The Shocking Rise in Mental Illness: What’s Really Happening? | Dr. Jaquel Patterson

The benefits of sauna and how that showed to decrease CRP levels. And also in studies that they did in Europe for men, that there was like decreased chance of things like schizophrenia. That's crazy.

Wait, you just want to stop there. You just said take a sick of sonic and help reduce psychiatric symptoms and even schizophrenia. Exactly. Welcome to the Doctor's Pharmacy, Cal. It's great to have you. And I'm so excited about our discussion because it's going to address one of the biggest crises we're facing today, which is an explosion in mental illness and the explosion of crisis in mental health. And we're seeing dramatically rising rates of depression, anxiety, ADD, bipolar disease, suicide rates. I mean, just all the numbers are going through the roof. And the question is really what is going on out there and how do we deal with this differently? Because our traditional approaches in psychiatry really have not adequately dealt with the crisis in mental health. And despite better medications and lots of medications, I mean, I think psychiatric medications are the leading category of drugs or maybe the second actually, I think it's the second actually after statins. We're not making a lot of progress. People don't really get much better from these drugs. The data on the effectiveness of them is sort of not that impressive. Sometimes often no better than a placebo. For some people, they can be effective, but it's really missing the very fundamental idea about what's causing this. And I remember learning about psychiatric disease in medical school and basically we're really good at classifying people according to symptoms. what are the symptoms that indicate you have depression or ADHD or anxiety or OCD or whatever it is, bipolar disease? And they were just descriptive, but they didn't tell you anything about the cause or the mechanism. And it's kind of been a black box, right? Because basically the joke is neurologists pay no attention to the mind and psychiatrists pay no attention to the brain. But brain dysfunction, it doesn't show up like other parts of dysfunction in our body. If we have arthritis, because our joints are inflamed, well we get a swollen joint and it hurts. But when our brain's damaged or inflamed, which we're gonna talk about, it doesn't show up as pain in the brain, it shows up as psychiatric symptoms. Yes. And so we kind of misappropriate meaning to these diseases, which we have seen just skyrocket in the last decade or two or even, you know, just, I wrote a book called Transform Your Solution 15 years ago and it was a lot then and it's getting worse and worse. It's like, it's getting worse. It's like watching a slow-moving tsunami. And I remember reading a book when I was in college called Madness and Civilization by a French philosopher called Michel Foucault. And he was very good at describing the historical context of mental illness throughout the ages. It was visitation by God or possession by demons or evil humors or whatever thing. Or maybe it's your, in your Oedipus complex with Freud or whatever the kind of latest version of the story was about psychiatric illness. And the truth is it, kind of mostly missed the mark about what's really going on. Because we see things, then we put labels on them, but we don't really think about the cause. What I'd love to talk to you about today is your experience as a clinician in the trenches seeing people with a whole array of mental illnesses that you've been able to sort of unpack through the lens of functional medicine rather than the old model. Name the disease and give the person a drug for that disease, right? And so I'm curious how you sort of started getting into, as a practicing clinician, what got you into this idea that we should be thinking differently about psychiatric illness?

Well, I actually, as a naturopathic physician, I've been practicing for over 15 or 16 years. And one of the things, Lyme disease was something I struggled with myself, also other family members, and treating patients with that, I started seeing a much larger growth of individuals with symptoms of anxiety and depression and mood changes. And it really forced me as a clinician and people practicing in the space and functional medicine space were getting to the underlying cause to find out why, what are the reasons, what are the causative agents? And so for many of my patients at that time that were struggling with it, I would see as I worked on the infection or worked on inflammation or immune tolerance, their symptoms or mental health symptoms went significantly improved or they were able to get off medication or it was no longer an issue. And so that's why I kind of went back, did additional two years of training in functional medicine, also in addition to ADHD. And there's so many factors that we don't look at, environmental factors, outside of things like genetics, because people often blame it on genetics or have a family history, which is definitely a contributing factor, but there are a lot of other factors outside of that, including infections, including, you know, trauma, including even TBIs and things like that. I'll see my patients. Yeah, traumatic brain injury will be significantly worse if there's also history of multiple concussions. So just we want to look at that full picture and there's more than just neuroinflammation, but it's a huge factor that a lot of physicians don't look at in their workup when they're working with the patient with mental health issues.

Yeah, I mean, I think That's really interesting because I had the same experience. You came at this through treating patients with Lyme disease and infections, which are inflammatory diseases, and basically by treating their body, their brains got better.

Exactly.

And I had the same experience when I was treating patients years ago. I started to see I was treating their gut or their allergies or their some other inflammatory problem and using the principles of functional medicine to restore balance in the body and their psychiatric symptoms would get better. whether it was things even like psychosis or ADHD or depression or anxiety or OCD or bipolar disease. I was like, this is really crazy because this doesn't, this isn't anything I ever read in a textbook. Like, I, I, when I wrote that book 15 years ago, I, it wasn't like a big thing back then. We're talking about the microbiome or nutritional Psychiatry or metabolic Psychiatry or the microbiome and Psychiatry. Now it's, it's out there in these major academic centers. We've had many of the researchers from these centers on the podcast, and we'll link to their podcast in the show notes. But it's been sort of a revolution. And the problem is most people suffering out there don't know this. And so I'd love to just sort of unpack a little bit about what are the causes of this rise in mental illness and what can we do about it? Like where do we start to think about it? How do we start to think about the causes? What are the reasons you mentioned neuroinflammation? What is that? How does it work and what causes it? Is that the only thing that's driving this crisis? And so help us understand that.

Anxiety, depression, mental health disorders have been on the rise, but after COVID and the pandemic increased significantly, especially for adolescents and young adults, where you'll see, for example, one out of three individuals at some point in their life have struggled with anxiety. For depression, for adults, it's around 10%, but when you look at adolescents, it's around 15% for depression and almost 30% for anxiety and also the leading cause of death is suicide for that age too. So I think it's multifaceted, loneliness, isolation, technology, social media, those things that we do which affect the neurotransmitters like dopamine, norepinephrine, and epinephrine, which affect your reward system, et cetera. But also infections, they have shown that After COVID, some of the individuals that actually had COVID initiated or potentially initiating factor for autoimmune conditions, like type 1 diabetes actually was one of the ones, lupus, MS. So there have been increases you can see in autoimmune conditions as well since 2020. So there's definitely a correlation. It's basically a COVID related autoimmune disease. Exactly. So you have like inflammation I say is like the first step, then there's immune tolerance or immune dysregulation than followed by psychiatric conditions. So if you look at autoimmune conditions or individuals with chronic disease conditions like type 2 diabetes, they're much more likely to have higher rates of mental health issues. And there's even studies that have shown higher levels of this enzyme called C-reactive protein, which is part an inflammatory protein that usually goes up initially with inflammation that high levels of CRP as a child increases significantly risks of schizophrenia later in life. And so that is chronic inflammation as a child is going to also increase your risk for mental health disorders.

Yeah, it's quite amazing when you think about the fact that psychiatrists never looked at the brain. And now psychiatric medicine is starting to look at the brain and doing even brain biopsies on people who've died who had certain conditions like autism or schizophrenia or looking at spinal fluid and what they're seeing is literally these brains on fire. And if you look at every single brain disease, pretty much, you know, Alzheimer's, Parkinson's, depression, anxiety, ADHD, autism, bipolar disease, schizophrenia, if you look at the brains, they're literally inflamed, like you'd have a swollen joint or a sore throat. And so in traditional psychiatry, there's really no treatment for it. take Advil, is that gonna work? Probably not, right? There are actually even studies I've seen using biologics like TNF alpha blockers, which are basically massively expensive, extremely powerful immune suppressing medication that have significant side effects. And they're talking about using that for depression as opposed to figuring out what the upstream causes are.

