Stuff You Should Know - How Dopamine Works

Episode Date: July 2, 2024

Dopamine is perhaps the most talked-about, most misunderstood biochemical in our bodies. It’s linked to not only addiction and depravity, but also focus, motivation, and living a productive life. How can one molecule be so many things to so many people?See omnystudio.com/listener for privacy information.

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or wherever you get your podcasts. Hear insightful, entertaining discussions on today's important health and wellness topics on the Health Discovered podcast from WebMD. Through in-depth conversations with experts, Health Discovered covers everything from tips for healthier living to the latest on therapy and mental health. My goal is to really destigmatize mental health treatment

and looking at it from a whole health perspective. Physical health and mental health can be intertwined. Listen to WebMD Health Discovered on the iHeartRadio app or wherever you get your podcasts. Welcome to Stuff You Should Know, a production of iHeartRadio app or wherever you get your podcasts. Welcome to Stuff You Should Know, a production of iHeartRadio. Hey, and welcome to the podcast. I'm Josh and there's Chuck and Jerry's here too. Three amigos back together again after some massively triumphant live shows.

Yeah. We did our little Northeast Spring Swing. Yeah. And it was great. This is a good show. Which one? The podcast topic that we did live. Oh, I gotcha.

That we're doing all year. I gotcha. It was pretty good. Sorry. I love that topic. That's what you call an on-secwitter. But it does feel good to be back, doesn't it? Back in the studio, back doing what we're born to do.

I kind of prefer on stage, but sure, this is great too. Do you? You like the thrill of the audience, the roar of the crowd, that bowl running at you? Yeah. Nice. I like it too sometimes when I'm not totally terrified because I drank too much energy drinks.

Well, I wonder if your dopamine receptors are functioning as they should. Yeah, that's a great question, Chuck. And that's a wonderful segue too because it just so happens that today the topic of this episode is dopamine. And there's probably no more misunderstood neurochemical, certainly neurochemical, maybe substance in your body at all, than dopamine. We used to think we had a really great handle on dopamine and what it does and how it works and it turns out that we are, every turn a new study comes along that

says, nope we're wrong, yep we're wrong about that. Well, what about, yep, wrong about that. Basically everything we know in popular culture. And I mean, if you've even gone to like Cleveland Clinic website or WebMD website or Harvard Health has some articles, you'll see this old antiquated, outdated view of what dopamine is being kind of paraded around. The idea that it's a pleasure inducing chemical that if something gives you pleasure

You're you're responding to a hit of dopamine and that is just absolutely not true Yeah, and this this may be the most oft covered Stuff you should know thing that hasn't gotten its own title yet. Yeah Man that dopamine is is the reigning champ right now. Yeah, we talk about this stuff all the time, it seems like. Yeah, we do, because it comes up a lot, and the reason why is because it turns out

it has a lot to do with more than just pleasure. Like everybody, yes, it is associated with pleasure, just not the way we've thought for very long, and it does a lot of other stuff too. Essentially, what it does is it signals things. It says, hey you, you behave, or you act up, you stop behaving. Something like that. I'm not quite sure exactly what it says.

I don't speak dopamine. But it's a neurotransmitter, so it's a chemical messenger in the brain at base. But it's associated with so many different things that of course dopamine comes up all the time in our podcast. It sure does. So it is, like you said, a neurotransmitter, one of more than a hundred of those bad boys functioning in our bodies. And like you said, it lets things communicate.

It's a facilitator. Um, but it's, it gets all the press for it's, um, you know, like the feel good stuff that you mentioned, um, addiction behaviors, whether it's gambling or drugs or, or the thrill of, uh, you know, those people that walk around on ledges and stuff. Ledge walkers. Yeah. Ledge walkers. Yeah, ledge walkers. But it does all kinds of things. That's just where it makes the newspaper headlines.

Right. But we should probably talk a little bit about just the neurotransmitter cycle that it goes through. Sure. So the whole thing starts, it turns out that dopamine is used throughout the body, but for the most part, it's used in the brain. The problem is, is if you had a big handful of dopamine and you just shoved it in your mouth,

it couldn't make it into your brain for use. It can't cross the blood-brain barrier, in other words. Fortunately, the thing that makes dopamine up, its essential ingredient, tyrosine, an amino acid, can cross the blood-brain barrier. And when it gets there, it gets a big fat hug from something called tyrosine hydroxylase. And that converts it into dopamine. And all of a sudden, your brain's like, yes, let's go. That's right. And we've known about it a long time, it's been around a long time. It is not exclusive to human beings.

No, that's a big one. Yeah, it's in all kinds of animals. But we are really kind of great at making it. And I was about to say hooked on it, but that implies the whole addiction thing, and I don't want to go down that road. But humans love this stuff, and we produce about three times as much as other primates do. Yes. And in fact, Emily Deans wrote an article in 2011, I think in Psychology Today.

