The Brain Science Behind Social Conflict And Depression | David Perlmutter & Austin Perlmutter

The westernization of the global diet is threatening our behavior, threatening our decision making and fostering an us versus them mentality that is pervasive around the world.

Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman and that's Pharmacy with an F, a place for conversations that matter. And if you care about your brain, if you care about decision making, if you think you are being brainwashed by by our culture and the media and digital media, then this conversation is gonna matter to you because it's with none other than my good friend from decades and decades, Dr. David Perlmutter of the Grain Brain fame. But before he was the Grain Brain doctor, he just was the neurologist that I would go to for anything and everything that had to do with anything regarding anything because he's so friggin' smart. He's got an amazing heart, a deep soul, and I just been honored to call him my friend for all these decades. and he's taught me so much. And when I was very sick, he helped me do things that helped me get better. So David, thank you so much for being on the podcast. David's a board certified neurologist. He's a four time New York Times bestselling author. He's on the board of directors and is a fellow of the American College of Nutrition. He went to the University of Miami Medical School. He got lots of awards. And he's on the editorial board of the Journal of Alzheimer's Disease. He's published extensively in many journals, including Neurology, Neurosurgery, Journal of Applied Nutrition. He lectures all over the world. He's gone to the World Bank, the International Monetary Fund, Columbia Scripps, New York University, Harvard University. He's killing it. His books are in 34 languages, including the number one New York Times bestseller that was on the list for a long, long time, published in 34 languages. Amazing. Grain Brain, the surprising truth about wheat, carbs and sugar with over 1 million copies in print. He's the editor of the upcoming collection, the Microbiome of the Brain that's going to be authored by top experts in the field. His new book with his son, Austin, is called Brainwash and it was just released in January 2020. And David, this is I think one of the most important books you've written because without fixing the things you're talking about in this book, it's going to be hard to do everything else you're asking people to do or that I'm asking or that anybody wants to do to change their life. So thank you David and Austin. I've known you for a long time. I've heard about you since you're a little baby boy. But now you're a doctor. You are a board certified internal medicine doctor. You went to the University of Miami, followed your dad's footsteps, I guess. You did your residency in Oregon, Health and Science University in Portland. Your academic focus is on the decision making process and how it's influenced by internal and external factors, how it changes our health, and our illness outcomes, because our decisions determine our health. That's true, right? Without your decision making fixed, all the rest of it doesn't matter, right? You can decide you want to eat better and exercise, but unless you have the right decision making apparatus, it's not hijacked, which it has been, we're going to talk about that, you can't make those good decisions. So you are debuting with this book, Brainwash, right? First one. Mazel Tov. And he's also interested in methods of improving burnout and poor mental health. in the medical field because, yes, doctors are among the most stressed, high suicide rates, drug use, etc. It's pretty bad. So, welcome to the Doctors' Pharmacy, David and Austin. We are delighted to be here, that's for sure. Okay, so that's half the podcast. And I'm so excited about this book. You really made a cultural impact with Grain Brain, helping break through the confusion about what's the deal with wheat and grains and brain function and overall health. But your book, Brainwash, is a little bit different because it's upstream. It deals with the cause of why we get to where we're getting to with our decisions and how our modern world threatens our ability to make good decisions. You know, life presents us with all sorts of opportunities and all sorts of temptations, which I certainly am pulled by every single day when I pick up my phone. Whatever we can eat when we want, we can eat whatever we want, wherever we want. We can have vast, exciting amounts of digital media that can take up all of our day. I had a friend once, I was sitting at an event lecture with her and she was on her phone constantly. I said, Give me your phone. I went to her screen time button and I opened it and it said 1,000 pickups in the day. Oh my gosh. It's like every 30 seconds she's picking up her phone. How does that affect our decisions, our concentration? We can buy goods and services come overnight in New York, you can get a drone delivery practically. You can have some in five minutes delivered to your apartment. But this 24/7 hyper reality poses real risks to our physical and mental states and our connections to other people because we're losing our social networks by being on social networks, which is a real problem. And it even disconnects us from the world at large. So how is our health our relationships and even our thinking being damaged by modern culture. In a word, aren't you? You can take as long as you want.

We'll be right back. You know, I think that you well characterized it by saying that this is top order kind of attention that we need to spend. It doesn't matter what advice people get, whether they read my book or your book or all the wonderful books that our colleagues are putting out. We don't suffer from a lack of information, we suffer from a lack of action. And that's what this book is all about. It's about regaining control over that process that you mentioned, the process of decision making. All of our chronic degenerative ills that plague the world today are really a result of poor decision making, of more impulsivity, catering to those types of foods that we know we all would want. those sweet foods, highly processed foods that are palatable, hyper palatable that are designed really to hack into our primitive desires. And we know what makes for good lifestyle choices. We know we should exercise. We know we should pay attention to the amount of sleep and the quality of sleep that we get. Most of us know that meditation happens to be a good thing, that we should get out and exercise, reconnect with nature, But unfortunately, so many of us don't do that. And one of the revelations that we had in the book was that we as healthcare providers, and this is what God Austin and I started on this path, tend to blame our patients for not following through. We go to the conferences.

I told you what to do to get better. Why don't you just do it?

We go to the conferences, we read the books, we get our CMEs, continuing medical education. We learn as much as we can.

You mean our CPEs.

Whatever they may be.

Continuing pharmaceutical education.

Well, basically. You didn't hear me say that. But the point is, and then we transmit that information as best we can, verbally to our patients, through written media, et cetera. But then the ball is dropped and we accuse our patients, we, why don't you follow through? And beyond that, people are doing a self-blame thing. Why did I drop my New Year's resolutions? I know I should be following Dr. Hyman's advice and eating this and not eating that, and yet they don't follow through. And it's not necessarily their fault when we recognize through many of the things you've mentioned that in our modern world, the deck is stacked against us.

Yeah. So how does it affect our thinking and our decision making? And how does that work?

Absolutely. Well, we've learned a lot in recent years about what actually goes into decision making. And it's really complex. It's kind of this field called neuroeconomics.

Wow. Neuroeconomics.

Yeah, it's a relatively nascent field. But what we're now understanding is, as it relates to decision making, there are a couple of core pieces we can pull out. And that is the prefrontal cortex, which is the frontmost part of the brain, one of the most recently developed parts of the brain, turns out to be absolutely essential in allowing us to make.

