It’s become alarmingly common to invoke dopamine as the root cause of so many problems. But this demonisation of a vital and versatile neurotransmitter risks causing serious consequences for us all.
I feel like I have to defend the use of shorthands. It is much easier to say I am addicted to social media than explain I have difficulty controlling the time I spend on social media although it gets in the way of my more long term goals and values and no matter how much I try to forgo the short term pleasure I get from social media to engage in activities that can help me get to my longer term goals I keep slipping back and then feeling dissatisfied with myself
Yes, those who think dopamin hit is a scientific explanation are using an erroneous and unhelpful model the same way that if someone thinks the pain they feel when they are dumped is literally because their heart is broken. But using the expression that I am heartbroken is a helpful shorthand.
I guess I am just saying let's not nitpick on how people talk
That's not an accurate comparison though. We say "heartbroken" when we've ended a relationship or experienced a loss. We don't say "I am having a heart attack". If we did, that would seriously confuse matters medically, and make it a lot harder for people experiencing a genuine heart attack.
We've even seen this play out in real life. For years, people with depression were dismissed or ignored because "everyone gets depressed sometimes". If now whenever we were sad we said "I am experiencing clinical depression", that would take us back a long way. Saying everyone is 'addicted' to whatever the current target of suspicion is, that's literally the same thing.
The fact that it's convenient doesn't excuse the harm and misunderstanding that genuinely results from this
Dean, thanks for the article, but there are some points where I find myself in disagreement.
I feel that if someone is trapped in a cycle of compulsively using their smartphone despite efforts to stop and perceptions that this is harmful to their life, why shouldn’t we classify this as addiction?
I do think that we can say with some confidence that part of what’s going on is being mediated by dopamine signaling in their brain’s reward system, so it does seem valid to talk about dopamine.
In the case of gambling addiction, certain people can become behaviorally addicted, and part of the problem is that the gambling experience has been intentionally designed to maximally elicit activity in their reward system.
The same is true of smartphone apps. Features on these apps have been intentionally designed to to maximize reward signaling in the human brain.
And for some people they find themselves unable to properly regulate their use when confronted with these apps.
I’m not sure then why we should shy away from the term addiction in this case when we do know that behavioral addictions are a valid class, and if a person is meeting criteria of compulsive use despite efforts to stop and perceived harm to their life.
Further, I’m not sure why we shouldn’t talk about dopamine in relation to this when the topic at hand is signaling in the brain’s reward system.
The problem with this is that addiction is a very significant and loaded label that even the leading medical organisations use very sparingly (e.g. the DSM which lists the criteria of all recognised mental health issues technically calls it 'Substance use disorder'). There's actually a complex history in medicine with the term addiction, with the medical community narrowly voting to drop the term altogether at one point, then reinstating it when this proved to be even more problematic in the long run.
It's a very specific disorder with a set range of criteria. There's a reason that a lot of medical bodies only officially recognise gambling as a non-substance addiction.
Put simply, the vast majority of behaviours labelled 'smartphone addiction' or whatever don't meet the criteria for the label. Sure, if someone's smartphone use does meet the required parameters, then sure. Label it as such. But "kids scrolling through TikTok too much" is not the same thing at all.
This isn't to say that you can't develop clinically unhelpful behaviours and compulsions around smartphone use, because you can. These are just different from addiction. E.g. in one of the more recent updates to the diagnostic criteria, compulsive and addictive disorders were separated, and acknowledged as distinct issues. Unhealthy phone use may be more suited to the compulsive issues bracket.
There's also been a effort to introduce 'problematic smartphone use' as a label, which I wholeheartedly support. My issue isn't that there's no problem at all, but that the wrong terms are being applied far too liberally, to the detriment of all involved.
As for why we shouldn't talk about dopamine in such contexts, I think I make my position clear, but I don't agree with the contention here.
Invoking dopamine regarding pleasurable stimuli doesn't add anything, it just implies a level of technical understanding that is often completely lacking. Apps are designed to maximise reward signalling in the brain, but technically so is anything ever created with the intent of other people enjoying it. Phrasing it like this implies tech companies have teams of neuroscientists figuring out how to hack the brain's workings via Angry Birds, or something. This is very much not the case, but it reinforces the 'tech is damaging our brains!' rhetoric that is so often misleading and harmful, and not at all evidence based.