She's an evolutionary psychiatrist. And she said that dopamine is what made humans so successful. And from what I can tell, the latest research about dopamine is that it essentially is what allows us to learn about the world around us. We make connections that collectively form our mental map of the world, of how we're to behave around other people, of how we do things like go get food. Like that dopamine is somehow behind all of it. And that because we're so responsive to dopamine

and we produce so much dopamine compared to other animals in the animal kingdom, that is conceivably what has allowed us to become as successful as we are compared to other animals. Isn't that nuts? Like it could all just come down to dopamine essentially. Yeah. And opposable thumbs maybe? Sure, but I mean what are opposable thumbs if you can't get the wherewithal to move it? True. But if you had the wherewithal to move it and you couldn't grab something, you'd probably be pretty frustrated.

You can use the heels of both hands, just like a thumb. Are you underselling the opposable thumb? Yes. I'm sick of the opposable thumb always hogging the spotlight. It's dopamine's time. You can get those removed, you know, see how you do. I guess that sounds like a dare to me, Chuck. Say goodbye to your tennis game.

I can play it just by holding the racket with both heels of my hand. Or I guess we should have said pickleball. That'd be more current, right? I don't play pickleball. I haven't tried it yet. I want to though. Okay. Well, there's plenty of places and people to play it with.

Yet I have found no one or no place. Oh, I'm sure somebody will write in and offer to play with with. Yet I have found no one or no place. Oh, I'm sure somebody will write in and offer to play with you. Of course. Then I go out there and I like blow my ACL or something. Oh, go on. That was nice. So at the highest level, you know,

we kind of talked about this a thousand times before, but dopamine functions as a neurotransmitter. It enables signals to pass through these gaps, these synapses, and make connection from neuron to neuron. And that's just sort of the bird's eye view, but there are all kinds of things that dopamine does, and depending what kinds of neurons it's talking to and it's introducing to one another,

it's gonna have different effects on the human body. Yes. So there's D1 to D5, I think, types of receptors, dopamine receptors, and four pathways that they follow. And like you said, depending on what receptor is being activated and what pathway is being followed, all sorts of different stuff can happen. Dopamines associated with motor control, learning, memory, malfunctions in it can result in psychosis. They use dopamine as a vasostimulant to treat heart conditions. It has just a cluster of different effects on the body depending on where it's being processed, like what pathway it's being processed, right?

And I think I said there's four of them total. Did you want to talk about those? I feel like we should. Okay. The first one is the nigrostriatal tract. Nice. You mentioned motor control first, and that's the tract that has to do with motor control.

Yeah. So if those aren't working correctly, the one that the dopamine neurons has to do with motor control. Yeah, so if those aren't working correctly, the dopamine neurons or the dopaminergic pathway in the nigrostriatal tract, that can result in Parkinson's. It's very famously associated with dopamine for anybody who has read Awakenings or saw the movie. Yeah.

Which we'll probably talk about a little bit more later. That movie? Yeah. Okay. I got a great, great bit up my sleeve. Okay. The second pathway is the mezzo-cortical pathway. That has a lot to do with executive functioning, prioritizing stuff, how your brain plans things,

how it files away stuff, and how it organizes your overall sort of priorities. Yes. And now it's time to talk about the most random dopaminergic pathway of all, the tuberoinfundibular pathway. Tuberoinfundibular. Yeah. I think you had it right the first time. Okay. We'll edit out the second one then. All right. We'll put in a slide whistle over it. So that connects the hypothalamus and the pituitary gland and it's from what I can tell, I was like, well, what else does it do?

It's sole, the sole role of this pathway is to block the production of milk or to, yes, to prevent the production of milk in the female breast of mammals. That's what it does. That's that, that's that pathway's role. And if you block that pathway, the milk production begins. Isn't that interesting? Yeah, we talked about that in the two-parter, the old breastfeeding two-parter. Oh, we did?

Oh, yeah. Oh, I don't remember that. Yeah, yeah. Wow, you got a great memory. That's where it all begins. No, I have a terrible memory. I know you're making fun of me. There's also the Meso-Limbic pathway.

We've talked a lot about the limbic system in many episodes, but reward and emotion, and this is the one that gets all the press, because this is the one that has to deal with addiction. Pleasure. And we're gonna talk a lot about reward and how reward factors into how dopamine works. Right, this is the reason why some people get

the chemical drawing of, the molecular drawing of dopamine like tattooed on their wrists, because they're so hedonic and into pleasure. That's why you might see somebody with that, because of that pathway. I never heard of that. Yeah, it's a thing. It unfortunately turns out to be a misinterpretation,

but it is a thing that people do sometimes. Sure. So, you know, we talked about misunderstandings about dopamine, and up until not too long ago, we didn't know a lot about exactly how dopamine worked in the body, and there was a misguided thought that there was something called volume transmission at work,

which was you just sort of, well, you don't flood. We'll talk about artificially flooding dopamine, which is also a problem, that resulted from this misnomer. But dopamine just went very slowly, it was not very specific at all, just kind of washed over the brain. And if it made some connections with various neurons, then that was kind of the dumb luck of dopamine, because dopamine is just dopey.

