← Passion Struck with John R. Miles
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John R. Miles
Coming up next on Passion Struck, the.
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Dr. Drew Ramsay
Algorithm is whatever social media feed or screen feed you might be on. It could be anything from your daily news to one of the social media to cruising YouTube, even going on LinkedIn. Just there's a lot of time that gets usurped. And so I think that's really the number one problem because how we learn, how we entertain ourselves, our little private moments when we go to the bathroom even right I always have our phone with us to, to access everything. That's certainly one of the problems everyone is noting. It's like you can't put it down.
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John R. Miles
Welcome to Passion Struck. Hi, I'm your host, John R. Miles. And on the show we decipher the secrets, tips and guidance of the world's.
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Most inspiring people and turn their wisdom.
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Into practical advice for you and those around you. Our mission is to help you unlock the power of intentionality so that you can become the best version of yourself. If you're new to the show, I offer advice and answer listener questions on Fridays. We have long form interviews the rest of the week with guests ranging from astronauts to authors, CEOs, creators, innovators, scientists, military leaders, visionaries and athletes. Now let's go out there and become Passion Struck.
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Welcome to passion struck, episode 646. Whether you've been with us on this journey for a while or you're just tuning in for the first time, I am so glad you're here. This is the show where we explore the mindsets, habits and decisions of the world's most extraordinary thinkers so you can unlock your full potential and live with intention. Before we dive into today's powerful conversation, I want to take a moment to reflect on last week's episodes that closed out our series on the power to do more. In episode 643, I, I sat down with Helen Lee Plen, who shared how tuning in to your inner energy alignment can help you move past limiting beliefs and reconnect with your core self. And on Thursday, I was joined by my friend Brian Keene, who unpacked how rewriting the stories we tell ourselves, especially the silent inherited ones, can spark massive.
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Change and lasting worth.
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Then on Friday, we kicked off our brand new series, Reclaiming Healing from the Inside Out. In that solo episode, I asked a hard but necessary question. Why are so many of us doing the right things and still feel anxious, exhausted or misaligned? The truth is, our current model of wellness is incomplete. And to truly heal, we need a deeper approach. One that touches not just our biology, but our emotions, our purpose and Our spirit. Which brings us to today's guest, Dr. Drew Ramsay. What if everything we thought were we knew about mental health was only half the story? What if mental wellness isn't just something we fix, but something we build? Dr. Ramsay is one of the world's leading pioneers in nutritional psychiatry. A clinical professor of psychiatry at Columbia University and the author of Healing the Modern Navigating the Future of Mental Health. He's reshaping the conversation around mental health when focusing solely on medication to integrating food, movement, sleep connection and purpose as powerful tools for brain fitness. In this eye opening conversation, we explore why mental fitness is not a goal, but a daily process of building and reinforcing brain resilience, the critical role of nutrition, how what you eat is either healing or harming you. We go into the loneliness epidemic and why Dr. Ramsay calls isolation the new smoking. How modern life from processed food to digital overload is sabotaging our cognitive health and the practical changes anyone can make today to start rebuilding their brain from the inside out. Dr. Ramsay's work is a timely reminder that our mental health is not just about avoiding breakdowns. It's about creating the conditions for our minds to thrive. If you've ever experienced brain fog, anxiety burnout, or even just felt off, this episode is for you. Before we get started, make sure you're subscribed to the show and if you haven't already, check out our substack@theignitedlife.net it's where I share bonus insights, journaling prompts, and behind the scenes reflections from every episode. Now let's dive into this transformative conversation with Dr. Drew Ramsey. Thank you for choosing Passion Struck and choosing me to be your host and guide on your journey to creating an intentional life. Now let that journey begin.
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I am so honored and thrilled today to have to have Dr. Drew Ramsey on Passion Struck. Welcome, Drew.
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Dr. Drew Ramsay
Hi there, John. It's great to be with you. Hey everybody, who's listening? Nice to see you.
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John R. Miles
I want to start off by congratulating you on your new book, Healing the Modern Brain. What was the thesis for you to bring this into the world and why is now the best time to do it?
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Dr. Drew Ramsay
Well, everybody's thinking about mental health and thinking more than ever around awareness, we all know. And unless we take action, unless we do things in our everyday life to take charge and change what's going on, especially if we're trouble or struggling with some aspect of our mental health or what I call our mental fitness, we've got to do something. And so I think I was really inspired to write this book now. This is my fifth book. I've been in practice for a long time, over 20 years. I've been writing a lot about food and mental health just because that has been a big missing piece. But it just struck me like food changed and then really we started eating stuff that was bad for our brain and bad for our mental health. There are these other aspects of our lives that the modern world has also taken a hold of, and we really think about, like, movement and exercise differently. We are very different creatures in terms of how much time we spend in nature, even how we relate. So I wanted to capture a framework to really ask people to take a step back, look at some of the new science and some of the real actionable steps that that information causes us to, like, almost have to take it when you learn some of this stuff because it helps your brain grow, it helps your mental health. And people just care more that about mental health than ever. It's a great time in the history of the world to be a psychiatrist because we're finally really taking the bull by the horns, as it were, around mental health.
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John R. Miles
I just want to go back to your previous book, and I was listening to a podcast you're doing with Amy Marin, who's been on this show before. And it really brings me back to some of the work by Chris Palmer that he came out with. And Chris was a guest on the show of. He made this quote to me that every mental health, I guess the way he framed it was all the different inflictions that we have for mental health can be tied to gut health in one way or another. And I was just hoping if you could maybe talk about that and whether you agree with them and if so, maybe just touch on it, because that was a really important part of your book.
