"Mental Health Experts Were Wrong!" - Scary Link Between Lifestyle & Mental Illness | Chris Palmer

I wanted to start by asking you about this mental health epidemic clearly rates of all kinds of mental health dysfunction mental health disease are going up but in your view where do you think we're going wrong I think the primary place we're going wrong is that right now the mental health field is still struggling to understand what exactly causes mental illness and without knowing precisely what causes it we have a lot of treatments but our treatments for the most part are symptomatic treatments meaning that they can reduce symptoms of the illness so an anti-depressant can improve symptoms of depression but we're not really curing depression with our treatment we're not always putting it fully into remission and people end up often times with chronic illnesses with chronic depression that waxes and waines it comes and goes sometimes it gets better with an anti-depressant and maybe somebody could be better for 2 years but then the depression comes back and then we have to increase the dose or change the medication and and people often have lowgrade symptoms of depression even when they're doing relatively well with an antidepressant it's not fully getting rid of all of the symptoms and I think that is probably one of the biggest places that we go wrong you've been practicing for 27 years paint a picture for us as how you were practicing 27 years ago 25 years ago 20 years ago compared to how you practice today you know what happened to shift your perspective so when I first began my career when I was you know in my fourth year of residency I was the chief resident of psycho pharmacology and what that me meant was that I did consultations on treatment resistant patients so people who had schizophrenia bipolar disorder chronic unrelenting depression personality disorders you name it but they were chronically ill they had been in and out of hospitals they had tried numerous medications and my role was to oversee a team of consultants and we would try to come up with what are the next rational medications to try um in order to try to get people better and at that point I was persuaded by the field that if we can just find the right pill we can get people better and we can get them all the way better maybe put their illnesses into remission change their lives improve their lives reduce their suffering that was the goal our goal was to help people and the the tool that we had was find the right pill and I went along that way for a few years hoping that if I could find the right pill maybe augment it with the right Psychotherapy maybe sometimes augment it with electrom therapy or transcranial magnetic stimulation well TMS actually didn't exist back then but ECT did and we were certainly using it then um so maybe if we augment in rare cases but if we can just find the right pill that was really the goal if we can just find the right pill we can get people better and after several years of that I quickly began to become discouraged and demoralized that for 95 plus perc of the patients that I was seeing we weren't finding the right pills we would find the right pill that might work for three months or a year sometimes even two or three years even in the highly functioning people that I was treating the business Executives and others I could get them better for a couple of years but then something would happen and the pill would stop working or the pills would stop working and we were right back where we started and people were in and out of hospitals their lives were sometimes devastated I mean they were taking their pills religiously and they would have horrible depressive episodes or manic episodes or psychotic episodes that were ruining their lives even though they were compliant with treatment it would disrupt everything they had to take time off from work sometimes they got fired from jobs some of them lost relationships divorces were happening boyfriends and girlfriends were breaking up with people over these episodes and I was I was frustrated and demoralized like why aren't we finding the right pills for all these people and I quickly began to realize I don't think that's going to be the answer yeah it's interesting that if you go back to root cause thinking you know you and me are both very passionate about trying to get to the root cause of our patients problems but often when we're thinking about a problem and we're not sure we've got the right solution I always think well what's the belief I need to hold in order for me to think the way that I'm currently thinking and then if I apply that through the lens of what you've just said it's the belief is that this patient has depression it's a thing that they've got and that the only way to manage this is by finding the right pills and if this pill is not working it simply means I haven't got the right pill yet or the right combination of pills but if you go back Upstream ago well hold on a minute what if the depression is a symptom of something else right what if pills are just one way to tackle the symptoms what if there were other ways to tackle these symptoms because we don't get taught that in medical school really do we we don't get taught that the model to me at least and in primary care we see a ton of mental health problems right but the model usually is some combination of medications and Psychotherapy it is and I think the medication piece many many mental health professionals will defend it as a root cause issue and in their mind the root cause of mental illness is a chemical imbalance in the brain it is a neurotransmitter imbalance and some people have a serotonin imbalance and so they do well with serotonergic medications like proac or Paxil or others and other people might have a neurotransmitter imbalance related to neopine phrine or dopamine and so they may do better with other types of anti-depressants or stimulant medications people with psychotic disorders like schizophrenia and bipolar disorder their problem is too much dopamine and so we need to block the dopamine receptors in their brain and that will bring about an anticho effect so I think many of the mental health professionals in their minds they think they are after the root cause um it's a chemical imbalance and we just need to figure out which chemicals in which patients and if we can just re balance our chemicals appropriately and that means get finding the right medication or combination of medications at the right doses in the right timing maybe sometimes at night sometimes in the morning maybe three times a day if we can just find that perfect combination we can balance their chemicals appropriately and they will be in remission and they will live happily ever after and the reality is that's all hogwash none of that's true many people who are listening right now or watching this have heard that depression for example is down to a chemical imbalance so I need to correct that chemical imbalance and if I can correct it I will no longer have depression you're saying that's hogwash yeah help us understand that so the anti-depressants do relieve suffering and do improve symptoms in some people but I actually don't think they're working in the ways that many people think they're working it's much more complicated than most people think so many psychiatrists even to this day will think that chemical imbalance is occurring in the brain so there's a neurop nephrine imbalance or a serotonin imbalance somewhere in the brain and this pill is going to correct that imbalance in those brain cells and that'll restore normal Health that's not at all the way the pills work so for serotonin for instance 90 to 95% of the serotonin in the human body is actually produced in the digestive tract not in the brain and then that leads to this whole exploding area of research the gut brain connection the gut microbiome what influence is it having on our brains and the more research that we're getting the more we're uncovering that whoa this is a huge field the gut actually plays a huge role in brain function and brain health and so we need a more comprehensive holistic way of understanding what is proac or Zoloft doing there's a high likelihood that in fact it's probably affecting the function of the gut and that that is somehow getting transmitted to the brain and affecting how the brain functions um the research that I've been doing over the last seven years strongly suggests something much broader than that and that is that although we are focused on individual neurotransmitters or sometimes we're F focused on hormones you know mental illness is due to stress and that's about cortisol it's cortisol mental illness is a cortisol problem and we actually have a fair amount of evidence that people with chronic mental disorders do have cortisol disregulation but it gets tricky really fast some people have too much cortisol other people have too little cortisol um so we know cortisol disregulation might be playing a role for some people but how does that work right now our field is just essentially shooting in the dark trying to understand it all yeah it's so interesting it's not one of the problems that we're looking for one cause and one solution right yes it's a serotonin imbalance right that's what causes depression so I can give you something to correct that boom but in many ways that's because of the scientific method by its very nature is reductionist right A lot of the time we have to narrow things WR down to study one thing and and try and go you know can this explain it or not but maybe it's multiple different inputs and in different patients those inputs are in differing amounts right so the way I approach pretty much all chronic health problems is the patient comes in of course I listen to the symptoms and my head I'm trying to put together what are they saying I'm Al always thinking what really is driving this how has this come about didn't just happen overnight what what are the inputs into this person's life over a number of years that means today they've come in complaining of these symptoms and in my head there's seven or eight core things I look at Food exercise sleep stress and you know that stress could be physical stress or emotional stress or trauma I look at things like how much time are they're spending outside what is their vitamin D level like I think about environmental toxins I think about chronic infections that they may have had and may still be underlying some sort of immune system dysfunction and I'm always thinking about are any of these relevant here and if so can I manipulate them can I help a patient impact them and I personally have been using that approach very successfully whether it be with someone with a mental health problem or or with an autoimmune disease or with type 2 diabetes it's what is the root cause and I I kind of feel there are there are certain insults that the body can get right there there's kind of there's not that many of course there's infinite amount of toxins that we could talk about but they all come under these broad categories and then with those insults the body depending on your genetic susceptibility depending on your individuality with those same inputs you might get type two diabetes with those same inputs someone else might get depression with those same inputs someone else might be diagnosed with you know an autoimmune disease I don't think these things are quite as separate as they've been made out you know we get Ted about these ICD 10 codes oh you've got depression you've got tyto diabetes uh you've got heart disease as if these things are completely separate and I think we're learning more and more that you know beyond Mental Health and I know your focus is primarily on mental health issues but you can expand your theory which I want you to outline very shortly I think you can expand it Beyond mental health it can also cover typ to diabetes obesity and even Alzheimer's I would say absolutely and it's interesting because I came to the exact conclusion that you just outlined but I came to it as an academic psychiatrist trying to understand what on Earth causes schizophrenia what causes bipolar disorder how can we understand chronic unrelenting depression how do these things fit together what is happening in the cells of the brain what are all of the clues that we have and how can I put them together to understand the larger picture and in the exactly the way you just described that the same insults might lead to depression in one person and type 2 diabetes in another for those who don't know this mental illness is completely in meshed with other chronic metabolic disorders so people with mental disorders on average are much more likely to develop obesity type 2 diabetes cardiovascular disease Alzheimer's disease and other types of disorders like that on average people with mental disorders die early deaths men lose about 10 years of life women lose about 7 years of life and this is for all diagnostic categories this is for ADHD and simple anxiety disorders and depression the people with the serious mental disorders like bipolar disorder and schizophrenia depending on what study you look at they're losing usually anywhere from 10 to 25 years of life on average and so it is all connected but I came at it as an academic psychiat Interest really focus on the brain but trying to look at the bigger picture wait there's a gut brain connection what exactly is the gut doing to brain function what is happening in cells and at the end of the day I was led to these tiny things in ourselves called mitochondria and it turns out we have a tremendous amount of Science and evidence um to to support that potentially metabolic disregulation or mitochondrial dysfunction there are lots of terms we could use and they're they mean slightly different things so I don't mean to try to make this simple but if we understand metabolic dysfunction that actually helps us understand why the brains of people with mental illness are malfunctioning and causing symptoms of chronic mental illness and then I tried to explore well what on Earth would cause that and I was led to everything you just listed yeah there's just so much I want to unpack with you I genuinely want this episode to be really practically useful for people because of how many people are suffering at the moment with their health Beyond mental health right couple of things I just want to clarify there you just mentioned that um people suffering with mental illness are more likely significantly to develop a whole host of other conditions like type 2 diabetes and obesity do we know which way that relationship goes and what I mean by that is do we know if people who have obesity or are you know carrying too much weight for example are they more likely to develop mental health problems as well uh so that's the first thing I just want to clarify yes it they are all strong bir directional relationships so people with diabetes are more likely to develop mental disorders a wide array of them we best studied are depression and anxiety disorders people with diabetes on average about twice as likely to develop depression but when they get it it lasts four times longer people with cardiovascular disease heart attacks Strokes much much more likely to develop depression anxiety symptoms three to five times more likely in many series uh people with obesity research paper just came out I think two weeks ago um people with obesity more likely to develop a wide range of mental disorders anywhere from 50% more likely up to 3 over 300% more likely ranging from psychotic disorders to depression and anxiety to ADHD to nicotine dependence M if you're obese you're more likely to become depend depending on nicotine meaning you're more likely to become a smoker or a vapor yeah I mean it's fascinating and I guess many people will jump to the conclusion I imagine when you talk about the relationship between people with obesity being more likely to develop depression and anxiety I guess some people will go yeah I get that that's to do with stress right they maybe have been fat shamed they're living in a society whereby being overweight can be looked down upon people can say nasty things at school as an adult you may be discriminated against so people may go that's a psychological issue right that's why they're also developing depression and anxiety but your central thesis to me