← The mindbodygreen Podcast
The mindbodygreen Podcast
605: The 9 pillars for a happier, healthier mind | Drew Ramsey, M.D.
00:57:58
Drew Ramsey, M.D., board-certified psychiatrist, psychotherapist, and author, joins us today to explain how all of us can take simple and actionable steps to improve our mental health, including the importance of dreams and adding in more movement.
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- [00:00]
A
Welcome to the mindbodygreen podcast. I'm Jason Wakab, founder and co CEO of mindbodygreen and your host, Doctor Drew Ramsey, a leading psychiatrist and pioneer in nutritional psychiatry, joins us to share the latest science on mood, nutrition and the habits that rewire the brain for resilience. We dive into why modern life is making us more anxious and depressed. From screen overload to hidden environmental factors, Dr. Ramsey breaks down the biggest drivers of the mental health crisis and offer practical strategies for building mental fitness like the best brain boosting foods, how your dreams reflect cognitive health, and why deep squats may be more powerful than you think. We also explore bdnf, the brain's natural growth factor and how to activate it to boost mood, sharpen focus and build long term resilience. If you want to feel better, think clearer and take charge of your mental health. This show delivers real science backed tools to get started. So in 2025, what are you seeing a lot of in your practice?
- [01:05]
B
Well, I'm seeing a lot of fatigue, mental fatigue in terms of people living their lives, continuing to work. I think you're probably a good example, Jason. You've got a lot going on and it's a stormy environment, complex environment for one's mental health, especially as we try and create security. We're seeing a lot of what we always see in mental health. People struggling with alcohol, people struggling with depression and anxiety. Those are our two, you know, top diagnoses. As I kind of go through the statistics in the book, actually it's grown there, 58 million Americans just with depression and anxiety. That's now up to 61 million Americans. So, you know, that's, I think some of what we're seeing, it's, it's a lot, just a lot of volume and it's a lot of, you know, how do I have a lot of empathy for all of my colleagues in primary care who are in trouble because I guess they're prescribing too much. And all of my colleagues in mental health who in the midst of all this noise, go and, you know, grind out a long day of taking care of people's mental health. 8, 10, 15 sessions. So, you know, I think in a lot of ways we're doing what we've always done. We try and take good care of people's mental health no matter what's going on. But part of what this book is about is, hey, the modern world. It's like both new knowledge we should take into the battle for our mental health, but also like kind of Some new. I guess we call them enemies, you know, some new players in the space that you have to be more concerned about. You're just going to bump into them.
- [02:39]
A
So let's talk about that. Let's talk about the drivers because we always want to, you know, hit on the root cause. And what are the new enemies, if you will, that you think are driving this mental health epidemic?
- [02:51]
B
Hang on, Jason. Let me make sure my ringer's off so my phone doesn't interrupt us. Right. I think that's. No. All good. No, I'm just saying that's number one. It's like the phone. Right. It's just that we're, We're. That's one of them, I think, volume, and I'm gonna call it like the neurochemical intrigue of the amount of content, volume that you have access to now. It's kind of like a. It's like a type of euphoria that you can check on your finances, your sports team, your loved ones, you can send a text, you can, you know, get into whatever geeky nerdy Reddit sub forum that you're part of. And so I, I think that's very. There's a lot of opportunity there for us, but it's, it's highly distracting and it's easy to kind of get avoidant.
- [03:42]
A
So it sounds like technology is a big driver.
- [03:46]
B
Some of technology. I mean, I think there's also. I don't mean to make quizzical. I know I'm here supposed to, you know, have a, you know, be with some expertise. But I think part of being a psychiatrist, part of being in the mental health space and being with people is being curious and a little fascinated by some of the changes we're seeing. You and I have spoken a lot over the years since last time we've spoken, I've spent a lot of time talking to AI and so have you. Our relationship has never been in a spot where we're informed by at least some. Some ideas that come out of these large language models. And so, like, that's, you know, is that good for mental health? Is it bad for mental health? Are there opportunities for it? You know, I have a lot of patients now. They've upgraded from Dr. Google to Dr. AI. Yeah, it's like me and Claude. Claude. A lot of chatgpt. Some of it doesn't have name, actually. One of my patients said, they said it's called they. And I said it's a they pronoun and said, yeah, you know, it's not. It's not gendered. It's a, it's like very. But there are specific questions that the chatbots get that are sometimes a little different than the questions that the patients are asking me. And so, so I think that's a new, there's just a new environment. And then I think, you know, the stuff that we all know about, there's a lot of polarization. People are busy kind of fighting with each other online. There's not a lot of hand holding and coming together. There's kind of been a loss of an American ideal that we're going to figure it out all together, all different because we're Americans, we love each other and you know, there's something about that that's gotten really disrupted. So I think that's taking a big toll on our mental health. And then I go into in some detail as I go through the tenants of mental health and of mental fitness, some of these just new challenges that you know, I think instead of a judgment, just maybe I'm asking, I'm asking for the first tenet which is self awareness of like hey, you might live in an urban environment. Likely if you're listening, you do about 80% of people are going to be living in urban environments. Somebody who grew up really in very rural America and then lived in Manhattan for almost 20 years, you know, there's things that I observed in myself and my patients in that environment. There's a lot of noise, there's a lot of stimulation, there's a lot of artificial light. There's not a lot of like clean fresh air unless you're really kind of intentional about your, your, the air quality in your house, in your apartment. So those are just all factors that influence our mental health. Everything that I just mentioned, massively, it just has a huge correlation with things like depression risk, you know, things that we just never really used to think about, like air quality, air pollution. That really has a lot to do with your mental health and your brain health. And so that, that's part of when we think like what's changed, what's going on in the mental modern world regarding our mental health and kind of barriers and challenges. Those are some of the ones that are very clear in the data.
