Dhru Purohit Show - Why You Need a Dopamine Detox: The Science Based Way to Master Self Control & Break Addiction Patterns with Dr. Alok Kanojia

Episode Date: November 25, 2024

This episode is brought to you by Momentous, Lifeforce, and One Skin. In today’s world, addiction takes many forms—whether it’s alcohol, drugs, social media, or snacking on ultra-processed foods. Certain key factors drive these behaviors and make breaking the cycle of addiction challenging. Today’s guest offers powerful insights into brain health and psychology, explaining why these behaviors occur and how we can break free. Today on The Dhru Purohit Show, Dhru sits down with Harvard-trained psychiatrist Dr. Alok Kanojia to explore addictions, how they start, and their impact on brain health. Dr. Kanojia explains the roles of dopamine and serotonin in addictive behaviors and reveals the lifestyle habits that deplete serotonin. He also shares his top tips for successful morning routines and the secret to mastering self-control. If you’re looking for insights into why we engage in addictive behaviors and advice on how to break free from the cycle, this episode is a must-listen! Dr. Alok Kanojia, known online as "Dr. K," is a Harvard-trained psychiatrist specializing in the intersection of technology and mental health. As the co-founder of Healthy Gamer, a mental health platform designed for the digital generation, Dr. Kanojia has inspired millions with his content while overseeing the mental health coaching of thousands of young people. Widely regarded as the leading expert on video game addiction, he is also recognized as one of the most prominent mental health authorities for the younger generation. In this episode, Dhru and Dr. K dive into: How addictions start (00:00:11) How social media impacts brain health (2:41) How dopamine and serotonin are impacted during these addictive behaviors (11:56)  Top lifestyle behaviors that rob us of serotonin (17:42) Morning habits that influence our need for dopamine hits (23:15) Dharma and self-control (28:50) How to find your purpose (38:35) Choosing discomfort (44:35) Improving self-control and sitting with the discomfort of being uncomfortable (49:25) Dr. K’s journey (01:00:45) Meditation practice and how Dr. K started his meditation practice (1:06:45) Ultra-processed foods, gut health, and depression (1:14:35) Dr. K’s PSA on mental health advice on social media and comfort crisis (1:20:05) Also mentioned in this episode: Dr. K’s Book: How to Raise a Healthy Gamer  Healthy GamerGG Spotify Podcast Healthy GamerGG Apple Podcast  For more on Dr. K, follow him on X/Twitter, Twitch, TikTok, Instagram, Facebook, LinkedIn, YouTube, and his website. This episode is brought to you by Momentous, Lifeforce, and One Skin.  Optimize your energy and mental clarity with the Momentous Three: Protein, Omega-3s, and Creatine made by and used by the best. Go to livemomentous.com and enter promo code DHRU to get 20% off any order.  Right now, you can save $250 on your first diagnostic and get personalized suggestions. Optimize your longevity and track your progress; go to mylifeforce.com/dhru!  Right now, One Skin is offering my community 15% off; just go to oneskin.co and use coupon code DHRU to save 15% and give your skin the scientifically proven, gentle care it deserves.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Kay, welcome to the podcast. Alcohol, overcaffeinating, pornography, shopping, and social media, help us understand what's going on in the brain and the body when these behaviors turn into addiction. And most importantly, what role do dopamine and serotonin play in this process? You know, when does something become an addiction? So we engage with all these things, whether you're talking about shopping or alcohol or whatever, because they do something for us, right? So some part of our brain is experiencing a reward of some kind. The problem is that when we start to get addicted to things,

these become solutions that create more problems than they solve. So if you look at someone who's struggling with like alcohol addiction, they may be using the alcohol to cope with negative feelings, depression, things like that. We use alcohol as liquid courage that helps us socialize better, be more comfortable at places. we can have a couple of drinks when we go to an office party so that we feel more relaxed and we feel more sociable. All addictions start out is like solutions to things.

And then over time, what happens is we start to become dependent on the behavior and the behavior starts to create problems. And then despite it creating more problems, we find that we can't stop. And that's really when we've achieved an addiction. And in terms of what's going on on the brain, well, it turns out that depending on what your choice is, whether it's alcohol or shopping or social media. What's happening in the brain is actually like quite different. So that's kind of the common pathway, but then there's a lot of detail about what circuits are affected and things like that.

Well, let's take, for instance, for my audience, something that I regularly hear is people feeling like they're abusing social media and it's impacting their life. It's robbing them of pleasure or it's impacting them from really pursuing the things that they want to pursue in life because they're feeling like they're losing motivation or comparison is seeping in. So can you talk a little bit more about what might be happening in the brain for somebody who feels like they're addicted to social media?

So social media addiction is like really interesting because the first thing to understand is that, see, substance use addictions. So these are things like alcohol, opioids, marijuana. These act in a very discrete way, right? So I have a molecule of alcohol that crosses the blood brain barrier and then activate something called the GABA receptor. So it's like very targeted. The issue with a lot of these technologies is that they're not nearly as targeted.

So we see a lot more of a whole brain effect. And the different problems that you described, each have, like, unique parts of the brain that they affect. So let's, like, run through those. So social media does a couple of fundamental things. The first is that it messes with our sense of identity. So if we think about, like, on social media, I have a representation of myself. And then when that representation of myself gets activated, there are really primitive circuits of the brain. of things like social status and social relationships and connectedness with other human beings,

social media activates all of those circuits. And the challenge that we really run into, just to give you like one really example, so a simple example is social media oftentimes leads to problems with body image, right? So we're seeing a rise in body dysmorphia in both men and women. And there are really simple ways that it does this. So anytime you use social media, there are a lot of apps now that will automatically filter and adjust your appearance. So if you take like a picture on an app like TikTok, it will apply a filter without you doing anything. And so over time, what happens is we start to build up an identity of ourselves that is a virtual

identity that gets a certain number of likes, dislikes, call it whatever you want. And then what happens is like literally when I look at like my pictures online, I'm a prettier version of what I see in the mirror. So I put forth this face to the outside world. And then I spend a lot of time and energy because now it's become a part of our jobs. it's become a part of our social circles, right? We have to be active on Facebook or Instagram or whatever, LinkedIn. So now I invest in this person, but then when I wake up in the morning and I look at myself in the mirror, I'm not that person.

What you see when you look in the mirror looks different from the pictures that you take of yourself, especially when we start applying filters. So there's already a little bit of a disconnect between the person that I really am and the person that I put forward. Then what happens is I start to feel inferior to my virtual self, right? because I'm just not as pretty when I look in the mirror. And so then like we can start to feel dissatisfied with ourselves. And then what happens is, okay, so now what I'm going to do is I'm going to start like using more filters.

And then we almost get like addicted to filters in the same way that we can get like addicted to Botox where we want to look a particular way. And why do people use Botox? It's because they want to look a particular way. And now you can do that virtually. And so at the same time, what we're doing is like creating kind of a false version of ourselves. And then we kind of have this like part of us that we don't like.

then we like the false version more than the real version. So we invest more and more time into our online presence and we start to like lose ourselves in the real world. That's just one aspect. A second aspect is comparison, right? Because social media is very, very, very good at making comparisons and making all kinds of comparisons. So the social media algorithms have figured out that the way to keep you addicted is by making you feel bad and making you feel good in an alternating way. So it'll show you things that make you feel good about yourself or maybe feel superior to other people. And then it'll show you things that make you feel bad about yourself. And so it's kind of like messing with your sense of identity.

And it really kind of gets messed up because if we look at the way that our brains have evolved, we haven't evolved to compare ourselves to millions of people, right? We evolved in tribes of like 300 people. So your social status was like somewhere between 1 and 300. But now on the internet, no matter how successful you are, how you look, you will always find someone who is doing better than you, who is more attractive than you, who is more successful than you, who is doing a better job of being a parent and having a career. So like, no matter where you go, you're going to end up feeling inferior. That's kind of the second aspect of social media. Third aspect, you talked about motivation.

So this is another thing that a lot of people like don't understand. So when you wake up in the morning, you have a limited. stock of dopamine. So we tend to think about dopamine as like being regenerated throughout the day, but there are studies that show that if you, you know, take mice and you give them cocaine, and then you have them do other behaviors, their ability to experience pleasure from the subsequent behaviors as well as be motivated to act afterward actually goes down. So we have this limited stock of dopamine. And anytime we activate dopamine, we create cravings. and we reinforce behavior.

