How to End Mental Illness with Dr. Daniel Amen

Coming up on this week's episode of the Doctor's Pharmacy.

Step number one is you get rid of the term mental illness and you call these things what they really are brain health issues that steal your mind. Get your brain right and your mind will follow. So the end of mental illness really begins with a revolution in brain health.

Hey, everybody, it's Dr. Mark Hyman. One part of my life that I'm consistently grateful for is good food. It helps me take care of my health and preparing tasty meals is one of my favorite ways to show love for people in my life. Now this time of year there are plenty of extra opportunities to bring community together over my favorite recipes. All the flavors of fall like sage and thyme and rosemary are taken to another level when paired with a good piece of clean meat. And that's why I want to take a minute to tell you about my favorite resource for ordering clean meat and seafood Butcher Box. Butcher Box makes it easy to get high quality, humanely raised meat that you can trust. Every month, I get 100% grass-fed and grass finished beef and wild Alaskan salmon delivered directly to my door. I honestly don't know what I did before I started using Butcher Box. It's as easy as it gets and the quality of their meat and seafood is incredible. Right now, Butcher Box has an amazing offer I'm excited to share with you. New customers can get a free 10 to 14 pound turkey, and I got one, plus $20 off their first box. Forget about reserving your turkey or waiting in crazy long lines at the market. Just get it delivered right to your doorstep. The turkey from Butcher Box is completely traceable from farm to fork and animal welfare certified with no antibiotics ever. And if turkey is not your thing, no worries. They got plenty of other delicious and sustainable options to add variety to your holiday feast and please everyone at the table. the holidays can be stressful enough, so don't let your meal planning be a part of that. Take advantage of this special offer from ButcherBox for podcast listeners. For a free turkey plus $20 off your first box, just go to butcherbox.com forward slash pharmacy. That's F-A-R-M-A-C-Y. Butcherbox.com forward slash pharmacy and enter the promo code, pharmacy F-A-R-M-A-C-Y at the checkout. I know you're gonna love ButcherBox as much as I do. And now let's get back to this episode of the Doctor's Pharmacy. Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman and that's Pharmacy with an F-A-R-M-A-C-Y, a place for conversations that matter. And if you know anyone who's had mental illness or you've suffered from any mental problems, this is the show you want to listen to because we're going to hear something that isn't talked about, which is that you're mental illness may not be what you think it is and can be fixed. In fact, we're going to talk about the end of mental illness with my friend and my colleague and teacher, Dr. Daniel Amen. Daniel and I go way back. We've known each other a long time. I first went to an Amen clinic where he scanned someone in my family in 2004 maybe and We've begun an extraordinary relationship this lasted over 15 years. And together we created something called the Daniel Plan, which was after Daniel from the Bible, although it could be Daniel, and with Rick Warren to put a faith-based wellness program in Saddleback Church, where we got 15,000 people to lose a quarter million pounds in a year and get healthy and fix their bodies and their brains. And, It's just been an extraordinary privilege in my life to know you and work with you. Dr. Daniel Amen has been called by the Washington Post the most popular psychiatrist in America and Discover Magazine listed his brain imaging research as the top neuroscience story for 2015. In fact, most psychiatrists treat the brain without ever looking at the brain. Daniel's a psychiatrist who thought, gee, maybe it would be a good idea to look at the brain and how it's functioning or not functioning. if we're gonna treat the brain and mental illness. He's a double board certified psychiatrist, 10 time New York Times bestselling author, amazing books that you've probably heard of, Change youe Brain, Change youe Life, Healing ADD, Memory Rescue, Change youe Brain, Change youe Grades, that sounds good, and the Daniel Plan, co-authored with Pastor Rick Warren and Dr. Mark Hyman, that's me. In March 2020, his book the End of Mental Illness will be published. This is going to be one of the most important books I think you've ever written because it reframes the conversation about mental illness in a way that I don't think anybody else is doing out there. He's the founder of the Amen Clinics, which has eight locations across the United States. He's got the largest database of brain scans related to behavior. I mean, think about that. We don't connect our brains to behavior, our mood. We don't look at imaging. We look at it if you have a tumor, but not if you have a mood disorder or if you have a psychiatric disorder, right? He's done 160,000 spec scans on patients from 121 countries. He's got a research team that's published more than 70 scientific studies. He's a lead researcher on the world's largest brain imaging and rehab study on professional football players who get their brain damaged all the time from knocking heads. His research has not only demonstrated high levels of brain damage in players, but also the possibility of significant recovery for many with the principles that underlie his work. In fact, I've seen those cases, I've seen those scans. It's impressive. This team has also published the world's largest functional brain imaging study on how the brain ages with over 62,000 spec scans. He's hosted 14 national public television shows about the brain and aired over 100,000 times. He's married to Tana and has a father of four children and five grandchildren. Daniel, I've had my brain scan with you twice and it's a very eye-opening experience.

So welcome to the Doctor's Pharmacy. Mark, it's such a joy. To be your friend, it's also a joy to be here and talk to the people who you touch.

Yeah, so, you know, I went to see you first when I was coming out of a period of mercury poisoning and real brain dysfunction, my broken brain, as I call it, and you've been on their broken brain docuseries. And there were a lot of holes in my brain. And I then have gone through using functional medicine, using your approach, And I scanned over a decade later and saw it was dramatically improved. And it was, you know, when you see that on yourself, you go, wait a minute. And I know, I know it's better because my brain's working better. And I go, you know, one of the stories we're telling ourselves about our emotions, our moods, our behaviors, our relationships, our ability to focus, our memory, our mood disorders, whether it's bipolar, schizophrenia, or anxiety or depression, What if the stories we're telling ourselves about those problems are just the wrong story?

