Fullständig transkription av Rewiring Your Dopamine Systems with Neil deGrasse Tyson and Anna Lembke

my job, I 75 00:04:36.050 --> 00:04:38.750 can't see my kids, but this is great. 76 00:04:39.129 --> 00:04:43.290 I wanna keep doing this. I wanna keep doing this. 77 00:04:43.310 --> 00:04:45.350 So tell me, what is dopamine specifically? 78 00:04:46.230 --> 00:04:49.379 So dopamine is a chemical that we make in our brains. 79 00:04:49.579 --> 00:04:52.079 It has many different functions, but one of the most 80 00:04:52.139 --> 00:04:56.709 important functions is that it's central to the experience of pleasure, reward, 81 00:04:56.949 --> 00:05:00.449 and motivation. And it may be even more important for 82 00:05:00.550 --> 00:05:03.310 motivation than for actual pleasure itself. 83 00:05:03.970 --> 00:05:04.829 Right. 84 00:05:04.889 --> 00:05:07.970 What do I hear about serotonin? When I hear about serotonin, 85 00:05:08.430 --> 00:05:09.990 is it synonymous with dopamine? 86 00:05:11.089 --> 00:05:15.089 It's not synonymous, but serotonin and dopamine are both neurotransmitters. 87 00:05:15.230 --> 00:05:19.410 Neurotransmitters are the molecules that bridge the gap between synapses 88 00:05:19.509 --> 00:05:24.050 to allow for finer tuning of our electrical circuits that 89 00:05:24.089 --> 00:05:27.230 make us who we are. And so dopamine and serotonin 90 00:05:27.350 --> 00:05:32.850 are related. They have distinct functions, however. And although serotonin 91 00:05:33.009 --> 00:05:36.500 is involved in mediating addiction to certain types of substances 92 00:05:36.540 --> 00:05:41.779 and behaviors, dopamine is considered the final common pathway for 93 00:05:42.079 --> 00:05:46.360 all reinforcing substances and behaviors, which is why neuroscientists tend 94 00:05:46.399 --> 00:05:49.199 to use it as a kind of universal currency for 95 00:05:49.290 --> 00:05:50.370 measuring addiction. 96 00:05:50.829 --> 00:05:53.990 So what triggers the release? What triggers the release, Professor, 97 00:05:54.269 --> 00:05:56.509 of the dopamine? Because it can't just be, you know what, 98 00:05:57.170 --> 00:06:00.050 brain says you have that now. Something must be triggering. 99 00:06:00.089 --> 00:06:00.449 Why can't it? 100 00:06:00.449 --> 00:06:02.850 Where is it triggering and what's it? Well, there you are. 101 00:06:02.889 --> 00:06:03.560 Why can't it? 102 00:06:04.449 --> 00:06:10.149 Yeah, so dopamine is released in response to reinforcing substances 103 00:06:10.209 --> 00:06:14.009 and behaviors. And by reinforcing, I mean things that are 104 00:06:14.610 --> 00:06:20.470 something that we deem necessary for survival, that typically feel good, 105 00:06:20.750 --> 00:06:23.240 or that our brains tell us this is important, you 106 00:06:23.269 --> 00:06:26.680 need to pay attention to it. So even like novelty, 107 00:06:27.199 --> 00:06:32.519 dopamine is very sensitive to novelty and newness. But for example, intoxicants, 108 00:06:32.639 --> 00:06:34.920 the sort of difference between something that is thought of 109 00:06:35.019 -->

00:06:38.040 as a drug or as very addictive and something that's 110 00:06:38.079 --> 00:06:41.319 thought of as not particularly addictive is how much dopamine 111 00:06:41.360 --> 00:06:43.959 is released in the reward pathway and how quickly it's released. 112 00:06:44.459 --> 00:06:47.600 And substances and behaviors that are highly addictive release a 113 00:06:47.620 --> 00:06:50.399 lot of dopamine all at once in this dedicated part 114 00:06:50.439 --> 00:06:51.920 of the brain called the reward pathway. 115 00:06:53.620 --> 00:06:59.050 Okay, reward pathway, new phrase, phrase of the day so far. 116 00:06:59.209 --> 00:07:01.629 What are we calling, what is a reward pathway? Is 117 00:07:01.649 --> 00:07:04.790 it simple as, it's a transmitter, it's how the delivery 118 00:07:04.829 --> 00:07:05.389 system works. 119 00:07:06.389 --> 00:07:09.649 Well, one of the exciting findings in neuroscience in the 120 00:07:09.689 --> 00:07:11.920 past hundred years or so is the discovery of a 121 00:07:12.019 --> 00:07:16.459 dedicated circuit in the brain that is central to this 122 00:07:16.620 --> 00:07:21.750 reward function, this motivation function. It consists broadly of of 123 00:07:21.790 --> 00:07:25.730 the nucleus accumbens and the ventral tegmental area. These are 124 00:07:25.829 --> 00:07:30.079 sort of basal forebrain nuclear structures. And then the prefrontal cortex, 125 00:07:30.459 --> 00:07:33.660 that large gray matter area right behind our foreheads. So 126 00:07:33.680 --> 00:07:37.420 that's a gross oversimplification. It's a very complex pathway. But 127 00:07:37.439 --> 00:07:42.240 that's in sort of reductionistic way what the reward pathway 128 00:07:42.279 --> 00:07:47.050 consists of. And that area is very rich in dopamine-releasing neurons. 129 00:07:47.310 --> 00:07:50.550 Right. So you gave us the location in the brain. 130 00:07:50.899 --> 00:07:53.740 where that occurs is what you're saying there. Is that right? 131 00:07:54.019 --> 00:07:54.439 That's right. 132 00:07:55.339 --> 00:08:02.329 Okay. But it's also that prefrontal cortex is also attached 133 00:08:02.410 --> 00:08:04.389 to our executive function, right? 134 00:08:04.790 --> 00:08:06.810 Exactly right. Yes. 135 00:08:07.029 --> 00:08:09.850 So that when that gets hijacked, then that puts us 136 00:08:10.009 --> 00:08:12.930 at risk of not being able to make the right 137 00:08:13.069 --> 00:08:16.319 decisions or to say no when we should say no 138 00:08:16.519 --> 00:08:21.290 or to be extremely capricious without even realizing why we're 139 00:08:21.329 --> 00:08:21.750 doing it. 140 00:08:22.430 --> 00:08:26.569 Yeah, very well said. So the prefrontal cortex is central 141 00:08:26.689 --> 00:08:31.540 to the ability to delay gratification, to appreciate future consequences, 142 00:08:32.000 --> 00:08:35.840 to tell autobiographical narratives or stories. And you might think 143 00:08:35.879 --> 00:08:38.360 of the prefrontal cortex as the brakes on the car 144 00:08:38.559 --> 00:08:41.259 and then the nucleus accumbens and ventral tegmental area, which 145 00:08:41.340 --> 00:08:45.019 is really rich in dopamine-releasing neurons, as the accelerator. So 146 00:08:45.059 --> 00:08:47.639 addiction is some kind of problem, either with the brakes 147 00:08:47.820 --> 00:08:49.139 or the accelerator or both. 148 00:08:50.039 --> 00:08:51.639 Wow. All right. 149 00:08:51.960 --> 00:08:57.870 So, Doctor, come across the phrase of dopamine rush. 150 00:09:00.289 --> 00:09:05.629 That's called cocaine, Gary. I'll handle this one for you, Doc. Yeah, Gary, 151 00:09:05.649 --> 00:09:09.509 that's called cocaine. We got that one. Chuck will take 152 00:09:09.529 --> 00:09:12.450 it from here. Chuck's got it from here. Yeah, okay. 153 00:09:12.549 --> 00:09:12.830 All right. 154 00:09:12.889 --> 00:09:13.309 I'm with you. 155 00:09:14.529 --> 00:09:17.289 They say when you get love struck, it's about a 156 00:09:17.330 --> 00:09:20.480 dopamine rush. So if we're falling in love, are we now, 157 00:09:21.039 --> 00:09:23.059 is it kind of that in a form of addiction? 158 00:09:24.179 --> 00:09:27.419 So maybe I can go back to some basic science experiments, 159 00:09:27.559 --> 00:09:30.799 looking at the response in terms of the release of 160 00:09:30.840 --> 00:09:35.259 dopamine to various stimuli. So we're always releasing dopamine at 161 00:09:35.279 --> 00:09:37.679 a kind of baseline tonic level. It's sort of like 162 00:09:37.700 --> 00:09:41.690 the heartbeat of the brain in some sense. But experiments 163 00:09:41.750 --> 00:09:45.210 in which a probe was stuck deep into this reward 164 00:09:45.230 --> 00:09:50.019 circuitry in rodents to measure dopamine release in response to 165 00:09:50.059 --> 00:09:55.279 different stimuli showed that dopamine firing increased above baseline 50% 166 00:09:55.279 --> 00:10:01.360 in response to chocolate, 100% in response to sex, 150% 167 00:10:01.360 --> 00:10:07.470 in response to nicotine, something like 225% in response to cocaine, 168 00:10:08.029 --> 00:10:12.409 and approximately 1,000% in response to methamphetamine. And indeed, if 169 00:10:12.730 --> 00:10:16.490 you match that behaviorally to whether or not a rodent 170 00:10:16.549 --> 00:10:20.120 will press a lever to get that substance or to 171 00:10:20.179 --> 00:10:23.240 engage in that behavior. You find that the more dopamine 172 00:10:23.279 --> 00:10:25.360 that's released, the more likely that rat is to press 173 00:10:25.399 --> 00:10:27.220 that lever until it dies. 174 00:10:28.159 --> 00:10:30.500 And when it comes to meth, they just rip the 175 00:10:30.539 --> 00:10:31.019 lever out. 176 00:10:31.440 --> 00:10:35.509 Right, essentially, essentially. Now, there is something a little artifactual 177 00:10:35.549 --> 00:10:38.490 about that in the sense that the way that meth 178 00:10:38.549 --> 00:10:43.779 works is to directly increase dopamine within the synapse.