Good, well thought out decisions.

So to put that into a little bit more easy to understand context, The prefrontal cortex is like the adult. It allows you to weigh the pros and cons to think about what are the long-term outcomes of these decisions. So you really want that prefrontal cortex to be activated to allow you to think through your actions. Yeah. Now on the other hand, there are other parts of the brain that do great things for us. These include parts of the brain like the amygdala and the general reward circuitry. They're essential.

They are- that's like your ancient fight or flight. reactive brain.

Exactly.

And unless you have that frontal brain going, hey, wait a minute, guys, shut up. It's not so bad.

You're not gonna die.

It's okay. It's the adult in the room.

Right.

The adult in the room. The adult in the brain. That's really it. So again, it's a complex system, but if you can understand a couple of the big parts of this decision making apparatus that is the brain, then you can understand how certain aspects of it, again, that more reactive, more primitive part of the brain, can be targeted by marketing, can be targeted by these hacks into your more primitive brain to keep you making these impulsive short-term decisions that then lead to all of these problems we see in the world, these preventable chronic diseases, high rates of anxiety, high rates of depression.

And political division and divisiveness and violence and aggression. Exactly. You know what you said just really struck me, Austin, because we are living in a culture where we're in constant conflict. I've never been alive, and I've been alive 60 years, in a time where there's so much divisiveness, so much opposition, so much hatred, whether it's between Republicans and Democrats, you know, white supremacists and black like me folks, or whether it's between vegans and paleos. It's like, what is going on that we are so in conflict? And why is our frontal lobe not kicking in? And how has our culture, the digital media, the food we're eating, and other stress factors, hijacking our ability to make decisions and damaging our frontal lobe connection.

Well, let me speak to the stress piece first. I think you probably want to talk about inflammation as a fundamental piece of this too. We all know chronic stress is a problem in our lives. No one's out there looking for more chronic stress. But now what we understand is that chronic stress disables the prefrontal cortex. When you look at these animal models, you see that the neurons in the prefrontal cortex shrive up when they're exposed to chronic stress. On the other hand, in the amygdala, they expand. You get more dendritic branches. It creates more connection. So in the amygdala, where you don't want that. So in essence, being exposed to chronic stress is rewiring brains to favor the types of activities that create chronic stress.

And again, let me just break this down. So what you said was, when you're into chronic stress, It kills the brain cells in your adult brain that helps you make good decisions. And it makes the ones grow in the fight or flight part of your brain where you can be angry, divisive, and run or fight.

Exactly.

So that's not good.

I wish it wasn't that way, but you look at these long-term studies in humans who have undergone chronic stress and you see that the prefrontal cortex is smaller. You can actually physically see that it is smaller in people who have had these life experiences. this chronic stress over time.

Is that like a frontal lobotomy by stress?

You know, it's actually in a way it's very similar because it is a disconnection and we talk in the book about something, a term that we coined which is disconnection syndrome.

Yeah, tell us about that.

Well, that is exactly what you were just alluding to and that is disconnection of this prefrontal cortex from the amygdala. Disconnecting, taking the adult out of the room, allowing the amygdala to make these decisions. that are impulsive and self-centered, meaning narcissistic, that lack empathy and that really enhance this us versus them mentality, strengthened by whatever it is that locks us into the amygdala, this disconnection from the prefrontal cortex. And you brought up digital experiences. What does social media do? It's anything but social. You go to a social media site that only caters to your point of view at the cost of castigating others who have a different point of view. That's not empathy. Empathy is me trying to see the world through Mark Hyman's eyes. How do you view something or even somebody who has really different views than I and seeing what is that like? We need that. In Washington, it's called reaching across the aisle, which isn't happening.

I mean, I just had an amazing experience last week. And if you're not open, you know, I met this guy who, you know, in my world would be the enemy, who works for one of the biggest food companies on the planet that's doing massive destruction, that's, you know, factory farming of animals. And I could have been like, he's the enemy, but I was curious and.

I, he was a human being.

And I was like, that's what makes him so interesting. Where are you coming from? What do you think? And what do you care about? And why did you do this? And what do you think about that? And it was like the most incredible relationship. And I feel like now this friendship with this guy who thinks differently than I do, but But we opened the door and now he's interested in learning about what I think and caring about who I am as a person, what all my conclusions were. And it's like that all is undermined by what you said, the digital technology.

You know, Mark, you and I have talked years ago about the value of diversity in terms of our gut bacteria. And the same thing holds for diversity of opinions. The more we are at peace with diversity of opinions, the more resilient we can be and the more we can move forward. in terms of our knowledge base and understanding about how the world works. And you hit the nail on the head that we are seeing much more about digging our heels in and defending our position, saying the world is flat, though it may not be.

Yeah, I think we, I just want to go back to what you said, David, for a minute, because I think people understand the degree in which our data is being captured, analyzed, targeted according to our personality, to our worst fears and personality traits. driving our decisions, driving our behaviors to the point that it's literally creating artificially constructed rallies that activate white supremacists versus activists for social justice or African Americans, bringing them to a location to have a riot. And they think they're coming to these decisions all by themselves, but the media is targeting them in very specific and scary ways. that I don't think people appreciate and they think it's their free will.

Exactly.

It's usurping our free will.

And that's the beginning of brainwash. We lay it out because it's time that people really fully understand what in the heck is going on around them. And you must do that if you're going to regain control. You've got to understand how the deck is stacked against you, the degree that by which you are being manipulated in terms of what you think is your free will and thought process, and then moving forward in the program what you can do to regain control, to basically bring the adult back into the room.

And you know, we think of these as social issues, as emotional issues, but what you're saying as a neurologist and as a Dr. Austin is that the biology is clear about how this is happening in our brains to disconnect us and to disconnect the parts of our brain that should be talking to each other and activating one that's causing divisiveness, conflict, and hatred and fear, and inhibiting the one that helps us have healthy relationships, empathy, connection, clear decisions, future thinking.

That is the fundamental premise of our new book. Oh my God. Exactly. And again, that's why we created this term called disconnection syndrome, because yes, it's a physical, a structural, and a functional disconnection from the prefrontal cortex, to the amygdala and back. And it also manifests then in our disconnection from our selves, our disconnection from our neighbors, disconnection from people who have other views, and ultimately even disconnection from concerns about the health of our planet.

