And so I mean what you talked about in terms of irritability, you know not feeling happy. Everything else like I kept trying to take a break quote unquote, right to not drink, and I would typically make it like three to four days before I’d be like, that’s it, I need a bottle of wine. And I would you know, I did that for a while when I was really serious about cutting back, I would go for days drink four days drink, and I would tell myself like, well, two bottles of wine, a week is way better than seven or eight. When I was doing that the whole time, my brain was like, just trying me and my body to get me back out of that pain cycle. Is that right?

20:39

Right. So the thing about the, you know, neuro adaptation, and those changes that are wrought in the brain with heavy, sustained consumption of drugs like alcohol, is that it can take quite a while for the brain to readapt after stopping drinking. And in my experience, it takes a minimum of 30 days of not drinking to really heal the brain and start for those Gremlins to hop off the pain side and for homeostasis, to be restored. So if you went for days, you know, I suspect that you just didn’t make it long enough to restore homeostasis, and at four days, you were probably at the peak level of those Gremlins jumping up and down. You know, on the pain side of the balancing give me more alcohol, just you know, so that you could be relieved of the psychological pain and suffering of protracted withdrawal. Yeah, it doesn’t necessarily manifest as the shakes, or you know, autonomic dysfunction, elevated blood pressure, heart rate, or the universal symptoms of withdrawal from any addictive substance, whether it’s a smartphone or alcohol. The Universal symptoms are again, anxiety, irritability, insomnia, depression, and intrusive rationalizations for why it’s okay to use, even though we set a different goal for ourselves.

Casey McGuire Davidson  22:03

So in the book, you talk about a patient, Delilah, who smokes pot every day. And the reason she smokes pot is her anxiety, she talks about how the very first thing she feels in the morning is anxiety. And I hear that from so many women, who I work with and who write to me who are saying, I drink because of my anxiety, I just can’t take it anymore. And you mentioned 30 days, I when I work with women, when I when my goal is to get them to 100 days. without alcohol. They feel better at 30 days, but often the whole last two weeks, they’re just counting down to when they can drink again, it’s like a reset. But you talk about Delilah and talking to her about trying the experiment of 30 days without smoking pot because you suspect that what felt like cannabis treating anxiety was actually the cannabis relieving the withdrawal, like the cause of the anxiety was the pot not the cure.

23:09

Yes, exactly. And let me just say that what I encounter in my clinic clinical practice is really similar to what you encounter patients presenting wanting help with anxiety, and depression and insomnia. and hoping I will prescribe them a pill or come up with some sort of magic. You know, psychotherapeutic wisdom. And instead, the first thing I often ask them to do is to give up their drug of choice for 30 days. And I also agree with you that 30 days is sort of just barely the beginnings, and of course, in 90 days really allows more substantial healing to occur. And in some, in some cases, it takes even longer than that. But for about 80% of patients that 30 days is enough to feel the benefits of not drinking and to get out of that vicious loop of constant intrusive craving. So in order to understand this subjective phenomenon that Oh, the alcohol is relieving my depression, anxiety, again, visualize the balance, right? And imagine that with alcohol on the pleasure side repeated over days to weeks to months to years, you’ve got a million Gremlins. Now on your pain side, you’ve downregulated your own dopamine production and your own dopamine receptors so that when you stop drinking, the very first thing that happens is that balance slams to the side of pain, and it will stay there for at least 30 days my experience. Those Gremlins are hopping hardest in those first two weeks and then come week three and four they start to dismount and get off. But in the meantime, of course if you drink, you will feel better right because it will temporarily relieve the problem of the balanced To pain and bring your balance level again, you probably won’t feel good because your long past really the alcohol working anymore in the way that it used to. But you may get out of this horrible dysphoria. That is the balance tipped to the side of pain. So subjectively It feels like the alcohol is relieving the depression. But really what it’s doing is accumulating more and more Gremlins on the pain side and driving the depression. And once my patients understand that, it helps them get through those first couple of weeks, because they can tell themselves, okay, I’m feeling bad, but it’s time limited. It’s the Gremlins on the pain side of my balance, I just wait long enough, they will get off, and I’ll get to a place where I’m feeling better. And again, about 80% of my patients who do this 30-day experiment, do feel better at Yeah, three or four weeks.

Casey McGuire Davidson  25:55

And so if you drink during that really tough period, you are just redoing the absolute worst part over and over and over again.

26:04

That’s right, you’re just again, priming the brain for more Gremlins. to hop on to the balance you’re just delaying the ability your brain’s ability to heal. Remember, what we want to do is for the brain to start to regenerate its own inner and dowdiness dopamine and dopamine receptors. But it’s not going to be able to do that. As long as you’re ingesting a substance like alcohol, which releases so much dopamine in the brain reward pathway.

