For their first 16 years as parents, Anna Lembke and her husband kept a strictly tech-free home. No Wi-Fi, and certainly no cell phones. Not even on family vacations. “We really wanted to be as present as possible for our kids,” she says.
But when the eldest of their four children entered high school and came home with a smartphone and a cell plan she had purchased herself, Lembke recognized it was time to adapt. Fortunately, she literally wrote the book on navigating digital addiction.
As a psychiatrist specializing in addiction, Lembke had seen the damage of compulsive overconsumption of digital media on the brain. And now, the vice she’d spent years warning others about had arrived at her doorstep.
“I’ve spent my career watching people become addicted to all kinds of digital media,” Lembke says. “We knew the dangers, which is why we raised our family in a minimalist tech environment. But even we couldn’t keep it out forever.”
Lembke, a professor of psychiatry and behavioral sciences at Stanford University, hadn’t set out to specialize in addiction medicine. As a young psychiatry resident at Stanford, she planned to focus on mood disorders – until she realized many of her patients weren’t just anxious or depressed. They were addicted.
“It wasn’t something I learned much about in medical school or residency,” she recalls. “But I kept seeing it in my patients, and I knew I needed to understand it better.”
She sought out guidance from Keith Humphreys, a psychiatry and behavioral sciences professor at Stanford known for his work on addiction medicine. “He became my mentor,” Lembke says. “He encouraged me, helped me get funding, and collaborated with me on research. If it weren’t for him, I might not have stayed in academia.”
Today, Lembke is the mentor. She is the medical director of Stanford Addiction Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. She also leads Stanford’s Addiction Medicine Fellowship, where she trains doctors across psychiatry, emergency medicine, internal medicine, and pediatrics to recognize and treat addiction.
“These are people willing to take an extra year of training, often for lower pay, because they care deeply about helping this vulnerable population of people with addiction,” Lembke says. When they finish, the fellows go out into the world and practice addiction medicine. They open treatment centers, integrate addiction care into their primary practice, and some join Stanford faculty. “We’re seeding the medical world with people who know how to treat addiction.”
Lembke’s research and clinical work have made her a leading voice on addiction. Her 2021 book, Dopamine Nation, explores how the brain’s reward system and modern society have created an epidemic of addiction, not just to substances but to behaviors like social media, gaming, and online shopping.
“When you look at the natural history of addiction in a person’s life, whether it’s traditional or digital drugs, most people start out using for one of two broad reasons: to have fun or to solve a problem,” Lembke explains. “The problem can be wide-ranging, from anxiety, depression, and attention, to loneliness and boredom. If it works to solve that problem or it’s fun, people tend to return to it again and again.”
The problem is that the brain adapts over time. People need more of the drug to feel the same high. Lembke says the trajectory is remarkably similar whether one is addicted to gambling, cocaine, or Instagram.
“The world we live in today is engineered for compulsive overconsumption,” Lembke says. “Our brains haven’t evolved to handle the constant flood of dopamine from digital technology. The result is more addiction, anxiety, and loneliness.”
That disconnection is Lembke’s biggest fear. “Digital media can connect us across time and space in ways that can be wonderful,” she says. “But it’s also true that digital media, and in particular social media, can create the illusion of connection when in fact no real connection is happening. When we’re mesmerized by the medium, we’re less likely to put in the time and effort needed to create real relationships in real life.”
Our brains haven’t evolved to handle the constant flood of dopamine from digital technology. The result is more addiction, anxiety, and loneliness.”
After what she calls a “very vigorous discussion” on digital etiquette and appropriate use, Lembke and her husband let their daughter keep her phone. Their younger children followed suit. But when their youngest son’s grades suffered from too much time on his phone, Lembke and her husband took it away. They explained, “It doesn’t make you better or worse than your siblings, this is just not working for you.” After the school year, with stricter limits in place, Lembke handed him the phone back.
Today, their home has Wi-Fi and cell phones, but the family still takes tech-free vacations. (After her bag and wallet were stolen on a trip to Chile, they now travel with one cell phone in case of emergency.) “You don’t have to go as far as we did,” Lembke admits. “We were extremists.”
At home and on campus, Lembke prioritizes real-world connections. Her team meets for lunch on the last Tuesday of every month at Stanford’s Arbor Cafe. “If we don’t meet in person, there’s no sense of place, much less a sense of fellowship,” Lembke says. “Breaking bread together is a way to connect and be real in the world, which is an increasingly rare commodity.”
Lembke considers it a great privilege to work alongside her patients who are facing their addictions. “People are endlessly interesting,” she says. “I don’t help everybody who crosses my path, but I can be helpful to some, and that is a great feeling.”