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Inspiration

Digital Addiction: Inside the DopamineCrisis Hijacking Our Brains

Oprah Winfrey
Oprah Winfrey
Aug 27, 2026
9 min read

The phone buzzes. You reach for it. An hour vanishes. You didn't plan to scroll that long, didn't want to spend money you don't have, didn't intend to lose the evening—yet here you are, swiping through one more video, one more image, one more notification. If this feels familiar, you're not alone. An estimated 27% of the global population now struggles with tech addiction: the compulsive, excessive use of digital devices for social media, shopping, gaming, or gambling. What was once dismissed as a bad habit has crossed into mental illness, and understanding why requires looking inside the architecture of desire itself.

Read · 10 sections

When Does Habit Cross Into Addiction?

The distinction matters. Dr. Anna Lembke, Stanford addiction psychiatrist and author of Dopamine Nation: Finding Balance in the Age of Indulgence, defines addiction not by how often you use something, but by four clear markers: out-of-control use, craving, compulsive behavior (using even when you don't want to), and consequences. "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," she explains. Add tolerance—needing more potent forms over time to feel the same effect—and withdrawal (the physiological response when you try to stop), and you've entered clinical territory.

This spectrum matters because addiction exists on a continuum. You can have mild, moderate, or severe addiction, each defined by symptom severity and frequency. But the threshold itself is real. A woman racking up $30,000 in credit card debt to feed an online shopping compulsion. A young man losing over $100,000 on sports betting apps while dropping out of three colleges. A gamer spending seven hours daily in virtual worlds, neglecting hygiene and meals. These aren't lifestyle choices; they're neurological hijackings.

How Algorithms Exploit the Reward System

The machinery behind this hijacking is deliberate. Algorithms don't just serve us what we search for; they inject novelty—unexpected content designed to interrupt boredom, extend watch time, and trigger compulsive clicking. "The 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," Lembke notes. This constant stream of novel stimuli does more than waste time. It surfaces extreme content that might never have occurred to users naturally.

The consequences ripple outward. Young people encounter drug use videos depicting synthetic drugs or novel concoctions they've never heard of—and then seek them out. Sexual content algorithms push the most extreme material first: choking, sadomasochistic acts, behaviors that now appear normal to users who might otherwise never have encountered them. The algorithm doesn't merely reflect human preference; it manufactures it, expanding the boundaries of what people consider possible, desirable, or acceptable.

The Dopamine Seesaw: Pleasure and Pain in Balance

To understand why scrolling becomes compulsive, Lembke uses an elegant metaphor: the balance scale. Imagine the brain's reward pathway as a seesaw. On one side sits pleasure; on the other, pain. When we experience something pleasurable—a hit, a win, a dopamine surge—the scale tips sharply upward. But the brain is a homeostatic system; it always seeks equilibrium. When pleasure spikes, pain rushes in to balance it. That crash, that emptiness, that urgent need to feel better again—that's the come-down. That's withdrawal.

This is why addicts need increasingly potent forms of their substance or behavior. "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," Lembke explains. A heroin user coming off the drug experiences the same physiological desperation. So does someone reaching compulsively for their phone after an hour away from it. The mechanism is identical. The only difference is the vector—but the brain doesn't distinguish between dopamine released by a chemical or dopamine released by a notification.

Shopping, Gaming, and Gambling: Three Case Studies in Compulsion

Online Shopping: A young woman described herself as emotionally unfulfilled. Rather than sit with discomfort, she shopped. Each purchase offered a temporary dopamine hit—anticipation, the click, the arrival. But the pleasure never lasted. The gap between what she felt and what she wanted to feel only widened, demanding larger purchases, more frequent orders. Soon she carried $30,000 in credit card debt, the shame of which only deepened her urge to buy again, perpetuating a cycle where the very behavior meant to soothe created the very pain it tried to escape.

Gaming: A young gamer described the experience as seductive precisely because of its dynamic reward schedule. "A lot of the game is rewarding, but also low lows can happen all within a like 20-minute span." That rapid oscillation between highs and lows creates a potent, unpredictable reinforcement pattern—the same mechanism that makes slot machines addictive. Dr. Niesha Glenn, the mother of a gamer son, watched her child abandon basic hygiene and nourishment, gaming 24 hours a day. He described it as entering a dissociative state: "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 and a judge-free zone as well."

Gambling: A young man who lost over $100,000 on sports betting apps articulated the addiction's core: "It's that adrenaline rush. It could be compared to someone who's addicted to drugs, you know, chasing that original high." He had lied to and stolen from his parents, dropped out of three colleges, and continued betting because the dopamine spike of a win—real or anticipated—overrode all other considerations. Gambling addiction moves especially fast because the reward cycles are compressed; you can lose thousands and experience dozens of dopamine surges and crashes in a single evening.

The Moral Compass Under Siege

One of addiction's cruelest features is its capacity to override values. When deep in addiction, people do things they're profoundly ashamed of—things they never believed they'd do. They steal, lie, manipulate, abandon responsibilities. This isn't moral failure; it's neurological override. The prefrontal cortex, which governs judgment and impulse control, becomes increasingly quieted as the limbic system and dopamine reward pathways dominate. The person is still there, but they're trapped behind a neurological barricade.

Recovery, therefore, requires more than willpower. It requires structural intervention—what Lembke calls "self-binding." This isn't shame-based restriction; it's compassionate architecture designed to protect yourself from your own addicted brain.

Self-Binding: Designing Recovery Into Your Life

Self-binding means removing access to the addictive substance or behavior before craving strikes. It's the difference between willpower (exhausting, moment-to-moment struggle) and design (removing the temptation altogether). A gambling addict deletes betting apps and gives financial control to a spouse. A shopper switches to cash-only transactions, making impulse purchases logistically impossible. A gamer gives their console to a friend, retrievable only after a set period of sobriety.

These aren't restrictions; they're frameworks for recovery. The brain in early withdrawal will experience genuine suffering—physical discomfort, emotional emptiness, intense craving. "You will feel worse before you feel better," Lembke emphasizes. But if the addictive behavior is structurally unavailable, the brain will eventually recalibrate. The dopamine set point will reset. Pleasure will return to normal stimuli. This takes time—weeks to months, depending on the severity and duration of use—but it works.

Community and Radical Honesty: The Two Pillars of Recovery

No one recovers alone. The 12-step model works precisely because it combines community, vulnerability, and what Lembke calls "radical honesty." Radical honesty means naming the specific ways addiction has harmed you and others; it means standing in rooms full of people you don't know and saying the things you're most ashamed of. This breaks the isolation and shame spiral that feeds addiction. It also creates accountability—you become known to others as the person trying to recover, and that identity gradually supersedes the identity of the addict.

The role of community extends beyond 12-step programs. People need people who understand, who don't judge, who've been in similar darkness. Gaming addiction forums, online recovery groups, and local support meetings all serve this function. The addiction itself promised community—a "judge-free zone" where the gamer could escape, where the gambler could feel part of something. Recovery replaces that false community with a real one.

The Reset: What Actually Happens in the Brain

When someone stops the addictive behavior and employs self-binding to prevent relapse, the brain doesn't immediately return to normal. First comes withdrawal: the set-point imbalance that Lembke describes as feeling worse before feeling better. The seesaw is stuck on the pain side. Dopamine dips below baseline. Everything feels gray, empty, pointless. This is precisely when relapse risk is highest, because the brain is screaming for relief.

But if the person endures this period without returning to the addictive behavior, something shifts. The dopamine system begins to recalibrate. The set point gradually normalizes. Natural rewards—a conversation, a walk, food, sex, creative work—begin to register again. The world regains color. This isn't instant, and it isn't linear, but it's real. The brain has remarkable neuroplasticity; it can relearn to find pleasure in non-addictive sources.

Prevention: The Role of Parental Awareness and Digital Design

For those not yet addicted, awareness is the first defense. Parents need to understand that handing a child a smartphone is not neutral; it's placing in their hands a device engineered by some of the world's best minds to be maximally compelling. A child's developing prefrontal cortex is even more vulnerable to hijacking than an adult's. Exposure to extreme content—drugs, violence, sexual material—happens incidentally, through algorithmic injection, not deliberate seeking.

