Conversations on Healing

Drew Ramsey

Nutritional Psychiatry: Using Food to Improve Mental Health

Featuring
DREW RAMSEY
Psychiatrist and assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons

Dr. Drew Ramsey is a board certified psychiatrist, author, and mental health advocate. He has been featured on a variety of talk shows, The New York Times and The Wall Street Journal. He is currently an assistant clinical professor at Columbia University College of Physicians and Surgeons. Dr. Ramsey founded the Brain Food Clinic, which is a digital clinical practice that blends nutrition and psychiatry to provide alternative treatment options for mental health diagnosis. His book, Eat to Beat Depression and Anxiety, incorporates research on how a mindful diet can greatly decrease levels of depression and anxiety. He also serves on the advisory board for both Men’s Health and the nonprofit Bring Change To Mind.

In today’s episode, host Shay Beider welcomes Dr. Drew Ramsey to discuss the intersection of mental health and nutrition. He defines nutritional psychiatry as the use of nutrition to optimize brain health and to treat and prevent mental health disorders. Dr. Ramsey talks about how, as a psychiatrist, he encourages choices around food to incorporate empowerment in making decisions. The two discuss some of the recent studies on incorporating various diets, including the Mediterranean diet, to greatly reduce levels of depression and anxiety. Dr. Ramsey shares his role with Men’s Health magazine, and how he has worked to decrease the stigma around expressing emotions that leads men to feel they need to “man up.” Shay and Dr. Ramsey close their conversation with alternative options for mental health treatment, and the importance of finding ways to treat the symptoms that keep you from living your best life.

Show Notes:

Introduction (00:00:02): Welcome to the “Conversations on Healing” Podcast, where host Shay speaks with renowned healthcare leaders, practitioners, and thought leaders to explore the world of wellness, the incredible powers of self-care, and what it truly means to heal today. Join us on this journey to become more whole healed and connected.

Hello, wonderful listeners. Welcome to the Conversations on Healing Podcast. I’m your host, Shay Beider. Our lovely guest today is Dr. Drew Ramsey. Drew is a board certified psychiatrist, author, and mental health advocate. His work has been featured by the New York Times, the Wall Street Journal, Lancet Psychiatry, the Today Show, BBC, NPR. He is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons, and founded the Brain Food Clinic, a digital mental health clinical practice. In today’s episode, we start by discussing the introduction to his newest book, “Eat to Beat Depression and Anxiety”, and the current state of the mental health epidemic. We talk about the rising field of nutritional psychiatry and how you can eat to optimize your brain health and prevent mental health disorders. We also discussed the importance of embracing the empowerment around food and eating to fuel your brain and your body. Dr. Ramsey shares some of the research surrounding the Mediterranean diet and its impact on reductions in depression in particular. Finally, we touch on the stigma surrounding mental health and how to reduce this in our communities and our society. Dr. Ramsey shares how he views healing both in himself and with his patients, and finds stigma free ways to treat various symptoms. He tells us about some interesting work he’s doing in the area of men’s mental health and how he’s giving power to men’s inner voices. I’m quite excited and delighted to dive into this conversation and explore the intersection between mental health and what we eat. So let’s get the conversation started. Well, I’d love to welcome you to the Conversations on Healing Podcast, Dr. Ramsey. It’s a delight to have you on the show. Thank you so much for joining me today.

Dr. Drew Ramsey Thank you so much for inviting me, Shay. Hi, everyone who’s listening, nice to be with you all for a little bit.

