The Melanie Avalon Biohacking Podcast Episode - #368 - Dr. Drew Ramsey

TRANSCRIPT

Dr. Drew Ramsey
Clinical depression is also the most disabling illness in the world and in America, and it's really undertreated, right? There are sixty million American adults right now with a mental illness. You know, about, oh, I don't know, sixteen, eighteen million have clinical depression.

Being socially connected increases your odds of survival, literally year to year, by fifty percent. Certainly people throw us off in our lives, and I'm not trying to say that we're always responsible, but there is that kind of brilliance in self-regulating and controlling our internal worlds.

Melanie Avalon
Welcome to the Melonie Avalon Biohacking Podcast, where we meet the world's top experts to explore the secrets of health, mindset, longevity, and so much more. Are you ready to take charge of your existence and biohack your life? This show is for you. Please keep in mind we're not dispensing medical advice and are not responsible for any outcomes you may experience from implementing the tactics lying herein.

So friends, are you ready to join me? Let's do this. Welcome back to the Melonie Avalon Biohacking Podcast. Oh my goodness, friends, what an honor to have Dr. Drew Ramsey on the show today. He is a legend in the mental health world. He has five books, has been featured all over the place, and I absolutely loved his newest book, Healing the Modern Brain, and talking with him all about it today. I definitely recommend his Healing the Modern Brain course, and you can get twenty percent off with the code Melonie at learn.drewramsey.com. We talk about so many things in today's episode, including all of the problems that the modern environment has on our brain and what you can do about it, a lot of fun stuff about relationships, including how variety might be the key to relationships. We also dive into dating, including my personal approach to dating and how I struggle with my perception of it and why it actually may be a good thing, the ultimate importance of self-awareness and making change, why your purpose may not be your passion, what foods you should eat for your brain, whether or not you should follow the Mediterranean diet, the problems with saying "I don't know" and what you should say instead, what ultimately leads to change, and so much more.

The show notes for today's episode will be at melonieavalon.com/modernbrain. Those show notes will have a full transcript as well as links to everything that we talked about, so definitely check that out. I can't wait to hear what you guys think. Definitely let me know in my Facebook group, IF Biohackers: Intermittent Fasting + Real Foods + Life. Comment something you learned or something that resonated with you on the pinned post to enter to win something that I love, and then check out my Instagram Find Me Friday announcement post, and again, comment there to enter to win something that I love. All right, I think that's all the things. As a brief reminder, you can get twenty percent off Drew's incredible Healing the Modern Brain course with the coupon code Melonie. And now, without further ado, please enjoy this fabulous conversation with Dr. Drew Ramsey. Hi, friends. Welcome back to the show. I am so incredibly excited about the conversation I am about to have. It is on one of my favorite topics with an incredible guest with an incredible book. So I am here today with Dr. Drew Ramsey. He is a board-certified psychiatrist, author, and a leading voice in nutritional psychiatry and integrative mental health. He has five books, including the one he is on here for today, which is called Healing the Modern Brain: Nine Tenets to Build Mental Fitness and Revitalize Your Mind, a comprehensive guide to cultivating mental fitness and revitalizing brain health.

Melanie Avalon
And he's been featured in the, The New York Times, The Wall Street Journal, The Today Show, NPR, all the things. He has three TED Talks, and it was, like a no-brainer when I saw the information about this book. I was an immediate yes, and it completely lived up to all my expectations.

So not only does Dr. Ramsey talk about his experiences with his patients and what he's learned over the years, like you might have guessed from the title , he dives into all of the things that we can actually do in our lifestyle to really optimize our mental health and wellness. And we'll talk-- I'm sure we'll talk about whether or not, you know, the role of pharmaceuticals, but whether or not you're using those, the things that you can do in your life, so movement and sleep and connection and engagement and, you know, finding a sense of purpose and it was just really, really fascinating.

So many, so many things that we can talk about. So Dr. Ramsey, thank you so much for being here.

Dr. Drew Ramsey
Oh, Melonie, thank you so much for having me. Everybody listening, I'm so excited to spend some time with you and talk about mental fitness and ev-everything that Melonie just said. So it's great to be with you.

Melanie Avalon
So I have so many questions for you. To start things off, because, you know, you have, like I said, you have nine tenets in this book.

First of all, how your, your personal story-- Actually, yeah, let's start there, your personal story. Did you always see yourself, like, wanting to do this, doing this, doing what you're doing today? What actually led to that?

Dr. Drew Ramsey
I've been a psychiatrist for a long time now, maybe about twenty-five years in the field. And, uh, you know, I think when I was younger, I, I definitely wanted to be a physician. That started pretty early in college, and I d-- I became an EMT. I just really like, I like this mix of science and caring and that idea that there's also this, you know, art of medicine. And then I just really liked all the new science that was coming out. I mean, it's just, the science has just always excited me, starting with, like, organic chemistry and just the idea that you could find something true about our health through science. You can understand more about how the mind works, what depression is. Uh, and so I grew up really rural Indiana on a farm with my folks. My parents were kind of gentleman farmers who'd moved from New York City and had about a hundred and twenty-six acres and, you know, had other jobs but were always growing stuff and tinkering and doing the things folks do when you have farm, experimenting. Had-- We had a lot of woods and forests, so I grew up in a very natural setting with a lot of very natural, organic food. And then began my training.

I went to college at Earl- Earlham College, got a great science education there, a little small liberal arts college in Indiana that's just a gem, a little Quaker school, which And I think really influenced this book in terms of wanting not just to focus on things like medications, which I'm excited to talk about. Yes, I certainly use them. But to think about some of the psychospiritual ways that people are struggling with their mental health, and regardless of what you're doing, you know, with psychotherapy, with medications, um, there are some things that we now know in the science are just so clear. You know, it really is the most basic of all the biohacking advice that you're hearing throughout Melanie's show and you're hearing throughout the movement, is this fundamental lifestyle stuff, and it maybe sounds and feels a little boring compared to like peptides, but it, it's really quite exciting in terms of what happens when people shift from the modern lifestyle, which is really, yeah, quite damaging to the brain. At least I try to present that very clearly in Healing the Modern Brain. Anyway, I, I go from this Quaker college to Indiana University Medical School, which is, uh, our nation's largest medical school and, uh, just a wonderful institution. I trained in Bloomington and then up in Indianapolis at what we call the Mecca. In Indianapolis, it's really this incredible medical center, really one of our nation's best. And then I get to go on and train in psychiatry for four years at Columbia University, and then started my re- really-- career really for about 20 years in New York. And so that, that brings us here. I got interested in food, Melanie, early in residency. I was a vegetarian in college. I was an athlete. I was always thinking about food and really excited about health and just living a healthy lifestyle. I, I guess I'm a little... I don't know, it's just always been intriguing to me.

Dr. Drew Ramsey
And then the science started really pouring in, and just sort of hard to ignore when you see interesting data about, hey, do your patient, you know, do your patients get better taking a fish oil pill or not? And one of the great things about being a clinician, and everybody, I feel like that's the credential that earns your ear for this hour, is that y-you're actually the person who sits in the seat and you decide whether to recommend something, and then people take it. And if it works or doesn't work, I wouldn't say you're on the hook for that, but that's, that's your recommendation. And so the ethics involved in that, the-- but, but the science involved in that really shifted.

I finished training in 2004, and so the studies really didn't exist until about 2000, let's say '9, 2010. We started seeing strong correlational data connecting food and mood. And, you know, by that point, I was pretty deep into this already of just thinking through, wow, you know, I'm, I'm meeting people at really hard moments with illnesses, depression, anxiety, bipolar disorder, uh, schizophrenia earlier in my career, substance use disorders. And we have all these really amazing tools, but there's something about how people are living their lives sometimes. It could be their sleep hygiene, it could be substances, it could be poor nutrition. It could just be living this kind of frantic, modern digital lifestyle. And you just kinda see that as a mental health professional and just think, you know, along with what other interventions can be effective, I, I really want that dialed in ideally for patients. There's just a difference treating somebody in the literature, in the data, in the research. There's a difference treating somebody with depression who's eating a diet of ultra-processed foods and someone who's eating a diet that's like the Mediterranean diet or a, a simple whole foods traditional style diet. And so in terms of this is just my personal story, uh, you know, uh, I got really intrigued by that, and there wasn't a lot of it in the field, and I, I kind of became like psychiatry's brain food guy. There are just a couple of us, but actually I'm going to the American Psychiatric Association conference. It's our annual conference, uh, tomorrow, and presenting on Saturday. I'm teaching nutritional psychiatry. I realize it's my twentieth year of presenting at this conference, which is a wonderful honor. But, you know, I think a lot of times people think in psychiatry, you know, we don't consider this stuff, and, and we really do. And then we'll talk more about the data, uh, which is really exciting. I want you to stay tuned for that, but I don't wanna... I guess the other part of the personal story is I, I got married when I was younger, and I have a, a wonderful wife and, and two great kids and a Bernedoodle. And I, um, I don't know what else to tell you about my, my personal story. Uh, I've spent a lot of time in therapy and, and as professionally, I just, I spend a lot of time seeing patients. I have a lot of patients that I, I've seen over, you know, years and years. I feel really privileged and honored to be in that position.

Dr. Drew Ramsey
Just gives you a great view on, you know, all the trends when, I don't know, GOPs are launched and you get fifteen or twenty different people taking them and talking about them and telling you about, you know, what actually happens, what it's actually like. Uh, it's just really a wonderful spot to be.

Melanie Avalon
Wow. Okay. So, so many things there.

I can actually tell you a little bit about my experience with, well, I guess therapists and psychiatrists. I think I've seen those two. Do you see a, a therapist or a psychiatrist?

Dr. Drew Ramsey
Yeah, yeah. I, I see a, a therapist. I've seen a New York psychoanalyst since I was... Gosh, I started seeing Ron for my first bout with him in a kinda more formal psychoanalytic frame, going multiple times a week on the couch when I was, boy, 26. And saw him pretty regularly and then took a break for a number of years, and then when I became a dad, I don't know, about six months into that, I wanted to be back in some sort of therapy, talking about some of just what comes up for people as you become a parent. It's just, I don't know, a, a lot of unexpected things and wonderful things and, and so yeah, I found that to be really central to my mental fitness and just my mental health.

And yeah, I find psychodynamic psychotherapy, um, this therapy that really is in some ways what people think about when they think about therapy. You know, talking about our, you know, free form inner world and having an analyst or therapist help us make meaning of it.

Melanie Avalon
Yeah. No, it's interesting because I was just thinking when you were, you know, talking about your approach to everything, and I was thinking how wonderful it is be- because I, I really wish that all of the-- again, I'm lumping it together. I'm lumping therapists, psychiatrists, and psychologists together, which I don't know if that's appropriate or not. But like going to a mental health, a mental health professional, I wish that they all had this perspective.

