Harvard Doctor Links Rising Psychiatric Illnesses to Cellular Metabolic Failure

哈佛医生将精神疾病发病率上升归因于细胞代谢衰竭 Chris Palmer 博士指出，严重精神障碍根源于线粒体功能障碍而非化学失衡，这使得针对性的饮食调整成为一种可行的治疗途径。 Chris Palmer 博士提出了精神病学领域的一种革新性框架，认为慢性精神障碍在本质上是由线粒体功能障碍驱动、影响大脑的代谢紊乱。结合其个人的童年创伤与数十年在哈佛的临床研究，他指出传统精神科治疗之所以经常失败，是因为忽略了这一根本病因。讨论探讨了超加工食品、环境应激源和创伤如何损害细胞代谢，以及生酮饮食与断食等干预手段如何恢复大脑能量并促使严重精神疾病实现缓解。 传统精神病学疗法面临巨大瓶颈，像 STAR*D 研究显示抗抑郁药等标准方案的长期缓解率仅约 35%，导致部分医疗体系甚至将难治性精神疾病归为绝症或提供协助自杀。 (6:24) 哈佛大学精神病学家 Chris Palmer 指出，慢性精神疾病本质上是大脑代谢障碍，线粒体作为细胞能量、神经递质和基因表达的调控核心，与精神健康密切相关。 (24:05) 急剧上升的精神疾病发病率并非仅由诊断意识提高引起，全美过去20年自杀率上升约 30%，“绝望之死”与急诊室精神科收治量均大幅攀升。 (21:29) 长期未解决的心理创伤会导致身体持续处于高代谢消耗状态，迫使细胞暂停日常维护转入生存模式，进而促发脑细胞功能紊乱并跨入精神疾病范畴。 (47:10) 通过低碳水或生酮饮食等代谢干预手段逆转代谢综合征，不仅能改善身体机能，在临床中甚至帮助患病数十年的难治性精神分裂症患者实现完全缓解并停药。 (69:29)

Harvard psychiatrist Dr. Chris Palmer argues that serious psychiatric disorders are fundamentally metabolic brain disorders driven by mitochondrial dysfunction. Consequently, targeted metabolic interventions—such as medical ketogenic diets and dietary modifications—can treat chronic, treatment-resistant mental illnesses that conventional psychiatric paradigms fail to resolve. Systemic Failures and the Escalating Psychiatric Crisis (11:33) Conventional psychiatric approaches are failing to curb an intensifying global crisis. Dr. Palmer points out that despite advances in pharmacology, the landmark STAR*D trial showed that only 30% of major depression patients achieve remission with a first-line antidepressant, and realistic re-analyses indicate that only 35% achieve lasting remission after four successive treatment levels. For severe conditions such as schizophrenia, standard modern care produces a full recovery rate of just 4%. Meanwhile, U.S. suicide rates have increased roughly 30% over the past two decades, deaths of despair have doubled, and adult bipolar diagnoses have doubled. Dr. Palmer refutes claims that these escalating numbers are merely an artifact of increased diagnostic awareness and reduced stigma, citing observations from veteran educators, overwhelmed emergency departments boarding acutely distressed youth, and extreme public health responses. These include Canada's expansion of assisted dying to individuals with treatment-resistant psychiatric conditions and UK health authorities designating certain severe eating disorders as terminal. Mitochondrial Energetics and the Physiology of Trauma (24:05) Rejecting simple chemical imbalance models, Dr. Palmer frames psychiatric symptoms as manifestations of cerebral metabolic failure. Mitochondria—cellular organelles derived from ancient symbiotic bacteria—generate cellular ATP while actively regulating neurotransmitter synthesis, steroid hormones, gene expression, and inflammatory pathways. Because the brain possesses exceptionally high energy demands, cellular disruptions in nutrient-to-energy conversion quickly trigger clinical psychiatric symptoms, even in lean individuals without systemic conditions like obesity. This metabolic framework also explains how severe psychological trauma manifests as chronic physical illness. An acute survival response floods the body with glucose, cortisol, and adrenaline, triggering hypermetabolism. If stress remains chronic, sustained high cortisol halts cellular maintenance and repair, sequestering messenger RNA into stress granules. Over time, neurons fall into disrepair, causing normal, protective survival reactions to transform into persistent biological disorders characterized by hyper-excitable pathways and unprovoked panic. Ketogenic Therapy and Mitochondrial Brain Repair (74:15) Because food directly governs human metabolism, dietary intervention can alter brain bioenergetics. Dr. Palmer stresses that the ketogenic diet is not a lifestyle fad but a clinical therapy developed over a century ago to treat refractory epilepsy, where it produces major improvements or full remission in two-thirds of treatment-resistant cases. When dietary carbohydrates are severely restricted, the liver converts fat into ketone bodies that cross the blood-brain barrier to fuel struggling neurons, decrease neuroinflammation, alter neurotransmitters, and stimulate mitochondrial repair and biogenesis. Dr. Palmer illustrates this mechanism with the case of Doris, a patient with a 50-year history of treatment-resistant schizophrenia, daily auditory and visual hallucinations, and six suicide attempts. After adopting a ketogenic diet at age 70, her hallucinations cleared within weeks, and her schizophrenia achieved full remission within months. She safely tapered off all psychiatric medications, lost 150 pounds, and lived independently and symptom-free for 15 years until her death at age 85. Parental Metabolic Health and Rising Neurodevelopmental Diagnoses (89:09) Addressing the quadrupling of U.S. autism rates over the past 20 years, Dr. Palmer argues that genetic evolution occurs too slowly to explain the increase, pointing instead to environmental drivers that compromise parental and fetal mitochondrial health. Epidemiological evidence shows that maternal obesity or maternal diabetes independently doubles the risk of an autism spectrum diagnosis in offspring, while the presence of both conditions quadruples the risk; paternal obesity likewise doubles the risk. Dr. Palmer links this vulnerability to the fact that only 7% of the U.S. population maintains optimal metabolic health, with the remaining 93% exhibiting markers of metabolic syndrome. Chronic exposure to ultra-processed foods, environmental toxins like microplastics and PFAS, and maternal gestational infections compounds mitochondrial dysfunction in offspring. For early intervention, Dr. Palmer advocates foundational lifestyle practices: establishing consistent sleep routines, spending time outdoors, avoiding over-the-counter sleep aids or melatonin for children, and eliminating mitochondrial disruptors such as alcohol, cannabis, and CBD in youth. While Dr. Palmer maintains that metabolic interventions can reverse severe conditions, he cautions that there is no universal diet plan and that protocols must be tailored to an individual's metabolic baseline, medications, and symptom severity. Furthermore, aggressive metabolic strategies like fasting carry distinct medical risks for underweight individuals or those with restrictive eating disorders, requiring careful clinical supervision.

哈佛大学精神病学家克里斯·帕尔默（Dr. Chris Palmer）提出，慢性精神障碍在本质上是线粒体功能受损所致的大脑代谢障碍，而非单纯的神经递质失衡。他认为传统精神医学在难治性病症上面临严重的临床瓶颈，而以生酮饮食为核心的代谢干预有望从细胞层面修复脑机能，提供全新的康复路径。 传统诊疗的疗效瓶颈与危机升级 (6:24) 帕尔默指出，精神障碍已成为全球疾病负担和致残的首要因素，但传统药物与心理治疗的疗效存在巨大局限。标志性的STAR*D抑郁症研究表明，一线抗抑郁药的临床缓解率仅约30%，即便经过四种连续方案的强化治疗，长期缓解率也仅在35%左右，且有半数患者因无效中途退出；对于精神分裂症，完全康复率仅有4%。这种疗效停滞迫使部分医疗体系走向极端，例如加拿大自2024年起允许难治性精神疾病患者申请医疗协助死亡（MAID），英国也将部分长期难治的严重进食障碍列为“终末期”。 他反驳了发病率上升仅仅源于“公众意识提高与诊断去污名化”的观点。过去20年间，美国自杀率上升约30%，由自杀、药物过量及酒精中毒引发的“绝望死亡”翻倍，孤独症确诊率也增加了三倍。一线教师与辅导员证实，学生严重行为失控的频次与剧烈程度呈前所未有的暴增，急诊室亦长期滞留大量处于急性精神危机的青少年。这些死亡率和急诊收治等硬性生理数据表明，当前的危机是真实且恶化的系统性生理灾难。 线粒体机制与大脑代谢障碍假说 (24:05) 帕尔默主张将慢性精神疾病重新定义为脑部代谢紊乱。大脑作为高能耗器官，其细胞能量代谢受损会直接表现为抑郁、妄想、幻觉和严重焦虑等精神症状。将神经递质、激素失调、炎症和遗传等传统假说串联起来的核心是线粒体。线粒体不仅负责利用食物与氧气生成ATP能量，在演化上源于内共生细菌并保留独立DNA，还直接调控神经递质合成、类固醇激素产生、炎症反应以及核基因表达。精神疾病的高风险基因本质上大多是影响基础代谢途径和线粒体功能的基因。 外部心理创伤同样会通过生理通路转化为慢性代谢损伤。急性压力会激活交感神经系统并释放皮质醇与肾上腺素，导致血糖飙升以应对危险；但若个体长期处于无法化解的应激状态，机体便会陷入持续的高代谢消耗。在此过程中，细胞会将用于合成新蛋白质和受体的信使RNA隔离至“应激颗粒”内，从而暂停日常的细胞维护与修复。长期的能量匮乏与失修导致脑细胞出现病理异常，使正常的创伤适应反应演变为器质性的精神障碍。 不良饮食与环境毒素削弱代谢防线 (63:54) 根据流行病学数据，全美仅有约7%的人口处于最优代谢健康状态，其余93%均至少带有一项代谢综合征指标。高糖与超加工食品的长期滥用会导致细胞产生过度氧化应激，直接破坏线粒体。研究数据显示，肥胖人群患双相情感障碍的风险高出50%，患抑郁或焦虑的风险高出25%；青春期体重激增使24岁前的抑郁风险增加400%，而儿童在9岁时的胰岛素抵抗更与精神病性高危综合征（精神分裂或双相前兆）风险增加500%密切相关。 针对孤独症与ADHD发病率在20年内剧增的现象，帕尔默强调短期的基因变异无法解释这种爆发，根源在于环境对父母及胚胎代谢健康的损害。数据显示，母亲若肥胖或患糖尿病，子女患孤独症的风险增加1倍；若两者兼备，风险则激增至4倍；父亲肥胖同样使患病风险加倍。超加工食品、微塑料、农药、“永久化学品”（PFAS）对线粒体DNA的破坏，以及孕期母体感染等复合因素，共同构成了神经发育障碍激增的环境驱动力。 生酮疗法机制与临床干预边界 (74:15) 生酮饮食在百年前便被开发用于治疗癫痫，临床证实能使约三分之二的难治性癫痫患者完全缓解或大幅改善发作频率。帕尔默阐明，限制碳水化合物能促使肝脏将脂肪转化为酮体，酮体跨越血脑屏障为神经元供能，可下调神经炎症、调节神经递质并刺激线粒体生物合成与修复。他在临床中救治了一位患病50年、体重达330磅且多次自杀未遂的70岁难治性精神分裂症患者多丽丝（Doris），该患者在采用生酮干预后数周内幻觉显著消退，数月内全面缓解并停用所有精神科药物，保持康复状态长达15年并减重150磅。 然而，帕尔默明确指出不存在通用的饮食处方，干预必须根据个体的基础代谢和病情精准制定。他本人曾通过低碳饮食在3个月内逆转了代谢综合征、慢性抑郁和强迫症，但强调单纯依靠刺激剂（如咖啡因阻断腺苷受体强制供能）或镇静剂仅是调节代谢油门与刹车，过量反致线粒体耗竭。此外，尽管禁食能重置线粒体功能，但对于体重过低、患有限制性进食障碍或癌症恶病质等严重消耗状态的患者属于绝对禁忌，必须在专业医疗严密监护下实施。 帕尔默的研究从线粒体和能量代谢视角重新审视重症精神疾病，为大量被传统医学边缘化或放弃的患者提供了摆脱终身服药和功能退化的新希望。然而，由于长期生活方式与严格饮食方案在人群随机对照试验中存在较高的依从性与伦理实施壁垒，且精神医疗界对营养代谢介入仍存普遍怀疑，基于生物标志物的代谢处方要在主流临床中全面落地，仍需更多系统性的循证医学证据支持。

## Background 该视频由知名访谈频道 The Diary Of A CEO（主持人为 Steven Bartlett）于 2024 年 1 月 25 日发布于 YouTube 平台。节目围绕哈佛大学精神病学家克里斯·帕默博士（Dr. Chris Palmer）的研究展开，深度剖析了饮食、细胞代谢与自闭症、多动症及重度精神障碍之间的惊人联系。 ## TL;DR 访谈打破了传统精神医学局限于“脑内化学物质失衡”的陈旧范式，提出严重精神疾病的本质其实是大脑细胞能量代谢与线粒体功能障碍。帕默医生通过详实的人群流行病学与实验机制指出，现代超加工饮食及父母代谢异常直接推动了自闭症、ADHD 和重度抑郁等精神病理的全球大爆发。依托生酮饮食逆转半个世纪精神分裂症等震撼临床病例，他强调通过营养代谢干预、断食与重建生活节律能有效修复受损的线粒体，为已被医疗系统放弃的难治性患者带来彻底治愈的全新希望。 ## Atmosphere & style 整场对话在压抑肃穆与振奋破局之间穿梭，既有严密硬核的细胞生物学与微观代谢机制拆解，更流淌着极具冲击力的真实生命创伤。帕默医生毫无保留地回忆了陪伴精神失常母亲跌入深渊、自身深陷绝望与自杀泥潭的长年剧痛，将深入骨髓的无助感淬炼为挑战医学僵局的熊熊战火。主持人的提问敏锐克制且饱含同理心，两人在冷静的科学求证与滚烫的情感救赎之间取得精妙平衡，带给听众一种震撼灵魂且充满希望的沉浸式倾听体验。 ## Bulletin - [25:40](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1540s) 精神疾病的本质是大脑代谢功能障碍。哈佛精神病学家帕默博士指出，精神障碍并非单纯的心因性障碍或“化学失衡”，而是脑细胞在利用食物与氧气生成能量时出现故障，其微观病理核心在于线粒体功能受损。 - [14:41](https://www.youtube.com/watch?v=3GVInaBCn_c&t=881s) 传统精神治疗面临疗效停滞，抑郁症真实长期缓解率仅约35%。精神医学规模最大的真实世界研究（STAR*D）复核显示，经历四轮调药后仍有约70%患者未脱离重度抑郁，而严重精神分裂症的长期临床康复率甚至仅有4%。 - [01:29:09](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5349s) 父母代谢异常是子代神经发育障碍激增的关键驱动因素。流行病学数据显示，母亲若同时患有肥胖和糖尿病，其子女患自闭症的风险暴增4倍，证明近20年自闭症与ADHD发病率成倍攀升绝非纯基因遗传所能解释，而是环境与代谢发生巨变的表征。 - [01:09:25](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4165s) 营养代谢干预具备逆转重度慢性精神障碍的潜力。生酮饮食通过提供酮体供能、改善线粒体生物合成并抑制神经炎症，不仅被用于难治性癫痫，更在临床上成功使患病长达53年的重度精神分裂症患者实现彻底完全缓解并逐步停药。 - [50:58](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3058s) 未化解的创伤会通过“超代谢状态”与应激颗粒诱发脑细胞长期失修。急性防御反应若无法关闭，持续升高的皮质醇将迫使mRNA被截留入应激颗粒中，日常修复与维保被强行中断，神经元失修后将直接导致突发性惊恐与广泛的情绪认知失控。 ## Key takeaways - [12:37](https://www.youtube.com/watch?v=3GVInaBCn_c&t=757s) 全球精神健康危机全面爆发，传统治疗手段停滞不前。全球约10亿人受精神障碍困扰，美国自闭症20年翻4倍，成瘾、自杀等“绝望之死”翻倍，而精神药物机制半个世纪未有本质突破。 - [14:41](https://www.youtube.com/watch?v=3GVInaBCn_c&t=881s) STAR*D抑郁症多层级治疗研究揭示抗抑郁药疗效局限。一线用药临床缓解率仅约30%，经历四轮不同方案切换后实际有效缓解率仅约35%，近三分之二患者经历长期治疗后依然重度抑郁。 - [25:40](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1540s) 精神障碍在大脑微观机制上是细胞代谢异常的投射。大脑消耗人体海量能量，当身体代谢受损、无法正常将养分转化为ATP能量时，神经元与胶质细胞便会发生功能失调，进而引发幻觉、抑郁或双相波动。 - [29:09](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1749s) 线粒体是连接神经递质、炎症、激素与心理创伤的核心枢纽。过去精神病学各执一词的碎片化假说在线粒体生物学上实现统合，线粒体调控网络的状态直接决定了个体的心理韧性与应激耐受阈值。 - [34:24](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2064s) 人类基因组中不存在特异性的单一精神病基因。增加双相障碍风险的基因同样会提高精神分裂症、癫痫与自闭症风险，这些高风险基因在底层几乎无一例外地指向调控或损伤细胞代谢与线粒体功能。 - [38:58](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2338s) 创伤反应本是进化赋予的生存机制，但长期未解会导致线粒体“超代谢（hyper-metabolism）”。当外在威胁消退后交感神经防御系统无法关闭时，长期的皮质醇毒性刺激会使细胞能量系统长期超负荷运转。 - [50:58](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3058s) 应激颗粒截留mRNA阻断DNA修护指令，促使神经元陷入病理性失修。为优先供应防御能量，细胞常规维护被旁路截断，长期失修的神经细胞使焦虑通路过度兴奋，导致毫无现实诱因下的严重惊恐发作。 - [56:36](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3396s) 饮食在调控新陈代谢方面拥有最高优先级，却长期被95%的精神科医生忽视。动物实验与大规模流行病学证实，超加工高糖饮食可直接诱导代谢综合征，并稳定引发抑郁与焦虑等大脑功能受损表型。 - [01:07:04](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4024s) 全美仅约7%成年人代谢完全健康，全身代谢异常显著放大神经疾病风险。青春期体重显著增加使24岁前抑郁风险激增400%，9岁时胰岛素抵抗使未来精神分裂症或双相障碍风险增加500%。 - [01:09:25](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4165s) 生酮饮食凭借深厚神经生物学机制创造重度精神分裂症完全缓解奇迹。70岁重度患者多丽丝在执行生酮饮食后数月内症状彻底消失并停用全部药物，健康生活15年未曾复发。 - [01:20:13](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4813s) 生酮饮食与断食的核心机制在于迫使机体发生代谢跃迁并修复线粒体。酮体不仅作为高效脑燃料，更能抑制脑部神经炎症、重塑神经递质平衡，但严重消瘦与厌食症患者严禁盲目尝试断食。 - [01:25:04](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5104s) 咖啡因与外源性物质是代谢运转的“油门与刹车”。咖啡因通过竞争性阻断腺苷受体踩下细胞加速踏板，若超量依赖促兴奋剂强行超负荷运转细胞引擎，将加剧氧化应激并加速线粒体功能衰竭。 - [01:29:09](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5349s) 自闭症与ADHD发生率爆炸式上升的底层根源是环境毒素与父母线粒体受损。