Casey McGuire Davidson  26:33

Yeah. And you talk about in the book, how Delilah came back after 30 days with glowing skin and a radiant smile and said that she felt so much better like the anxiety was so much less than before. She had a clear head her paranoia and suspiciousness were gone. She was saving money, she was enjoying events more sober and she hadn’t gone without pot in years and years and years. So had no idea that the reason she was feeling so bad was because of the substance she was using to make her feel better.

27:13

That’s exactly right. And Delilah is not an isolated example of a case that turned out well, that I hear that and I’ve heard it again and again over so many years, which is really why I wrote the book, I want people to understand what you know what I get to see so often in clinical practice, that what feels like it’s treating the underlying depression, anxiety is actually medicating withdrawal. It’s actually a balance, tip to the side of pain. And if we can just abstain for long enough, we can reassert homeostasis, and start to regenerate our own dopamine and opioids and serotonin and all that good stuff that makes us naturally feel good. One of the things that is also fascinating about this experiment in my clinical practice is again, how surprised people are when they come back, because he subjectively it just feels so much like the depression anxiety are separate things. And the alcohol is just an escape from psychiatric symptoms. And then when they stop and they see their depression, anxiety resolved without any other treatment. It’s a big aha moment for people. And it’s then a huge motivator to try to maintain those games.

Casey McGuire Davidson  28:32

Yeah, and, you know, I thought that was interesting. And I absolutely remembered that in myself. So for years, and honestly, I was completely oblivious. And that’s why I love this book, I want to send it to all the women I know who struggle with alcohol, because I would go to my therapist and say, you know, I have a really stressful job, my son, my marriage XYZ, I wake up at 3am, which I said, I have insomnia, which now of course I know is related to alcohol withdrawal, and is pretty universal to people who drink a lot. I said, I wake up at 3am I have insomnia. I’m incredibly anxious. And of course, I got put on an anti-anxiety med and Ambien, which still drinking a bottle of night, completely dangerous, incredibly dangerous. And I never told my therapist how much I was drinking. I gave this sort of universal Oh, I drink a couple of times a week, a couple drinks a night kind of thing. And that was a good decade before I realized what the issue was.

29:43

Wow. Yeah. You know, this always makes me sad to hear this because there’s so much ignorance in the medical profession when it comes to the problem of addiction. And so, so many misconceptions including general lack of knowledge, awareness about the addictive potential of the medications that we prescribe, including things like Ambien, Valium, Konini, advent, which are basically alcohol in pill form. So, and I just want to say, and I’m not above that ignorance, I myself was extremely ignorant about addiction when I graduated from medical school. And even when I finished my psychiatry residency, I didn’t really know much about addiction, didn’t want to treat it, it was really my patients who taught me about addiction, and I’ve come a long way since then. So really hoping to influence my colleagues as well in their practice.

Casey McGuire Davidson  30:38

And I’ve talked to a number of women who have finally gone to their doctor or their therapist, and said, I’m really worried about my drinking, and have been told, it’s not a big deal, just cut back, you’re fine. You aren’t, quote unquote, an alcoholic kind of thing. Like, you’re okay. And I think that’s both not understanding. And also like, in society, we all drink. So they probably have bought into, you know, the idea that this, that alcohol is sort of innocuous, and not a big deal. And, you know, you can handle it just cut back.

31:21

Yeah, it’s really unfortunate, because, you know, instead of doing the primary intervention of cutting back or eliminating, you know, a potent drug like alcohol, what we often do in the medical profession is and minimize, normalize and then pile on other drugs to correct the symptoms caused by the alcohol. And that’s really unfortunate. And it’s, it’s, it’s, you know, it’s interesting for me to just look back at how my own practice has changed in the last 25 years, and how the first thing I would have done 20 or 25 years ago, was to prescribe an antidepressant and maybe even a name zeolitic, and maybe even a sleep aid. And now I spend most of my career helping patients get off of those drugs. And the first thing that I recommend most of the time is a dopamine fast. And not just for people using alcohol. Also, for people who are on their smartphones too much, or people playing video games, or, you know, people who are workaholics I mean, whatever, you know, your dopamine is, it’s so important to eliminate it for a period of time to reset the balance, and to be able to see true cause and effect and what the true impact of that behavior is on your life.

Casey McGuire Davidson  32:30

Yeah, you also talk about which I know I did, that. Patients who are struggling with substance abuse, believe their addictions are fueled by depression, anxiety and insomnia. And you talk about a patient in particular David, who attributed his fatigue is in attentiveness to mental illness rather than sleep deprivation and over simple, overstimulation, right, and then use that to justify his use of pills.

