WHAT IS DOPAMINE FASTING?
With a catchy name like “dopamine fasting”, it is surprising that it involves neither dopamine nor fasting. Coined by psychiatrist Dr. Cameron Sepah, dopamine fasting is just new terminology for one approach to cognitive behavioral therapy (CBT) which can be used to help us modify ourunwanted behaviors . But let’s take a step back and ask: what is dopamine? How does it relate to habits, compulsions, or addictions? How can we use dopamine fasting to our benefit?
WHAT IS DOPAMINE?
In the brain,dopamine is aneurotransmitter that plays an important role in feelings of motivation, learning, motor control, and reward . It is typically synthesized from amino acid precursors in certain neurons and, upon stimulation, is released to communicate with other specific neurons . Dopamine signaling receptors are located throughout the body, not just the brain, making it a highly integrated molecule in many human diseases.Dopamine imbalances can contribute toneurological diseases like schizophrenia, ADHD, addiction, anxiety/depression, Parkinson’s disease, and many more depending on the cause and anatomicalregion of dysregulation.
DOPAMINE, HABITS, AND ADDICTIONS
Dopamine is involved in the formation of habits byreinforcingtheneural pathways associated with thebehavior . When we engage in a habitual orcompulsive activity, such as checking our phones, eating certain foods, or smoking,dopamine is released in the brain'sreward system, creating a sense of pleasure or reward. Over time, these dopamine-driven rewardsstrengthen the neural connections associated with the habit, making it more automatic and difficult to break.
Addiction is a bit more complex since it is defined by compulsively engaging in certain behaviors despite negative consequences . In the case of alcohol abuse, a habit transforms into an addiction when a person’s tolerance builds up, requiring increased consumption to achieve the dopamine-reward feeling we get but at great consequence to the person’s health. Dopamine fasting, or just CBT, can and should be implemented in any case where we want to break bad habits like excessive screen time or vaping which may have greater consequences on our mental and physical health than we realize.
DOPAMINE FASTING – A SIMPLE APPROACH TO CBT
Dr. Sepah states thatdopamine fasting is “an evidence-based technique tomanage addictive behaviors, by restricting them to specific periods of time, and practicing fasting from impulsively engaging in them, in order to regain behavioral flexibility.” Dopamine fasting is not about lowering dopamine by taking a drug, but about minimizing our opportunity to engage in our own specific problematic behaviors.This is then meantto reduce activating ourreward system unnecessarily . Since the focus is on modifying behavior using a conscious effort to change the way we feel about ourselves or our lives, it falls under the category of CBT. Importantly, dopamine fasting is NOT avoiding all stimulation/pleasure, but only the specific behaviors or stimuli that are problematic for you.
2 EXAMPLES: SCREEN TIME AND DERMATILLOMANIA
When it comes to our phone use,most of us can agree that we could do with less time on social media and lesscompulsive phone checking. In this case,Dr. Sepah recommends a few approaches: leaving your phone in another room, replacing phone checking with another fidget object, using social accountability to keep yourself from cheating,or blocking time out where you can engage with the behavior but setting strict limits.
Another example might becompulsive skin picking ordermatillomania . We know that touching or picking our faceis bad yet we continue to do it, especially when we are alone, stressed, or tired.When we lackexternal dopamine stimuli (social interactions, fun activities, or good sleep hygiene), we maypick our skin to feel in control of something or toprovide some sort of replacement stimulus. To refrain from this habit,usingpimple patches, fidget tools, taking progress photos of your skin, or engaging in social activities that make it difficult to perform the behaviorcan help prevent us from engaging in this poor habit.
 Fei YY, Johnson PA, Omran NAL, Mardon A, Johnson JC (2022) Maladaptive or misunderstood? Dopamine fasting as a potential intervention for behavioral addiction.Lifestyle Medicine 3, e54.
 Girault J-A, Greengard P (2004) The Neurobiology of Dopamine Signaling.Archives of Neurology 61, 641–644.
 Klein MO, Battagello DS, Cardoso AR, Hauser DN, Bittencourt JC, Correa RG (2019) Dopamine: Functions, Signaling, and Association with Neurological Diseases.Cell Mol Neurobiol 39, 31–59.
 van Elzelingen W, Warnaar P, Matos J, Bastet W, Jonkman R, Smulders D, Goedhoop J, Denys D, Arbab T, Willuhn I (2022) Striatal dopamine signals are region specific and temporally stable across action-sequence habit formation.Curr Biol 32, 1163-1174.e6.
 Nutt DJ, Lingford-Hughes A, Erritzoe D, Stokes PRA (2015) The dopamine theory of addiction: 40 years of highs and lows.Nat Rev Neurosci 16, 305–312.
 Sepah DC (2020) Dopamine Fasting 2.0: The Hot Silicon Valley Trend.The Startup.
 Lochner C, Roos A, Stein DJ (2017) Excoriation (skin-picking) disorder: a systematic review of treatment options.Neuropsychiatr Dis Treat 13, 1867–1872.