Are Mental Illnesses Really Metabolic Disorders? | with Dr. Chris Palmer

have we been thinking about mental illness the wrong way all this time and is mental illness really just metabolic disorder to tackle this topic we are joined today by Dr Chris Palmer Dr Palmer is a board-certified psychiatrist and an assistant professor of Psychiatry at Harvard Medical School he is also the director of the Department of postgraduate and continuing education at McLean Hospital Dr Palmer recently published his book Brain energy which I really recommend checking out if you have the chance you can also learn more on his website for the book brainenergy.com both of which we will link to in the description below we will have links to this book as well as books that Dr Palmer mentions in this video in the description below alright so hello I'm joined today by Dr Chris Palmer I'm so excited to have you we actually learned about your work through our audience a lot of people were recommending that we get in touch with you and interview you on the channel because you're doing some really amazing and kind of groundbreaking work around treating mental illnesses like schizophrenia so welcome I'm so excited to have you thank you for having me on I'm excited to be here yeah so just kind of briefly talking about it you talk a lot about the shortcomings of how we currently treat mental health disorders namely the sole focus on symptom reduction and have introduced a new Theory to get more directly at what the underlying problems may be with mental illness and so your theory the brain energy Theory argues that mental disorders are really metabolic disorders of the brain and it has been so fascinating digging more into your research and I want to get into that but I suppose could you just kind of start off first by explaining to our audience what metabolism is and what metabolic disorders are so metabolism most people know that word and they think about it as burning calories and they think that it relates to how much we weigh and that that's really primarily what it is it's like some internal furnace we're burning calories and if you have a high metabolism you're going to be thin no matter how much you eat and if you have a low metabolism then you're going to be overweight no matter how little you eat and in reality metabolism is in fact burning calories and it absolutely plays a role in our weight but it is so so so much more than that it is actually fundamental to the definition of all living organisms and in a nutshell the easiest definition is that it's the process of taking food and oxygen and turning it into energy or building blocks that get used to build ourselves or maintain ourselves and it also involves the management of waste products so we take food and water and oxygen and turn it into energy or building blocks and then there's some waste products that need to be managed that is what metabolism is at its core okay and you mentioned a lot of when you talk about metabolism about mitochondria specifically and their function in that can you talk a little bit more about that exactly so when we ask the question like what causes a metabolic disorder or a problem I realized I didn't answer that part of your last question too so it gets really complicated and actually scientists can't universally agree on what that means and what I'm arguing in brain energy is that if we look at a lot of cutting edge research that has occurred over the last 20 years in particular in a wide range of Medical Specialties so this includes the metabolic fields of obesity or diabetes or cardiovascular disease but it also includes the Aging field researchers trying to figure out what causes humans to age prematurely but also the neurodegenerative field what causes disorders like Parkinson's disease or Alzheimer's disease even some cancers are related to all of this um you have to get really granular and specific about well what does it mean to have a metabolic disorder and that all all of that leads us to these tiny things in ourselves called mitochondria so mitochondria most people know as the PowerHouse of the cell and that means they take food and oxygen and they turn it into ATP which is the energy currency of the cell and that's probably what you learned in Biology class and that's probably what the teacher asked you on the test or quiz and yes those things are true but in fact again Cutting Edge research over the last 20 years completely upends this simplistic definition of mitochondria mitochondria do so much more than that and when when we do a deep dive into the science of mitochondria that is when we can start to connect the dots of the mental health field yeah so I mean you mentioned in your book and in other talks about all the different functions mitochondria have and a lot of them seem to be highly linked to things that have to do with mental illness so things like you've talked about regulation and production of neurotransmitters that are commonly come up with mental illness serotonin dopamine um can you talk a bit more about all those different kinds of functions that they play as well absolutely and this you know this is something that the journey I've been on for the last like seven years and as I uncovered more and more of this Cutting Edge science that is what blew me away because as a psychiatrist I've known like we in the mental health field are trying to understand what causes the neurotransmitter imbalances or what causes hormone imbalances what causes the brain inflammation and how does it exactly cause mental illness um but but but psychological and social factors play a role trauma stress substance abuse all of these things play a role in mental disorders and you know up until now our field hasn't