00:00:00
if a woman has obesity and diabetes she has quadruple the risk of having an
00:00:06
autistic child but I want to go deeper and most people don't know this
00:00:12
something horrible has happened Dr Chris Palmer the Harvard psychiatrist whose groundbreaking new research could be the
00:00:19
missing piece to cure the mental health epidemic mental disorders are the leading cause of disease and disability
00:00:26
worldwide governments are actually labeling them as terminal illnesses and to allow people to die by assisted
00:00:33
suicide and they're going to allow them to die because they know what I'm saying is true they know that our treatments
00:00:39
fail people year after year after year and what I'm here to say is you can in
00:00:45
fact get better how I struggled with mental illness myself for 20 years I
00:00:51
tried to kill myself several times there was no hope for me
00:00:57
whatsoever and I was furious with the mental health field for being so
00:01:03
incompetent and I wanted to try to help and the thing that people have not open their eyes to is the science of
00:01:10
metabolic health and there's tiny things in our cells that can heal and recover people who have had chronic horrible
00:01:17
mental illnesses really yes and if autism is genetic it shouldn't quadruple in 20 years these are facts and we can
00:01:24
do something about it today but the easiest way to understand it is that
00:01:30
quick one this is really really fascinating to me on the back end of our YouTube channel it says that
00:01:36
69.9% of you that watch this channel frequently over the lifetime of this channel haven't yet hit the Subscribe
00:01:41
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00:01:48
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and you like this episode that you're currently watching could you please hit the Subscribe button thank you so much and I will pay that gesture by making
00:02:01
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
00:02:07
[Music]
00:02:13
deal Chris when you speak before we started recording you
00:02:18
speak with a deep authentic sense of
00:02:24
mission and that underneath there is a personal driver that is
00:02:31
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
00:02:37
you said the words that you said to me where does that drive begin for you what was the Catalyst moment in your life
00:02:43
that inspired you and gave you that fire that seems to be unquenchable to pursue the path that you've pursued you know I
00:02:50
struggled with mental illness myself starting in
00:02:55
childhood nobody recognized it nobody diagnosed it I didn't know what it was
00:03:00
nobody knew what it was I just knew I was different and somehow ostracized for who I was and it
00:03:08
just felt like part of who I am and then
00:03:13
a series of horrible tragic events happened in my extended
00:03:18
family when I was about 12 years old and my mother ended up having a
00:03:26
nervous breakdown she called it a nervous break break down it started with what we would call major depression
00:03:34
quickly escalated to depression with suicidality and then she developed
00:03:40
psychotic symptoms she became very delusional she got mental health
00:03:47
treatment but the treatment didn't work they basically were just kind of in
00:03:54
my 12-year-old mind the psychiatrists were just drugging her
00:04:01
and those drugs weren't making her symptoms better they weren't restoring her
00:04:06
health she went on to live the rest of her life with a chronic psychotic
00:04:12
disorder and that disorder completely ruined and devastated her life in so
00:04:19
many ways she lost everything she lost custody of her eight kids she lost all
00:04:27
of her money everything that courts didn't give her any support or any money
00:04:34
I had my own struggles even worse with mental illness
00:04:41
after all of that I ended up leaving home before I finished high school I had chronic depression and suicidality and
00:04:48
OCD and other things and the mental health field was worthless for me and
00:04:54
probably caused a lot of harm for me and so the the end of the day the
00:05:00
reason I'm a psychiatrist is because I recognize how horrible and
00:05:06
devastating mental illness can be and I came to the field
00:05:13
really angry with the mental health field for being so
00:05:18
incompetent and I wanted to try to help I wanted to try to maybe contribute to
00:05:23
better solutions for people my futile attempts to save you from the ravages of mental illness lit a
00:05:30
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
00:05:40
peace that's my mom and that's the dedication of the book her story and the
00:05:49
devastation to her life is the thing that drives me to this
00:05:55
day um and I just know that there are hundreds of Millions millions of
00:06:01
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
00:06:14
deserve better and I want to help them I want to get them better
00:06:20
treatment those people those people exist on some kind of I guess multiple
00:06:25
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
00:06:38
mental illness and so you know the
00:06:45
diagnoses are all over the map we have all of these different diagnoses and the
00:06:53
DSM 5tr the diagnostic and statistical Manual of Psych patry which is kind of
00:07:00
considered the Bible of Psychiatry and it has all of these labels in it um
00:07:06
schizophrenia bipolar disorder major depressive disorder alcohol use disorder which most
00:07:14
people know as alcoholism other addictions uh anorexia
00:07:22
nervosa but also autism autism spectrum disorder or
00:07:29
dementia that most people know as Alzheimer's disease that those are all of the labels
00:07:38
in our um in our kind of Bible of
00:07:43
Psychiatry and the reality is that when you look at the treatment
00:07:50
outcomes for people who are getting treatment for those diagnostic
00:07:56
labels there is no doubt that our treatments do work for a lot of people
00:08:03
millions of people and so millions of people are helped their lives can be saved by the
00:08:10
current treatments that we have and I'm not here to take that away from anyone
00:08:16
so for people who are getting treatment and those treatments are working keep getting that treatment I don't want to
00:08:22
interfere with anyone's access to those medications or
00:08:27
psychotherapies or electr convulsive therapy or whatever treatment they're getting I don't want to stand in the way
00:08:35
but there are far too many people just like my mother who did everything they were asked to do who took all of the
00:08:42
pills who showed up for their therapy appointments who did everything they were asked to do and they're not getting
00:08:49
better you know mental disorders as an as a whole are now the leading cause of
00:08:56
disease burden and disability worldwide and it's not because those people aren't
00:09:02
getting treatment many of them are getting treatment yes there are people who can't afford treatment or can't get
00:09:08
access to care but a lot of people are getting treatment I work at one of the best
00:09:15
psychiatric hospitals in the world I have the privilege of doing that and we
00:09:22
