The Real Reason Why We Can’t Stop Scrolling with Oprah and Dr. Anna Lembke

0:00When it comes to tech, when does a daily habit cross over into addiction?

0:05Dr. Anna Lembke:This has crossed the threshold from a bad habit into a mental illness. I hear you've racked up over$30 ,000 in credit card debt. What do you think is at the root of your shopping addiction? I feel unfulfilled in many aspects of my life. And instead of sitting with the discomfort, I resort to let me find something to buy. You spend as much as seven hours a day playing video games. Mm-hmm. And what is it about gaming for you? A lot of the game is rewarding, but also low lows can happen all within a, like, 20-minute span. I hear that you've lost more than$100 ,000 on sports betting apps. I know you dropped out of three colleges.

0:48You were lying. You were stealing from your parents. Yeah. What is it about online gambling that makes it so hard to quit? It's that adrenaline rush.

0:58Dr. Anna Lembke:It could be compared to someone addicted to drugs, you know, chasing that original high. And now we've entered into addicted brain. We need to use more of our drug in more potent forms, not to get high, but just to level the balance and feel normal. It's like the heroin addict coming off of the heroin. Exactly. And that is what is happening to your children when you try to take away the phones. That's what's happening to you when you can't get yourself and you can't stop scrolling. Exactly right. You're just scrolling, scrolling, scrolling. Yes. Hi, everybody. I'm glad to be here with you on the Oprah podcast.

1:31Over 3 million of you watched or listened to our episode on Gen Z tech addiction. Thank you for that. But as we're learning, it's not just one generation or group. Tech addiction can hook anybody, and a lot of people are hooked right now, at all ages, no matter your circumstances. And today on this podcast, I want to ask these questions. What's behind these addictions? What's happening inside our brains? Are we defenseless or can we actually do something about it? I'll be talking to people who are addicted to gaming, online gambling, and even shopping. That's a biggie for a lot of women. But first, here's a quick look at some of the moments from that episode that struck a chord.

2:19Dr. Anna Lembke:So my name is Dr. Nisha Glenn. This is my son, Amir Jenkins. He started his gaming at about five or six. When he got in high school, that's when I knew it was an addiction. He would not brush his teeth. He would not eat. Ooh. It was strictly. Amir. I mean, nothing. No showers in there on the game 24 hours a day. Can you take us to the point of understanding what that feels like when you're sort of caught up in the obsessiveness, obsession of it? I would say you almost forget where you are, in a sense. Like, when I play the game, I literally forget I'm in a house sometimes. It's so virtual, so intimate, and, you know, it's free, a judge-free zone as well.

3:08Dr. Anna Lembke:Mm-hmm. I was exposed to corn at the age of eight and have struggled with addiction for the past 20 years. I'm married to a corn addict. He has struggled since he was eight years old. I make it like my mission to watch his every move, which is so draining. Maddie and Kyle, thank you for being here. I know this is a hard thing to talk about, and I applaud your courage in being willing to speak about it because I hear this is really serious for a lot of people, like millions and millions of guys throughout the country and the world. How long have you all been married? We've been married six and a half years.

3:47Dr. Anna Lembke:So I would say like the last year is when I finally realized that like this addiction is so much deeper. And I'm like, how many times do I try to break a bad habit and I have to start over? And this is an addiction. Well, I know hearing Kyle and Maddie's story really hit home for a lot of people. Addiction to adult content is impacting millions of families and relationships. My team just checked in with them. Kyle has had a relapse and setback in his recovery, he says, and is now doubling down on his addiction classes. And Maddie told us that they still love each other and they're going to continue to fight for their marriage.

4:26Dr. Anna Lumpke is back with us, and she's a psychiatrist and chief of Stanford Addiction Medicine. And I just truly believe that her book is a must read. It's called Dopamine Nation, Finding Balance in the Age of Indulgence. Welcome back to the podcast, Dr. Lemke. Thank you. Thank you. In Dopamine Nation, you write, I was moved by this, you say, the internet promotes compulsive overconsumption, not merely by providing increased access to drugs, old and new, but also by suggesting behaviors that otherwise may never have occurred to us. I think that's what's happening to a lot of people. Can you give us an example of what you're seeing now that's new and different?

5:13Dr. Anna Lembke:Yeah, I mean, there's this real contagion effect where because the algorithm both feeds us videos and other content that we specifically search for, and also novel content that we didn't go looking for. That's right. Things are just popping up on your screen. And that's intentional, right? That injection of novelty is intentional to stave off boredom, to increase watch time, to keep us clicking and swiping even when we don't want to. Wow. So what ends up happening is there is this injection of very extreme content And this can impact behaviors because it makes people think of something that would never have occurred to them naturally.