I’m very excited to approach this topic because I think it’s an important one that really needs more airtime and play, and I have a hunch our listeners are gonna really enjoy it. I actually wanted to start today. I pulled a piece from the introduction of your new book, “Eat to Beat Depression and Anxiety”. And yes, there we go. For those who are watching on YouTube, he’s showing the book right now. But I wanna read directly from your introduction to start, because I think you begin in a very interesting way. The first sentence in your introduction is, “Psychiatric medicine and mental health care have a serious problem.” And then you go on to say, “Experts around the globe from the World Health Organization to the Pew Research Center all agree, we are in the midst of a mental health epidemic. Diagnoses of depression and anxiety disorders have snowballed over the past decade, now occurring more frequently in teens and young children. The number of suicides across the United States has skyrocketed during this time as well to a level beyond tragic. Anyone reading the headlines is aware that substance abuse issues are at an all-time high, too. Approximately one in four individuals will be diagnosed with a mental health condition like depression or anxiety over the course of their life. Chances are you or someone close to you has struggled with a mental health issue at some point”. And I feel like that excerpt does a really incredible job of just framing the issue. You know, that we’re in a place where this is serious, it matters, and it’s important to think kind of broadly about not only what is going on, but also how do we deal with it. So I wanted to start our conversation, you know, with that, give you a little bit of a chance to respond in terms of like how you’re seeing this problem and how you would, how you frame kind of the incredible rise in things like anxiety and depression in our society.

Well, thank you for, for starting with those words from the book. It’s always important for me as a practicing psychiatrist to frame conversations around food, around integrative care really with the seriousness of the situation and from a clinical standpoint. But it’s also a little strange to hear it in the midst of my clinical work today, just as I’m a very hopeful and optimistic psychiatrist and psychotherapist and I love helping people unlock all of the healing power and goodness that they have and, and to help them, whether it’s with words or being with individuals through challenging times in their lives or with medications or with food. So, but yeah, it’s a downer right now. Mental health, right? And, and we have a real, a real challenge, sounds like we’ve never had, right? We have polarization, people who don’t believe in folks like me.

You know, my psychiatry colleagues and I are, I know we don’t get unleashed to actually practice on our own until we’re, we have to be at least probably about 30 years old to make it through all the training. I went straight through college, medical school, four years of residency, really only thinking about mental health treatment. And so but there’s a real polarization around the sort of way we think about evidence, things like medications and how those are framed and, and other treatments for mental health. I think, you know, why I love being here in an integrative community is that when you’re struggling with illness or chronic illness or someone in your family has a chronic illness, what, whatever that is you need everyone to sort of line up behind that and provide tools at work. And, and so that’s where food is so great cuz you have to do it every day.

A lot of times, especially I’ve been thinking a lot about your audience and you know, when we have a chronic illness, we are involved in the healthcare system. And no matter where you are in the world that that’s frustrating usually. And especially I think in conventional medicine, right? Where there’s a lot of language and jargon and tests and advances. So, but back to mental health. There’s a big mental health crisis. Everyone needs a new set of tools, right? This isn’t optional anymore. You’re gonna end up struggling with depression or substance use or more and other serious issues at some point. I don’t mean that as a threat to fear monger, that’s just, those are the stats. So let’s be prepared. Let’s understand what do we need? What tools can we give our kids?

What tools? Also the hard part, can we as adults, like get better at? Cuz development doesn’t really stop. And, and then how, you know, initially can simple things like nutrition going to the grocery store today, or if you are traveling, you know, figuring out how you’re going to eat healthy on the road. Now, those are, those are really important questions that we sometimes minimize or, you know, we create these false diads, right? Whether, you know, gluttons who are enjoying ourselves or we’re, I don’t know sparse plant eaters who aren’t.

Yeah, I think, you know, it might be nice. Many of our listeners may not be familiar with the field of nutritional psychiatry and how what we eat affects our brain, affects our emotions. So can you share a little bit about that emerging field?

Yes, sure. Thank you for asking. Nutritional psychiatry is, is quite new. A lot of people haven’t heard of it. It really hasn’t existed for very long. The International Society for Nutrition and Psychiatry Research is really the, the first organization. I think we were first having conversations with some of the leaders in the field. There weren’t even a lot of us in the US that they had a, a conference 2015, 2016 in DC. So it’s very new. And then the data is new. We can all talk and have ideas about this food helps, or that food helps for this sort of illness, or this dietary pattern is good. But until we have research randomized clinical trials, it’s hard to, you know, put your foot down and say, “Hey, the field has to change!”. I’m really excited to be recording this today, because later today I’m having an Instagram live with the president of the American Psychiatric Association, Rebecca Brenda, who’s a psychiatrist and a lawyer.

