Rising rates of depression and anxiety in wealthy countries may be a result of our brains getting hooked on the neurotransmitter associated with pleasure, Anna Lembke, a psychiatrist and professor at Stanford University, reports in a Wall Street Journal article. A patient of hers, a young man in his early 20s, came to see her for debilitating anxiety and depression. He had dropped out of college, was living with his parents, and was vaguely contemplating suicide. He was playing video games most of every day and late into every night.
Twenty years ago the first thing she would have prescribed an antidepressant. Today she sees it altogether different and would put him on dopamine fast. She suggested that he abstain from all screens, including video games, for one month.
In her career as a psychiatrist, she has seen more and more patients suffering from depression and anxiety. Many of her patients have been otherwise healthy young people with loving families, elite education, and relative wealth. Their problem isn’t trauma, social dislocation, or poverty. It’s too much dopamine, a chemical produced in the brain that functions as a neurotransmitter, associated with feelings of pleasure and reward.
When we do something we enjoy—like playing online video games—the brain releases a little bit of dopamine and we feel good. As soon as dopamine is released, the brain adapts to it by reducing or “downregulating” the number of dopamine receptors that are stimulated. This causes the brain to level out by tipping to the side of pain, which is why pleasure is usually followed by a feeling of hangover or comedown. If we can wait long enough, that feeling passes; neutrality is restored. But there’s a natural tendency to counteract it by going back to the source of pleasure for another dose. We go back online.