- [06:41]
A
Well, if you think about the cost of living in 2025, technology is here, it's here to stay. I think it sounds like everyone needs to be mindful and self aware of how they're using technology or consuming media and if they're allowing it to have a negative impact on their life, whether it's you know, maybe spending less screen time, less media consumption, less news. That sounds like an opportunity. And then you're bringing up essentially the cost of living and the toxin load that most of us experience. Unless you live in the middle of nowhere, it's just you kind of have to chalk it up to living. But you also have to acknowledge it's taking a toll and there are things we can do to minimize the impact.
- [07:24]
B
Well, you and I are also talking at like a particular inflection point in that as parents and as people who are interested in health and wellness, where studies begin to come out that just shift how we think about our fear. We've all kind of been like, ah, plastic. You know, I think, you know, kind of ick, like let's minimize, let's store our food in glass stuff when we can, you know. But the notion that we have about. I think I saw about a teaspoon of microplastics and nanoplastics in our brain that it seems to concentrate. I think it was our brain and our liver. Large studies that came out in nature. You know, it just shifts. I think how you're thinking about things like exposure, that everybody's maybe being careful, but boy, it's a lot. And then wondering, what does that mean? What are the outcomes? How do I get that stuff out of me? So there are those stressors too, in the modern world.
- [08:17]
A
Yeah. Plastic's a big one. You write about that in the book we all hear. I think most of our listeners probably try to minimize their plastic consumption as a. If you're watching on YouTube, I'm drinking my glass mountain valley spring water.
- [08:30]
B
Yeah. And by the way, I think it's important to say good job. And for everybody who's listening who takes some steps, it's important to say good job. Because I think a lot of times we look at this and it's like, okay, so, you know, besides moving out to Wyoming, like, what. What are the solutions here in the real world? And I think it's important to note, and the book tries to really be clear about this. There's a lot of empowerment. There's a lot of opportunity for you. There's a lot of cool new science. It isn't just all bad news about all the bad toxins and horrible environments and phone addiction. I think that's one of the parts that I hope.
- [09:06]
A
So let's talk. I love cool new science. I love cool new science. Can you share some of your favorite cool new science?
- [09:13]
B
Yeah. Some of it you know about. And a lot of people know about, but let's talk about the lenses. So I set up nine tenets and they're tenants because they're things that we're all going to agree on, are great for our mental health and our brain health. I might share with you some, some new science in the book, but, you know, I think we all, everyone listening knows, hey, you sleep better, you take care of your sleep hygiene, you get that great night's sleep, you feel better, it's good for your brain. You know, we all know that same thing with movement, same thing with eating. But I try to look through all of these tenets through the lens of neuroplasticity, brain growth and repair. And that's cool and evolving science. And we don't have like a perfect biomarker. I share the story in the book, as I've talked about in a lot of my books, of bdnf, just because I feel a lot of people haven't heard about brain derived neurotrophic factor. And more than one of these things that like, oh, we want more of it, or oh, we should eat something. I mean, there are ways to increase bdnf. But what's exciting, I think is just it is a concept that you code for protein in your DNA that signals to your brain and your brain cells to grow more, to make more connections, to repair themselves, and even to give birth to new brain cells. So that's cool. New science in my mind, especially for me as a clinician, is I'm thinking, okay, you know, when people present with depression and anxiety and you're a biologically based guy like me, you're thinking about their brain and the neurons and like, what are you trying to shift know, what are you trying to get more of? And for sure, brain growth and repair is, you know, at the top of the list. That's also how a lot of things work. You know, people kind of people are so busy debating whether antidepressants work or not, sometimes they miss that. Like, wow, actually some of them drive neuroplastic factors. Like, that's very cool. So next piece of cool new science is really how inflammation relates to brain health and mental health.
- [11:04]
A
But let's part before we move on to inflammation. I'm gonna spend a moment on bdnf. Cause I don't think I agree. I don't think we talk about it enough. So if BDNF is essentially protective in terms of brain aging and plays a role in how we feel about ourselves, our mood, then the question is, well, how do we increase bdnf.
- [11:23]
B
I think it's important to see also a lot of our traditional treatments have this final common pathway in bdnf. How does psychotherapy seem to work? Well, your brain has to kind of grow new pathways. That's one of the reasons psychotherapy kind of takes time and works a little on a different timeline than things like antidepressants, things that the usual, usual suspects. Movement increases bdnf. You know, getting more of an exercise regimen, better sleep and better sleep quality over time. Eating more nuts protects you from having severely low levels of BDNF is really one of the only studies of food and dietary pattern in bdnf. There's not a perfect correlation like, oh, people with low BDNF have more depression. But there are some interesting, interesting kind of hints and clues in the data. For example, there are some mutations in the BDNF gene. And for people who have mutations in the BDNF gene, there's some interesting things that you see in terms of the risk of certain mental illnesses, the risk of cognitive disorders.
- [12:28]
A
You mentioned exercise with increasing bdnf. Do you have a, you subscribe to a specific exercise protocol in terms of, you know, a certain amount of cardio or walking or resistance training or you're a fan of all the above? Like if. Can you dial it in a bit for people here?