whereas 179 00:10:43.820 --> 00:10:47.779 something like food or sex works through other chemical cascades 180 00:10:47.870 --> 00:10:51.450 like serotonin, for example, as we talked about. But the 181 00:10:51.509 --> 00:10:53.990 final common pathway, again, for all of these is to 182 00:10:54.049 --> 00:10:57.029 release dopamine, which is why neuroscientists like to use it 183 00:10:57.090 --> 00:10:58.730 as this kind of common currency. 184 00:10:59.190 --> 00:11:01.269 And that goes back to what you were saying earlier 185 00:11:01.309 --> 00:11:04.350 about motivation. So when we eat, we get a little 186 00:11:04.409 --> 00:11:09.100 hit of dopamine because that satisfaction allows us to say, hey, 187 00:11:09.360 --> 00:11:13.389 I should do this again. Otherwise, we've would just not eat. 188 00:11:13.409 --> 00:11:16.009 It would be like, yeah, whatever, who cares? Which is 189 00:11:16.049 --> 00:11:18.940 why sometimes when people are really depressed, one of the 190 00:11:18.980 --> 00:11:21.259 things they do not do is eat. 191 00:11:22.100 --> 00:11:25.299 Right, yeah, very well said. And furthermore, if I eat 192 00:11:25.659 --> 00:11:28.919 a piece of broccoli, I personally will get very little 193 00:11:28.960 --> 00:11:32.340 dopamine release, most likely. Neither does anyone. 194 00:11:32.360 --> 00:11:33.820 Neither will anyone. 195 00:11:33.860 --> 00:11:40.210 Right. Exactly. Exactly. But if I eat a chocolate cupcake, 196 00:11:40.370 --> 00:11:42.529 I'll get a lot more dopamine. But now, qualifying the 197 00:11:42.570 --> 00:11:46.230 broccoli idea, if I haven't eaten for two days and 198 00:11:46.250 --> 00:11:49.289 you give me a piece of broccoli, that's going to 199 00:11:49.330 --> 00:11:51.639 be really yummy to me, right? That's going to release 200 00:11:51.700 --> 00:11:56.340 more dopamine. at least from my baseline than not. I 201 00:11:56.700 --> 00:12:00.340 thought it was really important that Chuck talked about sort 202 00:12:00.360 --> 00:12:05.379 of other contextual factors like depression, right, which then sort 203 00:12:05.419 --> 00:12:11.169 of hypothetically decrease baseline dopamine firing levels such that almost 204 00:12:11.470 --> 00:12:16.929 everything loses its salience or its attractiveness. Likewise, other co-occurring 205 00:12:16.970 --> 00:12:20.409 mental health disorders can have other impacts on our experience 206 00:12:20.480 --> 00:12:23.509 of reward. It's thought, for example, that people with attention 207 00:12:23.570 --> 00:12:29.730 deficit disorder might be relatively insensitive to dopamine firing, which 208 00:12:29.769 --> 00:12:32.330 is why they maybe tend to be sensation seekers and 209 00:12:32.370 --> 00:12:36.220 need more rewards to get any kind of response. 210 00:12:35.879 --> 00:12:36.820 At all or furthermore. 211 00:12:36.840 --> 00:12:39.440 So everybody's got a different baseline. It's a baseline thing. 212 00:12:39.500 --> 00:12:43.299 Yeah, that's right. Everybody's got a different baseline. 213 00:12:43.360 --> 00:12:46.600 What I wanted to ask you, Professor, was with the 214 00:12:46.639 --> 00:12:49.840 meth being as addictive as it is, is it working 215 00:12:49.879 --> 00:12:54.220 purely to... detonate the dopamine or does it have other 216 00:12:55.379 --> 00:12:58.539 little techniques that are engaging and triggering? 217 00:12:59.779 --> 00:13:02.779 Well, it's, yeah, it's, you know, the talk about dopamine 218 00:13:02.870 --> 00:13:07.750 is like an oversimplification of a very complex process. You know, 219 00:13:08.350 --> 00:13:15.110 meth works through other chemical cascades, other neurotransmitters. Also, you know, 220 00:13:15.789 --> 00:13:19.000 when we look at these experiments in rodents, you know, 221 00:13:19.039 --> 00:13:20.600 rodents at the end of the day are not people. 222 00:13:21.129 --> 00:13:25.090 And our brains are much more complex and we cannot 223 00:13:25.129 --> 00:13:28.169 ignore the very important concept of drug of choice, which 224 00:13:28.230 --> 00:13:32.649 is to say my particular wiring might lead me to 225 00:13:32.700 --> 00:13:37.580 be more attracted to certain types of reinforcers that are different. 226 00:13:38.029 --> 00:13:41.200 from what your particular brain is wired for, such that 227 00:13:41.299 --> 00:13:46.159 I might work very, very hard to repeat the experience 228 00:13:46.200 --> 00:13:49.740 I have on social media, but not necessarily for meth 229 00:13:50.059 --> 00:13:53.370 or alcohol or something else because my wiring is just 230 00:13:53.450 --> 00:13:54.009 my wiring. 231 00:13:54.610 --> 00:13:59.230 Right, yeah. That's so wild because you hear people say 232 00:13:59.269 --> 00:14:02.090 it all the time. Well, I shouldn't say you hear 233 00:14:02.129 --> 00:14:04.340 people say it all the time. I've heard people say 234 00:14:04.379 --> 00:14:07.990 it often where- Oh, I tried this and it just 235 00:14:08.070 --> 00:14:11.789 did nothing for me. It just did. Yeah. Yeah. You know, 236 00:14:11.840 --> 00:14:16.100 I tried to have alcohol, but it did nothing for me. Or, 237 00:14:16.120 --> 00:14:18.940 you know, I, I smoked marijuana once. I mean, it 238 00:14:18.980 --> 00:14:21.240 just didn't do a damn thing to me. I got 239 00:14:21.320 --> 00:14:23.379 sleepy and that was it. So, you know, that's what 240 00:14:23.419 --> 00:14:25.539 you're talking about, which is kind of fascinating. 241 00:14:25.580 --> 00:14:25.820 Yeah. 242 00:14:25.840 --> 00:14:26.379 Fascinating. 243 00:14:27.379 --> 00:14:30.759 But Anna, what about, what of this, what of the, uh, 244 00:14:31.299 --> 00:14:37.259 the stereotype depressed person who just broke up with, A 245 00:14:37.279 --> 00:14:39.080 woman just breaks up with her boyfriend and you see her, 246 00:14:39.399 --> 00:14:41.600 this is in movies all the time, in rom-coms, where 247 00:14:41.620 --> 00:14:43.960 she's sitting on the bed eating a box of

chocolates 248 00:14:44.019 --> 00:14:47.679 looking at some sad movie. So they're eating in that 249 00:14:47.720 --> 00:14:49.919 case rather than not eating. Is that a different kind 250 00:14:49.940 --> 00:14:55.570 of depression that responds? So they're basically compensating for that 251 00:14:55.970 --> 00:14:59.730 loss of pleasure because now all they have access to 252 00:14:59.830 --> 00:15:00.970 is a box of chocolates. 253 00:15:01.990 --> 00:15:04.990 Yeah, so there are many different risk factors for addiction, 254 00:15:05.190 --> 00:15:09.850 but one very well-known risk factor is severe stress. So 255 00:15:09.909 --> 00:15:12.730 if we have some kind of giant stressor in our life, 256 00:15:13.509 --> 00:15:17.970 it's very natural for us to reflexively turn to substances 257 00:15:18.029 --> 00:15:22.009 or behaviors that will release those feel-good neurotransmitters as a 258 00:15:22.049 --> 00:15:26.230 way to cope or compensate. One of my favorite experiments 259 00:15:26.289 --> 00:15:31.940 in the neuroscience literature in rodents is... a group of 260 00:15:31.980 --> 00:15:35.899 rodents was trained to press a lever for intravenous cocaine. 261 00:15:36.620 --> 00:15:39.559 And rats and mice will press that lever until exhaustion 262 00:15:39.720 --> 00:15:44.019 or death. If you then take the cocaine away, eventually 263 00:15:44.279 --> 00:15:48.120 that behavior of pressing that lever will extinguish, which is 264 00:15:48.159 --> 00:15:50.679 to say they'll stop pressing the lever. But if you 265 00:15:50.720 --> 00:15:54.129 then expose that rat or that mouse to a severe 266 00:15:54.210 --> 00:15:58.309 painful foot shock, the rodent will immediately run over to 267 00:15:58.330 --> 00:15:59.830 the lever and start pressing it again. 268 00:16:00.490 --> 00:16:01.149 Whoa. 269 00:16:01.809 --> 00:16:05.830 So that's a very nice paradigm for what we as 270 00:16:05.870 --> 00:16:11.259 humans do, that stressor is something that can kick off, exacerbate, 271 00:16:11.299 --> 00:16:16.220 contribute to maladaptive consumptive behaviors. And for people who are 272 00:16:16.320 --> 00:16:19.440 in recovery or abstaining from their drug of choice, if 273 00:16:19.480 --> 00:16:23.980 they then experience acute stressor, they will almost reflexively turn 274 00:16:24.059 --> 00:16:26.919 to or want to turn to you know, their addictive 275 00:16:26.960 --> 00:16:29.299 behaviors as a way to shore themselves up again. 276 00:16:29.320 --> 00:16:30.419 That is fascinating. 277 00:16:31.080 --> 00:16:32.559 I'm glad you like it, Chuck. 278 00:16:33.259 --> 00:16:34.720 That is amazing. 279 00:16:35.240 --> 00:16:38.669 Did you use the phrase maladaptive consumptive behavior? Isn't that 280 00:16:38.690 --> 00:16:39.690 the same thing as overeating? 281 00:16:40.769 --> 00:16:45.789 Yeah, so maladaptive consumptive behavior can apply to almost anything. 282 00:16:46.250 --> 00:16:47.769 That's overeating. Okay. 283 00:16:48.409 --> 00:16:50.470 Or something that might not otherwise be good for you, 284 00:16:50.889 --> 00:16:56.679 whether or not it's food. Hi, I'm Neil deGrasse Tyson, 285 00:16:56.720 --> 00:16:58.679 your personal astrophysicist. 286 00:16:58.860 --> 00:17:02.679 And I'm Lindsay Nix-Walker, senior producer of StarTalk. And Neil 287 00:17:02.700 --> 00:17:05.960 and I just co-authored a brand new StarTalk book coming 288 00:17:06.059 --> 00:17:07.259 out September 12th. 289 00:17:07.960 --> 00:17:10.779 Yeah, this is the third in a series of collaborations 290 00:17:10.819 --> 00:17:15.230 with National Geographic Books. And this one is titled To 291 00:17:15.309 --> 00:17:20.390 Infinity and Beyond. And it's available for pre-order from the 292 00:17:20.490 --> 00:17:26.420 StarTalk website, startalkmedia.com slash books. If you pre-order it, you 293 00:17:26.440 --> 00:17:29.970 get to gain access to a live stream that Lindsay 294 00:17:30.009 --> 00:17:34.170 Walker and I will do from this office. And you 295 00:17:34.210 --> 00:17:38.289 have the occasion to submit questions that we will answer. 296 00:17:38.650 --> 00:17:42.789 That's right. If you pre-order from startalkmedia.com slash books, we'll 297 00:17:42.849 --> 00:17:46.309 answer your questions about the book, the universe, Neil's favorite 298 00:17:46.329 --> 00:17:47.789 kind of cheese, whatever you want. 299 00:17:49.849 --> 00:17:52.390 All right. So we'll see you there and we'll see 300 00:17:52.410 --> 00:17:52.690 you then. 301 00:17:57.700 --> 00:18:02.440 So, Professor, is there a way naturally or through intervention 302 00:18:02.500 --> 00:18:08.210 chemically to regulate, to manage this dopamine release rather than 303 00:18:08.250 --> 00:18:11.470 just have it gushing and be out of control? Sure. 304 00:18:11.589 --> 00:18:15.089 I mean, that's what treatment and recovery is all about. 305 00:18:16.589 --> 00:18:19.690 We think of addiction as a biopsychosocial disease. That means 306 00:18:19.730 --> 00:18:22.900 there are biological, psychological, and social risk factors, and we 307 00:18:22.920 --> 00:18:26.119 have to intervene at the biological, psychological, and social level. 308 00:18:26.819 --> 00:18:29.619 So in terms of the biological level, we have medicines 309 00:18:30.099 --> 00:18:33.359 that can treat addiction. For example, we use a medicine 310 00:18:33.400 --> 00:18:37.539 that blocks opioid receptors and it's FDA approved not just 311 00:18:37.579 --> 00:18:41.079 to treat opioid addiction, but also alcohol addiction because we 312 00:18:41.119 --> 00:18:44.039 know that alcohol works not just on the GABA systems, 313 00:18:44.079 --> 00:18:47.500 but also on our endogenous opioid systems. And by blocking 314 00:18:47.539 --> 00:18:51.039 the opioid receptor, what we're probably doing is blocking the 315 00:18:51.099 --> 00:18:54.900 reinforcing effects of alcohol such that people will describe that 316 00:18:54.940 --> 00:18:58.440 when