And then I was thinking how it's kind of like all of the confusion with honestly everything with, with life. So like what type of exercise should you do? What type of diet should you follow? What-- I guess people pretty much agree on sleep, but there are a lot of things where there's so many different conflicting opinions, and I think this also probably happens whe-when people are seeing a mental health professional because You have to find the one that works well with you, and then how do you know what perspective they're coming from? And it's, it's just-- it's a passion of mine because I, I've been see-- So I've been seeing a therapist for maybe like a decade. I've been seeing my current one for, I mean, six or seven years, and I really love her, and I, I find it really, really important for my mental health and wellness, and I'm like, "Everybody should be seeing somebody all the time." Um, but, but then I also know that, again, you have to find the person that works for you. So... And I sometimes wonder if it could cause more harm than good if people are not matched up right or if people just want to prescribe pills. And so I'm always just-- I have a really weird relationship with all of it because I, I think everybody should be seeing these-- seeing a mental health professional, but then I also get worried, you know, if it's not the right match or if they're coming from a different perspective.

Dr. Drew Ramsey
That's a very valid and good con- That's a great way to put it on both sides, which is that what we really want is for people to be in the therapy where they feel a good fit. You said this thing that every therapist hoped for. You said, "I love my therapist." And that doesn't mean that she always agrees with you or she's sycophantic or, you know, she's just there cheering for you. Like, people hate that in their therapist. They want us to be authentic, real, objective and neutral.

And neutral doesn't necessarily mean anonymous, right? You can go on my Instagram, you can learn a lot about me. But neutral means that what you become, your goals, your values are truly yours. Like, the more that those get honed, uh, voiced, polished, like that's really what w-we're hoping for is there, is neutral therapists, right? That it's you becoming and, and really blossoming into you. And, and so you're also kind of wondering, which a lot of people do, like who's who. And so I'm, uh, in some ways a little unique. So I'm a psychiatrist. We're medical physicians, MDs or DOs. That means I have a full medical training. I used to help run codes when I was an intern and have worked in the CCU and ICU and NICU and all those places as a medical student or resident, a-and then focused in on psychiatry for four years. And so we're the folks, uh, mostly who are thinking about meds and medications, although our colleagues who are psychiatric nurse practitioners and certainly our colleagues in primary care do a lot of that.

But when things get a little complicated, uh, psychiatrists usually we're, we're the folks in terms of what we call psychopharmacology. These... You know, not, not just antidepressants, which, you know, people focus a lot on, but, uh, you know, I don't know, there's probably about a hundred different medications or so at our to-- at our, in our toolbox to think about maybe fifty, sixty that the modern psychopharmacologist is using these days. And then you're talking about therapy, which is talk therapy. Those, you know, there are over four hundred different types of talk therapy, and I think what you're kind of noting is that people can get trained in specific types of therapy and then kind of everybody fits that model. So if you're a, you know, all you do is trauma-informed therapy and someone comes to you with depression, y-you know, you see that in a certain way. Trauma certainly informs a lot of depression, but not every patient is there in that way. If you're just an IFS therapist, that's all you think about. You know, you kind of might inappropriately put people in frames or treatments that aren't great fits for what they're struggling with exactly. Or as you're noting, sometimes if you're just a, a meds guy and you see somebody with depression, you know, your option is refer to another therapist or if it looks appropriate, try meds. If you're a therapist who doesn't do meds, vice versa. There's lots of stories that we see of people who've been suffering with horrible, very treatable symptoms and, and they've been in a great therapy, it just hasn't been in all of what they need. And so...

Dr. Drew Ramsey
But I think what you're talking about, which is it's worth finding good fit, and good fit is somebody who y-you, you enjoy talking to and you see yourself developing, you see yourself setting goals and achieving them and-

Melanie Avalon
Yeah. I, I tend to overanalyze things. So like I said, love my therapist. I really feel value from the session.

Sometimes I wonder if... I'm like, "Am I just going in here to get ref-reflect?" And you kind of touched on this a little bit, which I don't think is happening, but I do wonder, like, am I just going in here to reflect back, I don't know, be told positive things about what I'm doing and, and then like carry on. But I do... Again, like I said, I think it's, it's so, so helpful for me personally. I, I do-- I-- We, we will dive into your book, I promise. I just have one last question about this 'cause you were talking about being the, you know, the neutral perspective. How do you feel about talking to like ChatGPT about problems? I have actually found it to be very helpful. And I'll like read what it says in my sessions with my therapist.

Dr. Drew Ramsey
I mean, I, I, uh... This is part, part of Healing the Modern Brain and the inspiration for it really was trying to understand k-kind of in early goings how the kind of, I'm gonna call it the algorithm, right? Whether it's on your social feed, whether it's, you know, uh, how these LLMs are answering to us. But, you know, how it is to be a human with human emotions and human expectations a-and also be in this world where a lot of our emotional drive and, and reactions during the day and content that we're fed is algorithmic. You can be very unengaged and get a very curated, seemingly engaged feed.

I also have a number of patients who, who talk to various LLMs and, and then I also treat a number of top computer engineers who've been really on the inside of this, working with some of the models that are, you know, maybe six months or a year ahead of what we're seeing. And so watching those kind of different tracks has been very interesting. There's a real evolution within the computer engineers of kind of overwhelm, shock, some depression. A-and then something happened about six months ago in terms of adaptation, quality, utility that, that really was quite fascinating. And, and moods improved, I would say, and, and functionality felt like it improved. This was now a tool for them.

You know, these are computer engineers. They, they know how to talk to computers, and the rest of us, uh, it's been very interesting. You can get a lot of, again, sycophantic advice, right? "Wow, Melanie, great job. What a great question. It's really amazing." And, and in some ways, like it drives us crazy. You can tune that down, of course. You don't just be a sycophant. And then that notion of you being able to always tune it- You being able to prompt it, you know, it, it's early goings. I think there's certainly an argument that chatting with AI can cause hypomania. That certainly happened with me, where you begin to feel a level of productivity, a level of creativity, of projects. You know, task completion becomes very hard. Uh, certainly there are reports of it causing delusions and psychosis and frank bad events.

And then I think there's, like, the kind of what I would call neurotic stuff. You're not feeling like you're a good dad, so you say, "Ugh, ChatGPT, I'm not feeling like I'm a good dad." So I talk to Claude a little. "Claude, I don't... You know, like, here's what I'm feeling, here's what I'm thinking. What do you think?" I mean, it's kind of ridiculous, right? I'm asking, like, a computer about, about my parenting. What I find that, that is very useful with the LLMs for people is how they frame things. It's a lot of what we do in therapy. "Wow, you're thinking about, in a catastrophic way, about everything in the future, where it seems like we need to really focus in on here today and these two or three things that seem to be really dysregulating you." And, and so there's a way that, that ChatGPT gives you an active conversation. Some of my patients really like it 'cause it's like, "Hey, you're not always available. It's two AM and I'm in crisis and I gotta get this out." I, I like to talk.

Dr. Drew Ramsey
I like the reactive, thoughtful ideas that some of these LLMs give me. So, you know, it, it's definitely, um... The argument for it, I think, is some access, right? I think the arguments against this is it's easy to trick and human-- the nuance of human conscious and unconscious thought and, and kind of minds. It's more than just symptoms and encouragement and supportive therapy. You know, this is people's lives are on the line, and people's futures are on the line, and their manifestation and actualization is on the line. Like, this, this is real stuff.

And so when you get the privilege of sitting with people clinically, I think a lot of folks have some notion that therapists are, you know, passive or we sit here or they go on forever. I really don't find that to be the case. There's a pressuredness because, you know, someone's life is in your hands and they've come to you in a very vulnerable state for help. So, you know, I, I think the LLMs are-- I, I saw a patient today who had, like, the most vivid and intense dream with multiple people, a couple people on my team who were in there. I mean, it was just like, I'm not sure ChatGPT can sit with all those feelings that, that generates. I don't think it can be embodied in that way. But I do think some people are using it for good and, you know, I try to be-- I try to keep an open mind. You know, ketogenics are the rage right now in nutritional and metabolic psychiatry, and I try to follow the data and be excited with the core of that, which are people are talking about how food and lifestyle impact mental health. What could be better? You know, when the GLPs came out, I tried to be curious. I have a lot of different patients who've taken them for a lot of different reasons. It's really interesting. And, and with this stuff with AI, my team and I are always asking ourselves what's authentic in terms of how can we be true to our patients and true to our audience, not make factual errors, but, you know, also stay us, and at the same time try to understand are these tools that can improve our messaging, improve our reach. You know, if I can get a good message about, I don't know, eating more trout or more lentils or growing your self-awareness or working through your trauma and reaching more people with that and having AI help me do that, that feels very core to what I hope to do here in terms of helping people with their mental health.

So, you know, it, it's early goings, really. Let's check back in and see what we think in five years or... I guess our agents will talk to each other in, like, five years and we'll see what they think.

Melanie Avalon
I know. It's kind of like we'll check back in five years, uh, assuming it hasn't, like, taken over completely and I feel-- Yeah, I feel like it's... I mean, I don't want to be binary, but I feel like I hope it stays in the vibe of the good, the good chat therapy sessions that I've had. I hope that is how it continues and that it doesn't just go south.

So, um, we will, we'll put out good vibes for that.

Dr. Drew Ramsey
I think the part that we're-- Let's, let's move on to the book, but I think the part for everybody listening to think about is what is your transference to the chat? How, how do you feel about it?

And as you notice yourself developing an attachment, as you notice yourself spending more time-- I've had this happen a few times where Friday night I, you know, I wanna check in with my wife and my kids, but I, I wanna go sit on the couch with Claude. I joke, I say Claude's my new boyfriend. A-and I, I've gone through a couple different periods of that. Really a lot of productivity, able to pull in a lot of data, able to check through a lot of, like, thoughts I might have about mental health, mental fitness. It, it's really quite exciting, but it, uh, I-- How do I put this? I'm not sure even with all the glorious output that I'm getting, it's the same kind of output or return that I get by investing in the people in my life. And, and it-- And, and I think for everybody, you know, that, that's kind of my metric as I hear this, is how are you using it to help and are you burning a lot of time on it and a lot of our planet's water on silly stuff, which I find, you know, oftentimes happens.

Melanie Avalon
Actually, to that point, like the people in your life and everything because, like I was mentioning, one of the tenets of your book is connection and one of the things I found really, really fascinating that you were talking about was I think people, I think people are pretty much... You know, they know that, like, social relationships are good for us. Like, we have that idea and I think people think oftentimes that it's like, it's all about just these really deep close relationships.

But you point out that, like, the variety is the key. Like, we need lots of different types of relationships and they're all helpful and, and so I, I think about-- I-- So I literally every day-- I know people do like Instacart and all this stuff. I literally every day go to the grocery store. I honestly, it's because it like hits a lot of these different tenets, so it gives me movement. I-- It makes me actually have to go. I have to go like pick up the stuff. It's got the food aspect. I feel like I'm a hunter-gatherer and I'm gonna g-go get my whole, you know, my whole foods at Whole Foods actually. And then the connection thing, like the, the soup They're not superficial, but like those day-to-day interactions with people who are not necessarily like your best friends ever, but like the peop- the grocery cashier, you know, the, the person in the store. So I actually-- that is actually one of my personal daily habits that I find really beneficial for my mental health. But, um, I, I liked that, that part about the, the connection, ab- about how, you know, it's, it's the variety that people need.

