57: Dr. Anna Lembke - Navigating Dopamine, Addiction, and Mental Health: Seeking balance in an Age of Indulgence

Join us in this insightful interview for The MindHealth360 Show and the How To Academy with Dr. Anna Lembke, Professor of Psychiatry at Stanford University School of Medicine and author of the best-selling Dopamine Nation. In this interview, Dr. Lembke explores the intricate balance between pleasure and pain governed by our brain's dopamine levels, and offers valuable strategies for finding balance in an age of indulgence. With the rise of digital drugs and behavioural addictions, such as social media, online shopping, gaming, and gambling, Dr. Lembke discusses the need for balance and the pursuit of pain in a world obsessed with quick dopamine hits. She explains that our biological mechanism of seeking pleasure and avoiding pain is well-suited for a world of scarcity, but it is mismatched for the overwhelming abundance of rewards in today’s society, leading to a global mental health crisis and addiction issues.  Dr. Lembke provides a deeper understanding of the neurobiology of pleasure and pain, shedding light on how these mechanisms work in the brain and their impact on mental health. She also teaches us to recognise and address addictive behaviours, whether related to substances or digital activities for greater health and happiness.

The latest episode of The MindHealth360 Show is an event replay done in partnership with The How To Academy and features Harvard Nutritional Psychiatrist Dr. Uma Naidoo. In this interview, Dr. Naidoo discusses the importance of food to mental health and healing as well as lessons from her new book, Calm Your Mind with Food, where she lays out both science and practical advice for using food as medicine for mental wellbeing. Dr. Naidoo tells us about the major advances made in understanding the gut-brain connection, which explain how food and its digestion  in the gut directly impacts the brain, mood and anxiety levels. Dr. Naidoo explains how the brain and gut initially derive from the same tissue during foetal development, and stay connected by the vagus nerve through a bi-directional communication pathway. She tells us that when food breaks down during digestion, some of the products are good and support healthy brain function, while others are toxic and lead to inflammation in the gut and brain, causing mental health symptoms. Psychological stress can change the make-up of the bacteria in the gut, encouraging the growth of bad bacteria and the reduction of good bacteria, and food can change brain function depending on whether it is healthy or unhealthy.  Dr. Naidoo talks about the foods to avoid (ultra-processed food, lots of added sugar, artificial sweeteners, and trans fats) and foods to seek out (healthy fats, clean proteins, fibre-filled vegetables and legumes) to maximise mental wellbeing. She talks about how different diets can be adapted to personal requirements and preferences, and how moderation and substitution work better than trying to cut out guilty pleasures entirely. We also discuss intermittent fasting, helpful supplements, and Dr. Naidoo’s CALMS acronym for what to look for at the store. Michelin-starred chef David Bouley described Dr. Naidoo as the world’s first “triple threat” in the food and medicine space: a Harvard trained psychiatrist, professional chef graduating with her culinary schools’ most coveted award, and a trained Nutrition Specialist. Her nexus of interests have found their niche in Nutritional Psychiatry. Dr. Naidoo founded and directs the first hospital-based Nutritional Psychiatry Service in the United States. She is the Director of Nutritional and Lifestyle Psychiatry at Massachusetts General Hospital (MGH) & Director of Nutritional Psychiatry at MGH Academy while serving on the faculty at Harvard Medical School. She was considered Harvard’s Mood Food Expert and has been featured in many media outlets, including the Wall Street Journal. Dr. Naidoo is also the national bestselling author of This Is Your Brain on Food. In her books, she shows the cutting-edge science explaining the ways in which food contributes to our mental health and how a diet can help treat and prevent a wide range of psychological and cognitive health issues, from ADHD to anxiety, depression, OCD, and others.