6:00Dr. Anna Lembke:You know, this happens with drugs. So kids seeing videos of other kids using like unusual drugs or synthetic drugs or drugs that they've, you know, concocted themselves. And then kids wanting to go and try that. It's especially prevalent with sexual content. So sexual images, people behaving in ways, for example, men choking women is not something that was, you know, would necessarily occur to somebody. But there's so much choking and other kind of sadomasochistic sexual content. And when people go looking for adult content, that's actually the first content that they see or that's, you know, pushed to them.

6:47Dr. Anna Lembke:that now you've got a lot of people engaging in sexual behaviors that are potentially harmful and dangerous, potentially. So it's this kind of thing. When it comes to tech, which has infiltrated, you know, all of our lives, every part of life, every waking moment, I think people are confused on this. Like, when does a daily habit, a thing that we've been doing and think that we need to do, cross over into addiction? Addiction is a spectrum disorder, right? You can have mild, moderate, or severe addiction depending upon the severity of the symptoms, how many symptoms there are. But there can also be this pre-addicted state that you might think of as risky use or even a bad habit.

7:34Dr. Anna Lembke:When I use the term addiction, I'm really saying this has crossed the threshold from being something that we would consider a bad habit into something that we would really consider a mental illness. Again, characterized by these four C's, out of control use, craving, compulsive use, meaning that I initiate use even against my desire and intention not to use, and then especially consequences. Plus tolerance, you know, which we've talked about, needing more potent forms over time to get the same effect, and also withdrawal. When I try to stop, I experienced this physiologic response that then pulls me back into it.

8:14You explain that pleasure and pain work like the balance of a seesaw. How does that impact addiction? Explain that to our audience here. Yeah.

8:26Dr. Anna Lembke:So I use this extended metaphor of a balance to communicate to my patients, my medical students, what's happening in the brain as we go from sort of healthy adaptive use of a substance or behavior to unhealthy maladaptive addictive use. So if you imagine that in your reward pathway, there's something like a teeter-totter that represents how we process pleasure and pain. When it tilts one way, we experience pleasure. When it tilts another, we experience pain. But there are certain rules governing this balance. And the first and most important rule is that the balance wants to remain level, which is what neuroscientists call homeostasis, sometimes referred to as set point.

9:09Dr. Anna Lembke:You refer to it in your wonderful book, Enough. Enough point? As the enough point. But it's the set point. That was Dr. Anya's word. It's the set point, right. Yeah, it's homeostasis. And our brains will work very hard to return to a level balance or homeostasis with any deviation from neutrality. So for example, when we do something that's pleasurable uniquely for our brain that releases dopamine the balance tilts toward the side of pleasure but no sooner has that happened that our brain will respond by down regulating dopamine transmission not just to baseline but below baseline so you need more more more right when we experience pleasurable activities like eating exercising or socializing It triggers our brain to produce the feel-good chemical called dopamine.

9:58The cycle of addiction begins when addictive substances and behaviors cause massive dopamine surges, which causes our brains to both produce less dopamine and at the same time absorb it less efficiently. This creates a dopamine deficit, which causes us to crave more and more of the substance or the behavior just to feel normal.

10:19Dr. Anna Lembke:And I like to imagine that process of neuroadaptation as these little gremlins hopping on the pain side of the balance to bring it level again. But the gremlins like it on the balance, so they don't get off as soon as we're level. They stay on until we're tilted an equal and opposite amount to the side of pain. That is the come down. That's the craving, the hangover, the moment of wanting one more potato chip or one more joint. I'll be standing in front of the pantry, just grazing, looking for what is the thing I can do to curb this anxiety that I'm feeling. Right, right. And remember, our brain wants to get back to homeostasis.

10:54Dr. Anna Lembke:So the fastest way to do that is to have another potato chip. Yeah. The problem is if we continue to consume our drug of choice over days to weeks to months to years, those gremlins start to multiply. And pretty soon we have enough gremlins on the pain side of the balance to fill this whole room. And now we've entered into addicted brain. We are in a chronic dopamine deficit state. Now we need to use more of our drug in more potent forms, not to get high, but just to level the balance and feel normal. And that is what is happening to your children when you try to take away the phones. That's what's happening to you when you can't get yourself, you can't stop scrolling.

11:34That's exactly right. You're just scrolling, scrolling, scrolling. Yes. Okay. 80 % of people coping with an addiction to online shopping are women. Listen to Safat's story.