Dr. Drew Ramsey
Yeah. Uh, that's such a great example, Melanie, because when we hear about connection and everybody... So the book has nine tenets, which I thought we'd all agree on, and maybe that doesn't sound exciting, but I wanted to share with you the neuroscience and the new mental health science behind some of these things that w-we know are true, but we often don't engage, uh, in with the intensity that's gonna benefit our mental health, things like self-awareness or one of my favorite tenets in the book, and really one, especially as a middle-aged guy that I really, you know, work hard on, try to keep track of really every week, is connection.

And everybody just listen to some of these statistics on connection and loneliness, right? As you age, particularly, being socially connected increases your odds of survival literally year to year by fifty percent, right? It is independent of age, health status, or lifestyle. This was a two thousand and ten meta-analysis of a hundred and forty-eight prospective studies, right? That, that's then followed up with a, a study that had three point four million participants in it and kind of verified that, that social isolation, just that in and of itself increases your mortality risk by twenty-nine percent. And so-- or just living alone increases your risk of death by thirty-two percent. You know, what, what you see is that, you know, we think about these risk factors, smoking, obesity, inactivity, but actually being lonely a-and, and being socially isolated, and, and that's different than being alone, as I hope everybody... Uh, we talk a lot-- I talk about this in Healing the Modern Brain, really asking you to make that distinction, 'cause sometimes when we are alone, it's like, "Oh, no. Like, what-- I'm s- what have I done? I don't have any friends." It's like, no, that's time when you're alone. That's really sacred, special time with yourself to listen to your favorite music, to, you know, literally dance like no one's watching, to journal, to go exercise, to, you know, batch cook something delicious for yourself. That, that's not lonely. Lonely is really feeling that there's no one to talk to, there's no one to share with, there's no one that... You know, it's-- when you see with your friend, it's like, you know, ten minutes in, it's like you just feel better. It's like, "This person knows me in the vast universe. This person, you know, gets a kick out of me, and I get a kick out of them." And so, you know, there's all the science, and this is how Healing the Modern Brain really works. I, I wanna really compel you with science here. So many people are asking for your ear, and between my clinical experience and the science, I hope to provide an argument that these very reasonable ideas need to be prioritized over w-what I find is often happening in the wellness and the biohacking movement. Like, people are really excited about injections, but they're not so excited about a good bedtime or stopping alcohol.

Dr. Drew Ramsey
People are really excited about, uh, you know, retreats and new technology and, you know, uh, all kinds of lights, but, y-you know, they're, they're not really good at putting in the time to build the intimacy, like emotional intimacy in their relationships. They're still struggling with listening, which we all struggle with sometimes.

But, uh, a-and, and so, uh, I think my hope with this book was really to, to, you know, double down in some ways on the stuff that you know. Everybody listening knows that self-awareness is like a r- is the key. You have no motivation without self-awareness. You know, everybody listening knows... You know, maybe you don't know why sleep is so good, and so I get into that in the book around the glymphatic system and this, again, just new science. Like we discovered the system in, I think it was twenty-fourteen, twenty-twelve? Twenty-twelve we discovered, University of Rochester, this, uh, how we drain waste from the brain. And so, you know, the book really tries to deliver some of the new exciting stories in the science along with some, you know, just clear clinical examples of how what I call mental fitness works, where you're going to the gym this week. If you're listening to a biohacking podcast, you're probably going to the gym most days of the week, and maybe you're intermittent fasting, and you're doing, you know, all this stuff. But I find the things like really honoring the sleep hygiene, honoring the connection-ness, getting time in nature, y-you know, it's often really neglected by people.

Melanie Avalon
So speaking of the self-awareness, I have a foundational question about that. But before we leave the, the connection section, I'm gonna tell you there was one thing in there that made me feel so, so seen. You talk about the role of dating, for example, and I have always felt... Okay, so I personally don't-- I'm not like seeking a long-term relationship romantically right now or anything like that. It's just not a priority for me.

I'm very much into social connection and friends and family and all the things, and I really like dating. That said, even though I don't want a long-term relationship, like I really like dating. I like first dates. I think they're fun. Um, I like adding to my, my friend group. I've always kind of felt like bad about that because I, I kind of feel like you-- when you're dating, the intention needs to be to find your forever person, but I just don't have that desi-desire right now, and you-- I'm paraphrasing.

Dr. Drew Ramsey
How do you not catch the feels for people you're dating?

Melanie Avalon
Normally, I, I just don't... I, I just, I just normally don't.

Dr. Drew Ramsey
But you don't like sound disappointed about that. It's an interesting approach to dating and I think one where y- it sounds like you're kind of excited about new people and like up to meet new people and connect and flirt and feel kind of excited, but it doesn't really need to like-- but it doesn't need to go anywhere for you. And, and I think what the-- and, and I think what you're noting a-a about the connection part of healing the modern brain, a-and I really appreciate you pointing it out, is, is I really try to ask people to dissect out and kind of create, uh, the different types of connections and create a kinda map. I, I really encourage people to actually map it out, where y-you know, you have these different types of connections. You were talking wonderfully about, like, the people in the grocery store. I remember this. I still remember. I used to live on, uh, 8th Avenue, right at 12th Street in New York City in the West Village, and Emilio was the guy, uh, working the deli. And Emilio's still there. I walked in the other day. I don't think he recognized me. It crushed me.

But right when my babies were born, uh, or my daughter actually, it-- I would... You know, I'd be in there every day with Emilio, getting a little treat, getting something that we need. Uh, you know, a-and, and so... And it just meant a lot. I still remember, you know. And so those types of connections matter.

I really loved working at these big hospitals because of all the people you could connect with a little bit. F- uh, I would always connect with the folks in the food service or the security guards, you know, or just the other doctors and residents, and it, it, it created this constantly kind of social interaction. One of the things I note about my life, which being a therapist, I'm often sitting, but I get... Every day is, like, just one deep, powerful, meaningful conversation after another, and I just feel so blessed that... It just feels, like, so healthy to really be with people. But this idea of thinking not just about, okay, best friend, that's great, or close friends in your friend group, okay, super important, but also sort of peripheral, like other parents at school or people that you see all the time in your yoga class but just don't know their name or institutions is one I talk about.

Being part of an alumni group, right? This isn't supposed to be your soulmate, right? And I think a lot of times I see people kind of confused that they're, they're doing alumni stuff, but they're really trying to date. And like, you know, alumni stuff's about honoring your institution. It's about giving back. It's about recognizing that so much helped create who we are. You know, it doesn't have to be a educational institution, but you know, when institutions help us, move us, encourage us, inspire us, you know, that, that's something that is often really powerful for people to be involved with. Your faith institution is a really ex- good example for so many people.

Dr. Drew Ramsey
I meet a lot of patients who are almost a little embarrassed by their faith, that they like church and they like singing the gospel and... You know, I, I love it when I hear that. It's like, wow, it's like, it's like mental fitness gold.

Like, get to church. Because, you know, when you have things, which a lot of us do in our lives that, again, feel great, help us feel connected. You know, it's funny, uh, how often we still, like, prioritize, like, work, being too busy, um, aspiring or striving as opposed to, you know, some of the simplicity of just how good it feels when we're connected to people.

Melanie Avalon
And by the way, I, I could... Well, that, that's all tangent. I could-- I'm always open to a long-term relationship. I just don't... It's not a priority.

So I liked, I liked that there was that, that perspective in the book that you could date, you know, and it doesn't have to be, like, a long-term thing. I was like, "Okay, I feel better."

Dr. Drew Ramsey
I'm gonna put on my therapist hat here. I'm glad you felt better because I think one of the things that gets oppressive for people or people who've gotten out of relationships, you know, it's just like that period of recovery of being with yourself, of being sad, of, uh, you know, kind of reconstituting your identity a little bit a-and then getting back out there and... You know, y-you, you like dating.

It's fun for you. And I, I really try to encourage people to be in that mindset of just like, you're going to meet another person. 'Cause you-- when you go with that expectation like, "Oh my gosh, you know, my princess is here finally," or, "My prince," you know, it's just, it's, you know, it's, it's really easy to be disappointed. And, and I think something that's very hard for people t-dating today is there isn't a lot of runway for people to get to know each other and fall in love. There just isn't. There, there's a way that between the fast kind of physical interactions to the expectation of dating to the way that there's kind of an expectation that, like, there's not some fool around by X number of dates, it means you're not really that into each other. A-and because of this, there's just all this really personal, super intimate stuff that happens before people actually even know each other, and it's all just what we call, like, transference stuff. Like, you have this fantasy about who the other person is and what you're gonna become with them, and it's not really based on that much reality. And, and then inevitably there's just... Y-you know, it kinda... A-as you can see, it kinda sets people up for a lot of disappointment.

Melanie Avalon
Yeah. It's, it's so true. And, and to that point, it-- very similar to you when you were saying how you are s- you feel so blessed that to have, you know, conversat- these deep conversations with people, that, that's why I love podcasting. I mean, a, that's a reason I love podcasting, is I get to have these very in-depth conversations.

It's very... Like, and I'm in... You know, I'm not doing anything else. I'm, like, in the moment. I get to really meet these humans, and so it's a blessing. It's a blessing. So I'm so happy that we're doing this right now. Thank you.

Dr. Drew Ramsey
Thank you. It's great to be here. It's great to be here doing the f- you, one of your favorite things.

Melanie Avalon
For Ten at Five connection. Okay, so my, my big self-awareness question, and this is the question that haunts me perpetually. So, like you said, it's the num- it's your first tenet in the, the nine tenets and, you know, it's found... You talk about how it's foundational because it's, it's the key to... You talk about how it's the key to... Like, people will talk about, like, mindfulness all the time and, like, what is that, and you're, and you talk about how it's the importance of self-awareness. Like, you can't really do anything else if you're not first aware.

How do people... I don't know how... How do you become aware? And what I mean by that is, like, for f- like, a specific example is, like, I kn- I know somebody right now who can be pretty emotionally volatile and pretty m- we're all... Not that we're talking about this person behind their back, but we're pretty certain this person is just in a different reality, like, in their head about everything. And How do you, how do you become self-aware? Like, does it require... I just don't know how-- I don't know how you can't see-- I don't know how you can see yourself if you can't see yourself.

Dr. Drew Ramsey
Oh, how do you learn to be self-aware? Well, th- that's a great question. It's probably one of the goals of psychotherapy, right? Like you were just talking a little bit about your therapy where you're saying your therapy is really supportive, right? So in some ways, you're kind of noting there's a way that y- maybe some insecurity and the positive attitude of your therapist interface in a way or interact in a way that's very helpful to you.

