The Real Reason Why We Can’t Stop Scrolling with Oprah and Dr. Anna Lembke

BUY THE BOOK! Dopamine Nation by Anna Lembke https://amzn.to/4xniLB7 Tech addiction or the compulsive, excessive use of digital devices for online activities like social media, shopping, gaming or gambling impacts an estimated 27% of the global population. On this episode Oprah sits down with Dr. Anna Lembke, Stanford addiction expert and the author of the New York Times bestseller Dopamine Nation, to understand what is driving these addictions and what we can do about it. We hear from a young woman whose online shopping habit caused her to rack up $30,000 in credit card debt, a young gamer who spends up to seven hours a day playing video games and a young man whose online gambling addiction led him to drop out of three colleges, steal from his family and lose over $100,000 on sports betting apps. 00:00:00 - Welcome Anna Lembke, author of “Dopamine Nation” 00:07:00 - When does tech use cross into addiction 00:09:45 - The dopamine crisis 00:11:20 - Addicted to online shopping 00:14:45 - Highs and lows of online shopping 00:17:00 - Self-binding 00:19:15 - Self-regulating cravings 00:22:16 - Addicted to gaming 00:24:50 - Long-term impacts of gaming addiction 00:27:30 - You will feel worse before you feel better 00:28:30 - Gambling addiction 00:37:50 - How strong is the addict mind? 00:42:30 - Addiction and your moral compass 00:44:07 - First step in curbing your addiction Follow Oprah Winfrey on Social: https://www.instagram.com/oprahpodcast/ https://www.facebook.com/oprahwinfrey/ Listen to the full podcast: https://open.spotify.com/show/0tEVrfNp92a7lbjDe6GMLI https://podcasts.apple.com/us/podcast/the-oprah-podcast/id1782960381

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Oprah Winfrey?

  When it comes to tech, when does a daily habit cross over into addiction?

• 0:05Speaker 01

  This has crossed the threshold from a bad habit into a mental illness.

• 0:11Oprah Winfrey?

  I hear you've racked up over $30,000 in credit card debt. What do you think is at the root of your shopping addiction?

• 0:18Speaker 02

  I feel unfulfilled in many aspects of my life. And instead of sitting with the discomfort, I resort to, let me find something to buy.

• 0:29Oprah Winfrey?

  You spend as much as seven hours a day playing video games.

• 0:32Speaker 02

  Mm-hmm.

• 0:33Oprah Winfrey?

  And what is it about gaming for you?

• 0:35Speaker 03

  A lot of the game is rewarding, but also low lows can happen all within a like 20-minute span.

• 0:41Oprah Winfrey?

  I hear that you've lost more than $100,000 on sports betting apps. I know you dropped out of three colleges. You were lying, you were stealing from your parents.

• 0:50Speaker 04

  Yeah.

• 0:50Oprah Winfrey?

  What is it about online gambling that makes it so hard to quit?

• 0:57Speaker 04

  It's that adrenaline rush. It could be compared to someone addicted to drugs, you know, chasing that original high.

• 1:02Speaker 01

  And now we've entered into addicted brain. 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.

• 1:14Oprah Winfrey?

  It's like the heroin addict coming off of the heroin.

• 1:16Speaker 01

  Exactly.

• 1:16Oprah Winfrey?

  And that is what is happening to your children. When you try to take away the phones, that's what's happening to you. When you can't get your cellphone, you can't stop scrolling.

• 1:24Speaker 01

  That's right.

• 1:24Oprah Winfrey?

  You're just scrolling, scrolling, scrolling.

• 1:26Speaker 01

  Yes.

• 1:28Oprah Winfrey?

  Hi, everybody. I'm glad to be here with you on the Oprah Podcast. Over 3 million of you watched or listened to our episode on Gen Z tech addiction. Thank you for that. But as we're learning, it's not just one generation or group. Tech addiction can hook anybody, and a lot of people are hooked right now, at all ages, no matter your circumstances. And today, on this podcast, I want to ask these questions. What's behind these addictions? What's happening inside our brains? Are we defenseless? Or can we actually do something about it? I'll be talking to people who are addicted to gaming, online gambling, and even shopping.

• 2:12Oprah Winfrey?

  That's a biggie for a lot of women. But first, here's a quick look at some of the moments from that episode that struck a chord.

• 2:19Speaker 05

  So my name is Dr. Nisha Glenn. This is my son, Amir Jenkins. He started his gaming at about five or six. When he got in high school, that's when I knew it was an addiction. He would not brush his teeth. He would not eat.

• 2:31Oprah Winfrey?

  Ooh.

• 2:32Speaker 05

  It was strictly.

• 2:34Speaker 06

  Amir.

• 2:35Speaker 05

  I mean, nothing, no, no, no showers in there on the game 24 hours a day.

• 2:41Oprah Winfrey?

  Can you take us to the point of understanding what that feels like? When you're sort of caught up in the obsessiveness, obsession of it?

• 2:51Speaker 06

  I would say you almost forget where you are in a sense. Like, when I play the game, I literally forget I'm in a house sometimes. I'm so virtual, so intimate, and, you know, it's free, judge-free zone as well. Mm-hmm.

• 3:09Speaker 07

  I was exposed to corn at the age of eight and have struggled with an addiction for the past 20 years. I'm married to a corn addict. He has struggled since he was eight years old. I make it like my mission to watch his every move, which is so draining.

• 3:23Oprah Winfrey?

  Maddie and Kyle, thank you for being here. I know this is a hard thing to talk about. And I applaud your courage in being willing to speak about it. Because I hear this is really serious for a lot of people, like millions and millions of guys throughout the country and the world. How long have you all been married?

• 3:45Speaker 07

  We've been married six and a half years. So I would say like the last year is when I finally realized that like this addiction is so much deeper. And I'm like, how many times do I try to break a bad habit? And I have to start over. And this is an addiction.

• 3:59Oprah Winfrey?

