Metabolic Psychiatry: Shifting From Symptoms to Root Causes

Key Quotes

"in any given year approximately 1 billion people are diagnosed with a mental illness that represents about 13 of the world's population in western countries the rates are higher one in two people will meet criteria for a mental illness at some point during their life mental disorders are one of the leading causes of disease burden and disability worldwide at the same time that the rates of obesity and diabetes are skyrocketing chronic diseases are skyrocketing the rates of mental disorders are also skyrocketing i point that out as it should not be considered a coincidence and yet most people in our field don't think about it that way i think that at the same time that people's physical health is getting worse their brains are impacted too"

Dr. Palmer highlights the staggering global prevalence of mental illness, noting that it is rising in parallel with other chronic diseases like obesity and diabetes. He argues that this correlation should not be dismissed as coincidental, suggesting a fundamental link between overall physical health and brain function. This observation challenges the traditional view of mental disorders as isolated conditions.

"the dsm 5 whatever it is now 10 11 12 is basically a catalog of symptoms defining people based on x y or z symptom and you have anxiety you have ptsd you have depression you have bipolar you have schizophrenia you have schizoaffective disorder you have whatever but it talks nothing about the cause or the mechanism and what became really clear to me was that psychiatric problems are basically framed by traditional medicine based on symptoms"

Dr. Palmer critiques the current diagnostic framework for mental illness, such as the DSM-5, for focusing solely on symptom catalogs rather than underlying causes or mechanisms. He asserts that this symptom-based approach fails to address the root of the problem, leading to a lack of effective treatment for many individuals. This perspective underscores the need for a paradigm shift in psychiatric diagnosis.

"i'm saying it is time for the mental health field to have a transformation a revolution you are a pioneer in this i would love for you to just close out by saying what do you think is next over the years i've worked with many trekkers athletes and even olympians people who consistently push their bodies to the limit one thing i always recommend to keep their energy up muscles strong and body resilient is timeline powered by mitopure"

Dr. Hyman frames Dr. Palmer as a leader in a necessary transformation within the mental health field, suggesting a "revolution" is underway. He expresses a desire to understand what the future holds for this evolving approach, hinting at the need for new tools and strategies beyond current practices. This sets the stage for discussing emerging paradigms in mental health treatment.

"and the reality is that mental disorders ruin lives they ruin families they cause tremendous suffering and there's still to this day is this tremendous stigma that comes with having a mental illness so like it's it's like god made a or nature made a massive mistake and a design flaw in creating human beings so that we have this massive amount of mental health issues that just doesn't make sense to me if you think you think about our evolutionary drives if we all were suffering from mental illness and depressed and our cave and not hunting we'd be all dead right"

Dr. Palmer expresses frustration with the current state of mental illness, emphasizing the profound suffering and stigma it causes for individuals and families. He questions the evolutionary logic of widespread mental illness, arguing that if these conditions were purely genetic and inherent flaws, humanity would not have survived. This challenges the notion of mental disorders as fixed, unchangeable conditions.

"and the reason this is so important is because if you make the assumption that these disorders are genetic and permanent and fixed it immediately instills hopelessness right that you are defective you are a defective human being and it's not your fault your parents gave you these genes it's not your fault that you are defective and you're going to have to take pills for the rest of your life in order to to manage your brain defect and so even the most compassionate psychiatrists have that mindset it's not their fault but they are damaged they are defective yeah and they do have to take their pills and i'm doing a good job and i want to get rid of that narrative that narrative needs to go away and be buried"

Dr. Palmer argues that viewing mental disorders as purely genetic and permanent instills hopelessness and a sense of being fundamentally defective. He criticizes the narrative that individuals must rely on lifelong medication for unfixable "brain defects." Dr. Palmer advocates for discarding this perspective, suggesting that a focus on treatable causes offers a more empowering and hopeful outlook.

"and what do we know now about those causes and and one of the mechanisms that are going on that are causing this brain dysfunction because it's things like insulin resistance inflammation oxidative stress mitochondrial dysfunction all these fundamental concepts that are rooted in functional medicine thinking that we've been talking about for decades it's happening in the brain and we know what's causing it and and yet we're not treating it"

Dr. Palmer connects mental health dysfunction to fundamental biological processes such as insulin resistance, inflammation, oxidative stress, and mitochondrial dysfunction. He points out that these concepts are well-established in functional medicine and have been discussed for decades. The core issue, according to Dr. Palmer, is that these known causes are not being adequately addressed or treated within the current psychiatric framework.

"so the the the part of the field that i really want to embrace which has been around for you know 50 60 years is this concept of biopsychosocial biological psychological and social those are the root causes and we know so adverse childhood experiences if they occur early enough in life they increase risk for all of the mental disorders and even autism spectrum if if you if an infant is severely neglected or abused that infant is at much higher risk of developing autism because they that infant will never learn appropriate social skills but every label in dsm 5 tr is increased um you're increased risk from adverse childhood experiences what else do adverse childhood experiences increase risk for obesity type two diabetes cardiovascular disease autoimmune disorders all sorts of other physical metabolic health conditions"

Dr. Palmer emphasizes the importance of the biopsychosocial model, highlighting adverse childhood experiences (ACEs) as significant root causes that increase the risk for mental disorders, as well as physical conditions like obesity and diabetes. He explains that ACEs can impact development and lead to biological changes that predispose individuals to a range of health issues. This underscores the interconnectedness of psychological, social, and biological factors in health.

"so i think there's many roads to rome and there's many things that can drive it but the brain only has so many ways of saying ouch and so when it when it's inflamed you don't feel it but when you look at the science people with depression have inflamed brains autism has inflamed brains alzheimer's has an inflamed brain all the psychiatric illnesses their brains are literally inflamed on fire but we don't feel it except as psychiatric symptoms and we think of it as something that is like you said genetic or because of it's in our head as opposed to it's on our body and there's something we can do to find the root cause and fix it