And referring to dopamine in the context of addiction and reward is basically a neuroscience tautology. Because those experiences are dependent on dopamine signalling. There is no non-dopamine equivalent process. Saying 'dopamine addiction' is basically saying 'addiction'. There is no addiction without dopamine. So either it's all dopamine addiction or none of it is. Hence labelling certain behaviours 'dopamine addiction' is misleading. It sounds more technical and therefore more official, more 'convincing', but it's a meaningless distinction.
The fact that it's used reveals the lack of insight of what's actually going on, which is never a good thing, when those who lack understanding are controlling the discussion.
I seriously doubt the reason depression was ignored in the past was people used the word depression too liberally. Using therapy talk was a side effect of mental health being taken more seriously and therapy becoming more accepted and popular, not the other way around.
In any case, I totally agree with you that over medicalization of every day phenomena and ubiquitous use of disorder language or neurochemicals as a shorthand has harms. But I don't think the language use is at the heart of this. The way we talk is usually the reflection of what concepts are taken more seriously and are accepted as more valid and how incentives motivate people to use those concepts for achieving practical or political goals (it is easier to get accommodation as a student if your use of social media is addiction which is a mental health issue)
I don't think we should nitpick how people talk, except when it is clearly feeding into a misunderstanding. People regularly compare social media use to drugs--it's even happening in the comments on this article! This is an unhelpful analogy that leads to mistaken assumptions, and in a world where legislation is drafted based on these misunderstandings, I think it's warranted to pick on these analogies
Great piece! I love the line “People struggling with genuine addictions have their issues devalued by overuse and dismissal, like if papercuts were regularly described as ‘amputations’.” I have been making the same point about “trauma”. We psychologists have long had a problem over generalization.
This is so important. Thanks for writing this. We plan to release a related post on the fearmongering surrounding dopamine “hits” and video games soon!!!
Biodiversity is another hijacked term that used to mean ‘the diversity of life’ and now means conservation of rare things. Perhaps a function of dopamine is to allow obfuscation to feel good.
Exactly! What DID dopamine do to deserve this? The neurotransmitter without which we could not move, learn or fall in love. Brilliantly written, moving effortlessly through a topic that is a minefield. Love the 'science garnish' term 😂. Could get into much more in-depth speculation about why these things happen, psychologically. Why we get hold of a scientific metaphor and can't seem to let go - but will spare you this time 😉. Maybe not fully aligned on some specific details - especially re behavioural addictions - definitions of behaviours can and do evolve, and sometimes for a good reason. The word 'trauma' is a good example. But anyways. A very good paper, thank you for a breath of fresh air (metaphorically of course). 🙏
Very useful to hear the argument spelled out like this. I am in the eating disorder world and “food addiction” gets thrown around often because certain foods elicit a “dopamine hit”. But it is so much more nuanced!
LOL oh man! I literally said I was planning to tag you in a note about it and just didn’t get around to it yesterday (@Carrie Reid-Knox can vouch for me saying I was planning to!)
It was literally because of you asking me to write about it that I reached out to Dean about if he would be interested in writing an article about this for me months ago. I decided to outsource hahahaha
Probably unrelated but I seem to be flooded with all the pleasure chemicals as I've been permanently orgasmic for 2 years. How can I medically confirm this? Is there a way to check my neurotransmitters? Thank you!
>we live in a society that, despite bombarding people with instructions to indulge themselves all day every day lest our economy collapse, regularly takes a dim view of anyone who pursues pleasure or enjoyment to a noticeable degree.
Yeah - it is oddly schizophrenic (to misuse another term).
And every generation has had old people saying "Kids these days!" (See Pessimits Archive's Substack)
I agree we shouldn't nitpick how people talk, but using medical/ scientific words too liberally usually has negative social connotations. People have been using terms too liberally, someone who's just feeling sad calls themselves depressed, and people often use the term OCD far too frequently to explain their affinity for cleaning (I have been told too many times that I have OCD because I like my surroundings clean and tidy). The goal is not to nitpick but to make people more mindful of the terms they are using.
How is the hit achieved? I know about the dopaminergic paths and actions but not clear how feelings are generated in the body. Is it via the HPA or are there other paths/particles?
On things being framed as "addiction" (or its kin terms, like "disorder") and brain chemicals, this seems to be necessary to medicalize the framing of the discussion. If behavior can be reduced to chemicals and called "addiction," then a medical (and often drug-based) response can be pushed on people. Incentives, incentives everywhere . . .