And we’re talking about food because the American Psychiatry Association did its first ever survey about food that told us such wonderful news. Like most Americans have an awareness that food affects mental health. I think it was 66%. And so that, that really tells us that in some ways, in a most fundamental way, you are what you eat. What we eat affects how we feel sometimes how we feel affects what we eat, what we already, you know, know about this in some way. And so then the real exciting question is how can we harness some of the new research? Which isn’t very surprising as we eat more whole foods, as we eat in a mind more mindful way, as we think about our balance of the plants and animals we eat and where they come from and how they’re raised we begin to enter into the caring of the cells in our brain, our neurons.

And that’s really what nutritional psychiatry about. Nutritional psychiatry doesn’t have a real formal definition. The way that I’ve been defining it and and speaking about it, is it’s the use of nutrition to optimize brain health. Because all of us can be involved in this and should be involved in this. Mental health no longer should be something where you only come and see me when it’s really bad. Like there should be no more rock bottom doorways into the mental health system cuz you’re all in it, everybody’s in it. You woke up this morning thinking about your mental health, you’re worried about something or maybe sad or maybe feeling awesome. And you checked in with yourself about that. And so we’re one of the years ago I visited an old farmer a man who studied pastures. His name’s gonna elude me for a minute. But we, in our early conversation, I said something proud. I was a young psychiatrist, I said, “I’m a psychiatrist”. And he looked at me and says, “We’re all psychiatrists”.

That’s a good answer.

It was a great answer. So nutritional psychiatry is the use of nutrition to optimize brain health and to treat and prevent mental health disorders. So if you’re a family that has a lot of mental health conditions or neuropsychiatric conditions out there looming in your genes and your ancestors. So that’s, that’s pretty much everybody listening. That’s me. That’s you. I mean, we all come from a set of genetics that have, have some individuals in our family who’ve struggled and and so what can we do? How can we prevent what, what can we do in our daily lives and daily rituals to really take care of our mental health? And, and you know, not that when we struggle with depression or other mental health disorders, just cuz we didn’t eat right, but not eating the proper foods certainly contributes, increases the risk of mental health concerns within populations. That’s very clear data. And, and then how we eat and when we’re struggling with mental health episodes is really really important. It turns out as five or six, depending on how you count now, randomized clinical trials showing shifting dietary pattern can help a significant portion. The most recent study, 36% of individuals with treatment resistant depression went into full remission. I mean, it’s really cool.

Yeah, it is really cool. One of the things I really like in your newest book, “Eat to Beat Depression and Anxiety” is you organize the information in a cool way. So you discuss the top food categories to beat depression and anxiety. And I actually had written some of these down cuz I thought it was informative. Plus I wanna keep these in my refrigerator personally, , these sort of, and it’s a nice way to do it cuz it’s about grouping it into these categories rather than you know, selecting a single food that you have to eat. So the categories that I had written down are leafy greens, rainbow fruits and vegetables, seafood, nuts, beans and seeds, meat, eggs and dairy. And then you have sort of a fun one at the end, dark chocolate. And then you also talk about good microbiome bugs, things like keefer and miso and sauerkraut. So I wanna give you a chance to talk about these food categories, why you think that’s a good approach to sort of how we think about what we eat.

All right. So Shay just dropped the knowledge bond on everybody. I wanna tell you my rhyme to remember it.

Oh, ok then. Let’s hear the rhyme.

As I’d say seafood, greens, nuts and beans and a little dark chocolate. And that in part comes from where I find it that people struggle a little bit, you know, like, Shay, how are your seafood meals this week?

Good. Actually.

Oh good. Can you tell us a little bit about them?

Yeah. I mean, the ones that come, like right off the top of my mind, I had these delicious grilled fish tacos from this local restaurant that is so good. And I love that. So those are amazing. Like that’s the first one that comes to mind right away.

