← Thriving with Addiction with Dr. Jonathan Avery
Thriving with Addiction with Dr. Jonathan Avery
Healing the Modern Brain with Dr. Drew Ramsey
00:37:15
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A
Welcome to the Thriving With Addiction podcast where we explore how recovery is not just about surviving, but about truly living. Each week we'll dive into the science stories and strategies that help people and families heal from addiction and build healthier, more resilient lives. I'm your host, Dr. John Avery.
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Let's get started.
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C
I'm John Avery, and welcome back to Thriving with Addiction Today. Today I'm joined by Dr. Drew Ramsey. Dr. Ramsey is a board certified psychiatrist, author and leading voice in nutritional psychiatry and integrative mental health. He is a fellow of the American Psychiatric association and the founder of the Brain Food Clinic and Spruce mental health. For 20 years, he served as an assistant clinical professor of psychiatry at Columbia University, where he taught and supervised psychotherapy and nutritional psychiatry. He's authored many great books, including the international bestseller Eat to Beat Depression and Anxiety, and also the latest book, Healing the Modern Nine Tenets to Build Mental Fitness and Revitalize youe Mind, which we'll dive into today. He's a dynamic speaker, podcast host and educator who has delivered three TEDx talks and his work has been featured by the New York Times, the Wall Street Journal, the Today show, npr, and other notable outlets. He lives in Jackson, Wyoming with his wife and family. Drew, thank you for joining.
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B
John, thank you. It's a treat to be with you. I'm stoked you're doing a podcast and everybody listening. I'm really, I'm excited to be with you for the next hour and talk about mental fitness and nutritional psychiatry.
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C
No, it's great to have you and I always think about you because every time I hear someone say who's living in New York City, you know what? I'm just going to leave New York. I'm going to move to Washington, Wyoming. But you're the guy that actually does it and lives there. Tell me about that transition.
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B
Wow. We're about five years in now and it's been really wonderful. Mostly it's been challenging. I'm in Jackson, Wyoming, which is a really wonderful, storied town. I knew it like a lot of people knew it as ski town. A place to come, have a fun time and ski deep snow and kind of encounter a mountain that's a little just gnarly at times and steeper. And what you find here is just this really dynamic community. I think the reason we moved here is we're kind of entering into this next chapter, kind of second half of our lives. Our kids are getting a little older, is, you know, my wife's very wise and she just knows us and Knows me and being around active folks, around people who are wanting to be very stimulated in their minds and involved and engaged in their creativity and I think most importantly engaged in really intentional community building.
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C
That's great. I mean, that's one thing I've always admired about you, is that you do practice what you preach. I mean, you eat well, you make these great moves for you and your family and your kids. You're careful around drinking, I've heard as well. So you practice sort of all this mental fitness yourself. And I think that's a great example to myself and to your patients and everyone.
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B
Now I'm careful. I stopped drinking four, four and a half years ago now. And yeah, it was something that I wasn't careful around. Actually a big part of my New York living was going from being kind of a rural farm kid and drinking a beer occasionally and to hitting that New York drinking scene where it's a really a socially acceptable thing. Most people are having several drinks a night or a lot of people are and really enjoyed that, enjoyed all the wine. And I feel like I was in New York when mixology came up and craft brew came up and that was all really exciting to me. And then learn more about thinking about my family, about my love of sugar, about all the genes of alcoholism that we had. And then, you know, when you become a parent and you have kids, you know, there's just as you say, the walking, the talk. It's in part just wanting to model that.
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C
Right? No, I think. Well, I appreciate you sharing your journey and just to dive into that broader journey in general. I know you grew up in, was it in Indiana and then you made your way to New York. Tell me a little bit about how you ended up being such a pioneer in nutritional psychiatry and in this field of talking about sort of mental fitness and all the sort of non medication things that are so important to mental health in a lot of ways.
