"The mechanism of our happiness and pain didn't evolve for this abundant world. Excessive indulgence in wealth and pleasure ultimately plunges people into pain."

Why does the unrelenting pursuit of happiness bring pain instead? Why is depression more common in a more affluent life?

Anna Lembke, a professor at Stanford School of Medicine, would say that it's because the human brain didn't evolve for happiness. The dopamine homeostasis mechanism in the human body inevitably causes hedonism, which over - pursues happiness, to fall into nihilism and pain.

This homeostasis mechanism is also related to modern people's overeating, staying up late, long - term addiction to mobile phones, etc. The imbalance in life caused by excessive indulgence and the pursuit of pleasure is described as "addiction" in medicine.

Anna Lembke's book Dopamine Nation: Finding Balance in the Age of Indulgence has become a popular science book since its publication. It answers the above - mentioned questions and proposes effective methods to guide readers to get out of anxiety and passivity and return to the normal life track.

Recently, Edu Guide had a conversation with Anna Lembke about the above topics: about the dopamine homeostasis mechanism, how it affects our experience of pleasure and pain in the real and virtual worlds, its relationship with modern people's loneliness, obesity, depression, internet addiction, and workaholic culture.

In addition, Anna Lembke also shared suggestions on balancing "happiness and pain" in life. The following is the full text of the conversation (with deletions), enjoy:

Edu Guide: What do you mean by the "balance between pleasure and pain" you mentioned in the book?

Anna: An exciting discovery in neuroscience is that pleasure and pain co - exist in the brain. The part of the brain that processes pleasure also processes pain.

By way of a very simple analogy, they are like the opposite sides of a balance. 

Imagine that in your brain, there's a seesaw, just like the ones in a children's playground. When we're at rest, this is our baseline level - no pleasure, no pain. That balance at that time is level with the ground. A bit different from an actual seesaw, it's slightly tilted, but we maintain at the baseline level. When we feel pleasure, the brain releases dopamine, and the "seesaw" deviates further from the baseline.

 Dopamine is a neurotransmitter that is crucial for pleasure, reward, and motivation. It's not the only neurotransmitter involved in the process, but it's a common way for neuroscientists to measure the addiction of substances or behaviors.

Now, back to our seesaw. When we do something pleasurable, it tilts in one direction. When we do something painful, it tilts in the other direction. This balance operates by certain rules. The first and most important rule is that this balance wants to stay level with its original state, which neuroscientists call "homeostasis".

Homeostasis is achieved within a limited set of conditions under which an organism can maintain life - compatibility. The rule of this balance is that for any deviation from neutrality, our brains will work very hard to restore the baseline level.

Edu Guide: Is homeostasis the core reason to explain "if people overly pursue happiness, it will bring pain"?

Anna: The unrelenting pursuit of pleasure leads to pain because our brains didn't evolve for too much pleasure.

We evolved in a pattern where we had to do a lot of upfront work to get a little reward. So, if you imagine again, this balance between pleasure and pain is actually designed for us to tilt to the pain side first. Because we get hungry, we get tired, we get lonely, we get cold. Then people have to do a great deal of physical labor, and dopamine is also involved in these activities, which gives people a little pleasure and brings us back to the baseline level.

On the contrary, what's happening now is too much pleasure, and eventually we end up in pain. Even so, using the substances (addictive behaviors or things) we choose can work too. Even when we tilt in the direction of too much pleasure, we'll feel better.

Why? 

Because temporarily, it relieves our pain, but we don't really get pleasure. We're just trying to escape our pain, which, by the way, is impossible. Because every time we use (or continue these behaviors), we just sink deeper and deeper into a state of dopamine deficiency.

 

Edu Guide: Evolution has made our balance tend towards some pain. But now we always have pleasure. Do you think this is the main reason why more and more people are showing symptoms of depression now?

Anna: I mean, it's astonishing that if you look around the world, in some countries, the rates of depression, anxiety, and suicide are rising. It's increasing the fastest in the world's wealthiest countries.

So it's a paradox, right? In countries with an abundant life, people also have more access to mental health treatment, but people seem more anxious, depressed, and miserable than ever before. So we really have to ask ourselves, what's going on there? 

I think part of the problem lies in this world of excess. Our pleasure - pain mechanism didn't evolve for this abundant world. To adjust or adapt to the dopamine balance mechanism, we have to lower the dopamine transmission below the baseline, which leads to symptoms of anxiety, depression, and even suicide.

 For example, if you look at the global data on suicide, for the first time in history, people in high - income countries are more likely to end their own lives than those in low - income countries. This has never been seen before.

Edu Guide: In terms of addiction, what do you think has changed the most for people in modern society compared to the previous generation?

Anna: I'd probably say the access to things is what concerns me the most, especially in the field of digital media. Because the more we expose our brains to addictive substances or behaviors, the more likely they are to change our brains and the greater the risk of getting into an addiction spiral.

When you think about things like videos, we don't think of videos as an addictive drug, but in fact, they're effective simulators of our brain's reward pathways. The more videos we watch, the more likely our brains are to respond to them. Now we have those very short - form videos, videos that start and end quickly, which are like a powerful drug. The faster the "addictive drug" takes effect and wears off, the more potent it is, that is, the more dopamine it releases and the more likely it is to make people addicted.

