if a woman has obesity and diabetes she

has quadruple the risk of having an

autistic child but I want to go deeper

and most people don't know this

something horrible has happened Dr Chris

Palmer the Harvard psychiatrist whose

groundbreaking new research could be the

missing piece to cure the mental health

epidemic mental disorders are the

leading cause of disease and disability

worldwide governments are actually

labeling them as terminal illnesses and

to allow people to die by assisted

suicide and they're going to allow them

to die because they know what I'm saying

is true they know that our treatments

fail people year after year after year

and what I'm here to say is you can in

fact get better how I struggled with

mental illness myself for 20 years I

tried to kill myself several times there

was no hope for me

whatsoever and I was furious with the

mental health field for being so

incompetent and I wanted to try to help

and the thing that people have not open

their eyes to is the science of

metabolic health and there's tiny things

in our cells that can heal and recover

people who have had chronic horrible

mental illnesses really yes and if

autism is genetic it shouldn't quadruple

in 20 years these are facts and we can

do something about it today but the

easiest way to understand it is that

quick one this is really really

fascinating to me on the back end of our

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[Music]

deal Chris when you

speak before we started recording you

speak with a deep authentic sense of

mission and that underneath there is a

personal driver that is

unimat and that is getting you out of

bed every day because I could see it in

your eyes I could see it in the way that

you said the words that you said to me

where does that drive begin for you what

was the Catalyst moment in your life

that inspired you and gave you that fire

that seems to be unquenchable to pursue

the path that you've pursued you know I

struggled with mental illness myself

starting in

childhood nobody recognized it nobody

diagnosed it I didn't know what it was

nobody knew what it was I just knew I

was different and

somehow ostracized for who I was and it

just felt like part of who I am and then

a series of horrible tragic events

happened in my extended

family when I was about 12 years

old and my mother ended up having a

nervous breakdown she called it a

nervous break break down it started with

what we would call major depression

quickly escalated to depression with

suicidality and then she developed

psychotic symptoms she became very

delusional she got mental health

treatment but the treatment didn't

work they basically were just kind of in

my 12-year-old mind the psychiatrists

were just drugging her

and those drugs weren't making her

symptoms better they weren't restoring

her

health she went on to live the rest of

her life with a chronic psychotic

disorder and that disorder completely

ruined and devastated her life in so

many ways she lost everything she lost

custody of her eight kids she lost all

of her money everything that courts

didn't give her any support or any money

I had my own

struggles even worse with mental illness

after all of that I ended up leaving

home before I finished high school I had

chronic depression and suicidality and

OCD and other things and the mental

health field was worthless for me and

probably caused a lot of harm for

me and so the the end of the day the

reason I'm a

psychiatrist is because I recognize how

horrible and

devastating mental illness can

be and I came to the field

really angry with the mental health

field for being so

incompetent and I wanted to try to help

I wanted to try to maybe contribute to

better solutions for

people my futile attempts to save you

from the ravages of mental illness lit a

fire in me that burns to this day I'm

sorry I didn't figure this out in time

to help you may you rest in

peace that's my mom and that's the

dedication of the book her story and the

devastation to her

life is the thing that drives me to this

day um and I just know that there are

hundreds of Millions millions of

people just like her with different

diagnoses with different

symptoms but the devastation to their

lives is the same and those people

deserve

better and I want to help them I want to

get them better

treatment those people those people

exist on some kind of I guess multiple

different spectrums of disorder what are

those spectrums of disorder

and what are what are those disorders

that you're referring to when you say

those people are the people that I want

to

help people who are diagnosed with a

mental

illness and

so you know the

diagnoses are all over the map we have

all of these different diagnoses and the

DSM

5tr the diagnostic and statistical

Manual of Psych patry which is kind of

considered the Bible of Psychiatry and

it has all of these labels in it um

schizophrenia bipolar disorder major

depressive

disorder alcohol use disorder which most

people know as

alcoholism other

addictions uh anorexia

nervosa but

also autism autism spectrum disorder or

dementia that most people know as

Alzheimer's

disease that those are all of the labels

in our um in our kind of Bible of

Psychiatry and the reality is that when

you look at the treatment

outcomes for people who are getting

treatment for those diagnostic

labels there is no doubt that our

treatments do work for a lot of people

millions of

people and so millions of people are

helped their lives can be saved by the

current treatments that we have and I'm

not here to take that away from anyone

so for people who are getting treatment

and those treatments are working keep

getting that treatment I don't want to

interfere with anyone's access to those

medications or

psychotherapies or electr convulsive

therapy or whatever treatment they're

getting I don't want to stand in the way

but there are far too many people just

like my mother who did everything they

were asked to do who took all of the

pills who showed up for their therapy

appointments who did everything they

were asked to do and they're not getting

better you know mental disorders as an

as a whole are now the leading cause of

disease burden and disability worldwide

and it's not because those people aren't

getting treatment many of them are

getting treatment yes there are people

who can't afford treatment or can't get

access to

care but a lot of people are getting

treatment I work at one of the best

psychiatric hospitals in the world I

have the privilege of doing that and we

see patients that aren't getting better

we see them all the time day in and day

out

and the crisis the tragedy is that some

governments are actually now moving to

labeling mental illnesses as terminal

illnesses the Canadian

government in March of

2024 is going to allow people to die by

assisted

suicide because of a treatment resistant

mental illness really yes they're going

to allow them to die and they're going

to allow them to die because they know

what I'm saying is true they know that

our treatments fail people year after

year after year and those people become

desperate and

hopeless and they give up on treatment

for good reason because they've

participated in treatment for decades

and it hasn't helped them and the

Canadian government has now made the

decision that they should be allowed to

die with the help of a

physician who can prescribe deadly

medications and make it easy for them to

die by

Suicide the UK is now labeling some

people with eating disorders as terminal

eating

disorders and that maybe you know if

they've exhausted treatment if they've

had treatment for several years or more

than a decade well treatment's just not

going to work for them so let's call

them terminally ill with an eating

disorder people are frustrated and

hopeless again I'm not talking about the

people for whom treatment's working if

treatment is working for someone if

they're taking a pill and it's working

fantastic you're lucky keep doing it and