11:44Dr. Anna Lembke:I have a shopping addiction and over the past three years, I've racked up over$30 ,000 in credit card debt. 99 % of it is shopping. I have said no to going out to dinner with friends, bought the cheapest thing at the grocery store just so I could buy that one thing, whatever it was in the moment. It's really shameful because I'm in my mid-30s. I have a good job and yet I'm struggling to pay rent because I keep spending more than I can afford. I was also scared to come on here and say this because it feels like I failed. Oh, yeah. Oh, wow. Okay. Safat joins us from Brooklyn. Hi, Oprah. What do you think is at the root of your shopping addiction?

12:24I was really interested to read about it because I go online and it's a dangerous thing. Let me just tell you, it's a dangerous thing. and you get a little, I guess I'm getting a little dopamine hit. Add to cart. So exciting. Add to cart again. Before you know it, I have three blouses for$24.99. None of which you need, probably. None of which I need. I didn't need that little crop top. So I have$24.99. Then I'm like, what else can I get? So does it feel like that? Is that what it feels like for you? You just get a little hit?

12:58Dr. Anna Lembke:Yes, it absolutely does feel like that. For me, the root of my addiction stems from, I think, childhood. I've talked about this with my therapist. And my family moved to America when I was six years old. And we moved to a upper middle class white neighborhood. And I noticed all the kids would get gifts, Christmas gifts, birthday gifts. And I was getting like hand-me-downs and sharing a room with my siblings. And so I think what I told myself in those moments is when you're older, you're going to be able to have these things. You're going to be able to fit in. So now that I have a job, what I'm realizing that I do on a regular basis is I buy these things almost to satisfy my inner child, to tell myself, OK, you've made it, right?

13:51Dr. Anna Lembke:And so that's become my coping mechanism. And additionally, I feel unfulfilled in many aspects of my life. And I think instead of sitting with the discomfort of the sadness or disgust or whatever I feel in myself, I resort to let me find something to buy because that's what I trained myself from a young age is what would make me happy. So I continue to do it. I get a little boost of dopamine. And then what I really feel is shame and guilt for doing it because I've accrued so much debt. Yeah. I hear you've racked up over$30 ,000 in credit card debt that you can't afford to pay. Yes, correct. So you feel good in the moment where you're ordering it?

14:41Do you feel good when you're adding to cart? And then when it arrives, you're ashamed? Yeah.

14:49Dr. Anna Lembke:A little. So as soon as I buy it, instead of feeling happy, I feel immense amount of shame and guilt. And then when it arrives, I'm excited to open the box. And I've also been for years now hiding my packages from my partner. Not that he absolutely has no problem with it. He's encouraging of me doing the best for me to get over the addiction. but I think internally I feel so much guilt that I will hide the packages. I will lie about it. So I'll open it and then I'll feel guilt and shame again. And then instead of dealing with it, I'll go and purchase something else. Dr. Limke, what do you want to say?

15:30Dr. Anna Lembke:Gosh, so much here. Okay. So you started talking about some early childhood experiences that you think contribute. And I think that's important to reflect on that. But I think there's a danger of spending too much time looking for the root cause of addiction when there doesn't actually need to be an underlying reason other than we're living in an addictogenic world where shopping has become drugified. The medium of being online itself constantly sends us triggers to buy. That's the whole business model of... You can't read an article without... What we're all trying to do now is filter out all the ads as you're trying to like communicate with anything.

16:14Yes.

16:14Dr. Anna Lembke:Yes. And we get a little hit of dopamine, not just when we're shopping, but just getting a reminder that we might be able to go shopping or that there might be something available. That actually also stimulates the brain's reward pathway and then sets up that state of craving that makes us want to go shopping. And the reason this is so important is because, yes, it's good to talk about your childhood and some early underlying, you know, issues that might be contributing to it. But you could talk about that all day, and it's not going to get at the root of the problem if you're still exposing your brain to this very addictive medium that's constantly triggering your brain, releasing dopamine, and then leading you down this road, which is why self-binding strategies are so important.

17:09Dr. Anna Lembke:Self-binding is where we create literal and metacognitive barriers between ourselves and our drug of choice so we can press the pause button between desire and consumption. So what does she need to do? So what you need to do is you need to delete any shopping apps that you have, right? You need to possibly get rid of any online pay vehicles, Anything that makes it easy and frictionless for you to buy something is definitely something that you should eliminate. You know, online shopping or shopping addiction is a huge and growing problem, especially as you commented, Oprah, among women. So these self-binding strategies are really key.

17:53Dr. Anna Lembke:If you really want to take it to the extreme, you will get rid of all of your credit cards and you will only carry cash and you will only buy in cash and not online. And this seems extreme, but what my patients discover is that it's actually so much easier than expecting that you can constantly stimulate your brain and then resist the pull that's created by all of these stimuli that are inviting us to consume. How does this sound to you, Safai? Yeah, that absolutely sounds like a great idea. something I've tried in the past is getting rid of my credit cards. What happened is when I'm in a anxious mindset or when I'm sad or depressed, I've opened up new cards.