And, and, and so becoming self-aware is... And I talk about techniques about this in the book, uh, and, and ways of doing this besides therapy, because the, the hope of the book is really to think about things in your life you're already doing, like sleeping, eating, exercising, a-and uplevel them a little bit. So we're oriented around brain health. And so self-awareness can be as simple as, like, when was the last time you went to the doctor? So if your answer is over a year, like, y- you know, there's something going on where you're not caring for your health according to recommendations, right? If you're a middle-aged person, you've not had your lipids checked. If you're forty-five and you haven't had a colonoscopy. Uh, you know, those are just some basic things where something's going on. You probably know you need that stuff, and you're, you know, it's always what we call acting out in mental health, right? As opposed to engaging in the things that we need to do that sometimes can be scary to us. Y-you know that, you know, not everybody can get self-aware, you know, and, and a lot of people have a sense of false self-awareness. You know, a lot of people in the kind of cult of therapy or cult of wellness really think about themselves as great listeners, really helpful, and, you know, it's really-- it, it's not true. It comes across as very ersatz to people. I think people who are self-aware are in generally this curious stance. A-and, and I think one of the ways you grow that muscle, and I, I do think you can grow it, is by trying to note places where you're really judgmental. You're talking about other people, and you're not talking about ideas, or you're not talking about things that inspire you. You're gossiping or you're externalizing. That's one of my favorites, right? Like, big red flag about self-awareness when I'm like, "Ugh, you know, I'm in a bad mood. You know why? 'Cause Melanie. Ugh. I thought this was by video. I was all excited, and Melanie ruined my mood." Right? Certainly, people throw us off in our lives, and I'm not trying to say that we're always responsible, but there is that kind of brilliance in self-regulating and controlling our internal worlds by in some ways filtering what we allow to penetrate, what gets in, what throws us off. And so self-awareness is, you know, really trying to build that ability. Wow, like, my heart's racing. I feel really nervous to talk to this person. I feel kind of scared. You know, that's like, you know, a lot of, a lot of people wanna fight against that, and I think, wow, man, that's, like, powerful data.

Dr. Drew Ramsey
The tool of self-awareness, the beginner tool, I think is journaling and getting comfortable just putting your inner stuff out onto the page. You never know what's gonna show up in a journal. I have a bunch of prompts in the book asking people to think about things, your strengths, your challenges, to, to try and maybe coax a little bit out of you of what people tend to talk about on the couch. But, but I think that self-awareness should be thought about like a muscle and that you're trying to build a capacity to listen, to be curious. Part of also self-awareness is building self-esteem.

We've put out a lot of content recently about self-esteem because, you know, uh, to do this stuff we're, we're talking about, right? To connect, to work through trauma and, and the tenet of unburdening, to think about your purpose, you know, you, you, you need to figure out a stance that has a sense of awareness not just about the self and what your capacities are and what your challenges are. You know, if you're destined to be a rock star, and you're just, like, brilliant on the guitar, and you've got an amazing rock star voice, and everybody loves it when you play and sing, and you're in law school, you know, that, uh, okay. I mean, that happens. But, but there's something ab-about that that needs to be understood and resolved, right? And, and so sel-self-awareness is really, you know, leading us to understanding our strengths, our challenges. Our patterns is a big one. Yeah. I hope your friend grows some self-awareness, and I think it's tough when you're with people who maybe don't have it, and, and people spend a lot of time wondering, like, how do you help someone with that? And, and this is where I think some of these parts of the book I hope encourage people. You can just hand them Healing the Modern Brain and be like, "Tenet one was really powerful for me, self-awareness," and see if that helps.

Melanie Avalon
I guess I'm really curious about what even makes people want to change in the first place. Like...

Dr. Drew Ramsey
Pain and anxiety, you know, uh, and, and I guess, you know, most of my work has been around depression and anxiety and that, you know, that doesn't always have, like, a pure psychological po-po-cause, but usually people wanna change... Maybe one of the effective ways I should say that people motivate change is that they are in pain. You know, they need to change something.

It's where that, you know, idea, which I really don't like, that you have to hit rock bottom 'cause you don't. But there is a way that that level of pain motivates change. I, I think also people change because they're inspired. People change because there's new science. People change... Gosh, I stopped drinking 'cause my, uh, my daughter was, like, eleven, ten. She just looked at me and she goes, "You know, when Mommy drinks beer, she doesn't act different. But when you drink beer, you're a different person."

Melanie Avalon
Oh, wow. Wow. Oh, man.

Dr. Drew Ramsey
Exactly, right? So, like, I don't know. Like, I, you know, had thought about not drinking, like lots of people do, for a lot of time. But that-- So, you know, all kinds of things motivate us to change. Maybe this conversation motivates somebody.

Maybe one of you listening is really, you know, this thing we're talking about, being in therapy, and is like, "Wow, I've never tried that." Or you're with a therapist that you don't feel a good fit, and you just haven't felt empowered to do something about that. Or you've not Thought about how isolated you've become. And so maybe this is the moment that motivates people, Melanie. I think it's, it- motivation and behavioral change is stuff that we s- you know, is studied a lot. There's certainly some basics around that. Um, I know a lot about helping people, like, for example, stop drinking. You know, there's just, like, some basic stuff that if you wanna do that helps, like not keeping alcohol in your house, right? Just like... So, you know, some things, um, having a, a coach or a partner, you know, helps where you don't have to bear the burden of all the motivation.

Listening to that basic rule, I, I heard this first from Rich Roll, I love this, which is around just like, you know, you you don't, like, exercise and, like, run marathons or, uh, like, incredible athlete 'cause it always f- feels great. And like sometimes it feels great, but, like, you do it because you've decided to do it, and that the, the, the action happens before the feeling, before the feeling of accomplishment, of endorphins and all that stuff. It's that y- you know, when you didn't feel like it, quote unquote, you did it. You got out there and you started running.

Melanie Avalon
Yeah, just as a side note, I, I love Rich Roll, and I, I actually listen to him because there's a, a main reason I listen to him is he... You know, he's very, very vegan. I'm very not vegan.

I eat I eat like... I'm very, like, almost carnivore-ish in my diet. But he inter- he interviews a lot of people similar to my show, so I feel, I feel like he keeps me really open-minded in the dietary realm because I get to hear his perspective on everything. So I, I really like his podcast.

Dr. Drew Ramsey
Yeah, Rich, I, I met Rich way back in the day before he started his podcast, right? Actually, as he'd start- stopped drinking. Really inspired me.

I met him... I was at a wellness event and he's still a little, uh, I don't, I hope it's okay, like a little twitchy, um, in the sense of just, like, there were a lot of people out throwing down and, you know, enjoying their wellness and, and it was be- I think it was right before he started his podcast. And yeah, just like really, really gentle spirit. I, I agree, like great, great energy and great interviews and I, I love the diversity of people.

Melanie Avalon
Yeah, same, same. Oh, one, one other thing.

So I, I love when there's, like, very specific things that are very actionable and implementable, and speaking of the self-awareness thing, you... And did you come up with this with your patients or I don't know where this, where this came from, but you were saying when people are talking, like, I guess when, if you're asking... I don't know if it's when you're asking questions or regardless, when people are talking, like, to you or be in a session, they'll often end the sentence with, "I don't know." Like, "I do this, you know, I don't know." And you say to replace it with, "I very clearly know." And I was like, "And that's, like, pretty mind-blowing." So I've started doing that, and it's very enlightening.

Dr. Drew Ramsey
I'm glad it's working for you. Everyone, the, the idea behind that is I just sit on my couch, I listen to someone, you know, some, like, uh, you know, like a, a mom telling me about some, you know, their, their teen, let's say, and their husband, and describing, like, a really complex situation, and they tell me just, like, in beautiful detail all of, like, psychology of what's going on and how they handled it and, and then they'd end and they'd be like, "I don't know." And, and it just struck me that they just really talked about a wonderful job they're doing, uh, they, they've been doing, like handling a very complex situation, and that they clearly did know. And, and it was just almost like a tick I hear where I, I, it feels to me a way that people... It's like people shot block a great three-pointer of self-esteem, you know, where it's like instead of saying like, "Wow, I, I c- I clearly know something about handling this family. That was a tough night, but I'm grateful I know this or that, that," right?

It's like, "Ah, I don't know anything. This is, this is hopeless." And so, yeah, I just, I, I, I like people... I, I think about putting points on the board, that the way we build self-esteem is accomplishing things and thinking about your accomplishments. It was, um, a, a lesson. I think I write about this in the book. Uh, very early on in my practice, I had a, a patient, uh, really chronic depression, and, you know, she just really wanted to focus on, like, some positive stuff one day. And it just really struck me of how often we're, like, turning over stones, thinking about, like, you know, all the pathology, all the struggle, all the, you know, traumatic stuff. And, and certainly that needs to get talked about, but I, I also feel that we all need to, uh, build self-esteem and understand the things that we do have great capacity for.

Melanie Avalon
Well, I love it. I love, yeah, like I said, I love really specific, implementable things.

I th- I think my favorite word tick adjustment, which I know I already did once, at least once in this episode, and that and it kills me every time I do it, it's replacing the word but with and because you realize when you say but, you typically that means you just negated whatever you just said.

Dr. Drew Ramsey
I love how we're all saying and now, but you know what I mean, but we're like a- and, and as well. And it's like, well, you just mean... Yeah, that one.

Melanie Avalon
And also.

Dr. Drew Ramsey
The tick I'm trying to get rid of is I think.

Melanie Avalon
I think. Wait, so in what way that people say it?

Dr. Drew Ramsey
Just don't wanna say that anymore, I think.

Melanie Avalon
At all?

Dr. Drew Ramsey
Yeah, at all. I don't, I just-

Melanie Avalon
I'm gonna start noting What do you replace it with?

Dr. Drew Ramsey
I don't think it, I don't think it needs to get said.

Melanie Avalon
Oh, you said I don't think. Does I don't think count?

Dr. Drew Ramsey
I'm not sure. It's just it, we often start ideas telling people what we think as opposed to just telling them our idea.

Melanie Avalon
That's a good one. Okay.

With, this could be a whole book. Okay. So we've mentioned and danced around... Although dancing, that's a topic. But we've danced around the whole, the food and the diet, and you mentioned the, the keto stuff. I was really curious. Yeah. Where, where are you these days with the whole ketogenic diet and for the brain? I was curious to read.

Dr. Drew Ramsey
Yeah. L- maybe we can back into it just thinking about, in some ways, the bigger body of evidence, which is the nutritional psychiatry evidence around what's the dietary pattern, dietary interventions in clinical depression. And everybody, the reason I focus a lot about depression is I think mood is really something that we all think about. You know, how, how are you feeling today? And, and when our mood is a little off, and you know it is, most people have about one day a month where their mood is just kind of off, it, it's really disturbing to us. We wanna understand it. Why are we feeling this way? We don't like it, of course.