So one of the biggest challenges that we see is dopamine is our primary motivating neurotransmitter. And if we kind of waste it all on social media, we've got no dopamine left to experience pleasure with normal things. And what's even more dangerous than that is like normally if you like work hard, right, if I wake up and I like work productively for four hours, I will feel some sense of accomplishment afterward. And that's because I have a lot of dopamine. So when I finish, I get some rush of pleasure. I'm like, oh, man, I'm done. like awesome. I did a great job. And then it's actually easier to work tomorrow, right? Because you've got some momentum. You feel pretty good about it. But when social media enters the picture,

it empties our dopamine stores. Therefore, our capacity to experience pleasure and behavioral reinforcement actually goes down for the rest of the day, which is what creates this experience that people have where like, after you spend some time using a device, you don't feel like doing anything else. And when you do it, it requires like, it's like a slog, right? You have to force yourself to do it. And then you don't get any sense of satisfaction, even though, like, in a different circumstance, doing like a solid chunk of work will, like, make you feel good. Right? You're like, yeah, I did it.

But that, our brain is just empty. So we don't have those feelings. You know, there's so much more awareness. You brought up dopamine. There's so much more awareness about dopamine than ever because of largely a lot of these incredible podcasts that are out there like yours. And you take it a step further. You say often, it's important for people to understand dopamine.

but sometimes dopamine unfairly gets all the intention when it comes to things like addiction and behavior in the body. Can you expand on that a little bit more? We have these different circuits. Like we have the sense of identity. We have a sense of community. So these are different parts of the brain that are getting activated. But I think a big challenge that we have is that a lot of what technology does and a lot of what we struggle with has nothing to do with dopamine. So a really good example of this is if we look at the amygdala and the limbic system.

So the amygdala is our survival center of the brain where we experience. fear and anxiety. And then our limbic system is more broadly like our emotional circuitry in the brain. And technology is addictive for a couple reasons. One is that it activates dopamine, which gives us pleasure and reinforces the behavior. But then the other thing that happens is anytime we use technology, it usually suppresses our negative emotional circuitry. If we look at addictions, all addictions do two things.

They give us pleasure and they take away pain. And usually what happens over time is we will actually. actually acclimatize or build tolerance to the pleasure. So if you look at someone who's struggling with alcohol, the first couple of drinks they have, they're having a blast or maybe they're enjoying it. And then later on, like when you're on drink number eight or drink number nine or drink number 10, it's no longer fun, right? So when I have patients that are like carrying fifths of vodka around and like tucking them

away in purses or in drawers at work or things like that, and they're drinking throughout the day, they're not drinking to have a blast. they're drinking to numb certain parts of their brain. And that's what we also see with technology, right? So like when you're kind of like when you're stressed out and you go and you like, you know, sit down for a couple of minutes and you pull out your phone and 30 minutes go by, it's not like you're having a blast and laughing and full of pleasure. It kind of numbs out all the stress and all the that you have to deal with and you got to

pick this up on the way home and you have to do this for your kids and then you got to do this. Then you got to pay your mortgage. You got to answer these emails. So it helps us kind of like mentally numb out. So I think that's one example of. of like circuits besides dopamine. But then there's also a lot that we don't understand about like motivation and behavior and how that can come from other parts of our brain in a more sustained way, which is why

if we get stuck with dopamine, it doesn't really work very well. Just to take it one step further on this, can you also talk about the role that serotonin plays as sort of a protective element against a lot of the brain hijacking behaviors that can be there when it relates to dopamine? serotonin and dopamine, I almost think about them as like inversely correlated. So the more dopaminergic your brain is, generally speaking, the less serotonergic it is, and the vice versa. So let's just run through a couple of examples and what that means.

So dopamine, first of all, is the neurotransmitter that governs pleasure, right? So it governs like having fun or pleasure. Serotonin is a lot more associated with contentment or peace. So if we think about like, you know, someone who is suffering from like a mood disorder, like major depressive disorder, and we prescribe them a serotonergic agent, an agent that boosts their serotonin transmission. These are not happy pills. They don't make us happy.

They make us less discontent, right? So what they kind of do is they take some of these like depressive feelings and they quiet those feelings. So it's not actually making you happy. It's moving from like negative 100 to zero. That's really what serotonergic medication does. And so when we boost serotonin transmission, we are sort of moving more towards contentment

as opposed to pleasure. So when you engage in a ton of pleasurable activities, do you feel content at the end of that? Right? So a lot of times when people think about, like when I play a bunch of video games or I drink a lot, I'm having fun,

but I don't feel like content and peaceful at the end. Maybe in the case of something like a vacation where you have a lot of relaxation and stuff and you're away from stress, you can get some degree of contentment. But generally speaking, people who, like, party really hard are not, like, Zen yogis who are, like, peaceful with their lot in life, right? They're not, like, chilling out. They're actually, like, really hungry.

And the more that you activate your dopamine, the less content you'll become. So a lot of times, you'll also see this in your kids. So when kids engage in video games and other dopaminergic activities, are they peaceful in content after, like, six hours of playing video games? not at all. I see this a lot with people who I've worked with who like party really hard. And when you party really hard, you don't feel like accomplished and proud at the end of it. You usually feel like pretty bad. So when people are addicted to video games and they play video games for like, you know, 40 hours a week for three months, they don't feel peaceful at the end of it. On the flip side, if you ask someone, okay, what makes you feel

peaceful and good in your life? It's usually some degree of accomplishment. Like if I go to the gym and I work out really hard, that is not dopaminergic. There's no dopamine. In fact, it's the opposite. opposite. There's a lot of suffering, right? There's pain, suffering, difficulty. If you think about something like, you know, childbirth, like childbirth is not a dopaminergic activity, but it makes people hopefully feel pretty good about themselves unless there's a serotonin problem, in which case you enter the realm of postpartum depression and things like that, right? So even there, it kind of makes sense. So we have to understand that serotonin and dopamine are kind of like inversely related, where the more that you do things that are serotonergic and make you feel good,

about yourself, like make you feel accomplished, make you feel content, or actually not dopaminergic. They're the opposite. So when you work really hard and you feel good about that, that's actually not a dopaminergic release. It can be some dopamine, but it's serotonin. So I think a lot of times what happens is people are so focused on optimizing their dopamine that they ignore the real source of peace and contentment and even a sense of accomplishment in life.

On that topic, what do you think are some of the top lifestyle behaviors that we have in our modern day and age that are robbing us of that serotonin response, that healthy response that's there. Like, is it the presence of something or is it the absence of something or is it both? And if it's both, what are some of the most common examples? How do we think about enhancing or optimizing our serotonin? So let's just think about this. Okay. So the first thing is that the more dopamine we engage, okay?

So when I do a lot of dopaminergic activities, what that literally does is, strengthen the dopaminergic circuit in our brain. So remember that the brain has a lot of like competing impulses. So like I want to eat a piece of fried chicken, but I should eat a salad. So some part of my brain is telling me I should do something. And another part of our brain is saying, I want to do something. So when we give into the dopaminergic part, it strengthens that part and allows it to become stronger than other parts. So we kind of know this a lot. from like kind of Eastern wisdom, right? That when you give into a desire, whatever you give into in your mind only grows. So if you let yourself eat unhealthy today, it becomes easier

to eat unhealthy tomorrow and easier to eat unhealthy the next day. And that's once again, because remember, dopamine creates behavioral reinforcement, right? So whatever we do, we're going to create cravings for and we're going to reinforce. So the first thing that a lot of people have sort of figured out is that when they use a lot of technology, that dopaminergic part of their brain is literally getting stronger and it starts beating out other parts of the brain that are telling you to do other things. So it becomes harder to motivate yourself. It becomes harder to like, you know, you become more irritable, you become more cranky. It's like if someone tells you to not use your phone, you'll get like cranky around that. So you like literally become more receptive to like dopaminergic

activity. So instead what we really want to do is focus on boosting our serotonics. system. So this is why like we're seeing an, you know, an unprecedented level of addiction in the world today, but we're also seeing an unprecedented level of hunger for meditation and mindfulness. And why is that? What do these do in our brain? So we know that, for example, meditation is an evidence-based intervention that improves things like depression and anxiety. And the primary medications that we use to treat those are actually serotonin-based medications. So meditation probably boosts our serotonin transmission in the brain. But I would say that they're also like different kinds of like mindset kind of shifts that we can

do. If you kind of think about, you know, what results in serotonin boosts, it's usually things that matter to us that are painful. So when I think about like, you know, when I stay up all night taking care of my sick kid, that's not pleasurable. It sucks. But the next morning, I feel really good about it. Even if I feel physically awful, I'm cranky, I'm not happy, I didn't get any sleep, I feel good about it because like I did my job as a dad, right? My kid is struggling and I'm there to help them and that like feels really good. So the serotonogic, serotonergic system is a system that activates when we feel accomplished. The problem in society today is that we don't focus, we don't, actually, it's not that we don't focus on accomplishment. We want accomplishment,

but literally how do you spend your day? You spend your day not thriving for accomplishment, you want to accomplish things, but you spend your day like wasting time on technological devices. And every time you spend time on that technological device, it's amplifying your dopamine system and reducing your serotonin system. Thank you for that breakdown. I'd love to make it even a little bit more real and turn that into like an example of a common morning routine.