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Dr. Drew Ramsay
I've been interested in gut health and before Chris, nutritional psychiatry has been an interest. There have been a lot of researchers around the world thinking about gut health and mental health and this idea of psychobiotics. I think that it's one of the frameworks. Does everything relate to gut health? Well, in this book, it's one of the lenses I use, and I'd say that neuroplasticity, inflammation, and those are definitely related to the microbiome. We want to think about mental health in new terms. What Chris Palmer, Uman Naidu, a number of people thinking about nutritional psychiatry and metabolic psychiatry as it's being called. Shabani Sethi is a wonderful example of a researcher at Harvard. I think we want to Be careful about all encompassing statements. Does everything relate to the gut trauma? Definitely affects gut diversity. But how I work through complex trauma doesn't just mean eating more fermented foods. And so I think we want to just be, I think, mindful. In this era, there are a lot of people who maybe aren't treating as many patients or aren't looking at the broad lens that we really need when we think about mental health. And then there are a lot of issues right now in mental health, like whether medications are effective or whether it is just all a gut health problem that I don't know. We want to just be very mindful that there are a lot of patients, there are a lot of clinicians, there's a lot of mental health healing that has been going on for a long time and a lot that's known about things like how gut health relates to our mental health.
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John R. Miles
Well, I think it's important to go over what mental fitness is because in the book you write, mental fitness is not a goal but a process. So I was hoping you can explain why it's a better model than just treating mental health issues.
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Dr. Drew Ramsay
I think that it's more efficient in the sense that we think about building mental health before we have problems is the hope. Right now we have an avoidance model. Realistically, your life's going well if you never meet a psychiatrist. It means you don't have a mental health problem. And we really need to shift that. It's very impractical. Just look at the numbers. 20% of all of our teens are going to have depression this year. That's up from 8%. So again, I think there's a lot of. Where I get concerned is there's a lot of talk and there should be like, where is that coming from? But that's millions and millions of teens with depression. What can we do? What can we help them learn and understand that helps them and navigate this illness or these illnesses and what can we do to prevent them? And so I think it's the idea of mental fitness is not to undermine. People need mental health treatment, people need medications, people need psychotherapy. This, if you're watching the video version, this couch behind me is an active psychotherapy and psychiatry couch. I see a lot of patients, so I want to keep that model intact. What this book is all about, it probably is a wake up call that the reason that system looks so broken in part is that we aren't engaging in the preventative aspects of mental health and in the parts around mental fitness that really it's a New science. Like, people don't think about their food in relation to their mental health. In terms of, like Kristen, a lot of people are talking about gut health in the microbiome. And when you think about, like the lenses in healing the modern brain, I say there are really three things that you need to up level and upgrade in terms of your knowledge base. You need to be thinking about the brain and mental health in terms of neuroplasticity, the brain. There are mechanisms of brain growth, brain waste removal and brain repair. I think it gets really oversimplified when we just say it's all energetics. It's like there's a lot more going on than that. We want to look through a lens of inflammation, right? Inflammatory pathways are. We just know more about them. And so how the brain regulates inflammation is different than the body, but very influenced by the body. And then we want to think about the microbiome. In part, it's new science, right? We didn't use that word 25 years ago when we were talking about health or mental health. And it's complex, complex. People have really tried to simplify. Oh, take a probiotic and now you have a diverse microbiome. And like, the war is won. And when we get reductionistic is what this model is, right? That all of your mental health is about this one gut bug, or all of your mental health is about gluten, or all of your mental health is about your mitochondrial dysfunction. It's just a horrible disservice to the complexity of what's going on with mental health. When people are struggling with things like trauma or phobias or character disorders, there's a lot about that doesn't relate to any of the things that I just said. It's often about sitting and understanding the self. And so that's where again, we want to combine the. These new lenses that biology and neurobiology and new great science is giving us. And we want to combine that with, say, like, the modern psychological approach that so many people are missing.
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John R. Miles
Thank you for sharing that Drew and you write in the book, let's face it, the idea that the health of our brains, which run on a multitude of hormones, neurotransmitters, proteins and other neurotropic factors, comes down to the level of a single molecule, is far too simple an explanation. And I think for so long we were looking at serotonin and things like that. Why does this outdated view persistent? And what would you like people to understand instead?
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Dr. Drew Ramsay
Well, it persists because it's a really great idea. Right. The chemical imbalance theory is brilliant because it means that one, you're not evil. So we need to like burn you at the stake because you have a mental health problem. It means that some of the guilt, shame, self doubt, like horrible things that mental health problems can do to us, we understand and explain those using modern science. And as I tell everybody, it's all chemicals up there, right? Whether it's the fats or the thyroid hormone or serotonin or bdnf, like these are all molecules. And we all know when things are not balanced upstairs, right? We feel differently when we take molecules. We drink a lot of coffee, right? We shift the balance of the chemicals in our brain. So the reason the chemical balance and, and imbalance theory is helpful to us is that it adds science to the complexity of our mental health. It's chemicals up there, everybody. If you have a problem with that idea, it's a little confusing to me because when I give people medications that influence serotonin, norepinephrine or dopamine, you see an effect right in front of you and so do patients. So where I'm asking people to grow up, level, get updated with their science and I don't mean to be mean, I just think there's a lot of immaturity in the space right now where everyone's really going after Prozac in a way that's like just not helpful and not well informed. Prozac's great medicine, really help for some patients. It's not a cure all. It's not just about serotonin. Actually, if you look at Prozac, it's an anti inflammatory in the brain, along with binding to the serotonin receptor and looking like it also has a lot of neuroplastic effects. You don't get to that through the noise, right? Because there's such a bias against pharma. And so I think in this book, what I really wanted people to do was to bypass what's happening right now. Let's argue about antidepressants and their efficacy and instead ask people to think about the brain as we should. It's incredibly complex. You want your mental health to be cared for by experts, not charlatans, not people filled with information, and certainly not people who don't have clinical experience. And that to get, I hope, excited. There's so much hope in all these ideas for all of us in terms of, again, what we can do, what we can have some control over when it comes to our mental health.