Why is the inflammation happening in the first place?

Classic traditional medicine. It's like, okay, well, It's inflammation in the brain. Okay, I got that, but let's figure out what drugs we can use to shut it off. Let's do chemo drugs. Let's do steroids. Let's do biologic. Let's do Advil. It ain't gonna work. Because one of the fundamental rules of functional medicine, if you're standing on tack, it takes a lot of ask to make it feel better. Take out the tack, remove the cost, right? And so from your perspective, what are.

The fundamental causes of this acceleration in brain inflammation? And then let's sort of unpack some of those and get into how we can start to diagnose them and how.

We can start to treat them?

So chronic infections are one, so area of focus for me in practice is Lyme disease and tick-borne diseases. Those have been heavily connected also even to other conditions like PANS and PANDAS that children will have, which causes acute inflammation of the brain. Neuropsychiatric, it's called pediatric acute neuropsychiatric syndrome. And that can be initiated from an infection like strep or walking pneumonia where the body is actually inflamed and attacking attacking itself, but triggered more towards the brain. So what happens is you have in your body, you have what's called the blood-brain barrier and that keeps things in and out for the most part. We keep most of the things out. There might be like a couple, one or two percent that can get leakage of solutes, et cetera, that'll go through the brain. Then after that, what happens is you have these, what's called microglia. It's part of the CNS, it's called glial cells, and microglia gets activated. And what microglia does is some brain. and microglia acts, like I say, it's like a cleaner. So it's coming in to help clean out any inflammation, debris. And so if it's highly activated, where you're seeing someone where the microglia is more active, there's more work it's doing to actually clean up these inflammatory mediators. And what ones that are triggered for anxiety and depression are things like interleukins like IL-6, IL-1, TNF, tumor necrosis factor. Those will also go up when there's chronic brain inflammation.

So those are cytokines, right? Those are cytokines. So cytokine storm from COVID These are bodies immune messengers that are good when there's something acute like an infection. Exactly.

That you wanna fight and you wanna bring inflammation to, but they're not good if they're chronic. If they're chronic, exactly. And so you'll look at IL-6, which precedes CRP, which I mentioned earlier, and that was shown to be highly elevated for individuals like post-COVID, long COVID, or have had chronic issues. So that one and has been definitely connected with really any chronic disease condition, and especially things like depression. It's one of the reasons why there's been tons of studies on things like turmeric, curcumin to help with depression. In fact, one recent study had showed having curcumin in your diet. So, I know you do a lot on food and diet that increases up four and a half times of stress resilience of just having that in your daily diet. And that's because of inflammation. And we're continuing to be an inflamed society based on environmental burn-in, plastics, toxins, metals like mercury and lead will increase up inflammation, actual trauma to the brain, chronic disease which influences circulation, blood flow, et cetera, infections like I mentioned, so many different causative agents of it.

Yeah, I'm generally a very happy person and I've always been happy. And I remember when I was very sick with mercury poisoning and then Lyme disease and Babesia, you know, I felt physiologically depressed and cognitively impaired. And it was interesting to me because I kind of knew, like my higher self knew, I wasn't depressed, I wasn't psychiatrically depressed, but there was some process going on in my body that was affecting my brain and literally causing me to have a broken brain. And we see this so much in our patients. And you mentioned a few things like latent infections tix, it could be viruses, it could be your microbiome out of balance and dysbiosis. You mentioned environmental toxins like I had the mercury that definitely causes anxiety, insomnia, depression. It could be diet and inflammatory diet. You talk about anti-inflammatory effects of curcumin, but there's an American diet we're eating which is primarily processed food or ultra processed food to me more specific, which is about 60% of our diet that's driving systemic inflammation in the body. So we see a lot of the reasons why we're getting this increase in psychiatric illness and yet the people who most need help are not really getting the answers.

Yes.

How do you start to approach someone who comes in with... because you're obviously seeing a lot of Lyme patients, but are people coming to you just for psychiatric stuff?

Yes, yes. We have a lot for solely anxiety and depression, also ADHD. We see a lot of children for that because often parents are looking at what else can I do before I have to put them on medication.

It's like 14% of kids are on medication.

It's very, very high. And you look at like when you just mentioned diet, diet, they've had studies on like flavonoids which are in more colorful, like citrus fruits, berries, things like that. They've shown increases in just having that amount has helped with anxiety and depression. So when you look at things also like ADHD, anxiety, mental health, There's sometimes is the we first have to work on like, what is their actual food and diet like? You know, because that's the basic because if they are deficient in minerals like iron, magnesium, zinc, those three are heavily connected with like how your dopamine, norepinephrine, epinephrine, focus, all of those factors. So those are huge things to first also initially look at.

So it's not just the things that are driving inflammation like inflammatory foods like sugar and processed food, not just toxins, not just infections, not just the microbiome, but it's also what we're missing.

Exactly.

As you were talking about this case of ADHD, I had a little kid I treated who just lived on junk food. He had all these allergies and all these other health issues, gut issues, headaches, anxiety, you know, irritable bowel. I mean, just the whole gamut of different things, asthma, insomnia, everything. But he had really bad ADHD and, you know, but when we looked at his diet, he was eating pretty much all processed food and never a vegetable in sight. And so he was massively deficient in, you know, all sorts of nutrients, particularly ones you mentioned, like zinc and magnesium, as well as some of the B vitamins, which are important in mood health. Can you talk about, you know, the role of some of these nutrients? Because I think, you know, we don't realize this, but 90 plus percent of Americans are deficient in one or more nutrients at an optimal, at the minimum level. Yes. to prevent a deficiency disease, not the optimal level we want for health. So what I might say is how much vitamin D do you need to not get rickets? Probably 30 units.

How much do you need to prevent a health? Maybe 3000, right? Yes, and there are tons. So you look at iron, I've seen a lot of people's changes in their blood work with ferritin and iron levels, which increases the blood flow to the brain. So of course you're also gonna be tired or having brain fog, et cetera. So nutrients are hugely important. Magnesium, when we look at it, most of the population is something like over half or more than half, I think it's like 80%, are deficient in magnesium because we're not getting it from the soil. But B vitamins, when you look at things like B6, B12, folate, those are all connected nutrients really important for mental health. And also they also help to feed the adrenal glands and thyroid. And they get depleted when you're more stressed. So the more stressed we are, the more B vitamins we're going to consume. And the only way you're getting that is from either diet or nutritional, you know, by nutritional supplementation as well. So that is kind of one of the first starts I have with patients and also many of those many medications that's what usually the first to get impacted are those is B vitamins. Yeah. Are antioxidants.

I mean, people don't realize that. You're right. Like, people don't realize it, you know, people, oh, don't, don't take this vitamin if you're on this drug, but it's actually also true the opposite. If you're on a lot of medication, you're losing a lot of nutrients.

Exactly, so you need something to augment it. So you become deficient in those things that often help, particularly with the mitochondria like B vitamins.

Yeah, and we're here at the Annual International Conference on Functional Medicine here in Las Vegas and you're giving a talk soon which is really about the interplay of immune function and psychiatric health. Exactly. And in there, you talk about this not just sort of at a high level, but you talk about some of the real specific mechanisms that are underlying this. And, let's sort of get into some of the science and the biology around this because you mentioned magnesium, for example, but a lot of the inflammatory things that we're doing that we mentioned affect this part of the brain that is something called an NMDA receptor, which is stimulated in ways that can be overstimulated to actually cause psychiatric symptoms. And also, it's been linked to dementia and so forth. But for example, magnesium plays a role in regulating this.