Maybe even some of your patients that have come in and told you how they spend their time in the morning, which often sets the tone for the day. What's an example of habits, lifestyles, behaviors that people participate in the morning that leaves them super deficient in building that serotonin and like keeps on hitting that dopamine button, which obviously strengthens that addiction towards those behaviors. Can you think of an example? Stay the hell away from technology for as long as you can. So generally speaking, I will strongly recommend that people don't use a technological

device for the first hour after waking up. Practically, this is very difficult because of a couple of things. One is that we no longer have magazines and bathrooms because we take our phones. So it's really hard to go to the bathroom in the morning without your phone. So there are a couple of like really specific behaviors that you have to target and give up. And oftentimes when I work with people who have technology problems, the hardest tech use to give up when we're not like so addicted that it's ruining our lives is actually the technology use in between things.

So when I'm in the on the elevator while I'm waiting for. while I'm sitting in traffic or if I'm sitting in an Uber while I'm on the toilet, we take our phones with us everywhere and they just infect all the parts of our day where we're not doing something. And anytime you do that, you're sort of starting to exhaust your dopamine for the day. And so your capacity for pleasure, your capacity for behavioral reinforcement goes down. So I know we've heard it a thousand times before, but you really have to understand what the damage of 15 minutes of cell phone use when you're taking your morning dump with your cup of coffee or if you have your cup of coffee and you're sitting down and scrolling on your phone for 15 to 30

minutes before you start your day, what that really costs you. And on the flip side, I think that one of the really interesting, you know, motivating things that I sort of like learned, you know, in the East and stuff, and I'm sure we'll get to that. We don't really understand where motivation comes from. So there is a dopaminergic motivation, which is the most of the most of the most of the motivation of immediate pleasure. So this is like the motivation of pleasure from like snorting cocaine or playing candy crush or something like that. But then there's also a serotonergic motivation, which is like the motivation that comes from the Sanskrit word, Dharma or duty. So when I'm like, you know, when I'm on call in a hospital, that's not pleasurable. Oftentimes it's very

unpleasant. People will be like high on cocaine and like yelling at me and stuff, right? I'm working in the emergency room. It's overnight. People are drunk. People are drunk. People People are homeless. People are upset. People are hurt. People are suicidal. People are psychotic. That's not a fun job. And yet when I go there, the attitude that I take, which is a huge part of serotonin, by the way, because when I work with my patients, what we do is we change their attitude. How do you see this? This, a 15-minute clinical encounter, there's no question that it sucks. But as long as I'm, I feel like I'm doing my duty, and this also relates to burnout, very effective at treating burnout, fixing burnout. As long as I'm as I'm like doing this for a greater purpose, right? Like if I'm taking care of my sick kid, that's worth it. If I'm at a hospital trying to help other human beings because this is my mission in life, it is worth it. And then something really cool happens. When we have a dopaminergic brain, we run away from pain and we seek pleasure at every opportunity. Life becomes a struggle of restraining my impulses towards pleasure and choosing things that I don't like.

But there's one really simple way to short circuit that whole system, which is to focus on Dharma, right? So if I'm like, if someone pulls a gun on me, like I want to run away from the gun, I don't want the gun. I'm not, I'm trying to get the hell out of that situation. I'll call the police. Now, if someone points a gun at my children, I'm stepping in the path of the gun. Even though like this is literally a life or death situation, my motivation in that moment is to do something incredibly dangerous than in a different circumstance, the intervention is the same. The gun is the same. The meaning is the same, right? It's like, it's dangerous. The more we sort of think about what is our duty in life, what's my purpose in life,

what am I really like on this earth for? And as we start structuring a life that aligns ourselves with that, then something cool happens. The hard things become things that you step into the path of, the things that you embrace. And you have kind of this deeper motivation that becomes resilient against pleasure. And whether things are pleasurable or painful, you kind of like embrace it all. And then people feel like super, super motivated in ways that is very confusing sometimes. But hopefully people will kind of understand some of those analogies. That's a great breakdown. I'm sure our audience and I myself had a couple light bulb moments, even though I feel this in my life, you're connecting the dots in a way that it's like,

oh, that's why this actually works. So the question I have for you, is the step for someone who's feeling like they lack a sense of self-control is one of the early steps for them to really ask themselves, what are their immediate purposes, their Dharma, what's the reason that they're here? Is that a good question to start off with? Or is that too big of a question for them to start off with? Yeah. So it's a, it is too big of a question and it's a great place to start.

Right. So I would say if you're struggling, like this is the first thing that I would say. I think we're way too caught up in self-control. So if we think about what self-control is, self-control is overcoming your impulse, right? The beautiful thing, like the work that I do is not about building self-control. I know it's weird because I do a lot of like addiction psychiatry work. I mean, we teach people how to pump up their self-control and meditate and all that good. stuff. But really, it's about changing the way that they see their life. And then self-control is no

longer an issue. When your body, your brain, your mind, and your spirit are aligned in the right direction, you don't need self-control. There is a spontaneity and an easeness of action, just like the gun analogy, right? So like when the circumstances are right and when I view the situation in the right circumstance, in the right way, then my behavior flows very naturally. And if people are listening to this, like, you know, I'm sure there have been times in your life where you did what you should do. You did the right thing. The right thing was hard and it was easy for you. Right?

The hard things that we do in life are not always hard. Sometimes something happens within us and that's really what the focus of the work is, is to sort of figure out, okay, what's going on inside you. Why are you the way that you are? Why are your desires in this direction? And let's understand those things. because in my experience as a psychiatrist, good diagnosis precedes good treatment. The problem is everyone is trying to change their life without really understanding what the problem is. Let's take it back to this analogy that we were talking about of somebody who's abusing social media.

They're starting off in the morning. The first thing they're doing is they're whipping out their phone. And they're not just like checking on anything that's urgent. They're sort of letting the narrative, the priorities of other people, be it the news that's on social media, the comparison, all the things that we talked about earlier. if they're going to want to break out of this sort of cycle that's there. And a big part of that is changing the outlook of how they even look at their life. What is the first step or what are some possible first steps that they could be taking? So here's my favorite step.

And this is how I work with people, right? So the first step is don't use it in the morning, but that's not a goal to achieve. What I want you to do is pay attention to what happens within you when. you don't use it. Right? So if I don't use it, what is my experience of going to the bathroom? And oftentimes, like, I don't know, this is going to sound so weird, but it's like kind of subtle. But like you really don't want to go to the bathroom without your phone. Even though it doesn't cost, like it's not like you get some great thing, but it's like this, like you just don't want to. It kind of doesn't matter either way, right? It's not like it's going to ruin your day. It's not

like you're going to become a billionaire if you stop using your phone in the bathroom. It's such a little thing. It's such an insignificant thing. But then why are you so attached to it? So oftentimes what happens is that in our life we have, we're overwhelmed with thoughts. We're overwhelmed with what we need to do. You know, 50% of people under the age of 30 are now living at home with their parents. There's like, you know, record levels of inflation, like wages aren't keeping up.

It's hard to buy houses. Like everything in life is getting harder. We want 15 minutes of relief from that. And this is what ends up happening is we don't really realize what we're using the cell phone for. And so the first thing that I would say is like just don't use it for 15 minutes and pay attention to yourself and watch what comes up. Watch what that discontentment is. Because then we get to another huge problem, which is that if you look at the brain, what motivates us is our discontentment. The most powerful motivators of human behavior are negative emotions.

Right? So if I'm like in a marriage and I've been in love for 20 years and my partner is unfaithful, that amount of negativity, that sense of betrayal, that sense of anger, that sense of sadness, the sense of shame, those are incredibly powerful motivators for me to potentially get divorced, move on with my life, right? Like, so negative emotions are actually our most powerful motivators. And one of the scariest things that we're doing is we have these negative emotions because we're not happy with our life.

and we've evolved to have negative emotions to help us correct what we are unhappy with. So what happens when I have this negative emotion because I feel ashamed about my appearance, but then when I start using a filter and I don't go to the gym, the problem just propagates. So instead of harnessing these motivators, because we're all about how to derive pleasure from making Excel spreadsheets, instead of harnessing these negative emotions, we're actually shutting them off with technology and the problems continue. So practically what I tell people to do

is pay attention to what's happening to you and then listen to yourself. As that negativity starts to arise, really listen to yourself. What is it telling you? What are you discontent in for life? And this is where a lot of problems arise. People think, oh, I can't do anything about it.

