Victoria's Secret Angel's Secret Battle: Sara Sampaio on Trichotillomania, Anxiety & the Pressure to Be Perfect

Summary

Podcast Summary: "Victoria's Secret Angel's Secret Battle: Sara Sampaio on Trichotillomania, Anxiety & the Pressure to Be Perfect"

Podcast: Change Your Brain Every Day
Hosts: Dr. Daniel & Tana Amen
Guest: Sara Sampaio
Date: March 20, 2026

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Episode Overview

This episode explores the mental health journey of supermodel Sara Sampaio, focusing on her personal battles with trichotillomania, generalized anxiety disorder, depression, and the hidden pressure of perfection within the fashion industry. Through an intimate conversation with Dr. Daniel Amen, Sara opens up about her symptoms, experiences with medication, existential fears, and how these have manifested physically and psychologically. Dr. Amen reviews Sara's brain scans, provides actionable advice, and offers hope through brain-based strategies.

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Key Discussion Points & Insights

1. Sara's Mental Health Journey

• Sara describes her diagnoses: generalized anxiety disorder, low-grade depression, and trichotillomania.
  • Quote: “I've been diagnosed with general anxiety disorder and like low grade depression. ... But I still just don't. I just don't feel good. ... I still get like ups and downs.” (00:55 – Sara)
• She discusses ongoing symptoms despite two years on Zoloft, including fatigue, physical anxiety (stomach and jaw issues), and persistent muscle tension.
  • She mentions struggling with obsessive thoughts, physical symptoms, and compulsive behaviors like eyebrow pulling and muscle tics.

2. Origins of Symptoms and Childhood Patterns

• Trichotillomania (compulsive hair-pulling) began around age 15, with earlier signs of body tics and compulsive behaviors as a child.
  • Quote: “Even before that I had already like a lot of like body tics. ... And now I have a lot of like, I feel the need of doing certain like body movements. I still do them.” (02:26 – Sara)
• Dr. Amen identifies these as related to anxiety and neurological patterns.
  • Dr. Amen notes: “It’s not because you want to be that way. It’s just your brain is wired that way.” (10:28 – Dr. Amen)

3. Impact of Loss and Existential Fear

• Sara's anxiety intensified after her grandfather’s death five years earlier, leading to panic attacks and a pervasive fear of dying.
  • Quote: “I just had this, like, big, overwhelming, like, fear of dying. I still have. ... So the way I've learned how to deal with is just not thinking about it.” (03:36 – Sara)
• She expresses existential dread, especially over the idea of nonexistence after death.
  • Quote: “It's really terrifying if there is just nothing. ... What if there is literally nothing and you just, like, stopped existing forever?” (04:40 – Sara)
• Despite a Catholic upbringing, Sara does not believe in God, heightening her anxiety over mortality.

4. Paranoia and Professional Pressures

• Sara acknowledges a persistent sense that "someone is out to get me"—a feeling that sometimes extends to her modeling career.
  • Quote: “I've always had that feeling that, like... Even in my job, sometimes it just feels like people are against me.” (07:19 – Sara)
• Dr. Amen encourages questioning negative thoughts: “It's not the thoughts you have that make you suffer. It's the thoughts you attach to that make you suffer.” (07:48)

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Brain Scans and Medical Insights

1. SPECT Brain Scan Results (08:09 – 11:16)

• Dr. Amen walks Sara through her brain scan images:
  • Most of her brain scans show strong, healthy function.
  • There is some “bumpiness,” which could result from past injury, lack of oxygen, infection, environmental sensitivities, or toxins.
    • Quote: “What I’d worry more about is why is it a little bit bumpy? ... The things that could cause it: lack of oxygen, anesthesia, drugs, alcohol molecules. ... Or an infection at some point.” (09:29 – Dr. Amen)
  • Dr. Amen is optimistic about brain recovery with targeted care.
• He identifies Sara’s “busy” brain and overactive posterior cingulate gyrus, which correlates with both intelligence and susceptibility to getting "stuck" on certain thoughts or routines.
  • Quote: “You like things a certain way, and if they’re not, it just bothers you.” (10:28 – Dr. Amen)
  • Sara, joking: “Finally confirmed it... Smart.” (10:42 – Sara)

2. Toxicity and Brain Repair

• Dr. Amen suspects possible toxins impacting Sara's brain and recommends strict avoidance during the healing period.
  • Plan includes follow-up scans to track progress.

