Do We Need to Detox From Dopamine?

Some experts believe many psychological problems stem from excessive outside intrusions rather than inner conflicts. Anna Lembke, professor of psychiatry at Stanford University, contends that many human problems today stem from a world increasingly designed to overstimulate the brain's dopamine system—and that includes artificial intelligence. Not least among our challenges is finding balance in an environment loaded with dopamine-rich stimuli.

Anna Lembke, MD

Source: Provided by Stanford Univesrity School of Medicine

From Fast Food to Pornography

In her 2021 book Dopamine Nation: Finding Balance in the Age of Indulgence, Lembke identifies the excessively high dopamine stimuli now throwing lives out of balance: digital media, pornography, processed foods, and addictive substances. Dr. Lembke combines neuroscience with patient stories demonstrating how high levels of dopamine can affect behavior and offers strategies for achieving contentment by regulating dopamine levels.

Artificial intelligence (AI), she contends, has created new avenues for dopamine stimulation, particularly through personalized content algorithms. She is concerned that by creating hard-to-resist AI-driven individualized stimuli, AI will have even greater potential to target the person and their weaknesses and trigger addictive behaviors.

Dopamine Fasting

Lembke encourages dopamine fasting—abstaining from activities such as social media for a set period as a way to restore the brain's natural responsivity to pain and pleasure—an approach similar in many ways to traditional addiction treatment models. Dopamine fasting—typically for 30 days, but at least five to 10 days—entails a break from old behavioral patterns, whether that means going back to nature for months or entering rehab. The goal is resetting the brain’s reward system by abstaining from highly stimulating activities.

After fasting, the goal is controlled reintroduction of the activity or substance. For example, the individual may adopt healthy alternative behaviors with sustainable dopamine boosts, such as from exercise, social interaction, or meditation. The person also may adopt new hobbies, such as playing board games with friends.

Activities involving some effort and delayed gratification help rebuild a balanced reward system. Dopamine fasting is not a medical detox. Instead, it’s simple, structured, and a self-imposed abstinence changing thought patterns and reducing exposure to high-dopamine triggers. Dopamine fasting is not cognitive-behavioral therapy (CBT), which offers long-term psychological tools to manage addiction and other issues. Instead, dopamine fasting is a reset and harm-reduction strategy.

When to Use Dopamine Fasting vs. Other Treatments

Behavioral addictions are a growing phenomenon, and within the world of medicine the field of behavioral addictions is gaining acceptance. Compulsive video gaming, excessive pornography use, and constant social media use are legitimate concerns today.

Dopamine fasting is best applied as a treatment for behavioral addictions such as to social media, video games, pornography, food, and online shopping. It’s useful for managing overconsumption and uncontrolled repetitive behaviors. However, for severe addictions, evidence-based treatments such as CBT, medication-assisted treatment (MAT), and peer support programs rare proven effective.

How Dopamine Fasting Helps

Many individuals, particularly in tech-heavy environments, report improved focus and mental clarity after a dopamine fast from social media, video games, and smartphone use. Tech entrepreneurs in Silicon Valley have popularized dopamine fasts, some claiming they feel less anxious, more productive, and better able to enjoy simple pleasures after a break from constant digital stimulation.

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Young adults, particularly men, report reduced compulsion to use pornography and improved relationships after abstaining for a period. Similarly, reducing social media use helps reduce anxiety and depression in some individuals, no longer be trapped in constant comparison to others. Many who successfully complete dopamine fasts say they enjoy small things again, like reading a book, going for a walk, or having a distraction-free conversation. (Yes, you can ignore your phone. Turn it off!)

Limitations of Dopamine Fasting

Critics argue that you cannot “detox” from dopamine, a naturally occurring neurotransmitter essential for survival. The real issue, they contend, is dopamine overstimulation, not dopamine itself. And while dopamine fasting may work for mild compulsions, it’s no substitute for real addiction treatment. Some researchers suggest that the reported benefits of dopamine fasting might be a placebo effect: People expect a reset, so they feel one. However, even if this is the case, it can still be of value if it helps people change their habits.

And then there are those who take dopamine fasting to extremes, avoiding all pleasurable activities, including socializing, listening to music, even making eye contact. This is not what Lembke recommends. Instead, she encourages moderation, not total deprivation.

While a dopamine fast may provide short-term relief, critics note, in the absence of long-term habit changes, people often relapse into old patterns.

Lembke’s work on dopamine and addiction builds upon and aligns with my own dopamine hypothesis of addiction, extending it to behavioral addictions and treatment. In 1984, I hypothesized that drugs artificially flood the brain with dopamine, first overwhelming but ultimately depleting natural reward pathways. Repeated drug use physically changes dopamine receptors, reducing sensitivity and leading to tolerance (needing more of the substance to achieve the same effect). Over time, natural rewards (like food and social interaction) become less pleasurable, reinforcing drug-seeking behavior. Withdrawal symptoms occur because the brain adapts to chronic dopamine overproduction and struggles to function without the drug.

Lembke and I agree that dopamine imbalances drive compulsive behavior. I focused on addiction to drugs and on anhedonia, the inability to feel pleasure, while Lembke expands the model to behavioral addictions, offering practical treatment applications.

Some people may be especially vulnerable to addictive behaviors because of what Kenneth Blum, Ph.D., calls reward deficiency syndrome: They seek out substances/activities to boost their dopamine action. Blum offers evidence that breakdowns of the cascade of reward in neurotransmission are fairly common, due to genetic and epigenetic influences.

The Behavioral Addiction Expert’s View

I asked Marc Potenza, M.D., Ph.D., a leading expert on gambling and other behavioral addictions, for advice on treating behavioral addictions. Getting some distance from an out-of-control behavior by taking a vacation or unplugging can be very liberating and allow the person to re-exert control, he says. "Psychotherapies have the most empirical support for helping people with gambling and gaming disorders and other conditions or behaviors involving excessive use of digital technologies. In particular, cognitive behavioral therapy has demonstrated efficacy in multiple studies, and its effects appear particularly durable, perhaps because it provides people skills they may use and optimize over time.”

Potenza is concerned that excessive use of digital technologies may influence brain development, adaptation, and addictions. His research underscores the importance of monitoring and regulating young people’s exposure to rewarding online activities, as they can lead to desensitization and impede relationships.

Summary

Lembke’s work on dopamine and addiction builds upon and aligns with my 40-plus-year-old dopamine theory of addiction, extending it from theory and the lab to behavioral addictions, and to patient evaluation and treatment. She emphasizes developing self-control and discipline to reassert control over dopamine-driven behaviors, building new skills to overcome addictive tendencies.

Unplug, detox, and reset, might be Lembke's mantra. She encourages exposure to natural rewards—intentionally engaging with people, exercising or walking in nature, and cold exposure—to rebalance the brain’s reward system and promote resilience.

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