see patients that aren't getting better we see them all the time day in and day
00:09:28
out and the crisis the tragedy is that some
00:09:34
governments are actually now moving to labeling mental illnesses as terminal
00:09:42
illnesses the Canadian government in March of 2024 is going to allow people to die by
00:09:51
assisted suicide because of a treatment resistant mental illness really yes they're going
00:09:59
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
00:10:05
our treatments fail people year after year after year and those people become
00:10:11
desperate and hopeless and they give up on treatment for good reason because they've
00:10:18
participated in treatment for decades and it hasn't helped them and the
00:10:24
Canadian government has now made the decision that they should be allowed to die with the help of a
00:10:30
physician who can prescribe deadly medications and make it easy for them to
00:10:36
die by Suicide the UK is now labeling some
00:10:42
people with eating disorders as terminal eating disorders and that maybe you know if
00:10:49
they've exhausted treatment if they've had treatment for several years or more than a decade well treatment's just not
00:10:56
going to work for them so let's call them terminally ill with an eating
00:11:03
disorder people are frustrated and hopeless again I'm not talking about the
00:11:10
people for whom treatment's working if treatment is working for someone if they're taking a pill and it's working
00:11:16
fantastic you're lucky keep doing it and I don't want to interfere with anyone's
00:11:21
access to that treatment but we can't hide from the
00:11:27
tragic realities of the the world for all of those people that are
00:11:33
they might have extreme anxiety depression schizophren osity these extreme sort of mental health
00:11:38
disorders what is it that you want to put into their hearts and Minds with your work with the message that you're
00:11:44
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
00:11:50
into but the very Topline message that you know maybe in a sentence you want those people to
00:11:56
have if you have been trying treatment and those treatments aren't working for you please don't give up there is hope
00:12:05
you can in fact get better if you understand the science you can get
00:12:11
better the mental health conversation the uh prevalence of mental
00:12:19
health lots of these things seem to have changed in the last 28 years what is the
00:12:24
state of mental health as we sit here today and how has that changed in the 28 years that you've
00:12:31
been at Harvard and working in this field I think I have a slightly
00:12:37
different perspective yours sounded more hopeful than mine you kind of said things have
00:12:43
changed in 28 years and tragically I actually feel like they haven't changed
00:12:49
a whole lot if you look at if you look globally
00:12:54
at the problem the problem of mental illness is increasing
00:12:59
it is not stagnant and is not decreasing it is increasing in prevalence throughout the
00:13:05
world prior to the pandemic about 1 billion people had a mental or substance
00:13:11
use disorder representing about 133% of the world's population and that was just
00:13:17
in one given year 2017 the pandemic added insult to injury
00:13:24
and rates are much higher now and the rates of mental illness have been in increasing across a wide range of
00:13:30
diagnostic categories rates of autism in the United States over the last 20 years
00:13:37
have quadrupled a four-fold increase rates of
00:13:43
ADHD are up and through the roof rates of bipolar disorder in adults a lot of
00:13:50
people think bipolar disorder that's genetic well in adults in the United States over the last 20 years rates have
00:13:57
doubled in children and Adolescence rates are through the roof up
00:14:02
exponentially thousandfold percent rates of plain old bread and butter depression
00:14:09
major depressive disorder the Gallup pole does an annual
00:14:15
survey in the United States of current and lifetime prevalence of depression
00:14:21
and just this year in 2023 rates of both both current
00:14:27
prevalence and lifetime prevalence reached alltime ever recorded highs so
00:14:32
we have a catastrophe we have an epidemic mental illness is a growing
00:14:39
escalating problem and I wish that I could say our treatments were dramatically better
00:14:47
there is no doubt we do have new treatment options we have ketamine and
00:14:53
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
00:15:05
medications that we have are no better than the old medications because they're all based on the same
00:15:13
mechanisms so companies are simply repeating what we already know kind of
00:15:19
sort of works and they're just making new molecules that kind of sort of do the same thing and so they still just
00:15:27
kind of sort of work they don't work for everyone and they even fail to work for
00:15:33
most people in the largest study ever done of depression when people come in the very
00:15:42
first anti-depressant treatment they get over 4,000 people treated at the best academic centers that we have in the
00:15:49
United States the first antidepressant treatment only about 30% get a
00:15:56
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
00:16:17
got a remission many of them are still having low-grade symptoms like all of their symptoms didn't go away and after
00:16:26
four levels of treatment the original published report said that
00:16:33
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
00:16:46
still clinically depressed after four levels of
00:16:52
treatment other researchers have challenged that 67% figure because the
00:16:57
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
00:17:12
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
00:17:27
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
00:17:40
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
00:17:53
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
00:18:11
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
00:18:26
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
00:18:39
to have a job or go to school only 4% of people with schizophrenia got that using
00:18:47
our best treatments available today those statistics aren't a lot
00:18:54
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
00:19:07
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
00:19:36
the sand the easiest place to get an accurate
00:19:42
read on the true prevalence of mental
00:19:47
illness and not just the recognition of it but the true prevalence of it is to
00:19:53
talk to school teachers who've been teaching for more than 30 years if you
00:19:58
ask them were you just not recognizing the
00:20:03
children 30 years ago who are screaming and tantruming in your classroom were
00:20:09
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
00:20:21
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
00:20:41
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
00:20:57
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
00:21:10
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
00:21:22
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
00:21:35
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
