Brain Food 101: Fueling Your Mental Health & Building Your Mental Fitness with Drew Ramsey, MD

[00:00:00] Dr. Drew Ramsey: This is really a very advanced and nuanced field with a lot of healing for a lot of people, but also recognize that there's some simple stuff. So like eating and sleeping and moving your body and building friendships and understanding yourself, that's absolutely essential to having optimal mental health and really optimal mental fitness.

[00:00:18] Dr, Melinda Ring: This is Next Level Health. I'm your host, Dr. Melinda Ring, Director of the Osher Center for Integrative Health at Northwestern University. On this show, we explore ways to take actionable steps towards optimizing our health with leaders in the integrative, functional, and lifestyle medicine fields who believe in science backed and time tested approaches to well being. Let's take your health to the next level

[00:00:50] Dr. Melinda Ring: Today we are talking about a topic I think we all need right now, how to build mental fitness. This is not just treating anxiety or depression, but cultivating a brain that's more resilient, focused and joyful, and to help us do that, I'm joined by somebody I've admired for years Dr. Drew Ramsey. Drew is a board certified psychiatrist, psychotherapist, and farmer. Yes. Farmer, who is also one of the pioneers of a field called nutritional psychiatry. The use of food as a foundational tool for mental health. He's the author of five books, including his newest one, Healing the Modern Brain, Nine Tenets to Build Mental Fitness and Revitalize Your Mind, which just came out this year. And in it he combines the latest science with deeply personal patient stories to show us what it really takes to heal the brain in today's overstimulated undernourished world. From SSRIs to Sardines' purpose to Plastic Exposure, Drew's book spans it all and I am so excited to talk with him today about how we can all build better mental health through our daily choices. Drew, welcome to Next Level Health.

[00:02:03] Dr. Drew Ramsey: Oh, Melinda, thank you so much. What a nice introduction. It's a treat to be with you and with everyone who's listening.

[00:02:08] Dr. Melinda Ring: Yeah. Thanks so much. So let's just jump in the concept right at the heart of your book, mental fitness. We hear a lot about physical fitness, like getting in our steps, mental fitness isn't oftentimes part of the conversation. So can we just start out by, you know, how do you define mental fitness and how does that differ from the more traditional approaches to mental health?

[00:02:32] Dr. Drew Ramsey: Well, mental fitness is about building our mental health, and as you know with physical fitness, we all know a lot about what we could do. Maybe we're not. Exercising three or four times a week. But we all know some exercises. We all know how to build our core or how to stretch a little bit, or that we should go on a walk or a run. It's accessible to us in some way. Mental health is a little more elusive and we know combined with maybe needing some education of just what are the basic parts of your mental health strength, how do you build it? How do you build flexibility? We also are facing new challenges. We just all are feeling it more and more, whether it's the stress from social media or the 24 uh, seven news cycle, or the microplastics, as you mentioned, that are in everything in our brain apparently too. There's just a lot that we're all dealing with now, and so this really requires us to have more of a plan. And as a psychiatrist, I see a lot of times our plan with mental health unfortunately, is avoidance. We have a lot of stigma around mental health conditions. People don't really think you come and see someone like me, a psychiatrist, and you know, you get a diagnosis and you walk out with an effective treatment and do better. But that's exactly what I do every day and all my colleagues in mental health do. And so helping people. Engage with mental health and think about their mental health prior to having any symptoms. Is the goal of mental fitness that you and I and everyone listening are very, you know, resilient, sort of alpha predator, neurological creatures? The brain is super complicated and a little bit fickle, and some of what we need for a healthy brain and good mental health is just eroding. In our culture, in the modern world. And so this book really asks people about mental fitness, as I define it, it's about knowledge. There's new stuff you need to learn, you have to learn about neuroplasticity. If you're gonna really be effective in taking care of your mental health and your brain health, that's your brain's natural ability to grow. So there's new knowledge, there's some new skills that people have. Maybe Melinda, you don't know how to make pesto. I bet you do, but some

[00:04:36] Dr. Melinda Ring: I do that. I do. Yep.

[00:04:38] Dr. Drew Ramsey: Yeah, right. You know, you and I know some people listening might not know. So there's some new knowledge and skills while you make pesto at home. You've just unlocked one of the most nutrient dense dishes and allowed yourself to eat pasta still, which is a big goal of mine, nutritionally my goal of mine. So mental fitness, right? Is, is knowledge, it's skills, it's in getting into good habits, getting into these habits that we know protect our mental health. And some of these are the tried and true tenets that we've known about. Everyone knows that sleep is really important for their health. Sometimes we don't extend that to how important it is for our brain health and mental health. And so mental fitness really asks us to take our day and think about each day as an opportunity to take great care of your most important asset, and that is your brain. And, that's what mental fitness is all about.