they drink, alcohol while they're taking naltrexone, it just 317 00:18:58.700 --> 00:19:01.940 doesn't taste as good. They're not as interested in having 318 00:19:02.440 --> 00:19:05.160 another drink, which is great because we can use it 319 00:19:05.200 --> 00:19:08.529 then to help people not just abstain, but to moderate 320 00:19:08.660 --> 00:19:11.630 their use. So that's one example of a biological intervention. 321 00:19:12.130 --> 00:19:15.130 Psychological interventions, there are many. One of the things we 322 00:19:15.190 --> 00:19:17.950 teach people is to kind of surf their urges or 323 00:19:18.049 --> 00:19:21.569 think through the drink. So these are like mindfulness practices 324 00:19:21.609 --> 00:19:24.809 so that they can learn to identify their triggers, not 325 00:19:24.869 --> 00:19:28.190 react to those triggers, to distance themselves, to wait those 326 00:19:28.250 --> 00:19:33.759 triggers out. And then in terms of social interventions, 12 Steps, 327 00:19:33.920 --> 00:19:38.319 Alcoholics Anonymous, Narcotics Anonymous, other 12 Step groups is basically 328 00:19:38.339 --> 00:19:43.509 a way to contextualize and socialize recovery so that you're 329 00:19:43.529 --> 00:19:45.970 in a sober social network so that you can reach 330 00:19:46.109 --> 00:19:49.609 out to another person when you're having urges or cravings 331 00:19:49.630 --> 00:19:52.759 and then that person can help you co-regulate. That's just 332 00:19:52.960 --> 00:19:55.529 one example of how 12-step works. 333 00:19:56.190 --> 00:19:58.430 Yeah, but if you know that there's chemistry going on 334 00:19:58.470 --> 00:20:00.589 in the brain, why would 12-steps work at all? 335 00:20:02.250 --> 00:20:07.650 Well, because 12-step changes brain chemistry. And we don't just, yeah, yeah. 336 00:20:07.730 --> 00:20:11.549 Is it more the social interaction or is it the 337 00:20:11.690 --> 00:20:16.859 disciplines that they introduce to your life? Or is it 338 00:20:17.059 --> 00:20:22.460 merely having a community around you that you're familiar with, 339 00:20:22.599 --> 00:20:26.869 that understands you, that brings you compassion? All these things 340 00:20:26.910 --> 00:20:29.849 that we tend to take for granted when we're living 341 00:20:30.490 --> 00:20:31.730 in normal social sets. 342 00:20:32.430 --> 00:20:34.230 I really think it's all of the above. So I 343 00:20:34.259 --> 00:20:38.619 think it's the foundational philosophy, the shifting the locus of 344 00:20:38.680 --> 00:20:43.119 control from inside of us to a power outside of ourselves, 345 00:20:43.160 --> 00:20:45.859 something greater than ourselves. It doesn't have to be a 346 00:20:45.940 --> 00:20:51.019 deified entity. It could just be the 12-step community. It's 347 00:20:51.059 --> 00:20:54.079 the working of the steps, all 12 of them, including 348 00:20:54.160 --> 00:20:57.569 especially step four, where we acknowledge what we have contributed 349 00:20:57.609 --> 00:21:00.410 to the problem and what our character defects are. which 350 00:21:00.450 --> 00:21:03.509 allow us to create a more valid narrative about our lives, 351 00:21:03.890 --> 00:21:07.240 which then also gives us access to more information to 352 00:21:07.279 --> 00:21:09.980 make better choices going forward. And then of course it 353 00:21:10.119 --> 00:21:13.519 is the social network, both the de-shaming that happens when 354 00:21:13.559 --> 00:21:16.740 you interact with other people struggling with addiction, but also 355 00:21:16.859 --> 00:21:20.400 as I talk about in my book, Dopamine Nation, a 356 00:21:20.440 --> 00:21:24.180 kind of leveraging the shame within the group such that 357 00:21:24.730 --> 00:21:27.009 people would not want to relapse because they would want 358 00:21:27.029 --> 00:21:29.440 to have to come back and declare themselves as as 359 00:21:29.480 --> 00:21:32.460 a newcomer, something that I label pro-social shame. 360 00:21:32.779 --> 00:21:37.200 So professor, when you've got these pathways and the dopamine 361 00:21:37.960 --> 00:21:43.019 is running and you talk about drug of choice, what 362 00:21:43.099 --> 00:21:45.880 else is out there that's triggering apart from some very 363 00:21:45.980 --> 00:21:47.099 obvious well-known ones? 364 00:21:48.240 --> 00:21:51.740 Well, it's important to recognize that you can get addicted 365 00:21:51.809 --> 00:21:56.009 not just to substances that we ingest, but also behaviors 366 00:21:56.089 --> 00:22:00.789 that we do. And because this motivational reward pathway is 367 00:22:00.849 --> 00:22:04.269 conserved over millions of years of evolution and across species, 368 00:22:04.690 --> 00:22:08.029 it's really fundamental to survival and to get us to 369 00:22:08.329 --> 00:22:12.910 be motivated to do anything. So theoretically, theoretically, you could 370 00:22:12.950 --> 00:22:16.140 get addicted to just about anything. And what we are 371 00:22:16.220 --> 00:22:18.900 seeing in the modern age, especially as more and more 372 00:22:18.960 --> 00:22:23.339 substances and behaviors have been made more potent, more reinforcing, 373 00:22:23.539 --> 00:22:27.829 more novel, more accessible, and come in greater and greater 374 00:22:27.890 --> 00:22:31.450 quantities is that we're seeing people get addicted to all 375 00:22:31.509 --> 00:22:34.130 kinds of things today that we would not have imagined 376 00:22:34.170 --> 00:22:36.920 possible in prior generations. 377 00:22:37.759 --> 00:22:43.559 Now, is it still considered an addiction if the behavior 378 00:22:43.720 --> 00:22:52.539 itself is not only acceptable, but maybe beneficial? I get 379 00:22:52.619 --> 00:22:54.779 up every day. By the way, this is an example, people. 380 00:22:54.819 --> 00:22:57.599 This is not my life. I get up every day 381 00:22:57.720 --> 00:23:00.440 at 6 a.m. and I head straight to the gym 382 00:23:00.460 --> 00:23:03.990 because my day isn't right unless I get up and

