Rebalancing Dopamine (Without “Dopamine Fasting”)
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Rebalancing Dopamine (Without “Dopamine Fasting”)
This is Dr. Anna Lembke. She’s a professor of psychiatry at Stanford, and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic—as well as running her own clinical practice, and serving on the board of an array of state and national addiction-focused organizations.
Today we’re going to look at her work on dopamine management…
Getting off the hedonic treadmill
For any unfamiliar with the term, the “hedonic treadmill” is what happens when we seek pleasure, enjoy the pleasure, the pleasure becomes normalized, and now we need to seek a stronger pleasure to get above our new baseline.
In other words, much like running on a reciprocal treadmill that just gets faster the faster we run.
What Dr. Lembke wants us to know here: pleasure invariably leads to pain
This is not because of some sort of extrinsic moral mandate, nor even in the Buddhist sense. Rather, it is biology.
Pleasure and pain are processed by the same part of the brain, and if we up one, the other will be upped accordingly, to try to keep a balance.
Consequently, if we recklessly seek “highs”, we’re going to hit “lows” soon enough. Whether that’s by drugs, sex, or just dopaminergic habits like social media overuse.
Dr. Lembke’s own poison of choice was trashy romance novels, by the way. But she soon found she needed more, and more, and the same level wasn’t “doing it” for her anymore.
So, should we just give up our pleasures, and do a “dopamine fast”?
Not so fast!
It depends on what they are. Dopamine fasting, per se, does not work. We wrote about this previously:
Short On Dopamine? Science Has The Answer
However, when it comes to our dopaminergic habits, a short period (say, a couple of weeks) of absence of that particular thing can help us re-find our balance, and also, find insight.
Lest that latter sound wishy-washy: this is about realizing how bad an overuse of some dopaminergic activity had become, the better to appreciate it responsibly, going forwards.
So in other words, if your poison is, as in Dr. Lembke’s case, trashy romance novels, you would abstain from them for a couple of weeks, while continuing to enjoy the other pleasures in life uninterrupted.
Substances that create a dependency are a special case
There’s often a popular differentiation between physical addictions (e.g. alcohol) and behavioral addictions (e.g. video games). And that’s fair; physiologically speaking, those may both involve dopamine responses, but are otherwise quite different.
However, there are some substances that are physical addictions that do not create a physical dependence (e.g. sugar), and there are substances that create a physical dependence without being addictive (e.g. many antidepressants)
See also: Addiction and physical dependence are not the same thing
In the case of anything that has created a physical dependence, Dr. Lembke does not recommend trying to go “cold turkey” on that without medical advice and supervision.
Going on the counterattack
Remember what we said about pleasure and pain being processed in the same part of the brain, and each rising to meet the other?
While this mean that seeking pleasure will bring us pain, the inverse is also true.
Don’t worry, she’s not advising us to take up masochism (unless that’s your thing!). But there are very safe healthy ways that we can tip the scales towards pain, ultimately leading to greater happiness.
Cold showers are an example she cites as particularly meritorious.
As a quick aside, we wrote about the other health benefits of these, too:
A Cold Shower A Day Keeps The Doctor Away?
Further reading
Want to know more? You might like her book:
Dopamine Nation: Finding Balance in the Age of Indulgence
Enjoy!
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What’s the difference between ADD and ADHD?
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Around one in 20 people has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood.
ADHD is diagnosed when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home.
Some people call the condition attention-deficit disorder, or ADD. So what’s the difference?
In short, what was previously called ADD is now known as ADHD. So how did we get here?
Let’s start with some history
The first clinical description of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still presented a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate.
Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions.
The first DSM, published in 1952, did not include a specific related child or adolescent category. But the second edition, published in 1968, included a section on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder.
It took a while for ADHD-type behaviour to make in into the diagnostic manual. Elzbieta Sekowska/Shutterstock In the early 1980s, the third DSM added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder with hyperactivity (ADDH) and attention deficit disorder as the subtype without the hyperactivity.
However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today:
- predominantly inattentive
- predominantly hyperactive-impulsive
- combined.
Why change ADD to ADHD?
ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons.
First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was initially named, little research had been done to determine the similarities and differences between the two sub-types.
The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions?
Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours may not necessarily be disruptive and challenging but are more likely to be forgetful and daydreamers.
People with inattentive behaviours may be more forgetful or daydreamers. fizkes/Shutterstock Why do some people use the term ADD?
There was a surge of diagnoses in the 1980s. So it’s understandable that some people still hold onto the term ADD.
Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits.
Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed.
How is ADHD currently diagnosed?
The three sub-types of ADHD, outlined in the DSM-5 are:
- predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions
- predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control
- combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive.