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Actionable Strategies and Support

1. Managing Automatic Negative Thoughts (ANTs)

• Dr. Amen introduces the concept of ANTs (Automatic Negative Thoughts) and gives Sara a physical “ant” as a reminder.
  • Quote: “The thoughts that just come into your mind automatically and ruin your day.” (11:41 – Dr. Amen)
  • Assignment: Write down 20 of her worst thoughts to begin the process of reframing and controlling them.

2. Nutritional and Supplement Recommendations

• Dr. Amen provides a customized supplement regimen:
  • Multivitamin, fish oil, brain boost: For cognitive and overall brain support.
  • Probiotic: To address the gut-brain connection.
  • Saffron: For mood support, noting its efficacy in 24 studies; can be used alongside Zoloft.
    • “Saffron ... can help your libido and help your mood and your memory.” (12:45 – Dr. Amen)
  • Magnesium (chewable): To reduce anxiety and physical tics.

3. Emotional Reassurance

• Sara expresses relief at putting words and understanding to her experiences.
  • Quote: "Sometimes it's just nice to ... understand a little bit more what's... something's just wrong, and I don't really understand what." (13:06 – Sara)
• Dr. Amen reassures her that her issues can be identified and improved.
  • “Something is wrong. ... And we're gonna find it. We're gonna fix it.” (13:27 – Dr. Amen)

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Notable Quotes & Memorable Moments

• “It's not the thoughts you have that make you suffer. It's the thoughts you attach to that make you suffer.”
  — Dr. Daniel Amen (07:48)
• “You like things a certain way, and if they’re not, it just bothers you.”
  — Dr. Amen (10:28)
• “Saffron ... can help your libido and help your mood and your memory.”
  — Dr. Amen (12:45)
• “Finally confirmed it. ... Smart.”
  — Sara Sampaio, on her brain scan results (10:42)
• “So the way I've learned how to deal with [the fear of death] is just not thinking about it.”
  — Sara Sampaio (03:36)

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Key Timestamps

• 00:55 – Sara details her symptoms & mental health history
• 02:26 – Origins and evolution of trichotillomania and tics
• 03:32 – Anxiety escalation following her grandfather’s death
• 04:40 – Existential fears and loss of faith
• 07:19 – Sara on feeling targeted at work and in life
• 08:09 – Dr. Amen reviews and explains brain scans
• 11:38 – Automatic negative thoughts ("ANTs") and mental self-help strategies
• 12:34 – Supplement plan and gut-brain connection
• 13:06 – 13:30 – Sara finds validation and hope for recovery

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Summary Takeaway

This episode offers an honest and relatable look at the invisible struggles even the most seemingly "perfect" figures face. Through scientific insights, brain imaging, and a compassionate, personalized approach, Dr. Amen gives Sara—and the audience—tools to reframe negative thought patterns, support neurological healing, and gain hope for mental health recovery.

Transcript

[A]

Every day you are making your brain better or you are making it worse. Stay with us to learn how you can change your brain for the better every day. Hi, Sarah.

[B]

Hi. Hi doctor, how are you?

[A]

Oh, so great to meet you.

[B]

It's nice to meet you too. I'm really excited.

[A]

Are you excited to see your brain?

[B]

I mean. Yeah, as long as there's nothing weird there, I'm happy. Never beautiful, do I. Yes, thank you. But it's busy, very busy. So let's go find out. Okay, let's. Let's figure it out.

[A]

I read your history, I looked at your scans, I just looked at your testing. So I have a good idea what's going on. But I want to hear from you, your goal and how can I be really helpful to you?

