The Art of Manliness - July 31, 2025


The Brain Energy Theory of Mental Illness


Episode Stats

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3


Summary

Mental illnesses of all kinds are on the rise, yet we seem no closer to being able to treat them effectively. My guest, Dr. Christopher Palmer, believes he knows exactly what the root cause of mental illness is, and thus how to finally resolve it for good.


Transcript

00:00:00.000 brett mckay here and welcome to another edition of the art of manliness podcast
00:00:10.740 mental illnesses of all kinds are on the rise yet we seem no closer to being able to treat
00:00:15.460 them effectively we're only able to treat the symptoms of mental illness but aren't often
00:00:19.680 able to put the illness into remission because its root cause has been a mystery my guest
00:00:23.980 however believes he knows exactly what the root cause of mental illness is and thus how to finally
00:00:28.280 resolve it for good his name is dr christopher palmer he's a harvard psychiatrist and the author
00:00:32.760 of brain energy a revolutionary breakthrough in understanding mental health today on the show
00:00:37.540 chris unpacks his theory of mental illness which basically comes down to this if your brain cells
00:00:42.100 aren't getting enough energy they're not going to function properly he explains how numerous and
00:00:46.660 seemingly diverse mental illnesses from anxiety and depression to adhd and alcoholism actually all
00:00:52.100 have a common pathway metabolic disorders while we typically think of metabolism as related to the
00:00:57.540 physical body it also greatly affects the mind and chris explains how you can have the kind of
00:01:02.000 metabolic problems that cause mental illness even if you're not overweight chris then shares how
00:01:06.560 certain lifestyle changes like switching to a ketogenic diet may be able to completely cure mental
00:01:11.480 illness after show's over check out our show notes at awim.is brain energy
00:01:15.800 all right dr christopher palmer welcome to the show thank you brett for having me so you are a
00:01:38.020 assistant professor of psychiatry at harvard medical school and you got a new book out called brain
00:01:42.540 brain energy where you lay out this new theory about a potential underlying cause of all mental
00:01:49.380 illness depression anxiety ocd even bipolar disorder it's really interesting but before we get into the
00:01:56.020 theory let's talk about why treating mental illness has been so difficult because you know mental health
00:02:02.460 is something society has been focusing more on uh we're talking more about it we're researching it more
00:02:07.840 you know millions billions billions of dollars have gone into studying it but more and more people are
00:02:14.160 struggling with mental illness the numbers keep going up so why has mental illness been so hard to treat
00:02:19.660 the end of the day the real reason is because nobody can say for sure what causes mental illness
00:02:28.480 all we know are some of the factors involved we know that neurotransmitters seem to play a role
00:02:35.840 hormones genetics and epigenetics inflammation but also psychological and social factors things like
00:02:44.660 trauma and stress and substance use and all of these things seem to play a role in mental illness but
00:02:53.840 nobody knows how they all come together nobody knows how they impact the brain to result in what we call
00:03:00.600 mental illness and so largely all we have are treatments that were usually discovered through serendipity
00:03:09.720 so you know the first antipsychotic medication was actually being used for anesthesia the first
00:03:17.620 antidepressant discovered was actually an anti-tuberculosis treatment and so these medications were
00:03:25.160 discovered through serendipity and we largely still don't fully understand how they work or why they
00:03:33.260 decrease symptoms but for the most part what is clear is that our treatments only decrease the
00:03:41.340 symptoms for the most part we don't have cures for mental illness and this even includes things like
00:03:49.120 psychotherapy that when somebody is suffering from post-traumatic stress disorder or even chronic
00:03:55.500 depression psychotherapy more often than not does not cure mental illness and so we are largely just
00:04:04.700 scrambling just throwing any treatments we can think of at people with mental illness but the sad reality
00:04:13.420 is when you look at the overall treatment outcomes and i don't say this lightly i'm a harvard psychiatrist
00:04:19.860 i take this field very seriously and more importantly i take the suffering of people with mental illness quite
00:04:26.460 seriously and for people who are getting effective help that's great and i'm not here anything away from
00:04:34.400 you if your medications are working for you that's fantastic if psychotherapy has cured you
00:04:40.780 that's fantastic i don't want to take any of that away but for most people with mental illness who get
00:04:49.040 treatment well over 50 percent of people who get treatment for mental illness they do not get
00:04:57.040 remission of illness meaning their illness is no longer there and even if they do get a remission
00:05:06.600 it is almost always short-lived meaning it can go away for six months or a year or so but the symptoms
00:05:14.460 are going to come back and you're going to have to be changing pills or finding a new psychotherapist
00:05:21.160 or doing something different because your illness is a chronic debilitating illness and you know although
00:05:29.060 that sounds really bleak and abysmal and pessimistic it is the reality and for anybody who questions that
00:05:38.220 the reality is that mental disorders are now the leading cause of disability
00:05:42.820 in the united states and on the planet and it's not because people aren't getting treatment it's because
00:05:48.540 our treatments are failing to work
00:05:50.500 and the number one disabling disorder of all psychiatric disorders it's not schizophrenia
00:05:58.080 it's not bipolar it's plain old simple depression depression disables more human beings than any
00:06:07.500 medical illness including heart failure cancer back pain all physical disorders depression disables
00:06:18.060 more people than anything else on the planet yeah and as you said there's what when people treat
00:06:24.560 mental illness there's basically there's two i guess in the history of mental health there is two
00:06:30.560 approaches there's there's a physiological approach and then there's the psychological so like the mind
00:06:36.100 body and so the body part is like well you know that what's going on is your brain uh it's not making
00:06:42.640 enough neurotransmitters so we'll give you a a drug that will help and that helps some people right
00:06:48.200 because maybe that that is a symptom they have lower serotonin for example maybe maybe we don't know
