Sawbones: Dopamine Detox

Speaker 1 Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun.

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Speaker 1 Pushed on through the broken glass and had ourselves a lucky run. The medicines, the medicines, the escalat macabre

Speaker 1 Hello, everybody, and welcome to Sabo. It's a marital tour of misguided medicine.
I'm your co-host, Justin McElroy.

Speaker 2 And I'm Sidney McElroy.

Speaker 1 Oh, it's so good to be here with you. So, we didn't talk about our introduction.
Usually, we brainstorm somewhat.

Speaker 2 No, usually you just kind of launch in with a.

Speaker 1 Oh, I was using the royal we. Sorry, I should have been more clear.
Yes, I, King Justin, usually come up with the bit.

Speaker 1 And actually, this week's bit is that I've started using the royal wee, apparently, and calling myself King Justin.

Speaker 2 How's that grab you? I love it. I think it's a fair distribution of labor since I do all the research for the podcast.

Speaker 1 And I do all the jokes. Some of the jokes.
Occasionally do some of the jokes.

Speaker 2 I think it's fair to say you do most of the jokes.

Speaker 1 I hung up the lights in the room and I point the microphones.

Speaker 2 You decorated.

Speaker 1 I decorated.

Speaker 2 I point the microphones. You do point the microphones.
I refuse to learn how to point the microphone.

Speaker 1 So I got that's my skill. I keep myself relevant.
But don't fight.

Speaker 2 You also keep changing the microphones.

Speaker 1 So important. That's how I keep myself relevant.
You know, without me, you would leave me for someone more capable

Speaker 1 because you would have the microphone thing figured out. So as long as I keep you sort of like dependent on my microphone pointing skills, then you, you will stay with me.

Speaker 2 That's my theory. I think we've entered into a lifetime pact with our podcast, though.

Speaker 1 Not the kids.

Speaker 1 No. Podcast.

Speaker 2 Yeah. Okay.
No, no, I mean,

Speaker 2 you know. Come and go.

Speaker 1 But podcasts?

Speaker 2 The podcast. I could, I mean, could I raise the kids on my own? Yeah.

Speaker 1 But we're talking, yeah, could you raise the kids on your own? But like, could you make TalkTua on your own? I don't think so. No, I don't think so.
Talk to a is the Hawk to a girls podcast.

Speaker 1 I wish I was lying. Welcome to Sawbones, a marital terror of this guy and message.
Sid, what are we talking about this week?

Speaker 2 Justin, you gave me the topic we're discussing this week.

Speaker 1 You know,

Speaker 1 the algorithm, my algorithm is not as bad as Sydney's, but she has sent me enough links that every once in a while I start getting some wild stuff. And the marketing, I feel like

Speaker 1 in the TikTok era, the marketing is so specific that it starts to get pretty scary, right?

Speaker 1 Because they start talking about like, well, okay, we have your algorithm and the AI has generated a song based on traits that we've noticed about you. And maybe this is the problem all along.

Speaker 1 So it's a very, it's a very unnerving thing to pop up in your feed.

Speaker 2 Justin, I think you need to do some soul searching because there was nothing, one, that I'd ever researched about this topic before. Right.
So I would, two, never have sent you links about it before.

Speaker 2 And three,

Speaker 2 I have not.

Speaker 2 Now, now I have that I've researched this topic, but prior to this, I didn't know that this was a popular medicine wellness. I mean,

Speaker 2 I had no awareness. I got no ads, no nothing.

Speaker 1 To be clear, I just meant that my algorithm thinks I'm open-minded health-wise.

Speaker 1 I'm open-minded from a health perspective.

Speaker 2 I think your algorithm may suspect that you would be interested in a dopamine detox.

Speaker 1 Yes, dopamine, the,

Speaker 1 I feel like it's become such a buzzword in the last 20 years.

Speaker 2 This is so, this is so strange to me. I mean, I'm obviously familiar with dopamine, and I guess I understood that maybe there was some popular ideas about dopamine, but the ads you showed me

Speaker 2 related to dopamine were truly surprising. I had no idea that the discourse is what it is.

Speaker 1 That is, that's thrilling, Sydney. That's really exciting for me because

Speaker 1 this has bombarded my feed enough times that I'm glad to know that it is an outlier and that I am outside the.

Speaker 2 Would you like to sort of give a general idea of what the ads, especially the ones you showed me?

Speaker 1 I will say this. We try to keep the show pretty like language, family-friendly.

Speaker 1 These ads are pretty buck wild. So we will be talking about some adult buck wild content in this episode.

Speaker 1 The ads that I started getting were about like

Speaker 1 not,

Speaker 1 it was like an addiction to dopamine. Basically, an addiction to stimulus.
You're like overstimulated. And that addiction is making you seek out like

Speaker 1 too much, like over over-masturbation, like, too much masturbation or masturbation, like addiction. And, like, so, like, regular intimacy isn't enough, and you don't feel creative.

Speaker 1 And it's all because of this, like, dopamine addiction that you have. And it's also weird because it's like this claymation art style that is clearly like all AI generated.

Speaker 1 And there's this AI-generated song. And I can't click the like, please don't show me AI stuff ever again button fast enough.
Hypersexuality and procrastination procrastination are interconnected.

Speaker 1 You might think you're procrastinating

Speaker 1 because you're lazy, but the real culprit is dopamine.

Speaker 1 But yeah, that is the vibe. It's like so surreal.

Speaker 2 It felt very, um, very similar to like a low-tee commercial to me.

Speaker 2 Yeah, it seemed very centered on like dopamine as having something to do with like there's a sad animated figure in a bed with another sad animated figure and one is sort of like peering under the covers forlornly and the other one is looking very like disappointed yeah and that's it yeah that is a weird

Speaker 2 like dopamine to there that bridge to me is a wild and i'm gonna take us on this journey but i still don't know that i fully understand how we've

Speaker 1 I mean do you do you understand do you not do you understand the the fake connection that the ad is trying to make?

Speaker 2 No, I understand the fake connection. I guess I just, there are lots of fake connections you could make.
This is a weird one. I understand why testosterone has.