[B]

I've been diagnosed with general anxiety disorder and like low grade depression. I've been on Zoloft for now I think two years. And I was on another one, two other ones before, but this is the one that has been fitting the most. But I still just don't. I just don't feel good. It's hard to explain, but it's like I'm always tired. I'm just like, I still get like ups and downs. I don't know, I just don't like feel. It's hard to explain, but it's like I don't feel good. And like I've learned how to cope with certain. Like my anxiety was very physical. Know I had like stomach issues, I had like jaw issues. Like I, I felt like my heart like the palpitations that I even had a whole like heart scan because I was like there must be something wrong. And so it's just I still feel a lot of these things. A lot of it's more calm down, like the obsessive thoughts and all of that. But you know, my Trico, like I pull on my eyebrows and I like. And then I also feel like my muscles are just always so tense.

[A]

And when did it start?

[B]

My Trico started when I was I think 15, I can remember. But even before that I had already like a lot of like body tics. Like I would do this with my eyes constantly. My parents even thought I had any like a problem with my eyes, but that kind of went away. I tend to pick a lot on my lips as well and. And now I have a lot of like, I feel the need of doing certain like body movements. I still do them.

[A]

Sort of like tics, right?

[B]

Yeah. I have one on my thumb this past couple of years and I don't like. Yeah, it's. Yeah, it's weird. I don't know. It's. I don't know if it's because I just have so much tension everywhere that I feel like it just releases. It.

[A]

Anxiety got worse after the death of your grandfather, and that was five years ago?

[B]

Yeah, a little bit over five. Yeah, five and a half or so. Something like that.

[A]

Panic attacks, fear of dying, that happen shortly after that.

[B]

And it's. What was more interesting was because, you know, I obviously love my grandfather, but, you know, he's been sick. He had been sick for a really long time, so we've been waiting for him to pass away for a while. So we kind of were expecting, but I don't know, must have something clicked. And it just created this, like, fear of dying. And I had other grandparents dying as well, but I guess because one, I was really young, the other one was more quick. I don't know what clicked in my brain, but all of a sudden I just had this, like, big, overwhelming, like, fear of dying. I still have. And I still, like, when I talk about it, like, makes me want to cry because it's the one thing that I still haven't been able to deal with. So the way I've learned how to deal with is just not thinking about it.

[A]

What do you think happens to you when you die?

[B]

I think that's the problem. I don't know. And it's like. It's really terrifying if there is just nothing. It's just like. I think that's what scares me the most. It's like. It's just. What if there is literally nothing and you just, like, stopped existing for ever? Like, ever? Like, it's. And that's just.

[A]

Were you raised religious at all?

[B]

I was raised Catholic.

[A]

Me too.

[B]

But I don't really believe in God. I, like. Like, yeah, I don't really believe in it.

[A]

When did that happen?

[B]

I've just always been very into science, and it's just. A lot of things just don't make sense. I just don't. I don't know. I just. I don't think I've ever really believed in it, to be honest.

[A]

So it was more what your family did?

[B]

Yeah, I mean, my. My. My parents aren't very religious, but, you know, I was baptized and I did first Communion and had to go to church a few times. I think part of me hated to go to church also. Why? I'm like, I don't want to be here. Like, I'd rather be out with my friends playing but, yeah, I just never really believed in it, I guess.

[A]

But then that makes the thought of death even scarier.

[B]

Yeah. And, you know, like, I can tell, like, the thing that makes the most sense to me is reincarnation. And that's the thought that makes it more bearable to me a little bit. Then it's like, I still don't know, you know?

[A]

So I'm a person of science, and I think it's harder to not believe because to think you and I are here by random chance, that has no design. That makes no sense to me. Right. If I look at your eyes and I'm like, how does that make sense? Because there's a law in physics called entropy. Things go from order to disorder. And yes, there's a lot of chaos in the world, but there's also a lot of beauty in the world. Tell me about the feeling someone's out to hurt you.

[B]

I. I wouldn't say, like, hurt, but I always feel like someone is out to get me. Like, I just. I don't know. I've always had that feeling that, like. Yeah. Even in my job, sometimes it just feels like people are against me.

[A]

Is that true?

