Are You Eating Your Way to Anxiety? Let’s Talk Mental Health!
In this episode, holistic endocrinologist Dr. Cassie Smith sits down with Dr. Drew Ramsey, a board-certified psychiatrist and author. They dive into the growing issue of anxiety and depression, focusing on how nutrition and lifestyle choices can impact our mental health.
Dr. Ramsey shares insights from his upcoming book, “Healing the Modern Brain,” and stresses the importance of gut health, hormones, and making practical lifestyle changes to boost mental fitness. Their discussion also touches on the benefits of following a Mediterranean diet, the role of Brain-Derived Neurotrophic Factor (BDNF), and the importance of taking a holistic approach to mental health.
Cassie info and links:
Check out the website
Follow Cassie on Instagram
Follow Cassie on Facebook
Follow Cassie on YouTube
Follow Cassie on TikTok
Guest info and links:
DREW RAMSEY, MD is a board-certified psychiatrist, author, and leading voice in Nutritional Psychiatry and integrative mental health. He is a Fellow of the American Psychiatric Association and the founder of the Brain Food Clinic and Spruce Mental Health. For twenty years, he served as an assistant clinical professor of psychiatry at Columbia University, where he taught and supervised psychotherapy and nutritional psychiatry.
Dr. Ramsey has authored five books, including Healing the Modern Brain and three e-courses. He is a dynamic speaker, podcast host and educator who has delivered three TEDx talks and his work has been featured by The New York Times, The Wall Street Journal, The Today Show, NPR and other notable outlets. He lives in Jackson, WY with his wife and family.
Learn more at www.DrewRamseyMD.com
Blog/Transcription:
0:03 welcome back to this week’s episode of hormones metabolism in you I’m your host Dr Cassie Smith I’m a holistic
0:10 endocrinologist thank you for joining me today I have a treat for you we are actually going to be talking to a board
0:17 certified psychiatrist today we’re going to be talking about ways that you can heal your brain in this modern world if
0:24 you’re struggling with anxiety depression or things like that this episode is for you Dr Ramsey is a board
0:31 certified psychiatrist author and leading voice in National Psychiatry and integrative mental health he’s a fellow
0:37 of the American Psychiatric association and the founder of the brain food clinic for 20 years he served as an assistant
0:44 clinical professor of Psychiatry at Columbia University where he taught and supervised Psychotherapy and nutritional
0:50 Psychiatry Dr Ramsey has authored five books including healing the modern brain
0:56 and three three ecourses he’s a dynamic speaker pod host and educator who’s
1:01 delivered three Ted X talks and his work has been featured by the New York Times The Wall Street Journal The Today Show
1:09 NPR and other notable Outlets he lives in Jackson Wyoming with his wife and his
1:14 family today in our podcast episode we discussed several things about healing
1:20 the modern brain we started out just talking in general about mental health and why we think it’s on the rise so he
1:26 gave us his reasoning as to how many people are suffer uing with mental health and why we think it’s on the rise
1:32 we also then transitioned into talking about how your gut plays a huge part in mental health so we talked about food
1:39 and food sources that we can eat or not eat to help with our mental health we talked about things like hormones not
1:45 only dopamine serotonin tryptophan but also hormones like bdnf which is a new
1:52 hormone that helps your brain actually heal itself we talked about what is estrogen progesterone testosterone due
1:58 to your brain we also talked about thyroid hormone and Insulin so these are all things that I’m going to talk about
2:03 in my book as well I have a book coming out about hormones and your gut and so
2:08 we tied that into mental health when we discussed our topics today I asked him
2:13 things in specifically about diet so I know you guys are going to have questions about does a low carb help
2:19 with anxiety and depression should I fast should I eat protein and if so should it be plant-based versus animal-
2:25 based and so he just went over some statistics and some facts about nutrition in general and mental health
2:33 most notably just how to keep yourself mentally healthy he talked about
2:38 exercise and sleep he calls these pillars and creating this mental Fitness so increasing your mental Fitness is
2:44 what he talks about in his book we also talked about different ways that you can increase mental filment mental Fitness
2:52 through things like a journaling and different Outlets that you can use to
2:58 help keep your mental um um Fitness you know elevated we interestingly also
3:04 talked about how anxiety and depression is actually doubled in people with
3:10 obesity and diabetes so we kind of tied all this back in to what we do at modern indocin and just some of the significant
3:17 health issues that people are struggling with so I hope that you enjoy this
3:24 episode today I have Dr Drew ramsy he’s going to be talking to us about about
3:30 mental health he actually has a book that’s coming out in the very near
3:35 future as well healing the modern brain and so I wanted to start by having him
3:41 tell you guys just a little bit about himself why he picked the field of Psychiatry and then a little bit about
3:46 his book and then we’re going to dive in to a bunch of amazing questions that you guys all want the answers
3:53 to Cassie thank you so much it’s such a treat to be with you and thanks for everybody who’s tuning in wherever you
3:58 are it’s really uh just always wonderful to get to spend a little time with folks thinking about mental health thinking
4:04 about this new idea of mental Fitness Cassie I got interested in Psychiatry because it’s the best field
4:11 in Medicine by far I mean the brain is the coolest most complex or again we
4:16 also are understanding more about the human brain than ever before and I think
4:21 even what I didn’t anticipate 25 years ago when I got into this field was people are more interested in mental
4:27 health than ever before and psychiatry’s always been of just great interest to me
4:33 I think personally just wondering about my own mood and boy what can I do to make it a little better a little less
4:38 anxious um I think in medical school I just really liked talking and listening
4:44 to patients and the idea got uh really intriguing to me of thinking about
4:49 people’s health concerns like a puzzle and if I could put the pieces together and collaborate with them in the right
4:55 way that they could return to to health that um and then I got I I was curious
5:01 about dreams I got really curious about Psychotherapy if you’re watching this on video that is a real live working
5:08 Psychiatry couch behind me with all the belt really it’s a good couch serves me well but I I love seeing people in
5:15 Psychotherapy and um I think also I got interested in psychiatric because it was
5:20 changing and part of what healing the modern brain asks in some ways just like my last book Eat to beat depression and
5:26 anxiety it asks us all to take a step back from the massive amount of misinformation that we have about mental
5:32 health and look at it through the lens of new science right 20 years ago nobody
5:39 in mental health was talking about neuroplasticity and brain growth now that’s what everybody’s talking about uh
5:44 and so that’s one of the lenses that I use in healing the modern brain to look at these different tenants and say hey
5:50 there are things in our everyday life we make choices about we don’t make choices about those kind of with the right
5:57 information like hey that choice helps your brain grow or makes your brain
6:02 shrink or another lens in the book is inflammation right there are sets of foods that you eat that cause more
6:09 inflammation and weight gain and metabolic problems and they’re foods you can eat that are correlated with uh
6:15 fewer metabolic problems uh you know a healthier outcomes lower risk of mental
6:21 health problems and so you know it’s a longwinded answer but I’m into
6:26 Psychiatry because I love mental health um I I love what I get to hear about in
6:31 terms of people um in really honest raw hard moments and I I like hearing that
6:39 version of life and then I guess probably the reason I love being a psychiatrist after all this time is just
6:44 people are really resilient and it just it it always gives me hope to meet people often in very very difficult
6:51 situations having really challenging symptoms and to to see them get better
6:57 um it just it’s just very inspiring ing so that’s why I like
7:02 Psychiatry so I feel like you said a couple things that kind of resonate with me I do I joke with people that if I
7:09 wasn’t an endocrinologist I would be a psychiatrist sometimes I feel like a psychiatrist right because if you do
7:15 listen to people and try to help them get better especially with their hormones then just I feel like I feel
7:21 like I do a lot of Psychiatry typ well there’s a lot a lot of feelings that come out and a lot of overlap right hormones or you know I mean serotonin
7:28 and all these neurotransmitters we call them neuro hormones I mean when we think about what is affecting you know what’s
7:34 radically shifted in my field it’s the care of per menopausal women in terms of thinking about how hormone replacement
7:40 therapy really shifts things and how you think about the management let’s say of depression and anxiety during the
7:46 peralal period so yeah there is a lot of Psychiatry and endocrinology yeah but the other thing I
7:52 find so fascinating about it to your point is like there are so many things you can do about it that don’t