Right, here's a great example of just how wrong we got dopamine. It turns out the process that dopamine is excreted and crosses into the synapse and creates like an electrical transmission in the brain is the exact opposite. Totally opposite. Of volume transmission.

It could not be more opposite than the idea that it just floods slowly across the brain is the exact opposite. Totally opposite. Of volume transmission. Yeah. It could not be more opposite than the idea that it just floods slowly across the brain and whatever it runs into it runs into. We found that in milliseconds, a precise squirt of dopamine hits exactly the right neuron in exactly the right places, right on the money. That's how dopamine is excreted. The exact opposite of volume transmission. Yeah, and we learned that not too long ago. 2018 medical researchers at Harvard

released this paper and said, hey, guess what, everyone, it's the opposite of everything you've been saying. And everyone went, oh, okay, sorry about that. Sure. my B. So after the dopamine is excreted and it does its job, it actually breaks down remarkably quickly. It turns into something, it's metabolized

into something called homo-vanillic acid, right? And from what I can tell, I don't know what the homo does to the vanillic acid, but vanilla, vanilla acid is the flavor of vanilla. So from what I can tell, if you tasted the, the, the Homo vanilla acid, which is like the metabolite found in cerebrospinal fluid that we test to see how much dopamine you have in your brain at any given time, it may taste like vanilla. Wow.

Isn't that interesting? It's gross. It is gross. And I don't know also if we said that just 20,000 neurons are capable of synthesizing dopamine, but that's a really small proportion of the total number of neurons we have, too, about 100 billion, I think.

Yeah, absolutely. You want to take a break? Yeah we'll break and we'll talk about well what everyone wants to hear about which is how dopamine and pleasure hold hands with one another. For so many people living with an autoimmune condition, the emotional toll is as real as the physical symptoms. Starting this May, join host, Martín Hackett for season three of Untold Stories, Life with a Severe Autoimmune Condition, a Ruby Studio production, and partnership with Arginics. From myasthenia gravis, or MG, to chronic inflammatory demyelinating polyneuropathy,

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an A from, from the teacher, like you're going to get a hit of dopamine and that's what, that's what your reward is. That's it's pretty old. It's an old idea. At least it dates back to the middle of the 20th century, which is we're getting further and further away from, which makes me gulp. But that idea being discredited is pretty old too. It didn't last very long. The problem is its legacy stuck around for a really long time. It's still around today. Yeah, for sure. There was a researcher, speaking of old, named James Olds in the 50s and 60s who

did some experiments with rats and said, hey, every time I give these rats a little electrical stimulation in just the right place, right there behind the ear, they're going to keep pulling that lever down or whatever act I'm making them do. They'll just do that over and over and over and over and over as long as I keep stimulating that area. Right. So what they said was, okay, there's something going on

with dopamine in this, I guess, pleasurable act that the rat is doing to itself. And that got followed up in the. Whoa, whoa, whoa. That got followed up in the seventies by a guy named Roy Wise, who depleted dopamine receptors in rats. And found that they would not seek out food and they wouldn't seek out methamphetamines that were just there on the offer.

Those rats could have as much meth as they wanted. And they were like, nah, I don't want any. And crucially, critically, Roy Wise and his colleagues misinterpreted that as a lack of experience of pleasure, not a lack of motivation. And it wasn't until the 80s that some other people came along and were like, no, we've been getting this wrong all this time.

Yeah, in the 80s they use sugar instead of methamphetamine, I guess. And once again, very kind of cruelly, they cut off, they didn't allow them any dopamine, they killed them off with drugs, but this time they gave them the sugar and they said, they're liking the sugar. You can tell by the look on that little guy's face

that he enjoys it, but, and this is the key, it's not coming back and saying, give me more sugar, give me more sugar. Right. Or give me more meth. Sure. So this whole thing, this changed our understanding, at least in the, like academia among people who

study this kind of thing, we realized we were misinterpreting what we were seeing and that a lack of dopamine didn't lead to a lack of pleasure called anhedonia or anhedonia. It was a lack of motivation to seek out that pleasure. That's the effect of not having enough dopamine that we found from those rat tests. So like this whole new framework of understanding

it kind of came along because to be clear, dopamine is very much associated with things that give us pleasure. And it does seem like the more pleasurable something is, the more dopamine gets released. Like for example, I think I saw like eating something that tastes really good increases your dopamine levels by 100% sometimes.

