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if a woman has obesity and diabetes she has quadruple the risk of having an autistic child but I want to go deeper and most people don't know this
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something horrible has happened Dr Chris Palmer the Harvard psychiatrist whose groundbreaking new research could be the
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missing piece to cure the mental health epidemic mental disorders are the leading cause of disease and disability
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worldwide governments are actually labeling them as terminal illnesses and to allow people to die by assisted
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suicide and they're going to allow them to die because they know what I'm saying is true they know that our treatments
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fail people year after year after year and what I'm here to say is you can in fact get better how I struggled with mental illness myself for 20 years I
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tried to kill myself several times there was no hope for me whatsoever and I was furious with the mental health field for being so
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incompetent and I wanted to try to help and the thing that people have not open their eyes to is the science of
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metabolic health and there's tiny things in our cells that can heal and recover people who have had chronic horrible
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mental illnesses really yes and if autism is genetic it shouldn't quadruple in 20 years these are facts and we can
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do something about it today but the easiest way to understand it is that quick one this is really really fascinating to me on the back end of our YouTube channel it says that
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69.9% of you that watch this channel frequently over the lifetime of this channel haven't yet hit the Subscribe
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00:01:48
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sure that everything we do here gets better and better and better and better that is a promise I'm willing to make you do we have a
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[Music] deal Chris when you speak before we started recording you speak with a deep authentic sense of
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mission and that underneath there is a personal driver that is unimat and that is getting you out of bed every day because I could see it in your eyes I could see it in the way that
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you said the words that you said to me where does that drive begin for you what was the Catalyst moment in your life
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that inspired you and gave you that fire that seems to be unquenchable to pursue the path that you've pursued you know I
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struggled with mental illness myself starting in childhood nobody recognized it nobody diagnosed it I didn't know what it was
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nobody knew what it was I just knew I was different and somehow ostracized for who I was and it
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just felt like part of who I am and then a series of horrible tragic events happened in my extended
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family when I was about 12 years old and my mother ended up having a nervous breakdown she called it a nervous break break down it started with what we would call major depression
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quickly escalated to depression with suicidality and then she developed psychotic symptoms she became very delusional she got mental health
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treatment but the treatment didn't work they basically were just kind of in my 12-year-old mind the psychiatrists were just drugging her
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and those drugs weren't making her symptoms better they weren't restoring her health she went on to live the rest of her life with a chronic psychotic
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disorder and that disorder completely ruined and devastated her life in so many ways she lost everything she lost custody of her eight kids she lost all
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of her money everything that courts didn't give her any support or any money I had my own struggles even worse with mental illness
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after all of that I ended up leaving home before I finished high school I had chronic depression and suicidality and
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OCD and other things and the mental health field was worthless for me and probably caused a lot of harm for me and so the the end of the day the
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reason I'm a psychiatrist is because I recognize how horrible and devastating mental illness can be and I came to the field
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really angry with the mental health field for being so incompetent and I wanted to try to help I wanted to try to maybe contribute to
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better solutions for people my futile attempts to save you from the ravages of mental illness lit a
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fire in me that burns to this day I'm sorry I didn't figure this out in time to help you may you rest in
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peace that's my mom and that's the dedication of the book her story and the devastation to her life is the thing that drives me to this
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day um and I just know that there are hundreds of Millions millions of people just like her with different diagnoses with different
00:06:07
symptoms but the devastation to their lives is the same and those people deserve better and I want to help them I want to get them better
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treatment those people those people exist on some kind of I guess multiple different spectrums of disorder what are those spectrums of disorder and what are what are those disorders
00:06:31
that you're referring to when you say those people are the people that I want to help people who are diagnosed with a
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mental illness and so you know the diagnoses are all over the map we have all of these different diagnoses and the
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DSM 5tr the diagnostic and statistical Manual of Psych patry which is kind of considered the Bible of Psychiatry and it has all of these labels in it um
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schizophrenia bipolar disorder major depressive disorder alcohol use disorder which most
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people know as alcoholism other addictions uh anorexia nervosa but also autism autism spectrum disorder or
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dementia that most people know as Alzheimer's disease that those are all of the labels
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in our um in our kind of Bible of Psychiatry and the reality is that when you look at the treatment
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outcomes for people who are getting treatment for those diagnostic labels there is no doubt that our treatments do work for a lot of people
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millions of people and so millions of people are helped their lives can be saved by the
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current treatments that we have and I'm not here to take that away from anyone so for people who are getting treatment and those treatments are working keep getting that treatment I don't want to
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interfere with anyone's access to those medications or psychotherapies or electr convulsive therapy or whatever treatment they're getting I don't want to stand in the way
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but there are far too many people just like my mother who did everything they were asked to do who took all of the
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pills who showed up for their therapy appointments who did everything they were asked to do and they're not getting
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better you know mental disorders as an as a whole are now the leading cause of disease burden and disability worldwide and it's not because those people aren't
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getting treatment many of them are getting treatment yes there are people who can't afford treatment or can't get
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access to care but a lot of people are getting treatment I work at one of the best
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psychiatric hospitals in the world I have the privilege of doing that and we see patients that aren't getting better we see them all the time day in and day
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out and the crisis the tragedy is that some governments are actually now moving to labeling mental illnesses as terminal
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illnesses the Canadian government in March of 2024 is going to allow people to die by
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assisted suicide because of a treatment resistant mental illness really yes they're going
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to allow them to die and they're going to allow them to die because they know what I'm saying is true they know that
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our treatments fail people year after year after year and those people become desperate and hopeless and they give up on treatment for good reason because they've
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participated in treatment for decades and it hasn't helped them and the Canadian government has now made the decision that they should be allowed to die with the help of a
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physician who can prescribe deadly medications and make it easy for them to die by Suicide the UK is now labeling some
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people with eating disorders as terminal eating disorders and that maybe you know if