7:57 necessarily involve just medication and I do think that there’s like a change in the way people are looking at psychiatry
8:03 in the field of Psychiatry whereas you know kind of even whenever I was in med school 15 10 15 years ago it was almost
8:11 like um you know mental health had this like negative stigma about it and I do
8:16 think that we’re becoming better we still have a lot of work a lot of you know room for growth but we’re becoming
8:22 better in this country of actually realizing that mental health is this you know condition this disease this illness
8:27 that we do need to treat or to help people understand how to fix and then the cool thing is there are people like
8:33 you who are showing people there ways you can do this through lifestyle choices right like through sleeping
8:39 better exercising better moving better just talking to yourself better things like that so it doesn’t always have to
8:44 be this prescription which is what I love because I feel like you know although sometimes those prescriptions
8:50 are needed a lot of the people that listen to this podcast will tell you well I want something that doesn’t
8:55 necessarily require a prescription right and so but there’s all this data out
9:00 there all this and it’s like what is true what is not true what do we need to do so I like that you’ve kind of
9:06 compiled all this to people for the all of this for people and the fact that you do it talking about the modern world I
9:13 think is fascinating and amazing because I do think my life my brain just the
9:19 things that go through my life and my brain every day are so different than 5 years ago PRI prior to the pandemic like
9:26 if you think about right now right you know 5 years ago we’re recording this the last week of February 5 years ago we
9:32 had no idea what was coming right like this was right before the shutdown and so just everything has changed a lot and
9:39 that affects your mental health a ton oh it really does and thanks for picking up on that theme in the book people ask
9:45 like what do you mean by the modern brain I’m like what do you mean what do I mean like you know like you you’re
9:51 feeling it um I don’t want to say that hey everybody has a mental health problem I think people get annoyed when
9:57 everything gets called depression anxiety trauma PTSD and you know some people really have those conditions and
10:03 and maybe some people don’t but I really wanted to transcend that argument like I don’t care whether you have it or not I
10:09 think the modern world is causing uh stress and causing a set of mental
10:14 health problems like never before and we can argue all kinds of ways about how
10:19 that’s happening why that’s happening how much of it is something in our food how much of it is digital media how much
10:26 of it is a loss of maybe some type of family values but for me as a clinician my job is
10:33 getting people better and so I’ll just and I’m curious about where things come from for sure I mean that’s probably we
10:38 do a better job of understanding root causes than anybody in medicine and Psychiatry people will say well you know
10:45 how is that given we don’t exactly understand the root causes of a lot of these illnesses It’s like because we sit
10:51 and listen and hear more than anyone else in the field of medicine just by virtue of what we do and so I I I think
10:59 that there’s as you said a lot that can be done and a lot that affects our mental health sometimes that we don’t
11:04 think about or we just haven’t like updated our knowledge you know it’s like when people are still talking to me
11:09 about serotonin it’s like I love serotonin but I love serotonin like I love Madonna Like when Just Like a
11:15 Prayer comes on in the grocery store I sing along I’m a fan when she Stars up in a movie I’m a fan right but there’s a
11:21 lot of other musicians that I like since the ’90s um a lot and my tastes have
11:28 evolved and there’s a lot more on my playlist and and that’s kind of how I feel about serotonin like I love serotonin very cool molecule very
11:35 misunderstood super cool neurotransmitter very involved in not just the regulation of mood but
11:43 intelligence sex drive appetite sleep regulation cognitive uh uh kind of focus I mean so
11:50 much going on with serotonin um but again I don’t want to have a conversation about mental health these
11:56 days turning with serotonin like I do in healing the botom brain I want to tell you about my favorite brain molecule
12:02 bdnf that’s the molecule of Hope right there because that is in our brain and it causes our brain to grow causes us to
12:09 give birth to new brain cells hubba hubba who doesn’t want I mean you’re I think Cassie a little younger than I am
12:14 I you’re my age boy you want more brain cells it’s like what do you want for breakfast it’s like I’d like some more brain cells um in all seriousness note
12:21 what a cool idea that there are things we can do and we can engage in our daily life right some of the I mean everybody
12:27 knows right you exercise more you eat a more Mediterranean style diet you get good quality sleep you have more of the
12:33 stuff called bdnf like flowing through your veins is it a perfect biomarker no
12:38 but just as a concept and something again where I feel empowered what helps me get up and get out and exercise what
12:45 helps me choose that avocado over the black and white cookie cuz my they’re right next to each other in our house
12:51 it’s hard for me it’s hard uh right I’m thinking okay I I know enough about sort of the
12:58 neuroplasticity what’s happening to help motivate me to make those choices that I think o you know over the long term and
13:04 the research really make a difference just take um take there’s this great study looking at uh MRI scans of people
13:11 who are in their early 60s and and they looked at the folks who are eating a Ultra processed food diet compared to
13:18 the F folks who are eating a more like Whole Foods or Mediterranean or traditional style diet right nor real
13:24 food and it’s just really obvious over five years you just see the people who are eating real foods they’re brains
13:29 particularly in this area of the left hippocampus which is the part of our brain that continues growing in adult life it’s just bigger like measurably
13:37 statistically significant bigger when you eat Whole Foods and that’s just one of the tenants so you know it’s to me as
13:45 you can see I get kind of bubbly and excited about it because it’s like hey there’s like a new set of real science
13:51 and understanding us it helps us make better choices and also helps us invest
13:56 in the activities that help our mental Fitness stay strong and
14:01 resilient okay so now I have additional questions for you but I want to start with this one so why do you think mental
14:12 health is on the rise do you think it’s really on the rise or do you think that now it’s not so much of a stigma to talk
14:17 about so we see it more in people that’s my question because I feel like when I
14:24 was in school you know early 2000s through graduating being 2011 and then
14:30 like I feel like people always had it from what you know I maybe I’m just easy to talk to I’m a good listener I’m like
14:37 you like I love to listen to people I can can get a lot of people tell me you
14:42 know my patients tell me all the time like you’re so easy to tell things to um but I feel like even in early 2000 way
14:49 prior to covid there was a lot of mental health it was just sort of like there was a stigma so it’s like people maybe
14:54 didn’t talk about it as much so do you think that there’s actually more of it
15:00 and probably so postco right because of trauma but or is it just that we’re talking about it more and if there is
15:05 more of it why do you think there’s more of it I think there’s both let’s take
15:11 something like adolescent depression so 2004 2005 like when I started doing
15:16 Psychiatry about 8% of our teens had clinical depression every year 10 years
15:23 later that pops up to 14.1% and today it’s 20% one in five
15:28 teens have depression so that’s changing faster than we can account for simply with increased awareness certainly
15:35 increased awareness is part of it you know today if you’re a resident in family practice or internal medicine or
15:42 you’re a nurse practitioner and you spot a case of depression talk to the
15:48 patients screen them for suicidal thoughts and give them a prescription for an
15:54 anti-depressant that I mean that’s really applauded by the medical system because we’re actually taking care of mental health we now screen people with
16:02 really simple like uh phq9 nine questions answer these question easy screener fill it out yourself and it
16:09 indicates likely whether you have depression or not and Primary Care setting we’ve got to remember that you know about 80% of all anti-depressants
16:16 in America aren’t written by a specialist psychiatrist physician like myself the majority and we we want this
16:23 but the majority are written by family practice doctors Internal Medicine doctors OBGYN doctors and psychiatric
16:28 nurses practitioners and and so because of that we have a lot more recognition but also
16:35 what’s the move all of those clinicians have most of them only have one move and that’s to prescribe an
16:41 anti-depressant I’m a fan of that move there’s nothing we’ve had before in history that does such a good job of
16:47 treating clinical depression and anxiety the side effect profiles is quite good I know there’s a lot of questions and
16:52 controversy about that but I’ve been using these meds for a long time uh the
16:58 the data can get confusing and I think it’s often misinterpreted um but uh the reason I
17:05 wanted to write this book is I just found that we were spend it’s it’s it’s kind of like uh the nutrition world the