Speaker 2 There's real information out there about testosterone, and then there's a lot of misinformation and kind of pseudoscience about what would taking testosterone do for a person.

Speaker 2 There's a lot of misunderstanding there. And I think people sometimes think it is a bit of a cure-all,

Speaker 2 especially for somebody who is assigned male at birth, any problems they're having.

Speaker 2 That is not

Speaker 2 all true. Dopamine is a weird plug-in to that sort of milieu,

Speaker 2 to my science mind, to my medical mind. I don't know how this happened, but I'm going to take you through the pseudoscience.
Okay, dopamine.

Speaker 1 Arvid Carlson discovered dopamine.

Speaker 2 He was a pharmacologist.

Speaker 2 He actually won a Nobel Prize for discovering, for his contributions to the neurotransmitter dopamine, to our understanding of it.

Speaker 2 He was, he went to medical school back in 1941. He

Speaker 2 was in the Swedish Armed Forces for a while, went back and studied. I mean, his main area of study were neurotransmitters in the brain and how do things work.

Speaker 2 At the time, we really didn't understand that there were different neurotransmitters that were distinct.

Speaker 2 And a neurotransmitter is, think of it as a chemical in your brain that is sending a signal from like neuron to neuron, brain brain cell to brain cell.

Speaker 1 Okay.

Speaker 2 By sending these little chemical signals, we're communicating things. We're changing thoughts, feelings,

Speaker 2 behaviors, movements. You know, we're making the brain work.
Okay. Right.
There are lots of neurotransmitters, not just dopamine. Many,

Speaker 2 I will say, which have entered our popular understanding. For instance, another neurotransmitter is serotonin.

Speaker 1 Limitless Bill. Oh.

Speaker 1 Sorry. Yeah, serotonin.

Speaker 2 Serotonin. And what do we think about serotonin?

Speaker 1 It's like the happiness chemical, right? You get serotonin and you're happy.

Speaker 2 We have a cultural understanding of serotonin. It is not complete.
It's more complex. But that's, I mean, that's often true in medicine.

Speaker 2 We kind of have a popular understanding and then the scientific nuance. So dopamine is another neurotransmitter.
At the time, we thought that it was just...

Speaker 2 a precursor of a different neurotransmitter, meaning that like it was a step in the production of norepinephrine, which does other things in the brain. But that's not true.

Speaker 2 Dopamine is its own distinct thing that has its own distinct activity within the brain.

Speaker 2 And basically in 1957, Dr. Carlson was the first guy to say, this is a different thing.
Okay. And he developed a way to measure dopamine in the brain.

Speaker 2 He found where the highest amount, there's actually a pretty localized area in the brain.

Speaker 2 where dopamine primarily comes from in the in the part of the brain the substantia nigra it doesn't really matter the point is dopamine comes from this one particular part of the brain primarily.

Speaker 2 And he was able to understand that. And then from there, he was able to understand, it's kind of interesting.
So you know that dopamine's there. You're trying to figure out what it does.

Speaker 2 So he blocked it.

Speaker 1 Oh, okay.

Speaker 1 How do you feel about it? Yes.

Speaker 2 What happens when you don't have it? And what he noticed was this loss of movement control primarily.

Speaker 2 I know this is going to sound weird because of our sort of cultural understanding of dopamine, but the first things we noticed is that if you didn't have dopamine, the symptoms that were produced looked like Parkinson's.

Speaker 1 Oh, hmm.

Speaker 2 Because Parkinson's primarily is a lack of dopamine.

Speaker 1 Oh, huh.

Speaker 2 I didn't realize that. I know.
That's why I think, and maybe this kind of explains why this was weird for me, this sort of connection.

Speaker 2 that you were building around, not you personally, but you know, the ads you were getting about dopamine.

Speaker 2 Because to me, when I think medically, dopamine, a lack thereof, is responsible for the symptoms we see in Parkinson's, which is also why, and this is something that he figured out,

Speaker 2 one of the treatments for Parkinson's is dopamine, L-DOPA.

Speaker 2 You can give someone replacement dopamine to help manage the symptoms of Parkinson's.

Speaker 1 That's fascinating.

Speaker 1 I never knew it was part of that.

Speaker 2 Dopamine is part of what initiates movements.

Speaker 2 So there's the gap between

Speaker 2 I want to raise my hand, I am raising my hand dopamine is part of that pathway okay okay so without dopamine and you can see this in some in some of the symptoms of parkinson's disease somebody wants to take a step forward and it takes them a while to initiate that movement

Speaker 2 okay gotcha okay so those were our first understandings of dopamine now i think it's interesting if there's not enough dopamine this is what things look like dr carlson began to wonder well if there's too much dopamine okay what would the

Speaker 2 you know or for instance, if you gave somebody L-DOPA and they didn't need it, what kind of, what would happen, right? What happens to the brain with too much dopamine?

Speaker 2 And what he began to see were symptoms related to what he perceived as schizophrenia.

Speaker 2 And so this became the dopamine theory of schizophrenia, that primarily what we what we have dubbed schizophrenia, the symptoms related to schizophrenia, hallucinations and delusional thinking, that it is connected to too much dopamine or overactivity

Speaker 2 of dopamine in the brain. And I will say at this point in history, we have a more nuanced understanding of psychotic disorders in general and schizophrenia.

Speaker 2 It's not as clear-cut as not enough dopamine equals Parkinson's, too much dopamine equals schizophrenia. There's more nuance.
There are other neurotransmitters involved.

Speaker 2 Glutamate plays a big role, we think, now in schizophrenia. And I won't get into this.
This isn't an episode about schizophrenia.

Speaker 2 But the point is, I don't want to leave you with the message that this is this simple. Yeah.
Like a lot of things with the human brain, it's all really complicated. It's all very nuanced.

Speaker 2 And there's lots of stuff happening to produce a certain constellation of symptoms. And then it will look different in different individuals.

Speaker 1 It's also, it also, I think,

Speaker 1 lends itself to misunderstanding so much because we think so much about how our brains work. I think that everybody wants to believe that they're just sliders.