Well that’s that’s wonderful because grow fish tacos are one of my favorite nutritional psychiatry interventions. It’s a great entry in terms of seafood. It’s also one of those ways you can really dress up seafood in a lot of different kind of flavor profiles, especially if you are having some folks who are a little seafood picky in your household. And I know a lot about that. I was a very, very picky seafood eater when I was younger. So that, that’s a great example. And also you make a nice move there. It grilled fish. And I love a fried fish taco, I’m not gonna lie, it’s one of my favorite beachside treats, but leaning towards more grilled food or, or even you know, think of how you, when you’re making fish at home can maximize the health benefits.

Those are some of the ideas we get into with seafood. How do you really aid individuals in thinking about themselves as eaters? And I think that’s one of the big moves nutritional psychiatry makes, and that I really work to make is trying to bridge the medical stance of psychiatry, which we really value something that is different than other physicians. We’re trained differently. Mm-Hmm. , right? We’re trained to one, sit with our feelings, our counter transference, and two, to be neutral. So I’m not here to tell you to be a vegan or a carnival or a carnivore or a keto or Mediterranean, because one that’s not super helpful to the individuals. You know, if Shay were, were my patient and working or working with one of our clinicians, the hope is really to understand what are the challenges in front of you and where are you struggling to define yourself as an eater? Like, where are you from? Where are your, you know, what did your ancestors eat? Like, not not just ancestors, but yours, you know, what are some of your favorite foods? Sometimes those aren’t the quote unquote healthiest foods, but boy, for our mental health, for our spirit, for our soul, those are the healthiest foods.

Right? Yeah.

So and, and so there are these food categories. Let’s get back to this where and this may be my recovery from my kale phase, let’s call it.

We’ve all had a kale phase if you’re into healthy living.

Oh, I had a real kale phase. I mean, I wrote a you know, an erotic cookbook about kale.

Just about kale

“50 Shades of Kale”. Yeah.

“Shades of Kale”. That’s right.

And I’d launched National Kale Day with Jennifer Easter Low. And we helped actually millions of students around America eat kale on national kale day, often for the first time. So yeah, I had a big kale phase, but you don’t have to eat kale. But thinking about leafy greens and, and thinking about the essential principles of nutritional psychiatry. And so before we get sort of into the food categories of what to eat there, there’s the kind of explanation why, and again, how nutritional psychiatry is a little different. When we approach food, we don’t wanna create a you know, a population of folks who have Orthorexia, where they’re thinking so much about the foods they eat, it preoccupies them. We I certainly want to avoid encouraging super foods and eating disorders or eating disorder behavior in any way. Mm-Hmm. and, and approaching using both, both the data and then some of the new science. My favorite drawing in the book is the new science of depression and anxiety. So often when people meet me, they think, like, all I’ve got is Prozac. And that’s like if I were a DJ and all I had was Madonna, like, you know.

Very limiting. Yeah. You gotta go beyond that. Not that there’s anything wrong with Madonna.

Like a who doesn’t, but there’s a lot, there’s a lot that’s happened. So thinking about things like the microbiome or things like inflammation, right? We didn’t think about inflammation and mental health that much. And oh, one of my gurus, I dunno if you should say that inside, but one of the individuals inside, I looked to Roger McIntyre, has a great review article with some colleagues called “Inflammation, and its Discontents”, right? Talking about how inflammatory processes directly affect how we feel, what infects affects inflammatory processes that we do every day. A lot of stuff, right? It’s not some mysterious inflammatory illness. A lot of individuals are struggling with that, but just basic inflammatory markers when you sleep better, right? That’s when we get the junk and the toxins out of our brain when we eat foods that don’t trigger inflammation.

When we eat in a way that fosters a healthy, diverse microbiome. We’re making moves that according to science are gonna help us based on how we started to understand depression more. Right? And soI think this is really great news. And again, it’s straightforward. I don’t think it’s often expensive food. And there are a lot of different steps which I think is helpful to an individual. So try to take some of this, what’s it like, new information about how we think about depression and anxiety, and then apply it in a, in a joyful and loving way to what you eat. Mm-Hmm. , I would say that’s, that’s the hope of these food categories.