[00:05:29] Dr. Melinda Ring: So I just wanna go back to one thing you said, because mental fitness isn't just like this feel good concept, it's really grounded in heart science, like neuroplasticity. And can you just explain for listeners who aren't familiar about why that's such a hopeful concept for people who may feel like they're just, you know, destined, they have depression or anxiety, they're just destined to have that forever.

[00:05:55] Dr. Drew Ramsey: Yes, this I get into in the book a little bit around the controversy with the chemical imbalance theory. Now I'm a big fan that our mood, our cognition, our minds are made up of a lot of chemicals and getting the balance of them right is obvious and important. And if you're a psychiatrist, chemical balance is a really clear, important thing. Another really clear and important thing that we've discovered that's new is this idea that the brain can repair itself, give birth to new brain cells, that your brain cells are constantly creating new connections and pruning out old, useless connections. The brain has its own inflammatory system. So neuroplasticity is really quite simply the ability of the brain to change, to grow. And to repair itself. Neurogenesis is the birth of new brain cells. We learned really during my career that the human brain keeps giving birth to new brain cells as you're an adult. This was news to us, very exciting. And so these give me hope in the book, introduced this molecule, both my last two books that talked a lot about BDNF, brain derived neurotrophic factor and just you know, when people think about psychiatry, they think about Prozac and serotonin. I'm like, those are great molecules. I love those molecules. But NF is like the molecule of hope, right? Because it says, Hey, my DNA codes for something that takes care of my brain, that that literally takes care of my brain cells. That's what this thing does. Wow. I want more of that. And then it leads to a natural question, especially if you're in, in, in my line of work, which is taking care of your patient's brains. What can we do in our everyday life to get more BD and F. You know, and in some ways that's a little oversimplified and in some ways it's not right. Most people are not engaged in some of the most important behaviors that promote more brain growth factors, and so that's a really important new concept. The other two that I talk about in the book, just to point those out, one is inflammation. Everyone's hearing a lot about inflammation and how it's involved in heart disease and diabetes and obesity. Wow. It's also really involved in our mental health particularly in depression and anxiety. There's been just a ton of new research that's come out. Maybe you saw the headlines about how fried foods might be one of the things causing more anxiety. They found this correlation with fried foods leading to, I think it was a 9% increased risk of anxiety in a population, and these researchers asked why. And they created a model using zebra fish, where they basically gave the zebra fish the bad stuff from fried food. And the bad thing in fried food is a molecule called acrylamide. And then they studied like, what does acrylamide do to brain cells? What does it do to the blood-brain barrier? And they found just incredibly high amounts of inflammation. These brains are dosed with acrylamide. Again, something found in french fries, it really caused a lot of inflammation, causing these brain cells not to be able to process fuels and fats as well. And, and so it, it's again, a lot of this new science in the field of nutritional psychiatry that really shows us. The power of everyday choices. This isn't saying you can never eat a french fry. Honestly, if you make oven baked fries at home, if you use an air fryer, you reduce acrylamide. I've seen in studies by 90%, but it, you know, if you're on that kind of fast food, it's easy. It's cheap. That you're eating a lot of french fries, you know, that is what we call low hanging fruit, right? It's an easy move to swap that up. You can still eat yummy potatoes, right? But there're just ways to do it where you're gonna get neuro nutrients, less acrylamide. And, and this is all to say that depression, anxiety and other, their met mental health disorders relate to inflammation. And so you, everybody listening, understand more of what that means, right? An easy way to understand what inflammation means is a hangover. So how hungover you are after you go out on a bender directly correlates with how inflamed your brain is. Inflammatory factors are higher when you have a worse hangover. And, and so it, that's, you know, in some ways a great way for people to understand. Most people listening probably have had a hangover, and it's just a good way to understand. Your brain feels bruised and off. 'cause it is. And, and so the last big idea in the book is that we kind of get into how I want people to frame mental fitness. It's around the microbiome, which is here. My my only prop for you all watching the video. I won't show you the brand, but this is a delicious can of kombucha and while drinking kombucha here, I'll take a sip. And, and millions of live bacteria are gonna go literally millions in every sip are gonna go down. Here we go. Hmm.

[00:10:31] Dr. Melinda Ring: Oh,

[00:10:32] Dr. Drew Ramsey: delicious.

[00:10:33] Dr. Melinda Ring: now?