But cocaine increases your dopamine levels 10 times that. So the more intense the pleasurable experience is, the more dopamine gets released. So it's definitely associated with it. What they found is like the dopamine is not making you feel pleasure. There's something else involved. It's just, it's never caught with the smoking gun, but it's always there when the dead body is found and it has this mysterious smile on its face because it knows you can't prove anything. Yeah, well it's liking versus wanting and that's a

theory of reward behavior where liking is that that pleasure that, that hits you get right when you put that bite of peanut butter pie in your mouth is that pleasure. Wanting is the motivation to earn the reward that you get out of having that peanut butter pie. Right. Like, you know, you're up in the hotel room, they don't have room service, but you can get up out of bed and you can get dressed and you can get down

the stairs because the elevator is broken and get that peanut butter pie if you want to. Uh, but dopamine isn't enough to motivate you to get up and go get that peanut butter pie necessarily, even though you have great, great memories of the taste of it on your tongue and you love that stuff. Right, but if you do get up and go get that peanut butter pie,

that means that in the past, you've had peanut butter pie or have created an image of the peanut butter pie you've never had that's so great that the dopamine is produced in enough amounts to actually get you up out of bed dressed and going down the stairs to get that peanut butter pie. They're related in that way. Yeah, absolutely.

So it's not actually causing the pleasure, it's just influencing how your brain is taking all this stuff in basically. And there are a couple of different ways of looking at how this happens. There's one theory called that it's prediction error. So you get more bang for your buck, basically. You expected to like that peanut butter pie, but this was the best peanut butter pie you've ever had.

Maybe the best dessert you've ever had in your life. And you're like, wow, that, your brain says, that was way, way better than I thought it was going to be, so it reinforces it. Right. To put it in computational terms, dopamine is a prediction error. Somehow that chemical measures the difference between what you expected and the amazing reward you got.

The greater the difference, the more pronounced the connection that dopamine is going to make between going and getting peanut butter pie and eating peanut butter pie. So you'll have more motivation to do it next time. Yeah. The other way of thinking about it is the dopamine itself is the motivational signal. So it's what makes me get out of that bed and put on my clothes and actually go down those stairs because I'm motivated to go get that reward.

Right. And this is where that awakenings anecdote comes in. Let's hear it. So you were talking about how, you know, the peanut butter pie motivating you to get out of bed and actually go. Um, that definitely jibes with research, particularly, um, something reported by Oliver Sacks in the book. And then later the movie awakenings, there was a, uh, an epidemic of something called encephalitic lethargia, uh, which is what happened to Robert De Niro's character.

Remember as a boy, he caught this thing and then he just kind of froze in place. It's where you develop Parkinson's symptoms so much that you just don't, you can't move. You don't, you're, you're, you cannot move. You have, you don't have the required dopamine to actually move. So you're just sitting there frozen in place

like a statue. But anybody who saw this movie remembers being amazed by this scene. If a certain patient is stimulated, their dopamine is stimulated just enough, they can actually overcome that being frozen in place. And so there's a famous scene where Oliver Sacks tossed one of the patients some oranges and she caught them.

Like she was a frozen statue and all of a sudden she's catching oranges and then juggles with them. Yeah. Or there's another patient that was on the beach, I believe in their wheelchair, saw someone drowning and was motivated to get up and go save the person and then come back and go back to this frozen statue kind of stasis. Great scene.

It is. So like that, that has to do with the motivational aspect of dopamine and that, given the right stimulus, even something that tremendous as just a crazy amount of Parkinson's symptoms can be overcome or overwhelmed by that dopamine hit. Yeah, absolutely. And then jumping back to that first one, the prediction error, they've done research on people who gamble, who play cards and play the slot machines and stuff, and they, their brains experience about the same amount of dopamine activity when they almost win.

Like, you got that big pot in the middle of the table, you're playing poker, and you lose at the last second, your dopamine level will be about the same as if you had actually won it. Yes. Which is pretty remarkable. And then I think it kind of qualifies as a third interpretation.

The most current study I've seen sees dopamine as essentially the thing that allows us to learn. If you connect one thing to another, it's because dopamine had you make that connection. And then depending on what kind of effect those two things have on you, that connection might be very, very strong. Yeah.