Well, and, you know, it’s fascinating. When you and I spoke previously, you mentioned how often when you bring up food with people, it elicits a lot of guilt or negative feelings. And we have through Integrative Touch, we have a 10 week TeleWellness course. And one of the topics that we talk about is healthy eating. And we go through some principles and discussion and it, it is amazing how that topic seems to elicit high reactivity. Like it’s automatically showed me like, wow, most people struggle with food. And so there is an interesting I think sort of challenge in your work because you do focus a lot on how food can help in a variety of ways. Not only decreasing inflammation but, you know, supporting healthy gut microbiome and right. All these different elements of supporting neuroplasticity and the way our brain functions. And so I’m curious how you sort of approach this, given that a lot of people carry a lot of negative feelings about food in general that from, you know, their history, culture, et cetera.

Well, I think you’re speaking about the deep psychological pains that a lot of individuals have about food. I think you’re probably talking about like the impact of the patriarchy on how we think about the shape of a person. And it’s just specifically the shape of a woman’s body and how that relates to food and how that relates to calories and how that relates to diet culture. And so I think the, the first is this notion that, you know, I’m not sure that we hate food as much as that’s an expression of the ways that we hate ourselves. Cuz food is nourishment, food is life, food is a reminder of miracles. That’s why no matter how I’m feeling at the end of winter, which can be a little cagey and tough for me, I plant stuff. Like, I actually last, last night, I realized I put some basil plants, some of that we don’t, I’m in Wyoming now, we don’t have any plants yet in the greenhouse.

I called, they were like there’s still like eight feet of snow on the ground around the greenhouse. I was like, okay, so like, maybe next week you’re gonna get the seedlings. I gotta like, no . So, but I went to the grocery store, got some basil put it in the ground, and last night realized I hadn’t watered it for a day, raced out there, gave it some water. You know, that, that way, that being part of the food cycle, thinking about yourself within how we create calories, how the planet creates calories, how the how we nourish and feed ourselves. I think that’s just a part of human existence that a lot of us and a lot of people struggle with. So that idea of hating food, you know there’s a lot of push and pressure to make decisions that aren’t about your empowerment.

And, and as I’m a clinician, you know, I’m like, I’m really about your empowerment. To get back to this idea of how people are struggling with food you know, there are lots of different ways ranging from access. I’m part of where we have our mental fitness kitchen, which is our, our free nutritional psychiatry cooking class that everyone’s welcome to attend. We want to help people have more skills to remind people, this is simple, to get rid of the fear mongering, right? There’s this one thing that you’re eating that’s like shutting it all down for you. It’s like, okay, , you know, that makes it really hard when you’re in a rush to grab something. So yeah, those, there’s a lot of misery when it comes to food. And, and that’s, that’s where the psychiatrist in me, and I think with my nutritional psychiatry colleagues and the people who think about food as medicine, we all have been really stepping up.

I mean, there’s really a huge movement afoot in medicine and in wellness to say like, food is a huge part of this. And it’s not just a simple, like, don’t eat gluten or don’t eat that. Those are gonna be great moves for people, but it’s really starts with a mindfulness and a love of the self. And if you’re struggling with that, I’m glad that you’re listening right now. I really am. That’s the that’s the thing that we all have to confront because caring for the self, caring for your frame, caring for your mind, you know, there are things no matter what situation you’re in, that you do have a little power over. It’s part I like about nutritional psychiatry, I think it can be very empowering because it’s, it’s about you pulling the levers within life that are possible for you right now to make that best choice.

And when you work with people who are struggling with depression and anxiety, I would think in particular someone who’s feeling depressed, the last thing they wanna add to their plate is like, oh my gosh, now I have to think about these food categories and I have to, you know, but on the other hand, it’s something that could so significantly impact the way they feel. So how do you approach that with patients and, you know, what do you find to be effective?