Our latest guest on The MindHealth360 Show, Dr. Janina Fisher, one of the world’s leading experts on treating trauma, explains the revolution in trauma treatment since Bessel van der Kolk’s work, which showed that trauma is not in the event itself, but rather in the body’s reaction to that event, which is stored in the body, the nervous system and the lower brain regions. This explains why talk therapy and CBT, which engage the brain’s higher prefrontal cortex, so often fail to address the root causes of mental health issues and are blunt tools when it comes to successfully treating trauma.  She explains that when we have an emotional reaction to an event or a person, we may actually be having a “feeling memory”, reacting to an implicit memory from a childhood trauma rather than to the actual person or event in the present. And this memory can trigger our nervous system’s animalistic response to an earlier threat – whether mammalian (fight/flight) or reptilian (freeze), in the present – dysregulating our nervous system and contributing to mental health symptoms such as depression, anxiety, panic, and lack of focus, memory and concentration. Dr. Fisher developed the groundbreaking TIST (Trauma Informed Stabilisation Treatment) to help heal trauma and educate and train trauma therapists around the world. Combining Dr. Dick Schwartz’ IFS parts work with mindfulness, clinical hypnosis, and Pat Ogden’s sensorimotor psychotherapy, her approach has proven very successful in sustainably treating trauma. Here she shares some key insights to help us understand the effects of trauma and nervous system dysregulation on our bodies, minds and behaviour, and gives us some top tips for recovery. Janina Fisher, Ph.D. is a licensed clinical psychologist and a former instructor at Harvard Medical School. An international expert on the treatment of trauma, she is an Advisory Board member of the Trauma Research Foundation and the author of three books, Healing the Fragmented Selves of Trauma Survivors: Overcoming Self-Alienation (2017), Transforming the Living Legacy of Trauma: a Workbook for Survivors and Therapists (2021), and The Living Legacy Instructional Flip Chart (2022). She is best known for her work on integrating mindfulness-based interventions into trauma treatment, and she is also the creator of Trauma-Informed Stabilization Treatment (TIST) therapy.

Deb Dana, LCSW, is a world-renowned clinician, consultant, author and speaker who has successfully put into practice Dr. Stephen Porges’ Polyvagal Theory (PVT), making it accessible and beneficial to hundreds of thousands of people around the world by developing therapeutic practices based on PVT. Deb has a busy career training therapists around the world on how to bring a Polyvagal approach into their clinical practice, and also works with agencies and larger systems to explore how to incorporate a Polyvagal perspective into organisational culture to make them safer, happier, and healthier places to learn, work and function. She is a founding member of The Polyvagal Institute, a consultant to Khiron Clinics, and an advisor to Unyte. She is the author of several books, including her latest Anchored: How to Befriend Your Nervous System Using Polyvagal Theory and Polyvagal Practices: Anchoring the Self in Safety. In this fascinating interview for The MindHealth360 Show, Deb discusses how the state of our nervous systems is essential to our mental and physical health and our daily energy regulation, and how we can understand and manage this state throughout the day using tools and techniques based on Polyvagal Theory. She talks about the hierarchy of the nervous system – from the ventral vagal state (social engagement, which is essential to health, growth and restoration), to the sympathetic state (fight-flight), and finally to the dorsal state (freeze, collapse) and how each one relates to different adaptive behaviours and pathways of neuroception, further influencing our nervous systems. She tells us of different strategies to move more quickly and easily from dorsal or sympathetic to ventral states so we can find calm, connection and healing in our lives. She also discusses the impact of loneliness; her “glimmers” of ventral activation (gone viral on Tik Tok) that we can use to self-regulate; and tells us how different peoples’ nervous systems require different interventions to find their way back to the ventral pathway which is essential to healing; as well as the importance of following the “intuition” of our nervous system. If we could all put Deb’s healing work into daily practice and better manage our nervous systems, our inner and outer worlds would be happier, healthier and safer places to live. 

Dr. Robert Hedaya has been practising functional medicine psychiatry for many years, and is a clinical professor of psychiatry at Georgetown University Medical Center. He is the author of Understanding Biological Psychiatry, The Antidepressant Survival Guide and Depression: Advancing the Treatment Paradigm, and the founder of the Whole Psychiatry and Brain Recovery Center, as well as a faculty member at The Institute for Functional Medicine (IFM). In this captivating interview for The MindHealth360 Show, Dr. Hedaya talks about how he uses Functional Medicine, focusing on nutrition, digestion, inflammation, toxicity, and hormone levels, and combines it with novel brain therapies which he bundles in his pioneering HYLANE protocol, for a truly personalised treatment for mental health and neurological disorders. HYLANE combines hyperbaric oxygen therapy (HBOT), qEEG guided transcranial laser therapy, and neural exercises to treat dysfunction in the brain. He has had great successes with treatment-resistant depression, anxiety, neurodegenerative and other brain disorders using this technology, sometimes even when not combined with functional medicine.  He also discusses how our brains can be deeply affected by socio-cultural, environmental factors and trauma, leading to dysregulation of the hypothalamic pituitary and adrenal (HPA) axis and epigenetic mutations which can affect vital functions such as methylation.