Speaker 1 That if you just move them up a little bit, it's like, oh, that did it. Yep, that's got it.
That's working better.

Speaker 2 And I think, I mean, I think that's one of the problems. We talk about this, I think, a lot on the show.

Speaker 2 One of the problems with modern medicine where there are some things we kind of figured out and are like, we'll treat this with this.

Speaker 2 It starts to make you believe that perhaps everything in medicine could be that way once we figure it out. We'll just take this pill for that.

Speaker 2 And I think like antibiotics are the beginning of that for me usually.

Speaker 2 We figured out that if you have an infection with this bacteria that is killed by this substance, which also doesn't kill you, so that's groovy.

Speaker 2 We can put that substance in your body, kill the bacteria, and you get better. That's so clear-cut.
That's so, that's such a

Speaker 2 simple idea.

Speaker 2 It's very

Speaker 2 attractive to think that everything in medicine could be that way.

Speaker 2 And the truth is, especially when it comes to, you know, psychiatry, behavioral medicine, neurology, the function of the human nervous system,

Speaker 2 it's just nothing is that clear-cut, really. Right.

Speaker 2 So anyway, what we figured out is that there is, dopamine definitely does play a role in psychotic disorders like schizophrenia.

Speaker 2 And you will see that a lot of the medications that were then developed to treat those conditions were aimed at reducing dopamine. Not just that.

Speaker 2 There are obviously other things that they do, but that was part of the process. So from a medical standpoint, and I'm not saying this is everything we ever know about dopamine, this is all it does.

Speaker 2 But when you start talking about dopamine,

Speaker 2 these are the initial things I think about

Speaker 1 are

Speaker 2 neurological, psychiatric disorders. Obviously, we know that dopamine also has something to do with

Speaker 2 developing.

Speaker 2 I don't even want to use the word addiction yet, although that is where I'm kind of driving.

Speaker 2 The desire to to repeat a behavior.

Speaker 2 Right. Yeah.
We know that if we do something that is pleasurable, dopamine is released, connecting that activity with the pleasure that we feel.

Speaker 2 Now, I will say a misunderstanding of this is, is dopamine causing us pleasure?

Speaker 1 I don't know.

Speaker 2 Dopamine alone is not responsible for this connection. Okay.
When you do something pleasurable,

Speaker 2 you are also releasing hormones like, or neurotransmitters like serotonin, oxytocin, endorphins.

Speaker 2 There are other pieces to this, right? It's not just the dopamine. The dopamine helps make the connection.
Okay. Yes.

Speaker 2 And this is why when we start talking about addictive behaviors, things that we crave, things that we seek to do again to bring us pleasure, this is where dopamine starts to enter the picture.

Speaker 2 Because it is true, you know, you, what's something that brings you pleasure?

Speaker 1 Me,

Speaker 1 you.

Speaker 2 Rated for this show.

Speaker 1 Rated for this show? Yeah.

Speaker 2 Whatever that is, PG.

Speaker 1 Yeah.

Speaker 1 Yeah. Organizing the silverware drawer.

Speaker 1 Okay.

Speaker 2 That's a great, that's a great example. Thanks.
That everyone, I think, can sympathize with.

Speaker 1 Okay, cool. Sympathize was an interesting choice of words that you did on Prompted.
Hmm. Hmm.

Speaker 1 Let me tumble that one around in the old noggin for a second.

Speaker 2 Okay. Got it.
How do you feel when you organize the silverware drawer?

Speaker 1 I used to feel happy, but I have a sneaking suspicion that it may not hit the same anymore.

Speaker 2 Do you crave organization of the silverware drawer?

Speaker 1 Do you think about it? I don't know the answer to that as well as you know my name. Of course, I crave organization in the drawer.

Speaker 2 No, but do you think about it when you're not doing it? Do you do you have the impulse to go do it?

Speaker 1 Okay, I want, can I give you a better example?

Speaker 1 I feel like maybe organization of the silverware drawer, while it does bring you pleasure is not quite i'm gonna give a better i'm gonna bet give us a better example i'm gonna give a better example uh solving the the crossword puzzle i for a while i was doing it every single day okay okay

Speaker 2 when

Speaker 2 you uh haven't done it yet in the day you know it's early in the day or maybe it's even later this could be a better example you're realizing the day is almost over and you haven't solved the crossword puzzle oh how do you feel bad

Speaker 2 do you you feel like you need it you need it How do you feel when you sit down and solve the crossword puzzle?

Speaker 1 Good.

Speaker 2 Right.

Speaker 2 So

Speaker 2 that sensation is not purely dopamine related. Dopamine had something to do with that, right? Dopamine was released the first time that you solved that crossword puzzle and felt pleasure.

Speaker 1 Right. It's the same as your...

Speaker 1 One of my favorite analogies for cigarette addiction is that it's like you're wearing an uncomfortable pair of shoes and that what you're really looking forward to all day is not smoke.

Speaker 1 It's taking off the shoes that you are currently wearing. And that's the pleasure: ah, I'm no longer wearing the shoes.
You know what I mean?

Speaker 1 It's not putting on the slippers, it's ah, thank God those things are off.

Speaker 2 And this is definitely connected to our developing an addictive behavior, right? And

Speaker 2 I will say that the difference between solving a crossword puzzle and the amount of dopamine that is released in that scenario, and

Speaker 2 let's say using methamphetamines,

Speaker 2 exponentially different. different.
So I think that it's really important in these conversations that we not sort of paint the addictive behaviors with a single brush.

Speaker 1 Yes.

Speaker 2 Because it, I think you're in danger of undermining the seriousness of certain addictive behaviors and the difficulty in ceasing them, as opposed to if you knew that doing the crossword puzzle was dangerous to your health.

Speaker 2 Just based on dopamine alone, my suspicion is it would be easier for you to stop doing the crossword puzzle.

Speaker 1 So,

Speaker 1 yes and no. Obviously, I wouldn't draw a parallel between like some of these substances you're drawing,

Speaker 1 but I have known people who in my life who have gone down the rabbit hole of some activities, enough gaming specifically, to where other parts of their life suffer and where their health suffers and where some parts of their life suffer.