at least is that all mental disorders are metabolic disorders of the brain yes right I'm just going to repeat that all mental disorders are metabolic disorders of the brain now we have covered metabolic dysfunction before on this podcast right but usually we talk about it in relation to obesity or type 2 diabetes but you're saying something that to many people is going to be hugely provocative that actually mental disorders are metabolic disorders of the brain so Dr Palmer what do you mean by that so there's a lot to unpack and maybe the first place to start is defining what is a mental disorder because right now DSM does you know the way we usually think about mental illness is the diagnostic in statistical manual or the ICD codes we've got these labels things like depression anxiety schizophrenia anorexia alcoholism or alcohol use disorder is the official name most people know what those things mean and when I say them most people have a clear picture of what I'm talking about depression yeah we kind of know what that is anxiety we kind of know what that is um but in fact DSM doesn't always distinguish between trauma reactions or normal reactions to adversity and brain disorders so let me give you a clear example so if a man was married and had two kids whom he loved dearly and his wife and children were killed tragically in a auto accident he would become depressed potentially even suicidally depressed he may feel like my life is over I I have no reason to live I want to join them I'm I'm I'm a man of faith I know that they're in heaven and I I'm ready to join them in heaven I can't I can't bear to live without [Music] them I don't consider that a brain disorder in fact I would say if that man did not become depressed he probably does have a brain disorder it would be highly unusual for him to not become severely depressed not necessarily suicidal how long does that man get to be depressed before DSM says he has a brain disorder he's got 13 days he gets 13 days to get over it so on day 14 if he is still struggling and still feels low and doesn't feel that life is worth living he he now has major depressive disorder so that would be reasonable from the profession to diagn knows him with major depressive disorder 14 days after his family and wife have died yes and that means maybe he's got a serotonin imbalance now and maybe he would benefit from some Prozac maybe Psychotherapy maybe some grief therapy any Common Sense mental health clinician should know that and most do most would give him grief therapy but according to DSM he now has a brain disorder and his brain disorder does not get distinguished from somebody else who has had chronic unrelenting suicidal depression for 20 years who says I don't know why I'm depressed that man at day 14 get lumps gets lumped into the same category as somebody else who I think does have a brain disorder if you're suffering from chronic unrelenting depression for 20 years and I ask this person why are you depressed and they say I have no idea I don't know what's wrong with me I just cannot snap out of it on on the surface I know I have a decent life but I am miserable I just I'm never happy I'm always so pessimistic I think maybe I'd rather be dead I think that person has a brain disorder but DSM doesn't distinguish those categories so if we go back to your theory that all mental disorders are metabolic disorders of course um making sure we're making the correct diagnosis of a mental disorder is of course very very important so using that example the the gentleman who's lost his family in a car accident who I think all of us would say rightfully you know feels sad depressed maybe suicidal you're not saying that's a metabolic disorder no I'm saying that is a normal human being that's a exactly he doesn't have a disorder that's what we would consider a normal response to a very very tragic unfortunate situation yes just like a child being bullied and teased relentlessly on the playground is going to be anxious but what if that person just to sort of you know follow this example through right so that man 14 days after could be diagnosed with major depressive disorder if they went to see a psychiatrist and they would be entitled to make that diagnosis based upon the current um guidelines yes but let's say they didn't make that diagnosis they thought okay listen I don't need to put a label on this guy he's really struggling at the moment you know you keep coming to see me we'll get him some counseling we'll try and give him some support and what if six months later he's still struggling right 6 months later he can't get out of bed he feels um indifferent about life he has got no motivation to go to work he can't gain pleasure in that weekend game of football that he used to play with his mates every week and have fun right at some point presumably things change in his body from that severe stressor that may put him into the category of having a brain problem or a brain energy malfunction yes you know we all have normal reactions to adversity in that example that we just discussed and there is a period of time over which most people will move on it doesn't mean most people will forget I don't mean to be cold and heartless this man is going to grieve the loss of his wife and children for years to come if not the rest of his life but he should be able to go on with life he should be able to begin to function again it doesn't mean he has to go out and get remarried or start a new family or anything else but he should be able as you said to get himself to work to be able to not think about the Deep pain and grief that he went through for at least periods of time during the day where he should be able to be productive in some way he's got to start moving on and the reality is that is normal too the major majority of human beings do move on from tragedy they they figure out a new life they figure out a new way maybe even to respect and honor their loved ones recognizing my loved ones would not want me to be essentially dead now they would want me to go on they would want me to continue doing my career because that has more impact on the world and so there are lots of ways to manage grief and get over I don't mean to be cold and heartless about this but at some point if he is unable to cope then we do classify that as a brain disorder and I believe it is a brain disorder his brain is not adapting his brain is not yeah coping with the adversity and moving on and and becoming adaptive to a new life and and when we look at that when we look at all of the biological research that we have done over many decades now it's not that we don't know a lot in the mental health field in the Neuroscience field we do know a lot and when we look at that and this is about all the brain scans that we've done on these patients about biomarkers that 've been measuring we look at that the central problem is that parts of his brain are metabolically compromised that the initial trauma or stress of losing your family actually takes a huge metabolic toll on people and I'm not saying that that is a quote unquote disorder but it is a major stressor to the system and that stressor can push some people over the edge into what we would later Define as a disorder um and most people however are resilient and most people can get through that stressor and move on and recover so but it's really about allowing an appropriate amount of time it's allowing recovery sometimes supporting and facilitating recovery so I don't at all mean to say this man doesn't need treatment or doesn't deserve treatment he certainly deserves talk therapy but he might start needing nutritional advice he may let his nutrition slip he might need substance abuse advice because he may start drinking himself to sleep every night yeah to deal with the loss and cope coping and now he's got an alcohol use disorder and now he may need treatment to get off the alcohol or to be able to sleep and and and get back to normal so we can help him restore his health um but to come back to your earlier question mental disorders or metabolic disorders of the brain what I'm arguing is that decades and Decades of research all point in the same direction and that you know if you ask these fundamental questions like well if there is even a neurotransmitter imbalance what could possibly cause it I mentioned cortisol disregulation if there are problems with cortisol too much too little what would cause that M women know this well women's hormones estrogen progesterone can have profound impacts on mood for some women that can happen around the time of menstrual periods it can happen around the time of pregnancy and postpartum and it can also happen around the time of menopause fluctuations in these hormones can cause depression anxiety it can cause OCD it can cause psychosis it can cause bipolar symptoms so all of these mental symptoms can be exacerbated by all of these different things and when we look at that research and try to put it together in one coherent way the easiest way way the easiest nutshell to explain it is that they all involve metabolism in brain cells and there is somehow metabolic compromise in those brain cells information is not enough to make change in your life you have to take action so to help you take action after watching this video I've created a free nutrition guide for you this contains the five most important practices I've seen in over two decades of seeing patients they work for you no matter what your dietry preference there's a step-by-step action plan to help you implement those changes in your life if you want to receive that free guide right now just click on the link in the description box below what does that mean right metabolic compromise in brain cells right A lot of people understand metabolism to be something to do with energy how we generate energy and your book is called brain energy right and so you know really in layman's terms what do you mean when you talk about this problem with metabolism in brain cells because I actually love your theory I actually think it does pull everything together really really beautifully and I really want people to get this and understand it because we're going to get to all these kind of um treatments all these things all these changes that we can make in our lives with or without doctors that can make a huge difference and actually the science can be quite complicated if we go into all the different Pathways but a lot of the actual practical applications are not that complicated which is what I love about it so yeah let's just really get clear what do you mean when there's this kind of metabolic compromise in a brain cell so most people think of metabolism as burning calories in the way you said and they think about it as it relates to obesity and maybe type 2 diabetes Maybe cardiovascular disease um but that's where metabolism begins and ends for most people it's about weight and if you have a slow metabolism you're probably way too much and if you have a rapid metabolism you're probably thin so number one it turns out that that's not always true um but much more importantly metabolism is so much more than that so in a in a basic sense a basic definition is metabolism is you know it's Universal to what we call living organisms so this goes from single cell bacteria or Yeast all the way up to humans and it's the process that living organisms use to take food and maybe oxygen and some other things and turn it into energy or building blocks that we use to make new cells or maintain our cells so we eat food we are our cells break down that food and either turn it into a cell membrane or a protein or some or or a neurotransmitter or a hormone that gets released so some of the food that we eat gets turned into physical things us what we are but the bulk of the food that we eat actually gets turned into energy and that is in the form of something called ATP and energy is what makes us work that what makes it's actually what makes life because as soon as there's no energy even if we still have the structure of cells even if we still have our DNA if there's no energy that is the definition of death yeah is when we stop making energy and so this process of metabolism building blocks and energy for the affect so many things and in the mental health field it's really important to break it down in it's kind of simplistic way so one thing starting from birth or starting even before birth metabolism is influencing cell development the development of our brains and our nervous systems metabolism is also influencing the structure and function of those cells cells and Metabolism if there are chronic problems with metabolism cells can actually begin to shrink shrivel up and die and that is ends up being associated with neurodegenerative disorders like Alzheimer's but those two middle ones the structure and function of cells are critically important and in a nutshell what I'm saying is that metabolic dysfunction results in problems with the structure and or function of cells and that is how we can understand mental illness at its core we should think about mental disorders as a malfunctioning brain a brain that is doing something or failing to do something that it should be doing so it's either doing something that it shouldn't be doing easy example of that is somebody who has a panic attack for no good reason they're sitting quietly in their home minding their own business and out of of the blue they have anxiety or a panic that's a malfunctioning anxiety circuit in someone's brain and other people's brains may fail to do things that they should be doing so some people have cognitive impairment or memory impairment or TR brain fog is a big term these days you're just not thinking clearly that represents your brain not quite firing on all cylinders the cells and networks aren't doing what exactly what they're supposed to be doing when we call those disorders mental disorders I'm arguing that the root cause of that in the overwhelming majority of cases and I suspect probably all cases is metabolic dysfunction I wonder if you could give us an example maybe a case from your practice where someone had a mental health diagnosis and then you by helping them dramatically change metabolism maybe through diets I know many people associate dietary changes or the ketogenic diet with your work and I know your work is much more than just diet but maybe that will be a really nice way to help people understand just how powerful what you're saying can be yeah so um you know I've now had many cases that are quite extraordinarily exceptional but um I think one that I'll share with you just somebody that I did a case report on and I spoke with her um at one point just to share with people the power of what this means because a lot of people know that you know diet exercise yeah that's probably good for maybe mild anxiety um sure that'll help people feel better or mild depression but I'm also talking about serious ious horrible debilitating treatment resistant mental disorders like schizophrenia and so I think I'll describe to you the case of a woman I changed her name in the book but she actually gave me permission to use her real name okay and in honor of her I'm going to use her real name her real name is Doris Doris had a horrible childhood out of the gate a lot of abuse and Trauma she undoubtedly suffered from depression and post-traumatic stress disorder at the age of 17 she began having hallucinations and delusions and was diagnosed with schizophrenia over the ensuing decades she tried numerous different antipsychotics mood stabilizers anti-depressants and other medications but none of them stopped her symptoms she was a chronic paranoid schizophrenic in every way she was tormented by hallucinations and delusions she gained massive amounts of weight she was unable to function on her own she ended up getting a courta appointed Guardian she had people come into her home to help her pay bills and with grocery shopping why because she was schizophrenic that's what happens to people with schizophrenia between the ages of 68 and 70 she was miserable hated herself hated her life and tried to kill herself at least six times and was hospitalized for those suicide attempts and in fact that's not unusual many people with schizophrenia die by Suicide it's torture and at the age of 70 she was referred by her primary care doctor to a weight loss clinic at Duke University where