[00:10:35] Dr. Drew Ramsey: Well, let's talk about it. There are actually studies for example, of nurses and, and drinking more kombucha. There are studies of people eating more and drinking more kafi, fermented dairy products, and they generally tend to show some good benefits in terms of people's ability to manage stress. Now, when we eat fermented foods and, and we think about the microbiome definition wise, microbiomes are all the organisms that live. And we mostly focus on the ones in our gut, but it's a little bit of a gross idea that we're basically covered in bacteria. And there are unique populations of bacteria that live in your ear canal, that live in your navel, that live between your toes and that also live in your intestine, mostly in your colon. And they serve a lot of different functions that the main takeaway from this is, is having people think about nutritional psychiatry more. A lot of my work has been. Helping people understand and translate this new science that what we eat plays a role in our mental health and brain health, both acutely how we're feeling day-to-day in terms of our risk of mental illness. People who eat a more ultra-processed food have a 50 to 70% increased risk of getting depressed. In a large study published in 2002, looking at thousands of nurses, people who eat a more Mediterranean style diet have a. Reduced risk of depression between 35 and 50%. So, there's something there especially if you come from a family that has mental health concerns or has depression, or you've had depression, that's research that really has an actionable result for you at lunch, at dinner, when you snack when you travel. A lot of people, you know, obviously know about this, that what we eat affects how we feel. But the microbiome is one of the new geekiest science ways that we think about, which really comes down to wanting people to eat more plants. The majority of Americans, 95% of Americans don't eat the daily recommended allowance of fruits and vegetables, right? 70, 80% of Americans don't. The daily recommended allowance of fiber. There's even a little bit of an anti fiber, anti plant movement these days. So, you know, the real clear science suggests that a lot of fiber in your diet is quite good for you. Plays a lot of different roles, eating plants and feeding your microbiome, which means eating a diversity of plants. Really. The top microbiome expert Tim Spector, a UK physician recommends. Trying to get 30 different plants a week, you know, and, and it's not that hard. I chopped up an onion, some garlic, and threw in some Bain parsley yesterday. That was four. I had some pasta. It was whole wheat. So maybe that gets me a fifth one five, right? That, that, and that was just a pasta meal yesterday. So, you know, there's a way of getting more plants and then eating more fermented foods. So that's a big tangent off of neuroplasticity. But those are the, those. Those are the big, those are the big themes in healing the modern brain, along with what I call modern psychological concepts. As you noted, I'm a psychotherapist, so I just spent a lot of time speaking and listening with people about their inner worlds, and I wanted to share some of what I felt was really important for people to hear and have goals for in terms of their mental fitness.

[00:13:48] Dr. Melinda Ring: So. Just to stay in the nutrition for a second before we go back and talk about all of the tenets as a whole. Um, I love the 30 plants, different plants in a week because that's, you know, here's an actionable thing to aim for, to cross off your list of how many did I get to almost gamify it. And I think you've also said seafood. Seafood, greens, nuts and beans.Um,

[00:14:14] Dr. Drew Ramsey: And a little dark chocolate. And a little dark chocolate, And then, and then. And, and then we did have a Northwestern physician uh, Catherine Roberts, who is in charge of student mental health. There, I started at the American Psychiatric Association Conference and she added in 'cause I didn't have a rhyme for it. Um, uh, Don't forget the rainbow celebration. And lots of fermentation, so, or something. Something like that. But getting, these are the food categories, everyone. And so nutritional psychiatry asks you to think about food differently, to really think about how you feed a brain cell. And what, what can you learn about that and understand about that that affects your daily food choices? For example, we all know Omega-3 fats are great for brain health, great for depression right. There's some debate about the supplements, but boy, when it comes to eating fish, the data signal is pretty good. Well, which fish has the most Omega-3 fats? I'll say wild salmon. Okay. Well, what other ones and what are the best ones for you? What are some of your favorite high Omega-3 fat recipes? So nutritional psychiatry asks us to increase the nutrient density. How many of these nutrients for brain health that we're getting in these food categories that we're talking about are the best places to start. So seafood, again, this is where we get our Omega-3 fats and lots of B vitamins, lots of zinc and magnesium. Uh uh, we got seafood, greens, nuts and beans, and a little dark chocolate. Again, these are really nutrient dense food categories. They don't, they allow us to get things like, you know, more white beans, the top source of potassium in our diet. You know, much higher than bananas. But again, one of those sleeper foods I really didn't know about where to build our skills. As I say, knowledge is part of mental fitness. So for me, I wasn't a big seafood eater, and so I really had to learn things like, what do you do, what do you do with it? You know, a tin of anchovies or sardines, how do you make that into something yummy that people eat? And, and so learn about these food categories by doing a little experimenting.And then I think probably the most important thing about nutritional psychiatry to emphasize is that it's very simple and very delicious. You know, unlike a lot of dietary plans that focus on your macros we kind of focus on the main culprit in nutritional psychiatry. The main problem people are having is they're eating too many ultra processed foods. They're eating too many calories. They're living with a lot of misinformation, gut their decisions about their nutrition and health, and they've kind of lost track that simple Whole Foods is really where it's at.