18:45Dr. Anna Lembke:So usually when I'm aware of what I'm doing, I can continue to do it and I can perform. But then as soon as I'm in a state where I can't regulate and I'm anxious or whatever it is, I will get more credit cards or I will subscribe to whatever it is. And I think I'd go back to that state. So I guess my question is, when I'm feeling like that, how do I self-regulate and how do I get myself to not do those things? Yeah. It's a wonderful description of the kind of dissociative state that we can go into vis-a-vis our drug of choice, where we're just sort of like, we're out of our minds, essentially, and we're just doing the behaviors.

19:28Dr. Anna Lembke:This is where self-binding matters because, you know, if it's harder for you to get the next credit card or you just have to take the time to get a credit card, you might be able to come out of that state. But more importantly, what you need to have is a list of other healthier coping strategies for when you get anxious. And this is where I really recommend also engaging in what we call mutual help groups or self-help groups. The prototypical one is Alcoholics Anonymous, but Alcoholics Anonymous was founded a hundred years ago. And since then there has been a proliferation of self-help groups for almost every maladaptive behavior you can imagine.

20:08Dr. Anna Lembke:And it can be an incredibly helpful and effective way for people. There has to be one for shoppers. There is, there absolutely is. And, and, you know, the 12 step model really works and it often involves getting a sponsor, somebody else in the group. And then in those moments when you're, you know, anxious or feeling cravings, you have somebody to talk to. And that person's typically available 24 seven and they know exactly what you're going through. And I say to my patients, you know, as much as I care about you, I'm not available to you 24 seven, but a 12 step sponsor, they would answer the phone in the middle of the night.

20:45Dr. Anna Lembke:So I think, and again, thinking about self-binding strategies, we massively co-regulate based on who is around us and the behaviors they're engaging in. So if you surround yourself with other people who understand this problem uniquely and that you can turn to for help, I think that will really help you in those moments. Because you're not alone. You are not alone. There are millions of people, most of them women, going through exactly the same thing that you're going through and you're a smart woman you're an intelligent woman you are a gracious and kind person you will overcome this if you choose to do that because you know how to put all the things together to overcome this it's it's it's a decision on your part right now as to how hard you want to work at it but i know you can do it you heard that from oprah So that's what you hear.

21:41You were raised to be able to do it. You were raised to be able to do it. That little girl coming from another land, another place, another culture, being in a surroundings where there were people that you didn't know, being able to manage yourself and succeed in that environment. You can do this. You can do this. This thing is not bigger than you. Okay?

22:03Dr. Anna Lembke:Thank you. I appreciate that. Yes. Oprah told me to stop shopping. It's absolutely. It's absolutely. Yeah, that's right. Thank you, Safat. Thank you. Thank you. Thank you for having me. You know, gaming has become a way of life for children and teens and young adults, too. Here's a quick look at Debra sharing her story. So I've got a question for the masses, for the masses, for the people. What were we doing before we started playing video games and getting addicted? Okay, because I feel like I haven't been playing video games that long. But at the same time, what was I doing beforehand? I lose hours playing these things.

22:39Dr. Anna Lembke:I'm talking minutes on hours on days. And I've only been playing video games for like a year. I've been playing for a year. So question, what were we doing beforehand? How are we spending our free time? Yeah, that's my question for you, Debra, who joins us from Chicago. What were you doing before? How do you answer that question? What were you doing before? Yeah, I feel like I had a collection of hobbies. I used to paint, like with acrylics. I would sew a lot of projects. Anything crafty and working with my hands was something that I found appealing to me. And now you spend as much as seven hours a day playing video games.

23:17Dr. Anna Lembke:Mm-hmm. And I think it's still in some ways, I use like a controller, so I still feel like it's still using my hands in some kind of way, so it still stimulates the same kind of crafting mindset that I have. But yeah, I'm spending a lot of hours, a lot of time of my day playing video games most of the time. And what is it about gaming for you? I think it's about two aspects that come to mind. The first is accessibility. So in comparison to my other hobbies, I require a lot of space and setup time. Given like with sewing, I need to get the fabric. I need to get the sewing notions for when it comes to cooking or baking.

23:49Dr. Anna Lembke:I have to grab the ingredients, go to the store potentially to grab things I'm running low of, preheat the oven. And then when it comes to gaming, it's just like, oh, I can just press a power button on my computer and just be on the game. And it's much more accessible, I think. And I hear most of your friends are gamers that you've never even met in person. And so that's the second component is the social aspect. I think as you play these games, a lot of them are online games where you can meet other people from around the world even. So in the midst of learning how to play this game, I've met people online that like are now forming a mini gaming community.