母亲或父亲肥胖使患病风险翻倍，双重代谢疾病更使风险增加4倍，受损的生殖细胞线粒体优先打击了对能量最饥渴的大脑器官。 - [01:34:04](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5644s) 儿童早期神经发育异常应优先采取清洁生活干预，坚决摒弃“唯药物至上”思维。严格杜绝外源刺激物，睡前两小时切断电子屏幕，利用熄灯降噪营造无聊氛围来顺应生理节律滑入深度睡眠。 ## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=3GVInaBCn_c&t=0s) 精神疾病危局与代谢科学的破局点 在节目的开篇引子中，哈佛大学精神病学家克里斯·帕默（Dr. Chris Palmer）抛出了一个令人震惊的事实：如果一位女性患有肥胖和糖尿病，她生下自闭症患儿的风险将暴增至常人的四倍。然而，更残酷且鲜为人知的事实正在发生——精神障碍目前已成为全球范围内导致疾病负担和伤残的首要诱因。令人心寒的是，部分国家的政府甚至开始将某些精神疾病定性为“绝症”，并立法允许患者通过医助自杀（安乐死）结束生命。政府之所以选择放行安乐死，其底层逻辑正是因为他们清楚精神科传统疗法的局限：年复一年，现有的治疗方案根本无法拯救这部分极度痛苦的患者。 帕默医生明确指出，绝望绝不是唯一的结局。他自己曾与严重的精神疾病抗争了长达二十年，历经多次自杀未遂，在彻底陷入无望的同时，也对传统精神健康领域的束缚与无能感到出奇愤怒。大众和学界长期忽视的核心，正是“代谢健康”（metabolic health）与细胞内微小结构——线粒体（mitochondria）的科学机制。正是这些微小的细胞工厂，蕴藏着治愈和逆转严重慢性精神疾病的钥匙。正如他所强调的，如果自闭症仅仅是一种由基因决定的疾病，它的发病率绝不可能在短短二十年间翻了四倍；这些冰冷的数据表明，环境与代谢机制正在发生剧烈变化，而人类完全有能力在当下采取行动。 ```mermaid flowchart TD accTitle: 代谢异常与精神健康危机传导路径 accDescr: 展现母体代谢异常、传统精神疗法失效以及转向细胞代谢与线粒体生物学的新路径。 subgraph Crisis["代谢与精神疾病流行现状"] A["母体健康异常<br/>（肥胖 / 糖尿病）"] -->|"患病风险翻 4 倍"| B["自闭症及其他发育神经障碍"] C["全球精神疾病负担剧增"] --> D["传统药物/疗法年复一年失效"] D --> E["极端政策转向：<br/>列为绝症 / 批准医助自杀"] end subgraph Solution["代谢医学破局之道"] F["深入细胞机制：<br/>代谢健康与线粒体生物学"] --> G["修复细胞能量与神经功能"] G --> H["实现严重精神疾病的康复与逆转"] end Crisis -.->|"亟需全新科学范式"| Solution ``` --- ### [01:30](https://www.youtube.com/watch?v=3GVInaBCn_c&t=90s) 频道订阅呼吁与访谈开篇 播客主持人史蒂文·巴特利特（Steven Bartlett）在正式进入长谈前插入了一则简短的数据分享：后台数据显示，该频道有高达 69.9% 的长期观众尚未点击订阅按钮。史蒂文借此向观众诚恳呼吁，订阅不仅能直接帮助节目邀请到更高水准的嘉宾、提升制作规格，更是维系节目品质的基石，他向观众郑重承诺，将用不断进化的内容深度来回报每一份支持。随后镜头切回演播室，史蒂文直言自己在开录前就敏锐地感受到帕默医生身上有一股极具辨识度、无法熄灭的真实使命感，那是一种每天清晨催促他破土而出的原始动力，并顺势将话题引向这股火焰最初被点燃的时刻。 --- ### [02:17](https://www.youtube.com/watch?v=3GVInaBCn_c&t=137s) 母亲的崩溃与破碎的童年记忆 面对主持人的发问，帕默医生坦白，自己对精神疾病的感知最早并非始于医学院的课堂，而是童年时期刻骨铭心的自我异化感。那时没有任何人能诊断或识别他的异样，他只觉得自己格格不入，并因与众不同而遭受孤立与排挤。然而，真正将整个家庭推入深渊的转折点，发生在他大约 12 岁那年。一场波及大家族的惨烈悲剧接踵而至，他的母亲随之经历了严重的“神经崩溃”（nervous breakdown）。这场崩溃起初表现为典型的重度抑郁症，但随后急转直下，迅速演变为伴随强烈自杀倾向的抑郁，最终恶化为彻底的精神病发作，母亲开始产生极度荒谬的妄想。 在当年仅有 12 岁的帕默眼中，精神科医生并没有带来任何治愈的奇迹，他们所做的一切“仅仅是用药物把母亲彻底麻醉”。那些大剂量的精神类药物既没能缓解母亲的妄想与痛苦，也没能换回她的健康。母亲自此跌入长达一生的慢性精神病深渊，生活被彻底摧毁： - 母亲在法律和现实中失去了一切，包括全部 8 个子女的监护权； - 她的个人积蓄被洗劫一空，在法庭上没有争取到任何经济资助或赡养费支持； - 随后的几十年里，她在漫长无望的精神折磨中凄惨度日。 这一幕童年悲剧给年幼的帕默留下了无法磨灭的心灵烙印，也让他第一次亲眼见识到精神疾病究竟能对一个鲜活的生命带来何等彻底的摧毁。 --- ### [04:37](https://www.youtube.com/watch?v=3GVInaBCn_c&t=277s) 绝望中的自救与献给母亲的誓言 家庭的崩塌让帕默自身的精神健康雪上加霜。在高中尚未毕业前，他就被迫离家独立谋生，深陷慢性抑郁症、自杀观念以及强迫症（OCD）的泥潭。在长达二十年的痛苦求索中，现有的精神卫生系统不仅对他毫无帮助，反而常常因不当处置给他带来更多创伤。帕默直言，自己最终决定走进精神医学领域，并不是出于某种学院派的优雅追求，而是怀揣着一股对精神病学界“无能与平庸”的巨大愤怒。他想要彻底弄明白，为什么整个体系在面对如此广泛的人类痛苦时显得如此束手无策。 主持人随后念出了帕默新书《Brain Energy》（脑能量）扉页上的致谢词： > “我当年拯救你脱离精神疾病蹂躏的徒劳尝试，点燃了一团至今仍在燃烧的烈火。对不起，我没能在你离开前及时解开这个谜题。愿你安息。” 这段献给母亲的文字让现场气氛陷入深沉的肃穆。帕默坦言，母亲一生的毁灭正是他战斗至今的终极引擎。世界上还有数以亿计的患者正深陷在与母亲相似的噩梦中，尽管他们病历上的诊断标签各异、表现出的症状千差万别，但生活支离破碎的悲剧本质却完全一致。这些人理应得到更有效、更有尊严的治疗，而不是被动等待终局。 --- ### [06:24](https://www.youtube.com/watch?v=3GVInaBCn_c&t=384s) 医疗系统的全面失败与“绝症”荒谬现状 谈及希望救助的人群画像时，帕默指出，精神医学的诊断分类极其庞杂，现行被奉为“行业圣经”的《精神障碍诊断与统计手册第五版修订版》（DSM-5-TR）中列满了五花八门的概念标签： - 精神分裂症（Schizophrenia） - 双相情感障碍（Bipolar disorder） - 重度抑郁障碍（Major depressive disorder） - 酒精使用障碍（Alcohol use disorder / 酗酒）及其他成瘾行为 - 神经性厌食症（Anorexia nervosa） - 神经发育与退行性病变：自闭症谱系障碍（ASD）、以阿尔茨海默病（Alzheimer's disease）为代表的痴呆症 帕默在此严谨地厘清了自己的立场：他并非全盘否定现代医学的成果。现有药物、心理治疗或电休克疗法（ECT）确实拯救了成千上万人的生命；如果某种常规疗法正在发挥作用，患者绝对应当继续坚持，他无意剥夺任何人的治疗手段。然而，医疗系统极力回避的冰冷现实是：**存在着数量庞大到触目惊心的患者群体，无论他们多么配合医嘱、按时服药、参加心理咨询，病情依旧年复一年地恶化。** 即便是身处全球公认顶尖的精神专科医院（哈佛医学院附属麦克莱恩医院），帕默与同事们每天依然要面对大量穷尽现有手段却毫无起色的疑难病例。更令人警惕的是，这种疗效断层正在催生极具争议的公共政策蜕变： - **加拿大安乐死政策**：加拿大政府原定于 2024 年 3 月推进新规，正式允许仅因“难治性精神疾病”（treatment-resistant mental illness）而痛苦的患者申请医助自杀。政府之所以走入这一步，本质上是因为官僚与医学界默认现行精神治疗方案已无力回天。 - **英国进食障碍定性**：英国部分医疗机构开始将部分长期治疗无效的进食障碍个案打上“绝症”（terminal eating disorders）标签，认为患者历经多年治疗仍未好转便属于不可救药。 帕默痛陈，社会绝不能对这些残酷的现实掩耳盗铃，任由深陷绝望的患者被系统性放弃。 --- ### [11:33](https://www.youtube.com/watch?v=3GVInaBCn_c&t=693s) 绝望中的希望：代谢机制带来的生机 当被主持人问及“如果只能用最核心的一句话，对那些身患严重焦虑、重度抑郁或精神分裂并处于绝望边缘的人说些什么”时，帕默医生给出了坚定的回答： > “如果你已经尝试了各种治疗却毫无起色，请千万不要放弃。希望依然存在。只要你理解背后的科学原理，你实际上完全可以好起来。” 他强调，传统观念习惯于将这些疾病视为不可逆的大脑器质性缺陷或纯粹的基因宿命，但前沿科学正在揭示能量代谢紊乱对脑神经功能的决定性影响。即便患者在传统精神医学的死胡同里撞得头破血流，从代谢与线粒体生物学切入的新范式，依然能够为打破这一僵局提供全新的科学路径与痊愈可能。 ### [12:37](https://www.youtube.com/watch?v=3GVInaBCn_c&t=757s) 精神疾病危机的全面爆发：停滞的疗效与暴增的患病率 克里斯·帕尔默（Chris Palmer）医生纠正了主持人略显乐观的看法。主持人认为精神健康领域在过去 28 年里取得了一定进展，但帕尔默指出，现实不仅没有变好，反而陷入了一场全球性的灾难。精神疾病的患病率正在全球范围内急剧上升，绝非停滞或减少。早在 2019 冠状病毒病疫情爆发之前的 2017 年，全球在单一年份内就有约 10 亿人患有精神障碍或物质滥用障碍，占全球总人口的 13%。而疫情的到来更是雪上加霜，导致各类精神障碍的发病率呈爆发式增长。 在美国，各类诊断标签下的患病人数均呈现惊人的攀升趋势。自闭症（Autism）发病率在过去 20 年间翻了两番（增长了 4 倍）；多动症（ADHD）的诊断率直冲云霄；常被大众归结为“纯遗传”的双相情感障碍（Bipolar Disorder），在成年人中患病率翻了一倍，而在儿童与青少年群体中，这一数字更以千倍百分比（thousandfold percent）指数级飙升。即便是最普通、最普遍的“家常便饭式”重度抑郁症（Major Depressive Disorder），在 2023 年盖洛普（Gallup）年度全美民调中，其当前患病率与终生患病率也双双创下历史最高纪录。 - 全球精神障碍患病规模（2017年）：约 10 亿人受精神健康或成瘾障碍困扰（占人口 13%）。 - 美国自闭症（过去20年）：患病率激增 4 倍（Quadrupled）。 - 美国成人双相情感障碍（过去20年）：患病率翻倍；儿童与青少年群体则呈爆发式增长。 - 抑郁症（2023年盖洛普数据）：全美当前患病率与终生患病率均打破历史极值。 --- ### [14:41](https://www.youtube.com/watch?v=3GVInaBCn_c&t=881s) 现代精神医学治疗的困境与抗抑郁药物的虚假幻象 面对这一场不断恶化的流行病，精神医学界的治疗手段却几乎没有本质突破。尽管临床上陆续出现了氯胺酮（Ketamine）、致幻剂（Psychedelics）、经颅磁刺激（TMS）以及若干新药，但新药物的核心机制依然在重复半个世纪前的老路。制药公司仅仅是在微调已知“勉强凑效”的分子，制造出大同小异的化合物，导致新药依然只是“勉强管用”，对绝大多数患者甚至完全无效。 帕尔默医生援引了精神医学史上针对抑郁症规模最大的真实世界研究（STAR*D 研究）。该研究在全美顶尖学术中心跟踪了超过 4,000 名患者： ```mermaid flowchart TD accTitle: STAR*D 抑郁症多层级治疗缓解率与现实脱落争议 accDescr: 流程图展示了抑郁症患者在第一阶段与第四阶段治疗中的实际缓解比例及学术争议 subgraph Phase1 ["初始抗抑郁治疗 (第一阶段)"] A["4,000+ 名抑郁症患者"] --> B["一线药物治疗"] B --> C["仅约 30% 达到临床缓解"] B --> D["约 70% 仍处于重度抑郁状态"] C -.-> E["缓解者中大量残留低度慢性症状"] end subgraph Phase4 ["经历四轮不同方案切换 (第四阶段)"] F["官方最初公布数据"] --> G["宣称累计缓解率 67%"] H["独立学者与临床复核"] --> I["半数患者因无效中途退出脱落"] H --> J["研究中途修改了临床缓解判定标准"] J --> K["按初始预设标准计算：实际缓解率仅约 35%"] K --> L["约三分之二（近 70%）患者经历四轮治疗后依然重度抑郁"] end ``` 在更严重的精神障碍（如精神分裂症）领域，现实更加严酷。一项涉及 6,000 名精神分裂症患者的大型长期研究表明，在使用目前最顶尖的医疗方案下，最终仅有 **4%** 的患者能够实现“临床康复”——即症状完全消除、具备良好的生活质量，并能重新回归社会工作或求学。帕尔默痛心地指出，这些惨淡的统计数据与 50 年前相比几乎毫无长进。 --- ### [18:59](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1139s) 并非“只是聊得更多”：校园崩溃、急诊危机与绝望之死 针对当前极具代表性的反驳观点——即“精神疾病并未真正增加，只是公众讨论增多、病名被过度标签化和过度诊断”，帕尔默直截了当地斥责这种说法完全是“将头埋进沙子里的鸵鸟行为”。他指出，要看清精神疾病的真实发病率，最简单的办法就是去采访教龄超过 30 年的中小学资深教师或心理辅导员。这些老教师会当面嘲笑这种“认知偏差论”：三十年前的老师绝不可能对在教室里大声尖叫、发脾气、考砸了便自残身体、陷入极度焦虑与绝望的孩子视若无睹；几十年前没有这种现象，并不是老师视而不见，而是如今青少年的神经与情绪系统确实发生了极其可怕的恶化。 这种恶化在急诊室（ER）表现得尤为直观与惨烈。在全美以及大多数西方国家的医院急诊科，青少年自杀未遂、双相情感障碍发作及突发精神病性症状（Psychotic）的送医人数呈雪崩式激增。由于医疗系统缺乏足够的床位和收治资源，无数崩溃的孩子只能被长期安置在急诊通道里，得不到系统性治疗，仅仅被施以大剂量镇静药物，甚至必须被身体束缚（Restrained）在担架病床上，以防他们自伤或逃跑。 更为不可辩驳的铁证来自死亡统计——法医与殡葬人员不会误诊死亡： - **自杀率飙升**：过去 20 年间，全美总自杀率上升了约 30%。 - **“绝望之死”（Deaths of Despair）翻倍**：涵盖自杀、酒精性肝病与药物过量致死在内的复合死亡指标在过去 20 年内**翻了一整倍（增长 100%）**。成瘾与过量吸毒本质上均属于美国精神医学学会《精神障碍诊断与统计手册》（DSM）中的精神疾病范畴。三十年前的人并不是死后没被发现，而是这些因精神痛苦导致的死亡事件在真实世界中成倍激增。 --- ### [24:03](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1443s) 抛弃“化学失衡论”：脑部代谢障碍才是核心根源 面对如此严峻的危机，主持人提出了核心疑问：大众文化、社交媒体上广为流传的“脑内化学物质失衡（Chemical Imbalance）”假说显然过于单薄且难以自圆其说。从自然选择与进化论的角度来看，人类不可能“天生就有缺陷”，必然是现代环境或人类的生活方式出了严重差错。 帕尔默对此深表认同，并引出了他多年研究的核心突破点：人们长期以来忽略了一门关键科学——**代谢（Metabolism）与代谢健康**。他明确断言，绝大多数长期、严重且导致脑功能失调的精神健康问题，本质上既不是纯粹的心因性障碍，也不是单纯的递质失衡，而是**大脑代谢异常所引发的脑部功能失调障碍**。精神与情绪的崩溃，正是大脑能量代谢通路发生系统性病变的直接病理表现。 ### [25:40](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1540s) 精神疾病的本质：大脑的代谢功能障碍 克里斯·帕尔默医生（Dr. Chris Palmer）提出了一个颠覆性的核心观点：几乎所有人对精神疾病都具有易感性，因为从本质上讲，精神疾病就是影响大脑的代谢障碍（metabolic disorders）。当前全球精神疾病发病率呈爆发式飙升，这绝非偶然——它与肥胖、超重、糖尿病以及前驱糖尿病等传统代谢疾病的发病率飙升是完全同步的。大脑本身就是人体耗能极高的大型器官，当全身的代谢环境恶化时，大脑首当其冲。 但这并不意味着肥胖是导致精神疾病的唯一驱动因素。很多人直觉上会问：“你的意思是大家先变胖，随后才患上精神疾病吗？”帕尔默纠正了这种误解。事实往往恰恰相反：许多体型消瘦的人同样存在严重的代谢异常，而在临床上，精神症状往往先于外在的身体代谢问题爆发。精神疾病本身正是大脑代谢失调的直接外在表征。当大脑无法正常摄取和利用能量时，其功能就会紊乱，进而表现为无缘由的持续抑郁、莫名爆发的极度焦虑、精神错乱与幻觉、双相情感障碍的情绪过山车，亦或是饮食失调与物质成瘾。 ### [27:25](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1645s) 用十岁小孩听得懂的语言解释代谢 当主持人史蒂文·巴特利特（Steven Bartlett）请求帕尔默用“讲给十岁小孩听的方式”解释代谢功能障碍时，帕尔默将极其复杂的生物化学归纳为一个极简模型：人体与大脑由数以万亿计的细胞构成，细胞要维持基本运转，最底层的要素就是“食物”与“氧气”。尽管细胞内部还需要维生素、矿物质、激素等各种复杂物质的精密配合，但所谓新陈代谢，其终极定义就是“利用食物和氧气来维持生命”。 代谢过程是将摄入的养分与氧气转化为细胞生存与工作所需的动力（能量）及构建原料。一旦“食物与氧气转化为能量”这一流水线上的任何环节出了差错，细胞就会陷入能量危机并发生功能失常。而当这个故障发生在大脑神经元与胶质细胞中时，大脑就会“短路”。临床上所有被诊断为精神疾病的症状——那些在外界毫无诱因、生活一切平顺的情况下突如其来的崩溃抑郁、恐慌发作或幻听妄想——本质上都是大脑细胞因代谢异常而向外发出的求救信号与功能失灵。 ```mermaid flowchart TD accTitle: 代谢功能障碍导致精神疾病的传导链路 accDescr: 展示食物与氧气如何通过细胞与线粒体转化为能量，代谢受损如何导致大脑细胞功能失调并诱发各种精神症状。 subgraph Input["能量输入与代谢转化"] A["营养物质 (食物)"] --> C["细胞代谢网络 (线粒体)"] B["氧气 (呼吸)"] --> C end subgraph Disruption["代谢失调与功能障碍"] C -->|"正常状态"| D["充足 ATP 能量供给<br/>细胞正常运作"] C -->|"代谢受损 / 线粒体故障"| E["能量匮乏与代谢紊乱<br/>细胞功能失调"] end subgraph BrainManifestation["大脑表征：精神疾病"] E --> F["神经递质 / 激素失衡"] E --> G["无诱因的重度抑郁与焦虑"] E --> H["双相障碍 / 精神错乱与幻觉"] end ``` ### [29:09](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1749s) 串联一切的前沿线索：深藏于细胞内的线粒体 为了探究“能量转换到底在哪里出了问题”，必须将目光聚焦到细胞生物学的前沿盲区——线粒体（mitochondria）。帕尔默指出，线粒体是细胞内将食物和氧气转化为能量与细胞构件的核心反应炉。过去精神病学界各执一词的碎片化理论，诸如“神经递质失衡”、“激素紊乱”、“慢性神经炎症”、“肠道微生物组异常”，乃至“童年创伤与心理应激”，之所以长期无法形成统一模型，正是因为缺失了连接这些孤岛的关键拼图。而深入研究线粒体科学，就能将这一切融会贯通。 线粒体科学甚至能解释极其微妙的个体心理韧性差异：为什么某些人遭遇重大创伤或感情破裂后能迅速自愈，而另一些人却陷在泥潭中彻底无法自拔、久久无法“走出来”？当一个人无法振作、心理防线全面崩溃时，这不仅仅是意志力的问题，更是线粒体能量调节网络发生功能失调（dysregulation）的生物学结果。 - **多系统汇聚的核心枢纽**：神经递质生成、激素平衡调控、大脑与全身的慢性炎症水平、肠道菌群信号反馈，全部与线粒体状态直接相关。 - **心理创伤与生理反应的桥梁**：急性与慢性心理应激会直接改变细胞线粒体的能量产出和形态，降低神经元对环境压力的耐受阈值。 ### [31:53](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1913s) 不仅仅是能量工厂：奇妙的线粒体演化与生物特性 针对线粒体的生理常识，帕尔默纠正了大众的认知局限。虽然教科书常把线粒体简单比喻为“细胞的能量工厂”，称其负责摄取氧气和食物生成三磷酸腺苷（ATP），但它的复杂性远超想象。除极少数特化细胞（如成熟红细胞在发育成熟过程中会脱落抛弃所有线粒体，因而寿命极其短暂且需不断更新）外，人体绝大多数细胞内都散布着成百上千甚至数万个高度动态的线粒体。 从演化生物学来看，现代多细胞生命的起源几乎是一个不可思议的奇迹。数十亿年前，线粒体曾是独立生存的原核细菌；在地球生命史上极具决定性的一刻，另一个单细胞生物将其吞噬（engulfed）。通常情况下被吞噬意味着死亡和消化，但这颗细菌与宿主细胞不仅存活了下来，反而建立起了不可分割的内共生关系。科学界认为这一关键内共生事件在地球漫长的演化史中或许仅仅成功发生过一次，正是这个共生体分化演进出了后世地球上所有肉眼可见的复杂多细胞生命——包括全部植物与动物。直到今天，线粒体在人体细胞内依然展现出独立的生命特征：它们自主分裂、复制、在细胞质中穿梭游弋、相互融合或出芽分离，甚至有策略地围绕在细胞核周围形成特定阵型，直接干预和调控基因的开启与关闭。 ### [34:24](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2064s) 基因、表观遗传与被误解的精神病遗传学 针对“精神疾病是否由基因决定、家族遗传有多大决定权”的疑问，帕尔默给出了客观严谨的解析。精神疾病确实具有家族聚集性，但纯粹的遗传基因并不能解释全部现象。环境因素可以通过表观遗传机制（epigenetic factors）给基因打上标签，像开关一样决定哪些基因被激活、哪些被沉默，而这些表观遗传标记同样可以跨代遗传给后代。 更为颠覆的是，人类基因组中根本不存在某种特定精神障碍的“特异性基因”。医学界从来没有找到过单一的“双相情感障碍基因”或“抑郁症基因”。科学研究发现，那些被证实会增加双相情感障碍发病风险的变异基因，同样也会显著提高精神分裂症、癫痫、孤独症谱系障碍（ASD）和重度抑郁症的发病几率。当遗传学家深入挖掘这些高风险基因背后的统一生物学通路时，惊人的一致性出现了：这些基因绝大多数都在直接调控或破坏代谢过程与线粒体功能。例如数年前针对精神分裂症极其罕见的超高风险致病基因的研究，科学家穷追不舍最终查明，该基因在微观层面破坏的正是线粒体的结构与效能，这构成了导致严重精神障碍的底层发病机制。 ### [36:48](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2208s) 线粒体代谢与无氧糖酵解的边界 为了严密求证代谢的定义，主持人追问：“代谢是否就等于线粒体的工作？”作为严谨的科研工作者，帕尔默指出，人体细胞内至少90%的代谢能量转换发生在线粒体内部，但这并非100%。细胞内还存在一种无须线粒体参与的古老供能机制——糖酵解（glycolysis），它同样能在细胞质中直接生成维持生命机器运转的通用“能量货币”ATP。 ATP负责在细胞各处流动，为受体蛋白的构象改变、离子泵的运转以及整个细胞机器的运转提供燃料。线粒体与糖酵解之间的转换关系在极限运动中体现得尤为直观：当一名马拉松运动员拼尽全力奔跑、最终因极度力竭不得不被迫停下脚步（即常说的“撞墙”崩溃）时，其生理本质正是体内的线粒体供能系统达到了超负荷极值（maxed out）。此时体内的线粒体数量不足或健康度不够，无法继续通过有氧代谢输送足够的能量来支撑肌肉高强度收缩，身体在耗尽线粒体产出后被迫转向效率较低的糖酵解途径，最终导致体能彻底透支而减速力竭。大脑在面临代谢危机时的运转机制，也同样存在这种能量供给脱轨的危机。 ### [38:20](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2300s) 线粒体与新陈代谢的生物学本质 在剧烈运动（如长跑）中，细胞在氧气供应相对不足或线粒体负荷达到极限时，会通过无氧糖酵解产生乳酸（lactic acid / lactate）。跑者血液中积累的高浓度乳酸不仅会导致肌肉酸痛，还会引发一系列生理连锁反应。 ```mermaid flowchart LR accTitle: 新陈代谢与能量转化示意图 accDescr: 展现食物与氧气如何通过细胞质和线粒体转化为生命能量与细胞构件的过程 subgraph Inputs["能量与物质输入"] F["食物营养"] O["氧气"] end subgraph Conversion["转化场所"] CYT["细胞质<br/>(无氧糖酵解/微量产能)"] MIT["线粒体<br/>(核心代谢枢纽)"] end subgraph Outputs["产物与结局"] ATP["能量 (ATP)"] BLD["生物结构构件"] DTH["细胞坏死 / 个体死亡"] end F & O --> CYT CYT --> MIT CYT -.->|"线粒体外微量"| ATP MIT --> ATP & BLD MIT -.->|"功能严重障碍或衰亡"| DTH ``` 从根本上说，新陈代谢是机体将食物和氧气转化为能量（ATP）或构建身体所需分子材料的核心过程。虽然在线粒体外部的细胞质中也能发生小规模的代谢转化（如产生乳酸的反应），但维持生命的核心产能机制完全依赖于线粒体： - 一旦人体绝大多数细胞中的线粒体出现严重功能障碍或死亡，生命活动便无法维系，个体将直接面临死亡，没有任何妥协的余地。 --- ### [38:58](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2338s) 创伤瞬间的生理风暴与急性代谢激活 当遭遇外在创伤性事件（Trauma）或极度压力时，外界事件并非停留在心理表层，而是瞬间穿透生理防线，引发一连串剧烈的生物学震颤。这种生理应激是人类进化而来的生存防御机制，本身并非“大脑故障”或“功能障碍”： - **普遍的急性应激反应**：任何正常人在遭遇创伤的刹那，都会出现恐惧、警觉度飙升（hypervigilance）、战斗或逃跑（fight-or-flight）、僵住（freeze）、甚至屈服/祈求宽恕等本能反应。 - **交感神经系统的暴力激活**：面对生存或安全受威胁的严酷情境，交感神经系统被迅猛唤醒。即使是不威胁肉体生命的“次级创伤”（如股市暴跌导致倾家荡产、社会地位崩塌、感觉自己一文不值并辜负了所有依赖者），也能触发同样的生理机制。 为了在绝境中求生，身体必须在短时间内调动海量能量： - **心率与血糖飙升**：血液循环提速，血糖急剧升高以向肌肉与关键器官输送即时燃料。 - **神经内分泌狂飙**：皮质醇（cortisol）与肾上腺素（adrenaline）如同潮水般席卷全身。 - **微观病理与表观遗传变动**：急性炎症反应（inflammation）同步被点燃，细胞层面发生表观遗传（epigenetic）修饰。 - **高强度的记忆烙印**：大脑在创伤瞬间启动超强记忆编码机制，将该威胁深深硬编码（hardwire）到神经网络中，警告机体：“你绝不能忘记这个威胁，你必须终生记住它，因为这关乎你的生死。” --- ### [44:05](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2645s) 创伤循环、行为模式化与认知重塑 面对威胁时所采取的应对行为，会连同存活的结局一起被大脑视作“有效生存策略”深植体内。如果一个人在某种极端境遇下做出了某种反应并活了下来，大脑便会确立一条默认法则：“当这种情况再次发生时，就照这样做，因为上次这样成功活下来了。” 这种防御循环常在日后的人生中演化为僵化的生活模式： - **小创伤（Small-t trauma）的隐性控制**：以人际交往为例，童年期经历的不安全感可能演变成成年后在亲密关系中反复逃避承诺的固定回路（触发诱因 $\rightarrow$ 产生恐惧 $\rightarrow$ 逃跑/提分手 $\rightarrow$ 结果强化），陷入一次又一次的创伤闭环。 - **超敏化（Hypersensitivity）与错误认知**：由于大脑已被硬编码为“时刻搜寻创伤可能重演的任何线索”，个体往往会过度解读外界细节。例如，伴侣的一个微小失误，就会被本能误判为即将遭到毁灭性背叛。 - **成人的理性反思与模式解耦**：克服这种创伤记忆不需要苛责当年的自己，而是承认“当时的年幼自我已经尽了最大努力保全生命”；随后以当下的成熟与智慧审视现实——当年的应对手段在如今的环境中是否依然是最优解，眼前的伴侣是否真的等同于过去的加害者。 --- ### [47:07](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2827s) 未解创伤、线粒体超代谢与精神疾病的演变 创伤后是否发展为精神疾病，取决于急性应激状态能否顺利关闭并恢复代谢平衡。面对相同的致命威胁，不同的应对结局决定了截然不同的病理走向： | 创伤情境与反应 | 生理与代谢状态 | 心理与病理后果 | |:--- |:--- |:--- | | **成功抵御 / 化解危机**<br/>（如遭遇持刀持枪抢劫，但凭借空手道黑带技能瞬间制服袭击者） | 遭遇威胁时血糖、心率飙升，但事后生理指标迅速回落至稳态基线。 | 体验到自我效能感与掌控感，甚至更加自信并充满自豪，创伤被健康消化，不演变为心理疾患。 | | **未解创伤 / 严重受创**<br/>（如遭遇严重殴打、身受重伤、陷入极端无助与恐慌） | 战斗或逃跑系统**无法关闭**，长期维持在高唤醒或低度慢性唤醒状态。皮质醇持续偏高，线粒体被迫长期高负荷运转，引发**超代谢（hyper-metabolism）**。 | 感到外部世界处处凶险，产生严重失眠；夜间微小的房门响动或梦魇都会诱发惊恐发作，重现恐怖记忆，最终演化为长期的严重焦虑障碍与精神疾病。 | 如果创伤无法得到排解与平复，皮质醇的长期毒性刺激会迫使线粒体处于持续超负荷运转的超代谢状态（hyper-metabolism）。即使患者在意识层面并未主动思考当年的恐怖场景，身体微观层面的应激代谢引擎却始终没有熄火，时刻准备着迎击随时可能降临的毁灭性危险。 ### [50:58](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3058s) 从创伤生存本能到细胞失修：精神疾病是如何发生的 在经历严重创伤后的头一两周内，人体的剧烈反应根本谈不上是一种“功能紊乱”或“大脑出格”，这完全是身体和大脑按照进化程序在精准地执行保护机制。当个体刚刚遭遇致命威胁、生命危在旦夕时，整套生理系统都会被强行推入战斗或逃跑（Fight-or-Flight）的自我防御状态。然而，这种高度警觉的生存特权需要付出极其昂贵的代谢代价。身体将所有可支配的能量倾斜向防御与警觉系统，意味着本该用于细胞日常维护、修补和清理的基础代谢通路被强行旁路和截断。 在细胞生物学层面，这种代谢资源的挤占具有极为具象的表现。细胞内部存在一种被称为“应激颗粒”（Stress Granules）的无膜结构：当细胞遭遇危机时，原本由 DNA 转录出来、用于合成新蛋白质、受体或执行常规清理修复的信使 RNA（mRNA），会被迅速截留并隔离在这些微小的应激颗粒气泡中。换言之，来自 DNA 的修复指令被中途打断，细胞无法开展日常维保。只要身体持续感到威胁，代谢资源就会源源不断地供给给高度警觉的防御机制——随时准备逃跑或反击，绝不敢放松警惕。 如果这种状态持续时间过长或严重程度过高，细胞就会不可避免地陷入“失修状态”（state of disrepair），并开始出现功能障碍。一旦这种情况在大脑神经细胞中蔓延开来，个体就正式跨越了界限——从正常的创伤应激生存反应，跌入病理性的精神疾病。此时，脑细胞因长期失修而失灵：认知与记忆能力大不如前；注意力严重涣散，甚至会被直接贴上注意力缺陷多动障碍（ADHD）的标签；焦虑神经通路更是变得“过度兴奋”（hyperexcitable）。患者可能正悠闲地坐在家中沙发上，脑海里没有半点可怕念头，电视里也没播放任何恐怖画面，却会毫无征兆地被突如其来的惊恐发作（Panic Attack）瞬间淹没。此时的大脑调节机制已然全面失灵，精神障碍便由此确立。 ```mermaid flowchart TD accTitle: 创伤应激向脑细胞功能障碍转化的代谢通路 accDescr: 展示严重创伤如何通过改变能量分配导致应激颗粒形成、细胞失修并最终诱发精神障碍。 subgraph S1["应激与能量转移"] A["严重威胁 / 创伤事件"] --> B["战斗或逃跑反应激活"] B --> C["代谢能量全面倾斜向自我防御"] end subgraph S2["细胞层面停滞"] C --> D["DNA 修复指令受阻"] D --> E["mRNA 被截留入应激颗粒"] E --> F["细胞日常维护与清理停滞"] end subgraph S3["病理质变与精神障碍"] F --> G["神经元陷入长期失修状态"] G --> H["焦虑通路异常超敏 / 认知受损"] H --> I["突发惊恐发作 / 精神疾病确立"] end ``` ### [55:27](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3327s) 细胞修复的希望：打破“终身化学失衡”的神话 面对陷入失修的大脑细胞，最令人振奋的消息在于：这些受损的细胞是完全可以被修复的，患者绝不需要在痛苦中煎熬终生。克里斯·帕尔默博士直言不讳地挑战了当今精神病学界的主流信条。长久以来，医学界习惯向患者灌输这样一套说辞：你患上的是基因决定的“神经递质化学失衡”，这种生理缺陷不可逆转，你唯一的出路就是终身服药控制。 帕尔默博士明确澄清，自己并不反对精神科药物，如果药物能切实帮助患者缓解痛苦、促进康复，理应“百分之百全力支持使用”。然而，医生不能仅仅止步于对症压制，而必须探究更为根本的生理真相——透过代谢与线粒体功能的视角，看清患者大脑和身体深处究竟正在发生什么，唯有如此，才能从根源上激活细胞自愈，帮助患者彻底摆脱疾病的枷锁。 ### [56:36](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3396s) 饮食、代谢与精神健康：被主流医学忽视的真相 当话题转向饮食与心理健康的关系时，帕尔默博士指出，绝大多数人对这两者之间的深刻联系毫无概念。更令人遗憾的是，临床一线高达 95% 的精神科医生甚至认为“饮食能够影响精神疾病”的说法极其荒谬可笑。然而，真正荒谬的恰恰是这种傲慢与无知。 只要愿意深钻现代医学过去一百多年所积累的全部科研成果——从浩瀚的神经影像学数据、遗传学研究，到神经递质、激素调控，再到童年不良经历（ACEs）与创伤研究——把所有碎片拼在一起就会得出一个无可辩驳的核心结论：精神障碍在本质上就是代谢性疾病。而在人类生理学中，没有任何因素对新陈代谢的影响能够超越饮食。饮食不仅在当下全球精神健康危机的爆发中扮演了推波助澜的关键角色，更为无数陷入绝境的患者开辟了一条通往彻底康复的希望之路。 - **主流临床认知断层**：约 95% 的精神卫生专业人员根本不相信食物与严重精神疾病存在因果关联。 - **跨学科科研证据聚合**：神经影像、基因组学、神经内分泌与心理创伤的研究最终在代谢与线粒体机制上彻底合流。 - **临床实践的必然结论**：饮食对代谢的调控作用是无可争议的生理事实，因此也必然是扭转精神疾病的核心抓手。 ### [59:01](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3541s) 个人经历的觉醒：低碳饮食如何治愈了帕尔默博士 作为一名坚守循证医学原则的科学家，帕尔默博士在学术层面对饮食的作用保持着审慎的“可能”表述，但在临床实践与个人生命经历中，他对此有着笃定的确信。在医学院求学以及担任住院医师期间，他长期饱受轻度抑郁症和强迫症（OCD）的折磨。雪上加霜的是，他的身体也亮起了红灯，确诊了严重的代谢综合征：高血压、高胆固醇以及前驱糖尿病。 讽刺的是，当时他并没有严重的体重超标，每周坚持锻炼，并且严格遵从当时医学界奉为圭臬的“健康饮食”指南——低脂饮食。为了省钱，他的食谱中充斥着各类低脂超加工食品，因为社会舆论普遍宣传“只要脂肪含量低就是健康”。结果，他的代谢综合征非但没有好转，反而日趋恶化。绝望之中，帕尔默博士决定彻底改变饮食结构，转而采取严格的低碳水化合物饮食（Low-Carbohydrate Diet）。 奇迹在短短三个月内发生： - **代谢综合征彻底消失**：血压、血糖与血脂指标在极短时间内全部恢复正常。 - **精神状态迎来质的飞跃**：不仅低度抑郁与强迫症状一扫而空，他的精神状态甚至达到了前所未有的巅峰。 - **性格层面的重塑**：他生平第一次体会到真正充满活力、快乐、自信与积极向上的心境，这让他感到难以置信——原来自己的生命底色中竟然也蕴藏着如此强大的正面能量。 ### [01:00:42](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3642s) 超加工食品、线粒体与因人而异的饮食干预 史蒂芬·巴特利特对帕尔默博士的自愈过程进行了提炼：转向天然健康的饮食，本质上是让细胞能量工厂——线粒体——重新恢复了天然正常的生理运转，从而能够合成正确的化学信号并维持大脑的动态平衡。与此同时，现代人日常摄入的大量超加工食品充斥着标签上各种生僻的人工合成化学添加剂，线粒体在进化历史上从未遭遇过这些人工复合物，完全不知如何应对，结果诱发了与严重创伤或恶劣环境应激别无二致的代谢紊乱。 当被问及“如果要让线粒体处于完美状态，具体该吃什么、不该吃什么”时，帕尔默博士特别强调，饮食干预绝不存在“千人一方”（one size fits all）的万能处方。每一套行之有效的营养代谢方案，都必须建立在对个体的心理与代谢现状深度评估的基础之上。 在现场互动中，史蒂芬以自己为例向博士咨询。作为一名曾管理庞大企业、背负数百名员工生计与薪资压力的创业者，史蒂芬坦言自己长期处于一种隐秘而持续的高压之下，偶尔甚至会在毫无征兆或仅仅产生轻微念头时，突然触发类似于战斗或逃跑的躯体焦虑反应。帕尔默博士随即对这种细微的自主神经兴奋展开了进一步的个性化问诊，探究这种焦虑感究竟是源于对现实压力的应激，还是大脑调节网络已经开始出现无端的过度放电。 ### [01:03:50](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3830s) 焦虑的演化适应性与创伤引发的高警觉性 在许多情境下，焦虑并不等同于疾病，而是一种完全“正常且健康”的生理与心理反馈。克里斯·帕尔默（Chris Palmer）医生指出，当你意识到自己正准备做一件极具风险的事情、即将做出某个可能颠覆他人生活或危及自身前途的决定时，感到紧张与焦虑具有高度的演化适应性。它会强迫你停下脚步，重新审视眼前的抉择，而不是盲目自信、轻举妄动。 一个人的过往经历和所受创伤，往往直接塑造了其压力反应的基调与敏感度。对于有创伤史的人而言，身体和大脑牢牢记住了“时刻处于极度警觉（hyper-alert）与高度戒备（hypervigilant）状态”曾经是帮助自己安全生存下来的关键机制。然而，当这种神经警觉系统遭遇不良生理环境的侵蚀时，原本的适应性反应就会演变成病理性的精神障碍。 ```mermaid flowchart TD accTitle: 创伤警觉与代谢恶化的双重叠加 accDescr: 展示个体的创伤历史与长期不良饮食如何共同削弱线粒体功能，导致原本的适应性警觉恶化为精神障碍。 subgraph Psychological ["神经与心理维度"] A["早期创伤与生存压力"] --> B["大脑固化超警觉机制 (Hypervigilance)"] end subgraph Metabolic ["生理与代谢维度"] C["长期摄入超加工垃圾食品"] --> D["线粒体功能受损与代谢综合征"] end B --> E["代谢危机触发临界点"] D --> E E --> F["重度抑郁、广泛性焦虑与精神病态"] ``` ### [01:05:05](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3905s) 超加工食品、代谢紊乱与精神疾病的动物实验依据 当史蒂文·巴特利特（Steven Bartlett）提问，如果一个本身具备某种精神健康易感素质的人，连续十年以加工垃圾食品为主食，是否会直接将自身的线粒体推向全面崩溃，进而大幅提高患上精神疾病的概率？帕尔默医生给出了坚定的肯定回答。尽管从医学伦理出发，科学界绝不可能开展一项让健康人类长期食用垃圾食品直至患病的随机对照试验（RCT），但大规模流行病学队列研究已经给出了极为明确的信号：大量摄入超加工食品的人群，罹患抑郁症、焦虑症等各类精神疾病的风险显著攀升。 在更为精细的实验室动物模型中，因果链条已被毫无争议地证实。研究人员给小鼠和大鼠喂食“致肥胖饮食”（obesogenic diet，通常为高脂肪、高碳水化合物的超加工配方）或模仿人类垃圾食品的“自助餐厅饮食”（cafeteria diet）。这些动物不仅迅速出现肥胖、前驱糖尿病与2型糖尿病，还表现出极其显著的抑郁与焦虑表型。由于动物无法表达注意缺陷多动障碍（ADHD）或精神分裂症的幻觉妄想，抑郁和焦虑行为成为了评估代谢损伤对动物大脑功能打击的核心窗口，其实验结果是“无可辩驳的真实”。 - **动物模型对照**：通过喂食高脂高糖的“自助餐厅饮食”，实验啮齿动物在出现肥胖与代谢综合征的同时，稳定诱发出抑郁与焦虑行为。 - **伦理与研究局限**：人类无法进行致病性饮食随机对照，但人群流行病学关联与动物因果机制形成了严密的相互印证。 ### [01:07:04](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4024s) 惊人的流行病学数据：代谢障碍如何贯穿所有精神病学诊断 史蒂文援引帕尔默医生的著作《大脑能量》（Brain Energy）第四章中的具体数据，探讨代谢与精神障碍之间盘根错节的联系。帕尔默医生进一步补充了更多震撼的临床数字，指出所有精神障碍的背后都存在着一条统一的纽带——代谢，而理解代谢的终极核心就是线粒体。 令人震惊的公共卫生现实在于，全美仅有大约 7% 的成年人不存在任何代谢健康问题，这意味着高达 93% 的美国居民至少表现出代谢综合征的一项生物标志物，包括前驱糖尿病、血脂异常、高血压或腹部脂肪过量堆积。面对庞大的代谢受损人群，帕尔默强调，饮食干预必须成为治疗与康复战略的核心支柱之一，同时需要兼顾睡眠、物质使用及用药史等综合维度。 | 疾病 / 代谢风险指标 | 伴随的神经或精神疾病风险增幅 | |:--- |:--- | | **确诊肥胖** | 双相情感障碍风险增加 **50%**；焦虑或抑郁风险增加 **25%** | | **青春期体重显著增加** | 24岁前罹患抑郁症的概率激增 **400%** | | **9岁时出现胰岛素抵抗** | 未来发展为精神病高危状态（如精神分裂症或双相障碍）的概率增加 **500%** | | **患有任何一种确诊精神障碍** | 晚年罹患阿尔茨海默病的风险增加 **50% 至 2,000%（20倍）** | | **美国成人代谢状况现状** | 仅 **7%** 完全健康；**93%** 至少具有一项代谢综合征指标 | ### [01:09:25](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4165s) 极端的临床奇迹：70岁重度精神分裂症患者多丽丝（Doris）的故事 为了打破大众认为“生活方式和代谢只适用于轻微亚健康，治不了真正重度精神病”的刻板偏见，帕尔默医生分享了一个极端的真人病例。患者名为多丽丝（Doris，在书中为保护隐私化名为米尔德丽德 Mildred，后经本人同意公开真名）。多丽丝童年时期遭受了极为可怕的虐待与创伤，17岁起便每天经历幻觉与妄想，被确诊为重度精神分裂症。在随后的半个世纪里，她尝试了无数抗精神病药物、情绪稳定剂和抗抑郁药，但幻觉从未停止。药物副反应与疾病折磨使她的体重飙升至约 330 磅（约 150 公斤）。 到 70 岁时，多丽丝的人生彻底支离破碎：她拥有法院指定的法定监护人，必须由专业护理人员上门代管财务、代缴账单和采购日用品。在 68 岁到 70 岁短短两年间，她因厌恶自我与生活，实施了至少 6 次自杀未遂并被反复强制收治。转折点发生在 70 岁那年，医生要求她减重并将其推荐到杜克大学（Duke University）的一个减重诊所，而该诊所恰好将生酮饮食（Ketogenic Diet）作为减重工具。多丽丝抱着试一试的心态开始执行生酮饮食，不可思议的转变随之发生： - **2周内**：在体重下降的同时，困扰她 53 年的幻觉与妄想症状出现戏剧性减轻； - **数月内**：精神分裂症的所有临床症状达到完全缓解（complete remission）； - **6个月内**：在医疗监控下逐步减停所有精神类药物，精神分裂症完全没有复发； - **长期转归**：多丽丝彻底告别精神病院与自杀念头，健康地生活了整整 15 年，减掉并维持了 150 磅（约 68 公斤）的体重，直到 85 岁高龄时因感染新冠肺炎（COVID pneumonia）安详离世。 ### [01:14:14](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4454s) 生酮饮食的百年历史与其对大脑和线粒体的生物学重塑 多丽丝的康复并非神秘的个案奇迹，而是深深植根于现代神经生物学机制之中。帕尔默医生解释道，公众常常将生酮饮食误解为一种危险的、容易诱发心脏病的“网红减脂饮食”（fad diet）。然而，生酮饮食实际上在 100 多年前由一名内科医生正式开发，其最初也是唯一的临床目的，就是用于治疗顽固性癫痫发作。过去一个世纪以来，医学界对生酮饮食对中枢神经系统的作用机制进行了极其深入的研究，它至今仍是治疗癫痫的权威循证医学疗法之一。 精神病学临床所开具的处方药中，有很大一部分本质上就是抗癫痫药物（如心境稳定剂丙戊酸钠、拉莫三嗪等），这早已表明癫痫与严重精神障碍在神经元异常兴奋、能量代谢障碍方面存在高度重叠。帕尔默指出，医学界对生酮饮食在大脑生物学层面的了解，远超任何其他饮食模式。它不仅能够重塑神经递质系统的平衡、显著降低脑部神经炎症、正向调节肠道微生物组，还能直接干预表观遗传学层面的基因表达。而最根本、最切中“大脑能量假说”的核心，在于它能从细胞底层显著改善线粒体功能并促进线粒体生物合成。 ### [01:15:52](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4552s) 生酮饮食对大脑与线粒体的深层修复机制 生酮饮食（Ketogenic Diet）并非只是一种权宜之计，长期坚持该饮食可以在细胞层面上真正修复线粒体功能障碍（Mitochondrial Dysfunction）。在癫痫临床医学界，神经科医生使用生酮饮食治疗难治性癫痫时，通常并不需要患者终身坚持，治疗周期一般为两到五年。对于难治性癫痫患者，约有三分之一的人能彻底摆脱癫痫发作，另有三分之一的人发作频率会显著降低。最令人惊叹的是，当患者在两至五年后遵医嘱逐步停止生酮饮食时，癫痫发作大多不会复发，这证明生酮饮食从根本上重塑并治愈了大脑。 关于生酮饮食为何能产生如此神奇的疗效，科学界过去存在诸多猜测。有人认为是因为去除了糖分和麸质（Gluten）这些潜在毒性物质，也有人认为是因为补充了肉类中的维生素 B12 或铁元素。然而，Dr. Chris Palmer 指出，尽管营养缺乏必须纠正，但大多数心理与神经疾病患者并无此类严重缺乏，生酮饮食的核心驱动力在于它迫使大脑与身体的代谢机制发生系统性转移。这种代谢跃迁完全由线粒体主导：饮食迫使肝脏分解脂肪，将脂肪转化为酮体（Ketone Bodies），同时进行糖异生以维持平稳血糖。 酮体随后穿过血脑屏障为脑细胞提供高效能量。但酮体的作用远不止于充当“备用燃料”，它们还能改变线粒体生物学特性、影响表观遗传调控、重塑神经递质平衡并抑制慢性神经炎症。正是这些以线粒体为核心的代谢重塑，最终创造了阻止癫痫发作、消除精神分裂症患者幻觉与妄想的惊人临床奇迹。 ```mermaid flowchart TD accTitle: 生酮饮食驱动的机体代谢与大脑重塑路径 accDescr: 展示限制碳水化合物摄入后，肝脏生成酮体并最终在分子层面上修复线粒体与大脑功能的过程。 subgraph Intake ["饮食干预"] A["极低碳水 / 高脂肪摄入"] end subgraph Metabolism ["外周代谢转换"] B["动员脂肪库"] C["肝脏脂肪酸氧化"] D["生成酮体 (Ketone Bodies)"] E["糖异生维持稳定血糖"] A --> B --> C --> D C --> E end subgraph BrainAction ["中枢机制与功能重塑"] F["酮体穿透血脑屏障供能"] G["修复线粒体呼吸功能"] H["调节神经递质与降低神经炎症"] I["长效逆转癫痫发作 / 消除精神病性症状"] D --> F --> G --> H --> I end ``` - 难治性癫痫对生酮饮食的响应率总计约达 2/3：约 1/3 的患者达到完全无发作（Seizure-free），另有约 1/3 的患者发作频率出现断崖式下降。 - 绝大多数因生酮饮食控制住癫痫的患者，在坚持 2 至 5 年的疗程后停用饮食，疾病仍可长期保持缓解状态。 --- ### [01:20:13](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4813s) 断食疗法、生酮饮食的渊源与临床禁忌 生酮饮食最初被医学界开发出来的初衷，正是为了在进食状态下“模拟断食”（Fasting）。在神经科学史上，医生们早就发现断食对大脑具有极强的镇静与保护效应。Dr. Chris Palmer 打了个极端的比方：如果你和朋友被困荒岛，朋友开始癫痫频繁发作，传统直觉往往是找食物喂他以维持体力，但实际上此时最有效、最能救命的干预手段是让他断食几天，这能迅速终止发作。然而，长期断食有饿死的致命风险，因此百年前的先驱医生设计出了生酮饮食，在提供基础热量与营养的同时，获取长期断食带来的神经生物学益处。 断食与生酮饮食在细胞层面上的机制高度重合：两者均能重塑线粒体生物学、激活细胞自噬、调节神经递质、优化肠道微生态，并显著改善胰岛素信号传导与胰岛素抵抗（Insulin Resistance）。因此，对于绝大多数人而言，间歇性断食对心理健康有明确的正向作用。 然而，断食疗法具有严格的医疗禁忌，绝非人人适用。Dr. Chris Palmer 特别提出两类绝对不应断食的群体： - **严重体重不足与进食障碍患者**：包括患有神经性厌食症（Anorexia Nervosa）、消瘦（Emaciated）或极度体重过低的人群。 - **伴有恶病质消耗的重度疾病患者**：例如因重度抑郁症（Severe Depression）导致食欲不振而急剧消瘦的患者，或因癌症等慢性消耗性疾病出现体重骤降的病患。对这些高危人群而言，盲目断食极其危险；即使尝试模拟断食的生酮治疗，也必须在严密且专业的医疗监护下进行。 --- ### [01:22:52](https://www.youtube.com/watch?v=3GVInaBCn_c&t=4972s) 高糖饮食、氧化应激与代谢健康危机 针对糖分对线粒体与代谢系统的破坏，Dr. Chris Palmer 作出了清晰的风险划分。对于极少数代谢极其健全的人而言，偶尔吃一次甜品或在节日期间摄入较高糖分，身体具备强大的代谢弹性来消化处理，并不会引发病理改变。然而现实情况极度严峻——目前整个人群中仅有约 7% 的人属于“代谢健康”（Metabolically Healthy），绝大多数人的机体代谢系统早已脆弱不堪。 长期高糖摄入会直接损伤线粒体。线粒体在燃烧过量糖分生成能量的过程中，会产生大量副产物——活性氧物质，进而引发**氧化应激**（Oxidative Stress）。氧化应激是数十年来医学界公认的细胞毒性来源。更关键的是，研究表明高水平的氧化应激与几乎所有的代谢紊乱及精神障碍（从抑郁症、双相情感障碍到精神分裂症）高度重叠，它本质上就是线粒体功能受损的直接生化投影。长期过量摄入糖分会导致血糖调节失控，高血糖进一步加速线粒体解偶联与功能退化，将大脑与身体彻底拖入恶性代谢循环。 - 全美乃至现代社会中，仅有约 7% 的人群符合全面的代谢健康指标。 - 氧化应激并非单一疾病的偶发指标，而是跨越代谢疾病与重性精神障碍的核心共同病理机制。 --- ### [01:25:04](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5104s) 咖啡因、腺苷受体与线粒体运转的“油门与刹车” 谈及咖啡因（Caffeine）与各类促充血兴奋剂（如健身 Pre-workout 补充剂），其实际生物学影响需要区别看待。天然的茶和咖啡本身富含多酚等多种对健康有益的植物化合物；而就纯咖啡因分子而言，它通过竞争性阻断细胞上的**腺苷受体**（Adenosine Receptor）来发挥作用。腺苷及其受体系统相当于人体的“天然刹车反馈循环”，主要功能是抑制细胞活性、降低代谢率并诱导困倦。 当咖啡因踩住腺苷这个“刹车片”时，细胞与大脑代谢系统就会被全面加速激活。对于处于脑部代谢低迷、精力涣散、困倦迟钝的人群，适量摄入咖啡因能起到提振能量、恢复清晰思维的积极作用。 但问题的关键在于不能过度刺激。Dr. Chris Palmer 用汽车驾驶作类比：腺苷受体与神经刺激的关系，正如汽车的“油门”与“刹车”。要想让汽车发挥最佳性能并维持长期平顺运转，必须在油门与刹车之间取得精密平衡。如果依赖超大剂量的咖啡因或促兴奋补剂将油门一脚踩到底（"floor the accelerator"），强行超负荷运转细胞引擎，不仅不能持久提供能量，反而会直接加剧氧化应激，甚至加速导致线粒体结构与功能的衰竭。 ### [01:27:10](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5230s) 代谢的油门与刹车：咖啡因与外源性物质的调节机制 克里斯·帕尔默医生（Dr. Chris Palmer）用驾驶汽车做了一个极其生动贴切的比喻：人体的细胞代谢与线粒体系统就像汽车的动力总成，你既不能过度踩踏油门，也不能在油门踩到底的同时猛踩刹车。