  Well, I know hearing Kyle and Maddie's story really hit home for a lot of people. Addiction to adult content is impacting millions of families and relationships. My team just checked in with them. Kyle has had a relapse and setback in his recovery, he says, and is now doubling down on his addiction classes. And Maddie told us that they still love each other, and they're going to continue to fight for their marriage. Dr. Anna Lomki is back with us, and she's a psychiatrist and chief of Stanford Addiction Medicine. And I just truly believe that her book is a must-read. It's called Dopamine Nation: Finding Balance in the Age of Indulgence. Welcome back to the podcast, Dr. Lomki. Thank you.

• 4:44Speaker 01

  Thank you.

• 4:45Oprah Winfrey?

  In Dopamine Nation, you write, I was moved by this, you say, "The internet promotes compulsive overconsumption, not merely by providing increased access to drugs, old and new, but also by suggesting behaviors that otherwise may never have occurred to us." I think that's what's happening to a lot of people. Can you give us an example of what you're seeing now that's new and different?

• 5:13Speaker 01

  Yeah, I mean, there's this real contagion effect where because the algorithm both feeds us videos and other content that we specifically search for, and also novel content that we didn't go looking for.

• 5:30Oprah Winfrey?

  That's right. Things are just popping up on your screen.

• 5:32Speaker 01

  Right, and that's intentional, right? That 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.

• 5:44Oprah Winfrey?

  Wow.

• 5:45Speaker 01

  So what ends up happening is there is this injection of very extreme content. And this can impact behaviors because it makes people think of something that would never have occurred to them naturally. You know, this happens with drugs. So kids seeing videos of other kids using like unusual drugs or synthetic drugs or drugs that they've, you know, concocted themselves. And then kids wanting to go and try that. It's especially prevalent with sexual content. So sexual images, people behaving in ways, for example, men choking women is not something that was, you know,

• 6:29Speaker 01

  would necessarily occur to somebody. But there's so much choking and other kind of sadomasochistic sexual content. And when, when people go looking for adult content, that's actually the first content that they see or that's, you know, pushed to them. But now you've got a lot of people engaging in sexual behaviors that are potentially harmful and dangerous, potentially. So it's this, it's this kind of thing.

• 6:57Oprah Winfrey?

  When it comes to tech, which has infiltrated, you know, all of our lives, every part of life, every waking moment, I think people are confused on this. Like, when does a daily habit, a thing that we've been doing and thing that we need to do, cross over into addiction?

• 7:17Speaker 01

  Addiction is a spectrum disorder, right? You can have mild, moderate, or severe addiction depending upon the severity of the symptoms, how many symptoms there are. But there can also be this pre-addicted state that you might think of as risky use or even a bad habit. 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. Again, characterized by these four Cs: out of control use, craving, compulsive use, meaning that I initiate use even against my desire and intention not to use. And then especially consequences. Plus tolerance, you know,

• 8:02Speaker 01

  which we've talked about, needing more potent forms over time to get the same effect. And also withdrawal. When I try to stop, I experience this physiologic response that then pulls me back into it.

• 8:15Oprah Winfrey?

  You explain that pleasure and pain work like the balance of a seesaw.

• 8:21Speaker 01

  Right.

• 8:22Oprah Winfrey?

  How does that impact addiction? Explain that to our audience here.

• 8:26Speaker 01

  Yeah, so I use this extended metaphor of a balance to communicate to my patients, my medical students, what's happening in the brain as we go from sort of healthy adaptive use of a substance or behavior to unhealthy, maladaptive addictive use. So if you imagine that in your reward pathway, there's something like a teeter totter that represents how we process pleasure and pain. When it tilts one way, we experience pleasure. When it tilts another, we experience pain. But there are certain rules governing this balance. And the first and most important rule is that the balance wants to remain level, which is what neuroscientists call homeostasis, sometimes referred to as set point. You refer to it in your wonderful book Enough.

• 9:11Oprah Winfrey?

  Enough Point?

• 9:12Speaker 01

  As, as the enough point.

• 9:14Oprah Winfrey?

  But it's, it's, it's the set point. That was Dr. Anya's word.

• 9:17Speaker 01

  Right, yeah, it's, it's homeostasis. And our brains will work very hard to return to a level balance or homeostasis with any deviation from neutrality. So for example, when we do something that's pleasurable uniquely for our brain, that releases dopamine. The balance tilts toward the side of pleasure. But no sooner has that happened than our brain will respond by down-regulating dopamine transmission, not just to baseline, but below baseline.

• 9:46Oprah Winfrey?

  So you need more, more, more.

• 9:48Speaker 01

  Right.

• 9:49Oprah Winfrey?

  When we experience pleasurable activities like eating, exercising, or socializing, it triggers our brain to produce the feel-good chemical called dopamine. The cycle of addiction begins when addictive substances and behaviors cause massive dopamine surges, which causes our brains to both produce less dopamine and at the same time, absorb it less efficiently. This creates a dopamine deficit, which causes us to crave more and more of the substance or the behavior just to feel normal.

• 10:20Speaker 01

  And I like to imagine that process of neuroadaptation as these little gremlins hopping on the pain side of the balance to bring it level again. But the gremlins like it on the balance. So they don't get off as soon as we're level. They stay on until we're tilted an equal and opposite amount to the side of pain. That is the come down. That's the craving, the hangover, the moment of wanting one more potato chip.

• 10:41Oprah Winfrey?

  Yeah.

• 10:42Speaker 01

  Or one more joint.

• 10:42Oprah Winfrey?

  Let's be standing in front of the pantry, just grazing, looking for what is the thing I can do to curb this anxiety that I'm feeling.

• 10:50Speaker 01

  Right, right. And remember, our brain wants to get back to homeostasis. So the fastest way to do that is to have another potato chip.

• 10:58Oprah Winfrey?

  Yeah.

• 10:58Speaker 01

  The problem is if we continue to consume our drug of choice over days to weeks to months to years, those gremlins start to multiply. And pretty soon, we have enough gremlins on the pain side of the balance to fill this whole room. And now we've entered into addicted brain. We are in a chronic dopamine deficit state. Now 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.