Lembke doesn't advocate abstinence but rather intentional use. This might mean device-free times and spaces, cash-only shopping budgets, gaming only on shared devices, or pre-commitment to limits before cravings arise. It might mean understanding your own vulnerabilities—the specific ways you're susceptible to compulsion—and building safeguards accordingly.

Where to go from here

If you recognize addiction in yourself or someone you love, the first step is naming it: shifting from "I have a bad habit" to "This has crossed into addiction." The second step is self-binding—removing access before willpower is tested. The third is finding community: a therapist, a support group, trusted friends who understand. Recovery is possible. The brain can reset. But it requires design, time, and the courage to sit with discomfort rather than scroll through it.

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Transcript

[0:01] When it comes to tech, when does a daily

[0:03] habit [music] cross over into addiction?

[0:06] >> This has crossed the threshold from a

[0:08] bad habit into a mental illness.

[0:12] >> I hear you've racked up over $30,000 in

[0:14] credit card debt. What do you think is

[0:16] at the root of your shopping addiction?

[0:19] >> I feel unfulfilled in many aspects of my

[0:22] life and instead of sitting with the

[0:25] discomfort, I resort to let me find

[0:29] something to buy.

[0:30] >> You spend as much as 7 hours a day

[0:31] playing video games.

[0:32] >> Mhm.

[0:33] >> And what is it about gaming for you?

[0:35] >> A lot of the game is rewarding, [music]

[0:37] but also low lows can happen all within

[0:38] a like 20-minute span.

[0:41] >> I hear that you've [music] lost more

[0:42] than $100,000

[0:44] on sports betting apps. I know you

[0:47] dropped out of three colleges, you were

[0:49] lying, you were stealing from your

[0:50] parents. [music]

[0:51] >> Yeah.

[0:51] >> What is it about online gambling that

[0:54] makes it so hard to quit?

[0:57] >> It's that adrenaline rush. It could be

[0:58] compared to someone who's addicted

[1:00] [music] to drugs, you know, chasing that

[1:02] original high.

[1:03] >> And now we've entered into

[1:05] >> addicted brain. We need to use more of

[1:08] our drug in more potent forms, [music]

[1:09] not to get high, but just to level the

[1:12] balance and feel normal.

[1:14] >> It's like the heroin addict coming off

[1:16] of the heroin.

[1:16] >> Exactly.

[1:17] >> And that is what is happening to your

[1:19] children when you try to take away the

[1:20] phone. That's what's happening to you

[1:22] when you can't get yourself or you

[1:23] [music] can't stop scrolling. You're

[1:25] just scrolling, scrolling, scrolling.

[1:26] >> Yes.

[1:28] >> Hi everybody. I'm glad to be here with

[1:30] you on the Oprah podcast. Over 3 million

[1:32] of you watched or listened to our

[1:34] episode on Gen Z tech addiction. Thank

[1:38] you for that. But as we're learning,

[1:40] it's not just one generation or group.

[1:44] Tech addiction can hook anybody and a

[1:47] lot of people are hooked right now at

[1:50] all ages, no matter your circumstances.

[1:52] And today on this podcast, I want to ask

[1:55] these questions. What's behind these

[1:58] addictions, what's happening inside our

[2:00] brains, are we defenseless or can we

[2:04] actually do something about it? I'll be

[2:06] talking to people who are addicted to

[2:07] gaming, online gambling, and even

[2:12] shopping. That's a biggie for a lot of

[2:14] women. But first, here's a quick look at

[2:16] some of the moments from that episode

[2:18] that struck a chord.

[2:19] >> So my name is Dr. Niesha Glenn. This is

[2:21] my son, Amir Jenkins. He started his

[2:23] gaming at about 5 or 6. When he got in

[2:26] high school, that's when I knew it was

[2:28] an addiction. He would not brush his

[2:30] teeth. He would not eat.

[2:32] >> Ooh.

[2:32] >> It was strictly

[2:35] >> Amir.

[2:36] >> nothing. No no no showers. In there on

[2:40] the game 24 hours a day.

[2:42] >> Can you take us to the point of

[2:44] understanding what that feels like when

[2:46] you're sort of caught up in the

[2:49] obsessiveness obsession of it?

[2:52] >> I would say you almost forget where you

[2:55] are, in a sense.

[2:57] Like when I play the game, I literally

[2:58] forget I'm in a house sometimes. It's so

[3:01] virtual, so intimate, and you know,

[3:05] it's free and a judge-free zone as well.

[3:08] >> Mhm.

[3:10] >> I was exposed to porn at the age of

[3:12] eight and have struggled with an

[3:13] addiction for the past 20 years.

[3:15] >> I'm married to a porn addict. He has

[3:17] struggled since he was 8 years old. I

[3:19] make it like my mission to watch his

[3:21] every move, which is so draining.

[3:23] >> Maddy and Kyle, thank you for being

[3:25] here. I know this is a hard thing to

[3:27] talk about, and I applaud your courage

[3:31] in being willing to speak about it

[3:34] because I hear this is really serious

[3:37] for a lot of people, like millions and

[3:39] millions of guys throughout the country

[3:43] and the world. How long have you all

[3:45] been married?

[3:46] >> We've been married 6 and 1/2 years.

[3:47] >> Mhm.

[3:48] >> So I would say like the last year is

[3:50] when I finally realized that like this

[3:53] addiction is so much deeper. And I'm

[3:54] like, how many times do I try to break a

[3:56] bad habit and I have to start over? And

[3:58] but this is an addiction.

[4:00] >> Well, I know hearing Kyle and Maddie's

[4:01] story really hit home for a lot of

[4:03] people. Addiction to adult content is

[4:06] impacting millions of families and

[4:08] relationships. Uh my team just checked

[4:11] in with them. Kyle has had a relapse and

[4:14] setback in his recovery, he says, and is

[4:16] now doubling down on his addiction

[4:19] classes. And Maddie told us that they

[4:22] still love each other and they're going

[4:23] to continue to fight for their marriage.

[4:26] Dr. Anna Lembke is back with us and

[4:29] she's a psychiatrist and chief of

[4:31] Stanford addiction medicine. And I just

[4:34] truly believe that her book is a

[4:35] must-read. It's called Dopamine Nation:

[4:38] Finding Balance in the Age of

[4:41] Indulgence.

[4:42] Welcome back to the podcast, Dr. Lembke.

[4:44] Thank you.

[4:45] >> Thank you.

[4:46] >> In Dopamine Nation, you write, I was

[4:49] moved by this, you say, the internet

[4:51] promotes compulsive

[4:54] overconsumption

[4:56] not merely by providing increased access

[4:59] to drugs, old and new, but also by

[5:02] suggesting behaviors that otherwise may

[5:05] never have occurred to us. I think

[5:07] that's what's happening to a lot of

[5:08] people. Can you give us an example of

[5:10] what you're seeing now that's new and

[5:12] different?

[5:13] >> Yeah, I mean, there's this real

[5:15] contagion effect where because the

[5:19] algorithm both feeds us videos and other

[5:23] content that we specifically search for

[5:26] and also novel content that we didn't go

[5:30] looking for.

[5:31] >> That's right. Things are just popping up

[5:32] on your screen.

[5:33] >> Right. And that's intentional, right?

[5:34] That that injection of novelty is

[5:37] intentional to stave off boredom, to

[5:39] increase watch time, to keep us clicking

[5:42] and swiping even when we don't want to.

[5:44] >> Wow.

[5:45] >> So, what ends up happening is there is

[5:47] this injection of very extreme content

[5:51] and this can impact behaviors because it

[5:55] makes people think of something that

[5:58] would never have occurred to them

[5:59] naturally. The you know, this is happens

[6:02] with drugs. So, kids seeing videos of

[6:05] other kids using like unusual drugs or

[6:08] synthetic drugs or drugs that they've,

[6:11] you know, concocted themselves and then

[6:14] kids wanting to go and try that. It it's

[6:16] especially

[6:18] prevalent with sexual content. So,

[6:21] sexual images, people behaving in ways

[6:24] for example, men choking women is not

[6:28] something that was, you know, would

[6:30] necessarily occur to somebody, but

[6:32] there's so much choking and other kind

[6:35] of sadomasochistic

[6:37] sexual content and and when when people

[6:40] go looking for adult content, that's

[6:42] actually the first content that they see

[6:45] or that's, you know, pushed to them that

[6:48] now you've got a lot of people engaging

[6:50] in sexual behaviors that are potentially

[6:53] harmful and dangerous potentially. Um

[6:56] so, it's this it's this kind of thing.