Figuring out something about food that makes them smile and, and trying to find something either empowering or goal worthy within the next week. Acknowledging it’s hard trying to really have empathy. Again, I think we’re psychiatry and mental health professionals are a little different is we’re really trained. And this is, I don’t wanna slam on my other colleagues. Everyone’s trained in empathy, but that real notion of if someone’s struggling with nausea or appetite or someone is having a hard time with their budget or, you know, there are all kinds of these all impact food and food choice. And so as opposed to a big prescriptive diet with all these food categories so you can fight inflammation and build your microbiome, we, I really wanna avoid that initially and mm-hmm. think about a couple goals, simple ideas. Hey, there’s been a lot of evidence about food and how it connects to mental health and how it connects to depression.

And, I’m wondering what your experience of that is. And if you hear, oh, for sure when I eat sugar, it really super depressed. You know, it just leads to a natural clinical conversation. Oh, how’s that going now? Oh, it’s going awful. Oh, let’s think about some healthier ways for you to get sweetness, maybe. And so now we’re working together because I want you to have some sweet treats if you’re really depressed and it helps you feel better. But I also don’t want you to engage in a behavior that, you know, makes you feel worse. And,I think that’s how it fits in. Mm-Hmm. ideally and I’m not sure how was hit the mark. My patients would be like, you know, how does this, he just says pesto. He says, pesto, pesto, pesto, pesto, . And he hounds you with pesto, tells you to plant basil and make pesto for your family. Cuz it’s true. I, I do a little cuz pesto hits so many food categories and it’s really fun to make and it’s so delicious. And the stuff you buy in the grocery store doesn’t have olive oil in it usually. Mm-Hmm. and the whole, one of the whole big things about pesto being great is it’s olive oil, basal or some other green nuts, garlic. It is all great stuff.

Right. And you do talk in the book about the Mediterranean diet, obviously pesto’s part of the Mediterranean diet, and obviously that’s not like the only diet, but there is a lot of data that that is a you know, sort of a well-respected diet. What are you seeing as most promising in the research and the literature? In terms of the very specific findings mm-hmm. around, you know, sort of diet, what we eat and impact in terms of depression and anxiety in particular.

All right. We’re gonna set away from pesto to research.

Pesto to research. I think it’s a natural transition.

Pesto diagram in the book so people can make their own pesto. It’s like a pesto formula.

You know, these diagrams in the book are beautiful. I have to say, for those listeners who go out and get a copy, it’s like very artistic. You have these beautiful diagrams like throughout the book .

Thank you, Shay, I wish I were like young and like I’d sketch them myself after my brain.

That would feel really good, right?

That, but that’s not true. They were a wonderful German woman who made initially, she was making sketches of podcasts that she listened to in the wellness world. Oh. And she made one of an interview I did with Max Lugavere for his podcast genius “Genius Life”. And it was a, it was really cute. I shared it. Everyone loved it. And so I dmd her and I was like, “Hey, you know, could you make a couple of these about some nutrients? Could we work together?” And then I got the book deal and I was sitting there really, you know, wondering how do you communicate the stuff that I was writing the book in the middle of the pandemic. So I was hole up with my parents and my kids, my wife and our old dog in rural Indiana on a farm.

And in like, everyone, you know, at really struggling. I mean, this is like, you know, may and June of 2020. And and it just kinda struck me that the illustrations needed to be part of the book. Just like recipes need to be part of all my books that, you know, you gotta walk the talk. You can’t be like, yeah, leafy greens are great. It’s like, here’s some ways you should do it. Here’s some fun ways like pesto. And so yeah, Katherine’s illustrations really elevated the book also for some of these concepts, right? Like, how is depression and anxiety different today? And to kind of see it on the page. I’m also, I think it’s probably, I, I have some something about, for me, seeing things visually and spatially really puts them in my mind in a different way. And so, yeah, thanks for knowing the illustrations.

Let’s move right to your question of evidence. So the evidence mostly is for depression. My colleagues Umma at Harvard, who’s the only named nutritional psychiatrist actually, who has the professorship. So Umma has a great, this is your brain on food book for everyone to host to check out. But it, she just did a scoping review on anxiety and nutrition where there’s a little bit, not a lot, there’s also just been a meta-analysis in review on bipolar disorder and nutrition a little bit. Not a lot, but if, if you know, you, you have anxiety or bipolar disorder, the idea that there have been scoping reviews, there are lots and lots of research studies. I’m most familiar with depression because that’s where the human trials have been. And when we look at things like anxiety, really minimal human trials of taking people on different diets, those are starting to come out.