Speaker 1 So, I do think I've seen it take a hold on people in a dependent sense.

Speaker 1 And I don't think that's dopamine, but I've seen some people where that's the only control they have in the world. And that is like, it becomes monumentally important in that sense.

Speaker 2 I think what you're hitting on here, though, and this is what we're going to talk about as we transition into, here's the science of dopamine.

Speaker 2 What are these other ideas? And I haven't even, let me say, this is not complete. I wanted to give you some background on our understanding of dopamine historically.

Speaker 2 Obviously, we know that dopamine plays a role in these different behaviors and that modulating our connection with them, breaking that sort of like pleasure that we feel when we experience that thing, whatever the, whether it's a cigarette or playing a video game, whatever it is, could be useful in stopping that behavior, right?

Speaker 2 What I want to challenge primarily is this concept of dopamine addiction and a dopamine detox as useful to your health and wellness and also just to sort of where did it come from.

Speaker 1 Okay. so we're going to talk about that all right let's do it after the billing department ah well let's go the medicines the medicines that escalate my cop before the mouth

Speaker 1 if you just don't know where to get started with a big a big project my

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It's a metaphor.

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Speaker 2 Oh, I knew all about the gift time.

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Speaker 1 All right, Sid.

Speaker 1 I'm ready.

Speaker 2 Okay, so I was trying to trace where did dopamine shift from a neurotransmitter that we understand as important in neurology, psychiatry, and then definitely an emerging understanding of addiction, substance use disorder, all kinds of addictive behaviors, right?

Speaker 2 Okay, we knew all that. That's under investigation.
We are still perfecting the best ways to manage.

Speaker 2 you know, substance use for as an example.

Speaker 2 But in 2019, there was an article that came out by Dr. Cameron

Speaker 2 Sipa, who wanted to talk about, this was on LinkedIn.

Speaker 1 Sure. His article.

Speaker 2 So when I say an article, I mean like he, like a the old standard. No, I don't mean like a peer-reviewed journal article.

Speaker 1 I mean

Speaker 1 he wrote a blog.

Speaker 2 He wrote a blog.

Speaker 1 Yeah. Okay.

Speaker 2 He's a he's a psychologist who primarily works with like CEOs. He's like a executive psychologist, I believe.

Speaker 1 Sure, luxury concierge psychologist.

Speaker 2 Well, I think that's helpful to know that that's his focus. This is not me.
I'm not demeaning any of this work at all.

Speaker 2 I am simply saying that, like, the idea of peak performance is very much where we're driving here. Right.

Speaker 2 He wrote an article on LinkedIn called The Definitive Guide to Dopamine Fasting 2.0, The Hot Silicon Valley Trend.

Speaker 2 So

Speaker 1 that I made it.

Speaker 1 I know. I'm guessing.
I have no idea.

Speaker 2 I'm just pulling that out. I don't know that it, I think this was already sort of a trend among the kind of like tech genius, millionaire, Silicon Valley.
Um,

Speaker 2 these are the same people who are trying to like live forever. You know what I mean?

Speaker 2 Like, that whole, that whole idea that through technology, longevity, yeah, yeah, we can do a bunch of stuff to ourselves, even though it's not a problem.

Speaker 1 Neurotropic, maybe, maybe some nootropic, absolutely.

Speaker 2 And I mean, if it feels a little limitless, Pill,

Speaker 2 I mean, I assume that I assume that movie grew out of this sort of of milieu.

Speaker 1 So, yes. Yeah, I think so.
I think that people saw a limitless pill and they're like, God, I wish there was a limitless pill, which we all do. Of course, we all watch a limitless pill.

Speaker 2 Sure. So

Speaker 2 what Dr. Sipa recommended was that

Speaker 2 dopamine is a problem for us because we are.

Speaker 2 We are so overstimulated. There's so much around us all the time.
And a lot of this is tied to screens. Now, there are other things.
He's going to talk about other other things.

Speaker 2 It's not just tied to technology and screens, but I think for a lot of people, they focused in on time on their phone, time on their computer,

Speaker 2 primarily time spent.

Speaker 1 See new things. It would be the thread.

Speaker 2 Yeah. And primarily time spent with like social media and that kind of thing.
Right. Okay.
So all of this stimulation is.

Speaker 2 overwhelming us and we're we're just getting constant releases of massive amounts of dopamine right to the point that we can't feel that rush when we actually experience pleasure.

Speaker 2 It's like we're up here all the time, and so we don't feel those normal peaks and valleys. Does that make sense? Yeah, yeah.

Speaker 1 We're like

Speaker 2 our tolerance has gotten so high for dopamine.

Speaker 1 Desensitized.

Speaker 2 And so what we need to do is

Speaker 2 detox or fast or whatever you want to call it, break your addiction to dopamine by reducing

Speaker 2 whatever these behaviors are.

Speaker 1 Okay.

Speaker 2 Right. And he ties it very much to like, this is what

Speaker 2 all of these like tech CEOs, all these millionaires, all these,

Speaker 2 I don't want to say, I keep wanting to say dudes because a lot of the, a lot of the way it's couched feels very

Speaker 2 manosphere, you know, manosphere because it is, I think. It does.

Speaker 2 But I mean, to be fair, he never says this is just for guys. I mean, that is never explicitly.

Speaker 1 It says boys only here on the screen with a big Z. It says no.

Speaker 2 But I think like

Speaker 2 it makes sense that you have gotten ads for this sort of stuff and I never have.

Speaker 1 Yeah, of course.

Speaker 2 They're targeting you as a demographic, right? Okay.

Speaker 1 You got the low-T ads, too.

Speaker 1 You know.

Speaker 2 Well, there you go.

Speaker 2 I get ads for

Speaker 2 romantic books about werewolves. There you go.

Speaker 2 And underwear. Okay.

Speaker 2 Those are probably tied together.

Speaker 1 Algorithm. Probably tied together.