So when I decided to be a psychiatrist, 1979, my dad 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. Nuts are good for you. So he doesn't- I recommend nuts all the time. He doesn't get Father of the Year Award. But 40 years later, I sort of understand where he's coming from, is we have diminished ourselves as a profession, psychiatrists, because we sort of don't act like real doctors. I mean, what medical specialist virtually never looks at the organ they treat?

Not to do a blood test or an x-ray or a scan, right?

Right.

And I was an x-ray technician when I was in the army. So I was first an infantry medic in 1972. Then I got trained as an x-ray technician and our professors used to say, how do you know unless you look? So when I decided to be a psychiatrist, I'm like, well, how do you know unless you look? Wow. That there's not one type of schizophrenic patient or one type of bipolar patient. And I always felt handicapped because cardiologists look, orthopedic doctors look, gastroenterologists look, everybody else looked. I was supposed to guess and I was not okay with that. And so when I got the opportunity in the late 80s to start looking at the brain, I was like a little kid, so excited. And when I looked at my own brain, I'm like, oh, that's not healthy because I played football in high school. I had meningitis twice as a young soldier. And I'm like, oh, no, I need to love and care for my brain. And oh, by the way, when you do that, your mood's better, your focus is better, your energy's better. So the whole idea, you meet six out of these nine criteria for depression, you're depressed. Well, heck, you and I can tell if somebody's depressed in 10 minutes. But what we can't do is tell what's the underlying brain pattern.

Or what's the cause, right?

And so why wouldn't you look so that you would have a sense of what to do? So the imaging just changed everything. And the second thing that changed everything was the ultramind solution, which is real.

Who wrote that book?

By Mark Hyman, my friend. and I told you this, I actually bought it for all the doctors. I have 40 doctors in my practice.

Oh wow. And I went- I wonder it was a best seller.

This is how you get the brain healthy. So the brain is an organ and your brain can have problems just like your heart can have problems. But most people who see a cardiologist have never had a heart attack. They're there to prevent them. So I am trying to create psychiatry where people know their risk factors and they attack them as soon as possible so that we can prevent depression, we can prevent bipolar disorder, we can prevent ADD, or if we can't prevent them, at least we treat them in a whole person functional medicine approach. I mean, what an idea. And when we do that, their brains look better.

Yeah, I mean, you've pioneered an extraordinary breakthrough idea. I mean, everybody goes, how do you keep your heart healthy? Well, I know. I exercise, I eat a healthy diet. You know, I don't smoke. I keep my blood pressure under control. But if you say to someone, how do I create a healthy brain? They're like, I don't know. And the doctors will say, I don't know. Maybe walking is good for your brain. They know now maybe eating better is healthier for your brain. These are ideas that just weren't in medicine until just recently, and you really helped bring that along. And I think that the challenge we have now is that we actually are in a period of time where the meaning we have given to mental illness we're discovering is wrong. The meaning when we say someone has depression or anxiety or bipolar or schizophrenia, it's kind of like shaming and blaming as opposed to like there's something wrong with you instead of like, Oh, you have a broken leg. Let's work on your broken leg. It's a very different frame.

It is. And that's what the imaging did for me because what I realized, and actually realized it fairly quickly, these illnesses aren't mental, they're brain. And that one idea begins to change everything. And the idea behind the End of Mental Illness and the title, I dedicated the book to my two nieces, Amelie and Alize. And they are loaded for mental illness in their family. We know there's a genetic component in their family history. There's schizophrenia, bipolar disorder, multiple suicides, OCD, PTSD, criminal behavior, depression. But genes only load the gun. It's what happens to us that pulls the trigger. and they were raised by two parents who were chaotic. They had substance abuse. They had machine guns with no license. Domestic violence. They were moved multiple times and about four years ago they were taken by Child Protective Services into foster care. And at the time my wife Tana was estranged from her half sister Tamara and we got a call from CPS and it was the worst- Child Protective Services. Child Protective Services, worst week in my marriage because I wanted to adopt the children. And she's like, I grew up in crazy. I do not want crazy in my family. And so we really had trouble. And we came up with a compromise, which was we wrapped services around their mother. We scanned her at our clinic in California. We got her in a drug treatment program. We did all the brain health things we do for our patients. And on Mother's Day, 2017, she got the children back. Wow. The end of mental illness is how do I end mental illness? in these girls and in their children and grandchildren. And how you do it, I write it out in the book. And step number one is you get rid of the term mental illness and you call these things what they really are, brain health issues that steal your mind, get your brain right and your mind will follow. So the end of mental illness really begins with a revolution in brain health. just like you and I did with the Daniel Plan. So it wasn't just those 15,000 people who got that, right? Thousands of churches around the world did our program.

We've got 30 in Cleveland doing it now.

And they decreased their medications for mental health issues. It improved their moods, their energy, their memory, their relationship. I mean, the stories you and I have heard.

I remember that woman who came up to me after six weeks when we went back to the church and she had been depressed her whole life in and out of psychiatric institutions, on medications, her marriage was struggling. She didn't know if she could work anymore. And she said, Dr. Hyman, is it possible that my depression could go away in three days? I'm like, well, yeah, if it was related to something you were eating. And it was. And she not only lost like 45 pounds, but she was able to get her life back in a way that that she really hadn't in decades and decades of traditional psychiatric treatment.

We heard that story just over and over again. Get your brain right, your mind will follow. But in order to get your brain right, you actually have to get your body right. So step number two is once we get rid of the term mental illness, you have to fall in love with your brain.

But before we go into that, I just wanna spend a minute on this 'cause it's such a big paradigm shift. If you think about all the labels we give people, we call it the DSM-5, which is basically the psychiatric manual that categorizes people according to their symptoms. It's a way of describing mental illness that doesn't actually represent the biology of what's going on. It doesn't represent the causes. And it guides people down a treatment path that really has been a massive failure for the most part, right?