they just so happened to be using the ketogenic diet and for whatever reason she decided I'll give it a shot and so she went to this weight loss clinic run by Dr Eric Westman and within two weeks not only did she start losing weight but she began to notice dramatic reductions in her auditory hallucinations within months all of her symptoms of schizophrenia were in full remission within 6 months she got off all of her psychiatric medications and remained in remission from [Music] schizophrenia Doris went on to live for another 15 years symptom free medication free out of psychiatric hospitals no more psychiatric professionals no more suicide attempts she also lost 150 pounds and kept it off sadly Doris passed away last year of Co pneumonia at the age of 85 I mean that's just it's such an incredible story a whole lifetime of pain a whole lifetime well up to the age of what 70 where she's struggling where she has people to help her she's suicidal paranoid schizophrenia and all the kind of discrimination in society that that comes along with that I mean sure we talk about mental health a lot these days but for many years and even now there's quite a lot of um discrimination against people who are suffering like that I've seen it I've seen it in patience and what's really interesting about that story is that she had trauma right so it's not as if you're necessarily saying and I want to really clarify this you're not saying that trauma didn't exist that this was due to highly processed foods and junk food that caused metabolic dysfunction and when we then changed her diet her symptoms get better you're not saying that what you're saying is that there was a series of stresses in her life trauma maybe there was some substance use maybe there was poor diet maybe there was a variet y of inputs that meant she had symptoms consistent with paranoid schizophrenia everything that the medical profession has available to it was thrown at her and nothing really stuck yet she goes to a weight loss clinic she's probably not even thinking about her schizophrenia she goes to something seemingly unrelated what's weight loss got to do with my mental health problem yet by going on a ketogenic diet she loses weight and she goes into complete remission that is absolutely remarkable how do you explain that you know how does your theory help us understand biochemically what might have been going on there so there's a lot to unpack and I just want to share another personal part of her story last time I spoke with her she actually almost begged me to share her story she said please tell my story far and wide tell anyone who will listen because of my story can spare even one person the torment that I experienced for decades it will be worth it yeah so please just tell my story to anyone who will listen and so the first thing I want to say is Doris is not an anecdote we now have numerous people who have been able to put their bipolar disorder and schizophrenia into remission using the ketogenic diet we have at least I think 10 controlled trials underway so this is a rapidly expanding field this is not um quackery this is not uh nonsense but when I first saw my own patient recover using a ketogenic diet and when I began to accumulate more cases and talk to more people like Dr Westman like Doris to try to understand what's Happening Here initially I was perplex that um this this doesn't make sense and um the godsend that I had was that the ketogenic diet is actually an evidence-based treatment for epilepsy it is a 100y old treatment that unbeknownst to most people most people have heard of Keto as like The Fad diet it's that all meat diet where people just eat hamburgers and bacon and it's really bad for your heart and nobody should do that keto diet it's really dangerous that's what most people know of the ketogenic diet well the reality is the ketogenic diet diet was first developed by a physician 100 years ago for one and only one purpose to stop seizures and so it's been around for 100 years we have a tremendous amount of research on it we have two Cochran reviews which are kind of the gold standard in the medical field for rigorous metaanalyses to to a to answer the question does this intervention actually work and how well is it supported and we've got at least two Cochran reviews that strongly suggest the ketogenic diet is in fact an evidence-based treatment for childhood and Adolescent uh epilepsy in adults the research literature is less compelling but we also have a tremendous amount of Neuroscience literature trying to understand what a diet how does a diet stop seizures cuz this diet can stop seizures even when medications fail to even in patients who've tried numerous anti-convulsant medications and their seizures don't stop sometimes the ketogenic diet can stop their seizures and so researchers biotech companies pharmaceutical companies have been trying to understand what is this diet doing and so we know a lot about it the diet changes neurotransmitters it decreases inflammation broadly including brain inflammation it changes the gut microbiome and some researchers actually think these changes in the gut microbiome might be its primary mechanism of action and then that leads to this gut brain connection um it reduces insulin and glucose levels meaning it improves insulin signaling or reduces what many people call insulin resistance it improves that one of the things that I ended up being led to in all This research though was I was trying to put the whole puzzle together in the best way I could and I was led to the fact that this diet improves mitochondria in two different ways pretty broadly um it stimulates a process that gets rid of old and defective mitochondria and it stimulates many cells to produce more mitochondria so that after somebody has done a ketogenic diet for several months or several years many of their cells in their body and brain actually have more healthy mitochondria than they did before they started the diet and what that means in my mind is that those cells become metabolically healthier or more metabolically resilient and for some people like Doris that can mean the difference between health or illness I mean so much to unpack there you're right people have heard of the ketogenic diet and it appears to be quite a controversial diet for a variety of reasons and of course a ketogenic diet can be done in a variety of different ways but let's just start with epilepsy for a minute you mentioned that it's been studied now for over 100 years is and I I've heard you say in in another talk that the ketogenic diet May well be the most studied diet we have when it comes to brain function yes so I think many of us are aware that it can help some people with epilepsy so my first question there is do you feel today in 2023 if somebody is diagnosed with epilepsy that as part of real informed consent they should be told that look there's a whole variety of things that we could offer you there were these medications here but there's also something called the ketogenic diet which would require you to do a b and c because I don't think that's happening but it seems like we should be offering that we should at least be saying this is an option I agree people should know because sadly tragically I know people who have treatment resistant epilepsy and are never even told that the ketogenic diet is a treatment option by no means am I suggesting Everybody Must do the ketogenic diet it's a choice and it's a it's a difficult choice there's no question in my mind taking a pill is much easier than doing this diet and if you can take a pill that does not give you many side effects that does not have many adverse effects on your health and it can completely and fully stop your seizures I would probably go with that um I would probably go with that so much easier than being on a rigorous medical version of the ketogenic diet but I have met people who have one person has a son who is in a chronic vegetative state because he has 20 to 50 seizures every day he is doesn't talk he can't function he can't go to school and people didn't even talk about the ketogenic diet with this family yeah and this man saw me give a presentation on the ketogenic diet for mental health conditions and approached me like could that be an option for my son and I'm thinking how is it possible that this wasn't offered to you this is in fact one of the gold standard treatments for treatment resistant cases and let me explain that so if you have tried three epilepsy medications and are still having seizures three is not a whole lot H if you've tried three epilepsy meds and you're still having seizures if the doctors prescribe another epilepsy medication the chances of you becoming seizure-free are close to zero very close to zero the chance if you get instead instead of trying a fourth medicine and if you try the ketogenic diet your chances of becoming seizure free are about 33% MH another 33% probability that you'll have a significant reduction in your seizure frequency for about a third of the patients it doesn't seem to work it's not always clear to me whether that's because the patients maybe aren't doing the diet right or maybe there are other factors involved so it's not a Panacea yeah it doesn't work perfectly for everyone I'm not here at all to say that but 66% of patients get significant Improvement and and a third of patients become seizure free yeah I mean it's incredible and again I want to reiterate it's not for everyone and clearly it can be very challenging for some people it's too hard to do uh in the long term they can't make it fit their lives but of course if your life is being really really severely affected by seizures for example you may go well wait a minute this is pretty hard um which is harder and that's you know we can't make that decision we as Physicians just simply have to offer options help patients make those decisions for themselves so I think that's really interesting regarding epilepsy a wi point there for me Chris which I'm always Keen to when I'm lecturing healthc Care Professionals or when I'm talking on this show is whenever we talk about lifestyle okay lifestyle is a tricky word isn't it because it can imply blame sometimes and I I certainly want to use the term don't use it to imply blame but when you talk to people about changing certain lifestyle behaviors if they can whether it's diet or movement or sleep or stress and and and I recognize that many people have got challenging lies and it can be hard to do so people will often say yeah prevention is better than cure yeah it's all about prevention and hey I don't dispute that but we can all also use lifestyle change as part of our treatment and I think this is the missing link a lot of the time in this conversation around changing our lifestyle it always comes down to prevention sure let's prevent things if we can but also lifesty can be a very powerful treatment and I think what you just said about epilepsy in the ketogenic diet shows that that's a lifestyle Behavior change yes it's a medical diet in that uh context but that is making quite a dramatic change to your dietary choices and seeing a huge therapeutic effect on your health so that's just another point I wanted to highlight yes and I if I can even just add just a little bit to what you just said just to make sure your listeners really get it I'm not at all saying that children with epilepsy are eating bad diets and that's why a ketogenic diet is helping them and likewise I'm not saying people with schizophrenia are eating bad diets and that's why a ketogenic diet is helping them so let me give you a couple of clear examples people can develop seizures after getting a chronic serious infection people can develop schizophrenia after getting a serious infection as well both of them can be consequences of a serious infection that infection is wreaking havoc on cells throughout the body and in some people it leaves those cells metabolically vulnerable those cells have higher levels of what's called oxidative stress and they're not functioning properly anymore and that results in seizures or schizophrenia symptoms in some people so the cause the root cause was actually an infection they could have been following a perfectly healthy diet but the treatment can for some of them be a ketogenic diet because the ketogenic diet is kind of a metabolic reboot if you will or it's a metabolic therapy it is changing metabolism broadly by offering an alternate fuel source in the form of ketones but also by reducing inflammation changing the gut microbiome changing hormone levels actually changing gene expression changing mitochondrial function so it's doing a wide range of things but the sound bite nutshell is it's changing metabolism or healing metabolism broadly and that can restore Health in some people yeah I'm I'm so glad you highlighted that point because we need to look at causes and treatment maybe a little bit differently you're saying look there's a whole variety of different causes right but whatever those causes are you know in your example of Doris right with paranoid schizophrenia you mentioned she had a traumatic childhood right you're not saying that because the ketogenic diet cured her that it was a high sugar diet that caused it you're saying that there was um a combination of impuls in her life that left her with parano schizophrenia and because of those combination of inputs she had a degree of metabolic dysfunction yes let's try and address that metabolic dysfunction in this case with a ketogenic diet and by treating the metabolic dysfunction suddenly all of her symptoms go away ex so it's it's subtly different but very very important so I really appreciate you mentioning that so what is going on in a ketogenic diet right what what let's if we take Doris's case for example you mentioned some of the things that happen reduce inflammation um you know less oxidative stress different gene expression there's all kinds of things that can happen but why do we think it is getting rid of a lot of these symptoms is it something to do with the ketones uh is it to do with glucose regulation is it to do with noradrenaline levels I mean do we know yet what what exactly is causing the relief in symptoms the real answer is we don't know um we have all of those Clues again we have a tremendous amount of research and we've got numerous mechanisms of action that are possible decreasing inflammation you know changing gene expression all of these other things but different scientists are in debates with each other about well I think it's the gut microbiome and that's why it's working for Doris others might say it's changing the glutamate and Gaba ratio and that's probably why it's working for Doris I you know my theory suggests that the central theme is to focus on mitochondria because if we focus on mitochondria we can actually begin to put a lot of those puzzle pieces together mitochondria help us connect the gut microbiome and the function of cells mitochondria help us understand gene expression or epigenetics mitochondria help us understand calcium regulation in cells quite importantly because they're a primary regulator of calcium and cells mitochondria actually help us understand neurotransmitter imbalances because they play a role in producing and releasing neurotrans mters including serotonin famous serotonin including dopamine including Gaba and glutamate mitochondria actually control the first step in the synthesis of cortisol MH and so if cortisol is disregulated an obvious place to look would be the first step in its synthesis which is mitochondria the re so the reason I'm focused on mitochondria is because we know the ketogenic diet stimulates two specific processes one called mitophagy which is getting rid of old and defective mitochondria and replacing them with new ones and it also stimulates a process called mitochondrial biogenesis um which is just the production of more mitochondria and so in my mind what happened in Doris's brain cells are that she had brain cells that either had defective mitochondria or insufficient mitochondria to perform their function normally and so those brain cells became fragile they were they were metabolically compromised they were fragile and they would sometimes fire off when they shouldn't or they would sometimes fail to fire when they should and that probably occurred widely in different areas of Doris's brain and