85: Dr. Anna Lembke: Dopamine Fasting: A Solution to Overwhelm, Depression and Anxiety in the Digital Age

In her presentation for the IMMH 2023 conference, Dopamine Fasting: An Early Intervention for Compulsive Overconsumption in the Digital Age, Dr. Anna Lembke explains how the pleasure–pain balance in the brain – once an adaptive survival mechanism – has become dangerously dysregulated in modern societies. Drawing from cutting-edge neuroscience and decades of clinical experience, she shows how our dopamine-overloaded world of constant stimulation and "drugified" everyday activities have created unprecedented vulnerability to addiction, anxiety, depression, and unhappiness. Through her clear, compassionate teaching, Dr. Lembke reveals how repeated exposure to high-reward experiences alters the brain's reward pathways, driving down our baseline dopamine and contributing to the modern mental health crisis.

Dr. Lembke brings a rare combination of scientific depth and clinical wisdom. Her work integrates neuroscience with the insights of recovery communities, and in this talk she introduces practical, accessible strategies for rebalancing the brain's reward circuitry. With characteristic clarity, she explains why dopamine fasting, behavioural recalibration, and the intentional pursuit of "healthy pain" can restore homeostasis and help patients overcome compulsive overconsumption.

In this richly informative and hopeful session, Dr. Lembke outlines the Plenty Paradox – her hypothesis that overabundance itself has become a source of physiological and psychological stress – and offers evidence-based tools to help clinicians and patients navigate the modern dopamine ecosystem. By understanding how the brain processes pleasure and pain, and by intentionally engaging in moderate stressors, she shows that we can elevate dopamine in a more stable, sustainable way, improve emotional resilience and mental health, and regain healthy control over habits.

In this episode, you will learn:

• Why overabundance and constant access to reinforcing stimuli have become major drivers of stress, addiction, and mental health symptoms such as depression and anxiety.

• How pleasure and pain operate like opposite sides of a balance within the same brain regions.

• How repeated exposure to intoxicants or high-dopamine behaviours lowers baseline dopamine and the hedonic set-point.

• Why modern life has "drugified" everyday experiences, making them more reinforcing and more accessible.

• Why dopamine fasting (short-term abstinence) is an effective intervention for resetting reward pathways.

• Why patients often feel worse before they feel better during a dopamine fast.

• How hormesis – the use of moderate, controlled discomfort – can elevate dopamine sustainably without a crash.

• Examples of hormetic practices such as cold exposure, exercise, fasting, prayer and meditation.

• Why "right-sized pain" matters, and how too much or too little discomfort can be counterproductive.

• Why behavioural activation, mindfulness and insight are crucial tools for restoring balance and supporting recovery.

I hope you find Dr. Lembke's wisdom helpful during this age and season of overwhelm, and that you are able to enjoy your family, friends, work and rest with full focus and presence these holidays and beyond.