Healing the Modern Brain with Dr. Drew Ramsey

DREW RAMSEY, MD is a board-certified psychiatrist, author, and leading voice in Nutritional Psychiatry and integrative mental health. He is a Fellow of the American Psychiatric Association and the founder of the Brain Food Clinic and Spruce Mental Health. For twenty years, he served as an assistant clinical professor of psychiatry at Columbia University, where he taught and supervised psychotherapy and nutritional psychiatry.

Dr. Ramsey has authored four previous books, including the international bestseller Eat to Beat Depression and Anxiety and three e-courses. He is a dynamic speaker, podcast host and educator who has delivered three TEDx talks and his work has been featured by The New York Times, The Wall Street Journal, The Today Show, NPR and other notable outlets. He lives in Jackson, WY with his wife and family. 

Learn more at www.DrewRamseyMD.com

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Transcript

SPEAKER_01 0:00

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. Let's get started. I'm John Avery and welcome back to Thriving with Addiction. 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 Brain: Nine Tenets to Build Mental Fitness and Revitalize Your 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, Jackson, Wyoming with his wife and family. Drew, thank you for joining.

SPEAKER_00 1:26

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.

SPEAKER_01 1:37

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 I'm just gonna leave New York and move to Wyoming. But you're the guy that actually does it and lives there. Tell me about that transition.

SPEAKER_00 1:53

Wow, we're about five years in now, and it's it's been really uh wonderful mostly. It's it's been challenging. Um I'm in Jackson, Wyoming, which is a really wonderful storied town. You know, uh I knew it like a lot of people knew it as you know, a ski town, a place to come have a fun time and ski deep snow and kind of encounter a mountain that's a little uh 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 a second half of our lives. Our kids are getting a little older, is um, my wife's very wise and she just knows us and knows me and being around active folks, uh around people who are wanting to be very stimulated in their minds and involved and engaged in their creativity. And and I think most importantly, in engaged in really intentional community building.

SPEAKER_01 2:44

That's great. And that's what 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 your family and your kids, you're careful around drinking, I I've heard as well. So you you practice sort of all this mental fitness yourself, and I think that's you know a great example to to myself and and to to your patients and everyone.

SPEAKER_00 3:07

Now I'm careful, right? I stopped drinking um four, four and a half years ago now. Um, 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 uh drinking a beer occasionally and into hitting that New York drinking scene where it's a really you know a socially acceptable thing. Most people are having several drinks a night, um, or a lot of people are, and um really enjoyed that, enjoyed all the wine and the and the I I feel like I was in New York when like mixology came up and craft brew came up, and that that was all uh really exciting to me. Um, 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 it's uh it's in part just wanting to model that. Right.

SPEAKER_01 4:03

No, I I think well, I appreciate you you sharing your your journey and and just to dive into that that broader journey in general. I know you you grew up in it 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 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.