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they've exhausted treatment if they've had treatment for several years or more than a decade well treatment's just not
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going to work for them so let's call them terminally ill with an eating disorder people are frustrated and hopeless again I'm not talking about the
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people for whom treatment's working if treatment is working for someone if they're taking a pill and it's working
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fantastic you're lucky keep doing it and I don't want to interfere with anyone's
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access to that treatment but we can't hide from the tragic realities of the the world for all of those people that are
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they might have extreme anxiety depression schizophren osity these extreme sort of mental health
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disorders what is it that you want to put into their hearts and Minds with your work with the message that you're
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spreading what is it that those people need to know and I I say that not as all of the details which we're going to go
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into but the very Topline message that you know maybe in a sentence you want those people to
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have if you have been trying treatment and those treatments aren't working for you please don't give up there is hope
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you can in fact get better if you understand the science you can get better the mental health conversation the uh prevalence of mental
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health lots of these things seem to have changed in the last 28 years what is the
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state of mental health as we sit here today and how has that changed in the 28 years that you've
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been at Harvard and working in this field I think I have a slightly different perspective yours sounded more hopeful than mine you kind of said things have
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changed in 28 years and tragically I actually feel like they haven't changed a whole lot if you look at if you look globally
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at the problem the problem of mental illness is increasing it is not stagnant and is not decreasing it is increasing in prevalence throughout the
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world prior to the pandemic about 1 billion people had a mental or substance use disorder representing about 133% of the world's population and that was just
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in one given year 2017 the pandemic added insult to injury and rates are much higher now and the rates of mental illness have been in increasing across a wide range of
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diagnostic categories rates of autism in the United States over the last 20 years
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have quadrupled a four-fold increase rates of ADHD are up and through the roof rates of bipolar disorder in adults a lot of
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people think bipolar disorder that's genetic well in adults in the United States over the last 20 years rates have
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doubled in children and Adolescence rates are through the roof up exponentially thousandfold percent rates of plain old bread and butter depression
00:14:09
major depressive disorder the Gallup pole does an annual survey in the United States of current and lifetime prevalence of depression
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and just this year in 2023 rates of both both current prevalence and lifetime prevalence reached alltime ever recorded highs so
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we have a catastrophe we have an epidemic mental illness is a growing escalating problem and I wish that I could say our treatments were dramatically better
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there is no doubt we do have new treatment options we have ketamine and psychedelics we've got transcranial magnetic stimulation which wasn't around
00:14:58
when I first started we have some new medications but the real answer is the medications that we have are no better than the old medications because they're all based on the same
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mechanisms so companies are simply repeating what we already know kind of sort of works and they're just making new molecules that kind of sort of do the same thing and so they still just
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kind of sort of work they don't work for everyone and they even fail to work for
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most people in the largest study ever done of depression when people come in the very
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first anti-depressant treatment they get over 4,000 people treated at the best academic centers that we have in the
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United States the first antidepressant treatment only about 30% get a remission that means 70% % still have major depressive disorder they have
00:16:02
enough symptoms to still be labeled clinically depressed even if the pill helped them a
00:16:09
little bit it didn't help them enough to make their symptoms enough of their symptoms go away now even those 30% who
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got a remission many of them are still having low-grade symptoms like all of their symptoms didn't go away and after
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four levels of treatment the original published report said that 67% got a remission after four different types of treatment for major depressive
00:16:40
disorder if we take that at face value that means onethird of patients are still clinically depressed after four levels of
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treatment other researchers have challenged that 67% figure because the reality is half of the people in that study dropped out because it just wasn't working out for them so we got a problem
00:17:06
there like this this protocol clearly isn't working out well for people when half of the people are dropping out of
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your study and the second problem is that there are some researchers who point out
00:17:19
that they changed the criteria for remission during the study they prospectively said they were going to Define remission in a very certain way using certain
00:17:35
metrics those researchers said if they stuck to their protocol only about 35% got a remission after four treatment
00:17:48
levels that would mean two-thirds of people after getting four levels of treatment are still clinically depressed and that is the current state
00:17:59
of affairs for depression something that we all know something that we've got so many
00:18:05
treatments for if we look at more quote unquote serious mental disorders like bipolar disorder and schizophrenia the results are abysmal the one large study of 6,000
00:18:20
patients with schizophrenia only 4% of the patients got a recovery meaning that their symptomss were in full and complete
00:18:32
remission they were they had a decent quality of life and that they were able to function in the world they were able
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to have a job or go to school only 4% of people with schizophrenia got that using
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our best treatments available today those statistics aren't a lot better than they were 50 years ago tra magically Chris when people say to you
00:19:01
or when people say the quite common rebuttal that the reason we're seeing this rise in mental health disorders is
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just because there's more of a conversation about it so more people are stepping forward we now have a word for it so there's just more labeling and
00:19:14
these mental health disorders like the ones you've named and even things like ADHD and autism um it's just because
00:19:20
there's more conversation going on and these things aren't in fact increasing that is a common argument and
00:19:30
I would argue that it's like just putting your head in the sand the easiest place to get an accurate
00:19:42
read on the true prevalence of mental illness and not just the recognition of it but the true prevalence of it is to
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talk to school teachers who've been teaching for more than 30 years if you ask them were you just not recognizing the
00:20:03
children 30 years ago who are screaming and tantruming in your classroom were you just not recognizing the children who were melting down when they got bad
00:20:15
grades and injuring themselves in class were you just not recognizing the level of Despair that you and anxiety that you see in children did you just have your head in
00:20:28
the sand back then and now since everybody's talking about it you see those behaviors you see those symptoms
00:20:35
the school teachers and the guidance counselors will laugh at you and say no no no something has happened something horrible has
00:20:50
happened I wasn't ignoring mental health 30 years ago I wasn't ignoring despair 30 years years ago I wasn't ignoring extremee anxiety and panic I wasn't ignoring Tantrums in my classroom 30
00:21:04
years ago they are skyrocketing in prevalence if we look at emergency rooms so emergency rooms in the United
00:21:17
States that's I can speak best about statistics here in the United States um but I think in most Western countries these statistics
00:21:29
are similar we have a crisis in mental health in emergency rooms in particular youth mental health but it's across the board we have all of
00:21:41
these children and adolescents showing up to emergency rooms having attempted suicide or they're becoming psychotic and they're diagnosed with
00:21:52
bipolar disorder at skyrocketing rates and and we don't have enough services to treat these people these kids these
00:22:04
adolescents our children we don't have places to put them so they sit in emergency rooms not getting Optimal Care simply getting medicated sometimes
00:22:16
restrained to a hospital gurnie so that they don't try to run away or hurt themselves talk to anybody in an emergency room we're see that those people weren't hiding in
00:22:31