So you're motivated to go seek it out again. But at base, what dopamine is doing is allowing us to form connections. Imagine the world. If we didn't connect one thing to another, like if I didn't connect turning on the computer and stepping up to the microphone and recording a podcast, like we wouldn't do anything. We would just be completely lost if we couldn't make connections and it seems like dopamine is the basis of all that. Yeah, pretty cool. Like the whole world would suffer

because we wouldn't be podcasting, Chuck. Oh, that's debatable. You know, we're not poo-pooing the idea that addiction and dopamine are heavily tied with one another. We're just sort of trying to point out that there's a lot of other things at play when it comes to dopamine and that sort of is unfairly maybe gotten all the press. But we do have to talk about it some more. We talked about it plenty of times, certainly

in our addiction podcast episodes. But it does play a pretty big role in drug abuse and addiction. It does reinforce the idea that you want to keep using those drugs because it's making you feel good. And when we're talking about, you know, you're talking about the woman juggling oranges in that movie and how remarkable that is. If they've given you Parkinson's drugs and they just flood your brain with dopamine, they found that 10% of the people that have had that treatment turn into gambling addicts. And I would imagine they're people who already gambled. I don't think it drove them to start gambling, but that just goes to show you the power of what a flood of dopamine will do to your brain. And it's

pretty clunky way to deal with it, I think. Yeah, I think that's what you were referring to earlier when you were saying like that understanding of volume transmission theory of dopamine release. That's what the drugs are based on, like that understanding and that misunderstanding and like yeah, that's what happens. It's like, yes, if it does crawl across the brain and runs into whatever neurons that it can trigger, it's going to have all sorts of other

knock on effects. Yeah, totally. So, um, I guess our current understanding of how dopamine relates to addiction is that, um, it connects drugs with pleasure. And as I was saying before, the more intense the experience, especially the reward, you can have a negative experience. And I think they're starting to figure out

dopamine has something to do with that too. But as far as we know, the more intense the reward, the greater the flood of dopamine. And so the greater the stronger the connection you make between pressing a lever and a scientist giving you a bunch of meth. Yeah, absolutely, but that is, to be clear, just part of the recipe of what leads to addiction.

Maybe there are people out there saying that, but I don't know if anyone really is saying it's all because of dopamine. It is part of the recipe in addition, obviously, to your genetics. Just the fact that drugs are out there and available and there are environmental pressures and influences. All kinds of reasons that people start to take drugs

or continue to take drugs. And as far as the continuation, dopamine is definitely a part of it. Right, and so one of the ways that you learn to take drugs is not just from the fact that your brain is flooded with dopamine, which allows you to make that connection very strongly, but the brain actually changes in response to

those increased floods of dopamine. Cause it's not set up to release dopamine like that repeatedly over long periods of time. It can do it once in a while, but you, you, you can't really do it too often because then the brain responds by shutting down dopamine receptors. The problem is, is that this means that you have to do more drugs to get that sensation, as far as you know, and that's what creates the cycle of addiction.

That to me smells vaguely of being almost out of date. Yeah, I know what you're talking about. But it does make sense then that the ideal drug would trigger a maximum release of feel good chemicals, but a minimum release of dopamine. If anybody could ever come up with a drug like that, people would be able to do drugs all the time and they'd never get addicted. Sure. But they have other negative effects on the body.

Sure. Sure. Can't forget about that. Yeah. Yeah. but they have other negative effects on the body. Sure, sure. Can't forget about that. Yeah, yeah. The other bad thing, obviously, if you're gonna do the amount of drugs it takes to shut down your dopamine receptors, because your body's like, wait, wait, wait, this isn't right, let me shut this down, is it's not just shutting down the dopamine receptor that makes you want to do more cocaine or whatever,

it's just shutting your dopamine receptors down. So you mentioned it earlier, anedonia, that's the idea that you don't receive pleasure from any activity. And if all of a sudden your dopamine has been shut down such because you've been doing drugs that you're not getting any kind of pleasant feel-good stimulation from life, then that could be another reason that you up your desire to do drugs. Yeah, and then there's one other factor involved that with fewer dopamine receptor sites,

remember you said that one of those dopaminergic pathways is related to executive function, like impulse control, responsibility, that kind of stuff. Yeah. Well, with lower levels of dopamine, the theory goes that you are more likely to engage in reckless behavior to get drugs. You might do things that you normally wouldn't do,

not because you're just this addict who has to have it, but partially also because you don't have the impulse control that you did before you became addicted to drugs and your dopamine receptor started shutting down. Yeah, and I think that's, I mean, we talked about it in the addiction app. It's not just the effect that the drug has on your body, the negative effects that it physiologically has on your body, but the behaviors that you start engaging in when you're under the influence of drugs

and want more drugs and maybe can't find the drugs, that's maybe almost worse than the physiological ramifications, you know? Oh yeah, for sure. And it also ties in with risk taking, because dopamine is connected to risk taking. In fact, they found that some people seem to be biologically, physiologically predisposed to risk taking based on their dopamine levels. In fact, they find that they have fewer what are called auto receptors. Apparently, over time we've evolved to create on dopamine neural cells a site called an autoreceptor that actually catches some of the dopamine. It helps regulate it, like it never makes it out. So it keeps the amount of dopamine down to a regulated level. So the fewer autoreceptors you have, if you're still pumping

out dopamine, you get a much greater impact from that dopamine and they have correlated that to risk taking. People who have fewer dopaminergic auto receptors take more risks, at least according to some studies. Yeah, and they've also done studies where they found that that risk should, or needs to be tied to a reward, like a gain basically. There was a study from the University of College in London in 2015 that said subjects whose

dopamine levels was higher, it was boosted artificially with medication, would choose risky options more often if it involved a potential gain. They didn't see that same thing going on if there was a potential loss involved. So there's definitely a tie to a gain or another way of saying that would be a reward. Yes. And then also that impulse control is also a huge hallmark of ADHD symptoms.