I don't want to interfere with anyone's

access to that

treatment but we can't hide from the

tragic realities of the the

world for all of those people that are

they might have extreme anxiety

depression schizophren osity these

extreme sort of mental health

disorders what is it that you want to

put into their hearts and Minds with

your work with the message that you're

spreading what is it that those people

need to know and I I say that not as all

of the details which we're going to go

into but the very Topline message that

you know maybe in a sentence you want

those people to

have if you have been trying treatment

and those treatments aren't working for

you please don't give up there is hope

you can in fact get better if you

understand the science you can get

better the mental health conversation

the uh prevalence of mental

health lots of these things seem to have

changed in the last 28 years what is the

state of mental

health as we sit here today and how has

that changed in the 28 years that you've

been at Harvard and working in this

field I think I have a slightly

different perspective yours sounded more

hopeful than

mine you kind of said things have

changed in 28 years and tragically I

actually feel like they haven't changed

a whole

lot if you look at if you look globally

at the

problem the problem of mental illness is

increasing

it is not stagnant and is not decreasing

it is increasing in prevalence

throughout the

world prior to the pandemic about 1

billion people had a mental or substance

use disorder representing about 133% of

the world's population and that was just

in one given year

2017 the pandemic added insult to injury

and rates are much higher now and the

rates of mental illness have been in

increasing across a wide range of

diagnostic categories rates of autism in

the United States over the last 20 years

have

quadrupled a four-fold increase rates of

ADHD are up and through the roof rates

of bipolar disorder in adults a lot of

people think bipolar disorder that's

genetic well in adults in the United

States over the last 20 years rates have

doubled in children and Adolescence

rates are through the roof up

exponentially thousandfold percent rates

of plain old bread and butter depression

major depressive

disorder the Gallup pole does an annual

survey in the United States of current

and lifetime prevalence of depression

and just this year in

2023 rates of both both current

prevalence and lifetime prevalence

reached alltime ever recorded highs so

we have a catastrophe we have an

epidemic mental illness is a growing

escalating

problem and I wish that I could say our

treatments were dramatically better

there is no doubt we do have new

treatment options we have ketamine and

psychedelics we've got transcranial

magnetic stimulation which wasn't around

when I first

started we have some new

medications but the real answer is the

medications that we have are no better

than the old medications because they're

all based on the same

mechanisms so companies are simply

repeating what we already know kind of

sort of works and they're just making

new molecules that kind of sort of do

the same thing and so they still just

kind of sort of work they don't work for

everyone and they even fail to work for

most people in the largest study ever

done of

depression when people come in the very

first anti-depressant treatment they get

over 4,000 people treated at the best

academic centers that we have in the

United

States the first antidepressant

treatment only about 30% get a

remission that means 70% % still have

major depressive disorder they have

enough symptoms to still be labeled

clinically

depressed even if the pill helped them a

little bit it didn't help them enough to

make their symptoms enough of their

symptoms go away now even those 30% who

got a remission many of them are still

having low-grade symptoms like all of

their symptoms didn't go away and after

four levels of treatment

the original published report said that

67% got a remission after four different

types of treatment for major depressive

disorder if we take that at face value

that means onethird of patients are

still clinically depressed after four

levels of

treatment other researchers have

challenged that 67% figure because the

reality is half of the people in that

study dropped out because it just wasn't

working out for them so we got a problem

there like this this protocol clearly

isn't working out well for people when

half of the people are dropping out of

your

study and the second problem is that

there are some researchers who point out

that they changed the criteria for

remission during the study they

prospectively said they were going to

Define remission in a very certain way

using certain

metrics those researchers said if they

stuck to their

protocol only about 35% got a remission

after four treatment

levels that would mean two-thirds of

people after getting four levels of

treatment are still clinically

depressed and that is the current state

of affairs for

depression something that we all know

something that we've got so many

treatments for if we look at more quote

unquote serious mental disorders like

bipolar disorder and

schizophrenia the results are

abysmal the one large study of 6,000

patients with

schizophrenia only 4% of the patients

got a recovery meaning that their

symptomss were in full and complete

remission they were they had a decent

quality of life and that they were able

to function in the world they were able

to have a job or go to school only 4% of

people with schizophrenia got that using

our best treatments available

today those statistics aren't a lot

better than they

were 50 years ago tra

magically Chris when people say to you

or when people say the quite common

rebuttal that the reason we're seeing

this rise in mental health disorders is

just because there's more of a

conversation about it so more people are

stepping forward we now have a word for

it so there's just more labeling and

these mental health disorders like the

ones you've named and even things like

ADHD and autism um it's just because

there's more conversation going on and

these things aren't in fact

increasing that is a common argument and

I would

argue

that it's like just putting your head in

the

sand the easiest place to get an

accurate

read on the true prevalence of mental

illness and not just the recognition of

it but the true prevalence of it is to

talk to school teachers who've been

teaching for more than 30 years if you

ask

them were you just not recognizing the

children 30 years ago who are screaming

and tantruming in your classroom were

you just not recognizing the children

who were melting down when they got bad

grades and injuring themselves in class

were you just not recognizing the level

of Despair that you and anxiety that you

see in

children did you just have your head in

the sand back then and now since

everybody's talking about it you see

those behaviors you see those symptoms

the school teachers and the guidance

counselors will laugh at you and say no

no

no something has

happened something horrible has

happened I wasn't ignoring mental health

30 years ago I wasn't ignoring despair

30 years years ago I wasn't ignoring

extremee anxiety and panic I wasn't

ignoring Tantrums in my classroom 30

years

ago they are skyrocketing in

prevalence if we look at emergency

rooms so emergency rooms in the United

States that's I can speak best about

statistics here in the United

States um but I think in most Western

countries these statistics

are similar we have a

crisis in mental health in emergency

rooms in particular youth mental health

but it's across the board we have all of

these children and adolescents showing

up to emergency rooms having attempted

suicide or they're becoming

psychotic and they're diagnosed with

bipolar

disorder at skyrocketing

rates

and and we don't have enough services to

treat these people these kids these

adolescents our children we don't have

places to put them so they sit in