Speaker 2 And now dopamine. So what he said is, okay, first of all, he says this is based on cognitive behavioral therapy or CBT, which is real therapy.

Speaker 1 Real.

Speaker 2 And in some ways, this is absolutely true, right? Like there, there are elements of CBT in everything we're talking about.

Speaker 2 The idea that you do something, there's a behavior in your life that is bringing you displeasure, that is infringing on your ability to live a quality life, that is harming yourself or others around you, and you would like to stop it.

Speaker 2 And you engage in CBT techniques in order to reduce this behavior in your life and then enjoy a happier, more quality life.

Speaker 1 It's better. Yeah.

Speaker 2 Like that's, and that's fine. Like, there's no, this is all real.
And you should engage in CBT if it is needed, right?

Speaker 1 And helpful. And helpful.
It doesn't work for everybody. Right.
Yes. We're at every problem.

Speaker 2 Nothing works for everybody.

Speaker 1 No fair. Agreed.

Speaker 2 So he said, first of all, put the stimulus away, make it harder to access. Okay.
Right.

Speaker 2 Engage in something alternative

Speaker 2 and prevent yourself in ways from doing the thing, you know, put in safeguards.

Speaker 2 Kind of like when you,

Speaker 2 I've seen the phones that people have now that are like the no,

Speaker 2 what are they called? It's like no distraction phones.

Speaker 1 Yeah, they're just like big screens that you can make phone calls and that's it.

Speaker 2 And like your apps are all hidden and you have to like search for them if you want to find them and stuff like that. Like put in safeguards for yourself.
Yeah. So like I get that.
Yeah.

Speaker 2 And so like some really basic things.

Speaker 2 And and this kind of grew into a lifestyle from these like basic, and these are really, these are like CBT techniques, right?

Speaker 2 To try to reduce the importance of something in your life in pursuit of happiness. Um,

Speaker 2 he went on to talk about like fasting schedules. And I think people really like the idea that they're doing something when they're not doing something.
I think that's so attractive to us, right?

Speaker 2 So, like, if right now I am not using my phone,

Speaker 2 even though I'm not doing anything, I'm doing something.

Speaker 1 It's like part of why,

Speaker 1 aside from the convenience, washing machines and dishwashers are so powerful. Yes.
Because you hear that sound and you think, I, through the power of technology, am washing dishes.

Speaker 1 In some sense, I am washing dishes right now.

Speaker 2 It's how we can. It's a huge boost.

Speaker 2 I can do the laundry for an entire day. Oh, yeah.

Speaker 1 But only in the first place. What did you do today? The laundry.

Speaker 1 Right. Okay.

Speaker 2 So he put out like a schedule.

Speaker 1 And and she was and 500 pages of werewolves having sex with vampires but also the laundry

Speaker 2 don't shame me you read it too didn't shame i'm not shaming you i'm just reading you're really really productive so he put out like a fasting schedule and a feasting schedule like this is you don't let yourself do whatever it is for these hours of the day sure you engage with it intensely for certain blocks of time

Speaker 2 Which is, I mean, that's true. Like, if you just say, I'm putting down my phone and never picking it up again, that's not helpful, right? We know that, like,

Speaker 2 trying to wean down a behavior typically is more effective than a cold turkey approach.

Speaker 1 Yeah, I guess that makes sense.

Speaker 2 I mean, within reason, if you're, if the thing you're trying to quit is murder, I would say cold turkey would be better.

Speaker 1 But.

Speaker 1 See, this is where it breaks down for me a little bit because I tend to think that like resetting your brain chemistry is more powerful here.

Speaker 1 Like just trying to like change something very major and then letting your brain like settle back down. Because Cause I think that this to me feels like, ah, finally, my brain is calm.

Speaker 1 Then you like jack back into the phone. It's like, ah, it's all there.
Like, it's all, I don't know. It feels like that up and down feels a little bit chaotic to me, but I don't know.

Speaker 1 I'm not a therapist.

Speaker 2 Well, I think what you're presupposing, though, is that any exposure is bad.

Speaker 1 No, I don't mean that. I just mean like I never, you never know what's going to be on there, I guess is my fear.

Speaker 2 He also, he, so he ties it, like it very much starts with technology, but then he kind of, this is where I think all this other stuff came from.

Speaker 2 So he expands it to emotional eating, internet gaming, internet slash gaming, gambling slash shopping, porn slash masturbation, thrill slash novelty seeking, and recreational drugs. Okay.

Speaker 2 Which again, this is just, I just think that this is.

Speaker 1 He's just sin. He's just doing sin.
Right. Like, it's just like, here's the sins you can have.

Speaker 2 And then he goes through like, here are all the things that are bad. And like, this is, and again, we're getting into pseudoscience here because he's like, emotional eating is bad.

Speaker 2 A lot of this is tied to intermittent fasting i should say that the intermittent fasting community kind of morphed not everybody it's not one-to-one but like there is a connection here between this and the dopamine detox that there are definitely ties people who were like well i don't eat for all these hours of the day and i feel so incredible because i'm so hungry.

Speaker 2 And so if I don't do these things for these hours, I'll also feel incredible. Like there's definitely a tie there.
And when he talks about food, it's in not,

Speaker 2 I mean, he talks about the dangers of ultra-processed foods,

Speaker 2 the dangers of sweet, salty, savory, spicy, and carbs and fat.

Speaker 2 It's almost all food.

Speaker 1 Yo.

Speaker 1 It's almost all food.

Speaker 2 And I mean, he like, as an example, he talks about pretzels. If pretzels are your vice.

Speaker 1 Then you're doing fine. You're doing fine.
Just eat pretzels, for God's sake.

Speaker 2 Obviously, he talks about internet and about gaming. Talks about internet.
Yeah, like these are problems. Social Social media, the clicking, the scrolling, the

Speaker 2 this is, I think, our like perception of dopamine. You're just like,

Speaker 2 and that's what you're looking for.

Speaker 2 Gambling and shopping, he kind of breaks this down that like boys gamble, girls shop. I don't know about that.
I think anybody can do whatever they want.

Speaker 1 This,

Speaker 1 this is, this is not all right.