their homes 30 years ago something's happening they are actively acting on mental health symptoms they are acting
00:22:44
out of Despair the suicide rate has gone up if you in the United States or the last 20 years total suicide rate has gone up by
00:22:55
about 30% but if you look at a different statistic called deaths of Despair it has doubled in 20 years deaths of Despair includes not only
00:23:10
suicides but also deaths from alcohol use drug overdoses and others those are mental health problems those are addictions they are mental health
00:23:22
disorders they are in DSM rates have doubled in 20 years people weren't dying 30 years ago and we just didn't recognize
00:23:34
it and now we're recognizing death now we're recognizing suicide we didn't really recognize it 30 years ago but now we recogniz no no no we we know we know
00:23:46
what death is morticians know how to recognize it and diagnose it and the rates are skyrocketing a doubling in 20 years that is nothing to
00:24:01
ignore that begs the question what do you believe is causing it because clearly you know when I've
00:24:08
heard people when I say people I mean just the you know the things you see in culture and media or maybe on Instagram
00:24:14
that say you know there's a chemical imbalance in people's brains I've always struggled with that I understand there
00:24:19
might be sometimes but I've struggled with that as a broad answer to a very complicated Nuance set of issues because
00:24:25
I just have a a bias to believing that hum aren't born broken you know I believe that you know my ancestors go
00:24:32
back very I've got a lot of ancestors that um I understand how natural you know natural selection and evolution works I don't think that I was born broken so I think maybe there's an
00:24:42
environmental factor maybe something I'm I'm doing or something we're doing as a society is increasing these rates of suicidality that you talk
00:24:49
about what you believe is the answer that we're missing or not talking about enough the root causes which we can can get to and and I have lots of ideas and
00:25:01
thoughts on it if you want to get into the weeds of like what are the exact causes we can talk about that but the
00:25:08
thing that people have not opened their eyes to is the science of what we call metabolism or metabolic health and what I ultimately am arguing
00:25:21
the easiest way for me to put it is that what I'm arguing is that mental health condition The Chronic serious ones in which the brain isn't functioning
00:25:34
properly brain disorders that are causing mental health symptoms those are the things I'm talking about now that
00:25:40
we're all susceptible to you believe I think we're all susceptible to it those in fact are metabolic disorders affecting the brain and so the easiest way to
00:25:52
understand why do we see skyrocketing rates of mental illness it's not a coincidence that we're seeing those skyrocketing rates at the same time that
00:26:04
we see skyrocketing rates of obesity overweight diabetes and pre-diabetes which are also metabolic conditions that all of those things are
00:26:18
rising simultaneously and that the brain is an organ and so some people can have metabolic problems
00:26:28
and some people can be thin and still have a metabolic problem so it's I'm not at all saying that obesity is the only driver because a lot of times people think about it in that way so are you
00:26:41
saying obesity comes first and then everybody gets a mental illness no I'm not saying it that way sometimes the
00:26:47
mental illness starts first because it's a manifestation of metabolic dysfunction in the
00:26:54
brain and it basically means the brain isn't working working right and so somebody might have unrelenting
00:27:01
depression or unexplainable anxiety or psychotic symptoms or bipolar symptoms or eating disorder symptoms or substance use disorder symptoms that they may
00:27:17
have symptoms but all of those things are a manifestation of metabolic dysfunction in the brain can you explain metabolic dysfunction to me like I'm a 10-year-old
00:27:28
the easiest way to explain it is that our bodies and our brains are made up of cells and all of our cells need two essential things to function properly
00:27:42
they need food oxygen those are the big ones that most people know it gets more much more
00:27:49
complicated fast because food contains all sorts of nutrients so we need certain vitamins and nutrients and
00:27:55
hormones are playing a role all sorts of things are playing a role but at the end of the day that's what metabolism is metabolism is taking food
00:28:02
and oxygen and keeping us alive they are fundamental to our health but also the function of our cells and when something
00:28:15
goes wrong in that process and there are lots of things that can go wrong when something goes wrong with
00:28:22
taking food and oxygen and turning it into energy the cell can malfunction and when it happens in your
00:28:33
brain it means that your brain can malfunction and the way that we know the brain is malfunctioning are all of the symptoms of mental illness when
00:28:46
somebody has depression for no good reason when somebody has anxiety for no good reason when somebody just has experiences like hallucinations
00:29:01
or delusions for no good reason that all of those things represent the brain malfunctioning if you could take me one step deeper into this idea of you know food and oxygen being converted into
00:29:14
energy in the cell um something goes wrong there what goes wrong why does it go wrong so the real answer is it's
00:29:26
extraordinarily comp licated there are many Pathways in metabolism there are many things that play a role but the
00:29:33
easiest way to understand it and the way to unify it the helpful insight the immensely helpful insight and this is new Cutting Edge
00:29:45
information most people don't know this but there are these tiny things in our cells called
00:29:56
mitochondria and they are actually the primary sites in our cells that food and oxygen are getting converted into energy or
00:30:09
building blocks for our cells when you do a deep dive into the science of mitochondria you can actually begin to
00:30:21
understand what's happening in the brains and bodies of people with mental illness and you can begin to understand all of these very complicated things like why
00:30:32
would neurotransmitters become imbalanced that's what what's causing a neurotransmitter imbalance if there even is one what's causing a hormone
00:30:43
imbalance what's causing higher levels of inflammation in the brains and bodies of people with metabolic and mental
00:30:51
disorders um what about the gut microbiome how does that play a role but what about stress and Trauma psychological stress trauma how do those
00:31:05
things fit in mitochondria are actually the scientific way to begin to connect all of those dots and help us
00:31:17
understand why the brains of some people quote unquote malfunction or why they are disregulated might be a better way to put it or why some people can't seem to
00:31:32
quote unquote get over it get over a trauma or get over a breakup with someone what's going on why aren't they more resilient why can't they pull it
00:31:43
together mitochondrial dysfunction as nerdy and sciency as that is can help us connect the dots what do I need to know about the mitochondria what it is I know it's in every cell in my body um is is
00:31:57
there anything else I need to know about it before we explore these through lines and how all these other things come back
00:32:02
and connect to the mitochondria so mitochondria are present in most cells in the body not not every single human the the glaring example are
00:32:13
red blood cells which actually lose their mitochondria they have them when they are first forming but then they
00:32:19
lose their mitochondria so red blood cells interestingly don't live all that long um we're constantly creating new
00:32:25
ones and turning them over so most people know mitochondria as the PowerHouse of the cell which means they
00:32:31
take food and oxygen and turn it into ATP and that's what most people learn in school they're the PowerHouse of the
00:32:37
cell but I'm here to tell you they are so so much more than that there are hundreds or thousands of them in most
00:32:45
cells they are highly Dynamic at one point you know the the theory of multicellular life on planet
00:32:58
Earth is that mitochondria were once Independent Living bacteria and that another single cell organism engulfed that very first
00:33:13
bacterium and the two of those organisms lived they stayed alive usually when you get engulfed by another organism that means getting eaten and you you die for whatever reason
00:33:27
these two stayed alive and they became symbiotic with each other and actually that event is thought
00:33:37
to maybe have only happened once on Earth and that single organism evolved into all multicellular life that we know today so all living
00:33:50
organisms that we can see with our eyes plants all animals are evolved from that same organism so mitochondria divide and replicate they
00:34:05
actually move around cells they fuse with each other they Bud off from each other they they form patterns around the nucle cell nucleus which plays a role in
00:34:19
which genes get expressed or don't get expressed they do all sorts of things when people say that we have a predisposition a genetic predisposition to mental health disorders and that you
00:34:30
know you'll have depression if depression runs in your family Etc is there Merit in that in your view is
00:34:35
there evidence to support that absolutely so we know that we know that mental illness runs in
00:34:41
families genes explain some of that but not all of that the environment actually
00:34:49
can influence things called epigenetic factors which are factors that control the expression of genes they turn genes on or off and those
00:35:05
epigenetic factors are actually inheritable you can inherit them from your parents and so it's not all strictly genetics um some of it is epigenetic so
00:35:19
first and foremost there are no genes that are specific to specific disorders most people think well you know if bipolar disorder runs in my family there must be a bipolar disorder
00:35:31
Gene and in fact there isn't a bipolar disorder Gene there are genes that increase risk for bipolar disorder but at the same time they also increase risk for schizophrenia and epilepsy and
00:35:44
autism and depression and other types of mental and neurological disorders and if you look at the unifying theme like is there a theme for
00:35:57
these genes is there a common pathway that can help us better understand mental illness the common pathway is that most of the genes are affecting metabolism and
00:36:09
mitochondria one research study that came out a couple years ago researchers have been looking for years at a a
00:36:17
