We Can Do Hard Things: Are You a Dopamine Addict? | Dr. Anna Lembke

Release Date: August 12, 2025

Introduction to the Episode and Dr. Anna Lembke

[02:18] Abby Wambach warmly welcomes listeners to the episode, emphasizing the central theme: understanding why common attempts to feel better often backfire and how to genuinely improve our well-being. She introduces Dr. Anna Lembke, a renowned expert in addiction medicine from Stanford University. Dr. Lembke holds significant roles, including Medical Director of the Stanford Addiction Medicine Program and Program Director for the Stanford Addiction Medicine Fellowship. Her extensive contributions to mental illness research, teaching, and clinical innovation have earned her numerous accolades.

Understanding the Pleasure-Pain Balance in the Brain

[04:56] Abby Wambach raises the foundational question: "Can you tell us what our problem is?"

[04:56] Dr. Anna Lembke delves into the brain's processing of pleasure and pain. She explains that these emotions are interconnected within the same regions of the brain, acting like opposite sides of a teeter-totter.

"Pleasure and pain are co-located in the brain... they work like opposite sides of a balance." ([04:56])

This balance, known as homeostasis, represents our baseline level of happiness. While individuals like Dr. Lembke and Abby have different baseline moods, the brain strives to maintain this equilibrium.

The Dopamine Addiction Cycle

[06:38] Dr. Lembke introduces dopamine as the brain's reward neurotransmitter, pivotal in reinforcing pleasurable behaviors. Each pleasurable activity releases dopamine, tipping the balance toward pleasure. However, the brain counteracts this by reducing dopamine transmission, often leading to a dopamine deficit state.

"With any deviation from a level balance or homeostasis, our brains will work very hard to restore a level balance... into a dopamine deficit state." ([06:38])

Repeated engagement in dopamine-releasing activities leads to neuroadaptation, where the brain becomes conditioned to require more of the stimulus to achieve the same level of pleasure. This cycle perpetuates addiction, making individuals seek more potent forms to escape the resulting pain and cravings.

Personal Reflections and Validation

[14:26] Glennon Doyle shares her personal journey of sobriety, nearly a decade without alcohol. She reflects on how understanding dopamine demystified her addiction, alleviating the shame often associated with it.

"It was a way to keep the dopamine going... learning about dopamine... took so much shame away." ([14:26])

Dr. Lembke responds emotionally, expressing gratitude for Glennon's testimonial and highlighting how patients often teach her as much as she teaches them.

Evolutionary Perspective on Addiction

[16:01] Dr. Lembke offers an evolutionary lens on mental illness and addiction. She posits that traits associated with addiction might have been advantageous in past environments, such as scrounging for scarce resources.

"People with addiction have bionic supersonic pleasure pain balances that are mismatched for our current environment." ([16:01])

This mismatch arises from a world of abundance and constant stimulation, where the evolutionary-driven pursuit of pleasure and avoidance of pain leads to overconsumption and addiction.

Steps to Overcome Addiction and Restoring Homeostasis

[27:42] Abby Wambach introduces the concept of overconsumption beyond clinical addiction, highlighting how everyday behaviors like excessive social media use can disrupt the pleasure-pain balance.

[28:59] Dr. Lembke outlines the long-term solution: restoring homeostasis through abstinence. She recommends a 30-day abstinence period to begin breaking the addiction cycle, emphasizing that while it's not a cure, it initiates recovery.

"The long term fix is actually to restore homeostasis... abstain from your drug of choice for long enough." ([28:59])

[30:08] Amanda Doyle requests a breakdown of the 30-day abstinence process.

[35:44] Dr. Lembke explains the typical progression:

• First 10-14 Days: Intense withdrawal symptoms—cravings, dysphoria, irritability, and insomnia.
• Weeks 3-4: Beginnings of improved mood and reduced cravings, offering hope.

She underscores the importance of counseling and peer support to navigate the challenging phases of recovery.

Parenting and Raising Children in a Dopamine-Driven Culture

[37:15] Dr. Lembke shifts focus to parenting, discussing the impact of a dopamine-centric culture on children. She warns against overemphasizing achievements, urging parents to foster environments where children are loved unconditionally, regardless of their successes.

"Those who are surrounded by people who love them just for who they are... will sink less and swim more." ([37:15])

[49:14] Glennon Doyle and Abby Wambach share personal anecdotes about handling their children's experiences in competitive sports, highlighting the emotional rollercoaster and the relief found in authentic support beyond achievements.

Embracing Life's Hardships and Finding Meaning

[41:13] Dr. Lembke connects the episode's theme to broader philosophical and spiritual concepts, referencing Buddha's Middle Way—the balance between extreme pleasure and asceticism.

"We're trying to figure out how do I live in a homeostatic balance and not reach for pleasure and not reach for pain." ([41:13])

She advocates for purpose and meaning over the pursuit of happiness, suggesting that aligning life with one's values offers a more sustainable form of fulfillment.

Abby and Glennon discuss the importance of non-attachment and the courage to embrace life's inherent challenges without constantly seeking dopamine-driven escapes.

"We don't have to reach for all the quick fixes because if there's not a problem, there's just life." ([56:12])

Conclusion

The episode culminates in affirmations of resilience and community support. Dr. Lembke, Glennon, and Abby emphasize that while life is inherently challenging, understanding the brain's mechanisms can empower individuals to navigate hardships more effectively. They encourage listeners to seek meaningful connections and embrace the hard parts of life as avenues for growth and deeper fulfillment.

Notable Quotes:

• Dr. Anna Lembke:

  "Pleasure and pain are co-located in the brain... they work like opposite sides of a balance." ([04:56])

• Glennon Doyle:

  "Learning about dopamine... took so much shame away." ([14:26])

• Dr. Anna Lembke:

  "People with addiction have bionic supersonic pleasure pain balances that are mismatched for our current environment." ([16:01])

• Dr. Anna Lembke:

  "The long term fix is actually to restore homeostasis... abstain from your drug of choice for long enough." ([28:59])

• Dr. Anna Lembke:

  "We're trying to figure out how do I live in a homeostatic balance and not reach for pleasure and not reach for pain." ([41:13])

• Abby Wambach:

  "We don't have to reach for all the quick fixes because if there's not a problem, there's just life." ([56:12])

This episode offers a profound exploration of how our brain's pursuit of dopamine-driven pleasure can lead to various forms of addiction, both clinical and behavioral. Through Dr. Lembke's expertise and the hosts' personal insights, listeners gain a deeper understanding of the underlying mechanisms of addiction and practical steps toward achieving a balanced, meaningful life.