Speaker 2 I don't even want to describe this picture. He has graphs, he has images, like stock photos for all of these.
The one for porn and masturbation is.

Speaker 1 It's a sliced ham.

Speaker 2 Let's not, yes.

Speaker 2 And he talks about, this is where this kind of comes into it, that like porn is okay, but how are you using?

Speaker 1 Can you read this first sentence, actually?

Speaker 1 Can you read that sentence?

Speaker 2 There's nothing intrinsically wrong with occasional porn viewing or masturbation for the person doing it, leaving aside the social implications for now. Okay, so stop there.

Speaker 1 If you have to clarify that, as a physician writing a blog post, you have already messed up so fundamentally. If you need to clarify that, like, masturbation isn't bad.

Speaker 1 Like, yeah, yeah, dude, you're a doctor. I didn't think for a second.
First of all, what does bad mean or wrong? There's nothing wrong. Like, what are you talking about? There's nothing wrong with it.

Speaker 2 Well, and he goes into...

Speaker 1 I assume because you're an adult, you don't think anything's wrong with masturbation, whatever that means.

Speaker 2 It's really interesting because there's obviously so much like societal taboo, and then there's like religious underpinnings to our different like belief structures around masturbation specifically, and then pornography that you're getting into a whole other

Speaker 2 human mess with that things that we feel and think but then he throws sex in there and he says sex is trickier to include in a dopamine fast given there's another person involved and thus maybe hard to schedule yeah by the way so you needed to like When can we dopamine fast together?

Speaker 1 By the way, Doc, you think there aren't other people involved? If I stop gaming,

Speaker 1 what if we needed a raid, man? What if the team needs their warlock, right? And I'm like, sorry, guys, dopamine fast. I can't be there to help you get all the great crystals that we need

Speaker 1 for the adventure. That's the same.
That affects other people. It affects other people.

Speaker 2 But he kind of suggests that maybe sex

Speaker 2 can, I mean, like just inherently could be bad.

Speaker 2 And the reason that he says is if you're doing it impulsively, started without clear intention, compulsively, repeated without clear intention, or high risk, which high risk, health hazardous, okay, set that aside.

Speaker 2 But what do you mean

Speaker 2 started without clear intention?

Speaker 2 I don't even know how to parse that.

Speaker 1 He tripped.

Speaker 2 And then he gets into like thrill-seeking behavior. I mean, basically, anything that makes you have like an adrenaline rush is bad.

Speaker 1 Basically, all good stuff. Like

Speaker 2 recreational drugs, alcohol cigarettes caffeine he says you got to get rid of caffeine too um he talks about like things you could do instead anytime man listen i know i'm a family doctor and i i understand that like nutrition and exercise are part of the things that i was trained to talk about all the time but i am not so naive as to think i could look at somebody who is i don't know i guess

Speaker 2 like cliff diving and masturbating every day and be like hopefully not at the same time that is a hazard. Instead of cliff diving and masturbating,

Speaker 2 have you tried taking a walk?

Speaker 2 Why do we say that to people? That's always the thing.

Speaker 1 Take a long walk. Have you tried taking here?

Speaker 2 That's not as fun as cliff diving and masturbating, I bet.

Speaker 1 Probably not, not at the same time, certainly.

Speaker 2 And so he offers other things.

Speaker 1 And then it says like

Speaker 1 writing and art, like creating stuff. If creating stuff doesn't give you a sense of pleasure, like I think you got bigger problems, man.
Like, if you're like, that's not fun, just making stuff.

Speaker 1 How is that like a TV show at all?

Speaker 2 Now, he gets it down to there's this chart at the bottom where he's talking about in toxicology, we have like the benefit of something at the beneficial dose.

Speaker 2 And then as the dose gets higher, you get into the toxic dose and the harm increases. This is wild to me because dopamine is not a toxin.

Speaker 2 But if you just look at this in the context of dopamine, you would assume that there is a toxic dose of dopamine.

Speaker 2 And unless we're talking about quite literally, ingesting dopamine, which is not what we're saying, right?

Speaker 2 There is not, I mean, you can't do something so much, so fun.

Speaker 1 So fun, you get poisoned.

Speaker 2 Yes, that you experience a toxic dose of dopamine.

Speaker 1 So, okay, I have it.

Speaker 2 I think this is where this came from because since then, it's grown into exactly what you talked about. There are supplements that you can buy that will help you.

Speaker 2 I don't even know what it, what they mean, like support your dopamine detox, break your dopamine addiction.

Speaker 2 There's a lot of stuff out there that's kind of been drawn from this stop masturbating, stop using pornography, where if you stop those things, not only is it sort of insinuated,

Speaker 2 I have to reference this article. Can I reference this article? Sure.

Speaker 2 My dear friend John, who's a psychologist, sent me this article, The Ultimate Test of Self-Discipline, Lockdown, and the NoFAP community,

Speaker 2 which Justin had to explain to me what no fap meant.

Speaker 1 Nice dox. Just a quick doxing for the day.
Thanks, Sid. Appreciate that.
Sister drive-by doxing on your sweet husband. I

Speaker 1 narrow your husband.

Speaker 2 I thought it was funny because I read the whole article and I couldn't find what it meant. And I do wonder if the author.

Speaker 1 She said, I don't know. She said, hey, y'all, here's what she said.
It was actually very precious. She said, I've read this whole thing.
I still don't know what FAP stands for.

Speaker 1 Can I, educationally, should we, should I say that?

Speaker 1 It is a puerile reference to masturbation.

Speaker 2 It's an onomatopoeiate.

Speaker 1 It's onomatopoeic,

Speaker 1 onomatopoetic. We'll move on.

Speaker 1 Okay. So

Speaker 1 I'm just a

Speaker 2 supportive guest. But in this, they talk about, and I have to imagine that this sort of like idea, and I'm not blaming this one psychologist.

Speaker 2 There were lots of these, especially like the executive psychologist kind of community, not just the individuals, but like people who buy into the psychology of success, I think, like that there's a certain right mindset that makes you a successful human.