383 00:23:04.029 --> 00:23:07.250 head straight to the gym. And I do that. If 384 00:23:07.349 --> 00:23:09.690 I could do it seven days a week, I do 385 00:23:09.750 --> 00:23:11.970 it seven days a week. If I could go twice 386 00:23:12.009 --> 00:23:15.059 a day, I'd go twice a day. You know, if 387 00:23:15.099 --> 00:23:18.420 you meet a person like that, I mean, the behavior 388 00:23:18.500 --> 00:23:22.119 is seen as good. So we don't say, hey, man, 389 00:23:22.220 --> 00:23:23.660 you might have a problem. 390 00:23:24.700 --> 00:23:29.180 Yeah, an excellent point and a good opportunity to define addiction. 391 00:23:29.319 --> 00:23:32.920 Addiction is the continued compulsive use of a substance or 392 00:23:32.980 --> 00:23:37.349 behavior despite harm to self and or others. So just 393 00:23:37.410 --> 00:23:40.369 very broadly speaking, if we're diagnosing addiction, we have to 394 00:23:40.410 --> 00:23:43.039 identify that it's doing some kind of harm. It might 395 00:23:43.079 --> 00:23:45.859 be a harm that that person sees for themselves. It 396 00:23:45.900 --> 00:23:48.049 may be a harm that they don't recognize, but that 397 00:23:48.309 --> 00:23:52.849 others recognize. Having said that, you are absolutely right that 398 00:23:52.890 --> 00:23:56.170 this is contextualized within a given time and place, and 399 00:23:56.190 --> 00:23:59.490 that if society has deemed certain behaviors healthy, even when 400 00:23:59.549 --> 00:24:04.609 people do them to the detriment of their own health, potentially, 401 00:24:04.769 --> 00:24:09.660 or other people's harm, then we might not call it 402 00:24:09.900 --> 00:24:13.759 an addiction. And you use exercise, and people can actually 403 00:24:13.799 --> 00:24:16.250 get addicted to exercise, you know, where they're continuing to 404 00:24:16.309 --> 00:24:19.930 engage in that activity despite being injured, despite not spending 405 00:24:19.990 --> 00:24:23.710 time doing other things that they value. Workaholism is another 406 00:24:23.769 --> 00:24:29.210 great example, people who are compulsively focused on work, money, achievement, 407 00:24:29.640 --> 00:24:31.819 and one that we celebrate in our culture and that 408 00:24:31.859 --> 00:24:35.660 we usually don't call out. So addiction is an interesting 409 00:24:35.740 --> 00:24:38.920 field because there is this, what I think it's a 410 00:24:38.960 --> 00:24:42.640 fascinating intersection between culture and biology. 411 00:24:43.220 --> 00:24:48.099 So, Professor, if it's something that's core and necessary for life, 412 00:24:49.380 --> 00:24:51.200 say water, how about then? 413 00:24:52.420 --> 00:24:55.900 Well, so And if you're addicted to water, you are 414 00:24:55.920 --> 00:25:00.759 the most boring person in the world. You need help. 415 00:25:00.819 --> 00:25:06.880 It is tasteless. It has zero calories. And you'll pee 416 00:25:06.900 --> 00:25:08.500 a lot. Right. 417 00:25:10.019 --> 00:25:10.680 Yes. 418

00:25:10.700 --> 00:25:14.980 So, Professor, has that been a notified addiction? 419 00:25:15.569 --> 00:25:19.029 Yeah, so I've seen one case of that in my career. 420 00:25:19.410 --> 00:25:22.559 It was actually very sad. It was a woman... with 421 00:25:22.599 --> 00:25:26.079 a very severe alcohol addiction who got into recovery from 422 00:25:26.119 --> 00:25:28.900 her alcohol addiction. That is to say she was no 423 00:25:28.940 --> 00:25:32.390 longer consuming alcohol. She was actively working on her health. 424 00:25:32.990 --> 00:25:35.970 But somehow or another, she discovered that if she drank 425 00:25:36.190 --> 00:25:40.309 water in copious amounts, she could feel altered. And she 426 00:25:40.329 --> 00:25:44.700 got addicted to that process and ultimately died of hypo... Well, 427 00:25:44.839 --> 00:25:50.960 she had several very severe episodes of hyponatremia. and almost 428 00:25:51.000 --> 00:25:52.549 died from those episodes. 429 00:25:52.609 --> 00:25:55.369 Washing out the electrolytes. You can't drink that kind of water. 430 00:25:55.410 --> 00:25:55.769 No, no. 431 00:25:55.769 --> 00:25:59.829 Yeah, it's very dangerous. Holy crap, I was only joking. 432 00:25:59.869 --> 00:26:01.150 Now I feel like a jackass. 433 00:26:01.230 --> 00:26:02.309 No, no, it's okay. 434 00:26:02.329 --> 00:26:02.829 That's right. 435 00:26:04.730 --> 00:26:07.789 We're all learning, Chuck. We are all learning. 436 00:26:08.150 --> 00:26:10.589 Chuck is special. You guys are the worst. 437 00:26:12.750 --> 00:26:15.930 So Professor, then there's this term sort of dopamine cleansing, 438 00:26:16.150 --> 00:26:21.720 dopamine fasting. Didn't they used to call that cold turkey 439 00:26:21.759 --> 00:26:23.720 or something similar back in the day? 440 00:26:24.400 --> 00:26:25.259 I haven't heard that term. 441 00:26:25.279 --> 00:26:27.519 I haven't turned that term lately, cold turkey. Yeah, dopamine 442 00:26:27.660 --> 00:26:33.500 fastie and cold turkey. Nobody does anything cold turkey anymore. 443 00:26:34.079 --> 00:26:36.980 That used to mean that you had the right stuff. 444 00:26:37.759 --> 00:26:42.990 So we still do ask people to quit cold turkey 445 00:26:43.170 --> 00:26:46.609 as long as they're not at risk for life-threatening withdrawal. 446 00:26:47.119 --> 00:26:50.759 It's important to remember that people with severe physiologic dependence 447 00:26:50.819 --> 00:26:56.599 to alcohol, benzodiazepines like Xanax, or in some cases opioids, 448 00:26:57.400 --> 00:27:00.000 can have such a severe withdrawal syndrome that they could 449 00:27:00.059 --> 00:27:02.940 actually die from that withdrawal syndrome. So we would not 450 00:27:03.039 --> 00:27:05.900 ask that of people who were at risk of a 451 00:27:05.940 --> 00:27:09.529 life-threatening withdrawal. We also wouldn't ask people to stop abruptly 452 00:27:09.589 --> 00:27:11.549 if they had tried repeatedly to do that on their 453 00:27:11.589 --> 00:27:14.339 own

and weren't able to. But it is an intervention 454 00:27:14.519 --> 00:27:16.940 that we do use as kind of an early intervention 455 00:27:17.119 --> 00:27:20.680 for people who are a little bit addicted all the 456 00:27:20.720 --> 00:27:25.549 way up to moderately addicted but not yet severely physiologically dependent. 457 00:27:26.289 --> 00:27:28.670 And we ask them typically, you know, in clinic to 458 00:27:28.730 --> 00:27:32.250 sort of try to wrap their heads around stopping for 459 00:27:32.250 --> 00:27:34.950 30 days because 30 days is on average the amount 460 00:27:34.970 --> 00:27:37.369 of time it takes to sort of reset these dopamine 461 00:27:37.410 --> 00:27:41.390 reward pathways and to sort of get that prefrontal cortex 462 00:27:41.450 --> 00:27:44.619 back online. and be able to make informed decisions about 463 00:27:44.660 --> 00:27:46.000 what they want to do going forward. 464 00:27:46.460 --> 00:27:46.680 Okay. 465 00:27:46.720 --> 00:27:52.059 We've talked about dopamine and how if it gushes and rushes, 466 00:27:52.079 --> 00:27:54.799 you know, we've got a problem that we, we battle 467 00:27:54.819 --> 00:27:59.559 to control. What if naturally occurring within people's bodies, there's 468 00:27:59.619 --> 00:28:04.970 not enough, as you said, that baseline, what happens then? What, what, 469 00:28:05.269 --> 00:28:08.009 because it's got to be an undetrimental effect if it's 470 00:28:08.309 --> 00:28:12.769 below base. So what conditions come forward if there is, 471 00:28:12.849 --> 00:28:14.430 like I say, a lack of dopamine involved? 472 00:28:15.009 --> 00:28:17.849 Well, you know, this is, there's not a whole lot 473 00:28:17.910 --> 00:28:23.079 of deep understanding of this yet, but some preliminary data 474 00:28:23.099 --> 00:28:29.700 suggests that depression is characterized by low levels of dopamine transmission. 475 00:28:30.640 --> 00:28:34.319 As I said before, there's some thinking that people with 476 00:28:34.359 --> 00:28:38.230 attention deficit disorder might at baseline have lower levels of 477 00:28:38.269 --> 00:28:42.970 dopamine transmission, making them less sensible or sensitive to rewards. 478 00:28:44.710 --> 00:28:48.160 And we also know, very importantly, that with repeated exposure 479 00:28:48.240 --> 00:28:52.119 to highly reinforcing substances and behaviors that release a lot 480 00:28:52.140 --> 00:28:55.980 of dopamine all at once, the brain tries to adapt 481 00:28:56.180 --> 00:29:00.980 to that increased dopamine firing by down-regulating dopamine transmission, not 482 00:29:01.029 --> 00:29:04.630 just to baseline levels, but actually below baseline levels. 483 00:29:05.309 --> 00:29:07.829 So if you're a person who abuses a drug that 484 00:29:07.990 --> 00:29:12.190 floods your brain with dopamine, then your brain says, oh man, 485 00:29:12.450 --> 00:29:14.869 we're making too much dopamine. We got to chill out 486 00:29:14.950 --> 00:29:18.339 on this dopamine production. So then you stop doing the 487 00:29:18.380 --> 00:29:21.119 drug and all of a sudden you have no dopamine 488 00:29:21.140 --> 00:29:24.519 where you should have dopamine. And does that mean at 489 00:29:24.579 --> 00:29:27.460 that point you're like, man, I need some drugs because 490 00:29:27.480 --> 00:29:29.720 I need some dopamine. Some dopamine. 491 00:29:29.779 --> 00:29:33.390 That's exactly right, Chuck. You said it really, really well 492 00:29:33.509 --> 00:29:35.329 and more clearly than I could have. 493 00:29:35.970 --> 00:29:38.319 Um so anna why do we have you when we 494 00:29:38.359 --> 00:29:39.839 have chuck so he could have. 495 00:29:39.779 --> 00:29:45.640 Just honestly i've been thinking that myself this whole time 496 00:29:45.720 --> 00:29:49.960 i was like the comedian could basically give the talk 497 00:29:50.440 --> 00:29:52.460 okay um Yeah. 498 00:29:52.539 --> 00:29:57.069 That's exactly what happens is that with repeated use of 499 00:29:57.670 --> 00:30:01.529 the same or similar reinforcing substance and behaviors, we eventually 500 00:30:01.670 --> 00:30:04.569 end up in this kind of dopamine deficit state. Now 501 00:30:04.630 --> 00:30:07.119 we need more of our drug in more potent forms 502 00:30:07.619 --> 00:30:10.420 over time, not to get high, but just to feel 503 00:30:10.480 --> 00:30:14.000 normal and stop the cravings. which is exactly why people 504 00:30:14.039 --> 00:30:18.299 with severe addiction will relapse even weeks after they've stopped using, 505 00:30:18.380 --> 00:30:20.819 even though they can objectively tell you, yes, my life 506 00:30:20.880 --> 00:30:24.289 is much better because I'm not using and my spouse 507 00:30:24.329 --> 00:30:26.730 is back and my job is back. And I, you know, 508 00:30:26.869 --> 00:30:29.049 from a physical health point of view, I'm doing better. 509 00:30:29.410 --> 00:30:32.529 But mentally, many of them are still struggling with those 510 00:30:32.670 --> 00:30:40.009 universal symptoms of that dopamine deficit state, which are anxiety, irritability, insomnia, depression, 511 00:30:40.509 --> 00:30:44.569 and cravings. And craving manifests in many different ways. It 512 00:30:44.609 --> 00:30:47.750 can be ruminations to want to use. It can be 513 00:30:47.910 --> 00:30:52.779 long-winded narratives that are essentially rationalizations for why I should use. 514 00:30:53.539 --> 00:30:58.259 So craving is really a wily kind of thing that 515 00:30:58.740 --> 00:31:01.000 swims through our brain and catches us unaware. 516 00:31:01.680 --> 00:31:06.730 So Anna, if for some reason dopamine stopped getting made entirely, 517 00:31:07.230 --> 00:31:09.630 does that itself have consequences? Is that the life of 518 00:31:09.690 --> 00:31:12.240 a depressed person or is there some other symptoms of that? 519 00:31:13.579 --> 00:31:18.000 It depends what part of the brain dopamine production decreased in. 520 00:31:18.099 --> 00:31:21.460 So for