emergency rooms not getting Optimal Care

simply getting medicated sometimes

restrained to a hospital gurnie so that

they don't try to run away or hurt

themselves talk to anybody in an

emergency room we're see

that those people weren't hiding in

their

homes 30 years

ago something's

happening they are actively acting on

mental health symptoms they are acting

out of

Despair the suicide rate has gone up if

you in the United States or the last 20

years total suicide rate has gone up by

about

30% but if you look at a different

statistic called deaths of

Despair it has doubled in 20 years

deaths of Despair includes not only

suicides but also deaths from alcohol

use drug overdoses and others those are

mental health problems those are

addictions they are mental health

disorders they are in

DSM rates have doubled

in 20 years people weren't dying 30

years ago and we just didn't recognize

it and now we're recognizing death now

we're recognizing suicide we didn't

really recognize it 30 years ago but now

we recogniz no no no we we know we know

what death is morticians know how to

recognize it and diagnose it and the

rates are skyrocketing a doubling in 20

years that is nothing to

ignore that begs the

question what do you believe is causing

it because clearly you know when I've

heard people when I say people I mean

just the you know the things you see in

culture and media or maybe on Instagram

that say you know there's a chemical

imbalance in people's brains I've always

struggled with that I understand there

might be sometimes but I've struggled

with that as a broad answer to a very

complicated Nuance set of issues because

I just have a a bias to believing that

hum aren't born broken you know I

believe that you know my ancestors go

back very I've got a lot of ancestors

that um I understand how natural you

know natural selection and evolution

works I don't think that I was born

broken so I think maybe there's an

environmental factor maybe something I'm

I'm doing or something we're doing as a

society is increasing these rates of

suicidality that you talk

about what you believe is the answer

that we're missing or not talking about

enough the root causes which we can can

get to and and I have lots of ideas and

thoughts on it if you want to get into

the weeds of like what are the exact

causes we can talk about that but the

thing that people have not opened their

eyes

to is the science of what we call

metabolism or metabolic

health and what I ultimately am arguing

the easiest way for me to put it is that

what I'm arguing is that mental health

condition The Chronic serious ones in

which the brain isn't functioning

properly brain disorders that are

causing mental health symptoms those are

the things I'm talking about now that

we're all susceptible to you believe I

think we're all susceptible to it those

in fact are metabolic disorders

affecting the

brain and so the easiest way to

understand why do we see skyrocketing

rates of mental illness

it's not a

coincidence that we're seeing those

skyrocketing rates at the same time that

we see skyrocketing rates of obesity

overweight diabetes and pre-diabetes

which are also

metabolic

conditions that all of those things are

rising

simultaneously and that the brain is an

organ and so some people can have

metabolic problems

and some people can be thin and still

have a metabolic problem so it's I'm not

at all saying that obesity is the only

driver because a lot of times people

think about it in that way so are you

saying obesity comes first and then

everybody gets a mental illness no I'm

not saying it that way sometimes the

mental illness starts

first because it's a manifestation of

metabolic dysfunction in the

brain and it basically means the brain

isn't working working right and so

somebody might have unrelenting

depression or unexplainable anxiety or

psychotic symptoms or bipolar symptoms

or eating disorder symptoms or substance

use disorder

symptoms that they may

have symptoms but all of those things

are a manifestation of metabolic

dysfunction in the brain can you explain

metabolic dysfunction to me like I'm a

10-year-old

the easiest way to explain it is that

our bodies and our brains are made up of

cells and all of our cells need two

essential things to function properly

they need food

oxygen those are the big ones that most

people know it gets more much more

complicated fast because food contains

all sorts of nutrients so we need

certain vitamins and nutrients and

hormones are playing a role all sorts of

things are playing a role

but at the end of the day that's what

metabolism is metabolism is taking food

and oxygen and keeping us

alive they are

fundamental to our health but also the

function of our cells and when something

goes wrong in that process and there are

lots of things that can go

wrong when something goes wrong with

taking food and oxygen and turning it

into

energy

the cell can

malfunction and when it happens in your

brain it means that your brain can

malfunction and the way that we know the

brain is

malfunctioning are all of the symptoms

of mental

illness when

somebody has depression for no good

reason when somebody has anxiety for no

good

reason when somebody

just has experiences like hallucinations

or delusions for no good reason that all

of those things represent the brain

malfunctioning if you could take me one

step deeper into this idea of you know

food and oxygen being converted into

energy in the cell um something goes

wrong

there what goes wrong why does it go

wrong so the real answer is it's

extraordinarily comp licated there are

many Pathways in metabolism there are

many things that play a role but the

easiest way to understand it and the way

to unify it the helpful insight the

immensely helpful

insight and this is new Cutting Edge

information most people don't know

this but there are these tiny things in

our cells called

mitochondria and

they are actually the primary sites in

our cells that food and oxygen are

getting converted into energy or

building blocks for our

cells when you do a deep dive into the

science of

mitochondria you can actually begin to

understand what's happening in the

brains and bodies of people with mental

illness

and you can begin to understand all of

these very complicated things like why

would neurotransmitters become

imbalanced that's what what's causing a

neurotransmitter imbalance if there even

is one what's causing a hormone

imbalance what's causing higher levels

of inflammation in the brains and bodies

of people with metabolic and mental

disorders um what about the gut

microbiome how does that play a role but

what about stress and Trauma

psychological stress trauma how do those

things fit

in mitochondria are actually the

scientific way to begin to connect all

of those dots and help us

understand why the brains of some people

quote unquote malfunction or why they

are

disregulated might be a better way to

put it or why some people can't seem to

quote unquote get over it get over a

trauma or get over a breakup with

someone what's going on why aren't they

more resilient why can't they pull it

together mitochondrial dysfunction as

nerdy and sciency as that is can help us

connect the dots what do I need to know

about the mitochondria what it is I know

it's in every cell in my body um is is

there anything else I need to know about

it before we explore these through lines

and how all these other things come back

and connect to the

mitochondria so mitochondria are present

in most cells in the body not not every

single human the the glaring example are

red blood cells which actually lose

their mitochondria they have them when

they are first forming but then they

lose their mitochondria so red blood

cells interestingly don't live all that

long um we're constantly creating new

ones and turning them over so most

people know mitochondria as the

PowerHouse of the cell which means they

take food and oxygen and turn it into

ATP and that's what most people learn in