But that's also where, like, I would, you'd be surprised, because when we spend a lot of time avoiding our problems, when we don't diagnose the issue, when we just avoid it, and we just hope it'll get better tomorrow, then, of course, we can't do anything about it. But understanding of the problem is the first step. Wow. So all these things that we started off the podcast with, and we ended up talking most about social media, but alcohol, overcaffeination, porn, shopping, and again, we talked about social media, which are all very different things, but the thing that they have in common is these are all behaviors and there's plenty more that we're all using, and I've been guilty of it, is to

prevent yourself from feeling something negative, but that negativity is actually could be the unlock of you taking action in the area that you feel discontent. Absolutely, right? Caffeine's a great example. So why do people get addicted to caffeine? They get addicted to caffeine for a couple of reasons. Sure, there's like a biological portion to it. But caffeine is a very psychological addiction. It is an addiction to not feeling tired. It is an addiction to really wanting a high level of performance in the next couple of hours. I mean, I had this problem. I was in residency. So I'm working like 80 to 80 hours a week on average. And I was up to three cups of coffee a day. I would have a cup of coffee at like 6 a.m. when I show

up at the hospital. I'd have another one afternoon like at 1 o'clock to stop that post lunch crash. And then around 4 or 5 o'clock I'm dragging and I have a bunch of notes to finish, which is like really boring work. So I'd have my third coffee of the day. And if I really paid attention to myself, what I found is that, first of all, when you get addicted to caffeine, it stops working. What caffeine really is is alone against future energy. So the way that caffeine doesn't give you more energy, it blocks your signals of tiredness and fatigue. So with this stuff, what we're really addicted to when I work with people who are addicted to caffeine and nicotine, what they're addicted to is the feeling of having energy. They hate being tired. They hate being

And they have to use caffeine in order to push through and get this work done because it's so important. But then they create this situation where they're like just setting themselves up to fail. Instead of actually having energy, you're substituting with caffeine never really works long term. And so that's where we really have to understand what is the psychological, what is it that is caffeine is really doing for you? And then what we want to do is like, okay, then let's fix that, right? So if you feel like you've got low energy, let's actually figure out how to improve your energy. And when you come out on the other side and you are resting well and you're meditating and working out and all that kind of stuff, which I know sounds impossible.

But when you're actually letting that negativity fuel you for progress, like you'd be amazed at how much transformation you can see. And then out on the other side when you're actually energetic, like it's amazing. Just one thing that I want to double click on is that where's the balance between you being in residency or your rotations or whatever it might be? And you're fulfilling and stepping into doing something tough, something hard. And caffeine was one of the tools in the toolbox to help you kind of get through the day for something that was tough and hard. But obviously there's these back-end consequences, as many doctors know, that they are just pushing their true feelings and, you know, they're not positive behaviors and their negative habits that are often making their own health detrimental when they're trying to take care of other people.

So where was that balance for you in that process, that caffeine was something that was helping you get through something? tough. The balance arises in a very simple way and then I'll tell you all practically what that looks like in my life. So the balance is to not become dependent on that thing as the only answer. So like

when caffeine became my only source of energy where I couldn't get other sources of energy, that's when we really get an addiction. So an addiction is when we like we start to rely on it. It's not an option. It's the only option. So very practically like what my life, I still

drink caffeine most of the time, unless I'm doing very serious meditation practices. But, and then what I've found is the way that you find that balance more practically is being able to tolerate tiredness. So what I found is that like, okay, on a particular day, I feel tired. Like, even today, like before this podcast, I was like, should I have a cup of tea before the podcast, you know, because I'm Indian and we have tea. It's like, I'll make a little bit of tea. It'll be right. So like, and then I was like, do I really need it? Right? No, I'll just go into this. I'll feel a little bit tired and that's okay. So the moment that I accept my tiredness is when I'm able to find balance. But I had a cup of coffee in the morning. Like, that's totally fine. So I think a big part of it is just being able to

sometimes accept the consequences of not giving into the addictive behavior. And once you become comfortable with discomfort, then addictions become way easier to handle. You know, to zoom out for a second again and come back to this idea of purpose. One of the most common things, you know, on YouTube, you can see what people on your channel are searching for. One of the top things that I often see people searching for that watch our content and videos is what is my purpose or do I have a purpose? And that really sort of brings up this larger topic, which is, I'd love to hear your perspective from both the Western and the Eastern side of does everybody have a purpose? and how do they go through this lens of finding out what it is

so that they can look at their life differently and change the way that they interact with like why they're here. One of the most fundamental questions we're all asked. Absolutely people have purpose 100%. So that's the first thing. Now the question is, why is it hard to know what your purpose is? And that's because we spend the majority of our lives ignoring ourselves. So if you look at like what we do to children,

what we do to boys, girls. This used to be very, very prominent for just women. Now it's starting to happen more to men. So we spend the majority of our lives, like, getting conditioned away from who we are. Right? So I, like, I'll give you a simple example. So when I was, you know, when I went to college, I was genetically premed. I was premed because I'm an Indian kid whose parents are doctors.

And when you're an Indian kid and you're 15 years old and people ask you, what do you want to be when you grow up? and you say, I want to be a doctor. So first I said, I want to be an environmentalist. No one was impressed. And then I said, I want to be a doctor. Everyone was like, oh, wow, amazing. Wonderful. Your parents are such good doctors.

You're going to be great doctor. So already at the age of 15, I had certain impulses. I had things that I liked. I started a business that was making $300 a week when I was in the seventh grade. And that was a lot of money back then. That was like real money. And then when my parents found out, my dad was like, he was kind of proud of me because he could see that I had that hustle,

but he made me shut it down. He's like, you need to focus on your studies. I look. So I had certain, some of these tendencies. And if you have these tendencies, what life will do, what society will do is squash them. Then what life will do is they'll tell you, hey, you should do this. You should become a doctor. Right?

Like, that's the right profession because everyone's impressed when you're a 15 year old kid and you say, I want to be a doctor. And so then you start striving for things that you don't want. You start striving for things that people tell you are good for you. And so then we choose a major in college, right? And then we choose a job. And how do we do those things? It's just kind of like, you don't really know what you want when you're 18 years old.

You have no idea what it's like to work a day. You don't know what it's like to have a career. You have no idea if you like engineering or medicine or whatever. You have no information. And then we get kind of locked in to a path. because now that I've spent four years studying this, I have to get a job in this, even if I don't like it.

And it requires so much momentum to shift tracks. And then everyone will tell you, oh, it's a waste. You wasted it all this time. Look, do it. You'll make good money, money, money, money, right? And so what starts to happen is we literally what we do is we take parts of ourselves and we squash them. And this gets worse with technology.

Because the more time you spend on the internet, the more time you learn, you should be doing things differently. Right? You need to be like meditating for an hour a day and stay off your cell phone in the first 15 minutes of the day and make sure you buy this clothing and make sure you look like this and make sure be something that you are not. Nothing on the internet tells you, hey, you're fine just the way you are. It's totally cool. You have advertisers. You have marketers.

You have AI that are measuring all these algorithms, figuring out what you want, figuring out what your weakness is. There was that whole scandal where, you know, Target or whatever figured out that people were pregnant before they knew and started mailing them catalogs. Right. So like people know and the internet knows about you and it tries to create dissatisfaction with who you are. And then what it does is tells you buy this thing and we'll fix that dissatisfaction. So if you look at this, basically it starts with a moving away from yourself and ignoring yourself. And then that gets amplified now that I'm unhappy. And the reason that you're unhappy, by the way, is you never listen to yourself in the first place. Right?

Because you chose a career based on what people. chose you to do instead of actually doing something that you found joyous. And that was naturally motivating. Like you would have worked your ass off if you like it. There's a disconnect. And now you feel a little bit empty. You don't know what you're doing. And then along comes the internet says, hey, that emptiness that you've got, use this body wash and it'll go away. Sign up for our course and we'll help you find the career of your dreams. And then it only amplifies it. And so the more that we get disconnected from ourselves, the harder it becomes to find out. purpose because the world can't tell you what your purpose is. They've been doing it and you've been

listening and look at where it got you. So the way to find purpose is to fundamentally reconnect with yourself. And that becomes hard because you don't like what's in there, right? Because you have ignored yourself for a while and you're not super happy with the person that you are deep down inside. And you recognize that there are some weaknesses that you try to keep at bay because other people sometimes see them too. And they're like, hey, you should really drink less. And you're like, no, I'm fine. It's not a problem. And then that evokes that. that denial, right? So it really starts with connecting back with yourself. And we know because pornography addiction, one of the two variables that correlates with pornography addiction is

meaninglessness in life. So if we're really thinking about overcoming that addiction, you have to have a good enough reason to resist all those impulses. You can't just cure addiction in a vacuum. There's got to be like motivation behind it, really something that is worth the pain, and that's where the taramma comes in, right? So when you are overcoming an addiction, that process is filled with pain, not pleasure. So you need some fuel that will make you stick with that. And that's purpose. On a tiny level, this idea of not taking your phone to the bathroom and just sitting with that discomfort, that could be a tiny way that people could get started with feeling what they're actually feeling. What did you suppress? What did you not say today that you wanted to say? What did you

not make progress on? You're just sitting there with you and your thoughts and your bowel movement, hopefully, but no other interruptions that are there to distract you from how you truly feel. Is that accurate? That's accurate. There's only one tiny inaccuracy, which is that you said it's a small thing, right? It's a tiny way. It's not small. It's the whole nine yards.