Yeah, it's true. So what you're saying is that there's this mental hijacking that happens, that our brains are manipulated and that they result in behaviors that leave us lonely, anxious, depressed, distressed, prone to being sick and overweight, unlike any time in history. So can you talk about this mental hijacking idea that you talk about in the book and how it undermines us?

Sure. Well, we've talked about this a little bit already, but again, the social media construct. Humans are, by their nature, a species that thrive when they're with other humans. It was essential to our survival. It's how you survive that saber-toothed cat coming up behind you. You had somebody there telling you, Hey, you need to look out, or maybe the raiding tribe. So we need to be integrated. People who have more connections tend to do better from a health perspective. And when those connections are severed, they do worse. Social media.

Belonging to a bowling club or knitting group actually makes you live longer, regardless.

Of what you eat. That's it, right? Connection is so important. And social media knows this. They know that we're looking to link up with other people, and they give us access to it. But we've got to ask this question of, is it actually what we're getting out of it? When you go online and you go on one of these platforms, are you really fostering good, strong social bonds or are you being polarized against other people? Are you just commenting on those people's posts that you dislike? And so I think there's a lot of good that can come from social media, but we have to be conscious of how we're using it and find out whether it is helping us to build empathy or is it just, again, putting us into these echo chambers where we're telling other people what they already know and becoming more divisive.

And it's what Austin said, I think, brings up a very good point that we're not anti-tech that's for darn sure. Look at us right here. You know, you've got your technology there and everything around us. We wrote a book just now based upon an unlimited access to knowledge. So that's utilizing technology for, you know, good purposes. So I think it's good to recognize, according to Kristen Lang, stating that technology is a useful servant, but a dangerous master. That was in 1921. That's a great one.

1921.

So again, we're not anti-tech. It's great, but we really want to be very mindful and intentional in terms of what we're doing. So we developed in the book the acronym, Passing the Test of Time, T-I-M-E. T, how much time are you going to dedicate to what you want to accomplish online? Is your experience intentional? What is your goal? Is it to connect to your high school class or is it to research something or whatever it is to go on social media, whatever it may be? Am are you mindful while you're online that you are staying the course and not being taken down a rabbit hole that's harvesting exactly what you talked about your previous time online? And finally, does it turn out to be empowering and enriching? Is it a net positive when it's all said and done? I think a lot of people when they finally turn off their tablets or phones don't feel the latter. Don't feel that it was net positive, feel degraded, insufficient and the need to purchase something or do something because of how their minds have been manipulated while they were having that experience.

Yeah, I very purposely do digital detox experiences because I feel so free when I don't have my phone. I mean Sunday I was in Big Sur, was up on a ridge and hanging out with some friends and the phone just put in another room. And I just was there watching the sun over the ocean and the sunset and I can't tell you how spacious life feels.

You can tell us. You absolutely can tell us.

You don't remember Austin but David and I are old enough to remember. the time before the internet, the time before our cell phones, the time before smartphones. And there was so much of a different quality to experience, right? You were present, you were thoughtful, you were online for something, you might talk to the person next to you, you're on a subway, you don't look at your phone, everybody's like, I remember going to Google and giving a talk there and they gave me a tour and I walked around into one of these rooms and they have this incredible food, green juices, this and that, wheatgrass. and it was this beautiful room where they had lunch and there was this big giant couch and there were like maybe 25-50 people sitting all on the couch on their computers, quiet. And I'm like, is this the silent lunch room? And they were like, no. And it was funny because when we talked to the HR people at Google about what the needs were for the Googlers, they call them, it was more social connection with each other and yet they didn't know how and they're all in their computers.

Well, getting back to your mention of being out in Big Sur and reconnecting to nature. That was part of what happened with you. You know, that's one of the big on-ramps for us in terms of helping offset disconnection syndrome. And it's something that needs to be talked about. And, you know, when you realize that 87% of Americans of our time is spent indoors with another 6% of our time in our cars, it doesn't leave a whole heck of a lot of time for being out in nature. which has some very powerful health benefits. Well, you're an outlier.

You take your boat and you go away for five days every summer.

I love that. Look, there's nobody who's going to tell you, oh, I was out in nature this morning and went for a wonderful walk in the park and I sure wish I could get back to the urban environment because I feel- I'll get back to my email. Yeah, right. But that's why we say leave your phone at home. But there's a robust amount of data being generated that's looking at the measurable, the quantifiable benefits of nature exposure. And it may just be like you have behind you a plant in your home or in your place of work or even a photograph of that plant or natural environment.

Yeah, I was terrified because I heard the story of how this filmmaker made these extraordinary films of nature. And they had this giant IMAX screen in Las Vegas where they show this because one day people are not going to have nature to go to. And the Bank of America building in New York inside, they have these images displayed on these screens all over the offices of nature.

There's a very prescient moment in the movie Soylent Green, where I think it's Edward G. Robinson is about to die. And just before you die, this is post-apocalypse time, Soylent Green, you know the movie. And just before you die, you get to see a movie of what the world used to look like. And he gets, all there's birds flying and then you know the rest, you know the rest of the story. We won't go there. But my point is though that what we're offering in this book are the ways to counter this pervasive disconnection that is consciously created to take us away and to lock us in to impulsive bad decision making.

Around food, around like exercise, around everything.

And what is so concerning is that, you know, making bad food decisions increases, as you've written about, inflammation. And inflammation compromises our ability to access the prefrontal cortex. So, yeah, wait, tell us about this.

Because everything causes inflammation, right?

Right, we've talked about that.

What causes inflammation and what does it do to the brain?

Well, what causes inflammation? How long a list do we need? A long one, just lack of restorative sleep, dietary indiscretion. Sugar. Lack of, well, sure, sugar and other refined carbohydrates, ultra processed foods, lack of exercise, sleep I mentioned, but very, very big, a lack of connection with nature, for example. Or people or humans. Yes, but even let's just talk about food. You know a little bit about food, we could probably mention this in this context. I heard about that. Food, the thing we eat. But when, you know, we talk about inflammation as a mechanism underlying our chronic degenerative conditions, the number one cause of death on planet Earth.