[00:16:50] Dr. Melinda Ring: Yeah, I love that. In the book you gave these very, you talk about that like, you know, it's not about calories, it's not about that. You know, focus on the nutrient density of the foods you're eating, and gave some really nice examples of, here's a smoothie and this is why it's so much better than these Sugarland smoothies you might have, and here's a great lunch you can do.And so really just simple. Concepts to, and, and of course those, those same foods are good for cardiovascular prevention and everything. So, I appreciate and support the dietary approach you took there.

[00:17:25] Dr. Drew Ramsey: Well, thank you. I'm glad to hear that it's always meaningful when physicians, you know, feel the advice is spot on. I think all of us, you know, tend to agree on some things that, you know, more whole foods is good and you know, I think the public in a lot of ways ends up confused as. You know, some of the details get debated, you know, like whether whole grains matter or not. And you know, at the end of the day, most people aren't eating a lot of whole grains. There's not a lot of farrow, there's not a lot of wheat berries. There's, you know, not a lot of quinoa in, in the general households. nutritional psychiatry again, is I think a very hopeful idea. It's not trying to say that if you have depression or bipolar disorder or struggle with addiction, that boy, you know, it must be 'cause you're not eating right. You know, nutritional psychiatry is a nuanced field trying to suggest that, hey, if you're struggling with your mental health, your brain is your most energetically demanding organ. Your brain is doing something. No other set of cells in the universe is known to do so. We know that it does better with a certain set of nutrients and those nutrients come in a certain set of foods. Let's eat more of those and have your brain be better nourished, better fueled, and you know, and, and I also like to mention along with the, the nutrition part. You know, people love to focus on what food to get with magnesium and, you know, which fish is amazing for Omega-3 fats. I love all that stuff too. But I also always wanna remind people that nutrition plays a huge part in our mental health because of the ways that it connects us to other people. One of the tenets of, of mental fitness is really around connection. And as, as I traveled around the country really years ago as I was starting nutritional psychiatry and talking about that more, you know, I, I have these like. Really wild encounters for a psychiatrist. Like us, I'd be at a food cafeteria conference and I'd be sitting with groups of people who literally are the folks I like. Trying to figure out how to get more farm fresh food into our school cafeterias, you know, like essentially angels on Earth. And you see this way that like, wow, like food connects us. Or I tell the story in the book where I started going to the Abington Square Farmer's Market when I was in New York City, and that sending my patients to farmer's markets on the weekends was one of the ways that I just found that again, food and the celebration of food and the growing of food connects us all. And so there is more than just the, oh, you know, what has the most vitamin B12. I mean, that's great stuff to geek out on, but it's also, I think, my encouragement that everyone uses food and, and you know, my hope with these. Conversations is that people get inspired to do something the next few days, the next week, but use food to connect, whether it's a double date or a potluck, or having a little picnic with some friends in the park that using, using this notion of nutritional psychiatry you know, both within the idea of nutrition, but beyond it too.

[00:20:12] Dr. Melinda Ring: Prevention is one thing, but sometimes patients who are actively depressed or actively anxious have trouble making those steps. It feels overwhelming to them when they're already in a place where they're discouraged or um, have just felt like they, you know, have too many things that they're trying to manage. How do you approach it in that case? Because I think that is a situation we see a lot where people are like, yeah, I believe food will make a difference in how I feel, but I just can't even take that first step.