[6:58] >> When it comes to tech, which has

[7:00] infiltrated,

[7:02] you know, all of our lives, every part

[7:03] of life, every waking moment, I think

[7:05] people are confused on this. Like, when

[7:09] does a daily habit, a thing that we've

[7:11] been doing and think that we need to do,

[7:15] cross over into addiction?

[7:17] >> Addiction is a spectrum disorder, right?

[7:20] You can have mild, moderate, or severe

[7:22] addiction depending upon the severity of

[7:24] the symptoms, how many symptoms there

[7:26] are, but there can also be this

[7:28] pre-addicted state that you might think

[7:30] of as risky use or even a bad habit.

[7:35] Uh when I use the term addiction, I'm

[7:37] really saying this has crossed the

[7:38] threshold from being something that we

[7:41] would consider a a bad habit into

[7:44] something that we would really consider

[7:46] a mental illness. Again, characterized

[7:48] by these four C's: out of control use,

[7:51] craving, compulsive use, meaning that

[7:54] >> Mhm.

[7:55] >> I initiate use even against my desire

[7:57] and intention not to use, and then

[7:59] especially consequences. Plus tolerance,

[8:03] you know, which we've talked about,

[8:04] needing more potent forms over time to

[8:06] get the same effect, and also

[8:07] withdrawal. When I try to stop, I

[8:10] experience this physiologic response

[8:13] that then pulls me back into it.

[8:15] >> You you explain that pleasure and pain

[8:18] work like the balance of a seesaw.

[8:22] >> Right.

[8:22] >> How does that impact addiction? Explain

[8:24] that to our audience here.

[8:27] >> Yeah, so I used this extended metaphor

[8:29] of a balance to communicate to my

[8:31] patients, my medical students, what's

[8:34] happening in the brain as we go from

[8:36] sort of healthy adaptive use of a

[8:39] substance or behavior to unhealthy

[8:41] maladaptive addictive use. So, if you

[8:43] imagine that in your reward pathway,

[8:45] there's something like a teeter-totter

[8:47] that represents how we process pleasure

[8:50] and pain. When it tilts one way, we

[8:52] experience pleasure. When it tilts

[8:54] another, we experience pain. But there

[8:56] are certain rules governing this

[8:58] balance, and the first and most

[9:00] important rule is that the balance wants

[9:02] to remain level, which is what

[9:04] neuroscientists call homeostasis,

[9:07] sometimes referred to as set point. You

[9:10] referred to it in your wonderful book

[9:11] enough

[9:12] >> Enough point.

[9:13] >> as as at the enough point.

[9:15] >> it's it's it's it's the set point. That

[9:16] was Dr. Anya's word,

[9:17] >> Exactly right. Yeah, it's it's

[9:18] homeostasis.

[9:20] And our brains will work very hard to

[9:22] return to a level balance or homeostasis

[9:25] with any deviation from neutrality. So,

[9:28] for example, when we do something that's

[9:30] pleasurable uniquely for our brain, that

[9:33] releases dopamine. The balance tilts

[9:36] toward the side of pleasure. But no

[9:38] sooner has that happened than our brain

[9:40] will respond by down-regulating dopamine

[9:43] transmission, not just to baseline, but

[9:45] below baseline.

[9:46] >> So, you need more, more, more.

[9:48] >> Right.

[9:50] >> When we experience pleasurable

[9:51] activities like eating, exercising, or

[9:54] socializing, it triggers our brain to

[9:56] produce the feel-good chemical called

[9:58] dopamine.

[9:59] The cycle of addiction begins when

[10:01] addictive substances and behaviors cause

[10:03] massive dopamine surges, which causes

[10:06] our brains to produce less dopamine and

[10:08] at the same time absorb it less

[10:10] efficiently. This creates a dopamine

[10:12] deficit, which causes us to crave more

[10:15] and more of the substance or the

[10:17] behavior just to feel normal.

[10:20] >> And I like to imagine that process of

[10:22] neuroadaptation as these little gremlins

[10:24] hopping on the pain side of the balance

[10:26] to bring it level again. But, the

[10:28] gremlins like it on the balance, so they

[10:30] don't get off as soon as we're level.

[10:31] They stay on until we're tilted an equal

[10:34] and opposite amount to the side of pain.

[10:36] That is the come down. That's the

[10:38] craving, the hangover, the moment of

[10:40] wanting one more potato chip, or one

[10:42] more joint.

[10:43] >> in front of the pantry just grazing

[10:46] looking for what is the thing I can do

[10:48] to curb this anxiety that I'm feeling.

[10:51] Yes.

[10:51] >> And remember, our brain wants to get

[10:54] back to homeostasis. So, the fastest way

[10:56] to do that is to have another potato

[10:58] chip. Yeah. The problem is if we

[11:00] continue to consume our drug of choice

[11:02] over days to weeks to months to years,

[11:04] those gremlins start to multiply, and

[11:07] pretty soon we have enough gremlins on

[11:09] the pain side of the balance to fill

[11:10] this whole room. And now we've entered

[11:12] into addicted brain. We are in a chronic

[11:17] dopamine deficit state. Now we need to

[11:19] use more of our drug in more potent

[11:21] forms, not to get high, but just to

[11:24] level the balance and feel normal.

[11:26] >> And that is what is happening to your

[11:28] children when you try to take away the

[11:30] phone. That's what's happening to you

[11:32] when you can't get yourself or you can't

[11:33] stop scrolling.

[11:34] >> That's exactly

[11:35] >> scrolling, scrolling, scrolling. Okay.

[11:37] 80% of people coping with an addiction

[11:39] to online shopping are women. Listen to

[11:43] Safa's story.

[11:44] >> I have a shopping addiction, and over

[11:46] the past 3 years, I've racked up over

[11:48] $30,000 in credit card debt. 99% of it

[11:52] is shopping. I have said no to going out

[11:54] to dinner with friends, bought the

[11:55] cheapest thing at the grocery store,

[11:58] just so I could buy that one thing,

[12:00] whatever it was in the moment. It's

[12:01] really shameful because I'm in my

[12:04] mid-30s. I have a good job, and yet I'm

[12:06] struggling to pay rent because I keep

[12:08] spending more than I can afford. I was

[12:10] also scared to come on here and say this

[12:12] because it feels like I failed.

[12:15] >> Oh.

[12:15] >> Yeah. Oh, wow.

[12:17] >> Okay.

[12:17] >> Yeah.

[12:18] >> Um Safa joins us from Brooklyn.

[12:20] >> Hi, Oprah.

[12:21] >> What do you think is at the root of your

[12:23] shopping addiction?

[12:25] I would I was I was really interested to

[12:27] read about it because I go online and I

[12:30] it's a dangerous thing. Let me just tell

[12:32] you, it's a dangerous thing. And you get

[12:35] a little I I I guess I'm getting a

[12:36] little dopamine hit. Add to cart. So

[12:39] exciting. Add to cart again. Before you

[12:42] know it, I have three blouses for

[12:44] $24.99.

[12:46] >> of which you need, probably.

[12:47] >> of which I need. Oh, well, I didn't need

[12:48] that little crop top. So, [laughter] I

[12:50] have to $24.99. Then I'm like, what else

[12:52] can I get? So, does it feel like that?

[12:55] Is that what it feels like for you? You

[12:57] just get a little hit or

[12:58] >> Yes, it absolutely does feel like that.

[13:01] I for me, the root of my addiction stems

[13:04] from, I think, childhood. I've talked

[13:06] about this with my therapist, and

[13:09] uh my family moved to America when I was

[13:11] 6 years old, and we moved to a

[13:14] upper-middle-class white neighborhood,

[13:16] and I noticed all the kids would get

[13:18] gifts, Christmas gifts, birthday gifts,

[13:20] and I was getting like hand-me-downs,

[13:22] and

[13:23] uh

[13:24] you know, sharing a room with my

[13:25] siblings. And so, I think what I told

[13:28] myself in those moments is when you're

[13:31] older, you're going to be able to have

[13:33] these things. You're going to be able to

[13:34] fit in. So, now that I have a job, what

[13:39] I'm realizing that I do on a regular

[13:41] basis is I buy these things almost to

[13:45] satisfy my inner child, to tell myself,

[13:49] "Okay, you're you've you you've made it,

[13:51] right?"

