Chronic indulgence in high-reward behaviors or substances can reset the brain to a dopamine-deficit state, causing anhedonia, anxiety, irritability, insomnia, and dysphoria.

“if I keep indulging again and again and again, ultimately I have so much on the pain side, right, that I've essentially reset my brain to what we call like an anhedonic, or lacking in joy type of state, which is a dopamine-deficit state. So that's really the way in which pain can become the main driver, is because I've indulged so much in these high reward behaviors or substances, that my brain has had to compensate by reward down-regulating my own dopamine, such that even when I'm not doing that drug, I'm in a dopamine deficit state, which is akin to a clinical depression. I have anxiety, irritability, insomnia, dysphoria.”