school they're the PowerHouse of the

cell but I'm here to tell you they are

so so much more than that there are

hundreds or thousands of them in most

cells they are highly

Dynamic at one point you know the the

theory of

multicellular life on planet

Earth is that mitochondria were once

Independent Living

bacteria and that another single cell

organism engulfed that very first

bacterium and the two of

those organisms lived they stayed alive

usually when you get engulfed by another

organism that means getting eaten and

you you die for whatever reason

these two stayed alive and they became

symbiotic with each

other and actually that event is thought

to maybe have only happened

once on Earth and that single

organism evolved into all multicellular

life that we know today so all living

organisms that we can see with our eyes

plants all animals are

evolved from that same organism so

mitochondria divide and replicate they

actually move around cells they fuse

with each other they Bud off from each

other they they form patterns around the

nucle cell nucleus which plays a role in

which genes get expressed or don't get

expressed they do all sorts of things

when people say that we have a

predisposition a genetic predisposition

to mental health disorders and that you

know you'll have depression if

depression runs in your family Etc is

there Merit in that in your view is

there evidence to support that

absolutely so we know that we know that

mental illness runs in

families genes explain some of that but

not all of that the environment actually

can influence things called epigenetic

factors which are factors

that control the expression of genes

they turn genes on or off and those

epigenetic factors are actually

inheritable you can inherit them from

your parents and so it's not all

strictly

genetics um some of it is epigenetic so

first and foremost there are no genes

that are specific to specific disorders

most people think well you know if

bipolar disorder runs in my family there

must be a bipolar disorder

Gene and in fact there isn't a bipolar

disorder Gene there are genes that

increase risk for bipolar disorder but

at the same time they also increase risk

for schizophrenia and epilepsy and

autism and depression and other types of

mental and neurological

disorders and if you look at the

unifying theme like is there a theme for

these genes is there a common pathway

that can help us better understand

mental illness the common pathway is

that most of the genes are affecting

metabolism and

mitochondria one research study that

came out a couple years ago researchers

have been looking for years at a a

high-risk Gene for

schizophrenia um and we know that people

who have this very very rare genes so

almost nobody has it but if you do have

it you're at high risk for developing

schizophrenia along with lots of other

mental illnesses but schizophrenia is

the big one and the researchers did this

deep dive into trying to understand what

exactly is this Gene doing and at the

end of the day they said it's affecting

mitochondria and that is probably how it

is causing schizophrenia metabolism that

happens as a result of the work of the

mitochondria is that accurate so want to

make sure I've I'm clear on them before

we proceed 90% of of metabolism at least

is occurring in mitochondria so

it's that definition as a scientist I

have to say isn't 100% accurate because

there is a thing called

glycolysis that can happen in cells

where you can actually produce ATP

without using mitochondria what's that

so ATP is usually known as the energy

currency of living organisms of cells

and so um and that that ATP ends up

making cells work it is the energy

that's flowing around cells or the

molecule that's flowing around cells to

make receptors work to to make all of

the Machinery of cells work and that

becomes relevant maybe some of your

listeners will know this if you exercise

really hard like you're running a

marathon or you're running as far as you

can get with a marathon before you

absolutely are exhausted and you just

have to stop your mitochondria will

actually become maxed out that is what's

preventing you from running is your

mitochondria max out and they they're

it's like you don't have enough of them

or they're not healthy enough and so

they just they can't keep you going they

can't keep your muscles going and so you

Peter out and when you Peter out you

start you turn to this process called

glycolysis which actually ends up

producing lactic acid or lactate and so

Runners will get higher levels of LA

lactate and and then that can create

soreness and all sorts of things um but

uh yeah that's so metabolism is really

the process of taking food and energy

food and oxygen I'm sorry and turning it

into energy or building blocks and that

can occur on a small scale outside of

mitochondria but as soon as the

mitochondria in most of your cells are

dysfunctional or dead you you die

there's no way around it

so let's use some of those examples that

you gave earlier you talked about stress

and Trauma and these kinds of things I'm

really Keen to know how a traumatic

event can have an impact on your

metabolism your mitochondria which then

manifests as a mental illness um so if

we take trauma for example people go

through early trauma in their life I

don't know there's a I mean you had a

very traumatic upbringing how do you

think that maybe even in your case if

you were able to see inside of your body

and what was happening that external um

traumatic event came into your body in

some way caused a physiological reaction

had an impact on your metabolism which

results in a mental health disorder of

source it gets a little complicated

because it it goes through a couple of

stages so I'll try to walk you through

it in the simplest way I

can when somebody is first

traumatized everybody if they are normal

will have

symptoms if you get traumatized you will

experience fear

you will experience

hypervigilance you will want to fight or

flee or you might freeze or you might

surrender you might beg for forgiveness

or Mercy or what

you everybody is going to have those

reactions in my mind those reactions are

not disorders they are not

malfunctioning brains or malfunctioning

anything

um so everybody will have that

however when that

happens it immediately changes your

metabolism your metabolis the easiest

way to understand it is the sympathetic

nervous system gets turned on fiercely

if the trauma is really

bad because you have to defend

yourself your life is threatened your

safety is

threatened traumas can even be less

extreme than that you can have highly

stressful events in which maybe even

though your physical life isn't

threatened maybe all your money is

threatened the stock market crashes and

you lose

everything and you now think I'm

worthless I'm

penniless I'm losing my status in

society I'm going to have to live a very

different life I've just disappointed

everybody who depends on

me that could be a trauma even though by

definition because it doesn't threaten

your life it's not technically

considered a trauma so for those people

that are you know they've been through a

traumatic event what then is going on in

their body as it relates to metabolism

based on that traumatic event trauma

immediately changes

metabolism so trauma puts us

into

this you know most people know it as

fight ORF flight

mode um and again there are other

responses that one can have you can

surrender you can freeze you can do

other things but um when people feel

threatened either physically or their

reputation is threatened or their

identity is

threatened immediately they're nervous

system and hormones are

changing and the reason they're changing

is because your our bodies are hardwired

to protect us and in order to protect us

it means that we need more energy and we

need it now we need more energy in order

to be able to run or fight or whatever

we need to do and that means that our

heart rate goes up our blood glucose

goes up cortisol is flowing

[Music]