33:04

Right, exactly. So I see that so often, you know, where people are not practicing basic wellness, they’re not getting enough sleep, they’re not getting exercise, they’re not eating right, they’re working too hard. And then they’re surprised that they’re tired, anxious, and depressed. And I just think, you know, if I had to do what you do every day, I too, would be tired. I think our bodies have limits, right? We can’t expect our bodies to go beyond you know, what our normal human limits, we all have to make sure that we get enough sleep and that we make time for exercise, especially given how sedentary most of our jobs are now, you know, we have to make sure we don’t have too much stress in our lives to the extent that we can control that. And everybody’s level is different. You know, some people can tolerate more stress than others, we have to learn to know ourselves and what our own limits are. But instead, what people are doing is using substances taking pills, using all kinds of compensatory, unhealthy behaviors to compensate for a lifestyle that is fundamentally unhealthy.

Casey McGuire Davidson  34:16

Yeah, and you know that so it’s sort of like self-care, especially in that first 30 days is really important, because you’re not imagining that you’re, you know, if you’re drinking, you haven’t had a good night’s sleep sometimes in yours. You probably are overworked, over scheduled stressed out you’re definitely anxious just by virtue of what you were talking about with the pleasure, pain balance. So you know, really digging into self-care and sort of we talked about just bubbling up and lowering the bar is really important.

34:53

Yeah, I always warn patients when they take this experiment on that they’re gonna feel worse before they feel better. They should conceptualize it, like having the flu, they’re going to feel potentially really, really sick. Now, one caveat to all this is, this is a person who’s at risk for life threatening withdrawal. Obviously, I would not recommend the experiment of just stopping. Those are individuals that need a medically monitored detoxification. But barring that possibility, what I warn people of is, you know, you may need to take a couple weeks off work, you certainly want to let your loved ones know what you’re doing, and that you’re going to feel really ill. If it goes better than that great, but I want to paint like the worst case scenario for patients, because it is a front burner problem, it’s not something that they can sort of, do, you know, on the back burner while they’re still, you know, picking up their kids and coaching soccer and you know, going to work or you know, running PTA or whatever it is they really have to it’s an illness, you know, in their brain has become, to some extent diseased. And the, the way to treat that is to abstain, at least at the beginning. And that is a huge stressor on the system.

36:09

Yeah, yeah, definitely. I know, in my first week, I felt overly sensitive, like I was walking around without my outer layer of skin, even rageful. And I am absolutely not a rageful person, but I was just like, so angry. And I mean, it was it was crazy. Yeah, I mean, you’re really getting at the way that our, you know, brains, push us to drink again, you know, in a way those Gremlins jump up and down really hard on the pain side of the balance, you know, to drive, you know, to drive us to us, again, not to mention that just purely from a psychological construct. It feels like taking away a best friend, right? Yeah, priding ourselves or that one thing that we could do for ourselves, especially, I think, you know, at the risk of sounding sexist, so many women are in caretaker roles. And so, alcohol can sometimes, and this is for men, too. You know, sometimes when people aren’t, they they’re not good at getting their own needs met or vocalizing their needs or standing up for themselves. And then alcohol becomes the way that they meet their needs and stand up for themselves and take care of themselves. So for all those reasons, it’s also really hard to let it go.

Casey McGuire Davidson  37:33

Yeah. And I found for myself, and a lot of women I work with that. It actually really took off after I had kids. So before I had kids, I went to yoga, I went to Pilates. I took guitar lessons, I did all these things in addition to work. And then I had to go to work and pick up my son at daycare, and, you know, get him food to take care of him play with him. You know, Legos get into bed. And I could do all that while having wine. Like it was like multitasking.

38:08

Mm hmm. Yeah, yeah. Yeah. Not to mention that there’s this whole, you know, mommy drinking culture, loaded by the industry. That very much. normalizes that, yes, that kind of consumption and is, you know, unfortunate.

Casey McGuire Davidson  38:25

Well, let’s talk about that. Because in the book, you talk about how one of the biggest risk factors for getting addicted to any drug is easy access to it. And, you know, just in my own life, alcohol is literally everywhere, and anything, you know, literally most drinkers surround themselves with other drinkers. And, you know, there was alcohol and is at first birthday parties at the I take my daughter to little kickers soccer skills, and they serve wine and beer for the parents in the, you know, two year old four year old seven year old soccer practice during their 15 minute lessons. I mean, it literally is attached to every event.

39:13

Yeah, yeah, no, this is really you know why the book is called dopamine nation, we are living in this really unprecedented time of universal access to all kinds of addictive drugs and behaviors. And it you know, if alcohol is not the drug that tips to your pleasure, pain, balance to the side of pleasure, trust me, there’s something else out there, you know, coming along soon that you will encounter, which is why I think that in many ways people in recovery from addiction are really modern day prophets for the rest of us because if they can figure out how to navigate this dopamine saturated world and the rest of us to

Casey McGuire Davidson  39:52

do you I’ve heard from different people that the balance is changing, like the heaviest drinker is our baby. boomers and Gen X, which I’m Gen X, and somehow millennials or Gen Z or whatever, aren’t drinking as much, maybe they’re like getting their hits on social media or something else, like what have you seen there, yet, and the what the data show is that rates of alcohol use and alcohol addiction are going up in the United States, and in many other countries all over the world. The rates are going up highest in women, and in older people. So alcohol addiction has increased 50% in women in the past couple of decades and 85% in older people. The reason that’s interesting is because those are demographics that were previously thought, relatively protected for a variety of reasons from alcohol addiction, and no longer are. In fact, Millennials show some of the highest rates of alcohol addiction among women. Contrary to what you’ve, oh, you know, millennia, I had hoped for the younger generation.