Ben Greenfield is one of the world’s leading biohackers. Voted by the NSCA as America’s top personal trainer, he is also a health consultant, nutritionist, physiologist, competitive athlete, 13-time Ironman triathlete and New York Times bestselling author of 13 books, including the wildly popular Beyond Training: Mastering Endurance, Health, & Life and Boundless: Upgrade Your Brain, Optimize Your Body & Defy Aging. With a focus on brain hacks for improving mental health, in this fascinating interview Ben explains why rebooting communication between our nervous system and brain is fundamental to our mental health and wellbeing. He discusses why our emotions, intellect, motivations, cravings, focus and ability to feel whole, human and “boundless” can be drastically impacted when communication between our brain and body is poor. The interview packs a punch and covers an extensive discourse on the many biochemical causes of poor mental health (including neurotransmitter and hormone imbalance, insomnia, dysregulated nervous system, poor diet and gut issues), and he suggests surprisingly simple ways we can recover from anxiety, depression, low mood, stress, poor memory, addiction, fatigue, poor motivation etc. In this lively and incredibly educational conversation, learn why neurotransmitters (serotonin, dopamine, acetylcholine) can drive poor mental health; discover why neurotransmitter testing, DNA testing and hormone profiles offer helpful tools for understanding the root causes of poor mental health; and discover how our diets (protein and amino acid intake, ketogenic diets etc) are the building blocks of our neurotransmitters and our hormones, and why when depleted or dysregulated they are a major cause of poor mental health. Discover how diet, quality sleep, cold therapy, calming the nervous system and taking care of our Soul can hack our brains for greater happiness and health, enabling us to become truly “boundless” in mind, body and spirit.

Addressing the survival of our civilization, this is one the most pressing interviews ever featured on the MindHealth360 Show. Daniel Schmachtenberger is one of the most brilliant systems thinkers and social philosophers of our time. Combining astounding intellect and depth of knowledge with profound concern and wisdom, he is tackling the many issues that threaten humanity. Founder of the Civilisation Research Institution (a think tank focused on preventing global catastrophic risks) and founding member of The Consilience Project (which publishes cutting edge research on catastrophic risk), he advises governments and institutions on the risks we face as a species and planet (such as AI, exponential tech, biological warfare, species extinction, climate change, biodiversity loss, dead zones in oceans, and the global health crisis, and is a much sought-after speaker whose interviews regularly reach hundreds of thousands of people worldwide.  In this vital and deeply thought-provoking interview, Daniel focuses on the epidemic of poor mental health. He explains why our world system is inherently unhealthy, why poor mental health (anxiety, depression, addiction, ADHD, body dysmorphia, suicidality) is linked to our collective (rather than individual) trauma, and why our health is inextricably linked to the political, economic, sociological structures in which we live, which disregard the true meaning of life and our fundamental wellbeing. An expert in Integrative Medicine through his own struggles with chronic illness, Daniel has helped open several Functional Medicine clinics, and is head of R&D at Neurohacker Collective, which develops high performance nutraceuticals.  With 1 in 5 people on a mental health drug and with suicide rates in the US increasing by 36% between 2000 and 2021, Daniel rightly views the status of our metal health as a catastrophic risk and very real crisis. He looks at our global health from a complex and holistic systems-perspective, and argues that we urgently need to attend to our planet, society and each other in order to heal – and even save –  ourselves before it’s too late. Discover why the world crises we face are impacting our mental health, why a profound shift into modernity (and away from an evolutionary lifestyle based in nature, good nutrition and community) is killing us, and why it ultimately takes a collective, holistic and fundamental redesign of civilization to restore our individual well-being. It is my longest interview yet, but well worth listening to it in its entirety in its life-affirming, thought provoking, sobering and vital pearls of wisdom from one of the great thinkers of our time.