Our outcomes are no better than they were in the 1950s.

Yeah, and mental illness is on the rise. I mean, I looked recently at the costs of healthcare. over the next 35 years, it was $95 trillion. And the most expensive disease was mental illness and depression. Why? Not because you're in the hospital, but because you lose quality of life, you lose productivity, you can't work, you can't function, you can't be a happy member of society. And so, you know, we have to sort of get over the idea that mental illness is a psychological and emotional problem. and start with the premise that it's a brain problem, fix that, and then, yeah, you might have to deal with some psychological and emotional issues, but you can't do it in the reverse order. It's very hard. I always say, I can give you a lot of morphine if you have a broken ankle. Might help you walk a little bit, but it's not gonna fix your ankle, right?

So I think of it in four big circles that we all have a biology. So that's the hardware of your brain, the actual physical functioning of your brain. If you try to program that, without fixing the hardware, it's not going to work. So there's the biological circle, there's a psychological circle, how you think, is really important. So I think of that as software. There's a social circle, which is who you hang out with. So in the computer analogy, think of that as network connections, right? You become like the people you hang out with. And one of the things I may have gotten from you is if you want to get healthy, find the healthiest person you can stand and then spend as much time as him or her as possible. Right. If all your friends are eating McDonald's.

And having french fries and beer and watching TV all day, you're going to be probably overweight and unhealthy. If they're all drinking green juice and.

Going to yoga class, they're probably going to be healthier. And then there's the spiritual circle, which is why the heck do you care? Why are you on the planet? What's your sense of meaning and purpose? Both you and I work really hard because we're both very purposeful people and we believe we're here to do something important. And if you don't have meaning in your life, it's sort of hard to, if you don't know the why, it's hard to do the what.

Yes.

And so, but going to therapy, and I'm a huge fan of therapy, once your brain works right makes the most sense otherwise It demoralizes you. There's actually side effects to going to therapy with a troubled brain because it won't work. And then people have spent money, they've spent time, they've spent energy, and it's not working. So they get demoralized and wonder what's the matter with them. And it could have been the head injury, it could have been the toxic exposure, like you talked about what happened to you in China when you were there. It's so many different potential It could be because your body's chronically inflamed because your gut's not healthy.

Right.

And get your body right, get your brain right, your mind's better, your mood's better. And we're going the wrong way, just like you said. Tom Insel, who is director of the National Institute of Mental Health, said the DSM that you mentioned is 100% reliable. What that means is if you make a diagnosis with depression today using the DSM, you'll make the diagnosis tomorrow. But then he went on to say it was zero percent valid.

Right.

Because it's not based on any underlying neuroscience. So you see, and that's why my profession dismissed scans because it didn't fit their diagnostic model. So rather than throwing out the Bible and going with neuroscience, they threw out neuroscience and said, oh, imaging's not helpful. And, you know, it's like many-- Michael.

Pollan said once that psychiatry is brainless, right?

It is. And I'm trying to change that because why should I be a diminished medical profession that other people make fun of? I'm not okay with that because it hurts millions of people. You can try and kill yourself today in every major city in the world and no one will look at your brain. Yeah, that's insane.

Yeah, scary. So thank you for reframing mental illness to be primarily a brain disorder that can be fixed by fixing your body and then fixing all these other circles, right? Because it's much easier to fix your other circles if your brain's working, if you're not mercury poisoned, or your thyroid's not working, or you're not B12 deficient or vitamin D deficient, or you're not pre-diabetic, all those things will mess up your brain, right? So it's much easier to do the work of actually creating meaning and purpose in your life and being happy and dealing with the psychological issues if your brain's working properly.

No question about it. And if you've been traumatized, and so many people have because they've been raised by parents who have brain issues, then it changes your brain in a negative way. So put the brain in a healing environment, the psychological work becomes so much easier.

So why is it so prevalent today? I mean, every 14 minutes someone commits suicide, every eight minutes someone dies of a drug overdose. 51% of the population at some point in their life have some mental issue. A quarter of the women population in this country are on antidepressants. Like, what's going on?

Well, there's a part in the book, a writing device that I just love. It's called if I Was an Evil Ruler and I wanted to create mental illness in America, how would I do it?

Yeah. And basically create the food system we have.

Basically, I create American society where our food system, you know more about this than anyone, our food system is broken, right? I mean, 70% of us are overweight. 40% of us are obese. I published two studies that show as your weight goes up, the size of your brain goes down, which should scare the fat off anybody.

Size and function of your brain.

Size and function of your brain. And because the fat on your body is not innocuous, it increases inflammation, it stores toxins, and it takes healthy hormones and turns them into unhealthy cancer promoting. forms of estrogen. And so if you just think about that, that one thing by itself, our food, I actually think is responsible for almost half of the mental health challenges in America. There's this fascinating study from Australia where they looked at two outer islands. One of them had fast food restaurants, the other one didn't. And then they looked at their Omega-3 index. And the island with fast food restaurants had significantly lower Omega-3 index and five times the level of depression. Think about that.

Yeah, of course.

Just with the food.

There was some kid recently that went blind from eating Pringles and french fries because he was so vitamin deficient. He basically had xerophthalmia, which is from vitamin A deficiency. I mean, think about it. Junk food is gonna make you blind, not just fat and demented and diabetic.

Well, and that's one of the reasons I'm a fan of multiple vitamins because we're basically a vitamin deficient society with deficiencies and magnesium and vitamin D and choline and vitamin B and C, Bs and C. And so I just think it's a smart thing to sort of hedge your bet. 97% of the population is low in omega-3 fatty acids. They have suboptimal levels. I actually did a study of 50 consecutive patients who came to our clinic. We're not taking fish oil. 49 of them had suboptimal Levels.