00:06:52.820 but then other there's another field of cancer well no it's not a a body or physiological thing it's just
00:06:58.460 it's a psychological though your mind it's got uh maladaptive thoughts so if you do talk therapy
00:07:04.440 that will help well it helps some people and that's the thing it's like it's hit or miss like you know
00:07:09.760 the the medication might help someone but not help another person and then talk therapy might help
00:07:15.100 somebody but not the other person and it's because there's doctors are just having to figure out well
00:07:20.860 what's the uh the symptom that we need to reduce you're not actually treating the underlying cause
00:07:25.420 you're just trying to reduce symptoms so people have a functioning life absolutely i mean i think most
00:07:33.560 mental health clinicians who are treating patients are desperately hoping to treat the underlying
00:07:39.320 cause you know i think the mental health clinicians who are prescribing pills are hoping
00:07:43.620 to address that chemical imbalance and i think the psychotherapists who are delivering psychotherapy are
00:07:49.600 hoping to you know relieve the trauma in that person so that the person can let go of their trauma
00:07:57.680 and move on with their life but again when we look at the treatment outcome studies
00:08:04.500 even with the best of intentions even with the best efforts from all of these clinicians i'm not here
00:08:12.920 to fault any of them i i you know i'm one of them we're all doing our best but our current model of
00:08:22.120 mental health and mental illness and how to treat it is failing miserably and the other problem with
00:08:31.640 mental illness is there's no objective criteria right there's not like a an mri scan where you
00:08:36.180 can look on someone's brain who comes in with depression say yeah you've got depression i mean
00:08:40.600 there's been some studies saying that you know parts of the brain might light up less if you have
00:08:44.380 depression but that there's nothing definitive about or there's not a blood test you could take and
00:08:49.160 say yeah you've got ocd and so it's it's really you have to talk to the patient and it's like it's
00:08:55.080 there's subjective things in there and you can't downplay the subjective because if someone feels awful
00:08:59.720 you have to take them on their word but it gets tricky because like you're trying to a doctor's
00:09:04.360 trying to figure out well he says this if we do this will it change the outcome so that's the other
00:09:09.280 hard thing there's no definitive test for mental illness unlike cancer where you can look and say well
00:09:14.180 you got a tumor or there's a blood test and we still see the cancer there absolutely and it's really
00:09:20.360 interesting because if there is a definitive abnormality identified it's no longer considered a mental
00:09:27.140 illness so for example people with cancer often have mental symptoms they often can get severely
00:09:35.080 depressed and fatigued they can have concentration difficulties they can even have symptoms consistent
00:09:40.700 with like cognitive impairment even so far as dementia they can get delirious where they're
00:09:46.880 hallucinating or delusional and we don't call that a mental illness because we know that they have
00:09:54.280 cancer and they're getting cancer treatment and both cancer and its treatments can sometimes cause
00:10:00.380 those symptoms so in those cases we don't call it mental illness and so the sad reality is that
00:10:08.240 the people for whom we can't identify an objective cause we we put them in the category of mental disorders
00:10:16.660 so the goal is if if we could find an underlying common pathway for mental illness there was this would
00:10:23.080 allow us treatment could be more effective right because you could find the underlying thing and
00:10:28.100 let's start getting into your theory here the the first connection i'd like to make is that one thing
00:10:32.560 you note for potential underlying pathway for mental illness is that mental illnesses depression anxiety
00:10:39.820 ocd bipolar they all there's some overlap there what do you mean by that what are some examples of
00:10:45.440 overlap with mental illness so you know on the surface you know dsm it makes sense so dsm describes
00:10:56.100 different diagnostic categories ocd depression schizophrenia alcohol use disorder or alcoholism and
00:11:03.520 anorexia nervosa most people know what those things mean and they paint very different pictures of the
00:11:10.860 types of people that have those disorders the symptoms that those people are having and the
00:11:17.080 treatments that might be effective for those people and so on the surface dsm makes sense but when you
00:11:23.600 actually look at real people who have mental illness first and foremost it turns out that most people
00:11:31.140 have more than one certainly most people who are getting treatment do so on average one study found that
00:11:38.000 people getting treatment for mental health had three and a half different diagnoses so right there we
00:11:45.340 start to see some breakdown in these diagnostic distinctions so for example you could have
00:11:52.680 schizophrenia or anorexia but if i look at a group of people with schizophrenia they're much much more
00:11:59.420 likely to also have depression on top of their schizophrenia they're also more likely to have anxiety on top of
00:12:05.840 their schizophrenia and weight i thought those were different disorders with different causes
00:12:11.100 now a lot of people think well if you were schizophrenic wouldn't you be depressed and anxious
00:12:15.620 but it's not so simple because it turns out that people with depression and anxiety are actually more
00:12:21.680 likely to go on to develop schizophrenia too but if i look at a group of people with anorexia
00:12:27.360 they're also more likely to be depressed and anxious and you're like well well yeah i guess that makes sense
00:12:35.200 too but wait i thought these were all different disorders and now i'm looking at these different
00:12:40.360 people and clearly the schizophrenic person is having hallucinations and delusions and the person with
00:12:46.020 anorexia is starving herself or himself but and so those are clear differences but a lot of the other
00:12:54.960 symptoms and comorbid diagnoses start to overlap i think much much more important is that when we look at
00:13:03.380 root causes for mental illness because we do know some genetics is a clear example we have identified
00:13:10.520 some high risk genes for mental illness and most people think well you know they must be specific
00:13:20.080 to specific disorders like there must be some schizophrenia genes and some bipolar genes and some depression
00:13:25.820 genes and some anorexia genes but in fact that's not true at all and we know this we've had the human