41:07

Yeah, no, no, there are more women. I think, you know, the data show that the rates of alcohol addiction in women have been climbing again for several generations and, and that climb has been the steepest among college age. You know, and a little bit older, so mainly millennials, with, especially with dangerous drinking patterns, binge drinking patterns. It’s also true, though, that the norm today is polypharmacy. So very seldom do people who are, you know, using alcohol in an addictive way, just use alcohol, they’re often using, you know, cannabis in various forms. They’re using psychedelics, they’re using nicotine products, they’re using, you know, stimulants. So it’s really, it’s really normative now to see polypharmacy. But even in the context of polypharmacy, people usually have their drug of choice, the thing that they like best or turn to most, yeah, and that, that, again, goes back to just the supply, easy access is everywhere.

42:11

Because we haven’t changed our brain, our brain, our primitive brains haven’t changed, what’s changed is the ecosystem. And access is probably the biggest contributor to the increasing rates and increasing risk of addiction in the modern world.

Casey McGuire Davidson  42:26

Yeah, and I, I can only assume that during the pandemic, drinking and heavy drinking just increased, because, you know, in terms of availability, and time and sort of freedom to drink, everybody was home, right? So I used to not start drinking till 6pm when I walked in the door, you know, once you’re at home, 24/7, that barrier has been removed.

42:51

Exactly. And not only are you right next to your refrigerator, so potentially right next to it, but you have nobody looking over your shoulder, you’re in your pajamas, and you don’t have to be at work early the next morning, right? You can be at work late the next morning again in your pajamas. So we have seen an increase in alcohol consumption, just based on sales reports, during quarantine and during the pandemic. And we’ve also seen an increase in treatment seeking for substance use disorders. During that time. Some of that is good. So it’s not all that people are getting more addicted, there’s some element of people, some people having more time to actually address their health problems. So I’ve seen patients actually get into recovery during quarantine in a pandemic. So this has been a relatively healthier time, with less time spent commuting more time for themselves and for wellness, but certainly plenty of patients for whom quarantine and COVID has been really hard.

44:00

Yeah, some people say sort of this social pressure to drink or the drinking occasions if they decide to do what you call dopamine fasting if they decide to stop drinking, it’s easier right? Because you’re not being invited to happy hours or necessarily book clubs as often when the wine is flowing. A lot of people didn’t go out to eat for a very long time and so that was easier as well. You know, you go to a restaurant, the very first thing they ask you is what you want to drink and bring you the you know, beer and wine and cocktail menu before they even bring you food menu. So it’s been both.

Right exactly agreed.

44:41

You have a whole big section on what you call self-binding. What I when I was reading it, thought of as my years and years of attempting to moderate you know in terms of both physical barriers between you know you and your beverage of choice. Putting rules in about when you’re going to drink, like, I’m only going to drink when I’m out, or I’m only going to drink when I’m home, or I’ll never drink before 6pm. But tell us about that concept of self-binding.

45:13

Yeah, so finding is the idea that our willpower is limited, and it lasts about a day. And we have more willpower when we wake up in the morning than we do before we go to sleep. But even the best willpower is not going to be able to overcome the physiologic drive to restore homeostasis, or to challenge those Gremlins on the pain side of the balance. So in order to be able to, you know, abstain, if that’s our goal, or moderate, if that’s our goal, we really have to put barriers in place before we have the desire to use. And those barriers take many different forms, I divide them broadly into space, time and meaning. Space just means geographic space, you know, for example, not having alcohol in the house. Again, whether your goal is abstinence or moderation just not having an easily at hand. Or I will have patients who travel a lot, who will call the hotel in advance and ask them to remove the minibar. Simple things like that steps you can take to make sure that it’s harder for you to get to the alcohol. Time is exactly what you talked about. This is really more for folks who are attempting to moderate trying to restrict it to certain days of the week, certain amounts, you know, certain milestone achievements, I’m only going to drink after I finish all my work or whatever it is. Again, I think you point out well that moderation doesn’t work for everybody. And in fact, there’s the real danger of what’s called the abstinence violation syndrome, that people are able to abstain, then when they do go back to trying to drink in moderation. In fact, they slip immediately back into even heavier use than prior to abstaining. And that that is a really good indicator that moderation is not an option for that individual, that there’s somebody who probably will need to abstain for the long haul. And then meeting is just a way of categorizing our substances. So for example, when it comes to alcohol, some people are able to moderate by just sticking to beer and not using not you know, not drinking hard liquor or wine or some of their favorite wine or something like that. So they kind of mitigate the reinforcing effects. I will also add that we now have medications that can function as self-binding strategies. For example, something like now trek zone literally blocks the opioid receptor. Alcohol works on the endogenous opioid system by releasing opioid in our brains, which then in turn releases dopamine. So by blocking the opioid receptor, but now Trek’s own does is decreased. The rewarding feelings we get from alcohol, which for a lot of people really helps them either not drink at all, or drink less when they do drink. There are other GABA and glutamate modulators out there that people can use and even a medication called de sel from, which acts as a deterrent. Which if people take that they’ll get by and they drink they’ll get violently ill. So these are an abuse.

