Reading notes for "Dopamine Nation" (2021), by Anna Lembke

In this book, the author, a psychiatrist, recounts stories from a few of the patients of her clinical practice.

What I find interesting about this story-driven approach is that it “puts a face” on each of the struggles related, which in turn makes each story more relatable and memorable.

I think the overarching theme is that we've -- as humans, as a society -- worked so hard to eliminate every inconvenience and every painful experience that we've also inadvertently stopped enjoying simpler pleasures.

(Of course the above is not a reality for every income level and every country, but the point is that “even” individuals in the richest-countries are being diagnosed and medicated for mental health issues at an unprecedented rate. Kindly let me sidestep all of these valid societal inequality concerns.)

The book reports how individuals from her practice -- or even the author herself -- engaged in self-destructive addictive behavior that put them away from their own goals, but that they weren't able to let go of doing.

A major insight from that fact is recognizing that the behavior has some function, which is often avoidance through distraction from hard feelings or thoughts.

The author then goes on to explain the biological mechanism where dopamine acts in the brain. I previously though that dopamine was a neurotransmitter related to pleasure, but it is more accurately described as the neurotransmitter related to the anticipation of pleasure. It's responsible for the wanting and craving.

Our brains are capable of adapting to just about every circumstance, good or bad. This mean that we can get used to a constant series of positive experiences, start assuming that as the new “normal” baseline, and start perceiving even a minor inconvenience as a major setback or frustration.

In short, over time, we are wired to develop tolerance to recurring experiences -- including pleasurable ones -- and start seeking ever more extreme forms. When the supply unavoidably ends, the balance then tips on the opposite side and we may feel miserable, despite nothing objectively bad actually occurring.

The antidote to that? Accepting that pain is an integral part of life. It is not the goal to avoid every painful experience or hardship, we should not try to live despite our painful experiences, but instead, we should try to live with our pain.