And so clinical depression is also the most disabling illness in the world and in America, and it's really undertreated, right? There are sixty million American adults right now with a mental illness. You know, about Oh, I don't know, sixteen, eighteen million have clinical depression. You know, we're talking about, let's say fifteen to twenty percent of adolescents will have a depressive episode. A-and so the-- you know, a question we've all had is, is food really changed? And in my first book in twenty eleven with Tyler Graham was The Happiness Diet, which kind of looked at how much food has changed in really the last hundred years, and how some of those changes really have put a lot of very strange things in our diet. And so all this data starts coming out, looking at, you know, if you eat an ultra-processed food diet, you have a fift-- uh, the people who eat the most processed food have a fifty-three percent increased risk of depression. For every ten percent of calories that you eat ultra-processed food. So let's say you, you know, eat four hundred calories, uh, of processed food instead of real food every day, right? You just increased your risk of depression, that's about twenty percent of your calories, by twenty-two percent. Every ten percent, uh, increase in processed food increases your risk of depression by eleven percent. And so all this data's been coming out, and then there are all these amazing clinical trials that have come out looking at if you take treatment as usual, so you're in some therapy, you're maybe taking a medication, and, and you're better, right? You're in what we call you have a response, right? You're not as suicidal, you're sleeping better, you're more hopeful, but you're not in full remission, right? You still have some mood symptoms. You're not a hundred percent better. So if you, in that situation, add on a Mediterranean-style diet... This was the SMILES trial that was published in twenty seventeen. And, and you see about thirty-two percent of people who get the Mediterranean diet go into full remission. And, and, you know, we talk a lot about social support. We just talked about connection, really important. The control group in the study was a connection, kind of a social support group. So they did crafts, they talked. And, and so only eight percent of people got better in that group. So it just shows like how powerful the Mediterranean diet can be.

Dr. Drew Ramsey
And so then a number of studies followed that, the Healthy Med trial, the AMEND trial, which was of young men with depression, where they just gave them two nutritional psychiatry counseling sessions, and thirty-six percent of these young men went into full remission from their depression. So really powerful data.

And so i-in this en-en-- kind of environment, metabolic psychiatry begins to emerge m-mostly under the helm of Shabani Sethi at Stanford and Chris Palmer at Harvard and Georgia Edis. Uh, and, and these are psychiatrists who are thinking about kind of how mental health disorders have a metabolic component to them, potentially. So how we metabolize energy, how our cells respond to insulin. And so metabolic psychiatry utilizes a ketogenic diet and, and probably also as it evolves, e- what are called exogenous ketones. Uh, ketones are the breakdown products of fat. So fat can't cross the blood-brain barrier and provide energy to our brain cells. And so as you decrease the carbohydrates and you're eating like a keto or, or a carnivore diet like Melanie is, and you're getting less than sixty grams of carbohydrate a day for many days in a row, your liver begins to get really good and, and ramp up turning fat cells into ketones. Ketones are a three-carbon fuel, and over time, about seventy-five to eighty percent of your brain fuel is coming from ketones. So there have now been three or four pilot trials. There's been o-one actual study of ketogenic diets for mental health disorders. It's exciting because it's a certain shift and evolution that oftentimes we thought about ketogenic diets as really like being horrible for your lipid profile, being dangerous even for heart disease, and, and they certainly can be, if not done right. But we haven't really thought about what's now called the well-formulated ketogenic diet. You know, if I'm eating avocados, salmon, oysters, full-fat yogurt, right? I just named some of my favorite brain foods, and that's pretty ketogenic diet. If I'm, you know, crunchy vegetables, right? But really keeping my carbohydrates low. So there are ways to do a ketogenic diet that aren't the kind of, you know, bacon, butter, you know, just very high saturated fat type of ketogenic diet that's always concerned our cardiology colleagues. The studies are interesting. They're pilot trials, so it's important to note that people get a lot of support. They get free food, they get food hampers, they're getting their bloods taken, they're doing rating scales. And so the problem with pilot trials is, you know, we don't know if, if, for example, you have somebody who's also getting coaching, they're getting lots of yummy Mediterranean food like feta cheese and hummus, uh, you know, are they gonna do just as well? It's also to note that, you know, most of the trials in nutritional psychiatry have been around depression or anxiety in the Mediterranean style or kind of more traditional style diet. And in the first trial here by Shabani Sethi was with people with severe mental illness.

Dr. Drew Ramsey
Uh, it was, uh, twenty-one people, I think sev-- no, it was twenty-three people, and nineteen of them had bipolar disorder, four of them had schizophrenia. It was a really fascinating trial, though. Shabani Sethi's trial was like something like sixty or, or... Th-there was a very large percentage of people, I think it was sixty, seventy percent, who were not in, in anywhere close to remission from their illness going into the trial. And then at the end of the trial, almost everybody was in remission.

They had lost a lot of visceral fat. I think it was like a thirty percent loss of visceral adiposity, which is wonderful. That's that kind of belly fat that we worry about. The, the lipid profile had been pretty, you know, like not a huge shift or, uh, concerning-- in a concerning way, and also these patients were monitored really carefully. And, you know, most importantly, people's mental health just like got remarkably better. So a, a lot of this work has been funded by a wonderful foundation, the Baszucki Foundation, which is been really, really generous in supporting, I think six or seven clinical trials of ketogenic diets. There's a trial, a pilot trial out of Ohio State of depression, where self-reported and clinician-reported mood rating scales, there was a seventy percent improvement in mood, which is just You know, really striking. And again, I think what's exciting is whether it's a Mediterranean diet or a ketogenic diet, what we want people, especially young people, to be understanding is that at the end of the fork, you're making a choice about your brain health. And it's not the only vote, right? Eating perfectly does not guarantee you're not going to get dementia, not going to get depression or won't have a panic attack or won't relapse in alcohol use disorder, let's say.

But it helps. It helps in the data. It helps in your overall health. It helps in terms of living a life of what I would call mental fitness values that you have worth, that your brain is amazing and that it deserves these nutrients that we understand really fuel it and take care of it and some new ones. You know, a lot of people haven't really thought about their microbiome beyond taking a probiotic. And that's a horrible way to think about your microbiome. It's just besides being a waste of money, it's just not how you want to take care of your gut health. In my opinion and in most people's opinions.

And so really becoming more familiar with in Healing the Body Brain, I talk about the new science of mental health and that, you know, people are always talking about serotonin and I'm happy to talk about serotonin. But people are often surprised to hear that I just love that molecule because anybody who's in neuroscience or mental health loves serotonin because it is so fascinating. It's like we love dopamine or norepinephrine or GABA or glutamate because this is like the language we speak. It's like a word. It's like it's like saying I hate I hate where it's like it's a word. Serotonin is one of these one of what hundred and sixty plus neurotransmitters in our brain. And it's amazing what it does.

Dr. Drew Ramsey
It really helps you regulate our homeostasis, our sex drive, our intellect, our appetite. It's really fascinating. Sorry, I feel like I've gone off on a rant about ketones and serotonin here, Melanie, and you have other questions.

But sorry, I just I just think that that the in Healing the Body Brain, I try to encourage people to think as modern mental health professionals think. We do not sit around thinking about serotonin or low serotonin. We haven't for like 30 years. The chemical imbalance was to try and help you as a public not be so nasty to yourselves that the reason you're depressed is because you're a horrible person. The reason the chemical imbalance theory came about and is talked about is to try and share with the public that there are chemicals in your brain that regulate how you feel. And when they are out of whack, you do not feel well. When there's a certain mix of chemicals, you can have psychosis, you can have mania, you can have depression, you can have suicidal thoughts, period. That's just very clear in the science.

So in Healing the Body Brain, I really want to encourage people think with us about the new science of mental health, which is around neuroplasticity. I want your brain to be in a mode of growth and repair at all times. And there are ways and I kind of go over them very clearly in these tenets of mental fitness. There are ways that we can do a better job with increasing the main neurotrophic factor, the main brain growth factor that we have BDNF. You can eat more nuts, you can exercise more, you can go to psychotherapy. Every time that Melanie and I go to therapy, our brain squirts out a little bit more BDNF. That's actually how therapy changes us is it literally rewires your brain, right? If all you're thinking about is what a loser you are and how anxious you are and how everybody thinks you're horrible and right. And after several months of therapy, you're mostly thinking about your business plan and your girlfriend and your apartment and your fashion and your generosity.

Oh, wow, that's brain growth. And that happens the way that our brain repairs the way that all therapies work. Meds, talk therapies, TMS is through neuroplasticity, through our brain's ability to change and shift connections. The second is inflammation. This gets talked about so much in terms of gut health and heart health, but it doesn't get talked enough in terms of mental health and brain health. Depression is an inflammatory illness for a lot of patients. When you look at patients who don't get to better with traditional antidepressant therapy or talk therapy, a lot of them have very high inflammatory markers. When you look at people who are on an anti-inflammatory and on an antidepressant, the antidepressant is about twice as effective.

When you look at some of the medications that treat depression like Prozac, it's really wild to me. Like if people were really biohackers, they'd all take Prozac. Like there wouldn't be a biohacker like worth anything.

Dr. Drew Ramsey
No credentials like Dave Asprey wouldn't let you into the conference unless you were taking fluoxetine because Prozac is a central anti-inflammatory. It promotes brain growth and brain repair. It has a wonderful long acting half-life. It's actually the treatment for antidepressant withdrawal syndrome. It's a really cool medication.

And so inflammation, sorry to go off on a rant about Prozac. Inflammation is a wonderful way for us to think about mental health. Why? Because when you have inflammation in your brain, you have three symptoms. You have more anxiety, you have brain fog and you have depression. And it's just very clear. Those are the circuits that get activated by inflammation. You know, if think about last time you got sick, you just kind of get a little down, a little sad, right? You get like a little worried, like, you know, what's wrong with you? You want to isolate. And then if I ask you math questions, you're like, oh, I'm kind of sick. I don't know what 32 plus 16 is. And so, you know, not all depression is inflammation, but it's something that when people are struggling with their metabolic health, they're struggling with their gut health, they're struggling with excess inflammation. It definitely, definitely affects their mental health.

Last one's the microbiome, just like inflammation, microbiome, kind of like, yeah, obviously very intermingled. But those three concepts, I just like I wish everybody talking about serotonin would just stop and they'd talk about those three concepts. Not that I'm not interested in the conversation. It's just that Most of the people talking about antidepressants don't use them. They don't prescribe them. They don't take them. They haven't been benefited by them. That's not the people who are saying, like, "These are awful."

Melanie Avalon
It's funny, I had a, a major flashback with the inflammation because I literally have had a conversation with my therapist. I w- I went through a period-- I-- 'cause I agree with you so much about the inflammation.

I definitely went through a period of time, though, and I went through a period of time where I think I was overly fixated on inflammation, and I just remember my therapist being like, "Melanie, not everything is inflammation." I was like, "But it is."

Dr. Drew Ramsey
Such a great point, and it's also-- we should also say, like, inflammation's really important. It's your body's alarm system. If your inflammatory system wasn't working, you wouldn't make it through the night, period. You'd just be done. You wouldn't wake up.