Yep, that’s commonly known as an abuse Yeah, now tracks on an abuse or two, I hear often as if you’re having trouble moderating or stopping is a suggestion to talk to your doctor about them. What do you think of both of those?

48:36

I think they’re great tools. They’re nudges. Okay, they’re not they’re not cures. Along with the other behavioral interventions, they can be really helpful. The nice thing about naltrexone is that it’s useful for people for whom it works. So these are also they’re very idiosyncratic, they’re not going to work. Some people, they’re great people, they don’t do anything at all. But for people for whom they work. Now track stone is nice because it can help not just with absence, but also with people for whom the goal is moderation. And abuses are really effective. And obviously, it’s just for an absent in school, you can’t moderate it because you get sick if you drink on it. But its what patients tell me about Antabuse is that it basically takes the decision off the table, they have to decide once a day to stop drinking it or have to keep deciding all day long, which I thought was a great way to kind of describe it. You know, you take your advice in the morning, it’s like done can’t drink. Yeah, and that interestingly takes away cravings for people because once they know they can’t drink, they kind of stop thinking about drinking. Yeah, there are also other medicines out there that are not necessarily FDA approved, but can be used off label to help people curb you know the urges to drink in particular, Topiramate is one that I like it also has a side effect of weight loss so that can be nice. None of these agents are in and of themselves addictive or habit forming, which is really important.

50:05

What was that last one? You mentioned? I hadn’t heard about that.

 

50:08

Topiramate or Topamax can be helpful off label for people who are trying to stop or decrease drinking.

Casey McGuire Davidson  50:16

And is that similar to now trek zone or it doesn’t, it sounds like it doesn’t make you sick. If you drank Nope,

50:22

it doesn’t make you sick. It works by a different mechanism altogether. It works on the GABA and glutamate systems, it’s actually an anti-seizure medicine. But people report that it changes the appetitive desire to drink, and also the appetitive desire for carbohydrates, which is why it’s sometimes used off label for binge eating.

50:44

Okay, that’s really, really interesting. And, you know, when you talked about self-finding, and the rules, and I don’t know, a single woman who goes for a longer time period without alcohol, and most of the women I work with have been trying to moderate often for years, right? And just have figured, you know, made all the rules because we none of us want to give up our drug of choice. So I know I did all the things and that might work. For some people, it didn’t for me, I mean, I was like, I’m only going to drink to drink site, switch the beer, because red wine was like, my jam, I did the water in between each one. I actually switched from a bottle of wine to box wine. That was a bad call. But my idea was not a good idea. And it’s crap wide. But it was like, Oh, well, if I don’t see the bottle, and that there’s only a quarter left, I could just have Yeah, that was bad.

51:47

Yeah, I mean, you know, people are out there doing the research, you know, collecting the data. I mean, at some point, you know, what I say to patients, if they’re just keep moderating, and there’s no, we’re gonna say, you know, you really may be somebody who’s just better off staining. And if you try staining for six months, and kind of do an honest accounting of how that was, you might just decide it was worth it. I mean, one of the things that is really an important reframe, is when we take away our drug of choice, it feels like we’re depriving ourselves, but really, we’re not we’re giving ourselves a huge gift. But it’s a delayed gift. It’s not something we’re going to reap the benefits of right away. It’s going to come later, in subtle and many intangible forms.

Casey McGuire Davidson  52:32

Well, you’re giving yourself the gift of not going through that withdrawal constantly, and having your dopamine reset and just you said, being able to experience pleasure in your daily life and not waking up with that constant anxiety. Yeah,

52:49

yes, exactly. And being able to take real joy in things that are not related to drinking. Yeah, those are, those are huge gifts, and you don’t get the hangovers and feeling like garbage and stomach being upset and weight gain and all the other things.

53:05

Yeah. Oh, yeah. No, there’s lots of lots of things to be gained. But it’s just hard to remember that in the moment when you know, when you’re having cravings, or you’re feeling bad. And yeah.