I mean, it's striking when you start to look and test, which most doctors don't. I mean, you actually are scanning people's brains. I scan their bodies through testing that looks at all these variables that most doctors don't look at.

Right?

How many doctors look at omega-3 levels in your body? Most don't. But it's essential for my practice because I can't tell what's going on if I don't know what's happening.

Now, it's 25% of the membranes in your brain are made of omega-3 fatty acids. and so if they're low, your brain's not going to talk very well to itself. Yeah.

I mean, if you're listening, I think most people, and I think this is true, I've seen in my family, I've seen it in my patients, most people with some type of mental disorder, there's a stigma. There's a sort of a blame game going on, and there's a shame about it. What your work is really doing is stopping that, saying that's just nonsense. It's like, would you shame somebody for having cancer or diabetes or an autoimmune disease? No, you wouldn't. You would try to sort through what's going on and look at the biology and that's what you've done. So tell us why people are suffering from things like depression, anxiety, bipolar disease, ADD, panic disorders, bipolar, you know, schizophrenia, even addiction. Why should they be hopeful now?

Because if they see it from a brain perspective, what we've learned is you're not stuck with the brain you have. Probably the biggest advance in neuroscience over the last 20 years is this concept of neuroplasticity, that you are not stuck with the brain you have. You can make it better. And every day you're making about 700 new hippocampal cells. So the hippocampus has stem cells. and the hippocampus, you know, is Greek for seahorse. So every day you're making about 700 new baby seahorses and your behavior is either helping them grow or it's murdering them. And one of the things I think is really interesting, my 16 year old daughter, she and I, I'm 65, we're both making about 700 new baby stem cells in our her hippocampus, hers are more likely to stick around than mine because of blood flow. So new research, brain cells don't age. It's your blood vessels that age. So anything that damages your blood vessels damages your brain. So if you know how to increase blood flow, so things like exercise and ginkgo and beets and rosemary and pepper, I mean, really simple things can actually help improve the function of your brain.

Ping Pong, that's your thing.

Table tennis. But you're not stuck with the brain you have. You can make it better. And most people don't know that. I was just in Florida.

By the way, Dr. Amen is a mean table tennis player who whips my ass every single time. It's embarrassing.

And there's actually a study from England on who lives the longest. So they looked at sports. And so if you don't play any sports, you don't live long.

Tennis players live seven years longer.

If you play football or soccer, you don't live longer than anybody else.

Because you're butting your head with the ball.

People who play racket sports live the longest. And that's why I play table tennis. Because you got to get your eyes, hands, and feet all to work together. While you think about the spin on the ball.

Yeah, yeah, I picked up tennis when I was 45 and I work out as much as I can. It just makes me so happy and I think it has kept me younger.

And... Well, it activates your cerebellum. And the cerebellum, you know, the young people listening, you're not gonna know who this is. It horrifies me. I call the cerebellum the Rodney Dangerfield part of the brain. It gets no respect. Even though it's 10% of the brain's volume, It contains 50% of the brain's neurons. And the cerebellum is not just involved in coordination, it's involved in processing speed and thought coordination. And so when you play tennis, you're activating the cerebellum, which, oh, has reciprocal connections with your frontal lobes. So it's actually making you smarter, more focused. It's really a great game.

Yeah, I get so... And there are.

No head injuries with... No. Tennis or table tennis.

And then you're not paying attention and the ball hits you. So, actually, when I'm really clumsy, I'll hit myself in the head with a racket. But that's not usual. So, this conversation is fabulous because we're reframing mental illness to brain health. And you have in your book, the End of Mental Illness, a simple way of thinking about this you call bright minds, the 11 risk factors that steal your mind and how you avoid them. Can you take us through that?

So a number of years ago, I realized if you want to keep your brain healthy or rescue it, if it's headed to the dark place, you have to prevent or treat the 11 major risk factors that steal your mind. And bright minds is the mnemonic we came up with. And the B is for blood flow. Low blood flow is the number one brain imaging predictor of Alzheimer's disease. It's also associated with addictions, it's associated with depression, it's associated with ADHD and schizophrenia. So you want to do everything you can to protect your blood flow. And 40% of 40-year-old men have erectile dysfunction. Do you know what that means? 40% of 40-year-old men have brain dysfunction. If you have blood flow problems anywhere, it likely means they're everywhere.

Right.

So you know you have blood flow problems if you get a scan, because spect is a blood flow study. If you have hypertension, if you have any form of heart disease, if you don't exercise. So it just gives you some very simple things to do. The R is retirement and aging. When you stop learning, your brain starts dying. And, you know, I turned 65 this year, and I've seen thousands of 60, 70, 80 year old brains. And the news is not good. It's sort of like, you know, as we age, our skin begins to fall off our face. The same process happens in the brain, unless you're serious about it, right? I mean, I have your scan 10 years apart, and as you got older, your brain got better. Well, how exciting is that? that you're not- Make me happy.

I'm very competitive.

With the brain you have. The eye is inflammation that, I mean, both you and I know, it's a disaster. Inflammation is a disaster for every organ in your body.

It's true.

Including your brain. And so people can measure their omega-3 index, see where you are after progress.

But before you go into what you can do, it's important to underscore this. from the research today that depression is inflammation in the brain, that autism is inflammation in the brain, that ADD and dementia are inflammation in the brain. And if that's true, then the question is what's causing the inflammation? How do you stop it? And how do you fix it? So tell us about that.

So if you have a low Omega-3 index, taking Omega-3s can be really helpful. You have to get your gut right, because having this thing, and I'm a psychiatrist, I didn't know one thing about leaky gut until I read the UltraMind Solution. And then I'm like, oh, you have to get your gut right. Because if your gut's not right, your brain's not right. You're likely to have things get inside your body that have no business in your body, which causes an autoimmune or an inflammatory response. So food really matters. Sugar is Pro-inflammatory and foods that quickly turn to sugar, bread, pasta, potatoes, rice. You want to, you often say, eat them like a condiment. That less is better. Recreational drug. Recreational drug.

