August 09, 2019

#Dopamine #Fasting Is The Hot New #SiliconValley Trend

Dopamine Fasting - The Hot Silicon Valley Trend

Dr. Cameron Sepah | 7 Aug 2019

In the age of the "attention economy", many of us are highly overstimulated at best and addicted at worst, and we don't even know how bad our behavior is. As I wrote about, Americans spend a whopping 11 hours a day engaging with media of some kind! It's unclear what the long-term implications of this overstimulation are on our brains, but in my experience working with executive clients in my private practice, I've observed that this interferes with our ability to focus/sustain attention, regulate our emotions in healthy/non-avoidant way, and enjoy simple/mundane tasks that seem boring by comparison. So what's the treatment?

What is Dopamine?

Dopamine is the neurotransmitter in our brains that's responsible for motivation and reward. Dopaminergic drugs (e.g. stimulants such as Adderall, cocaine, & methamphetamine) act on dopamine receptors like a key opening a lock, and over time, downregulate these receptors and makes us less sensitive to dopamine. This requires using more and more of the drug to get the same effects, thus starting the cycle of addiction. But even behaviors such as gaming or gambling can become problematic through the motivation and rewards of near misses and wins.
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This is not to demonize dopamine; it's an important brain chemical, and people who are low in it (whether naturally or by taking antipsychotic medications) can be lethargic, emotionally flat, and anhedonic (taking little interest of pleasure in things). And properly-prescribed dopaminergic medications can help people with ADHD & Parkinson's improve their ability to focus and regulate their behavior. Rather, the point is to give our brains a chance to go through a purposeful withdrawal from dopamine overstimulation that lets our brains return to balance and homeostasis.

What is Dopamine Fasting & Why Do It?

No alt text provided for this image Just as intermittent fasting has become all the rage in Silicon Valley and beyond, I am popularizing "dopamine fasting" as the antidote to our overstimulated age. Dopamine fasting has precedent from psychiatric practice. As a clinical professor of psychiatry, my residents often prescribe stimulant medications like Adderall or Ritalin to patients with ADHD. Patients are sometimes advised to take "drug holidays" by taking it for the 5 days it helps them work/study, and take 2 days off on the weekend when it's less important, in order to avoid building a tolerance to the drug, where the effects fade and you increasingly need a higher dose. 

Regardless of whether we are stimulating our dopamine receptors exogenously (from outside the body by taking a stimulant drug) or endogenously (from inside the body, by engaging in a stimulating behavior), the same principle applies. A benefit of dopamine fasting is that it helps retain the pleasure of the behavior instead of getting tired of it. More importantly, you are training yourself to have more control and flexibility over whether or not you engage in a behavior (e.g. choosing not to procrastinate when it's important).

What to Dopamine Fast From?

No alt text provided for this imageIn my clinical experience, I find the behaviors that are most problematic/prone to addiction are:
  • Pleasure eating
  • Internet/gaming
  • Gambling/shopping
  • Porn/Masturbation
  • Thrill/novelty seeking
  • Recreational drugs 

This list is neither inclusive nor exclusive. I've seen versions of "dopamine fasting" that say absolutely no digital devices, but I find this to be missing the point. For example, browsing compulsively through various articles on your phone can definitely be addictive, while reading a single book on a Kindle Paperwhite device (which has no options for distraction) is probably fine. To decide what to fast from, simply regard whether it's highly pleasurable or problematic for you, and thus you may need a break from.

The Schedule

No alt text provided for this imageA suggested schedule for dopamine fasting is as follows:
  • 1-4 hours at the end of the day (depending on work & family demands)
  • 1 weekend day (spent it outside on a Saturday or Sunday)
  • 1 weekend per quarter (go on a local trip)
  • 1 week per year (go on vacation!) 
Again, these are guidelines, not strict rules. If it's easier to start by dopamine fasting for 1 hour a day (vs. 4 hours a day), then go for it, and then try to ramp up to what you're willing to do and sustain long-term (e.g. 2 hours/day). Perfect is the enemy of good. So like Nike: just do it. Let's now tackle each of the six major vices in turn:


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