Is There a Mental Illness Epidemic? - with Dr. Daniel Amen | The Empowering Neurologist EP. 92

Well, hi everybody. Dr. David Perlmutter here. Welcome again to The Empowering Neurologist. You know, one of the most understated but certainly very important issues of our time as it relates to health and medicine and illness is mental illness. significantly on the rise, you know, in parallel with a lot of the other chronic degenerative conditions. But we don't seem to want to talk about it. And to be clear, our lifestyle choices play a very significant role in mental illness as they do in other chronic degenerative conditions. And yet, we seem to live in a world that tries to just make us think that for our various mental illness issues, there is a quick fix. We know that just is not satisfying enough for those of us who want to first look at prevention and second look at more integrative approaches to dealing with these problems. Our guest today is Dr. Daniel Amen. His new book is The End of Mental Illness. Let me just read a little of the subtitle: How Neuroscience Is Transforming Psychiatry and Helping Prevent or Reverse And then he lists a lot of common mental illness problems of our time. Let me tell you a little bit about Dr. Dan Amen, one of my favorite guests on the program. He is a physician. He is double board-certified psychiatrist and 10-time New York Times bestselling author. He's the founder and medical director of Amen Clinics in Costa Mesa, as well as San Francisco, Bellevue, Washington, Reston, Virginia, Virginia, Atlanta, Georgia, New York, New York, and the Amen Clinics have the world's largest database of what are called functional brain scans that relate then to behavior, totaling more than 125,000 scans on patients from virtually around the world, 111 countries. He is a distinguished fellow of the American Psychiatric Association, the highest award that they give to their members, and he is the lead researcher on the world's largest brain imaging and rehabilitation study that is currently being done on professional football players. His research has not only demonstrated high levels of brain damage that we are seeing in football players, but he also showed the possibility of— this is really important— significant recovery for many of the principles using many of these principles that underlie his work. He is the co-author and author of 70 professional articles that appear in our most well-respected peer-reviewed journals, as well as 7 book chapters and over 30 books, including the number 1 New York Times bestseller called The Daniel Plan. Dr. Amen's published scientific articles have appeared in some of our most well-respected peer-reviewed medical journals, And he's also been featured in things like Newsweek, Time, Huffington Post, ABC World News 2020, BBC London Telegraph, Parade Magazine, New York Times, New York Times Magazine, Washington Post, LA Times, Men's Health, to name but a few. So Dr. Amen's out there. He's getting his word out there that guess what? Our lifestyle choices play a significant role in terms of the destiny Not just of our brains, but of our mental state. We're going to jump right into our interview right now. Hello, Dr. Dan Amen. How are you doing?

David, what a joy to be with you.

I'll just say at the beginning now that I've already— people have seen the introduction, but the reason that this, I think, is your 3rd or possibly 4th time on the program There are 2 reasons for that. Number one, I really, really like you. Number 2 is the work that you're putting out is absolutely foundational. It's paradigm shifting. It is supportive of many of the rest of us who are stepping out, and it's helping so many, many people. For all of our viewers, that's why we keep seeing Dr. Dan Amen, because he keeps doing the work. All set?

Thank you so much.

All right. The, the, what I, where I wanted to start is, I mean, here the book is called The End of Mental Illness, a bold claim. Uh, as I read the book, I realized, uh, you're standing on pretty firm ground making that claim in your title, uh, especially as we go through the book. But first of all, why do we want, I mean, how big of a challenge is this? What's going on with mental illness? How big of an issue is it?

So we're actually working on the wrong paradigm, which is why the title, These Are Not Mental Illnesses, They're Brain Illnesses. And just that one shift decreases stigma and gets people excited about getting help. The problem is massive and it's getting worse. Since 1999, suicide has increased 33%. percent, while cancers declined 27%. Virtually every other medical specialty is making progress on the illnesses they're treating. Psychiatry is not. And just since I've been a psychiatrist, ADHD has quadrupled, major depression has quadrupled, and This is not okay with me. According to a study from the National Institute of Mental Health, 51% of us at some point in our life will have a mental health challenge. We need to get on top of this problem, but the only way we're gonna do that is with a brand new paradigm. You remember when Sandy Hook happened, that horrible tragedy? President Obama came on television and said we need more money for mental health, yet virtually all of the young school shooters have had mental health care. More money for doing the same thing we are doing is going to just get us more of what we have.