Yeah, and NMDA receptors. When you look at even vitamin D, vitamin D has shown that people that have autoimmune conditions or chronic disease conditions, the lower their vitamin D levels are, lower than 40, the worsening of the actual symptoms. Their symptoms are more pronounced. And so NMDA, we look at things like, because it can affect GABA and glutamate and GABA in terms of altering what that balances and glutamate will be more of an excitatory neurotransmitter, so that's gonna cause mood changes, irritability, a lot of variability in the mood itself.

That's why when you have MSG, you get the MSG headaches and brain fog. Exactly. That's monosodium glutamate. And GABA is basically another neurotransmitter that's.

Kind of like valium in the brain, right? Yes, and it's like an inhibitory neurotransmitter and so it's interesting when you look at inflammation, especially for things like schizophrenia and depression, markers that are actually anti-inflammatory like IL-10, for example, go down. And then the markers that are more pro-inflammatory like IL-6 will go up. And so those like IL-10 is actually connected to dopamine, which is related to depression and mood. Also GABA, there's a change where GABA will go down, which actually helps to support anxiety and to make you feel better. And so you'll see this kind of shifting where it's like, more glutamate and things that are more triggering to the brain and inflamed versus things that are kind of more calming, like a dopamine or GABA.

So we're basically taking in too many things that are driving brain inflammation and we're not doing the things that help reduce brain inflammation. Yes.

For our diet or lifestyle or exercise or, you know.

The balance is completely off. Yeah. And, you know, it's really heartbreaking because you and I see this in our practices that It's not like we can cure all mental illness from all patients from all things, but this model of functional medicine psychiatry is actually a profoundly effective model for treating mental health issues if people understood what to do. And we've had Christopher Palmer on the podcast who's talked about brain energy and the metabolic and mitochondrial dysfunctions underlying psychiatric disease and treating schizophrenia with a ketogenic diet. These are highly anti-inflammatory approaches. Yes. And so, you know, what have you seen clinically in your practice when you start to apply this? What are the kinds of things you're discovering? What are the tests you're doing to help identify these problems? What are the treatments you're starting to kind of apply to help people with this problem of neuroinflammation?

Well, there's a lot of different tests. So one thing I say is through the conventional labs, you are gonna look at the inflammatory markers, like I mentioned, CRP, IL-6, you might want to look at ESR, some just basic core inflammatory markers because oftentimes someone with mental health issue, they're not running, they're not looking at inflammation as it relates to, they might run it for a different reason, but they're not necessarily looking at it.

Dr.

Yeah, and so you want to look at those other nutrients like RBC zinc, RBC magnesium, all the core nutrients that you can do. I also do urinary tests or specialty urinary tests to test for the neurotransmitter, so I look at that. I also look at other factors that can contribute that people don't necessarily think of, like histamine and allergies. I was in practice when you asked that question. I started seeing a group of a lot of kids that would come in every time the season changed. And histamine-- We're worsening psychiatric symptoms. Yeah, we're worsening psychiatric symptoms. And if you look at it, histamine actually crosses, it follows a circadian rhythm, so it's a little bit typically worse in the morning and then later in the evening. HistaMine is also an excitatory neurotransmitter, so people don't think of it like that. And so you'll see like all these mood changes, increased anxiety, and for many of those patients, I might just say, hey, get on antihistamine or, you know, natural ones would be things like quercetin, stinging nettles, and so that will actually help because they become less inflamed. So you'll see like when someone is having, when I put them on an antihistamine during that time and some general anti-inflammatories, everything kind of cools out. So that's also like looking at things like that or mold, environmental factors, mold suppresses the immune function, increases epistamine, it causes brain fog and focus, it can cause mood changes. So there are so many pieces environmentally. Yeah, me as well. I also had Babesia like you. So I'm laughing when you were speaking because I'm like, I've had all of those two Lyme, Babesia, and Babesia is one as well as Bartonella that affects the neurological symptoms. system. So at that time, when I had it when I was in school, I was like completely drenched. I actually was wearing, I didn't even realize for like a year and a half, like all dark colors because I would be completely soaked, but it was on one side. And so I was told what a lot of my patients are told and the patients that you've seen is, it's in your head, you're just anxious. And I was like, but I'm having this happen when I'm just going to the grocery store and things where I'm not anxious. I'm not actually, should be anxious or stressed out. And so that's the story. Oh, anxiety store can be anxiety producing. and then you start having more. So that was the one thing that when I first started working with patients and also learning about Lyme disease, that a lot of them see about at least seven to nine doctors or many of the patients that come to see functional medicine providers before they actually get treated and diagnosed. And so I was one of them dealing with these symptoms that especially with women in particular will get kind of written off of you have a lot going on, you have a lot on your plate, which we do. but what else could it be besides just pure stress and anxiety? Yeah.

And it's sometimes important to dig and it's not like everybody with depression is the same cause or everybody with ADD is the same cause. And we label people and then we think they're all the same. You have depression, anxiety, ADD, bipolar, OCD, whatever it is, schizophrenia. These are just labels that have nothing to do with the underlying root cause, which can be many things, right? And so, you mentioned a lot of them in your talk around infections. We talked about toxins, poor diet, stress, trauma, and even aging itself can actually drive inflammation in the body. So all these things can be actually tested for and diagnosed and treated. And what kinds of clinical outcomes are you seeing when you start to treat a patient? Maybe you can share some cases. so sort of make it more real for people. I think it's abstract a little bit. I mean, okay, inflammation. And we'll talk about what inflammation does to the brain. Maybe we could just share a little.

Bit about the cases that you think are relevant to illustrate this connection. Yes, I've definitely had patients where they're, especially my patients with autoimmune conditions like rheumatoid arthritis, and they've gotten sick or an infection like COVID, and you'll see their CRP levels go up high, their ferritin levels go up, which can go up as an acute inflammatory response. And with that, you'll see like rheumatoid factor increase significantly, or they got another infection, like I mentioned, like Lyme disease, and all of a sudden their ANA or their titers will go up. So I've had many patients where we've worked with, you know, like that situation where when we've worked on the inflammation, when we've worked on the infections, I'll actually see it where their antibodies like are no longer positive, where rheumatoid factor is no longer showing, or the ANA is like at 140 versus like 1260, which is a marker for autoimmune conditions. So what you'll see is like, and that's also something in conventional medicine, they'll say that's gonna be the same for.

The rest of your life, right?

Right, you'll never recheck. Yeah, you don't recheck, like, yeah, like you'll see, you'll see like Hashimoto's and their number is 500 and they're like, well, it's always gonna be positive. Well, then why did I get my patient to go below 100? There was something we were working on that was causing triggering of inflammation. So we started testing in our office because people were coming back during COVID with like, wait, I just treated, you've been well, I haven't seen you in a long time, all the same symptoms were getting like reactivated. Like, I remember one of my patients had Lyme disease completely fine, hadn't seen him for a year and a half after COVID had, you know, Bell's palsy, all of the symptoms they had from like a year and a half or two years ago. And so we just had to put them either back on the protocol as well as like immune modulation. You could just see the numbers all cleared out. So I'm looking at it as a, what are the things that are triggering up inflammation which are making these things that are like underlying actually get worse? And then looking at that in its entirety and making sure, because you can also go down one rabbit hole, like making sure you don't, even in the space of functional medicine, you're looking at not everything's lime, not everything's mold, not everything, yeah. Like how are you making sure to be open to other causes? Because I've even had one of my interesting cases, a patient with RA wasn't treated, it didn't get worked up for tick-borne diseases, worked on that, RA got better, had was well, hadn't seen for a period of time. And all of a sudden, all the symptoms came back. And my question to her was, what happened? What's changed in your life? Like, what has happened? And sure enough, it was like a loss of a family member, but that person didn't connect that that would cause inflammation. And so my recommendation was, well, I'm not going to recommend anything. You need to see a therapist. And sure enough, the person after a month that said they reached out and said, Dr. Patterson, I don't know if it's just me, but all of my symptoms are gone. And so I'm like, yes, stress and something like that can actually completely trigger up all of those symptoms you had before. But there's this kind of disconnection between that. We don't really pay as much respect as we have on stress and inflammation, how cortisol, how that actually can impact the whole inflammatory response as well.