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John R. Miles
Drew, we started the whole conversation by talking about gut health, and it's linked to mental health. And in the book, you describe that the brain is an enigmatic electric store made up of the proteins, fats, and vitamins you eat. And you also say that more and more scientists are understanding that healthy brains are made, not born. What does this mean for someone who feels like they're stuck with a brain that isn't working the way that they want it to?
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Dr. Drew Ramsay
My intention is that it should be a hopeful message. It should mean that there is a way that you should look at your refrigerator in your plate that's different than 15 or 20 years ago. If you're feeling your brain is broken, like you're feeling depressed to cognitive fog, irritable, easily overwhelmed. Some of that is the psychology of the modern world. There's a lot more going on that's very concerning. It's very understandable that people are having more existential crises of what's it all about? More insomnia, more anxiety. At one point during the pandemic, a substantial portion of American adults that had suicidal thoughts in the month prior. There's a lot going on right now in terms of our mental health. I don't love the idea that your brain is permanently broken. I know it certainly feels that way. Certainly mine has felt that way at times. And I think that's, again, what neuroplasticity and this molecule of hope BDNF give us. It's this notion that our brains can grow and change. John, if you and I, like, move to a remote Japanese fishing village a year from now, our Japanese would be okay, and we. We would know a lot about fish and fishing. And that's a function of neuroplasticity. And so just like that analogy, my brain can grow, change, learn about my symptoms, learn about how to manage them. If you're somebody with clinical depression, and for whatever reason, he's never played sports, he never had a real athletic stance. And you pick up movement of any type, whether it's walking or going dancing or going to the gym or playing a pickup basketball game or dodgeball game, it doesn't really matter. You start moving your body, you begin to shift biology in terms of your brain. And all of these factors, neuroplasticity, inflammation in the microbiome.
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John R. Miles
Absolutely. And I think this is a good lead in to talk about epigenetics. And for a listener who's been listening to this podcast for a while, you may remember I did some interviews on this topic with Dr. Kara Fitzgerald, Mark Hyman, Scene McDermott, Lucia Oronica, who's out of Stanford, if you want to go to any of those and do a bigger deep dive. But, Drew, in the book, you talk a lot about epigenetics and how our lifestyle choices can modify gene expression. And you share the story of Brian in the book, who's a patient who believed he had a broken brain because of his family history. How do our daily habits override our genetic predisposition?
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Dr. Drew Ramsay
This is a great example of a patient who'd gotten some genetic testing. And so there's a big movement in psychiatry maybe 15, almost 20 years ago, where we had a genetic test, the MTHFR gene. And if you had bad versions of the MTHFR gene and you took L methylfolate, you bypass that BAT gene and your problems like depression would be solved. A real specific root cause idea. And the problem was, it's not true in the treatment data. It's not true in some of the deep science data. It's certainly interesting for patients who are struggling. An interesting piece of information I write about that in that experience is that as a early doc who was doing some genetic testing back then, I had this very hard experience. And it's part of where I think psychiatry needs to have more of an influence on how we're thinking about health and mental health, is that it sounds great to give people genetic testing and learn information. And then you sit with the reality of that with patients. One, that the data is bad, right? When you've got a bad version of a dopamine receptor, a bad version of a BDNF gene, it doesn't actually mean a lot in terms of predicting what's going to happen to your mental health. The genes that people really tout and are great, they're used horribly in public space. I meet patients all the time say, oh, I can't try that because it's toxic to me. Which is not in any way what genetic tests tell us. I got really concerned, to be honest with you, John, because you'd sit and you'd see people who don't have a lot of, let's say, training around things like ethics and boundaries would be giving people genetic tests that don't have really the data to support them, telling them a lot about their mental health. And because mental health is so mysterious, there is that temptation to do it. I remember the first time I gave these tests, I felt like doctor of the Future talking about people's this version of the serotonin receptor. And they'd be like, oh, this explains it. And you'd be like, I'm so glad we have this new information. And over time, if you sit with this, it's just not true. And so there's in some ways a whole kind of population of people who've been sold this like totally false bill of goods about their health and mental health based on either one. Crappy genetic tests that aren't commercial grade. The error rate is huge. I probably have, I think I have a bad version of the APOE gene. I've got an APOE4 gene and then I realized it's not a commercial grade test. Well, it helps me. I eat a little more of the Mediterranean diet. It's also when I can't remember a name, I get a little more spooked and worried. And if you think about, you know, if that data is true or not really matters to my health and my health choices probably. And there's a problem with quality and genetic testing, there's a problem with interpretation. And then I'm going to say there's a charlatan misuse of the tests which leave people feeling really concerned about their health in ways that they probably maybe shouldn't be. Epigenetics is the hopeful message that you are dealt the hand of cards and we can learn how to play poker. I tell the story. I used to play when I was in New York. I had a buddy who's like a mass genius hedge funder guy and he'd bring people together to play poker and it would take him like, I don't know, it would take him like eight minutes to take everyone's money. It was just incredible. This guy knew how to play poker better than anyone I'd ever met. It was just like we used to joke. It's just I would go over and just make a pile of money in front of him. It was a shorter, more efficient thing anyway. We can be the same with our genes. And so I don't want to disparage, which I think it sounds like I am, that genetic testing can be helpful in some situations. I don't want to in any way diminish our enthusiasm for progress, that we're going to learn more about genes, genetics and epigenetics. It's going to really be incredible. But I want people to, for all of this noise, feel very clearly empowered that what you do today over time influences gene expression. And this isn't like a woo wellness weird notion. There's like very clear science and so engaging in these tenets. The reason I call them tenants, John, is that principles that we agree on for the most Part, we might argue about serotonin in the community or SSRI efficacy, or whether you should eat meat or not, or whether you should take supplements or not. I don't think anybody's arguing about the importance of sleep and sleep quality. I don't think anybody's arguing about our loneliness epidemic and that you've got to do more than ever before to connect. And so that's where these tenets come from. In some ways that I found a lot of patients and a lot of health influencers like myself were spending time kind of arguing about specialty items or like arguing about red dyes. It's like, let's, you know, the big piece of the piece, like what's really in front of you as an individual in terms of optimizing more around your mental health. There are things that the new science of mental health and mental fitness really show us you should be doing.