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B
I've gotten to work with lots of great people and psychiatry is an amazing field. I think part of that journey is really for me just paying attention to things that really stir me. And so I think I've had this real blessing of perspective of getting to be in real rural America. I'm really comfortable, dirty in the woods, sleeping on the ground, farming whenever. I don't know, I don't get to do that much but anymore but you know, digging in the dirt, I dig a great hole. I like to ride a tractor. When we moved back to my parents farm, boy about 2017 and my mom had never let Me have a chainsaw. When I was younger, she was like, too scared, which is like. It's like a. It's like a big mark against you as a country boy. You know, you just like, you gotta have it. And so finally I was over 40. I got to get my chainsaw and, oh, I got my chainsaw skills going. So I love all that stuff. And. And how do you go from there to New York? I know. I also love the city. I'd spent a few years when I was really young actually in Long island before my parents moved. Really rural Indiana. Grew up in Crawford County. If you look at the map, it's right. Right on the border of Kentucky. We call it Kentuckiana where we're from. And. And Crawford County's poorest county in Indiana and one of the greenest. There's this beautiful Hoosier National Forest here, there that. Hope anybody listening who can help, please do your job at some of the oldest trees we have in America, unfortunately now being cut down. But Crawford county is great to me, a great place to kind of. And a great place, weirdly to launch. Indiana sent me out into the world. I went to Earlham College, which is a really kind of very international liberal arts school in Richmond, Indiana. And almost everybody there does an international program. And so through that school kind of spent some time traveling, spent some time down in Ecuador as working in a clinic, and then went on to Indiana University Medical School, which a lot of people don't know. IU is now known for football and basketball, but it's also our nation's largest Medical School. Over 300 physicians every year. And so it's educated really more of American physicians, I think just about any medical school. And it's an amazing place. The Mecca is one of those states where it's really the center. And then came out to Columbia was really fortunate to do adults psychiatry training. I was young. I moved there when I was 26. And. And so I guess I'm just describing the journey, John. I don't know how it happened, man. Like, I really like food. I really like farms. I'm an enthusiastic guy. I think I was the first person from IU to go to Columbia. And you know, it's a very storied institution. It was really intimidating, to be honest. I'm not like an Ivy League guy. I'm not from that world. But they really embraced me and all my energy and. And then the food thing, I just kind of. It to me came quite naturally. It was in residence. I think it's 2002 that one of the first articles came out looking at a correlation between seafood consumption and the rate of bipolar disorder at a national level and found this correlation. And at the same time, those first, remember, like fish oil was just starting to like, be a thing and heart disease. But also there's some early, like, hey, does this work in depression? And I remember I just got really curious like, what are these omega 3 fats? And why do we only think fish oil? Like, why don't we tell people to eat salmon? And then I said, wow, there's more fish oil in this little salmon steak than there is in all these fish oil pills. And it just, I think for me, it then led to realizing as I sat with patients, I was really early in my private practice and I work in a community mental health center and I just realized I wasn't asking patients about food. All of you who are in community mental health or have been involved with some of those second generation antipsychotics, they cause a lot of weight gain often. And so for the first time in my career, I was in this place where I'm giving medications. People are getting better for their psychiatric illness. They're getting worse in terms of their metabolic health. And then kind of look at me like, what do I do? And I didn't really feel equipped. You know, we have some training in nutrition and behavioral change, obviously a psychiatrist. So I think that's kind of where nutrition came from. Of just then starting to present with Emily Deans, A great colleague has this wonderful blog, Evolutionary Psychiatry at the APA conference. APA started accepting stuff, you know, and it just kind of snowballed from there.
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C
You've been a real pioneer. I mean, I think your, your books, I mean, when I was going through training, I mean maybe we talked about omega 3 fatty acids and in passing, and I think even today there might be one lecture if that in most psychiatry residencies. And it's still very underappreciated. We don't talk about it enough with our patients. And we need people like you sort of going out there and spreading the good word that this is really important not just for your physical health, but for your mental health.
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It's interesting to be often in situations where I'm still, people are a little surprised and excited. And it's common sense in a certain way that our brain is our most metabolically active organ. All of you listening who are in recovery, you're seeing your default mode network and your brain neurochemistry, like change. I mean, that's as we were talking earlier about stopping drinking. That's just so. Let's say it's like surprising that you see your brain in this state where it really is thinking about that drink at 5 o' clock and you just don't ever think about alcohol again. Like someone cast a magic spell on you. And to me, I think that represents the hopefulness and the magic of neuroplasticity. This idea that our brain changes, it repairs itself. If I'm in a bad mood now, I can do things that boost my brain growth factors. I can go exercise. I can do things that improve my sense of connectedness. I could call a friend to send me a picture of his son hitting the home run last night. And I haven't had a moment to say, like, wow. And I know that'll make me feel good, right? Just in the sense of doing my part of keeping a friendship active so well.