It's everything. It's 100%. If you can do that. So I want you to think about all the things that you're doing in life that you are unhappy with. Every single one of those things that you are doing is because you cannot tolerate discomfort. Why am I not going to the gym today? Because I'd rather sit on my... It is the discomfort of going to the gym that keeps you at home.

If you think about diet, right? What's the problem with diet? Well, I like the way that this makes me feel, and I don't like the way that this other thing. I don't like the taste of salad. It's uncomfortable. I don't like it. So all of our negative behaviors

come from the inability to tolerate discomfort. And so if you can get really, really good at that, it is enough. So I want you to take any problem, anyone who's listening is, think about the problems that you really struggle with. When you struggle with those problems, what is it that you're running away from? It's discomfort.

And if you can just learn to tolerate discomfort, you don't even have to fix it. That's the other thing that a lot of people think they have to fix their problems. You don't have to fix your problems. You just have to be able to tolerate the negativity of them. And that in and of itself is like arguably the whole nine yards. That'll change everything. And are you also saying that it doesn't necessarily have to be that same activity? So let's say my audience here is especially a lot of women that are in that sort of 45,

plus age group. And they've really gotten focused in the last couple of years with a lot of the guests that we've had on about the importance of prioritizing, keeping, and even building lean muscle mass as they age because of how protective it is to the body and falls and other stuff and how also metabolically protective it is for using glucose in the body and all sorts of other aspects for it. So for a lot of them that are new to resistance training, if they really want to make progress in the gym, they're not even, they're having a hard, let's say somebody's listening and they're having a hard time even getting started. Could they take another activity in their life that is uncomfortable, something where they're learning how to put up with discomfort, and that's,

by making progress in that and putting up with some discomfort, it could actually strengthen their will and their resolve to want to feel like they're wanting, they're not wanting to avoid the gym in the future. I basically guess what I'm saying is that, Does it have to be an activity in that same category, or can we practice discomfort in other categories? And those receipts are things that we can take along with us. What do you think, Drew? Yeah, seems like any area where you can be uncomfortable is something that will build your resolve in every other area in your life.

So if we look at meditation, meditation is like the most overpowered thing that you can do because it leads to cortisol improvements. It leads to even visualization in one study. a geriatric population, you can have a geriatric population that visualizes working out. They don't have to get up. They just visualize it. It can improve hand grip strength by up to 68%. Just the visualization of working out can improve your actual strength.

It's kind of weird, but you can look at meditation. Meditation is a treatment. It's really bizarre because generally speaking, when we look at mental illness, we have different treatments for mental illness. Psychosis is treated one way. Depression is treated another way. Bipolar is treated another way. anxiety is treated in another way.

Personality disorders like narcissism are treated another way. But meditation is the one thing that treats them all. Studies for improvements in psychosis, mood disorders, anxiety disorders, even personality disorders. How does that work? So there are some fundamental principles that make us better at being human. And one of those is the frontal lobe. So anytime you tolerate discomfort, there are signals coming from your brain that this needs to change. change. So I feel hungry. I'm craving something. Or this workout, I want to stop at seven reps

instead of eight because I feel exhausted. So if we look at like what is meditation doing, what is the translatable behavior that gives you benefits everywhere? It is simply strengthening your frontal lobe because the frontal lobe controls everything else. So you get better at tolerating your emotions. The tolerance of discomfort can apply to physical activity, emotions, difficult conversations, going in and telling your boss, hey, I really deserve a raise. And when they don't give it to you, saying, looking for another job, walking in and then handing your resignation, you don't want to disappoint them. They've done so much for you.

Right. And like we get so caught up in all of these emotions, all of these cravings, and simply the tolerance of discomfort is kind of like the magic bullet. And so as we train those in any way, it actually helps all of the others. You know, you put out this video on self-control. this conversation is so much bigger than self-control, but one of the things I really liked about that video is you talked about this framework of ways to improve self-control by basically not suppressing ourselves, not suppressing stress, not suppressing emotional regulation, and then

most importantly, not losing this idea of the internal conflict that relates to, you know, us wanting to do something good and us being pulled towards our sort of bad habits. Can you talk about that framework in the context of this conversation? So self-control is fascinating because I don't think most of us really understand what it is. So if we look at where self-control comes from in the brain, it comes from probably this part of the brain called the anterior cingulate cortex and other parts of the frontal lobe. But what's really interesting is that part of the brain is also the same. part of the brain that monitors internal conflict. So I want you all to think about a moment where

you are trying to exert self-control. When you try to exert self-control, you are conflicted. You can never be trying to exert self-control unless you are conflicted. Does that make sense? Yep. Right? So, and then there's a couple of other subtle things, right? And this is what's fun about, like, doing addiction psychiatry work is really tunnel down into like what's subjectively happening. And I would ask my patients, you know, how do you know whether you're going to like win or lose your battle with like an addiction? And oftentimes what happens is they stop thinking about it. So what happens is you kind of know like, okay, like I'm going to give in. I don't know if this makes sense, but you kind of know that you're going to give in before you give in.

And what's what starts to happen is that you stop monitoring the conflict. You stop paying attention to the conflict because the conflict goes on and on and on until it's over. and you think one side wins, but it's not that one side is winning. It's that you stop paying attention to it. And if you look at most of our behaviors where we struggle with self-control, it's when we're behaving on autopilot, right? I ate one potato chip. And then the next 99, I struggle with the first one,

but the next 99 are on autopilot. So self-control and awareness, we think that these are two different things. I have to be aware of the conflict and then I have to control it. But it turns out that these are actually the same. and as long as you are aware of your internal conflict, you will, that's actually the same thing as self-control. And what kind of happens is we like lose sight of it.

I don't know if that kind of makes sense. It slips away from our mind. And then we're like, ah, scre-like, whatever, right? That's what we do in our head. We stop thinking about it. We stop focusing on it. And there's a really interesting technique called urge surfing, which we use in addictions,

where if you think about like an impulse to use, that's not going to last forever, right? So the nature of the human body is that, you know, when I get hungry, if I don't eat, the hunger goes away, and then it'll return and it'll go away, and then it'll return, it'll go away. What happens is any time I have a desire to do something, that desire won't last forever. So really, the war, this is where a lot of people get messed up because they think I have to conquer this.

You don't have to conquer it. All you have to do is watch it and wait it out. You don't actually have to win. You just need to focus on inaction. all you need to do is sit still for long enough and then it'll go away on its own. Let's take that example of snacking. Snacking is one of those things where for a lot of people who are addicted to snacking, the research shows that sometimes up to like 25, 35% of their total caloric intake in a day

can come from this like over snacking that's there. So if there's somebody listening today who's like, you know, I always get caught up with that sort of bag of chips and then all the goals that I had for the day kind of fall out of place, what would be some advice that you would share with them to notice that initial behavior and to actually just sit there? There's nothing they need to do just to feel the discomfort. Yeah, I mean, I think feeling discomfort is huge. So if you think about people who spend 30% of their calories snacking, they are not aware of what they're doing, right? So you like board the train and then the train takes you to wherever you end up. That's their experience. So you may be

aware at the very beginning, but they're not usually aware of the whole journey. So what I would strongly recommend is that, first of all, you don't make it easy for yourself to snack automatically. So in tech platforms are really good at this. We have things like biometrics so that we can auto log in. It saves our login. They make it super easy for us to engage in technology, right? So if they, if you have an impulse to like watch a TikTok, TikTok, is designed to help you satisfy that impulse within a second. Because if they can get you started, they can hook you for 15 minutes. So all of the tech platforms are trying to reduce the time between you having an impulse and you engaging in the technology. And what we've learned, and this is actually really fascinating, so

even if you look at the research on suicidality, so most people, everyone thinks that people who kill themselves are like planning for months in advance. The research shows that 60 to 70% of people who decide to make a suicide attempt do so within five minutes of the attempt. 40% within 60 seconds. So people have this impulse to kill themselves and then they act on it. So what we really need to do if we want to control our behaviors is stretch out the time between impulse and action. So don't carry chips around. Make them far away from you. Make it so that you have to get in the car and drive to the corner store and then like pick up a so then you have 15 minutes to like overcome that impulse. That's the first thing. And usually within that process, what happens

is we have space for awareness because when you're driving there and I've done this, we're like, I'll drive to like a fast food place, but on the drive there, I'll turn around and go home. I'll be like, I don't want to do this. Right. So you need space for like the part of you that wants to be healthy to like get a say. It's like, you know, saying like, oh, hey, we're going to have an election. The election is in 30 seconds and whoever's here right now gets to vote. That's not how it works. So you need to give yourself time. That's number one. Second thing, and there was actually, it's funny you talk about snacking because I had a teacher, a guru, who was addicted to potato chips and they were a monk. And so their teacher, they were like,