17:12 reason I wrote nutrition books in mental health and and kind of came up with this idea of nutritional Psychiatry is I
17:17 found that people were spending all their time arguing about whether they should be a vegetarian or not and people were spending all of their time arguing
17:24 about whether they should eat meat or not and and that was it and I just thought wow there’s so so much
17:30 microplastics in your food right there’s so much opportunity because 90% of
17:35 Americans aren’t eating the recommended daily allowance of fruits and vegetables there’s this notion that our diet is failed that’s ridiculous right what’s
17:43 failed is our education around nutrition and what’s failed in a lot of ways is
17:48 our control over our choices um but the idea that we should be confused where some of the mental
17:54 health epidemic and some of the Obesity and diabetes epidemics coming from from like there’s no there shouldn’t be
18:00 confusion about that it’s very clear in the nutrition literature and I think because of that as you have more obesity
18:06 you have more diabetes right then you’re double both of those conditions independently double the risk of clinical
18:12 depression and so you know again some of the increase it shouldn’t be too confusing as we’re struggling more with
18:18 weight what is it like 75% of our country struggling with weight now as
18:24 right 70% so as we’re struggling with diabetes and pre-diabetes you know those
18:31 illnesses drive a ton of inflammation right and as we now know inflammation is one of the drivers of depression about
18:38 30% 30 to 40% of patients who have treatment resistant depression meaning they’ve tried multiple evidence-based
18:44 treatments that haven’t worked and they haven’t gotten better 30% of those patients have high
18:50 levels of inflammation and so you know when you combine hey we have more awareness you walk in and you say I have
18:56 sociophobia it gets diagnosed and there’s Treatment available you walk in and you say I’ve been feeling I don’t
19:02 know a little off your clinician now will say like hey how how’s your mood been what’s been going on you feeling start asking screening questions for
19:09 depression so more awareness more treatment and then we have a number of
19:15 things that are also driving psychiatric illness right we’ve never had so much
19:20 microplastic do we’re not sure what that does yet but it doesn’t look like it does good things uh we’ve never had food
19:26 that is quite like this uh we’ve never had such a sedentary lifestyle and then
19:32 you throw on top of that this kind of change in socializing we have we have this digital environment we have a lot
19:38 that’s distracting us on our screens we have a harder time keeping our connections our surgeon generals has
19:44 issued a warning Vivic mury did about this loneliness epidemic they say
19:49 loneliness is the equivalent of what 3/4 of a pack of cigarettes a day that’s the helpful equivalent
19:56 so so all those things kind of combined together I I think contribute to some of what we’re seeing I think it’s to know
20:02 you know there’s some mental illnesses like the the incidents of um or the prevalence of schizophrenia or bipolar
20:09 disorder that aren’t kind of shooting up as much but again anytime you have increased awareness and you have a
20:14 better system of treatment you’re you’re going to see some some increases like this but I think the reason I go through
20:20 those numbers it has everyone concerned because they’re skyrocketing in a way
20:25 that’s really concerning yeah so to your I completely agree with all that and you know I
20:32 inflammation I think is the key to all diseases all chronic disease processes a lot of it starts in your gut and so I’m
20:39 writing a book about that which I you know I completely agree with that there so 70% of Americans are either obese or
20:47 overweight to clarify 93% of Americans actually have a form of insulin
20:53 resistance I see this so if you really look at a fasting insulin level it should be five or less unfortunately you
20:59 know the guidelines or the reference ranges a lot of times we’ll say 18 19 is normal but we know with insulin levels
21:06 above five you have significant inflammatory markers and cyto kindes at a fasted state which is causing
21:12 inflammation in your brain right making type three diabetes what we call and so I I agree with all that and so I think
21:18 to your point like the the change in lifestyle the change in our food or
21:24 whatever we call Food these days um and I want to talk to you about that as well and then just this loneliness as well
21:30 after the pandemic like all these things have changed so many things that you know mental health seems to be on the
21:37 rise but what I mean the good thing I I think is that people realize it right
21:43 like most of the people who come to see me now men included which shout out to the men out there who oh yeah I treat
21:49 tons of bros lots of guys lots of men I I love men of all age my I don’t mean to call them Bros like younger men in their
21:55 20s man I have a bunch of guys right now who have uh they’ve got kids so over the
22:01 past year I’ve had this new phenomenon of young men showing up to their video Psychotherapy sessions with their baby
22:07 strapped on and they’re like bouncing they like hey Doc and it’s like the ultimate Flex in therapy you’ve been
22:13 coming for a few years and now I mean it it’s really uh in all seriousness it
22:18 warms my heart it’s like nothing I’ve ever experienced before as a clinician where you meet often a young man you
22:24 know struggling in college let’s say you know uh and you know a few years later
22:30 you’re getting to sit with them as a you know husband dad all that stuff it’s it’s really it’s wonderful and yeah
22:36 that’s part I mean part of it is like people come in and they’re like I think I have depression or um you know I know a lot
22:43 of times a have patients come to see me and you know I’m a holistic or known as kind of Integrative guy but they’ll come and see me because they they want
22:50 medications from me because they feel I have a more holistic approach and maybe we’ll try some other things or at least
22:56 I’m aware of that that if I feel they need medications it’s like okay um and
23:02 so it it’s uh you know it’s a really complex landscape right now because also there’s so much information I mean first
23:07 of all there’s just a profound anti Psychiatry movement there are a lot of people who are deeply suspicious of
23:13 Psychiatry there’s a lot of vast misinformation about Psychiatry you know probably the most scrutinized and most
23:20 monitored medications on the planet are psychiatric medications but you know a
23:25 lot of people feel like I don’t know we’re very irresponsible with them so it’s uh it’s hard for people to get
23:31 appropriate care and in that context you know we also have you know not just do we have more treatment and more
23:37 diagnosis we have a lot more mental health disability than we’ve ever had before but let’s talk about positive
23:43 stuff Cassie is like it’s like it’s I mean it’s really frightening and I think it’s important to go over I think again
23:49 the book comes from this which is to say if we’re in this model it’s like helpless this mental health epidemics
23:55 coming for us right there’s a a lot of misinformation fearmongering a lot of
24:01 charlatans in the mental health space What do we do and that’s where this book comes from is is like you know what you do you build your mental Fitness like a
24:09 fortress right nobody is coming to save any of us right there are evidence-based
24:15 tools whether it’s one of the great psychotherapies or whether it’s like the tools I go over in the book make mapping
24:21 out your web of Connection getting involved with the journal um you know getting out into nature I mean each of
24:27 the tenants that I go through I picked because I don’t think you’re going to disagree with
24:33 me we it just we’ve all experienced it it’s like we I serve you great healthy
24:39 food for a week like the best stuff I think we all agree you’re going to feel a little more energized right we get
24:46 your sleep dialed in if you’ve had bad sleep literally tomorrow you’re going to think boy what it’s if we get your sleep
24:52 on you’re going to feel great so these are things you’ll recognize as working for your mental health and the night
24:58 again I hope what surprises people is like all the cool brain science like we were talking about inflammation you know what else drives up your inflammation
25:04 your inflammatory markers being socially isolated like if you don’t go out on a Friday night I mean I’m Aller people
25:10 taking the night off Etc you don’t always have to go out but if we isolate you don’t socialize it’s like bad for
25:17 levels of inflammation and it decreases the diversity of your microbiome who knew like who knew it’s so wild that
25:24 there’s this kind of final common Pathways of neuroplasticity inflammation and and um this new science of the
25:31 microbiome and the gut and how it relates to mental health So speaking of decreasing your
25:38 gut diversity and microbiome why do you think or how does
25:44 gut health play a part in mental health so like you mentioned a few things but
25:50 you know and I talk to people about this all the time like what you eat your point of like eating you know a lot of
25:56 fruits and vegetables also fiber fiber is key we like no one in this country gets enough fiber nobody and no one
26:03 thinks about it as a mental health nutrient right you ask people like what’s a good nutrient F metal health everyone’s like omega-3 fats B12 26:09 magnesium but nobody’s like fiber and I mean fiber probably is one of the most
26:15 important nutrients for your mental health and your gut health and yeah last of 68% of Americans don’t meet the