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C
That's a good jumping off point to your latest book. So what is going on with the, with the modern brain? Like, tell me your take on all these factors that are impacting mental fitness and the modern brain these days.
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B
Oh, boy. I just think about all the new words in your field, John. It's such a treat to talk with you as a vice chair of addiction and just, well, there's so much going on and how that's changing in our world. And I'm so grateful for leaders like you who, you know, these things that honestly, I don't know as much about as I should, like kratom and like Delta 8. And it's just great to have experts like you and have this podcast to just keep educating us, I think right now and everybody listening. I'm sure you appreciate this. It's hard to know who to trust. And so we find folks like John who have this really rare myth because it's a really rare mix. Everybody, where you're out in public, you're doing a podcast, and you're a vice chair of an Ivy League department in addiction. And so anyway, I'm just really grateful for you. In this podcast, what I hope to do is create a little bit of a map for everyone, like an eat to beat depression and anxiety. There's some literal maps and illustrations like, hey, this is how depression and anxiety has changed. When you talk to psychiatrists like John and me, we think about things like inflammation and neuroplasticity in your microbiome, you know, and all the other stuff and your medications and your dynamics. But, you know, these things are kind of true now. And then there are these, these factors of things that we can do and engage with that can help us combat again what's true about the challenges to our modern brain. So I talk about substances and vices, we talk about the screens, I talk about some of the more subtle pollution. A lot of people don't have an air filter in your bedroom. If you look around this office, I have three HEPA filters in here. Why I spent all my time in here. I can have the cleanest, best quality air. Why wouldn't I? Because that's a spot that I do have control. There's a lot of dirty air I've sucked in when I didn't have control, riding on the subway. So when we have control, exerting it and allowing us to feel more empowered in the modern world, I think is a big part of the book and a big part of my hope for what happens when you are able to step back from all of this noise about what to do, what to eat, how to live forever. The peptides you should take, you know, how you should be sleep maxing and look maxing and max maxing and take a step back and think about some of the things that where ancient wisdom and modern science connect. Everyone throughout time has known sleep is healing and restorative in a past to the great grand unconscious. Who listening does not love a juicy wild dream like wow wow, like there's no drug like a good dream, right? We've gotten this, you know, new science, right? The glymphatic system, literally how you drain the waste out of your brain. Obviously missing piece in the sense that, you know, we burn more fuel in our brain than any other organ. So two, you know, 20% of all of your calories is burned up here. Anytime you burn fuel, you create waste. Like what, what happens to the waste in the brain? Just some of those things kind of like nutrition. I was like, wow, hadn't thought about that before. And what a better and more compelling way for us to talk to everyone listening, all of our patients, ourselves, our family, about sleep. It's not hey, I want you to get eight hours, it's hey, your brain needs to drain out. It's about a teaspoon of waste that, and I don't, I wonder what that looks like. This black sludge is what I imagine. And, and you gotta get it out. All those like amyloid plaques and tau tangles, all that stuff, you get it outta your brain. So obviously sleeping a little bit more and draining out a little bit more waste, it should be really motivating for us. So that's what I mean by the modern world. We don't sleep, we're on the screen. A lot of, you know, complex diets, a lot of confusion and then. Sorry John. The last thing is the disconnection we're listening to really the data we're seeing that the being digitally connected is leading to us being socially disconnected. And I think just as importantly is whether you're proximal or next to people. I think what I've noticed is the way that we're having a hard time in our digital relationships creating depth, closeness and intimacy. So that's what we're up against.
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C
We're up against a lot. And if you don't mind, add a little color to sort of some of these addictive things that get in the way of mental fitness. And tell me some of what you've learned about drinking that made you stop and what you recommend for folks. And also sort of those ultra processed foods that are also sort of in the mix in terms of both being addictive and tanking our mental health.