• 11:26Oprah Winfrey?

  And that is what is happening to your children when you try to take away the phones. That's what's happening to you when you can't get your cellphone. You can't stop scrolling.

• 11:34Speaker 01

  That's exactly right.

• 11:34Oprah Winfrey?

  You're just scrolling, scrolling, scrolling.

• 11:36Speaker 01

  Yes.

• 11:36Oprah Winfrey?

  Okay. 80% of people coping with an addiction to online shopping are women. Listen to Safat's story.

• 11:44Speaker 02

  I have a shopping addiction. And over the past three years, I've racked up over $30,000 in credit card debt. 99% of it is shopping. I have said no to going out to dinner with friends, bought the cheapest thing at the grocery store just so I could buy that one thing, whatever it was in the moment. It's really shameful because I'm in my mid 30s. I have a good job, and yet I'm struggling to pay rent because I keep spending more than I can afford. I was also scared to come on here and say this because it feels like I failed.

• 12:14Oprah Winfrey?

  Oh, yeah.

• 12:15Speaker 01

  Oh, wow.

• 12:16Oprah Winfrey?

  Okay.

• 12:17Speaker 01

  Yeah.

• 12:18Oprah Winfrey?

  Safat joins us from Brooklyn.

• 12:20Speaker 02

  Hi, Oprah.

• 12:21Oprah Winfrey?

  What do you think is at the root of your shopping addiction? I was really interested to read about it because I go online and I... It's a dangerous thing, let me just tell you. It's a dangerous thing. And you get a little... I guess I'm getting a little dopamine hit. Add to cart, so exciting. Add to cart again. Before you know it, I have three blouses for $24.99.

• 12:45Speaker 01

  Yeah, none of which you need, probably.

• 12:46Oprah Winfrey?

  Yeah, none of which I need. Oh, I didn't need that little crop top. So I have $24.99. Then I'm like, what else can I get? So does it feel like that? Is that what it feels like for you? You just get a little hit or...

• 12:58Speaker 02

  Yes, it absolutely does feel like that. For me, the root of my addiction stems from, I think, childhood. I've talked about this with my therapist. And my family moved to America when I was six years old. And we moved to a upper-middle-class white neighborhood. And I noticed all the kids would get gifts, Christmas gifts, birthday gifts. And I was getting like hand-me-downs and, you know, sharing the room with my siblings. And so I think what I told myself in those moments is when you're older, you're going to be able to have these things. You're going to be able to fit in. So now that I have a job, what I'm realizing that I do on a regular basis

• 13:42Speaker 02

  is I buy these things almost to satisfy my inner child to tell myself, okay, you've made it, right? And so that's become my coping mechanism. And additionally, I feel unfulfilled in many aspects of my life. And I think instead of sitting with the discomfort of the sadness or disgust or whatever I feel in myself, I resort to let me find something to buy because that's what I trained myself from a young age, is what would make me happy. So I continue to do it. I get a little boost of dopamine.

• 14:24Speaker 02

  And then what I really feel is shame and guilt for doing it because I've accrued so much debt.

• 14:32Oprah Winfrey?

  Yeah. You've racked up over $30,000 in credit card debt that you can't afford to pay.

• 14:37Speaker 02

  Yes, correct.

• 14:38Oprah Winfrey?

  So you feel good in the moment where you're ordering it? Do you feel good then when you're... You feel good when you're adding to cart? And then when it arrives, you're ashamed?

• 14:47Speaker 02

  Yes.

• 14:48Oprah Winfrey?

  Yeah.

• 14:49Speaker 02

  A little... So as soon as I buy it, instead of feeling happy, I feel immense amount of shame and guilt. And then when it arrives, I'm excited to open the box. And I've also been for years now hiding my packages from my partner. Not that he absolutely has no problem with it. He's encouraging of me doing the best for me to get over the addiction. But I think internally, I feel so much guilt that I will hide the packages. I will lie about it. So I'll open it and then I'll feel guilt and shame again. And then instead of dealing with it, I'll go and purchase something else.

• 15:28Oprah Winfrey?

  Dr. Limkey, what do you want to say?

• 15:30Speaker 01

  Gosh, so much here. Okay, so you started talking about some early childhood experiences that you think contribute. And I think that's important to reflect on that. But I think there's a danger of spending too much time looking for the root cause of addiction.

• 15:47Oprah Winfrey?

  Yeah.

• 15:47Speaker 01

  When there doesn't actually need to be an underlying reason other than we're living in an addictogenic world where shopping has become drugified. The medium of being online itself constantly sends us triggers to buy. That's the whole business model of...

• 16:06Oprah Winfrey?

  You can't read an article without... What we're all trying to do now is filter out all the ads as you're trying to like communicate with anything, yes.

• 16:14Speaker 01

  Yes. And we get a little hit of dopamine, not just when we're shopping, but just getting a reminder that we might be able to go shopping or that there might be something available. That actually also stimulates the brain's reward pathway and then sets up that state of craving that makes us want to go shopping. And the reason this is so important is because, yes, it's good to talk about your childhood and some early underlying, you know, issues that might be contributing to it. But you could talk about that all day. And it's not going to get at the root of the problem if you're still exposing your brain

• 16:56Speaker 01

  to this very addictive medium that's constantly triggering your brain, releasing dopamine, and then leading you down this road, which is why self-binding strategies are so important. Self-binding is where we create literal and metacognitive barriers between ourselves and our drug of choice so we can press the pause button between desire and consumption.

• 17:20Oprah Winfrey?

  So what does she need to do?