26:20 recommend daily allowance and again to that note I don’t I don’t find that
26:25 people also know their top source you know it’s easy to say like we need more magnesium but you know there’s so much
26:33 like people spend endless amounts of time on Instagram trying to figure out which form of magnesium to take
26:39 glycinate sulfate threonate but none of us know the top food source of magnesium
26:46 right or what are your top three food sources or what just like some go-to everyday magnesium sources that you like
26:53 to eat or which Seltzer like everybody likes Seltzer one of them has more magnesium than the others which one none
27:01 of us know these very basic questions to one of the most important minerals that the humans eat potassium is my other
27:07 favorite one right besides banana it’s like mystery nutrients like one of the most important minerals in
27:14 our body nobody gets enough of it and like where else do you find it besides bananas it’s like what do you do if you
27:20 don’t eat bananas right just white beans by the way is the answer for potassium uh but just some of this basic nutrition
27:27 education you know it’s like if you had a Ferrari in the garage I don’t know it’s probably got some special things it
27:33 needs you probably at least check in on that or I guess if you have a Ferrari maybe you have a staff to check in on those things but you wouldn’t just
27:39 ignore it you know uh and so yeah I enough to get on a little tiate about
27:44 nutrition it just I think we over complicate it there’s some foods that have more of each of these nutrients and
27:50 and just like with these other tenants be besides nutrition there’s a set of
27:55 behaviors that just pack more punch when it comes to improving your mental health and so again so many people I think are
28:02 just spending time on the wrong things I would agree with that you know I think yes to your point fiber um you
28:10 know we have a I have a list on our website of just my favorite fiber rich foods and fiber like Foods how much
28:16 fiber they have by content um and when you ask people because I talk to people about fiber all the time what foods do
28:22 you have that that have fiber in them the only answer I ever get from anyone is like well I eat chia seeds and I’m
28:29 like okay well what other foods do you eat the you know nobody knows that avocado has fibers Ras avocado you know
28:35 dark chocolate has a ton of fiber or lentils because I say lentils on every podcast I do because lentils are so
28:41 incredible they’re so easy to cook they’re so amazing for you um well
28:47 raspberries have a lot of antioxidants too and so they actually have blackberries do too but raspberries have a ton of fiber I love avocado wonderful
28:54 source of fiber and so just like there’s so many things and all the beans don’t forget the beans so amazing everyone’s
29:00 like oh they make you fart and it’s like yeah if you eat more of them you have less of that problem and also wow that’s
29:07 kind of what happens when you eat fiber is you have a little bit of gas and in fact if you don’t have any gas it’s it’s
29:13 a little bit of probably a problem so more fiber I think we agree for that and
29:18 and I hope and and I bet everybody listening knows something about that it’s just again one of those uh simple
29:25 things think about what you ate today and yesterday just kind of go through it breakfast lunch dinner and snacks just
29:32 kind of in loose form and you know how many plants were on there you know and I start seeing myself all the great little
29:38 moves that um my wife makes that I’m very grateful for um with uh but things
29:45 like yesterday there was like a bunch of celery and cucumber Spears laid out you know just as were like you know getting
29:51 dinner ready and just sitting on the table a little salad dressing a little olive oil to dip it in
29:58 man I I ate so many of those it was so good I just kind of had one of those days where I had had the healthiest
30:05 eating day that could ski lunch and so you know just little thing more veggies um more Seafood I have my little
30:11 rhyme Cassie Seafood greens nuts and beans and a little dark
30:16 chocolate Seafood greens nuts and beans and a little dark chocolate I like it so
30:23 since we’re talking about food then let’s here are the couple things that that people will talk about and you kind
30:29 of mentioned this one of them is fasting does fasting actually help your brain
30:36 your gut any of that and then also low carb you know there’s this whole thing that people throw around about low carb
30:42 and I guess we could throw into the mix the protein because you brought it up is animal versus plant protein any
30:47 different what would be your answers to those as far as if we’re trying to help our brain okay well I think uh going
30:56 backwards let start with protein and animal versus plant-based protein you know you want to have a complete protein
31:01 so if you’re mixing your plants together in a way that’s giving you all the amino acids I’m fine with that I treat lots of
31:06 vegetarians and even some vegans you know supplementing B12 maybe supplementing some minerals which most
31:12 vegans already do that usually gets folks there I mean it is to note that there are some large studies that have
31:18 shown people who follow a plant Ford or vegan diet are more susceptible and in some populations like there was a study
31:25 of British uh vegans and 52% British vegan men 52% of them had Frank B12 31:33 deficiency another 21% had B12 insufficiency so they’re just like on
31:38 the low end so 73% of that population had problems with B12 just as an example
31:43 a lot of vegans I treat these days or consult with you know they know about this they’re taking their B12 they’re having their levels checked regularly uh
31:52 you know so I think uh there’s also lots and lots of controversy and talk about
31:57 the environmental impacts and the difference you know I think a lot of times people are comparing you know a
32:03 conventional uh steak let’s say or hamburger with uh maybe not uh you know
32:08 a regenerative hamburger compared to tofu compared to Impossible Burger so
32:14 again it can get very confusing I tend to tell people to keep it simple and the
32:20 science seems to be clear that it’s a diet that you can stick to and that
32:25 matters for weight and weight loss um doesn’t matter if it’s vegan or uh
32:31 Mediterranean it if you stick to it and ear in a caloric deficit you’ll lose weight um Cassie I’m forgetting your
32:38 first two questions oh that’s okay so you’re so what I hear so far is that you want to make sure your protein is fully
32:45 sourced meaning you’re getting all the amino acids so sometimes that’s difficult to do if you just eat plant protein now to be fair there are ways
32:52 you can mix certain plant proteins together and get all your essential amino acids one of the ways is corn worn
32:58 and black beans um there’s a third thing that goes with it and it’s escaping my mind but the Mayan culture has figured
33:05 this out so there’s a Mayan culture that is vegan and I saw this on a Blue Zone
33:10 documentary but there’s a place in the Blue Zone where Mayan people live and they don’t eat a lot of meat and they
33:17 eat almost every meal was black beans corn like corn tortillas and something
33:22 else so there are ways you can get it with you get definitely you can get a complete protein mixing vegetables
33:28 together I think that and even now that you know the controversial thing doesn’t get talked about is everyone loves talk
33:34 about the B12 deficiency but there’s actually been a recent study that you can be sufficient on B12 not eating B12 33:40 but beating B12 analoges and plants and so uh even the you know the B12 pieces
33:46 up in the air so but if yes but then eating animal sourced protein assuming
33:51 that it is good sourced animal protein and you’re eliminating a lot of the fats will get you all your essential amino
33:57 acids the other question people have what about low carbon what about fasting low
34:02 carbon fasting I put those in a similar category low carbon fasting are both about inducing ketosis where you’re
34:09 breaking down fat products into three carbon uh fuel sources ketones and so
34:16 ketogenic diets right where you’re decreasing your carbohydrate intake under 60 grams a day uh this means
34:24 you’re just not going to have enough glucose to run your brain and so so your body uh and your liver in particular
34:30 gets very good at turning your fat stores or fats that you eat into ketones
34:36 and so when you’re fasting for shorts amount of time you’re you’re doing this
34:41 um and also when you’re eating a low carb diet you’re That’s a classic ketogenic diet you’re doing this there’s
34:47 very little data that this has good mental health effects there’s Buzz about it right now in part because of some
34:55 case reports and some popular books there is new science there was a pilot study a year ago of 23 individuals uh I
35:03 think 18 had or 19 had bipolar disorder four had schizophrenia who were put on a
35:09 modified ketogenic diet with coaching uh and great follow uh this was by Shabani
35:17 seti and her group at Stanford in the metabolic Psychiatry uh division there
35:22 and they had wonderful outcomes you know the caution with that is it’s a pilot trial so the this isn’t a randomized
35:28 trial everyone’s getting a lot of coaching but the good news there people had a 36% decrease in their visceral
35:34 adiposity that kind of fat around our organs and and people in their psychiatric measures had uh great
35:42 improvements and so you know this was exciting to see and and so I think you know ketogenic diets are one of those
35:48 diets that people think about for mental health we don’t have depression data yet although those studies are underway as I