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So I wish you could screen share right now, John. I'd share this slide. You probably know it from a research study on hangovers and inflammatory factors. And it shows at 4 hours and at 12 hours what happens are inflammatory factors are our body's natural amazing beautiful immune system that when there our alarms, they go off and we respond. You know, when our body gets ready for, you know, an attack, a virus, something stressful. When we drink alcohol right away at four hours and then at 12, there's a massive increase. Your CRP, which C reactive protein and what it sounds like, it's, it's, it, it's one of our main markers of inflammation, just starts going up. By four hours it's up 80% and it stays high like that. And at the same time as those inflammatory factors, your body's response are going up. Your, your innate antioxidant capacity that your genes code for stuff that's a heck of a lot better than vitamin C. Right. It's an amazing antioxidant things called superoxide dismutase and glutathione. Right. They're incredible. Well, as soon as you start drinking, those start dropping. So now your brain is in the spot again where there's a lot more inflammatory factors, interleukin 6 CRP and there's less capacity to deal with free radicals. And so that data came out after I was drinking. I try not to be entitled non drinker, you know, I don't want people to think I'm entirely sober. I engage in bad moods, anger. I procrastinate. I've done a ketamine training. You know, I. I've gotten really interested in holotropic. You know, there are ways that I'm interested in altering my psyche, but. But with the alcohol, I think the notion of one. I looked at my family history, and there's just a lot of morbidity. There's a lot of alcoholism, and you just sit with that, even if you're a responsible drinker. I didn't drink in the morning, and I never drank at work. And I thought about the moments where I was really not feeling well. For me, that was in the morning. And I hate it when I know that I'm doing something that's bad for me. And so when I would wake up in the morning and I would feel nauseous or I'd feel like I would feel the specificity of it that I didn't want. I didn't drink wine. I didn't drink cocktails. I wasn't interested. There could be a fridge full of beer. I wouldn't touch it. I was only interested in drinking IPAs. And I'd never had anything that I'd always liked to drink, but I was like, what I'd have, it's kind of whatever. And as it got more dialed in and specific like that, it just. I don't know. I noticed myself earlier in the day on a weekend. I noticed. And so I just. And I think part of the. Of moving out of New York and then being on a really rural farm is the recycling. And I hear this from so many people. I'm sure you, too, have just like, man, just like. It's a. It's a big bag of bottles and cans, and then it's the refueling and restocking, and I just. I got. I don't know, I just got kind of exhausted and embarrassed by that. So those were the things that helped me, I think.
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C
And I think your story highlights something important that it's not. I mean, sometimes we think when the drinking gets really severe and it's. There's sort of obvious, you know, blatant implications to our body and to our function and family, friends. But even subtle, less, you know, more sort of acceptable drinking does really cause this inflammation and get in the way of our sleep and our mental fitness more than I think we. We appreciate at times.
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B
Oh, it's so much. And then I think when you stop, there are these. There was something I learned. I'd done. I'd done a dry January. You Know, I'd taken time off, I'd showed myself I'm not an alcoholic, you know, and. And what I notice is after, you know, 30 days, there was definitely a loss, maybe two weeks, a loss of that almost like habitual thought about it. But it was really at 90 days when I noticed I stopped worrying that I was getting subtly demented. I just felt sharp again. I felt creative again. I felt a little more in touch with my mood kind of swings in some ways. I think there's just also the way of, as you put day after day together, you just, you feel good about yourself. I mean, there's a way that no matter when I'm down, it's like, you know, I did that and it was a really good thing. So. Yeah, and I also think there's a lot of encouragement of. I run a practice. My clinic is really focused on harm reduction. If I go out and have a beer tonight, I'm going to be, I think, curious and maybe a little regretful, but I'm going to think about all of the harm reduction I've done and want to get back into that stance. And I just think that's a really helpful stance for people. One that doesn't get emphasized, I think. I'm guessing, John, you, you know, this is where you've really seen your field shift, right. And that was a very helpful mindset for me and that's very helpful for my patients. If I can go, you know, help you go from drinking really aggressively and binge to having a beer with your buddies when you're, you know, at a bar only and only having two. I think that's amazing. So.
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C
No, I agree completely. And that shift's been so important. And the other shift that you've highlighted is just being really careful around the food we eat and its relationship to. I mean, whereas, you know, drinking has been. Hasn't been a challenge for me, for me necessarily. It's those sweets, it's the Chick Fil A. It's the these other things that sneak in.