ADHD diagnoses continue to rise among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses.
However, some international experts contest the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors.
Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.
Kathy Gibbs, Program Director for the Bachelor of Education, Griffith University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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6 Daily Habits To Keep Your Brain Young & Sharp
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Without brain health, we do not have health. So here are six ways to keep it in order:
Food for thought
The six areas to focus on are as follows:
- Physical exercise: as we at 10almonds sometimes say, what’s good for the heart is good for the brain (because the brain is only as healthy as the circulation feeding it). For this reason, the recommendation here is for physical exercise that improves heart health—so, walking, running, swimming, dancing, etc.
- Healthy diet: shocking nobody, this is important too. Specifically, a diet rich in fruits, vegetables, and healthy proteins and fats is important—partly for the heart benefits that give indirect benefits to the brain, and partly because the brain is built of stuff and so we have to consume that stuff in order to rebuild it (omega-3s features strongly here, for instance). Remember to hydrate, too! The body can’t do anything without water.
- Good sleep: yes, the famous 7–9 hours sleep per night, and yes, even at your age, whatever that might be. This is important for memory consolidation, cell repair, toxin removal, and more. Sleep deprivation, on the other hand, leads to cognitive decline and brain shrinkage.
- Mental stimulation: ideally, engaging those parts of the brain you most wish to protect (e.g. language, memory, or whatever is most important to you).
- Social interaction: this one gets underestimated a lot, but it’s important to have meaningful conversations (not just polite smalltalk from a small menu of stock phrases), and that these should be two-way, i.e. involving both listening/reading and speaking/writing. Ideally, all four of those, which for most people means online and offline social interactions.
- Stress management: because chronic stress damages brain cells and accelerates cognitive decline, it’s important to manage that; practices like mindfulness meditation go a very long way and make a big difference.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Physical Exercises That Build Your Brain ← this is different from just exercising for one’s heart and thus the brain by extension, and rather, is specific exercises that strengthen specific parts of the brain.
Take care!
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Stop Self-Sabotage – by Dr. Judy Ho
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A lot of books of this genre identify one particular kind of self-sabotage, for example, they might pick one out of:
- Bad habits
- Limiting self-beliefs
- Poor goal-setting
- Procrastination
…etc, slap a quick fix on whatever they chose to focus on, and call it a day. Not so with Dr. Ho!
Here we have a much more comprehensive approach to tackling the problem of unintentional self-sabotage. With a multi-vector method, of which all angles can be improved simultaneously, it becomes much less like “whack-a-mole”… And much more like everything actually getting into order and staying that way.
The main approach here is CBT, but far beyond what most pop-psychology CBT books go for, with more techniques and resources.
On which note…
There are many great exercises that Dr. Ho recommends we do while reading… So you might want to get a nice notebook alongside this book if you don’t already have one! And what is more inspiring of optimism than a new notebook?
Bottom line: this is a great, well-organized guide to pruning the “why am I still doing this to myself?” aspects out of your life for a much more intentional, purposeful, effective way of living.
Click here to check it out on Amazon today, and stop sabotaging yourself!
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What’s behind rising heart attack rates in younger adults
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Deaths from heart attacks have been in decline for decades, thanks to improved diagnosis and treatments. But, among younger adults under 50 and those from communities that have been marginalized, the trend has reversed.
More young people have suffered heart attacks each year since the 2000s—and the reasons why aren’t always clear.
Here’s what you need to know about heart attack trends in younger adults.
Heart attack deaths began declining in the 1980s
Heart disease has been a leading cause of death in the United States for more than a century, but rates have declined for decades as diagnosis and treatments improved. In the 1950s, half of all Americans who had heart attacks died, compared to one in eight today.
A 2023 study found that heart attack deaths declined 4 percent a year between 1999 and 2020.
The downward trend plateaued in the 2000s as heart attacks in young adults rose
In 2012, the decline in heart disease deaths in the U.S. began to slow. A 2018 study revealed that a growing number of younger adults were suffering heart attacks, with women more affected than men. Additionally, younger adults made up one-third of heart attack hospitalizations, with one in five heart attack patients being under 40.
The following year, data showed that heart attack rates among adults under 40 had increased steadily since 2006. Even more troubling, young patients were just as likely to die from heart attacks as patients more than a decade older.
Why are more younger adults having heart attacks?
Heart attacks have historically been viewed as a condition that primarily affects older adults. So, what has changed in recent decades that puts younger adults at higher risk?
Higher rates of obesity, diabetes, and high blood pressure
Several leading risk factors for heart attacks are rising among younger adults.