[13:52] And so, that's become my coping

[13:55] mechanism. And additionally, I feel

[13:59] unfulfilled in many aspects of my life.

[14:02] And I think instead of sitting with the

[14:05] discomfort of the sadness or disgust or

[14:09] whatever I feel in myself, I resort to

[14:13] let me find something to buy because

[14:15] that's what I trained myself from a

[14:17] young age is what would make me happy.

[14:20] Uh so, I continue to do it. I get a

[14:22] little boost of dopamine. And then

[14:26] what I really feel is shame and guilt

[14:29] for doing it because I've accrued so

[14:31] much debt.

[14:32] >> Yeah. I hear you. You've racked up over

[14:34] $30,000 in credit card debt that you

[14:37] can't afford to pay.

[14:38] >> Yes, correct.

[14:39] >> So, you feel good in the moment where

[14:40] you're ordering it? Do you feel good

[14:42] then when you're You feel good when

[14:44] you're adding to cart.

[14:46] And then when it arrives, you you're

[14:47] ashamed.

[14:48] >> Yes.

[14:49] >> Yeah.

[14:49] >> A little So, I as soon as I buy it,

[14:52] instead of feeling happy, I feel immense

[14:55] amount of shame and guilt. And then when

[14:58] it arrives, I'm excited to open the box.

[15:02] And I've also been for years now hiding

[15:04] my packages from my partner. Not that he

[15:07] absolutely has no problem with it. He's

[15:10] encouraging of me doing the best for me

[15:13] to get over the addiction. But I think

[15:16] internally, I feel so much guilt that I

[15:19] will hide the packages. I will lie about

[15:22] it. So, I'll open it and then I'll feel

[15:24] guilt and shame again and then instead

[15:26] of dealing with it, I'll go and purchase

[15:28] something else.

[15:29] >> Dr. Lembke, what do you want to say?

[15:30] >> Gosh, so much here. Okay, so you started

[15:33] talking about some early childhood

[15:35] experiences that you think contribute

[15:38] and I think that's important to reflect

[15:40] on that. But, I think there's a danger

[15:43] of spending too much time looking for

[15:45] the root cause of addiction when there

[15:48] doesn't actually need to be an

[15:50] underlying reason other than we're

[15:52] living in an addictogenic world where

[15:55] shopping has become drugified. The

[15:58] medium of being online itself constantly

[16:02] sends us triggers to buy. That's the

[16:05] whole business model of

[16:07] >> You can't read an article without what

[16:09] we're all trying to do now is filter out

[16:11] all the ads as you're trying to like

[16:13] communicate with anything. Yes.

[16:15] >> Yes. And we get a little hit of dopamine

[16:18] not just when we're shopping, but just

[16:22] getting a reminder that we might be able

[16:25] to go shopping or that there might be

[16:27] something available, that actually also

[16:30] stimulates the brain's reward pathway

[16:32] and then sets up that state of craving

[16:35] that makes us want to go shopping.

[16:37] And the reason this is so important is

[16:39] because yes, it's good to talk about

[16:42] your childhood and some early

[16:44] underlying, you know,

[16:46] issues that might be contributing to it,

[16:49] but you could talk about that all day

[16:52] and it's not going to get at the root of

[16:54] the problem if you're still exposing

[16:56] your brain to this very addictive medium

[17:00] that's constantly triggering your brain,

[17:03] releasing dopamine and then leading you

[17:05] down this road, which is why

[17:06] self-binding strategies are so

[17:08] important. Self-binding is where we

[17:11] create literal and metacognitive

[17:13] barriers between ourselves and our drug

[17:15] of choice so we can press the pause

[17:18] button between desire and consumption.

[17:20] >> So, what does she need to do?

[17:21] >> So, what you need to do is you need to

[17:24] delete any shopping apps that you have,

[17:27] right? You need to possibly get rid of

[17:30] any online pay vehicles, anything that

[17:35] makes it easy and frictionless for you

[17:38] to buy something. It is is definitely

[17:41] something that you should eliminate. You

[17:43] know, online shopping or shopping

[17:45] addiction is a huge and growing problem,

[17:47] especially as you commented Oprah, among

[17:49] women.

[17:50] >> Mhm.

[17:50] >> So, these self-binding strategies are

[17:52] really key. If you really want to take

[17:54] it to the extreme, you will get rid of

[17:56] all of your credit cards, and you will

[17:58] only carry cash, and you will only buy

[18:01] in cash, and not online.

[18:03] And this seems extreme, but what my

[18:06] patients discover is that it's actually

[18:09] so much easier

[18:11] than expecting that you can constantly

[18:14] stimulate your brain, and then resist

[18:17] the pull that's created by all of these

[18:20] stimuli that are inviting us to consume.

[18:23] >> How does this sound to you, Subha?

[18:24] >> Yeah. That is that absolutely sounds

[18:27] like a great idea, something I've tried

[18:30] in the past

[18:31] is getting rid of my credit cards. What

[18:35] what happened is when I'm in a anxious

[18:40] mindset, or when I'm sad or depressed, I

[18:43] opened up new cards. So, usually when

[18:47] I'm aware of what I'm doing,

[18:50] I can continue to do it, and I can

[18:52] perform, but then as soon as I'm in a

[18:55] state where I can't regulate, and I'm

[18:57] anxious, or whatever it is, I

[19:00] I will get more credit cards, or I will

[19:03] subscribe to whatever it is, and I think

[19:06] I go back to that state. So, I guess my

[19:08] question is, when I'm feeling like that,

[19:11] how do I self-regulate, and how do I get

[19:13] myself to not do those things?

[19:16] >> Yeah. It's a wonderful description of

[19:18] the kind of dissociative state that we

[19:19] can go into vis-a-vis our drug of choice

[19:22] where we're just sort of like we're

[19:24] we're we're out of our minds essentially

[19:26] and we're just doing the behaviors. This

[19:29] is where self-binding matters because

[19:32] you know, if you if it's harder for you

[19:34] to get the next credit card or you just

[19:36] have to take the time to get a credit

[19:37] card, you might be able to come out of

[19:39] that state. But more importantly, what

[19:42] you need to have is a list of other

[19:44] healthier coping strategies for when you

[19:47] get anxious. And this is where I really

[19:50] recommend also engaging in what we call

[19:52] mutual help groups or self-help groups.

[19:56] The prototypical one is Alcoholics

[19:57] Anonymous, but Alcoholics Anonymous was

[20:00] founded 100 years ago and since then

[20:01] there has been a

[20:02] proliferation of self-help groups for

[20:05] almost every maladaptive behavior you

[20:07] can imagine and it can be an incredibly

[20:10] helpful and effective way for people

[20:12] >> one for shoppers since it's such a big

[20:14] thing.

[20:14] >> There absolutely is. And And you know,

[20:17] the 12-step model really works and it

[20:20] often involves getting a sponsor, um

[20:22] somebody else in the group and then then

[20:24] in those moments when you're, you know,

[20:26] anxious or feeling cravings,

[20:29] you have somebody to talk to. And that

[20:31] person's typically available 24/7 and

[20:34] they know exactly what you're going

[20:35] through. And I say to my patients, you

[20:37] know,

[20:38] as much as I care about you, I'm not

[20:40] available to you 24/7, but a 12-step

[20:43] sponsor, they would answer the phone in

[20:45] the middle of the night. So, I think And

[20:47] again, thinking about self-binding

[20:48] strategies, we massively coregulate

[20:52] based on who is around us and the

[20:54] behaviors they're engaging in. So, if

[20:56] you surround yourself with other people

[20:58] who understand this problem uniquely and

[21:00] that you can turn to for help, I think

[21:02] that will really help you in those

[21:04] moments.

[21:05] >> Cuz you're not alone. You are not alone.

[21:07] There are millions of people most of

[21:10] them women going through exactly the

[21:12] same thing that you're going through.

[21:14] And you're a smart woman.

[21:16] >> Yeah.

[21:16] >> You're an intelligent woman. You are a

[21:19] gracious and kind person.

[21:21] You will overcome this if you choose to

[21:25] do that.

[21:26] You know how to put all the things

[21:28] together to overcome this. It's It's

[21:30] It's It's a decision on your part right

[21:32] now as to how hard you want to work at

[21:36] it. But I know you can do it.