Casey McGuire Davidson  53:16

Let’s talk about social media. Because I know, you know, phones are literally everywhere. I have to say my husband and I were talking about this book last night, we have a seven year old daughter who is like, on YouTube constantly, you know, it after school and sports and like she like literally like flaps or have it bikes, like look at all those dopamine hits, like that’s like hugging by second. And obviously, it’s not just her, we’re on our phones all the time. So it’s hard to abstain from social media, right?

53:51

It’s really hard. But I would argue that it’s really addictive, it’s really a drug. And we have to collectively and individually start to conceptualize it as such, which doesn’t mean we’re going to get rid of it or even that we should get rid of it. And hopefully most of us will be able to figure out how to coexist with it and consume it in, you know, in moderation. But we won’t be able to do that. I don’t believe until we openly acknowledge that it really is a drug and that it releases dopamine. And it calls it you know, it drops us right into this compulsive loop, where we feel good when we’re doing it. And then the moment we stop our pleasure, pain balance tip to the side of pain, and we’re mentally preoccupied with wanting to reach for it again, feeling restless, anxious, like we’re missing something. For parents, I really do recommend that you do not give your child their own device. Yeah, well, you know, age 13 or 14, and that prior to that them having their own device to closely monitor and regulate the time that they have on screens because it is a drug and you don’t want to get your kid into this loop of that being the Only rewarding and reinforcing thing. Yeah, they do. Now your daughter sounds like she swims and does other things. But even so if she is, and every kid is different, some kids, you know, can kind of take it or leave it, the screens, most kids not. So you really want to explain to your kid, you know, this is basically like eating a bag of potato chips, or a great big piece of chocolate cake. We can do that at birthday parties. And maybe, you know, after we’ve done our homework and eating our vegetables, you know, we can have a little slice of cake, but it’s not something that, you know, you can be doing before those things, or even every day, you know, it’s a, it’s a special treat for a special occasion. And if we do it too much, we will get sick.

Casey McGuire Davidson  55:45

Yeah. And I see that, like, again, with the pandemic, and quarantine, you know, in terms of that time block self-binding, really went off the rails because I was working all day. And she was home, right? School only take so long that was on a screen too. And so the balance got really out of whack. As opposed to now where, you know, school all day soccer three times a week, and if you weren’t what, you know, we eat dinner, there’s bedtime, you know, I’m, I believe I absolutely need to get better and do better than I’m doing right now. But like, thank God, I’m not trying to monitor it and handle it, you know, for multiple hours a day.

56:33

Oh, yeah. I mean, you and millions of parents across the globe, are very grateful that kids are back in school and that they have, again, activities that don’t, don’t involve being on a screen at home. It’s just it’s been really, really hard, I think, but it’s for adults, too, right? You talk about the alerts that go off, like, when a text comes in, I get a ding when an email comes in, obviously Facebook likes or Instagram. You know, we get that dopamine hit too and go through that higher low if like, you don’t get any interaction or likes or, you know, how does that work?

 

57:12

Well, that’s again, the dopamine dopaminergic system, the pleasure, pain balance. So what happens when we get an alert? We’re just like one of Pavlov’s dogs. Pavlov, you know, he realized that his dogs, the dogs would salivate when presented with a slab of meat, and they eagerly ate it. And then he trained them to know that if they heard a bell, and then would, that the meat would follow a few minutes later, they would stab salivate just when they heard the bell, they didn’t even have to wait for the meat, and they were already salivating. And then subsequently, neuroscientists could show in mice with a similar kind of paradigm, that when the light went off, so they stuck a probe in the rats’ brains, rats’ mice in their brains to measure actual dopamine levels. And our dopamine is always kind of firing at a constant low level. And then when we ingest a reward, it goes way up, right, and addictive substances have even more dopamine than things that are not particularly addictive. But what happens when you condition the brain to know that a reward is coming like, like through an alert, that causes a little mini dopamine spike that isn’t as big as what we get with the reward itself, but it’s still a mini reward. But here’s the interesting piece right after that mini reward that comes with the trigger or the alert or the light or the sound, the brain compensates by going not just to baseline dopamine levels, but actually below baseline dopamine levels. So again, we have the balance tip to the side of pain, we’re in a little mini deficit state and that’s what drives the motivation to go get the drug. So that’s exactly what’s happening. When we’re online. We’re working, we’re being productive, getting something done. And then an alert goes off, and we see Oh, I got a text. Immediately, we get a little release of dopamine, followed by a little dopamine deficit state and then we’re craving we’re mentally preoccupied, restless, anxious, it can take many different forms. Oh, I’m missing something. Oh, is that my kid? Oh, was that my boss? Oh, did I win the lottery, you know, whether your brain skews positive or negative. It’s all kinds of thoughts that are driven by this dopamine devastate that basically get us to stop what we were doing, which was working productively, and go check that text. Yeah, this loop can be repeated and is repeated for many of us hundreds of times in a single day. Which is why turning off your alerts is really important. The other thing I really recommend for people who are in the public sphere like you know like you and myself and you know, doing these kinds of, you know, shows that we believe in order pass on messages is that we actually don’t look at likes and don’t I never watched my interviews. So you know, because I don’t want to be about me, I want it to be about the ideas and about helping people. And the moment it becomes about me, then, you know, I also become vulnerable to this kind of vicious cycle of sort of narcissistic dopamine, which I don’t want to do. So you know, making your phone grayscale, so it’s less appealing, turning off your alerts, not paying attention to likes or comments or anything like that, you know, I mean, in moderation, obviously, there may be are some venues where it makes sense to do that. But these are the types of things that you know, we need to think about, so that we reduce really the potency and the addictiveness of our interactions online.