that resulted in Doris's specific brain symptoms that we call schizophrenia and what I imagine the ketogenic diet doing this is speculation speculation based on a lot of science we do have science showing that the ketogenic diet improves mitochondrial function in the ways that I described but again the the gut microbiome researchers might argue with me and say Chris Palmer no it's not it's not mitochondria it's the gut microbiome so there will some be some who take me on but I believe that if if cells have enough healthy mitochondria they actually will function properly and that is really one of the critical keys to so many of our chronic not just mental disorders but disorders yeah it goes beyond mental health this a lot of people say that mitochondrial dysfunction is at the root of many cancers mitochondrial dysfunction is at the root of Alzheimer's mitochondrial dysfunction is the root of frankly most of our chronic illness yes and so let me try and summarize what I've got so far and you can tell me whether I've got this accurate or not you're making the case that in pretty much all mental illness there is some degree of metabolic dysfunction in the brain okay whatever the cause is it has resulted in the brain not been able to utilize energy properly or as well as we might like and then bringing mitochondria into that conversation I guess any metabolic dysfunction has mitochondrial dysfunction behind it it has to right exactly so effectively what I think you're saying is that if you are suffering with a mental illness you have a degree of mitochondrial dysfunction especially in your brain cells and therefore if we're going to try and treat reach you by looking at root cause we have to find ways to improve the function of your mitochondria yes accurate yes okay and then if we go back to what I said towards the start which are these sort of seven or eight factors that I look at in patients well what's really interesting is they all Impact mitochondria they do right the diet you choose to eat you mentioned a ketogenic diet but also a whole food diet for many people will improve mitochondrial right so that's food let's go to exercise you know one thing I'm doing a lot of in my own life um and I follow these wonderful people on Twitter Alan cousins and I think Inigo Sam Milan I think on you know what low heart rate training does for our mitochondria right so we can manipulate our mitochondrial function through specific types of exercise right so that's food that's exercise sleep sleep affects mitochondria right stress right stress is a big one I think let's just pause on stress for a minute because a lot of people will understand that traumatic events can lead to mental health problems and I've spoken to Gabel matate I think four times on the show over the last years and maybe we're going to chat again later this year and of course Gabel talks a lot about trauma and the capitalist society in which we're living and the pressure on people and how that is contributing to this mental illness epidemic now then I was thinking this morning how do we put that through the lens of Chris's model and I'm thinking well presumably the trauma is causing mitochondrial dysfunction is that fair to say or how how would you how would you put some of Gabel mate's work or people who say trauma is the cause of mental illness not metabolic dysfunction I'm not convinced that those things are mutually exclusive they can actually fit together if we look at your model I think they can you raise a common concern or misunderstanding about what I'm arguing um so I appreciate this opportunity to explain it so trauma causes a flood of stress response in a human being mhm and um when people are traumatized usually part of that definition involves some kind of a life-threatening circumstance either real or perceived that the person thinks that I might die because of this experience um and we have all sorts of adaptive mechanisms that go into play when we think we're going to lose our lives and so the body goes on high alert your heart rate is going to go up um your entire nervous system is primed to be hypervigilant you are going to startle at any sound you are going to run as fast as you can you are going to fight as hard as you can you are going to cower as much as you can you're going to hide in whatever way you can you're going to do anything possible but all resources all metabolic resources heart rate blood sugars endorphins neurotrans all hands are on Deck to save your life in whatever strategies you end up deciding to use that takes a metabolic toll we have an entire body of research documenting that mitochondria are directly involved in the human stress response MH so the human stress response is usually composed of at least four four different things so one is we get a flood of adrenaline two is we get cortisol everybody knows that three we get an increase in inflammation and four we get gene expression changes at least in the hippocampus because our our brains are wired to remember this experience for a long time your life is almost threatened you better remember this this is Salient so genes are changing to store this memory to embed this memory forever so that you never forget because this will Prime you then to try to avoid danger in the future so those four buckets adrenaline cortisol inflammation and epigenetic changes or changes in gene expression are all happening researchers did a study where they genetically manipulated mitochondria in four different way ways and all four of those stress responses were altered mhm which strongly suggests if not proves that mitochondria are playing a role in the stress response we know from other researchers they are involved in releasing adrenaline from the cells that release adrenaline we know they're controlling this the first step in the synthesis of cortisol so cortisol release we know that they're playing a role in epigenetics we know they're playing a role in inflammation turning it both on and off so mitochondria are involved so I could digress and we could get really nerdy and talk about cell biology and biochemistry and all that other stuff but I know nobody wants to hear that I'm going to rest on that to say there is an abundance of research I am not speculating this is not a speculation this is proven pretty well yeah in highly reputable scientific studies published in some of the best journals we got but I want to take a step back and make this make sense to people why would trauma why should we think about trauma as a metabolic problem well as you said everybody already kind of intuitively knows trauma that causes mental illness which mental illness is exactly is it just PTSD actually no trauma is associated with higher rates of PTSD and depression and anxiety and addiction to alcohol opioids anything and bipolar disorder and schizophrenia so now we need to be thinking about Doris again her trauma likely contributed to her development of schizophrenia what else does trauma do people who have traumatic childhoods are more likely to develop obesity yeah type 2 diabetes cardiovascular disease dementia and they're much more likely to die early deaths on average in one study people who have six or more adverse childhood experiences commonly referred to as Aces people who had six or more Aces die 20 years younger than people who have no no Aces so trauma affects metabolism it affects both mental and metabolic health and we need to connect these dots I mean I really appreciate you going through that because I think that's what's powerful about your theory is that it ties all these seemingly separate research areas into one unifying Theory you know because yeah how does trauma actually cause this like a very simple way people can think about this I think is that trauma is a huge stressor on the body and we know one of the things that happens when your stress response gets activated is that your blood glucose goes up right that is part of the stress response that helps you deliver uh more sugar to your brain so that you can actually fight or flee the Predator that's trying to attack you right yeah so that's what the body does and so if you think about trauma through that lens it's like yeah well of course there's going to be an impact on our physiology and then I guess if we follow that thread and think well okay then if we're trying to treat someone who's got some form of mental illness okay you mentioned Doris where um you know by going on a ketogenic diet seemingly most things have not everything got better and of course with some people it's probably not going to be just one thing they they're possibly going to need therapy for their trauma but actually also they may respond to changing their diet as well right instead of saying oh it was trauma that caused it so you need to deal with your trauma it's like no no it'll be helpful to see a therapist and there's of course all kinds of modalities that treat trauma but at the same time we're pretty sure that you have got some form of metabolic dysfunction in your brain so why don't we also help you change your diet so at least we can keep stable blood sugars which you know in some people are going to help more than others like I guess what the point I'm really trying to elaborate on is that it's not either or is it it's like you can change your diet and you can get therapy for your trauma you don't have to choose which one you're going to do absolutely and and I would want to go even just a tiny step further and say therapy for the trauma may help you deal with some of the psychological aspects but it may not fully address the physiological aspects so therapy for your trauma may or may not reduce your risk for cardiovascular disease which you are now at risk for because you've had trauma it may not reduce your risk for obesity Psychotherapy typically doesn't result in weight loss for most people yet trauma increases your risk for developing obesity and so trauma is having both psychological social and physical impacts on your body and I actually believe that a more comp comprehensive treatment approach that maybe addresses all of those so let's let's address the psychological aspects with Psychotherapy let's maybe think about the social aspects how can you get safe meaningful relationships again you know you may be afraid of people for good reason you've been hurt you've been betrayed you trusted somebody and they hurt you how can you develop new relationships um people may need help with that but I think we need to focus on the physiology yeah in order to help people heal their brains and heal their bodies at the same time yeah I love that and I guess when trauma happens as a child you know we have these windows don't we in human development you know before the age of seven you are very vulnerable in many ways to the inputs you're getting we we're seeing that the early years are so important for our long-term health so I guess if you experience trauma at the age of five then that trauma yes it's having a psychological impact but it's also changing your physiology and it may well be changing the set point of your nervous system possibly for good right so that therefore let's say you're an adult dealing with the consequences of that trauma yes having Psychotherapy to try and deal with some of that and process it is useful but you may also need to deal with the fact that your nervous system has been set differently than it might have been set had you not experienced that trauma and that then could have an impact on your metabolic function or your metabolic dysfunction and therefore you need to address that as well you do and so an easy way to think about it is that when people are immediately traumatized as I said your your sympathetic nervous system gets revved up your your defenses are on high alert all Hands-On deck everything you've got try to save your life so blood sugar's going up heart is pumping as fast as it can or as as fast as it needs to at least eyes are dilating like you are ready to fight flee freeze hide whatever you're going to do you are ready to go to save your life when people are repetitively traumatized or when people experience a horrific unimaginable trauma that system can remain on high alert for understandable reason you may feel like I'm never safe anymore I can never let my guard down those people end up developing problems sleeping because their body is on high alert all the time it doesn't want you to sleep it certainly doesn't want you to sleep soundly because what if an attacker walks into your room while you're sleeping yeah you need to wake up you need to wake up at the sound of a pin drop that is your body trying to save your life but unfortunately if you have gotten past the danger and that's a big F so if you're a soldier on the battlefield and you're still on the battlefield those are all adaptive responses and I don't want to interfere with any of them I do want you to wake up at the sound of a pin drop if you are a battered woman still living with your abusive partner I want you to wake up at the sound of a pin drop yeah I don't want you to sleep soundly he may he may kill you in your sleep you you cannot be sleeping soundly you should not be sleeping soundly you should not be medicating yourself to sleep soundly because you really are in physical danger so but once people are out of the danger yeah and they've been out of danger for a time and they they their body their brain should be readjusting and recognize wait it's safe now I can sleep the majority of people do that the majority of people their body adapts it it adapts to the safety and it allows people to sleep when When people's bodies don't adapt what I'm arguing is that metabolic dysfunction somewhere in your brain or body is preventing those cells from making the switch to safety mode and that leaves people with this diagnosis that we call PTSD and that leaves their trauma system their hyper alert safety system on high alert most of the time or all of the time and unfortunately we need sleep to repair our body to store memories to clear toxins and waste molecules from our brains when we sleep all of those things are happening MH if you're not sleeping well because your body thinks you are in danger your body is not repairing itself it's not healing itself it's not getting rid of waste products in the ways that it should and that is taking a toll on your overall Health and Longevity and so in addition to dealing with the psychology of the trauma part of the psychological work may be just helping the person understand you are safe now but then the person needs to readjust their physiology they need to learn how to sleep soundly through the night without substances without pills they need to learn how to reduce their heart rate in the ways that you described and that might be meditation or mindfulness or stress reduction practices they can change their diet to try to Foster some of this healing they can maybe do exercise movement other strategies to try to Foster all of this but they need to get their body back into resilient safety mode yeah it's it's just so interesting and probably don't have time to go into movement in depth but I know there's many therapists out there who you know after trauma your body gets stuck in certain movement patterns and simply you know accessing different movements can also help you heal from some of that trauma or some of that stuckness within your body which I think's really really interesting but just to finish off then on this kind of part where we're talking about again going back to your central idea that all mental illness has metabolic dysfunction somewhere at its heart or pretty much all um and if you've got metabolic dysfunction you have mitochondrial dysfunction right and so we're just going through that list now of the things in society that potentially can negatively impact mitochondrial function so we we mentioned food exercise sleep stress we mentioned trauma what about environmental toxins so what about things like alcohol marijuana cyanide right these things are mitochondrial toxins for many people these things can absolutely contribute to the development of mental illness so how do you think about uh toxins when we're thinking about your model in exactly the way you just described so all of those things are known mitochondrial toxins or they have toxic effects on mitochondria again that's not speculative Decades of research documenting