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B
We get to have a little nutritional psychiatry session with an expert in addiction around ultra processed foods. There is data, right, that the ultra processed foods. There's a food addiction scale. I think we've all experienced that. And John, you did ask earlier, like, what about the ultra processed foods? Yeah. So it's really interesting to talk to you about that right now that the data has really matured. If you look at things like the nurses health study 2 and this is a great study that follows nurses who, you know, are pretty accurate Reporters in terms of filling out health surveys because it's the data that informs their practice and nurses are better than doctors. There I said it. So but they, the nurses health study, when they look at the nurses in what's called the top quintile, the 20% that eat the most processed food, the risk of depression is 50% greater. And you see this correlation really kind of clearly. If you look at all of the data put together, all of the correlational studies, if you eat more kind of processed food or modern style diet with all these processed foods, you have again between like a 20 to 40% increased risk of depression. Another study that I really loved, look at university students. And there's a whole now big set of data that's come out about college students and diet. And as we're worried about adolescent mental health and we launch kids into college, it would be great if we all stop saying freshmen 15. Unless you're talking about the 15amazing nutrient dense foods that they could eat to help their mental health, like lentils and wild salmon and nuts and healthy leafy greens and rainbow vegetables. Those 15 are okay. But instead we send our kids off with this like, oh, here's awful cafeteria food. You're going to gain weight and be unhealthy and binge drink. Good luck. And I don't think we should be surprised in some ways, and not everybody does that, but we shouldn't be surprised then when we see this is when mental health concerns hit in late adolescence a lot of times. And so anyway, lots of data about if you look at university students, there was a study in Spain that followed them over five years and found those who again ate the most Mediterranean style diet, one of these traditional style diets with a lot of nutrient density, they had a 35 to 50% decreased risk in getting depression during college. So that's just like really powerful data. Then when you test that in the randomized trials, you take people from ultra processed foods and put them on a Mediterranean diet, a traditional diet, you see this response, improved response to depression treatment. There's a few trials now where about one of them, 36% of patients, young men who went from eating lots of ultra processed foods to eating more plants and more hummus and more olive oil, they had a 36% of those patients went into full remission from the depression, their depression. So you know, that's the kind of data that, you know, both on the randomized trial side, on the correlational study side, there's this strong signal when it comes to what should we talking Patients about is, hey, tell me about your diet and what you're eating. You have this thing, this value, this interesting idea about how you nourish yourself or not. And the more I can be curious about it and kind of help you paint a more colorful picture for yourself around you as an eater, then I'm helping fuel your brain, but I'm also helping you kind of manifest more in your personhood. Like John, you're from a place, your family's from a place, you have favorite foods like chick fil a is, you're one of them. Right? So right away that begins. That's a jumping off point for a nutritional psychiatry conversation. John, when are you craving the sweets? What sweets are you craving? Is it at night? Is it all the time? What are your favorites? And then you're beginning to think like, how do I translate this? Like, what about the sweetness of like. I know this is going to be a stretch to start, but some of those like caramelized vegetables, you know, like oven roasted like cauliflower or broccoli and like a, you know, a nice sauce. Did that get hit a little sweetness for you or some of the pastas?
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C
Yeah, no, that scratches an itch for sure.
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B
So everybody. So nutritional psychiatry is really trying to. I would be trying to figure out John's favorite sweets and I'm sure you can guess what I'd be leaning towards if you've seen Eat Complete, which is a recipe book. I'm leaning towards this concept called nutrient density, which is trying to think about how do we honor that. John likes sweet. And thinking about what that's about and what we could do about that and when it's happening. But that's a little bit about nutritional psychiatry and you know, trying to meet people where they are, think about what they're, you know, curious about and then create some like challenges and goals.
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C
And I think you have a great rhyme about what we're supposed to eat. Right. Do you mind sharing that? Yeah.
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B
Yours is Chick Fil A. Chick Fil A. Chick fil A.
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More chicken. Yeah.
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B
Yours, my little rhyme is seafood, greens, nuts and beans. Rainbow celebrations. Don't forget the fermentations. And that second part is by Katherine Roberts, who's run student mental health at Northwestern and was way back in the day my resident. And so I'm at the APA conference and added that in so just to give credit where credit is due. And everyone, that's because his food. And when I think about food, you might know me from my book 50 Shades of Kale. If you're in academia. I just. Little tip for you, don't write a sex book about a vegetable. I just like. It's not. It's not going to do. You get teased and it's not going to do great things for you if you're just not taking seriously. After that, everyone laughed. But you know what we're after. There is leafy greens, whether it's microgreens or bok choy or little gem Caesar, little gem lettuce, which I love in the Caesar. All of those are nutrient dense. All of those have 20 to 30 cups calories in a cup. All of those have lots of vitamin C and some folate and lots of interesting phytonutrients. And so that's where this food category, seafood, you know, food categories for me are around. All right, like, what can I do better? So we look for some diversity, right? If I'm just eating wild salmon, you know, then I'm missing out the bivalves, like mussels, clams and oysters. Clams, number one source of B12, 1,401% of vitamin B12, and 3 ounces of clams. Holy pasta, Van Gole. That's all I have to say.