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John R. Miles
Absolutely. And I just wanted to touch on something you were talking about, because I've done a lot of these epigenetic tests myself, and not going to go into the name, but I was sponsored for a while, but by one of the bigger ones that's doing tests. And I remember taking my test results and giving them to Kara Fitzgerald to look over. And we were going over the biomarkers, and she was just saying that even though these are good things to look at, you are really missing in this test, like six or seven of the key biomarkers that should be measured. And it's creating a gap in what you're looking at. So to your point, I think if someone's listening to this, they just need to do their research on which are the best tests to do. And a number of people have come out with better ones. But I'll leave that for the listeners to look for. Unless you want to give some suggestions.
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Dr. Drew Ramsay
No, I live in Wyoming now. I like to remind people it's the Wild west and that marketers are genius. And probably my other piece is, if you're going to venture into the world of genetic testing, I think you should do so with a real expert, somebody who has some training, not just by the testing company, but actual training in some genetic testing. A medical degree, nurse practitioner degree, Someone who's spent time thinking about this and that you're incorporating into a treatment plan, because otherwise you're just. You're getting a lot of data on your own, which for some people is great. For some of my patients, it just creates a lot of anxiety.
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John R. Miles
Yes, absolutely. Well, today I released an episode by Professor Sandra Matz, who Teaches at Columbia and she really studies the world of big data, algorithms, AI. And it was a nice tie into a quote that you have in your book, which is our daily lives are set up to all but guarantee we feel distracted and overwhelmed. But you write that the modern world is creating a crisis of mental health. And it's not only these algorithms, it's the ultra processed foods that we were talking about earlier to social media, to the ever expanding environmental toxins that are all around us. And I wanted, for the listener's sake, to hear from you. What do you see are out of all these different things, the biggest external threats that they need to focus on today for their mental fitness?
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Dr. Drew Ramsay
The one I'm feeling right now, John, is less time where the algorithm has the grip on, on my attention. The algorithm is whatever social media feed or screen feed you might be on. It could be anything from your daily news to one of the social media, to cruising YouTube, even going on LinkedIn, just there's a lot of time that gets usurped. And so I think that's really the number one problem, because how we learn, how we entertain ourselves, our little private moments when we go to the bathroom even, right, we always have our phone with us to access everything. And that's certainly one of the problems everyone is noting. It's like you can't put it down. I've noticed that as the stress of a book launch has gone off, how it just feels such a nice little reward to have a little time to myself, as I put it. So I think that's what I think. The other is the bandwidth, just the amount, right? So if we have this kind of, this Dunbar's number, this idea that we can keep our tribe of 150, 200 people, wow. Think about how many people you're actually connected to now. Especially for anybody who's spending a little time on social and then having metrics around that, who looked at this, who didn't, how many people liked things, what's trending, how you're not trending. Lots of people have talked about this. I think this book, Healing the Modern Brain, looks at some of the science on how this creates a lot of distraction for us and then just really gets into the actionables, like what you gonna do about it? Everybody knows they're not supposed to look at their phone before bed. People still take their phones into the bedroom. It's just not, it's not like a viable option. There are a lot of other aspects of the modern world, and I go through the nine different tenants that kind of sink through. You're talking about some of the tenet of engagement and how in some ways engagement is really there's more opportunity than ever. I live in reasonably rural Wyoming, and I'm able to teach, able to see patients around the world. I'm able to learn. Oh, my gosh, there's so much learning and education. How cool. That's like a new opportunity for my brain. And so it's not all bad. Some of the stuff that I would say in the books that and I share patient stories of how I saw patients in New York dealing with this. And I also, in this book, share more of my own story of being a Manhattan psychiatrist right there on the Upper west side of Manhattan and moving back to very rural Indiana with my wife and kids, back to our farm, and then eventually migrating here to Wyoming. And so I use some of that as context of looking at some of the data that's in the book right in front of us about what urban living does. So good for me and my training and for my friendships and development. Also, a lot of artificial light, a lot of noise. Growing up as a country boy, I was really sensitive to the noises in the city. A lot of stimulation that just disrupts some natural cycles. And so in the book, I'm not suggesting we all move out to the country, to Wyoming or wherever, but that we pay attention to what some of the data says. And you look in your life for where there are actionable steps where this is, like, particularly meaningful for you. With a silly example, you have a massive construction site on your walk to work, and you live in the city. It takes maybe two, three extra minutes to avoid that block. But every morning, not getting this big blast of noise and sound and it might do something for you. I just give you a little more peace of mind in the beginning of your day. So, you know, whether it's little things like that or, as you noted, different foods to eat. Again, I hope the book helps people feel inspired, feel hopeful in this era, and then get to it. It's like mental health needs care right now.