Well, it's been said that doing the same thing over and over and looking for— expecting a different outcome is the definition Of insanity. With antidepressant use increasing 400% since the 1990s, it's exactly what you're calling for, and that is a different paradigm. I want to go back to some language that you just used where you're characterizing mental illness as a brain disorder. The reason I believe that's important is it It gives it a locus. It gives us a place to look, a place to understand causality, a place to understand how our therapies may or may not be effective. It's always been this ethereal thing about mental illness, or maybe your neurochemistry is off, but you really are really solidifying a view that there are brain issues related to the manifestations that we call mental illness. Right.

Well, and you write about it, you know, in Grain Brain, that if you eat potentially toxic foods, your mood's not good. You can't think. You wrote about it in Brain Maker, which I just love. If your gut's not right, your brain's not right. We need to see the brain as a physical organ that lots of things are acting on, and when you get that organ right, people's moods are better, their behavior is better, their focus is better, their memory is better. And in 1979, when I told my dad I wanted to be a psychiatrist, he asked me why I didn't want to be a real doctor, why I wanted to be a nut doctor and hang out with nuts all day long. And my dad never really got Father of the Year award, But that really hurt my feelings. But 40 years later, I sort of get where he was coming from. I mean, what medical specialty makes diagnoses based on symptom clusters with no biological information, but just this theory that, oh, your neurotransmitters are off without measuring them, and let's try this medication? Right. for that medication. It just is— I'm ashamed of it. And we can do better. We must do better if we're going to stem this tide. You know, suicide is the second leading cause of death among people 10 to 34 years old. That's a disaster. We should be so concerned About that and just having them see psychologists or psychiatrists that recommend more medication is just, it's not the answer.

Yeah. I mean, we do live in a society that unfortunately wants us to believe that depression is a Zoloft deficiency or Paxil deficiency. And you are among a very small group of individuals who challenge that whole paradigm of, you say one disease and I say a treatment. I think Dr. Kelly Brogan has been very vociferous about making this clear, that we are not deficient in these drugs, and there are physical substrates that you have beautifully characterized with your scans that typify these issues. We wrote about this recently in BrainWash, that even our decision-making has substrates in the brain, differences between activation of one part of the brain, the prefrontal cortex, And a more impulsive part of the brain, along with other areas, the amygdala. And to be sure, you've been talking about this lifestyle impact and how we can have— look for changes in brain functionality based upon lifestyle choices for quite some time. I have the pleasure of holding onto not just your new book, But I got a whole series of your books where you've been talking about this for a long time, as many of us have been. But I think the new book is very much indicating that this is an epidemic. It is not looked at in that way, and that many of the mechanisms that are underlying other well-understood chronic degenerative diseases that Explain, that are responsible for mortality— coronary artery disease, Alzheimer's, diabetes, cancer— are at play as it relates to mental health as well, and you make that very clear. Let's just jump in and look at a few of the ways that we're able to look at the physicality of the brain in terms of how it then manifests as mental illness. And you've been a huge proponent of imaging. So what are we learning about mental illness from imaging the brain? And be, if you could, specific about the types of imaging that you're doing.

