“ The interview ”: Dr Anna Lembke is afraid of what modern life does

We live at a time when everything is available at all times. Just on your phone, you can order lunch, bet on sport, read this story, watch porn, chat with a friend, chat with a foreigner, chat with a large language model or buy a car. Dr. Anna Lembke says that all this convenience and abundance make us less happy, and there is a lot of research to save it: in the developed world, we are more soliable, more anxious and more depressed than ever.

Lembke is a psychiatrist who works at the Double Diagnosis of the Median Diagnosis of the Stanford University, where she sees patients with all kinds of dependencies, opioids and alcohol to what she calls “digital drugs” Who, she says, put us in a “transverse state of Trunelike where we waste track of time. In his best -selling book, “Dopamine Nation”, on science behind dependence, Lembke maintains that our brains are wired to constantly seek stimulation, and that modern life, with its endless flow of content and other things , makes it almost impossible to fight this desire.

At the same time, scientific breakthroughs in medical interventions and new cultural habits, such as the decrease in alcohol consumption, hold a certain promise. My own experience reflects these recent changes. Dependence works in my family. In 2020, my sister, who fought against alcoholism for years, died of hepatic insufficiency – something that I shared with Lembke before the start of our interview. His “death of despair” made me change my own behavior. After a life of obesity, I started to take Ozempic, which reduced my obsessive relationship with food. And two years ago, I stopped drinking alcohol. But even if I feel physically well, losing weight and becoming sober has not stopped other destructive behaviors, such as online purchases, to get back to it. It is a dynamic that Lembke knows – both in his work and in his personal life. How to find the balance in a world that nourishes the temptation to us, she says, is a struggle for all of us.

You published “Dopamine Nation” in 2021 with the thesis that the overabundance of modern culture has constantly stimulated us by dopamine. And that has only accelerated since then, I think. In general, have you seen things in your practice that were not there before? So, to put it in perspective of my first row clinical seat: in the early 2000s, we saw a sudden increase in people addicted to the same pills as their doctors prescribed them for chronic and minor pain conditions, leading to our epidemic current opioids. But also, middle -aged men arrived with severe internet drug addiction and compulsive masturbation. Mainly men who had been able to consume pornography in reasonable moderation without much trouble in their lives until the advent of the Internet – then above all, in the first decade of the 2000s, the smartphone. And it was probably our first signal for behavioral dependencies. And then around 2012, 2013, we saw a group of adolescents brought by their parents mainly for the disorders of taking the Internet. Then, almost 2015, 2016, we started to see the first signal of dependence on social media, online purchases, an enormous increase in dependence on online game. And then what I would say that I have seen mainly in the past five years, it is a kind of dependence broadcast on the Internet. People will have their medication of choice, whether shopping or social media or video games or pornography. But if it is not available, they will move on.

This chronology is – and I will use the word – very sober. Yeah.

How do you define dependence? Drug addiction is continuous compulsive use of a substance or behavior despite the prejudice to oneself and / or to others. Above all, there is no brain sweeping or blood test to diagnose dependence, and there will not be for a very long time, if never. We always bask our diagnosis on what we call phenomenology, which are models of behavior that are repeated between individuals, temperaments, cultures, periods, etc.