They don't even a condiment. Sugar is a recreational drug. It's fine, but.

Didn't you say the four white powders?

Deadly white powder.

Deadly white powder, white flour.

White sugar. cocaine and too much salt.

So diet really does matter. And our processed foods are loaded with pro-inflammatory omega-6s. So corn and soy, we're overloaded with them. I mean, not that they're evil, but they're not the right choice as primary staples in our diet.

But also things like infections and mold and other things.

We're gonna get there. So the eye is inflammation and so get your gut right, omega-3 fatty acids, the G is genetics. And the big lie with genetics is I have obesity in my family and that's why I'm fat. Well, the fact is I have obesity in my family. I have a brother and sister who are 150 pounds overweight, but I'm not. Why?

You're wearing a skinny suit.

Because I know the behaviors that make it likely to be so. So genes are not a death sentence. What they should be is a wake up call and tell you what you're vulnerable to so that you get serious about prevention.

I mean, you're in better shape now than when I met you 15 years ago.

Sure.

You lost more weight, you get more muscle, and you're 15 years older.

And I work on it. Right, but because I love what I do. quite frankly, I have four children. I never want to live with them. I love them. I want to be independent for as long as possible. I don't want them being worried about taking away my driver's license. That means I have to take care of my body because my body will then take care of my brain. But that causes you to think ahead, which is of course a brain function. The H is a national epidemic that nobody knows. It's head trauma. Head trauma is a major cause of psychiatric illness and nobody knows about it because psychiatrists, psychologists, marriage and family counselors, counselors, they never look at the brain. And so that fall out of a second story window that caused you to be angry and depressed, nobody's thinking about rehabilitating the damage that occurred. That's why you really shouldn't let your children hit soccer balls with their head play tackle football. And if you've been in a car accident and then you got depressed, somebody should look at your brain and then you should go about rehabilitating it. That's what I did with the big NFL study. And we published a study, 80% of our players get better in as little as two months.

It's amazing.

By putting them on our Bright Minds program. So I'm pretty excited about that. The T is toxins. And when I first started scanning people, I mean, it was really clear that marijuana, alcohol, cocaine, methamphetamines, heroin are bad for your brain. But then I would see these toxic scans of people who never use drugs. And I'm like, oh no. I had not one lecture on mold exposure when I was a psychiatric resident or heavy mercury or mercury poisoning or lead exposure. None of that. And so we often we find ourselves working up a toxic brain. And did you know 60% of the lipstick sold in the United States has lead in it? So I think that is the kiss of death. And so I know you know this app, Think Dirty. And when I downloaded it, you can scan all of your personal products. I threw out half of my bathroom because it was basically toxic. Things like parabens and phthalates, they're called hormone disruptors. which we're gonna get to in a second, but you don't want, whatever goes on your body goes in your body and affects your body. So you have to get rid of the toxins. And basically it's decrease exposure and support the four organs of detoxification. Kidneys, drink more water, gut, eat more fiber, liver, stop drinking. I'm just not a fan. I mean, we can talk about it. But it disrupts liver function and sweat with exercise or take saunas. People who take the most saunas have the lowest incidence of Alzheimer's disease. So M is something I call mind storms. It's abnormal electrical activity in your brain. So if you have a hot spot in your temporal lobes or cold spot, what we see it's akin to seizure activity. So sometimes anticonvulsants can really help. A ketogenic diet has anticonvulsant properties. There's this great book, it's written in 1980 by Jack Dreyfus, who's the founder of the famous Dreyfus Mutual Fund. And he said, A remarkable medicine has been overlooked. And it was Dilantin, which is an old anticonvulsant. He'd been going to see psychiatrists forever. He said, Three days on Dilantin. he didn't need a psychiatrist anymore because it had balanced his brain. And so the second eye is immunity and infections. If you look at a map of the United States and you look at the highest incidence of schizophrenia, overlay the highest incidence of Lyme disease, they're identical.

Incredible.

Incredible. Anybody in the West or the Northeast or the Northern Midwest should be screened for Lyme if they have a psychotic disorder. You just need to screen them for it because if they have it, treating it may actually treat their, quote, mental illness that is not mental. It's brain.

The body you treat the brain.

Yeah. N is neuro hormone deficiencies. D is diobesity. You know, as your blood sugar goes up and your weight goes up, your brain gets smaller as we talked about. It's getting your weight right, your blood sugar right, and S is sleep. This is how you keep your brain healthy.

Pretty common sense. Right, but nobody's put it together. It's like, you know, it's a functional.

Medicine approach to Psychiatry with Imaging.

It reminds me of what T.H. Huxley said when he heard of the theory of evolution. He said, how stupid not to have thought of that. You know, it's so self-evident and yet medicine is so behind the times on this. And the end of mental illness, this book, I think, hopefully will change the conversation, will be not just about providing more services or programs, but providing the right services and the right programs. And that's so, so important.

So.

Tell us about some of the biggest ahas you've had from looking at thousands, literally hundreds of thousands, of brain scans. What are the things you've learned from looking at people's brains?

So, the first one is you can make it better. I mean, I love that concept that I saw this patient in May and he had mold exposure. He grew up on a farm and was exposed to a ton of pesticides. He was a mixed martial artist and so on. And that's true for most of our patients. You know, if you end up at one of our Amen Clinics, it's not one of the Bright Minds risk factors you have. You often have seven. and three months later I scanned him again after supplements and hyperbaric oxygen and his brain was radically better. And he's so excited. In fact, when he saw his scan the first time, he doesn't have children, but he said, It's what I imagine if I had children. When I saw my brain for the first time, I fell in love with it and knew I would never, ever do anything purposefully to hurt it. And so he fell in love with his brain. So I love that. The second big lesson is mild traumatic brain injury ruins people's lives and nobody knows about it. And our society...