Yeah, I think it's a really important point because stress, either exacerbates or causes like 95% of all those is and, you know, whatever is going on, it's going to magnify it and increase your inflammatory state. Exactly. And, you know, in your talk, you really went deep into understanding how neurotransmitters, the brain messenger chemicals, get dysregulated by various insults and all the things we talked about, you know, poor diet, stress, toxins, allergens, gut microbiome, you know, infections, viral infections, Lyme disease, whatever, right? There's a common mechanisms that those all result in. that drive an inflammatory state in the brain. And you mentioned looking at some of the biomarkers like IL-6 and C-reactive protein, and these are tests we can do through regular laboratory tests, which, by the way, I don't get checked very often by my regular doctor, but you talk about actually when this state of inflammation is going on in the brain, what's actually happening? How do neurotransmitters get affected? You know, what's happening with the brain.

That causes all these psychiatric symptoms? so you'll actually see altering of, for example, NMDA receptors being impacted, which can cause that issue with glutamate. And then there's this altered, you should have an altered balance of, for example, GABA, which is more relaxing, an inhibitory neurotransmitter versus glutamate, which is triggering. So if you're having those ratios change, you're going more into a state that's excitatory, which is going to cause anxiety, depression. You'll also see some of those protective cytokines like IL-10, which are going to help with inflammation, will go down because you're going to have more of the pro-inflammation. And that is actually one of the big factors feeding into things like dopamine, which make you feel good. And dopamine is one of the ones that can go lower for somebody that's depressed. And when you're inflamed, you're dopamine lower. Exactly. It'll go lower as those inflammatory markers increase up. So it kind of it shifts the whole balance. So we need a little bit of each one. So it's not I always tell people it's like we do want a little bit, you know, we do want some glutamate. Of course. We want those things, but it's what that balances and what happens is with inflammation, it changes not only causing the direct damage to the area of the body, but also changing the neurotransmitter, the ratios, which will put you more in a state that is going to be more imbalanced.

Yeah, yeah, I think that's right. And I think, you know, we end up causing trouble with the overproduction of excitatory neurotransmitters that stimulate pathways like you mentioned, or the lack of neurotransmitters that help us with mood like dopamine or serotonin, right? And, you know, one of the tests we do in functional medicine is called an organic acid urine test, which seems like a crazy thing to do is check your urine if you're having psychiatric issues. But, in, in my patients is one of the most important tests that I do. And it's something we used to do only for people with inherited metabolic disorders, and you can get it a lab, but it's, it's really about the more subtle changes that occur in the biomarkers that relate to what's going on in your body. And, and, you know, one of the, one of the things we see is an increase in chonic acid, which is a sort of a marker of a.

Pathway that increases up in terms of inflammation and is also marker looked at when we're looking at neuroinflammation. And it changes tryptophan and these are all precursors for things like serotonin. So, choline and pathways also marker of concern when it comes to neuroinflammation.

Yeah, you can see that's sort of a sign of B6 deficiency. And that is B6 is required to convert tryptophan from your diet into 5-hydroxytryptophan in serotonin. And then, when that's not working or when there's inflammation, it also blocks an enzyme.

Can you talk about that enzyme, the IDO enzyme? Yeah, so it blocks the enzyme that's going to help with it's causing more of the increased metabolism to, like you said, in terms of the 5-HT, in terms of serotonin. So it's going to impact that pathway directly, which is going to be increasing up inflammation, but then again, the ones that are helping with things like anxiety are now getting blunted or impacted negatively where it's actually interfering with the production of it.

And one of the biomarkers we see on the organic acids is quinolinic acid. A lot of big words I know out there, but this is a biomarker you can check in your urine that indicates that the serotonin is getting shunted down a different pathway, which then leads to more anxiety, more depression, and you're getting this byproduct which is highly inflammatory in of itself. and it's a toxic kind of metabolite in the brain. And you can see it in the urine. And I can tell when my patients' brains are inflamed, they have high levels of this, whether it's a neurodegenerative disease, whether it's ADD or autism or depression. And so, you know, we can start to understand the biochemistry of this and the neurobiology of this in ways that allow us to actually directly intervene with.

Therapies that can fix these problems. Exactly. And the cholinergic pathway is like kind of the precursor to all of those ones that you just discussed. And so also the great thing with like the oat test which you mentioned, there's also a section that tests for catecholamines and those are all connected with norepinephrine, epinephrine, it checks for like HVA and all of those pieces in terms of your dopamine and also even like fatty acid metabolism because we know fatty acids help to drop down CRP which we're talking about with inflammation. And so if you don't have a good balance of omega-3, omega-6, omega-9, you're going to be again more pro-inflamed, which also is going to negatively impact your mental state and your physical body, obviously. But there's been tons of studies on just omegas as well just for the mental health. And part of it is that downregulation of decreasing of the CRP levels.

So, one of the things that I have been reading about, which I find fascinating, and it's kind of kind of comports with what we're seeing in our society, which is this increase in dysregulated social behavior, aggression, divisiveness. Friends can't talk to each other anymore. Families are breaking up over political issues. There's just whatever is going on, there's just something happening where our social cohesion is breaking down. I mean, I think most Americans are pretty middle of the road and are not on the extremes, but the extremes are what we see and hear about. But there is still a level of real divisiveness in our society and a real level of like increased in aggression and school shootings and violence. And now, I mean, we see it every day and I become almost immune to these stories, which, you know, if you ever had had one, it would have been a big deal. And we didn't have this when I was growing up. It wasn't like every day or every week there's a new shooting in some school. And the level of just oppositional behavior and anger and hostility. And I mean, it's like, I have a social media account. I just like sometimes I put stuff up that's sort of benign and you get like a litany of hatred. And I'm like, what is going on out there? And why are people acting like this? And part of it's, you know, they can hide behind their social media handle or whatever, but I do think there's something fundamental happening to the brain. And I've mentioned this before in the podcast, but when I was writing my book about the food system and the way our food was affecting us, I wrote a lot about the social aspects of it. particularly, so the studies that I came across around prisoners who, when fed a healthy diet, would decrease their violent crime in prisons by 56% and adding a multivitamin reduced it by 80%. And in juvenile detention centers, when kids were fed healthy diets versus the crap that they were eating, the violent crime went down by 97%. The restraints went down by 75%. Suicide, which you mentioned, went down 100% in an age group of teenager boys, which is the third leading cause of death. And that's just simply cleaning up the diet, which is moving them from an inflammatory to an anti-inflammatory diet. So I have this theory, which is that a lot of our social disruption right now is really related to some level of neuroinflammation. And when I was sort of reviewing your work, you were talking a lot about what happens to the adult in the room, which is sort of the person you know, knows we shouldn't go punch somebody in the nose, right? We want to. The adult in the room gets disconnected from the ancient limbic reptile brain. And there's this weird disconnection that happens for the adult is gone. And so the, it's like, we call it the amygdala hijack, which is the hijack of our behavior and our thoughts by this ancient part of our brain, which is all about survival, fight or flight, right? So can you talk about the science around this phenomena that we're seeing around neuroinflammation affecting the connection between the kind of grown-up mature person who's supposed to know how to conduct themselves socially and in life with the ancient part of our brain that just, you know, would kill anybody or do a stupid. So how, what is the science behind that? Can you unpack that?

