When I Fully Arrived on the Internet
The dopamine orthodoxy, the silent majority, and what the industry won’t say
When I fully arrived on the internet making content about a year ago, I was excited to teach what my patients have told me “needs to get out there.” That spark carried me very far, and into a YouTube push that I had planned out for many years.
It didn’t take long for me to start getting comments that I had never been asked in my office.
Concepts like dopamine and serotonin have always made sense when meeting with a patient face to face. On the internet, it was a completely different story. Wading through this noise, I was repeatedly asked for evidence, which initially was surprising. These perspectives come from 20,000 hours of actually doing the work.
After shaking the dust off my academic mind I began to dig deeper on the evidence hierarchy, ensuring my clinical teaching points to specific sources. It didn’t take long until I finally realized: on the internet nobody knows what they’re talking about.
The simple fact: in any chat room or Discord server there are no longer individuals, but members of a tribe. Indeed, despite all our technological advancements, the true path to understanding this new plane of existence lies in our most primitive instincts. That is how we can best understand the way information is filtered through the internet. The truth and knowledge from our world get filtered back through a tribe.
This is why I got comments calling into question my opinion because it didn’t align with dopamine receptor orthodoxy. The tribe asks for accommodation, but I am most concerned with my patient and their individual situation.
After all, what good are invisible brain chemicals if you don’t understand how they connect with your anatomy?
Despite the tribes that are present on the internet, that doesn’t account for everybody. There exists a silent majority of individuals online, just the same as I see in my practice. They are the untold number of adult patients I have seen over the past decade who do not identify with the collective tribe. That tribe has dominated the conversation for far too long with little industry pushback.
The industry has been complicit in appeasing a mob. Rather than pointing out the structural dilemma of internet communication, the field has stayed quiet about mechanics of group psychology understood in advertising circles for well over a century.
So what is the answer?
The key is understanding what the goal is. Validation must come from within. The trap is this unchecked impulse to connect with others. The internet is a trap for any soul who ventures down the lonely corridors of Reddit where they will never be known truly.
ADHD can lead to many real life answers when the diagnosis is discovered online. The silent majority sees something and seeks treatment out in the real world. The problem is the narrative that is so confusing.
If this ever digitized world is going to resist devolving into tribal warfare, media literacy needs a drastic dust off and widespread refresh. At the rate we’re going, I wouldn’t be surprised if the DSM becomes a diagnostic label that signals group membership rather than individual pathology.