Between 2009 and 2020, diabetes and obesity rates increased in Americans ages 20 to 44.During the same period, hypertension, or high blood pressure, rates did not improve in younger adults overall and worsened in young Hispanic people. Notably, young Black adults had hypertension rates nearly twice as high as the general population.
Hypertension significantly increases the risk of heart attack and cardiovascular death in young adults.
Increased substance use
Substance use of all kinds increases the risk of cardiovascular issues, including heart attacks. A recent study found that cardiovascular deaths associated with substance use increased by 4 percent annually between 1999 and 2019.
The rise in substance use-related deaths has accelerated since 2012 and was particularly pronounced among women, younger adults (25-39), American Indians and Alaska Natives, and those in rural areas.
Alcohol was linked to 65 percent of the deaths, but stimulants (like methamphetamine) and cannabis were the substances associated with the greatest increase in cardiovascular deaths during the study period.
Poor mental health
Depression and poor mental health have been linked to cardiovascular issues in young adults. A 2023 study of nearly 600,000 adults under 50 found that depression and self-reported poor mental health are a risk factor for heart disease, regardless of socioeconomic or other cardiovascular risk factors.
Adults under 50 years consistently report mental health conditions at around twice the rate of older adults. Additionally, U.S. depression rates have trended up and reached an all-time high in 2023, when 17.8 percent of adults reported having depression.
Depression rates are rising fastest among women, adults under 44, and Black and Hispanic populations.
COVID-19
COVID-19 can cause real, lasting damage to the heart, increasing the risk of certain cardiovascular diseases for up to a year after infection. Vaccination reduces the risk of heart attack and other cardiovascular events caused by COVID-19 infection.
The first year of the pandemic marked the largest single-year spike in heart-related deaths in five years, including a 14 percent increase in heart attacks. In the second year of the pandemic, heart attacks in young adults increased by 30 percent.
Heart attack prevention
Not every heart attack is preventable, but everyone can take steps to reduce their risks. The American Heart Association recommends managing health conditions that increase heart disease risk, including diabetes, obesity, and high blood pressure.
Lifestyle changes like improving diet, reducing substance use, and increasing physical activity can also help reduce heart attack risk.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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5 Steps To Quit Sugar Easily
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Sugar is one of the least healthy things that most people consume, yet because it’s so prevalent, it can also be tricky to avoid at first, and the cravings can also be a challenge. So, how to quit it?
Step by step
Dr. Mike Hansen recommends the following steps:
- Be aware: a lot of sugar consumption is without realizing it or thinking about it, because of how common it is for there to be added sugar in things we might purchase ready-made, even supposedly healthy things like yogurts, or easy-to-disregard things like condiments.
- Recognize sugar addiction: a controversial topic, but Dr. Hansen comes down squarely on the side of “yes, it’s an addiction”. He wants us to understand more about the mechanics of how this happens, and what it does to us.
- Reduce gradually: instead of going “cold turkey”, he recommends we avoid withdrawal symptoms by first cutting back on liquid sugars like sodas, juices, and syrups, before eliminating solid sugar-heavy things like candy, sugar cookies, etc, and finally the more insidious “why did they put sugar in this?” added-sugar products.
- Find healthy alternatives: simple like-for-like substitutions; whole fruits instead of juices/smoothies, for example. 10almonds tip: stuffing dates with an almond each makes it very much like eating chocolate, experientially!
- Manage cravings: Dr. Hansen recommends distraction, and focusing on upping other healthy habits such as hydration, exercise, and getting more vegetables.
For more on each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Which Sugars Are Healthier, And Which Are Just The Same?
- Mythbusting The Not-So-Sweet Science Of Sugar Addiction
Take care!
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Radical Longevity – by Dr. Ann Gittleman
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Dr. Gittleman takes a comprehensive approach, advising us about avoiding AGEs, freeing up fascia, stimulating cellular rejuvenation, the mind-gut connection, keeping the immune system healthy, and more.
The “plan” promised by the subtitle involves identifying the key factors of nutrition and lifestyle most impactful to you, and adjusting them accordingly, in a multistep, author-walks-the-reader-by-the-hand process.
There’s also, for those who prefer it, a large section (seven chapters) on a body part/system by body part/system approach, e.g. brain health, heart health, revitalizing skin, reversing hair loss, repairing bones, muscles, joints, etc.
The writing style is quite casual,butalso with a mind to education, with its call-out boxes, bullet-point summaries, and so forth. There is a “select references” section, but if one wants to find studies, it’s often necessary to go looking, as there aren’t inline citations.
Bottom line: we’d love to see better referencing, but otherwise this is a top-tier anti-aging book, and a lot more accessible than most, without skimping on depth and breadth.
Click here to check out Radical Longevity, and get rejuvenating radically!
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