It's fine, mild.

Where you might not even lost consciousness. So when I met Tana, you know...

Like if I bumped my head in a doorway because I'm tall.

You know, probably not that, but if you fell down a flight of stairs, if you're in a car accident, even going 10 miles an hour, if you look at that accident in slow motion, there's this whiplash that occurs and your brain floats in your skull, which means it slams against the front and then it slams against the back.

Falling off a jungle gym when I was five.

That can, and in my head, getting a concussion. Or, you know, when I scanned Tana.

After I met her, that's my wife.

That's what you do on the first.

Date, you put your, no, but I do it.

Perspective, Before I fall in love with them.

She said, Excuse me, come here. Go in the scan.

She never heard the line where I wanted to see your naked brain. And I could tell she'd had a head injury in the past. And she goes, no, but I didn't. And I said, well, you're over in a car accident. And then all of a sudden, 'cause she said, no, no, no, no. She said, oh, we was in a car going 75 miles an hour. Her sister fell asleep at the wheel. and got so she flipped the car two and a half times and then they came to a stop and I'm like, oh, you don't think that had an impact on your brain? So things that people have forgotten or don't even think about. So that was a big aha. I grew up Catholic, like not kidding Catholic. My mom was serious about the whole thing and so I sort of had the idea of good and evil as black and white. or free will is black or white. And when I started scanning people, people started sending me real, people did really bad things. We've done over 100 murderers. And I began to go, free will is not zero or 100. It's gray. That most of us have about 80% free will. But if you have that accident, maybe that's 50%. And that six pack of Michelob may take your free will away. And so when President Obama, after Sandy Hook, said we need more services for mental health, well Adam Lanza had seen multiple psychiatrists. He was on multiple medications. We don't need more money for mental health as it's currently practiced.

That's what I was saying.

Virtually all the school shooters have had a psychiatric history where nobody looked. at their brain.

So tell us some stories of people who've mentioned the head trauma, you've mentioned the football players, you mentioned your sister-in-law. If someone comes in and has bipolar disease or depression, what are you seeing? What areas of their brain are not working? And what are the kinds of things that you've seen? Because what you're basically saying is that, Mark, when you say someone has depression or bipolar or schizophrenia, it's meaningless. It doesn't tell you the why. and that looking at the scans, you can have 100 scans of people with depression and they might all need different things.

Well, let me tell you a story from the book. It's one of my favorite all-time stories of a couple who failed marital therapy. Now, I don't know if you went to marital therapy. I certainly did in the past. And it's hard. Well, this couple went for three years, spent $25,000, and then the therapist gave them an F. She flunked them. she said, get divorced. Well, they got really upset with her. And when they got angry at her, she said, well, I know a doctor in Costa Mesa, California, who takes care of really difficult people. You should go see him.

And so as part of our process.

We scanned them both. And the wife actually had a pretty healthy brain. His brain was just full of holes, just like a drug addict. Yeah. And when you say holes, you mean.

Areas that aren't getting blood flow. Right.

Areas of decreased perfusion. How we render them, they look like they have holes in them. And just like a drug addict. But in his history, he said he didn't drink and never did drugs. Now, it's the first thing they teach us in psychiatry school about addicts. They lie. They lie. They lie a lot. And so in front of his wife, I went, Are you sure you've never done drugs and you don't drink? And he said, Dr. Amen, I have many problems. That's not it. Now, the therapist diagnosed him, with a mixed personality disorder with narcissistic and antisocial features. And so she basically called him a jerk. That's our way of calling someone a jerk. Saying you're a psychopath. Right.

And so when he said he wasn't.

Doing drugs, I looked to the wife and I said, Is that true? And she said, oh yes, Dr. Ramon. He doesn't drink. He's never done drugs as far as I know. He's just an asshole.

It comes by naturally.

And like you, I laugh, but in my head I went, well, then why does his brain look so bad? And I went through the differential diagnosis. Drugs, alcohol, probably not. If, you know, he and his wife says no, an environmental toxin, anoxia, lack of oxygen at some point, severe hypothyroidism, severe anemia, an infection. And so my next question to Dave was, where do you work? he said, I work in a furniture factory. I said, what do you do? He finished furniture. He was doing drugs. He was doing the worst drug of abuse, which is inhaling organic solvents. Because what do organic solvents dissolve? Fat. 60 of the solid weight of your brain is fat.

Wow.

So they were damaging. And so in that, they call that VOCs.

They're off-gassing from all the furniture. and carpets and paint and...

Which is why every firefighter often have toxic brains because when you light the couch on fire, it's producing all of those chemicals in the brain. And so after she told me that, I said, after he told me that, I said to the wife, I said, so when did he become an asshole? She said, what do you mean? I said, did you marry him that way? Do you have father issues you're trying to work out? And she said, no, he was great when we got married. It wasn't until about five years ago, and then she put her hand over her mouth.

And that's when he got that job.

God, about the time he got that job, he started to change. And so it shifted from he's an asshole to he's sick. In his attempt to being a good husband, by going to work and supporting his family. He's being poisoned. And so for me, I took him out of that job, at least that position in the plant where he worked, put him on a rehabilitation program, and they didn't really need marital therapy. What he needed was brain rehab. And get your brain right. It's easy. I mean, both you and I are married, and you know, it's hard to be married with a good brain. But with a bad brain, it's really hard. But no marital therapist thinks about, well, what about the physical functioning of the two brains that are in front of me?

Well, that's a radical idea. You know, you have to get a brain scan in order to go to therapy.