- [12:45]
B
Yeah. So in the book, I call it movement. And I do that because there are a lot of people in the wellness space wanting you to, you know, like, build your big muscles and, and, and eat a lot of protein and, and have very specific recommendations which again, for some people are very helpful to have that type of kind of structure and protocol. I think what I see over time is where people build more fluid habits. You're in the habit of getting up and moving your body. You're in the habit of stretching before you go to bed at night. Most nights. You're in the habit of. I love it like when we go to yoga class and the yoga instructor looks around at all these like, stressed out people and says, maybe it's the first time you've checked in with your body today. And we are like, oh yeah, for sure. And so there's, there's something about getting in the habit of moving your body. I'm in a really like very cool, active community now, living out in Jackson, Wyoming. And it's really a fascinating place to go from a culture where you're trying to, like trying to exercise a few times a week to. This is a culture where if you're not like doing two a day activities and maybe three, you're not really living. It's not even about the exercise. It's just like being in shape enough to go run 20 miles on a trail or go hike up the Grand Teton, just, you know, like do a lap. It's incredible and really inspiring. So in terms of like things that increase bdnf, you know, there, there certainly are thresholds in the data, certainly the depression criteria of kind of recommendations. If you look at all of the major organizations, they're asking. The research is suggesting about 150 minutes, you know, and I think, you know, a mix of aerobic and weights is kind of what people are looking for. When you build muscle and do weightlifting, you do release. And I write about these in the book. You release what are called myokines, which are, you know, you don't just have neuro neurons and brain nerve cells in your brain. You also have nerve cells, you know, through in neurons throughout your body. The ones in your brain are kind of special. But, you know, it's important to note, especially as you age, like me, you know, keeping all of those neurons healthy and alive, the ones that are, you know, far away from the blood supply and the nutrients, the ones in your toes and your fingers, you know, you, you get more sensitized and feel that, you know, if you're not taking care of it, you get signals from your body right away.
- [15:14]
A
Well, it's this idea of incorporating movement in everything you do rather than carving out, which I think is a challenge for busy people. You know, I gotta go to the gym and crank out an hour or hour and a half or whatever it is, versus I'm all about carving out time to work out and deep squat also.
- [15:30]
B
Sorry to interrupt, Jason. Like, this was my biggest deep squat I was in Bermuda with editor of Men's Health magazine, Rich, dormant. And when we were kind of all struck, he's a really strong, really flexible guy, great tennis player, but he couldn't do a deep squat. And it's like stuck with me. It kind of, I don't know, it just feels like a kind of naturally very important exercise, especially for men, especially as they age, to be able to keep the kind of hips open and flexible.
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A
So deep squat is something we should all be looking to do for our brain health.
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B
Yes, I think for your brain health. How does that relate to brain health? Well, it relates to brain health that it keeps you flexible, it keeps you nimble, it keeps you moving, it keeps you in your body. And that keeps you moving in all the other ways. Just that I think the focus as you age shifts in a way to stability, to strength, to balance, to flexibility, just as things age. I liked your question though, Jason, of like, what else increases bdnf? Because I do think it's important to note all of these tenants. What I think I'm trying to line up for people is a framework by which by engaging in these things, as opposed to a lot of the false idols that sometimes we kind of chase. By investing in these tenants, we are engaging in what science suggests is best for our overall long term brain health, our cognitive health, our risk of depression. And, and the book really sort of says, like, hey, times have changed. As we were noting earlier in our conversation, there's more kind of coming for your mental health than ever before. And so there's both like more opportunity, more science. We know more about neuroplasticity and inflammation and the microbiome. But you know, there's also more of a challenge. And so the other tenants in the book, it's very cool, like things like going into the forest and forest bathing decreases inflammatory factors, actually breathe in molecules, these phytocides that the trees produce that have this biological effect on us or the book. I talk a lot about the tenet of connection. And as we have connections with people, as we aren't isolated, it's kind of very clear that's protective for our brain in a variety of ways. And so BDNF isn't a perfect biomarker. But like I said, it's a great framework. It's a lens that I think about things. When people are improving and feeling better, I don't just think, oh, like they've got more serotonin. And I think, hey, this, this brain is kind of. You can almost like hear it usually. It makes a really clear sound when the brain, like everything gets like lubricated, all the gears are running. It's like a really, it's an obvious thing all clinicians know. It's the sound of human laughter. It's like when you've seen somebody, especially somebody where they've been depressed for months. Like it's like the clearest thing when people walk through the door and like their brain's working and they're feeling good. It just, you see a smile and then you like hear laughter and it's just, I don't know, there's like no clearer diagnostic sign in the medical world than that.
- [18:31]
A
So in terms of connection, I'm assuming not all connections are created Equal as it relates to mental health. Can you talk about, like, your.
- [18:39]
B
Your.
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A
Like what. What constitutes a meaningful connection versus a connection? Because one can make the argument.
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B
I, like, want to quiz you, Jason. I've known you for so long, I'm like, oh, I want to hear about the connections in your life which. Or you know my view.
- [18:53]
A
Well, I'll share my view after you share yours. But I think there's a difference. I think in some ways we're more connected than ever and that it becomes a question of quality of connection and meaningful connections and the power of loose connections. But I'm not the. I'm not the md. I want. I want to hear your view on connections and how you would prescribe.