• 17:21Speaker 01

  So what you need to do is you need to delete any shopping apps that you have, right? You need to possibly get rid of any online pay vehicles. Anything that makes it easy and frictionless for you to buy something is definitely something that you should eliminate. You know, online shopping or shopping addiction is a huge and growing problem, especially, as you commented, Oprah, among women. So these self-binding strategies are really key. If you really want to take it to the extreme, you will get rid of all of your credit cards and you will only carry cash and you will only buy in cash and not online. And this seems extreme,

• 18:05Speaker 01

  but what my patients discover is that it's actually so much easier than expecting that you can constantly stimulate your brain and then resist the pull that's created by all of these stimuli that are inviting us to consume.

• 18:22Oprah Winfrey?

  How does this sound to you, Safat?

• 18:24Speaker 02

  That absolutely sounds like a great idea. Something I've tried in the past

• 18:30Speaker 01

  Okay.

• 18:31Speaker 02

  is getting rid of my credit cards. What happened is when I'm in an anxious mindset or when I'm sad or depressed, I opened up new cards. So usually, when I'm aware of what I'm doing, I can continue to do it and I can perform. But then as soon as I'm in a state where I can't regulate and I'm anxious or whatever it is, I will get more credit cards or I will subscribe to whatever it is. And I think I go back to that state. So I guess my question is, when I'm feeling like that, how do I self-regulate? And how do I get myself to not do those things?

• 19:15Speaker 01

  Yeah. It's a wonderful description of the kind of dissociative state that we can go into vis a vis our drug of choice, where we're just sort of like, we're out of our minds, essentially. We're just doing the behaviors. This is where self-binding matters because, you know, if it's harder for you to get the next credit card or you just have to take the time to get a credit card, you might be able to come out of that state. But more importantly, what you need to have is a list of other healthier coping strategies for when you get anxious. And this is where I really recommend also engaging in what we call mutual help groups or self-help groups. The prototypical one is Alcoholics Anonymous. But Alcoholics Anonymous was founded 100 years ago.

• 20:00Speaker 01

  And since then, there has been a proliferation of self-help groups for almost every maladaptive behavior you can imagine. And it can be an incredibly helpful and effective way for people...

• 20:12Oprah Winfrey?

  There has to be one for shoppers since it's such a big thing.

• 20:14Speaker 01

  There absolutely is. And, you know, the 12-step model really works. And it often involves getting a sponsor, somebody else in the group. And then in those moments when you're, you know, anxious or feeling cravings...

• 20:27Oprah Winfrey?

  You have somebody to talk to and talk through it.

• 20:28Speaker 01

  You have somebody to talk to.

• 20:30Oprah Winfrey?

  Yes.

• 20:30Speaker 01

  And that person's typically available 24/7. And they know exactly what you're going through. And I say to my patients, you know, as much as I care about you, I'm not available to you 24/7. But a 12-step sponsor, they would answer the phone in the middle of the night. So I think, and again, thinking about self-binding strategies, we massively co-regulate based on who is around us and the behaviors they're engaging in. So if you surround yourself with other people who understand this problem uniquely and that you can turn to for help, I think that will really help you in those moments.

• 21:04Oprah Winfrey?

  Because you're not alone. You are not alone. There are millions of people, most of them women, going through exactly the same thing that you're going through. And you're a smart woman. You're an intelligent woman. You are a gracious and kind person. You will overcome this if you choose to do that.

• 21:25Speaker 02

  Appreciate it.

• 21:26Oprah Winfrey?

  Because you know how to put all the things together to overcome this. It's a decision on your part right now as to how hard you want to work at it. But I know you can do it.

• 21:38Speaker 01

  You heard that from Oprah.

• 21:39Oprah Winfrey?

  Yeah.

• 21:40Speaker 01

  So that's that you.

• 21:40Speaker 02

  Right, right.

• 21:41Oprah Winfrey?

  You were raised to be able to do it.

• 21:43Speaker 01

  Yeah.

• 21:43Oprah Winfrey?

  You were raised to be able to do it. That little girl coming from another land, another place, another culture, being in a surroundings where there were people that you didn't know, being able to manage yourself and succeed in that environment. You can do this. You can do this. This thing is not bigger than you. Okay?

• 22:03Speaker 02

  Thank you.

• 22:04Oprah Winfrey?

  All right.

• 22:04Speaker 02

  I appreciate that.

• 22:05Oprah Winfrey?

  Yes.

• 22:05Speaker 02

  Oprah told me to stop shopping, so I.

• 22:07Oprah Winfrey?

  It's absolutely. It's absolutely.

• 22:09Speaker 01

  Yeah, that's right.

• 22:10Oprah Winfrey?

  Thank you, Safat. Thank you.

• 22:11Speaker 02

  Thank you.

• 22:12Oprah Winfrey?

  Thank you.

• 22:12Speaker 02

  Thank you for having me.

• 22:13Oprah Winfrey?

  You know, gaming has become a way of life for children and teens and young adults, too. Here's a quick look at Deborah sharing her story.

• 22:20Speaker 03

  So I've got a question for the masses, for the masses, for the people. What were we doing before we started playing video games and getting addicted? Okay, because I feel like I feel like I haven't been playing video games that long. About the same time. What was I doing beforehand? I lose hours playing these things. I'm talking minutes on hours on days. And I've only been playing video games for like a year. I've been playing for a year. So question, what were we doing beforehand? How are we spending our free time?

• 22:53Oprah Winfrey?

  Yeah, that's my question for you, Deborah, who joins us from Chicago. What were, what were, what were you doing before? How do you answer that question? What were you doing before?

• 23:04Speaker 03

  Yeah, I feel like I had a collection of hobbies. I used to paint like with acrylics. I would sew a lot of projects, anything crafty and working with my hands. It was something that I found appealing to me.

• 23:14Oprah Winfrey?

  And now you spend as much as seven hours a day playing video games.

• 23:17Speaker 03

  Uh huh. And I think it's still in some ways, I use like a controller. So I still feel like it's still using my hands in some kind of way. So it's still seeming the same kind of crafting mindset that I have. But yeah, I'm spending a lot of hours, a lot of time of my day, playing video games most of the time.

• 23:32Oprah Winfrey?