35:55 understand it I think at Ohio State University there’s a study the um there’s a great Family Foundation the
36:00 bazooki foundation that’s been funding a number of randomized Trials so you know I would say like a year or two we’re
36:05 going to have actually a lot more high quality data on people engaging in ketogenic diets understanding the
36:12 metabolic kind of changes that can happen you know there is some concern about raising people’s LDL um uh there
36:18 was also a little bump in the study of C reactive protein uh but boy the metabolic markers were incredible so
36:26 those are kind of my my thoughts I mean in terms of it being a specific diet for something like resistant depression or
36:33 bipolar disorder um but you know it’s certainly something worth to try it’s certainly something that I speak about
36:39 with patients who have tried a number of things that haven’t worked and you know the way to think about it is you’re kind of Shifting the fuel of the brain from
36:46 primarily glucose to being ketones and there’s some notion that can be a little bit more um uh a little less
36:53 inflammatory or a little more quotequote anti-inflammatory and then there an idea the ketones themselves are like mood
37:00 stabilizing in the way that um this diet ketogenic diets were initially used for Pediatric epilepsy and there’s a lot of
37:07 overlap in the medications that are used for epilepsy things like loten and and medications that are used to managed by
37:14 polar disorder and depression I prescribe a lot of mogene for those two conditions so that’s a little those are
37:20 my thoughts on kind of low carb diets I would say people thinking more in the
37:25 morning of a higher protein lower carb breakfast as a way to kind of extend an
37:31 overnight fasting that’s something that I find very effective and helpful for people and maintaining Focus you know
37:37 think about that contrast of like a big heavy pancake breakfast versus like an egg half an avocado and some coffee with
37:45 cream like you know very different metabolically in terms of those two meals although pancakes are
37:52 delicious yeah I think that you know with the fasting and the ketogenic thing what kills me to is like if you’re
37:58 listening to this you have to think each person is different I see this from a metabolic standpoint metabolically if
38:04 you’re trying to lose a lot of weight things like that there are some definite benefits of that when you take these
38:11 things to extreme though especially women that are still cycling that’s where you can get into trouble so women
38:17 are not men and men are not women and a lot of times studies are done on men and so what I see is the women who try to do
38:24 this and try to fast you know 18 20 hours day in their you know the back
38:30 half of their cycle or their follicular phase of their cycle when their progesterone is supposed to be high they start messing with their hormones and so
38:36 I just think you know that’s what’s frustrating to me in social media is like oh yes everyone should fast
38:41 everyone like it depends it depend it depends it depends onal is working it
38:47 depends on how well your thyroid is working it depends on where you are in your cycle if you’re a woman men are very different it’s also easy to back
38:54 into an eating disorder right I mean it’s easy to call it fasting and just have people who aren’t eating enough um
39:02 and and I also again that that for everyone listening that notion of sustainability now the foods I recommend
39:09 I was eating 10 years ago I’m eating today um I I can’t imagine I’m going to
39:14 stop eating because they’re foods that humans have always eaten and you know that I feel they’re working because you
39:21 know I’m in a healthy spot um if you’re not in a healthy spot and you look at
39:26 your plate you look at your fridge and there’s a lot of processed food there’s a lot of stuff with a lot of ingredients
39:32 um you know you’re looking at your plate it’s not a lot of vegetables or you eat a lot of vegetables you’re always hungry
39:38 you know you’re missing food categories like you don’t ever eat fermented foods or you haven’t eaten any Seafood for a
39:44 while even though you like it you know we’re focused on food but you know I hope with all of these tenants like with
39:50 food what I just listed was a bunch of opportunities and I think often it’s it’s really portrayed as you know
39:56 horrible shameful you know failures where we’re not doing this or not doing that and I don’t want healing the modern
40:02 brain to be a book that invokes that I want healing the modern brain to be a book that allows people to think about
40:09 and assess where they are you know the first tenant is self-awareness and that’s because I find
40:15 so often we have a what in mental health we call an externalizing stance where we’re really
40:21 looking towards others towards institutions towards practitioners to in
40:27 some ways you know have a kind of magic solution and sometimes we certainly have some insightful ideas certainly I have a
40:34 a variety of foods and interpretations and medicines and supplements that you know uh can feel like magic when they
40:42 work and and they’re a good fit but I also think there’s just so much that we all can do and it’s really hard to know
40:49 what’s the right Next Step sometimes when we’re struggling with our mental health and that’s where again building more robust mental Fitness and then
40:56 thinking about these 10 again principles that we agree on like we all know that more self-awareness is probably good for
41:02 our mental health you know we all know having more connection and more time in nature and better sleep is good for our
41:09 mental health and so asking you to really focus on and and Tackle these issues one by one um and create a life
41:16 of mental Fitness is really the the hope of the book and how it’ll affect you I
41:21 like that so create mental Fitness so I want to kind of transition
41:26 to something different besides food I want to talk about hormones for just a second and how
41:34 hormones can help you heal the modern brain and when I say hormones I’m not only talking about things like serotonin
41:39 dopamine tryptophan I want to hear more about this hormone that you were talking
41:44 about the BN B bdnf brain brain derived neurotrophic Factor but then I also want
41:51 to talk a little bit about estrogen testosterone progesterone thyroid hormone insulin things like that briefly
41:57 because I want somebody to hear I want my listeners to hear it from somebody like you and not just me so let’s start
42:05 with like estrogen testosterone progesterone do you feel like those hormones have a beneficial role in brain
42:12 health yeah I mean I think those those hormones have a huge role in brain health you know when we look at
42:18 something like estrogen and progesterone and just the way that there’s been such a shift in the literature and and kind
42:24 of how we treat women over the past really just years and so it’s been very interesting then as a psychiatrist
42:30 having a number of my patients who have been struggling with depression anxiety in the context of per menopause go from
42:37 maybe trying therapy or an SSRI or mental Fitness and lifestyle changes to
42:43 now having access to things like hormone replacement therapy where they’re getting estrogen and
42:49 progesterone um and also having uh this new class of medications the gp1s where you know people are going
42:57 from really having a lot of food noise just a lot of struggle with food and eating to losing a lot of weight and not
43:05 feeling that noise and having those same medicines actually help a lot of people with alcohol and alcohol
43:11 craving so it it’s um you know I think hormones certainly play a role I think
43:17 there’s you know a long history in male uh health and I’d say even in male
43:23 mental health of probably thinking like testosterone is like the master controller um in a way that you know
43:31 it’s not very clear in the data we generally don’t use a lot of testosterone when treating depression although you know sometimes um we know
43:38 that uh testosterone in men drops I think it’s 70% uh over like the decade 50 to 60 at
43:46 least I’ve seen those statistics um I think that you know certainly the message is that hormones
43:52 play a role in our mood and our mental health is clear to Every Woman listening as you all have more of a hormonal cycle
44:00 and whether it’s cognitive clouding or just certain thoughts that you know I treat a lot of women where it’s like a
44:05 couple days with their cycle it’s just you know until you kind of have a sense of what’s going on it can just be very
44:12 distressing like really really disturbing depression tearfulness Suicidal Thoughts even um and so you see
44:19 that happen cyclically and it’s it’s all hormones it’s kind of when people talk about how there’s not a chemical
44:25 imbalance it’s like what what do you think’s going on up there it’s all chemicals imbalance I mean it’s it’s
44:31 it’s maybe not as simple as it’s you know just a simple chemical imbalance but uh it’s you know they’re certainly
44:38 involved in in terms of couple the other ones you mentioned like insulin right wow I mean just like again we haven’t
44:43 really thought about that as being so critical or involved for mental health but you know we know so many people are
44:49 insulin resistant and being insulin resistant that’s just a real different experience when you eat carbohydrates
44:55 right you get real like when I get high blood sugar I get super slumpy
45:01 sluggish I I’ll just pass out and like kind of knot off I it’s quite embarrassing um I get
45:07 moody uh so you know I think what people
45:13 probably need to hear is that when something is feeling off we don’t always know the root cause but boy there are