It's called inflammaging, right?

Inflammaging as well. It enhances that whole cascade dealing with aging. But the number one cause of death on the planet are the chronic degenerative conditions, which are basically inflammatory conditions. Now in brainwash, we identify inflammation as threatening this connection between the prefrontal cortex and the amygdala, which means that this westernization of the global diet that you've written so much about, aside from its concerns with reference to increasing Alzheimer's, coronary artery disease, diabetes, you name it, the westernization of the global diet is threatening our behavior, threatening our decision making and fostering an us versus them mentality that is pervasive around the world.

This is the diet line. This is headline news, guys. You know, this is news for me and I feel like I'm in the know, but I didn't understand that inflammation disrupts the connection between your frontal lobe and your amygdala, which is your adult in the room and your crazy uncle who doesn't stop drinking, smoking and yelling and fighting with everybody.

How does that... That's the aha moment. Halfway through reading this book. I'm like, what? Halfway through this book, we looked at each other and we just said, Do you realize what we've uncovered now?

Wow.

We look around and see what's going on around our planet right now with respect to total disregard for the planet, total disregard for our neighbors, and certainly aggressive approaches to what goes on in other countries. And now we understand that this isn't the entire explanation, but it's factoring in. And you've talked so extensively about this global change in food. but it's threatening our decision making. What is the biology?

How does the inflammation disrupt this link between the amygdala and the frontal lobe?

Well, there are a lot of things.

Go ahead, Austin. Sure. Let's talk about, first of all, how inflammation changes thinking. And it's not news to most people that if you have higher levels of systemic inflammation, you have a higher chance of developing dementia. So we know there's this link between inflammation in the bloodstream and cognitive problems in the long term. What researchers have found more recently is that if you induce inflammation in a person, so if you give them something that creates higher levels of inflammation, they start feeling off and they start feeling off in a specific way. That is, they develop depression. Yes. They develop all the symptoms of depression. Wait, headline news.

Depression is inflammation of the brain.

There you go.

Yeah. And it's really beyond that. It's total body inflammation. So, you know, when we talk about inflammation, we say, well, Alzheimer's is an inflammatory everywhere of the brain. We're talking about systemic inflammation. So when we have this crappy diet that is global now, inflammation is induced throughout the body and affects us from anus to ulna, as it were, and everything in between. But, you know, beyond that, not to your fingertips.

No, it just stops at your elbow. It depends on your butt to your elbow.

But, you know, yes, we've talked about it in the context of these degenerative conditions. But again, getting back to in the context of our mood, in our context of how we see our neighbors, and understand that the prefrontal cortex that we're trying to stay connected to is what allows us to be empathetic. It's what allows me to look at your opinion and share the view that you have through your eyes of the world around us. It's that empathy that allows me to be more compassionate towards what I do with myself, how I plan to treat my future self, and even how I plan to conduct my behavior as it relates to the health of the planet itself. So we are distancing ourselves from empathy, we are fostering hatred, fostering an us versus them mentality, and locking ourselves into an impulsive mindset.

So literally, you know, the inflammation of the brain and the body causes the inflammation of our emotions and our behavior.

Exactly. It really does. And we use that terminology. You bet. We use that terminology. I'm really feeling, oh, I'm just on fire right now. And we know it to be true. Let me give you an example.

He's a hothead.

Yeah, a hothead. I love it. You're up all night for whatever reason. You're traveling or you're a medical resident, whatever you may be. And how do you feel the next day? You darn well know.

Feel like crap.

You feel like crap and your decisions are impulsive. You eat crap because you just choose something quickly. You're not thinking about your future.

And you crave more carbs if you don't sleep.

You absolutely do. You crave carbs to the extent that the average increased caloric consumption in somebody who chronically deprives himself or herself of sleep is 380 kilocalories a day.

It's like a pound a week.

It's a pound about every week. That's right. And it doesn't take long. When you gain that weight and you increase your body fat, what does that do? It compromises your ability to get a good night's sleep. That creates yet another feed-forward cycle. And we know that body fat is a prime source of inflammation in the body as well. So this becomes feed-forward and things get worse and worse and worse. and what we offer in the new book are the off ramps. Now we have a 10 day plan, 10 different things to think about, but it doesn't matter which off ramp you start with. Each of those will in some way improve your momentary decision making. It might be just dedicate that tonight you're gonna get a good restorative night's sleep or finally get 20 minutes of exercise or learn how to meditate, whatever it may be, which will then pave the way for better decision making moving forward. Most importantly, most importantly in the beginning of the book, we call out these hacks, these threats where things are being, they've gone askew.

So we're going to get into the details of how to protect ourselves from being brainwashed, your 10-day brainwash program or reset for your brain. But before we do, I want to come back to the science of what the internet and digital technology does to the structure and function of our brain, to our decision making, and how do we lower that risk? How do we manage that? I mean, like I said, I saw my friend who had a thousand pickups on her phone and it's was like in the afternoon already, just in one day. How do we deal with that? What does the science tell us about the effect of these technologies?

Well, I think it's clear that we're still early on in knowing what happens when we're exposed to the amount of digital technology that we're exposed to. We know that the average American spends about four hours a day watching TV, and that person will also spend about two hours a day on their smartphone. And that isn't even including all these other exposures to media that we're getting just walking around in New York City. So the question is then, what is that doing to our brains? We've got some initial evidence in One study they showed that people with excessive social media use had changes in the corpus callosum. So less connectivity in the part of the brain that literally connects the two hemispheres of the brain. And you can see that too with internet addiction.

So it's a superhighway between the two sides of your brain.

Right.

And it's not working right. That's exactly it. Yeah. And again, I think it's early on, so we're not exactly sure what are the implications of this. What we can say though is It's worth questioning what we're doing with this digital exposure time. So for example, if you're turning on the TV and watching the news each day, and that news is incredibly stressful, we know that's not good for you.

If you turn on the news and-.

Where's the good news channel? Where's the good news channel?

It's all bad news.

Where is it? I'm looking to watch it. Who's gonna be- I am. You know, inspiring stories. The Dalai Lama said that the brain we build reflects the life we lead. And that means that if you constantly are exposing yourself to negativity and fear-based kind of media, you're going to rewire your brain to gravitate more towards that type of life, and therefore you're not going to watch the Good News Channel.