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C
These are great tips for me. No, I appreciate it. And for everyone. I think this is so important. I mean, it's prevention. It's a part of treatment if mental health issues develop. And for my patients, you know, I've been using your book Healing the Modern Brain for my folks in early recovery, when they're often asked, like, what's a good resource as I work on getting my life on track after substances have sort of got in the way of my, you know, mental health and fitness and nutrition. And yours, through these nine core tenants really is a nice guide. And we talked about some of them. You know, nutrition, sleep, certainly movement and exercise. But can you run me through some of the other ones that you would recommend, especially as people sort of enter recovery and try to change things for the better for themselves?
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B
John, I'm absolutely honored to hear that you're using the book. I mean, there's just no greater thing that you hear as an author, especially in a context like this, and helping people early in recovery. And thanks for getting me back on track to talk about healing the Modern brain just a little for a minute. So the idea, everybody, was these nine core tenets are things we all know are true. I got a little tired of arguing with the vegans or the carnivores or the sleep maxers or the longevity people or the peptide people and I thought, you know, we all agree on some things. Why don't we start there? Because none of us are doing as much as we need to. And I also thought there was a lot of new science. I found a lot of people didn't know about neuroplasticity and sleep or how your social connections connect to the diversity of your microbiome. A microbiome is all the organisms in your gut. And generally eating a lot of different plants and fermented foods is really good for things like, like your anxiety and your friendships. I mean, it's just this wild way we have of influencing or what regulates inflammation in our body. The first tenant is self awareness and self awareness. Really. You know, John and I are psychiatrists and, and, and we are taught from the very beginning, like, well, what are you feeling? This patient walked in the room. What were you feeling? And, and the reason is, is we know that that's the most sensitive antenna and diagnostic tool that we have. Our giant alpha sitting with your giant alpha predator brain and feeling things. And so self awareness is really asking you to honor this just incredible wisdom you have if you're anxious. Yeah, they're horrible anxiety disorders. But there's also a way that anxiety is a signal to us and learning. A lot of our work is learning to regulate that and kind of dial that to know what our anxiety leads us to in terms of making our environment feel safer and more secure. You can journal, you can go to groups. We get a lot of self awareness from our work and trying to achieve goals. I love sending people to like intramural sports, which is places where you see yourself in action. And I always remind people, self awareness is about being kind to ourselves and curious and aware. Because by being self aware, you're naturally looking for things that you maybe don't. Like my drinking and my foamy burps in the morning, I hated that. And I was anxious about it until I changed it. So self awareness. We talked about nutrition, which is the second tenets, and then movement in terms of treatment and people in recovery. Boy, there is no drug like exercise and that it feels great and it takes just a little bit longer than getting high. But I don't know, when I get out here and I'm like, I get in this super trippy headspace and I love it and I'm so grateful for it. So movement. We talked about sleep and just again, the importance of making your bedroom a sleep sanctuary. I feel like, stop being a weenie about sleep hygiene. That's what I Tell you, like, stop with this whole, like, oh, sleep hygiene is like, I try to go to bed at 10. I'm like, the hell you do. Like, your bedroom's mess. You get, like, all kinds of artificial fibers and plastics everywhere. You don't have an air filter. It's dusty. You know, it's like, make that room like the perfect, like, humidified HEPA filtered air. And everyone. I realized this takes a little expenditure, a little bit, not a lot. And again, for a couple, maybe a hundred bucks, maybe less, you can again create this place where your brain, your most important asset, rests, recovers. All right, so you've already heard the sleep rants. You know, some of the other tenants, we talk about connection. I was just talking to a patient today who's, like, concerned about how he's a friend as a younger man. And I'm so grateful to be in this conversation with him and how do we make friends? And I talked about, in the book. I talk about the web of connection. There are the institutions he's gone to, some really storied institutions. How do you feel connected to those who's in your immediate environment of the relationships that you're needed to work on and build? I do a really bad job of this. I'm a friendly guy, so