been able to connect the dots and what I'm arguing is that mitochondria specifically connect all of those dots so you mentioned production and regulation of neurotransmitters they also play a key role in hormone production some really key hormones like cortisol estrogen testosterone they play a pivotal role in epigenetics which is the expression of genes from the nucleus so they send all of these signals to the nucleus that turns genes on or off they play a key role in calcium regulation which helps turn cells on and off they play a key role in inflammation turning inflammation both on and off fascinatingly they also play a key role in psychological and social stressors so when humans are stressed either physically or psychologically mitochondria actually play a role in our stress response they are controlling cortisol levels or at least playing a role in cortisol levels they're playing a role in the release of neurotransmitters they're playing a role in the inflammation that ensues and even the epigenetic changes that ensue and so when we take a comprehensive look at the function of mitochondria we can start to connect the dots of mental illness more importantly when we look at like well what would happen if a cell has dysfunctional or malfunctioning mitochondria we can actually start to make sense of how the brain might malfunction and how that might result in mental symptoms right that's really interesting so you mentioned environmental factors playing a role in terms of how this comes about but what sorts of things impair or impact mitochondrial function is it just these environmental factors or what else plays a role so definitely genetics and epigenetics play a role and you know that's important because we know that mental disorders can run in families people largely think of that as genetic and I actually think we have more than enough evidence to say that's not actually the right answer anymore um that the answer appears to be epigenetic mothers and fathers can transfer epigenetic signals to their children and that can be transferred to those children's children and um the reason that distinction is important it still says that mental disorders run in families but the reason that distinction is important is because epigenetics can be changed fairly easily sometimes with lifestyle strategies or lifestyle interventions whereas genetics are fixed and permanent and so genetics epigenetics can play a role diet plays a role exercise plays a role sleep plays a role light exposure getting some sunlight during the day avoiding light at night when we should be sleeping in a dark room that plays a role substance use plays a role and the key substances that we know are highly associated with mental illness directly impact mitochondrial function and Metabolism things like alcohol marijuana smoking cigarettes those things all play a direct role in mitochondrial function and that can start to help us connect the dots between how do those play a role in mental illness and in people with mental illness and uh I'll stop there I could probably go on forever but there are lots of exciting roles but the good news is that you kind of already know them this isn't new information this is about putting together a lot of stuff that we've known for a long time but now once and for all we can start to make sense of it and once we can make sense of it it leads to new treatment strategies and new Solutions I think that's something I find really exciting about this theory is that it's not just this New Concept it's really pulling together things that we already know like you said and kind of making sense of it so what does treating this through diet look like so there are lots of dietary strategies that can be used so I I look at diet in two different ways so one is looking at dietary patterns um or ingredients in our diet that are harmful and so we want to look at that and we want to remove that or change those behaviors or change those aspects of our diet but then there are also dietary strategies that can be really beneficial and helpful um so the dietary strategies that can be harmful highly processed foods are known to impair mitochondrial function they are highly associated with obesity and type 2 diabetes and if you don't know this are also highly associated with things like depression anxiety disorders and even Alzheimer's disease the type 2 diabetes or insulin resistance is really important so we we actually just got a very large um controlled trial over 24 years where researchers followed children from the ages of 0 to 24. and what they found was that the children had the highest levels of insulin resistance beginning age nine had a five-fold increased risk for having a psychosis at risk mental state by the time they turned 24 and what that means is that high levels of insulin resistance in childhood make it more likely that somebody might be diagnosed with bipolar disorder or schizophrenia that is directly impacted by diet and more importantly we can use dietary strategies to treat insulin resistance and with hope maybe reduce the risk of somebody ever having a first episode the so those are just a couple of the harmful things that diet can do the beneficial things that diet can do we can use some dietary strategies like intermittent fasting or the ketogenic diet to actually help improve mitochondrial function and improve metabolism overall now obviously for some people especially in the mental health community we need to walk the line in a careful balanced way we're not here to set off Eating Disorders we don't want people being underweight we don't want people obsessing about Foods in a maladaptive way but and I already can I already hear the people in the eating disorder Community