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John R. Miles
And Drew, you've brought up the core tenants several times in the book. You lay out nine of them. And on this podcast, we don't have time to go through all of them. So I'm going to cherry pick from the list some of my favorites, but I'm going to start with the first one, which is self awareness. And the ironic thing to me is when you ask people, are they self aware, Typically, the answer you get back is yes. But what I found out, even with myself, that we like to think we're self aware, but in reality we often lack more self awareness than we would like to admit. And I thought maybe I would ask it in this way. Why did you think it was important to make this the first of the core tenants? And what in your mind does it actually mean in practice for someone to be self aware?
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Dr. Drew Ramsay
I made it the first step because I found it to be the most important one for me. And I think also the hardest part about therapy for patients, you just sit with yourself. And if I'm really doing my job well as a therapist, I'm really creating a very neutral environment, free of judgment. I'm just here to try and understand what your version of the best life for you is going to be and what's in the way of it. As a simple way I think about my job, self awareness, we have to start there. Because if it's like that famous business saying, you can't manage what you don't measure. And so if we're not aware that we're really irritable or grumpy and unaware, more of just saying it offhand. I've met people who like to tout their challenges a little bit, though they're aware of it. It's like, okay, aware in terms of understanding who we are and where the opportunities are for us, skills we have, assets that we're bringing to the table, particular interests or drives or kind of attitudes. And then to be aware of our challenges is probably just a way that we often head into wellness. And I think it's part of where people feel this yo yo roller coaster effect of, oh, it's another headline, it's another toxin that I need to avoid and another superfood I need to eat. And self awareness allows you. It empowers you to take a big step away from that. Like all those people. I was just, as we say in the cut, I was just talking like, what really matters is what's in front of you on your plate. What really matters is in terms of where you are in the life cycle right now. Like you specifically right now. Because if you're in your 20s, you're just dealing with things a different set of issues than you are if you're in your 30s or in your 40s or in your 50s. It's just the landscape in the menu changes. And so self awareness really asks you to stop being so general, so sloppy, so misinformed with your mental health and to really do that cold, hard reality check. Who are you? Where Are you. What are you struggling with right now? What is the big obstacle in front of you? And that is the first step that is the most empowering step for all of us. They say psychotherapy at its root is give. Putting words to feelings, actually creating language around this complex chemical imbalance up here. And self awareness is, in some ways the process of doing that. This thing I can't figure out. Now I've got words for it. They're not quite right. Now I've got the words for it that are just right. And now I'm empowered with those words, with my awareness to step into mental fitness and really create it for myself.
- [32:32]
John R. Miles
So, Drew, another one of the areas I wanted to touch on is sleep. And this is something that for a lot of my adult life, I struggled with. And I realized that chronic stress was impacting it. I realized that not getting into a strong circadian rhythm was impacting it. And one of the things that I cut out about two years ago, completely, completely, was alcohol, because I realized that was really getting in the way of. Of getting deep sleep. I want to explore this topic through your book. And in this chapter, you introduce a person named Peter Tripp, who was one of New York City's top radio personalities in the 50s and 60s. And he has this interesting idea to raise money for the March of Dimes. And maybe I'll use that as the intro and you can take it from there.