And so ADHD is very commonly associated with some sort of dopamine deficiency. And from what I've seen, there isn't an across the board, we haven't discovered some across the board type of brain that's like, yep, if you have this brain, you have ADHD and vice versa. And we're not even certain exactly what effect the dopamine is having. We're almost just kind of like seeing effects that are the behavior of people with ADHD and saying, hey, we know that dopamine does that, or if you don't have dopamine you're more likely to do this. So there's this correlation. It's just not, it's

never been like completely shown yet. I think it probably will be at some time, but we don't really know how ADHD is linked to dopamine. But there's, we're almost certain that dopamine drives at least some of the ADHD symptoms. It's just because of that, people have made leaps in understanding. Like there's a longstanding myth about people with ADHD that they do these impulsive behaviors

to get a hit of dopamine. Well that's based on that old idea that dopamine is a pleasure producing chemical or a reward producing chemical. Where instead it might be that people do these behaviors that are impulsive because they don't have the dopamine that can regulate their impulses, and so they have less impulse control. We're just still sorting it out, I guess. Yeah.

All right, should we take our final break here? Yeah. All right, we'll take a break and we'll talk about, oh boy, it's gonna be so much fun, social media right after this. For so many people living with an autoimmune condition, the emotional toll is as real as the physical symptoms. Starting this May, join host, Martín Hackett, for season three of Untold Stories, Life with a Severe Autoimmune Condition,

a Ruby Studio production, and partnership with Argenics. From myasthenia gravis, or MG, to chronic inflammatory demyelinating polyneuropathy, also known as CIDP, Untold Stories highlights the realities of navigating life with these conditions, from challenges to triumphs. In this season, Martina and her guests discuss the range of emotions that accompany each stage of the journey.

Whether it's the anxiety of misdiagnosis or the relief of finding support in community, nothing is off limits. And while each story is unique, the hope they inspire is shared by all. Listen to Untold Stories, Life with a Severe Autoimmune Condition on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Beth? Yeah, babe. Do you think they can hear us?

Yeah, those are mics. Guys, we are back. We are so excited. It is season two of your favorite New Girl Rewatch podcast. We have got a new season, we got a new name, and we got a brand new episode every week, starting July 2nd. Yeah, I am so excited for you folks to check out this mess around. When I say it's gonna get weird,

I mean, it's gonna get weird. Just save it for the show. Okay, that's probably for the best. We've got some of your favorite people from the New Girl universe. We've got the creator and show runner, Liz Merriwether. We got the Max Greenfield, Olivia Munnn we also have some of your least favorites like like

Jake Johnson no I'm just saying like if you're listing off your favorites like he'd be he's still a favorite just Hannah what's up we do have Jake Johnson yeah listen to the mess around on the iHeartRadio app Apple Podcasts or wherever you get your podcasts or wherever you get your podcasts. Do do do do do do do do. We all know what that music means. Is somebody getting coronated? No, it's time for the Olympics in Paris.

The opening ceremony for the 2024 Paris Games is coming on July 26. Who are these athletes? When are the games they're playing? We may be looking for the sports experts to answer those questions, but we're not that. Well what are we? We're Two Guys. I'm Matt Rogers. And I'm Bowen Yang.

And we're doing an Olympics podcast? Uh yeah. We're hosting the Two Guys Five Rings podcast. You get the two guys, us, to start every podcast, then the five rings come after. Watch every moment of this 2024 Paris Olympics beginning July 26th on NBC and Peacock. And for the first time, you can stream the 2024 Paris Games

on the iHeartRadio app. And listen to Two Guys Five Rings on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. My name is Curly. And I'm Maya. And welcome to The Super Secret Bestie Club Podcast. A super secret club where we talk about super secret things.

Yeah, like secrets that are super. That's what it is. In each episode, we'll talk about love, friendship, heartbreaks, men, and of course, our favorite secrets. Get in here! How's your spirit? My spirit is, it's poppin'. I was like, text your ex, I'm like, touch the blame.

