Hooked: How Common Obsessions Lead to Depression

We are wired to pursue pleasure, but too much often backfires — among both children and adults. Here’s how to break the cycle and restore balance.

This article is part of a Wise & Well Special Report: The United States of Depression.

Gregory is an intelligent and kind young man in his mid-20s. At age 16, he dropped out of school. He still lives with his mother. Suffering from anxiety and depression, he has worked a smattering of entry-level, part-time jobs…none lasting more than a few months.

Gregory’s main preoccupation? Video games. He plays them for hours on end, every day and into the wee hours of the morning.

It would be easy to dismiss Gregory — whose name has been changed here to protect his identity — as just another lazy, unmotivated poster boy for Gen Z. But the fact is, you may be more similar to Gregory than you think.

As experts are increasingly learning, today’s easy access to over-stimulating behaviors — such as gaming, gambling, shopping, sexting, texting, Facebooking, and surfing the Web — provide near-constant enticement. And frequently giving in to those temptations can lead to obsession, addiction, anxiety, and depression, says psychiatrist Anna Lembke, MD, author of Dopamine Nation: Finding Balance in the Age of Indulgence.

“Whether it’s sugar or shopping, voyeuring or vaping, social media posts or The Washington Post, we all engage in behaviors we wish we didn’t, or to an extent we regret,” Lembke writes. By engaging in too much pleasure, we’re becoming “more unhappy, more anxious, more depressed, more irritable, and less able to take joy in the things that used to give us joy.”

More miserable than ever

Surveys confirm this miserable state of affairs. A Gallup poll earlier this year indicates depression affects nearly one in five Americans. That’s the highest rate since the organization first asked about it in 2015, and rates continue to climb. Rates are even higher among teens and young adults.

Some research places the blame on digital devices. A 2018 study of high school students, published in the journal Emotion, found that teens whose eyes are habitually glued to their smartphones are significantly unhappier.

“By far the largest change in teens’ lives between 2012 and 2016 was the increase in the amount of time they spent on digital media, and the subsequent decline in in-person social activities and sleep,” study lead author and San Diego State University professor of psychology Jean M. Twenge said in a statement. “The advent of the smartphone is the most plausible explanation for the sudden decrease in teens’ psychological well-being.”

Though the study does not prove cause and effect, other research has supported the link.

As Lembke puts it, “The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation.”

Too much of a good thing

Whether it’s sex, sugar, or social media, the response within our brain is the same: It produces the “feel-good” neurochemical called dopamine, which brings feelings of pleasure and motivation.

As Lembke explains, the brain releases chemicals to keep pain and pleasure in balance, like opposite sides of a see-saw. This is why pleasure is often followed by a sense of comedown, or hangover.

If we can wait long enough, this uncomfortable feeling passes, and balance is restored. But it can be difficult to resist the temptation for long, and many people will soon return to the source of pleasure for another “hit.”

If the pattern persists, the thinking goes, the brain’s set point changes, and we experience the same symptoms of withdrawal experienced from any addictive substance: anxiety, depression, insomnia, and craving.

Now we need to keep playing video games — or eating candy, or watching porn, or engaging with our drug of choice — not so much to feel pleasure, but to avoid pain and depression.

The ancient brain in the modern environment

The balancing seesaw of pleasure and pain made sense in the days of early humans, who had to constantly search for food, water, and shelter, Lembke says. Our ancient ancestors had to do enormous amounts of work for relatively small rewards. It was dopamine that kept them moving and always looking for the next reward.

Today, because we are literally surrounded by pleasure — food, drink, and all forms of entertainment — our ancient wiring is woefully mismatched for our modern environment.

As Lembke puts it: “We have more access to more reinforcing drugs and behaviors than at any point in human history. We are drinking from a firehose of dopamine.”

Dopamine’s role in motivation is evident in a famous 1995 experiment in which rats were bioengineered to have no dopamine receptors in the brain. The scientists found that if they put food directly into the rats’ mouths, the rats would eat and seem to derive pleasure.

But if scientists set the food only inches away, the dopamine-deficient rats didn’t eat. They wouldn’t bother to move for it — even to the point of starving to death.

What does this mean for humans? According to researchers, we need dopamine not only for the experience of pleasure…but also for the motivation to do the work that later results in pleasure.

How to identify and break the cycle

You may not be so lacking in motivation that you won’t lift a finger to get to your food. But perhaps you suspect you’re a bit out of kilter.

It could be that you’re having trouble cutting back on the time you’re spending with your favorite guilty pleasure. You may be neglecting important areas of your life, such as sleep, relationships, or personal hygiene. Or you may have tried to cut back, but are set back by symptoms of withdrawal, such as irritability and brain fog.

To restore balance, Lembke recommends a “dopamine fast.” This involves identifying your unhealthy, compulsive behaviors and taking a break from them, generally for about 30 days. (She warns that people addicted to substances such as drugs and alcohol should approach withdrawal under the care of a professional.)

The initial goal of a dopamine fast is to get your pleasure-pain balance back into sync. Lembke says her patients have found it easier to eliminate an addictive behavior entirely at first, and later re-introduce it in moderation. For example, after 30 days, you’re likely to be able to enjoy just a single scoop of ice cream or an hour of video gaming.

According to Lembke, three types of barriers can help control addictive behaviors:

• Physical: Create distance between yourself and your addiction. This could involve removing tempting items from your home, car, or office. If you’re addicted to digital behaviors such as online gambling, gaming, or shopping, it could mean putting your laptop away when your work is done or deleting certain apps on your cell phone.
• Chronological: This involves putting a time limit on compulsive activities. For someone with an addiction to food, this could involve intermittent fasting. For a video gamer or compulsive shopper, it could mean setting a timer when accessing your favorite games or online sites.
• Categorical: A categorial barrier refers to limiting yourself from the types of lures that may control you. For example, if you find reality TV addicting, you might try watching sitcoms or news programs instead. Hooked on sports betting? Refrain from surfing sports-related Internet sites, listening to sports radio, or watching sports on TV.

The benefits of balance are worth the pain

In this age of abundance, everyone is vulnerable to compulsive overconsumption. Reducing reliance on unhealthy enticements isn’t easy, since it causes the brain’s pleasure-pain balance to initially tilt toward the side of pain. Those first, tentative steps make us feel cranky and on edge.

“But if we can keep it up long enough, the benefits of a healthier dopamine balance are worth it,” Lembke says. “Our minds are less preoccupied with craving, we are able to be present in the moment, and life’s little unexpected joys are rewarding again.”

This article is part of a Wise & Well Special Report: The United States of Depression. If you or a loved one is depressed, it’s vital to talk about it. Because depression increases the risk of suicide, consider calling the confidential National Suicide Prevention Lifeline at 1–800–273-TALK (8255) for English, 1–888–628–9454 for Spanish, or call or text 988. Global support in 44 languages is available from Befrienders Worldwide.