45:18 some things you want to check off your list like if you start seeing me and you have depression I don’t really want to
45:24 prescribe a medication until we know it’s not B12 deficiency or your thyroid
45:30 is off in some way I don’t think that’s a very common cause of clinical depression but for almost everybody who
45:36 has uh low thyroid I would say depression is a very common symptom for those patients
45:43 um thyroid is also used there’s certainly some clinicians who tried to optimize thyroid a little bit more feel
45:49 a thyroid is quote unquote sluggish and so giving people thyroid hormone is for some people part of their kind of
45:55 treatment depression protocol um I don’t do a lot of that but I certainly have some patience on a little
46:00 bit of croid or cytomel um I think and then I just think
46:06 as you said my favorite one is bdnf brain derived neurotrophic factor which is again just the idea that our body
46:12 makes a neuro hormone that causes our brain to grow and repair itself that’s awesome I want more of that um and then
46:20 to honor all these neurotransmitters I feel like there’s so much like BS on the internet of like oh depression’s not a
46:25 proac deficiency and I’m like what a stupid idea I don’t know who came up with that dumb idea it’s like that
46:31 stupid was it Thomas Edison quote like the doctor of the future will give no
46:36 drugs it’s like are you kidding me like do you understand what Thomas Edison was looking at in terms of medicine I think
46:42 that was an Edison quote and and like what a ludicrous idea we’re not like
46:48 we’re not going to give any medicines like why why would we not give effective medicines and know why would we think
46:54 about I don’t know like uh you know great a great example is hyper thyroidism right you know it’s like a
47:02 metabolic it’s like a a condition is it needs to be treated it’s not like a deficiency of something I don’t know I
47:09 just get a little frustrated sometimes where again there’s a very very powerful anti Psychiatry movement of foot um that
47:17 Lo loves to uh well I’m not sure what it loves to it loves to not be
47:23 accountable so I think you know to your point I think sometimes when people people are talking about that the whole
47:28 like not prescribing drugs this is more functional medicine based providers I’m more functional medicine based but there
47:33 is two different camps like there are types of illnesses that do require medications I think there are a lot of
47:40 illnesses or diseases or chronic issues that people get put on medications where
47:46 we are masking root symptoms symptomology things like that I
47:52 sometimes I think there is a kind of um there’s a problem that functional
47:57 medicine has had and that it often adopts an anti- Psychiatry language
48:03 right that medicines are toxic I mean I’ve seen a number of top functional medicine dos like their first move is to
48:08 stop all the meds and it’s just it’s so irresponsible when that happens stop all
48:14 the meds and load people up with supplements now that’s also I think um a very accurate critique that in a lot of
48:22 cases people are struggling with um you know undertreated pre-diabetes weight
48:28 gain uh you know mild thyroid problems and you know a loss of connection and
48:35 you know well- meaning clinicians can put them on on anti-depressant and they just stay on it forever and it’s not
48:41 clear how effective it is um so you know I think there’s certainly a lot of that
48:46 that happens as well right so I think to kind of recap from what you were talking about in general couple things hormones
48:54 so estrogen progesterone I saw three women today who we’ve put on hormones recently changed their mood anxiety
49:02 tremendously so I do think that EST you know we know that estrogen helps with blood flow to the brain we know that progesterone helps with your mood and
49:09 also your sleep when you’re in a better mood and you’re sleeping better you are going to feel better from your comment
49:14 about testosterone I also have seen a ton of men who do really well with testosterone now the ones I find that
49:21 anxiety and depression is helped a lot with testosterone are the younger ones so if you have a 20 something yearold
49:27 you know kid that doesn’t have a lot of testosterone or has a level that’s lower because of anxiety gut issues whatever
49:34 and a lot of times you can use Clomid in these kids especially if it’s a pituitary issue you don’t even have to give them testosterone and I call them
49:41 kids they’re adults but they’re you know 20s when you take a 20-year-old’s testosterone from 300 to 7 or 800 their
49:50 mood is drastically different um I also find a lot of times in you know even in older men as they depending on where
49:56 they were at as they lose their testosterone and how quickly they lose it you can change anxiety depression
50:02 type feelings and and maybe with men they won’t say anxiety and depression but what I hear from my patients men is
50:08 I don’t want to get off the couch I don’t want to play with my kids I don’t want to take walks with my wife they don’t want to do things that they used
50:14 to do with their family that made them happy in my mind that is a form of depression in a lot of men’s mind that
50:20 is not that is just I’m tired um and so I do see that testosterone helps I do see there are a subset of patients with
50:27 significant hypothyroidism that can get depressed and so in those people I you
50:32 know fixing that helps and to your point with insulin patients with insulin resistance they are just their brain
50:40 doesn’t work right they’re foggy they’re tired they and so in all those conditions with all those hormones I’m
50:46 not saying that that’s always the the fix all be all and to your point I do think there is a subset of people who do
50:51 need good psychiatric medications and somebody like yourself so I think I take a as a holistic doctor a middle of that
50:58 road approach I think that when I see people like you I want to make sure there’s something not causing them to
51:05 have anxiety depression that we could fix like insulin resistance thyroid issues hormonal issues I do like to look
51:11 at Vitamin levels things like that and make sure those are at least adequate give them supplements tell
51:17 them D I mean there’s definitely some clear culprits with and then there are some things like you know we all love to
51:22 be evidence-based doctors there there’s no evidence that repleting V vitamin D does anything for depression or
51:28 depression prevention except in people who already had depression um but that said you know it’s a fat soluble hormone
51:36 and uh we tend to supplement in the winter and want people to have a robust level um but I think it’s a good example
51:43 where the evidence hasn’t been you know as clear as we would like um so it it’s
51:49 uh yeah but there are a number of things we definitely want to check and rule out and you know I think Psychiatry has
51:55 always tried to do that at its best I think as you note there’s maybe a little bit more complexity now medically in
52:01 understanding what’s going on with someone’s metabolic Health um and then you know there’s as I said there’s just
52:07 a lot of Suspicion um uh you know the the I would say that most young men
52:13 would rather take testosterone than zolof you know one of the reasons is when you give zolof to young men who
52:20 have anxiety and depression you have to talk about the sexual side effects and you know selling that is sometimes a
52:25 little hard that said was one of the top medications that’s given by fims it’s zolof for premature
52:34 ejaculation and so you know in certain contexts these medicines are celebrated
52:39 and you know and in other contexts they’re you know they’re really uh I think not and so um but I think what is
52:46 important everybody listening is that you know there’s a lot of good options you know whether your depression gets
52:51 better from uh an SSRI or Psychotherapy or more mental Fitness or uh if
52:57 appropriate testosterone like what’s important is that you’re treating your clinical
53:02 depression yeah know I would agree with that and do your point as well some of the so I don’t get a lot of referrals
53:08 from other providers anymore because I am more functional medicine-based Endocrinology the my number one referral
53:14 source though is psychiatrists because they’ll send me people that have come to them with anxiety and depression who
53:20 they want to just make sure they don’t have any significant you know hormonal issues which I think is great and so
53:27 you’re you know talking about zolof I kind of wanted to go there I wanted to ask you a couple questions about
53:32 medications for listeners because I know these are the questions that the listeners are going to want to have but
53:38 before we start with that you were just talking about Zoloft and so that is true I use Zoloft for premature ejaculation I
53:46 psychiatrist use Zoloft for anxiety and depression can you explain to listeners why one medication could be used for
53:54 those separate things and and cause different sexual side effects so that people understand that yeah so serotonin
54:00 is really involved in sexual uh desire and Climax and so something that often
54:05 happens is you know when people are really really depressed they don’t have sexual desire they don’t uh you know
54:11 have a lot of motivation or feeling like you know excited and hopeful so for
54:16 patients with depression a lot of times their sexual drive goes up on these medications over time a lot of people
54:21 will report sometimes you know it’s about a third of people a little diminished sexual drive and for men
54:26 there can be a delay in orgasm not for all men but for some men and so instead
