Physician burnout is widely recognized as a crisis in medicine affecting over 50% of all physicians. Characterized by exhaustion, depersonalization and lower sense of personal satisfaction, burnout in physicians continues to increase despite a greater focus and proliferation of wellness programs.

 While there are several systemic contributing factors including moral injury, increased workload, and EMR/workflow inefficiencies, there is another cause of physician burnout largely within our control to change - digital overstimulation and dopamine depletion.

The True Role of Dopamine:

Many of us think of dopamine as a pleasure molecule that makes us feel good. While this is true, dopamine is also a motivating molecule that pushes us to pursue our dreams, build relationships and learn new skills. In a normal healthy state, the brain releases dopamine to help drive us toward our important goals and then releases more dopamine once we have achieved those goals. This balance between the motivating and pleasure aspects of dopamine is really the key to living an engaging and fulfilling life.

Big tech through social media apps has intentionally hijacked this normal dopamine circuitry by providing multiple quick, easy spikes of dopamine each day via notifications, likes, streaks, messages, infinite scroll, autonext videos etc. This depletes our dopamine reserves and shifts the balance away from longer-term motivation to short, immediate pleasure. All of our dopamine is used up in these hundreds of micro hits, leaving the brain hungry for more. Since the “reward” of social media apps is easy and only requires checking our phones, we become hooked on the promise of another hit. This creates a very real dopamine addiction cycle based purely on pleasure that essentially short-circuits our larger dopamine balance.

Additional external stimuli prevalent in medical practice include EMR alerts, email notifications and messaging which provide low grade almost constant stimuli that also siphons our dopamine reserves.

Imagine dopamine as a valuable resource, such as money. We start the day with a big paycheck and spend a little bit every hour on junk food and treats. By the end of the day, we have nothing left for a nutritious, healthy and satisfying meal. As physicians, we often feel exhausted and unsatisfied at the end of our days.

Most of us  live in a state of constant dopamine depletion as the brain has been rewired to crave quick easy (pleasurable) rewards at the expense of motivating us to pursue meaningful activities that now seem too boring and difficult.

This state of dopamine depletion has several defining features and is likely a large contributing factor to many common conditions such as burnout, generalized anxiety disorder, stress, depression, ADHD.

Common Symptoms of Dopamine Depletion

● Low motivation or energy, feeling unmotivated to complete tasks or achieve goals. ● Loss of pleasure in activities that previously brought joy (anhedonia).

● Fatigue and persistent tiredness despite adequate sleep.

● Depression, persistent sadness, or mood swings.

● Anxiety, nervousness, or feeling restless.

● Difficulty concentrating, forgetfulness, or problems with memory.

● Sleep problems, such as insomnia or trouble staying asleep.

● Low sex drive or reduced libido.

While the above symptoms are uncomfortable and unpleasant, the real harm of this state of dopamine depletion lies in what it prevents us from doing - living engaged lives filled with meaning and fulfillment.

Given the myriad of issues in medicine, there is no shortage of people and circumstances to blame for physician burnout. Too many physicians have resigned themselves to “getting through the day to finally relax at home” or “looking ahead to retirement”. But changing our external circumstances may not be the solution if our internal world does not change.

Scrolling on our phones to take breaks does not work because of the dopamine depletion that comes from multiple micro hits, leaving us feeling bored, depleted, and unsatisfied.

Without the balance of the motivating effects of dopamine, we are left compulsively chasing quick pleasure hits, similar to a rat in a cage constantly pushing a lever for food.

Our phone has become our cage and scrolling has become our lever.

To free ourselves, we must first restore the balance and wiring in our brains, both of which are fortunately reversible.

A 7-day Digital Dopamine Detox consists of the following:

1. Delete all social media and email apps from phone.

2. No social media for 1 week.

3. Check email once or twice per day on a web-browser.

4. Keep phone in central spot when at home. Go to this place when you need to check messages or make calls.

5. Replace the time with exercise, reading, writing, walking in nature, creating art or any other meaningful activity that feels good to do.

6. After 7 days, you can use social media on web-browsers and check once or twice per day along with email. Schedule these times in advance.

7. Keep phone free of social media and email apps. Use the phone like Steve Jobs intended - talk , text and music only.

This approach removes the ease of getting rapid dopamine hits from mindless scrolling, creates helpful friction, and encourages intentional use. While it may feel challenging at first, the payoff is significant: lower anxiety, a calmer mind, and a happier, more connected life.

Dr. Katyal MD FACR holds a Bachelor of Science degree with University Honors in Chemical and Biomedical Engineering from Carnegie Mellon University and a Medical Degree from New York University School of Medicine. He completed an internship, followed by a residency in radiology, and a fellowship in body imaging at the University of Pittsburgh Medical Center. After achieving success in the medical field, Dr. Katyal turned his focus toward understanding and teaching the principles of well-being. He recognized the importance of harnessing the power of the subconscious mind and obtained advanced certifications in Rapid Transformational Therapy, Positive Psychology, and high-potential coaching. Currently, Dr. Katyal works with adolescents, young adults, and families to identify and overcome mental barriers that hinder their potential. His unique methodology combines neuroscience, Eastern spirituality, and positive psychology to help individuals experiencing anxiety, depression, screen addictions, and performance-related challenges.

Dr. Katyal is aware of the significant pressures that young people face in today's high-stakes environments and is committed to empowering them to reprogram limiting beliefs, achieve peak performance, and lead authentically fulfilling lives. Please visit his website for more information and articles. Sanj lives with his family in Pittsburgh, Pennsylvania. His hobbies include kayaking, writing, and hiking. sanjkatyal.com