- [19:12]
B
The reason I like hearing your view, Jason, and everybody else share my thoughts is because I've seen Jason. I've known Jason for a very long time, and I've seen you grow mindbody Green, grow an organization. And from a very early impression I had of you is that you had built a great team. You had people that really loyal to you. You had one of the early, like, super cool spaces in Brooklyn. And it was just very clear that people felt connected to you, but they also felt connected to the company and to the brand and to the mission. And so when we talk about connections in the book, I ask people to go through an exercise to think about the different areas of connection in your life and to create a bit of a map of connection. When I'm sitting with patients initially and people say, what are you trying to do in that initial couple of sessions? It's like I'm kind of creating a visual landscape. It's like a place inside my mind that only you get to go. And it has the players, it has the characters in your life, the relationships that are meaning. It has the places you go, it has all the foods you eat, has your grocery store. There are all these places that it's like my brain has to fill it in. To be your psychiatrist, I need to know who are all the meaningful relationships, who are the meaningful institutions. And so I wanted to try and approximate that for people a little bit. Because when I sit with folks who really have a. I sit with so many people who have incredible mental fitness, like some of my patients. The book's dedicated to my patients because I just get inspired over and over again. Just you see people make these choices, you're like, huh? It's like, wow, really, like, do great things for their mental health. And so. So this idea of connection, thinking about the institutions, right? You Know, as you get older, like you went to a university, like, did they give you a scholarship? Was it a good experience? Was it an experience you wish were better and you could help be better for someone else? You know, for some people, super meaningful. Other people have kind of grown away from some of these institutions that, you know, were formative for them. So I think, you know, thinking about your job and your. Where I hit, see a lot of people in professional crossroads not feeling fulfilled, not feeling engaged, especially these days, struggling, you know, work at home, go back to work. And so as you, you know, kind of sort out the connection to your professional identity and to your work, you know, when people are at it, are working with institutions where they feel again, aligned to the mission, aligned to the leadership, loyal boy. It does such great things for their mental health. So that's some of the. As you're saying, there's a variety of different types of connections. And then I think the book also asks people to just take a little step back. Oh, got kind of messy. Everyone's everything now. Everybody hears everything now. And just remember, vulnerability is an important word in mental health, but it's not the only word in mental health. There are a lot of people in my life that I don't really want them to know much about my vulnerability. Happy to share a little bit. But like, I don't know, my patients, my kids, like, mostly want them to know that about my strengths, to be quite honest. Happy to be vulnerable. It's just like, it's not really where it belongs. So understanding, like where your vulnerability belongs to, what connections deserve in kind of merit and I would also say can handle your vulnerability. I think those are the types of ideas that are also in the chapter, kind of asking people to really make sure you're with the connections you have that are important, that you're being, I would say, like appropriate and boundaries within those relationships.
- [22:55]
A
In your view, at least. In my view, it feels like women are way better than men.
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B
No, you just stop right there. Women are better than men. That's full stop.
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A
But in terms of connection, they are in midlife, I would say yes.
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B
Do you belong to a book club?
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A
No.
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B
Have you ever belonged to one?
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A
No.
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B
Me either. None of the guys I know. And when I think about starting one with the guys, I'm like, it's like, especially now that I don't drink. It's like no beers and just books. It's sort of interesting. My wife, actually, my wife and my daughter are in a book club. They've read. We move to this new community, they know all these people, they've read all these books with all these other women moms and daughters, I'm like, wow. So I, I think that there's something to, to really learn about that. If you look at the data, right, on male mental health, it gets kind of bad, right? 50%, one in two men are going to struggle with a substance use disorder in their lifetime. 80% of men won't ever seek help for their diagnosable mental health disorder. So you have panic disorder, you have bipolar disorder, you have alcohol use disorder, you're never going to talk to a mental health professional. 80%. And so, you know, there's a way that I think women do a better job engaging with their mental health and engaging with their emotional life. I think women also, because having a more pronounced hormonal cycle and pronounced menopausal period, men go through andropause too. Like, you know, I mean, Jason, you and I are. Our testosterone levels are dropping like a shot over this decade and those drop by 40 to 70%. And I look forward to going through that with you. Holding hands, bro. Like, I'm fine with that. Rei Co Op knows when you're up at 4.30am on a Saturday for a long run and you're actually excited. Not everyone gets it, but we do at rei. We're here for people who get outside gear up for your next run in store or@rei.com.
- [25:04]
A
You know, I'm cold plunging every day, so stay tuned on that. I'm doing my N of one experience.
- [25:09]
B
Drew, so, you know, I've, I'm still hanging in there. So I'm in the sauna all the time and I can feel it's working.
- [25:16]
A
Cole, do you know about there. There are some interesting studies and anecdotally I've known a handful of people who've had tremendous results with cold plunge in terms of increasing their testosterone levels. So I am doing my own out of one study. So what we. I will share the results.
- [25:35]
B
I'm, I'm excited to see your numbers. I think it's a fascinating era we live in where people can look at metrics that, you know, conventional medicine sort of has, like harder to get right and, and do more self experimentation. I think I'm more team sauna than team cold plunge, but I'd cold plunge with you. You know, it's because you live in.
- [25:57]
A
Wyoming and I live in Miami and.
- [25:59]
B
It'S like my walk to work is a cold plunge.
- [26:02]
A
Exactly. I also love infrared sauna, but I.
- [26:04]
B
I think these Are both examples, everybody listening, though, of ways that I'm super excited that all of you are getting more engaged in your mental health and mental fitness. I think part of the book comes from. I just see it in the movement. You know, I see these cool organizations like Daybreak or having sober dance parties or other ship in New York which has, like, I don't even know, like saunas and DJs and like young cool people all having, like, healthy, connected time and learning. It's just. It's a really cool time, whether it's cold plunging or sauna culture, where I hear there's more explicit motivation for people around mental health, mental fitness, self care. Being explicit about it being a little more. I mean, it's a kind of rigorous about it. Like, it's essential. And yeah, I think it's important to celebrate that.
- [26:51]
A
You mentioned, you know, we talked about protein resistance training. I would say in the past. We've been at this for quite a while. We've known each other for over a decade. That is one of the biggest shifts I've seen among women, resistance training. Like the idea that, like, you need to build and maintain lean muscle mass as you age for longevity reasons, not necessarily for aesthetics. And then in that bucket, I would say alcohol. And it is unbelievable in the last couple years how many people have reduced their alcohol consumption or just cut it out, period. And not necessarily from people who've had a problem of drinking too much. They just said, you know what? It's not worth it. I'm measuring. I'm wearing my wearable. Longevity. This isn't good. The better hrv. Better rhr. I feel better. I'm just. I'm done. In your view, I'm assuming you probably. That came up a lot in some of your conversations with patients. Alcohol.