00:13:34.100 genome mapped for over 20 years the top researchers have been on this we have had artificial intelligence
00:13:41.720 on the job we know with certainty there is not one gene in the whole human genome that confers risk for
00:13:51.280 any one specific mental disorder instead one gene confers risks for lots of different mental disorders
00:13:59.920 so one gene might confer risk for schizophrenia and depression and bipolar disorder and alcoholism
00:14:08.520 and epilepsy and cognitive impairment so when we look at a root cause like that it starts to you know
00:14:18.440 the the diagnoses really start to overlap a lot and when you start to look at all of that kind of
00:14:24.560 scientific data and all of the research that we have it turns out that mental illnesses are actually not
00:14:31.020 that distinct from each other after all even though the symptoms can be wildly different i'm not here to say
00:14:38.800 that psychosis is the same thing as depression those represent different areas of the brain malfunctioning
00:14:45.920 or they different represent different degrees of malfunction in the brain but they are actually
00:14:51.740 not as distinct as most people believe okay so let's get into the theory in brain energy and so this idea
00:15:00.560 that the all these mental illnesses they have there's something in common there there's overlap so
00:15:04.640 suggest that there's some underlying thing that's causing all of them and the argument you're making is that
00:15:09.940 that thing could be metabolic ill health and now we're going to dig into the details of how this
00:15:15.920 works i think it's really interesting but first you point out this idea that metabolism and mental
00:15:21.260 illness are connected this isn't a new idea we've other scientists have you know decades ago have kind of
00:15:26.380 made that suggestion how did they make that connection like where does that connection come from that
00:15:30.360 okay if you have depression then you have something wrong with your metabolism what how did that
00:15:36.220 connection happen so interestingly those connections go back centuries so in the 1800s it was well
00:15:46.240 documented that diabetes and insanity run in the same families and insanity was the term they used for
00:15:57.860 what we would now call schizophrenia and bipolar disorder largely but the researchers noticed that
00:16:05.340 in one family there seems to be a much higher likelihood of both diabetes and psychotic symptoms and it goes
00:16:19.280 both ways so if you have somebody with psychosis and they have children those children are more likely to
00:16:25.400 go on to develop diabetes but vice versa if you have somebody with diabetes and they have children
00:16:32.000 those children those children are more likely to not only develop diabetes but also develop a psychotic
00:16:37.920 disorder beginning in the 1940s we have had an accumulating and growing body of evidence that there are
00:16:47.140 metabolic abnormalities in the brains and bodies of people with mental disorders especially the chronic
00:16:54.060 serious mental disorders but it goes across the board depression anxiety PTSD all the way to bipolar and
00:17:01.580 schizophrenia you know we've done all of these brain imaging studies pect scans spec scans functional MRI
00:17:10.620 guess what those scans are measuring they're measuring brain metabolism so all of those studies are showing
00:17:17.700 differences in metabolism and cutting-edge research over the last 20 years has gotten much more specific
00:17:26.280 and granular all the way down to genes specific risk genes all the way down to the cellular level
00:17:33.160 identifying innumerable metabolic problems in people with mental illness so yeah just refresh your
00:17:40.780 metabolism is just your body's way of using energy or taking food and converting into energy and i think
00:17:45.940 people typically when they think about metabolism they think about things like diabetes because your
00:17:50.680 insulin is not working right or your cells aren't responsive to insulin or obesity if you have a
00:17:56.120 problem with obesity something's wrong with your metabolism where it's storing more fat than using the
00:18:00.020 energy but a point you make is that the big metabolic conditions we typically think of like diabetes
00:18:05.520 obesity even cardiovascular problems if you look at these people who are getting treated for those
00:18:10.760 issues oftentimes they have their there's mental health issues going on there right depression anxiety some
00:18:17.460 other serious ones and you know it's a it's correlation right so people would say well you know of course
00:18:23.480 someone who had a heart attack is going to be depressed right you had a heart attack but you said well
00:18:28.500 you're saying well hold on here well maybe there's something else going on there like maybe there's an
00:18:32.580 under like there's a connection beyond just having a heart attack but maybe the heart attack
00:18:37.300 and the depression has an underlying underlying cause it's that metabolism absolutely and we have an
00:18:44.600 abundance of evidence this is not speculation at all we have decades of research looking at the
00:18:51.180 connection for instance between heart attacks and depression and the you know as you said on the
00:18:59.520 surface a lot of people are like well if you had a heart attack wouldn't you be depressed and as
00:19:03.760 intuitive as that seems it the relationship actually goes the other way too people with depression
00:19:10.660 are twice as likely to have heart attacks and people with all chronic all mental disorders all of them
00:19:18.700 across the board whether they're chronic or not all mental disorders on average they die early deaths
00:19:26.100 on average men are losing 10 years of life women are losing seven years of life and guess what they're
00:19:33.460 all dying of the primary number one cause of death in the mentally ill across the board whether you've
00:19:41.180 got anxiety adhd schizophrenia bipolar alcoholism the number one cause of death is heart attacks
00:19:48.980 but in the mentally ill they are occurring almost a decade earlier on average so i think a lot of people
00:19:55.960 want to be thinking this is how does metabolism affect your mental health because i think most people think
00:20:01.280 metabolism they think well diabetes blood sugar weight gain so how does the metabolism affect your brain
00:20:07.800 what's going on there so at the end of the day metabolism you know is as you said it's about
00:20:14.200 taking food and oxygen and turning it into energy or building blocks that get used to maintain or grow cells
00:20:21.180 and energy and building blocks are essential to the function of all cells and that includes brain cells