Like, our inflammatory system is amazing, and I find so many times people are trying to fight it, like, let's get rid. And it's also, you know, taking all these anti-inflammatories, and it's just, again, it's like not paying attention to the data. If you take a bunch of antioxidants before you exercise or a bunch of anti-inflammatories, you just don't get a lot of the benefits of that exercise, that part of the wear and tear is what sort of triggers our body's healing and, and kind of growth systems.

Melanie Avalon
I will say, speaking of the BDNF, I think the dietary approach-- I think, I said it, the dietary approach that has probably had the biggest effect on my personal mental health is doing fasting every day, which definitely increases BDNF. When I started doing that, I was blown away by how it regulated my mood and had that effect on me.

So I love, I love intermittent fasting for me personally.

Dr. Drew Ramsey
It's really-- It's one of the things I've really loved as a nutritional psychiatrist is seeing the variety of ways and kind of approaches that people have. A lot of times people meet me, and they expect that, like, I'm gonna be really anti-vegan or really anti-carnivore or, you know, for or against intermittent fasting.

And it-- you know, I think when you see people like that, you can tell right away they're not clinicians. You know, right now I'm treating carnivores and vegans, and I a-adore working with both of them, and they have different nutritional needs, and the conversation's different, and who they think is right about nutrition is different. And, you know, that they're, they're allowed to have those opinions in my mind and in my practice, right? That's their values.

Melanie Avalon
Yeah, I just want people to find the diet that, that works for them. And actually, the Mediterranean diet would be a nice kind of... I don't know if it's an analogy or metaphor. It relates, though, to the idea of that there are so many different factors because there-- even with the Mediterranean diet, there's not a single definition for it. And I was reading a study where they-- I think they looked at, like, every isolated piece of the Mediterranean diet to see, you know, what was the food that was having the effects. And there wasn't one part of it that was the thing.

It was, you know, all of it. And then it might also even speak to, like, the Mediterranean lifestyle, which brings in, you know, connection and all these other things. So yeah, I don't think there's one right answer is my point.

Dr. Drew Ramsey
Yeah, and I, you know, I was just at the Mediterranean. I went to Siracusa, which is on the eastern coast of Sicily, and it's the origin of the Mediterranean diet. And I was in Italy for the first time in my life, you know, as someone who's been talking about Mediterranean diet and research, and I was struck by two things.

I was struck, one, by how racist this concept is. You're not talking-- We're not talking about the Algerian or the Libyan diet or the Moroccan diet or even the Turkish diet. We're mostly talking about, like, tapas and, like, Northern Italian food. You know, fresh, plant-forward.

Melanie Avalon
Olive oil.

Dr. Drew Ramsey
Yeah, olive oil. Uh, so I think that, that's bothered me a little bit. I think the other thing that bothers me is when you look at studies like the Mind Diet Trial, which is pushing a Mediterranean dietary pattern to help with dementia, you know, it's a very, very kind of complex carbohydrate-heavy diet. And, and I think in the kind of eating pattern that I, I tend to advise or prescribe a-and tend to try and follow, there's, there's a little bit more fat and protein and a little less just even the, even the good carbs, right? Even broccoli is, you know, glucose at the end of the day. And, and so not that I'm anti-glucose or, or, you know, an-anti-carbs in that way, but I, I just think that the Mediterranean diet ends up being very vague.

I'm from rural Indiana. When you tell people to eat the Mediterranean diet, we're gonna go to Pizza Hut or Famiglia for pasta or go get a hero, right? We're not gonna, like, get some olive oil and, you know, roast some garlic. And maybe, you know, I mean, I don't mean to throw shade on my Hoosier compatriots, but just that, that I think being explicit with people... And then this thing where like, oh, let's analyze the Mediterranean diet to find out exactly what it is. I just think that's not a good way for us to ever think about diet anymore. Y-You know, everybody's in such a complex food milieu and food environment. I'm about to go through an airport tomorrow, right? I'm gonna be in San Francisco with colleagues. I'm gonna be at a conference with, like, lots of free coffee. And, uh, you know, I, I don't-- How do I put it? Like, I'm gonna adhere to my values and eat good brain food, but y-you know, I'm also going to be in a lot of, uh, different environments with all kinds of different things. And so, you know, the, the-- just strictly following a Mediterranean diet, I think to a lot of people, that doesn't make much sense.

And so in my work and in my books, I try to focus on the food categories. Uh, "Eat to Beat Depression and Anxiety" goes through food categories and kind of introduces you to the way that I-I've tried to influence nutritional psychiatry in my career, which is really being a constant source of information about food instead of supplements, right? People wanna know what type of magnesium to take. I ask them what their favorite magnesium food is, and I, and I get a blank stare. And, and that's the type of situation that, that I, I just find a little concerning.

You know, you, you have really the most amazing thing in the known human universe between your ear-ears. There's just nothing, nothing like it, right? You have as many connections in your human brain potentially as there are cubic meters in the entire known universe. It is just, like, wildly complex. Think about all the stuff, all the stuff that you do, and you don't need a giant data center. You just need, like, some hummus, kale, and wild salmon, and you can go make a piece of art. You can write a book. You can do research. You might be a little slower than the superintelligence, but it's wild that how much the human mind does.

Dr. Drew Ramsey
So, uh, you know, I, I think people Taking that seriously, honoring the brain, caring for it is y-you know what I hope and, and that being done with food and thinking about these food categories. I have my little rhyme, seafood, greens, nuts and beans, and a little dark chocolate. Rainbow celebrations, don't forget the fermentations. And I've said this-- I've probably said this 100,000 times in public at this point, and, and I'll keep saying it because when people look at the menu, that's what I hope they think.

"Okay, is there a great seafood, great wild seafood choice here? All right, I get a little... Can I get a little side salad? Can I get some greens?" Now, why? It, it has to do that these food categories really, uh, stand up to the, the rules of nutritional psychiatry, which revolve around something called nutrient density. You get more brain nutrients for calorie, per calorie from certain foods than from others, right? A, a can of Coke has 140 calories. A small kale salad with olive oil and lemon juice dressing has 140 calories. You know, guess which one has a ton more nutrients? It's just astounding. And so that, that's really my hope, is that people begin thinking. You know, you can go through what, you know, the study of like what, what matters in the Mediterranean diet. But, you know, I can also just tell you, like you're probably not eating enough lentils. You're probably not eating enough raw, unsalted nuts, right? It's just a wonderful snack. You're probably not eating enough fermented foods or I would hope, well, hope you maybe think about eating more fermented foods daily if you can. Yogurt, kefir, kimchi, sauerkraut, miso. Because we know in the research that combination of fermented foods and more plants is really what is kind of the secret recipe for a healthy, diverse microbiome.

And, and so I, I think there are a set of foods and food categories that help people adhere to the Mediterranean diet. Uh, you know, more pesto is probably one of my top recommendations 'cause it's such a great yummy sauce, but it's just, again, it's nuts, basil, which is one of the most interesting leafy greens out there, uh, garlic, olive oil, and a little like Parmesan, which Parmesan has more protein, I think, per gram than, uh, I think any other food. I think I saw that somewhere. So, uh, you know, it's super yummy protein dense sauce that goes wonderfully on everything, on wild salmon, on gnocchi, in your salads.

Melanie Avalon
Yeah. I, I just love-- Because I think people get very trapped in the ultra-processed food world and your taste buds will change and these foods are delicious.

Like, you can find the, the foods that work for you that, you know, really support the brain. And I think, I think with the MIND diet, I actually had the-- So I had the authors of the official MIND diet. One of them is the daughter of the woman who really like did that whole study originally. And I th- I think for me personally, I use the MIND-- The MIND diet is a good example to me of my own cognitive bias because I'm-- I actually am a really big fan of wine. So I'm like s- "Wine, MIND diet, good for my brain." So that's why I like the MIND diet.

Dr. Drew Ramsey
How, uh, how have you done with the recent, uh, you know, kind of, uh, what people are describing as very clear data that, you know, there kind of isn't a safe limit or f- like health function of, of alcohol or wine?

Melanie Avalon
Yeah. So I'm extremely fascinated by the current sober, curious culture and the headlines surrounding things like that, and I will not give like an hour-long monologue on this. I'll just say that, well, one, I think, I think one of the big problems in the literature in general is that everything gets lumped into one category. So it'll be like alcohol, or it'll be like wine or beer, and it doesn't take into account the, the type, the quality, the alcohol content. I mean, they'll do like standardized drinks, but that's not usually standardized for alcohol percentage, which can have a big effect. So like I only drink organic low alcohol wines from Europe. I mean, that's pretty much it, and it, it makes a, a big difference for me.

I do think... I do-- And I was just interviewing Dr. Tommy Wood last week. He has a, also a book on brain health, and he had a really extensive overview on, on the literature on alcohol intake. And I, I think if you step back, I think the, it, it shows pretty clearly that moderate intake, at the very least, seems to be neutral, possibly, possibly beneficial for certain conditions. Obviously, heavy intake is not good. And I understand that there's-- It seems like abstinence has less of a positive effect, but I understand that that's confounded because a lot of abstainers were either heavy drinkers before, so that might be why they're not drinking. I, I think it's a cultural thing. I think there's like a vibe right now of wanting to have a... And I th- I think it might be people wanting to have a sense of... I'm going on like an esoteric tangent, but I think it might have something to do with-- I think people like grasping at things where they feel like they have a sense of control, and I think the, the cool thing right now to do that is to be like not drinking. But I'm, I don't wanna take away-- I've, I think there are a lot-- I'm not saying everybody should drink, and I completely support people who choose not to drink. I just, I wonder how much of it is the vibe of society right now.

Dr. Drew Ramsey
Yeah, I think, I think alcohol consumption's like at the lowest rate it's been in the US maybe ever. It's really been a fascinating thing, particularly around young men drinking less or just, you know, especially as they're like dating, seeing the effect of not drinking and just, you know, kind of a change in feeling that, uh, people describe.

Melanie Avalon
I'm fascinated by it. I just want people to live their, their best lives so... But I am, I am very curious about this movement.

But I literally-- I, I can only-- If I were to drink different than the way I drink, I would not feel good and I would not want to engage in that mental head space. So I found like what works for me personally.

Dr. Drew Ramsey
I think that's what's important. It's very, it's very sticky and very indoctrinated into our culture and Very much how we tend to socialize and kind of justify socializing. So it's, you know, it's really hard to in some ways separate out some of the, you know, socializing effect versus the, you know, kind of clear health effects. But I guess also the idea of, you know, a lot of people thinking about it just in terms of better mental health and whether it's just cutting back or, you know, finding, you know, kind of special bottles or bottles that work for you like you've done. You know, it's really wonderful to see people examining their relationship with alcohol.