So I'm a classically trained psychiatrist. I was trained on symptom clusters lead to diagnoses, and then you either do therapy, medication, or both. But before I went to medical school, I was an X-ray technician when I was in the Army. And our professors used to always say, how do you know unless you look? And so when I fell in love with psychiatry, I realized we needed to look. And in 1987 or 1988, I started doing a study called quantitative EEG, which looks at the electrical activity in the brain. I was just so excited. I had more information. To help my patients. But in 1991, I went to a lecture on brain SPECT imaging, S-P-E-C-T. And SPECT is a nuclear medicine study that looks at blood flow and activity. It looks at how the brain works. It's similar to a PET scan, but it's generally less expensive, more clinically available. Right. And I just fell in love with it. I started ordering it on all of my complicated patients, and right away I went, oh, these are not mental illnesses, they're brain illnesses. And some of the big lessons from SPECT, but you'll also find it with quantitative EEG, or those people who do PET, or arterial spin labeling, which is an MRI-based procedure is that depression is not one thing. ADHD is not one thing. I actually have whole books on healing ADD, which is ADD is 7 different things. And if you give everybody Ritalin, you're going to make some people better, no question, and you're gonna make a whole bunch of other people worse, which is why it's a controversial medication. I wrote a book called Healing Anxiety and Depression, where there's at least 7 different types of anxiety and depression. Stop giving everybody an SSRI like Lexapro or Zoloft, because when you do that, some people get better, but you hurt other people. In fact, virtually all psychiatric drugs have black box warnings, which means these things can hurt the wrong people. I wrote a book on addiction saying it's at least 6 different things, and I wrote another one on obesity. It's like, stop giving everybody the same program. It's— there are impulsive overeaters, compulsive overeaters, sad overeaters, anxious overeaters. And it's— so the big first lesson was all psychiatric illnesses have multiple types. The second big lesson is mild traumatic brain injury is a major cause of psychiatric illness. Brand new study over the weekend. 50% of homeless people had a significant brain injury before they were homeless. The brain is soft, the skull is hard, the skull has sharp bony ridges. Damage the brain, you damage your decision-making, which is why I'm not a fan of kids hitting soccer balls with their head or playing tackle football. And then I learned there's so many things that are just toxic for brain. Function. Yes, drugs and alcohol. Marijuana is not going green. I published a study on 1,000 marijuana smokers. Every area of their brain is lower in blood flow, but also the air we breathe, the toxins we put on our body, the pesticides we consume, all of these have a negative impact On the brain, which we can see on scans. But probably the 2 biggest lessons is— how do I say this? Freud was wrong. He was about 2.5 feet too low when he talked about penis envy. I've not seen one case in 40 years. It's brain envy people should have, that when people see their scans, They get serious about brain health. Nobody loves their brain. Why? You can't see it. You can see the wrinkles in your skin or the fat around your belly. You can do something when you're unhappy with it, but the scans immediately decrease stigma and increase compliance. And then the most important lesson I've learned, the lesson I love the most, is you're not stuck with the brain you have. You can make it better, and I can prove it. So, at Amen Clinics, we did the world's first and largest study on active and retired NFL players, brain imaging and rehabilitation studies, at a time when the NFL was having trouble admitting they had a problem. We scanned 300 players, high levels of damage in virtually all of them, but 80% of our players get better when we put them on a rehabilitation program, which I talk about in The End of Mental Illness. So, I, you know, that message just, it keeps me writing, it keeps me excited, it keeps me, you know, trying to lead this fight where if you don't look, you don't know, stop lying about that, and you can make this brain better. You can make your brain better.

Well, let me get back to, you know, the value of these scans. And just the pure physicality of the brain and the imaging of its functionality. Chapter 4 of your book talks about why it's important to know your brain type. What does that actually mean?

So, what we learn through imaging is not everybody's brain is the same. We see people who are spontaneous, persistent, sensitive, cautious. And knowing your type, even if you never have sort of a mental health issue, it's just so important to know, well, what are the exercises I should do? What are the supplements I should do? And it goes back to this idea I talked about with obesity. It's, let's stop giving everybody the same program and honor the fact that everybody's different. Yeah. For example, the ketogenic diet, and I'm a fan of it for people who have seizures, and I'm also a fan of it for people who have ADD. It really helps them focus. They don't have the blood sugar swings that they get with the standard American diet. But for people who have OCD, it makes them mean because they concentrate better on the things that upset them. And so they need more healthy carbohydrates because carbohydrates actually drive serotonin into the brain. You actually need an insulin response to get tryptophan into the brain, which then turns into serotonin. So you want to know your type so that you know how to eat, what are the right supplements, For you, what are the exercises that can be helpful?

So, this sounds a little bit, well, a lot like personalized medicine for mental health based on brain types.

It's exactly what it is. And then from there it's like, well, how do you keep your brain healthy? And, and I think the 3 big innovations that I've done for my field, I'm not sure they quite appreciate it yet, but one, it's imaging. If you don't look, you don't know. 2, natural ways to heal the brain. And 3, do it in a functional or integrative model, which I learned from you and my friend Mark Hyman. And it's— if you want to keep your brain healthy or rescue it if it's headed for trouble, you have to prevent or treat the 11 major risk factors. that steal your mind. And that's actually the bulk of this book. It's— I go after each one of them and show how they're related to mental health problems and how you can correct them.

Yeah, that's what I wanted to emphasize right now. Yes, we can identify our lifestyle choices. You talk about sleep and diet and toxins and trauma, etc. But, you know, I certainly want to emphasize That you're really making it clear that there is recoverability. I mean, we can talk about particulate matter in the air we breathe, et cetera, but even amongst the NFL players, as you described, the Dalai Lama said that the brain we build reflects the life we lead. And we can make choices, the life we lead, to build a better brain, to recover. To be clear, when you and I were in medical school, that would have been just considered to be preposterous.