00:20:29.560 if your brain cells are not getting enough energy or they aren't getting enough nutrients
00:20:35.740 guess what they aren't going to function properly and at the end of the day that is the easiest
00:20:43.180 simplest way to i can explain my theory is that if your brain cells aren't getting enough energy
00:20:50.540 they aren't going to function properly and that that malfunction can paradoxically be one of two
00:20:59.020 things cells can actually become underactive but cells can also become overactive or something we call
00:21:07.100 hyper excitable and and those two states kind of under activity of a cell or over activity or
00:21:16.040 hyper excitability of a cell can result in all of the symptoms all of them that we call symptoms of
00:21:23.800 mental illness so that is the easiest way for us to understand symptoms of depression or post-traumatic
00:21:30.780 stress disorder or even schizophrenia well what you do in this book you kind of walk people through
00:21:36.480 is how metabolism affects these different underlying causes of what we typically think of mental illness
00:21:41.800 so for example neurotransmitters right like you know there's something off with your dopamine or
00:21:46.720 serotonin but you point out research that metabolism plays a role in our neurotransmitters how does metabolism
00:21:54.040 affect our neurotransmitters so at the end of the day you know when metabolism is extraordinarily
00:22:01.080 complicated and in order to really start to understand what controls metabolism or what it means to have a
00:22:10.100 metabolic malfunction you actually have to start to go to this other level of the cell in these tiny
00:22:16.700 little things in most of our cells called mitochondria and mitochondria actually help us understand the
00:22:24.440 connections between metabolism and brain function so to answer your specific question what does metabolism
00:22:32.500 have to do with neurotransmitters I'm going to focus on metabolism but more importantly on
00:22:38.900 mitochondria which are these master regulators of metabolism and it turns out that mitochondria are
00:22:44.880 instrumental in producing the building blocks that make neurotransmitters so they produce the building
00:22:52.040 blocks and the energy required to make serotonin and dopamine and norepinephrine and GABA and
00:23:00.120 acetylcholine and other neurotransmitters but they also are directly involved in the release and the
00:23:11.200 regulation of these neurotransmitters and when researchers take mitochondria out of a cell but
00:23:18.320 kind of infuse artificially infuse energy or ATP into that cell the neurotransmitters actually do not get
00:23:27.200 released so it turns out that mitochondria are playing a critical role not just in metabolism but
00:23:34.680 in brain function broadly gotcha okay so the mitochondria can be off in that it's not it's not
00:23:42.200 producing enough energy right or it's producing too much so like the hyper excitability would be
00:23:47.880 something like bipolar disorder when you're having a manic phase like the cells your mitochondria is
00:23:52.580 probably producing too much energy for the cells in your brain and example of it being not enough be
00:23:57.700 like depression is that right it starts to get to it so hypomania and our mania is the one clear
00:24:05.560 example of the brain actually producing too much energy broadly almost every other disorder is actually
00:24:13.460 not producing enough energy and one of the paradoxes of this theory based on rigorous science and
00:24:21.860 you know decades of clinical observation one of the paradoxes is that when a cell is energy deprived
00:24:28.000 it can actually become overactive which is counterintuitive but cells have kind of an on cycle
00:24:39.280 and they have an off cycle they they get turned on but they also get turned off and energy is required
00:24:47.820 to do both of those things so cells needing energy to get turned on that kind of makes sense to most
00:24:54.200 people most people will get that but one of the paradoxes is that once a cell gets turned on it
00:25:01.200 actually has to have enough energy to turn itself off and that is a paradox because that can result so a cell
00:25:10.780 can get turned on and be on very weekly maybe it's only really operating at 60 capacity but it may not
00:25:18.980 have enough energy to fully turn itself off and that results in hyper excitability which can result in
00:25:27.960 some of the symptoms of mental illness we're gonna take a quick break for a word from our sponsors
00:25:32.340 and now back to the show so sometimes brain cells don't get enough energy and paradoxically this means
00:25:47.240 that they can't turn off which leads to them being to have hyper excitability right and then hyper
00:25:54.040 excitability can lead to mental illness do we know what it is about the hyper excitability of brain cells
00:26:00.700 that causes something like depression because like your depression you think well there's low energy
00:26:04.840 so what's going on there yeah it's a great question hyper excitable means that that cell is doing
00:26:11.960 something in an exaggerated way or it's doing something at the wrong time when it really shouldn't
00:26:20.000 be doing that so let me give you an easy example that i use in the book and that is pain so pain is a
00:26:28.540 normal human sensation we all experience it whenever we injure ourselves but people who have pain
00:26:36.280 disorders have hyper excitable pain nerves or hyper excitable pain systems in their brain and what
00:26:44.800 that means is that they experience pain for no good reason or if they just twist or turn the wrong way
00:26:52.880 they can experience excruciating pain and that pain can go on for minutes or hours even it just doesn't
00:27:01.420 stop all of those are representations of a hyper excitable pain system so when we think about something like
00:27:09.900 depression depression is actually hardwired into the human brain it is a normal human emotion
00:27:18.220 depression it is and and it is hardwired in our brains it's actually hardwired in the brains of
00:27:24.320 many other animals like rats and mice and those serve as models for researchers who are trying to
00:27:31.220 understand depression so like pain depression is a normal thing but when it gets turned on for no reason
00:27:41.000 or when it fails to stop or when it kind of gets you know going in an exaggerated way those can all be
00:27:50.560 reflections of a hyper excitable depression kind of pathway or depression system in the human brain and so what
00:28:00.200 that means is that if your depression systems or networks are hyper excitable that is somebody who will
00:28:06.760 experience depression for no good reason and or they might experience depression for a clear reason
00:28:12.620 maybe somebody was mean to them or somebody scolded them but they have a hyper kind of exaggerated