[21:39] >> You heard that from Oprah. So that's you

[21:41] heard it.

[21:41] >> Right. We [laughter] were raised to be

[21:43] able to do it.

[21:43] >> Yeah.

[21:44] >> You were raised to be able to do it.

[21:45] That little girl coming from another

[21:48] land, another place, another culture

[21:50] being in a surroundings where there were

[21:53] people that you didn't know, being able

[21:55] to manage yourself and succeed in that

[21:57] environment, you can do this. You can do

[22:00] this. This thing is not bigger than you.

[22:03] Okay?

[22:03] >> Thank you. I appreciate that.

[22:05] >> Yes.

[22:06] >> Oprah told me to stop shopping, so I

[22:08] stopped.

[22:09] >> It's absolutely

[22:10] >> Yeah, that's right.

[22:10] >> Thank you, Shavod. Thank you.

[22:12] >> Thank you. Thank you for having me.

[22:14] >> You know, gaming has become a way of

[22:15] life for children and teens and young

[22:17] adults, too. Here's a quick look at

[22:19] Deborah sharing her story.

[22:21] >> So I got a question for the masses, for

[22:22] the masses, for the people. Um

[22:25] What were we doing before we started

[22:27] playing video games and getting

[22:27] addicted? Okay. Because I feel like I

[22:30] feel like I haven't been playing video

[22:31] games that long.

[22:33] At the same time,

[22:35] what was I doing beforehand? I lose

[22:37] hours playing these things. I'm talking

[22:41] minutes on hours on days. And I've only

[22:45] been playing video games for like a

[22:45] year.

[22:48] I've been playing for a year. So

[22:50] question, what were we doing beforehand?

[22:52] How are we spending our free time?

[22:54] >> Yeah, that's my question for for you,

[22:56] Deborah, who joins us from Chicago.

[22:57] [laughter]

[22:59] What were you What were What were you

[23:01] doing before?

[23:02] >> [laughter]

[23:02] >> How do you answer that question? What

[23:04] were you doing before?

[23:05] >> Yeah, I feel like I had a collection of

[23:07] hobbies. I used to paint like with

[23:09] acrylics. I would sew a lot of projects,

[23:11] anything crafty and working with my

[23:12] hands

[23:13] was something I found appealing to me.

[23:15] >> And now you spend as much as 7 hours a

[23:17] day playing video games.

[23:18] >> Mhm.

[23:19] And I think it's still in some ways I

[23:21] use like a controller. So I still feel

[23:22] like it's still using my hands in some

[23:23] kind of way. So it's still the same same

[23:25] kind of crafting mindset that I have.

[23:27] But yeah, I'm spending a lot of hours, a

[23:29] lot of time of my day

[23:31] playing video games most of the time.

[23:33] >> And what is it about gaming for you?

[23:35] >> I think it's about two aspects that come

[23:37] to mind. The first is accessibility. So

[23:39] in comparison to my other hobbies, I

[23:41] require a lot of space and setup time.

[23:43] Given like with sewing, I need to get

[23:45] the fabric, I need to get the sewing

[23:47] notions. For when it comes to cooking or

[23:49] baking, I have to grab the ingredients,

[23:51] go to the store potentially to grab

[23:52] things I'm running low of,

[23:54] preheat the oven. And then when it comes

[23:55] to gaming, it's just like oh, I can just

[23:57] press the power button on my computer

[23:59] and just be on the game and it's much

[24:01] more accessible, I think.

[24:03] >> And I hear most of your friends are

[24:04] gamers that you've never even met in

[24:06] person.

[24:07] >> And so that's the second component is

[24:09] the social aspect. I think as you play

[24:11] these games, a lot of them are online

[24:12] games where you can meet other people

[24:14] from around the world even.

[24:15] So in the midst of learning how to play

[24:17] this game, I've met people online that

[24:18] like are now forming like a mini gaming

[24:20] community. And because of that, whenever

[24:22] someone's online, they'll send a message

[24:24] saying okay, do you want to get on and

[24:25] play? So they're like oh, like cool

[24:27] person, nice friendship that I'm

[24:28] building with this person. Of course,

[24:29] like I'll get on and bond over this game

[24:31] with you. So then there's like voice

[24:32] chat that you can talk to each other on

[24:34] and they encourage a lot of times for

[24:35] you to stay online even.

[24:37] >> So you're here to ask a question

[24:40] because you think that's become an issue

[24:43] for you, a problem?

[24:44] >> I have a question to see like the longer

[24:46] term impacts of it. I think because like

[24:48] I mentioned in the video, I've only been

[24:49] playing for about a year,

[24:51] but I'm starting to see differences in

[24:52] like how I carry myself but then also

[24:54] other people and I'm curious about

[24:56] are there any psychological or like

[24:58] emotional impacts when it comes to

[24:59] having extremely high highs cuz a lot of

[25:01] the game is rewarding for like doing

[25:03] good things in the game, but also low

[25:05] lows can happen all within a like

[25:07] 20-minute span. And I feel like knowing

[25:09] that, what kind of impact does that have

[25:11] on the body for extended periods of

[25:12] time?

[25:13] >> All right. Dr. Lemke, what do you want

[25:14] to say to Deborah?

[25:16] >> You know, one of the negative

[25:18] consequences of our addictive behaviors,

[25:22] especially our consumption of video

[25:24] games and other digital media, is the

[25:27] very important but subtle consequence of

[25:31] opportunity costs.

[25:33] And what I mean by opportunity costs is

[25:35] all of the other things we're not doing

[25:38] because we're spending all of our time

[25:40] online. And in your case, it's, you

[25:43] know, the crafts you're not doing, the

[25:45] people the friendships you might be

[25:47] making with people who actually, you

[25:49] know, live in and around where you live

[25:51] that you could meet up with in person.

[25:53] >> Human connection versus virtual

[25:54] connection. [clears throat]

[25:55] >> That's it. And it's not to say that

[25:57] there can't be virtual connection. You

[25:59] know, th- those can be meaningful

[26:01] connections, too. A lot of people talk

[26:03] about the community they build online

[26:05] and and that can be a community, but

[26:08] a you know, a po- potentially positive,

[26:09] but not when it replaces all of our

[26:13] other communities. So, I think that

[26:14] that's the first thing I want to say.

[26:16] And then in response to your question,

[26:19] I think you articulated it really well.

[26:22] It it appears to me that video games are

[26:25] your drug of choice because it didn't

[26:26] take you very long after you started

[26:28] playing that it was consuming many, many

[26:30] hours in your day, displacing other

[26:32] activities you used to enjoy, which gets

[26:35] to

[26:36] this hijacked brain. When we are

[26:39] constantly exposing our brains to this

[26:42] highly reinforcing intoxicant,

[26:45] one of the things that happens is we

[26:47] have this narrowing of our focus

[26:50] where other things are no longer

[26:52] enjoyable.

[26:54] They lose their salience. Salience is

[26:57] what makes something attractive to us.

[26:59] So now I could well imagine that if you

[27:01] tried to go back to doing your crafts,

[27:04] you would be frustrated. You would be

[27:05] bored. The rewards would be too delayed.

[27:09] And you know, in my sense is what you

[27:11] might want to do is take a break from

[27:14] video games for long enough to kind of

[27:17] reset your reward pathways so that the

[27:20] world can open itself up again to you.

[27:23] And the reason I always recommend 4

[27:24] weeks is because in the first 2 weeks,

[27:26] you will probably feel worse before you

[27:28] feel better. You'll be in withdrawal,

[27:30] right? Those gremlins on the pain side

[27:32] of your balance that have accumulated

[27:34] will smash you.

[27:35] >> the last time you were here and you said

[27:36] 4 weeks recommending a 13-year-old be

[27:39] off the phone for weeks. Everybody in

[27:40] the control room went, "Oh, that's never

[27:42] happening.

[27:43] >> [laughter]

[27:43] >> 4 weeks is too long." Cuz 4 weeks feels

[27:45] like, "How can I do that?" But if you

[27:48] don't do it for 4 weeks, go ahead.

[27:50] >> Yeah, what we see in clinical care and

[27:52] what the the published literature

[27:53] suggests is if you don't do it for long

[27:55] enough, all you experience is the

[27:57] withdrawal and you're like, "Well, wait

[27:59] a minute. I need this thing to not be

[28:00] depressed and anxious." You don't

[28:02] realize that the depression, anxiety,

[28:04] restlessness when you're not playing is

[28:06] a result of playing.