Dr. Richard Schwartz is the Founder of IFS (Internal Family Systems), an evidence-based therapy which is revolutionising traditional psychotherapy. IFS has shown to be remarkably successful where other therapies have proven to be ineffective or unsustainable in helping patients resolve issues with addictions, anxiety, depression, eating disorders, self-harm, suicidality, and other mental health problems. Its strength lies in its simple and intuitive premise that we each have parts (the fearful part, the caregiver, the perfectionist, the overachiever, the grieving part, the addict, etc, usually formed in childhood) which are often at odds with each other and can cause us to act in ways which are destructive to ourselves and others (while in fact, they are actually trying to protect us). Uniquely combining cognitive and somatic approaches, IFS teaches us to pay attention to our different parts and their relationships in order to successfully heal trauma and poor mental health.  In this fascinating interview, Dr. Schwartz explains why damaged or conflicting parts can lead to emotional pain, physical illness and mental crisis. He helps us discover why there are no “bad” parts, and how when our parts are allowed to feel safe and heard, feelings of compassion, curiosity, calm and confidence flourish. He identifies these qualities as forming our “Self”, and has found them to be fully present (though often repressed) in even his most traumatised patients. As such, IFS is one of the therapies most aligned with spiritual traditions in that it recognizes that we all have a healthy and intact “Self”, separate from our parts. He shows that by listening to these wounded parts with compassion and courage from a place of “Self”, and then speaking and acting with “Self Leadership”, speaking for our parts, rather than from our parts, we can substantially improve our professional and personal relationships, our lives, mental and physical health and happiness.  Dr. Schwartz has a PhD in family therapy, has taught at a number of institutions including University of Illinois, Northwestern and Harvard University, and has authored many best-selling books including No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model and You Are The One You've Been Waiting For: Bringing Courageous Love To Intimate Relationships.

Clinical neuropsychologist Dr. Mario Martinez has spent years interviewing healthy centenarians around the world, and studying the effects of culture, beliefs, thoughts and feelings on our biochemistry, longevity and health. He is the best selling author of The MindBody Code: How to Change the Beliefs That Limit Your Health, Longevity, and Success. In this thought-provoking interview, he outlines the profound influence cultural contexts have on the immune system, the endocrine system and the regulation of the nervous system, and how our culture influences our mental health and life expectancy. Backed by scientific evidence, he reveals that longevity is learned rather than inherited. Discussing top tips on how to defy falling rates of life expectancy in the West, he explains how our minds and bodies are heavily influenced by our cultural attitudes towards health and ageing, and why feelings of shame, disempowerment and hopelessness are worse for our mental and physical health than stress. The pioneering founder of Biocognitive Science, Dr. Martinez shows why self-worth is key to living beyond 100 and explains how we can remodel our physiology through our thoughts and actions to promote health, happiness and longevity.

Dr. Datis Kharrazian is an award winning clinical research scientist, Harvard trained academic professor and world renowned Functional Medicine expert. He is at the forefront of developing evidence-based treatments for mood disorders as well as autoimmune and chronic neurological diseases, which are used by academic institutions as well as by thousands of health care providers. A Fellow of the American College of Nutrition, Diplomate of the Board of Nutrition Specialists, member of the American Association of Immunologists, and a Fellow of the Royal Society of Medicine, he is also the bestselling author of Why do I Still have Thyroid Problems?, and Why Isn’t My Brain Working? In this very complex and captivating interview, Dr. Datis Kharrazian explains why conventional medical approaches to brain health are ineffective, and why neuroinflammation – rather than neurochemical imbalance such as low serotonin – is the true cause of poor mental health. With a focus on psychoimmunology, he sheds light on cutting edge research into glial cells (which are responsible for ‘cleaning’ the brain), and explains how they dictate all aspects of health. Revealing the concrete link between primed glial cells and chronic neuroinflammation, he outlines why immune activation is the most common cause of poor mental health (anxiety, depression, insomnia, OCD, etc), neurodegeneration (autism, ADHD, Parkinson’s, etc) and autoimmune diseases (MS, diabetes, IBD, etc). He explains that our brains, thoughts and emotions can all cause neuroinflammation and in turn poor mental health, and shows how anxiety, depression, autoimmunity, and other chronic health symptoms can be treated successfully through functional neurology models that address and treat neuroinflammation. He also offers real hope that although identifying the causes of glial cell activation and neuroinflammation can seem complex and overwhelming (and can include a vast array of biochemical, environmental and psychological stressors, mould, toxins, viruses, leaky gut, trauma, injury, stress, etc), wellness can be achieved through relatively simple lifestyle and dietary treatments.