00:28:21.240 response that they get super depressed and it lasts for days or hours whereas most people would you know
00:28:28.840 move on and be able to to be okay with that okay so a metabolic ill health can cause a neurotransmitter
00:28:36.740 imbalance and also another thing that you know psychologists psychiatrists know that influence mental
00:28:43.360 illness are hormones cortisol thyroid hormone testosterone estrogen but that's also driven by metabolism correct
00:28:52.620 absolutely yeah so one of the things that is so wonderful about this theory is that it connects all of the
00:29:01.160 dots that we know in the dots that we know in the mental health field so it turns out that you know
00:29:06.740 mitochondria again play an instrumental role in the production of key hormones like cortisol estrogen and
00:29:14.020 testosterone but a hormone like thyroid hormone like you mentioned actually plays a critical role in
00:29:20.900 metabolism and the function of mitochondria even a hormone like insulin which most people think of as a
00:29:28.020 diabetes thing it turns out insulin is actually located throughout the brain and plays a powerful
00:29:33.920 role in the way your brain functions and also plays a powerful role in brain metabolism okay so we would
00:29:41.240 have with insulin like how does it influence mental illness or mental health do we know that we do so we we
00:29:48.260 have again so that's probably one of the clearest connections that goes back to the 1800s this connection
00:29:54.980 between diabetes and mental illness we know that people with type 2 diabetes or even type 1 diabetes are
00:30:02.180 much more likely to develop mental disorders and pretty much all of them across the board depression
00:30:09.000 ptsd substance use disorders but also bipolar and schizophrenia you know over the last 20 years we have
00:30:17.260 neuroimaging research showing that people with bipolar disorder and schizophrenia have abnormalities and insulin
00:30:23.580 signaling in their brain here's a very clear study that i just want to share with people that really
00:30:31.080 drills this home for everybody and why this matters you know one study looked at 5 000 kids and followed them
00:30:39.720 from the ages of 1 to 24 and they found that the kids who had the highest levels of insulin resistance
00:30:46.140 since beginning at age 9 were five times more likely that's 500 percent more likely to develop
00:30:53.820 bipolar disorder or schizophrenia or be at risk for those disorders 500 percent more likely that is not
00:31:04.800 trivial and that kind of information gives us clear strategies to possibly prevent mental illness in young
00:31:15.340 people it also gives us you know lots of treatment options as well well another cause or symptom that
00:31:25.100 mental health practitioners have been treating in recent years to decrease mental illness symptoms is
00:31:30.900 inflammation so there's been research showing that people with you know major depression for example
00:31:36.060 are some people some of them are highly inflamed and inflammation goes back to metabolism correct
00:31:42.900 absolutely so metabolism influences inflammation and inflammation influences metabolism now you know
00:31:52.720 everybody's heard inflammation that's what that's the cause of everything that ails us these days
00:31:57.860 and yes in fact people with mental disorders are more likely on average to have higher levels of
00:32:04.320 inflammation but i'm here to argue that inflammation in and of itself is neither necessary nor sufficient
00:32:12.040 meaning inflammation can't explain all mental illness and not all people with mental illness even have
00:32:19.020 higher levels of inflammation at least not that we can measure so inflammation is an important factor
00:32:24.920 it clearly plays a role for some people but i don't think in and of itself it is the key instead we have to
00:32:33.620 rise above that and see the broader connections through what we call metabolism and mitochondria
00:32:39.660 okay so i think people are seeing here now that metabolism it underlies a lot of these things
00:32:45.120 it connects a lot of these things that we often treat as disparate things so let's talk about like i mean
00:32:50.740 what what are the things that mess up our metabolism and then maybe we can walk through some of these things
00:32:56.660 and how you've used you know diet or exercise or reducing stress to not only fix people's metabolism
00:33:04.880 which can help their diabetes or obesity or cardiovascular but it also fixes or can treat
00:33:11.780 the mental illness so let's talk about diet for example how does our diet mess up our metabolism
00:33:16.720 and in turn can cause mental illness yeah so i think everybody knows if you eat a bad diet
00:33:25.260 you're more likely to become obese or diabetic so i think most people intuitively know a bad diet
00:33:33.040 can mess up metabolism what i think most people probably don't know is that a bad diet can also lead to
00:33:40.620 higher rates of mental illness so i just mentioned that study in kids so a bad diet can lead to insulin
00:33:47.980 resistance which can then go on to lead to much higher rates of bipolar disorder and schizophrenia
00:33:54.380 but much much more common are depression and anxiety disorders and other types of disorders
00:34:03.060 so a bad diet can do all of those things and what do i mean when i say a bad diet
00:34:08.820 i mean a diet that causes metabolic dysfunction so a diet that causes higher levels of inflammation
00:34:16.660 inflammation or a diet that impairs hormonal status or a diet that impairs mitochondrial function
00:34:24.500 and you you're probably wondering well what the hell are you talking about chris palmer like what what
00:34:29.960 does that mean what is a bad diet well a bad diet can include a lot of highly processed foods
00:34:38.180 that are high in sugar high in fat that's kind of the deadly combination is that sweet spot lots of
00:34:47.160 sugar and lots of fat that is not a good diet for any human being on the planet or animal on the planet
00:34:53.980 for that matter but you know unfortunately we have added all sorts of chemicals and processed things
00:35:00.760 you know i i i outlined some of the literature on trans fatty acids those actually are really
00:35:08.040 horrible for physical health like heart attacks but they're also really horrible for mental health
00:35:14.020 they result trans fatty acids have been found to result in higher rates of depression irritability
00:35:20.240 even alzheimer's disease in people so again so mental symptoms and so clearly our diet you know
00:35:29.100 it's not rocket science in a way i think everybody understands what you eat can affect your heart
00:35:36.640 like in a very clear and concrete way like what you eat can actually clog up the arteries of your heart
00:35:44.120 and result in a heart attack on some level it's kind of a no-brainer to just understand that what you