example, if we had a decrease in dopamine 521 00:31:21.480 --> 00:31:24.000 production in the part of the brain called the substantia nigra, 522 00:31:24.019 --> 00:31:26.839 which is a discrete and separate part from the reward pathway, 523 00:31:28.059 --> 00:31:30.319 then we would end up with Parkinson's disease, which is 524 00:31:30.460 --> 00:31:34.059 a movement disorder. So dopamine, as I said, has different 525 00:31:34.099 --> 00:31:38.240 functions and it's also very essential for movement. And it's 526 00:31:38.339 --> 00:31:41.960 probably no coincidence that that the same neurotransmitter that's important 527 00:31:42.000 --> 00:31:45.160 for movement is also important for pleasure, reward, and motivation 528 00:31:45.720 --> 00:31:49.059 because we typically need to move our bodies in order 529 00:31:49.140 --> 00:31:53.460 to get the reward that we want. Unfortunately, today, that's 530 00:31:53.720 --> 00:31:57.519 no longer necessarily true. We're now living in a time 531 00:31:57.559 --> 00:31:59.329 and place when we can just sit on the couch 532 00:31:59.400 --> 00:32:01.430 and swipe right and swipe left and have it delivered 533 00:32:01.930 --> 00:32:02.710 to the doorstep. 534 00:32:03.430 --> 00:32:06.329 Wait, so why can't you reverse engineer that and cure Parkinson's? 535 00:32:07.009 --> 00:32:08.710 You said there's a section of the brain, if it 536 00:32:08.730 --> 00:32:13.680 stops making dopamine, you have Parkinson's. So why not introduce 537 00:32:13.980 --> 00:32:16.519 dopamine back into the brain and then cure Parkinson's that way? 538 00:32:17.539 --> 00:32:22.069 So that's, in effect, how we do treat Parkinson's. So 539 00:32:22.269 --> 00:32:26.089 if you had Parkinson's and I gave you dopamine, a 540 00:32:26.130 --> 00:32:28.490 spoonful of dopamine, it would do absolutely nothing because it 541 00:32:28.509 --> 00:32:31.509 doesn't cross the blood-brain barrier. So instead, I have to 542 00:32:31.549 --> 00:32:35.730 give you something called L-DOPA, which is a dopamine precursor 543 00:32:35.750 --> 00:32:38.740 that does cross the blood-brain barrier. And then that gets 544 00:32:38.799 --> 00:32:42.220 converted into dopamine, which then gives you more dopamine in 545 00:32:42.240 --> 00:32:44.460 the substantia nigra, which then allows you to have more 546 00:32:44.539 --> 00:32:49.809 fluid movements to counteract the disease of Parkinson's. Unfortunately, it 547 00:32:49.910 --> 00:32:53.630 binds nonspecifically throughout the brain. So that means that that 548 00:32:53.670 --> 00:32:56.910 dopamine I gave you is now binding to dopamine receptors 549 00:32:56.950 --> 00:32:59.029 in the reward pathway. And what we see is about 550 00:32:59.069 --> 00:33:02.609 a quarter of people treated with L-DOPA for Parkinson's end 551 00:33:02.670 --> 00:33:07.849 up with some kind of compulsive, consumptive behavior, like pathological gambling, 552 00:33:07.910 --> 00:33:09.829 pathological shopping, et

cetera. 553 00:33:13.670 --> 00:33:16.369 Well, let's pick up some of the modern addictions that 554 00:33:16.390 --> 00:33:20.980 we see with gambling as legal lately as it's ever been. 555 00:33:21.000 --> 00:33:24.680 I see ads, I see And then, of course, the 556 00:33:24.799 --> 00:33:27.059 ads are accompanied with a little phone number at the bottom, 557 00:33:27.440 --> 00:33:29.759 have a gambling problem, call this. And I just think 558 00:33:29.799 --> 00:33:35.119 to myself, we have people exploiting the susceptibility of innocent 559 00:33:35.640 --> 00:33:40.769 members of the general public to gambling urges. And I'm 560 00:33:40.829 --> 00:33:45.750 saddened by this because they're hijacking our neurochemistry to make 561 00:33:45.789 --> 00:33:48.849 this happen. And of course, that also brings up social media, 562 00:33:49.269 --> 00:33:52.750 the addiction to how many likes you're going to get, 563 00:33:52.970 --> 00:33:57.970 what Could you just reflect on this modern emergence of 564 00:33:58.029 --> 00:34:01.359 addiction relative to the classical addictions we all grew up with? 565 00:34:02.299 --> 00:34:05.559 Yeah, so I'm equally sad. And I agree with you 566 00:34:05.680 --> 00:34:10.159 that these corporations are really preying on people who are 567 00:34:10.199 --> 00:34:14.389 vulnerable to addiction and also making us all, broadly speaking, 568 00:34:14.429 --> 00:34:18.969 more vulnerable to addiction. One of the biggest risk factors 569 00:34:19.030 --> 00:34:23.150 for addiction that people often discount is simple access. If 570 00:34:23.210 --> 00:34:25.150 you live in a neighborhood where drugs are sold on 571 00:34:25.170 --> 00:34:27.130 the street corner, you're more likely to try them and 572 00:34:27.150 --> 00:34:29.590 you're more likely to get addicted to them. And what 573 00:34:29.610 --> 00:34:33.719 we're seeing with gambling, especially for example, online sports betting, 574 00:34:33.739 --> 00:34:36.500 which has now become legal in multiple states in the union, 575 00:34:37.199 --> 00:34:39.920 is that in those states, we're seeing a 300 to 576 00:34:39.920 --> 00:34:45.119 500% increase in calls to pathological gambling hotlines. So it's 577 00:34:45.159 --> 00:34:50.340 very clear that as gambling becomes more accessible, especially through 578 00:34:50.389 --> 00:34:53.550 a mobile app, we are going to have more people 579 00:34:53.719 --> 00:34:57.300 who are struggling with gambling addiction. And very sadly, I 580 00:34:57.420 --> 00:35:01.059 would add to that, that these corporations actually often specifically 581 00:35:01.179 --> 00:35:04.099 prey on people who get addicted to gambling. So they 582 00:35:04.179 --> 00:35:07.619 track those people and they pursue them and they proffer. 583 00:35:07.639 --> 00:35:09.239 Because they can track them. 584 00:35:09.659 --> 00:35:12.900 Yeah, they give them money. They give them money to 585 00:35:13.000 --> 00:35:17.329 allow them to gamble. And they also change the algorithm 586 00:35:17.389 --> 00:35:19.920 to make sure that they win early on. And then 587 00:35:20.079 --> 00:35:22.940 by getting them hooked, then it's really, it's very. 588 00:35:23.079 --> 00:35:25.139 It's a classic drug dealer move. 589 00:35:25.199 --> 00:35:25.880 That's right. 590 00:35:26.159 --> 00:35:28.840 That's the oldest line in the book is the first 591 00:35:28.940 --> 00:35:30.030 one is always free. 592 00:35:30.489 --> 00:35:35.650 Right. Exactly right. So it's really, it's really, it's very distressing. 593 00:35:36.349 --> 00:35:40.250 So professor, you talked about movement being a trigger, right? 594 00:35:40.449 --> 00:35:44.989 Historically in our primal brain, we are now, the primal 595 00:35:45.010 --> 00:35:48.409 brain that we have is now fighting some serious modern technologies. 596 00:35:48.900 --> 00:35:52.139 So I'm going to upgrade to cartoon garish colors. I'm 597 00:35:52.159 --> 00:35:53.909 going to give you movement. I'm going to give you... 598 00:35:54.519 --> 00:35:57.500 How many other strategies are out there that are keeping 599 00:35:57.699 --> 00:35:58.440 my attention? 600 00:35:58.480 --> 00:35:59.010 Because that's the. 601 00:35:59.260 --> 00:36:02.050 For me, the product that's generated in social media is 602 00:36:02.139 --> 00:36:03.849 my attention time. Right. 603 00:36:03.869 --> 00:36:05.070 It's the new currency. They can do that. 604 00:36:05.510 --> 00:36:05.929 Yeah. Yeah. 605 00:36:06.920 --> 00:36:07.389 That is it. 606 00:36:07.480 --> 00:36:11.659 So how are they making sure I am utterly fixated? 607 00:36:11.719 --> 00:36:14.630 Yes, and please take your time explaining this so that 608 00:36:14.690 --> 00:36:20.449 I can take notes for my own social media accounts. 609 00:36:20.469 --> 00:36:21.750 All right. 610 00:36:22.449 --> 00:36:26.280 Yeah, so you're getting at, you know, what is one 611 00:36:26.300 --> 00:36:31.340 of the huge issues in considering these digital devices and 612 00:36:31.380 --> 00:36:37.690 these digital media as... as having genuine product liability. Just 613 00:36:37.710 --> 00:36:41.880 the way that we think of cigarettes as having inherent harm, 614 00:36:42.320 --> 00:36:45.139 there's now a shift toward thinking about the inherent harm 615 00:36:45.340 --> 00:36:48.599 of digital media of all sorts because of the built-in 616 00:36:48.679 --> 00:36:52.480 design functions. And I think the first and foremost, the 617 00:36:52.659 --> 00:37:00.179 design function of 24-7 portable accessibility that increases access wherever 618 00:37:00.239 --> 00:37:04.469 we are, whenever we are, has made an enormous impact 619 00:37:05.110 --> 00:37:08.070 on the addictive potential and the number of people struggling 620 00:37:08.090 --> 00:37:12.469 with digital addiction, addiction to technology and to the internet. 621 00:37:12.650 --> 00:37:17.820 So in the early 2000s, with the advent of smartphones, 622