high-risk Gene for schizophrenia um and we know that people who have this very very rare genes so
00:36:24
almost nobody has it but if you do have it you're at high risk for developing schizophrenia along with lots of other
00:36:30
mental illnesses but schizophrenia is the big one and the researchers did this deep dive into trying to understand what exactly is this Gene doing and at the end of the day they said it's affecting
00:36:43
mitochondria and that is probably how it is causing schizophrenia metabolism that
00:36:49
happens as a result of the work of the mitochondria is that accurate so want to make sure I've I'm clear on them before
00:36:54
we proceed 90% of of metabolism at least is occurring in mitochondria so it's that definition as a scientist I have to say isn't 100% accurate because there is a thing called
00:37:08
glycolysis that can happen in cells where you can actually produce ATP without using mitochondria what's that so ATP is usually known as the energy
00:37:20
currency of living organisms of cells and so um and that that ATP ends up making cells work it is the energy that's flowing around cells or the
00:37:33
molecule that's flowing around cells to make receptors work to to make all of the Machinery of cells work and that becomes relevant maybe some of your
00:37:45
listeners will know this if you exercise really hard like you're running a marathon or you're running as far as you
00:37:52
can get with a marathon before you absolutely are exhausted and you just have to stop your mitochondria will
00:37:59
actually become maxed out that is what's preventing you from running is your mitochondria max out and they they're
00:38:05
it's like you don't have enough of them or they're not healthy enough and so they just they can't keep you going they
00:38:11
can't keep your muscles going and so you Peter out and when you Peter out you start you turn to this process called glycolysis which actually ends up producing lactic acid or lactate and so
00:38:24
Runners will get higher levels of LA lactate and and then that can create soreness and all sorts of things um but
00:38:33
uh yeah that's so metabolism is really the process of taking food and energy food and oxygen I'm sorry and turning it into energy or building blocks and that can occur on a small scale outside of
00:38:47
mitochondria but as soon as the mitochondria in most of your cells are dysfunctional or dead you you die
00:38:55
there's no way around it so let's use some of those examples that you gave earlier you talked about stress
00:39:00
and Trauma and these kinds of things I'm really Keen to know how a traumatic event can have an impact on your
00:39:07
metabolism your mitochondria which then manifests as a mental illness um so if we take trauma for example people go
00:39:13
through early trauma in their life I don't know there's a I mean you had a very traumatic upbringing how do you think that maybe even in your case if
00:39:21
you were able to see inside of your body and what was happening that external um traumatic event came into your body in
00:39:27
some way caused a physiological reaction had an impact on your metabolism which results in a mental health disorder of
00:39:34
source it gets a little complicated because it it goes through a couple of stages so I'll try to walk you through
00:39:41
it in the simplest way I can when somebody is first traumatized everybody if they are normal will have symptoms if you get traumatized you will
00:39:54
experience fear you will experience hypervigilance you will want to fight or flee or you might freeze or you might surrender you might beg for forgiveness
00:40:06
or Mercy or what you everybody is going to have those reactions in my mind those reactions are not disorders they are not
00:40:17
malfunctioning brains or malfunctioning anything um so everybody will have that however when that
00:40:29
happens it immediately changes your metabolism your metabolis the easiest way to understand it is the sympathetic nervous system gets turned on fiercely
00:40:43
if the trauma is really bad because you have to defend yourself your life is threatened your safety is
00:40:55
threatened traumas can even be less extreme than that you can have highly stressful events in which maybe even though your physical life isn't threatened maybe all your money is
00:41:07
threatened the stock market crashes and you lose everything and you now think I'm
00:41:15
worthless I'm penniless I'm losing my status in society I'm going to have to live a very different life I've just disappointed everybody who depends on
00:41:30
me that could be a trauma even though by definition because it doesn't threaten your life it's not technically considered a trauma so for those people that are you know they've been through a
00:41:42
traumatic event what then is going on in their body as it relates to metabolism based on that traumatic event trauma immediately changes
00:41:53
metabolism so trauma puts us into this you know most people know it as fight ORF flight mode um and again there are other
00:42:07
responses that one can have you can surrender you can freeze you can do other things but um when people feel
00:42:17
threatened either physically or their reputation is threatened or their identity is
00:42:23
threatened immediately they're nervous system and hormones are changing and the reason they're changing is because your our bodies are hardwired
00:42:35
to protect us and in order to protect us it means that we need more energy and we
00:42:41
need it now we need more energy in order to be able to run or fight or whatever we need to do and that means that our heart rate goes up our blood glucose
00:42:52
goes up cortisol is flowing [Music] adrenaline is flowing through the body inflammation is actually occurring and epigenetic changes are
00:43:08
occurring memory formation is occurring in a powerful way during a trauma memory our brains are hardwiring this event so that we remember it we remember
00:43:25
this threatened us and you cannot forget this this is not a trivial moment you must remember this for the rest of your life because it's threatening your survival and you must remember how to
00:43:38
respond to this again not necessarily because our responses can be all over the map sometimes our responses can be
00:43:45
quite effective and other times people can die they don't respond effectively and they are killed I mean that would be the worst case scenario and then there's
00:43:56
everything in between where you you get a suboptimal outcome you end up homeless with your psychotic mother that's not a
00:44:03
very effective response when I asked that question I was asking as we see patterns in trauma like a trauma pattern
00:44:08
there's a trigger there's a response and then you know I even think about some of the low you small te traumas that I had
00:44:15
in my life that meant that I would run from romantic commitment for the rest of my life for example and it was like a
00:44:21
pattern I was going through the same Loop over and over again trigger Steve's response is like this causes this
00:44:26
outcome trigger so I was wondering if I learned at that very young age that cycle
00:44:32
somewhere in my like neurons in my brain so that's why I said do we then learn the response to that trauma at that
00:44:39
point as well we we learn the response we remember the response that we did MH and as long as we've survived that is the ingrained memory the ingrained
00:44:52
memory is when this happens do this because this is what I did and I survived it and so that becomes the default and then that becomes a default
00:45:05
pattern for many people MH at some point in life it can be act actually be quite useful to look at that response okay so
00:45:17
when I was 5 years old or 20 years old or whatever and that thing happened I responded this way and I survived it
00:45:28
great but how's this working out for me now is that the optimal response it's not about beating yourself up for I should have done something different back then it's simply about
00:45:43
recognizing and honoring I I did what I thought I was the right thing to do I did my best back then but I'm smarter now I'm older now I'm Wiser now
00:45:57
if I could do it again if I could go back in time as my smarter wiser self would I do it differently and what would the outcome be if I did it
00:46:10
differently and then that becomes highly relevant to today so when I'm in this romantic relationship now I keep having this urge to break
00:46:23
up because this person is disappointing ing me in this way and I feel like she or he is going to threaten me or betray me or
00:46:35
whatever and is that the right approach is it true that this person is going to betray me like the person in the past
00:46:46
did or am I hyp sensitive to that am I again we're wired to look for any clue that a trauma might happen again so we're we're going to over interpret things
00:47:02
sometimes in an in a in an erroneous way so that early trauma or that trauma I experienced made my body go into that survival mode fired all kinds of ways and my glucose levels went out my all of
00:47:16
these things all metabolism related stuff happened how does that then cause a mental health disorder at some point
00:47:22
down the line if that trauma is not resolved so for some people they can experience a trauma they can be quite
00:47:34
effective at mitigating it and move on with their life somebody could get into a fight
00:47:42
somebody could get mugged on the street they're just walking down the street somebody pulls a knife on them or a gun
00:47:48
on them and wants to Rob them if somebody manages that trauma highly effectively let's say you happen to have a black belt in karate and you disarm
00:48:02
your as salent very quickly and rapidly you may not think twice about the trauma you may actually be emboldened after that traumatic event and think I'm quite effective and
00:48:13
skilled wow those karate classes really came in handy and um I'm quite powerful and maybe even feel a little more confident than you normally would and that's the interpretation element right of the situation so two people could be
00:48:26
in the same situation but have so that person still had the same physiological reactions a gun in your face or or wherever that person's glucose was going
00:48:39
up their heart rate was going up all of those metabolic changes were occurring but so that's a success story and that's probably a resilient person
00:48:50
who moves on and never thinks twice about that trauma or rarely think thinks about it and thinks about it with pride if they do think about it in the case where it doesn't go well at all let's
00:49:04
leave the extreme out where the person is murdered let's leave something less severe than that but the person is
00:49:16
beaten they are injured severely they are terrified to go out in public for fear that there could be another one