00:35:51.880 eat can also affect your brain if it's affecting your heart it's probably affecting more than just your heart
00:35:58.700 it's going throughout your body and the brain happens to be connected to everything and and the brain is
00:36:05.460 actually one of the more energy consuming organs and so a lot of what you eat a lot of those calories
00:36:13.400 and substrates and all the breakdown products a lot of that's going up to your brain to fuel your brain cells
00:36:19.920 well another thing you point out in this the diet section of how what we eat can influence our mental
00:36:26.960 health or because it's in its influence our metabolism is that doctors have known for a long
00:36:33.020 time that if you want to treat epilepsy one thing you can do is do fasting or like a ketogenic diet
00:36:40.100 right there's something about a ketogenic diet that reduces epilepsy symptoms particularly in children
00:36:44.660 they know this with kids and again that shows like well there's a metabolic thing going on there
00:36:48.680 right absolutely to drill some of this home and make it like real for people to help them understand
00:36:57.440 it might actually be helpful to share a story if i may yeah sure that'd be great you know i think most
00:37:03.200 people understand that if you eat a healthy diet it might help depression or anxiety or even adhd symptoms
00:37:09.220 i think most people get that but what i'm saying is that diet especially a dietary intervention like the
00:37:15.300 ketogenic diet can actually impact what most people think is an incurable chronic mental disorder
00:37:21.920 so you mentioned we have decades of research showing that the ketogenic diet for instance can stop
00:37:28.460 seizures that's a real thing seizures are real and people can actually die from them and so doing
00:37:35.340 a specific type of a diet like the ketogenic diet can actually stop seizures but the work that i've been
00:37:42.040 doing over the last six years is using the ketogenic diet in people with chronic serious mental illness
00:37:47.540 and so the story that i'll share with you as a woman i used a different name i used fake names for
00:37:53.300 everybody in the book but she actually gave me permission to use her real name so in this interview
00:37:58.440 i'm going to use her real name her real name is doris doris was diagnosed with schizophrenia when she was 17
00:38:04.240 years old she had daily hallucinations and delusions over the ensuing decades she tried numerous
00:38:11.460 antipsychotic and mood stabilizing medications but none of them worked to stop her symptoms they did
00:38:17.600 cause her to gain a lot of weight doris was tormented by her illness and between the ages of 68 and 70
00:38:25.120 she tried to kill herself at least six times when she turned 70 her doctor referred her to a weight loss
00:38:31.900 clinic at duke university where they were using the ketogenic diet and for whatever reason she decided
00:38:37.580 to give it a try within two weeks not only did she start losing weight but her hallucinations and
00:38:45.100 delusions started going away within months all of her symptoms of schizophrenia were in full and complete
00:38:52.200 remission within six months she was off all her psychiatric medications and remained in full and complete
00:39:00.220 remission doris went on to live for another 15 years medication free symptom free out of hospitals no more
00:39:13.040 psychiatrists or psychologists no more suicide attempts when i last spoke with doris she said she was happy to be
00:39:23.120 alive and she actually asked me pleaded with me to share her story with anyone who would listen in the hopes that
00:39:32.080 her story might help even one other human being sadly doris passed away this past january at the age of 85 of
00:39:42.240 covid pneumonia i want to let people know doris is not alone i now have dozens of cases of similar patients
00:39:52.860 achieving seemingly miraculous recoveries from what we know is what we currently think of as chronic mental
00:40:01.280 disorders there are clinical trials underway at least five controlled clinical trials some of the
00:40:07.660 leading psychiatrists and neuroscientists are hot on this trail but i'm passionate about making these
00:40:13.820 treatments and these in this theory and this information available to people now because people want help now
00:40:21.660 that's really powerful so i mean it's a perfect example you treat a metabolic condition
00:40:25.700 you treat the mental illness and that was just the diet intervention changing to a ketogenic diet
00:40:30.620 and that's again to say you know ketogenic might not be for everybody right like i don't want i don't think
00:40:36.220 you don't want to give the impressions like well you know if you have depression going to keto diet it'll cure
00:40:40.660 depression maybe but that's something you have to talk to a psychiatrist or psychologist about
00:40:45.740 so we've been talking about how mental illness may be caused by metabolic problems and how these
00:40:52.400 metabolic problems can be caused by things like poor diet and things like that and i think when most
00:40:57.640 people think about metabolic problems we associate them we associate with things like you know obesity
00:41:02.700 and diabetes as we discussed but we probably all know people who are they got a healthy weight
00:41:08.920 they seem to eat a healthy diet but still deal with things like depression so what's going on there
00:41:15.220 if mental illness is possibly caused by metabolic problems why are there some people who don't have
00:41:21.640 the typical metabolic problem markers nonetheless experience mental health issues so the first thing
00:41:29.620 that i want to clarify in that in this person that you're saying is depressed so i want to understand
00:41:35.120 is this a normal depression or is this a depression disorder and so in the way that i described pain and
00:41:44.960 hyper excitability same deal goes for depression so depression can be a normal response to adversity
00:41:51.960 so if if a kid is getting bullied and teased relentlessly or if somebody just got dumped by the love of their
00:42:00.360 their life they are going to be depressed that is all normal they do not have a brain disorder they are
00:42:08.240 having normal reactions to adversity it doesn't mean they don't need help i think a lot of those people
00:42:16.200 do need help but the help is obvious and common sense it is human compassion and support whether that
00:42:23.940 is through friends family whether it's through a psychotherapist really doesn't matter to me
00:42:29.620 but that person needs compassion and support because they you know are experiencing adversity in their
00:42:38.180 life if we're talking about somebody who has depression for no good reason or that depression is really