adrenaline is flowing through the

body inflammation is actually

occurring and epigenetic changes are

occurring memory formation is occurring

in a powerful way during a trauma

memory our brains are hardwiring this

event so that we remember it we remember

this threatened us and you cannot forget

this this is not a trivial moment you

must remember this for the rest of your

life because it's threatening your

survival and you must remember how to

respond to this again not necessarily

because our responses can be all over

the map sometimes our responses can be

quite effective and other times

people can

die they don't respond effectively and

they are killed I mean that would be the

worst case scenario and then there's

everything in between where you you get

a suboptimal outcome you end up homeless

with your psychotic mother that's not a

very effective response when I asked

that question I was asking as we see

patterns in trauma like a trauma pattern

there's a trigger there's a response and

then you know I even think about some of

the low you small te traumas that I had

in my life that meant that I would run

from romantic commitment for the rest of

my life for example and it was like a

pattern I was going through the same

Loop over and over again trigger Steve's

response is like this causes this

outcome

trigger so I was wondering if I learned

at that very young age that cycle

somewhere in my like neurons in my brain

so that's why I said do we then learn

the response to that trauma at that

point as well we we learn the response

we remember the response that we did MH

and as long as we've survived that is

the ingrained memory the ingrained

memory is when this happens do this

because this is what I did and I

survived it and so that becomes the

default and then that becomes a default

pattern for many people MH at some point

in

life it can be act actually be quite

useful to look at that response okay so

when I was 5 years old or 20 years old

or whatever and that thing happened I

responded this way and I survived it

great but how's this working out for me

now is that the optimal

response it's not about beating yourself

up for I should have done something

different back then it's simply about

recognizing and honoring I I did what I

thought I was the right thing to do I

did my best back then but I'm smarter

now I'm older now I'm Wiser now

if I could do it again if I could go

back in time as my smarter wiser

self would I do it differently and what

would the outcome be if I did it

differently and then that becomes highly

relevant to today so when I'm in this

romantic relationship

now I keep having this urge to break

up because this person is disappointing

ing me in this way and I feel like she

or he is going to threaten me or betray

me or

whatever and is that the right approach

is it true that this person is going to

betray me like the person in the past

did or am I hyp sensitive to that am I

again we're wired to look for any clue

that a trauma might happen again so

we're we're going to over

interpret things

sometimes in an in a in an erroneous way

so that early trauma or that trauma I

experienced made my body go into that

survival mode fired all kinds of ways

and my glucose levels went out my all of

these things all metabolism related

stuff happened how does that then cause

a mental health disorder at some point

down the line if that trauma is not

resolved so for some

people they can experience a trauma they

can be quite

effective at mitigating it and move on

with their

life somebody could get into a fight

somebody could get mugged on the street

they're just walking down the street

somebody pulls a knife on them or a gun

on them and wants to Rob them if

somebody manages that trauma highly

effectively let's say you happen to have

a black belt in karate and you disarm

your as salent very quickly and

rapidly you may not think twice about

the trauma you may actually be

emboldened after that traumatic event

and think I'm quite effective and

skilled wow those karate classes really

came in handy and um I'm quite powerful

and maybe even feel a little more

confident than you normally would and

that's the interpretation element right

of the situation so two people could be

in the same situation but have so that

person still had the same physiological

reactions a gun in your face or or

wherever that person's glucose was going

up their heart rate was going up all of

those metabolic changes were

occurring but so that's a success story

and that's probably a resilient person

who moves on and never thinks twice

about that trauma or rarely think thinks

about it and thinks about it with pride

if they do think about it in the case

where it doesn't go well at all let's

leave the extreme out where the person

is

murdered let's leave something less

severe than that but the person is

beaten they are injured

severely they are terrified to go out in

public

for fear that there could be another one

just like that that

person their fighter flight system is

not turning

off their fighter flight system is now

on at least at a low level possibly a

very high level for a very prolonged

period of

time they are now afraid of the world

immediately after that type of horrific

assault they are now afraid of the world

they probably aren't sleeping as well

and what's happening physiologically and

we know this is that those higher

cortisol levels are actually causing

something called hyper metabolism their

mitochondria are actually working on

overtime because the body is still

primed for the world is

unsafe everything is unsafe Maybe that

person who assaulted me is going to

somehow figure out where I live and come

through that door any minute so you're

sleeping at night and you hear a sound

or you hear a

creek and you panic and you wake up and

you're startled and you're terrified or

you sleep at night and you have a

nightmare and you wake up and you're

reliving that experience and just you're

horrified and overwhelmed again is it is

this conscious because you know often

you speak to people with severe anxiety

and they have panic attacks and they

don't know what why they're having panic

attacks they can't name something that

they're scared of or a fear they have no

this is not at all conscious so at this

point in the week or two after a

horrific trauma like I've

described I would argue this is not a

disorder this is not the brain

malfunctioning this isn't the body

malfunctioning the brain and body are

doing precisely what they are programmed

to do protect

you your life is in

danger why because somebody just tried

to take it and they were close they came

close to taking your life they could

have killed you and so your body and

brain are trying to protect you

unfortunately that comes at a

cost all of this energy going toward the

defense system means that

energy that should be going toward

maintaining your cells

is actually being bypassed

sometimes so we know this so for example

there are these things called stress

granules where cells that are trying to

just do basic ho hum everyday repair

work create some new proteins or new

receptors or you know do some cleanup

work the code for those which are called

messenger RNA

actually get sequestered in these little

bubbles called stress

granules and what that means is that

they're not getting done the the

messages are starting from your DNA

because the cell is saying hey I need

some repair work over here send some new

proteins over here to do some repair

work when your body is in fighter flight

mode those messages actually get

interrupted and that means means bottom

line it means that when you feel

threatened your body is diverting

metabolic resources toward your

self-defense system hypervigilance be

ready to run at any minute be ready to

fight off the offender at any minute you

cannot feel safe don't feel

safe when that goes on for a prolong

period of time your cells can fall into

a state of disrepair because metabolic

resources are not going towards cell

maintenance if that occurs long enough

or in a severe enough way it means that

some of your cells can now fall into a