- [33:27]
Dr. Drew Ramsay
Well, Peter does this. He keeps himself up for days, and it just ruins his mental health. He ends up having, as I understood it through the history, like, lifelong problems. And we don't think about the lack of sleep as dangerous. In some ways, folks like yourself, John and me, and I think a lot of people listening, sometimes we wear a little bit of a badge, right? We're getting so much done. We're working. So the idea, again, if we take a modern science look at what sleep is doing, we've all got to up level. And I feel like earlier in the podcast, John, a little scolding. And I want to be clear with everybody, that includes me. Why? Because there's whole new parts of the brain that we never discovered, we didn't know existed. There's a new part called the glymphatic system. I think it was 2014, it was discovered, like, wow. And it's the part of the brain makes sense. The brain is your most metabolically active set of tissue, right? Your neurons burn more calories than any other cells in your body by far. What do you do with all that waste? And so the glymphatic system, it's like the lymphatic system for the body or the glymphatic system drains and helps pull the waste out of the brain. We do this during sleep, we do it during non rem, as I understand it, mostly deep sleep. And so the idea again, if you're not getting some good quality deep sleep, your brain just doesn't have as much time to clear out waste. Is that going to do you in one night, two nights? Probably not. But there, there is some way that we feel it, right? That kind of foggy, almost hungover feeling. It's actually shown in the studies that the quality, the amount of a hangover directly relates to the amount of inflammatory factors that you've triggered. And I think about sleep a little same way, like how bad your sleep deficit impairs. You really has to do with in some ways how much inflammation is triggering. So I'll just say one. John, I love the move you make. I made that move. Everybody listening who's over the age of 45. It's not an uncommon move at our age, folks, but alcohol is horrible for you, horrible for your brain anytime, right? We're in wellness and there's just one study, like everybody else quotes the Harvard egg study. And to me that just means like, we really don't really know much about how eggs impact health, do we? Just have that one study. And it's the same thing with alcohol. As a doctor, like everybody's, the boys can have two and the little ladies, they can just have one. And it both reeked to the patriarchy. But where are these recommendations coming from other than the idea, this quaint notion of, oh, we're in the Mediterranean region, we're going to have a little wine for lunch and then after dancing we're going to take a nap. That's not how people are drinking in America at all. And so I love that you stopped drinking for your sleep quality and for your overall mental fitness and mental health. And is I joke with everybody there, There are a lot of ways in the modern world in 2025 to have fun on a Friday night. Lots of legal ways these days. Alcohol should not be your substance of choice and if it is, you should swap it out. That's great for your sleep. I feel like I'm droning on about sleep here. And so I want to practice self awareness. And just in the book I go over real specific ideas to up level, go beyond this. Oh, sleep hygiene. I try and get my eight hours like boo Shah, boo Shao, you do get a sleep tracker. Tell me right, because I'll tell you. I try to get eight hours but I know that I only I get six hours of sleep. I've been tracking my sleep for five years now and I'm embarrassed about that. I'm aware of it. I was aware I'm on a night I think nine of sleeping through the night. I'm a middle aged person. I have a lot of that mid insomnia and I've done two things about it everybody during this book. It was really bad and in the middle of the night my brain is not in a very good spot. I'm much more chemically imbalanced. It's like you don't believe in the chemical imbalance. Wake me up at 2am and talk to me about the state of the world. It won't be this nice guy here it so I had to really sit with that guy. It's actually I started journaling a lot in the middle of the night for 45 minute session because I just, I couldn't sit there worrying. I hate it when I doom scroll in the middle of the night. And so I got up, I treated it as it was a period of necessary wakefulness is what I decided. It wasn't just to get up and go pee and worry. And I found a lot of solitude in the journaling. And then I finished my sauna and so now I spend about 30, 45 minutes in a sauna before I go to bed. Sleep right through the night because I missed the journaling a little bit. I was like I wish I had a little insomnia so I could get some good angsty pages down. So all to say, I'm a psychiatrist, I've got access to I know all the meds and the supplements and all that stuff. But what's really helped my sleep has been journaling, sauna and of course being active during the day and getting a lot of early morning light. I walk to work usually like 7, 7:30am trying to get a lot of natural light. That's a great recommendation. So again all easy free available to your recommendations. Move your body early morning, late and then when you're having insomnia address it. And then in the book I go a lot into bedroom stuff and not like hanky panky but I keep using this word like up level upgrade. I just you I bet your bedroom could do some work in terms of making it like a real just haven for sleep.
- [38:44]
John R. Miles
Those are all great suggestions and if you're a listener one of my favorite episodes that I did, if you really want to go deep on sleep, was with Sarah Mednick, who's one of the world's experts on it, and she teaches at the University of California, Irvine. And I would recommend you go back and listen to that episode. So, Drew, an area that I really want to hunker down in is your tenant on connection. And in the book you write about, I think a scenario that's common, and it plays out whether this is gaming or people in a sports league. But you write about Ronnie and he's watching a game. Doesn't matter what game it is. Let's just say it's football with others. But he's also engaging in an online fan group. And when he's asked has he ever met any of these people in person, the answer is, of course no. And where I wanted to go with this in this example is how is social media tricking our brains to thinking we're socially engaged when we're actually doing the opposite?