Ego will have you crying over a closed door that had nothing behind it. And I say, be yourself, have fun, and have a good giggle. Listen to the Super Secret Bestie Club as part of the My Kultura Podcast Network, available on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. All right, so we're back and we promised talk of social media because I think everyone is pretty hip to the fact now that notifications and the dings and the likes and the loves and the hearts and all the things that come through various, interacting with various social media platforms.

He just sounded so old, dude. I know, that's great. In this case, I love being old. I don't want any of it. Yeah, I'm with you. But in any case, all of that stuff combines to give you a hit of dopamine and it's specific and you're like, fine, that's great, great whatever but it's specifically structured and built that way and coded that way so

that you will become addicted to that social media platform and they have admitted as such in 2018 it was it was a big news item when they were I don't know it was like congressional testimony or something. Can't remember exactly, but there was a VP at Facebook who came out and was basically like, hey, this is something we did on purpose. And it was a core foundation was the really the quote that kind of stuck out with how people behave using our platform.

Like it was a part of the core strategy to get people to come back again and again and again. Yeah, and that strategy was based on, this was Chamath Palihapedia, who was a VP of user development at Facebook. And they said that this was based on short-term dopamine-driven feedback loops. And, you know, this is all old news to us now. I mean, this was six years ago. Think about how much our understanding of what social media does to us.

But in 2018, that was a groundbreaking admission. But it's true. And I mean, that's essentially how social media works. Like you get the app, and you start to realize that if that little badge number comes up and says, hey, you have like two notifications, you go into it, you're gonna get some sort of reward of some sort. You're gonna like you said get a ding or a like or a heart or something like that and that is a reward to you. And so based on the

Mesolimbic theory of dopamine the mesolimbic theory of dopamine, we get a dopamine hit and so we learn to come back. And apparently also randomness has a lot to do with it because as we start to be able to predict when we'll get a reward, that dopamine stops being a part of that whole experience. So if it can be done randomly, we don't know when we're gonna get a reward. It has a maximum effect of releasing dopamine and thus teaching us to go back to social media over and over and over again. Yeah, totally.

There's also this psychiatrist named Dr. Cameron, S-E-P-A-H, I guess, SEPA? Is that how you'd say it then? SEPA or SEPA? Mm-hmm. Is that how you'd say it then? SEPA or SEPA? Okay, one of those three. Who came out and said, all right, there's this term that I'm going to float out there, and it's called a dopamine fast.

And the idea when that was floated was people heard that and they said, oh, well, dopamine just means just it's just a catch-all term basically for for any sort of addictive behavior like reinforcement. And you can go on a dopamine fast and like, you know, put that put that social media app down for a couple of weeks. And when you come back, it's just like your brain's going to have a little rest from that thing and you're going to feel amazing about how much you love it when you come back. And that's not at all what Dr. Cameron was talking about or meant.

No, huh? Dr. Dr. Sipa Seppa was basically saying like, like he really misused dopamine fast and even said to the New York Times, like, I he really misused dopamine fast. And he even said to the New York Times like, I didn't mean it like that. Don't take it like that. I don't mean it literally.

And everybody said, too late. We're going to take it literally. And so there was this movement, I think people still do it, of self-denial of everything from like people stopped interacting with other people, people stopped eating foods they found pleasurable, they stopped talking if they didn't need to, anything that could conceivably give you a release of dopamine. And their premise was that if they did that,

it would be like going and drying out on heroin or cocaine so that when you come back that that first experience again with heroin or cocaine is that much more amazing because you've kind of replenished your endocannabinoids and opioids and all that stuff. Dopamine does not work like that. If you stop flooding your brain with dopamine it doesn't replenish, it doesn't need to replenish, that's not how it works. But that's what people were doing, they just completely misinterpreted it,

and it was based on faulty science, and Dr. Sipa essentially using the wrong term. Yeah, I think the idea that he was talking about was, hey, put that stuff down, and go do other things that you find pleasure in. Right. Live in the world or go out in nature or, you know, kind of get a hold of your life again so you don't feel like you're, you know, tied to this social media app for your happiness.

Yeah. Our moms used to call it going to play outside for a while. Right. Or summer, I think, is another term it used to be called. Yeah. But instead this guy called it a dopamine fast and people really took a left turn with it. So he identified six compulsive behaviors or categories that he was saying, you

could really, you could really do a good for yourself by taking a, a dopamine fast or a break from emotional eating, excessive internet usage and gaming, gambling and shopping, porn and masturbation, thrill and novelty seeking, which I took to mean taking a break from thrill kill murder sprees. Right. And recreational drugs. Yeah.

But he also said, you know, anything that you feel like has got a hold on your life, if you just stop and step away from it, it will have less a hold of your life. So TV would definitely be in there, probably for a lot of people. But if you step back and look at what this guy's talking about, it's the most basic thing that people

have been doing for eons. And yet, just by slapping dopamine fast on it, it became sticky and buzzy and brainstormy or javasormy and like super corporate and people just really got into it and started thinking like, you know, if I, if I fast from dopamine, when I come back, I'm going to have so much dopamine that I'm going to be the most motivated, focused, greatest UX PM of all time. Yeah.