[00:20:49] Dr. Drew Ramsey: Well, I think sometimes this is where we make a bit of a misstep with patients who have depression and anxiety, and we kind of align with the overwhelm that, you know it can feel like a lot and, and, you know, certainly it's a symptom of depression and anxiety to feel very disempowered, to feel overwhelmed, to feel panicky, to have cognitive fog and feel like it's hard to sequence things. And, and it, it becomes a kind of a catastrophic thinking where, you know, we're not talking about a five course meal here that, you know, you cook for seven hours and spend all your money on expensive groceries. I'm talking about lentils. Maybe some peanut butter. I'm talking about swapping out your ice cream for more, maybe full fat yogurt with fresh berries and granola. and, and and so I, I think it's really important to keep it simple. And I think you're right. You know, a lot of nutrition advice gets overwhelming. I even felt this as I started in this field. I, I kept feeling like, oh my gosh, like, what, what foods have B six again? You know, like it was, it was all this stuff to memorize and learn. And what I found over time is that there are a set of foods that really work for me, work for my patients that have these nutrients. And, and you'll hear me talk about them over and over again. That's where the seafood, greens, nuts and beans and a little dark chocolate came from is just like, those are all great places, right? Add some rainbows of vegetables and some fermented foods. You know, it's pretty hard to go wrong, and, and so I think that, you know, you're entirely right. Patients can feel overwhelmed. The way I handle this clinically is I ask people where they are around it. Hey, I'm curious how nutrition and food plays a role for you when it comes to these symptoms. Some people say, I hadn't thought about it. Other people say, oh, I know you're gonna make me eat kale now, aren't you? Right. And so I, I'm trying to kind of assess their, both attitudes, some of their skills. Oh, you know, I love Food Doc, but I, I just, I don't enjoy anything anymore. Right. Well, right there. I, I kind of, for me as a clinician activates this idea of sort of savoring. Right. That, that really I have a couple patients now with bed, what's called anhedonia, right? They're not enjoying things. So they're going and they're, you know you know, petting their dog or, or gardening or eating at their favorite restaurant, and it's like, ugh, just kind of like gray. So that's really horrible. Part of what you wanna do is sort of interrupt your default mode, network your mind and really draw all of your brain power into focusing on what pleasure you can find. You know, so often we're wanting pleasure to be this automatic thing that is like it washes over us. And so those are a couple of the ways where, you know, if people have an interest, I'm looking for a couple of foods they might enjoy. Wanting to hear about any meals that they really help. It feels like maybe it calms them down. I wanted to hear about any challenges they feel they're having with food, so I can maybe brainstorm with them a little bit about simple swaps.

[00:23:36] Dr. Melinda Ring: Yeah.

[00:23:36] Dr. Drew Ramsey: I really love a crunchy sweet smack in the middle of the afternoon. I'm gonna hand you a bag of dark chocolate almonds and have you really, again, eat them slowly. Savor them, chew them well. So those are some of the ways that I, I try and in some ways, keep it simple. You know, I also find a lot of patients who are struggling, especially with depression, have a lot of carbohydrate craving to eat. Two, depression and anxiety. Actually, we have some graphics or some sketches in the book and one of them is brain food to beat carb craving. I think I'm the only doctor who's officially recommended a burrito to patients. Uh, But trying to, again, look at when we have that carb craving, we can go for the cookies, we can go for candy or ice cream's. A big problem for me, or a big challenge, you know, we can also go for a piece of fruit. We can also, again, I think I already said, sort of yogurt or make a smoothie with cake and protein powder. You know, again, get some of that sweetness, get a treat, but also get a lot of nutrients or the other one, I to get oven roasted vegetables or boy, you know, if, if you have depression, you need some yummy carine as you used to go into french fries. Ah, you know. It takes a little while, but you know, it's really easy to chop up a sweet potato, regular potato, a little olive oil, salt, maybe some rosemary sliced in the oven. You know, you end up with these really nice oven roasted potatoes that are delicious and good for you. So

[00:24:51] Dr. Melinda Ring: So help them find even just one or two small changes they can make at a time, instead of feeling like I need to get rid of everything I'm doing

[00:25:00] Dr. Drew Ramsey: Oh yeah. I think that's and, and don't, yeah. I think don't be overwhelmed and don't oversell. Right. It's a, it's a part of it. You know, if I know if I can get you eating a more Mediterranean style diet and getting you moving your body, I've just had you engage in probably the two most evidence-based treatments for depression. The right number needed to treat for exercise and depression is two numbers needed to treat for a Mediterranean diet and some other randomized trials is four. The right number needed to treat for TMS is about six numbers needed to treat for an SSRI. Antidepressants are about seven. Everyone listening that that number needs to treat is like how many patients, Melinda, I would need to talk to about something and prescribe for one of them to go into complete remission. And so you see it, boy, like exercise and movement is super powerful. We don't do a great job in medicine. I think of doing more than saying that like, get in your steps or you know, like exercise is really important I find as a psychiatrist with more time. I get to hear more about it. You know, do you like rumba? Do you like to go dancing? I write a lot of it in the book about a study of showing that really, you know, the top recommendation, Melinda, should I, and I should make if you're depressed, is we should say like, I want you to head to this uh, tango class Thursday night. And I tell the story of a patient who, well, because dancing is one of the movements with the largest effect size for treating clinical depression, but it's, you know, when we say exercise, it's kind of like you mentioned with food. Patients get kind of overwhelmed. They think about their running shoes. And like feeling like, like, you know. Awful 'cause. Right, right. It's not like it's, and so really getting movement into your life, as I call the, the tenet, and don't call it the tenet of exercise in the book, everyone, I call it the tenet of movement. Because I find a lot of times we, you know, I, I do this too, where I think that, you know, exercise is like two hours in the gym running a lot and lifting. You know, that's great for you if you're in the habit of that, but I find a lot of us aren't in the habit of that. And I find where I do my best movement is when I'm in nature, when I'm with my dog, when I'm out with friends on a snowboard or on a bike, I. Yeah, never a question of how long or do I need to do more? I'm, I'm just, go, go, go. And so I try to take some of those lessons also that I've heard from patients and heard from patients who have found so much solace and movement through hiking and walking and dancing and, and trying to just get more of that going in our lives. Again, is a, this like oppressive medical advice is just