  And what is it about gaming for you?

• 23:35Speaker 03

  I think it's about two aspects that come to mind. The first is accessibility. So in comparison to my other hobbies, I require a lot of space and setup time. Given like with sewing, I need to get the fabric. I need to get the sewing notions for when it comes to cooking or baking. I have to grab the ingredients, go to the store potentially to grab things I'm running low of, preheat the oven. And then when it comes to gaming, it's just like, oh, I can just press a power button on my computer and just be on the game. And it's much more accessible, I think.

• 24:02Oprah Winfrey?

  And I hear most of your friends are gamers that you've never even met in person.

• 24:07Speaker 03

  And so that's the second component is the social aspect. I think as you play these games, a lot of them are online games where you can meet other people from around the world even. So in the midst of learning how to play this game, I've met people online that like are now forming a mini gaming community. And because of that, whenever someone's online, they'll send a message saying, hey, I want to get on and play. So then you're like, oh, like cool person, nice friendship that I'm building with this person. Of course, like I'll get on and bond over this game with you. So then there's like voice chat that you can talk to each other on. And they encourage a lot of times for you to stay online even.

• 24:37Oprah Winfrey?

  So you're here to ask a question because you think that's become an issue for you? A problem?

• 24:44Speaker 03

  I have a question just to know like the longer term impacts of it. I think because like I mentioned in the video, I've only been playing for about a year. But I'm starting to see differences in like how I carry myself, but then also other people. And I'm curious about, are there any psychological or like emotional impacts when it comes to having extremely high highs? Because a lot of the game is rewarding for like doing good things in the game. But also low lows can happen all within a like 20 minute span. And I feel like knowing that, what kind of impact does that have on the body for extended periods of time?

• 25:12Oprah Winfrey?

  All right. Dr. Lembke, what do you want to say to Deborah?

• 25:16Speaker 01

  You know, one of the negative consequences of our addictive behaviors, especially our consumption of video games and other digital media, is the very important but subtle consequence of opportunity costs. And what I mean by opportunity costs is all of the other things we're not doing because we're spending all of our time online. And in your case, it's, you know, the crafts you're not doing, the people, the friendships you might be making with people who actually, you know, live in and around where you live that you could meet up with in person.

• 25:53Oprah Winfrey?

  Human connection versus virtual connection.

• 25:55Speaker 01

  That's it. And it's not to say that there can't be virtual connection. You know, those can be meaningful connections too. A lot of people talk about the community that they build online. And that can be a community, but you know, potentially positive, but not when it replaces all of our other communities. So I think that that's the first thing I want to say. And then in response to your question, I think you articulated it really well. It appears to me that video games are your drug of choice because it didn't take you very long after you started playing, that it was consuming many, many hours in your day, displacing other activities you used to enjoy, which gets to this hijacked brain.

• 26:38Speaker 01

  When we are constantly exposing our brains to this highly reinforcing intoxicant, one of the things that happens is we have this narrowing of our focus where other things are no longer enjoyable. They lose their salience. Salience is what makes something attractive to us. So now I could well imagine that if you tried to go back to doing your crafts, you would be frustrated, you would be bored, the rewards would be too delayed. And you know, in my, my sense is what you might want to do is take a break from video games for long enough to kind of reset your reward pathways so that the world can open itself up again to you.

• 27:22Speaker 01

  And the reason I always recommend four weeks is because in the first two weeks, you will probably feel worse before you feel better. You'll be in withdrawal, right? Those gremlins on the pain side of your balance that have accumulated will smash you down.

• 27:34Oprah Winfrey?

  I know the last time you were here and you said four weeks recommending a 13 year old be off the phone for four weeks. Everybody in the control room went, oh, that's never happening. Four weeks is too long. Because four weeks feels like, how can I do that?

• 27:46Speaker 01

  Yeah.

• 27:47Oprah Winfrey?

  But if you don't do it for four weeks, go ahead.

• 27:49Speaker 01

  Yeah, what we see in clinical care and what the, the published literature suggests is if you don't do it for long enough, all you experience is the withdrawal. And you're like, well, wait a minute, I need this thing to not be depressed and anxious. You don't realize that the depression, anxiety, restlessness when you're not playing is a result of playing. Right? And you need to abstain from long enough to allow your reward pathways from homeostasis to reset itself.

• 28:15Oprah Winfrey?

  It's like the heroin addict coming off of the heroin.

• 28:17Speaker 01

  Exactly.

• 28:18Oprah Winfrey?

  You got to go through the shakes first.

• 28:19Speaker 01

  You got to get out of that, that state of craving.

• 28:22Oprah Winfrey?

  Okay, explore that, okay?

• 28:23Speaker 03

  Okay.

• 28:24Oprah Winfrey?

  Okay.

• 28:24Speaker 03

  Thank you so much.

• 28:26Oprah Winfrey?

  Thank you so much, Deborah. You may or may not be surprised to know that nearly 50% of men aged 18 to 49 have an online sports betting account. I didn't know this.

• 28:38Speaker 01

  Yeah, it's really a scourge.

• 28:41Oprah Winfrey?

  Here's another shocking stat. Nearly one in five people with a gambling disorder will attempt suicide. One in five. That's the highest suicide rate of any of the addictions. Now Matt is joining us from Massachusetts. My team saw you nodding while Safat was talking. I hear that you've lost more than $100,000 on sports betting apps. $100,000 that you could not afford to lose. So tell us how this happened, Matt.

• 29:13Speaker 04

  Well, thank you for having me on. You know, my story starts when I was 14 years old. That was the first, that was when I placed my first bet. My father had given me some money to bet on the Patriots and Seahawks Super Bowl. And you know, I won. I hit that first bet. And it was a feeling I never really felt before. I was sitting on my friend's couch. I've compared it to hitting a game winner in a basketball game while I was sitting on that couch. It was unbelievable. I, deep down, I kind of knew I loved gambling then. But it's, it's difficult to gamble when you're a 14 year old, right? It's you need help, you need adults to give you access or give you money. So I really didn't start gambling consistently until I turned 19. I was a freshman in college.