this in some of the best neuroscience and medical journals that we have available so if people are skeptical or just unaware of this you can look it up the toxicity of alcohol has been known since the 1960s and researchers in the 1960s knew it seems to be toxic to mitochondria and that's how it results in therosis of the liver for instance um oxidative stress in the liver results in therosis that is mitochondrial in nature and it's also well known that people who are exposed to these toxins can have a wide variety of both mental disorders and also metabolic disorders they can die early deaths from things like heart attacks they're more likely to develop diabetes and you know one so one really good example is actually smoking cigarettes so smoking cigarettes you get nicotine yes but you also get thousands of toxic chemicals in the smoke and those chemicals are toxic to many parts of the cell including mitochondria but cigarette smokers are a great example of what I want to illustrate because when I say metabolic Health it's not about weight it's about mitochondrial function cigarette smokers are a perfect example example of this so cigarette smokers on average are thinner than nonsmokers M they usually do not have a weight issue compared to non-smokers and in fact in the 1950s and 60s cigarette companies advertised to women in particular keep your slim figure slim gems and other cigarettes that were marketed specifically to control your appetite way less because nicotine can do that so cigarette smokers on average don't have a weight problem or they have less of a weight problem than nonsmokers do and yet everyone knows they're more likely to have heart attacks well heart attacks that's a metabolic disorder yeah what else are cigarette smokers more likely to get they're twice as likely to develop insulin resistance resistance in type 2 diabetes even though they weigh less than non-smokers MH so that's now a clear example where if you understand the whole Theory you start to separate type 2 diabetes even from being overweight it's not necessarily a weight issue yes weight and obesity do increase your risk dramatically for type 2 diabetes but they're not the only thing they not the only thing toxins to mitochondria across the board increase your risk for type 2 diabetes what else do cigarette smokers get pretty much all of the mental disorders cigarette smokers are more likely to develop depression anxiety schizophrenia bipolar other addictive disorders like alcoholism they are more likely to develop mental disorders across the board in your view because the cigarette smoke is damaging the mitochondria yes and so mitochondrial dysfunction sits behind the development of mental health problems it sits behind the development of obesity it sits behind the development of type two diabetes dementia many forms of cancer if not all right so and this is what when I've been think about your work Chris and preparation for you to come to the studio today I've been thinking about this really goes beyond mental health you know but you almost need to hook it onto mental health so that people can actually think about it otherwise it becomes too broad it's like oh this is everything well kind of mitochondrial Health kind of is everything isn't it it is and in in many ways it's important to hook it with everything else everything else is going up in prevalence as well yes so you know so broadly speaking you know we have a mental health epidemic mental disorders across the board are rising significantly a lot of people know rates of burnout are high rates of anxiety disorders rates of depression rates of depression actually reached an all-time ever recorded high in a Gallup poll just a few weeks ago all time ever recorded high for current prevalence and lifetime prevalence 10 years ago the lifetime prevalence of major depressive disorder was thought to be 20% that's now up to 30% of the population I mean what would just if we just pause there for a minute what does that say about us what does that say about the evolution of humanity that we now have an alltime record here I mean it's not good is it it's not good and to go further it's not just depression yeah it's anxiety disorders it's also anxiety disorders in youth I just saw a study based on outpatient practices in the United States tripled the number of Youth who are diagnosed with an anxiety disorder has tripled in about 10 years in the United States bipolar disorder bipolar disorder has skyrocketed in youth largely because it was not recognized never diagnosed prior to the 1980s and now it's much more commonly diagnosed but in adults in the last 15 years rates of bipolar disorder have doubled in adults these are supposed to be fixed lifetime genetic disorders genetic disorders don't double in prevalence in 15 years yeah and I just want to point out that so we've got mental disorders skyrocketing across the board across a range of diagnostic categories at the exact same time that the rates of obesity diabetes and pre-diabetes are skyrocketing and what I'm arguing is they are very much connected at a biological level and we need need to recognize that and think about it because we can treat all of them simultaneously with common sense lifestyle strategies we we do not need to focus only on mental health and have a mental health prevention strategy and over here we're going to have an obesity prevention strategy and over here we're going to have a diabetes prevention strategy let's have a human health prevention strategy using common sense lifestyle strategies like that you talk about all the time yeah I mean I so agree Chris I mean it's so hard sometimes to get that message across because people consider these things completely separate and you know I released my first bot back in 2017 uh in the UK called the four-pillar plan in America called how to make disease disappear and I outline you know the four core things that I felt influen Health the most that we also have a fair degree of uh control over about changing in our lives food movement sleep and stress and what's really interesting over the years I have had so many messages like you will get from your book that oh Dr you know I I put my type two diabetes into remission from reading that book I've cured my depression for reading that book I no longer have anxiety from implementing what was in that book um etc etc I.E if you focus on the creation of Health in a human it is amazing how often these seemingly separate diseases start to get better maybe they're not quite as separate as we've thought maybe they're not quite as separate as we've been taughts to make sure you're taking action after watching this video I've created a free guide to help you build healthy habits we can all make short-term change but can those changes become a fundamental part part of our life often they don't and that's why in this free guide I share with you the six crucial steps you need to take they're really really effective if you want to get hold of that free guide right now all you have to do is click the link in the description box below you know and it it it's again of course there are some variations that need to happen for particular conditions I don't mean to denigrate that or or or um you know underemphasize how important that is but it is amazing how often when you pay attention to the basics and improve metabolic health and mitochondrial function it's kind of incredible what kind of symptoms can start to get better isn't it it is it it exactly and and I agree with you when people if people already have an illness and life-threatening symptoms I am all for modern medicine yeah and using strategies if somebody is in diabetic keto acidosis this is not the time to be talking about lifestyle strategies they need insulin and they need it right away yeah they are in a life-threatening emergency if somebody is having a heart attack they need Interventional Cardiology to save the day to clear that artery to do whatever needs to be done if somebody is psychotic and aggressive or suicidal if somebody is manic and out of control they need standard psychiatric treatments to save their lives to keep them safe to keep others safe I'm not at all arguing against the use of standard Interventional treatments when People's Health has deteriorated significantly but at the same time all of these basic Common Sense lifestyle strategies can help people heal and recover from all of those disord ERS and more importantly can definitely play a role in prevention yeah and if I can I would I would love to at least expand on one case just to really drive this home because a lot of people I know are probably still skeptical like Chris Palmer you can't really be serious what are you talking about so there was a longitudinal study of 5,000 children from the ages of 1 to 24 researchers this was a painstaking study over you know two decades two and a half decades um the children who had the highest levels of insulin resistance beginning at age nine had a fivefold increased risk for a psychosis at risk mental state by the time they turned 24 oh wow that means they were 500% more likely to be at risk for schizophrenia or bipolar disorder they were three times more likely to already be diagnosed with bipolar disorder or schizophrenia so when we are talking about holistic treatments when we are talking about prevention strategies preventing a life sentence of schizophrenia potentially preventing bipolar disorder which is also a life sentence for a lot of people insulin resistance that that's supposed to be diabetes or weight if we recognize that in children at age nine and intervene appropriately we might not only be able to help them keep the weight off or prevent obesity we might not only prevent type 2 diabetes because those are clear unequivocal consequences of identifying insulin resistance and addressing it early but we might also prevent crippling lifelong chronic disorders along with the anxiety disorders and the depression that also accompany people with diabetes people who with obesity so we're really preventing a wide range of physical and mental disorders using the same treatment strategies these youth simply have a biomarker that they are beginning to have imp impairment in metabolic function or impairment in mitochondrial function it is a biomarker it shows us early signs they are not yet ill this is a beautiful opportunity yeah to actually see what we can do to prevent all sorts of human diseases that we right now all assume are different and you know if we think about that we think about that as adults if anyone listening to this right now has ever lost a significant amount of weight and they ask themselves how did they feel afterwards a lot of the time they will tell you I had more energy my mood improved right now that's normally put down or the energy at least is put down to the fact that you know some of the weight has been lost that's why I've got more energy but you could also make the case that that what you were doing to help you lose weight was possibly probably improving mitochondrial function and there that is going to increase your energy that's also going to improve your mood right these things are not necessarily that desperate so I think that's another way that people can think about it perhaps Chris can I just pause on the the schools for a minute you mentioned how much anxiety is going up in children and teenagers and as a father myself I think about the school system a lot and one of the things that's really top of mind for me at the moment is the amount of screen time kids are being given at school and in the evenings right so like you I'm always trying to think about root causes we know that sleep deprivation will affect how kids can concentrate the next day it's going to affect how they perform it's going to affect their focus it's also going to affect how much empathy they have how creative they are and we haven't really gone deep into sleep yet but you know I'd love to know your thoughts on sleep but the research I'm familiar with shows that sleep deprivation can be causative of mental illness not just associated with causitive of we know that keeping your brain stimulated in the evening is going to make it more challenging to fall asleep we know that too much light exposure in the evening bright light exposure blue light exposure may be problematic with sleep and just five years ago nobody did any homework on screens right so it was possible for people to do their homework and it not be on a screen since coid I understand that because of lockdown screens were very helpful at helping people still get an education but I feel an inertia has set in in many schools whereby oh we can now do everything on screens in the day and in the evenings and I have been extremely worried about how much homework my own son who's now 13 is getting on screens and I'm wondering how is that going to go over subsequent years if that increases that's not going to help him sleep well that's clearly going to increase risks of mental illness across a population so if I think about something that we can do across society that may have Myriad effects on rates and mental illness I kind of feel that schools not giving homework in the evening on screens would be incredibly helpful you are a Harvard trained psychiatrist right with all your knowledge with your new book with the mental energy Theory right in terms of what I'm just saying now do you think that screen usage in the evening in kids is going to be contributing to mental illness 100% you're you're right on the money unfortunately and interestingly screen use is also associated with all the metabolic disorders the more you use screens the more likely you are to develop obesity diabetes cardiovascular disease um it it is removing um you know there was one study a report that just came out a couple of months ago that looked at cell phone use in Youth and the younger the child is when the child gets his his or her first cell phone the more more likely that child is to develop a mental disorder so that is one practical easy takeaway for parents hold out as long as you can do not get your child a cell phone because there was a clear unequivocal linear it's rare that you get such a striking linear dose response curve the more years the child had a cell phone the more likely the child was to have a mental illness so that is something you can really easily do and you know some of the billionaires who help develop cell phones refus to get their children cell phones because they knew that these are these are not just tools to call people these are made to be highly addictive screens that engage people and encourage them to come back so we we have fairly good data of strong correlations at least between cell phone use and both mental and metabolic disorders I think that's enough for now screens are doing a few things so screens are having a Toxic effect on sleep in exactly the way you just delineated screens are also depriving people of engaging in the real world whether that's through mindfulness so engaging with your own body and just being mindful or meditating just being aware of you you yourself whether it's engaging in the physical world going out and exercising or playing with others but probably most importantly it is depriving people of human contact human relationships with each other and so even if you're on Zoom with a friend it is not the same thing as being in person with that friend when two humans are together they see each other they see each other's entire body you respond to a lot of non-verbal cues you can make eye to eye contact and whether you realize it or not those things have powerful effects on our brains our brains are hardwired to Crave that yeah We crave human connection because human connection is about survival it's about safety that we are we are programmed to stay with other humans to be with our family with our tribe we are programmed any parent knows this you're kid is clinging to you in a in a crowded place or something that's all programmed but your kid is not clinging to a screen your kid is clinging to a human a living organism and and when we look at screens we're not getting those same inputs and I think our brains perceive that and you know we have an epidemic of loneliness right now and I think screens contribute to that epidemic oh if we if we if we engaged with other humans even for a tenth of the time that we're