00:49:28
just like that that person their fighter flight system is not turning off their fighter flight system is now
00:49:40
on at least at a low level possibly a very high level for a very prolonged period of time they are now afraid of the world immediately after that type of horrific
00:49:54
assault they are now afraid of the world they probably aren't sleeping as well and what's happening physiologically and we know this is that those higher
00:50:07
cortisol levels are actually causing something called hyper metabolism their mitochondria are actually working on overtime because the body is still
00:50:19
primed for the world is unsafe everything is unsafe Maybe that person who assaulted me is going to somehow figure out where I live and come through that door any minute so you're
00:50:31
sleeping at night and you hear a sound or you hear a creek and you panic and you wake up and
00:50:38
you're startled and you're terrified or you sleep at night and you have a nightmare and you wake up and you're
00:50:44
reliving that experience and just you're horrified and overwhelmed again is it is
00:50:50
this conscious because you know often you speak to people with severe anxiety and they have panic attacks and they
00:50:55
don't know what why they're having panic attacks they can't name something that they're scared of or a fear they have no
00:51:01
this is not at all conscious so at this point in the week or two after a horrific trauma like I've described I would argue this is not a
00:51:12
disorder this is not the brain malfunctioning this isn't the body malfunctioning the brain and body are
00:51:18
doing precisely what they are programmed to do protect you your life is in danger why because somebody just tried to take it and they were close they came
00:51:32
close to taking your life they could have killed you and so your body and brain are trying to protect you unfortunately that comes at a cost all of this energy going toward the
00:51:46
defense system means that energy that should be going toward maintaining your cells is actually being bypassed
00:51:59
sometimes so we know this so for example there are these things called stress granules where cells that are trying to just do basic ho hum everyday repair
00:52:13
work create some new proteins or new receptors or you know do some cleanup work the code for those which are called messenger RNA actually get sequestered in these little
00:52:27
bubbles called stress granules and what that means is that they're not getting done the the
00:52:34
messages are starting from your DNA because the cell is saying hey I need some repair work over here send some new proteins over here to do some repair
00:52:46
work when your body is in fighter flight mode those messages actually get interrupted and that means means bottom line it means that when you feel
00:52:59
threatened your body is diverting metabolic resources toward your self-defense system hypervigilance be
00:53:08
ready to run at any minute be ready to fight off the offender at any minute you cannot feel safe don't feel safe when that goes on for a prolong
00:53:19
period of time your cells can fall into a state of disrepair because metabolic resources are not going towards cell maintenance if that occurs long enough
00:53:32
or in a severe enough way it means that some of your cells can now fall into a state of disrepair and they can begin to malfunction when that happens if it's
00:53:47
happening in brain cells that's when I would say the person has crossed the line from a normal survival reaction to
00:54:00
trauma if their cells in their brain begin to malfunction now because they are on a state of disrepair they that can turn into what
00:54:11
we call a mental illness and that means that maybe they can't remember like they used to it means that maybe and and now
00:54:21
they're they can't pay attention like they used to now somebody might say hey maybe you've got some ADHD going on or
00:54:30
they their anxiety Pathways become what's called hyper excitable and now their anxiety pathways are being triggered even when they
00:54:42
shouldn't be triggered and out of the blue they're having panic attacks or anxiety symptoms they can be sitting in
00:54:49
the comfort of their own home not thinking any scary thoughts not having any not watching anything on television or anything that's really disturbing and
00:55:01
out of the blue they can just be overwhelmed with a panic attack and that person I would say if they have a panic attack for no reason that person's brain is now malfunctioning it is
00:55:15
disregulated and I would say that that person has now crossed over into what I would call a mental disorder where their brain is in fact malfunctioning
00:55:27
now the great news the hope and we can get to more of it is that that those cells can be repaired we can fix that we can do
00:55:39
something about that the person does not need to be like that forever this notion that they now have a chemical imbalance that they were probably genetically predisposed to and
00:55:53
now we've got to just medicate them for the rest of their life I don't agree with that I'm not at
00:56:01
all opposed to medication if medications can be helpful to that person 100% let's
00:56:06
use them Let's help that person heal and recover but I want to go deeper I want to understand what is happening in that person's brain and body using this kind
00:56:21
of information about metabolism and mitochondria and how can we effectively help them heal and repair and and recover you know we talk a lot about
00:56:34
diet and food on this show um as it relates to metabolism and mental health diet so diet is
00:56:46
huge and most people have no clue that diet plays any role in mental illness or mental health 95% of mental health clinicians think
00:57:00
it's laughable that anybody would suggest that diet can play a role in mental illness I think it's laughable what do you think I think if you do a deep dive into the
00:57:17
science all of the science that we have accumulated over the last 100 years and longer sometimes that if you do a deep dive into all of those neuroimaging studies that we've
00:57:29
been doing all of the genetic studies we've been doing all of the neurotransmitter and hormone studies and
00:57:36
Trauma studies and adverse childhood experiences studies if you do a deep dive into the science and you understand what is happening in the brains and bodies of
00:57:47
people as a consequence of those things or what could be causing those things if
00:57:54
you put it all together you come to this sound bite that mental disorders are metabolic in nature and there is no questioning whatsoever it is
00:58:10
incontrovertible that diet plays a massive huge role in metabolism and therefore I believe very strongly that
00:58:25
diet might be playing a role in the mental health epidemic that we are seeing and it also might provide an Avenue of Hope and healing and
00:58:40
recovery and I use the word might is the scientist in me is the clinician in me I know without
00:58:51
certainty it can heal and recover people who have have had chronic horrible debilitating mental illnesses and I know from my own personal
00:59:02
story when I was in medical school and residency I'm still suffering from lowgrade depression OCD other symptoms but I also developed what's called
00:59:12
metabolic syndrome I developed high blood pressure high cholesterol um pre-diabetes and I wasn't really overweight I was EX exercising I
00:59:25
was following a lowfat diet mostly a processed foods because they're cheaper but that was the diet that was touted as a health a healthy diet it was low in
00:59:36
fat and as long as it was low in fat that was supposed to be good for us and my metabolic syndrome just kept getting worse and worse and so at some point in order to treat my metabolic
00:59:49
syndrome I changed my diet to essentially a low carbohydrate diet and within 3 months my metabolic syndrome was
01:00:03
completely gone but the thing that just dumbfounded me was that my mental health was better than it had ever been
01:00:17
in my entire life and I just couldn't believe what I was experiencing I didn't know that I could be that kind of a person I didn't know that I could be happy and positive and energetic and
01:00:31
confident I had no idea I I didn't think that was in me and by changing my diet all of those
01:00:39
things happened at the level of the mitochondria are you saying do you believe that because you changed your diet to more sort of natural healthier foods
01:00:53
at the level of the mitochondria the mitochondria were able to function more more naturally themselves and in a in a
01:00:59
more um yeah functional way which meant that they released the chemicals they released in the processes they go through were more consistent with
01:01:11
positive mental health is that like the simpleton's way of understanding it and before then you talked about man-made
01:01:17
compounds in the foods Etc I'm assuming you're saying that some of the modern foods that we eat the ultr processed food that have all these random named chemicals inside them that we see on the
01:01:27
labels the mitochondria don't know how to deal with that so it's causing the same sort of disregulation and dysfunction that they might see if we'd
01:01:34
gone through like an extreme trauma or something else or some other adverse environmental situation it's just this
01:01:40
dysfunction of the mitochondria which is causing the KnockOn effects we see but there's many things that can cause
01:01:46
dysfunction in the mitochondria and we name we went through a bunch of them earlier is that like a simple way of
01:01:51
understanding it 100% okay great it's perfect so super interesting okay so on that point then
01:01:57
we have to zoom in on this thing of diet if you wanted my mitochondria to be perfect and maybe even give me a case that of I don't know patients you've worked with that you've you you've
01:02:08
prescribed a certain diet to what diet what food would you tell me to eat and what would you tell me not to eat so I actually don't have a one siiz
01:02:19
fits all prescription and so I to say that up front so I would want to know who am I working with and how is their mental and
01:02:33
metabolic Health now me so you yeah so I would want more details are you having symtoms of any mental health condition I would say no however I can I can have
01:02:47
moments where I feel a little bit anxious so you know I've been through a lot of I'd say like stressful events in my life because I was running a big business we had hundreds of employees
01:02:58
paydays all the time so I had this at one point I had this constant subtle stress and so I would want to know do you feel like you have anxiety For No Good Reason sometimes
01:03:11