- [27:53]
B
Yep, alcohol came up a lot for my patients. It always kind of has been a subject of being in psychiatry. People often see you with a question about, am I drinking too much? I'm also a physician who was always suspicious because I'm always a little suspicious when there's just one study, like the Harvard egg study. Like, anybody have any other egg studies for us out there, you know, or. And we'd always hear about the same advice. It's fine for the gentleman to have two drinks with the little ladies that can have one drink every night. That's fine. Especially red wine. And that was kind of the advice. Actually had a slide in my slide I could joke about. When you take a nutritional history in New York, you know, then you kind of get A little. People get anxious and tell you, but they drink, you know, two glasses of Super Tuscan every night for their brain health. And so alcohol really shifted, both for me personally. I went, I moved to New York as a farm boy, actually didn't really drink very much at all, and then really fell in love with drinking in New York. Boy, it's really fun to drink in New York. Fun to stay up late. Everybody drinks, everybody has a cocktail, two glasses of wine, then another. Not everyone, but a lot of people. And I think that's part of kind of urban culture now. And part of, I don't want to call it gluttony culture, but part of like, we're going to work really hard. Work hard, play hard, right? And play hard means like a lot of alcohol. And so then as the data really shifted about a year ago, where a number of studies came out, just basically like, hey, actually there's no health benefit and just risk. I thought it was really funny when just not funny. I thought it was surprising when a study comes out saying, hey, alcohol increases the risk of lots of cancers and death. That anybody was surprised. I don't think anybody in medicine is like, alcohol has never been something that is really very good for you. So that shifted with that. It's very cool question, how do you have fun on Friday night? And it turns out in 2025, there's a lot of different ways that everybody is thinking about fun. Some, you know, There are now 20 plus states where all the cannabis products are legal and people who you never would think are trying them, trying them for sleep, trying to relax, trying them instead of drinking. Some states, psychedelic products are more easily accessible. There's all kinds of other psychotropic stuff kind of out there in the conversation. So it's a very, It's a very interesting time for people to be drinking less. I think on that subject, it's. It's great. It's great for our health. I think it's been an elephant in the room where everyone's like, oh, like the health crisis, what it's about. And I'm all for getting chemicals out of food, but I'm a little concerned that we know what the problem is in American health. The problem is we drink too much, we eat too many calories, and too many of them are delicious, refined carbohydrates that are sweet and salty and we can't stop. And those are probably like the two of the main drivers of metabolic illness in America. So I think we should be cautious sometimes when we're maybe Seeking and going through a lot of activities where we don't want to miss kind of the elephants and the things that really are clear that we need to do a better job with.
- [31:08]
A
And as it relates to, you know, you mentioned, I think everyone is on the same page, that you probably shouldn't drink much, if any. You also mentioned cannabis and psychedelics. One could argue, myself would argue that we may look back on cannabis and say maybe that wasn't such a good idea in terms of our mental health. Specifically for the young developing brain, which actually is 25 years old, which was something I wasn't familiar with until recently. Like your brain until 25 can lead to psychosis, mental health issues and then.
- [31:42]
B
Ooh, risk of psychosis.
- [31:44]
A
Yeah, not good risk.
- [31:45]
B
It just. So everybody's on the same page. Cannabis gets pegged as a safe product. One, there's a new set of data to cannabis for sure, smoking cannabis, but maybe even taking edibles, increased risk of heart disease, like increased risk of stroke. So that's new data that most people haven't heard about. The reason for that is because cannabis THC in particular tends to raise heart rate, raise blood pressure. The known psychological risk has been teenage psychosis. And people really don't know enough about this that people again, think about it as a safe product. A lot of teens are experimenting, you end up with very high concentrated THC vapes and products, high concentrations of edibles, and people just end up triggering a psychosis. It's really it, you know, quite concerning, especially if you have any. Not to be fear mongering. It's just like it's important public health. If you have psychotic disorders in your family, you have, yeah. And to remember in the genetics, psychotic disorders like schizophrenia and bipolar disorder and even depression and mood disorders, you know, there tends to be some overlap. So it just really, it's one of those things that's always been couched at safe. And I think, you know, for the advocates trying to decriminalize cannabis, you know, it is important to point out for the most part, in the right settings can be very safe. But I think it's, you know, very fetishized. And so I think, you know, when you think about this shift, you said less alcohol. Like I said, I've always loved drinking. It's funny to see my photo albums come back and I've got like a, you know, big smile and a beer in my hand, a lot of them. I stopped drinking about three and a half years ago. It's very strange, Jason, to be in a stage of Life where, you know, I've kind of struggled in a certain way. I was one of those people to have a few drinks a day, don't drink more on the weekend when I could, during the pandemic, started drinking. There's actually a. There's the story of a patient in the book, Charlotte. And, you know, I animized all the patients, but she starts drinking a lot in the pandemic. And, you know, let's just say I identify with that patient. It was something that a lot of us struggled with. So then to be on the other side of it, not drinking at all, not something I think about. It's. It's really interesting how it shifts your health. Maybe a little less fun, certainly a lot more active, certainly opened up a whole, like period of the day, 5:00am to like 7:30am really interesting, productive, kind of happy time, I'd say, not usually what you experience when you're drinking. So again, of ways that I hope the book will maybe influence or excite people is to think about ways to be. There's a tenant. One of them is the tenet of engagement. And what I noticed over time is I went from being like engaged, like caring about the wine, like being curious, to being kind of more habituated when it came to alcohol. And so being engaged is about being curious, about being, exploring. It's about investing time in activities, hobbies, relationships that do something for you and your spirit, yourself, your soul.
- [34:45]
A
So you've got these tenets. I'm going to go through all of them just to summarize briefly. So you've got self awareness, nutrition, movement, sleep connection, engagement, grounding, unburdening and purpose. I want to spend a moment on sleep. I thought this was interesting. You ask your patients about their dreams. Tell us more.