00:37:18.960 --> 00:37:21.599 we saw a huge increase in the number of people 623 00:37:21.619 --> 00:37:27.469 struggling with addictive, pathological gambling, pornography viewing, And then as 624 00:37:27.530 --> 00:37:30.389 time went on, we started to see video, addictive video 625 00:37:30.409 --> 00:37:33.269 game use, addictive shopping, addictive social media use. 626 00:37:33.670 --> 00:37:35.809 It's because they could take it with them. It's with 627 00:37:35.829 --> 00:37:36.739 them at all times. 628 00:37:36.840 --> 00:37:39.820 That's right. That's a huge part of it that people, 629 00:37:39.840 --> 00:37:42.940 I think, really don't fully appreciate. And it's important to 630 00:37:43.000 --> 00:37:45.559 realize that because that means that the intervention is going 631 00:37:45.619 --> 00:37:48.800 to be separating ourselves for some period of time every 632 00:37:48.840 --> 00:37:51.690 day from our digital devices. And that's what we're not doing. 633 00:37:51.710 --> 00:37:55.409 We're basically almost cybernetically enhanced with our devices with us 634 00:37:55.469 --> 00:37:55.929 at all times. 635 00:37:56.480 --> 00:37:58.980 That's so true, because in the 80s, when I was 636 00:37:59.059 --> 00:38:02.030 growing up, if you wanted to take porn with you, 637 00:38:02.179 --> 00:38:05.329 that was really quite an undertaking. Right, good luck. 638 00:38:05.690 --> 00:38:06.869 Good luck, right? 639 00:38:08.309 --> 00:38:08.570 Yes. 640 00:38:09.010 --> 00:38:13.610 So, Professor, how do you ensure security of the mind, 641 00:38:14.010 --> 00:38:16.159 particularly in the younger age groups? 642 00:38:16.679 --> 00:38:17.739 I like that phrase, yeah. 643 00:38:17.900 --> 00:38:22.579 And how do you get that holistic protection? 644 00:38:23.480 --> 00:38:23.619 What. 645 00:38:24.239 --> 00:38:27.190 What levels of engagement and where does it come from 646 00:38:27.289 --> 00:38:29.349 for this to be something we can carry forward? 647 00:38:29.369 --> 00:38:30.650 You got to lock your kids in a box. 648 00:38:31.230 --> 00:38:32.489 Yeah, so yeah, exactly. 649 00:38:32.530 --> 00:38:35.389 Wait a minute. You don't do that already? Am I 650 00:38:35.429 --> 00:38:39.210 the only one that does that? Wait. Is there something 651 00:38:39.230 --> 00:38:39.889 wrong with that? 652 00:38:41.030 --> 00:38:41.730 Oh, no. 653 00:38:42.710 --> 00:38:43.469 I think J.K. 654 00:38:43.510 --> 00:38:46.050 Rowling got there before us. 655 00:38:46.079 --> 00:38:47.940 Harry Potter under the stairs. 656 00:38:48.199 --> 00:38:49.940 Yeah, I mean, first of all, I want to say 657 00:38:49.980 --> 00:38:53.860 that this is both an individual problem and a collective problem. 658 00:38:54.230 --> 00:38:57.949 That means we need both bottom-up solutions where we individually 659 00:38:58.070 --> 00:39:02.980 change our habits as individuals and as families, but we 660 00:39:03.019 --> 00:39:08.199 also need top-down interventions, schools,

corporations that make and profit 661 00:39:08.340 --> 00:39:11.780 from the media and the devices, the federal government who 662 00:39:11.800 --> 00:39:14.840 can impose regulations. It needs to be coming from both 663 00:39:14.980 --> 00:39:17.480 ends in order for us to get a handle on 664 00:39:17.519 --> 00:39:23.250 this huge worldwide collective problem. And specifically in terms of 665 00:39:23.309 --> 00:39:26.730 what can be done beyond the kinds of individual and 666 00:39:26.789 --> 00:39:29.329 family interventions that I talk about in my book, when 667 00:39:29.349 --> 00:39:31.699 you think about it from a policy perspective, I think 668 00:39:31.739 --> 00:39:34.460 about it as in three categories. We can try to 669 00:39:34.519 --> 00:39:38.539 change the design, which is what you were talking about earlier, Gary, 670 00:39:39.780 --> 00:39:42.579 this idea of like the bottomless bowls, the flashing lights, 671 00:39:43.119 --> 00:39:45.800 the AI algorithms that learn what we've liked before and 672 00:39:45.820 --> 00:39:50.340 then push content similar but slightly different than what we've 673 00:39:50.360 --> 00:39:54.480 watched before, which then keeps people's engagement, their attention, makes 674 00:39:54.519 --> 00:39:58.690 it more compulsive, pushes them to extreme versions, more potent versions. 675 00:39:59.090 --> 00:40:02.150 So we need to change the design in order to 676 00:40:02.210 --> 00:40:06.550 decrease the liability of the products. We also need to 677 00:40:06.590 --> 00:40:11.719 think about access. So limiting access, as we've talked about, 678 00:40:12.389 --> 00:40:14.860 It's not just what we're doing online. It's the sheer 679 00:40:14.960 --> 00:40:18.360 quantity and frequency of viewing that screen, which is changing 680 00:40:18.420 --> 00:40:22.340 our brains and leading to morbidity and mortality. And when 681 00:40:22.360 --> 00:40:25.780 I think of access, really low-hanging fruit, in my opinion, 682 00:40:25.860 --> 00:40:29.090 is the school system. It seems to me very obvious 683 00:40:29.510 --> 00:40:33.670 that children should not be having their smartphones with them 684 00:40:34.070 --> 00:40:38.250 during school hours, especially not during class, but also potentially 685 00:40:38.309 --> 00:40:41.059 not at all. And what we're seeing is some schools, 686 00:40:41.320 --> 00:40:44.590 typically private schools that have more resources, have taken phones 687 00:40:44.670 --> 00:40:47.389 away and given their students flip phones. And what you're 688 00:40:47.409 --> 00:40:50.929 hearing is you're hearing about huge improvements in student well-being 689 00:40:50.949 --> 00:40:54.530 and student mental health. You're hearing teachers and administrators say 690 00:40:54.860 --> 00:40:56.559 the schools are noisy again. 691 00:40:56.679 --> 00:40:56.940 Why? 692 00:40:57.000 --> 00:41:01.280 Because kids... are engaging with each other. So this is. 693 00:41:01.340 --> 00:41:03.320 So a flip phone is just a phone. It's not. 694 00:41:03.840 --> 00:41:06.539 It's boring. It's boring. A kid's not going to spend 695 00:41:06.579 --> 00:41:07.679 their time on a flip phone. 696 00:41:07.739 --> 00:41:09.940 But they can't complain that they don't have phone access 697 00:41:09.980 --> 00:41:11.480 to an emergency call. 698 00:41:11.179 --> 00:41:13.500 To home or something. That's exactly right. 699 00:41:13.619 --> 00:41:15.900 So how much of this is covered in your Dopamine 700 00:41:15.940 --> 00:41:18.139 Nation book, which came out just a couple. 701 00:41:18.019 --> 00:41:18.519 Of years ago? 702 00:41:19.500 --> 00:41:22.949 Dopamine Nation focuses very much on what we as individuals 703 00:41:23.159 --> 00:41:26.510 and we as families can do And it describes in 704 00:41:26.570 --> 00:41:29.610 simple terms the neuroscience of what's happening and why we 705 00:41:29.630 --> 00:41:33.769 get addicted to potentially almost anything, and then specifically steps 706 00:41:33.829 --> 00:41:37.230 that we can take. So it's not much focused on policy. 707 00:41:37.610 --> 00:41:39.829 But since it came out, I've been more and more 708 00:41:39.869 --> 00:41:46.409 involved in policy discussions, and trying to consider what can 709 00:41:46.429 --> 00:41:49.090 be done beyond the level of the individual and the 710 00:41:49.130 --> 00:41:49.889 individual family. 711 00:41:49.909 --> 00:41:53.170 And what about family policy? Because I'm sure right now, 712 00:41:53.269 --> 00:41:56.849 anybody who's a parent who is listening to this is thinking, 713 00:41:57.610 --> 00:42:00.210 it's impossible for me to stop my kids or get 714 00:42:00.250 --> 00:42:02.460 them off of the video games, to get them off 715 00:42:02.659 --> 00:42:05.460 of the tablet, to stop them from... And by the way, 716 00:42:05.519 --> 00:42:09.320 there's social media companies now push out all the content everywhere. 717 00:42:09.659 --> 00:42:12.150 So if you keep your kids off of X, Twitter, 718 00:42:12.190 --> 00:42:15.050 whatever that is, or Facebook or whatever, they're just going 719 00:42:15.070 --> 00:42:18.130 to get it on YouTube or YouTube Shorts or whatever, 720 00:42:18.789 --> 00:42:25.150 or on Discord. So what do you do to curtail, 721 00:42:25.650 --> 00:42:29.010 aside from the draconian measure of ripping the phone away 722 00:42:29.050 --> 00:42:31.599 from them, what do you do to curtail their behavior? 723 00:42:32.139 --> 00:42:32.940 You put them in a box. 724 00:42:34.619 --> 00:42:39.019 We already talked that. 725 00:42:40.340 --> 00:42:43.110 You know, you don't put the kid in the box, 726 00:42:43.150 --> 00:42:45.949 but you probably should put the devices in a box. 727 00:42:46.610 --> 00:42:49.809 Oh, so you, you are an advocate of literally snatching 728 00:42:49.869 --> 00:42:50.510 it away from them. 729 00:42:50.630 --> 00:42:53.679 So let me, let me qualify that for kids up 730 00:42:53.739 --> 00:42:56.980 until a