yelling at me how dare you talk about intermittent fasting or a restrictive diet like ketogenic diet but I'm here to tell you if used in a safe and proper way they can be powerful metabolic treatments and mitochondrial treatments and they can help some people heal and recover from chronic disorders sometimes right so what exactly is happening in the brain when a person is on a ketogenic diet so the the quick answer that I'll give for the keto diet a lot of people know the keto diet is a weight loss diet some people think of it as a fad diet and some people think it's a dangerous diet it's all those and eating bacon and steak all day and no fruits and vegetables nothing else it's an awful toxic diet everybody's gonna have a heart attack unbeknownst to all those people the ketogenic diet is actually a 100 year old evidence-based treatment for epilepsy it can stop seizures even when medications fail to stop seizures the reason that is important to me as a psychiatrist is because we use epilepsy treatments in Psychiatry all the time in illnesses like bipolar disorder schizoaffective disorder and schizophrenia and um so the the names for if you for those of you who may not know you probably recognize some of these names Depakote Tegretol Lamictal Neurontin or Gabapentin Valium Klonopin Xanax Topamax or Topiramate all of those are seizure medicines most of them were actually developed for the treatment of seizures and yet you're probably familiar at least one or two of those names because either you've been on them or you know somebody who's been on them because we use them in tens of millions of people with mental disorders and so in that way using the ketogenic diet to treat mental disorders is nothing different we are using an evidence-based treatment for epilepsy to treat mental disorders and in fact we have Decades of Neuroscience research on this diet we know that it changes neurotransmitter systems decreases brain inflammation changes calcium channel regulation Central to my thesis it actually improves mitochondrial function improves mitochondrial biogenesis and those things can have powerful healing effects for people with mental disorders I believe so if some eugenic diet roughly how long can it take for a person to start seeing benefits to their Mental Health it's really fascinating because just like a medication the ketogenic diet doesn't work overnight so it's not like you do the keto diet and within two days poof all your hallucinations or delusions are gone um what I have seen I'll outline a typical trajectory if people start ketogenic so number one I just have to say this I have to back up and say if you have schizophrenia or know somebody with schizophrenia or schizoaffective disorder or bipolar disorder please do this with medical supervision this is a real medical treatment it's not something to Wing on your own it's not that the keto diet is dangerous but it's that the keto diet is powerful and when you pair a powerful intervention with what can sometimes be a dangerous brain disorder people can end up in trouble or with dangerous symptoms I just want people to get effective help so with that said the typical trajectory that I notice if I start somebody with schizophrenia on the ketogenic diet the first week is awful and it symptoms can actually get worse before they get better so this is the reason I backed up and said please do this with medical Zoo but I symptoms can get worse there's something called the keto flu or keto adaptation and I just want people to get through that safely um once they get through that adaptation usually within two to four weeks I begin to notice a pretty powerful antidepressant effect people start so with no Med changes at all people start noticing that they have more energy their mood is improving yes they're losing weight and some people just assume oh maybe they're feeling better because they're losing weight I actually think it's a brain effect it's the the diet is actually impacting brain function in the same way that it can stop seizures it's actually restoring brain function so this antidepressant effect starts first the antipsychotic effect can take anywhere from probably two to four months in real in reality so most of the people that I've worked with usually around that two to four month Mark and you have to stay on the diet consistently you can't be cheating every weekend or because that would be like taking a medication and stopping your medication every weekend that that's a recipe for disaster same deal with this diet that you have to be consistent with it you have to do it all the time but if you if you're consistent with it usually around that two to four month Mark people will spontaneously notice hallucinations start to go away or maybe they they just get quieter or maybe people can start to ignore them when they you know when before they couldn't ignore them they felt compelled to listen or even respond um and delusions start to go away I will say I usually notice that the hallucinations go first and then the delusions start to go away which is a pattern I've noticed for you know over 27 years in clinical practice even when medications work that's usually what I notice is that the hallucinations start to go away first and then the delusions just seem to have like a stickiness to them they they're harder to make go away I think if nothing else because people remember that you know people are out to get me that's a fact I know it and and it can be harder to start to challenge that or to forget about it or to to think maybe that's not true anymore right um but yeah it's so that usually I tell people when they try the diet let's give it at least three months before we make a decision about whether this is something that's