54:32 of finishing kind of quickly like a few minutes it maybe takes a little longer and uh this can really help especially
54:39 if young men are struggling with their confidence and just not feeling a lot of prowess in the bedroom or new or just an
54:46 anxious kind of person so that’s how it it uh Works a way to think about this
54:51 again is serotonin is very involved in sex drive climax cognition
54:57 creativity you know when people talk about how oh it’s not about chemicals it’s like I don’t know you see people in
55:02 low serotonin States uh or in the midst of a depression they have a very
55:07 different feel their thought patterns are different you see people when they’re an elevated serotonin States uh
55:14 you know they’re very happy they want to connect and hug and touch and you know dance so it it’s
55:21 um again the med the medications in some ways get a very bad wrap
55:27 uh which is a shame because you know we’re at a point in history we have more safer better monitored medications than
55:33 ever before in human history so I don’t want to give meds a pass like oh they’re great and they always work but I do
55:39 think they can be helpful for a lot of people and I think what’s really hard is when you take one and it works it’s like
55:44 you know everybody has a comment on it from so I think what’s important to know about these medicines is that they’re an
55:50 option if you have people in your family that respond well to them that can be an indication the genetic testing is not
55:57 particularly helpful in picking medicines although lots of people will tell you is it is that data is
56:02 exceptionally biased um and so uh but
56:08 you know again for certain symptoms excessive tearfulness excessive worry and an anxiety Suicidal Thoughts
56:16 excessive irritability um really really bad worry and poor sleep they can be
56:21 real game changers for people when they work I completely agree so two other
56:27 questions about medications that I kind of want to ask that I think a lot of people have questions one is you know a
56:34 lot of women listen to this podcast what medication can I take for my anxiety and depression that’s not going to make me
56:39 fat because you know you hear that oh I don’t want to take any of those medicines because they all cause weight gain so I want you to address that
56:46 because there are some medications that do not cause weight gain although you know and the reason and I want people to
56:51 understand this too some of those medications are needed because some forms of depression and anxiety cause
56:57 weight loss and so sometimes people literally when they’re depressed they won’t eat anything and so being able to
57:03 give them a medication to help their depression and also help stimulate their appetite is a good thing but not in
57:08 everyone and so that’s where you have to have a provider that understands the medication they’re prescribing you so I want you to speak to that is there a
57:14 medication I know there is several that you can give someone for anxiety and depression that will not cause them to L
57:20 to gain weight because that’s the number one reason women tell me they’re not getting on these medications the other thing that I okay you can go ahead yeah
57:26 I mean yep well just say that um uh mental Fitness does not cause weight
57:33 game and so is where I kind of tried to focus on some tenants to not sidestep meds but to really focus again on what
57:39 you can do every day in your life I would say that meds you know the anti-depressant well Butrin I think on
57:45 Tik Tok is known as sexy skinny happy um my patients tell me because it’s weight neutral it’s stimulating and it’s a bit
57:51 of an appetite suppress and it’s actually one half of the weight loss medicine contra I think some of the anti-depressants
57:58 like Prozac are a little more stimulating um and so tend to have a little less weight gain and then I think
58:04 with you know uh how do I put it um when people are feeling better they often
58:10 it’s much easier to be more active and so and then I also my people you know it’s not forever it’s a trial I think
58:15 the major barrier we see is people don’t know whether meds help them or not because you know everyone gets very critical like oh it’s trial and error
58:22 it’s like folks everything about our health is trial and error it’s not like you go on an anti-hypertensive and it’s
58:27 always perfect you try it and it’s like ah I feel a little tired okay you try a different one it’s the same thing with
58:32 anti-depressants you make a good and reasonable uh uh suggestion and you know
58:37 I’m very humble in this we try we think you know I’d let people know these are the anticipated side effects this is my
58:42 cell phone if you have problems we we monitor it closely and see what happens um you know so uh yeah
58:52 I I I think in terms of weight gain a significant weight gain is certainly something you want to watch out for with
58:57 like the second generation antis psychotic medications like the zyis and the squills of this world I think for
59:03 some of the more sedating anti-depressants again you just want to be aware of it and pay attention to it
59:08 but I have lots and lots of patients who take these medicines and don’t gain any weight and don’t have any sexual side
59:14 effects and it’s really important for people to hear about that symptom relief yeah no I would completely agree
59:21 with that and then the other question that people ask me a lot is if I start this medicine do I have to take it
59:27 forever and so we talk about that not always but I think it’s important for people to also understand this isn’t
59:33 always a medication you can just cold turkey stop so can you kind of talk to that you you
59:39 can’t we always used to stop these medicines and then there was concern about anti-depressant uh withdrawal side
59:46 effects that happens in most recent study in just 3% of patients that it’s severe and we always do the same thing
59:53 which we give you proac fluoxitine which is a very long long acting anti-depressant to have the taper be
59:58 much slower um do you have to take it forever well uh we should point out that one in four women over the age of 60 Tak
1:00:05 an anti-depressant and so lots of people worry about that statistic I’m a little different most of the women over the age
1:00:12 of 60 in my life they’re pretty Wise Women I call them matriarchs and I think
1:00:18 sometimes um I don’t know they’re probably taking those medicines because they work and so do you always have to
1:00:25 stay on it no uh do you need to taper off a little more slowly than we thought in the past for some people for sure um
1:00:31 I think that a lot of times folks uh don’t know the good effect that it can have and so
1:00:38 we’re weighing this decision just based on side effects and not wanting to be on a medicine I encourage people if you’re
1:00:44 struggling with symptoms you’ve tried a lot of Lifestyle stuff you’ve tried therapy it’s an interesting thing to
1:00:49 consider um I feel like we’re talking a lot about meds now I’m about to talk about like
1:00:55 psychedelics kemy and all the new meds and snris versus ssris and um I always
1:01:01 encourage people like you know just going to see somebody and talk about it or asking people you know talk to a
1:01:07 healthcare provider with mental health training about your symptoms and your history and ask them what they think and
1:01:12 you know get an opinion I mean it doesn’t mean you have to people come see me is like I don’t want to tell you all this stuff then I have to take a
1:01:18 medicine it’s like that’s why it’s called voluntary treatment like you know I just have recomendation so I want to
1:01:23 go back really quick to B and D or bdnf where’s that made is that made in
1:01:29 your gu is that like no bdnf is made in the brain and so
1:01:34 the brain makes bdnf um you make some compounds that are like bdnf myocin uh
1:01:41 in your muscles when you work out and those tend to those uh SS that show kind of trigger more bdnf production but bdnf
1:01:47 is brain derived and so you make neuro growth factors everywhere because if you think about it you’ve got brain you’ve
1:01:52 got nerves and nerve cells everywhere in your body you’re always need to kind of repair uh and take care of them but you
1:01:59 know nerve cells generally don’t regenerate very much in adult life and so but bdnf it’s a brain derived
1:02:05 neurotropic factor and again it it’s just a very cool molecule for us to know about for us to think about and for us
1:02:12 to try and Trigger more of in our lives perfect so not necessarily made in your
1:02:18 gut made in your brain but definitely we want more of it is there things we can do to make more of it besides you said
1:02:23 eating good food right like eating fruits vegetables things like that well there are a few things like nuts are
1:02:30 probably correlated with one of the few studies showing uh a kind of relationship between Foods we eat and
1:02:36 bdnf levels so eating more nuts protects you from severely low levels of bdnf as
1:02:41 a in general the Mediterranean diet is what gets recommended um exercise certainly has good data about increasing
1:02:48 bdnf um and you know I think a number of the things we talk about in the book the tenant of connection is really uh
1:02:55 important there’s even some data looking at purposefulness and there being more nerve growth factors and people have
1:03:00 more intention in their lives and so all of the tenants really are are the way the book is organized is kind of looking
1:03:06 first at what is neuroplasticity and bdnf and explaining that and then going through the different tenants really
1:03:13 explaining some of the researchs how those how that tenant is connected to things like more brain growth and more