咖啡因和葡萄糖虽然作用机制截然不同，但本质上都是在给身体“踩油门”，刺激细胞的能量生成。然而，一旦摄入过量，身体就如同开到极速失控的车辆，要么彻底失控撞毁（crash and burn），要么大脑为了自保不得不强行踩死刹车——这种“同时猛踩油门和刹车”的极端代谢拉扯，对细胞和身体造成极大的磨损与伤害。无论是咖啡因、酒精还是大麻，它们在微观层面都在直接干预细胞的线粒体与代谢运作，本质上就是细胞层面的油门与刹车，关键在于掌握分寸，避免矫枉过正。 帕尔默医生坦承自己绝不反对适量使用这些物质，并主动公开了自己的“偏好与习惯”：他每天早晨必定喝咖啡，常规摄入量严格控制在两杯左右。这就是他的身体节律，但他绝不在下午碰任何含咖啡因的饮品，因为他深刻体会到，一旦下午饮用咖啡，就会直接破坏当晚的睡眠结构，进而打乱整个身体的神经代谢平衡。 ### [01:29:09](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5349s) 自闭症与多动症激增的代谢真相：打破纯遗传学神话 主持人史蒂芬·巴特利特（Steven Bartlett）指出，无数焦虑的父母在社交媒体上向他求助，试图理解为什么如今越来越多的孩子被确诊为自闭症（Autism）和注意力缺陷多动障碍（ADHD）。当被问及这些神经发育障碍与代谢之间究竟有何关联时，帕尔默医生斩钉截铁地回答：“关联就是全部（The link is everything）。”早在 1985 年，科学界就首次提出了自闭症的线粒体理论，随后数十年的研究更是爆发式地证实了线粒体功能障碍与自闭症之间的紧密咬合。在美国，过去 20 年间自闭症的确诊率暴增了整整四倍。许多人困惑不解：婴儿出生时甚至还没怎么吃过固体食物，饮食与代谢怎么可能引发自闭症？而且医学界一直宣称自闭症主要由遗传决定。帕尔默医生对此一针见血地反驳：如果一种疾病纯粹由基因决定，发生率绝不可能在短短 20 年内翻四倍，这种爆炸式增长只能说明环境因素在深刻地重塑基因表达与细胞功能。 随后，帕尔默医生列举了一组令人震惊的流行病学代谢数据，揭示父母的代谢状态如何直接投射到下一代的神经发育上： - **母亲肥胖**：生下自闭症患儿的风险直接翻倍（增加 100%）。 - **母亲患有糖尿病**：生下自闭症患儿的风险同样翻倍。 - **母亲同时患有肥胖和糖尿病**：生下自闭症患儿的风险暴增至正常情况的整整四倍。 - **父亲肥胖**：生下自闭症患儿的风险同样翻倍。 帕尔默医生特别强调，列举这些数据绝不是为了进行“肥胖羞辱”（fat shaming），绝不能对肥胖父母指指点点、归咎于他们贪吃。肥胖并非单纯的“卡路里进出”问题，而是身体细胞代谢与线粒体系统已经出现实质性功能障碍的外在病理表现。这种损伤可能由深加工食品中的人造化学添加剂诱发，也可能源自广泛存在的杀虫剂农药、微塑料以及所谓的“永久化学品”（PFAS 等 forever chemicals）。当父母的生殖细胞与机体带着受损的线粒体孕育后代时，这种能量代谢缺陷就会传递给孩子，并优先攻击对能量需求最为严苛的大脑器官。如果在怀孕期间母亲不幸遭受细菌或病毒感染，线粒体面临的代谢风暴会进一步恶化，自闭症风险还将成倍叠加。他极其沉重地指出，新冠大流行带来的感染潮，预示着未来几年儿童神经发育障碍的发生率可能会攀升到更加惊人的地步。 ```mermaid flowchart TD accTitle: 父母代谢异常与儿童自闭症发病机制 accDescr: 展示环境化学物与饮食问题如何通过线粒体损伤传递并导致儿童神经发育障碍 subgraph ENV["环境毒素与现代生活方式"] A["深加工食品与化学添加剂"] B["环境污染物 / 农药 / 微塑料"] C["孕期感染（如流感、新冠病毒）"] end subgraph PARENT["父母机体代谢异常"] D["线粒体功能受损 / 细胞能量代谢障碍"] E["代谢综合征：肥胖 / 糖尿病"] end subgraph CHILD["子代神经发育受损"] F["受损线粒体与代谢缺陷遗传传递"] G["高能量需求脑组织能量代谢不足"] H["自闭症谱系 / ADHD 等神经发育障碍风险暴增"] end A --> D B --> D D --> E E --> F C --> F F --> G G --> H ``` ### [01:34:04](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5644s) 早期生活干预：从拒绝盲目用药到回归无聊 面对这一令人心悸的现状，帕尔默医生给出了充满希望的解药：只要父母及早识别信号并尽早介入，年轻大脑的可塑性完全有机会扭转病局。对于症状初期的儿童或存在早期代谢与心理健康隐患的孩子，第一步永远是精准识别问题根源，第二步则是坚决推行以线粒体健康为核心的“清洁生活干预”（clean living）。 他强烈呼吁家长彻底戒除“用药至上”的思维定势，绝对不要把药丸当成万灵丹。无论是精神类处方药，还是针对失眠滥用的褪黑素（Melatonin）及非处方助眠药，都在强行扭曲儿童尚未发育完全的神经系统。更健康的干预手段应当是系统性地重建家庭生活节律： - **严格剥离外源性精神刺激物**：坚决远离酒精、大麻及各类 CBD 制品。 - **重构数字界限与深度睡眠**：在睡前两小时彻底切断所有电子屏幕，防止蓝光和过度多巴胺刺激破坏睡眠轴。 - **找回现实连结与生活意义**：增加现实中的家庭互动、真实的人际陪伴与情感归属感。 - **善用“无聊”来促进入睡**：全家人一起进入熄灯降噪的晚间休整状态，放下数码产品，给孩子读一本睡前故事，或者做一些平淡枯燥的慢节奏活动。当孩子抱怨“太无聊了、好困啊”时，这正是大脑神经递质与线粒体顺应生理节律、顺利滑入深度睡眠的最佳信号。 ### [01:35:56](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5756s) 赞助商播报：商业拓客与精准睡眠调温工具 在节目的商业赞助插播中，史蒂芬·巴特利特为企业管理者与创业者推荐了 LinkedIn Ads，指出其坐拥全球 10 亿会员、7000 万商业决策者以及 1000 万 C 级高管资源，是自身投资回报率最高的付费社交广告平台，并为听众提供了 100 美元的广告测试抵扣金。紧接着，史蒂芬分享了自己对抗失眠的长期摸索，推荐了睡眠科技品牌 Eight Sleep 的智能温控床垫套（Pod Cover）。该产品能独立调节床垫两侧的温度，根据睡眠监测数据自动调温，帮助其大幅改善了因睡眠匮乏而导致的日间情绪波动与注意力涣散。 ### [01:37:52](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5872s) 痛苦回忆的序曲：与陷入妄想的母亲同住是怎样的绝望？ 广告播报结束后，对话氛围急转直下，重新回到了沉重而私密的情感地带。史蒂芬提及帕尔默医生此前曾讲过的一段刻骨铭心的经历——为了挽救深受严重精神疾患摧残的母亲，年轻的帕尔默毅然搬去与她同住照顾。史蒂芬动容地询问，作为一名深爱着母亲的儿子，目睹至亲完全陷入可怕的“偏执妄想（delusional）”之中，那种精神上的剥离与无力感究竟是怎样的滋味？这与照顾患有阿尔茨海默病（认知障碍症）的长辈相比，又有怎样更撕心裂肺的创伤？如果当时有人站在门外目睹那一切，那个支离破碎的家庭日常到底在经历何等残酷的折磨？ ### [01:38:26](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5906s) 与重度抑郁症母亲同住的童年绝望与情感麻木 当被问及如果能化身一只飞虫窥探他当年的内心会感受到什么时，Chris Palmer 坦言那段经历“简直可怕到了极点”。刚搬去和母亲一起住时，他们手里还有一点积蓄，挤在一栋出租屋（rooming house）里单租房间。但随着钱财耗尽，外界微薄的救济难以为继，母子俩最终沦落街头、无家可归。比物质匮乏更致命的是精神上的折磨：从踏入那个环境的第一天起，与一个身患重度抑郁、伴有严重自杀倾向和精神病性症状（psychotic）的人朝夕相处，那种绝望会像毒气一样渗入骨髓。他形容那就像生活在一团令人窒息的绝望阴云之中，弥漫在空气里，每一次呼吸都沉重不堪。他曾竭尽全力想要逗母亲开心、让她振作起来，但一切尝试都只是徒劳。 在最初的头三四个月里，年幼的 Chris 几乎每天晚上都把脸深深埋进枕头里失声痛哭，竭力不让哭声被母亲听见，因为他不想给母亲增添丝毫负担。然而面对彻底崩塌的生活，他完全不知所措。大约四个月后，某种生理机制仿佛彻底断裂了——他发现自己再也哭不出来了，整个人陷入了完全的情感麻木。由于幼小的心灵根本无法承受这种排山倒海般的痛苦与绝望，潜意识筑起了坚硬的防御，甚至在此后的整整 20 年里，他彻底丧失了流泪的能力。他心中固执地认为“哭泣是软弱的象征，哭泣毫无用处，它根本解决不了任何现实问题”。 更令人心碎的转变发生在一两年之后。刚开始陪伴母亲时，Chris 心中还没有自杀的念头，他拼命想要活下去，唯一的动力就是保住母亲的性命。但长期浸泡在压抑绝望的泥潭中，约一年后，他自己也开始滋生出强烈的自杀意念，并在此后多年饱受折磨。他多次试图结束自己的生命，陷入自残，做出了各种自毁行为。如果当时有人问他，他会百分之百笃定地回答：自己绝对活不过 20 岁，生命已无路可走，活着只剩下无法忍受的痛苦。 ### [01:42:23](https://www.youtube.com/watch?v=3GVInaBCn_c&t=6143s) 上一位嘉宾的提问：你想作为怎样的人被世人铭记？ Steven Bartlett 动情地评价，Chris Palmer 的著作《Brain Energy》（脑能量）之所以极其重要，是因为它不仅充满了勇气，去挑战现有精神病学体系的僵局，更在现代人焦虑、抑郁、强迫症（OCD）与创伤后应激障碍（PTSD）等精神健康危机愈发普遍的当下，开辟出了一条走出绝望的全新出路。随后，Steven 提出了播客的传统保留环节——由上一位不知名嘉宾留给 Chris 的问题：“Chris，你因你的专业研究与工作而闻名，但抛开这些光环，作为一个人本身，你希望因什么而被世人铭记？” 听到这个问题，Chris 略作沉思后给出了发自肺腑的回答。他表示，比起医学上的学术成就，他更希望人们记住他曾是一个彻底放弃过自己的人。他曾经深信自己绝不可能拥有未来，绝不可能过上有意义、哪怕只是差强人意能够忍受的生活。然而，这一切最终都彻底逆转了。他希望自己的经历能成为一记灯标：如果连身陷如此绝境的他都能重获新生，那么任何一个当下正处于同等绝望深渊中的人，也同样拥有走出来的可能。 - **自绝望到新生的心路转折**： - 核心领悟：即使人生跌入谷底、自杀念头如影随形，神经与代谢系统的修复依然能带来彻底重生的契机。 - 传递信念：向深陷精神痛苦的人证明，“绝望并非不可逆转的终局”。 ### [01:44:08](https://www.youtube.com/watch?v=3GVInaBCn_c&t=6248s) 献给母亲的未能如愿之火，拯救了千千万万个家庭 Steven 朗读了 Chris 在《Brain Energy》扉页写给母亲的一段感人至深的献词：“我曾徒劳地试图把你从精神疾病的蹂躏中拯救出来，那份无力感在我心中点燃了一团熊熊烈火，至今仍在燃烧。对不起，我没能在有生之年及时找到答案来挽救你。愿你安息。” Steven 动容地指出，尽管 Chris 没能来得及救回自己的母亲，但他在过去 28 年的临床与医学研究中所倾注的心血、智慧与全部热情，通过这本书和他的代谢精神病学研究，正在挽救成千上万个家庭。那些素未谋面的母亲、父亲、女儿和儿子，正因为 Chris 找到的代谢机理与治疗干预途径而重获健康与团聚。代表无数得到救赎却未曾有机会当面致谢的人们，Steven 向 Chris 表达了最崇高的敬意与感谢。 ```mermaid flowchart TD accTitle: 从童年创伤到医学突破的救赎之路 accDescr: 展示 Chris Palmer 从幼年面对重度精神疾病母亲，到自身经历心理崩溃，最终在科研中找到代谢突破并拯救无数家庭的心理与科研历程。 subgraph Trauma["早年创伤与心理泥潭"] A["目睹母亲重度抑郁与精神失常"] --> B["陷入贫困与无家可归"] B --> C["情感麻木封闭（20年无法哭泣）"] C --> D["自残与强烈自杀意图（笃定活不过20岁）"] end subgraph Mission["科学探索与救赎"] D --> E["执念化为驱动力（28年潜心医学与精神病学研究）"] E --> F["提出《Brain Energy》脑代谢理论"] F --> G["未能挽回母亲的遗憾，转化为挽救千千万万家庭的希望"] end ``` ### [01:45:22](https://www.youtube.com/watch?v=3GVInaBCn_c&t=6322s) 结语与健康生活倡议 在节目的尾声，主持人 Steven 照例分享了健康生活方式的相关建议，并提及了节目长期赞助品牌 Huel 及其新推出的 Daily Greens 蔬果粉产品。他提到，对于维持健康的肠道微生态（gut microbiome）与整体身心健康而言，日常摄入足量的绿色蔬果往往十分困难，而补充这类富含 91 种源自天然食物的维生素、矿物质与营养素的膳食补剂，提供了一种简单高效的补充方式。最后，Steven 引导观众查看简介中的延伸访谈链接，探索更多关于代谢、生活习惯与精神神经科学的深度对谈。 ## Notable quotes > [00:00](https://www.youtube.com/watch?v=3GVInaBCn_c&t=0s) 如果自闭症仅仅是一种由基因决定的疾病，它的发病率绝不可能在短短二十年间翻了四倍；这些冰冷的数据表明，环境与代谢机制正在发生剧烈变化，而人类完全有能力在当下采取行动。 — Chris Palmer > [04:37](https://www.youtube.com/watch?v=3GVInaBCn_c&t=277s) 我当年拯救你脱离精神疾病蹂躏的徒劳尝试，点燃了一团至今仍在燃烧的烈火。对不起，我没能在你离开前及时解开这个谜题。愿你安息。 — Chris Palmer > [06:24](https://www.youtube.com/watch?v=3GVInaBCn_c&t=384s) 存在着数量庞大到触目惊心的患者群体，无论他们多么配合医嘱、按时服药、参加心理咨询，病情依旧年复一年地恶化。 — Chris Palmer > [11:33](https://www.youtube.com/watch?v=3GVInaBCn_c&t=693s) 如果你已经尝试了各种治疗却毫无起色，请千万不要放弃。希望依然存在。只要你理解背后的科学原理，你实际上完全可以好起来。 — Chris Palmer > [24:03](https://www.youtube.com/watch?v=3GVInaBCn_c&t=1443s) 绝大多数长期、严重且导致脑功能失调的精神健康问题，本质上既不是纯粹的心因性障碍，也不是单纯的递质失衡，而是大脑代谢异常所引发的脑部功能失调障碍。 — Chris Palmer > [38:20](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2300s) 一旦人体绝大多数细胞中的线粒体出现严重功能障碍或死亡，生命活动便无法维系，个体将直接面临死亡，没有任何妥协的余地。 — Chris Palmer > [44:05](https://www.youtube.com/watch?v=3GVInaBCn_c&t=2645s) 当这种情况再次发生时，就照这样做，因为上次这样成功活下来了。 — Chris Palmer > [56:36](https://www.youtube.com/watch?v=3GVInaBCn_c&t=3396s) 精神障碍在本质上就是代谢性疾病。而在人类生理学中，没有任何因素对新陈代谢的影响能够超越饮食。 — Chris Palmer > [01:29:09](https://www.youtube.com/watch?v=3GVInaBCn_c&t=5349s) The link is everything — Chris Palmer > [01:42:23](https://www.youtube.com/watch?v=3GVInaBCn_c&t=6143s) 如果连身陷如此绝境的他都能重获新生，那么任何一个当下正处于同等绝望深渊中的人，也同样拥有走出来的可能。 — Chris Palmer ## Mentioned Dr. Chris Palmer, Steven Bartlett, Dr. Aditi Nerurkar, The Diary Of A CEO, Brain Energy, DSM-5-TR, 麦克莱恩医院 (McLean Hospital), STAR*D 研究, Gallup, 杜克大学 (Duke University), Huel, Eight Sleep, LinkedIn Ads ## Video description If enjoyed this episode with Chris Palmer , I recommend you check out my conversation with Dr. Aditi Nerurkar, which you can find here: https://www.youtube.com/watch?v=FN0_ow76hU8 00:00 Intro 02:17 The Painful Reason Why I Became a Psychiatrist 06:24 The Health System Is Failing Us 11:33 Who Are the People You Want to Help? 19:04 Are We Seeing More Mental Health Issues Because It’s Being Spoken About More? 24:05 What's Causing This Mental Health Epidemic? 27:27 The Cutting-Edge Research on the Link Between Metabolism and Mental Health 31:55 How Is the Mitochondria Crucial in Fixing Mental Health Issues? 39:00 How Does the Mitochondria Relate to Trauma? 44:08 What's Happening in Our Bodies When We Experience Trauma? 47:10 How Does a Change in Metabolism Cause a Mental Health Disorder? 56:36 What Role Does Diet Play in Our Mental Health? 01:00:45 The Foods We Should Be Eating for Good Mental Health 01:09:29 A Surprising Case Study From Your Practice 01:17:16 The Benefits of the Keto Diet 01:20:13 How Does Fasting Help Our Mental Health? 01:25:04 Caffeine and the Mitochondria 01:29:09 What's Causing the Rise in Autism and ADHD? 01:37:56 What Was It Like Living With Your Depressed Mum? 01:42:23 The Last Guest's Question Follow Chris: Twitter - https://bit.ly/3Sw7Fqj Instagram - https://bit.ly/47MPuCb You can purchase Chris’s book, ‘Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health’, here: https://amzn.to/3tUyPyQ Get tickets to The Business & Life Speaking Tour: https://stevenbartlett.com/tour/ Follow me: https://beacons.ai/diaryofaceo Sponsors: Huel Greens: https://my.huel.com/DiaryofaCEOJan24 Eightsleep: https://www.eightsleep.com/uk/steven/ CODE: STEVEN (save $150 on the Pod Cover) Linkedin Ads: https://www.linkedin.com/doac24 [Source](https://www.youtube.com/watch?v=3GVInaBCn_c)

[0:00] Chris Palmer: 如果自闭症仅仅是一种由基因决定的疾病，它的发病率绝不可能在短短二十年间翻了四倍；这些冰冷的数据表明，环境与代谢机制正在发生剧烈变化，而人类完全有能力在当下采取行动。 [4:37] Chris Palmer: 我当年拯救你脱离精神疾病蹂躏的徒劳尝试，点燃了一团至今仍在燃烧的烈火。对不起，我没能在你离开前及时解开这个谜题。愿你安息。 [6:24] Chris Palmer: 存在着数量庞大到触目惊心的患者群体，无论他们多么配合医嘱、按时服药、参加心理咨询，病情依旧年复一年地恶化。 [11:33] Chris Palmer: 如果你已经尝试了各种治疗却毫无起色，请千万不要放弃。希望依然存在。只要你理解背后的科学原理，你实际上完全可以好起来。 [24:03] Chris Palmer: 绝大多数长期、严重且导致脑功能失调的精神健康问题，本质上既不是纯粹的心因性障碍，也不是单纯的递质失衡，而是大脑代谢异常所引发的脑部功能失调障碍。 [38:20] Chris Palmer: 一旦人体绝大多数细胞中的线粒体出现严重功能障碍或死亡，生命活动便无法维系，个体将直接面临死亡，没有任何妥协的余地。 [44:05] Chris Palmer: 当这种情况再次发生时，就照这样做，因为上次这样成功活下来了。 [56:36] Chris Palmer: 精神障碍在本质上就是代谢性疾病。而在人类生理学中，没有任何因素对新陈代谢的影响能够超越饮食。 [89:09] Chris Palmer: The link is everything [102:23] Chris Palmer: 如果连身陷如此绝境的他都能重获新生，那么任何一个当下正处于同等绝望深渊中的人，也同样拥有走出来的可能。

[2:17] Dr. Chris Palmer: My futile attempts to save you from the ravages of mental illness lit a fire in me that burns to this day. I'm sorry I didn't figure this out in time to help you. May you rest in peace. [19:04] Dr. Chris Palmer: If you ask school teachers... 'Were you just not recognizing the children 30 years ago who were screaming and tantruming in your classroom?... Did you just have your head in the sand back then?' The school teachers and guidance counselors will laugh at you and say no... Something horrible has happened. [24:05] Dr. Chris Palmer: It's not a coincidence that we're seeing those skyrocketing rates [of mental illness] at the same time that we see skyrocketing rates of obesity, overweight, diabetes, and pre-diabetes. [39:00] Dr. Chris Palmer: When somebody is first traumatized, everybody if they are normal will have symptoms... In my mind, those reactions are not disorders, they are not malfunctioning brains... However, when that happens, it immediately changes your metabolism. [47:10] Dr. Chris Palmer: When that goes on for a prolonged period of time, your cells can fall into a state of disrepair because metabolic resources are not going towards cell maintenance... That's when I would say the person has crossed the line from a normal survival reaction to trauma... into what I would call a mental disorder where their brain is in fact malfunctioning. [74:15] Dr. Chris Palmer: Unbeknownst to most people [85:01] Dr. Chris Palmer: Think about a car: you have an accelerator and a brake. If you're going to maximize the car's function, there's a right balance... You don't want to floor the accelerator, and you don't want to be pushing on the accelerator and the brake at the same time. [100:32] Dr. Chris Palmer: I remember the first three or four months I lived with her, I cried myself to sleep every night—just sobbing into my pillow so that she wouldn't hear me... After about four months, I lost the ability to cry. I became numb... That persisted with me for probably 20 years.

