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Dr. Mike Smith (Host): The Molecule of More. How a Single Chemical in Your Brain Drives Love, Sex, and Creativity. Welcome to The GW HealthCast. I'm Dr. Mike Smith, and today's topic: Dopamine. Driving Your Brain Into the Future. My guest is Dr. Daniel Lieberman. Dr. Lieberman is a Professor and Vice Chair for Clinical Affairs in the Department of Psychiatry and Behavioral Sciences at George Washington University, and he's the author of The Molecule of More and is affiliated with The George Washington University Hospital. Dr. Lieberman, welcome to the show.

Dr. Daniel Lieberman (Guest): Thank you for having me.

Host: Wow, so Dopamine — I don't think I've had any guests come on to talk about a neurotransmitter. Just so my audience understands, let's start with some of the basics. What is Dopamine specifically, and why are you so interested in it?

Dr. Lieberman: As you mentioned, Dopamine is a neurotransmitter. That's a chemical in the brain that influences how our brain behaves. I would say that Dopamine is probably the single most interesting neurotransmitter in the brain. It's sometimes called the neurotransmitter of sex, and drugs, and rock ‘n roll.

I became interested in it primarily through my work with patients who are struggling with addictions. Addictions are a funny thing. From the outside, it looks like people are engaging in a voluntary behavior, but the behavior is so incredibly destructive, it appears that their actions are completely irrational. What I learned from my work with these patients is that it's really not the way it is at all. From the inside, these people are experiencing overwhelming feelings of craving. That is making their choice to use drugs not really so voluntarily. In the case of addictions, this neurotransmitter, Dopamine, has largely taken over their life, and it requires some very difficult changes in their life to overcome it.

I was impressed by how powerful this neurotransmitter was, and I began to look at other roles it played in the brain. What I found really astounded me — the wide variety of roles it plays from sex, to love, creativity, even politics. What I found was so interesting. I thought that I needed to write a book and share this with the world.

Host: Right, that's great. Help us understand then, what is it about Dopamine? As we both have said it's a neurotransmitter — for my audience members, a neurotransmitter is basically a brain chemical messenger between brain cells. What is unique about Dopamine? Is it where it works? Is it the receptors that it's binding to? What makes it so powerful that it even influences politics?

Dr. Lieberman: A lot of people have heard about Dopamine, and if they have they've probably heard about it in terms of being the reward molecule. It's what makes us feel good when we do things like eat when we're hungry, have sex, win a competition, but that's really only a tiny slice of what it does. As a result of evolutionary pressures, the brain is divided into two. There is one set of brain chemicals, neurotransmitters, that are designed to help us manage the present moment. In the present moment we experience things with our sense, we have emotions, and we do things like appreciate and enjoy the things we have. Some of these neurotransmitters for the present moment are things like Oxytocin, Serotonin, and Endorphins.

Then we have Dopamine. Dopamine is the neurotransmitter that helps us manage the future. From an evolutionary point of view, the single most important thing about the future is to be alive when it comes. What Dopamine does is it pushes us onward to maximize future resources, and that's whey we call the book The Molecule of More. Dopamine makes you want more.

A simple example is if you're scrolling through a list of social media posts, you may be scrolling, and scrolling, and scrolling until you're totally bored, but for some reason, you can't seem to stop. That's Dopamine. Dopamine is saying, "If you keep going, it's very possible you'll find something that will have an influence on your future well-being. Don't stop."

It's the same chemical that makes us crave going to our social media page when we ought to be doing something else. It's the same chemical that makes us crave eating unhealthy foods and engaging in activities that might not be so good for us but tricks our brains into thinking this is evolutionarily helpful.

Host: Yeah, yeah. Dr. Lieberman, I remember back in medical school, and we were studying the brain, studying neurotransmitters, and I do remember Dopamine being a very special one. I remember the four C's of Dopamine. The letter C. There was Cognition, Concentration, Coordination, and the more important, Compensation. Is that kind of what you're referring to? It's like I'm doing some activity and I keep doing it even if I'm bored, but I know there's going to be some compensation for it in the future. Is that same thinking you have about Dopamine being that neurotransmitter of the future?

Dr. Lieberman: I think that that is right. Compensation is a good word because it begins with the letter C, of course. I prefer reward because reward has more emotional overtones.

Host: Ah, yeah.

Dr. Lieberman: The kinds of promises Dopamine makes to us are very emotional in nature. For example, let's say that you are shopping for a new TV. You might have all kinds of wonderful fantasies about how your future life is going to be so much better with your giant, new big screen TV. That's Dopamine. Making promises about compensation. But because this is a neurotransmitter that only processes the future, once you get that TV it comes into the present and Dopamine shuts down. That's why having things that we previously desire so much can often be a disappointment.

