Neuroscientist: What To Do When You Feel Like Doing Nothing (Unmotivated, Burnt Out, Unhappy)

Here are the top 10 key takeaways from neuroscientist Camilla Nord's conversation with Dr. Rangan Chatterjee on why pleasure is vital for mental health and how small actions can transform our wellbeing.

1. Pleasure is central to mental health

The loss of pleasure, or anhedonia, is a core symptom of depression that's often overlooked. Dr. Nord explains that this symptom can be particularly disabling because it creates a negative cycle. When people stop experiencing pleasure from activities they once enjoyed, they become less motivated to engage in those activities, which further worsens their condition.

Dr. Nord emphasizes that experiencing pleasure is fundamental to maintaining good mental health. In her research, she found that pleasure can actually help counteract pain and improve overall wellbeing. This is why she begins her book on mental health with an exploration of pleasure and pain mechanisms in the brain.

2. Pain and depression share neural circuitry

There's a significant biological overlap between chronic pain and depression. Dr. Nord explains that experiencing chronic pain in the past makes a person more likely to develop depression in the future. Surprisingly, the reverse is also true—those who have experienced depression are more likely to develop chronic pain later on.

This relationship exists because the neural circuits supporting chronic pain overlap with those that become dysfunctional in depression. Both conditions affect how we perceive our internal world and form negative beliefs. Understanding this connection provides insights into how the brain and body interact to alter our experience of the world, either positively or negatively.

3. Laughter has measurable physiological benefits

Laughing with friends triggers the release of endogenous opioids in the brain, which act as natural painkillers. Dr. Nord references an experiment where people watching comedy videos with friends showed opioid release in brain scans. After this social laughter experience, participants were able to hold uncomfortable wall-sit positions for longer periods.

This demonstrates that pleasurable activities like laughter can have immediate physiological effects that help us overcome physical discomfort. Dr. Nord also mentions research showing that couples who laugh during arguments experience less physiological stress (lower cortisol levels) and report higher marital satisfaction.

4. Small, consistent actions can transform mental health

The conversation highlights how small, consistent actions can significantly impact mental health. Dr. Chatterjee shares a story about a depressed patient who began recovering after starting to play with a toy train set that had previously given him joy. By engaging in this simple pleasurable activity, the patient experienced improvements across multiple areas of his life.

Dr. Nord explains that this works because these small actions create a "positive prediction error" in the brain. When something is better than expected, the brain adjusts its model of the world to be more positive. Starting with small, achievable tasks also reduces the perceived "effort cost" that often prevents action when someone is depressed.

5. Dopamine functions as a learning signal

Dopamine is often misunderstood as simply a "pleasure chemical." Dr. Nord clarifies that dopamine actually functions more as a learning signal about unexpected rewards. She describes experiments with monkeys where dopamine neurons initially fired when juice was delivered, but later shifted to fire at the light that predicted the juice.

If the expected reward doesn't appear (like water instead of juice after the light), dopamine neurons decrease their activity. This "prediction error" mechanism helps the brain learn what to expect from the environment. It's not that dopamine causes pleasure directly, but rather that it helps us learn what is unexpectedly positive or negative.

6. Motivation involves a cost-benefit analysis in the brain

Motivation requires overcoming the energy cost associated with effort. Dr. Nord explains that our brain constantly weighs whether an action is worth the energy it will consume. Different people have varying sensitivities to effort costs and potential rewards, which affects their motivation levels.

Our motivation also fluctuates with our circadian rhythms and chronotype. Morning people show higher motivation early in the day, while night owls perform better later. Understanding these patterns can help us schedule demanding tasks when our motivation naturally peaks, rather than fighting against our biology.

7. Interception affects how we interpret bodily signals

Interception is our ability to sense and interpret internal bodily signals. Many mental health conditions feature disrupted interception, leading to misinterpretations of normal bodily sensations. For example, someone might interpret an increased heart rate as anxiety or illness rather than a natural response.

Activities like yoga, meditation, and exercise can improve interception by helping people recognize and interpret their bodily sensations more accurately. Dr. Nord shares how practicing hot yoga helped her overcome panic attacks by teaching her that similar physical sensations (rapid heart rate, sweating) could be experienced without fear.

8. The placebo effect is powerful and works through expectations

The placebo effect isn't just "all in your head"—it creates measurable physiological changes throughout the body, even in the spinal cord. Dr. Nord explains that our expectations powerfully shape our experience, including how we perceive pain, illness, and treatment effectiveness.

This principle extends to psychedelic therapy, where Dr. Nord notes that many participants can tell if they've received a psychedelic versus a placebo. However, in studies where participants only received placebos but were told they were taking psychedelics, over 50% reported psychedelic-like experiences. This demonstrates how powerfully our expectations can shape our experience.

9. Antidepressants work by changing perception, not just chemistry

The traditional view that antidepressants work by correcting a "chemical imbalance" (serotonin deficiency) is oversimplified. Dr. Nord explains that while SSRIs increase serotonin levels immediately, mood improvements take weeks. Research shows what happens first is a shift in how people interpret ambiguous information.

After taking antidepressants, people begin to interpret neutral or ambiguous situations more positively rather than defaulting to negative interpretations. This perceptual shift may be the key mechanism through which antidepressants help some people overcome depression. However, this also explains why they don't work for everyone—they're effective primarily for those whose depression is driven by negative perceptual biases.

10. There's no one-size-fits-all approach to mental health

A central theme throughout the conversation is that mental health treatments must be personalized. Dr. Nord emphasizes that what works miraculously for one person might do nothing for another. This is because depression and other mental health conditions can have different underlying causes for different people.

Rather than viewing treatments as universally effective or ineffective, we should recognize that various approaches—from medication to lifestyle changes—may work differently for each individual. The key is finding what works for you. Dr. Nord encourages people to stay hopeful, noting that while the perfect treatment might not yet exist for everyone, the rapid pace of research means new and more personalized approaches are constantly being developed.