And also the trauma, like when you look at kids with what they said have shown the trauma from all these events that you were talking about, there's just long term, we don't even know yet, longer term issues with things like anxiety and depression as a result of the trauma that's happening during that time.

It's genetic.

Exactly, there's complete changes. So we have what's called the prefrontal cortex that develops for kids up until 26 years of age. We have what's called the amygdala.

That's why the car rental companies don't rent cars to anybody over Under 25.

Because of that.

Because they know their brain is not fully developed. A grown-up in the room is not in the car.

It's not actually going to be the one driving, right? So, we have the hippocampus, which is for memory. And those actually both take a hit for anxiety and depression, which makes sense because you look when somebody has significant depression or anxiety, you'll see a lot of memory issues, like flightiness for people with anxiety, brain fog, forgetfulness, Yeah, they'll.

Even call it pseudo-dementia.

People get older, they get pseudo-dementia. Yeah, exactly. And actually even the risk of dementia is up higher for people with mental health issues as well, because likely because of the neuroinflammation. So you'll see like those areas, amygdala is more connected with like anxiety and that's what controls emotions and that piece with like the nine-year-old driving the bus versus, you know, the adult driving the bus. And so if you're constantly getting taxed with that and everyday day-to-day trauma, that is going to be more dysregulated. I mean, they've had studies that show women passing, in terms of being anxious during pregnancy, having an impact on their babies that are born of the baby, the child having more anxiety and things like that. So the development of the prefrontal cortex, which is like impulse, impulses can develop up until 26 years of age. Other areas of the brain that get affected, amygdala, like I mentioned, hippocampus, and other centers that help to regulate our emotions. So if there's constant inflammation on those areas or constant stress, which causes a dysregulation of cortisol levels, those will all could potentially impact those long term too as well.

So do you think my theory is right that a lot of the social discord is happening as a result of brain inflammation that's caused by all the factors we talked about?

Yeah, I mean, they have tons of studies on technology's impact on dopamine and that every time you have like a hit, like even a ring on your cell phone or, you know, did it like when you get your text, you get a dopamine hit for that. So one of the pieces is the more and more you have it, the more of a resort, like you're having less, your body's constantly needing to push out dopamine for everything with technology. One example I had, it was great because I did a urinary test and I was trying to get the person, I was actually working with someone that I didn't Know was a big gamer. And so we did the test and at the evening the cortisol was like, was the same that you would have in the morning to wake up because your cortisol should be higher in the morning to wake up. And low at night. And then I said, what were, and I knew right away, I'm like, were you playing like video games? And she looked and was like, how did, how did you know? I'm like, this number, there's just a lot of like hyperactivity. Her dopamine levels were high, norepinephrine, epinephrine, cortisol was through the roof. So of course, she's going to have sleep issues, which she was having. So you'll see that too. I mean, a lot of young people that are also in technology, they're staying up till late at night, as you know, and it interrupts their sleep. And if they're not getting good quality sleep, of course they're not going to be able to focus in class. Of course, they're not going to be able to emotionally regulate as well. So all of those things have these like kind of added effects that can cause, cause issues. But definitely technology with dopamine And as much as the parent can work with reducing it in small bits, I don't try to say stop completely. I say let's cut 15 minutes at a time so it doesn't seem as significant. But that's what the great thing about tests are because you can actually see and show and demonstrate and then it's easier to get people to say, oh, okay, this is why.

I had a nephew who is a super addictive gamer and just didn't have a life other than gaming. And long story short, he lived with me for a while and I took it all away. I literally just hit it. And it was literally like watching someone go through heroin withdrawal. He went ballistic. And I was like, wow, this is like a highly addictive thing. So I think that, and he had ADHD and it just made it worse. It made it a lot worse. And I think we had this incredible moment happening in the field of psychiatry where we're beginning to understand the brain in mental health, not just the mind. And talk therapy can be helpful. Sometimes psychiatric medication can be helpful, but it's a pretty limited tool set. And now we have a whole new set of tools. So when you see someone come in and they can have anything, anything from schizophrenia to bipolar disease to depression, there's a process you go through to try to figure things out. you know, because depression is not a Prozac deficiency. Right. Exactly. And, and, you know, it's kind of how we treat it. Right. We, we, we, I call it the naming, blaming and taming game. This came from my mentor, Sid Baker. He says we, we named the, the disease by the symptoms, and then we blame the name for the cause, and then we tame it with a drug. So we say, oh, the reason you're hopeless and helpless and have no interest in life and don't, can't sleep and have no interest in sex and don't have an appetite and you feel sad and you want to cry all the time is because you're depressed. that's what's causing your symptoms. Well, no, that's just a name that we give to people who share those symptoms. The cause could be you're eating gluten and that's causing brain inflammation. Or you had a been having a bad diet and had reflux because you eat 20 fried foods and end up on an acid blocker for 10 years, which depletes your B12 and zinc and.

Magnesium or because you maybe have no vitamin D and that causes depression. And you're looking to see, like, where does it land? I always say that for autoimmune conditions, it's like to me, it's all the same thing. There's different names, right? You know, but it's like, where does it? I say, like, land. And that's why people have, like, three autoimmune conditions. And I'm like, is it really three different ones, or is there their system just attacking itself and it's finding the very weakness? Yeah. Right.

It's like Aspen trees, you know, like, they all look like separate trees, but they're all one underneath. Exactly. Still the same. And so that's kind of how. How most diseases are. They're not comorbidities. They're not things. it just happened to be randomly showing up. I'm like, you know, this, this, you know, kid that I was mentioning before at ADD had like 12 different diagnoses, like, and was on seven different medications and was seeing five or six or different specialists. And, and no one asked, how are all these things connected?

Like, these just, he asked, and when did it start? And how did it start? And things like that, you know, the.

Beauty is, then we can start to actually think differently about how to approach these problems and start to think about the common the common root causes and how to one do the diagnostic evaluation, which can pick a lot of these things up, and also the treatment strategies. And it can be something simple, like, you know, like I mentioned with depression, I mean, it can be a B vitamin deficiency. And I was writing my book, and I think I was talking to somebody on the phone about it, whatever, and he heard me, we're talking. It was like, I was fixing my TV in my office, and I had happened to be working when he was there. And he's like, oh, yeah, I was seeing what you're saying. And, you know, I was really severely depressed, and And then I took these B vitamins, like B6, folate, B12, and it went away. And actually, methylfolate or deplin is actually a prescription drug, quote drug, which is an activated form of folate that psychiatrists use for treating depression.

Yes.

But it's all like kind of this, like one thing at a time. It's like still the drug model. It's not really a holistic view of the body as a system. so, Dr. Hansen, when someone comes to you, see you, and they're suffering from, whether it's depression or whether it's more PTSD or maybe they're having some psychotic kind of borderline issues or bipolar, where do you start and then how do you kind of find the things that are driving the problem? And then what are the sort of steps you take to help resolve that?

I think my most important thing is to also meet people like where they're at. So initially, I'm trying to get you to do what you want to do.

I just want people to do what I want to do.

I know how to get you better.

Do what I say.

You don't get to choose. That would make life a lot easier, right?

I'm pretty actually convincing because I said, look, let's try this for 10 days.