Thanks a lot. That's just not how it works, unfortunately. No. Yeah. I guess that's a weird way to end this whole thing, but that's how it ends. Huh? Yeah. I mean, that's our current understanding.

Yeah. I feel like this is one we would be able to do five years from now just to kind of revisit. What do you think? Nah. Okay. I mean we've never done that. That's dopamine as we understand it in 2024 everybody. That's right. If you want to know more about dopamine, go out and read about it, but be very specific and selective of who you go read. There are some popular people who know what they're talking about out there, but there's plenty that don't.

So I guess if you run across somebody who refers to dopamine as a pleasure chemical or something like that, just turn around and walk away and go find somebody else. How about that, Chuck? That sounds good. Chuck said that sounds good, everybody, and that means it's time for listener mail.

I'm gonna call this from a conductor. We heard from quite a few conductors so far, and that's just on day one after release. So it's pretty great to know that there are people out there that know about this stuff better than we do. That's amazing. Hey guys, thank you so much for the episode about conductors. I squealed with joy when I saw it in my feed

as I started my hour long commute. I teach high school orchestra and I'm an orchestral, or orchestral, excuse me, musician with former aspirations of becoming a professional conductor, so it's fun to hear an outsider's perspective. You're wondering what exactly is on each musician's stand during a performance. I love Chuck's analogy of it being like an actor's script with only their lines, and that's pretty close. But sometimes there are small annotations of what to listen for from other sections of the orchestra particularly after a long section of

inactive playing or rests to help figure out what you where you are in the music that's the part remember I just couldn't believe there'd be like nothing to cue you and I saw other stuff where there were sometimes numeric notations and other conductors said there were long bars and things that you would pay attention to. Back to the email though. This is another key job of the conductor which you didn't touch on as much, is they have the entire score. They often give entrance cues to specific instrumentalists or sections. Additionally, there are usually rehearsal markers that delineate the beginnings of phrases or larger sections.

This not only makes rehearsing easier, but also gives greater structure and scaffolding to the player. It's similar to punctuation or paragraph structure in a novel. Experienced musicians can often almost more or less feel their entrances based on their contextual knowledge of the piece and the music phrasing. There's an old adage that you spend your time practicing at home to learn your part. Rehearsal time is spent learning everyone else's. Oh that's cool. It's pretty good. The conductor is the facilitator of this process. You hit the nail on the head guys, the interpreter of the score. That is from

Brittany. Me and Chuck, we did it. Yeah we got, I think four or five conductors all wrote in and said like, we did a pretty darn good job on it. So that feels great. Tell me they said bravo. I didn't see a bravo. Sorry. Maybe we'll get one someday. That's pretty good. Who is that from? Brittany?

Yeah, Brittany. Thanks a lot Brittany. Who is that from? Brittany? Yeah, Brittany. Thanks a lot, Brittany. We appreciate that. And to all the conductors who wrote in, thank you to you all. And if you want to be like all the conductors who wrote in like Brittany, you can send us an email too. Send it off to stuffpodcast at iHeartRadio.com.

Stuff You Should Know is a production of iHeartRadio. For so many people living with an autoimmune condition like myasthenia gravis or chronic inflammatory demyelinating polyneuropathy, the emotional toll can be as real as the physical symptoms. That's why in an all new season of Untold Stories, Life with a Severe Autoimmune Condition from Ruby Studio and Argenics, host Martine Hackett gets to the heart of the emotional journey for individuals living with these conditions. To find community and inspiration on your journey, listen now on the iHeart Radio app, Apple podcasts, or wherever you get your podcasts.

Hear insightful, entertaining discussions on today's important health and wellness topics on the Health Discovered podcast from WebMD. Through in-depth conversations with experts, Health Discovered covers everything from tips for healthier living to the latest on therapy and mental health. My goal is to really destigmatize mental health treatment

and looking at it from a whole health perspective. Physical health and mental health can be intertwined. Listen to WebMD Health Discovered on the iHeartRadio app or wherever you get your podcasts. Guys, we are back. We are so excited. It is season two of your favorite. Guys, we are back. We are so excited. It is season two of your favorite New Girl Rewatch podcast.

We have got a new season. We got a new name. We've got some of your favorite people from the New Girl universe. We've got the creator and showrunner, Liz Merriwether. We got the Max Greenfield, Olivia Munn. We also have some of your least favorites, like Jake Johnson. Lamorne. Hannah, what's up? We do have Jake Johnson though Yeah, listen to the mess around on the iHeartRadio app Apple podcasts or wherever you get your podcasts