That's true. I have a friend who's probably the happiest person I know, maybe other than the Dalai Lama, and she knows nothing about what's going on in the world. I once sent her a picture of me and Vice President Biden at the Vice President's house in Washington, and she's like, who's that old guy? And I'm like, that's the Vice President. And I'm like, wow, maybe that's good.

It might well be. But we know that as humans, there is this negativity bias, and that might probably have served us well in our ancestral times to be really aware of things that were negative, that were potentially threatening to us. But these days, that type of bias is being, it's truly being preyed upon. we are being preyed upon day in and day out. And we have a wonderful graph in Brainwash that demonstrates the increased negativity of news over the past several decades. It's sort of like the frog in the water that's getting warmer and warmer. We don't really respond to it acutely, but it's happening. I mean, watch the news and just ask yourself how much it's positive. There's always the human interest story at the end of a firefighter saving the cat or whatever it may be. But by and large, it is so aggressive. There's either an alert sign flashing on the bottom of the crawler on the bottom of the screen, or you're in a situation room, or everything is breaking news. And it's always lighting up the amygdala. And the more you challenge that, the more you light up your amygdala day in and day out, the more it's going to function, the more it's going to grow. and the less likely you are able to tap into the part of the brain, which is our gift as humans, this prefrontal cortex, that allows forward thinking decisions and acting with empathy.

Yeah, so powerful. So now let's talk about how to fix this disconnection syndrome. And there's a lot of medicines you use that are unconventional, but they work. And when I mean medicine, I mean things like food, exercise, meditation, nature. So tell us how you plan to get us to be able to make good decisions, to decrease the inflammation in our brain, to dial down the amygdala and upregulate the frontal lobe and do it in a way that actually works so that we can make good decisions for ourselves and for our communities and for the planet, which we all desperately need.

Yeah, what a question.

And, you know, it's so fundamental.

You know, the bottom line is the things we're recommending are, for the most part, completely free. You might have to buy a pair of tennis shoes, but it turns out that this ancient wisdom about what we need to be doing to reconnect to balance in our lives, to high quality of health, it's all there and it's now been substantiated in the research. What we talk about is a series of steps that a person can kind of jump in on at any given point, which will give them now access to that prefrontal cortex. and when you do that, it allows you to then make more and better decisions. So it's a feed forward cycle in your favor. You've outlined some of those steps already. The first one that we lay out is you need to reclaim your control over your digital habits, right? So this is a very functional thing that you can do to start regaining some autonomy from these stressors in your life. But then we move very quickly into what can you add in? to start improving the quality of your life.

And something that-- so I shouldn't have all my devices duct-taped to my body at all times.

It makes it hard to go through security at the airport.

Hang on, I'm gonna say, I got a call coming in. So again, it's setting healthy boundaries with the things that are not helping you, and then it's bringing in the stuff that is going to help you. So we talked about nature. Getting outside for 20 minutes a week has been associated with lower levels of stress. It doesn't take that much. We said you can just put a plant in your home. You can even put a picture of nature in your home and be getting these benefits, as well as something like essential oils. And then we build into that. So we talk about how do you start fostering the empathy that is going to help you connect to other people and propagate this sense of completion with this balanced part of your brain where your prefrontal cortex is activated, you're fostering more oxytocin, which then connects you from the love hormone. Yes, it is. It's gotten a lot of press recently, but something that we don't talk about enough is it actually integrates the prefrontal cortex with the amygdala and lets them communicate. So you don't have that tile.

More sex. More sex, yeah. We have to connect with people. We have to hold hands. We have to look in each other's eyes. We have to touch each other.

We have to hug each other. We just smile at each other. That's the way we're designed, right? This isn't anything brand new to people. This is how humans were kind of designed to be. Wherever you think that design is coming from, We've been spending a lot of time doing that and it's worked out pretty well for us. But as of late, we've decided isolation.

Is superior to being connected. And that is what is called social media. What a misnomer. We're not social on social media. We are isolated.

Yes, we get isolation media. Wow. So how do we get control of our digital technology? Because, you know, it's hard. I mean, we're on our phones, we're checking our email, we get text messages, notifications, do we turn off our notifications? Do we, Do we put our phone on airplane mode most of the time and then just pick it up and watch? How do we do that?

Do we delete all the apps? Do we delete social media? I think everything you've said is something that you could do, which would be of benefit. Now we know that even when two people, strangers, are sitting next to each other and they put a phone between them, it lowers the quality of their interaction. It lowers the amount of perceived empathy that they expected the other person was giving towards them. So putting your phone in the other room, it is so simple and yet It will probably do more than just about anything else to improve the quality of your interactions with the people around you. Yeah. So that means-- so when I have.

Dinner parties, I have a box in the center of the table. There you go. Puts the phone in the box, close it up, and nobody can touch it.

It used to be the keys.

Right.

Yeah. So it was, you know, it's distracted driving, putting your phone away when you're driving in the car. You talk about a really quick way.

To lower accidents across the country. But I just wonder how the Uber driver texts me back when I'm-- you-.

Probably don't want to know. But let me pick up from where Austin was and that is step number two or could be step number one depending on what your needs are and that is the incredibly undervalued importance of sleep. No one talks about it and here's something we do for a third of our lives. We don't exercise for a third of our lives eight hours a day. We don't eat for like eight hours a day but yet This is a-.

We should eat within eight hours.

And it's not downtime. It is anything but downtime. We recognize that sleep is when our glymphatic system is activated, we're taking the garbage out, as we've talked about before, how fundamentally important it is for the consolidation of memory, et cetera. We know that one night's sleep deprivation in one study led to a 60% increased activation of the amygdala. when people were confronted with negative images. 60% increased response of the amygdala when people saw something threatening versus those who had gotten a good night's sleep. That means just that single night has a huge effect on the amygdala. Let's spin that if we can.

Then you had coffee on top of that.