00:42:45.620 exaggerated and unrelenting then i'm going to say that person does have a brain disorder
00:42:51.360 and that that brain disorder is due to a metabolic problem in their brain and i'm really glad you brought
00:42:59.460 up this point about well doesn't a metabolic problem mean people are fat and diabetic well people who
00:43:08.520 are overweight or obese do on average tend to be more metabolically unhealthy and certainly people with
00:43:16.480 diabetes type 2 diabetes are more metabolically unhealthy but there are many other causes of metabolic problems
00:43:26.040 in the human body so let me give you a clear example that will hopefully kind of help people understand
00:43:34.740 this so one of the other causes of metabolic problems are toxins things that are toxic to these things in
00:43:43.380 our cells called mitochondria and they cause any toxin will cause metabolic problems and one clear easy to
00:43:52.440 understand example is smoking cigarettes so smoking cigarettes is actually associated with weight loss
00:44:00.820 on average people who smoke cigarettes weigh less than people who don't smoke cigarettes so this is not a weight
00:44:10.880 issue anymore this is a smoking issue and yet we know with certainty based on decades of research people who smoke
00:44:21.780 cigarettes are more likely to have heart attacks and strokes those are metabolic disorders they're also
00:44:30.480 interestingly more likely to have insulin resistance and develop type 2 diabetes even though most people think of
00:44:40.420 insulin resistance and type 2 diabetes as being related to weight or obesity smokers even though they're thin
00:44:49.060 tend to develop higher rates of insulin resistance and diabetes but guess what else smokers are more likely
00:44:57.520 to develop depression so one study actually followed over 14,000 Korean adults over several years and they measured
00:45:08.960 whether they were smokers and or whether they were depressed and the people who were not depressed but they
00:45:16.020 were smokers were much much more likely to go on to develop depression in the subsequent years however the reverse
00:45:26.060 association was not found so people who were depressed were not necessarily more likely to go on to become smokers and so the researchers in that study concluded
00:45:35.960 concluded that smoking seems to cause or contribute to an increased risk for the development of depression
00:45:44.460 so if i summarize all of that one metabolic toxin smoking cigarettes results in higher rates of cardiovascular disease
00:45:56.160 insulin resistance type 2 diabetes and depression even though smokers weigh less
00:46:05.060 so we need to stop thinking about metabolic problems as a weight issue because it is much more than just weight
00:46:13.800 well another toxin obvious one would be alcohol as well right
00:46:18.580 absolutely and believe it or not people who drink high amounts of alcohol are more likely to what have heart attacks
00:46:28.980 they're also more likely to develop type 2 diabetes interestingly they're more likely to develop mental disorders
00:46:37.220 including depression so again one metabolic toxin alcohol we know with certainty based on decades of research
00:46:46.740 is a mitochondrial poison and that is poisoning your metabolism and that can result in both mental and metabolic disorders
00:46:57.540 and then other things too you talk about in the book that could affect metabolism but you might not see someone with the obvious signs that they have a metabolic issue like weight gain
00:47:06.280 if you're lonely right i think there's studies that show that your likelihood of cardiac problems goes up
00:47:12.360 insulin resistance also goes up and that can cause things like depression as well
00:47:16.960 absolutely so everybody knows that loneliness could be associated with depression that just kind of makes sense
00:47:24.980 and that's usually what people think but loneliness as you mentioned also results in higher rates of metabolic disorders
00:47:32.480 heart attacks strokes and actually premature death and so that is one of the major themes of brain energy
00:47:41.380 is that mental and metabolic
00:47:45.000 are interchangeable
00:47:47.420 and closely
00:47:49.120 and you know
00:47:50.440 closely related
00:47:51.760 and interconnected
00:47:53.720 that we can't talk about mental symptoms or mental disorders without talking about metabolic
00:47:59.680 but we also can't talk about metabolic disorders like heart attacks or even obesity without thinking about mental symptoms and mental disorders
00:48:10.420 okay so even if you're not overweight you can still have metabolic problems because there are metabolic disruptors that don't show up in weight gain
00:48:19.480 things like smoking and drinking can damage your metabolism
00:48:23.140 something else that can damage your metabolism is stress and lack of sleep
00:48:28.480 a lack of exercise can damage your metabolism
00:48:31.600 and you know that's why exercise can improve mental health
00:48:35.280 so a bunch of things beyond diet can affect metabolism
00:48:38.460 and that in turn can affect your mental health
00:48:41.980 how do you imagine this brain energy theory
00:48:45.640 of mental health
00:48:46.940 you know will change how doctors diagnose and treat people with mental illness
00:48:51.340 I mean I guess example I mean right now like most people if they go to a psychiatrist
00:48:54.320 like man I'm just I've got OCD
00:48:56.260 or severe depression
00:48:58.880 the typical thing as well
00:49:00.640 we'll maybe do some talk therapy do a pill
00:49:02.480 with this brain energy approach
00:49:04.080 kind of walk us through like let's say someone walks into you
00:49:06.500 say I've man I've got major depression
00:49:08.300 potentially major depression
00:49:09.540 what would you do
00:49:10.740 I would actually want to do
00:49:14.240 a comprehensive assessment
00:49:16.040 of all sorts of mental health
00:49:18.480 markers which we currently do
00:49:20.360 anyway so I'm going to look for other types of symptoms
00:49:23.480 OCD symptoms
00:49:24.780 anxiety symptoms
00:49:25.780 psychotic symptoms
00:49:26.860 bipolar symptoms
00:49:28.000 all sorts of them
00:49:29.480 to really get a full picture of brain function
00:49:32.120 but the huge change
00:49:34.780 is that I am now also going to be looking
00:49:37.480 at metabolic markers
00:49:39.620 biomarkers
00:49:40.900 lifestyle factors that we know impact metabolism
00:49:44.020 I'm going to be asking that person about their diet
00:49:46.580 about their exercise
00:49:48.080 about sleep
00:49:49.540 stress levels
00:49:50.640 their use of substances
00:49:52.200 their use of medications
00:49:53.580 and I'm going to be
00:49:56.080 putting all of that information together
00:49:59.240 in one coherent way
00:50:01.540 I'm going to try to understand
00:50:03.380 what are all of the factors
00:50:04.860 that are