Because what if it's the head trauma? Or what if it's the toxic exposure? Or what if it's you just both have a terrible diet leading to inflammation? and you both have inflamed brains, which means now you're anxious and depressed and you take things the wrong way. This is not the sign of love, right? When your brain works right, you tend to be more empathic, more thoughtful, more loving. You can see things from their point of view, not just your own.

Right, I mean, it's a very different framing instead of you're a jerk to your brain is broken and takes your brain and you're not a jerk anymore. And you've seen this over and over again.

Thousands of people. We actually do a formal outcome study on everybody we see. So I have outcomes on 6,500 patients. We have the best outcomes. On average, if you come to Amen Clinics, you're complicated. You have 4.2 diagnoses, you failed 3.3 providers, and five medicines. At the end of six months, if.

We treat you- so you're a resort doctor.

The doctor of last resort. Doctor of last resort. Just like you. At the end of six months, 84% of our patients say they're better.

How many?

84%.

That's unbelievable.

For a treatment resistant group. But we get to look at their brains. How do you know unless you look? I mean, it's insane that we're not looking at the brain.

What's also fascinating in your work is that it's not like you're anti-psychiatric medication. You're gonna use whatever the right tool is, whether it's exercise or sleep, or diet or supplements. But you also, just so fascinating to me, you can look at someone's brain and see which areas are working or not working and then you can match the medication specifically to that exact issue. It's sort of like an antibiotic. We use different antibiotics if you have strep or different antibiotics if you have Clostridium or different antibiotic if you have pseudomonas. It's really specific. And we don't do that in psychiatry. So we guess based on their symptoms, but we don't look at the areas of their brain that are working or not. And that's so fascinating to me.

Well, another one of the big ahas is depression is not one thing. Yeah. Seven things. ADD is not one thing. It's at least seven things.

Maybe more.

Addictions, at least five different things. You can be an impulsive addict, often with ADD, a compulsive addict, closer to OCD, a sad addict, an anxious addict, an impulsive compulsive addict, a temporal lobe addict, often based on head trauma or these mindstorms. And people are trying to medicate what's going on, but if you don't really understand their brain and you put everybody in a 12-step program, it's not going to be as effective as it could be. is if you know what type of brain they have and tailor the treatment. The same with obesity. You and I have talked about this before. You have impulsive overeaters, compulsive overeaters, sad overeaters, anxious overeaters, know your type so you can target the treatment. To put someone on a ketogenic diet that has a compulsive overeater brain, you make them mean. I was on Rachel Ray's show and we were talking about this and she's a, people can actually go to brainhealthassessment.com and take our free brain type test. And she was a type three, which was a compulsive overeater. And she goes, oh, I went on the ketogenic diet and I was so mean, I wondered why my husband didn't leave me. So balancing your food to the brain type can be really helpful.

So, talk about supplements because there's a lot of controversy about supplements. A lot of data is coming out lately that supplements don't work. I think that the story is more complex than that.

I'm a huge fan of supplements and, you know, I mean, full disclosure, I own a supplement company, BrainMD, and the reason I do, I mean, I had not one thought when I was younger about owning a supplement company, but when first started doing scans in 1991, I realized some of the medications I prescribed, particularly opiates and benzos, are toxic to brain function. And I remember in medical school, I'm sure you do too, this term first do no harm, use the least toxic, most effective treatment. So I started to research, well, is there any science behind natural supplements? And at the time, there already was. There were science behind SAMe and L-tryptophan and 5-HTP and omega-3 fatty acids, and magnesium, and B vitamins. Vitamin D. There's a whole field of orthomolecular psychiatry, and I got really excited about first do no harm. And so in the end of mental illness, there are actually whole sections on if you have depression, what are the 10 things you should do before you go on an antidepressant? If you have anxiety, what are the 10 things to do? If you have ADD or an addiction, what are the things to do before you go on medicine. And I'm not opposed to medicine. I use all the tools in the toolbox. I mean, if you have bipolar disorder or schizophrenia, medicine is the first thing I'm thinking about for you to stabilize the situation until I can try to understand those bright minds risk factors and go and attack each of them. The science is always fascinating and you want to go, okay, who funded the science and that's true on both sides. You know, is it the supplement companies or is it the pharmaceutical companies?

Or the food companies.

The people that make Zoloft actually did a study on St. John's wort and they found it didn't work. Except when you actually read the study, it did work except for the most severely depressed people. But that wasn't the headline. The headline was St. John's Wort doesn't work. Well, the fact Zoloft doesn't work for severely depressed people, nothing works, no singular product. And one of the reasons why supplements don't work, like ginkgo or vitamin E, is the brain does not get sick in one way. So, single supplement like single medicine ingredients often don't work. You have to take a multiple mechanism approach. And that's why Brain and Memory Power Boost, our memory formula, has seven things in it so that we can attack multiple risk factors at once.

I think it's very important. People don't understand what they do. They actually regulate all these biochemical processes in the body. They regulate hundreds and hundreds, thousands of enzymes in the body that are required to make your chemical reactions go. so for example, if you don't have B6, you can't convert tryptophan from your diet, from your turkey, into serotonin. It's just simple biology, but somehow these supplements are seen as these weird things that aren't really part of our biology, but they are essential. And I think that's something that I've learned and the widespread nature of these deficiencies and the other things that go on are really important.

Choline, for example, There's a widespread deficiency in choline, and choline helps you with memory, and it helps you with learning. And people who are vegans often have deficiencies in choline because they're easier to obtain for things like eggs and meat and poultry and fish. And so if you know that, then supplementing with it can really help you. and that way you might not have to give up the lifestyle that you've chosen, whether it's being a vegan or a vegetarian.

Yeah, it's so important. And I think what you said is really important. People think of them as sort of single target, single agents, but they work as a team. You know, Michael Jordan, best basketball player ever arguably, right? But he couldn't win an NBA championship on a team by himself. You know, he needs all the other players.