We’ll have a, you know, this, this will sound outdated here in a few years, maybe even a few months, the clinical trials for depression have focused mostly on the Mediterranean diet in the epidemiological studies where they look at populations and we’re, we’re sort of thinking about, okay, let’s compare people in a, you know, in a population who eat a very Western diet versus people who eat a very quote unquote traditional diet. A diet of more whole foods, a diet of less fried food a diet maybe with some, some more vegetables and plants in there. Less fast food, less what’s called ultra processed food. When, when you look at those epidemiological studies, the decrease in depression for populations that eat a more, more whole foods type diet, you decrease the risk of depression by about 18% in the meta lyses. So that, that’s great.

If you think about that in a, you know, if that were true, right? Because epidemiological studies just teach us correlation. But let’s say if that were true, so you’re sending, you know a million kids off to college if you could decrease the depression rate in that population by 18%, I mean, that would be, that’s enormous. That’s 180,000 families who aren’t struggling with depression, which is a scary illness for parents. That’s some of the data the days around the Mediterranean diet. And I think that leads to a question. So the, the other trials, the Smiles trial by Felic Jaco was the original seven nutritional counseling sessions given to individuals who had clinical depression, who are already most of them in some type of treatment, getting like a SSRI medication antidepressant or in some therapy.

She found that 32.3% of patients went into full remission from their depression when they adopted a Mediterranean diet. And when you look at what people did, they mostly were cutting out ultra processed foods. Oh yeah. They added in like, you know, some legume meals a week and a fish meal a week. And, but it really, look, you know, what we can do in our daily lives. So they tell people, like when you hear the crinkle of the package, that’s your first hint, , that’s your first hit. Okay? Then you’re looking at an ingredient list. That’s your second hint. You’re, you’re, you’re like dancing with the devil here cuz you’re on the ultra processed food is, there aren’t a lot of crinkles when it comes to the broccoli. I, I pick it off the shelf. It has one ingredient. I don’t have to look and not like looking for like try for me, like holding it this far away, wondering where my reading glasses are.

And so that, you know, that’s the big move in the Smiles trial. In the subsequent trials, it was very interesting. The next was Healthy Med, which is 152 patients who were given a group Mediterranean diet cooking class. And, and so this is a really interesting trial cause the patients were very depressed. And often we think about like, oh, like let’s talk about food. It’s like, you’re a little down, right? And, and what I sort of think is, needs to be myth busted about that Shay. Is it, you know, that’s sort of saying patients with severe mental illness shouldn’t be focused on nutrition and like, no, that’s where nutritional psychiatry came from. Like my initial work this field was like 2004. I finished residency. I got a job working in a community mental health center. A couple years later I, as the director of their day program, I was working with a brilliant young psychiatrist, Christina Urian.

And we were taking care of patients primarily had struggling with schizophrenia effective disorder. And because of the medications and, and because of that illness, we’re just really struggling with diabetes, obesity just a lot of medical illness vernon. And so nutrition is something that should be considered in mental health. Mm-Hmm. , Chris Palmer really writes quite eloquently about this in his new book, “Brain Energy”, right? Talking about how patients with severe mental illness like schizophrenia can really respond to to dietary changes. Mm-Hmm. . All right. More still next few studies and we’ll, well, we can go back to it. But you asked about the data and what the data shows. So again, it’s mainly Mediterranean diet, which leads the question for all of you. Like, what’s that mean? Like what kind of means get rid of all the fats in your house other than olive oil for a while, see what happens.

I can’t get rid of butter. Cause I like butter on toast a lot in the morning. I do, like, that’s part of my nutritional psychiatry, mental health plan right now. But and maybe not the best choice, but I’m working but really focusing on olive oil, right? That’s when you’re doing oven roasted vegetables and olive oil with little salt and pepper and it’s a great simple, inexpensive meal. People gobble up those vegetables usually. You know, thinking about nuts, beans, and legumes, like where are those in your diet? Like Shay, how, how’s your lentil game?

