matters in addictions. "There are other parts of the brain that are much more important in controlling temptation," states Trevor W. Robbins, professor of cognitive neurobiology and director of research at the Institute of Behavioral and Clinical Neuroscience at the University of Cambridge. .

Another problem with dopamine starvation is the lack of empirical evidence. According to psychologist David Tsall, without supporting clinical trials, dopamine fasting has no evidence of safety or efficacy.

"I think it's a very dangerous thing because we don't have enough evidence to evaluate the efficacy and safety of dopamine fasting," notes Tsall.

The expert also emphasizes that quitting the drug will look different for many people. Some can quit smoking abruptly, others need to quit gradually. Some need additional tools and help, others can cope alone.

"It's also important to understand why a person is addicted. Whether he or she can cope with the stresses of life without drugs or another habit. Such people may need new strategies. And if they quit before they're ready and fail, they may end up feeling even worse than before," Dr. Zall explains.

Experts agree on one thing: Today's society has serious drug and alcohol addiction, obesity, and digital media problems. And using methods that even partially limit bad habits can encourage people to live more conscious lives. Although dopamine fasting has no evidence base yet, which causes contradictory opinions among experts, it has already become a part of effective therapy in the practice of doctors.