Yeah, that's why I'm really not. But the spin is then we know that a good night's sleep can be really good at placating the amygdala, at least keeping you level, and that might be the entrance point. That might be the on-ramp for you or for somebody else to say, look, I'm gonna dedicate tonight to getting a good night's sleep. And even further, I'm gonna dedicate to learning more about my sleep. Yeah, I go to sleep and I think I get seven hours of sleep, but what is the quality of that sleep? Who knows? Do you have enough REM sleep? Do you have enough deep sleep? What is your sleep latency? And there's a lot of wearable devices out there now. We use an Oura ring. I know you're big with an Oura ring. that gives us great information about the quality, not just the quantity, and I think it's really important. This is incredibly underrated when we recognize that reduction of restorative sleep activates the amygdala, increases impulsivity, and therefore- and you.

Give the tips for fixing your sleep in there?

Oh, we have a whole section on that. But increases our impulsivity and our self-centeredness, are less likelihood to be involved in things that are empathetic. We want to reconnect. So getting a good night's sleep is a powerful tool to offset what we're talking about, disconnection syndrome, reconnect to the prefrontal cortex, allowing more thoughtful decision making and implementation of all the great information that's out there.

I wonder what messed up. 70% of Americans don't get good sleep.

That's a little bit of an overestimate from what we've read, but it's that way in Japan, that's for sure.

A lot.

But, you know, great book, Matthew Walker, why We Sleep. I mean, who knew all the reasons that sleep is so darn restorative? We used to think, oh, it's just passive, it's downtime. But we know the brain is exquisitely active in various stages of sleep doing things, housekeeping, consolidation of memory. But now we recognize the importance of sleep in offsetting disconnection syndrome. It's also anti-inflammatory, right? That's a very powerful mechanism and also is associated with reduced cortisol.

And cortisol is again the stress hormone, fight or flight hormone, the one that's going to create divisiveness, conflict, and bad decision making in response to others and yourself.

Yes, and let me just take that a bit further for any of your tech weenie kind of Avids who really like to follow the science. We understand that inflammation through what's called the kynurenine acid pathway may compromise available serotonin in the brain. We're aware of that. Cortisol does the same thing. Yeah.

So, what David's saying is that when there's inflammation, your brain chemistry gets screwed up and you can't make a happy mood chemical, serotonin, from its precursors. And so, you end up creating these inflammatory byproducts, can uric acid and quinolinic acid, which all create inflammation. We actually can test, and I see that on my patients with an organic acid test, you can actually see these patients who are inflamed, their brain chemistry isn't right. So we have brain fog, inflamed brains, and depression, anxiety, and sleep issues.

As you would expect. And when we see this all the time and review this literature, it just solidifies what we're trying to do here in the outreach.

So at the end of the day, you want people to reclaim their lives. people who reclaim their decision making ability, you want them to sort of disconnect from the forces out there that are pushing us in ways that drive harm to ourselves and harm to our communities and harm to society. Essentially what you're saying. This is a big idea.

Austin has always said, look, if you don't take control, somebody else will, and that's what's happening. And as it gets back to this decision making, it really doesn't matter a lot if you you choose to be vegan, paleo, or you want to go full in on keto, whatever it is, these are probably pretty good diets across the board in terms of inflammation. But it doesn't matter that you've chosen one or the other. It's the implementation part.

Right.

So how do people get to the right decisions? What else do they have to do?

Go ahead, Oz.

Sure. I want to just make one point.

How do you fix your decider? Yeah.

So that is these, the central question. And I want to just outline this so that everyone understands exactly what we're talking about. When it comes to the health outcomes or outcomes in general we care about, we know that we want to be making good choices that lead us towards losing that extra belly fat maybe, that get us to the gym when we want to go to the gym. And so as providers, we tell our patients, here's what you need to do. We take it upon ourselves to say, I know what I need to do. And when we don't do those things, we say it's a deficit of one of two things. One is it's the information. We didn't have the right information. We weren't eating the right foods. Or we say it's a deficit in willpower. We say you just didn't want it enough. And that is a paradigm that creates a whole lot of blame, a whole lot of fault. So for patients, sure, but as we've said before, for each of us individually, when we can't bridge that gap between who we are now and who we wish we could become if we made those good decisions, and what we've missed in this is the role of the brain in determining our choices. It is, as you said, it's the decider. It is the decision-making engine. And what we're talking about here is how the environment, how our lifestyle modifications and the like change our brain and how those changes in the brain then lead to good or bad decisions. Set us up for good or bad decisions. So, as you said right in the beginning, it's getting upstream. and no longer just putting all the blame on ourselves or on other people for this lack of willpower or lack of information. So it starts with, again, the first half of the book, understanding where these people have hacked into our brains, where corporations who maybe aren't evil or anything but are just trying to sell, let's say, a sugary product are hacking into our more primitive reward mechanisms and keeping us hooked, keeping our neural structure or our neural architecture literally programmed so that we can't escape these traps.

Yeah, some of these big food companies hire research scientists to put kids in a functional MRI scanner to look at what's happening in their brain the most.

That's right, it's their brain the most. That's frightening to me. And so this is the point that my dad also just made, which is if you don't do anything, if you say, I'm gonna take the world as it is and not worry about it, other people will make your choices for you. And what does that mean? Well, we get the world we have right now, where people are struggling with these preventable conditions. So it's even by not making that choice of worrying about it, you're still making a choice. You're allowing, you're choosing to let other people define your brain and choose your decisions. The alternative is exactly what we've been talking about today, which is if you start first understanding how that's happening and next how you can make interventions to rebuild, rewire, and reconnect your brain for good choices, you're taking back your life and you're taking back those outcomes.

You know, we've said that people make bad choices, eat the bad foods, don't sleep enough, don't get exercise. But the reality is when you don't get enough sleep and eat the bad foods and don't exercise, then you're making bad decisions. It compromises your ability to make bad decisions.

So it's sort of a circular problem.

It is a vicious cycle. And we drew it out in the book as a graphic. You know, the good news here, the positive spin is Newton's law that says an object in motion tends to remain in motion, meaning if you just get yourself to go in motion, exercise, that will enhance your decision making to commit to further exercise and you'll then stay in motion. We've got to break these vicious feed-forward cycles and to emphasize the point that we talked about earlier, the self-blame part of this. You know, I didn't follow through on my New Year's resolutions Why did I eat that? How come I didn't go to the gym? All these things that we know are good for ourselves, people looking in the mirror and blaming themselves, you know, feeling this incredible self-blame that is not productive in any way, need to realize how much the deck is stacked against them moment to moment so that they can't make those good decisions. And for us as healthcare providers, we've got to reframe the way we look at people who don't make good decisions and realize how much the deck has been stacked against them and work with them at this higher level now to first foster better decision making and then give the information so that the field is ready to accept the players.