Speaker 2 Right. And we got to get you into it, which I will argue all day long.
And that has nothing to do with these individuals. I will argue that to the cows come home.

Speaker 2 But I think that from that sort of thought, like I am going to

Speaker 2 withhold pleasure from myself in a variety of ways in order to gain

Speaker 2 better cognitive function, more focus, more intelligence, to experience pleasure more when I actually do a thing. I think that's where this came from.

Speaker 2 This sort of, if I can not, I mean, and really in the, as far as I can tell, in the NOFAP community, it's very clearly like, I'm not going to orgasm.

Speaker 1 Yes.

Speaker 2 I'm going to withhold that from myself

Speaker 2 in every way possible. Yes.

Speaker 2 For as long as possible. Yes.
And

Speaker 2 Some of it, I think for some people is tied to a

Speaker 2 desire to eventually have sex with a partner and experience.

Speaker 2 I've seen that in the article, quote unquote, real sex.

Speaker 1 Yes. Idea being that your drive to do so would maybe be stronger.

Speaker 2 And that it will be better.

Speaker 1 Better.

Speaker 2 That it will be more pleasurable because you withheld.

Speaker 2 But then there's also this sort of like

Speaker 2 mainly in the involuntarily celibate community

Speaker 2 where it is a power within itself that you are preserving some essential masculine energy

Speaker 2 it does start to sound a little testosterone-y because it's like you will be stronger your biceps will be bigger

Speaker 2 you'll you'll be a

Speaker 2 more

Speaker 1 dominant presence in a room so I think yeah I don't even know what the word you know what I mean you you will become alpha yeah I think you will become the alpha yes of the of the territory right

Speaker 1 I I have a theory about this and let me know when you know when you want to hear my theory because I I have a theory about it.

Speaker 2 I want to hear you. That's really all I wanted to talk about.
With it, there's lots of books, and apps, and programs you can buy, and like I said, pills.

Speaker 2 And now I'm getting ads on Facebook for pills that I could take to fix my dopamine.

Speaker 1 I think, okay, so this is a very quick version. The only missing piece here that I think I, as a former game journalist, can help with here.

Speaker 1 The dopamine thing was

Speaker 1 very, very huge in gaming. This idea that dopamine was a stand-in stand-in for the sorts of

Speaker 1 addictive behaviors that like that are very cheap to come by in video games, that are easy to replicate and manipulative almost in a sense, right?

Speaker 1 That idea of the rat hitting the feeder bar, once the dopamine became part of the like popular imagination, that idea of a rat hitting a feeder bar became very big in gaming, right?

Speaker 1 Because it's like people latched onto that idea of dopamine being a chemical that was released when you're playing video games in a specific way. And that this idea that people who were too

Speaker 1 spent too much time on video games or were addicted, if you want to use that word, had this like, it was a dopamine issue because they were getting such quick hits from it and nothing else could like replicate that because it is this, it is a electronic tool, right?

Speaker 1 Almost like vaping is for cigarettes, right? It is an electronic facsimile of that sense of progression or satisfaction, right? You're getting the dopamine without actually doing anything.

Speaker 1 And of course, in dopamine here is being utterly misconstrued, like because of what you've talked about. Dopamine is really

Speaker 1 standing in for the idea of addiction or mental addiction, you know, addiction to gaming specifically here, right? But I think that that idea of dopamine

Speaker 1 amongst people who gamed,

Speaker 1 which I think there's a huge overlap with the people that you are talking about right now, especially, you know, 10, 15, 20 years ago when they were maybe learning some of these basic fundamentals of science, might have really taken purchase.

Speaker 1 This idea that there, I think it is very logical if you look at how much discussion there was in the world of video games about dopamine and it being like a

Speaker 1 way that games would like basically addict you.

Speaker 1 like would get you hooked and that was the problem the idea that people would have internalized that and and and hooked all that to that chemical for a lot of people that that would take place in the zeitgeist.

Speaker 1 I think that that might have been a really big contributor because that was a very big part of the discussion.

Speaker 1 And I could see that over the years morphing into a sort of self-hatred where it's like all that time I spent playing video games, I was just depleting my stores and desensitizing myself.

Speaker 1 And that's my problem: I spent too much time there. I could see them wanting to build that argument.

Speaker 2 That's such a, I mean, it's unfortunate that if that's what grew from that, because what has to be tied to that is

Speaker 2 why is receiving

Speaker 2 a dopamine surge, and not just dopamine, it's all the other chemicals we talked about from doing well in a video game. Why is that inherently inferior to other things you could do in your life?

Speaker 2 And the reason that we would want to think that is productivity, productivity based on what society wants from you.

Speaker 2 This is all capitalism again, trying to force upon people what makes your time worthwhile and what doesn't count as worthwhile time.

Speaker 1 Yeah, but I think that you can also, I agree with that, but I think that you can also have personal like things that you would like to achieve with your life where that does make it difficult if you

Speaker 1 are getting a sense of satisfaction from something that is not actually nourishing you or people around you.

Speaker 2 And I think that that is exactly where CBT could be helpful.

Speaker 1 This is what I'm saying, right? And it's not dopamine either.

Speaker 1 It's what's going on with you that,

Speaker 1 you know, that you're so dependent on this sensation. And are there like healthier ways of getting this feeling that are maybe longer-lasting or a little bit more like soul-sustaining?

Speaker 2 I think that that's a really helpful conversation.

Speaker 2 And I definitely think that, you know, I mean, there are plenty of studies, if we start looking, especially at like younger people, that can correlate social media use with depression, with negative mental health outcomes.

Speaker 2 And so so the idea that there is a connection between

Speaker 2 less happiness or more, you know, chronic illness related to some of these things as opposed to other activities. Absolutely.
I agree with all that, especially when we're talking about youth.

Speaker 2 That being said, I think that this idea that depriving yourself of all pleasurable activities will give you superpowers. Well, I mean, essentially.

Speaker 1 Yeah, right. Yeah.