[28:08] Right? And you need to abstain from long

[28:11] enough to allow your reward pathways

[28:13] from homeostasis to reset itself.

[28:16] >> the heroin addict coming off of the

[28:17] heroin.

[28:18] >> Exactly.

[28:18] >> to go through the shakes first.

[28:20] >> to get out of that that state of

[28:22] craving.

[28:22] >> Okay, explore that, okay?

[28:24] >> Okay.

[28:24] >> Okay.

[28:25] >> Thank you so much.

[28:26] >> Thank you so much, Deborah. You may or

[28:28] may not be surprised to know that nearly

[28:30] 50% of men

[28:32] aged 18 to 49 have an online sports

[28:36] betting account. I didn't know this.

[28:38] >> Yeah, it's really a scourge.

[28:41] >> Here's another shocking stat. Nearly one

[28:44] in five people with a gambling disorder

[28:47] will attempt suicide. One in five.

[28:50] That's the highest suicide rate of any

[28:54] of the addictions.

[28:56] Now, Matt is joining us from

[28:57] Massachusetts. My team saw you nodding

[29:00] while Safwat was talking. I hear that

[29:02] you've lost more than a hundred thousand

[29:04] dollars on sports betting apps. A

[29:07] hundred thousand dollars that you could

[29:08] not afford

[29:10] to lose. So, tell us how this happened,

[29:13] Matt.

[29:14] >> Well, thank you for having me on.

[29:16] You know, my story starts when I was 14

[29:18] years old. That was the first That was

[29:20] when I placed my first bet. Uh my father

[29:21] had given me some money to bet on the

[29:23] Patriots and Seahawks Super Bowl. Um

[29:25] and you know,

[29:26] I won. I hit that first bet.

[29:29] Um and it was a feeling I never really

[29:31] felt before. I was sitting on my

[29:32] friend's couch. I've compared it to

[29:35] hitting a game winner in a basketball

[29:36] game while I was sitting on that couch.

[29:38] Um it was unbelievable. I Deep down, I

[29:41] kind of knew I loved gambling then.

[29:43] Um but it's it's difficult to gamble

[29:45] when you're a 14-year-old, right? It's

[29:46] you need help. You need adults to give

[29:48] you access or give you money.

[29:50] So, I really didn't start gambling

[29:52] consistence consistently until I turned

[29:54] 19. Uh I was a freshman college. I went

[29:57] to a small division three school in

[29:58] Boston to play basketball.

[30:00] I got hurt early on in my freshman year.

[30:02] Um

[30:03] and I decided I was done. I didn't want

[30:04] to play basketball anymore.

[30:06] So, you know, now I have all this free

[30:08] time. I have access to more money than

[30:10] I've ever had before. Um and I needed to

[30:13] fill that void. You know, that structure

[30:14] that basketball uh had given me my

[30:16] entire life was gone.

[30:18] So, you know, I gradually start

[30:20] gambling, you know, in the morning, in

[30:21] between class, and I start gambling

[30:23] during class.

[30:24] Um and it gets to the point where I'm

[30:26] gambling

[30:27] around the clock, you know, eight hours

[30:29] a day.

[30:30] Um I wasn't socializing. I wasn't

[30:31] exercising. Um

[30:33] you know, I was everything I was doing

[30:35] was to try to gamble more and more. You

[30:37] know, in the summertime, I would go home

[30:38] and I would save up money that was

[30:40] supposed to last me through my freshman

[30:41] year of college or my sophomore year of

[30:43] college.

[30:44] And within weeks of getting back to

[30:45] school, it was all gone. You know, I had

[30:47] no money. I was gambling thousands and

[30:49] thousands of dollars away in weeks.

[30:51] Um you know, 90 to 95% of it was online

[30:54] sports gambling. There was some casino

[30:56] games involved, but it was really online

[30:58] sports gambling.

[30:59] >> Help us to understand that. What is it

[31:01] about online gambling that makes it so

[31:04] hard to quit?

[31:06] >> I think it's because it can seem

[31:08] at the at the outset at the beginning it

[31:10] can seem so harmless, right? There's no

[31:12] There's not a lot of physical signs.

[31:14] You're not addicted to a substance.

[31:15] You're not addicted You're not having

[31:18] withdrawals, right? So, it can start

[31:20] harmless.

[31:21] But, it's that it's that adrenaline

[31:22] rush. At least for me, I got that

[31:24] adrenaline rush that was so strong.

[31:27] Right? I'm not a physical adrenaline

[31:28] junkie. I don't want to, you know, jump

[31:30] out of a plane or go bungee jumping.

[31:31] But, that adrenaline that I got from

[31:33] gambling,

[31:34] I loved it. I thrived on it.

[31:36] >> It's so interesting cuz I was reading

[31:38] your background and you shared with one

[31:40] of my producers that it it wasn't even

[31:43] the

[31:45] when you [snorts] were 14 years old and

[31:46] had that first experience

[31:48] that got you hooked. It was that you won

[31:52] Didn't you win $20,000 at one point,

[31:55] right?

[31:56] >> Yeah, when I was 19, um freshman in

[31:58] college, I put in I put $100 into a

[32:00] gambling account. Um and within 2 days I

[32:03] ran it up to $20,000. You know, and I'm

[32:05] At that age, I'm thinking that's all the

[32:07] money in the world, right? I'm taking

[32:09] pictures of it. I'm sending it to

[32:10] everybody I know. Like, look what I just

[32:12] did. Look at this.

[32:13] And 2 days later it was gone. You know,

[32:15] I didn't I didn't withdraw a single

[32:16] penny.

[32:17] >> You didn't even You didn't even get to

[32:19] spend it.

[32:20] >> No. No. Not even a little bit. I gambled

[32:23] it all the way.

[32:24] And I think a part of me was chasing

[32:25] that

[32:27] that first big hit ever since. You know,

[32:28] it could it could be compared to someone

[32:30] who maybe addicted to drugs, you know,

[32:33] chasing that original high. Yeah. I was

[32:35] chasing the first big win.

[32:37] And I I had to surpass it. But I never

[32:39] did. I never did.

[32:40] >> Never did and still haven't surpassed

[32:43] it.

[32:43] >> No, I have not.

[32:44] >> No. What do you want to say, Dr. Limkey?

[32:46] >> Oh my gosh, so much. Um well, first of

[32:49] all

[32:49] >> Why is gambling so addictive and what's

[32:51] going on in the brain there? What's

[32:52] going on in Matt's brain with that?

[32:54] >> Right.

[32:54] >> Yeah.

[32:55] >> So, monetary rewards again light up that

[32:59] same reward pathway as drugs and

[33:01] alcohol, release dopamine, um work

[33:04] through essentially the same trajectory

[33:08] as addiction to drugs and alcohol, where

[33:10] we start using usually to have fun or to

[33:12] solve a problem. If it works for us, we

[33:14] go back again and again. And eventually,

[33:17] if we cross over into addiction, we're

[33:19] now marshaling all of our available

[33:20] resources to get the drug, use the drug,

[33:22] recover, and use again. Gambling is a

[33:26] very well-recognized,

[33:29] very potentially severe and

[33:31] life-threatening addiction, just like

[33:33] addiction to drugs and alcohol. And

[33:35] >> And and and and also, did you hear me

[33:37] say this earlier, Matt, that one in five

[33:40] people who are gamblers end up suicidal?

[33:44] >> Yeah. I- it

[33:45] >> Yeah.

[33:45] >> Yeah.

[33:46] >> I can understand why, cuz you end up

[33:47] losing everything. You're chasing,

[33:49] chasing, chasing, chasing, chasing. You

[33:51] lose everything. You're betting, you

[33:53] know, you lose your family, you can't

[33:54] pay your rent, you can't pay the car's

[33:56] taken away, everything. Yeah, you lose

[33:58] everything.

[33:59] >> And it's so inexplicable from the

[34:01] outside because you just feel like

[34:03] >> Well, stop.

[34:04] >> Just stop. Like just stop.

[34:05] >> Yeah.