sometimes it can feel a little bit like that um it's very infrequent I'd say but I can also have moments where I just think of something and then I get the same kind of like it's almost like
01:03:24
the fal FL response has just kicked in but you think of something adverse or stressful yeah yeah yeah so so the so
01:03:32
the one thing I would say about that and we could get into a lot more details which we probably don't want to do Now podcast but my my strong guess based on
01:03:45
just what you've said is that that level of Stress and Anxiety is quote unquote normal okay because you you are sensing I have to go
01:03:57
do something that's really scary right now or I have to go do something that's going to ruin someone's life or that
01:04:06
that might threaten My Success it is normal and actually healthy to have anxiety and stress in those
01:04:17
situations the anxiety and stress can sometimes be quite helpful and adaptive because it can make you pause and reflect on is this really what I want to do as opposed to being overly confident
01:04:31
and just [Music] proceeding your own personal history almost certainly informs your level of stress response and again so if you go back to
01:04:45
your own traumas you're going to remember when I'm facing a situation like this it's
01:04:51
helpful to be on hyper alert it's helpful to be hypervigilant and your body and brain
01:04:59
will remember that helped you navigate this safely and effectively but if I have that profile if I have that sort of mental health profile now as I sit here and then for the next decade I
01:05:12
ate processed junk food am I going to send my mitochondria into disarray which is going to increase the probability that I have a mental health disorder yes I think yes we've
01:05:26
got you know we there's no way we will ever be able to do a human randomized controlled trial to test that precise unethical hypothesis but we have large
01:05:37
epidemiological studies that strongly suggest that people who eat a lot of ultra processed food have higher risk for developing depression
01:05:50
anxiety and other mental disorders and based on the science the granular science based on animal models so we can
01:06:02
do that to mice and rats and in fact that's exactly what we see in mice and rats we feed them an obesogenic
01:06:12
diet which is usually high in fat high in carbohydrates Ultra processed foods some
01:06:19
researchers have C fed rats and mice cafeteria Di diets where they feed them a lot of delicious junk food and those mice develop higher rates of obesity but
01:06:33
also higher rates of diabetes and pre-diabetes and oh by the way also higher rates of depression and anxiety because those are the two things that we
01:06:45
can kind of measure in M rats we can't necessarily measure ADHD symptoms it's really hard to actually measure psychotic symptoms um but we can measure depression and
01:06:57
anxiety symptoms pretty well in animals and so in animal models we know that that's unequivocally
01:07:02
true and we see the same in humans though because I was reading your book and in chapter 4 you say people with ADHD are more likely to develop obesity
01:07:09
people are who are obese are 50% more likely to develop bipolar and 25% more likely to develop anxiety or depression
01:07:16
and weight gain around the time of puberty leads to a 400% increase in the chance of
01:07:21
depression by the age of 24 yes and insulin resistance at age nine makes increases your chances of developing a psychotic at risk mental
01:07:35
state which is like meaning you're at high risk for developing schizophrenia or bipolar disorder 500% and
01:07:42
Alzheimer's all mental disorders are associated with an increased risk of Alzheimer's disease anywhere from the lowest is 50% increase risk and the
01:07:55
highest is 2,000% increased risk and the thread that unites all of these problems
01:08:01
is metabolism metabolism and at the end of the day you have to talk about mitochondria in order to understand metabolism um only 7% of
01:08:17
US citizens have no signs of metabolic health problem meaning 93% or so of us residents will have at
01:08:31
least one of the biomarkers of metabolic syndrome meaning they have pre-diabetes
01:08:39
or abnormal lipids or high blood pressure or abdominal obesity or abdominal fat excessive abdominal fat so what do we offer those 93% so those people
01:08:54
diet interventions would absolutely be a part of a healing strategy a part of it not the only strategy I would want to know about their sleep I would want to know about
01:09:07
substance use I would want to know about medications lots of things but for dietary interventions I would want to
01:09:14
meet them where they're at and just find out well where are you at what are you eating do you have preferences or
01:09:22
demands for what your diet should be could you give me a case study then maybe a more extreme case study from
01:09:28
your practice that you've seen I could I can give you the simple cases where which probably apply to the
01:09:41
majority of human beings on the planet but if it's okay I'd rather give you the extreme case because a lot of people are skeptical they they probably hear me
01:09:53
saying this and they think well you're just talking about General Health and Wellness what about people with real
01:09:59
mental illness what about people like your mother whose lives were decimated by mental illness this doesn't have
01:10:06
anything to do with them and what I'm here to say is no actually this has everything to do with
01:10:13
them too but yes it applies to just common everyday people but you know probably so one story
01:10:25
that I will just share to just because it's probably one of the most powerful stories I know it was a
01:10:34
woman whose real name was Doris and um in the book I called her Mildred because I changed everybody's names but she actually gave me permission to use her real name so in
01:10:45
honor of her I want to use her real name so she was a woman who actually had a horrible abuse of childhood lots of trauma and by the time she turned 17 she
01:10:57
started having daily hallucinations and delusions and was diagnosed with schizophrenia over the ensuing decades she tried numerous antipsychotic
01:11:09
mood stabilizers um anti-depressants and other medicines but none of them stopped
01:11:17
her symptoms she remained with all of the symptoms of schizophrenia she ended up gaining a
01:11:23
massive amount of weight she ended up weighing about 330 lb by the time she was 70 her life was devastated by this
01:11:37
diagnosis she had a cour appointed Guardian to manage her financial affairs and other Affairs she had professionals coming into her home to help her with paying bills and grocery shopping and
01:11:49
stuff like that because she couldn't do it for herself which is not at all unus usual for people with schizophrenia and
01:11:56
between the ages of 68 and 70 she tried to kill herself at least six times and was hospitalized for those suicide attempts she hated herself and
01:12:07
she hated her life when she was 70 years old her doctor told her you're overweight and you need to go lose some weight and she
01:12:17
was she was referred to a weight loss clinic at Duke University where they just so happened to be using the ketogenic diet as a dietary inter as a weight loss
01:12:29
tool and for whatever reason she decided to give it a try and so she tries the ketogenic
01:12:36
diet and within two weeks not only does she start losing weight but she notices dramatic reduction in her hallucinations and delusions within months all of her
01:12:49
symptoms of schizophrenia were in full and complete remission she starts tapering off her psychiatric
01:12:56
meds within about six months she was off all of her psychiatric meds and her symptoms of schizophrenia remained in [Music] remission Doris went on to live for
01:13:09
another 15 years symptom free medication free out of psychiatric hospitals no more suicide attempts she stopped saying
01:13:23
mental health professionals pretty quickly because they were kind of worthless in their mind they hadn't really helped all that
01:13:30
much she lost 150 lbs and kept it off until the day she died she ended up dying at the age of 85 of Co
01:13:42
pneumonia and um but her story tells us like we could get if if you want we don't have to we could get into the science of the ketogenic diet and what it's doing to metabolism and mitochondria I love to know but there's
01:14:00
an entire story that helps us understand what happened to her and how exactly that resulted in her really spectacular and almost miraculous
01:14:12
recovery so so unbeknownst to most people most people know that ketogenic diet is a fad diet and a lot of people
01:14:19
are really worried about it they they've heard that it's dangerous you know it'll give you a heart attack you'll
01:14:25
die unbeknownst to most people the ketogenic diet was developed over a hundred years ago now by a physician for
01:14:32
one and only one purpose it was developed to stop seizures and in fact the ketogenic diet has been studied
01:14:43
extensively for its effects on the brain over the past 100 years and it is an evidence-based treatment for epilepsy and the reason that is so
01:14:57
important is because we use epilepsy treatments in Psychiatry all the time lots of the
01:15:04
medications that we prescribe to psychiatric patients are in fact epilepsy treatments and so we know that there's a
01:15:11
lot of overlap between epilepsy and mental illness and that treatments that help with epilepsy can also help with
01:15:19
mental illness and so we actually know more about the biology of the ketogenic diet and its effects on the brain than we do any other dietary
01:15:30
intervention it changes neurotransmitter systems it decreases brain inflammation
01:15:36
it changes the gut microbiome in beneficial ways it actually changes gene expression or epigenetics but most important and relevant to my theory is it improves
01:15:48
mitochondria and mitochondrial function and and if you do it long enough over a long enough period of time you can actually
01:16:00
repair mitochondrial dysfunction in cells at least for some people and and then you can actually stop the diet so in the epilepsy world
01:16:12
when neurologists use this diet to stop seizures it's usually not a lifetime treatment they usually only need to do the diet for anywhere from two to 5 years
01:16:23
many people about a third of people who have treatment resistant seizures will become
01:16:28
seizure-free and another third so 2/3 total another third will have a dramatic reduction in seizure frequency so that leaves a third for whom it's not really working but these
01:16:40
are people with treatment resistant epilepsy and there's no treatment that's going to work for everybody because we
01:16:46
need to look at all the other things involved if say somebody has seizure sensation they get rid of their seizures on a ketogenic diet usually they have to do it for two to five years somewhere in