00:21:47
suicide or they're becoming psychotic and they're diagnosed with
00:21:52
bipolar disorder at skyrocketing rates
00:21:58
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
00:22:10
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
00:22:23
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
00:22:37
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
00:22:50
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
00:23:03
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
00:23:17
mental health problems those are addictions they are mental health
00:23:22
disorders they are in DSM rates have doubled
00:23:28
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
00:23:40
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
00:23:52
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
00:24:37
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
00:24:54
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
00:25:15
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
00:25:27
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
00:25:45
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
00:25:58
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
00:26:11
which are also metabolic conditions that all of those things are
00:26:18
rising simultaneously and that the brain is an
00:26:23
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
00:26:35
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
00:27:09
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
00:27:22
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
00:27:34
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
00:28:07
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
00:28:28
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
00:28:39
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
00:28:54
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
00:29:07
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
00:29:19
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
00:29:39
immensely helpful insight and this is new Cutting Edge
00:29:45
information most people don't know
00:29:51
this but there are these tiny things in our cells called
00:29:56
mitochondria and they are actually the primary sites in
00:30:02
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
00:30:14
science of mitochondria you can actually begin to
00:30:21
understand what's happening in the brains and bodies of people with mental
00:30:26
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
00:30:37
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
00:30:57
what about stress and Trauma psychological stress trauma how do those
00:31:05
things fit in mitochondria are actually the
00:31:10
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
00:31:24
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
00:31:37
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
00:31:51
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
00:32:07
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
00:32:52
theory of multicellular life on planet
00:32:58
Earth is that mitochondria were once Independent Living
00:33:05
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
00:33:19
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
00:33:44
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
00:33:57
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
00:34:10
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
00:34:24
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
00:34:58
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
00:35:10
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
00:35:25
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
00:35:36
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
00:35:50
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
00:36:02
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
00:36:35
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
00:37:01
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
00:37:14
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
00:37:28
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
00:37:38
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
00:38:16
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
00:38:38
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
00:39:47
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
00:40:01
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
00:40:12
reactions in my mind those reactions are not disorders they are not
00:40:17
malfunctioning brains or malfunctioning anything
00:40:23
um so everybody will have that however when that
00:40:29
happens it immediately changes your metabolism your metabolis the easiest
00:40:35
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
00:40:48
yourself your life is threatened your safety is
00:40:55
threatened traumas can even be less extreme than that you can have highly
00:41:01
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
00:41:23
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
00:41:36
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
00:41:48
based on that traumatic event trauma immediately changes
00:41:53
metabolism so trauma puts us into
00:42:01
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
00:42:28
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
00:42:46
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
00:43:01
body inflammation is actually occurring and epigenetic changes are
00:43:08
occurring memory formation is occurring in a powerful way during a trauma
00:43:17
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
00:43:32
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
00:43:50
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
00:44:46
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
00:44:58
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
00:45:11
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
00:45:23
responded this way and I survived it
00:45:28
great but how's this working out for me now is that the optimal
00:45:36
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
00:45:48
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
00:46:04
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
00:46:16
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
00:46:29
or he is going to threaten me or betray me or
00:46:35
whatever and is that the right approach
00:46:41
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
00:46:55
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
00:47:09
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
00:47:29
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
00:47:54
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
00:48:08
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
00:48:19
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
00:48:32
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
00:48:45
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
00:48:55
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
00:49:10
severe than that but the person is
00:49:16
beaten they are injured
00:49:22
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
00:49:35
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
00:49:47
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