[B]

Sometimes? Yeah. Yeah.

[A]

It's always good to question your thoughts. Like, I don't have any tattoos, but if I got one, it would be. Is it true? Like, when I had a thought? It's not the thoughts you have that make you suffer. It's the thoughts you attach to that make you suffer. Want to see your scans?

[B]

Yes.

[A]

So we did a study called spect. And SPECT looks at blood flow and activity. It looks at how your brain works. And it basically shows us three things. Good activity, too little or too much. And then my job is to balance it. If it's low, we can find ways to stimulate it. If it's too high, we want to calm it down. This is a healthy brain. And on the left, full, even, symmetrical activity. The top left, we're looking underneath the brain just like this. The bottom right, we're looking down from the top like this, and then one side. Color doesn't mean anything. It's the shape.

[B]

Okay.

[A]

Should just be big and firm. The image on the right, color does mean something. Blue is average activity. Red is the top 15%. White is the top 8%. And you see all the white here in the cerebellum. It has half the brain's neurons, so that's why it's usually the most active. You have a lot of great brain function. I have seen a lot of brains, but it's this little bumpiness.

[B]

Why is that bump there so.

[A]

Could be from a past concussion. It's not a big deal. I. I wouldn't. What I'd worry more about is why is it a little bit bumpy? And the things that could cause it. A lack of oxygen at some point, anesthesia, drugs, alcohol molecules. You already told me you're environmentally very sensitive.

[B]

Yeah.

[A]

And so. Or an infection at some point. Okay. We're gonna get that healthier. The cool thing is, over time, we can reverse it. That's the exciting thing. This is really interesting. So remember I told you I could see where you would get stuck on things? Your brain's gear shifter is right here. You like things a certain way, and if they're not, it just bothers you.

[B]

Yeah.

[A]

And it's not because you want to be that way. It's just your brain is wired that way. You also have a busy. This is called posterior cingulate gyrus, and that actually goes with intelligence.

[B]

Finally confirmed it.

[A]

Whenever somebody says, you don't have a brain, you go, nope, I do. And it's big and it's beautiful.

[B]

Smart.

[A]

So what I want you to take away from this is I have a beautiful brain. It's busy, and it looks like something's toxic. So the first thing with any toxic is avoid it. So if you're doing anything toxic, avoid it while we're repairing your brain. The cool thing is we could do it again in six months and go, how are we doing?

[B]

Yeah.

[A]

We did one of our patients after two months, his brain was radically better, but it was way worse than your. You have a beautiful. But it's busy. Yeah. Despite being unduly. If. If you want, I'll teach you how to kill the ants.

[B]

Okay. And where are the ants again?

[A]

Automatic negative thoughts.

[B]

Okay?

[A]

The thoughts that just come into your mind automatically and ruin your day. I'm gonna let you take him home, and I want you to put him where you can see him every day. And if you can write down 20 of your worst thoughts, I'll teach you how to get rid of them, okay. It's so helpful. So whenever you feel sad or mad or nervous or out of control, start writing down what you think, okay? So what we're gonna do, I'm gonna give you these supplements. So one of them is two packets, multiple vitamin fish oil, and a brain boost that should help your memory. I'm gonna give you a probiotic to help your gut, because there's a gut brain connection.

[B]

Yeah.

[A]

Saffron. Love Saffron 24 studies showing it improves mood, like antidepressants. You can take it with the Zoloft.

[B]

Okay.

[A]

And it should. Can help your libido and help your mood and your memory.

[B]

Great.

[A]

And then I'm gonna give you magnesium.

[B]

Okay.

[A]

They're chewables. And I want you to take one to three a day. And the goal with the magnesium is lower your anxiety and decrease the ticks.

[B]

You know, sometimes it's just nice to put, like, to understand a little bit more what's. You know, because it's. It's. It's this past few months, even years, it's just like. I just feel like something's just wrong, and I don't really understand what.

[A]

Something is wrong.

[B]

Yeah.

[A]

And we're gonna find it. We're gonna fix it.

[B]

Yeah. Right.