on screens it would probably get rid of a lot of the loneliness epidemic yeah just on that sort of screen use in the evening I think there's two other facts is what two things to mention one is and why I'm so against schools giving homework on screens to children and I'm I'm very open to hearing um you know alternative view points some teachers may make a case and you know some people will say that it's a tech heavy world now we need to get our kids ready for it we need them skilled and able to use all these all this technology so that they can enter the job market but my argument would be yeah sure do that in the day do that in the morning where it's going to have less impact on your Cadian Rhythm don't do it in the evening do not send home do not send children home asking them to go on Brightly lit screens that we know can play Havoc with your sleep like at what cost you give a good education like it's like what what's the point of a good education if the cost of that is mental illness it doesn't make any sense to me or cognitive impairment cognitive we need to think about the these children's brains developing yeah and we need to Foster again whole person whole child care so if you're trying to educate a child and that and that child is malnourished you're fighting an uphill battle you're not going to be very successful and the intervention that's going to be most important is nourishing that child and I agree with you the excessive screen exposure May in fact be adversely affecting neurodevelopment broadly and that may have effects not just on Mental Health but on cognitive Health on people's ability to function in society with other humans yeah to work on teams to to work in service sectors if they're expected to serve other humans in any way whether you're a physician a nurse um or an engineer working on a team with other Engineers you you need to be able to deal with other humans and and I think that needs to be factored into a well-rounded educational plan and so I completely agree with you I don't think any kid nowadays is going to come out of school not knowing how to use technology I don't think that's our biggest fear and I think the the the other problem that um for parents is that a lot of social uh activities are on screens right so let's say your child loves to play computer games right and the school is also sending homework on screens like that's pretty much the entire evening is being spent on screens possibly messing up your Cadian biology which of course means they're going to be tired the following day and struggling the following day so I kind of I know we've sort of um spent a bit of time here but I think it's really really important if we're talking about mental illness we're talking about mental illness rates going up what are some structural societ things we can get right to make it less likely I would say for me and of course I'm biased because of the age of my own children I would say not giving homework on screens would be right up there if you were in front of a school board at the moment and they said Dr Palmer we think it's important that our children are doing two hours of homework at night on screens give me your top three reasons why not what would you say I would say number one there's no evidence to the best of my knowledge that that is going to improve their life skills their cognitive abilities their even aptitude scores um there's a whole body of research actually on homework in general documenting that homework actually does not improve success in life it does not improve SAT scores it does not you know in the United States it doesn't it does not result in the gain that everybody thinks it does so that's number one number two again if you want your child your student to be alert attentive participating engaged and well- behaved the next day in class you want that child to get a good night's sleep if you are demanding two hours of screen time homework and that results in that child not sleeping as well you're going to see this child chronically as less optimal than that child is truly capable of being you're going to see that child as maybe a little bit behaviorally disturbed maybe dozing off every now and then maybe a little fidgety maybe he's got ADHD now because of sleep deprivation he's a little restless and if you just got him a decent night's sleep on a regular basis he wouldn't be restless but now we're going to medicate him for his ADHD and then he's going to probably need an anti-depressant soon for his anxiety and depressive symptoms and so I'm going to focus on that and you asked for three I don't know if I give you three that's well that's fine it's just two clear ones I guess I wanted uh back up from your expertise because I feel very very strongly about it and I think across Society I think it would be a great topic for teachers to engage in I'm sure many are already but again I think it's this inertia that's set in postco across Society you you mentioned how important social connection is right for our well-being one thing that's happened a lot over coid is that people started doing their social activities on screens because of lockdowns whether it be their yoga class or whatever it might be and they are still doing it now on screens they haven't gone back to that in-person yoga class which has so many powerful benefits so through the lens of mitochondrial dysfunction through the lens of all mental disorders are metabolic disorders how does loneliness affect that again uh lots of Empirical research showing at a minimum Cor ations and we have some very good emerging data on actually the biology and mechanisms of action so broadly speaking people who are lonely are more likely to have some kind of mental symptoms depression anxiety something that's common sense most people I think understand that and recognize that what's less well understood is that people who are chronically lonely or score high on loneliness you know surveys are also more likely to have metabolic disorders including heart disease and including dementia the United States Surgeon General just issued a report I think a month or two ago loneliness increases risk for depression anxiety cardiovascular disease dementia and premature mortality so people die earlier death if they are lonely so that is consistent with the theme that I'm arguing that mental health and metabolic Health are inseparable so you can have one factor loneliness that drives both mental and metabolic problems um do we have any evidence that that's influencing metabolism or mitochondrial function we do have some um in in particular we know that loneliness is associated with an increased stress response exactly and so we go back to everything that I said about the stress response all four of the major buckets of the human stress response are impacted by specifically by mitochondria and or impact mitochondrial function we have other lines of evidence showing increased you know inflammation which is one of the Hallmarks of the stress response um and there are actually specific you know some research Studies have shown there are specific types of immune cells that get activated from loneliness and genetic expression can change after loneliness and that loneliness confers so they've done some prospective studies even in animal models including primate models um that loneliness increases risk not just for depression but also for infections and not being able to fight off infections appropriately so it's impacting metabolic Health broadly there is no way to understand that by excluding mitochondria can I say it's 100% exclusively mitochondria no there are lots of Pathways with human biology but mitochondria are absolutely imp Ed and playing a role in all of that and the consequence again is aligned with my broad message mental health and metabolic Health are inseparable one factor loneliness increases risk for both we can look at all of the factors a bad diet increases risk for all of it metabolic and mental disorders um inflammation from an infection increases risk for all of it smoking cigarettes a toxin increases risk for all of it it is it is you know in some ways this research has just been hiding in plain sight like how did we not recognize this and yet when people really understand the detailed science of it it has the potential to completely transform the mental health field reduce suffering improve millions of people's lives improve the health of millions of people and potentially save billions of dollars we can take people who are disabled now from mental disorders and turn them into productive taxpaying [Music] citizens we can give them not only reduce their suffering and their pain but give them back their dignity and self-respect I see sit with these people day after day year after year for 27 years a lot of people think you know oh well if I had disability that would be great I could just lay around all day and do nothing and get get a check well the reality is that people on disability are usually living poverty level lives that's not anything you want to really strive for but I have sat with schizophrenic patients in tears desperate to just hold some kind of a job so that they can earn a little bit of money so that they can hold their head high and say I made some money I can do something useful I want to be useful these people are desperate to contribute to society to contribute to their families yeah it's really powerful really really powerful um let's talk about diets you mentioned the ketogenic diet and you mentioned the case of Doris and how that particular diet for Doris was lifechanging so if we just zoom out and look at mental health or mental illness more broadly one of the things that people can do to improve their metabolic health and their mitochondrial function which in turn May improve some of their mental health symptoms is change their diet does everyone have to go kiso no absolutely not so you know diet is such a controversial area some people want all plant-based other people like vegetarian other people like animal sourced Foods people get really worked up and passionate about diet different cultures have different dietary patterns and dietary Customs diet ends up impacting so much of society we have celebrations around diet around holidays religious practices sometimes include specific diets so by no means is there a one- siiz fits-all diet for all humans or all human health and you know so even with the ketogenic diet there are vegan versions of it vegetarian versions there you can do an Asian influenced version you can do all sorts of Customs practices Foods um spices can be added or subtracted to result in a diet that might be right for you as a rule of thumb the diet advice that I give people often say so what's your diet advice my diet advice is there's not a one-size fitall diet for everyone that's my advice not a one-size fits all I need to know more I need to know who are you what are you dealing with some people might need to lose weight we have an obesity epidemic other people may need to gain weight I deal with people who have anorexia nervosa I deal with people who are severely depressed and emaciated I've dealt with cancer patients after their chemotherapy and radiation they can lose tremendous amounts of weight the dietary intervention for them is to help them gain weight but to put on healthy tissue not just gain lots of fat but to gain some muscle uh lean tissue as well while they're gaining weight so different people need different diets the general rules of thumb that I endorse broadly eat real Whole Foods get rid of as much processed food as you can don't drink any calories you don't need to drink calories yeah liquids that you consume yes you need liquids they ideally are going to be water unsweetened coffee unsweetened tea whether it's black tea green tea other types of tea tea coffee water there was a Harvard study that just came out in the last six months documenting that at least for people with type two diabetes those who consumed primarily water tea and coffee had better outcomes than people who consumed anything else if you can try to get off of sweetened everything try to get away from added sugar but also added artificial sweeteners new evidence is coming out that artificial sweeteners May in fact not be safe and may not in fact not be good for metabolic health and mental health so the World Health Organization just issued a report two months ago I think um actually strongly against artificial sweeters broadly um and documenting that they they may have adverse effects on Obesity and diabetes the mental health literature is more sparse but we have one animal model published in a very prestigious Journal documenting that aspartame in mice induces anxiety and that unfortunately is transmitted transgenerationally to their offspring so Aspartame is found in most diet sodas so Diet Coke if you like Diet Coke that's zero calorie it's supposed to be good for you well we have an anxiety disorder epidemic and we have at least animal model data very clearly on unequivocally showing that aspartam increases risk for anxiety symptoms and that that gets transmitted from parents to children and from recollection the the amount of aspart in that study it wasn't that high was it no that was it was they they used the dose a dose in mice that would be kind of equivalent to somebody who drinks several diet sodas a day so it was doable but people so to be clear I always take the pr precautionary principle I have never been a fan of diet drinks I've never recommended them to my patients uh I know it's a very controversial area and people love to you know say no drink them there's no evidence it's better than the full fat at least it's going to help people lose weight and for me it's always been look we just don't know enough yet it's I think it's better to try and avoid the Stu if you can some people will hear you talk about that study and go well that's a mouse study yeah right it is a mous study what the hell has that got to do with humans is what some people might say to you how would you respond to that so what and what I would say is that if you are drinking sugar sweetened Beverages and you cannot stop and you are overweight or obese and God forbid you're pre-diabetic or diabetic and you say I might be able to switch to diet sodas but I'm not going to drink water unsweetened tea or unsweetened coffee then I would say yes please go ahead and switch um the World Health Organization actually just came out and said don't bother switching you're not going to improve your health so I would probably say at this point consuming a lot of sugar is potentially more toxic to your health than consuming artificially sweetened beverages however what I would really say is this yes if if you're somebody who wants to hold out for more data great hold out for more data in the meantime the world is sinking look at the H the health of the human population skyrocketing rates of obesity diabetes and mental disorders if you want to wait for the definitive data to come in for you and your family well good luck to you I hope you are spared but there's a good chance you are going to drown with everyone else and there's no reason to assume that artificially sweetened anything sugars beverages or desserts or candy there's no reason to assume that that is good for human health and that gets into this concept of do some people become addicted to processed foods or sweetened Foods I mean Sugar's been around for Millennia but we didn't always have the Obesity epidemic that we have you know grandmothers would make pies and cookies at holidays for Millennia probably at least hundreds of years we didn't have an obesity epidemic people could stop eating grandma's cookies they can't stop eating the highly manufactured processed foods that are designed to be consumed repetitively and so whether we call that food addiction whether we call it addiction to highly processed Ultra processed foods whether we call it um just you can't eat just one like the L potato chip commercial says however you want to think about it is less relevant but what I would say is you know and I say this is somebody who grew up on Kool-Aid and junk food I actually grew up I could not stand the taste of water it was too plain for me I was raised only drinking Kool-Aid that's all I would drink for a liquid I I guess I would sometimes drink milk but it was usually sweetened it was chocolate