SPEAKER_00 4:27

Um I I've gotten to work with lots of great people, and psychiatry is an amazing field. Um I think part of that journey is really for me, uh just paying attention to things that really stir me. And so I I think I've had this real blessing of perspective of getting to be in real rural America. I'm really comfortable, like dirty in the woods, uh sleeping on the ground, um farming whenever I don't know, I don't get to do that much, but uh anymore, but you know, digging in the dirt. I dig a great hole. I know I like to rot a tractor. Um, we moved back to my parents' farm uh 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. Um uh I'd spent a few years when I was really young actually in Long Island before my parents moved really rural Indiana. I grew up in Crawford County. If you look at the map, it's right uh right on the border of Kentucky. We call it Kentuckyana, where we're from. And um and uh Carford County is the poorest county in Indiana and one of the greenest. There's this beautiful Hoosion National Forest here, uh, there that I hope anybody listening who can help protect, please do your job. It's some of the oldest trees we have in America, um unfortunately now being cut down. But uh Carford County is uh was great to me, a great place to kind of um and a great place weirdly to launch. Indiana sent me out um into the world. I went to um Erlum College, which is a really kind of very international liberal arts school in Richmond, Indiana. Um, 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 uh working in a clinic, um, and then went on to Indiana University Medical School, which a lot of people don't know. IU is uh now known for football and basketball, but it's also our nation's largest medical school, over 300 physicians every year. And so I was educated really more of American physicians than I think just about any medical school, and it's an amazing place. Uh the Mecca is one of those states where it's really the center. Um and then and then came out to Colombia. I was really fortunate to do adult psychiatry training. I was young, I moved there when I was 26. And um 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. Um, I I think I was the first person from IU to go to Colombia, and you know, it's a very storied institution. It was uh really intimidating to be honest. I'm not like an Ivy League guy, I'm not from that world, um, but they really embraced me and all my energy. And and then the food thing, I just kind of to me came quite naturally. It was in residence, I think it's 2002 that one of the first articles came out looking at um uh a correlation between seafood consumption and the rate of bipolar disorder at a national level, and and found this correlation. And at the same time, those first remember like fish oil was just starting to like be 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 like we tell people to eat salmon? And then I said, wow, there's like more fish oil in this like little salmon steak than there is in all these fish oil pills. And it just, I think uh for me, it it then led to realizing as I sat with patients, I was really early in my private practice and 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 uh second generation antipsych uh 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, you know, kind of look at me like, what do I do? And I didn't really feel equipped. But, you know, we have some training in in nutrition and 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, um, at the APA conference. APA started accepting stuff, you know, um, and then it just kind of snowballed from there.

SPEAKER_01 8:56

You've been a real pioneer. I mean, I think your your books, I mean, I when I was going through training, I mean, maybe we talked about omega-3 fatty acids in in passing. And I'm I think even today there might be one lecture, um, if that, that in most psychiatry residencies, and it's still very under-appreciated, and we don't talk about it enough with our patients, and we need people like you sort of going out there and and spreading the good word that this is really important not just for your physical health, but for your mental health.

SPEAKER_00 9:28

It's interesting that to be in a often in situations where I'm still people are a little surprised and excited, and you know, it's common sense in a certain way that our brain is our most metabolically active organ. You know, all of you listening who are in recovery, you know, 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 it's like what I say, it's like surprising that you see your brain in this state where it really is thinking about that drink at five o'clock to you just don't ever think about alcohol again, like uh someone cast a magic spell on you. And 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 I can do things you know, uh that that boost my brain growth uh 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 a home run last night. And I haven't had a moment to, you know, say, like, wow. And I know that'll make me feel good, right? Just in the sense of uh doing my part of keeping a friendship active.

SPEAKER_01 10:34

So well, that's that's a good jumping off point to your to your latest book. So what is going on with the with the modern brain? Like how uh tell me tell me your take on all these factors that are that are impacting mental fitness and the modern brain these days.

SPEAKER_00 10:47

Oh boy, I just think about all the new words in your field, John. I mean, 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 Kratum and like, you know, Delta VIII. 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 mix. 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, right? What's it like to be a teen in America today when mom and dad are tripping on ayahuasca and then kind of are different when they come back or want you to try it? That that's happening. That's happening in your practice. That's how, you know, we've we've got even here in this little tiny, small Wyoming town, there's some mommies and daddies who kind of come under the spell and and they're guides now. Right. And so people who have real serious mental health problems are going to them. And so there's this real the modern brain is up against that. Obviously, our screens and social media. I talk about this in healing the modern brain, trying in always this book. What I hope to do is create a little bit of a map for everyone. Like in Eat to Beat Depression and Anxiety, there's some literal maps and illustrations of like, hey, this is how depression and anxiety has changed. When you talk to psychiatrists like like John and me, we think about things like inflammation and neuroplasticity and 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. Um, and and then there are these these factors of things that we can do and engage with that that um uh uh 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. And 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 why wouldn't I? Right? Because that's a 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. Or uh, but so when we have control, exerting it and 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 uh 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 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 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 uh, you know, new science, right? The gymphatic system, literally how you drain the waste out of your brain, obviously missing teeth 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 one of those things, kind of late nutrition. I was like, wow, I 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. And I don't I wonder what that looks like, this black sludge is what I've had. And and you got to get it out. All those like amyloid plaques and tau tangles, all that stuff, you get it out of your brain. So obviously, sleeping a little bit more and draining out a little bit more waste it should be really motivating for us. Um, so 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 the disconnection. We're listening to really the data, we're seeing that the the being digitally connected is leading to us being socially disconnected. And and and I think just as importantly as uh um whether you're proximal or next to people, I I think what I've noticed is the way that we're having a hard time in our digital relationships, creating depths, closeness, and intimacy. So that's what we're up against.