I kind of assume a familiarness and closeness. And I'm kind of like a golden retriever. I used to be. And I've, like, mellowed in andropause a little bit. But, you know, something I need to learn about myself. Like, less bouncy talk. Less. Less. You can see I'm struggling with it in this podcast. So excited to see you, talk with you. So. So connection. My wife's been really good about that as we moved here. Right. Making sure and going and volunteering and meeting people and going to lunches really inspired me to just, you know, relationships are one of our greatest assets, and we've got to invest in them. You know, I talked in the book, the next tenet is engagement. And engagement is really asking you to fight the algorithm that. Because it's so good. But if I just listen to the algorithm, you know, I get fed some mix of, like, avalanches and women, you know, kind of talking about wellness and. And sex bots and bro influencers and, like, none of his stuff, honestly, that I want or feels good for me. And so if I'm in that automatic habit of I wake up and I'm not feeling well and I doom scroll, you know, I'm not engaged with what's going on. If I wake up in the middle of the night, I'm not feeling well. And I journal about it, which was a huge discovery for me. I almost always get to like a line. There was the one the other day, I was like, I can't do it all. It was like the simplest thing. And I was in work and I was in session. I was thinking like no, but I can do this and I love doing this settled over me. And so you know that that notion of engagement, engagement with the self, engagement with your connections and I think particularly engagement with your mind. Then we begin to think about some of the other tenants grounding being out in Wyoming wasn't an accident. I'm from a very, I grew up on 125 acres and you know, I'm just very in awe and happy out in the wilderness. I just, it's a great place for me. I like to get on, on a walk. I think throughout time walking and walking out in nature has been a great, of great healing value to mental health. And we all have wonderful parks around us. We all have shoes.
- [34:21]
C
And it's another thing these, these seem sort of like matter of fact or sort of, you know, common sense as you said earlier, but they're really evidence based. I mean you've talked a lot about how for example, being out in nature has been shown to help with depression, anxiety. You've talked about the negative ions. I mean there's, there's real like solid evidence that this is, this works.
- [34:42]
B
There's cool science. I mean but along you know, just with like the nutrition and the sleep, the socializing, the engagement, there's studies that, you know, you vastly decrease your risk of lifetime depression if you have a hobby. And of those things that for me as a clinician, it's like I learned a long time ago, it's like gotta ask people what their hobbies are.
- [34:59]
C
And I think psychiatry at times or people's perception of it is, and even addiction treatment is that it's been increasingly sort of medicalized that you come to us to get medications. And I just love how this approach appreciates maybe all the other stuff that sometimes gets lost in terms of how we can really, you know, not only get well, but sustain wellness and really truly find what this life is all about.
- [35:24]
B
Yeah. And I think it's what this field is missed and what psychiatry needs to be really bold and brave about. It's like, no, you get me. When you get a psychiatrist, you get someone like me and John in your corner and we are tenacious as hell. And we're more informed and educated about brain networks and neuroscience and treatments than ever before in human history. If you need Prozac, like, no problem, easy peasy. You need interpretations, you need therapy, you need accountability, you need referrals, you need encouragement, you need smart interpretations about your dynamics, like, oh, yeah, we got all that too. So, yeah, I, I, I, I appreciate that, John. And I really, again, I really appreciate you showing that. Like, no, you're so much more than an ant. Abuse treatment or naltrexone. Right. If someone is struggling with substance use disorder of any type, you, your fellows, your colleagues, if they end up, if they're lucky enough to end up in a chair across from you, they're going to get better. And that's a hope that I don't think we've had before in our human history. And it's just really, it's great.
- [36:30]
C
Well, I love that and I love you. I feel better equipped to tackle Chick Fil A and everything. Got it. Man in my life for this time with you today. So I really appreciate you taking the time to share all your wisdom with me with us today.
- [36:46]
B
Well, thank you, everybody.
- [36:47]
A
Thanks for listening to the Thriving With Addiction podcast. If you found today's episode helpful, please follow and subscribe wherever you listen to your podcasts and share it with someone who might benefit. You can also connect with me on Instagram, LinkedIn and YouTube or visit thrivingwithaddiction.com to learn more. Stay tuned for next week's episode. And remember, thriving is possible.