[00:27:28] Dr. Melinda Ring: Yeah.

[00:27:30] Dr. Drew Ramsey: Necessary care of the human frame.

[00:27:34] Dr. Melinda Ring: So you've mentioned a few of these. So in, in this, in your new book, you have this sort of thoughtful architecture where you start with self-awareness. Like as the foundation of where everything else is built. And then you go through these core lifestyle practices now, like nutrition, movement, sleep connection, and then there's what I would think of as a little more intangible, almost psychospiritual elements, engagement and grounding unburdening purpose. You start with self-awareness, so why is self-awareness so critical to healing the brain and, and then, you know, as like a follow up are in your practice, have you seen that some of those areas are more overlooked or most transformative for your patients?

[00:28:27] Dr. Drew Ramsey: Self-awareness is the most important first step because you're aware of your challenges until you're curious about yourself, who you are and what your strengths are. It's very difficult to make changes. In the chapter about self-awareness, I talk about some of what I see clinically. A lot of, for example, the defense of externalization, right? Where we lose our control, we give it over to other people, other objects, institutions, because we tend to. Blame them. And it's, it's much more potent for us to be empowered to sit in a stance of thinking about what choices we have in front of us to move forward towards more health. And, and, and so self-awareness really is. It. Part of what we do in psychotherapy a lot is trying to have people see patterns in their behavior. A lot of times that's what drives people to psychotherapy. So it's really, you know, a part and parcel of my every day is sitting with people for hours as they're curious about themselves. I think self-awareness is also just a very powerful one for me personally, or just as a psychiatrist trying to spend a life and spend a career understanding myself, my emotions, my thoughts to the best of my ability and, and to do that for my patients. And so self-awareness is very important. I think the finance pros say it best, right? You can't me. You can't, you can't manage what you, what you don't measure. And so maybe it's not the finance pros, but you know, this idea of. We need some sense of assessment. And so self-awareness is

[00:30:02] Dr. Melinda Ring: All right.  Do you still include medications in your practice? Do you still, you know, think they have value? Especially if you are known as a nutritional psychiatrist and people may come to you looking for more holistic or root cause types of things.

[00:30:20] Dr. Drew Ramsey: Yeah, I'm, I'm a, a big fan of psychopharmacology. It often really confuses me how people will be like big fans of the psychedelic movement, but not understand that psychopharmacology or people will, you know, lecture me about the chemical imbalance of serotonin, but then tell me about psilocybin's great will. Psilocybin is a serotonin drug right? Binds to the five HD two A receptor. So I. I am a big believer in modern psychiatry. Modern psychiatry has helped understand and map out the brain. There are about a dozen neurotransmitters that I can influence with medications in my practice. I think what, what the challenge has been as psychiatry has gotten pushed into a spot of meds only. And so being in private practice, I get to sit with my patients. I sit with patients for 45 minutes. You see me for meds, you get me for a full session because there's so much that influences how we feel. I definitely prescribe meds. I think the meds work really well for some people and they face so much stigma. If you're doing great on Zoloft, everybody's like, do you still need that? Is it that serious? Do you know the long-term side effects of that? Also, I think people love to emphasize, or the media loves to emphasize. Kind of the Antip psychiatry studies where you see a correlational study that people with on antidepressants have an increased incidence of dementia, and that really gets blown out of proportion in a way that people don't end up getting treatment. I think it's also super important, and part of my work is to note, hey. SSRIs aren't the only thing we need to treat depression effectively, and I don't think psychiatry ever said that, you know, this is really a way that like a Western medical model has contorted psychiatry into being. All I do is give you Prozac, and that in no way is all that I do. The meds are fascinating, right? When you look at something like Prozac, people think about it as an SSRI. Well, it's actually an anti-inflammatory agent and an SSRI and a brain growth stimulator. And so that sounds a little different when you see that some of these medicines influence BDNF, this molecule that we've been talking about, when you think about medications in context, you know, a a lot of people live in the world of depression and anxiety and they don't see the bigger world of psychiatry. They don't spend time in psychiatric emergency rooms or inpatient units where they see that 1% of our population is struggling with schizophrenia. You know, we have a significant part of our population that's struggling with bipolar disorder, A-D-H-D-P-T-S-D. For some of these patients, you know, medicines are lifesaving and essential. And so I, I think a lot of times psychiatry really gets, you know, belittled and berated and um, the anti psychiatry movement really takes hold. You know, I'd note that I think all the medicines that I prescribe every day are generic medications at this point. And so the, you know, the idea that there are tools at hand that we have like. A year long surprise supply of an SSRI medication is like five to $10 for most patients for a year. So if that helps, like let's just say you have horrible inside, let's take care of a patient I treated recently. Horrible panic attacks, lots of dread, catastrophic thinking. panic, anxiety started having dark thoughts, dangerous thoughts, suicidal thoughts. Within a couple of weeks of being on a good mix of medications, really started to find his way. I was really impressed. It took a little bit to get the right combination of medications but with some expert consultation. You know, it's maybe two months after this and this person is back to full functioning, you know, dating,