Oh, no question. We were taught that you're born with all the brain cells you'll ever have, and if you lose them, oh well. And it was a lie. Now, it was a lie based on, you know, what we knew at the time, but your hippocampus, for example, part of your limbic brain, one of the most important structures, in your brain has— makes new stem cells every day, up to 700 of them. And I think of the hippocampus, well, it comes from the Greek word, 2 words actually, for seahorse, because it's shaped like a seahorse. And you make 700 new baby seahorses every day. And your behavior, Hmm. the environment you put these baby seahorses in, is either growing them so they become part of your big hippocampus, or it's murdering them. And my daughter, who's 16, she and I make the same number every day, but hers are more likely to stick around than mine because as you age, blood vessels become damaged. So, there's actually research that suggests brain cells don't age, it's the blood vessels around them. around them that age causing them to shrink. And I've just seen a whole bunch of older brains and it's not good news. Um, you know, as we age on spec, the brain gets less and less active, but it doesn't have to if they do the strategies you talk about in Brainwash. I talk about in The End of Mental Illness. I mean, it's just so exciting to go, oh, I don't have to. age. I can really take control of how quickly my brain deteriorates.

I was very taken by the COVID last week of Lancet Neurology, which showed the outline of a brain, and then within that outline were all the good foods, broccoli, all the right foods that we've been talking about for years. So, things are, I think, are turning around a little bit. And, you know, as it relates to food, and certainly other things like sleep and exercise, you make it very clear that there is this mechanism that's deeply involved here, and it is inflammation. So if you could just unpack that a little bit, because I think there is the time now that people are sort of getting their arms around the idea that inflammation might be bad for our coronary arteries. And being— playing a role in that disease, coronary heart disease. But how does inflammation relate back to mental illness?

If you have inflammation in your body, you have a higher risk of depression. You have a higher risk of autism. You have a higher risk of Alzheimer's disease. We're learning it actually is playing a major role in brain health, which then I mean, let's just get this clear. Brain health controls mental health, that when your brain works right, your mind works right. And so if your brain is inflamed, then you're going to have a struggle with how you think, with how you feel, with how you behave, with how you act. And so what are some of the major drivers of inflammation? And you write about this as well. Well, it's our processed food diets, it's sugar, it's gum disease is a major cause of inflammation. I used to not really care about my teeth until I saw all the research on periodontal disease and heart disease, and then the studies started coming out on periodontal disease and Alzheimer's disease. Unhealthy gut is probably the major cause. of inflammation that if you end up with this thing you write about, and I talk about in The End of Mental Illness, leaky gut syndrome and what causes it, you have foreign bodies that get inside your bloodstream causing an autoimmune response and inflammation. Low levels of omega-3 fatty acids, which is rampant in the United States. There was actually a study that said 97% of the population had suboptimal levels of omega-3 fatty acids. I partnered with OmegaQuant, and we did 50 consecutive patients who came to Amen Clinics in Costa Mesa, Southern California, and we did their omega-3 index. If they were not on fish oil, 49 of the 50 had suboptimal levels. Imagine that. And we know low omega-3 Uh, go with higher inflammation, but also higher ADHD, higher depression, higher memory problems. And so flossing, taking omega-3 fatty acids, probiotics, getting rid of the processed foods and sugar, all are critical strategies for brain health. So I go, these are not mental illnesses. They are brain illnesses. Get your brain right. Your mind will follow.

Well, let me comment on a couple things. A note to viewers, I just bought— actually, no, I have had it now several months— a rechargeable— it's like a Waterpik. It's not that brand, so I'm not being brand-specific here, but even if you travel, you can use this device in addition to brushing and flossing. So that relationship with periodontal disease, I think, is huge, but you do talk in the new book about actual infections and the role that infections may be playing in mental illness, which I think was kind of a lot of new information for many people.