I feel like I have to defend the use of shorthands. It is much easier to say I am addicted to social media than explain I have difficulty controlling the time I spend on social media although it gets in the way of my more long term goals and values and no matter how much I try to forgo the short term pleasure I get from social media to engage in activities that can help me get to my longer term goals I keep slipping back and then feeling dissatisfied with myself
Yes, those who think dopamin hit is a scientific explanation are using an erroneous and unhelpful model the same way that if someone thinks the pain they feel when they are dumped is literally because their heart is broken. But using the expression that I am heartbroken is a helpful shorthand.
I guess I am just saying let's not nitpick on how people talk
That's not an accurate comparison though. We say "heartbroken" when we've ended a relationship or experienced a loss. We don't say "I am having a heart attack". If we did, that would seriously confuse matters medically, and make it a lot harder for people experiencing a genuine heart attack.
We've even seen this play out in real life. For years, people with depression were dismissed or ignored because "everyone gets depressed sometimes". If now whenever we were sad we said "I am experiencing clinical depression", that would take us back a long way. Saying everyone is 'addicted' to whatever the current target of suspicion is, that's literally the same thing.
The fact that it's convenient doesn't excuse the harm and misunderstanding that genuinely results from this
Dean, thanks for the article, but there are some points where I find myself in disagreement.
I feel that if someone is trapped in a cycle of compulsively using their smartphone despite efforts to stop and perceptions that this is harmful to their life, why shouldn’t we classify this as addiction?
I do think that we can say with some confidence that part of what’s going on is being mediated by dopamine signaling in their brain’s reward system, so it does seem valid to talk about dopamine.
In the case of gambling addiction, certain people can become behaviorally addicted, and part of the problem is that the gambling experience has been intentionally designed to maximally elicit activity in their reward system.
The same is true of smartphone apps. Features on these apps have been intentionally designed to to maximize reward signaling in the human brain.
And for some people they find themselves unable to properly regulate their use when confronted with these apps.
I’m not sure then why we should shy away from the term addiction in this case when we do know that behavioral addictions are a valid class, and if a person is meeting criteria of compulsive use despite efforts to stop and perceived harm to their life.
Further, I’m not sure why we shouldn’t talk about dopamine in relation to this when the topic at hand is signaling in the brain’s reward system.
The problem with this is that addiction is a very significant and loaded label that even the leading medical organisations use very sparingly (e.g. the DSM which lists the criteria of all recognised mental health issues technically calls it 'Substance use disorder'). There's actually a complex history in medicine with the term addiction, with the medical community narrowly voting to drop the term altogether at one point, then reinstating it when this proved to be even more problematic in the long run.
It's a very specific disorder with a set range of criteria. There's a reason that a lot of medical bodies only officially recognise gambling as a non-substance addiction.
Put simply, the vast majority of behaviours labelled 'smartphone addiction' or whatever don't meet the criteria for the label. Sure, if someone's smartphone use does meet the required parameters, then sure. Label it as such. But "kids scrolling through TikTok too much" is not the same thing at all.
This isn't to say that you can't develop clinically unhelpful behaviours and compulsions around smartphone use, because you can. These are just different from addiction. E.g. in one of the more recent updates to the diagnostic criteria, compulsive and addictive disorders were separated, and acknowledged as distinct issues. Unhealthy phone use may be more suited to the compulsive issues bracket.
There's also been a effort to introduce 'problematic smartphone use' as a label, which I wholeheartedly support. My issue isn't that there's no problem at all, but that the wrong terms are being applied far too liberally, to the detriment of all involved.
As for why we shouldn't talk about dopamine in such contexts, I think I make my position clear, but I don't agree with the contention here.
Invoking dopamine regarding pleasurable stimuli doesn't add anything, it just implies a level of technical understanding that is often completely lacking. Apps are designed to maximise reward signalling in the brain, but technically so is anything ever created with the intent of other people enjoying it. Phrasing it like this implies tech companies have teams of neuroscientists figuring out how to hack the brain's workings via Angry Birds, or something. This is very much not the case, but it reinforces the 'tech is damaging our brains!' rhetoric that is so often misleading and harmful, and not at all evidence based.
And referring to dopamine in the context of addiction and reward is basically a neuroscience tautology. Because those experiences are dependent on dopamine signalling. There is no non-dopamine equivalent process. Saying 'dopamine addiction' is basically saying 'addiction'. There is no addiction without dopamine. So either it's all dopamine addiction or none of it is. Hence labelling certain behaviours 'dopamine addiction' is misleading. It sounds more technical and therefore more official, more 'convincing', but it's a meaningless distinction.