• 29:56Speaker 04

  I went to a small division three school in Boston to play basketball. I got hurt early on in my freshman year and I decided I was done. I didn't want to play basketball anymore. So you know, now I have all this free time. I have access to more money than I've ever had before. And I needed to fill that void. You know, that structure that basketball had given me my entire life was gone. So you know, I gradually start gambling, you know, in the morning, in between class, and I start gambling during class. And it gets to the point where I'm gambling. Around the clock, you know, eight hours a day. Um, I wasn't socializing, I wasn't exercising. Um, I was, everything I was doing was to try to gamble more and more. You know, in the summertime, I would go home and I would save up money that was supposed to last me either my freshman

• 30:41Speaker 04

  year of college or my sophomore year of college. And within weeks of getting back to school, it was all gone. You know, I had no money. I was gambling thousands and thousands of dollars away in weeks. Um, you know, ninety to ninety-five percent of it was online sports gambling. There were some casino games involved, but it was really online sports gambling.

• 30:58Oprah Winfrey?

  Help us to understand that. What is it about online gambling that makes it so hard to quit?

• 31:05Speaker 04

  I think it's because it can seem, at the, at the outset, at the beginning, it can seem so harmless, right? There's no, there's not a lot of physical signs. You're not addicted to a substance. You're not addicted, you're having withdrawals, right? So it can start harmless, but it's that, it's that adrenaline rush. At least for me, I got that adrenaline rush that was so strong, right? I'm not a physical adrenaline junkie. I don't wanna, you know, jump out of a plane or go bungee jumping, but that adrenaline that I got from gambling, I loved it. I thrived on it.

• 31:36Oprah Winfrey?

  It's so interesting because I was reading your background and you shared with one of my producers that it, it wasn't even the, when you were fourteen years old and had that first experience that's gotten you hooked. It was that you won. Didn't you win twenty thousand dollars at one point, right?

• 31:55Speaker 04

  Yeah, when I was nineteen, um, freshman in college, I put in a hundred dollars into a gambling account. Um, and within two days, I ran it up to twenty thousand dollars. You know, and I'm, at that age, I'm thinking, that's all the money in the world, right? I'm taking pictures of it. I'm sending it to everybody I know, like, look what I just did. Look at this. And two days later, it was gone. You know, I didn't, I didn't withdraw a single penny.

• 32:17Oprah Winfrey?

  You didn't even, you didn't even get to spend it?

• 32:20Speaker 04

  No, no, not even a little bit. I gambled it all away. And I think a part of me was chasing that, that first big hit ever since. You know, it could, it could be compared to someone who may be addicted to drugs, you know, chasing that original high. I was chasing the first big win and I, I had to surpass it, but I never did. I never did.

• 32:40Oprah Winfrey?

  Never did, and still haven't surpassed it?

• 32:43Speaker 04

  No, I have not.

• 32:44Oprah Winfrey?

  No. What do you want to say, Dr. Lembke?

• 32:46Speaker 01

  Oh, my gosh, so much. Um, well, first of all.

• 32:48Oprah Winfrey?

  First of all, why is gambling so addictive? And what's going on in the brain there? What's going on in Matt's brain with that?

• 32:53Speaker 01

  Right.

• 32:54Oprah Winfrey?

  Yeah.

• 32:54Speaker 01

  So monetary rewards, again, light up that same reward pathway as drugs and alcohol, release dopamine, um, work through essentially the same trajectory as addiction to drugs and alcohol, where we start using usually to have fun or to solve a problem. If it works for us, we go back again and again. And eventually, if we cross over into addiction, we're now marshaling all of our available resources to get the drug, use the drug, recover and use again. Gambling is a very well-recognized, very potentially severe and life-threatening addiction, just like addiction to drugs and alcohol.

• 33:35Oprah Winfrey?

  And, and, and also, did you hear me say this earlier, Matt, that one in five people who are gamblers end up suicidal?

• 33:43Speaker 01

  Yeah.

• 33:44Speaker 04

  Yeah.

• 33:46Oprah Winfrey?

  I can understand why, because you end up losing everything. You're chasing, chasing, chasing, chasing, chasing.

• 33:50Speaker 01

  Absolutely.

• 33:51Oprah Winfrey?

  You lose everything. You're betting, you know, you lose your family, you can't pay your rent, you can't pay, the cars take it away, everything. Yeah, you lose everything.

• 33:58Speaker 01

  And it's so inexplicable from the outside because you just feel like, well, just stop, like, just stop.

• 34:05Oprah Winfrey?

  Yeah.

• 34:05Speaker 01

  But what really happens is that people who get addicted to gambling are ultimately not even interested in the monetary wins. That, that's how it begins. But what it eventually becomes is the desire to be in this alternative, self-created universe, where all of the rest of your problems fall away. And you've created this world within a world where you can have the illusion, again, that you're controlling, that you're moving forward.

• 34:38Oprah Winfrey?

  That's why there are no clocks in casinos.

• 34:39Speaker 01

  Yes, yes.

• 34:40Oprah Winfrey?

  And no windows.

• 34:41Speaker 01

  Yes, exactly. And there's some very interesting brain studies of pathological gamblers showing that there's a surge of dopamine when they win, just like there would be for someone who's not addicted to gambling. But with pathological gamblers, people who are addicted to gambling, they actually get a surge of dopamine when they're losing. And the understanding of that is that on some level, and this is a phenomenon called loss chasing. People who are addicted to gambling want to lose on some level because then it justifies.

• 35:15Oprah Winfrey?

  Chasing, chasing it.

• 35:16Speaker 01

  That's right, staying in the game longer.

• 35:18Oprah Winfrey?

  Staying in the game.