- [35:06]
B
Dreams are an undervalued mental health signal. Freud called dreams the high road to the unconscious. And Freud gets a lot of criticism. But when you sit with patients like clinicians, like I do, you know, therapists and people bring in their dreams, it's hard not to begin to see the meaning in them sometimes. So it's so clearly, so clear to you and the patient. It's been interesting to me how much excitement there is about the psychedelic movement. Whereas really dreams are just a lot like a psychedelic journey, a good dream. So my patients will come in with a good dream and share it. And I mean, they could be on the psychedelic journey mat describing the same thing. It doesn't sound any different. I like dreams as a signal. Dreams happen in a certain period in the Sleep cycle sort of when we're kind of coming out of deep sleep and almost on awakening and that's where you kind of, you know, kind of come to a little bit remember a bit of a dream. And I think it's a signal that our, our, our, our brain is kind of doing what it needs to do. There are a lot of people I speak with say, oh, they don't remember their dreams, they never dream. And I think partially people haven't been asked about their dreams. They don't have a place to kind of deposit dreams or a request that, hey, when you sit up, you know, don't hop on the phone, sit center down, check in with yourself, try and bring anything with you from the dreaming world. So yeah, I'm an old school psychiatrist, I'm a psychodynamic psychiatrist. So we believe in the unconscious. And so dreams are part of what some patients bring into the session. And I adore dream work.
- [36:42]
A
So if I'm listening, could you give us a primer on what are some of the questions we should ask ourselves if we all want to do a little bit of morning analysis on ourselves?
- [36:53]
B
I'm going to tell you to follow the Jungian dream folks on. They've got a young I'm trying to remember. There's a podcast, it's all about Jungian interpretation of dreams and tell you to be invested with your dreams. And I think the way that healing the modern brain asks you to think about dreaming is one metric. But what I asked you to really do is to actualize sleep hygiene and to get beyond. It's kind of lame, superficial advice. Like, it's like when people say, like, eat a better quality diet. You should eat healthier. It's like, ah, like, you know, my food advice is like, how many lentils did you eat? You eat lentils this week, Jason? You eat any pesto? You're down there in Florida. How's your seafood intake? Right. I've got some specifics. And the same thing with sleep. You know, real sleep experts, when they talk to you about your bedroom, they want to hear about the air quality. Like we mentioned earlier in the conversation, you know, air quality really relates to inflammatory factors and lots of people taking all kinds of things to try and regulate their inflammation. But they're breathing polluted air all day and all night. And so it's an opportunity again for you to have, you know, eight, 10 hours of really filtered, really clean air. A lot of people still burn candles inside their home or incense in their bedroom. And what I think is hard about this. And it's so hard in wellness, right? We're trying to do something that like someone told us is healthy or we feel is healthy or is even sometimes like part of our culture. And it ends up being like, really, like bad for our health. And so, you know the other one that was about the tea bags, those fancy nylon tea bags are just like, spew out microplastics, right? Just like, ugh. I hated that because I love those fancy tea bags. I thought, like, oh, I'm buying the premium tea. Like, this is a really good moment, this premium tea. So, you know, I think all to say with sleep, be aware of the glymphatic system, which again, when you asked me earlier what's new science that I'm excited about, the glymphatic system is the really thin layer of cells in your brain that it. It's like the brain's waste management system, it operates, it just got discovered. It's like 2014. It's like crazy, right? But we didn't know about it. You can't really image it that well, but it's like the lymph system for the brain. And so, you know, if it kind of makes sense, brains, three pounds, you know, 90 billion neurons. They're your most active cells, right? So you just want to think about all those mitochondrias. You're just feeding them calories and cranking to the point they make electricity very cool. Well, just like any engine, you feed it a lot of fuel. There's going to be byproducts, there's going to be waste. And so, you know, this very metabolically active organ, your brain has to get rid of a lot of waste. And that's what the glymphatic system is for about 7 grams of waste a night. I saw estimated in one paper. It's like a teaspoon, right, or something like that. That's where we hope all again, that microplastic going to get out of our brain. Actually, researchers don't know exactly, but, you know, I would guess some of it's going to come out of the glymphatic system. And so that's happening at sleep. Again, why you want to have a regulated sleep where you're cycling, very dark room, maybe white noise machine, or have like an air filter that makes a little just to kind of not pull you out of sleep. And then just having that discipline when you wake up, don't go right to see how many likes you got on Instagram or, you know, just try to settle Back down, rest your body.
- [40:23]
A
One way to measure if I'm wearing a wearable, look at my deep and REM in the morning, see how I'm doing.
- [40:29]
B
I do that and then I look. When I sleep through the night, I look and I kind of see what happened. And I can often see, oh, like you woke up at 2am for like a couple of minutes and then you fell back asleep.
- [40:38]
A
What's interesting, you mentioned dreams and I've noticed when I've had a bad dream, my heart rate will spike, which is fascinating, or my HRV will flatline. Like it really shows you the impact of sleep, specifically your dreams.
- [40:56]
B
Yeah, it's a very, you know, it's your neurons, your brain cells, they're just as active at night. It's important you know this. You know, you're resting your body, but you, you know, part of your body, your brain still very, a lot of parts of your body are still very active. So you're doing so much, you're consolidating memory. You're, you know, everybody knows you do something about better regulating emotion. So, you know, again, it's one of those basic pieces. I talk about it in the book as a psychiatrist and talk about some of how we're trained. Just like sleep is just one of those fundamental essential things that it's hard to get your mental health optimized if we don't fix problems with your sleep.
- [41:37]
A
If you want to know how someone's day is going, ask them how their sleep was the prior night. So of the nine tenets, it's nine, right?
- [41:44]
B
There are nine tenants.
- [41:46]
A
What's been game changing for you?