Well, there's a— so there's a mnemonic to help people get through these 11 risk factors, Bright Minds. And the second I in Bright Minds is immunity and infections. I'm in a new docuseries with Justin Bieber. Justin came out publicly, you know, he's been one of my patients for the last 5 years, and he had antibodies, so an autoimmune response attacking the dopamine receptor sites in his brain. And then we learned he also had Epstein-Barr and Lyme, had exposure to those infections And I have to tell you, I think I've scanned maybe 2,000 people with Lyme disease. It's bad news. And in the book, I tell the story of Adriana, who's 16 years old, beautiful, straight-A student, uh, comes from a loving family. They go on vacation to Yosemite, and when they get to their cabin, they're surrounded by 6 deer, and they think it's a magical moment. But 10 days later, Adriana starts hallucinating, becomes delusional. She becomes aggressive. Her parents put her in a psychiatric facility. They diagnose her with schizophrenia. The meds don't work. Another psychiatric hospitalization. And the doctor who was trained at Stanford said to the mother, you need to accept that she has schizophrenia. It's a lifelong progressive disorder and she needs this medication and you need to stop looking for another reason for the problem. Well, if you knew the mom, she didn't do well with that conversation and ended up bringing her to our clinic. And when we scanned her, her brain was on fire. And we're like, why is her brain on fire? Turned out she had Lyme disease. From the deer ticks and on an antibiotic over the next year, she got her brain back. And this was now 8 years ago. She went on to graduate from high school, graduated from Pepperdine with honors, got her master's degree from the University of London in human resource management. Adriana is normal. And was that a mental illness? Absolutely not. was a brain that was being attacked by an infection, and when we got her brain right, much like Justin, her life became better. You see, and this happens so often. If you— and there's this map in the book from Schizophrenia Bulletin where if you look in the United States at the highest incidence of Lyme disease, it's basically the Northeast, the North Midwest, and the If you look at the highest incidence of Lyme and then overlay the highest incidence of schizophrenia, they're virtually identical. So if you have a psychotic disorder in these places in the world, you should at least be screened for Lyme. And often the lab tests may be normal, but people had joint pain. Right. Or, you know, in Justin's case, he had these funny tics and was very sensitive to sounds. Um, and I had known him for a while, so I'm like, something changed. And for him it was this infection and autoimmune response.

Well, I think it's, it's the difference between being schizophrenic, meaning the symptoms of schizophrenia versus having Schizophrenia, having a thing. You know, I used to always be so taken when parents of my patients would say, my child is ADHD. Well, he's ADHD. No, he— that's not who he is. It's not like he is an Episcopalian or he is a Caucasian. It's not part of his essence. He has certain manifestations of something that may be going on. Well, behind the curtain, why don't we try to pull the curtain back and see what is the cause of these symptoms? But again, so often in our society, it's looked upon as a drug deficiency, an antipsychotic in the case of schizophrenia or an antidepressant, as we talked about earlier. And it's not an easy road to hoe, as you know. We're up against a lot of challenges from mainstream medicine that wants to continue to perpetrate this belief and this mentality in terms of treating individuals. Without question, it comes from higher up in terms of who wants us to be simply using medications exclusively and not getting to the cause. I thought it was very interesting at a conference I attended this past weekend with many people you know and respect that because a lot of it dealt with nutrition and lifestyle. In the 11th hour prior to the conference, the CME credits were removed. How is that? The continuing medical education, so where doctors get credit for attending a conference, this one having to do with lifestyle, nutrition, etc., the CME credits got yanked by the certification body. God forbid doctors should learn that Our choices are powerful in terms of things like chronic degenerative conditions and certainly mental health. You also jump into, in your book, which I think is really very welcome, and that is the incredible value of sleep and the fact that it is so undervalued in our society of the stay-up-late, high achiever, et cetera. Yeah. What can you talk to us about as it relates to sleep and mental health?

Well, let me go back to the CME issue just for a second, because one of the things I just love about you is you're always teaching us the science and all of your work is really well-referenced. And in The End of Mental Illness, I went, okay, big title, you better reference the heck out of this book. It's got 1,084 references in it. There are actually 60 pages of references at the back. So the idea that a CME provider wouldn't provide those, it's just unconscionable to me because there is as much science for this new integrative approach to mental health as there is for the old science that really doesn't work. And there've been huge food fights among very powerful people in psychiatry. So in 2005, I went to the American Psychiatric Association and Tom Insel, who was director of the National Institute of Mental Health, basically said the DSM, which is how we diagnose things, is 100% reliable, which means if you make a diagnosis with these criteria today, you'll make them tomorrow. But then he went on to say it's 0% valid because it's not based on any underlying neuroscience. And then NIMH, National Institute of Mental Health, will actually not fund a study if you just make diagnoses based on the DSM, which is the status quo. So what I really love, they're really thoughtful people going, We need another way. And Dr. Insel recently gave a great testimonial for a book on inflammation in psychiatry. So, so I think you're making a difference and we're making a difference. It's just slow because of so much money involved in sort of keeping the status quo. But the status quo is broken and a whole bunch of people know that. Yeah. When it comes to sleep, it's so important. Teenagers who sleep just 1 hour less than their peers have a higher incidence of depression and suicide. When you sleep, your brain cleans or washes itself. And if you don't get enough sleep or you don't get healthy sleep because you're sleeping next to your phone or the room is warm or You're constantly being distracted, or you don't really see it as a priority. There's just a higher incidence of mental health challenges across the board. I'm doing a 6-month program now with the Newport Beach Police Department. We're creating a brain-healthy police department and police officers. And one of the big challenges is sleep because of their shift work. Yeah. And so really making that a priority. People who engage in shift work, higher incidence of obesity, which is a major mental health risk, a higher incidence of, um, ADHD symptoms and more mistakes toward the end of their shifts, um, when they are becoming sleep deprived.