So now we have these very effective video forms and nearly unlimited access. We have incredible novelty.

We have this huge, endless, almost infinite supply. This can lead to a very dangerous risk of addiction. 

As I said before, we get bored, we have more disposable income and more time. We feel more estranged and isolated from each other. So now there are more people living alone than ever before. 

So, there's social isolation now.

Addiction often serves as a substitute for interpersonal relationships. 

We use these "drugs (addictive behaviors or things)" as a way to respond instead of forming attachments to other people. All these increase the risk.

Edu Guide: What's the relationship between loneliness and addiction?

Anna: Loneliness is an inevitable by - product of addiction and abstinence.

The key to getting off drugs is: besides quitting the substances we use, we have to return to other people and start building or reconnecting meaningful relationships.

When we're lonely, we're more likely to become addicted to something. On the other hand, even people with wonderful families and friends can become addicted.

During the process of addiction, people distance themselves from those social relationships and use addictive things to replace social relationships, and then lie about their addictive habits out of shame.

 Then, out of shame, they use more of their "drug" to stop feeling ashamed. Eventually, people fall into a very terrible vicious cycle, which I call "destructive shame".

What they need to do is actually return to the community, build deep connections with the community, admit their addictive behaviors with radical honesty, and try to live in a different way.

 

Edu Guide: Nowadays, many people have become obese. They eat far more than their bodies need. Do you think overeating is another form of addiction?

 

Anna: Yes. Why does this happen? Because the food supply has become like an addictive drug.

Commercial companies add fat, salt, sugar, and spices to food. 

Even when we reach the point of satiety, it's still very hard for us to stop eating - because food not only gives us the calories we need but also releases far more dopamine in our brain's reward pathways than it should. So now our brains are confused.

It says, "Oh, wait a minute. I've tilted to the pain side. Eat some more to get me back to homeostasis." So this is a real problem. 

Our food supply attracts people in an addictive way.

What we see in the United States and many parts of the world is that people have to adjust their physiology to adapt to this "drug - addicted" food supply. How do people do it? 

They're taking drugs like GLP - 1 receptor agonists (usually used for weight loss and blood sugar control), which can change their dopamine balance set - point.

I don't blame people for doing this because the food has become like a "drug" now. But what we need to do is to make companies responsible for removing these unhealthy sugars, fats, salts, and flavors from food.

 

Edu Guide: Regarding work addiction, why do some people tend to spend a lot of time working?

Anna: Nowadays, especially in white-collar jobs, companies incentivize through bonuses, stock options, social media celebrations, workaholic culture, and the potential financial rewards of white-collar jobs, all of which make people enthusiastic about dedicating themselves to their work.

In fact, compared to the 1950s, we are seeing for the first time that white-collar workers are working more than ever before. However, those in menial and blue-collar jobs are leaving the labor market, especially young men.

Where have they gone? They stay at home playing video games and watching movies.

So you see this peculiar divergence: white-collar jobs, which are highly monetized and highly rewarded, make people addicted and become workaholics.

But blue-collar jobs are menial, unrewarding, and life is tough, so people are exiting the labor market and working less.

Edu Guide: Why do some of us enjoy pain itself and feel pleasure from it?

Anna: There is an interesting scientific study showing that some neurons in the reward pathway release stimulants directly when experiencing pain.

Some people might get such a reward. They may be more sensitive to pain, which will be their chosen 'addictive drug.' This is clearly different from the hormetic effect I mentioned.

When we engage in difficult tasks, our bodies respond as a self-regulating healing mechanism, and we indirectly receive dopamine.

 This is different from the dopamine we get directly from pain. But this is a very interesting field—there indeed seem to be neurons that release dopamine directly during pain.

 I do think that people's natures vary somewhat; some just like pain more or seek challenges more than others, while others may want to avoid these things.

Edu Guide: How do we view the boundary between addiction and normal behavior?

Anna: When I use the term addiction, I refer to a psychopathological issue, which is basically defined as: continuing to use substances or behaviors compulsively despite causing harm to oneself and/or others. So this is really the dividing line—does it cause harm? Sometimes it's harm we recognize. Some are harms we don't see, but others can see.

There are no brain scans or blood tests to diagnose addiction.

It is actually judged based on phenomenology or behavioral patterns, which can be confirmed across different periods, cultures, ages, and demographics—so addiction is a range of disorders.

When we see an extreme form of addiction, we all recognize it—causing significant harm to oneself or others, which is very sad.

Edu Guide: If you were to give advice on better managing addictive behaviors or balancing pain and pleasure, what would you suggest?

Anna: One of my suggestions is to try talking about your problems, find a friend, family member, or loved one, or go online to find a group of people struggling with a certain addiction and share your issues. Because doing so makes it easier to start thinking about how to change behavior.

Then another thing I strongly recommend is 30 days of dopamine fasting. Do it with friends, do it with family. But this can be a good way to collect data on ourselves, data we can't access in any other way.

We have just released the official ‘Addiction’ workbook, which details the method of dopamine fasting chapter by chapter, including how to prepare, how to do it, and what to do after. I think this is a great way for each of us to collect data in our own lives and become our own scientists.