01:16:58
there and their clinician will help them decide how long they should do it and then they can stop the diet and most
01:17:07
often the seizures don't come back it seems to actually heal the brain what is that diet adding or subtracting from the body that's causing that pretty phenomenal effect do people know the
01:17:20
real answer is we don't entirely understand we don't know I mean the ketogenic diet removes sugar for example it does um pretty much EX entirely I mean
01:17:33
I've been on that diet for about was on the diet for about eight weeks or so just a try and I could I couldn't have anything
01:17:40
with sugar in it pretty much no sugar no carbohydrates very few carbohydrates the so some people will argue well the diet is getting rid of gluten and gluten
01:17:52
is is maybe the toxic thing other people will argue oh the diet is adding like some extra protein or meat and maybe
01:18:01
that's replacing a nutrient deficiency like vitamin B12 deficiency or something like that or iron deficiency and all of those things might be true for some
01:18:13
people I don't think those are the primary explanation I mean obviously if somebody
01:18:19
has vitamin B12 deficiency replacing vitamin B12 is essential somebody has iron deficiency yes recognizing that and
01:18:26
replacing it but most people don't have those deficiencies and they can still have mental symptoms or mental health problems I believe what the diet is doing is it it forces a transition in
01:18:40
brain and body metabolism essentially and that act that transition is actually mediated through mitochondria so the ketogenic diet forces your liver to
01:18:52
start producing Ketone bodies so it forces your liver to break down fat so you're you're losing fat from your fat stores but that fat is being shuttled to
01:19:03
the liver and then the liver takes that fat and breaks it down um and I mean I shouldn't say all of the fat is being shuttled to the liver some of the fat is going to muscles and other tissues and
01:19:15
just being used directly but a fair amount of the fat is actually being shuttled to the liver and
01:19:21
then that fat is being converted into Ketone bodies some of it is being converted into glucose so that you maintain normal glucose levels through this those Ketone bodies are then going
01:19:34
up to the brain and fueling brain cells but those Ketone bodies are actually doing so much more they're they're
01:19:41
changing mitochondrial function they're changing epigenetics they're changing neurotransmitters and inflammation and
01:19:48
all sorts of things but at the end of the day I'm convinced that it's really the metabolic changes and the mitochondrial changes that are
01:19:59
so important and that are so instrumental in these dramatic improvements and things like stopping
01:20:06
seizures or stopping hallucinations and delusions what about F fasting there's been a lot of talk especially recently about fasting and the impact that that can have on our mental health do you
01:20:17
think fasting is a positive for our mental health I so it depends on the person okay and so the ketogenic diet actually mimics the fasting State that's what
01:20:30
that's why it was produced all right the ketogenic diet was actually developed by a
01:20:36
physician recognizing that fasting can have really powerful brain effects including stopping seizures if you if you're out on an island and Your Friends start seizing uncontrollably the best
01:20:48
thing to do is to fast them even if the seizures stop intermittently you would think oh let's feed you to you know keep up your sustenance and you know take
01:20:58
care of you the best thing to do for your friend if they are seizing repetitively over days or months the
01:21:07
best thing to do is to fast your friend and to tell them let's have you go without food for a few days and that can stop the seizures wow the the challenge
01:21:18
with fasting is that you could starve to death if you do it long that's not a that's not a very good treatment for your friend on the island and this physician who developed the ketogenic
01:21:29
diet recognized that and so that's why he developed the ketogenic diet was really looking to see can we mimic the fasting state with a
01:21:40
diet and um and get these longer term benefits so back to your question can fasting play a role 100% yes fasting can play a
01:21:51
role and fasting is doing pretty much the same thing that the ketogenic diet is doing it's changing mitochondrial
01:21:57
biology it's improving mitochondrial function changing neurotransmitters changing the gut microbiome improving
01:22:04
insulin signaling and insulin resistance it's doing all sorts of beneficial things there are a couple of caveats
01:22:12
with fasting though one is that people who are underweight should not fast so that includes people with eating disorder ERS who are emaciated or underweight but it also includes people
01:22:27
like who have had severe depression and lost weight as a result of their severe depression or people
01:22:34
with cancer who have lost a significant amount of weight fasting is not good for them
01:22:41
fasting mimicking diets like ketogenic diets May in fact be very powerful for those people but it but they it needs to
01:22:49
be done in a safe supervised Medical Way sugar what impact does that have on the
01:22:54
mitochondria if I've got a super high sugar diet is that impacting my mitochondria in some way and therefore
01:23:00
my metabolism it is um so low low intake of sugar in people who are otherwise healthy is perfectly fine and acceptable so you
01:23:16
know lots of people can consume treats every now and then or desserts a few times a week or you know special holiday they can maybe even
01:23:28
binge on sugar over the holidays and they don't have any problems as a result of it and that is fine if that's the way it's working out
01:23:40
again only 7% of the population is metabolically healthy so the majority of people that's not the way it's working out so high levels of
01:23:51
sugar over time we know can impair mitochondrial function so there's this term called oxidative
01:24:04
stress and oxidative stress is primarily it's directly related to mitochondria because mitochondria are producing the energy and then that energy production
01:24:16
results in oxidative stress and and oxidative stress we've known for decades is bad for cells and it is highly correlated with
01:24:27
all of the metabolic disorders and all of the mental disorders high levels of oxidative stress at in different cells
01:24:33
and different people with different diagnoses high levels of oxidative stress are a unifying theme but that is
01:24:41
a reflection of mitochondrial dysfunction so we know that if you eat if you eat a lot of sugar over
01:24:47
time it can disregulated glucose levels and then those high glucose levels can cause
01:24:55
mitochondrial dysfunction and you can end up kind of on the downward spiral what about caffeine and these stimulants there's like pre-workout stimulants and you know before you do a workout you
01:25:07
have a big dose of this pre-workout and it kind of makes you go like you know do you have a view on caffeine in
01:25:14
these sort of energy stimulants I do so so so caffeine gets complicated because we have to talk about whether it's in tea or coffee or not cuz tea and coffee are are different
01:25:28
stories and they have other compounds that almost certainly are beneficial to human health um and whether it's the caffeine itself or not is still kind of
01:25:39
a question an open question caffeine stimulates metabolism in cells we know that so it it blocks
01:25:50
the adenosine recept ctor and the adenosine recept the function of the adenosine receptor and
01:25:57
adenosine on it is to slow a cell down it's basically a a feedback loop that slows cells down it it inhibits their function so when we block a Denine we
01:26:09
basically stimulate the system and we stimulate our brains and if you have low metabolic brain function that can actually be really good if you are
01:26:24
feeling tired and sluggish it can make you feel energized and clear thinking the challenge is that you can overdo it so when you stimulate it too
01:26:39
fast that in and of itself can end up causing oxidative stress or mitochondrial dysfunction maybe the easiest way to think about it is this if you think
01:26:50
about a car you have a an accelerator and a break if you're going to maximize the cars function there's a right balance for all
01:27:04
of that you don't want to floor the accelerator and you don't want to underdo the accelerator likewise you want to determine like you don't want to
01:27:15
be pushing on the accelerator and The Brak at the same time so when we think about metabolism and mitochondria when
01:27:22
we think about caffeine or even glucose caffeine and glucose are stimulating the system they are through different mechanisms but they are both
01:27:35
stimulating energy production but when you overdo it it would be like flooring the
01:27:43
accelerator and then possibly putting on the break at the same time because you don't want to be going that fast because you're going to crash so either you're going to floor the accelerator crash and
01:27:54
burn or you're going to floor the accelerator and slam on the brake at the same time you're not serving your car
01:28:01
well by doing that by flooring the accelerator and pushing on the brake and when we use substances like caffeine or alcohol or
01:28:13
marijuana which are all working at the level of metabolism and mitochondria when we use those substances in essence we're using accelerators or brakes for
01:28:25
cells and we can overshoot or undershoot so it's not that I'm against the use of
01:28:31
those things if you use reasonable small to moderate amounts of those on a regular basis I'm all for it so I drink coffee every day every morning to
01:28:44
disclose my bias to disclose my bias I drink coffee every morning um about two cups of coffee every morning but that's my routine I don't go beyond that I don't
01:28:56
drink coffee in the afternoon um when I do drink coffee in the afternoon I notice it starts to interfere with my sleep and then that throws me off I have to ask you as well I've had so many
01:29:08
parents messag me about autism and ADHD so many you know I've had so many concerned parents message me specifically on Instagram saying please Steve you know I've had a child
01:29:20
diagnosed with um ISM they're trying to understand it they're trying to get good information on it you've used the word
01:29:26
autism and ADHD as we've been speaking about metabolism what is the link in your view everything the link is
01:29:34
everything so the really the mitochondrial theory of autism actually was first proposed in
01:29:41