SPEAKER_01 15:28

We're up against a lot. And 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 the what you've learned about drinking that made you stop, and then what you recommend for folks, and also sort of those ultra-processed foods that are that are also sort of in the mix in terms of both being addictive and and tanking our mental health.

SPEAKER_00 15:50

So I 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 four hours and at 12 hours, what happens? Our inflammatory factors are our body's natural, amazing, beautiful immune system that when there are alarms, they go off and we respond. You know, and our body gets ready for an attack, a virus, something stressful. Um, 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 is what it sounds like. It's it's 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, they'll start dropping. So now your brain is in this spot again where there's a lot more inflammatory factors, uh 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 um uh entitled non-drinker. Um, you know, I don't want people to think I'm uh entirely sober. Um I engage in bad moods, anger, um, I procrastinate, uh, I've done a ketamine training. Uh you know, I I I um I've gotten really interested in holotropic breed. You know, there are ways that I'm interested in altering my psyche, but but with the alcohol, I think the the notion of one, I looked at my family history and there's just a lot of morbidity, there's a lot of um alcoholism. And uh you just sit with that, even if you're a responsible drinker, you know, I didn't drink in the morning and I never drank at work. And um I I thought about the moments while I was really not feeling well. For me, that was in the morning, and I just I 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 um uh I would feel the specificity of it, that I I didn't want I didn't drink wine, I didn't drink um cocktails, I wasn't interested. There could be a fridge full of beer. I wouldn't touch it. I I was only interested in drinking IPAs. It was like, and and I'd never had anything that I'd always liked to drink, but you know, I was like, what I'd have five, it's kind of whatever. And as it got more dialed in and specific like that, it it just I don't know. I I noticed myself, you know, earlier in the day on a weekend. I noticed and and so I just um and um I think part 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, of just like, man, it's 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 I got I don't know, I just got kind of um exhausted and embarrassed by that. So those were the things that helped me.

SPEAKER_01 18:55

I think um 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 uh 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.

SPEAKER_00 19:19

Oh, it's so much. And then I think when you stop, there are these 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 noticed is after, you know, a 30 days, there was definitely a loss, maybe a two weeks, a loss of that almost like habitual thought about it. But it was really at 90 days when I noticed I I stopped worrying that I was getting subtly demented. And I just felt sharp again, I felt creative again. Um, I felt uh a a little more in touch with my mood, kind of swings in some ways. Um I I think there's just also the way of as you put day after day together, you just 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 uh I also think there's a lot of encouragement of uh I I run a practice, my my clinic is really focused on harm reduction. If I go out and have a beer tonight, I I'm gonna be uh I think curious and maybe a little gr regretful, but I'm I'm gonna think about all of the harm reduction I've done and and want to get back into that stance. And I just think that's a really helpful stance for people. Um, 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. Um and and that was a very helpful mindset for me. And that's very helpful for my patients. If I can go you've you know, help help you go from drinking really aggressively in bingey to having a beer with your buddies when you're you know at a bar only and only having two, uh I think that's amazing.