Well, it is really a central theme in what we're talking about as well, decision-making. You're right. I mean, we as medical doctors went through this incredible life stress challenge called residency where we were sleep deprived for several years and were required to make life and death decisions that next Yeah. What a setup. What a setup for making mistakes, and mistakes were made. I mean, there's a book that's actually called Mistakes Were Made. You are so right. You mentioned the brain cleaning itself up, the activation during deep sleep of the glymphatic system. Dr. Walker recently described in a study how even the accumulation of beta amyloid in the brain is increased even with a single night of sleep deprivation. We know that impulsivity is increased, and we know that when challenged by a threatful image, the amygdala, or fear center, is 60% more active in people who did not get a restorative night's sleep in comparison to those who did. So, you know, I really want our viewers to know that there are so very many answers In your book for questions that we've had for a long time, and how wonderful it is now that we're really, through your work, getting to the sense that, you know, the brain is not disparate with respect to the rest of the body, that these ideas of lifestyle, nutrition, and sleep, and exercise, etc., are just as valid, if not more so, as it relates to the brain. Absolutely. And from my perspective, it has been always cognitive health. Your perspective is mental health, and we are talking about exactly the same thing. So your book goes so far to open up eyes in terms of prevention of mental illness, you know, certainly part of your subtitle. I want to read to our viewers your inscription To me in the book, it says, David, help me end mental illness. I want to help you with that, and that's why you're on the program today. We're doing everything we can to let the world know about this really— I'm going to tell you, I think you've got some great books out there, but this may be the best of all because I think everything you've done comes together in this book. Certainly, the spec experience does. But the recommendations and the levers to pull moving forward, I think, are so very well delineated. So you did an amazing job.

Well, thank you, my friend. I am— I think this is the most important book that I have written. It's just such a monstrous problem. And I actually dedicated it to my 2 nieces who Tana and I ultimately adopted. Uh, because they're loaded for mental illness. They have schizophrenia in their family along with bipolar disorder, depression, addiction. I mean, almost anything you can think of. And they were raised with chronic stress. So we know genes load the gun. It's what happens to us that pulls the trigger. And they were taken into foster care and their parents struggled with addiction and depression and domestic violence. So the whole idea behind The End of Mental Illness is how do I end it in them? And their babies and grandbabies. And they're both— they're 10 and 15 now. They're both A students. They're social. They're happy. This is serious. And it's personal to just so many of us that it's a message that I'm just excited to share.

Well, I think it brings up a very interesting point. I know we're closing, but I just wanted to emphasize that You know, there is a real appreciation that pretty much our genes determine everything about us, including our risk for mental illness. You know, if it runs in the family, then we're basically destined, or certainly a lot more likely. And I think, you know, if we look at the leading edge, we recognize that, as you say, maybe our genes predispose us, but there is an awful lot that we can do to offset those genetic predispositions, and also change the expression of those very genes that may be indeed increasing our risk via engaging various lifestyle changes that can absolutely change what we call epigenetically the expression of those genes that may be detrimental, not just as they relate to mental illness, but all kinds of issues, including dementia and heart disease, et cetera. So, my friend, give our love to Tana, and I wish you the best, and I'm so very, very excited about the new book.

Thanks, David. I'm so grateful for our friendship and for your help.

We'll talk soon. Bye for now. I sure enjoyed that. One of my favorite guests, of course, Dr. Daniel Amen. Again, the new book, The End of Mental Illness: A Bold And I think based upon what you heard today, he can substantiate that, you know, we can indeed reduce our risk for mental illness based upon adopting various lifestyle choices. And in addition, think about how these lifestyle choices and others of the techniques he described today can be very helpful and in the area of, in fact, Reducing the impact of these diseases. Well, I hope you enjoyed our program today. I sure did. Thank you for joining us. I'm Dr. David Perlmutter. Bye for now.