[00:33:47] Dr. Melinda Ring: you're, you're an integrative psychiatrist, you're, you're not throwing out the western

[00:33:52] Dr. Drew Ramsey: Yeah, no, I mean the, the best use of the word integrative is folks who really want to integrate both what we know in modern medicine and modern science and modern psycho-pharmacology. You know, this is really a very advanced and nuanced field with a lot of healing for a lot of people, but also recognize that there's some simple stuff. So like eating and sleeping and moving your body and building friendships and understanding yourself, that's absolutely essential to having optimal mental health and really optimal mental fitness.

[00:34:24] Dr. Melinda Ring: because you mentioned this was a young gentleman. I, you know, there is this man's mental health crisis. Our, I think we're seeing rise up in our country. And can you just talk a little bit, I have two sons in their twenties, a husband who after navigating his own health anxiety, became actually a men's health and wellness coach. So I know it's complicated for men's engage in their mental and emotional health, and you've been a really important voice in this space. So what would you do? Say, how can, how can we help break through the stigma and reach men to help them get their mental fitness going?

[00:35:01] Dr. Drew Ramsey: I think that's a good question for your husband because it sounds like he's doing that and, and what I've just blown away is all of the men and, and women who are stepping up to this, who are encouraging sons to do talk therapy, I'm a product of talk therapy. I started going to therapy when I was in my twenties and in medical school and started taking care of my mental health. I still go to therapy. I had a session yesterday. I think that's part of keeping me tuned up. That's a different idea than a lot of men have about how they keep themselves tuned up. I think it's really growing though. You know, optimization is, I guess, one goal men have, but also just keeping your head above water, being a good man you know, achieving your goals, starting a family. For me, being a husband, you know, these are. The things that don't go on your resume, but they really pay huge dividends and, and I would say are the next layers of adult male development that don't get talked about. Like development doesn't end when you're 18. It kind of starts, and male development doesn't really. End. Right. What I learned in my thirties, in my forties, now I'm in my fifties. Wow. I mean, it's just all really, really nuanced and different, and so the male mental health movement has some things that are missing. We have no male mental health centers in the United States. Folks, when I'm wrong, please somebody comment and let me know. 'cause I'm not yet, I've been saying this for a decade. It's just wild. I love our women's mental health centers, the idea that they're specialized psychiatrists and clinicians, physicians who uh, psychologists, therapists, right, who focus on women's mental health, what happens to women around pregnancy with their mental health? What about perimenopause and menopause? Like, that's a specialty. You can do a fellowship in it. Male mental health. We got, I, I mean, it's like a few of us talking, like listening to Scott Galloway. That's like your, you know, that, that's so all to say there's um, a lot more in terms of resources. I think all men listening should be aware that your mental health should be your top priority, right? That's the, the top cause of disability for you is not your heart health. The top cause of disability for men in America is mental health and substance abuse. By far, that's the biggest enemy you're fighting when it comes to your health. And so I want people to feel inspired and hopeful. A big shout out to Men's Health Magazine and Greg Scott Brown, they've both been instrumental in partnering with me in allowing us to talk a lot about male mental health and talk with a lot of men and women about male mental health. I think my last comment is just like treatment works. And I think a lot of men hem and haw and then they go to one eval and they're like, oh, treatment doesn't work. And that's like not an effort at all. Like triple works if you, it's like anything for a man, it works. If you want it to work, buddy, it will. I guarantee it. But you've gotta put in the effort. You have to make it something that works. And you know, when you're struggling with your mental health, you're having, struggling with trauma, struggling with things that have happened to you, it's hard sometimes for men to pivot and get back into that stance. US men love being in, which is, we feel powerful, we feel in control of ourselves, we feel respected, we feel in connection, we feel the value. It's like the best. So