going to work for you or not I want you to give it a fair chance that's helpful I actually I started learning about the ketogenic diet and I tried it back in 2020 the beginning of 2020 so interesting timing to try a new diet dawn of a global pandemic lots of different stressors but I stopped probably just before the three month mark because I didn't feel like it was having much of an effect and it became hard to stick to the diet with kids home 24 7 now and whatnot so but I'm definitely interested in trying it again and so knowing that that's the two to four month parameter is kind of something to be worried of is good to know so thank you um are there any other means such as supplements or anything like that Beyond diet that may be able to improve mitochondrial function as well because you know this is not an easy diet and it may not be possible for some people so is there anything else that can work to improve mitochondrial function so the good news is again so there are lots of Common Sense health and wellness strategies that you've all heard of that you're going to think well yeah we've all heard that but I'm also going to say this a lot of people with schizophrenia are not doing these things so let me be clear even though you're going to say this is nothing new if you're not doing it then it is something new so you got to start doing it good sleep that means regular bedtime regular wake-up time me light exposure good light in the morning avoiding light at night all of those things impact mitochondrial function and circadian rhythms stress reduction exercise improves mitochondrial function checking for any vitamin or nutrient deficiencies or hormonal imbalances is really critical because those can play a role and affect mitochondrial function um so all of those things can play a role the really to be honest with you that is the most exciting thing to me existing strategies that we have today and the reason it's exciting for me is because I am seeing dozens of patients recover from they are putting their symptoms of schizophrenia or bipolar disorder into remission and moving on with their lives and achieving things they thought were impossible and that's the most exciting thing to me but also exciting is that this research opens up entirely new areas for research Pursuit there are many supplements that researchers have been trying actually for decades because it's not that this is a new Theory researchers have known mitochondrial dysfunction is playing a role in mental illness and so that's that was the basis of all of the clinical trials of antioxidants for instance giving people with schizophrenia vitamin E we did lots of Trials on that in the hopes that the vitamin E would correct the mitochondrial dysfunction it doesn't and so giving somebody a simple supplement that is supposed to be a mitochondrial supplement is not effective and simply getting good sleep and not doing anything else probably won't put schizophrenia into remission it certainly won't hurt it'll help and we kind of already know that but I I believe that people need comprehensive strategies so you need to probably do more than one of these things you need to kind of give the person the maximum chances of recovery right I like taking that holistic approach Beyond just treating with medication and really looking at all the factors that impact how to achieve Wellness so what has it looked like as a clinical psychiatrist treating your patients mental illness by treating metabolic disease yeah I'm going to be honest with you when I first started this the first patient that I saw I was initially in disbelief I I actually the patient that I was treating um his father was very involved in his life and his care and I think fortunately for me this patient was also seeing a clinical psychologist for occasional therapy as well I actually had to go to both of them at different times and ask them are you seeing what I'm seeing because I'm because I I can't believe this is happening it he's only on a diet and his hallucinations are going away and he's he's like coming to life and I've never seen him this way have you like Dad have you seen like What's Happening Here the father and the psychologists were both equally in disbelief and yet saying no it's true it's we're seeing it too this is real what is this what is going on since then I have had patience who come from wealthy families for instance they have had access to the best care in the world they've seen numerous psychiatrists leading psychiatric professionals experts in the world they've flown all over the country for expert consultations they've tried dozens of medications they've been in and out of hospitals or private Residential Treatment programs and at the end of all of that they were told there's nothing more we can do for you you have a treatment resistant chronic persistent mental disorder and they and the families were told you you kind of need to change your expectations for life like it's okay that you don't work it's okay that you don't finish college it's probably not going to happen with the illness that you've got and then they come to me and within three months the illness is in remission I remember one such person so his parents are literally billionaires and he was almost in tears at one point saying for the first time I think maybe I can be normal and I remember just being like dumb struck by that statement like you're a billionaire then your biggest hope and dream was just to be normal and all the money that you have couldn't get you that and then I did oh my God how does that happen I it so there's a part of me that has so many stories like that where I almost want to like cry foreign because it's heartwarming it's amazing it seems like a miracle