• 35:19Speaker 01

  So it becomes this horrible, self-fulfilling prophecy, an alternate universe. The real world falls away, the, the complete loss of perspective. And my heart just goes out to you. And also, let me say, the other millions of people around the world who are struggling with very severe gambling addictions, which, by the way, has never been easier. In the United States, online sports betting used to be illegal everywhere. In the last decade, it has become completely normalized, gone online, is incredibly accessible. And now even sports franchises are colluding with these sports betting corporations,

• 36:04Speaker 01

  encouraging people who watch sports to bet. It's terrible. And we see a three hundred to five hundred percent increase in calls to pathological gambling hotlines in states where online sports betting has been made legal. Which brings us, Oprah, back to this concept of access. One of the biggest risk factors for addiction is not your childhood trauma, you know, not something about you uniquely and, and, you know, lack of willpower. It's simple access to our drug of choice.

• 36:39Oprah Winfrey?

  And doesn't mean you're a bad person. It doesn't mean that you had all these horrible things happen to you. Yes. And Matt, how common would you say this issue is among your peers, the young men you know?

• 36:52Speaker 04

  I think the issue, it can be common. I would say most males that I've interacted with, you know, when I was in college or even now, when I was a twenty-six-year-old, they gamble on some level because it is so accessible, like what Dr. Lembke said, right? My, my gambling accelerated once it became legalized in Massachusetts.

• 37:10Speaker 01

  Yes.

• 37:10Speaker 04

  It was just so, it was so quick. It was so accessible.

• 37:14Oprah Winfrey?

  Yeah.

• 37:14Speaker 04

  Um, but I, I think especially college-aged males, right? They have all this freedom now and, you know, it's so accessible. Everyone that I'm in contact with gambles on some level.

• 37:26Oprah Winfrey?

  Yeah, and also, not only accessible, but nobody would even know. I mean, if you're a drug addict, we can see it. If you're a food addict, we can see it. If you're, you know, even a shopping addict, there's all this, you know, all the things that Safad is hiding around her home.

• 37:43Speaker 01

  Right.

• 37:43Oprah Winfrey?

  Um, what is your question for Dr. Lembke? Do you have one?

• 37:48Speaker 04

  I do. Um, you know, I've been in recovery from gambling since October of twenty-four.

• 37:54Speaker 01

  Congratulations, that's.

• 37:56Speaker 04

  Thank you so much, I appreciate it.

• 37:58Speaker 01

  Yeah.

• 37:58Speaker 04

  Um, you know, during that time, I've also been sober. Um, I don't identify as an alcoholic, but I was just curious, you know, how strong is the addict mind? Like, someone like me who does not identify as an alcoholic, you know, am I prone to other addictions, either alcoholism, drug addiction, wherever it may be? You know, because I have an addict mind, I am addicted to gambling. Am I prone to other things as well?

• 38:21Speaker 01

  Yeah. So family and twin studies suggest that some people are innately more vulnerable to addiction than others and that if it's not one thing, it'll be another. So there are differences there in terms of, you know, how we come into the world and how likely it is that we will get addicted if exposed to our drug of choice. Um, for example, if you have a biological parent or grandparent with an alcohol addiction, you are more likely to develop an alcohol addiction, even if raised outside of that substance-using home.

• 38:54Oprah Winfrey?

  Wow.

• 38:54Speaker 01

  So genetics is a piece of this. Um, the other part of your question is sort of like, you know, are, are all of these, I, I, this is what I understood your question to be, that, you know, how does the alcohol relate to the gambling? Because it's interesting that you gave both of them up, and I think that was really smart. Because, um, you know, we talked about drug of choice and how when we meet that drug of choice that's uniquely suited to our brain, it's like a lock and a key. But on the other hand, all reinforcing substances and behaviors release dopamine in our brain's reward pathway. And anytime we're using any substance or behavior, even if it's not our drug of choice, we're pinging that reward pathway and kind of setting ourselves up for relapse to our drug of choice.

• 39:39Speaker 01

  So, which is why very often, when folks are trying to give up whatever their drug of choice is, we also recommend that they give up drugs that are adjacent to that drug. And somehow, I don't know if you got advice to do that, or you instinctively knew that giving up alcohol would be important so that you wouldn't be disinhibited and more likely to gamble. And we see that all the time. You know, encouraging folks, give both of these things up together. For example, there's good data showing that people who try to quit drinking, who smoke cigarettes, if they give up cigarettes at the same time, they'll have better outcomes for both. And I think that, you know, that relates to a lot of other sort of paired addictions as well.

• 40:20Oprah Winfrey?

  Can I ask you this, Matt? What got you into recovery? Was it that you had to, you, you had to hit bottom? I know you dropped out of three colleges. You were going through a lot.

• 40:30Speaker 04

  Yes.

• 40:31Oprah Winfrey?

  Your personality changed, you were lying, you were doing all kinds of things, stealing from your parents?

• 40:36Speaker 04

  Yeah, that's kind of what made me hit bottom. You know, I just, I couldn't pay my bills anymore. I was gambling, wearing my rent money, my utility money, and I started stealing from, uh, family members. Um, you know, and I ended up forging a check in my parents' name to pay my rent. Um, at that point, you know, our relationship is somewhat crumbling. And we had a conversation and I ended up going to a treatment center called Heron Wellness in Massachusetts. Um, you know, I spent three months there as an inpatient.

• 41:03Oprah Winfrey?

  Was it hard to come clean to your parents?

• 41:07Speaker 04

  Uh, yes. Stealing from them, it's, you know, when I was doing it, it felt awful.

• 41:14Speaker 01

  Yeah.

• 41:14Speaker 04

  But it's, you know, as soon as you get that money, I'm off and running again gambling. And that, that guilt and that shame is out of your mind until you lose again. And it's almost like you come back to reality. Um, you know. But the thing that helped me was, you know, going to Heron Wellness and spending five months there in treatment. You know, I didn't have a phone for almost two months. I had no access to technology. You know, getting that break. Um, you know, just getting away from it really helped me, you know, center myself and really see how insane I was behaving and what I was doing to people around me.

• 41:46Oprah Winfrey?