That's what I say. I'm like, let's try removing this food for a week and see how you feel. And then people come back and they're like, oh yeah, it worked. So I think the one thing when people see naturopathic doctors, functional medicine doctors, they're gonna get tons of lab work done initially. that's always really important to me in the assessment because I'm going to look at environmental factors like I mentioned, like metal, lead. You mentioned when you were saying about juvenile delinquency of like changing food, there are studies that even show there's a higher rates of schizophrenia after the age of 14 being or actually juvenile delinquency and schizophrenia if they've drink from like private well water and poor water. So even when you're talking about food, it's like what is the quality of their water? What is their environment by way of pollution? I've had children that we've had- Parasites who- Exactly. Even parasites where they've had ADHD and then they found that there was a lot of mold in their bedroom and they removed that and all the kids' symptoms were gone. Or I've had even adults that were exhausted and then when I did the assessment, I find out they drink four ounces of water and I'm like, okay, if you try to drink water, they come back. They're like, I feel completely new. like how is your body eliminating toxins? So that's what I said meeting people were at because there could be just basic things that people aren't even aware of. But typically with assessment, it's going to include like their metals, it's going to include things like you said, like a OAT test, I'm going to look at other infections, organic acid tests I'm going to look at. Especially if someone's like that rule of like ever since of like I got sick at this time and then ever since then this happened for women, a lot of times hormones. So like after they have a baby, after they have a kid, you'll see those hormones drop down, which hormones actually are like estrogen can be if it's in a high amount more pro-inflammatory and testosterone more anti-inflammatory. So you'll see when there's a shift of that or the cycle or perimenopause autoimmune conditions will go up too. So I'm looking to see like what that pattern is of like when it actually became dysregulated and getting as much like laboratory assessment but like really having deep in-depth conversations of their stories.

Because you can, oh yeah, I was fine until I moved in that house.

Exactly.

Tell me about that house. Well, you know, it was okay, but it was a little damp basement or it had like, I think we had mold in the bathroom or something. And you get these clues. And I think, you know, in traditional medicine, we sort of ignore most of those clues.

Like, you know, your psychiatrist didn't ask.

About mold or how much tuna you ate. Or were you inflamed or. Yeah, no, it's true. And I, you know, I think you mentioned lab testing. You know, I co-founded a company called Function Health, and we do a full panel of lab testing, and we look at a lot of things that do affect psychiatric health from your nutritional levels of vitamin D, of evaluation of the B vitamins through homocysteine and methionine acid, which are ways they're looking at B12, folate and B6. We look at red cell magnesium, we look at zinc, we look at also other factors like metabolic Health, insulin resistance, which can affect depression, look at sex hormones can affect mood, we look at heavy metals. So we, we got to really, and we look at inflammation, you know, I don't, it's mind-blowing to me, but in our population and we've done 55 million biomarkers on over 40,000 people and 46% have high CRPs. 30% have high ANA, 67% have a nutritional deficiency, whether it's iron like you mentioned, or homocysteine problems, or magnesium or omega-3s. We look at all these things as part of a fundamental panel to see what's going on. It's amazing if you start to fix these things, people get better. and sometimes you have to go deeper, right? It's not just always just cleaning up your diet and, and eliminating inflammatory foods and adding a number of nutrients that may be helpful for your brain or nutrient deficient. And it may also be like, okay, well, I gotta deal with the heavy metals, or I gotta deal with Lyme disease, or I gotta deal with the B, or I gotta deal with mold. And those are, those are things that we don't really deal with well with traditional medicine. But if you're seeing a functional medicine doctor, you know, they can see you in your practice in Connecticut. They can come to our, our Center in the, in Lenox, Massachusetts, the Ultra Wellness Center, and we deal with all these chronic complex issues. And we deal with the sort of the crises in mental health. And I did a documentary series years ago called the Broken Brain. And it's really about how most of our brains are not working properly. And we don't really have a great way to deal with brain disorders because our whole thinking has been completely wrong.

And focus and I mean, I have so many, I feel like over half my patients you ask about brain fog or focus, it's like, more than half of them have an issue. It's this of the activity with their brain and managing everything that they're doing and rates of what ADHD going up and anxiety. Is it truly that or is it, you know, we're just doing too much as a society? Part of what I talked about in the presentation giving for IFM too were the other things outside of like even diet is like the benefits of like sauna and how that showed to decrease CRP levels and also in studies that they did in Europe for men that there was like decreased chance of like things like schizophrenia, forest bathing.

That's crazy, wait, you just want to stop there. You just said take a sick of sonic and help reduce psychiatric symptoms and even schizophrenia.

Exactly, schizophrenia. Yeah, and this was a study of men at large for like decades. And they showed that there were lower rates of things like schizophrenia. If you look at also it decreases CRP levels, which we keep talking about with inflammation, you also look at like forest bathing. There was a study in Japan to show that the CRP levels went down significantly with more forest bathing and lasted for a period of time. So these are all the things that you can get people to do in small steps that just shows there's that lack of connection, like loneliness, I think is a huge factor. And that's one of the biggest things we're always trying to work at in our office. Even with anxiety, they've shown the most effective is doing that with group therapy, like Treatment plus therapy, I think it takes a community, but it's like you doing things to detach yourself from technology.

Like.

Grounding, sauna, those things, but then also your community of people around you to be able to support you as well.

Yeah, I think that's really important. And I think dealing with the things like exercise and social connection and detoxification, saunas which regulate your autonomic nervous system, being nature. These are all therapies, right? And they can be really effective. But, you know, sometimes people have real stuff going on that you can do all those things that it may not completely get better. And, I experienced that. I mean, I had a lot of brain issues when I had mercury poisoning, and I was in my mid-30s and I cognitively was so impaired. I couldn't focus, think, remember where I was at the end of a sentence. I went from listening to 30 patients' stories a day and not taking any notes and being able to dictate all their charts and remember everything I did, and to basically not really be able to be able to remember what happened in the past. Which is scary, especially in your 30s.

Yeah.

And I could feel the brain dysfunction. And I've had mold toxicity and I've had Lyme disease, and I think they sometimes cause residual things. How green is that? And I'm always learning, and I'm always learning and treating myself, and experimenting. And I, I do pretty well. I've written, like, you know, 20 books in 20 years and do a lot of stuff, but I still, you know, had, didn't feel like my brain was back to a hundred percent. And so I did, I did a test, which was actually from Germany, where they look at your cellular levels of toxins, which is something that's hard to do because toxins are not in, obviously, for those listening, easy to measure in the blood because they're often stored in the fat. And so we can measure the fatty membranes and what's in the cells. And I have, like, mold toxins. and pesticides and lots of heavy metals and, you know, dysfunctional, a lot of dysfunctional Pathways that related to this and oxidative stress. And I. Because I could feel myself, like, sometimes just boink out, like, my. This, like, my brain would just hit the wall.

And.

And I knew it was physiological, but I. And I. Even with all the stuff I do, I wasn't able to sort of fully crack that. And I recently did a protocol, which has been around for a long time, but it's a modified version called the PK protocol, which you probably know about, which is essentially using the to replace your cell membranes that are toxic with newer healthy substrate for the membrane, which is phosphocholine. It's basically a kind of a fatty compound. And I did like a whole bunch of IVs of it, and I redid my test after it, and I was like dramatically down on all the toxins. And my brain has come back online in a way that I didn't realize I was still affected, you know?

Yeah. That's one of my favorite ones. Phosphocholine, because it just protects. the brain, but there's tons of studies on it for dementia and also for ADHD. And I usually like the phosphatidylserine, which actually also helps regulate cortisol levels. So oftentimes do it at nighttime. I personally love to take because I wake up ready to go. My brain is sharp and I'm ready to go. But it's yeah, because I think it drops the cortisol, but it also has that effect on your brain, your memory, supportive that people tend to feel better when they get up.