certain age. And I would say this is 731 00:42:57.059 --> 00:43:00.809 usually around 11 or 12. I believe that we as 732 00:43:00.869 --> 00:43:05.150 parents still have enough control, generally speaking, in the household, 733 00:43:05.250 --> 00:43:08.530 especially if we're co-parenting with somebody that agrees with us 734 00:43:08.610 --> 00:43:12.389 and we can organize it together. And I think it's 735 00:43:12.429 --> 00:43:15.280 very possible and also good to sit down as a 736 00:43:15.300 --> 00:43:18.639 family and say, hey, we've been using devices in this way, 737 00:43:18.800 --> 00:43:21.920 but it's not healthy. And here are the reasons why. 738 00:43:22.000 --> 00:43:24.699 And so as a family, we need to make some changes. 739 00:43:24.820 --> 00:43:27.420 And I've seen families do this. And it can be 740 00:43:27.559 --> 00:43:30.639 very distressing for all comers because very often parents are 741 00:43:30.699 --> 00:43:33.039 as addicted as kids. But to do it together as 742 00:43:33.079 --> 00:43:36.619 a family with younger children can be so healthy for 743 00:43:36.679 --> 00:43:39.789 families to just really reorient. It doesn't mean your kid's 744 00:43:39.849 --> 00:43:42.409 never on the device, but they're on the device for 745 00:43:42.429 --> 00:43:45.210 a limited quantity of time after they've done their chores 746 00:43:45.230 --> 00:43:47.670 and their schoolwork as a kind of thing that they've 747 00:43:47.889 --> 00:43:50.809 earned for good behavior for a limited amount of time 748 00:43:50.969 --> 00:43:53.070 and not every day. And then not every day is 749 00:43:53.170 --> 00:43:56.039 really key. If you want a number of hours There's 750 00:43:56.360 --> 00:44:00.800 some general consensus less than two hours a day. Now, 751 00:44:00.960 --> 00:44:03.440 once you, I know, and I'm talking, and I'm not. 752 00:44:03.480 --> 00:44:06.449 Talking about you. Wait, who's going to raise my kids 753 00:44:06.489 --> 00:44:08.070 if they're only allowed to watch this? 754 00:44:08.090 --> 00:44:10.849 Yeah, exactly. But it's important. It's important to get in 755 00:44:10.869 --> 00:44:14.070 there while they're little because it lays the foundation for, 756 00:44:14.230 --> 00:44:17.989 you know, their wiring and their neurological scaffolding that they're 757 00:44:18.010 --> 00:44:20.849 going to be left with the rest of their adult lives. Now, 758 00:44:21.010 --> 00:44:25.500 once kids get to be about 13, they're no longer 759 00:44:25.539 --> 00:44:27.780 in your control. They're going to do what they're going 760 00:44:27.800 --> 00:44:29.940 to do. But at that point, what we can do 761 00:44:30.000 --> 00:44:32.340 as parents is model the behavior that we want to see, 762 00:44:32.820 --> 00:44:36.960 give them feedback on what we're observing, use contingency management, 763 00:44:37.019 --> 00:44:41.780 which is punishments and rewards to incentivize the kinds of 764 00:44:41.820 --> 00:44:44.190 behaviors that we want to see, and just talk about 765 00:44:44.210 --> 00:44:46.769 it openly as a family and try to have a 766 00:44:46.789 --> 00:44:51.070 certain tech etiquette around when it's appropriate to use devices 767 00:44:51.110 --> 00:44:53.690 and when it's not. When we're having friends over for 768 00:44:53.710 --> 00:44:56.869 a meal, you shouldn't be on your device. You should 769 00:44:56.909 --> 00:45:00.150 be looking them in the eye, greeting them, spending some 770 00:45:00.190 --> 00:45:03.230 time talking, not just being. So I think these are 771 00:45:03.250 --> 00:45:05.409 the conversations we really have to have. 772 00:45:05.989 --> 00:45:09.110 Yeah, but does that mean there's no hope through legislation 773 00:45:09.190 --> 00:45:12.699 or Congress or lobbying the companies themselves? 774 00:45:13.300 --> 00:45:17.559 Oh, absolutely. That's the third piece of it is hold 775 00:45:17.579 --> 00:45:20.809 the corporations accountable. And the way to do that is 776 00:45:20.869 --> 00:45:26.599 really through various types of nudges through policy reform and regulations. 777 00:45:27.079 --> 00:45:30.639 And just to give an example, I talked about thinking 778 00:45:30.679 --> 00:45:34.880 that kids should have as a top-down policy no smartphones 779 00:45:35.039 --> 00:45:39.829 during school hours. And, you know, the federal government could 780 00:45:39.889 --> 00:45:43.590 do that by, they give lots of funds to public schools. 781 00:45:43.610 --> 00:45:45.829 You know, they could say either we're not going to 782 00:45:45.889 --> 00:45:48.869 give you as much of those funds unless you manage 783 00:45:49.800 --> 00:45:52.099 technology in your school in a different kind of way. 784 00:45:52.219 --> 00:45:53.900 Or they could sweeten the pot and say, we will 785 00:45:53.920 --> 00:45:58.619 give you more funds if you do something like implement 786 00:45:58.699 --> 00:46:03.110 some kind of new smartphone use policy in your school. 787 00:46:03.469 --> 00:46:05.969 So there are ways to get in there. And there 788 00:46:05.989 --> 00:46:08.409 are precedents as well. So for example, the age 21 789 00:46:08.409 --> 00:46:12.389 drinking laws, which are now universal in every state, really 790 00:46:12.449 --> 00:46:14.730 came to be because the federal government said, well, we're 791 00:46:14.750 --> 00:46:17.449 not going to give you highway funds if you keep 792 00:46:17.469 --> 00:46:20.469 your drinking age lower. So there are ways to kind 793 00:46:20.510 --> 00:46:21.679 of create these nudges. 794 00:46:22.320 --> 00:46:22.920 To strong arm. 795 00:46:23.000 --> 00:46:27.460 So professor, they're called smartphones, right? There must be a way. 796 00:46:27.539 --> 00:46:29.860 I mean, I'm not technically gifted in any way, but 797 00:46:30.019 --> 00:46:32.119 you build in a phone and you've got to have 798 00:46:32.159 --> 00:46:35.489 a trust program here where if it's going to a 799 00:46:35.530 -->

00:46:37.909 young person under the age of 11 or 10, say 800 00:46:37.929 --> 00:46:41.210 like that, then it gets time to shut down on 801 00:46:41.369 --> 00:46:43.889 usage per day? As you said, no more than two 802 00:46:43.929 --> 00:46:45.210 hours or whatever the limit might be. 803 00:46:45.230 --> 00:46:46.710 Yeah, there are apps for that. Surely there is a 804 00:46:46.750 --> 00:46:49.030 way for that. Yeah, they do. 805 00:46:49.070 --> 00:46:50.719 They must then be mandatory. 806 00:46:51.010 --> 00:46:54.159 Well, there are lots of software apps that do that, 807 00:46:54.199 --> 00:46:57.139 but these kids very early on figure out all kinds 808 00:46:57.179 --> 00:46:57.659 of workarounds. 809 00:46:57.679 --> 00:46:58.960 All kinds of ways of workarounds. 810 00:46:59.039 --> 00:47:02.360 But what you're implying is actually something that I don't 811 00:47:02.400 --> 00:47:05.199 think has been done to any great degree, which is 812 00:47:05.280 --> 00:47:08.559 that there should be hardware implementation. So, for example, I 813 00:47:09.519 --> 00:47:12.659 I'm not an engineer or a computer science person, but 814 00:47:12.699 --> 00:47:17.329 I can imagine a school laptop that might help, especially 815 00:47:17.389 --> 00:47:20.949 for younger children, avoid some of the content that we 816 00:47:20.989 --> 00:47:24.570 want them to avoid. So not just expecting software companies, 817 00:47:24.610 --> 00:47:27.250 but also hardware companies. But this gets to the whole 818 00:47:27.309 --> 00:47:33.469 content issue, which is very hard to regulate because it's 819 00:47:33.530 --> 00:47:36.510 in direct conflict with privacy laws. So for example, in 820 00:47:36.610 --> 00:47:40.360 some states, I think Louisiana is one of them, they've 821 00:47:40.400 --> 00:47:42.719 implemented a law that says in order to sign up 822 00:47:42.760 --> 00:47:46.679 for a website like Pornhub, you have to prove that 823 00:47:46.739 --> 00:47:49.090 you are, I think, 21, and you have to do 824 00:47:49.130 --> 00:47:52.090 that by uploading your driver's license. But of course, nobody 825 00:47:52.130 --> 00:47:53.929 is going to go on Pornhub wants to upload their 826 00:47:53.969 --> 00:47:56.719 driver's license and be associated with having done that. So 827 00:47:56.760 --> 00:47:59.519 now they've worked out having like these third party sites, 828 00:47:59.659 --> 00:48:02.000 which kind of anonymously process. 829 00:48:02.019 --> 00:48:05.260 You can register with the third party site and your 830 00:48:05.320 --> 00:48:08.030 registration with that third party site allows you access to 831 00:48:08.050 --> 00:48:08.989 the porn site. 832 00:48:09.050 --> 00:48:09.670 That's it. 833 00:48:09.690 --> 00:48:11.710 Chuck, why do you know that? Chuck, why do you 834 00:48:11.989 --> 00:48:15.349 know that? Because I have a very good friend in Louisiana. 835 00:48:15.550 --> 00:48:20.349 You got a friend. You've got a friend. Okay. All