[0:00] if a woman has obesity and diabetes she [0:03] has quadruple the risk of having an [0:06] autistic child but I want to go deeper [0:10] and most people don't know this [0:12] something horrible has happened Dr Chris [0:15] Palmer the Harvard psychiatrist whose [0:17] groundbreaking new research could be the [0:19] missing piece to cure the mental health [0:21] epidemic mental disorders are the [0:23] leading cause of disease and disability [0:26] worldwide governments are actually [0:28] labeling them as terminal illnesses and [0:30] to allow people to die by assisted [0:33] suicide and they're going to allow them [0:34] to die because they know what I'm saying [0:36] is true they know that our treatments [0:39] fail people year after year after year [0:43] and what I'm here to say is you can in [0:45] fact get better how I struggled with [0:48] mental illness myself for 20 years I [0:51] tried to kill myself several times there [0:54] was no hope for me [0:57] whatsoever and I was furious with the [1:01] mental health field for being so [1:03] incompetent and I wanted to try to help [1:06] and the thing that people have not open [1:08] their eyes to is the science of [1:10] metabolic health and there's tiny things [1:12] in our cells that can heal and recover [1:15] people who have had chronic horrible [1:17] mental illnesses really yes and if [1:19] autism is genetic it shouldn't quadruple [1:22] in 20 years these are facts and we can [1:24] do something about it today but the [1:26] easiest way to understand it is that [1:30] quick one this is really really [1:31] fascinating to me on the back end of our [1:33] YouTube channel it says that [1:36] 69.9% of you that watch this channel [1:38] frequently over the lifetime of this [1:40] channel haven't yet hit the Subscribe [1:41] button I just wanted to ask you a favor [1:44] it helps this channel so much if you [1:45] choose to subscribe helps us scale the [1:48] guest helps us scale the production and [1:49] it makes this show bigger so if I could [1:51] ask you for one favor if you've watched [1:53] the show before and you've enjoyed it [1:54] and you like this episode that you're [1:55] currently watching could you please hit [1:57] the Subscribe button thank you so much [1:59] and I will pay that gesture by making [2:01] sure that everything we do here gets [2:03] better and better and better and better [2:04] that is a promise I'm willing to make [2:06] you do we have a [2:07] [Music] [2:13] deal Chris when you [2:15] speak before we started recording you [2:18] speak with a deep authentic sense of [2:24] mission and that underneath there is a [2:28] personal driver that is [2:31] unimat and that is getting you out of [2:33] bed every day because I could see it in [2:35] your eyes I could see it in the way that [2:37] you said the words that you said to me [2:39] where does that drive begin for you what [2:41] was the Catalyst moment in your life [2:43] that inspired you and gave you that fire [2:45] that seems to be unquenchable to pursue [2:48] the path that you've pursued you know I [2:50] struggled with mental illness myself [2:53] starting in [2:55] childhood nobody recognized it nobody [2:58] diagnosed it I didn't know what it was [3:00] nobody knew what it was I just knew I [3:02] was different and [3:04] somehow ostracized for who I was and it [3:08] just felt like part of who I am and then [3:13] a series of horrible tragic events [3:15] happened in my extended [3:18] family when I was about 12 years [3:22] old and my mother ended up having a [3:26] nervous breakdown she called it a [3:29] nervous break break down it started with [3:31] what we would call major depression [3:34] quickly escalated to depression with [3:38] suicidality and then she developed [3:40] psychotic symptoms she became very [3:44] delusional she got mental health [3:47] treatment but the treatment didn't [3:50] work they basically were just kind of in [3:54] my 12-year-old mind the psychiatrists [3:58] were just drugging her [4:01] and those drugs weren't making her [4:03] symptoms better they weren't restoring [4:05] her [4:06] health she went on to live the rest of [4:10] her life with a chronic psychotic [4:12] disorder and that disorder completely [4:15] ruined and devastated her life in so [4:19] many ways she lost everything she lost [4:23] custody of her eight kids she lost all [4:27] of her money everything that courts [4:30] didn't give her any support or any money [4:34] I had my own [4:37] struggles even worse with mental illness [4:41] after all of that I ended up leaving [4:43] home before I finished high school I had [4:45] chronic depression and suicidality and [4:48] OCD and other things and the mental [4:51] health field was worthless for me and [4:54] probably caused a lot of harm for [4:56] me and so the the end of the day the [5:00] reason I'm a [5:01] psychiatrist is because I recognize how [5:04] horrible and [5:06] devastating mental illness can [5:09] be and I came to the field [5:13] really angry with the mental health [5:16] field for being so [5:18] incompetent and I wanted to try to help [5:21] I wanted to try to maybe contribute to [5:23] better solutions for [5:25] people my futile attempts to save you [5:28] from the ravages of mental illness lit a [5:30] fire in me that burns to this day I'm [5:33] sorry I didn't figure this out in time [5:35] to help you may you rest in [5:40] peace that's my mom and that's the [5:44] dedication of the book her story and the [5:49] devastation to her [5:51] life is the thing that drives me to this [5:55] day um and I just know that there are [5:58] hundreds of Millions millions of [6:01] people just like her with different [6:04] diagnoses with different [6:07] symptoms but the devastation to their [6:11] lives is the same and those people [6:14] deserve [6:15] better and I want to help them I want to [6:18] get them better [6:20] treatment those people those people [6:23] exist on some kind of I guess multiple [6:25] different spectrums of disorder what are [6:28] those spectrums of disorder [6:30] and what are what are those disorders [6:31] that you're referring to when you say [6:33] those people are the people that I want [6:34] to [6:35] help people who are diagnosed with a [6:38] mental [6:39] illness and [6:42] so you know the [6:45] diagnoses are all over the map we have [6:49] all of these different diagnoses and the [6:53] DSM [6:55] 5tr the diagnostic and statistical [6:58] Manual of Psych patry which is kind of [7:00] considered the Bible of Psychiatry and [7:03] it has all of these labels in it um [7:06] schizophrenia bipolar disorder major [7:09] depressive [7:11] disorder alcohol use disorder which most [7:14] people know as [7:17] alcoholism other [7:19] addictions uh anorexia [7:22] nervosa but [7:24] also autism autism spectrum disorder or [7:29] dementia that most people know as [7:32] Alzheimer's [7:33] disease that those are all of the labels [7:38] in our um in our kind of Bible of [7:43] Psychiatry and the reality is that when [7:46] you look at the treatment [7:50] outcomes for people who are getting [7:53] treatment for those diagnostic [7:56] labels there is no doubt that our [7:59] treatments do work for a lot of people [8:03] millions of [8:04] people and so millions of people are [8:07] helped their lives can be saved by the [8:10] current treatments that we have and I'm [8:13] not here to take that away from anyone [8:16] so for people who are getting treatment [8:18] and those treatments are working keep [8:20] getting that treatment I don't want to [8:22] interfere with anyone's access to those [8:26] medications or [8:27] psychotherapies or electr convulsive [8:30] therapy or whatever treatment they're [8:31] getting I don't want to stand in the way [8:35] but there are far too many people just [8:37] like my mother who did everything they [8:40] were asked to do who took all of the [8:42] pills who showed up for their therapy [8:44] appointments who did everything they [8:46] were asked to do and they're not getting [8:49] better you know mental disorders as an [8:52] as a whole are now the leading cause of [8:56] disease burden and disability worldwide [9:00] and it's not because those people aren't [9:02] getting treatment many of them are [9:04] getting treatment yes there are people [9:06] who can't afford treatment or can't get [9:08] access to [9:10] care but a lot of people are getting [9:13] treatment I work at one of the best [9:15] psychiatric hospitals in the world I [9:19] have the privilege of doing that and we [9:22] see patients that aren't getting better [9:25] we see them all the time day in and day [9:28] out [9:31] and the crisis the tragedy is that some [9:34] governments are actually now moving to [9:38] labeling mental illnesses as terminal [9:42] illnesses the Canadian [9:45] government in March of [9:47] 2024 is going to allow people to die by [9:51] assisted [9:52] suicide because of a treatment resistant [9:55] mental illness really yes they're going [9:59] to allow them to die and they're going [10:01] to allow them to die because they know [10:03] what I'm saying is true they know that [10:05] our treatments fail people year after [10:08] year after year and those people become [10:11] desperate and [10:13] hopeless and they give up on treatment [10:16] for good reason because they've [10:18] participated in treatment for decades [10:21] and it hasn't helped them and the [10:24] Canadian government has now made the [10:26] decision that they should be allowed to [10:28] die with the help of a [10:30] physician who can prescribe deadly [10:34] medications and make it easy for them to [10:36] die by [10:38] Suicide the UK is now labeling some [10:42] people with eating disorders as terminal [10:45] eating [10:47] disorders and that maybe you know if [10:49] they've exhausted treatment if they've [10:51] had treatment for several years or more [10:53] than a decade well treatment's just not [10:56] going to work for them so let's call [10:58] them terminally ill with an eating [11:03] disorder people are frustrated and [11:06] hopeless again I'm not talking about the [11:10] people for whom treatment's working if [11:12] treatment is working for someone if [11:14] they're taking a pill and it's working [11:16] fantastic you're lucky keep doing it and [11:20] I don't want to interfere with anyone's [11:21] access to that [11:23] treatment but we can't hide from the [11:27] tragic realities of the the [11:30] world for all of those people that are [11:33] they might have extreme anxiety [11:35] depression schizophren osity these [11:36] extreme sort of mental health [11:38] disorders what is it that you want to [11:40] put into their hearts and Minds with [11:43] your work with the message that you're [11:44] spreading what is it that those people [11:46] need to know and I I say that not as all [11:48] of the details which we're going to go [11:50] into but the very Topline message that [11:53] you know maybe in a sentence you want [11:55] those people to [11:56] have if you have been trying treatment [11:59] and those treatments aren't working for [12:01] you please don't give up there is hope [12:05] you can in fact get better if you [12:08] understand the science you can get [12:11] better the mental health conversation [12:15] the uh prevalence of mental [12:19] health lots of these things seem to have [12:21] changed in the last 28 years what is the [12:24] state of mental [12:26] health as we sit here today and how has [12:29] that changed in the 28 years that you've [12:31] been at Harvard and working in this [12:34] field I think I have a slightly [12:37] different perspective yours sounded more [12:39] hopeful than [12:41] mine you kind of said things have [12:43] changed in 28 years and tragically I [12:47] actually feel like they haven't changed [12:49] a whole [12:50] lot if you look at if you look globally [12:54] at the [12:55] problem the problem of mental illness is [12:58] increasing [12:59] it is not stagnant and is not decreasing [13:02] it is increasing in prevalence [13:04] throughout the [13:05] world prior to the pandemic about 1 [13:08] billion people had a mental or substance [13:11] use disorder representing about 133% of [13:14] the world's population and that was just [13:17] in one given year [13:20] 2017 the pandemic added insult to injury [13:24] and rates are much higher now and the [13:27] rates of mental illness have been in [13:28] increasing across a wide range of [13:30] diagnostic categories rates of autism in [13:34] the United States over the last 20 years [13:37] have [13:39] quadrupled a four-fold increase rates of [13:43] ADHD are up and through the roof rates [13:47] of bipolar disorder in adults a lot of [13:50] people think bipolar disorder that's [13:52] genetic well in adults in the United [13:55] States over the last 20 years rates have [13:57] doubled in children and Adolescence [14:00] rates are through the roof up [14:02] exponentially thousandfold percent rates [14:06] of plain old bread and butter depression [14:09] major depressive [14:12] disorder the Gallup pole does an annual [14:15] survey in the United States of current [14:18] and lifetime prevalence of depression [14:21] and just this year in [14:23] 2023 rates of both both current [14:27] prevalence and lifetime prevalence [14:28] reached alltime ever recorded highs so [14:32] we have a catastrophe we have an [14:36] epidemic mental illness is a growing [14:39] escalating [14:41] problem and I wish that I could say our [14:44] treatments were dramatically better [14:47] there is no doubt we do have new [14:50] treatment options we have ketamine and [14:53] psychedelics we've got transcranial [14:56] magnetic stimulation which wasn't around [14:58] when I first [15:00] started we have some new [15:03] medications but the real answer is the [15:05] medications that we have are no better [15:07] than the old medications because they're [15:10] all based on the same [15:13] mechanisms so companies are simply [15:16] repeating what we already know kind of [15:19] sort of works and they're just making [15:22] new molecules that kind of sort of do [15:24] the same thing and so they still just [15:27] kind of sort of work they don't work for [15:30] everyone and they even fail to work for [15:33] most people in the largest study ever [15:37] done of [15:38] depression when people come in the very [15:42] first anti-depressant treatment they get [15:44] over 4,000 people treated at the best [15:46] academic centers that we have in the [15:49] United [15:50] States the first antidepressant [15:53] treatment only about 30% get a [15:56] remission that means 70% % still have [16:00] major depressive disorder they have [16:02] enough symptoms to still be labeled [16:05] clinically [16:07] depressed even if the pill helped them a [16:09] little bit it didn't help them enough to [16:12] make their symptoms enough of their [16:14] symptoms go away now even those 30% who [16:17] got a remission many of them are still [16:20] having low-grade symptoms like all of [16:22] their symptoms didn't go away and after [16:26] four levels of treatment [16:29] the original published report said that [16:33] 67% got a remission after four different [16:36] types of treatment for major depressive [16:40] disorder if we take that at face value [16:44] that means onethird of patients are [16:46] still clinically depressed after four [16:50] levels of [16:52] treatment other researchers have [16:54] challenged that 67% figure because the [16:57] reality is half of the people in that [16:59] study dropped out because it just wasn't [17:02] working out for them so we got a problem [17:06] there like this this protocol clearly [17:08] isn't working out well for people when [17:10] half of the people are dropping out of [17:12] your [17:12] study and the second problem is that [17:16] there are some researchers who point out [17:19] that they changed the criteria for [17:23] remission during the study they [17:27] prospectively said they were going to [17:29] Define remission in a very certain way [17:32] using certain [17:35] metrics those researchers said if they [17:39] stuck to their [17:40] protocol only about 35% got a remission [17:45] after four treatment [17:48] levels that would mean two-thirds of [17:50] people after getting four levels of [17:53] treatment are still clinically [17:56] depressed and that is the current state [17:59] of affairs for [18:01] depression something that we all know [18:04] something that we've got so many [18:05] treatments for if we look at more quote [18:09] unquote serious mental disorders like [18:11] bipolar disorder and [18:13] schizophrenia the results are [18:16] abysmal the one large study of 6,000 [18:20] patients with [18:22] schizophrenia only 4% of the patients [18:26] got a recovery meaning that their [18:29] symptomss were in full and complete [18:32] remission they were they had a decent [18:34] quality of life and that they were able [18:36] to function in the world they were able [18:39] to have a job or go to school only 4% of [18:43] people with schizophrenia got that using [18:47] our best treatments available [18:51] today those statistics aren't a lot [18:54] better than they [18:55] were 50 years ago tra [18:59] magically Chris when people say to you [19:01] or when people say the quite common [19:03] rebuttal that the reason we're seeing [19:05] this rise in mental health disorders is [19:07] just because there's more of a [19:08] conversation about it so more people are [19:09] stepping forward we now have a word for [19:11] it so there's just more labeling and [19:14] these mental health disorders like the [19:15] ones you've named and even things like [19:17] ADHD and autism um it's just because [19:20] there's more conversation going on and [19:22] these things aren't in fact [19:24] increasing that is a common argument and [19:30] I would [19:32] argue [19:33] that it's like just putting your head in [19:36] the [19:37] sand the easiest place to get an [19:40] accurate [19:42] read on the true prevalence of mental [19:47] illness and not just the recognition of [19:50] it but the true prevalence of it is to [19:53] talk to school teachers who've been [19:55] teaching for more than 30 years if you [19:58] ask [20:00] them were you just not recognizing the [20:03] children 30 years ago who are screaming [20:06] and tantruming in your classroom were [20:09] you just not recognizing the children [20:13] who were melting down when they got bad [20:15] grades and injuring themselves in class [20:19] were you just not recognizing the level [20:21] of Despair that you and anxiety that you [20:25] see in [20:26] children did you just have your head in [20:28] the sand back then and now since [20:31] everybody's talking about it you see [20:32] those behaviors you see those symptoms [20:35] the school teachers and the guidance [20:37] counselors will laugh at you and say no [20:41] no [20:42] no something has [20:45] happened something horrible has [20:50] happened I wasn't ignoring mental health [20:53] 30 years ago I wasn't ignoring despair [20:57] 30 years years ago I wasn't ignoring [20:59] extremee anxiety and panic I wasn't [21:02] ignoring Tantrums in my classroom 30 [21:04] years [21:06] ago they are skyrocketing in [21:10] prevalence if we look at emergency [21:13] rooms so emergency rooms in the United [21:17] States that's I can speak best about [21:20] statistics here in the United [21:22] States um but I think in most Western [21:26] countries these statistics [21:29] are similar we have a [21:31] crisis in mental health in emergency [21:35] rooms in particular youth mental health [21:38] but it's across the board we have all of [21:41] these children and adolescents showing [21:44] up to emergency rooms having attempted [21:47] suicide or they're becoming [21:50] psychotic and they're diagnosed with [21:52] bipolar [21:54] disorder at skyrocketing [21:57] rates [21:58] and and we don't have enough services to [22:01] treat these people these kids these [22:04] adolescents our children we don't have [22:07] places to put them so they sit in [22:10] emergency rooms not getting Optimal Care [22:14] simply getting medicated sometimes [22:16] restrained to a hospital gurnie so that [22:19] they don't try to run away or hurt [22:23] themselves talk to anybody in an [22:26] emergency room we're see [22:28] that those people weren't hiding in [22:31] their [22:32] homes 30 years [22:34] ago something's [22:37] happening they are actively acting on [22:41] mental health symptoms they are acting [22:44] out of [22:45] Despair the suicide rate has gone up if [22:50] you in the United States or the last 20 [22:52] years total suicide rate has gone up by [22:55] about [22:56] 30% but if you look at a different [22:59] statistic called deaths of [23:03] Despair it has doubled in 20 years [23:07] deaths of Despair includes not only [23:10] suicides but also deaths from alcohol [23:13] use drug overdoses and others those are [23:17] mental health problems those are [23:19] addictions they are mental health [23:22] disorders they are in [23:25] DSM rates have doubled [23:28] in 20 years people weren't dying 30 [23:32] years ago and we just didn't recognize [23:34] it and now we're recognizing death now [23:38] we're recognizing suicide we didn't [23:40] really recognize it 30 years ago but now [23:42] we recogniz no no no we we know we know [23:46] what death is morticians know how to [23:49] recognize it and diagnose it and the [23:52] rates are skyrocketing a doubling in 20 [23:56] years that is nothing to [24:01] ignore that begs the [24:03] question what do you believe is causing [24:05] it because clearly you know when I've [24:08] heard people when I say people I mean [24:10] just the you know the things you see in [24:12] culture and media or maybe on Instagram [24:14] that say you know there's a chemical [24:16] imbalance in people's brains I've always [24:18] struggled with that I understand there [24:19] might be sometimes but I've struggled [24:20] with that as a broad answer to a very [24:23] complicated Nuance set of issues because [24:25] I just have a a bias to believing that [24:27] hum aren't born broken you know I [24:29] believe that you know my ancestors go [24:32] back very I've got a lot of ancestors [24:34] that um I understand how natural you [24:37] know natural selection and evolution [24:39] works I don't think that I was born [24:41] broken so I think maybe there's an [24:42] environmental factor maybe something I'm [24:44] I'm doing or something we're doing as a [24:46] society is increasing these rates of [24:47] suicidality that you talk [24:49] about what you believe is the answer [24:51] that we're missing or not talking about [24:54] enough the root causes which we can can [24:58] get to and and I have lots of ideas and [25:01] thoughts on it if you want to get into [25:02] the weeds of like what are the exact [25:04] causes we can talk about that but the [25:08] thing that people have not opened their [25:10] eyes [25:11] to is the science of what we call [25:15] metabolism or metabolic [25:18] health and what I ultimately am arguing [25:21] the easiest way for me to put it is that [25:24] what I'm arguing is that mental health [25:27] condition The Chronic serious ones in [25:30] which the brain isn't functioning [25:34] properly brain disorders that are [25:36] causing mental health symptoms those are [25:38] the things I'm talking about now that [25:40] we're all susceptible to you believe I [25:42] think we're all susceptible to it those [25:45] in fact are metabolic disorders [25:48] affecting the [25:50] brain and so the easiest way to [25:52] understand why do we see skyrocketing [25:54] rates of mental illness [25:58] it's not a [26:00] coincidence that we're seeing those [26:02] skyrocketing rates at the same time that [26:04] we see skyrocketing rates of obesity [26:08] overweight diabetes and pre-diabetes [26:11] which are also [26:13] metabolic [26:15] conditions that all of those things are [26:18] rising [26:20] simultaneously and that the brain is an [26:23] organ and so some people can have [26:26] metabolic problems [26:28] and some people can be thin and still [26:31] have a metabolic problem so it's I'm not [26:35] at all saying that obesity is the only [26:38] driver because a lot of times people [26:40] think about it in that way so are you [26:41] saying obesity comes first and then [26:43] everybody gets a mental illness no I'm [26:44] not saying it that way sometimes the [26:47] mental illness starts [26:49] first because it's a manifestation of [26:52] metabolic dysfunction in the [26:54] brain and it basically means the brain [26:57] isn't working working right and so [26:58] somebody might have unrelenting [27:01] depression or unexplainable anxiety or [27:05] psychotic