And, you know, one of the things I, I talk about in Healing the Modern Brain, kind of the front matter and the intro to the book is, is talking about what do I mean? Like, what's the environment your brain's living in? And, and I go over some of these things, and substances is one of them. Light and noise pollution are another. You know, microplastics and ultra-processed foods are another. But just these, these components of the modern lifestyle that, you know, the data, uh, begins to come reasonably clear are contributing to the mental health epidemic. And, and what I like about these factors is there are things that we can do. We, you know, we can't change our genes. You know, cer-certainly there are lots of great treatment options. Not, not everybody has access to those or not everybody is of a culture that kind of thinks about mental health and mental health treatment in the way that for someone like me does. You know, what I hope people see in this, whether it's the, the, the food work in nutritional psychiatry or the encouragement in mental fitness and self-awareness and connection, is that there's a lot you can do. And, and, and really, you know, not feeling alone or that you're in a state that is hopeless is just absolutely essential to getting through those hard times in your mental health.

Melanie Avalon
Yeah. And actually, one big question about that and I'll-- oh, one last comment about the, the alcohol.

It it actually, I actually kind of tie it into one of your tenets 'cause you, you talk about the role of like, you know, finding things you love to do and hobbies. So like, like for me with drinking, I never open a bottle of wine at home and don't take 20 minutes to learn about the varietal, take tasting notes. Like it's a whole experience for me. It's not just like throwing back alcohol . Um, so for me, it's actually a hobby.

Dr. Drew Ramsey
Yeah. You see that where the, you know, the dopamine is around like learning new things and exploring and learning about all the great, you know, vineyards and soils and all that.

Uh, you know, I think what happens a lot of times is people just, you know, tend to get a drink of preference and you kind of often you can spot it clinically where, you know, people are just drinking the same thing. It, it's serving more of a physiological relaxing, getting out of kind of a, a little low level of alcohol withdrawal more than it is, you know, what you're talking about, which is, you know, a kind of effort and thought behind it and, you know, is, isn't leading to lots of hangovers and lots and lots of drinks every week.

Melanie Avalon
Yes, exactly. And it's shocking what is in conventional wine. So like friends, if, if your wine is dying your teeth red, that's not from the wine, it's because there's an additive called Mega Purple which is approved for use in the US and it's literally a dye. Like there's stuff there's stuff in conventional drinks which is not good for you.

So maybe one last question to end on would be, 'cause you were talking about depression and so I had a-- it's so interesting. I had a period of time in my life, I call it my black hole period of time and it's, it wa- it was probably about four... I, I don't know how long it was. A couple years maybe. And I didn't-- I-- if you looked at me, I would-- it would look like I met all of the criteria for depression. So like I, I was very lethargic. I didn't do anything social. I only worked. I kind of felt a little numb. So I think I would've ma- I, I probably would've matched the DSM criteria. That said, and I never identified as depressed and I didn't think I was depressed. And I had-- and it's because I always had a sense of purpose. Like I always n- felt hopeful and I always knew that I would get out of this funk that I was in and it would-- I would come out on the other side even though maybe I seemed to look depressed. Um, and the last tenet of your book is, is purpose. I'm, I'm-- so I'm wonder- I've been haunted by wondering about that for, for ever since it happened. Like can you be depressed if you have a sense of purpose still and hope?

Dr. Drew Ramsey
Yeah. Yeah. You can, you can be depressed and, and be nailing all te- all nine tenets of mental fitness. You can be, you know, well off financially, good looking, well educated, have an amazing job, all the stuff and, and still get any of these mental illnesses. It's really where, you know, when you spend time in my field you, you see that mental illness does not discriminate and you see people who have everything and are, are doing everything right and are suffering so much with their mind it just, you know, rocks your world.

And I, I think a sense of purpose helps. I think there's a lot of pressure on younger people to prematurely understand their purpose. Purpose is not actually something most of you listening are going to be able to say. Right? Like you might think my purpose is being a doctor, right? And healing people and, and, and like I lo- I've like-- look, yes, I love that. But obviously I come up to some other stuff and, and then I guess in my own personal narrative there are other things that kind of resonate to me, um, like connecting and being creative and, I don't know, healing from certain things. And I think we turn it into this, this thing, right? Your purpose is to spread health and biohacking information or your purpose is to, uh, you know, for someone is to, you know, be a physician or be a mother or, you know, do this thing. And, and, and we define purpose so, so much in terms of like work function. You know, very rarely do you hear people like, "What's your sense of purpose?" It's like, "I'm really trying to achieve a hi- achieve a higher level of, of spiritual enlightenment," or, "I'm, I'm really, really trying to build community." Uh, sometimes. You know, so often purpose is this very kind of ego, selfish, personal, work-driven thing. And so I, I think with purpose, what I was asking in this chapter, it's a very short chapter. It's a tenet that kind of says these things stack, right? You start with self-awareness 'cause you can't make change without self-awareness. And then we begin-- we go into the basic nutrition. I, I don't think I can change your brain and your mind as well if it's not nourished. And so I wanna make sure it's nourished well. That also gives you a lot of confidence because you're, like, no longer part of this whole, like, wild diet war conversation. You're now eating according to nutritional psychiatry for brain health. Uh, we, we, we put in movement, right? Not exercise, but movement 'cause whether you're doing tai chi or going on a walk or doing yoga or doing a triathlon, honestly, I don't care. I want you outside moving your body. And everybody else can debate how many minutes, and it's like, what I think helps people is moving. I tell this great story of a study on dancing and a patient that I treated. But we stack all these up with the idea that then a-as you're kind of sitting on this, all this function, all this activity, all these connections, right?

Dr. Drew Ramsey
Then you begin to get a sense, more clear sense, more, more clarity around your purpose in life, and that the purpose probably comes and has a lot to do with the processes that you feel drawn to or that in-- you enjoy. If you really love making music, there's always a song in your heart. Your, your purpose is probably tied to that.

You know, I, I love seeing patients. I love sitting with people. I, I, I love helping people get better. It's just like, I don't know. There's, there's nothing quite like a forty-five minute psychotherapy session to me. Uh, just like, it's almost like magic. And, and so that's me. Um, other people, you know, fixing bikes. I mean, I, I live in a community with all these amazing athletes, these mountain athletes. What their purpose is, is, you know, kind of pushing the limits of their bodies, but also exploring these beautiful mountains and little-- in ways, finding little crooks-- nooks and crannies that nobody else can get to. I mean, it's really... There's all kinds of things to do with your life. I think my encouragement is that people are very engaged, one of the tenets, in terms of your choosing and understanding, you know, your, your, your challenges, but also the great strengths you're bringing to this. And then to think about your purpose. You know, oftentimes purpose does involve being of service. You know, later in life, I'm a lot older than Melanie, when you get into your fifties like I am, there, there's a, a natural shift that begins to happen. Something, something softens in the insecurity that we all have about what we're doing with our lives and what we achieve and how we stack up. And it becomes more clear that being of service, being connected, uh, being gentle, being regulated, uh, it all sounds kind of boring, but it, it, it, it's that, that there's a great kind of spiritual transcendence that happens in that state.

You begin to kind of float a little bit more. You, uh... Jung talked about this. He said that you, you begin to notice these more and more moments of synchronicity. You bump into friends at the airport when you're traveling for the summer in Germany. You think about someone and they call you. You know, you think of this the other day. I just really needed to call this therapist who's in a clinic right down the street from me, and I just keep forgetting, and I've seen her twice and gotten her number. I keep forgetting. She's also from New York, and so, uh, just something about New York therapists, we, we vibe. And, and I, and I just bumped into her, like walking out of the doctor's office. I mean, just like... You know, so who knows? Maybe these are all just coincidences. But as, a-as you get these tenets together, get a sense of purpose, feel a sense of, of living more attuned with your values and your purpose, uh, you know, again, the idea is not that it prevents all mental health problems.

Dr. Drew Ramsey
It's that as you encounter mental health challenges, you know, as you're ill, as one of your relatives is ill, as your parents pass, as you struggle with substance use disorder, like whatever happens in the next decades of your life, that you have a much bigger, better toolbox, and y-you have a kind of insulation and a resilience that the mental health challenges aren't as frightening.

Melanie Avalon
With the, the purpose thing, it's, it's so interesting because kind of like the question about the self-awareness as f-as far as how do you, you know, how do you become self-aware? And, and with the purpose, it's like, how do you find your purpose?

And something I've been grateful for, although now I wonder because you clarify that purpose is not necessarily passion, that, you know, your passion, those might be different things. I've just been grateful though that I've always felt... I've never like wondered-- I've never felt the need to like search for my purpose. I've always just felt it, even if I can't define it.

Dr. Drew Ramsey
You know, some people have more of that. I mean, there is, you know, with all of these things that we're talking about, depression and anxiety, sense of purpose, how active you are, you know, there, there's a real kind of spectrum of human, of humans, right? I mean, one of the joys of being a psychiatrist and a mental health professional i-is you just get this delight in, in kind of getting to know all kinds of different people. And it, you know, it's kind of like being in the flower shop. It's like every-- it's like so much beauty and, and creativity and, and, and struggle, and it's just, it's really, uh, lovely.

But some people are like you, Melanie. They have a really clear sense of purpose, um, really clear sense of faith, really clear sense of, you know, occupational satisfaction. And, you know, other people, uh, struggle with it much more. You know, uh, I, I think in the book I, I really wanted to get away from this notion of like, find your passion. I mean, I appreciate that. I just don't think it's a good concept 'cause that's not what it looks like. You know, I work with young men, you'd be like, "Hey, f-you know, follow your passion." And they're like, "My purpose is porn?" It's like, "No. It's not your purpose." It's like, you know... A-a-a-and again, I think my main concern is there's a pressure that people-- pressure people feel That they're doing things wrong because they don't feel purpose, as opposed to a sense of looking for purpose and meaning within the day-to-day life, within the processes you're involved with. Because this other model, right? Oh, you're not living your passion. It just, uh, uh, most people don't wake up feeling a great sense of passion. You know, maybe a subtle sense of purpose, maybe some days great passion. But, you know, passions burn very hot, very fast. You know, they change. There's a lot of dopamine at first, and then it fades. So that's where I, I really... You know, I'm all for passionate stuff. I just-- I think when it comes to your life, there's something steadier, there's something more consistent, there's something that i- is more clear and more psychospiritual for you.

Melanie Avalon
Well, I am just so grateful for everything that you're doing. Oh, and by the way, thank you.

I'm specifically, personally, selfishly grateful that you just said that your therapy sessions are, you know, a magic time for you because I, I don't know why I, I have not been able to let this go, but one of the things with my own sessions that I... will sometimes pop into my head is I think I, I get concerned that the pers- you know, my therapist, like, "Do they really wanna be listening to me talk right now?" Like, like, how embarrassing is this?

Dr. Drew Ramsey
No, no. People say that a lot. People are like, "Oh, aren't you sick of hearing about this?" And, you know, it's really-- I don't... I, I really don't have that experience. I, I know it sounds like maybe I'm making that up, but it's really true.