Yeah. So, so, so what I meant to share with that story is that, you know, it's an ongoing process to figure out the levels at which we're all affected because, you know, we do live in a world with a lot of toxins. We live in a world with a crappy diet. We live in a world with a lot of stress. We live in a world with things that destroy our microbiome. We live in a world with, where we have things like mold or tick infections or latent infections, long covet, all of that. There's a huge role in dysregulating our brain function. So, this is kind of really a whole new era in psychiatry. It's a whole renaissance going on. I don't know if you saw, but there's a whole series of articles in the Economist recently, which is not a medical journal. Not a medical journal. But the whole thing was on psychiatry and the revolution in psychiatry and how maybe we should be looking in the body to fix the brain.

And that was the subtitle of my book, How to Fix youh Broken Brain by Fixing youg Body First. Yeah, and I see a lot of openness now too in the psychiatric conventionally trained of looking at the diet, the food, the lifestyle, and then also what those medications can have impacted, like by way of we talk, you know, nutrient deficiencies or are there particular things, nutrients that are missing. So it's, it's going to be. And as we see the rates of mental health issues continue to rise, there's got to be a lot more level of awareness of, like, what are all the other causative factors besides just genetic.

It's true. And then genes play a role, right? They can set up the sage. And I think maybe part of what we're seeing with the mental health crisis is partly epigenetic. So epigenetics, right, are the ways in which our genes are expressed or controlled. So can you share some of your understanding about how epigenetics might affect us? You mentioned, you know, kids born to women who are stressed, whether it was a Holocaust victim survivor or or a 9/11 survivor who was pregnant at the time and their babies have all kinds of dysregulated stress response receptors that are genes that get kind of switched on that are not good for us. Exactly. So can you talk about how that may be playing a role in terms of, you know, the sort of degradation of our mental health as a society and how the epigenetics might play a role in that?

Yeah, and it definitely doesn't, even when you look at things like, you know, autoimmune conditions, multiple infections, especially with the genetic predisposition, family members with autoimmune conditions like myself, there's gonna be a higher risk factor for having autoimmune conditions. So I always say like those genetic steps, those information shows you that that could be a possible concern for you, risk factor, but then the concern is like then what do you actually do for that? Like what are the things you're removing by way of, you know, being aware of, you know, plastics, being aware of like environmental exposures, like what are the things for me, Like my family have family history of autoimmune conditions, lupus, rheumatoid arthritis. For me, I know having infections might be problematic for turning something on, I say. So what are those things that we know potentially are risk factors and then what do we do to help to augment what it's connected with and how do we actually decrease it as much as we possibly can? Yeah.

And there's not just epigenetics, which is how genes are regulated, which definitely affected by, you know, for example, what happens to your mother in utero, was she stressed, was she have a bad diet, were there toxins exposure, you know, all those things can affect. They get passed down. And that can manifest, you know, later on in life in the child or even the grandkid. You're also talking about certain genes. So, there are genes that do affect your risk of mental illness that we can test, that affect dopamine receptors, that affect cortisol receptors. Because everything in your body is made from your genes, right? All your receptors, all your tissues, all the proteins, that's what your genes do. And so, when you have certain at-risk genes and you put them in the wrong environment, genes load the gun, but the environment pulls the trigger.

Exactly. And, there's tons of tests now that even test for neuroinflammation like in terms of antibodies to particular markers that can cause inflammation in the brain too. So, those are all going to be helpful risk factors to know, okay, I'm leaning towards this, what do I do to actually help to support it fully?

Yeah. So what are the foundational principles of diet, lifestyle supplementation that can work for a lot of people? It's not going to be personalized, but let's just like, what's your foundational neuro-psychiatric brain health approach?

Okay. So typically, while I'm always looking at what lifestyle things we can do, one of the things that's really important to me is, I always say, what brings you joy? So I think, yeah, what actually brings you joy? Because a lot of people stop doing those things. Oh, yeah. Maybe I should do an add disclaimer, disclaimer of what brings you doing that's healthy. So, so I find a lot of people stop doing like they love to dance or they love to hike and they stop doing all those things that, you know, that they have anxiety and depression. It's like you need to do more of that. And so those things get lost because we live in busy world. And so some of the thing in terms of approaches, like how do I get people back to doing some of the things they love to do before? Because then you're happier, your neurotransmitters are better, dopamine, endorphins, everything, if you're doing something that you actively feel better. So I look at that or that.

That you really, that brings you joy.

Vitamin J deficiency. Vitamin J. Exactly. Oh, I like that. So, so we have that, then obviously exercise, but I try to get people just walking. There's tons of studies that shown Walking is just as effective if you're consistent. So I try to go in baby steps of looking at all those things and then with food, really looking at things that are more like color, as many more plant-based foods that you can have as possible. I don't try to initially remove a lot of things because I don't initially, maybe Dr. Hyman probably is stricter on that because first I try to-- you-.

Want to get better, you got to.

Get rid of it. I try to get them to do more adoptive better behaviors and then start removing those things that are like really bad. Let's remove one thing at a time. So I do that. And then when it when I definitely do the lab assessment and blood work. But the other thing that's helpful is like things like amino acids, amino acid powder, amino acid blends. Those are often the precursors to many of the neurotransmitters. So we look at tyrosine, which is connected with dopamine, norepinephrine, and then the pathways dopamine, norepinephrine, epinephrine. So I'll look at that. I'll look at tryptophan. So an amino acid as supplemental like- Because you're thinking they're eating a protein, they're getting all the amino acids. Dr. But they're not oftentimes and then especially kids because they just don't eat as well. They might not get enough from their sources. So I'll often look at amino acids as kind of a beginning function. I look at a lot of like core minerals like magnesium, zinc, selenium. You do have to be careful with balancing zinc though and copper and so I check for that too because a lot of people just take zinc year round and so you want to look at that because that can affect the mental state as well. so those are some of the initial things. And then oftentimes I'm looking at other things like adaptogens or things that can overlap. I mentioned turmeric. So I might use turmeric because they're also inflamed, but that also helps with depression. Ginger, I can incorporate that in their food. Ginger is connected with helping with GABA, which we talked about earlier, to help improve mood, but also ginger not only helps with digestion, it also helps with inflammation as well. So I always try to look as a practitioner you're working with anybody's working with. Are they looking at, yeah, are there things that we can also cover two or three things at the same time? I'm looking at their gut microbiome. Oftentimes I will do a stool test and there tends to be issues with that. Chronic people, chronic diseases have lower levels of things like lactobacillus and bifidobacterium and particular ones are more protective with anxiety and mental health issues. Ramnose is one that's connected lactobacillus ramnose, lactobacillus plantarum. So I'll look at those in a stool test, but I also try to, and you get that all from like fermented foods and eating well, but most of us can't get enough, so we might have to do things like a probiotic. So you really want to look at that whole piece, but then also going backwards to see like when did it begin? Was it after they were sick, had a lot of digestive issues? Because you'll see increases of anxiety and depression also for people with IBDs, it's like much higher. with inflammatory bowel disorders like ulcerative colitis and Crohn's. So again, if the rate is higher, then you have to think there is.

Some relation to the gut and mental health.

Yeah, the gut and mental health. Because you have IBD, but you're the other way.