  You got to step away from it.

• 41:48Speaker 01

  Yeah.

• 41:48Oprah Winfrey?

  To see yourself, yes. Do you like who you are becoming or return to self?

• 41:54Speaker 04

  Yes.

• 41:54Oprah Winfrey?

  Much, it, I feel like I was, I'm returning to the person I was before I started gambling.

• 42:00Speaker 04

  You know, I can be a good son, a good brother, a good friend. You know, I can have honest intentions. And I think that's what I'm most proud of today.

• 42:08Oprah Winfrey?

  Wow. Well, thank you for sharing your story with us.

• 42:11Speaker 01

  Yeah, thank you for sharing with us and with the world. And it takes a lot of courage to be there.

• 42:16Oprah Winfrey?

  I know a lot of people listening are going to hear themselves and see themselves in you. And so we thank you for having the courage to share it, really.

• 42:24Speaker 04

  Well, thank you for having me on. It was an honor.

• 42:26Oprah Winfrey?

  Continued success in your recovery. Go well with that.

• 42:28Speaker 01

  Yes, yes, keep going.

• 42:30Oprah Winfrey?

  Go well with that.

• 42:31Speaker 04

  I will. Thank you so much.

• 42:32Speaker 01

  Oprah, can I say one thing about moral compass and addiction?

• 42:38Speaker 01

  When people are deep in their addiction, they will often do things that are outside their moral compass. Matt talked about stealing from his parents, you know, incredibly shameful, so brave of him to admit that. But I think it's really important for us to understand that when the reward pathway gets hijacked by this drug of choice, we really are not ourselves. And we are really are vulnerable to doing things that are outside of our moral compass. Essentially because our brain comes to mistake our drug of choice, in Matt's case gambling, for a, something that we need for survival. Dopamine is really our survival neurotransmitter. It says, approach this thing, get it, you need it to survive.

• 43:22Speaker 01

  So I just think it's really important for people to understand that, you know, we, we would, most of us, do things that we're very ashamed of outside of our morality, once we get into that hijacked brain state of addiction.

• 43:38Oprah Winfrey?

  That's an important thing to say, I think. And we, I think a lot of people realize that when they have family members who are severe drug addicts, like your family member on crack cocaine or on heroin, you say, oh, that's not who I know them to be.

• 43:55Speaker 01

  Yes.

• 43:56Oprah Winfrey?

  But we don't think the same about it when it's shopping or gambling.

• 44:01Speaker 01

  Yes, right.

• 44:01Oprah Winfrey?

  Thank you for bringing that to our attention.

• 44:03Speaker 01

  Yep.

• 44:03Oprah Winfrey?

  You say by practicing radical honesty, that my guests today are actually taking the first step in curbing their addictions. So being able to be honest about what, what is actually going on.

• 44:16Speaker 01

  Yeah.

• 44:17Oprah Winfrey?

  How does radical honesty work?

• 44:19Speaker 01

  So radical honesty is where we make a commitment to tell the truth about everything.

• 44:24Oprah Winfrey?

  Yeah.

• 44:24Speaker 01

  And this is really important in recovery. In my experience, the patients who can get into and maintain recovery are the ones who make a commitment to truth telling, primarily because they've learned that if...

• 44:35Oprah Winfrey?

  That's what Safat, Deborah and Matt have all done today.

• 44:38Speaker 01

  Yeah, just by showing up and sharing in this way. Um, but, but it means that we can't even lie about like, you know, why we didn't want to go to the party or why we're five minutes late for the meeting. Because we're all prone to lie. The average adult tells one to two lies per day. Usually it's small lies to cover up our own foibles or selfishness. But when we make this commitment to radical honesty, what happens is we are then also forced to see the behaviors for what they are.

• 45:05Oprah Winfrey?

  I would, I would see how a commitment to radical honesty really creates another vibration for you. You're operating at another level.

• 45:13Speaker 01

  Yeah, nice.

• 45:14Oprah Winfrey?

  Yeah.

• 45:14Speaker 01

  Yeah, that's right. And it also importantly gets us out of this shame loop.

• 45:18Oprah Winfrey?

  Yes.

• 45:19Speaker 01

  We have heard as a recurring theme here, how much shame people feel about their addictions. And, and that is so true, so common. We all feel horrible shame at not being able to control these behaviors. And shame itself can perpetuate the addiction because it's such a horrible feeling that then we just keep using to not feel those feelings. So a way to get out of this destructive shame cycle is to commit to being honest with another human being, as these folks did today, as a way, again, to become aware of our behaviors, but also to create that vulnerability that allows people to really connect with us. Right? It becomes a source of intimacy that then becomes its own source of positive and healthy dopamine.

• 46:03Oprah Winfrey?

  You are so good at helping us understand ourselves.

• 46:06Speaker 01

  Thank you.

• 46:07Oprah Winfrey?

  And understand our addictions. And if you want to know more, read Dopamine Nation. So thank you so much, Dr. Limke, for being here. And thank you to Matt and Safat and Deborah for your radical honesty and sharing your stories. Dr. Limke's New York Times bestseller, Dopamine Nation, is available wherever books are sold. See you next time. Go well. If you are among the 57% of Americans who feel they are addicted to their smartphones, Dr. Anna Limke's book Dopamine Nation, it's a must read. She breaks down why smartphones are so addictive and shares tangible ideas for how to manage your relationship with technology. You can buy her book by scanning the QR code you see on your screen right now.

• 46:48Oprah Winfrey?

  Our listeners tell us that the podcast is resonating with you and is serving as a bright spot in your day. That means a lot to me. So here's the thing, I would really appreciate it if you like and subscribe to the Oprah Podcast on YouTube or wherever you podcast. It's, it's just a quick tap of the subscribe button. And that way you won't miss an episode in your queue. You don't have to pay anything. I know subscribe usually means you're paying something, but this time it means you just are notified when there's something new. There are many more to come that we're excited about. So thank you for watching and listening.