SPEAKER_01 20:52

So I agree completely. And that's just been been so important. And 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 um 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.

SPEAKER_00 21:15

We get to have a little nutritional psychiatry session with an expert in addiction around uh 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?

SPEAKER_01 21:31

Yeah.

SPEAKER_00 21:31

So it's really interesting to talk to you about that right now. The 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 um, but they uh 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 in 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 freshman 15. Unless you're talking about the 15 amazing nutrient-dense foods that they could eat to help their mental health, like lentils and you know, wild salmon and uh nuts and uh, you know, healthy leafy greens and rainbow vegetables. Um, those 15 are okay. But instead, we we send our kids off with this like, oh, here's awful cafeteria food, you're gonna gain weight and be unhealthy and binge drink, good luck. Right. And I don't think we should be surprised in some ways, and not everybody does that, that uh, but we shouldn't be surprised then when we see uh this is when mental health concerns hit, right? In late adolescence, uh, a lot of times. And so, um, anyway, lots of data about if you 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 percent decreased risk in getting depressed during college. So that's just like really powerful data. Then when you test that in the randomized trials, uh it you know, you take people from ultra-processed foods and put them on a Mediterranean diet, a traditional diet, you see this response, uh, improved response to depression treatment. Um there's uh a few trials now where about one on the 36% of patients, young men, who went from eating lots of ultra-processed foods to eating more plants and more hummus and uh more olive oil. They had a 36% uh of those patients uh 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, um, there's just strong signal when it comes to what should we be 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 and 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 uh in your personhood. Like John, you're from a place, your family's from a place, you have favor foods, not like Chick-fil-A's you're one of them. Uh, right. So right away that begins that 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 an oven roasted like cauliflower or uh broccoli and like uh you know a nice sauce. Uh, is that does that get hit a little sweetness for you or some of the pastas? Yeah, no, that that that scratches an itch for sure. 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 you know 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.

SPEAKER_01 26:03

And I think you have a great rhyme about what we're supposed to eat, right? Tutti, do you mind sharing that? Yeah, your yours is Chick-fil-A, Chick-fil-A, Chick-fil-A.

SPEAKER_00 26:12

More chicken, yeah. Yeah, yours uh uh by little rhyme is seafood greens, nuts and beans, rainbow celebrations, don't forget the fermentations. Uh and that second part is by Catherine Roberts, who's uh run student mental health at Northwestern and was way back in the day my resident. And uh so I'm at the APA conference and added that in. So just to give credit where credit is due. And and everyone, that's because is food. Uh uh, and when I think about food, you might know me from my book, 50 Shades of Kale. If you're in academia, I just a little tip for you don't write a sex book about a vegetable. I just thought you're not it's not gonna do it, it's not gonna do you get teas and it's not gonna do great things for your view, it's not taking seriously after that. You know, everyone laughs. But uh, you know, what we're after there is leafy greens, right? Whether it's microgreens or bok choy or little gem Caesar or little gem lettuce, which I love in the Caesar, um, all of those are nutrient dense. All of those have 20 to 30 cups uh 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, it's 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 three ounces of clams. Holy pasta von Gole. That's all I have to say.

SPEAKER_01 27:44

These are great tips for me. No, I 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 and yours through these nine core tenants really is a nice guide. And 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 that you would recommend, especially as people sort of enter, enter recovery and and try to, you know, change things for the better for themselves?

