Are You Getting Your Daily DOSE? A Physician's Guide to Neurochemical Balance

As physicians, we understand the science of neurotransmitters perfectly well in theory. We can recite their pathways, functions, and pharmaceutical interactions with ease. Yet somehow, we fail to apply this knowledge to our own lives in meaningful ways.

I've been thinking a lot about DOSE recently – the acronym for Dopamine, Oxytocin, Serotonin, and Epinephrine – and how these essential neurochemicals shape our daily experiences, behaviors, and overall well-being. More importantly, I've been reflecting on how we as physicians, particularly women physicians, often seek these chemicals in ways that don't serve our health or happiness.

The Dopamine Dilemma

Dopamine is the pleasure and reward neurotransmitter that evolved to reinforce behaviors essential for our survival. Finding food, reproducing – these activities trigger dopamine release to ensure we continue these species-preserving behaviors.

But in our modern world, we've engineered dopamine triggers that hijack this natural system.

What we see in our physician community (and ourselves):

• Reaching for sugar-laden coffee drinks between difficult patients
• Scrolling social media during brief moments of downtime
• That glass (or two) of wine that feels "deserved" after a grueling day
• Constant people-pleasing and inability to say no, seeking the approval dopamine hit

These dopamine sources aren't inherently "wrong" – our brains are working exactly as designed. But when these become our primary coping mechanisms, we create cycles that don't align with our deeper goals and values.

Questions to consider:

• Where are you currently getting your dopamine hits throughout the day?
• Do these sources align with your health goals and the person you want to be?
• What small pleasures could you intentionally incorporate throughout your day rather than saving all your reward-seeking for the end when you're depleted?

The Oxytocin Opportunity

Oxytocin, often called the "love hormone," drives human connection. It's what bonds parent to child, partner to partner, and friend to friend.

Yet as physicians, our connections are often hurried, clinical, and insufficient. We have brief, task-oriented interactions with patients. We text family between appointments. We miss social events due to on-call schedules.

Consider this: When was the last time you experienced deep, meaningful connection – the kind that makes you feel truly seen and valued?

Simple ways to boost oxytocin include:

• Longer, intentional hugs (10-20 seconds) with loved ones
• Making eye contact during conversations
• Physical touch (appropriate and consensual, of course)
• Quality time with friends where phones are put away
• Meaningful patient interactions where you can be fully present

The Serotonin Solution

Serotonin regulates mood and feelings of well-being. It's no coincidence that many physicians end up on SSRIs at some point in their careers.

What's fascinating is how much our lifestyle affects serotonin production. Much of our serotonin is produced in the gut, influenced by our microbiome, which in turn is affected by diet, stress, and sleep patterns.

As physicians, we routinely ignore our basic physical needs:

• Delaying bathroom breaks
• Eating processed foods grabbed on the go
• Working through the day in windowless rooms without natural light
• Sacrificing sleep to finish charting

What if, instead of treating the serotonin deficiency after it develops, we proactively created conditions for optimal serotonin production?

The Epinephrine Equation

While we often think of epinephrine in terms of fight-or-flight stress responses, it's also about energy and excitement. The problem? Many of us are channeling this through less-than-optimal sources.

We over-rely on caffeine, thrive on deadline pressure, and jump from one emergency to the next. Our bodies become accustomed to this high-alert state, making it difficult to downshift.

Healthier sources of that "good energy" include:

• Regular exercise
• Healthy intimacy
• Novel experiences and adventures
• Challenging yourself in non-work domains
• Cold exposure (if you're braver than me – I have Raynaud's and will pass on the cold plunges!)

A Personal Note on Making Changes

Recently, I made the decision to abstain from alcohol in 2025. Not because I had a problematic relationship with it by any conventional measure – I never drank daily or excessively – but because I didn't like how much I wanted it sometimes.

This illustrates an important point: We don't have to wait until something becomes a clinical problem before we decide to make a change. We can notice our patterns, reflect on whether they're serving us, and choose differently.

Your DOSE Reflection Exercise

I invite you to take five minutes right now to reflect on your current DOSE patterns:

1. Dopamine: Where are you seeking pleasure and reward? Are these sources sustainable and aligned with your values?
2. Oxytocin: How are you meeting your need for meaningful connection? What relationships need more intentional attention?
3. Serotonin: Are you honoring your basic physical needs for sleep, nutrition, movement, and sunlight?
4. Epinephrine: How are you channeling your energy and excitement? What healthy challenges could replace unhealthy ones?

Remember, as physicians we've been trained to ignore our basic needs in service of others. But this approach isn't sustainable. By understanding and intentionally managing your DOSE, you can create a foundation for wellbeing that makes you not only a happier person but also a better physician.

I'd love to hear your reflections. What did you discover about your current DOSE patterns? What small change are you planning to implement? Leave a comment below or email me at [email protected].

Dr. Megan Melo is a physician and certified coach who helps women physicians end overwhelm and build sustainable careers and lives. She hosts the podcast "Ending Physician Overwhelm" and works with clients who are ready to prioritize their wellbeing without sacrificing excellent patient care.