Speaker 2 Is a really, I mean, it's false. It is a way to make you feel like you've achieved something when

Speaker 2 I just, I would push back against the idea that simply withholding pleasure from yourself, not doing things that you enjoy would give you superpowers, you know, or that you've the goal of like the way to accomplish something is to not do something.

Speaker 1 No, I agree. I, I, 100%.

Speaker 1 Yeah, I don't think that that will be, it's not certainly a long-term fix. I think that it's, you know what is tough, though? I do think that our brain, I think we are so over

Speaker 1 taxed a lot of the times with our,

Speaker 1 overstimulated is not quite the right word here, but I feel like our senses are and our synapses are so taxed constantly by being connected digitally a lot that I think that when you stop, when you take a break like this, it can feel

Speaker 1 transformative. You know, it can feel like you've discovered the secret because your brain maybe is like quiet for the first time in a long time.

Speaker 1 And it's like, yeah, there's, there's also something to like putting the screen down for a little bit and letting you're and like trying meditation or running or whatever.

Speaker 1 There's something positive there too.

Speaker 1 And that's kind of, I feel like what they're piggybacking off of is like, hey, you know, if you stopped everything that could possibly be unhealthy that you're doing, and then you replace that with running and doing art, that would probably fix stuff for you.

Speaker 1 It's like, oh, no kidding.

Speaker 1 Yeah, no way. No more salty, sweet, fatty foods.
And I'll run all the time and I'll be like, like, I'll be feeling good. Like, oh, thank you, Doc.

Speaker 2 But that's also, I mean, the problem is everything you just said, yes, I guess

Speaker 2 if we all went for a run,

Speaker 1 more or less.

Speaker 2 I mean, I, you know, exercise, generally speaking, is a healthy activity. Um,

Speaker 2 not looking at your phone right before bed, we think improves sleep quality. Like, there, I mean, yes, there's some really basic things here that are absolutely true.

Speaker 2 I think what's dangerous is one, painting it as you need to make this gigantic lifestyle overhaul that will be incredibly difficult.

Speaker 1 And it's been a systemic problem for you for years that has been holding you back from your real potential.

Speaker 2 Because one, when you make gigantic, like if you decide I

Speaker 2 drink too many Diet Dr. Peppers in a day,

Speaker 2 so what I'm going to do is never drink Diet Dr. Pepper again, that change for me would be incredibly difficult.
And statistically, I would be likely to fail.

Speaker 2 But if I said, I am going to drink one less every day to start with and start from there, I could probably achieve that, right? That will motivate me to continue down that road.

Speaker 2 And maybe eventually I do get to a point where I never drink a diet, Dr. Pepper again.
I don't know why. I don't know why I did that.
I don't know. I mean, they're fine.

Speaker 1 It's fine. It's not a problem.
I'm not on hypotheticals to do them.

Speaker 2 But like you get my point.

Speaker 2 I mean, that generally, those sorts of changes, if you're trying to like some sort of lifestyle factor, something that you want to change, those are more sustainable and more successful and can leave to a higher quality of life and make you feel good.

Speaker 2 Trying to punish yourself or create a sense of shame when you do something generally is not as useful because we aren't rats at a feeder bar. That's the other part of all this.

Speaker 2 And that's why we kind of, it gets lumped into these. The fact that you would put all of these behaviors on the same list as like addictive substances.

Speaker 2 I mean, you cannot in the same conversation talk about, you know, playing video games too much or looking at TikTok too much or masturbating too much and also being addicted to methamphetamines, being addicted to heroin, being addicted to, I mean, even nicotine, you know, I mean, these are not the same.

Speaker 2 These are complex,

Speaker 2 you know, illnesses that require multifactorial solutions, everything,

Speaker 1 medications and therapy, all the other stuff. Supportive services.

Speaker 1 Yeah, yeah, yeah. There's behavioral and chemical and societal factors.

Speaker 2 You know, we have to think about socioeconomics and like housing status and food security. And I mean, there's so many things that go into these more complex issues.

Speaker 2 You can't just toss them on a list and say, it's dopamine.

Speaker 1 Right. That's been the.

Speaker 2 Yes, that's my problem. And certainly

Speaker 2 there's no evidence that taking these supplements for, I don't even know what they would do to your dopamine because I think dopamine is the problem.

Speaker 2 You certainly shouldn't try to deplete all your dopamine. You couldn't.
And if you did, there could be major problems. You shouldn't add extra dopamine because there could be major problems.

Speaker 2 Just don't mess with yourself. Unless your doctor tells you to do it.

Speaker 1 Just don't mess with your dopamine. Okay.

Speaker 2 Yeah. Dopamine is not the problem.

Speaker 2 And if you need help reducing a behavior, I would seek professional help to reduce the behavior.

Speaker 1 It's me.

Speaker 1 Hi.

Speaker 1 I'm the problem.

Speaker 1 It's me. Thanks for listening to Sawbones.
Do you want to come to Candle Nights? You can on December 6th. You should come.
You should. There's tickets for it.
Let me tell you the link, okay?

Speaker 1 Because I don't want to mess it up. It's bit.ly

Speaker 1 candle nights 2025. Now, is that true or not? There's no way of knowing.

Speaker 1 Bit.ly

Speaker 1 forward slash candle nights 2025 is

Speaker 1 yes, that is the website, bit.ly forward slash candle nights 2025. Go there.
You can get tickets to watch the show, but you can also get a virtual stream ticket to watch the show later.

Speaker 1 That's included with your live ticket, but you can also get that independently there. And all proceeds from that show are going to go to Harmony House, which what is that, Cydney?

Speaker 2 Harmony House is a day shelter here in Huntington for people experiencing homelessness.

Speaker 2 We provide a variety of services, both, you know, basic like food and showers and clothes and hygiene, and also get people connected with housing resources to get them in apartments and help them with whatever supportive services they need after that.

Speaker 2 And I'm the doctor there.

Speaker 1 Me too. That's going to do it for us.
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Speaker 1 And thanks to you. you

Speaker 1 to listen. That's going to do it for us for this week.
Until next time, my name is Justin McElroy. I'm Cindy McEroll.
And as always, don't drill a hole in your head.

Speaker 1 All right.

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