[34:06] >> But what really happens is that people

[34:09] who get addicted to gambling

[34:11] are ultimately not even interested in

[34:15] the monetary wins. That That's how it

[34:17] begins. But what it eventually becomes

[34:20] is the desire to be in this alternative,

[34:24] self-created universe where all of the

[34:26] rest of your problems fall away and

[34:28] you've created this world within a world

[34:31] where

[34:32] you can have the illusion again that

[34:35] you're controlling, that you're moving

[34:37] forward.

[34:38] >> That's why there are no clocks in

[34:39] casinos.

[34:40] >> Yes. Yes.

[34:41] >> And no windows.

[34:41] >> Yes, exactly. And there's some very

[34:43] interesting brain studies of

[34:46] pathological gamblers showing that

[34:49] there's a surge of dopamine when they

[34:51] win, just like there would be for

[34:53] someone who's not addicted to gambling.

[34:55] But with pathological gamblers, people

[34:57] who are addicted to gambling, they

[34:59] actually get a surge of dopamine when

[35:01] they're losing.

[35:03] And the understanding of that is that on

[35:06] some level, and this is a phenomenon

[35:08] called loss chasing,

[35:10] >> Yeah.

[35:10] >> people who are addicted to gambling want

[35:12] to lose on some level because then it

[35:14] justifies chasing chasing it. That's

[35:17] right, staying in the game longer. So it

[35:19] becomes this horrible self-fulfilling

[35:22] prophecy, an alternate universe, the

[35:25] real world falls away,

[35:27] the complete loss of perspective. And my

[35:30] heart just goes out to you, and also let

[35:32] me say the other millions of people

[35:34] around the world who are struggling with

[35:36] very severe gambling addictions, which

[35:39] by the way has never been easier.

[35:43] In the United States,

[35:46] online sports betting used to be illegal

[35:48] everywhere. In the last decade, it has

[35:52] become completely normalized, gone

[35:55] online, is incredibly accessible, and

[35:57] now even sports franchises are colluding

[36:01] with these sports betting corporations,

[36:04] encouraging

[36:06] people who watch sports to bet. It's

[36:08] terrible. And we see a 300 to 500%

[36:13] increase in calls to pathological

[36:15] gambling hotlines in states where online

[36:19] sports betting has been made legal.

[36:22] Which brings us, Oprah, back to this

[36:23] concept of access. One of the biggest

[36:26] risk factors for addiction is not your

[36:28] childhood trauma, you know, not

[36:30] something about you uniquely and and you

[36:33] know, lack of willpower. It's simple

[36:36] access to our drug of choice.

[36:39] >> And it doesn't mean you're a bad person.

[36:41] It doesn't mean that you had all these

[36:43] horrible things happen to you. Yes. And

[36:46] Matt, how common would you say this

[36:48] issue is among your peers, the young men

[36:50] you know?

[36:53] >> I think

[36:54] the issue it can be common. I would say

[36:56] most males that I've interacted with,

[36:58] you know, when I was in college or even

[37:00] now when there's a 26-year-old, they

[37:02] gamble on some level because it is so

[37:04] accessible like what Dr. Lunke said,

[37:06] right? My

[37:07] my gambling accelerated once it became

[37:09] legalized in Massachusetts. It was just

[37:11] so it was so quick. It was so

[37:13] accessible.

[37:14] >> Yeah.

[37:15] >> Um but I I think especially college-age

[37:18] males, right? They have all this freedom

[37:20] now and you know,

[37:22] it's so accessible. Everyone that I'm in

[37:25] contact with gambles on some level.

[37:27] >> Yeah, and and also not only accessible,

[37:29] but nobody would even know. I mean, if

[37:32] you're a drug addict, we can see it. If

[37:34] you're a food addict, we can see it. If

[37:36] you're, you know, even a shopping

[37:38] addict, there's all this, you know, all

[37:40] the things that

[37:41] uh Safa is hiding around her home.

[37:43] >> Right.

[37:44] >> Um

[37:45] what is your question for Dr. Lunke? Do

[37:46] you have one?

[37:48] >> I do. Um you know, I've been in recovery

[37:51] um from gambling uh since October of '24

[37:54] um and there's still a stigma around it.

[37:57] Thank you so much. I appreciate it.

[37:58] Yeah. Um

[38:00] you know, during that time I've also

[38:01] been sober. Um I don't identify as an

[38:03] alcoholic, but I was just curious, you

[38:05] know,

[38:06] how strong is the addict mind? Like

[38:08] someone like me who does not identify as

[38:10] an alcoholic, you know,

[38:13] am I prone to other addictions, either

[38:15] alcoholism, drug addiction, whatever it

[38:17] may be? You know, because I have an

[38:18] addict mind, I am addicted to gambling.

[38:20] Am I prone to other things as well?

[38:21] >> Yeah.

[38:22] So family and twin studies uh suggest

[38:26] that some people are innately more

[38:28] vulnerable to addiction than others. And

[38:31] that if it's not one thing, it'll be

[38:33] another. So, there are differences there

[38:36] in terms of, you know, how we come into

[38:38] the world and how likely it is that we

[38:40] will get addicted if exposed to our drug

[38:42] of choice.

[38:43] >> Mhm.

[38:44] >> Um for example, if you have a biological

[38:46] parent or grandparent with an alcohol

[38:48] addiction, you are more likely to

[38:50] develop an alcohol addiction even if

[38:52] raised outside of that substance-using

[38:54] home.

[38:54] >> Wow.

[38:54] >> So, genetics is a piece of this. Um the

[38:58] other part of your question is sort of

[39:00] like,

[39:01] you know, are all of these I I this is

[39:03] what I understood your question to be,

[39:05] that you know, how does the alcohol

[39:07] relate to the gambling? Cuz it's

[39:08] interesting that you gave both of them

[39:10] up, and I think that was really smart.

[39:13] Because um you know, we talked about

[39:15] drug of choice and how when we meet that

[39:17] drug of choice that's uniquely suited to

[39:19] our brain, it's like a lock and a key.

[39:21] But on the other hand, all reinforcing

[39:23] substances and behaviors release

[39:24] dopamine in our brain's reward pathway.

[39:27] And anytime we're using any substance or

[39:30] behavior, even if it's not our drug of

[39:32] choice, we're pinging that reward

[39:34] pathway and kind of setting ourselves up

[39:37] for relapse to our drug of choice. So,

[39:40] which is why very often when folks are

[39:43] trying to give up whatever their drug of

[39:45] choice is, we also recommend that they

[39:47] give up drugs that are adjacent to that

[39:51] drug. And somehow, I don't know if you

[39:52] got advice to do that or you

[39:53] instinctively knew that giving up

[39:56] alcohol would be important so that you

[39:58] wouldn't be disinhibited and more likely

[40:00] to gamble. And we see that all the time.

[40:03] You know, encouraging folks, give both

[40:05] of these things up to get together. So,

[40:06] for example, there's good data showing

[40:08] that people who try to quit drinking who

[40:10] smoke cigarettes, if they give up

[40:11] cigarettes at the same time, they'll

[40:13] have better outcomes for both. And I I

[40:15] that, you know, that relates to a lot of

[40:17] other sort of paired addictions as well.

[40:21] >> Can I ask you this, Matt? What got you

[40:23] into recovery? Was it that you had to

[40:25] you had to hit bottom? I know you

[40:27] dropped out of three colleges. You were

[40:29] going through a lot.

[40:30] >> Yes, it

[40:31] >> Your personality changed. You were

[40:33] lying. You were doing all kinds of

[40:35] things, stealing from your parents.

[40:37] >> Yeah, that's kind of what made me hit

[40:38] bottom, you know, I just I couldn't pay

[40:40] my bills anymore. I was gambling away my

[40:41] rent money, my utility money, and I

[40:43] started stealing from

[40:45] uh family members. Um you know, and I

[40:47] ended up forging a check in my parents'

[40:49] name

[40:50] to pay my rent. Um at that point, you

[40:52] know, our relationship is somewhat

[40:54] crumbling.

[40:55] And we had a conversation, and I ended

[40:56] up going to treat a treatment center

[40:58] called Herren Wellness in Massachusetts.

[41:00] Um you know, I spent 3 months there as

[41:02] an inpatient.

[41:04] >> Was it hard to come clean to your

[41:05] parents?

[41:07] >> Uh yes. Stealing from them it's you

[41:11] know, when I was doing it, it felt

[41:13] awful.