I'm addicted to potato chips. And so they would like try to control their addiction and they were living in a monastery and stuff. And it like worked for a while, but they'd always relapse. always relapse. So they went to one of their teachers and they're like, how do I overcome this? I'm trying to become a monk. I'm trying to become desireless and conquer all my whatever's. And so their teacher said, so don't resist the addiction anymore. Instead, what you should do is be aware of it. So actually carry potato chips with you wherever you go. Keep a bag in your room, keep a bag in your backpack. Everywhere you go, you should have access to potato chips. But when you eat the potato chips, you need to be fully aware before you eat them, when you eat them. When you eat

them and after you eat them. So what is this desire for potato chips? Where does it come from? Where does the desire exist within you? Pay attention, really look at it. As you eat the first chip, what happens to the desire? How many chips does it take to end the desire? And after how long is the desire return? How long do you feel satisfied? What is the satisfaction of the first chip, the 30th chip, the 50th chip? And as this person engaged in this practice, now this person had some meditative training, which I think is kind of necessary before you do this, but it works really well. I've used this with my own addictive tendencies.

You'll start to realize that your addictive behaviors don't actually satisfy anything. All they do is create more problems. And once that realization sets in that, and no matter how many potato chips I eat, I will always want more chips. This is an exercise in futility. I only buy myself temporary enjoyment.

And then I want more. later. It's like it's never ending. Once that understanding really settles into your brain, once your frontal lobes understand what the real advantage and disadvantage are, then the addictive behavior will start to melt away more and more and more. You know, two different approaches. One, in your instance, you're talking about creating friction and having space between you and the snack, right? You got don't keep it in your house. You often hear people who are on this podcast, talk about that. And another one, which is like, hey, what does it look like to fully live in it and be fully aware the whole way through? I'm guessing for the majority of people, but I'd love to

get your thoughts on this. Probably the first framework is probably going to be the framework that's going to be more useful for a lot of individual who are listening today because they don't have that meditative training. And is that your sort of sense of things? Yeah. So I don't think, I don't think it's more useful or less useful. I think it's more accessible or less accessible. Let's understand the problem with the first method. The first method will help you resist, but it won't change the craving. We're basically setting up in an environment

to bypass ourselves. We're assuming that we're always going to lose, right? Does that kind of make sense? We're not actually conquering anything within us. We're just shaping an environment. It's like we're not learning how to swim. We're just putting on floaties and jumping in the water. We're doing, having the external environment.

do the work for us. So that's a great place to start and your instinct is right there. And when I'm working with an alcoholic or someone who's suicidal, one of the best evidence-based things that we can do is remove the suicidal means from the home. So get rid of your gun. So we absolutely need to do that. But even that's what I do with my patients the first day, let's get the noose and the gun out of your house. Good job. That will, that's only, that's going to help some, but it doesn't really change you as person. It doesn't really allow you to be conquered, but conquer the addiction and be free of it. And long term, that's our goal. Like long term, it's not that we need to structure our environment so that you're like a robot who's like, you know, responding to this environmental stuff and you're

not really in control. Long term, what we want is I want you to be surrounded by potato chips. And I want you to be able to control yourself because you understand yourself. And in the patients that I work with that are suicidal, you know, we'll get to the point where even when they're happy, they'll have suicidal thoughts, but they're truly centered and like in control. So they'll even tell me, right? A lot of times psychiatrists freak out. And they'll say like, oh, you know, I'm having suicidal thoughts and I'll just ask them a couple of years. And I'll be like, is that something we need to worry about? And they'll be like, no. Like, it's okay. And so what we're really talking about is what do you want to shape? Do you want to shape the outside to make things easy on

yourself? Or do you want to shape yourself so that like easy and hard is the same difficulty? for you. I'd love to chat about your personal journey. You're not just a clinician and an educator on these topics. You actually suffered with some addiction in your journey. And you've used a lot of these tools at various stages of your journey to put your framework out there that you talk about through your healthy gamer platform. So talk a little about the origin story, being in med school, being in university, being addicted to video games. I think our audience would love to hear about that. You know, I grew up the son of Indian immigrants who were both doctors. And so, as I said earlier, I was genetically pre-med.

And so I went to college, but I didn't really care about, the only thing I cared about for being a doctor was like the prestige that comes with. So I was like, I was 18 years old. I went to the University of Texas at Austin. I was going to be a doctor, not just any doctor, best doctor. I'm going to go to Hardward, right? Because that's what good Indian kids do. So, like, that's what my goals were.

but like I had no actual motivational drive. So I played a bunch of video games, started in high school, started to become a problem there, but then I basically failed out of college. So my first year in college, I had less than a 2.0 GPA. Half of my transcript was literally F's.

And then, so I was on academic probation and barely made it through my second year. So it was on the verge of getting kicked out and like had, all I had to do was get higher than a 2.0 GPA. And so I had managed to get like a 2.1 or something. So two years of college in, I've got like an average of less than one. So I had a 2.1 my last semester.

And before that, it was like a one point something. And so, and my parents tried everything. They tried to like, you know, punish me. And they tried like tough love and love and like, they just didn't know what they were dealing with because I was really addicted. So I went to India. I spent three months at an ashram studying yoga and meditation and like fell in love with it. So my whole life, like, I wanted things, but I could never.

never get myself to do them. So I had like desires, like I had goals, but I couldn't motivate myself. And on the flip side, I was like a slave to my desires when it came to video games. And I was playing video games for like 16 to 20 hours a day, like seven days a week. Like just wasn't going to class for like a month at a time. So I would, I would like order fried rice by the pound and fuel myself with like two liter bottles of soda and like pounds of fried rice at like 20 hour stretches. And so what I loved about India is I discovered like a system of learning that teaches me about myself. So in the way that we can learn algebra, like we learn about desire, where does desire come from? What happens if you satisfy it? All that kind of stuff. So decided to become a monk.

Spent the next seven years studying with different like teachers in India, went a little bit to South Korea and Japan. And I was going to become a monk. My teachers at the age of 21, I tried. They said, you need to come back when you're 30. And then if you still want to do it, we'll take you. But they still continued teaching me. Ended up meeting my wife, decided that the monk thing wasn't necessarily the path that I wanted to be on.

And then I was kind of stuck because, like, I graduated from college, had a 2.5 GPA, but then like, what am I going to do? So decided to apply to med school, got rejected from 120 med schools over three years before I finally got accepted to one. and then went to med school was going to do oncology

but then fell in love with psychiatry because I loved the mind. So I ended up doing my psychiatry training at Harvard. Big irony that I wound up there. And the interesting thing is when I went back to med school I didn't care at all about going to Harvard or anything like that.

I didn't even look at my grades. So it was super embarrassing but I didn't go to the award ceremony like when I graduated and I won two awards and one of my mentors are like, where are you? Like I wanted to present this award. and I was like, I didn't know I was going to win anything.

I never looked at my grades because I didn't care about grades. I was just like, I'm going to learn medicine. That's what I'm here for. So ended up training at Harvard and then started this whole healthy gamer thing. So when I was there in 2015, I went to one of my mentors and I was like, tell me about technology addiction. Like, what are we doing there? And no one really knew anything because everyone was focused on the opioid crisis. So I started getting interested in as a second year resident, started working on technology addiction.

in 2015. And then I started streaming on the internet. And streaming on Twitch, which is a gaming platform, and started teaching gamers about video game addiction. And someone was once like, isn't that kind of like holding an Alcoholics Anonymous meeting in a bar? And I was like, yeah, that's probably where we should hold AA meetings because that's where the people who have alcohol problems are.

And was stunned when Healthy Gamer grew. We were the fastest growing stream on Twitch for about three months and really discovered that people like want to learn about themselves and was really surprised because when I started streaming, I was thinking like, okay, I had done neuroscience research at Harvard for a couple of years too. And so I was like, okay, I'm prepared with like my neuroscience stuff, my psychiatry stuff, my clinical stuff. Like this is what people are going to want to learn. And what I discovered was a gigantic appetite for the spiritual stuff, all the stuff that I've learned in India over the course of seven years. All these things about meditation and purpose and the soul and like all this other

weird stuff. And so now what we try to do is like combine both of those. So what is the neuroscience of enlightenment? How do we understand addictions from a karmic perspective and a neuroscience perspective? And so something about using both of those methodologies has been very, very helpful for people. One of the things he talked about was like a turning point for you. And I'm also curious about how you ended up there, whether it was your parents pushing you, whether you had the motivation, but you ended up in this ashram. And a big part of that was meditation. What is your advice for people who are listening to the conversation right now and are feeling like, you know, that feels like a vehicle that I could be using to step more into who I am and sit with the

discomfort that's there in life to actually step deeper into my purpose and ask these bigger questions and see what kind of answers show up for me. If somebody wants to get started with meditation. It's such a broad spectrum. What are your recommendations? Because I'm sure you get this question all the time. What I would recommend is that people actually try a practice. So I don't usually do this, right? I teach meditation on a podcast, but I feel inspired today by the direction of your questions. So I would tell them to do a practice called Kayash Tirum. So Kaish Thiram means stillness of the body. Practice is super simple. All you do is sit still and don't move anything. You can breathe, but you don't move anything.