1985 and since then we have had an explosion of research linking mitochondria and mitochondrial dysfunction to autism specifically as I've mentioned to you
01:29:53
the rates of autism have gone through the roof in the United States they've quadrupled in the last 20 years and
01:30:00
people think well what does that have to do with diet those kids haven't eaten a diet yet well their parents have and let
01:30:09
me share a couple of Statistics so people are scratching their heads where's all this autism coming from I
01:30:16
thought autism was genetic and if autism is genetic it shouldn't quadruple in 20
01:30:24
years quadrupling in 20 years means something in the environment is causing it and to to provide just one piece of evidence to support what
01:30:36
I'm saying if a woman has obesity she has doubled the risk of having an autistic
01:30:48
child if a woman has diabetes she has double the risk of having an autistic child if a woman has both obesity and
01:31:01
diabetes she has quadruple the risk of having an autistic child if a man is obese he has double the risk of having
01:31:15
an autistic child so people are scratching their heads trying to figure out where is all
01:31:21
this a ISM coming from well look around in the population are the rates of obesity
01:31:27
going up are the rates of diabetes going up the answer is unequivocally yes and that is a reflection it's not
01:31:40
about fat shaming I don't want anybody to hear that and wag their finger at fat people and say oh you're causing autism because you're overeating it's not that simple that's not the way it
01:31:53
goes people with obesity have a metabolic or mitochondrial problem that is why they have obesity now that might be caused by the foods they're
01:32:05
eating but they don't know any better usually they think it's just about calories and what I'm here to say is no
01:32:12
there's more to food than just calories it might be those chemicals in the food that you're eating or something else or
01:32:18
it might be chemicals in our environment it might be pesticides or microplastics the forever
01:32:27
chemicals that are becoming more and more ubiquitous all of these things disrupt metabolism and mitochondrial
01:32:34
function and so when I talk about obesity and diabetes increasing risk for autism it's not about fat shaming it's about
01:32:46
understanding it's about understanding that the parents have a metabolic problem already that means that they
01:32:53
have a problem in their cells with their mitochondria and they then pass those on
01:33:00
to their children and in some cases it may not show itself immediately as obesity or diabetes it might show itself as a brain condition because lots of other things
01:33:16
can play a role and if an obese woman for instance also has an infection during pregnancy that's going to increase her risk for having an autistic child even more so she couldn't help whether she
01:33:30
got an infection or not tragically we just had an epidemic called covid and the early signs are telling
01:33:42
us that in fact neurodevelopmental disorders are going to increase as a result of that we already had a
01:33:50
quadrupling of the rates of autism we are likely to see even worse statistics going
01:34:01
forward the hope is that if we understand that science we can do something about it now today if you understand if you see signs
01:34:15
of autism in your child if you s see signs of metabolic or mental health conditions in your children if we intervene early enough we can probably
01:34:27
do something about it how number one by recognizing the problem and then two for some people it could be as simple as
01:34:39
dietary interventions or just hyperfocusing on good clean living so that means prioritizing sleep little less screen
01:34:51
time little more human contact purpose and life you know family connection no alcohol no alcohol no marijuana no CBD try to avoid pills try to avoid
01:35:06
pills for everything that ails you if your child's sleeping please try methods other than
01:35:13
pills including melatonin and over-the-counter pills don't just whip out a pill for your child not being able
01:35:20
to sleep at least try some other interventions like let's get you off the screen two hours before bed let's
01:35:28
develop a routine in our household that we're all going to wind down we're all going to turn off the electronics maybe I'm going to read you a bedtime story or we're going to play a game or we're
01:35:40
going to do something really boring that everybody's going to say this is so boring I'm getting sleepy and I'm going
01:35:47
to say great you're it's so boring that you're getting sleepy that means you're going to go to sleep because it's
01:35:54
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get started now the link is in the description below if you listen to this podcast frequently there's something I
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talk about very often and that is the subject of sleep and so I dug down a pretty deep sleep Rabbit Hole to figure
01:37:03
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savings I have to ask you mentioned that you moved in with your mother to try and save her um when she had was suffering with a
01:38:01
multitude of sort of mental health disorders what is that like as a child I I was trying to imagine if I moved in with my mother when she was you use the
01:38:13
word delusional right what is that like I've heard people speak to me about a parent with dementia and that kind of
01:38:21
that loss but what is the loss like that you experienced if I was a fly on the wall in those moments what would I have
01:38:26
seen and if I was a fly inside of your heart what would I have felt it was actually really horrendously
01:38:38
awful um when I first moved in with her we had a little bit of money still and so we were living in a rooming house we were renting rooms
01:38:52
at some point the money ran out and the support that we were getting wasn't enough and that's when we became homeless but almost from day
01:39:07
one living with someone who is severely depressed and suicidal and psychotic it's hard to not feel that
01:39:20
your self it's like you're living in this just oppressive cloud of Despair and it's everywhere it's in the air like when you're in the home with
01:39:39
that person it's in the air that you're breathing it it's hard to describe it but that hopelessness just overwhelms I mean you try to cheer the person up
01:39:55
and it's just feudal and I remember I think the first like three or four months I lived with
01:40:06
her I like cried myself to sleep every night like just sobbing crying crying into my pillow so that she wouldn't hear me CU I didn't want to burden
01:40:19
her but I did know what to do I was just I was it was just overwhelming and after about four months I actually I couldn't cry
01:40:33
anymore I just lost the ability to cry I became numb I just I I couldn't tolerate those emotions that just
01:40:45
despair I couldn't I couldn't manage it that actually persisted with me for probably like like 20 years I wasn't able to cry for like 20
01:40:58
years there was a part of me that just felt like you know crying is weakness and crying is feudal it doesn't do
01:41:06
anything it doesn't solve any problems um it's interesting CU When I was with her I hadn't gotten to the point of
01:41:22
suicidality myself I was desperately wanting to stay alive to see if I could help her and keep her alive within about a year of that
01:41:34
though I started developing my own suicidality and um and that persisted in me for years
01:41:46
after um I tried to kill myself several times I was injuring myself I was doing all sorts of [Music] things I was very I was actually
01:42:00
convinced if you asked me at the time I would have said I was 100% certain that I wouldn't be alive to the age of 20 I I knew with certainty that I would
01:42:11
be dead and I knew that I just couldn't tolerate living and that there was no hope for me
01:42:19
whatsoever Chris thank you your um book is full of solutions and it's full of Hope and I think that's why it's such an
01:42:26
incredibly important book and it's a a book that has The Bravery to illuminate another set of answers and another path forward out of the Despair
01:42:37
and the epidemic of mental health um illness that we're unfortunately I agree we're heading we are in and increasingly heading towards if that makes sense it's
01:42:47
certainly increasing in prevalence a revolutionary breakthrough and understanding mental health and
01:42:53
improving treatment for anxiety depression OCD PTSD and much more brain energy really really remarkable book and Once upon once in a while books come along that challenge the status quo in
01:43:05
the most necessary way and your book is certainly one of them we have a closing tradition on this podcast where the last
01:43:10
guest leaves a question for the next guest not knowing who they're leaving it for and the question that's been left for you is you were known for your work
01:43:18
Chris but what would you like to be known for as the human that you are I think I would like people to know like I've shared with you
01:43:34
today that I was somebody who had given up on myself who actually thought there's no possible way I could ever have a future
01:43:47
I could ever live a meaningful or even tolerable life and that all has changed and if it can change for me and
01:44:00
you happen to be one of those people in a similar state right now it can change for you
01:44:08
too Chris thank you thank you so much you know there's this um there's this wonderful quote that I read earlier from the start of your book where you send that message to your
01:44:19
mother my fure T attempts to save you from the ravages of mental illness lit a fire in me that burns to this day I'm
01:44:26
sorry I didn't figure this out in time to help you may you rest in peace but I have to point out the fact that the work you're doing the passion you're bringing to it the wisdom and the 28 years of
01:44:38
study and Care you've put into all of the work that exists in your book and your wider work is saving many people's
01:44:47
mothers thousands of people's of their mothers their fathers their daughters their sons and that I think is an absolutely
01:44:58
incredible thing so be on behalf of all of those people that you'll absolutely never meet you'll meet many of them sure
01:45:03
many of them messages you message you but all of the ones that aren't able to or haven't yet I just want to extend a
01:45:09
big thank you for the work you've done in your life for those mothers for those fathers for those daughters and for those
01:45:15
Sons thank you Steve [Music] as you'll know if you've listened to this podcast before I'm an investor in a company called hu I'm on their board and
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