[41:14] >> Yeah.

[41:14] >> But as you know, as soon as you get that

[41:16] money,

[41:17] I'm off and running again gambling. And

[41:19] that that guilt and that shame is out of

[41:21] your mind until you lose again. And it's

[41:23] almost like you come back to reality.

[41:25] Um

[41:26] you know,

[41:27] but the thing that helped me was, you

[41:28] know, going to Herren Wellness, spending

[41:30] 5 months there in treatment. You know, I

[41:32] didn't have a phone for almost 2 months.

[41:33] I had no access to technology. You know,

[41:35] getting that break,

[41:37] um you know, just getting away from it

[41:39] really helped me, you know, center

[41:41] myself and really see how

[41:44] insane I was behaving and what I was

[41:45] doing to people around me.

[41:47] >> You got to step away from it.

[41:48] >> Yeah.

[41:49] >> To see yourself. Yes. Do you like who

[41:51] you are becoming?

[41:53] Or returning to yourself? Yes.

[41:55] >> Much it I feel like I was I'm returning

[41:58] to the person I was before I started

[42:00] gambling. You know, I can be

[42:02] a good son, a good brother, a good

[42:04] friend. You know, I can have honest

[42:06] intentions. And I think that's what I'm

[42:08] most proud of today.

[42:09] >> Wow. Well, thank you for sharing your

[42:11] story with us. Thank you. Thank you,

[42:13] Matt.

[42:13] >> with us and with the world and takes a

[42:16] lot of courage to be

[42:17] >> a lot of people listening are going to

[42:18] hear themselves and see themselves in

[42:20] you.

[42:21] And so we thank you for having the

[42:22] courage to share it, really.

[42:25] >> Well, thank you for having me on. It was

[42:26] an

[42:26] >> Continue success in your recovery. Go

[42:28] well with that.

[42:29] >> Yes, yes. Keep going.

[42:30] >> Go well with that. Go well

[42:31] >> I will. Thank you so much.

[42:32] >> Oprah, can I say one thing about moral

[42:34] compass and addiction?

[42:37] When people are deep in their addiction,

[42:41] they will often do things that are

[42:43] outside their moral compass. Matt talked

[42:44] about stealing from his parents, you

[42:46] know, incredibly shameful, so brave of

[42:48] him to admit that. But I think it's

[42:50] really important for us to understand

[42:52] that when the reward pathway gets

[42:54] hijacked by this drug of choice, we

[42:57] really are not ourselves. And we are

[42:59] really are vulnerable to doing things

[43:02] that are outside of our moral compass.

[43:05] Um, essentially because our brain comes

[43:07] to mistake our drug of choice, in Matt's

[43:10] case gambling, for a something that we

[43:13] need for survival. Dopamine is really

[43:16] our survival neurotransmitter. It says,

[43:18] "Approach this thing, get it. You need

[43:21] it to survive."

[43:22] So I just think it's really important

[43:24] for people to understand that, you know,

[43:27] we we would most of us

[43:29] do things that we're very ashamed of

[43:31] outside of our morality once we get into

[43:35] that hijacked brain state of addiction.

[43:39] >> That's an important thing to say, I

[43:40] think. And we I think a lot of people

[43:44] realize that when they have family

[43:45] members who are severe drug addicts,

[43:49] like your family member on crack cocaine

[43:51] or on heroin, you say, "Oh, that's not

[43:54] who I know them to be."

[43:56] >> Yes.

[43:56] >> But we don't think the same about it

[43:59] when it's shopping or gambling.

[44:02] Thank you for bringing that to our

[44:03] attention.

[44:04] >> You say by practicing radical honesty

[44:07] that my guest today are actually taking

[44:10] the first step in curbing their

[44:12] addictions. So, being able to be honest

[44:15] about what what is actually going on.

[44:17] >> Yeah.

[44:17] >> How does radical honesty work?

[44:19] >> So, radical honesty is where we make a

[44:21] commitment to tell the truth about

[44:23] everything.

[44:24] >> Yeah.

[44:25] >> And this is really important in

[44:26] recovery. In my experience, the patients

[44:28] who can get into and maintain recovery

[44:30] are the ones who make a commitment to

[44:32] truth-telling. Primarily because they've

[44:34] learned

[44:35] >> That's what Savat, Deborah, and Matt

[44:38] have all done today.

[44:39] >> by showing up and sharing in this way.

[44:41] Um but but it means that we can't even

[44:43] lie about like, you know, why we didn't

[44:45] want to go to the party or why we're 5

[44:47] minutes late for the meeting because

[44:48] we're all prone to lie. The average

[44:50] adult tells one to two lies per day.

[44:52] Usually it's small lies to cover up our

[44:54] own foibles or selfishness. But when we

[44:56] make this commitment to radical honesty,

[44:59] what happens is

[45:00] we are then also forced to see the

[45:03] behaviors for what they are.

[45:05] >> I would I would see how a commitment to

[45:07] radical honesty

[45:09] really creates another vibration for

[45:12] you. You're operating at another level.

[45:14] >> Yeah.

[45:15] >> Yeah, that's right. And it also

[45:16] importantly gets us out of this shame

[45:18] loop. We have heard as a recurring theme

[45:21] here how much shame people feel about

[45:23] their addictions. And and that is so

[45:25] true, so common. We all feel horrible

[45:28] shame at not being able to control these

[45:31] behaviors. And shame itself can

[45:34] perpetuate the addiction because it's

[45:36] such a horrible feeling that then we

[45:37] just keep using to not feel those

[45:39] feelings. So, a way to get out of this

[45:42] destructive shame cycle is to commit to

[45:45] being honest with another human being as

[45:47] these folks did today as a way, again,

[45:50] to become aware of our behaviors, but

[45:52] also to create that vulnerability that

[45:54] allows people to really connect with us.

[45:57] Right? It becomes a source of intimacy

[46:00] that then becomes its own source of

[46:01] positive and healthy dopamine.

[46:04] >> You are so good at helping us understand

[46:06] ourselves

[46:07] and understand our addictions. And if

[46:09] you want to know more,

[46:10] read Dopamine Nation. So, thank you so

[46:12] much, Dr. Lembke, for being here. And

[46:15] thank you to Matt and Safa and Debra for

[46:17] your radical honesty and sharing your

[46:19] stories.

[46:20] Dr. Lembke's New York Times best-seller,

[46:23] Dopamine Nation, is available wherever

[46:25] books are sold.

[46:26] See you next time. Go well.

[46:29] >> If you are among [music] the 57% of

[46:30] Americans who feel they are addicted to

[46:32] their smartphones, Dr. Anna Lembke's

[46:34] book, Dopamine Nation, is a must-read.

[46:37] She breaks down why [music] smartphones

[46:38] are so addictive and shares tangible

[46:40] ideas for how to manage your

[46:42] relationship with technology. You can

[46:44] buy her book by scanning the QR code you

[46:46] see on your screen right [music] now.

[46:48] >> Our listeners tell us that the podcast

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Your brain's dopamine system creates a seesaw balance between pleasure and pain. When you experience a dopamine spike from scrolling or gaming, pain rushes in to balance it, creating a crash. To feel normal again, you need more of the behavior. This isn't a willpower problem; it's a neurological one.
Algorithms intentionally inject novel content to interrupt boredom and extend engagement. They also surface extreme material that users might never seek naturally, potentially shaping behaviors and normalizing content that would otherwise seem unthinkable.
Self-binding means removing access to the addictive behavior before craving strikes—like deleting apps, switching to cash, or giving a console to a friend. It replaces exhausting willpower with structural design, protecting your brain from temptation while dopamine recalibrates.
Recovery varies by severity and duration of use. Initial withdrawal can last weeks to months, during which you'll feel worse before better—the set point is imbalanced. With consistent abstinence and self-binding, the dopamine system gradually recalibrates and natural rewards begin registering again.
Yes. Deep addiction quiets the prefrontal cortex (judgment center) and amplifies limbic system reward-seeking. People steal, lie, and abandon values they hold dear—not from moral failure, but from neurological override. Recovery requires compassionate structural support, not shame.
Yes, for most people—but it depends on individual vulnerability. Some people have genetic or psychological predisposition to addiction. Awareness of your own triggers and intentional use (device-free times, cash budgets, shared devices) can help prevent crossing into compulsive use.

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