Host: That's interesting.

Dr. Lieberman: It's because we have a transition from Dopamine to one of the here, and how neurotransmitters, and we don't always do that well.

Host: Yeah. That's very interesting the way you said — by the way, I agree with you. I think reward is the right word, but it doesn't fit with the four C's, so I guess the professor wanted me to remember the four C's.

Dr. Lieberman: It does not, that's right.

Host: This all sounds great, but let's go into maybe the potential downside to all of this. If I'm doing something that may be destructive, but I have this idea that there's a reward, that's not necessarily good. Is there supposed to be some sort of balance with this?

Dr. Lieberman: There is. We live in a very dopaminergic society. We're constantly bombarded by advertisements telling us that our life is not good enough and we need more of something. We tend to go into dopaminergic overdrive in which we are always paddling upstream for that next reward and never appreciating the things that we have. There's an old saying that goes: to travel hopefully is better than to arrive. That's a saying of the highly dopaminergic person. It's a dark saying in a way because it means that the things we work so hard to get we never enjoy. You think about the kind of person who's able to earn enough money to buy a beach house. Well, paradoxically, this is probably the kind of person who is least able to enjoy that beach house. Somebody who is highly dopaminergic, highly driven, highly ambitious all they care about is working for more, working for what's next.

Host: Ah, yeah.

Dr. Lieberman: And it's very, very difficult for them to stop and enjoy the present. We balance it with these here, and now neurotransmitters, neurotransmitters that help us appreciate what we have to use our senses to take in the present and to use neurotransmitters like Oxytocin that orients us to relationships, so we can simply enjoy being with friends and family. To get the most out of life, we've got to balance that. We've got to be able to fire up Dopamine when it's time to work for a better future but turn it down when it's time to enjoy the present moment.

Host: I’ve got to tell you, I'm really interested in your book. This is a fascinating topic to me, and I'm sure my audience is just soaking this up. Tell us a little bit more about the book, The Molecule of More. If I were to read this what would I learn, and what would be the main message you would want me to gain from reading your book?

Dr. Lieberman: Well, it is a book about the brain, but one of the things our reviewers have commented on over, and over again is how accessible it is to the lay reader. We worked very hard to make it clear, understandable, and fun. It's full of all kinds of anecdotes that illustrate Dopamine at work.

As you work your way through the book, you learn more and more about the different facets of life that Dopamine influences. We spoke about love, addiction, creativity, mental illness. We talk about politics. We talk about immigration. All of these behaviors are powerfully influenced by Dopamine. And perhaps the most ancient piece of wisdom is found at the Oracle of Delphi in Greece. That is: Know Thy Self.

What my hope is that people will take away from this is to be able to recognize in their own lives and their own brain when Dopamine is driving their behaviors and when the here, and now chemicals are driving their behaviors, to be able to make a deliberate, conscious decision about whether these are the right neurotransmitters for any given situation. This will allow people to take better control over their lives and decide is now a time to look forward to the future or is it better just to enjoy the present moment?

Host: Yeah. That's a great point. I guess in practical terms — and I don't know if you really go over this in your book — but how do we do that? If I notice that maybe the behavior is maybe too much for that reward, that compensation, what do I do? Do I just put that down and go do something in the here, and now? Do I ground myself into talking to somebody who's sitting right next to me? Is it as simple as that?

Dr. Lieberman: It's as simple as that, but it is incredibly difficult despite the simplicity.

Host: Right.

Dr. Lieberman: Think about when you're talking to another person. What are you doing? Are you listening with all of your attention or are you thinking about what you're going to say next? Are you daydreaming and thinking about something completely different? Typically, it's one or two of those latter activities. Just simply listening and paying attention with everything we've got is something we don't ordinarily do with loved ones. When we do do it, our loved ones can tell, and it has a powerful effect on the relationship. Living in the present moment — and sometimes this is referred to as mindfulness — is something that is relatively simple, but at the same time, it's difficult, challenging, and very, very powerful.

Host: Yeah. The book is called The Molecule of More: How a Single Chemical in Your Brain Drives Love, Sex, and Creativity. Where is the book available?

Dr. Lieberman: It's on Amazon, Barnes and Noble, and most local bookstores.

Host: That's fascinating, Dr. Lieberman. I want to thank you for the work that you're doing, and thank you for coming on the show today and sharing what I consider to be just a phenomenal and amazing topic. You're listening to the GW Healthcast. Please visit GWDocs.com to get connected with Dr. Lieberman or another provider, or call 1-888-4GW-DOCS to schedule an in-person or virtual appointment. I'm Dr. Mike Smith. Thanks for listening.