- [39:54]
Dr. Drew Ramsay
I think anytime we're getting a regular exposure to someone's life and they're sharing with us, we begin to feel a connection and attachment to them. A big work in psychotherapy and modern mental health is thinking through your attachment and attachment style. As you get close to people, does it make you anxious? Does it make you calm down? Does it make you disorganized? Like, what. What happens as you grow close, grow dependent to people. And Rodney's a good example, I think, of someone who just the kind of creep of the modern world that it's easy through, maybe like fantasy football and watching and all of the digital tools to watch and all of the very entertaining sports shows to be a fan in isolation. And I think there are a lot of different things like this now where there's so much we can do for ourselves. You want to learn to bake sourdough bread. Like, you don't need to go to the bakery down the street or take a trip, right? You can just take, like, a amazing class with one of the best sourdough bread bakers in the world, probably. And so how we end up then, you know, in real life, connecting with people and what the value of that is. Been a real topic of interest for me as a psychiatrist and a psychotherapist, because you see these connections and especially real connections with people and those real. They can be digital, but real in terms of content. There is a depth and appropriate depth of content within these relationships. It's just something that a lot of people have struggled with pre pandemic and certainly the pandemic made it more challenging for people. So you have this kind of mashup of a new digital environment, a new set of tools to connect, new opportunities to connect. And I see it really on my couch on how it's affected dating. Just a different landscape as you're dating now than ever before. And then we want to think again about just the actionables. And also, of course, because it's healing the modern brain. It's. I'm always going to be telling you about neuroplasticity, inflammation of microbiome. In the book, weird things happen when you isolate. Your microbiome gets less diverse, huh? Most of the science is, look, at the end of the day, eat more fermented foods, eat more plants. Your microbiome would be more diverse. And that's good. This idea of like, specific strands leading to specific health outcomes, that has not been so clear, but the idea that, like, social isolation shifts our microbiome is like, huh? Where the idea that inflammatory factors go up when you're more socially isolated and they go down when you spend more time with people, just like, cool stuff. And then I like it because it's also. Actually, I just posted about connection on my Instagram and I'm sharing a couple moments where I'm really feeling it. Today I posted this video where I'm in this new community. It's a wonderful community, like, incredibly interested in mental health, but it's a very intense, athletic community. And I was out on this ski track by myself and I got overwhelmed with this feeling of connection that even though I'm not seeing them all the time, there are all these people in the community that they've been on the same path. I could see their ski tracks right in front of mine. And I was setting down the path for the folks who are going to come after me. And I was thinking, we're all taking in these gorgeous views and. And just for me, a really nice moment of connection. Or the pumpkin sale at our local elementary school where all the kids help unload the pumpkins and you're sitting there with all the other parents. It's just this great feeling of connection for me. So maybe just a couple of examples of from my life. And then certainly when working with people like Ryan and Ronnie and there, there's all kinds of anonymous patient stories, stories from my couch that I've changed some details to protect the confidentiality of my patients, but they're general themes that I've seen happen over and over again. And this theme with Ronnie. Of people having some sense of attachment, connecting, maybe like a weekly call with family, but not really feeling an intensity or a depth to their connection and then not working. What I call the connection, which in the book, I get really specific about this, that you got to map it out a bit for yourself, because it's a mix of friends, family, lovers, intimate relationships, institutions, mentors, a lot of different types of connection in our lives. And one of the things I've seen people struggle with, my expert opinion, where people get, like, gummed up, is we confuse one type of relationship for another. We're looking to connect to, let's say, an institution and wanting it to serve us in a way that, like, that's a little bit more of what a mentor does or what a parent or a partner does, or it's not really what institution is going to do for you.
- [44:28]
John R. Miles
And that social webbing exercise was one of my favorite portions of that chapter. I'm glad that you brought that up.
- [44:35]
So, John, you.
- [44:36]
Dr. Drew Ramsay
I want. I know you want to go to the tent, but I wanted to hear. You just intrigued me. Earlier, we were talking about self awareness, and you mentioned for sleep you'd stop drinking yourself. Was there something for your self awareness, especially as a gu that, like, has helped you?
- [44:51]
John R. Miles
There have been a number of things. So I realized that. So part of this was a journey. Drew. I had been suppressing a lot of traumatic things that had happened in my life, everything from sexual trauma to personal assault trauma to combat trauma. I had a lot of it. I'd been pushing this stuff away for decades. And it all culminated in 2017 and two events that happened within a week of each other. I was confronted by an armed burglar in my house. And I came face to face for the first time since I was in combat with a gun pointed at me. And then four or five days after that, one of my best friends committed suicide. And it not only unearthed the trauma from those two situations, but unearthed everything. And I just came to this realization that I had been taught, especially in the military, that to be a strong man, don't go and talk to specialists, keep this stuff hidden. You're going to learn, lose your security clearance, all this bs. And I decided that this time, my way out of this was I needed to permanently deal with it. So I went into cognitive behavior therapy, specifically cpt. And then I did EMDR or. And then I did prolonged exposure. Tried some other modalities, but when I got really clear on the stuck points that were holding me back, I was able to process it without having to use any medical intervention. And then once I started to get clear on it, I still wasn't sleeping the way I wanted to. So I started to really explore what's causing this. Is it my sleep hygiene? Is it other behaviors that I'm doing? Is it still too much stress? And I think a couple things that I figured out was one, being in a very healthy relationship with my wife, who I had met at the time, allowed me to not feel like I had to rely on alcohol to hide aspects of myself, but I could just be me and it made it easier to make that breakthrough. And so it was a number of changes that I put in place that over time allowed me to ground myself and to really lean in on my differences are my strengths. And I was hiding a lot of things that actually are my superpowers. And when I got really clear about that and who I was, it really showed me the importance that I was using alcohol as a blocking mechanism and that I could be a much stronger person if I didn't have it in my life. And I saw then all the other benefits that it has brought into my life. And I was talking to a friend of mine recently who stopped drinking about a decade ago and he was kind of laughing, he goes, life becomes normal without drinking. Just like it became normal for you when you were drinking after a while, didn't it? And I said yes. And it's actually nice. Very welcoming how much more productive I am now when I'm not drinking compared to when I was.
- [48:01]
Dr. Drew Ramsay
Thank you for that. And I hope everybody listening, you hear this, this path. And a mix of like frank mental health concerns and great evidence based treatments I think also demonstrates something where we're often hopeful mental health, like we'll have a course of CBT or therapy or try this medicine like, and it's better. And I love your story because I think it represents the real world. With each of these experiences, you're gaining skills, perspective, different tools, right? And eventually it coheses where you get a kind of language to appreciate more about yourself and transcend. Here in my clinic in Wyoming, I've got my little slogan is traverse. Because I think about mental health crises and often where I meet people is needing to traverse through something often very treacherous where you need someone, you need help being tied to the mountain and then to transform. But something inside of us has to shift. Maybe it's stopping drinking and it's a lot more than that, as you hear in John's story. And then that allows us to transcend and I love the way that you put it. Transcending of you're accessing these parts of yourself as a lightness when you talk about it. Right. Of something really is living above or beyond the traumas that you shared. Thanks for sharing all of that, John. It's a really nice way to hear about. Yeah, it's a real world example of what we just think about as mental health. But if we put it like a mental frame fitness framework where you're racking up points and building this kind of new machine, as it were, new self.