Absolutely correct. And the brain doesn't get sick in one way, so it's not going to get better often by just doing one thing.

I think that's really what the premise of functional medicine is, is that it's not just about treating the disease with a pill. It's about looking at all the variables that create imbalance in the body or the brain and fixing those. You can't just do one thing. And that's what we were trained in medical school, do one thing, and then that's it. It's called Occam's Razor. And that was sort of the epitome of being a good doctor, was you found that one single magic thing, that magic pill that fixed everything. Now, what you're saying is that this is just a nonsense idea that doesn't reflect the complexity of our biology or our brains.

And, well, if you believe Irving Kirsch from Harvard, that antidepressants by themselves really work no better than placebo, except for the most severely. depressed people and even then not very well. And now I've been a doctor like you for a long time and I know they do work when I target them properly to someone's brain and they work better when I get them to eat right. They work better when I get people to exercise. They work better when I use supplementation. They work better when I optimize their hormones. They work better when I get them to sleep. And you know one of the other big ahas, And I'm not a sleep doctor, but sleep apnea damages your brain.

For sure.

And you can actually see it on a scan. So I have gotten so many brains better just by getting a sleep study and then having them wear a CPAP. And so many men, they don't want to wear the CPAP because, you know, it doesn't make them feel masculine. But without it, they're literally murdering thousands of brain cells every night.

Yeah, it's pretty frightening. So all these things are necessary. You can't just do one thing. You have to follow the whole Bright Mind model, which is essentially a functional medicine framework, but you've sort of crystallized in these really easy mnemonic. And I think in your book, you break it down for people and you give them really practical strategies for how to do this on their own. And I remember, you know, in the Ultramind Solution I wrote 10 years ago, I basically said, well, how do I treat patients? What questions do I ask them? What conclusions do I make from those questions? And then what do I do? What's my algorithm? And I essentially created that in the book. I said, okay, fill out a questionnaire. Do you have magnesium deficiency? Do you have omega-3 deficiency? Do you have vitamin D deficiency? Is your thyroid out of whack? Do you have gut issues? Are you toxic? Are you pre-diabetic? And is your sex hormones working or not? And I basically gave them a score. And then I said, well, if your score is over X, then you should add these few things. Do these different diet things, do these different supplements, see how you do. And then if that doesn't work, then go see a doctor. But not only doctors, you have to check these specific tests and do these specific things. And this one woman came to see me after I'd written the book. It was maybe a year later or so, and I said, so, hi, how are you doing? Why are you here? She says, well, I don't really have anything. I said, well, why did you come? She said, well, it took me nine months to get this appointment. I said, oh, she said, I read your book, the Alter Mind Solution, and I just follow what it said. and everything went away. And I'm like, okay, well, why are you here then? She said, well, I thought maybe you could tell me something new. I don't know. And it was like. And then I realized, you know, a lot of this, not all of it, but a lot of this can be done at home by people learning how to take care of their brains. And that's the work you've done. That's your contribution to the world. It's really. It's really amazing. I I think you should win the Nobel Prize for this. But anyway, that's just me. But I think it's. It's such a powerful model shift at brain. a shift, a frame shift, a paradigm shift for what we need to do in this era of expanding mental illness. Our kids' brains are being destroyed. You know, there's suicide on the rise, Alzheimer's on the rise. And if we just thought about how.

To take care of our brains, it would all change. I worked with BJ Fogg.

Do you know BJ?

Yeah. Behavior change guy. At Stanford on behavior change. We worked with him for six months and created 50 tiny habits for brain help. But my favorite one is takes three seconds. Before you go to make a decision, ask yourself, is this good for my brain or bad for it? And if you can answer that with information and love, because doing the right thing is never because you should do it. It's because you love yourself. You love your life, you love your family, you love your mission. If you can answer that question with information and love, you're really going to be on the road to brain health and the end of mental illness.

That's so great, Daniel. Is there anything else you want to share with us? Where can people find help if they're struggling with brain illnesses?

So, if they go to aminclinics.com, they can learn all about the eight clinics we have around the country. Tana and I have a podcast. You've been on it. Thank you. Called the Brain Warriors Way podcast. Brain www.mindfulevolution.com, we've done 500 of them now. Yeah, we would, and they can get the end of mental illness when it comes out in March.

Fantastic. I'm so excited for your new book. I think it's going to change the way we think about mental illness and we need it because we have a crisis, everybody's talking about it. The solutions that are out there may be incremental, yours is a quantum jump in how we have to think about mental illness. So thank you for your work, Daniel. Thank you for being a guest in the Doctor's Pharmacy. And if you love this podcast, please share with your friends and family on social media. Subscribe wherever you get your podcast. Leave a comment. We'd love to hear from you. And we'll see you next time on the Doctor's Pharmacy. Hi everyone, it's Dr. Mark Hyman. So two quick things. Number one, thanks so much for listening to this week's podcast. It really means a lot to me. If you love the podcast, I'd really appreciate you sharing with your friends and family. Second, I want to tell you about a brand new newsletter I started called Mark's Picks. Every week, I'm going to send out a list of a few things that I've been using to take my own health to the next level. This could be books, podcasts, research that I found, supplement recommendations, recipes, or even gadgets. I use a few of those. And if you'd like to get access to this free weekly list, all you have to do is visit DrHyman.com/picks. That's DrHyman.com/picks. I'll only email you once a week, I promise, and I'll never send you anything else besides my own recommendations. So just go to DrHyman.com/picks. That's P-I-C-K-S, to sign up free today.

Hi everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. this podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's licensed healthcare practitioner and can help you make changes, especially when it comes to your health.

Don't forget, there's a way to listen completely ad free with Hyman plus on Apple podcasts. You can enjoy every episode without any breaks. Just open Apple podcasts and tap try free to start your seven day free trial.