00:50:06.420 causing harm to this person's metabolism
00:50:10.320 so that might be a bad diet
00:50:13.400 and poor sleep
00:50:15.040 maybe they're not prioritizing sleep
00:50:17.120 they're on their computer
00:50:18.180 they're staying up all night
00:50:19.640 binge watching Netflix
00:50:21.000 and then they don't get enough sleep
00:50:22.980 I'm going to recognize
00:50:24.820 that those are
00:50:26.440 impairing metabolism
00:50:27.740 and
00:50:29.740 I'm going to try to address those first
00:50:32.160 before I start throwing pills
00:50:33.740 at this person
00:50:34.640 and even
00:50:35.600 probably before I start
00:50:37.220 psychotherapy
00:50:38.120 with this person
00:50:39.380 I'm going to
00:50:40.500 use lifestyle factors
00:50:42.440 for clear and unequivocal
00:50:45.020 metabolic problems
00:50:46.720 and
00:50:47.860 I'm going to see
00:50:49.160 what I get
00:50:49.920 for a lot of people
00:50:51.080 I think that's going to solve the problem
00:50:52.980 and
00:50:54.280 the beauty
00:50:55.680 of this theory
00:50:56.760 is that at the same time
00:50:58.540 I'm addressing their depression
00:50:59.780 I'm also
00:51:00.760 addressing their weight issues
00:51:02.760 I'm also
00:51:03.820 reducing their risk
00:51:05.200 for prediabetes
00:51:06.260 or diabetes
00:51:07.020 I'm reducing their risk
00:51:08.540 for a heart attack
00:51:09.520 I'm making this person
00:51:11.060 a happier
00:51:11.900 healthier
00:51:12.600 person
00:51:13.600 overall
00:51:14.340 I'm treating the whole person
00:51:16.300 not just
00:51:17.700 brain symptoms
00:51:18.780 I'm treating
00:51:19.860 all of it
00:51:20.880 some people
00:51:22.140 may still
00:51:22.960 you know
00:51:23.460 we may go through everything
00:51:24.640 and say
00:51:25.260 well we can't really find
00:51:26.380 anything wrong
00:51:27.440 they're following a good diet
00:51:29.300 they're getting adequate sleep
00:51:30.740 they're not too stressed
00:51:31.880 I'm
00:51:33.260 I'm still open
00:51:34.500 to using
00:51:35.080 antidepressants
00:51:36.240 and talk therapy
00:51:37.220 and psychotherapy
00:51:38.060 and even more invasive
00:51:39.460 treatments
00:51:40.180 like ECT
00:51:41.420 and TMS
00:51:42.280 if those are needed
00:51:43.620 but I think that
00:51:45.420 the metabolic theory
00:51:46.380 of mental illness
00:51:47.140 opens up entirely
00:51:48.240 new ways
00:51:49.140 to think about
00:51:50.300 what's happening
00:51:51.060 all the way down
00:51:52.320 to the cellular level
00:51:53.420 and much more importantly
00:51:55.100 it opens up
00:51:56.020 entirely new ways
00:51:57.220 to treat these disorders
00:51:58.440 and put these disorders
00:51:59.720 into full remission
00:52:01.080 as opposed to
00:52:02.360 just reducing symptoms
00:52:03.580 well you were talking
00:52:04.920 about talk therapy
00:52:05.520 I just had the thought
00:52:06.260 I mean I think
00:52:06.680 what might be going on there
00:52:08.660 why talk therapy
00:52:09.540 is useful
00:52:10.240 we typically think
00:52:11.100 well talk therapy
00:52:11.640 is useful
00:52:11.980 because it helps you
00:52:12.660 get over like
00:52:13.900 maladaptive thinking patterns
00:52:15.340 for example
00:52:15.960 but I think it's
00:52:16.940 what a lot of talk therapy
00:52:18.280 does
00:52:18.480 is like
00:52:18.720 you're talking to someone
00:52:19.880 you have like
00:52:21.000 someone you can trust
00:52:22.040 and talk to
00:52:22.600 which feels good
00:52:23.400 reduces stress
00:52:24.660 you learn skills
00:52:26.740 cognitive skills
00:52:27.960 so that you
00:52:28.820 basically reduce stress
00:52:30.200 which affects metabolism
00:52:32.020 like that's
00:52:32.940 that's what's going
00:52:34.240 that's potentially
00:52:34.800 what's going on
00:52:35.420 yeah
00:52:35.720 absolutely
00:52:36.700 and I think
00:52:38.280 that's a really
00:52:38.800 important point
00:52:39.760 so this theory
00:52:40.740 doesn't replace
00:52:42.040 existing treatments
00:52:43.800 that we know
00:52:44.580 work for some people
00:52:45.840 this theory
00:52:47.040 simply offers
00:52:48.180 a completely new way
00:52:49.840 to understand
00:52:50.700 how and why
00:52:51.900 something like
00:52:52.740 psychotherapy
00:52:53.320 or an antidepressant
00:52:54.720 might be working
00:52:55.420 yeah
00:52:55.820 and I think
00:52:56.480 for someone who
00:52:57.760 is listening to this
00:52:58.780 you know
00:52:59.160 I think this would be great
00:53:00.020 I mean like
00:53:00.460 if someone has like
00:53:01.280 severe mental illness
00:53:02.320 like schizophrenia
00:53:02.840 things like that
00:53:03.780 you'd have like
00:53:04.760 severe interventions
00:53:05.600 like maybe
00:53:06.060 okay we're going to
00:53:06.680 completely switch up
00:53:07.500 your diet
00:53:07.860 try keto
00:53:08.460 of course you want to
00:53:09.500 talk to a doctor
00:53:10.180 about that
00:53:10.780 but even if you don't
00:53:11.940 have any like
00:53:12.760 mental health issues
00:53:14.200 like this
00:53:14.900 I think this information
00:53:15.700 explains like
00:53:16.440 why you should
00:53:17.220 focus about like
00:53:18.380 eating well
00:53:19.100 and exercising
00:53:20.000 and reducing stress
00:53:20.960 because
00:53:21.280 not only is it going to
00:53:22.180 help your body
00:53:22.780 but it's going to
00:53:23.360 help your mind as well
00:53:24.240 absolutely
00:53:25.160 yeah
00:53:26.060 well Chris
00:53:27.180 this has been a great
00:53:27.680 conversation
00:53:28.180 where can people go
00:53:28.860 to learn more about
00:53:29.420 the book
00:53:29.740 and your work
00:53:30.240 the one website
00:53:31.920 I'll direct people to
00:53:32.940 is
00:53:33.320 brainenergy.com
00:53:35.900 so
00:53:36.460 brainenergy.com
00:53:37.580 awesome
00:53:38.520 Dr. Chris Palmer
00:53:39.520 thanks for your time
00:53:39.980 it's been a pleasure
00:53:40.480 thank you Brett
00:53:41.860 for having me
00:53:42.560 my guest today
00:53:43.820 my guest today was
00:53:43.920 Dr. Chris Palmer
00:53:44.640 he's the author
00:53:45.320 of the book
00:53:45.680 Brain Energy
00:53:46.300 it's available
00:53:46.880 on amazon.com
00:53:47.760 and bookstores
00:53:48.180 everywhere
00:53:48.500 you can find
00:53:49.160 more information
00:53:49.580 about his work
00:53:50.020 at his website
00:53:50.720 chrispalmermd.com
00:53:52.600 also check out
00:53:53.420 our show notes
00:53:53.820 at aom.is
00:53:54.700 slash brainenergy
00:53:55.680 where you can find
00:53:56.380 links to resources
00:53:57.220 where you can delve
00:53:57.620 deeper into this topic
00:53:58.660 well that wraps up
00:54:06.920 another edition
00:54:07.540 of the AOM podcast
00:54:08.400 make sure to check out
00:54:09.360 our website
00:54:09.760 at artofmanless.com
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00:54:12.860 thousands of articles
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