state of

disrepair and they can begin to

malfunction when that happens if it's

happening in brain

cells that's when I would say the person

has crossed the line from a normal

survival reaction to

trauma if their cells in their brain

begin to malfunction now because they

are on a state of

disrepair they that can turn into what

we call a mental illness and that means

that maybe they can't remember like they

used to it means that maybe and and now

they're they can't pay attention like

they used to now somebody might say hey

maybe you've got some ADHD going on or

they their anxiety Pathways become

what's called hyper

excitable and now their anxiety pathways

are being triggered even when they

shouldn't be triggered and out of the

blue they're having panic attacks or

anxiety symptoms they can be sitting in

the comfort of their own home not

thinking any scary thoughts not having

any not watching anything on television

or anything that's really disturbing and

out of the blue they can just be

overwhelmed with a panic attack and that

person I would say if they have a panic

attack for no reason that person's brain

is now malfunctioning it is

disregulated and I would say that that

person has now crossed over into what I

would call a mental disorder where their

brain is in fact malfunctioning

now the great news the

hope and we can get to more of it is

that that those cells can be

repaired we can fix that we can do

something about

that the person does not need to be like

that

forever this notion that they now have a

chemical imbalance that they were

probably genetically predisposed to and

now we've got to just medicate them for

the rest of their

life I don't agree with that I'm not at

all opposed to medication if medications

can be helpful to that person 100% let's

use them Let's help that person heal and

recover but I want to go deeper I want

to understand what is happening in that

person's brain and body using this kind

of information about metabolism and

mitochondria and how can we effectively

help them heal and repair and and

recover you know we talk a lot about

diet and food on this show um as it

relates to metabolism and mental

health

diet so diet is

huge and most people have no clue that

diet plays any role in mental illness or

mental health

95% of mental health clinicians think

it's

laughable that anybody would suggest

that diet can play a role in mental

illness I think it's laughable what do

you think I

think if you do a deep dive into the

science all of the science that we have

accumulated over the last 100 years and

longer sometimes

that if you do a deep dive into all of

those neuroimaging studies that we've

been doing all of the genetic studies

we've been doing all of the

neurotransmitter and hormone studies and

Trauma studies and adverse childhood

experiences studies if you do a deep

dive into the

science and you understand what is

happening in the brains and bodies of

people as a consequence of those things

or what could be causing those things if

you put it all together you come to this

sound bite that mental disorders are

metabolic in nature and there is

no questioning whatsoever it is

incontrovertible that diet plays a

massive huge role in

metabolism and therefore I believe very

strongly that

diet might be playing a role in the

mental health epidemic that we are

seeing and it also might provide an

Avenue of Hope and healing and

recovery and I use the word might is the

scientist in

me is the clinician in me I know without

certainty it can heal and recover people

who have have had chronic horrible

debilitating mental

illnesses and I know from my own

personal

story when I was in medical school and

residency I'm still suffering from

lowgrade depression OCD other symptoms

but I also developed what's called

metabolic syndrome I developed high

blood pressure high

cholesterol um pre-diabetes and I wasn't

really overweight I was EX exercising I

was following a lowfat diet mostly a

processed foods because they're cheaper

but that was the diet that was touted as

a health a healthy diet it was low in

fat and as long as it was low in fat

that was supposed to be good for us and

my metabolic syndrome just kept getting

worse and worse and so at some

point in order to treat my metabolic

syndrome I changed my diet to

essentially a low carbohydrate diet

and

within 3

months my metabolic syndrome was

completely

gone but the thing that just dumbfounded

me was that my mental

health was better than it had ever been

in my entire life and I just couldn't

believe what I was experiencing I didn't

know that I could be that kind of a

person I didn't know that I could be

happy and positive and energetic and

confident I had no idea I I didn't think

that was in

me and by changing my diet all of those

things

happened at the level of the

mitochondria are you saying do you

believe that because you changed your

diet

to more sort of natural healthier foods

at the level of the mitochondria the

mitochondria were able to function more

more naturally themselves and in a in a

more um yeah functional way which meant

that they released the chemicals they

released in the processes they go

through were more consistent with

positive mental health is that like the

simpleton's way of understanding it and

before then you talked about man-made

compounds in the foods Etc I'm assuming

you're saying that some of the modern

foods that we eat the ultr processed

food that have all these random named

chemicals inside them that we see on the

labels the mitochondria don't know how

to deal with that so it's causing the

same sort of disregulation and

dysfunction that they might see if we'd

gone through like an extreme trauma or

something else or some other adverse

environmental situation it's just this

dysfunction of the mitochondria which is

causing the KnockOn effects we see but

there's many things that can cause

dysfunction in the mitochondria and we

name we went through a bunch of them

earlier is that like a simple way of

understanding it 100% okay great it's

perfect so super

interesting okay so on that point then

we have to zoom in on this thing of

diet if you wanted my mitochondria to be

perfect and maybe even give me a case

that of I don't know patients you've

worked with that you've you you've

prescribed a certain diet to what diet

what food would you tell me to eat and

what would you tell me not to

eat so I actually don't have a one siiz

fits all

prescription and so I to say that up

front so I would want to know who am I

working

with and how is their mental and

metabolic Health now me so you yeah so I

would want more details are you having

symtoms of any mental health condition I

would say no however I can I can have

moments where I feel a little bit

anxious so you know I've been through a

lot of I'd say like stressful events in

my life because I was running a big

business we had hundreds of employees

paydays all the time so I had this at

one point I had this constant subtle

stress and so I would want to know do

you feel like you have

anxiety For No Good Reason sometimes

sometimes it can feel a little bit like

that um it's very infrequent I'd

say but I can also have moments where I

just think of something and then I get

the same kind of like it's almost like

the fal FL response has just kicked in

but you think of something adverse or

stressful yeah yeah yeah so so the so

the one thing I would say about

that

and we could get into a lot more details

which we probably don't want to do Now

podcast but my my strong guess based on

just what you've said is that that level

of Stress and

Anxiety is quote unquote normal okay

because you you are sensing I have to go

do something that's really scary right

now or I have to go do something that's

going to ruin someone's life or that

that might threaten My

Success it is normal and actually

healthy to have anxiety and stress in

those

situations the anxiety and stress can

sometimes be quite helpful and adaptive

because it can make you pause and

reflect on is this really what I want to

do as opposed to being overly confident

and just

[Music]