00:50:01
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
00:50:13
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
00:50:25
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
00:51:06
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
00:51:26
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
00:51:38
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
00:51:53
maintaining your cells is actually being bypassed
00:51:59
sometimes so we know this so for example there are these things called stress
00:52:06
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
00:52:21
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
00:52:40
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
00:52:53
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
00:53:13
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
00:53:25
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
00:53:39
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
00:53:52
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
00:54:06
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
00:54:36
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
00:54:56
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
00:55:07
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
00:55:21
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
00:55:34
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
00:55:45
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
00:56:14
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
00:56:28
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
00:56:41
health diet so diet is
00:56:46
huge and most people have no clue that diet plays any role in mental illness or
00:56:54
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
00:57:07
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
00:57:23
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
00:57:41
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
00:58:02
metabolic in nature and there is no questioning whatsoever it is
00:58:10
incontrovertible that diet plays a massive huge role in
00:58:19
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
00:58:31
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
00:58:56
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
00:59:07
lowgrade depression OCD other symptoms but I also developed what's called
00:59:12
metabolic syndrome I developed high blood pressure high
00:59:17
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
00:59:31
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
00:59:41
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
00:59:56
and within 3 months my metabolic syndrome was
01:00:03
completely gone but the thing that just dumbfounded
01:00:10
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
01:00:23
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
01:00:44
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
01:01:05
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
01:01:22
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
01:02:03
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
01:02:14
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
01:02:25
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
01:02:40
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
01:02:53
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
01:03:03
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
01:03:19
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
01:03:39
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
01:03:50
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
01:04:12
healthy to have anxiety and stress in those
01:04:17
situations the anxiety and stress can sometimes be quite helpful and adaptive
01:04:23
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
01:04:38
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
01:05:05
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
01:05:18
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
01:05:31
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
01:05:43
ultra processed food have higher risk for developing depression
01:05:50
anxiety and other mental disorders and based on the science the
01:05:56
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
01:06:25
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
01:06:40
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
01:06:51
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
01:07:29
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
01:07:48
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
01:08:08
have to talk about mitochondria in order to understand metabolism um only 7% of
01:08:17
US citizens have no signs of metabolic
01:08:22
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
01:08:46
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
01:09:00
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
01:09:35
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
01:09:47
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
01:10:19
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
01:10:39
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
01:10:50
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
01:11:03
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
01:11:29
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
01:11:43
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
01:12:01
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
01:12:12
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
01:12:22
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
01:12:41
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
01:13:02
symptoms of schizophrenia remained in [Music] remission Doris went on to live for
01:13:09
another 15 years symptom free medication
01:13:15
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
01:13:35
until the day she died she ended up dying at the age of 85 of Co
01:13:42
pneumonia and um but her
01:13:48
story tells us like we could get if if you want we
01:13:53
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
01:14:05
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
01:14:38
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
01:14:50
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
01:15:25
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
01:15:41
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
01:15:55
enough over a long enough period of time you can actually
01:16:00
repair mitochondrial dysfunction in cells at least for some
01:16:05
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
01:16:17
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
01:16:34
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
01:16:52
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
01:17:13
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
01:17:25
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
01:17:47
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
01:18:06
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
01:18:32
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
01:18:46
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
01:18:57
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
01:19:10