Yeah, the other way around. Yeah, I think that's true. Even irritable bowel, I remember reading a paper years ago, and I think it was in New England Journal where they talked about, you know, the rethinking of psychiatric illness that was related to a bowel. We just think that people, when I, when I went to medical school, it's like, if you have your no ballots, because It's all in your head. It's not a real disease. Yeah, it's not a real disease. You're just anxious and stressed, so take a little Valium. We used to give this stuff called Librium, which is basically Valium. And, it turns out that it's the abnormal bacteria and the leaky gut and the inflammation that's feeding back to the brain from the gut imbalances of the bacteria and leaky gut that's driving the brain inflammation.

It's probably one of the biggest factors. Exactly. And, they also regulate some of the bacteria, like I mentioned, lactobacillus rhamnosus, is also helping with things like GABA and so there's definitely a huge connection there and most individuals with either chronic disease conditions or mental health conditions will have an impact 100% on their gut microbiome.

And we talk a lot about probiotics but now there's a whole field of psychobiotics which are probiotics that affect brain function.

That are more particular, yes. And they've been studied with mice and such.

Can you talk about this whole field of psychobiotics?

Yes, sure. Is it legit or like Yeah, there's definitely been studies, Raminus and Plantarum are two of the ones that have been studied where they had done studies with mice and they actually for depression too and anxiety. I don't know exactly how they decided what it qualified for a depressed mice, but.

They don't eat.

And so basically they exchanged that bacteria just like how they were doing with the fecal microbiota transplants and they found that those those mice were actually like not depressed or not anxious, but then the ones that they gave it to were more anxious or depressed. So, there is definitely some subspecies, different strains that have been studied to help with mental health state as well that actually can potentially improve it.

Yeah, and you talk a lot about the, you know, this sort of even in schizophrenia, how there's, you know, yeah, psychosis. And I think, you know, we don't think of, wow, autism or psychosis being connected to gut bacteria, but it often can be. I remember I had a kid with autism, it was pretty severe autism, and we looked at his stool test and he had Giardia. Oh, wow. Which is a, you know, pretty significant parasite that causes malabsorption and nutritional deficiencies and inflammation. And I basically just treated his parasite with a drug, Flagyl, and the kid's autism got better. Wow, that was crazy. It doesn't mean all kids with autism have this thing. These are just common ways the body has to say ouch. There's not that many ways the body has to say ouch, right? Depression, anxiety, psychosis, ADD, these are things that there's a pretty finite set of problems that can occur, but from a very, almost infinite variety of different- Of reasons. Reasons, right. And so that's why psychiatry has to really shift. I think one of the fields that's really emerging around this is metabolic psychiatry and mitochondrial health and psychiatry. And Suzanne Goh has been on the podcast, talked a lot about the role of mitochondria in autism and a lot of mitochondrial deficiency in these are dysfunction in these kids. Chris Palmer, who's been on the podcast, also talked about from his book, Brain Energy, the role of poor metabolic health, and is actually using ketogenic diets to.

Treat mental health issues. So I wonder what your perspective is on that. And he's using it for schizophrenia.

Bipolar disease. What's your perspective on that?

They have had studies. I saw ketogenic and more so for actually schizophrenia in terms of ketogenic diet being more supportive for that because of the body fueling, basically, especially with the mitochondria piece that you mentioned in the right way. There's also what's called the mind diet is another one that's very similar to Mediterranean diet probably has the most studies. for mental health and includes when you look at Mediterranean more like higher levels of acrylamide, which is one that now has been shown for cognitive support and tons of benefits of that particular strain.

And acrylamide produces GABA. So basically, you don't have to take a neurotransmitter supplement. You take a probiotic or you feed that probiotic with polyphenols and then you'll get naturally occurring Beneficial.

Yes. And then when I often test people, they're often deficient in like a acrylmenzia or they don't have enough lactobacillus and all of those things that are actually protective for them. So we look to see how we're actually gonna fully augment that and then how do we get to the state where they're managing it as much as they can through diet and we don't have to do as much by supplementation.

Yeah, it's just an extraordinary moment to be in this field of psychiatry. Any other exciting stories you want to share about some cases that got better from using this?

Yeah, I think I tend to work with a lot of children with PANS and PANDAS and also that have kind of coupled with ADHD, et cetera. And so it's just been many patients where the parent, when a child has PANS or PANDAS, what happens is there's acuity of symptoms. So overnight, the parent, I remember one of my first cases, the parent said, My daughter went in to go take a shower and she came back and she was a different kid. They start getting scared of eating, that they're gonna choke on their food, they start having a lot of issues at nighttime, OCD, significant anxiety, and even getting pulled out of school. So my reward is to be able to see now having these children within like a few months being able to get them back, you know, to school or I've had kids that have been out of college for a year because of their illness with tick-borne diseases and now they're fully back and one kid I just saw the other day, she's going into a nursing program and I'm like, wow, that's amazing to see. And these are individuals that would have fallen through the cracks and just told to get on psychiatric med and may have tried it and they haven't changed. I get a lot of stories, especially with the parent, because overnight it changes the whole family dynamics.

Yeah, I mean, the kids respond so well, too.

It's quite amazing.

I mean, grown-ups are a little harder, but yeah, kids, it's instant. It's really amazing. They have a basic overall healthy sort of substrate, basically. It reminded me of a kid I.

Had with pandas, which is this pediatric.

Associated neuroinflammatory disease that causes OCD and horrible behaviors. It's potentially really scary for the parents. and this kid had, you know, positive strep antibodies and inflammation. And I said, well, geez, you know, it's not. You can't just throw any biotics at it because it may not really work. But actually, I recommended intravenous ozone for this kid, which was kind of a little out of left field, but I really understood the role of ozone and decreasing inflammation and being a powerful germicide. And this kid completely got better, and it was amazing, you know, and, like, and for good, you know. So I think there's so many people suffering out there with a whole array of mental health. issues, whether it's just sort of, you know, low grade depression or anxiety or more severe depression or more severe mental illnesses like bipolar disease or OCD or pandas or autism or, or schizophrenia or psychosis or a whole range of things that now we're sort of beginning to finally understand. And, and I think we're getting to closer to what the truth is.

And so, I agree. Even, like, infections that, that, you know, controversial, like after covet, it's like, oh, you can still have long-term symptoms because with Lyme disease, for example, it was told after you got antibiotics, you're good to go. But when you look at it, there's what's called post-treatment Lyme disease about up to 30% can continue to have symptoms, especially like arthritic and joint pain and those types of symptoms. So I think there's now become greater awareness of like, oh, these little micro assaults or infections can cause different areas.

Of impact on the body, including mental health issues. Well, I mean, you're such a pioneer. You're doing such great work in this field. I think people need to know more about your work. They can find you on your website, womeninlime.com?

Yes, womeninlime.com, my practice is Fairfield Family Health in Connecticut, and we're also having a summit shortly. It's called Lime Heal Hers. And the reason we did that was because one of the things that's important to me was to have represented different faces and we wanted to have it where it was all women, because they never do that for events. So we did a whole lineup of different topics. So check that out, because we're having another summit in August. So we definitely look at that as well. And you also have a book, Women in Lyme.

Yes, Women in Lyme.

I have a couple books, Women in Lyme, and then the other one was on long COVID and what to do. It's actually a great book, because it's a small, short book that I did with another doctor in my office, Dr. Madeya. And so that's a great one. And I'm pretty active on Instagram, naturopathic.physician.

Where I try to post out information too. Well, thank you so much for what you do, Dr. Patterson. This has been an amazing conversation. I hope it's been helpful for people listening because people struggling out there. I mean, mental health is, you know, obesity and mental health are the two biggest things facing us. And by the way, they're not unrelated. They are, though. So, I'm excited to keep learning from.

You and I hope everybody checks out your work.

And keep up the good work.

Thanks so much for having me. Great discussion.

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