symptoms or bipolar symptoms [27:09] or eating disorder symptoms or substance [27:12] use disorder [27:14] symptoms that they may [27:17] have symptoms but all of those things [27:20] are a manifestation of metabolic [27:22] dysfunction in the brain can you explain [27:25] metabolic dysfunction to me like I'm a [27:27] 10-year-old [27:28] the easiest way to explain it is that [27:31] our bodies and our brains are made up of [27:34] cells and all of our cells need two [27:38] essential things to function properly [27:42] they need food [27:44] oxygen those are the big ones that most [27:46] people know it gets more much more [27:49] complicated fast because food contains [27:51] all sorts of nutrients so we need [27:53] certain vitamins and nutrients and [27:55] hormones are playing a role all sorts of [27:56] things are playing a role [27:58] but at the end of the day that's what [28:00] metabolism is metabolism is taking food [28:02] and oxygen and keeping us [28:05] alive they are [28:07] fundamental to our health but also the [28:11] function of our cells and when something [28:15] goes wrong in that process and there are [28:18] lots of things that can go [28:20] wrong when something goes wrong with [28:22] taking food and oxygen and turning it [28:25] into [28:26] energy [28:28] the cell can [28:31] malfunction and when it happens in your [28:33] brain it means that your brain can [28:37] malfunction and the way that we know the [28:39] brain is [28:40] malfunctioning are all of the symptoms [28:43] of mental [28:44] illness when [28:46] somebody has depression for no good [28:50] reason when somebody has anxiety for no [28:54] good [28:55] reason when somebody [28:58] just has experiences like hallucinations [29:01] or delusions for no good reason that all [29:05] of those things represent the brain [29:07] malfunctioning if you could take me one [29:09] step deeper into this idea of you know [29:11] food and oxygen being converted into [29:14] energy in the cell um something goes [29:18] wrong [29:19] there what goes wrong why does it go [29:23] wrong so the real answer is it's [29:26] extraordinarily comp licated there are [29:28] many Pathways in metabolism there are [29:30] many things that play a role but the [29:33] easiest way to understand it and the way [29:35] to unify it the helpful insight the [29:39] immensely helpful [29:41] insight and this is new Cutting Edge [29:45] information most people don't know [29:51] this but there are these tiny things in [29:53] our cells called [29:56] mitochondria and [29:57] they are actually the primary sites in [30:02] our cells that food and oxygen are [30:06] getting converted into energy or [30:09] building blocks for our [30:11] cells when you do a deep dive into the [30:14] science of [30:16] mitochondria you can actually begin to [30:21] understand what's happening in the [30:23] brains and bodies of people with mental [30:26] illness [30:27] and you can begin to understand all of [30:29] these very complicated things like why [30:32] would neurotransmitters become [30:35] imbalanced that's what what's causing a [30:37] neurotransmitter imbalance if there even [30:40] is one what's causing a hormone [30:43] imbalance what's causing higher levels [30:45] of inflammation in the brains and bodies [30:48] of people with metabolic and mental [30:51] disorders um what about the gut [30:53] microbiome how does that play a role but [30:57] what about stress and Trauma [31:01] psychological stress trauma how do those [31:05] things fit [31:07] in mitochondria are actually the [31:10] scientific way to begin to connect all [31:14] of those dots and help us [31:17] understand why the brains of some people [31:21] quote unquote malfunction or why they [31:24] are [31:25] disregulated might be a better way to [31:28] put it or why some people can't seem to [31:32] quote unquote get over it get over a [31:35] trauma or get over a breakup with [31:37] someone what's going on why aren't they [31:40] more resilient why can't they pull it [31:43] together mitochondrial dysfunction as [31:47] nerdy and sciency as that is can help us [31:51] connect the dots what do I need to know [31:53] about the mitochondria what it is I know [31:55] it's in every cell in my body um is is [31:57] there anything else I need to know about [31:58] it before we explore these through lines [32:01] and how all these other things come back [32:02] and connect to the [32:04] mitochondria so mitochondria are present [32:07] in most cells in the body not not every [32:10] single human the the glaring example are [32:13] red blood cells which actually lose [32:15] their mitochondria they have them when [32:17] they are first forming but then they [32:19] lose their mitochondria so red blood [32:21] cells interestingly don't live all that [32:23] long um we're constantly creating new [32:25] ones and turning them over so most [32:27] people know mitochondria as the [32:29] PowerHouse of the cell which means they [32:31] take food and oxygen and turn it into [32:33] ATP and that's what most people learn in [32:35] school they're the PowerHouse of the [32:37] cell but I'm here to tell you they are [32:39] so so much more than that there are [32:42] hundreds or thousands of them in most [32:45] cells they are highly [32:49] Dynamic at one point you know the the [32:52] theory of [32:54] multicellular life on planet [32:58] Earth is that mitochondria were once [33:01] Independent Living [33:05] bacteria and that another single cell [33:08] organism engulfed that very first [33:13] bacterium and the two of [33:16] those organisms lived they stayed alive [33:19] usually when you get engulfed by another [33:21] organism that means getting eaten and [33:24] you you die for whatever reason [33:27] these two stayed alive and they became [33:30] symbiotic with each [33:32] other and actually that event is thought [33:37] to maybe have only happened [33:39] once on Earth and that single [33:44] organism evolved into all multicellular [33:47] life that we know today so all living [33:50] organisms that we can see with our eyes [33:53] plants all animals are [33:57] evolved from that same organism so [34:02] mitochondria divide and replicate they [34:05] actually move around cells they fuse [34:08] with each other they Bud off from each [34:10] other they they form patterns around the [34:15] nucle cell nucleus which plays a role in [34:19] which genes get expressed or don't get [34:21] expressed they do all sorts of things [34:24] when people say that we have a [34:26] predisposition a genetic predisposition [34:28] to mental health disorders and that you [34:30] know you'll have depression if [34:31] depression runs in your family Etc is [34:33] there Merit in that in your view is [34:35] there evidence to support that [34:37] absolutely so we know that we know that [34:39] mental illness runs in [34:41] families genes explain some of that but [34:45] not all of that the environment actually [34:49] can influence things called epigenetic [34:53] factors which are factors [34:58] that control the expression of genes [35:01] they turn genes on or off and those [35:05] epigenetic factors are actually [35:07] inheritable you can inherit them from [35:10] your parents and so it's not all [35:13] strictly [35:15] genetics um some of it is epigenetic so [35:19] first and foremost there are no genes [35:22] that are specific to specific disorders [35:25] most people think well you know if [35:26] bipolar disorder runs in my family there [35:28] must be a bipolar disorder [35:31] Gene and in fact there isn't a bipolar [35:34] disorder Gene there are genes that [35:36] increase risk for bipolar disorder but [35:38] at the same time they also increase risk [35:40] for schizophrenia and epilepsy and [35:44] autism and depression and other types of [35:48] mental and neurological [35:50] disorders and if you look at the [35:52] unifying theme like is there a theme for [35:57] these genes is there a common pathway [36:01] that can help us better understand [36:02] mental illness the common pathway is [36:05] that most of the genes are affecting [36:07] metabolism and [36:09] mitochondria one research study that [36:12] came out a couple years ago researchers [36:14] have been looking for years at a a [36:17] high-risk Gene for [36:20] schizophrenia um and we know that people [36:22] who have this very very rare genes so [36:24] almost nobody has it but if you do have [36:27] it you're at high risk for developing [36:28] schizophrenia along with lots of other [36:30] mental illnesses but schizophrenia is [36:32] the big one and the researchers did this [36:35] deep dive into trying to understand what [36:38] exactly is this Gene doing and at the [36:40] end of the day they said it's affecting [36:43] mitochondria and that is probably how it [36:46] is causing schizophrenia metabolism that [36:49] happens as a result of the work of the [36:50] mitochondria is that accurate so want to [36:52] make sure I've I'm clear on them before [36:54] we proceed 90% of of metabolism at least [36:58] is occurring in mitochondria so [37:01] it's that definition as a scientist I [37:04] have to say isn't 100% accurate because [37:06] there is a thing called [37:08] glycolysis that can happen in cells [37:11] where you can actually produce ATP [37:14] without using mitochondria what's that [37:17] so ATP is usually known as the energy [37:20] currency of living organisms of cells [37:24] and so um and that that ATP ends up [37:28] making cells work it is the energy [37:31] that's flowing around cells or the [37:33] molecule that's flowing around cells to [37:35] make receptors work to to make all of [37:38] the Machinery of cells work and that [37:43] becomes relevant maybe some of your [37:45] listeners will know this if you exercise [37:48] really hard like you're running a [37:50] marathon or you're running as far as you [37:52] can get with a marathon before you [37:54] absolutely are exhausted and you just [37:56] have to stop your mitochondria will [37:59] actually become maxed out that is what's [38:01] preventing you from running is your [38:03] mitochondria max out and they they're [38:05] it's like you don't have enough of them [38:07] or they're not healthy enough and so [38:09] they just they can't keep you going they [38:11] can't keep your muscles going and so you [38:13] Peter out and when you Peter out you [38:16] start you turn to this process called [38:18] glycolysis which actually ends up [38:20] producing lactic acid or lactate and so [38:24] Runners will get higher levels of LA [38:26] lactate and and then that can create [38:28] soreness and all sorts of things um but [38:33] uh yeah that's so metabolism is really [38:36] the process of taking food and energy [38:38] food and oxygen I'm sorry and turning it [38:40] into energy or building blocks and that [38:43] can occur on a small scale outside of [38:47] mitochondria but as soon as the [38:49] mitochondria in most of your cells are [38:51] dysfunctional or dead you you die [38:55] there's no way around it [38:57] so let's use some of those examples that [38:58] you gave earlier you talked about stress [39:00] and Trauma and these kinds of things I'm [39:02] really Keen to know how a traumatic [39:04] event can have an impact on your [39:07] metabolism your mitochondria which then [39:09] manifests as a mental illness um so if [39:12] we take trauma for example people go [39:13] through early trauma in their life I [39:15] don't know there's a I mean you had a [39:16] very traumatic upbringing how do you [39:18] think that maybe even in your case if [39:21] you were able to see inside of your body [39:22] and what was happening that external um [39:25] traumatic event came into your body in [39:27] some way caused a physiological reaction [39:30] had an impact on your metabolism which [39:31] results in a mental health disorder of [39:34] source it gets a little complicated [39:37] because it it goes through a couple of [39:39] stages so I'll try to walk you through [39:41] it in the simplest way I [39:43] can when somebody is first [39:47] traumatized everybody if they are normal [39:51] will have [39:52] symptoms if you get traumatized you will [39:54] experience fear [39:56] you will experience [39:58] hypervigilance you will want to fight or [40:01] flee or you might freeze or you might [40:03] surrender you might beg for forgiveness [40:06] or Mercy or what [40:08] you everybody is going to have those [40:12] reactions in my mind those reactions are [40:15] not disorders they are not [40:17] malfunctioning brains or malfunctioning [40:21] anything [40:23] um so everybody will have that [40:27] however when that [40:29] happens it immediately changes your [40:33] metabolism your metabolis the easiest [40:35] way to understand it is the sympathetic [40:38] nervous system gets turned on fiercely [40:43] if the trauma is really [40:44] bad because you have to defend [40:48] yourself your life is threatened your [40:53] safety is [40:55] threatened traumas can even be less [40:59] extreme than that you can have highly [41:01] stressful events in which maybe even [41:04] though your physical life isn't [41:05] threatened maybe all your money is [41:07] threatened the stock market crashes and [41:09] you lose [41:11] everything and you now think I'm [41:15] worthless I'm [41:20] penniless I'm losing my status in [41:23] society I'm going to have to live a very [41:25] different life I've just disappointed [41:28] everybody who depends on [41:30] me that could be a trauma even though by [41:34] definition because it doesn't threaten [41:36] your life it's not technically [41:38] considered a trauma so for those people [41:41] that are you know they've been through a [41:42] traumatic event what then is going on in [41:45] their body as it relates to metabolism [41:48] based on that traumatic event trauma [41:51] immediately changes [41:53] metabolism so trauma puts us [41:57] into [42:01] this you know most people know it as [42:03] fight ORF flight [42:04] mode um and again there are other [42:07] responses that one can have you can [42:09] surrender you can freeze you can do [42:11] other things but um when people feel [42:17] threatened either physically or their [42:19] reputation is threatened or their [42:21] identity is [42:23] threatened immediately they're nervous [42:26] system and hormones are [42:28] changing and the reason they're changing [42:31] is because your our bodies are hardwired [42:35] to protect us and in order to protect us [42:38] it means that we need more energy and we [42:41] need it now we need more energy in order [42:44] to be able to run or fight or whatever [42:46] we need to do and that means that our [42:49] heart rate goes up our blood glucose [42:52] goes up cortisol is flowing [42:56] [Music] [42:57] adrenaline is flowing through the [43:01] body inflammation is actually [43:05] occurring and epigenetic changes are [43:08] occurring memory formation is occurring [43:11] in a powerful way during a trauma [43:17] memory our brains are hardwiring this [43:21] event so that we remember it we remember [43:25] this threatened us and you cannot forget [43:28] this this is not a trivial moment you [43:32] must remember this for the rest of your [43:34] life because it's threatening your [43:36] survival and you must remember how to [43:38] respond to this again not necessarily [43:41] because our responses can be all over [43:43] the map sometimes our responses can be [43:45] quite effective and other times [43:48] people can [43:50] die they don't respond effectively and [43:53] they are killed I mean that would be the [43:55] worst case scenario and then there's [43:56] everything in between where you you get [43:58] a suboptimal outcome you end up homeless [44:00] with your psychotic mother that's not a [44:03] very effective response when I asked [44:05] that question I was asking as we see [44:07] patterns in trauma like a trauma pattern [44:08] there's a trigger there's a response and [44:10] then you know I even think about some of [44:12] the low you small te traumas that I had [44:15] in my life that meant that I would run [44:17] from romantic commitment for the rest of [44:19] my life for example and it was like a [44:21] pattern I was going through the same [44:22] Loop over and over again trigger Steve's [44:25] response is like this causes this [44:26] outcome [44:27] trigger so I was wondering if I learned [44:30] at that very young age that cycle [44:32] somewhere in my like neurons in my brain [44:35] so that's why I said do we then learn [44:37] the response to that trauma at that [44:39] point as well we we learn the response [44:43] we remember the response that we did MH [44:46] and as long as we've survived that is [44:49] the ingrained memory the ingrained [44:52] memory is when this happens do this [44:56] because this is what I did and I [44:58] survived it and so that becomes the [45:02] default and then that becomes a default [45:05] pattern for many people MH at some point [45:08] in [45:11] life it can be act actually be quite [45:14] useful to look at that response okay so [45:17] when I was 5 years old or 20 years old [45:20] or whatever and that thing happened I [45:23] responded this way and I survived it [45:28] great but how's this working out for me [45:32] now is that the optimal [45:36] response it's not about beating yourself [45:38] up for I should have done something [45:40] different back then it's simply about [45:43] recognizing and honoring I I did what I [45:47] thought I was the right thing to do I [45:48] did my best back then but I'm smarter [45:52] now I'm older now I'm Wiser now [45:57] if I could do it again if I could go [46:00] back in time as my smarter wiser [46:04] self would I do it differently and what [46:07] would the outcome be if I did it [46:10] differently and then that becomes highly [46:13] relevant to today so when I'm in this [46:16] romantic relationship [46:19] now I keep having this urge to break [46:23] up because this person is disappointing [46:26] ing me in this way and I feel like she [46:29] or he is going to threaten me or betray [46:33] me or [46:35] whatever and is that the right approach [46:41] is it true that this person is going to [46:43] betray me like the person in the past [46:46] did or am I hyp sensitive to that am I [46:51] again we're wired to look for any clue [46:55] that a trauma might happen again so [46:58] we're we're going to over [46:59] interpret things [47:02] sometimes in an in a in an erroneous way [47:07] so that early trauma or that trauma I [47:09] experienced made my body go into that [47:11] survival mode fired all kinds of ways [47:13] and my glucose levels went out my all of [47:16] these things all metabolism related [47:17] stuff happened how does that then cause [47:21] a mental health disorder at some point [47:22] down the line if that trauma is not [47:26] resolved so for some [47:29] people they can experience a trauma they [47:32] can be quite [47:34] effective at mitigating it and move on [47:38] with their [47:39] life somebody could get into a fight [47:42] somebody could get mugged on the street [47:45] they're just walking down the street [47:46] somebody pulls a knife on them or a gun [47:48] on them and wants to Rob them if [47:51] somebody manages that trauma highly [47:54] effectively let's say you happen to have [47:57] a black belt in karate and you disarm [48:02] your as salent very quickly and [48:05] rapidly you may not think twice about [48:08] the trauma you may actually be [48:09] emboldened after that traumatic event [48:11] and think I'm quite effective and [48:13] skilled wow those karate classes really [48:16] came in handy and um I'm quite powerful [48:19] and maybe even feel a little more [48:21] confident than you normally would and [48:23] that's the interpretation element right [48:24] of the situation so two people could be [48:26] in the same situation but have so that [48:28] person still had the same physiological [48:32] reactions a gun in your face or or [48:37] wherever that person's glucose was going [48:39] up their heart rate was going up all of [48:42] those metabolic changes were [48:45] occurring but so that's a success story [48:48] and that's probably a resilient person [48:50] who moves on and never thinks twice [48:53] about that trauma or rarely think thinks [48:55] about it and thinks about it with pride [48:57] if they do think about it in the case [49:00] where it doesn't go well at all let's [49:04] leave the extreme out where the person [49:06] is [49:07] murdered let's leave something less [49:10] severe than that but the person is [49:16] beaten they are injured [49:22] severely they are terrified to go out in [49:24] public [49:26] for fear that there could be another one [49:28] just like that that [49:31] person their fighter flight system is [49:35] not turning [49:36] off their fighter flight system is now [49:40] on at least at a low level possibly a [49:44] very high level for a very prolonged [49:47] period of [49:48] time they are now afraid of the world [49:51] immediately after that type of horrific [49:54] assault they are now afraid of the world [49:58] they probably aren't sleeping as well [50:01] and what's happening physiologically and [50:04] we know this is that those higher [50:07] cortisol levels are actually causing [50:10] something called hyper metabolism their [50:13] mitochondria are actually working on [50:17] overtime because the body is still [50:19] primed for the world is [50:22] unsafe everything is unsafe Maybe that [50:25] person who assaulted me is going to [50:27] somehow figure out where I live and come [50:29] through that door any minute so you're [50:31] sleeping at night and you hear a sound [50:34] or you hear a [50:35] creek and you panic and you wake up and [50:38] you're startled and you're terrified or [50:40] you sleep at night and you have a [50:42] nightmare and you wake up and you're [50:44] reliving that experience and just you're [50:46] horrified and overwhelmed again is it is [50:50] this conscious because you know often [50:52] you speak to people with severe anxiety [50:54] and they have panic attacks and they [50:55] don't know what why they're having panic [50:56] attacks they can't name something that [50:58] they're scared of or a fear they have no [51:01] this is not at all conscious so at this [51:04] point in the week or two after a [51:06] horrific trauma like I've [51:08] described I would argue this is not a [51:12] disorder this is not the brain [51:14] malfunctioning this isn't the body [51:16] malfunctioning the brain and body are [51:18] doing precisely what they are programmed [51:20] to do protect [51:22] you your life is in [51:26] danger why because somebody just tried [51:29] to take it and they were close they came [51:32] close to taking your life they could [51:35] have killed you and so your body and [51:38] brain are trying to protect you [51:40] unfortunately that comes at a [51:43] cost all of this energy going toward the [51:46] defense system means that [51:51] energy that should be going toward [51:53] maintaining your cells [51:56] is actually being bypassed [51:59] sometimes so we know this so for example [52:03] there are these things called stress [52:06] granules where cells that are trying to [52:10] just do basic ho hum everyday repair [52:13] work create some new proteins or new [52:17] receptors or you know do some cleanup [52:21] work the code for those which are called [52:24] messenger RNA [52:25] actually get sequestered in these little [52:27] bubbles called stress [52:29] granules and what that means is that [52:31] they're not getting done the the [52:34] messages are starting from your DNA [52:38] because the cell is saying hey I need [52:40] some repair work over here send some new [52:43] proteins over here to do some repair [52:46] work when your body is in fighter flight [52:50] mode those messages actually get [52:53] interrupted and that means means bottom [52:56] line it means that when you feel [52:59] threatened your body is diverting [53:02] metabolic resources toward your [53:04] self-defense system hypervigilance be [53:08] ready to run at any minute be ready to [53:10] fight off the offender at any minute you [53:13] cannot feel safe don't feel [53:16] safe when that goes on for a prolong [53:19] period of time your cells can fall into [53:22] a state of disrepair because metabolic [53:25] resources are not going towards cell [53:28] maintenance if that occurs long enough [53:32] or in a severe enough way it means that [53:36] some of your cells can now fall into a [53:39] state of [53:40] disrepair and they can begin to [53:44] malfunction when that happens if it's [53:47] happening in brain [53:49] cells that's when I would say the person [53:52] has crossed the line from a