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
01:19:27
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
01:19:54
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
01:20:11
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
01:20:24
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
01:20:41
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
01:20:53
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
01:21:12
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
01:21:23
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
01:21:35
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
01:21:46
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
01:22:20
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
01:23:05
low low intake of sugar in people who are otherwise
01:23:11
healthy is perfectly fine and acceptable so you
01:23:16
know lots of people can consume treats every now and then or
01:23:22
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
01:23:33
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
01:23:46
the majority of people that's not the way it's working out so high levels of
01:23:51
sugar over time we
01:23:56
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
01:24:10
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
01:24:22
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
01:25:01
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
01:25:21
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
01:25:33
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
01:25:45
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
01:26:03
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
01:26:18
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
01:26:32
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
01:26:44
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
01:26:56
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
01:27:10
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
01:27:29
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
01:27:48
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
01:28:07
when we use substances like caffeine or alcohol or
01:28:13
marijuana which are all working at the level of metabolism and mitochondria
01:28:18
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
01:28:38
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
01:28:50
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
01:29:02
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
01:29:14
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
01:29:46
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
01:30:29
it and to to provide just one piece of evidence to support what
01:30:36
I'm saying if a woman has
01:30:42
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
01:30:56
child if a woman has both obesity and
01:31:01
diabetes she has quadruple the risk of having an autistic
01:31:08
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
01:31:35
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
01:31:46
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
01:31:59
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
01:32:39
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
01:33:08
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
01:33:23
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
01:33:36
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
01:33:56
even worse statistics going
01:34:01
forward the hope is that if we understand that
01:34:08
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
01:34:22
conditions in your children if we intervene early enough we can probably
01:34:27
do something about it how number one by
01:34:33
recognizing the problem and then two for some people it could be as simple as
01:34:39
dietary interventions or just hyperfocusing on
01:34:45
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
01:34:58
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
01:35:33
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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01:37:03
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01:37:52
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
01:38:07
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
01:38:32
felt it was actually really horrendously
01:38:38
awful um when I first moved in with her we had
01:38:45
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
01:38:58
enough and that's when we became homeless but almost from day
01:39:07
one living with someone who is severely depressed and
01:39:13
suicidal and psychotic it's hard to not feel that
01:39:20
your self it's like you're living in
01:39:27
this just oppressive cloud of
01:39:33
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
01:39:47
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
01:40:01
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
01:40:14
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
01:40:27
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
01:40:38
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
01:40:50
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
01:41:14
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
01:41:29
help her and keep her alive within about a year of that
01:41:34
though I started developing my own suicidality and
01:41:41
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
01:41:53
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
01:42:05
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
01:42:31
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
01:42:42
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
01:42:58
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
01:43:25
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
01:43:39
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
01:43:53
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
01:44:13
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
01:44:31
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
01:44:52
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
01:45:20
[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
01:45:26
they sponsor this podcast and I have a very exciting announcement to make this product called Daily Greens is one of
01:45:32
the most highly requested products at hu but it's never been sold in the UK before
01:45:37
until now it's often difficult to get all of the greens into our diet that we need to have a healthy gut microbiome
01:45:44
and a healthy body and with Hues Daily Greens product with one scoop every morning a very very delicious scoop you
01:45:50
can get 91 vitamins minerals and Whole Food Source nutrients into your diet the
01:45:57
most important Point here is I genuinely believe it tastes delicious it's May my favorite heel product ever for all the
01:46:03
reasons I've described so if you want access to this product the link is in the description below it launches in the
01:46:08
UK in January because of the demand I'm pretty sure it's going to sell out do you need a podcast to listen to
01:46:16
next we've discovered that people who liked this episode also t absolutely
01:46:21
love another recent episode we've done so I've linked that episode in the description below I know you'll enjoy
01:46:33
[Music] it