Dopamine Nation: Finding Balance in the Age of Indulgence

by Anna Lembke

I feel horror, compassion, and a vague and disquieting sense that it could have been me.

The use of antidepressants like Paxil, Prozac, and Celexa is rising in countries all over the world, with the United States topping the list. Greater than one in ten Americans (110 people per 1,000) takes an antidepressant, followed by Iceland (106/1,000), Australia (89/1,000), Canada (86/1,000), Denmark (85/1,000), Sweden (79/1,000), and Portugal (78/1,000). Among twenty-five countries, South Korea was last (13/1,000). Antidepressant use rose 46 percent in Germany in just four years, and 20 percent in Spain and Portugal during the same period. Although data for other Asian countries, including China, are not available, we can infer growing use of antidepressants by looking at sales trends. In China, sales of antidepressants reached $2.61 billion in 2011, up 19.5 percent from the previous year.

Dopamine may play a bigger role in the motivation to get a reward than the pleasure of the reward itself. Wanting more than liking. Genetically engineered mice unable to make dopamine will not seek out food, and will starve to death even when food is placed just inches from their mouth. Yet if food is put directly into their mouth, they will chew and eat the food, and seem to enjoy it.

“We are cacti in the rain forest.”

rats given unlimited access to cocaine for six hours per day gradually increase their lever-pressing over time to the point of physical exhaustion and even death. Increased self-administration under extended access conditions (six hours) has also been observed with methamphetamine, nicotine, heroin, and alcohol. However, rats who have access to cocaine for only one hour per day use steady amounts of cocaine over many consecutive days. That is, they don’t press the lever for more drug per unit time with each consecutive day.