proceeding your own personal history

almost certainly informs your level of

stress

response and again so if you go back to

your own

traumas you're going to remember when

I'm facing a situation like this it's

helpful to be on hyper alert it's

helpful to be

hypervigilant and your body and brain

will remember that helped you navigate

this safely and effectively but if I

have that profile if I have that sort of

mental health profile now as I sit here

and then for the next decade I

ate processed junk

food am I going to send my mitochondria

into disarray which is going to increase

the probability that I have a mental

health disorder yes I think yes we've

got you know we there's no way we will

ever be able to do a human randomized

controlled trial to test that precise

unethical

hypothesis but we have large

epidemiological studies that strongly

suggest that people who eat a lot of

ultra processed food have

higher risk for developing depression

anxiety and other mental

disorders and based on the science the

granular

science based on animal models so we can

do that to mice and rats and in fact

that's exactly what we see in mice and

rats we feed them an obesogenic

diet which is usually high in fat high

in

carbohydrates Ultra processed foods some

researchers have C fed rats and mice

cafeteria Di diets where they feed them

a lot of delicious junk food and those

mice develop higher rates of obesity but

also higher rates of diabetes and

pre-diabetes and oh by the way also

higher rates of depression and anxiety

because those are the two things that we

can kind of measure in M rats we can't

necessarily measure ADHD symptoms it's

really hard to actually measure

psychotic symptoms

um but we can measure depression and

anxiety symptoms pretty well in animals

and so in animal models we know that

that's unequivocally

true and we see the same in humans

though because I was reading your book

and in chapter 4 you say people with

ADHD are more likely to develop obesity

people are who are obese are 50% more

likely to develop bipolar and 25% more

likely to develop anxiety or depression

and weight gain around the time of

puberty leads to a

400% increase in the chance of

depression by the age of 24

yes and insulin resistance at age

nine makes increases your chances of

developing a psychotic at risk mental

state which is like meaning you're at

high risk for developing schizophrenia

or bipolar disorder 500% and

Alzheimer's all mental disorders are

associated with an increased risk of

Alzheimer's disease anywhere from the

lowest is 50% increase risk and the

highest is 2,000% increased risk and the

thread that unites all of these problems

is metabolism

metabolism and at the end of the day you

have to talk about mitochondria in order

to understand

metabolism um only 7% of

US

citizens have no signs of metabolic

health problem

meaning

93% or so of us residents will have at

least one of the biomarkers of metabolic

syndrome meaning they have pre-diabetes

or abnormal lipids or high blood

pressure or abdominal obesity or

abdominal fat excessive abdominal fat so

what do we offer those

93% so those people

diet interventions would absolutely be a

part of a healing

strategy a part of it not the only

strategy I would want to know about

their sleep I would want to know about

substance use I would want to know about

medications lots of things but for

dietary interventions I would want to

meet them where they're at and just find

out well where are you at what are you

eating do you have preferences or

demands for what your diet should be

could you give me a case study then

maybe a more extreme case study from

your practice that you've

seen I could I can give you the simple

cases

where which probably apply to the

majority of human beings on the

planet but if it's okay I'd rather give

you the extreme

case because a lot of people are

skeptical they they probably hear me

saying this and they think well you're

just talking about General Health and

Wellness what about people with real

mental illness what about people like

your mother whose lives were decimated

by mental illness this doesn't have

anything to do with

them and what I'm here to say is no

actually this has everything to do with

them

too but yes it applies to just common

everyday people

but you know probably so one story

that I will just share to just because

it's probably one of the most powerful

stories I know it was a

woman whose real name was

Doris and um in the book I called her

Mildred because I changed everybody's

names but she actually gave me

permission to use her real name so in

honor of her I want to use her real

name so she was a woman who actually had

a horrible abuse of childhood lots of

trauma

and by the time she turned 17 she

started having daily hallucinations and

delusions and was diagnosed with

schizophrenia over the ensuing

decades she tried numerous antipsychotic

mood

stabilizers um anti-depressants and

other medicines but none of them stopped

her symptoms she remained with all of

the symptoms of

schizophrenia she ended up gaining a

massive amount of

weight she ended up weighing about 330

lb by the time she was

70 her life was devastated by this

diagnosis she had a cour appointed

Guardian to manage her financial affairs

and other Affairs she had professionals

coming into her home to help her with

paying bills and grocery shopping and

stuff like that because she couldn't do

it for herself which is not at all unus

usual for people with schizophrenia and

between the ages of 68 and

70 she tried to kill herself at least

six times and was hospitalized for those

suicide attempts she hated herself and

she hated her

life when she was 70 years old her

doctor told her you're overweight and

you need to go lose some weight and she

was she was referred to a weight loss

clinic at Duke University where they

just so happened to be using the

ketogenic diet as a dietary inter as a

weight loss

tool and for whatever reason she decided

to give it a try and so she tries the

ketogenic

diet and within two weeks not only does

she start losing weight but she notices

dramatic reduction in her hallucinations

and

delusions within months all of her

symptoms of schizophrenia were in full

and complete remission

she starts tapering off her psychiatric

meds within about six months she was off

all of her psychiatric meds and her

symptoms of schizophrenia remained in

[Music]

