I read Dopamin Nation by Anna Lembke on May 26th, 2025

This is a book about the pain and pleasure: our brains process pain and pleasure in the same place, and they work like the opposite side of a seesaw. The brains always try to maintain the homeostasis, — with prolonged and repeated exposure to pleasurable stimuli, our capacity to tolerate pain decreases, and our threshold for experiencing pleasure increases. In another word, we’re all miserable because we are working so hard to to avoid be miserable.

The chase of pleasure

Dopamine was first identified as a neurotransmitter in 1975 by independent researchers, Arvid Carlsson and his team in Lund, Sweden, and Kathleen Montagu based outside of London. The dopamine played an essential role for our ancestors to adapt to a world of scarcity: it was released in the brain’s reward pathway for eating food, being sheltered etc for a better chance to survive.

With the agriculture revolution and industrialization, the food and products are massively abundant. Our instinct to chase the pleasure leads to endemic addiction and risks of fatality: high blood pressures 13%, tobacco use 9%, high blood sugar 6%, physical inactivity 6%, and obesity 5%.

Today, 6.5 trillion cigarettes were sold annually worldwide. Anti-depression use rose 46% in Germany in just 4 years, 20% in Spain and Portugal during the same period. In China anti-depression reached $2.61 billion in 2011, 19.5% growth from the previous year. Prescriptions of stimulants(Adderall, Ritalin) in US doubled between 2006 and 2016. What is going on?

Epidemic addiction

The opponent-process theory in psychology was discovered by Richard Soloman and Jonh Corbit in the 1970s. The most important contribution is the application on the addictive behaviors: the drug addiction is the result of pairing of emotional pleasure and withdrawal symptoms. Overtime, the levels of pleasure decreases, and the levels of withdrawal symptoms increase. The patients have to increase the potence of drug to gain the similar level of pleasure.

Trauma, social upheaval, and poverty also contribute to the addition risk. The opioid epidemic in the US underscored the compound effects of these social factors. Princeton economists Anne Case and Augus Deaton have showed that the middle-aged white Americans without a college degree are dying younger than their parents, grandparents and great-grandparents.

DOPAMINE

The author proposed the DOPAMINE framework to detoxicate the addiction:

One of the trick is to block the access we have learned in the kindergarten. Frog and toad could not stop eating the delicious cookies. They tried to put the cookies into the box, sealed with ropes, put on the shelf; but nothing worked. At the end frog brought the cookies to the outside and invited birds to eat them up. I think the physical and mental obstacles could help us to cool down the desire.

The detoxication takes time, the rule of thumb suggested by the author, is four weeks. If the dopamine fasting failed, we might want to seek the help from psychiatrists to address the addiction and other psychiatric disorders at the same time. The chronic addiction may trigger the brain to encodes a long-term memories of rewards and associated cues by changing the shape and size of dopamine-producing neurons, aka experience-dependent plasticity, which can last a life time and persist long after the drug is no longer available.

More than one in twenty American children takes a psychiatric drug on a daily basis. As a parent, how could we help our children to better prepared the sensory rich and causal poor world? The author challenged the concept of children being psychologically fragile, and suggested the chidden to be exposed to the struggles as to build the endurance. This would improve their threshold for pain in the future.