The fact that it's used reveals the lack of insight of what's actually going on, which is never a good thing, when those who lack understanding are controlling the discussion.
I seriously doubt the reason depression was ignored in the past was people used the word depression too liberally. Using therapy talk was a side effect of mental health being taken more seriously and therapy becoming more accepted and popular, not the other way around.
In any case, I totally agree with you that over medicalization of every day phenomena and ubiquitous use of disorder language or neurochemicals as a shorthand has harms. But I don't think the language use is at the heart of this. The way we talk is usually the reflection of what concepts are taken more seriously and are accepted as more valid and how incentives motivate people to use those concepts for achieving practical or political goals (it is easier to get accommodation as a student if your use of social media is addiction which is a mental health issue)
I don't think we should nitpick how people talk, except when it is clearly feeding into a misunderstanding. People regularly compare social media use to drugs--it's even happening in the comments on this article! This is an unhelpful analogy that leads to mistaken assumptions, and in a world where legislation is drafted based on these misunderstandings, I think it's warranted to pick on these analogies
Great piece! I love the line “People struggling with genuine addictions have their issues devalued by overuse and dismissal, like if papercuts were regularly described as ‘amputations’.” I have been making the same point about “trauma”. We psychologists have long had a problem over generalization.
This is so important. Thanks for writing this. We plan to release a related post on the fearmongering surrounding dopamine “hits” and video games soon!!!
As soon as I see the word dopamine I inwardly groan
Thank you!!! I often felt this, but could not articulate it.
Biodiversity is another hijacked term that used to mean ‘the diversity of life’ and now means conservation of rare things. Perhaps a function of dopamine is to allow obfuscation to feel good.
Exactly! What DID dopamine do to deserve this? The neurotransmitter without which we could not move, learn or fall in love. Brilliantly written, moving effortlessly through a topic that is a minefield. Love the 'science garnish' term 😂. Could get into much more in-depth speculation about why these things happen, psychologically. Why we get hold of a scientific metaphor and can't seem to let go - but will spare you this time 😉. Maybe not fully aligned on some specific details - especially re behavioural addictions - definitions of behaviours can and do evolve, and sometimes for a good reason. The word 'trauma' is a good example. But anyways. A very good paper, thank you for a breath of fresh air (metaphorically of course). 🙏
“science garnish” is the perfect description lol thank you
Very useful to hear the argument spelled out like this. I am in the eating disorder world and “food addiction” gets thrown around often because certain foods elicit a “dopamine hit”. But it is so much more nuanced!
@Tommy Blanchard bro you finally wrote it and didn’t alert me?! We’re beefin
LOL oh man! I literally said I was planning to tag you in a note about it and just didn’t get around to it yesterday (@Carrie Reid-Knox can vouch for me saying I was planning to!)
It was literally because of you asking me to write about it that I reached out to Dean about if he would be interested in writing an article about this for me months ago. I decided to outsource hahahaha
That’s what they all say…jk, jk, but I had to give you a hard time about it 🩵
Probably unrelated but I seem to be flooded with all the pleasure chemicals as I've been permanently orgasmic for 2 years. How can I medically confirm this? Is there a way to check my neurotransmitters? Thank you!
It doesn’t even cause feelings of pleasure. It gives you that uncomfortable urge to get up and do something. That’s what it’s for.
>we live in a society that, despite bombarding people with instructions to indulge themselves all day every day lest our economy collapse, regularly takes a dim view of anyone who pursues pleasure or enjoyment to a noticeable degree.
Yeah - it is oddly schizophrenic (to misuse another term).
And every generation has had old people saying "Kids these days!" (See Pessimits Archive's Substack)
I agree we shouldn't nitpick how people talk, but using medical/ scientific words too liberally usually has negative social connotations. People have been using terms too liberally, someone who's just feeling sad calls themselves depressed, and people often use the term OCD far too frequently to explain their affinity for cleaning (I have been told too many times that I have OCD because I like my surroundings clean and tidy). The goal is not to nitpick but to make people more mindful of the terms they are using.
How is the hit achieved? I know about the dopaminergic paths and actions but not clear how feelings are generated in the body. Is it via the HPA or are there other paths/particles?
On things being framed as "addiction" (or its kin terms, like "disorder") and brain chemicals, this seems to be necessary to medicalize the framing of the discussion. If behavior can be reduced to chemicals and called "addiction," then a medical (and often drug-based) response can be pushed on people. Incentives, incentives everywhere . . .