- [41:48]
B
Oh boy. I mean a few of them have. It's hard not to say nutrition just because all my other books have been about nutritional psychiatry and the way that I get to think about food and then thinking kind of opening up this field of nutritional psychiatry with a few colleagues really to, hey, part of when we're taking care of a patient, we want to know what you're eating. And there are some foods that have more nutrients that are good for your mental health, like folate, vitamin B9 and B12. And there's certain foods that have more of those. So I think for me that's been game changing. I spent some of my life, especially in college, I was part of this kind of low fat, no cholesterol, high carb, vegetarian diet and really would have a hard time just like it. I don't know, just it's with energy, with sleep, with kind of puffiness, with mood. So Nutrition's really on my own kind of personal journey of mental health. Just really been, I don't know, in some ways, like wonderful, simple. I want to say they're just, I don't know. I live on a handful of, you know, coffee, kombucha, lentils. That's it. No, but you know what's in your.
- [42:52]
A
Top five grocery list? I love a good grocery list. Give me your top five foods.
- [42:55]
B
Oh, my top five grocery list. Well, I need organic half and half for my coffee. Coffee and half and half. Those two things that can get me to about noon. Well, I really, that just. It's like I'm somewhere in like a keto fasting coffee state. I just only. Unlike some colleagues, it only goes in my mouth. Just to be clear about. That's the type of coffee I'm talking about. Let's see. Fatty fish. When I think about organizing my weekly diet, the thing that I tend to focus on is where to get natural omega 3 fats, how to do it in a way where I'm not getting lots of my microplastics. And so, you know, I tend to look for the small fish, anchovies, sardines, or cuts. You know, where I'm getting a steak of like a wild salmon, you know. Next food category I think that's new and challenging for all of us is fermented foods. I'm sipping my kombucha here. So, you know, not a lot of colony forming units, but some. I'm going to have a kefir smoothie later with probably some. I'm doing more protein powders, I think just one as I've gotten older, but two, just. I think everybody has a family. Like, meat's gotten kind of expensive and so, you know, some fruits and veggies that kind of go in there. I mean, I'm always, when I look at the cart, hoping it's mostly plants. So any crunchy veggies I can chop up and oven roast. You asked for my top five and it's just like, I don't know, olive oil and vegetables. So that's not like any vegetable. Any. Any vegetable. And any fruit, which I know is not maybe narrowing things down, but those are bananas and white beans, I'm going to say, are kind of always. I'm giving you like a top 20 list. Just those are really the only. Those are the only two foods that have potassium in like big quantities. And nobody gets enough. Everybody's like so fixated on magnesium. Love magnesium.
- [44:45]
A
Well, we'll have to send you our grass fed whey protein powder and our electrolytes with creatine. And I will point out that our electrolytes with creatine leads with 400 milligrams of potassium because we are big believers in potassium. Only 100 milligrams of magnesium than 350 of sodium. So I'm going to send that to you.
- [45:02]
B
Okay, you can do that. I'm behind on the creatine craze and you know, it's hard to ignore just a lot of people in the space and you know, there's some research on mood and cognition. And so I'm, I'm, I'm, I, I'm curious, I'm a little curious.
- [45:17]
A
It's game changing in terms of lean muscle mass and then the brain health benefits and then as specifically for women as they get older, bone health at higher dosage.
- [45:27]
B
I think I've had this idea that you need to challenge Jason and probably not good in the midst of book promoting of healing the modern brain to say this, but I have some almost stubbornness that I want to get it from food. I want to get from simple movements. I want to get it from taking care of my mental health and building deeper, closer connections in my life. I want those to be the drivers of longevity for me. I almost want, want the stubbornness around my belief in those to get me to like 100. Like I want to look just like this in 50 years from now when I'm 100 years old. Like, not that different. When you say what happened, it's like, you know, Jason just kept eating those foods I told you about 50 years ago, 100%.
- [46:09]
A
I always say it always food and lifestyle first. But I think there are some nutrients you just can't get from food. So like astaxanthin, like the amount of salmon you have to eat to get enough acids, there's not gonna happen. Same with creatine, same thing.
- [46:21]
B
But your kids, I think people would even argue with omega 3 fats. You know, it's just like, okay, it's great, but like how many sardine, anchovies and salmon meals are you gonna have? And if you have kids who are, I don't know, it's like a lot of mood disorders in your family and you want them to take a lot of omega 3 fats. That's definitely where people are moving towards a supplement.
- [46:41]
A
Right? And again, I'll emphasize they're called supplements. They are a supplement to an existing behavior.
- [46:49]
B
You know, people I think, miss that sometimes, right, that, that it's and People also, I think, end up on very complex regimens. The way I handle it in my practice, everybody, there are a few things like vitamin D in the winter, or if you've never tried omega 3 fats and you don't eat fish and you have anxiety and depression, it's like, you know, the data is mixed, but if it works for you, that's wonderful. You know, there's things a lot of people try, like some magnesium at night to help sleep quality. And I think what people miss is, you know, it works or it doesn't. And people, you know, on both medicines and supplements, it's really, you know, I would say, kind of clear.
- [47:25]
A
You can't supplement or medicate your way out of a poor diet or poor exercise habits. And diet and exercise and sleep and stress. You know, all. All the things we talk about are foundational. You've got to build a very strong base. And then the right supplement protocol or pharmalogical protocol can take things to the next level. But you gotta have the strong foundation first.
- [47:54]
B
I hope so. You know, I hope what healing the modern brain helps people do is focus on a framework around mental health to build a strong foundation. It felt to me that, you know, as we're talking about movement, it's easy because we all know movement. If I said, hey, I want everybody here, look, you know, having a bigger bicep by this many inches is going to, like, add 22 years to your life. I wouldn't have to tell you a bunch of exercise. You probably know a variety of ways to build biceps or build your core or stretch. With mental health, it didn't really feel as much. And it kind of, again, it feels like all of us know, we, I hope every day, but if not every day, a few times a week, there's time in your schedule for exercise and movement. It's like, if you're going to do that for your mental health, what would it be like? What would you spend your time doing? And then kind of, how disciplined are you about it? And how do you kind of denote the payoffs?
