Dopamine Detox: Rewiring Pleasure and Brain Health

Like intermittent fasting, a dopamine detox is a trendy fast with roots in ancient traditions. Your brain naturally produces dopamine, so you can't fast completely from it. Instead, the focus is on restricting dopamine-boosting activities for a set time to help manage addictive behaviors.

In her 2020 bestselling book, Dopamine Nation, Anna Lembke, MD, argues that modern people need to restore depleted dopamine levels due to an age of indulgence. Overabundance, Dr. Lembke believes, is causing chronically low dopamine levels, especially in wealthier nations, and may explain the global increase in depression, anxiety, and unhappiness.

In a recent Stanford University lecture, she stated, “Overabundance itself is one of the most important modern-day stressors…We were not physiologically wired for this world of overwhelming overabundance, which we have created.”

I believe that what's happening is that we as both individuals and nations are exposed to so many high-reward substances from our coffee, to that first text that we read, to our Netflix binge at night, that we're all in a chronic dopamine deficit state, barely able to enjoy the modest rewards of life and experiencing more and more anxiety and depression.

Anna Lembke, MD

What is her solution? Dr. Lembke recommends a 30-day fast from activities that cause a powerful dopamine rush.

Let’s take a deeper look at her idea.

What is dopamine, and why does it matter?

Dopamine is a well-known neurochemical the body requires to function. A 2019 review published in Current Opinion in Neurobiology states, "Dopamine controls motor functions, motivation, and reward-related learning."

Activities like engaging in social media, sex, food, learning a new skill, or nailing a goal cause a surge of dopamine — often known as the 'feel-good' neurochemical. But dopamine offers more than just pleasure. It’s also crucial for motivation and reward for activities like meeting goals, accomplishing something hard, or learning a new skill.

When dopamine hits your brain, pleasure and reward hit it, too. Frustratingly, however, it’s immediately followed by pain, or a let-down, to keep us motivated and moving toward the next goal. As a result, dopamine levels quickly peak and trough.

Scientists believe this pleasure–pain brain game originated from early human existence when people worked to constantly meet basic needs like food, water, safety, and shelter. It's an impressive way to keep humans motivated for survival.

However, Lembke argues that humans are not designed for the modern onslaught of dopamine we receive from our daily caffeine, text messages, sex, movies, social media, sugar, emails, evening alcohol, or all the other easily available dopamine-boosting triggers.

Neurotransmitter mechanisms get complicated, but, in essence, current research supports Lembke's theory that humans face a deep dopamine deficit due to overindulgence. Too many highs and lows damage one’s baseline dopamine levels.

Fasting from dopamine-surging behaviors may be the answer to restoring normal levels.

Step 1: a 30-day dopamine detox

Thanks to social media, detoxing from dopamine became a trendy fad in 2019. Called a 'dopamine fast' by Californian psychiatrist Cameron Sepah, PhD, the concept and its flashy name hit the Silicon Valley tech world and spread globally.

The name 'dopamine fast' is a bit misleading, Sepah admits. Your body won’t allow a complete dopamine fast. Instead, the idea is to fast from highly dopamine-stimulating activities to help restore a healthy dopamine baseline.

Sepah’s "Dopamine Fast 2.0" is similar to Dr. Lembke’s recommendation of a 30-day break from one of the pleasure behaviors you rely on, whether it’s video games, drugs, pornography, vaping, or the foods you crave and rely on every day. According to Lembke, research says 30 days is necessary to reset your dopamine baseline.

Dr. Sepah notes that a sudden cold-turkey detox isn’t required and can be dangerous for serious drug and alcohol addictions. One can restrict the behavior more gradually. For some people, however, cutting the addictive behavior completely is easier.

Keep in mind, if you are considering a fast from a severe drug or alcohol addiction, please see a doctor before doing so. Extreme withdrawals can be deadly without medical assistance.

Step 2: restart the behavior carefully

After a 30-day fast, Lembke recommends reintroducing the behavior in moderation. The goal is to maintain the newly restored dopamine levels and rebuild a healthy, tempered relationship with your 'drug' of choice, as Lembke calls it. Some people may need to continue abstinence.

In her book, she warns that the 14th day of a detox can feel pretty miserable. For those who stick with it, however, the payoff is powerful. Once the pain-pleasure rollercoaster calms down, one’s brain finds a restored natural dopamine balance, which can increase your pleasure in even the simplest things.

Lembke recommends trying the fast for two weeks if four sounds too long. If two weeks is too long, try a week. If that’s too long, try a 24-hour fast. It may not reset reward pathways, but it can reveal withdrawal symptoms.

According to Lembke, the five universal signs of withdrawal are:

1. Anxiety
2. Irritability
3. Insomnia
4. Depression
5. Craving

If you exhibit these signs with a 24-hour fast, you may be more addicted to the behavior than you realize.

Step 3: set a barrier between you and addictive behaviors

Dr. Lembke says setting literal and psychological obstacles between you and your drug of choice can help you restore a healthy relationship with it. She says this allows us to "press the pause button between desire and consumption," to keep us from relying only on willpower.

There are four barriers she recommends:

• Physical distance. Set a real distance between you and the behavior. For example, remove addictive foods from your home or put your phone in the garage when taking a break. If you're obsessed with video games, use two different computers for working and gaming.
• Chronological boundaries. Set a time schedule for when you will and won't engage in addictive behaviors. The 30-day fast is an example of a chronological barrier. Once you reintroduce the addictive behavior, you can set shorter time barriers, like turning off your device during work or silencing your phone from 7 pm to 8 am. If certain foods are addicting, intermittent fasting from those foods may help.
• Categorical obstacles. This means limiting particular categories of your drug of choice. For example, reality TV may be impossible to watch in moderation. To manage the addiction, one can cut reality TV but watch sitcoms moderately. Or maybe Facebook is too addicting, but LinkedIn isn’t.
• Chemical barriers. Dr. Lembke says there are a growing number of drugs that research suggests may help, too. For example, the weight loss Ozempic may help some people abstain from alcohol, according to early research.

Try radical honesty

Lembke’s book offers a chapter on the powerful surge of dopamine from radical honesty. This level of vulnerability with others can be terrifying. But, as Lembke explains, when one is radically honest with a safe loved one, it promotes intimacy, which is a potent source of dopamine.

When humans connect, dopamine and oxytocin, another powerful neurochemical, work together to increase both intimacy and pleasure.

Embracing the pain

To reset healthy dopamine levels, one must embrace the pain of the dopamine crash after the pleasure hit, according to experts. This pain is welcome because it stimulates us toward our next goal.

Rather than seeking another quick hit from an ultimately unfulfilling addictive behavior, experts recommend rejecting the quick fix and embracing the pain, even if this means the pain of a 30-day dopamine detox.

Lembke also reminds readers that exercise, cold water baths, meditation, prayer, and fasting are healthy ways "to get our dopamine indirectly by paying for it upfront." In other words, these activities feel uncomfortable or painful in the moment but boost our dopamine in the end.

A dopamine detox is not a withdrawal from all behavior or a push to monasticism or masochism, as some early adopters thought.

Instead, it’s a return to old human traditions around the globe of resting one’s brain, withdrawing from everyday addictive activities, and balancing dopamine levels, which may help restore pleasure, motivation, focus, and attention.