1:03:19 bdnf wild stuff like you wouldn’t think that like more journaling increases the executive functioning in the prefrontal
1:03:26 cortex like the front new part of your brain but it does if you engage in in self-reflective journaling it studies
1:03:32 show over two to three months your brain just gets more function in that area
1:03:38 okay so I think we kind of touched on most of the things that I wanted to talk about I want to kind of transition to
1:03:45 these three questions that I ask at the end of all of my podcasts and don’t overthink them super
1:03:52 easy but people love this part what is one food that is most beneficial and why
1:03:58 and let’s say for brain health yeah I I think the food that
1:04:04 people are missing that’s most beneficial for brain health would be sardines because it’s low cost
1:04:09 especially for women it’s very high in calcium and it’s high in the omega-3 fats and I think it’s a good example of
1:04:15 a food that is easy is inexpensive and we just don’t have a lot of recipes in our culture for it so there’s a great
1:04:21 pasta conard recipe I recommend I think it’s up on my website but you can also just Google it
1:04:26 um but you know the fatty fish the small fatty fish I think are my top recommendation in terms of just that’s a
1:04:31 food most people are missing I think I’ve had a second one it’ll be working your fermented food game okay I’ve never
1:04:37 had anyone say sardin so that’s a new one what is one thing that anyone can do
1:04:42 for their health that’s 100% free let’s say their brain what is one thing anyone can do to improve their brain health
1:04:49 that’s 100% free I like the one we just mentioned which is journaling and so there are a
1:04:56 lot of journaling prompts in healing the modern brain but you know self-awareness is the first step to mental Fitness and
1:05:02 journaling is a great way to get there and it’s you know buyers I like to spend a little money I buy a nice mol skin
1:05:09 journal and I have these nice pens I like but I try to do a couple Pages day or you’re just writing about how you
1:05:14 feel what’s going on you said there are prompts in the book like yeah I’ve got some prompts in the
1:05:21 book I tend to I tend to try and get my fears out on the page my accomplishments I try to to if I have clear guidance for
1:05:27 myself to to put that down there and kind of circle it or bold it or to see if there are lessons from the day I like
1:05:34 that for the day fears accomplishments and lessons that’s good and then the last
1:05:41 question that I have for you what is one thing you wish you would have known about brain health that you would have
1:05:46 done differently 15 years ago
1:05:52 personally um I probably wish I would have stopped drinking alcohol earlier I think we’ve gotten a lot of headlines
1:05:58 recently about the cancer risk but we’ve known forever about both the cancer risk of alcohol but also just the mental
1:06:04 health risk of alcohol and I haven’t had any alcohol for about three and a half years now and I didn’t have a huge
1:06:10 problem drinking I just found that it became one of those things that most Knights I’d be having a couple of ipas
1:06:16 um and it’s just really bad for my gut health really bad for my mood really bad for my anxiety and so I I probably wish
1:06:23 I would have uh uh just thought through alcohol intake a little bit more uh
1:06:28 carefully early in my life that it’s probably one answer and I think the
1:06:33 other ansers I would have started using a sauna at night more because it’s really helped me from with my sleep over
1:06:40 the past year alcohol and sauna so I would like you now to kind of let
1:06:47 everyone know obviously you have a book coming out you can talk a little bit more about when where people can get it
1:06:54 where people can find you website social media all those things it’s super easy everybody um
1:07:03 kessy thank you so much for this conversation first of all it’s just really fun to get into the details of hormones and mental health and mental
1:07:09 Fitness I’m easy to find everybody I’m Drew Ramsey MD so you can find me on Instagram at Drew Ramsey MD my website’s
1:07:16 Drew Ramsey md.com we have a healing the modern brain course what would be so meaningful is for folks to check out the
1:07:23 book and pre-order the book it’s uh avail aailable everywhere books are sold and to to spread the word about mental
1:07:29 Fitness I mean really I hope there’s something from this conversation maybe it’s lentils I haven’t said pesto yet pesto oh amazing um but I’d love I’d
1:07:38 love to have you join in our community where we think about mental Fitness and nutritional Psychiatry all the time and
1:07:44 I hope this helps you in your mental health journey I know it can get really complex and scary and nerve-wracking and
1:07:50 really hard to know who to trust and I hope uh I’ve I’ve earned your trust as an expert in the space and I hope to be
1:07:56 of help and thanks so much for this great conversation for spending this time with us I hope you enjoyed this
1:08:02 episode of hormones metabolism in you I think that we did a great job taking a deep dive into mental health and just
1:08:09 how it has changed in the modern world I appreciate Dr Drew Ramsey coming on and teaching us things we can do to make our
1:08:16 brain better in this modern world I like how again we discussed all of these
1:08:21 different aspects that cause anxiety and depression all the things you can do from a lifestyle perspective I
1:08:28 definitely want you to make sure that you check out his book I think it’s going to be revolutionary I’m planning on getting a copy of it myself I like
1:08:35 how he talks about mental Fitness and I plan on using some of the prompts in the book to work on my mental Fitness if you
1:08:42 found this episode helpful or entertaining or just that it provided
1:08:48 value to you and you know someone that it may provide value to as well anyone
1:08:53 that you know struggling with anxiety depression or just wanting to become more mentally fit or healthy then please
1:09:00 make sure that you share this episode with them I would greatly appreciate that if you like our podcast and what
1:09:06 we’re doing please make sure that you like follow us and leave us a revieww reach out to me on social media please
1:09:13 and let me know who you’d like for me to interview what questions you want answered this is how I get the ideas for
1:09:18 my podcast and then also remember that modern endocrine is now licensed in 21 1:09:24 states we would be happy happy to help you make sure that there isn’t anything with your mental health or in your
1:09:30 medical Journey that is prohibiting you from becoming your best self we do do extensive blood testing we do Dutch
1:09:36 testing which is Advanced hormonal testing and gut health testing we take care of a lot of people with anxiety
1:09:43 depression mental health issues we do not prescribe mental health medications but we make sure there’s nothing going
1:09:50 on that would be causing that and then if you need those medications will get you to the right people like Dr Ramsey
1:09:56 so keep all that in mind if you’re interested in becoming a patient check out our website and then please make
1:10:01 sure that you follow us or that you tune in next week so that you get our next episode of hormones metabolism in you
1:10:08 have a great week the information presented including
1:10:13 any materials discussed referenced or linked within this podcast are for General educational purposes only not
1:10:21 the practice of medicine no doctor patient relationship is formed for from you listening to this podcast or
1:10:27 utilizing any of the information provided I am a doctor but I am not talking to you as your doctor the
1:10:33 information provided is not intended to diagnose or treat health problems or take the place of the professional
1:10:40 medical care provided by your doctor if you are experiencing any health problems
1:10:45 including problems you believe have been touched upon in any respect within this podcast you should consult your doctor
1:10:52 about the problems without delay you may ask doctor whether he or she believes the information I have provided would be
1:10:58 helpful to you but you should still consult your doctor immediately and follow his or her medical advice as your
1:11:04 treating physician I’m just here to provide you basic knowledge about the issues we discuss so you are more aware
1:11:11 of them and can better discuss them with your doctor that’s why we call it back to the basics join me on the next
1:11:18 episode as we continue our journey [Music]
Disclaimer:
The information presented including any materials discussed, referenced, or linked within this podcast are for general educational purposes only, not the practice of medicine.
No doctor-patient relationship is formed from you listening to this podcast or utilizing any of the information provided.
I am a doctor, but I am not talking to you as your doctor. The information provided is not intended to diagnose or treat health problems or take the place of the professional medical care provided by your doctor.
If you are experiencing any health problems, including problems you believe have been touched upon in any respect within this podcast, you should consult your doctor about the problems without delay. You may ask your doctor whether he or she believes the information I have provided would be helpful to you, but you should still consult your doctor immediately and follow his or her medical advice as your treating physician.
I’m just here to provide you with basic knowledge about the issues we discuss so you are more aware of them and can better discuss them with your doctor.
That’s why we call it Back to the Basics. Join me on the next episode as we continue our journey.