milk something I had to put some kind of syrup in it because plain milk was too plain so I don't mean to sit here and judgment no I don't mean to sit here as high and mighty I know everything and I've been there I've I've been in a place where I was addicted to those foods and what I can tell people is if you really make a commitment to try to give them up the first two to three months are going to be really really rough and you're going to have cravings and you're maybe going to be irritable and you're maybe even going to think life's not worth living without Sweets how could I possibly go on with life if I don't have sweets but if you can get through 3 months of it your whole perspective will change yeah I promise you you you can get over that addictive those addictive Cravings they will go away and life often times will be so much better you'll notice wow my brain fog went away wow my sleep is getting better my me I didn't even know I had a mental problem but now I feel so sharp and I feel so much better who who knew and so just try it for three months and and your taste buds will change what you uh consider tasty and nourishing will completely change but Chris what if someone says well yeah you grew up on that stuff and You' turned out all right you went to Harvard you've been a psychiatrist for almost three decades why should I not drink fizzy drinks every day why should I not feed that to my kids cuz you turned out okay and you drank them oh well I have a long sob story that that I I'm happy to go into if you want we probably don't I don't know if we have time for that or not but maybe know ifie if the story I did not do okay on the Kool-Aid and the dunk food um I I had a long history through childhood and early adulthood of um chronic mental illness uh OCD um I had all sorts of trauma and AD adversity in my life um my mother developed a psychotic disorder and I went to live with her for a while we were homeless together for a while um I actually left home before I finished high school I was completely on my own um and all the while I'm drinking my fizzy drinks and my Kool-Aid and my junk food I am not well at all uh in terms of Mental Health and um and then by the time I was in my 20s I had metabolic syndrome I had pre-diabetes I had horrible lipids wow and um I had high blood pressure and it just kept going higher and higher uh and my doctor kept trying to push me on pills and I realized if I go on pills for all of these things in my 20s I'm going to have heart attacks when I'm in my 40s or 50s and that is what prompted me to change my diet I recognized I can't do this this this is a a path to nowhere and that was actually one of the first Clues to me that changing diet can actually improve mental health because I changed my diet just trying to get rid of my metabolic syndrome recognizing I can't be having high blood pressure I and I don't want to be on pills for it I I need to control this some other way you went on low carb type diet didn't you from from what I understand I did I did and I had I had been religiously practicing a lowfat diet which was highly recommended at the time now it included a lot of processed foods but I wasn't told that those were harmful or dangerous I so I was eating pastries but they were no fat pastries so that was good for you and I was eating you know big bowl of no fat ice cream cuz that's good for you um nobody told me it wasn't and yet my metabolic syndrome was getting worse everything was getting worse and eventually I ended up on a low carbohydrate diet and again the adaptation was tough it the the first month was particularly tough and um but after 3 months my metabolic syndrome was completely gone but in addition I also noticed dramatic Improvement in my mental health my sleep my cognition my mood everything was getting better and so back to your original question I didn't turn out okay actually yeah if I had stayed on that path I probably would have had my first Heart Attack by now I don't take any medication for metabolic anything these days I don't take any prescription medicines and um and I'm in my 50s and so uh I turned out okay because I recognized the power of Lifestyle interventions and yeah proper diet and exercise and other things yeah I appreciate you sharing that first of all I think it's incredibly inspiring for people to know that it's never too late to change right you can make a change Doris in her 70s made a change and transformed the quality of her life you made a change in middle age and transformed the quality of your life weight high blood pressure metabolic syndrome mood everything's getting better so I appreciate you sharing that and to me we'll be back to the conversation in just a moment now many of us struggle to find time to eat all of these incredible Whole Foods that's why I'm a big fan of good quality Whole Food supplements like this one that's been in my own life for over three years now it contains over 75 Whole Food Source ingredients vitamins minerals pre and Pro iotics and can help us support our energy focused digestion and our immune system ag1 are giving my audience a fantastic offer oneyear supply of vitamin D and five free travel packs with your first order you can see all details at drink a1.com forli more or just click on the link below and now back to the conversation that really it helps me understand a lot because one of the things I really like about you Chris and and I can really feel it when you're talking to me here but I can also feel it online in your tweets so this feels personal it feels like you really really care you don't have to do this right you don't have to go around the world spreading this message right and I'm sure you sometimes face uh I guess criticism or opposition that's many of us do when when we try and share messages online these days but I really get that sense that you not only because of your own health but from what you've seen you've seen people in Desperate States and you've seen that sometimes the tools we have simply don't help very well so you are seeking out a different way you're trying to build the evidence base and you trying to share it with the world I am and um I think the thing that most passionately drives me is that you know I'm I'm literally hearing from thousands of people many of them sharing success stories yeah that they read my book or they heard me on a podcast or they read some article that featured my work and they made one or two or three changes fairly straightforward they did it on their their own because their doctor didn't know anything about this their doctor said no you need another pill or you need more psychotherapy but they heard me and they made some changes and they reach out in gratitude with I I can't even count the number of people who have said you saved my life or you changed my life or and this is a wide range of human beings I'm hearing from Physicians who have read my work one burned out physician who said he was ready to retire from clinical practice heard me on a podcast made three changes diet sleep exercise and he no longer wants to retire he's no longer burned out he loves his practice again he had no idea that his mental health could be related to diet sleep and exercise another physician just reached out to me yes yesterday chronic lifelong depression anxiety got treated by the world experts in depression and anxiety got somewhat better heard me on a podcast read my book implemented two changes has a new life and is full of enthusiasm and I think the thing that drives me is I recognize Millions more people need to know this people are suffering needlessly lives are destroyed and so I'm like constantly trying to figure out how do I get the message to them yeah how do I get the message to their clinicians so that their clinicians can learn about this it's not that hard you know how to do it I know how to do it we can teach them it it really isn't that hard you know I I thought things would you know not not solely because of this but I don't know how much you know about my career Chris but back in 2015 and 2017 I made a series of uh BBC documentaries that have gone around the world to over 70 countries now and I would basically go and live alongside families who had been sick most of them had been under GPS or Specialists most of them were on medications but they were still struggling and I would go in with TV cameras for four to six weeks and see if I could help them and in every single case their conditions were either put into full remission or they were significantly better and I didn't use a single drug it was all done through small changes to their lifestyle and there was one particular case and I don't think this one's on YouTube anymore unfortunately but there was one particular lady who had been suffering with severe panic attacks and anxiety for years and it was affecting how she felt about herself and interactions with her family she was a mother and you know we discussed various things but one of the things she ended up doing because she actually loved to cook but she hadn't cooked in years she was just self-medicating with alcohol all the time frankly and just about four to five weeks off a completely whole food diet and I think at the time I think I may have given her the whole 30 book which is a kind of paleo type uh diet uh she wanted to and she was cooking some of the recipes from it I'm not kidding you four to six weeks 70 to 80% reduction in symptoms right 70 to 80% that wasn't keto right it wasn't measuring ketones it wasn't tracking anything it was just simply let's cut out all the takeaways all the highly processed foods yes she had help and support because I was there there was TV cameras there so of course I recognized that that people can struggle to make these changes they can be hard they often need supports often their friends and their family and their work colleagues maybe it's working against them because that you know they're being exposed to foods that they're not wanting to consume yet they can't resist but nonetheless to see that kind of dramatic improvements and that went out to 5 million people in the UK on television right and I was thinking this is great people are seeing just how powerful this is back in probably 27 we're 6 years on now and I still do not believe from what I know talking to colleagues if someone is coming in with a mental health problem to their healthc care professional I think in the vast majority of cases diet is not coming up right it's not being brought up it's probably the same in America and and even you know let's rewind back to 2017 I'm sure you're very familiar with uh Professor Feliz Jacker smiles trial right randomized control trial showing us that in this group a small group I think it was 67 patients from recollection statistically significant changes for people who've already been diagnosed with modate to severe depression by going on a modified Mediterranean diets absolutely remarkable yet this really speaks to your point which is what drives you to keep trying to drive home this message is that people are going to their healthc Care Professionals and they're still not hearing this information exactly which and I think that the problem for me lies in that they hear it on a podcast or they read it in a book and then they go to their healthc care professional to validate the information hey Doc listen I heard this podcast last week you know they were talking about diet and mental health and how it might be helpful what you think oh no D and and the healthcare Ral will often say and I I understand it's from the training it's it's how they've been taught I know diet's got nothing to do with it right don't I don't know what that was but diet's got nothing to do with it no we'll we'll we'll work on your medications we'll we'll see if we can get you another referral or whatever it might be and I'm not saying that with judgments it's just so frustrating that people are suffering how many Doris's are out there right how many Doris's are out there whose lives are being decimated by metabolic dysfunction and potentially maybe a diet not even as Extreme as a ketogenic diet maybe something easier to implement for people what if that was to change things and sometimes you don't need a complete Revolution do you to the diet sometimes it's small tweaks that can make quite a big difference so went on a bit of a r there I didn't mean to but I like you you're very very passionately about this Chris yeah no I I 100% agree and I applaud like all you do and again it's just heartbreaking to think that you have somebody who knows what you know dedicate himself for four to six weeks to help someone improve their life and you can transform their lives imagine if we had a whole Health Care system with teams of professionals doing that on a regular basis we don't need to move into people's lives with TV cameras we could have a dietitian assigned to patients when appropriate we could it doesn't have to all from The Physician it can come from psychologists and therapists it can come from health and wellness coaches there are lots of professionals that we might and and these aren't lifelong treaters necessarily sometimes people only need 3 to six months or even one month to get started they just need the education and the support they need to change their habits get in the Rhythm know how to do it themselves and then they can live happily ever after independently on their own in the mental health field this is particularly relevant because unlike other fields we in the mental health field have Hospital systems and residential treatment programs that keep people long term there is no reason why mental health patients many of them can't get exactly what you did in the BBC series they're living in group homes yeah there's no reason why that group home staff can't learn these tools and techniques and put everybody there on a an appropriate diet and an appropriate movement plan or exercise routine let's get rid of the screens after 400 p.m. let's you know make sure everybody gets to bed at a decent time wakes up at a decent time let's get rid of the toxic substances like smoking and alcohol and marijuana and other things and and instead of just housing them for Life maybe we actually help them recover and move out yeah and live happily ever after now will some of them relapse if if they don't have that kind of support maybe but what some of them might not why not give them the chance why not give them the chance of recovery and remission and living a normal healthy productive life I want to talk briefly just about ketosis an MCT oil and whether patients have to go or certain patients have to go into ketosis in order to heal before that I just want to share a very quick story with you which relates to what you just said and and I'm sharing it I haven't I used to share it on the podcast because um I wrote about it in my first book but I haven't shared it for a little while but I I just want to share it to show people that even small changes sometimes can make a big difference it was uh again I called this patient in in the book I had permission to to share the story someone called Devon who was 16 years old and had ended up in the ER at the weekend after harming themselves and I was the GP I saw the patient in the week with a letter from A&E or or the ER explaining what happened and saying could you start um Devon on anti-depressants and explain what had happened and without going into the whole story essentially I was really confused because I thought I know this family pretty well over the years I never had detected anything what on Earth has gone on where this 16-year-old has ended up trying to harm themselves and so I was trying to figure out what was going on first thing I identified was heavy heavy social media use and again I I explained to them that I thought this could be playing a role here would they be interested in me helping them change this and this guy was desperate right he tried to harm him so I said okay sure do you think it'll make a difference I said look I don't know but I I really think it could make a difference and so over a period of four weeks we got him to not be on his phone at all for social media or anything for 1 hour before bed and for 1 hour in the morning morning I gradually moved him up to that point and little by little he started to show signs of improvement okay and then when I was asking about his diet it