SPEAKER_00 28:29

John, I mean, I'm absolutely honored to hear that you're using the book. I mean, there's just no greater, uh, 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 rebut is all about organisms in your gut, and and generally eating a lot of different plants and fermented foods is really good for things like your anxiety and your friendships. I mean, it's just this wild um way we have of influencing our uh what regulates inflammation in our body. The first tenet is self-awareness. And self-awareness really, you know, John and I are psychiatrists, and it 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 predator brain sitting with your giant alpha predator brain and and and feeling things. And and so self-awareness is really asking you to honor this just incredible wisdom you have. If you're anxious, yeah, there are 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, you 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. Um, we've got a lot of self-awareness from our work and trying to achieve goals. Um, I love sending people to like intramural sports, which is places where you see yourself in action. And and I always remind people, self-awareness is about being kind to ourselves and curious and aware, you know, because because by being self-aware, you're naturally looking for things that you maybe don't like, like like my drinking and my foamy burps in the morning. I hated that. And I was anxious about it until I changed it. Uh so self-awareness, we talked about nutrition, which is the second tenet, uh, and then movement, you know, in terms of treatment and and people in recovery. Uh boy, you know, just there is no drug like exercise. And that uh it feels great and it takes just a little bit longer than getting high. But I don't know. When I when I get out here and I'm on like a racket in this like super trippy headspace, and I love it, and I'm so grateful for it. So uh movement, we talked about sleep and just again the importance of making your bedroom a sleep sanctuary. I have to like stop being a weenie about sleep hygiene. That's what I tell people. 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 a mess. You you've got like all kinds of artificial uh 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. Um, and everyone, I realize 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. Right of just uh I was just talking to a patient today who's like concerned about how he's a friend as a younger man, and I and I'm so grateful to be in this conversation with him. And um and like, how do we make friends? And I talked about in the book, I talked about the web of connection. You know, there are the institutions. He's gone to some really storied institutions. Like uh, how do you feel connected to those, right? 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. Like, I'm a friendly guy, so I kind of assume uh familiarness and closeness, and I'm kind of like a golden retriever. I used to be, and I've like mellowed an anthrause a little bit, but you know, something I even learned about myself, like less bouncy, talk less, less so you can see I'm struggling with it in those podcasts. I'm so excited to see you talk with you. So, so connection. Um, 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 uh really inspired me to just, you know, relationships are one of our greatest assets and we've got to invest in them. Um uh, you know, I talked in the book Annext 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 um uh uh women, uh, you know, kind of uh talking about wellness and um and sex bots and bro influencers and like none of this stuff, honestly, that I I I want or feels good for me. And and so if I'm in that automatic habit of I wake up and I'm not feeling well and I doom scroll, uh you know, I'm not engaged with what's going on. If I wake up in the middle of the night and I'm not feeling well and I journal about it, which it was a huge discovery for me, I I almost always get to like a line. There was the one the other day, I was like, I I um I can't do it all. I was like the stiffless thing. And I was in work, uh, and then I was in session, I was thinking like, no, but I can do this, and I love doing this. Settled over me. And so uh, you know, that that notion of engagement, um engagement with the self, engagement with your connections, um, and I think particularly engagement with your mind. Uh then um uh we begin to think about some of the other tenants, uh grounding, which you know, being out in Wyoming wasn't uh accident. Um I'm from a very I grew up on 125 acres, and uh I, you know, I'm just very um uh in awe and and and happy out in the wilderness. Um 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.

SPEAKER_01 34:57

And it's another thing, like these these seem sort of like um 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 um 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.

SPEAKER_00 35:18

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 it's one of those things that for me as a clinician, it's like I learned a long time ago, it's like you gotta ask people what their hobbies are.

SPEAKER_01 35:34

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 this other stuff that sometimes gets lost in terms of how we can really, you know, not only get well, but sustain wellness and and really find what this life is all about.

SPEAKER_00 36:00

Yeah, and I think it's what this field has missed, and what psychiatry needs to be really bold and 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, 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. Um 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 now traxone, 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 gonna get better. And that that's just uh that's a hope that I don't think we've had before um in our human history. And it's just really it's great.

SPEAKER_01 37:06

Well, I I I love that and I love you. I feel better equipped to tackle Chick-fil-A and and and everything, man. I really appreciate you taking the time to share all your wisdom with with me with us today. Well, thank you, everybody. 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 positive.