right. 836 00:48:20.849 --> 00:48:21.030 Okay. 837 00:48:21.050 --> 00:48:24.230 So, Professor, let's get to the content aspect. I mean, 838 00:48:24.289 --> 00:48:28.070 it's not just the porn or online gambling. There is 839 00:48:28.269 --> 00:48:33.769 extreme content that comes through, and it is getting extreme 840 00:48:33.829 --> 00:48:35.210 reactions from individuals. 841 00:48:35.230 --> 00:48:36.250 You're a psychiatrist. 842 00:48:37.110 --> 00:48:42.139 Are we hardwired to react extremely to extreme content? 843 00:48:43.179 --> 00:48:46.019 Let me sharpen that question. I'm all with it, but 844 00:48:46.039 --> 00:48:47.940 I want to tune it specifically because we've got to. 845 00:48:48.269 --> 00:48:52.409 wrap this up very shortly, is we are seeing content. 846 00:48:52.449 --> 00:48:55.699 Forget the kids now. The adults are being fed content 847 00:48:55.820 --> 00:49:01.519 by the algorithm that enrages us and motivates us to 848 00:49:01.960 --> 00:49:06.320 act in some way. And in the limiting case, it 849 00:49:06.360 --> 00:49:08.840 motivates us to commit violence against some group. 850 00:49:08.860 --> 00:49:10.250 We're going to the Capitol. 851 00:49:13.969 --> 00:49:18.789 So this is not so much addiction, but there's definitely 852 00:49:18.829 --> 00:49:22.039 a brain thing going on. on there that's being fed 853 00:49:22.639 --> 00:49:24.599 and that we can, we're reacting in a way that 854 00:49:24.619 --> 00:49:27.969 we think is completely sensible, but it's not when you 855 00:49:28.010 --> 00:49:29.199 take one step back from it. 856 00:49:30.329 --> 00:49:30.690 Yeah. 857 00:49:30.750 --> 00:49:34.190 And I think we can hypothesize that dopamine is involved 858 00:49:34.230 --> 00:49:38.849 in this process too. Um, that, essentially when we see, 859 00:49:39.289 --> 00:49:42.030 when our opinion is validated with a large group and 860 00:49:42.070 --> 00:49:44.739 then we're experiencing an emotion at the same time that 861 00:49:44.820 --> 00:49:48.300 many other people are experiencing that emotion, that's one of 862 00:49:48.360 --> 00:49:51.360 the ways that we feel connected to other people, right? 863 00:49:51.480 --> 00:49:56.369 Sharing an emotional experience. And we know that feeling connected 864 00:49:56.409 --> 00:49:59.730 to other people releases oxytocin, which is our love hormone, 865 00:49:59.789 --> 00:50:02.989 which binds to dopamine receptors in the reward pathway, which 866 00:50:03.050 --> 00:50:05.550 then release dopamine. So we, I think there is this 867 00:50:05.610 --> 00:50:08.739 sense in which we are kind of getting high off 868 00:50:08.780 --> 00:50:12.280 of this group experience, whatever it may be, whether it's, 869 00:50:12.860 --> 00:50:16.539 you know, people watching people watching other people make music. 870 00:50:16.639 --> 00:50:18.900 Like now, you know, it's not just videos of people 871 00:50:18.940 --> 00:50:21.420 making music. We watch other people having

a reaction to 872 00:50:21.440 --> 00:50:24.440 the music and that makes it more potent because we're 873 00:50:24.480 --> 00:50:26.539 having a shared emotional experience. 874 00:50:26.780 --> 00:50:30.440 They're called reaction videos. Yeah. They're for everything. They got 875 00:50:30.460 --> 00:50:30.739 it for. 876 00:50:31.800 --> 00:50:34.920 I've even been encouraged to get, I've posted a reaction 877 00:50:34.960 --> 00:50:38.880 video to a TikTok. Just for that context. Because I 878 00:50:38.889 --> 00:50:42.179 was duly notified by someone one-third my age on our 879 00:50:42.219 --> 00:50:44.340 staff that that was a thing to do for a 880 00:50:44.380 --> 00:50:48.159 particular posting by another person who made music about the planets. 881 00:50:48.219 --> 00:50:49.619 And then I was. 882 00:50:49.559 --> 00:50:52.389 Reacting to the planets. It was cute. It was very cute. 883 00:50:52.449 --> 00:50:58.489 It was not. We weren't promoting insurrection, okay? Good to know. 884 00:50:59.369 --> 00:51:02.309 Professor, this sort of safety in numbers didn't, back in 885 00:51:02.369 --> 00:51:04.309 my day, used to call that herd mentality. 886 00:51:04.909 --> 00:51:08.619 Right, herd mentality, feeding frenzy, these types of things. 887 00:51:08.659 --> 00:51:11.340 But I mean, what's the term? Is it rageaholic? 888 00:51:12.239 --> 00:51:15.159 Yeah, rageaholic. I mean, you know, it is important to 889 00:51:15.199 --> 00:51:18.400 realize that you can get addicted not just to sort 890 00:51:18.440 --> 00:51:21.619 of positive stimuli, but actually aversive or negative. You know, 891 00:51:21.639 --> 00:51:24.119 people are doom scroll. They get addicted to the news. 892 00:51:24.199 --> 00:51:27.039 They get addicted to becoming enraged. I think that the 893 00:51:27.079 --> 00:51:31.929 addiction phenomenon could even... apply to like a domestic violence 894 00:51:31.989 --> 00:51:36.190 situation where people kind of get addicted to the uncertainty 895 00:51:36.510 --> 00:51:42.420 of that kind of, you know, violent relationship, which is 896 00:51:42.469 --> 00:51:44.860 maybe why, you know, sometimes people keep going back. 897 00:51:44.880 --> 00:51:45.500 They can't leave it. 898 00:51:45.659 --> 00:51:47.579 And what about people jump out of airplanes for fun? 899 00:51:49.150 --> 00:51:54.190 Yeah, so that's been researched to some degree. And what 900 00:51:54.210 --> 00:51:57.329 they find is that after the first jump, there's this 901 00:51:57.389 --> 00:52:02.170 kind of like paralyzed terror in the aftermath. But with 902 00:52:02.289 --> 00:52:07.690 subsequent jumps, people get just frankly euphoric. There's an enormous high. 903 00:52:08.110 --> 00:52:11.050 But also with people who jump all the time, they 904 00:52:11.090 --> 00:52:13.789 develop anhedonia, which is to say they develop a kind 905 00:52:13.809 --> 00:52:16.130 of depressed state. There's probably like a flooding of their 906 00:52:16.150 --> 00:52:18.840 brain of neurotransmitters. And then it's too much and then 907 00:52:18.860 --> 00:52:22.340 you have this kind of compensation so that it's possible 908 00:52:22.929 --> 00:52:24.630 and it's hypothesized even in the literature. 909 00:52:24.650 --> 00:52:27.650 Well, there's an answer. There's an answer to that. The 910 00:52:27.690 --> 00:52:29.530 next jump you make, just do it without the shoot. 911 00:52:30.690 --> 00:52:33.510 That's it, right? Or go higher and higher or whatever 912 00:52:33.550 --> 00:52:35.309 it is. 913 00:52:35.489 --> 00:52:39.110 Thank you, Chuck, for solving that problem for us here. Gary, Gary, 914 00:52:39.130 --> 00:52:40.010 we got to close this down. 915 00:52:40.090 --> 00:52:44.010 I know, but before we do, what's the next big addiction? 916 00:52:44.719 --> 00:52:45.599 Is he going to be AI? 917 00:52:45.780 --> 00:52:48.380 Oh my God, that sounds like the worst reality show ever. 918 00:52:49.679 --> 00:52:52.340 That's big addiction. 919 00:52:53.360 --> 00:52:57.139 Gosh, I know. I'm trying hard to prevent people from 920 00:52:57.179 --> 00:52:57.840 getting addicted to more stuff. 921 00:52:57.860 --> 00:52:59.150 But we've already seen that movie. It was called Her. 922 00:52:59.829 --> 00:53:00.690 That movie's been made. 923 00:53:01.389 --> 00:53:02.909 Yes, yes, that's right. 924 00:53:02.929 --> 00:53:09.269 Yeah, the main character's addicted to this AI woman on 925 00:53:09.289 --> 00:53:11.409 his phone. And then you see everybody around him addicted 926 00:53:11.429 --> 00:53:13.429 to their own AI lover. 927 00:53:13.619 --> 00:53:16.320 Right, their own devices, yeah. 928 00:53:16.659 --> 00:53:21.059 It's because people were left to their own devices. There 929 00:53:21.099 --> 00:53:23.659 you go. I saw what you did there. 930 00:53:23.679 --> 00:53:27.360 You saw what I did there. Listen, Anna, this has 931 00:53:27.389 --> 00:53:30.949 been a delight. On a sad topic, you shed some 932 00:53:31.030 --> 00:53:32.889 important light on it for us all. 933 00:53:32.929 --> 00:53:33.510 Great stuff. 934 00:53:33.550 --> 00:53:37.610 And it clearly doesn't or shouldn't end here. We will 935 00:53:37.769 --> 00:53:41.030 totally find another reason to bring you back on. because 936 00:53:41.090 --> 00:53:44.739 this is a never-ending challenge that we all face, if 937 00:53:44.800 --> 00:53:47.820 not for ourselves, but for loved ones or certainly for 938 00:53:47.880 --> 00:53:51.559 society at large. So thank you for your expertise there. 939 00:53:51.980 --> 00:53:54.849 And your two books, give me the names of those again. 940 00:53:54.889 --> 00:53:55.769 I love the first one. 941 00:53:55.829 --> 00:53:57.389 What was that? What's that called? 942 00:53:57.429 --> 00:53:58.190 Drug Dealer MD. 943 00:53:58.210 --> 00:54:01.409 Drug Dealer MD. Great title there. Who publishes these, by 944 00:54:01.429 --> 00:54:01.579 the way? 945 00:54:03.250 --> 00:54:06.530 The first is Johns Hopkins University Press and the Dopamine 946 00:54:06.570 --> 00:54:08.880 Nation is published by Dutton Penguin Random House. 947 00:54:08.889 --> 00:54:09.179 Wow. 948 00:54:09.239 --> 00:54:10.820 So that means it's got good distribution there. 949 00:54:10.940 --> 00:54:11.360 Okay. 950 00:54:11.480 --> 00:54:13.500 We'll look for that. All right. 951 00:54:13.800 --> 00:54:15.340 So Anna, thank you for being on StarTalk. 952 00:54:16.579 --> 00:54:18.179 You're welcome. Thank you for inviting me. 953 00:54:18.280 --> 00:54:22.699 All right. Chuck, Gary, we out. Yep. Pleasure. All right. 954 00:54:22.800 --> 00:54:26.579 This has been Neil deGrasse Tyson, your personal astrophysicist for 955 00:54:26.599 --> 00:54:30.980 StarTalk Special Edition on addiction. Until next time, as always, 956 00:54:31.000 --> 00:54:32.559 keep looking up.