So usually what we want to do is sit in a way that your spine is straight, your neck is straight, your head is straight. So the spine should be straight. You can even do it lying down, but I think it's better to sit. If you want to sit in a meditated posture, like lotus posture or something like that,

sit cross-legged, you can sit with a small pillow underneath your hindquarters so that you're a little bit elevated and you can sit up straight more easily. So if you want to sit up straight naturally, by the way, all you need to do is have your knees lower than your hips and you'll naturally sit up straight. So you just want to elevate your hips, keep your knees low, cross your legs if you can, and just sit still.

That's it. That's it for about five minutes. Perfectly still. There's a beautiful introduction to meditation because it's really, really hard. So 60 seconds will go by and then like you'll start to have an itch and then you'll start to feel uncomfortable. Your muscles will ache. And then by the end of about five minutes, your body will be in an absolute state of torture. It's going to feel terrible.

And then something beautiful happens when I teach Kaish Theorem. What people discover is that the breath that they take for granted becomes blissful. So as long as they're concentrating on their breath, all of the sensations of the body will be tolerable. But if you're not concentrating on the breath, then like the body lights on fire. Like it's so uncomfortable. Now, if you have like a slip disc or a medical contraindication or something, like then don't do this. practice. Always talk to your doctor if you've got a medical condition. Like, that's really important. But it's a beautiful practice because what you learn is like to be with yourself. Like you're here in the

present. You're not going to think about anything. You're not going to worry about paying your mortgage. You're not going to worry about what you have to do for dinner today. All of the thoughts will leave as you struggle to just survive this moment. And a lot of beautiful things happen with Kaiash Theorem. One is that you start to fall in love with your breath. And then you start to realize, like you learn a very important lesson, which is that no matter how much pain I'm in, I can concentrate on the breath. And for three breaths, for a few moments, I can find solace. I can find peace.

And that is transformative. So the ability to find a few moments of peace when everything is falling apart will change the way that you live in the world. Now you no longer need the world to give you peace. The basic problem that we have in life is we become dependent. on the world to give us peace, happiness or unhappiness. Oh, I want this promotion. If I don't get the promotion, I'm going to be devastated.

And if I do get the promotion, I'm going to be grateful. Right. So my happiness becomes dependent on anything except for you. Does this person love me or not love me? Do they say yes or do they say no? Do they forget my birthday, remember my birthday? So we're going through life and our happiness is outsourced to everybody else. And no wonder we're unhappy.

because we're not in control of our own happiness. And we think that controlling our happiness means achieving our goals. It isn't. Because what happens when we achieve our goals? We move the goalposts and we have new goals. It doesn't work. It's not like you work for your eighth year and you're like, oh, this is the final promotion. Now I'm done.

That's not what happens. We always want more. So, Kayaish theorem is a beautiful practice that shows you that your happiness and your contentment in this moment is dependent on, of all things, your breath, and there can be other things too. But you will find some way to find solace, which is like beautiful. And then you can use that technique any time you're like struggling. You can tap into your breath and be still. And then it does all kinds of other things, right?

So it teaches you to tolerate discomfort. It teaches you how to be in the present. See, this is where a lot of people struggle because I say meditation is about being in the present. I don't know. How do I be in the present? The way you be in the present is by engaging in a practice that forces you into the present. You don't have to try. Another great example of being in the present, stand on one leg for how long until you're in the present?

It's not going to take very long. You can't think about anything else, right? Maybe for 15 seconds you can do it, but then your mind is forced to the present. That's the way that meditation should be learned. Meditation is not about trying to get your brain or mind to do anything. when you have a competent teacher, they will show you how to swim. And the swimming will be automatic as long as you stick with the practice. And then you will learn how to be in the present.

You will learn how to tolerate the discomfort. All that stuff will happen automatically. That's the beauty of it. So I think, you know, that's where I would say people should start. Now, where do they go after that? I mean, you can get an app or whatever. But I find that going to a real meditation teacher, like, is really good. Because these apps and stuff are like, they're great in a lot of ways.

Like, they can make it easy for you to stick with a practice and stuff. they're not bad, but they really are based on, you know, they're not based on spiritual growth, which is really what this like tradition offers and really like mastery of the self, right? I've never heard of anyone becoming enlightened from using an app. So it's a great place to start and then find a teacher. And you could do that meditation. Yeah. Once a day.

Sure. As a starting place. Sure. Right? That's a great place to start. Or once a month. Or once a month. Or just once and never again.

All of those are acceptable. So I'm really curious on just a personal level, what actually got you to go from this place where, like, what was the bridge between I'm addicted to video games, playing them 16 to 20 hours a day, eating buckets of fried rice and Coke and other stuff? How do you make the leap to, oh, let me actually go to an ashram? What actually led to that openness of wanting to even take a shot on that in the first place? I'd say like just absolute desperation. So like I had tried everything. Like I knew I was screwing up my life. And I couldn't fix it. My parents were saying, do this to fix it, do this to fix it, do this to fix it. And I think there was a really great, you know, I asked my dad, and so my dad suggested it. And it wasn't, so a couple of things. One is he didn't force me. It was a suggestion.

So like one day, I still remember, it was like two in the morning and he was like talking about, like, you know, what's going on with you? Like, what are we going to do? And so he's like, you need to go to India. And I was like, what am I going to get there? And he's like, I don't know. But you need to do something. And that was the right level of emotional energy.

for me. That's where I was. Something needs to change, but I have no idea who it is, what it is. And then also when my parents were like, this will fix it. I don't know if this makes sense, but if you all have struggled with something, sometimes the last thing that you want is like answers from other people. And that's because their answers aren't going to work because they're not you. So people will suggest things all the time. But like it's not going to work for you because they don't understand your life. They really don't know what they're talking about when they give you random-ass answers. Like, sure, on some level, it is theoretically the right thing to do. But in terms of your motivation, where you are even spiritually, it's not right. And you know that. So you like

reject their answers. So my dad was like, you know, you should go. You need to go. And I said, what am I going to get? And he said, I don't know. And so I just took a leap of faith because I was desperate and nothing else was working. You know, you mentioned previously, and a lot of our audience knows this, is that we're dealing with an explosion of addiction across the board through so many different avenues. One of the things that we talk a lot about on this podcast is basically how what we do to our body also influences our brain and vice versa. What are your theories about sort of this milieu of ultra-process foods that we live in today and their relationship with making it harder to break free of addiction because of how they hijack sort of the functioning of our body?

Do you have any feelings on that? Yeah, so it's a mess. And I think you already touched on a couple of the big parts. So here's what a lot of people don't really know. There are two bacteria in your gut that protect you from anxiety. There are two bacteria in your gut that make you more anxious. There are two bacteria that protect you from depression. And there are some bacteria that make you more depressed.

So we know this is something that we haven't really understood until now. But in Ayurvedic medicine and traditional Indian medicine, their first line treatment for mental health issues is dietary change. And so it's really interesting because they claim that they can really improve mental health. And I've started instituting some of that stuff with my patients. It works really well. So I'll start my patients on things like SSRIs, which are serotonergic medications. And then eight months from now, whether they can go off of the SSRI and whether they don't relapse or they do relapse,

depends on the degree of their dietary change. That's what I've observed clinically. So when they make the dietary changes, they don't. need the SSRI. So what I've found, so if you really look at it, the first thing to understand is that your gut has a bunch of bacteria. And the bacteria that grow there depend on what you feed them with. So some bacteria can break down complex carbohydrates. Some bacteria use simple carbohydrates. So there are certain bacteria that will love processed food. And when you eat processed food, those bacteria, you're fueling them. And they're at war with the other bacteria.

and they'll actually out-compete those other bacteria, and they'll destroy those bacteria. Now, the problem is some of the bacteria in your gut do things like make serotonin precursors. So the building blocks for our neurotransmitters come from some bacteria. And that's probably why some bacteria are protective against anxiety,

because they have some kind of triptophan metabolism, which then enhances your serotonin production in the brain, and you get endogenous serotonin production. So that's just one of the many avenues that we know that your diet will very, very directly affect your mental health. So there are other systems at play as well. We haven't even touched on inflammation. But some bacteria, our body has learned over millions of years of evolution. Like lactobacillus is a really good example.