- [49:29]
John R. Miles
I think it's everything that I now try to talk about on the podcast. It all came down to a whole bunch of intentional choices that I made from my diet to who I was allowing in and out of my inner circle, to my mental health, to the relationships I wanted to cultivate, to the career I wanted to to be in where I was serving people instead of feeling like I didn't have a lot of meaning in my job. So it was a lot of changes that I made that once I really opened up that self awareness lightning bulb really allowed me to make a ton of choices for the better I feel and how I'm living. Drew, I know we are very short on time, so I wanted to end by you yourself have a podcast, you have other books for people to dive into. Where's the best path place for people to go to take advantage of everything that you do?
- [50:20]
Dr. Drew Ramsay
Well, I hope you just got the best of me, everybody, because it's been fun to be with you and to talk with John. I'm easy to find everywhere. DrewRamseyMD.com is my website. Drew Ramsey MD is my Instagram. I've got some free downloads on the website. There's an E course, Healing the Modern Brain along with the book and you can check all that stuff out. But most important to me, it just. This is a really great conversation about some of the tenets of mental fitness. And it's really important to me in all this work that if it hits, you do something with it. And so whether I made some jokes about lentils and pesto and you haven't had any pesto in a while. Okay, we got your lunch order. Or whether some of what John shared about not drinking or unburdening himself from significant trauma, combat trauma, really stuff that a lot of us have a hard time even appreciating. And just that took a while, but then was an essential step. If something hit you about this show and it matters to your mental health and mental fitness, I just hope that you'll start taking care of that in some way. That would be the most important thing for me. And then otherwise, I hope you'll check out the book. I hope it helps you in your mental fitness journey, helps create a framework around the actionable things that as a psychiatrist I really love to see when my patients are doing. I love to see it when I'm doing them. And I hope it helps you do more of these really key core pieces to our mental health. That again, the reason it's the modern brain is we just, we got to do more to take care of it. And your brain deserves it. All of our brains deserve it. So John, thank you so much for all you do to spread a great message of health and I really appreciate you having me on as part of this launch. It means a lot to get to meet you and just to share with everybody in your community about mental health and mental fitness. So thank you so much.
- [52:00]
John R. Miles
You're welcome, Drew. And it was an honor to have you and congratulations on the book and I hope it turns out to be as successful, if not more successful, than your other books.
- [52:10]
Dr. Drew Ramsay
Well, thank you so much. I appreciate that. Fingers crossed.
- [52:13]
John R. Miles
That's a wrap on this powerful, deeply Insightful conversation with Dr. Drew Ramsey. From his radical reframe of mental health as mental fitness to his case for connection as medicine, to the small, actionable steps that can rewire your brain from the inside out, this episode reminds us that real healing isn't just about addressing illness. It's about creating the conditions for your.
- [52:33]
Mind and body to thrive.
- [52:34]
Here are a few key takeaways I.
- [52:36]
Invite you to carry forward.
- [52:38]
First, mental fitness isn't a fixed state. It's a daily practice like training a muscle. Second, your diet isn't just fuel, it's information for your brain. Every bite sends a message. Third, loneliness is not just emotional, it's biochemical connection is one of the most potent natural antidepressants we have. And most importantly, your brain is changeable. With intention, nourishment and aligned action, you can shape it towards clarity, resilience and joy. If today's episode sparks something in you, I'd be so grateful if you left a five star review on Apple or Spotify. It helps us reach more people who are ready to take ownership of their mental well being. You'll find full show notes, video highlights and links to Dr. Ramsey's work@passionstruck.com or you can watch the full episode on our YouTube channel at John R. Miles or the clip at Passion Struck Clips. And if you haven't already joined, check out our free substack theignitedlife.net there I'll share companion prompts, nutritional guides and reflections inspired by today's conversation. Now here's what's coming next on Passion Struck. We're continuing our Reclaiming Illness series with a bold, no holds barred conversation with Dr. Erica Schwartz, a pioneer in integrative medicine and the author of Don't Let yout doctor Kill how to Beat Physician Arrogance, Corporate Greed, and a Broken System. We'll also discuss the hormonal health crisis, especially for women, and why it's so often misdiagnosed or ignored the broken incentives in traditional medicine and what you can do to take back control of your care, and how to become your own best health advocate in a system that too often prioritizes profit over people.
- [54:12]
Dr. Drew Ramsay
I think most health care is protocol driven and one of the things that I talk about in the new Donage or Die to Kill you is how AI is going to change that. I say that what's going to happen is that AI can take over all the algorithms and all the protocols and will now force by doing that, it'll force the conventional medical education to change because that's where all the problems come from. Really, it's the conventional medical school because the same education I received 50 years ago in a medical school is being given to people today.
- [54:52]
John R. Miles
Until then, remember, you're not broken, you're not behind. You are building day by day, choice by choice. Live boldly, lead with intention, and above all, live life. Passion struck.