and quite honestly there's another part of me that is heartbroken because I know millions of people need this information and are not getting it millions of people I can empathize with what you're saying about um the things you're told in terms of well you need to reframe how you engage with your life and that sort of thing and I think that that's what a lot of people with mental illnesses like schizophrenia are often told and so I guess that just leads me to ask you know why isn't nutrition taken more seriously as a form of prescribed treatment why are we so focused collectively in the medical system on medication and these types of interventions as opposed to looking more holistically at things like Diet when they're clearly so effective I I think you know In fairness I think because you know although once you understand the science and once you understand the tool like ketogenic diet it's it's implementable it's understandable and actually it's not that in the grand scheme of life in the grand scheme of having a disabled life it's not that hard at all and yet it's not intuitive like if you ask somebody what's a healthy diet the overwhelming majority of human beings on the planet would not say the ketogenic diet so so it's it's a dietary treatment or a dietary strategy that's mimicking the fasting state so it's an unusual dietary strategy um and so in those ways it's not obvious it's not necessarily intuitive um and yet again I want to come back to yet this diet stops seizures and we use seizure treatments all the time so this is kind of a no-brainer the other reason I think a lot of people in them in the medical field mental health field are skeptical of this is because our field has gone through many phases where people have said schizophrenia is caused by a niacin deficiency that we have that phase in the 70s 80s and so let's put every person diagnosed with schizophrenia on niacin and that'll cure them all it didn't work we've gone through maybe B vitamins maybe lots of vitamins uh healthy fruits and vegetables Mediterranean diet get rid of gluten it's all gluten if gluten causes schizophrenia if we just get rid of gluten that'll solve a problem and there are these case reports out there there are rare people who will say niacin saved me nice and cured my schizophrenia or a gluten-free diet seemed to cure my schizophrenia or whatever so we have these rare cases but they don't work for the overwhelming majority of people so mental health professionals are appropriately skeptical and appropriately thinking is this just another one of those fads is this just another one of those things where some crazy person now it's Chris Palmer he's just got some Wackadoo idea about like oh this is gonna save everyone with mental illness and by no means do I think the ketogenic diet is going to save everyone I think the ketogenic diet is one of Many metabolic interventions and that is the reason you know I was mindful of that from day one like nobody's gonna believe this I need to understand the detailed science I need to make sense of this and through that process I developed this larger theory that goes far beyond diet that goes to again what seems like Common Sense holistic things like stay away from the marijuana stay away from the alcohol they're not good for your brain they're not good for your mitochondria they can trigger psychotic symptoms smoking smoking cigarettes is awful for mitochondria and yet the majority of people with schizophrenia are smoking so there are lots of things that are happening to people with mental health conditions like schizophrenia that I think if people really fully understand the big picture and the science it's going to open our eyes and we're going to realize oh my gosh we've got we got a lot of changes to make we've really got a lot of work to do here And yet when I say that like let's get off the cigarettes the cigarettes might be harming your brain everybody's kind of like well yeah I guess that kind of makes sense it's pretty obvious actually now that you say it and and yet we're not insisting that people with schizophrenia stop those cigarettes we're not insisting we're not letting them know the magnitude of the damage they are doing and so you know we think well you know if I was disabled what what's the harm I mean they're disabled anyway they're suffering they're tormented who cares let them smoke um and what I'm saying is no let's not take that approach let's take a comprehensive holistic scientific approach Let's help them fully recover so we're not just gonna take away the good quote-unquote addictive or good thing for them we're not just going to take away their cigarettes and leave them to be miserable um we're gonna help them heal so that they can thrive in life on you I really appreciate that approach and thank you so so much for taking the time to sit down with us and talk about all this it's been really really interesting thank you very much thank you for having me on so thank you so much again Dr Palmer for joining us in today's interview I know I learned a lot and I hope that you as the audience did as well make sure to check out the links in the description below to Dr Palmer's book his website and any books that he mentioned as well thank you so much everyone for watching and as always wishing you and your loved ones good health we'll see in the next video bye

Channel: Living Well with Schizophrenia

Views: 40,478

Keywords: schizophrenia, schizoaffective, schizoaffective disorder, mental health, mental illness, metabolic disorder, metabolism, metabolic health, brain energy, chris palmer, dr. chris palmer, brain energy theory, keto, ketogenic diet

Id: AOwa7w3RpE8

Length: 35min 17sec (2117 seconds)

Published: Mon Feb 20 2023