This helps us digest milk. And like lactobacillus, like our immune system is like, oh, that's my ally. So if lactobacillus is hanging out in our gut, like our immune system doesn't usually get upset. But when we have these ultra-processed foods that select for these new kinds of bacteria, our body thinks, and rightly so, that these are not our friends. They haven't lived here for a long time. They're new. So it creates an inflammatory response.

That inflammatory response can be whole body, right? So it's somewhat localized, but also travels to the brain. And we know, for example, that people who are depressed have an inflammation in the brain as well. So we know this, and this is super common sense, because when you get the flu, what happens to your mood. Right? You feel like, and that's like biologically driven.

It's not like, you know, you're not depressed. You just feel depressed. And you know it is a consequence of inflammation. And that's evolutionary, by the way. So depression is actually our body's way of telling us

to conserve energy. So don't get out of bed. Just hang out. It makes you feel weak. It makes you feel energyless. And that is because it is trying to encourage you to rest. And that's why we feel sad

and cranky and stuff, right? So there's a lot of stuff there that's evolutionary. But those are just two of the mechanisms through which food is incredibly important for mental health. Totally. And I know with the gaming culture, not that I was like a huge part of it, but there's not always the best options that are there when individuals are participating. And for that matter, any sort of addiction that people have, it tends to lead to addiction in other areas. And one of the biggest things that we all tend to abuse is food, ultra-processed food in society, excess calories, excess sugar, over-drinking. overcaffeinated. So all these things are linked in together. But the good news is, as you mentioned

before, is when we start to build up receipts of doing things that are difficult, slowly by slowly, it makes it easier to practice that agency on all avenues of our life. Absolutely, right? And I think you touched on another really good thing, which is ultra-processed foods are highly dopaminergic, which means that they elevate that dopamine serotonin and balance gets enhanced. So when you eat a bunch of ultra-processed foods, you don't feel

peaceful, content, and accomplished. You've given into that dopamine and you feel like some degree of regret and guilt afterward, right? So it also is working

on that level. Dr. Kay, this has been great. You know, sometimes at the end of the interview, I like to hand it over to the guest and give them an opportunity

for, is there any advice right now that's trending on social media, on YouTube, you know, you have a huge YouTube platform. I hope my audience clicks on your show below and subscribes to it. There's a lot of

great information, even if you're not somebody or has a family member that's into gaming. There's a lot of really great masterclasses you have and other great content. So I highly recommend everybody check it out. But are there any trending advice that you've seen, maybe even the last couple weeks, that you feel it's important to kind of have a little bit of a public service announcement that following this trend, even if it's well intention, might be a misguided approach to this topic of addiction, purpose, happiness. Yeah, so I have two thoughts. The first is a really short one.

So a recent study came out about ADHD information on TikTok and found that 95% of ADHD information on TikTok is wrong. So the first, like, kind of PSA is be super careful about mental health information on the internet because at least on one platform and one diagnosis, the majority of it is like just wrong. So be careful about that. The second thing is in terms of, I think, what people are missing is that we're trying, we're not focused on changing ourselves. We're focused on altering our environment to make things easy for us.

Right. So it's kind of like we have a society where if you look at everything, we're like, okay, what are the tips? How do we detox off of dopamine? How do we brain hack or biohack or all this kind of stuff? I know you guys cover this stuff. And I think it's good. Like, it's good to inform people. But there's a subtle thing that's going on, which is that we're trying to make.

things easy for ourselves. So if I take these nutraceuticals or I take magnesium before I go to bed at night, like it helps me sleep. Like that can be good. But I think what's really, really subtle here is that we're relying on our environment to make our life easy instead of learning how to live a hard life. Instead of adapting and becoming like stronger, it's almost like, you know, at some point we started having escalators and elevators instead of stairs. And now what I'm seeing in the wellness space, which I think people need to be super careful about, is are you basically like creating an elevator for wellness where you're outsourcing all of the work to a particular protocol or a particular regimen or a particular thing? And I'm going to do it this way,

this way, this way. And I'm all for that stuff. I think that that stuff is healthy. And that's why I kind of like your term of like a PSA, but just be a little bit careful about what are you doing here. Because oftentimes what I end up seeing is that when people are like so focused on optimization and productivity, they like kind of lose sight of like, like, you know, they lose sight of the big picture very easily. And they're trying to optimize. They're trying to harness their dopamine, maximize their dopamine, boost their motivation in a particular direction. And in doing so, all they're trying to, they're not really gaining control over themselves. They're just using this instrument like in a different way. They're like taking a donkey and like

putting it down a particular track, but they're still not in control of the donkey. I don't know if that kind of makes sense. It totally makes sense. What's the, what's the, the best way to take an honest audit of where one stands within that idea that you just present? How can you check in with yourself and say, where do I stand on that spectrum of I'm pursuing this thing of trying to make my life super easy or protocol driven and I'm losing the bigger picture or, hey, I'm using these tools as an appropriate mean, but I'm not getting lost in them. How do we take an audit of that? So what I would say is that for all the stuff that you're trying to optimize in your life, I would say go a little bit deeper and ask yourself,

why do you want to optimize this? What is the end goal for you? And what are you, if I could wave a magic wand and give you the perfect protocol where you could like, what would your life look like? What are you really looking for? Right? What's the end? So if I want to make more money or I want to be more successful, like what's the point of that? What is the end dissatisfaction that you are trying to fix by fixing your life? And then what you need to do is ask yourself, what makes this so dissatisfying to me? Why is this so important to me? I think that's really the important question. Because if you want to ask, like, you know, you asked like, well, how did I go to India? And the biggest thing, I mean, I'm still still the same guy. Like, whether I failed out of college or I'm

teaching or whatever, like faculty at Harvard Medical School, whatever, I'm still the same dude. And the biggest difference for me is I started accepting what I was unhappy about. I started saying, okay, this is who I am. I'm a loser. And like, that's me. And that's okay. That's huge, right? It doesn't mean that I give into it. So what it means is that I accept that I am a flawed human being and I'm going to do whatever I can to move forward. So I think really getting to that route, because I work with a lot of people. I work with some people who are like degenerate gamers who are 26 years old, don't have a job, don't accomplish anything. And I also work with people who are billionaires who have a accomplished a lot and they're still unhappy. And so really think about by all means improve your

life. I'm not saying don't improve your life. But what is the, what is the psychological need that you're trying to fulfill and really get in touch with that? Because you may not need to do all of that stuff to fix that. You can come to peace with that. You can accept that and you can be pretty chill here and now. You don't have to solve every problem in your life to be happy. That's great advice. Dr. Kay, this has been fantastic. You know, you're going to be a new name for a lot of our audience here who may not be familiar with your work. So I'd love for you to just, as we're winding down here, give us the lay of the land of everything that you're up to

and how people can continue this conversation further, whether it be working with you directly, I know your courses, your different content channels, if you wouldn't mind just sharing with our audience. Yeah, so I think you mentioned that there are a lot of women in your audience. So like a couple of things. One is like I wrote a book on parenting, and I know it's kind of weird,

but like how to raise a healthy gamer is the book. And it's a book about like how parenting, can understand screen time and screen addiction and how to prevent it in your kids. So that's one thing that if there are parents in the audience that are struggling with like having kids, which I know is like a problem that I'm dealing with, like I have a seven-year-old and a nine-year-old. So that's one resource. And second thing is just check out our YouTube channel. So I know we're a healthy gamer and that's how we started five years ago.

But I would say that, you know, less than 10% of our content is about video game addiction now. It's just really mental health for the digital generation. We had an amazing video recently on female bullying, which I think is like, one of these things that is like under discussed. So there's a lot of like passive aggressiveness and a lot of nastiness with especially women bullying other women. So we cover all kinds of different topics just around mental health, motivation, understanding the neuroscience, understanding the spirituality.

So check out our YouTube channel, which is Healthy GAMRG. Amazing. We'll link to all that in the show notes below. Dr. Kay, it's been such a pleasure to dive into these topics with you. Thank you for the reminder of just how much we have agency and how we. we don't have to fix everything. We just have to put in the work on a regular basis and pay attention to the discomfort that we're all going through. That's a big step in the right direction. And to do that, it might require some healthy boundaries with some technologies, some processed food, other things

that are out there so they don't hijack our brain. But hey, that's the mission and the journey that we're all going on together. Yeah. So I think the thing about all those boundaries and enforcement and stuff is like it's so much work. So like I think if you settle what's on the inside, life becomes just way chiller. I like that approach. Well, thank you again for coming on. Super appreciate it. Thanks a lot, Drew.

Hi, everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do

to support this podcast is share it with a friend, share with a friend who would benefit from listening. Number two, before, I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter, and it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset, to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email

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