So you're saying that if someone comes in with diabetes from eating all kinds of junk, we shouldn't be focused on fixing their blood sugar but fixing their decider.

Well, if you fix their blood sugar, obviously their decision making is going to improve. Interestingly, But you're saying go upstream. Absolutely. This is higher level.

50 to 80% of people don't do what their doctor tells them. It's not because they're bad people. Exactly.

They don't care. This is the statistic. I'm impressed. I know you've done some reading.

This is the page 128. This is the medical paradigm we basically have is that your patient goes into the office, they sit down with the provider, provider says, I don't understand. We talked about this. You need to exercise more. You need to eat healthier food. You haven't done it. Do you not get this? The patient says, oh no, I get it. I just couldn't do it. And so the doctor says, well, patient is non-compliant. That's what goes in the note.

Oh.

And then you sign the note because.

There'S one of those- Such a judgmental- you-'re non-compliant. We need more empathy. We need to understand now, as you well know, that people are having their.

Decision making- How about you're not non-compliant? I'm ineffective. doing the right thing because I don't understand how to actually fix your decision.

We're gonna work on that. Yeah. Our mission moving forward is to really get this word out that we as healthcare providers need to be thinking about this, that people don't have the hard wiring in their brains to make better decisions. Okay, so David, I'm a doctor.

I see patients. You guys are doctors. I'm in my office, someone comes in and, you know, I work with them a bunch and I get them all the right information. They're just struggling. Some people do it, but a lot are struggling. How are you going to help me fix my patient's decision?

You look at a patient in the eye and you say, Look, there are a host of things that you can do to get better from whatever the problem may be. If it's these lifestyle issues, the weight gain, the diabetes, type 2 type, whatever it may be. But I'll tell you what, first of all, for the next week, we're going to focus on sleep. Let's just see if we can get you a good night's sleep. And as you mentioned, how prevalent sleep issues are. Let's just focus on that. Then next week when you come back and you've got a week of good sleep under your belt, we'll look at a couple other things that we can incorporate into your program. Maybe you'll teach that person how to meditate. We know that meditate is a super highway to the prefrontal cortex and really transcends all types of meditation and even prayer. It all kind of does the same thing. So maybe we introduce that.

Now, with the forks, that are with the meditation.

You bet. Or even the medication, because people don't often take their, we go meditation before medication. People don't often take even the medications that they are prescribed. So set the stage for them to be more acquiescent, to be more likely to follow through before all the recommendations are made. Otherwise, you set yourself up for failure as a physician.

I think the other point on that is when we lay out all of these different interventions, things like changing your diet, getting more exercise, going out into nature or even meditating, that gives you a menu now. And so the patient comes in and says, I can't exercise, not because I'm physically unable, but because I'm mentally unable. I cannot get myself out onto the street and jog, do push-ups, whatever. That just isn't their thing. Now we know exercise is good for executive function, for better decision making, so that would be nice if they could, but that's not where you start. You say, well, are you willing to go outside and spend some time in nature? Maybe they are. So you give them that 20 minutes of nature exposure, which lowers stress, which lowers inflammation, which fosters better decision making. And then you come back to the exercise. Now they have a brain that is engineered for better choices and it may not seem to be this incredible mental block anymore. So again, it's finding these back doors into where you're trying to get to because so many of these times patients know what they want. They want to be somebody who exercises, but they can't get their brain to be on their team. They say it, I want to be somebody who eats healthy, but the brain says, no, we're gonna eat ice cream and chips tonight. And that's what winds up happening. So the goal here is to get your brain on your team so you're not constantly fighting against it and having people label you as not having enough willpower. That's just not a sufficient answer anymore.

That's true. You know, it's interesting, I just had this recent experience that it was really shocking to me, even though I've been doing this forever, you know, over the holidays, I went to New Zealand, my wife's family, you know, there's all kinds of stuff. And I ate pretty well.

I cooked Christmas dinner, even though I'm.

Jewish, and I made it super healthy. It was just like. That's empathy. Yeah, it was really, really healthy, but delicious. You know, I didn't have any junk and, you know, we had, like, you know, the chocolate for dessert and stuff, but there was other places I went where it wasn't like that. And there was ice cream and there was stuff I usually don't eat. and I just felt myself like falling off and wanting more and more.

Exactly.

And then I came back and my wife and I decided to do like a 10-day reset, which is based on my new program, the 10-day reset program, which you can get at getpharmacy.com and, and then we did sort of a clean vegetable diet. And then I did, I did, we did actually three days of juice fasting, just green juices, and then started back in with the 10-day reset. And I, it's been so fascinating to me because I know exactly what to do. I've written a bazillion books about it, but I don't always do it and sometimes I fall into the bad decision making. And when I did the reset on my system, I know it decreased inflammation. I know it helped me sleep better. I know it helped me actually function physiologically better and I now find it like not a problem. Like I was traveling in airports, sometimes I'll break down and I was like, no, it's no problem. I have no issues. I'm always getting a pizza across from me. I don't care. And I wouldn't order the food on the airplane.

You've reconnected. So you brought the adult back into the room.

Yeah.

That's our central thesis here.

It's so fascinating to me because I was like, wow, I kind of know, but this was such a visceral experience where my desires changed. You're in the same boat as the.

Patient who doesn't follow through. I mean, you have a doctor that's speaking to you. It happens to be your own voice saying, you shouldn't eat this, do this, but yet you can't help yourself. And this is a terrible play on words. It's a feed forward cycle. You had a couple of indiscretions while you were out in New Zealand, you ate some ice cream. Next thing you know, your willpower is kaput. But you at least tried to rein it in by doing one thing or another, and that's really what we're getting at. And imagine in the doctor-patient relationship, you say, you know, Mrs. Jones, we're gonna work on this. It's not gonna happen overnight, but before we really jump into your program, let's say, Here's what I want you to do. Again, as I mentioned, good night's sleep. I want you to walk around the block a couple times. And by the way, I would like you to buy a house plant. Leave it at that. Maybe next week you bring a couple of things into the else into the program. You talk about meditation, you talk about reconnection, you talk about keeping a gratitude journal, all of these things to further strengthen the connection. Then you end up like you ended up after you finally did your reset. finally in control, able to walk through an airport and bypass the Cinnabon's.