remission Doris went on to live for

another 15

years symptom free medication

free out of psychiatric hospitals no

more suicide attempts she stopped saying

mental health professionals pretty

quickly because they were kind of

worthless in their mind they hadn't

really helped all that

much she lost 150 lbs and kept it off

until the day she died she ended up

dying at the age of 85 of Co

pneumonia and

um but her

story tells

us like we could get if if you want we

don't have to we could get into the

science of the ketogenic diet and what

it's doing to metabolism and

mitochondria I love to know but there's

an entire story that helps us understand

what happened to her and how

exactly that resulted in her really

spectacular and almost miraculous

recovery so so unbeknownst to most

people most people know that ketogenic

diet is a fad diet and a lot of people

are really worried about it they they've

heard that it's dangerous you know it'll

give you a heart attack you'll

die unbeknownst to most people the

ketogenic diet was developed over a

hundred years ago now by a physician for

one and only one purpose it was

developed to stop

seizures and in fact the ketogenic diet

has been studied

extensively for its effects on the brain

over the past 100 years and it is an

evidence-based

treatment for

epilepsy and the reason that is so

important is

because we use epilepsy treatments in

Psychiatry all the time lots of the

medications that we prescribe to

psychiatric patients are in fact

epilepsy

treatments and so we know that there's a

lot of overlap between epilepsy and

mental illness and that treatments that

help with epilepsy can also help with

mental

illness and so we actually know more

about the biology of the ketogenic diet

and its effects on the brain than we do

any other dietary

intervention it changes neurotransmitter

systems it decreases brain inflammation

it changes the gut microbiome in

beneficial ways it actually changes gene

expression or

epigenetics but most important and

relevant to my theory is it improves

mitochondria and mitochondrial

function and and if you do it long

enough over a long enough period of time

you can actually

repair mitochondrial dysfunction in

cells at least for some

people and and then you can actually

stop the diet so in the epilepsy world

when neurologists use this diet to stop

seizures it's usually not a lifetime

treatment they usually only need to do

the diet for anywhere from two to 5

years

many people about a third of people who

have treatment resistant seizures will

become

seizure-free and another third so 2/3

total another third will have a dramatic

reduction in seizure

frequency so that leaves a third for

whom it's not really working but these

are people with treatment resistant

epilepsy and there's no treatment that's

going to work for everybody because we

need to look at all the other things

involved if say somebody has seizure

sensation they get rid of their seizures

on a ketogenic diet usually they have to

do it for two to five years somewhere in

there and their clinician will help them

decide how long they should do it and

then they can stop the diet and most

often the seizures don't come back it

seems to actually heal the brain what is

that diet adding or subtracting from the

body that's causing that pretty

phenomenal effect do people know the

real answer is we don't entirely

understand we don't know I mean the

ketogenic diet removes sugar for example

it

does um pretty much EX entirely I mean

I've been on that diet for about was on

the diet for about eight weeks or so

just a

try and I could I couldn't have anything

with sugar in it pretty much no sugar no

carbohydrates very few

carbohydrates

the so some people will argue well the

diet is getting rid of gluten and gluten

is is maybe the toxic thing other people

will argue oh the diet is adding like

some extra protein or meat and maybe

that's replacing a nutrient deficiency

like vitamin B12 deficiency or something

like that or iron deficiency and all of

those things might be true for some

people I don't think those are the

primary

explanation I mean obviously if somebody

has vitamin B12 deficiency replacing

vitamin B12 is essential somebody has

iron deficiency yes recognizing that and

replacing it but most people don't have

those deficiencies and they can still

have mental symptoms or mental health

problems I believe what the diet is

doing is it it forces a transition in

brain and body metabolism essentially

and that act that transition is actually

mediated through mitochondria so the

ketogenic diet forces your liver to

start producing Ketone bodies so it

forces your liver to break down fat so

you're you're losing fat from your fat

stores but that fat is being shuttled to

the liver and then the liver takes that

fat and breaks it down um and I mean I

shouldn't say all of the fat is being

shuttled to the liver some of the fat is

going to muscles and other tissues and

just being used

directly but a fair amount of the fat is

actually being shuttled to the liver and

then that fat is being converted into

Ketone bodies some of it is being

converted into glucose so that you

maintain normal glucose levels through

this those Ketone bodies are then going

up to the brain and fueling brain cells

but those Ketone bodies are actually

doing so much more they're they're

changing mitochondrial function they're

changing epigenetics they're changing

neurotransmitters and inflammation and

all sorts of things but at the end of

the day I'm convinced that it's really

the metabolic changes and the

mitochondrial changes that are

so important and that are so

instrumental in these dramatic

improvements and things like stopping

seizures or stopping hallucinations and

delusions what about F fasting there's

been a lot of talk especially recently

about fasting and the impact that that

can have on our mental health do you

think

fasting is a positive for our mental

health I so it depends on the person

okay and so the ketogenic diet actually

mimics the fasting State that's what

that's why it was produced all right the

ketogenic diet was actually developed by

a

physician recognizing that fasting can

have really powerful brain effects

including stopping seizures if you if

you're out on an island and Your Friends

start seizing uncontrollably the best

thing to do is to fast them even if the

seizures stop intermittently you would

think oh let's feed you to you know keep

up your sustenance and you know take

care of you the best thing to do for

your friend if they are seizing

repetitively over days or months the

best thing to do is to fast your friend

and to tell them let's have you go

without food for a few days and that can

stop the seizures wow the the challenge

with fasting is that you could starve to

death if you do it long that's not a

that's not a very good treatment for

your friend on the island and this

physician who developed the ketogenic

diet recognized that and so that's why

he developed the ketogenic diet was

really looking to see can we mimic the

fasting state with a

diet and um and get these longer term

benefits so back to your question can

fasting play a role 100% yes fasting can

play a

role and fasting is doing pretty much

the same thing that the ketogenic diet

is doing it's changing mitochondrial

biology it's improving mitochondrial

function changing neurotransmitters

changing the gut microbiome improving

insulin signaling and insulin resistance

it's doing all sorts of beneficial

things there are a couple of caveats

with fasting though one is that people

who are underweight should not fast so

that includes people with eating

disorder ERS who are emaciated or

underweight but it also includes people

like who have had severe

depression and lost weight as a result

of their severe depression or people

with cancer who have lost a significant

amount of

weight fasting is not good for them

fasting mimicking diets like ketogenic

diets May in fact be very powerful for

those people but it but they it needs to

be done in a safe supervised Medical Way

sugar what impact does that have on the

mitochondria if I've got a super high

sugar diet is that impacting my

mitochondria in some way and therefore

my metabolism it is um so

low low intake of

sugar in people who are otherwise

healthy is perfectly fine and

acceptable so you

know lots of people can

consume treats every now and then or

desserts a few times a week or you know

special holiday they can maybe even

binge on sugar over the

holidays and they don't have any

problems as a result of it and that is

fine if that's the way it's working out

again only 7% of the

population is metabolically healthy so

the majority of people that's not the

way it's working out so high levels of

sugar over

time we

know can impair mitochondrial function

so there's this term called oxidative

stress and oxidative stress is primarily

it's directly related to mitochondria

because mitochondria are producing the

energy and then that energy production

results in oxidative stress and and

oxidative stress we've known for decades

is bad for

cells and it is highly correlated with

all of the metabolic disorders and all

of the mental disorders high levels of

oxidative stress at in different cells

and different people with different

diagnoses high levels of oxidative

stress are a unifying theme but that is

a reflection of mitochondrial

dysfunction so we know that if you eat

if you eat a lot of sugar over

time it can

disregulated glucose levels and then

those high glucose levels can cause

mitochondrial dysfunction and you can

end up kind of on the downward spiral

what about caffeine and these stimulants

there's like pre-workout stimulants and

you know before you do a workout you

have a big dose of this pre-workout and

it kind of makes you go like you

know do you have a view on caffeine in

these sort of energy

stimulants I do so so so caffeine gets

complicated because we have to talk

about whether it's in tea or coffee or

not cuz tea and coffee are are different

stories and they have other compounds

that almost certainly are beneficial to

human health um and whether it's the

caffeine itself or not is still kind of

a question an open

question caffeine stimulates metabolism

in cells we know that so it it blocks

the adenosine recept

ctor and the adenosine recept the

function of the adenosine receptor and

adenosine on it is to slow a cell down

it's basically a a feedback loop that

slows cells down it it inhibits their

function so when we block a Denine we

basically stimulate the system and we

stimulate our

brains and if you have low

metabolic brain function that can

actually be really good if you are

feeling tired and sluggish it can make

you feel energized and clear

thinking the challenge is that you can

overdo it so when you stimulate it too

fast that in and of itself can end up

causing oxidative stress or

mitochondrial

dysfunction maybe the easiest way to

think about it is this if you think

about a car you have a an accelerator

and a

break if you're going to maximize the

cars

function there's a right balance for all

of

that you don't want to floor the

accelerator and you don't want to

underdo the accelerator likewise you

want to determine like you don't want to

be pushing on the accelerator and The

Brak at the same time so when we think

about metabolism and mitochondria when

we think about caffeine or even

glucose caffeine and glucose are

stimulating the system they are through

different mechanisms but they are both

stimulating energy

production but when you overdo it it

would be like flooring the

accelerator and then possibly putting on

the break at the same time because you

don't want to be going that fast because

you're going to crash so either you're

going to floor the accelerator crash and

burn or you're going to floor the

accelerator and slam on the brake at the

same time you're not serving your car

well by doing that by flooring the

accelerator and pushing on the brake and

when we use

substances like caffeine or alcohol or