- [48:47]
A
We covered a lot today. You know, alcohol, psychedelics, cannabis, movement, sardines, of course. Is there anything we didn't touch on that you want to touch on before we close?
- [49:00]
B
You know, there are two quick tenets that I want to share with everybody that are in the book that are really, I think, important for people today. One of them is called unburdening. And unburdening is about how to acknowledge and kind of think about, in some ways, the trauma, movement There's a lot of talk about trauma today. There's a lot of talk about ptsd, a lot of excitement about a new, you know, set of treatments. And. And at the same time, I find a lot of people are burdened by maybe not, you know, massive trauma in the sense of a violent trauma or a robbery, but really burdened in terms of a massive personal trauma in terms of things that have maybe happened to them. A bad boss, a toxic relationship that got you scared about trusting people. And so I ask people to take a look at some of that. There are lots of ways to deal with our trauma besides going to therapy. That's one way. I talk a lot in the book and write in the book about journaling and some of my experience with journaling and that helping with unburdening. And then the last tenant, which I just think is really important today, is around purpose. It's like so many people are feeling fatigued and a little lost and confused, and so helping people think in a very simple way about your purpose and some of the, again, statistics and ideas and research behind that and how it really bolsters your mental health. You find people have a sense of intention or purpose. They're just very protected against depression, against anxiety disorders, even cognitive disorders. So those are a couple the tenants. And again, I hope people hear this as a really hopeful, encouraging directive, though, that you got to take great care. You deserve to take great care of your mental health and your brain health. And to do that, I think it requires a little bit more than, you know, we've ever had to do for our mental health. And I think that requires us, again, to build more mental fitness. So I hope the book helps.
- [51:01]
A
Jason, well said. And to double click on purpose, in my view, it is the most undervalued in terms of longevity. I think you could have the best markers in the world, but if you're lacking purpose, I don't think there's going to be a great outcome in terms of achieving your idea, ideal health span.
- [51:18]
B
Yeah, you're a great example also, because your sense of purpose is also linked to your faith. I loved it when you came onto my podcast and talked more about your faith and being a Christian and, you know, part of a way that I think for a lot of people who have spirituality and religion in their life, some of that purpose is maybe more built in, whereas other folks who maybe, you know, weren't raised in that way or aren't feeling attached to, you know, a certain religion at this moment in your life, you know, sometimes need Some help on kind of like how to pursue that or how to get a little bit more, like, clear and committed to a set of values that allow you to. To, you know, again, better live with purpose.
- [51:58]
A
Yeah. And I. I Love, you know, Dr. Lisa Miller, who talked about. Is a dear friend here in Miami who's done incredible work at Columbia. You know, she'll talk about the implications of mental health and that children are essentially children who have. Who are connected to a parent or caregiver in a spiritual sense. And she's a very broad definition of that. It could be going to church, it could be, you know, a gratitude practice, a walk in the park. But like, this. This greater idea of spirituality that the children are, I think, like, four or five times less likely to experience depression. Like, how could you not be a believer in terms of the mental health implications? Like, figure out like, that is just so critical.
- [52:37]
B
Well, I think, you know, also these. These ideas give you a sense, one, that you're not alone, like, that other people have thought about this so hard, that there's a set of, you know, there's a set of scriptures, there's some songs, there's, you know, there's. There. There's, you know, a sense of. Of belonging that I think is very protective and. And then also a notion that these are complex human emotions that people have struggled with them and can sort it out. I think that, you know, those are really helpful messages that kids get in a relationship like that.
- [53:09]
A
I think for, you know, us grownups, it's what's my purpose in the world? And I think it also transcends spirituality and that, like, what am I working? You know, what.
- [53:17]
B
What.
- [53:17]
A
What am I doing? Am I. Am I contributing? Am I helping people? Am I. Am I doing something? What. What am I, you know, is it hard for me to get out of bed or I can't wait to get out of bed to do something? And I think when people lose that, they lose their will to live and doesn't matter how healthy you are.
- [53:36]
B
Yeah. It's become clear to me now as I've gotten older that my purpose here is to get us talking about mental health and to get people doing things about mental health and to be here to care for people's mental health. And I found a lot of inspiration in how part of that purpose is getting to be in these really creative spaces, whether it's making fun, content with you, or sitting with my patients, talking about, like, a wild, interesting dream that they had that, you know, I sit there sometimes and I think, how how blessed am I in the situation? Like, I don't know that anyone else will get to hear about this beautiful moment, this dream, this connection this individual made, this, you know, step. Step up to whatever was in front of them that they just did. So it's. Yeah, it's. It's a treat to be here spreading a message of mental fitness with you, Jason, and. And encouraging everybody who's listening to take some steps and to make sure you're healing your modern brain in a daily way, not in an onerous, horrible way. All these things should be fun. They should be delicious. I'm asking you to dance more, to hug and kiss more, to write more journal entries, to go out to the national parks and walk around out in the woods without your shoes on. You know, stuff like that.
- [54:51]
A
Well, always a pleasure, Drew. And I'm encouraging you to write your next book on dream interpretation, and we will have you back to go through all the wild and crazy dreams of your patients. Let's do it. Sure to be a bestseller. Everyone loves, loves that.
- [55:04]
B
I'm excited to share the next with you, Jason. I'll tell you. I'll tell you all about it, but thank you so much for having me on. Thank you, everybody, for all the support of healing the modern brain. And it's a treat. I can't wait to continue the conversation. I'll talk to you soon.