Casey McGuire Davidson  1:00:43

And I had to do that, even with news like after the election, and during the run up to the election, I was getting news alerts from New York Times, and NPR and CNN just popping up on my phone. And it was just, I could feel it, like spiking my dopamine, like lighting in my brain. And I went to turning them all off and just consuming news, like, first thing in the morning and in the evening, and even reading it not watching any cable news coverage, because it was so you know, I didn’t need to follow the ups and downs of every intricacy small thing that happened. And I was like, Okay, I just need to learn what the digested impact without the drama was, because it was making me really unhappy.

Yeah, I think you’ve really described it well, that the medium really matters. And the medium in which we get a lot of our news online, has made the news a drug. And where we’re constantly getting bombarded by you know, oh, this happened that happened. Knowing these little sorts of sensational snippets that release dopamine in our reward pathway, our, our dopamine is about novelty. It’s not just about reward motivation. It’s about newness, about novelty about, you know, what do I need to pay attention to? And so we can easily get caught in that loop. And the antidote is, as you realized, to get your news in a less sensational format, a different medium, long form journalism, more long form podcasts, something that’s slow news, you know that.

Yeah, you know, click you into this kind of craving state. Yeah, not the clickbait headline, kind of thing. And you talk about the different levels of dopamine. So dopamine measures the addictive potential of the substance. More dopamine, how fast it is, the more addictive the drugs. So you talked about chocolate increases dopamine above baseline 50%. Sex is 100%. Nicotine is 150. amphetamines are about 1000. What about alcohol? What level is that in terms of the spectrum of, of the addictive potential of this substance?

1:03:02

So those series of experiments, we’re not done with alcohol, okay? It’s interesting alcohol. Some rats, it’s very difficult to get them addicted to alcohol, other rats that are genetically predisposed and bred for that will get addicted to alcohol. Alcohol is also interesting because it primarily works on the brain’s endogenous opioid system. So we make our own opioids. And alcohol triggers that system along with the endogenous GABA system, GABA is a calming neurotransmitter. And ultimately, the final common pathway of alcohol is dopamine. But it’s not as easily quantified because of the relatively indirect method by which it gets there.

Casey McGuire Davidson  1:03:50

So it’s in there somewhere, but not with a specific percentage of.

 

That’s right, how it definitely in there, it’s definitely in there. But in that particular experiment, it wasn’t one of the substances that was that was looked at.

Casey McGuire Davidson  1:04:05

Okay, awesome. Well, so if any woman’s listening to this and thinking about their own consumption of whether it’s alcohol or prescription drugs, or social media, anything, what advice do you have for them,

1:04:19

I advise a 30-day dopamine fast, where we eliminate our drug of choice for 30 days, knowing that will feel worse than the first two weeks. But if we can make it two weeks three and four, will reap the benefits not only of a dopaminergic system that has returned to homeostasis, but we’ll also be able to see with more clarity, the true impact of our drug choices and I use drugs very broadly to include any reinforcing substance or behavior will be able to see the impact of our choices on our lives, which is very hard to do when we’re in it. And when we’re chasing that dopamine feeling. In the book, I talk about my own addiction. To romance novels, which, you know, can sound sort of trivial and silly, but I really did, you know, get somewhat addicted to that. And I, I was startled when I did a dopamine fast, how hard it was to give up my nightly consumption, which is something that had just become really ingrained behavior. And I experienced a lot of withdrawal that felt very physical, especially with insomnia. But by the time I got to 30 days, I felt better. And I was also really able to see Wow, I really had become addicted so it can be regulatory in that way. And then I recommend deciding Okay, do I want to do you want to continue to abstain? Or do you want to go back to using in moderation and if you do, go back to using in moderation, make sure that you create self-binding strategies and especially that you’re honest with yourself and others about what you’re actually using or doing? Because it can be really easy to slip into. You’re telling lies to mostly to ourselves? Yeah, behavior.