normal [53:57] survival reaction to [54:00] trauma if their cells in their brain [54:03] begin to malfunction now because they [54:06] are on a state of [54:08] disrepair they that can turn into what [54:11] we call a mental illness and that means [54:14] that maybe they can't remember like they [54:16] used to it means that maybe and and now [54:21] they're they can't pay attention like [54:22] they used to now somebody might say hey [54:25] maybe you've got some ADHD going on or [54:30] they their anxiety Pathways become [54:33] what's called hyper [54:36] excitable and now their anxiety pathways [54:40] are being triggered even when they [54:42] shouldn't be triggered and out of the [54:44] blue they're having panic attacks or [54:47] anxiety symptoms they can be sitting in [54:49] the comfort of their own home not [54:52] thinking any scary thoughts not having [54:56] any not watching anything on television [54:58] or anything that's really disturbing and [55:01] out of the blue they can just be [55:02] overwhelmed with a panic attack and that [55:07] person I would say if they have a panic [55:09] attack for no reason that person's brain [55:11] is now malfunctioning it is [55:15] disregulated and I would say that that [55:18] person has now crossed over into what I [55:21] would call a mental disorder where their [55:24] brain is in fact malfunctioning [55:27] now the great news the [55:30] hope and we can get to more of it is [55:34] that that those cells can be [55:36] repaired we can fix that we can do [55:39] something about [55:41] that the person does not need to be like [55:44] that [55:45] forever this notion that they now have a [55:48] chemical imbalance that they were [55:50] probably genetically predisposed to and [55:53] now we've got to just medicate them for [55:56] the rest of their [55:58] life I don't agree with that I'm not at [56:01] all opposed to medication if medications [56:03] can be helpful to that person 100% let's [56:06] use them Let's help that person heal and [56:10] recover but I want to go deeper I want [56:14] to understand what is happening in that [56:16] person's brain and body using this kind [56:21] of information about metabolism and [56:25] mitochondria and how can we effectively [56:28] help them heal and repair and and [56:32] recover you know we talk a lot about [56:34] diet and food on this show um as it [56:37] relates to metabolism and mental [56:41] health [56:42] diet so diet is [56:46] huge and most people have no clue that [56:50] diet plays any role in mental illness or [56:54] mental health [56:57] 95% of mental health clinicians think [57:00] it's [57:01] laughable that anybody would suggest [57:04] that diet can play a role in mental [57:07] illness I think it's laughable what do [57:10] you think I [57:12] think if you do a deep dive into the [57:17] science all of the science that we have [57:19] accumulated over the last 100 years and [57:23] longer sometimes [57:25] that if you do a deep dive into all of [57:27] those neuroimaging studies that we've [57:29] been doing all of the genetic studies [57:31] we've been doing all of the [57:33] neurotransmitter and hormone studies and [57:36] Trauma studies and adverse childhood [57:38] experiences studies if you do a deep [57:41] dive into the [57:43] science and you understand what is [57:46] happening in the brains and bodies of [57:47] people as a consequence of those things [57:51] or what could be causing those things if [57:54] you put it all together you come to this [57:59] sound bite that mental disorders are [58:02] metabolic in nature and there is [58:07] no questioning whatsoever it is [58:10] incontrovertible that diet plays a [58:13] massive huge role in [58:19] metabolism and therefore I believe very [58:23] strongly that [58:25] diet might be playing a role in the [58:28] mental health epidemic that we are [58:31] seeing and it also might provide an [58:35] Avenue of Hope and healing and [58:40] recovery and I use the word might is the [58:43] scientist in [58:45] me is the clinician in me I know without [58:51] certainty it can heal and recover people [58:54] who have have had chronic horrible [58:56] debilitating mental [58:59] illnesses and I know from my own [59:01] personal [59:02] story when I was in medical school and [59:05] residency I'm still suffering from [59:07] lowgrade depression OCD other symptoms [59:11] but I also developed what's called [59:12] metabolic syndrome I developed high [59:15] blood pressure high [59:17] cholesterol um pre-diabetes and I wasn't [59:22] really overweight I was EX exercising I [59:25] was following a lowfat diet mostly a [59:27] processed foods because they're cheaper [59:31] but that was the diet that was touted as [59:34] a health a healthy diet it was low in [59:36] fat and as long as it was low in fat [59:38] that was supposed to be good for us and [59:41] my metabolic syndrome just kept getting [59:43] worse and worse and so at some [59:46] point in order to treat my metabolic [59:49] syndrome I changed my diet to [59:52] essentially a low carbohydrate diet [59:56] and [59:58] within 3 [60:00] months my metabolic syndrome was [60:03] completely [60:05] gone but the thing that just dumbfounded [60:10] me was that my mental [60:14] health was better than it had ever been [60:17] in my entire life and I just couldn't [60:21] believe what I was experiencing I didn't [60:23] know that I could be that kind of a [60:25] person I didn't know that I could be [60:27] happy and positive and energetic and [60:31] confident I had no idea I I didn't think [60:34] that was in [60:36] me and by changing my diet all of those [60:39] things [60:40] happened at the level of the [60:42] mitochondria are you saying do you [60:44] believe that because you changed your [60:46] diet [60:47] to more sort of natural healthier foods [60:53] at the level of the mitochondria the [60:55] mitochondria were able to function more [60:57] more naturally themselves and in a in a [60:59] more um yeah functional way which meant [61:03] that they released the chemicals they [61:05] released in the processes they go [61:07] through were more consistent with [61:11] positive mental health is that like the [61:12] simpleton's way of understanding it and [61:15] before then you talked about man-made [61:17] compounds in the foods Etc I'm assuming [61:19] you're saying that some of the modern [61:22] foods that we eat the ultr processed [61:24] food that have all these random named [61:26] chemicals inside them that we see on the [61:27] labels the mitochondria don't know how [61:29] to deal with that so it's causing the [61:31] same sort of disregulation and [61:32] dysfunction that they might see if we'd [61:34] gone through like an extreme trauma or [61:36] something else or some other adverse [61:37] environmental situation it's just this [61:40] dysfunction of the mitochondria which is [61:42] causing the KnockOn effects we see but [61:45] there's many things that can cause [61:46] dysfunction in the mitochondria and we [61:48] name we went through a bunch of them [61:49] earlier is that like a simple way of [61:51] understanding it 100% okay great it's [61:53] perfect so super [61:55] interesting okay so on that point then [61:57] we have to zoom in on this thing of [61:59] diet if you wanted my mitochondria to be [62:03] perfect and maybe even give me a case [62:05] that of I don't know patients you've [62:06] worked with that you've you you've [62:08] prescribed a certain diet to what diet [62:11] what food would you tell me to eat and [62:14] what would you tell me not to [62:15] eat so I actually don't have a one siiz [62:19] fits all [62:22] prescription and so I to say that up [62:25] front so I would want to know who am I [62:28] working [62:29] with and how is their mental and [62:33] metabolic Health now me so you yeah so I [62:37] would want more details are you having [62:40] symtoms of any mental health condition I [62:43] would say no however I can I can have [62:47] moments where I feel a little bit [62:49] anxious so you know I've been through a [62:53] lot of I'd say like stressful events in [62:55] my life because I was running a big [62:56] business we had hundreds of employees [62:58] paydays all the time so I had this at [63:00] one point I had this constant subtle [63:03] stress and so I would want to know do [63:06] you feel like you have [63:08] anxiety For No Good Reason sometimes [63:11] sometimes it can feel a little bit like [63:14] that um it's very infrequent I'd [63:19] say but I can also have moments where I [63:21] just think of something and then I get [63:22] the same kind of like it's almost like [63:24] the fal FL response has just kicked in [63:27] but you think of something adverse or [63:29] stressful yeah yeah yeah so so the so [63:32] the one thing I would say about [63:34] that [63:36] and we could get into a lot more details [63:39] which we probably don't want to do Now [63:42] podcast but my my strong guess based on [63:45] just what you've said is that that level [63:48] of Stress and [63:50] Anxiety is quote unquote normal okay [63:54] because you you are sensing I have to go [63:57] do something that's really scary right [63:59] now or I have to go do something that's [64:02] going to ruin someone's life or that [64:06] that might threaten My [64:09] Success it is normal and actually [64:12] healthy to have anxiety and stress in [64:16] those [64:17] situations the anxiety and stress can [64:20] sometimes be quite helpful and adaptive [64:23] because it can make you pause and [64:26] reflect on is this really what I want to [64:28] do as opposed to being overly confident [64:31] and just [64:32] [Music] [64:34] proceeding your own personal history [64:38] almost certainly informs your level of [64:41] stress [64:42] response and again so if you go back to [64:45] your own [64:47] traumas you're going to remember when [64:49] I'm facing a situation like this it's [64:51] helpful to be on hyper alert it's [64:54] helpful to be [64:56] hypervigilant and your body and brain [64:59] will remember that helped you navigate [65:02] this safely and effectively but if I [65:05] have that profile if I have that sort of [65:07] mental health profile now as I sit here [65:09] and then for the next decade I [65:12] ate processed junk [65:15] food am I going to send my mitochondria [65:18] into disarray which is going to increase [65:20] the probability that I have a mental [65:22] health disorder yes I think yes we've [65:26] got you know we there's no way we will [65:29] ever be able to do a human randomized [65:31] controlled trial to test that precise [65:34] unethical [65:35] hypothesis but we have large [65:37] epidemiological studies that strongly [65:40] suggest that people who eat a lot of [65:43] ultra processed food have [65:46] higher risk for developing depression [65:50] anxiety and other mental [65:52] disorders and based on the science the [65:56] granular [65:58] science based on animal models so we can [66:02] do that to mice and rats and in fact [66:04] that's exactly what we see in mice and [66:07] rats we feed them an obesogenic [66:12] diet which is usually high in fat high [66:15] in [66:16] carbohydrates Ultra processed foods some [66:19] researchers have C fed rats and mice [66:23] cafeteria Di diets where they feed them [66:25] a lot of delicious junk food and those [66:28] mice develop higher rates of obesity but [66:33] also higher rates of diabetes and [66:37] pre-diabetes and oh by the way also [66:40] higher rates of depression and anxiety [66:44] because those are the two things that we [66:45] can kind of measure in M rats we can't [66:48] necessarily measure ADHD symptoms it's [66:51] really hard to actually measure [66:53] psychotic symptoms [66:55] um but we can measure depression and [66:57] anxiety symptoms pretty well in animals [66:59] and so in animal models we know that [67:01] that's unequivocally [67:02] true and we see the same in humans [67:04] though because I was reading your book [67:05] and in chapter 4 you say people with [67:07] ADHD are more likely to develop obesity [67:09] people are who are obese are 50% more [67:12] likely to develop bipolar and 25% more [67:14] likely to develop anxiety or depression [67:16] and weight gain around the time of [67:18] puberty leads to a [67:19] 400% increase in the chance of [67:21] depression by the age of 24 [67:24] yes and insulin resistance at age [67:29] nine makes increases your chances of [67:32] developing a psychotic at risk mental [67:35] state which is like meaning you're at [67:37] high risk for developing schizophrenia [67:39] or bipolar disorder 500% and [67:42] Alzheimer's all mental disorders are [67:45] associated with an increased risk of [67:48] Alzheimer's disease anywhere from the [67:51] lowest is 50% increase risk and the [67:55] highest is 2,000% increased risk and the [67:59] thread that unites all of these problems [68:01] is metabolism [68:04] metabolism and at the end of the day you [68:08] have to talk about mitochondria in order [68:10] to understand [68:12] metabolism um only 7% of [68:17] US [68:18] citizens have no signs of metabolic [68:22] health problem [68:25] meaning [68:27] 93% or so of us residents will have at [68:31] least one of the biomarkers of metabolic [68:35] syndrome meaning they have pre-diabetes [68:39] or abnormal lipids or high blood [68:42] pressure or abdominal obesity or [68:46] abdominal fat excessive abdominal fat so [68:49] what do we offer those [68:51] 93% so those people [68:54] diet interventions would absolutely be a [68:58] part of a healing [69:00] strategy a part of it not the only [69:03] strategy I would want to know about [69:05] their sleep I would want to know about [69:07] substance use I would want to know about [69:09] medications lots of things but for [69:12] dietary interventions I would want to [69:14] meet them where they're at and just find [69:16] out well where are you at what are you [69:18] eating do you have preferences or [69:22] demands for what your diet should be [69:25] could you give me a case study then [69:27] maybe a more extreme case study from [69:28] your practice that you've [69:31] seen I could I can give you the simple [69:35] cases [69:38] where which probably apply to the [69:41] majority of human beings on the [69:44] planet but if it's okay I'd rather give [69:47] you the extreme [69:49] case because a lot of people are [69:51] skeptical they they probably hear me [69:53] saying this and they think well you're [69:54] just talking about General Health and [69:57] Wellness what about people with real [69:59] mental illness what about people like [70:02] your mother whose lives were decimated [70:04] by mental illness this doesn't have [70:06] anything to do with [70:08] them and what I'm here to say is no [70:11] actually this has everything to do with [70:13] them [70:14] too but yes it applies to just common [70:17] everyday people [70:19] but you know probably so one story [70:25] that I will just share to just because [70:27] it's probably one of the most powerful [70:29] stories I know it was a [70:34] woman whose real name was [70:36] Doris and um in the book I called her [70:39] Mildred because I changed everybody's [70:41] names but she actually gave me [70:43] permission to use her real name so in [70:45] honor of her I want to use her real [70:47] name so she was a woman who actually had [70:50] a horrible abuse of childhood lots of [70:53] trauma [70:54] and by the time she turned 17 she [70:57] started having daily hallucinations and [70:59] delusions and was diagnosed with [71:03] schizophrenia over the ensuing [71:05] decades she tried numerous antipsychotic [71:09] mood [71:11] stabilizers um anti-depressants and [71:14] other medicines but none of them stopped [71:17] her symptoms she remained with all of [71:20] the symptoms of [71:21] schizophrenia she ended up gaining a [71:23] massive amount of [71:25] weight she ended up weighing about 330 [71:29] lb by the time she was [71:33] 70 her life was devastated by this [71:37] diagnosis she had a cour appointed [71:40] Guardian to manage her financial affairs [71:43] and other Affairs she had professionals [71:45] coming into her home to help her with [71:47] paying bills and grocery shopping and [71:49] stuff like that because she couldn't do [71:50] it for herself which is not at all unus [71:53] usual for people with schizophrenia and [71:56] between the ages of 68 and [71:58] 70 she tried to kill herself at least [72:01] six times and was hospitalized for those [72:04] suicide attempts she hated herself and [72:07] she hated her [72:08] life when she was 70 years old her [72:12] doctor told her you're overweight and [72:14] you need to go lose some weight and she [72:17] was she was referred to a weight loss [72:20] clinic at Duke University where they [72:22] just so happened to be using the [72:24] ketogenic diet as a dietary inter as a [72:27] weight loss [72:29] tool and for whatever reason she decided [72:31] to give it a try and so she tries the [72:33] ketogenic [72:36] diet and within two weeks not only does [72:39] she start losing weight but she notices [72:41] dramatic reduction in her hallucinations [72:45] and [72:46] delusions within months all of her [72:49] symptoms of schizophrenia were in full [72:51] and complete remission [72:54] she starts tapering off her psychiatric [72:56] meds within about six months she was off [73:00] all of her psychiatric meds and her [73:02] symptoms of schizophrenia remained in [73:05] [Music] [73:06] remission Doris went on to live for [73:09] another 15 [73:11] years symptom free medication [73:15] free out of psychiatric hospitals no [73:19] more suicide attempts she stopped saying [73:23] mental health professionals pretty [73:24] quickly because they were kind of [73:26] worthless in their mind they hadn't [73:28] really helped all that [73:30] much she lost 150 lbs and kept it off [73:35] until the day she died she ended up [73:38] dying at the age of 85 of Co [73:42] pneumonia and [73:44] um but her [73:48] story tells [73:50] us like we could get if if you want we [73:53] don't have to we could get into the [73:55] science of the ketogenic diet and what [73:57] it's doing to metabolism and [73:58] mitochondria I love to know but there's [74:00] an entire story that helps us understand [74:02] what happened to her and how [74:05] exactly that resulted in her really [74:09] spectacular and almost miraculous [74:12] recovery so so unbeknownst to most [74:15] people most people know that ketogenic [74:17] diet is a fad diet and a lot of people [74:19] are really worried about it they they've [74:21] heard that it's dangerous you know it'll [74:23] give you a heart attack you'll [74:25] die unbeknownst to most people the [74:28] ketogenic diet was developed over a [74:30] hundred years ago now by a physician for [74:32] one and only one purpose it was [74:35] developed to stop [74:38] seizures and in fact the ketogenic diet [74:41] has been studied [74:43] extensively for its effects on the brain [74:47] over the past 100 years and it is an [74:50] evidence-based [74:52] treatment for [74:54] epilepsy and the reason that is so [74:57] important is [74:59] because we use epilepsy treatments in [75:02] Psychiatry all the time lots of the [75:04] medications that we prescribe to [75:06] psychiatric patients are in fact [75:07] epilepsy [75:09] treatments and so we know that there's a [75:11] lot of overlap between epilepsy and [75:13] mental illness and that treatments that [75:16] help with epilepsy can also help with [75:19] mental [75:20] illness and so we actually know more [75:25] about the biology of the ketogenic diet [75:27] and its effects on the brain than we do [75:28] any other dietary [75:30] intervention it changes neurotransmitter [75:32] systems it decreases brain inflammation [75:36] it changes the gut microbiome in [75:38] beneficial ways it actually changes gene [75:41] expression or [75:43] epigenetics but most important and [75:45] relevant to my theory is it improves [75:48] mitochondria and mitochondrial [75:52] function and and if you do it long [75:55] enough over a long enough period of time [75:58] you can actually [76:00] repair mitochondrial dysfunction in [76:03] cells at least for some [76:05] people and and then you can actually [76:09] stop the diet so in the epilepsy world [76:12] when neurologists use this diet to stop [76:14] seizures it's usually not a lifetime [76:17] treatment they usually only need to do [76:19] the diet for anywhere from two to 5 [76:22] years [76:23] many people about a third of people who [76:26] have treatment resistant seizures will [76:27] become [76:28] seizure-free and another third so 2/3 [76:32] total another third will have a dramatic [76:34] reduction in seizure [76:36] frequency so that leaves a third for [76:38] whom it's not really working but these [76:40] are people with treatment resistant [76:42] epilepsy and there's no treatment that's [76:44] going to work for everybody because we [76:46] need to look at all the other things [76:48] involved if say somebody has seizure [76:52] sensation they get rid of their seizures [76:54] on a ketogenic diet usually they have to [76:56] do it for two to five years somewhere in [76:58] there and their clinician will help them [77:00] decide how long they should do it and [77:03] then they can stop the diet and most [77:07] often the seizures don't come back it [77:10] seems to actually heal the brain what is [77:13] that diet adding or subtracting from the [77:16] body that's causing that pretty [77:17] phenomenal effect do people know the [77:20] real answer is we don't entirely [77:23] understand we don't know I mean the [77:25] ketogenic diet removes sugar for example [77:29] it [77:30] does um pretty much EX entirely I mean [77:33] I've been on that diet for about was on [77:35] the diet for about eight weeks or so [77:37] just a [77:38] try and I could I couldn't have anything [77:40] with sugar in it pretty much no sugar no [77:43] carbohydrates very few [77:45] carbohydrates [77:47] the so some people will argue well the [77:50] diet is getting rid of gluten and gluten [77:52] is is maybe the toxic thing other people [77:55] will argue oh the diet is adding like [77:57] some extra protein or meat and maybe [78:01] that's replacing a nutrient deficiency [78:03] like vitamin B12 deficiency or something [78:06] like that or iron deficiency and all of [78:09] those things might be true for some [78:13] people I don't think those are the [78:15] primary [78:17] explanation I mean obviously if somebody [78:19] has vitamin B12 deficiency replacing [78:21] vitamin B12 is essential somebody has [78:23] iron deficiency yes recognizing that and [78:26] replacing it but most people don't have [78:30] those deficiencies and they can still [78:32] have mental symptoms or mental health [78:34] problems I believe what the diet is [78:36] doing is it it forces a transition in [78:40] brain and body metabolism essentially [78:44] and that act that transition is actually [78:46] mediated through mitochondria so the [78:49] ketogenic diet forces your liver to [78:52] start producing Ketone bodies so it [78:54] forces your liver to break down fat so [78:57] you're you're losing fat from your fat [78:59] stores but that fat is being shuttled to [79:03] the liver and then the liver takes that [79:05] fat and breaks it down um and I mean I [79:10] shouldn't say all of the fat is being [79:12] shuttled to the liver some of the fat is [79:13] going to muscles and other tissues and [79:15] just being used [79:16] directly but a fair amount of the fat is [79:19] actually being shuttled to the liver and [79:21] then that fat is being converted into [79:24] Ketone bodies some of it is being [79:27] converted into glucose so that you [79:29] maintain normal glucose levels through [79:31] this those Ketone bodies are then going [79:34] up to the brain and fueling brain cells [79:38] but those Ketone bodies are actually [79:39] doing so much more they're they're [79:41] changing mitochondrial function they're [79:44] changing epigenetics they're changing [79:46] neurotransmitters and inflammation and [79:48] all sorts of things but at the end of [79:51] the day I'm convinced that it's really [79:54] the metabolic changes and the [79:56] mitochondrial changes that are [79:59] so important and that are so [80:02] instrumental in these dramatic [80:04] improvements and things like stopping [80:06] seizures or stopping hallucinations and [80:09] delusions what about F fasting there's [80:11] been a lot of talk especially recently [80:13] about fasting and the impact that that [80:14] can have on our mental health do you [80:17] think [80:18] fasting is a positive for our mental [80:21] health I so it depends on the person [80:24] okay and so the ketogenic diet actually [80:28] mimics the fasting State that's what [80:30] that's why it was produced all right the [80:32] ketogenic diet was actually developed by [80:34] a [80:36] physician recognizing that fasting can [80:39] have really powerful brain effects [80:41] including stopping seizures if you if [80:43] you're out on an island and Your Friends [80:45] start seizing uncontrollably the best [80:48] thing to do is to fast them even if the [80:50] seizures stop intermittently you would [80:53] think oh let's feed you to you know keep [80:56] up your sustenance and you know take [80:58] care of you the best thing to do for [81:00] your friend if they are seizing [81:03] repetitively over days or months the [81:07] best thing to do is to fast your friend [81:10] and to tell them let's have you go [81:12] without food for a few days and that can [81:15] stop the seizures wow the the challenge [81:18] with fasting is that you could starve to [81:20] death if you do it long that's not a [81:23] that's not a very good treatment for [81:25] your friend on the island and this [81:27] physician who developed the ketogenic [81:29] diet recognized that and so that's why [81:32] he developed the ketogenic diet was [81:35] really looking to see can we mimic the [81:38] fasting state with a [81:40] diet and um and get these longer term [81:44] benefits so back to your question can [81:46] fasting play a role 100% yes fasting can [81:49] play a [81:51] role and fasting is doing pretty much [81:54] the same thing that the ketogenic diet [81:55] is doing it's changing mitochondrial [81:57] biology it's improving mitochondrial [82:00] function changing neurotransmitters [82:02] changing the gut microbiome improving [82:04] insulin signaling and insulin resistance [82:07] it's doing all sorts of beneficial [82:09] things there are a couple of caveats [82:12] with fasting though one is that people [82:16] who are underweight should not fast so [82:20] that includes people with eating [82:22] disorder ERS who are emaciated or [82:25] underweight but it also includes people [82:27] like who have had severe [82:29] depression and lost weight as a result [82:32] of their severe depression or people [82:34] with cancer who have lost a significant [82:36] amount of [82:38] weight fasting is not good for them [82:41] fasting mimicking diets like ketogenic [82:44] diets May in fact be very powerful for [82:46] those people but it but they it needs to [82:49] be done in a safe supervised Medical Way [82:52] sugar what impact does that have on the [82:54] mitochondria if I've got a super high [82:56] sugar diet is that impacting my [82:58] mitochondria in some way and therefore [83:00] my metabolism it is um so [83:05] low low intake of [83:08] sugar in people who are otherwise [83:11] healthy is perfectly fine and [83:14] acceptable so you [83:16] know lots of people can [83:19] consume treats every now and then or [83:22] desserts a few times a week or you know [83:26] special holiday they can maybe even [83:28] binge on sugar over the [83:31] holidays and they don't have any [83:33] problems as a result of it and that is [83:36] fine if that's the way it's working out [83:40] again only 7% of the [83:42] population is metabolically healthy so [83:46] the majority of people that's not the [83:48] way it's working out so high levels of [83:51] sugar over [83:54] time we [83:56] know can impair mitochondrial function [84:01] so there's this term called oxidative [84:04] stress and oxidative stress is primarily [84:08] it's directly related to mitochondria [84:10] because mitochondria are producing the [84:13] energy and then that energy production [84:16] results in oxidative stress and and [84:19] oxidative stress we've known for decades [84:22] is bad for [84:23] cells and it is highly correlated with [84:27] all of the metabolic disorders and all [84:29] of the mental disorders high levels of [84:31] oxidative stress at in different cells [84:33] and different people with different [84:35] diagnoses high levels of oxidative [84:38] stress are a unifying theme but that is [84:41] a reflection of mitochondrial [84:42] dysfunction so we know that if you eat [84:45] if you eat a lot of sugar over [84:47] time it can [84:49] disregulated glucose levels and then [84:52] those high glucose levels can cause [84:55] mitochondrial dysfunction and you can [84:58] end up kind of on the downward spiral [85:01] what about caffeine and these stimulants [85:04] there's like pre-workout stimulants and [85:06] you know before you do a workout you [85:07] have a big dose of this pre-workout and [85:09] it kind of makes you go like you [85:12] know do you have a view on caffeine in [85:14] these sort of energy [85:17] stimulants I do so so so caffeine gets [85:21] complicated because we have to talk [85:22] about whether it's in tea or coffee or [85:24] not cuz tea and coffee are are different [85:28] stories and they have other compounds [85:30] that almost certainly are beneficial to [85:33] human health um and whether it's the [85:36] caffeine itself or not is still kind of [85:39] a question an open [85:41] question caffeine stimulates metabolism [85:45] in cells we know that so it it blocks [85:50] the adenosine recept [85:52] ctor and the adenosine recept the [85:55] function of the adenosine receptor and [85:57] adenosine on it is to slow a cell down [86:01] it's basically a a feedback loop that [86:03] slows cells down it it inhibits their [86:06] function so when we block a Denine we [86:09] basically stimulate the system and we [86:12] stimulate our [86:14] brains and if you have low [86:18] metabolic brain function that can [86:21] actually be really good if you are [86:24] feeling tired and sluggish it can make [86:28] you feel energized and clear [86:32] thinking the challenge is that you can [86:34] overdo it so when you stimulate it too [86:39] fast that in and of itself can end up [86:42] causing oxidative stress or [86:44] mitochondrial [86:46] dysfunction maybe the easiest way to [86:48] think about it is this if you think [86:50] about a car you have a an accelerator [86:54] and a [86:56] break if you're going to maximize the [86:59] cars [87:01] function there's a right balance for all [87:04] of [87:06] that you don't want to floor the [87:08] accelerator and you don't want to [87:10] underdo the accelerator likewise you [87:13] want to determine like you don't want to [87:15] be pushing on the accelerator and The [87:16] Brak at the same time so when we think [87:20] about metabolism and mitochondria when [87:22] we think about caffeine or even [87:26] glucose caffeine and glucose are [87:29] stimulating the system they are through [87:33] different mechanisms but they are both [87:35] stimulating energy [87:37] production but when you overdo it it [87:39] would be like flooring the [87:43] accelerator and then possibly putting on [87:46] the break at the same time because you [87:48] don't want to be going that fast because [87:50] you're going to crash so either you're [87:52] going to floor the accelerator crash and [87:54] burn or you're going to floor the [87:56] accelerator and slam on the brake at the [87:58] same time you're not serving your car [88:01] well by doing that by flooring the [88:05] accelerator and pushing on the brake and [88:07] when we use [88:09] substances like caffeine or alcohol or [88:13] marijuana which are all working at the [88:16] level of metabolism and mitochondria [88:18] when we use those substances in essence [88:21] we're using accelerators or brakes for [88:25] cells and we can overshoot or undershoot [88:29] so it's not that I'm against the use of [88:31] those things if you use reasonable small [88:35] to moderate amounts of those on a [88:38] regular basis I'm all for it so I drink [88:41] coffee every day every morning to [88:44] disclose my [88:46] bias to disclose my bias I drink coffee [88:50] every morning um about two cups of [88:52] coffee every morning but that's my [88:54] routine I don't go beyond that I don't [88:56] drink coffee in the afternoon um when I [88:59] do drink coffee in the afternoon I [89:02] notice it starts to interfere with my [89:04] sleep and then that throws me off I have [89:06] to ask you as well I've had so many [89:08] parents messag me about autism and ADHD [89:11] so many you know I've had so many [89:14] concerned parents message me [89:15] specifically on Instagram saying please [89:18] Steve you know I've had a child [89:20] diagnosed with um ISM they're trying to [89:23] understand it they're trying to get good [89:24] information on it you've used the word [89:26] autism and ADHD as we've been speaking [89:28] about metabolism what is the link in [89:31] your view everything the link is [89:34] everything so the really the [89:36] mitochondrial theory of autism actually [89:39] was first proposed in [89:41] 1985 and since then we have had an [89:44] explosion of research linking [89:46] mitochondria and mitochondrial [89:48] dysfunction to autism [89:50] specifically as I've mentioned to you [89:53] the rates of autism have gone through [89:55] the roof in the United States they've [89:57] quadrupled in the last 20 years and [90:00] people think well what does that have to [90:03] do with diet those kids haven't eaten a [90:05] diet yet well their parents have and let [90:09] me share a couple of Statistics so [90:12] people are scratching their heads [90:14] where's all this autism coming from I [90:16] thought autism was [90:18] genetic and if autism is genetic it [90:20] shouldn't quadruple in 20 [90:24] years quadrupling in 20 years means [90:27] something in the environment is causing [90:29] it and to to provide just [90:32] one piece of evidence to support what [90:36] I'm saying if a [90:39] woman has [90:42] obesity she has doubled the risk of [90:45] having an autistic [90:48] child if a woman has diabetes she has [90:53] double the risk of having an autistic [90:56] child if a woman has both obesity and [91:01] diabetes she has quadruple the risk of [91:06] having an autistic [91:08] child if a man is [91:11] obese he has double the risk of having [91:15] an autistic [91:17] child so people are scratching their [91:19] heads trying to figure out where is all [91:21] this a ISM coming from well look around [91:24] in the [91:25] population are the rates of obesity [91:27] going up are the rates of diabetes going [91:30] up the answer is unequivocally [91:35] yes and that is a reflection it's not [91:40] about fat shaming I don't want anybody [91:42] to hear that and wag their finger at fat [91:46] people and say oh you're causing autism [91:48] because you're overeating it's not that [91:51] simple that's not the way it [91:53] goes people with obesity have a [91:56] metabolic or mitochondrial problem that [91:59] is why they have [92:01] obesity now that might be caused by the [92:03] foods they're [92:05] eating but they don't know any better [92:07] usually they think it's just about [92:09] calories and what I'm here to say is no [92:12] there's more to food than just calories [92:14] it might be those chemicals in the food [92:16] that you're eating or something else or [92:18] it might be chemicals in our environment [92:22] it might be [92:23] pesticides or microplastics the forever [92:27] chemicals that are becoming more and [92:28] more ubiquitous all of these things [92:31] disrupt metabolism and mitochondrial [92:34] function and so when I talk about [92:38] obesity and [92:39] diabetes increasing risk for autism it's [92:44] not about fat shaming it's about [92:46] understanding it's about understanding [92:48] that the parents have a metabolic [92:51] problem already that means that they [92:53] have a problem in their cells with their [92:57] mitochondria and they then pass those on [93:00] to their children and in some [93:04] cases it may not show itself immediately [93:08] as obesity or diabetes it might show [93:10] itself as a brain [93:12] condition because lots of other things [93:16] can play a [93:17] role and if an obese woman for instance [93:20] also has an infection during [93:23] pregnancy that's going to increase her [93:25] risk for having an autistic child even [93:28] more so she couldn't help whether she [93:30] got an infection or [93:32] not tragically we just had an [93:36] epidemic called [93:38] covid and the early signs are telling [93:42] us that in fact neurodevelopmental [93:45] disorders are going to increase as a [93:47] result of that we already had a [93:50] quadrupling of the rates of autism we [93:53] are likely to see [93:56] even worse statistics going [94:01] forward the [94:04] hope is that if we understand that [94:08] science we can do something about it now [94:12] today if you understand if you see signs [94:15] of autism in your child if you s see [94:19] signs of metabolic or mental health [94:22] conditions in your children if we [94:25] intervene early enough we can probably [94:27] do something about it [94:30] how number one by [94:33] recognizing the problem and then two for [94:37] some people it could be as simple as [94:39] dietary [94:40] interventions or just hyperfocusing on [94:45] good clean living so that means [94:48] prioritizing sleep little less screen [94:51] time [94:52] little more human contact purpose and [94:55] life you know family connection no [94:58] alcohol no alcohol no marijuana no [95:02] CBD try to avoid pills try to avoid [95:06] pills for everything that ails you if [95:08] your child's [95:09] sleeping please try methods other than [95:13] pills including melatonin and [95:14] over-the-counter pills don't just whip [95:17] out a pill for your child not being able [95:20] to sleep at least try some other [95:23] interventions like let's get you off the [95:25] screen two hours before bed let's [95:28] develop a routine in our household that [95:31] we're all going to wind down we're all [95:33] going to turn off the electronics maybe [95:35] I'm going to read you a bedtime story or [95:38] we're going to play a game or we're [95:40] going to do something really boring that [95:42] everybody's going to say this is so [95:44] boring I'm getting sleepy and I'm going [95:47] to say great you're it's so boring that [95:50] you're getting sleepy that means you're [95:51] going to go to sleep because it's [95:54] bedtime want to talk to you about our [95:56] sponsor LinkedIn for all the [95:57] entrepreneurs and business owners that [95:58] listen to this podcast you'll probably [96:00] want to hear this one so stay tuned for [96:01] a second whenever you're scaling and [96:03] building a business your business needs [96:05] are completely unique and I've been [96:06] there I know what struggles you're [96:08] facing and what allows you to land your [96:10] next dream client and one tool that is [96:13] an absolute must is LinkedIn ads you'll [96:16] have direct access to a billion LinkedIn [96:18] members yes a billion members access to [96:21] 70 million decision makers and 10 [96:24] million c-level Executives on LinkedIn [96:26] the pool of individuals that LinkedIn [96:28] allows you to access is insane and [96:30] uncomparable and you'll know if you [96:32] follow me on LinkedIn how prolific I am [96:34] on LinkedIn LinkedIn to me is actually [96:36] the highest returning paid social [96:39] platform and I don't think people quite [96:41] realize that so I'm giving you the diio [96:43] community a [96:44] $100 credit on your next LinkedIn ad [96:47] campaign head to linkedin.com doac 24 to [96:51] get started now the link is in the [96:53] description below if you listen to this [96:55] podcast frequently there's something I [96:56] talk about very often and that is the [96:58] subject of sleep and so I dug down a [97:01] pretty deep sleep Rabbit Hole to figure [97:03] out how I could sleep better one of the [97:05] things that I found is a brand called [97:06] Eight sleep that sponsor this podcast [97:09] and that is the cover that I have on my [97:10] bed I saw the variance in my performance [97:13] my ability to talk my mood and [97:15] everything that matters to me when I'm [97:17] unslept it regulates the temperature of [97:20] both sides of my bed individually so my [97:22] partner can have cold I can have a [97:24] little bit warmer and it learns about my [97:26] body and sets my bed to the temperature [97:29] that I need to have optimal sleep the [97:33] brands that I talk about on this this [97:34] show the podcast sponsors that I have [97:36] are brands that I love and use and eight [97:38] sleep is one of them they've made that [97:40] piece of foam that we all sleep on for [97:42] eight hours a day smart I've put a link [97:45] in the description below but you can go [97:47] to 8sleep.com [97:49] stepen for exclus exive holiday [97:52] savings I have to ask you mentioned that [97:55] you moved in with your mother to try and [97:56] save [97:57] her um when she had was suffering with a [98:01] multitude of sort of mental health [98:03] disorders what is that like as a child I [98:07] I was trying to imagine if I moved in [98:10] with my mother when she was you use the [98:13] word delusional right what is that like [98:17] I've heard people speak to me about a [98:18] parent with dementia and that kind of [98:21] that loss but what is the loss like that [98:23] you experienced if I was a fly on the [98:25] wall in those moments what would I have [98:26] seen and if I was a fly inside of your [98:28] heart what would I have [98:32] felt it was actually [98:34] really horrendously [98:38] awful [98:41] um when I first moved in with her we had [98:45] a little bit of money still and so we [98:48] were living in a rooming house we were [98:50] renting rooms [98:52] at some point the money ran out and the [98:55] support that we were getting wasn't [98:58] enough and that's when we became [99:03] homeless but almost from day [99:07] one living with someone who is severely [99:10] depressed and [99:13] suicidal and [99:17] psychotic it's hard to not feel that [99:20] your [99:22] self it's like you're living in [99:27] this just [99:29] oppressive cloud of [99:33] Despair and it's everywhere it's in the [99:36] air like when you're in the home with [99:39] that person it's in the air that you're [99:42] breathing it it's hard to describe [99:47] it but that hopelessness just overwhelms [99:52] I mean you try to cheer the person up [99:55] and it's just [99:57] feudal and I [100:01] remember I think the first like three or [100:04] four months I lived with [100:06] her I like cried myself to sleep every [100:10] night like just sobbing [100:14] crying crying into my pillow so that she [100:16] wouldn't hear me CU I didn't want to [100:18] burden [100:19] her but I did know what to do I was just [100:23] I was it was just [100:27] overwhelming and after about four months [100:30] I actually I couldn't cry [100:33] anymore I just lost the ability to cry I [100:36] became [100:38] numb I just I I couldn't [100:42] tolerate those emotions that just [100:45] despair I couldn't I couldn't manage it [100:48] that actually persisted with me for [100:50] probably like like 20 [100:53] years I wasn't able to cry for like 20 [100:58] years there was a part of me that just [101:00] felt like you know crying is weakness [101:02] and crying is feudal it doesn't do [101:06] anything it doesn't solve any [101:10] problems [101:14] um it's interesting CU When I was with [101:19] her I hadn't gotten to the point of [101:22] suicidality myself I was desperately [101:26] wanting to stay alive to see if I could [101:29] help her and keep her [101:31] alive within about a year of that [101:34] though I started developing my own [101:37] suicidality [101:39] and [101:41] um and that persisted in me for years [101:46] after um I tried to kill myself several [101:49] times I was injuring myself I was doing [101:53] all sorts of [101:54] [Music] [101:56] things I was very I was actually [102:00] convinced if you asked me at the time I [102:02] would have said I was 100% certain that [102:05] I wouldn't be alive to the age of [102:08] 20 I I knew with certainty that I would [102:11] be dead and I knew that I just couldn't [102:14] tolerate living and that there was no [102:16] hope for me [102:19] whatsoever Chris thank you your um book [102:22] is full of solutions and it's full of [102:23] Hope and I think that's why it's such an [102:26] incredibly important book and it's a a [102:28] book that has The Bravery [102:31] to illuminate another set of answers and [102:34] another path forward out of the Despair [102:37] and the epidemic of mental health um [102:39] illness that we're unfortunately I agree [102:42] we're heading we are in and increasingly [102:45] heading towards if that makes sense it's [102:47] certainly increasing in prevalence a [102:50] revolutionary breakthrough and [102:51] understanding mental health and [102:53] improving treatment for anxiety [102:54] depression OCD PTSD and much more brain [102:58] energy really really remarkable book and [103:01] Once upon once in a while books come [103:02] along that challenge the status quo in [103:05] the most necessary way and your book is [103:06] certainly one of them we have a closing [103:08] tradition on this podcast where the last [103:10] guest leaves a question for the next [103:11] guest not knowing who they're leaving it [103:12] for and the question that's been left [103:14] for you is you were known for your work [103:18] Chris but what would you like to be [103:20] known for [103:21] as the human that you [103:25] are I think I would like people to [103:29] know like I've shared with you [103:34] today that I was [103:36] somebody who had given up on [103:39] myself who actually thought there's no [103:43] possible way I could ever have a future [103:47] I could ever live a meaningful or even [103:50] tolerable [103:53] life and that all has [103:57] changed and if it can change for me and [104:00] you happen to be one of those people in [104:02] a similar state right now it can change [104:05] for you [104:08] too Chris thank you thank you so much [104:11] you know there's this [104:13] um there's this wonderful quote that I [104:16] read earlier from the start of your book [104:18] where you send that message to your [104:19] mother my fure T attempts to save you [104:21] from the ravages of mental illness lit a [104:23] fire in me that burns to this day I'm [104:26] sorry I didn't figure this out in time [104:28] to help you may you rest in peace but I [104:31] have to point out the fact that the work [104:34] you're doing the passion you're bringing [104:36] to it the wisdom and the 28 years of [104:38] study and Care you've put into all of [104:41] the work that exists in your book and [104:42] your wider work is saving many people's [104:47] mothers thousands of people's of their [104:50] mothers their fathers their daughters [104:52] their [104:53] sons and that I think is an absolutely [104:58] incredible thing so be on behalf of all [104:59] of those people that you'll absolutely [105:01] never meet you'll meet many of them sure [105:03] many of them messages you message you [105:05] but all of the ones that aren't able to [105:07] or haven't yet I just want to extend a [105:09] big thank you for the work you've done [105:11] in your life for those mothers for those [105:13] fathers for those daughters and for [105:14] those [105:15] Sons thank you [105:19] Steve [105:20] [Music] [105:22] as you'll know if you've listened to [105:23] this podcast before I'm an investor in a [105:24] company called hu I'm on their board and [105:26] they sponsor this podcast and I have a [105:28] very exciting announcement to make this [105:30] product called Daily Greens is one of [105:32] the most highly requested products at hu [105:34] but it's never been sold in the UK [105:36] before [105:37] until now it's often difficult to get [105:40] all of the greens into our diet that we [105:42] need to have a healthy gut microbiome [105:44] and a healthy body and with Hues Daily [105:46] Greens product with one scoop every [105:49] morning a very very delicious scoop you [105:50] can get 91 vitamins minerals and Whole [105:54] Food Source nutrients into your diet the [105:57] most important Point here is I genuinely [105:58] believe it tastes delicious it's May my [106:01] favorite heel product ever for all the [106:03] reasons I've described so if you want [106:05] access to this product the link is in [106:06] the description below it launches in the [106:08] UK in January because of the demand I'm [106:11] pretty sure it's going to sell [106:13] out do you need a podcast to listen to [106:16] next we've discovered that people who [106:18] liked this episode also t absolutely [106:21] love another recent episode we've done [106:23] so I've linked that episode in the [106:25] description below I know you'll enjoy [106:33] [Music] [106:35] it