was a classic teenagers high sugar highly processed junk food diet he was having sugary cereals in the morning um and it was really obvious that he was getting hungry a lot of the time so I I didn't know all the science that I now know that what I said to him was look you're getting hungry a lot I because of what how you're eating every 2 hours when you're feeling hungry it's not just a hunger problem it's also a stress problem in the body your sugars are going up 2 hours later your sugars are crashing that's releasing a Cascade of stress hormones like cortisol like adrenaline that's also potentially impacting your mood go really what might my diet might be impacting this as Hey listen I don't know 100% but but I've got a strong suspicion that it is all all I did with his him I didn't go all paleo I didn't go all whole food I just said listen instead of having sugary cereal in the morning if you can have something let's say eggs and avocado right keep your blood sugar stable maybe take some nuts uh around with you I know there's issues now with schools and allergies okay this is right so just trying to cave out of that but this is what I said to him at the time right when you're hungry snack on that that will keep your blood sugar stable I am not kidding you right that completely transformed his life those two things that's all I did six months later I got a letter from his mom because I hadn't seen him for a while saying Dr chassi you've completely changed his life he's now happy he's engaging with his friends he's engaging with his communities he's well right and I I've done a quick summary version of that story because I didn't change everything I changed two things and I think that everything I did with him speaks to the theory you outline in brain energy right it all fits with that and I think one of the most important things is also at the age of 16 instead of labeling him right and then for the rest of his life he knows oh I have depression right I empowered him to help him realize oh wow there are things in my life there are things in my behaviors that are impacting my mental state he may relapse again at some point he may fall into all patterns but he got a deep understanding at 16 that oh how I live my life absolutely influences my mental States so I hope you don't mind me sharing that story but I think it really speaks to your work and also how simple it can be sometimes absolutely no thank you for sharing the story and actually you know stories like that are the thing that have empowered me to keep going because you already figured that out with him you may or may not have understood fully like what is causing the depression in his brain exactly at the cellular level at the you know serotonin level or neopine phrine level or whatever like what exactly is causing it and and will this really work but you did two simple interventions and they helped and transformed his life MH and I come at it again as an academic psychiatrist saying you know I've been studying and and just immersed in the Neuroscience literature trying to understand what causes depression in kids like that what causes suicidality how can we understand it how can we better intervene what pills should we use what Psychotherapy should we use right now the mental health field would largely ignore your story and they would say that's one anecdote and who knows why he got better lucky him but we deal with real depression Dr chattery we deal with real depression and we need powerful serotonergic medications or mood stabilizing medications or psychotherapies those are evidence-based treatments and what I'm hoping to do with my work is Bridge those two fields to say wake up traditional academic mental health neuroscientist professionals wake up look at the evidence look at the detailed evidence at the cellular level and you can understand yeah why a change in diet and a change in social media use and Improvement in sleep I'm a I'm guessing been in sleep why those things could put into remission a horrible case of major depressive disorder with suicidality so that's a really serious disorder and you put it into remission and he kind of sort of lived happily ever after at least in the follow-up time that you got yeah and you know the thing is look does that happen every time no but did it happen that time yeah right and does it happen every time no and then we need to be looking for other causes we need to be looking for okay if if we start with the framework that this is a metabolic problem in the person's brain so again we're excluding this kid is being bullied and teased yeah or this kid is madly in love with somebody who's not reciprocating his love um because you know Romeo and Juliet That's a classic everybody that is not a brain disorder it is not a brain disorder if you're madly in love with somebody and they don't like you back um it is normal to be depressed and the the treatment for that might be Psychotherapy the treatment for that may just be friends and family helping you through that crisis in life um so I'm not saying those people have metabolic disorders of their brain I think they're just normal human beings going through normal human suffering but um but if we really think it's a metabolic problem and diet and cell phone use and sleep don't do it I'm going to be looking for are you using substances are you smoking marijuana are you using alcohol um are you taking any prescription meds that might be harming your metabolism are you do you have an infection or do you have signs of chronic inflammation do you have an allergy do you have gut problems do you have you know know if you have gut symptoms and maybe there's something going on in your gut you've got inflammation there maybe that needs to be addressed maybe you're allergic to certain foods maybe so there are lots of things that we can try but it's not rocket science it's not rocket science sometimes I not to say that everybody should be able to heal themselves without the help of a medical professional because I think sometimes it is complicated yeah yeah for sure and sometimes medical professionals do need to be helpful and help you you think through all of the different complicated things that could be going on but to medical professionals this shouldn't be rocket science this is what we're trained in and we can do this yeah and I just want to make clear like none of us are saying that oh just do one two three things with the ELA suddenly you have no mental illness anymore and none of us are trying to say that I think we're just trying to broaden the conversation and say these things all need to be looked at as part of the treatment strategy right we shouldn't just be looking in one area we should be looking in all these areas and seeing what we can influence and manipulate I just want to very quickly if we can just finish off on that thought about diet MCT oil and keto and the the reason I'm bringing it the the I think the take-home message to people is with respect to diet is as you mentioned let's try and cut out the sugars and go to Whole Foods and see what happens right obviously that patient Doris went on a ketogenic diet now of course we don't know what might have happened had she just done a whole food diet rather than a keto diet but there is quite a bit of research on ketogenic diets in your experience do some people with certain problems need to go those few steps further Beyond just Whole Foods and actually you know drastically cut out carbohydrates to help encourage keep Tois maybe take MCT oil and things like that or you know just just help us understand at the end here Chris if you can is that sometimes needed in in your in your experience it is so the easiest place to start is just what with what we know in epilepsy because we have a robust literature and I am a mental health professional I'm not an epilepsy specialist so some might say why are you talking about epilepsy the reality is we use epilepsy treatments in psychiatric all the time and there's a lot of overlap between the basic pathophysiology so when when researchers scan the brains of people with epilepsy they're very very similar to the brains of people with mental disorders people with epilepsy also have much higher rates of mental disorders broadly across the whole board schizophrenia bipolar disorder depression anxiety suicidality all of it so what we know from the epilepsy literature is the Mediterranean diet does not stop SE it doesn't so so there is something unique and special about carbohydrate restriction the two evidence-based treatments for epilepsy are the ketogenic diet and there are a lot of different versions of it you can do you know supplement with MCT oil you can do different ratios again you can do vegan vegetarian you know um uh omnivore carnivore lot lots of different versions of these diets um or a low glycemic index diet so low glycemic index diet is a more Whole Foods diet but you're getting rid of pretty much grains and sugars and mo you're getting rid of a lot of high high glycemic indexed fruit so you're probably not eating bananas or pineapple and that works for epilepsy and that works for epilepsy it does not appear to work as well as the ketogenic diet but for some people it works and that's all they need and it's easier to do theogenic diet so it's a it's a kind of a form of a low carb diet that's working and sometimes it's not enough and they have to go full keto much easier and and exactly like the patient that you described the young man I've had people where all I did was remove sugar and from the diet and that was enough or remove processed foods and that was enough but for patients with epilepsy which is a very serious brain disorder with very serious sometimes life-threatening symptoms the two evidence-based treatments are low glycemic index diet and ketogenic diet I have reason to believe that that probably is also going to apply to people with bipolar disorder and schizophrenia I see their disorders as a more serious metabolic brain disorder than somebody with mild anxiety or somebody with even depression and and for those patients then if you feel that they need a full-on ketogenic diet do you measure ketones I do how do you do that so if if it's at all possible and some some patients just you know can't afford it um but if it's at all possible I measure blood ketones using a blood Ketone monitor so that's just like a um it's just a a glucose meter for people with diabetes they prick their fing they get a little drop of blood and they measure it there if people can't afford that um you can do urine ketone strips but I definitely strongly recommend testing for ketones one way or another um what level do you want if if I'm treating somebody with bipolar disorder or schizophrenia I'm typically looking for ketones greater than one at a minimum ideally greater than 1 five in the blood so in the blood my ideal is 1.5 to3 in a blood meter for beta hydroxy berate um and the reality is I've had a lot of patients who actually do amazingly well when they have their ketones at like 1.7 to two or or three and it when they drop down to 0.6 for instance which is still ketosis but just a much lower level their psychotic symptoms or their bipolar symptoms might start to come back so you can actually see a correlation between symptoms in these patients and their Ketone level on individual patients yes across studies so like in the epilepsy literature epil you know neurologists have actually been studying this for decades trying to see is there a clear correlation should we be prescribing a certain Ketone level for everyone and they don't see that pattern across patients so it's bioindividual is what we're saying is that for some patients some patients might get a robust clinical response at a ketone level of 0.5 and they may say I'm in remission and if they do I'm going to I'm going to say great keep doing what you're doing and we're good but if they get to 0.5 and they say my hallucinations are still prominent or I'm still having depressive symptoms or suicidal symptoms I'm going to push the envelope I'm going to try to get them to a higher level of ketosis by modifying the diet the modifications are usually to add more fat maybe in the form of MCT oil um and or further restrict carbohydrates Andor protein so it gets complicated quickly this is something that I do not recommend people do on their own if you're if you're trying to treat epilepsy please don't do that on your own and if you're trying treat schizophrenia and bipolar disorder with a medical ketogenic diet I actually routinely say please don't do it on your own you deserve competent Medical Care yeah and a physician or dietician or other trained health care professional there are lots of professionals who really know how to do this and they can help you and they can help monitor your symptoms for your serious brain disorder and help you hopefully get a recovery Chris this just amazing hearing all this information um the the book is just fantastic and I think for anyone who wants to learn more there's a lot of Science in there there's a lot of research there's a lot in there that will help people any psychiatrist or professional who is looking after people with mental health problems I think would absolutely benefit from understanding that patients of course as well uh and and I think Chris we've opened up so many doors during this conversation I don't think we've closed them all so hopefully that means that I might be able to tempt you for a part two at some point in the future to continue discussing this just to finish off Chris for someone who's feeling inspired by what you've said by your work but feels I don't know where to start what would you say to them um I I you know I I don't mean to try to sell the book at all but I do want people to understand the big picture and all of the different factors that can play a role because it's not just diet it's diet and sleep and exercise and substance use and toxin exposure and other things so I want people to understand that big picture um if you can uh people can go to the a website brain energy.com we're developing I've got a team of volunteers right now we're just trying to develop some articles and give resources because we are hearing from literally thousands of people around the world who want more we've got a self assessment that people can do for free um where I walk people through some of the biomarkers or some of the symptoms that you should be on alert for and if you have any of those symptoms it's going to give you clues that maybe I've got some inflammation or you know maybe I could benefit from losing a little bit of weight or maybe you know my hormones are off balance and I should talk to my doctor about uh getting tested or um you know maybe you know getting hormone replacement therapy if if appropriate or indicated so website um I think if people follow us on the website and or follow on social media a lot of the people following me on social media are doing these treatments and they are there and ready to help reach out like I see this happening all the time like I cannot give medical advice on Twitter you can't we we Physicians cannot give medical advice but you'll find lots of peers on Twitter and other social media channels who will give you their advice take it with a grain of salt because they're not medical professionals but you should not have to be alone in this fight if you are fighting for a recover recovery from a serious mental illness you can get a lot of support from people and yeah yeah well Chris I think you you are tirelessly doing incredible work you're giving so many people across World hope thanks for coming on the show thank you for having me on the show thanks so much if you enjoyed that conversation I think you are really going to enjoy this one about the impact of sugar on your body and brain when you consume sugar you are poisoning your mitochondria sugar and cyanide do the same thing this is the toxin

Channel: Dr Rangan Chatterjee

Views: 413,470

Keywords: the4pillarplan, thestresssolution, feelbetterin5, wellness, drchatterjee, feelbetterlivemore, ranganchatterjee, 4pillars, drchatterjee podcast, health tips, nutrition tips, health hacks, live longer, age in reverse, self help, self improvement, self development, personal development, motivation, inspiration, health interview

Id: SSbpupbdqRw

Length: 168min 23sec (10103 seconds)

Published: Wed Oct 25 2023