Casey McGuire Davidson  1:06:00

Yeah, I know, I did that I stopped drinking for a year, really four months and then I got pregnant with my daughter, and then decided after she was born, that it was sort of situational that I could handle it now that my life was less stressful. And you know, the idea of I’m gonna have a couple glasses of wine on a date night with my husband. And very quickly I was back to Oh, I’m gonna have wine in the house and have wine every night and then you know, basically a bottle of wine or more a night It took me 22 months to get sort of the day I finally quit drinking after thinking that I was going to moderate and trying for that entire time.

1:06:45

Yeah, no, it’s that’s such a classic story and you know, for me too, after a month of not reading, you know, erotica, I binge for a weekend and then I realized wow, I really have a problem. So I gave it up for an entire year but it and then now I don’t I don’t read it because it doesn’t do anything for me anymore. That’s one of the hardest things about neuro adaptation is our drugs. Stop working for us, you know, yeah,

Casey McGuire Davidson  1:07:10

I have to say I watched Bridgerton and then a friend of mine had a book signing with the author, which is super cool. She lives in the Seattle area. And then I read all books at the eight series and that I read the four prequel books and anyway, so I hear you.

Yeah. That it’s not that we’re not allowed to have any indulgences, you know, we can have those indulgences. But there are certain ones that we the ones that really fit our particular lock and key, just kind of need to avoid and the other ones we need to do in in moderation. The other thing too, that I recommend in my book and I have a whole chapter dedicated to it is that the best way to get your dopamine is actually indirectly by doing painful things. By pressing on the pain side of the balance in small to moderate doses, we get the Gremlins hopping on the pleasure side of our balance, which is you know what’s called hormesis. hormesis is Greek for set into motion. And by introducing painful and or noxious stimuli, like exercise or ice-cold water baths, or making ourselves do things that make us anxious. What we do is we stress our system in the opposite direction and get our own production of opioid serotonin dopamine.

Casey McGuire Davidson  1:08:28

Oh, that’s why exercise works. Yeah, exactly. Exercise itself is noxious to cells. But what the body does as a healing response and starts to generate more opioids and more dopamine and more serotonin so that you end up getting dopamine indirectly, which is the right way to get it because it’s that way they call it like the runner’s high kind of thing.

Exactly. Yeah.

Oh, that’s interesting. And I don’t think it was painful, but I used to when I was playing guitar, just get so overcome with emotion and happiness and, you know, just emotions that I did not agree that is actually a great example of foot fits into this painful category. It’s not the playing guitar is painful, but it’s effortful, right? It’s ever full. It’s not an easy, quick fix. It’s not an it’s not, you know, a stimulus that immediately releases dopamine, it’s kind of secondary game because you had to probably practice enough to get to a point where, you know, you felt good doing it. You know, it’s the kinds of effortful engagement in our lives, slowly over time, leading to delayed rewards, which is the best source of dopamine.

Casey McGuire Davidson  1:09:36

Yeah, that’s great. Bad.

1:09:39

We need dopamine. We need it but we have to get it the right the right way.

Casey McGuire Davidson  1:09:43

Yeah, not in that intro bringing this hit constant. That’s right.

1:09:47

Yep. Not getting bolus all at once. Yeah.

Casey McGuire Davidson  1:09:51

Well, I really appreciate you coming on this show. I love your book. Like I said, I had audible book and then I was like, Okay, I need the hardcover. So I can underline and dogear it. And it’s because you really you do use these metaphors to explain what I’ve experienced what I see people experience in scientific terms, but very, very relatable terms and actionable terms in in terms of like, Oh, now I get it, why I felt that way and why this works and why that doesn’t work. So thank you so much for that.

1:10:28

Oh, you’re very welcome.

Casey McGuire Davidson  1:10:32

Hey there before I jump off this episode, I want to remind you that you can sign up for my brand new 60-minute masterclass, The 5 Secrets To Successfully Take A Break From Drinking, even if you’ve tried and failed in the past, by going to hellosomedaycoaching.com/class. Now, this training will not be around forever. So if you’re interested in figuring out what you’ve been doing up until now, and why it hasn’t been working, and exactly what to do. Instead, I encourage you to take a few moments, sign up, pick a time that works for you, and actually attend the session. I’ll teach you how to shift your thinking. So you can get out of the really shitty cycle of starting and stopping and starting again, and it’s okay if you’re thinking that you don’t actually want to stop drinking. I promise you, if you attend this class, you will change the way you’re approaching this process. So save your spot. Go to hellosomedaycoaching.com/class, and I can’t wait to see you there.

So thank you for coming on here. I couldn’t appreciate it more. 

Thank you for listening to this episode of The Hello Someday Podcast. If you’re interested in learning more about me or the work I do or accessing free resources and guides to help you build a life you love without alcohol, please visit hellosomedaycoaching.com. And I would be so grateful if you would take a few minutes to rate and review this podcast so that more women can find it and join the conversation about drinking less and living more.