People will sometimes say, like, literally the same thing, same lines. They'll come, they'll tell you the same encounter, same memory. People who, like, aren't older, aren't demented. A-and there's a way that's like, wow, it's really... it's, like, fascinating. Is that that, like, they, like, don't think I registered? Or is that it, it stuck in their mind? Or do they not remember telling me? Or they need to... Or d- Y-you know, a-and so, you know, I, I, I think like all jobs, there are moments that are more riveting or exciting than others. There are moments that are scarier and more tense than others. There-- Like you've seen in session. You know, good sessions can have a lot of laughs, a lot of tears. I was just sitting with someone who lost a dear relative. You know, and, and there's, there's a mix of, like, incredible grief and sadness, questions, you know, so many different feelings. And I, I haven't found it to get boring or repetitive. I, I think I, I was calculating the other day. I think I've spent almost, like, forty thousand hours listening to people in session now. You know, especially those early years where you're just... you know, you're in the hospital all the time. And then, you know, for most of us, you know, between thirty and forty hours is kind of pretty much maxing out h-how much of this work a human spirit can kind of do and, and tolerate in a sense of just it, it is very, um... I, I wouldn't call it emotionally draining 'cause that's not accurate. It's really invigorating work. It, it pulls you in like nothing else. But it is... you know, it, it, it is kind of like a marathon. You know, when you sit and listen for ten hours, fourteen hours, when you're sitting with people and really struggling, when the answers aren't clear. People have tried two or three medicines, they've tried a therapy, they've tried psychedelics, they've tried all the stuff, and they're still suffering. You know, my hope is with all this work that people just feel, one, they're not alone. That that's really been, for me, when I struggle with my mental health, the worst symptom is thinking that no one cares and that you're alone. I've, uh, how foolish that is and how wrong it is, but how powerful that can feel when you're struggling with your mental health, when you're hurting in your spirit and, and, and in your mind and your mood. So, so I hope people, you know, as you say, feeling seen or it's lovely to hear a couple ideas resonate with you and stick with you. It's been such a just real honor to get to spend time with you all listening and, and to get to put out these books and be on so many podcasts like this one talking about mental fitness and mental health. And I hope people... you all feeling my encouragement that you can do it. And I don't know what it is in front of you right now, but I, I just...

Dr. Drew Ramsey
that, that is the singular joy in some ways of my job, is just you believe in the human spirit 'cause you see people do it over and over and over again. I have met people, and I have just been like, uh, especially early in my career, like, w-wha-- like terrified. Like, what is gonna happen? And then you see like, oh my God, that person is gonna reach, like, just downshift to a whole new level. They're gonna pull it together in ways you never imagined. And, and then you get to see the other side, which is what I think so many people don't see. You get to see the people whose Olaf works and they don't have panic, and they graduate and get a girlfriend and have a family. You get to see the people who never were diagnosed with bipolar disorder and, and they get on just a touch of lithium and they are, like, golden. Just feel ... And so, you know, the, the, the stories of mental health recovery I think don't get enough time, and we hear a lot of the concerns about meds and a lot of the concerns about the healthcare system, but we, we don't often hear that, you know, patients do really well in mental health settings often and in mental health treatments.

And, and adding more lifestyle is, you know, people kind of have ignored that all of the major medical societies, you know, the American Psychiatric Association, the World Psychiatric Association, the British Psychiatric Association, the American Medical Association, right? E-everybody has exercise and nutrition as a, you know, first-tier intervention for mental health concerns. And so, you know, that's been a massive shift over the past fifteen years, and it's just been, you know, it's been really exciting to see that happen.

Melanie Avalon
Amazing. Okay, friends.

So now you can see why you need to go get "Healing the Modern Brain" now. And so you have an online course, Healing the Modern Brain course, and listeners can get twenty percent off with the code Melanie. So what does that course provide for them?

Dr. Drew Ramsey
Well, thank you, Melanie, for bringing it up, and I hope everybody... The course is a video course to accompany the book in a way, to walk through. For people who want more Talking more video, more science, more stories, and really to activate and engage around changing your life with some of these tenets. Healing the Modern Brain is a video e-course on my site and twenty percent off with the code Melanie because we want, we want you to engage with your mental health.

I have a couple other courses on there as well and a few other books. Eat to Beat Depression and Anxiety is in eleven languages and, and really one of the best-selling nutritional psychiatry books. I have Eat Complete, which is a wonderful cookbook with over a hundred nutritional psychiatry-informed recipes and all the info you ever wanted to know about the twenty-one most important nutrients for mental health. And we try and put out a free, uh, we do put out a free newsletter every Friday and, uh, love engaging with my community on Instagram. And so I'm, I'm really easy to reach, everybody. I'm sure Melanie will put up links, but I'm DrewRamseyMD on Instagram, and that's my website. And I just really appreciate getting a little bit of your time, and I hope you hear my encouragement, and I hope you eat more lentils and more pesto because of this. We didn't talk about the bivalves. I hope you have oyster date night and pasta vongole, and I hope you use all this information to just take amazing care of yourself, your mental health, your brain health, and build your mental fitness.

Melanie Avalon
Well, thank you so much, Dr. Ramsey. So this was absolutely incredible. I'm, I'm real- I'm just blown away by everything that you're doing and especially all the sentiments that you end with, like your understanding and appreciation and love for humankind and just wanting the best and then providing the actual tools and resources so people can do that.

So friends, we will put links to everything in the show notes. Definitely check out the book. Definitely check out the course, Healing the Modern Brain. And again, you can get twenty percent off with the code Melanie. And the very last question I ask every single guest on this show, super quick and easy. It's just because I am very much obsessed with the importance of mindset. So what is something that you're grateful for?

Dr. Drew Ramsey
Well, every day I try to use mindfulness and be grateful for something really small that's right in front of me, something really simple that I usually take for granted, like all the books on my bookshelf I haven't read that I'm looking at right now or haven't read thoroughly, and not to feel that as a burden or as a failure, but just be grateful they're there, they're waiting for me or my dog, um, or just how good my coffee tastes in the morning. A-and so I really think being in that mindset, that mindfulness mindset of gratitude is something you have to really train yourself for.

But especially being a therapist and kind of having to switch states very quickly, I, I find that over time, my ability to do that with a few breaths and really just trying to find something. The other day I just found like I have this great, these great plants in my office. If you look at any of our videos, you'll see them in the background. And I just somehow was pulled into like the architecture, all the veins and the leaf and all of the biology that was like right in front of me, like all the detail. And so I would encourage everybody to engage in more of that, especially right now as, you know, we're recording both during Mental Health Awareness Month, so happy Mental Health Awareness Month. But you know, we're also recording during an era with a lot of disruption, whether it's AI, whether it's wars, uh, whether it's the tone of conversation online. A-and, and so it's, it's really important to emphasize and accentuate what your nervous system is able to do besides doom scroll, your ability to focus, accentuate, observe, be curious. We talk a lot about in our practice about using your, you know, sensing exercises. Look around right now and, and, and name, say it out loud, five different things that you see. Really quickly, four things that you hear. You know, as soon as you turn off the podcast, just listen around. Like, what are three things you're feeling on your body? And, and, and it's, it's always amazing to me how powerful our minds are and our ability to focus in on... You know, I, I love those stretch classes where you're focused on like your little toe, and it just gets ignored all the time. But anyway, I think that, that's in terms of my-- it's a long list, but I think it's, it's my, my request about being sort of grateful is to, to try and be in that stance about very small things right now in the moment. Like really small things, like the way that your shampoo smells or the, the fact that you have clean water in your tap. Go get a glass right now, but drink it with like a sense of like, that is so rare. Like, you are living in an era of humanity where there is more sort of available to you, more, more treatments and understanding of your mind and mental health than ever before. So anyway, that, that would be my request or my encouragement for everybody today.

Melanie Avalon
Oh, I love it so much, especially the plants. I'm looking at all the plants I have in my apartment, and again, another tenet we didn't even get to was the, the nature.

Dr. Drew Ramsey
We did talk about grounding in nature. This was recorded in Jackson, Wyoming, so you know, I hope that's enough of a testament that, uh, the woods, the mountains, the forests, the oceans, like these are the places where your spirit soars, and so get out into them. There's even molecules that you breathe in when you're in a forest. I was looking at this data right before we talked. Going into an actual forest increases the activity of one of your very specialized immune cells called natural killer cells for thirty hours after you're in the forest, right? So there's this immune kind of like activation and, and our-- you know, this is where we evolved. So yes, get into the forest, take a deep breath. There are these little molecules that trees spit out called phytocides, which do all kinds of great things for us. So anyway, enjoy your plants.

Melanie, uh, we'll have to get back on here in a year or two. This like fr- I don't know how old you are. You look a lot younger than me, but you're-- like going from dating to long-term relationship, I'm going to be really fascinated and, uh-

Melanie Avalon
I don't know. We'll see how ... No, would love to have you back.

Dr. Drew Ramsey
It's hard as a therapist to hear that with a nice creative young woman and just, you know, not, not that everyone has to get into relationships, but When you have this kind of enthusiasm around people, around knowledge, right, around, uh, connecting, it's just a, it's a curious thing. So I look forward to talking more in the future, and I really, really appreciate you focusing just for a little bit on my, my work and me, and that you have read the book clearly and feel inspired by it.

That just... It really means the world to me, Melanie. I really appreciate it.

Melanie Avalon
Thank you so much. I echo all of that back to you.

And, and by the way, you can tell when a person has a really strong gratitude practice when they respond with what you were saying about, like, the little things, because that's when... 'Cause it's so true. Like, there are so many little things everywhere, and, um, I think it's a wonderful way to build gratitude.

Dr. Drew Ramsey
I find this especially with, like, social metrics, where, like, you know, you can get really wrapped up that, like, thousands of people didn't get your message. But, like, isn't it incredible that more than one person hears your message?

Like, it's... Isn't that just, like, that, that, that people are passively taking in whatever? I mean, it's just, like, that kind of stuff where, uh, you know, I, I find it's just very important to fight this kind of modern metriced evaluation of our life, you know, what our reach is, and, and, and really to, you know, fi- find the importance of the rock in front of you and the next time you're walking next to a little creek or river and sit with it for a bit. So I look forward to our no- next, our next conversation, Melanie. Thank you so much.

Melanie Avalon
Are you writing another book right now?

Dr. Drew Ramsey
You know, I'm, I... Yes, I'm at work on... I, I've got a... Yes, I've got one idea that I'm really excited about that I'm cranking on, and then I have a one really personal book about kind of identity and trauma that I'm really scared to write but, but have been trying, have been, have been trying to write. So, uh, but yes, thank you for asking.

I, I hope, I hope st- books still exist, and I hope that I'm fast enough to get another one out before goodness knows what happens.

Melanie Avalon
I know, right? That's how I feel.

Oh my goodness. I think hopefully they will. Well, would love to have you back in the future. This was absolutely enlightening, delightful, inspirational.

Thank you for what you're doing, and yeah, enjoy the rest of your day in Wyoming.

Dr. Drew Ramsey
Thank you, Mel- Melanie. Take care.

Melanie Avalon
You too. Bye.

Thank you so much for listening to The Melanie Avalon Biohacking Podcast. For more information and resources, you can check out my book, What When Why, as well as my supplement line, Avalonex. Please visit melanieavalon.com to learn more about today's guest, and always feel free to contact me at contact@melanieavalon.com. And always remember, you got this.