Yeah, I mean, I usually don't go for Cinnabon's, but I'll buy the chocolate covered almonds. I'm like, oh, I feel bad for myself. I'm traveling, I'm all by myself. I want to be home with my wife. I'll just buy some chocolate. None of that was there. And I easily could have done it. And it was all around me, but it was just the most interesting thing. I was like, wow, this really works.

Being aware of it is really important, but that's an impulsive type of behavior that's ultimately threatening to make things worse. It's like Gary Taubes talked about saying that we don't get fat because we eat more, we eat more because we're getting fat. Meaning that our fat cells have their own agenda.

They have a mind of their own.

They want to grow more fat cells. They want higher levels of ghrelin and they want to increase inflammation which further locks us into impulsivity.

Yeah, so great. I mean, I think this is a meta book, right?

It is exactly that.

This is a meta book because there's a lot of great advice out there. There's a lot of great programs. You and I have written them and some people take it and run with it, but a lot of people don't. A lot of people struggle and the sustainability issue is the key. So anybody can do something for 10 days, but then how do you sustain it? And unless you deal with the meta issues of how your brain is working or how your brain is broken, you can't change your life, you can't show up in your family and be loving and connected, you can't show up for your work and mission in life, and you can't be in service, which is the highest gift that we can all give to ourselves and others, because you're stuck in a brain that's in fight or flight, the adult's gone from the room, you're making bad decisions, and it's taking the world down. And, you know, I do believe that, you know, a big driver of this is our inflammatory lifestyles. And that, you know, is driven by lack of exercise, stress and so forth. But the food has got to be the biggest driver of inflammation. And it's such a doorway in that people can get the doorway out.

It's a doorway out, though.

Food is out of their diet.

And that's why, you know, we so honor the perspective that you are taking moving forward to really address what's going on with food on a global level.

Yeah.

And how exciting that is. You know, we have involvement with how that is happening. And that is a huge driver. It is, again, it's a feed forward cycle that perpetuates impulsivity. When we see that here in America of the 1.2 million different foods sold in the grocery stores, that 68% have added sugar or sweeteners, packing into our desire for sweet and creating this persistent- Dr.

Additives and chemicals. You know, I just remember reading the study I wrote about in my book, Food Fix. right? Which was about feeding kids and, you know, violent kids and juvenile detention centers a healthy diet. And what it did to them was so striking. Their aggression levels changed, their oppositional behavior changed, their violent behavior changed, their willingness to be cooperative and helpful improved, their homicide, I mean, their, sorry, suicide rates dropped a hundredfold.

But why would we want to change their diets if we could just medicate them?

Well, yeah, it's a good idea.

Right?

I'll buy stock in the drug company, forget about the food. No, it doesn't work. The medications actually don't work. They're not powerful enough.

That's the answer we're looking for.

To overcome the effects of the food. I mean, if there was a drug that could reduce violent behavior, aggression, opposition, conflict by 50 to 100%, I mean, it would be the best-selling drug of all time. But there is one, it's called food.

Yeah, and if there were a drug, this is this is a bit off topic, that was associated with such a profound reduction in Alzheimer's risk as exercise, it would also be a home run drug.

Yeah, and when you stack all these things that you're talking about, sleep, meditation, it's interesting how you talked about the primary things not being exercise and diet, but sleep and meditation, which I think is important for people to hear because you can't start to unwind that stress response activating the amygdala unless you start to get sleep and calm your brain down through meditation.

We've all been in situations where our amygdalas are really kicked in and it's not necessarily easy to rein it in in an acute way. I describe an experience I had in a big box store once when somebody was being, may I say, disparaging first towards me and I was cool with that. But then aggressive towards my wife. And I was within moments of being aggressive and inappropriate. And luckily I was able to bring the adult into the room and rein in my amygdala-based response. You bet. But we know that that often isn't the case with many people who do not have that highway connected to the prefrontal cortex and can't rein themselves in. You know, you accidentally cut somebody off in the car. And the next thing you know, they're driving you off the road. You know how people respond. I watched it just the other day and I couldn't believe my eyes. I watched it unfold in front of a parking lot. Somebody cut somebody off.

But that said-- I did that once on getting off an off-ramp, but I didn't really realize that I cut somebody off or did something. And he was in front of me on the off-ramp and he stopped the car on the off-ramp, blocked me and ran out of the car and started jumping on my car, smashing my windows. I had to lock the door. Terrified. I'm like road rage. What the hell? And this guy probably said, you can.

Say whatever you want. You can say sorry, whatever, but you know, things happen. So, you know, to conclude on a positive note, an empowering note, a note that looks forward to a better time and a better place, everybody's got the tools. We just, they're in everybody's toolbox. They just need to know how to use them.

Yeah, sort of like Dorothy and the Ruby Red Slippers. We can go home and tap your heels together. Yeah, and it's meditation, sleep, anti-inflammatory diet, exercise, and right relationship with your digital technology, which you talk about all in the book. It's one of the greatest contributions, I think, to the science of how we have to get out of this mess of conflict, divisiveness, chronic disease, and destruction. And I am so excited about this book, Brainwash. It's, I think, the culmination of a lot of years of thinking and work that you've done and it's something that is going to, I think, change the way we think about how people change their behavior and change their lives and change their ability to make good decisions, which determines everything in your life. I mean, if you make good decisions, you have a great life. If you make crappy decisions, you have a crappy life. So this is just a tremendous book and I am so excited about it. I think everybody should get a copy. Detox your mind for clear thinking, deeper relationships and lasting happiness. Brainwash, you can go to brainwash.com, is that it? Brainwash book. Brainwash book, brainwashbook.com and check it out, order it, use it, fix your picker and decider and you'll be happier for it. So thank you guys for joining us on the Doctor's Pharmacy. Thank you, Mark. If you love this conversation and it mattered to you, please share your comments with us. We'd love to hear from you. Share with your friends and family on social media. And if you don't subscribe already, subscribe wherever you get your podcasts. 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. Forward slash PIX. That's drhyman.com/pix. 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/pix. That's P-I-C-K-S to sign up free today.