This week we’re chatting with Dr Anna Lembke, a psychiatrist and the author of Dopamine Nation.

Hi, Anna! If you could recommend One Good Thing everyone can do to improve their mental health, what would it be? 

Do something that is hard. Move your body, take a cold shower, read a challenging book, write a thank-you note, clean out your closet, say you’re sorry, order your coffee by talking to the barista rather than using the app.

Interesting. Why is this your One Good Thing?

Conventional wisdom tells us that when we are struggling, we should reward ourselves with some kind of treat: a nap, a piece of cake, a Netflix binge. But the truth is that the pursuit of pleasure leads to pain, and pain, in all its myriad forms, enhances our ability to feel pleasure.

Wait, so we should be pursuing pain? How does this work?

This is the science of hormesis. Hormesis is Greek for ‘to set in motion’. This branch of science shows that when a living organism is exposed to mild to moderate doses of noxious (painful) stimuli, the painful stimulus sets in motion the body’s own healing mechanisms, which in turn increases the transmission of feel-good chemicals like dopamine, serotonin, our endogenous opioid system and our endogenous cannabinoid system.

By paying for these chemicals up front, we avoid the dopamine-deficit state that is triggered by easy pleasures, which in turn perpetuates a cycle of intoxication and craving that leads to pain.

Interesting. Are there any ways we can do your One Good Thing incorrectly? How can we avoid those pitfalls?

Hormesis relies on right-sized pain. Not too little and not too much. Self-harm like self-cutting or overexercising would be examples of too much pain, which initially lead to a release of feel-good neurotransmitters that are quickly depleted, exhausting the possibility of future utility and setting us up for physical harm without benefit.

So something like a cold shower is a great idea, but anything that causes harm is a no-go. How do you personally do your One Good Thing? 

I try to start every day with a little dose of pain, usually by forcing myself out of bed at first waking and going for a walk, a bike ride or a swim, often in the dark. This never gets any easier. 

My brain isn’t able to remember, on waking, how good I feel afterwards. So I can’t think about it. I have to decide the night before that I’m going to do it, at a time I still remember that it’s worth it.

How has doing your One Good Thing changed your life? 

My morning dose of pain works as an excellent anti-anxiety and anti-depressant drug, although with no more than a 24-hour half-life, which means I have to keep doing it regularly to maintain the benefits. But it’s worth it, physically and spiritually. It’s a literal reminder every day that after darkness comes the dawn.

Dopamine Nation: Finding Balance In The Age Of Indulgence by Dr Anna Lembke is out now in paperback.

Frame Of Mind is Stylist’s home for all things mental health and the mind. From expert advice on the small changes you can make to improve your wellbeing to first-person essays and features on topics ranging from autism to antidepressants, we’ll be exploring mental health in all its forms. You can check out the series home page to get started.

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