[00:38:10] Dr. Melinda Ring: That's great. You're the role model of, you know, and I love, I appreciate your VUL vulnerability in sharing your personal story. And you know, and I, and honestly I think especially older generations may still have so much stigma around the idea of. Mental health that you're reframing as mental fitness is gonna reach men who may not otherwise have been willing to explore that

[00:38:36] Dr. Drew Ramsey: I hope so. You know, I'm not the most competitive guy, but I do challenge men. Like, go ahead. I want someone who's more mentally fit than I am. And, you know, I, I have my good days and my bad days too, but uh, I, I think the idea that we can do more than flex, right? We can do more than lift, like strength is more than MUSC. I like that idea. I like the idea of being a strong man. For all of us, every man listening, it, it, it is much more than our physical strength. It's our ability to listen. It's our ability to create boundaries and protect people. It's our ability to create foundations for other people to stand on. These are all great things men do. And, and so you know, I, I think we're at this great inflection point where men are being asked to lean into real modern masculinity, self-aware, powerful, thoughtful, trustworthy. That, that's what masculinity is missing, and, and it's, it's something that everybody can bring back a little bit every day.

[00:39:36] Dr. Melinda Ring: Thank you so much. Uh, I will definitely, I already sent your book, but I will be sending the podcast to my family as well. Um, So, so maybe just to close. One personal takeaway, something simple and powerful that you hope listeners would walk away to to get to their next level of mental health

[00:39:57] Dr. Drew Ramsey: Well, lentils, I didn't say lentils six or seven times as well. I just said that's an easy takeaway folks, like a lot of you didn't eat lentils this week, and if you did, you'd have the top source of folate. Amazing source of fiber, really yummy. Great source of pro, plant-based protein, 18 grams in a cup. I think that that's what I am, I really spent a lot of time. The summer thinking about the tenet of grounding and, you know, whether it's winter or summer it doesn't really matter. We often have our time and nature be, you know, influenced by the seasons, but really it should be a constant for you. That you are a natural creature, that there's a lot of solace and a lot of spirituality for all of us within nature. I think we can all agree when we stand in awe of something at the edge of a big lake or an ocean or at the base of a huge mountain, you know, something happens. You go out into that deep forest, something takes your mind someplace. And, and and so I, I would leave everybody with encouragement to really spend some time in big nature and deep nature with a, you know, a couple of people that you love. It's a wonderful place to take your relationships. You know, we often think about getting closer as like, all right, sitting down and having a talk and, you know, getting closer. I've found, especially as I've gotten older, it is about doing things together, going places together, having adventures, getting out into the big nature. And so I think for today, what really strikes me is. Especially with so much focus on, you know, our national lands and, and the great asset of our national lands for all of us. And I think here in Jackson, I'm, I'm, I'm feet from our National Elk Preserve. Something a lot of people don't know we have. And, and looking at some of these big, beautiful Teton mountains, which, you know, so many millions of Americans come to every summer. And, and I, I think there's something for us in the vastness, especially right now, you know, is there's so much confusion, so much in some ways danger and, and mental health problems waiting for us on our screen. Getting back out of the little screen into the big screen, that big sky that, that would be my encouragement right now for everyone.

[00:42:01] Dr. Melinda Ring: So you're, you're recommending land, love, and lentils.

[00:42:05] Dr. Drew Ramsey: Land love and lentils. Melinda, I love that. Yes, ma'am.

[00:42:08] Dr. Melinda Ring: All right. Well, Drew, thank you again so much for sharing your work and your wisdom. You've given us a roadmap that takes mental health out of the clinic and into the kitchen, the bedroom, the forest, and to our daily routines. And so for those of you who are listening, I highly recommend healing the modern brain. It's incredibly readable, and most importantly, hopeful. And until next time, be well and keep leveling up. Thank you for joining me on this episode of Next Level Health. I hope you found some inspiration and practical insights to enhance your wellness journey. Don't forget to leave a comment on YouTube or review on Apple Podcasts. I'd love to hear your thoughts and suggestions for future topics or speakers. Be sure to follow Next Level Health with me, Dr. Melinda Ring, as we continue exploring the path to healthier, happier lives, together.