Worried about slipping into the winter blues? A “dopamine menu” could help.

Popularized on social media, a dopamine menu is a list of positive activities that people can do to feel better during a tough period, family physician Dr. Mike Sevilla told CBS News. 

“People normally go to social media to get their dopamine hit, which is basically making them feel better, but usually after something like that they don’t feel as good,” he said. 

Dopamine, a neurotransmitter in the brain, plays a crucial role in mood and motivation. Dopamine menus may be particularly helpful for neurodivergent people, as well as for combatting seasonal slumps, explains Michelle Hunt, a psychotherapist at Empower Your Mind Therapy.

“Neurodivergent individuals tend to have reduced (or) limited dopamine, which impacts every function in the body,” Hunt said, but she adds that anyone can benefit from trying out the method. “Understanding and addressing dopamine levels can significantly enhance an individual’s ability to cope with the ups and downs of seasonal changes.”

While anyone can use this technique any time of year, Sevilla says it can be especially helpful as days get shorter, darker and colder. 

“That’s usually when people isolate themselves, they get more depressed, and they tend to go to these unhealthy behaviors like social media,” he said. “Especially as we’re getting into the winter months, it’s really great to for people to be prepared. A dopamine menu is a lot about just being prepared.”

Dopamine menu ideas

So, what should go on your dopamine menu? Anything that brings you joy — with bonus points for something active, Sevilla said.

“Physical activity does give you a dopamine hit, so you would physically feel better, but it also is better for your well-being,” he said, suggesting simple activities like walking your pet. “Not only is it very functional, it also is good for you.”

Other ideas include: 

• Fall or winter baking
• Grabbing a coffee (or having a call) with a friend
• Going on a fall foliage walk
• Cleaning up your home while listening to music
• Reading a book

“It doesn’t have to be a big event (or) be an all-day thing,” he said. “Maybe it’s an hour or two, and that can be enough of a dopamine hit to to get you feeling better and to get you making better choices.”

Dopamine menu template

Hunt likes to break down dopamine menus into different categories, which can be tailored to a person’s needs in different moments. 

Appetizers — These include limited-effort activities with immediate reward, she explained. For example:

• Watch a funny short video 
• Wash your face or some other form of self-care
• Run up and down the stairs or stretch for a couple of minutes

Entrees — These are still accessible, but with a bit more effort.

• Have dinner with someone you are close to
• Clean a room of your home or complete a task
• Play a board game 

Sides — These are supportive activities that complement more challenging tasks. 

• Call someone to catch up
• Listen to an audiobook or podcast
• Take a bath

Desserts — These are activities that can be indulged in periodically, but which should be kept limited. 

• Play a game on your phone
• Take a nap
• Order takeout
• Purchase something you want

Specials — These are more of an effort (and expense) but can be enjoyed periodically when accessible.

• Plan a trip
• Explore a new restaurant or event

As you discover what works for you, Hunt suggests keeping all your senses in mind.

“For the dopamine menu, it is recommended to use tailored sensory input to shock the body into being more present by increasing dopamine. If watching a video isn’t helpful, maybe something with smell or texture may be more appropriate,” Hunt said. 

Slickly designed websites. Unbelievable markdowns. A simple online search for semaglutide, the active ingredient in Ozempic or Wegovy, can lead consumers down a rabbit hole of seemingly reputable online pharmacies in search of weight loss drugs at a discounted price. The temptation is clear for many Americans, but some of those deals come with a potentially deadly cost.

U.S. consumers pay higher prices for weight loss drugs than any other country in the world, according to a 2023 KFF study. Cheaper alternatives online, however, are not always what they seem.

“People are really taking a risk by ordering these products online and not knowing the supplier that’s sending it to them,” said Salvatore Ingrassia, port director for Customs and Border Protection at New York’s JFK Airport.

CBP agents are on the front lines, intercepting counterfeit prescription drugs, which pour into the country. These include knockoffs of popular weight loss drugs.

Customs officials allowed CBS News a rare look into their operations, showcasing seized misbranded or counterfeit medications. Over two days, agents confiscated products from countries including Israel and Bangladesh. One shipment of suspected counterfeit Wegovy was hidden inside a Mickey Mouse puzzle for children.

While these counterfeit drugs may look legitimate, they often contain dangerous substances.

 “We’ve found things like antifreeze and incorrect amounts of active ingredients in these products,” said Ingrassia.

In September, customs agents in Cincinnati’s port inspected 63 shipments containing apparently counterfeit and unapproved medications. That included several boxes containing counterfeit Ozempic, Wegovy and Trulicity injections. Other medications, including Botox and minoxidil, used for hair growth, were also seized by the authorities.

The FDA is taking action

The Food and Drug Administration has issued warnings to multiple online pharmacies selling suspected counterfeit products. The letters demand the sites stop selling the products that are in violation of FDA’s standards or face legal action. Despite their efforts, a quick internet search by CBS News in September 2024 found these websites remain active or redirect users to other sites offering these questionable drugs. 

The Food and Drug Administration told CBS News it cannot comment on enforcement actions. 

The health concerns of counterfeits

The dangers to health are real. Novo Nordisk reported one counterfeit pen contained the diabetes medicine insulin. The user was hospitalized after administering the counterfeit pen.

Authorities have arrested individuals involved in selling counterfeit drugs, including a Long Island woman suspected of selling misbranded Ozempic online. The woman pleaded not guilty to the charges and is out on bond. Court documents show that one victim reported lesions and infections after using the medication.

Former FDA director of investigations in the Chicago area, Ricki Chase, an expert in tracking counterfeit products, warns consumers to stay vigilant.

“If you’re buying a drug legitimately priced at thousands of dollars for just $65, you should be asking questions,” she said.

What can consumers do?

Chase advises consumers to only buy these drugs with a prescription from well-known pharmacies. Real weight-loss medication pens should have unique identification codes and proper labeling.

If the label smears or appears misaligned, it’s likely counterfeit. Uneven glue seams, lot numbers with crooked print, and cheap looking colors are also signs the products could be counterfeit, according to Chase.

Ultimately, she believes the best defense is using sound judgment.

“Don’t risk your health trying to get healthy,” she said.

Novo Nordisk, the maker of Ozempic, Rybelsus and Wegovy, said in a statement to CBS News: “It’s important that patients are aware that Novo Nordisk is the only company in the U.S. with FDA-approved medicines containing the main ingredient semaglutide. FDA has not approved any generic versions of semaglutide.”

Eli Lilly, makers of Mounjaro and Zepbound, also used for weight loss, told CBS News: “Lilly has taken steps to help inform people about the risks posed by counterfeit, fake, and unsafe or untested products, creating lilly.com/real-medicine which includes a tool to help determine whether you have genuine Lilly product. “

The National Association of Boards of Pharmacy has sent up a Safe Site Search Tool which allows users to verify if a website selling medications has been vetted. You can also review a list of the current websites that have been accredited by the NABP here.