Good. I love lentils. I’m a big, like bean eater, in general. Now. I love beans.

How do, how do you respond to all the bean haters who are telling us that like we’re sucking the minerals out of our body with the lectins and whatever other problems people say beans have?

Well, I mean, I guess some of this goes back to, for me, like my ancestry and my grandmother was, she was very much a person of like everything in moderation. And she had a farm, she grew up on a farm. And she had a lot of good, just very like, practical life advice. And when people would obsess about anything, she’d be like, mm-hmm. Don’t do that. Like, just in moderation. And so I guess my bean approach is in moderation. You know, like, I eat beans, I don’t stress too much about the deficits cuz there’s obviously so many positive things to that.

Yeah, I mean I, okay, I’m glad to hear that. I also think the data I’ve seen is that all of the, those compounds for fear mongering and, and people eating cooked beans have nothing to worry about. All these kind of anti nutrient concerns cook out of beans. And then I think we also just have the proof is in the pudding data. Mm-Hmm. , look at all the blue zones, all of the longus live people and, and think about fiber. Where do you find fiber?

Exactly.

And then just, yeah, salt mm-hmm. . so thinking about beans, thinking about seafood, especially the ones that are tough for a lot of them you know, it depends. We have a really nice international audience here, it sounds like. So it really varies around the world. But some cultures, America is one of them sort of struggles with what I call real seafood anchovies, sardines, scallops, right? Things that are lower on the food chain. Things in terms of concerns about contaminants, which is like all food now are lower on the food chain, so you worry less about those or can worry less about those. But, you know, working on a seafood game a little bit now, these are ways that we can Mediterranean the Western diet mm-hmm. . and then, and then these, the last two trials just quickly we’re both in college students, which is really exciting.

And this notion, you know, it’s a big life transition. You’re 17 or 18 or 19 going off to university, right? In, in America there’s this like freshman 15, the idea that everyone gains 15 pounds and you’re suddenly at a cafeteria. A lot of universities require people to go to the cafeteria, and some colleges do a great job and some don’t. Now, cafeteria food, school food is not renowned for nutritional benefits. There’s some awesome work being done on this. Dan Gusty who leads a group called Brigade, gets chefs into schools to cook healthy food for kids with like such passion and mission. It’s really great to see some of these changes, but you know, in this transition, helping advise, hey, it’s a big time in your life, big time to be taking care of your mental health. One way you can do that is by eating these foods.

So these trials, two of them were in Australia. One is they gave a young depressed freshman, a box of olive oil, nuts, nut butter, cinnamon and turmeric. And a 13 minute video that sort of described some, some of these connections between food and mental health and said, we’re gonna call you in a week and check in. And they did. And then at that call, they checked in for five minutes, how’s it going? Then they called a week later for five minutes and checked in. And these college freshmen who were depressed, they had a significant decrease in the depression rating scales. Whereas the folks who didn’t have the intervention, their depression rating scale creeped up a little bit. Mm-Hmm. And so just to, you know, to go into college with some support like that, it’s very interesting data to see. The final study was just published last year, the amend trial in Australia, Jessica Bees, did this trial.

I’ve got an interview up with her on my YouTube channel that sort of goes through the study. It was in young men and no one has ever studied depression in young men before. And no one had ever done a nutritional intervention with young men before. And of course, most people like the cliche is like, ah, these, you know, young bros, they just want like protein shakes and you know, burgers. And Jesse said this really tricking thing. She said, you know, most of the young men, they were just really happy to be seen that someone would cared about them and had suggestions that they could do. And they had a 36% remission. So you have a hundred percent of people who are, you know, in some treatment, but they’re still having a lot of depressive symptoms and struggling. 36 of them would just go into full remission and not have any depression anymore, just with this dietary intervention. So it’s not everybody, but this is in some ways a tricky population and that, that they’re individuals who can be a little resistant to treatment. Mm-Hmm. Not that they don’t want treatment, but that treatment doesn’t work with them. It’s so horrible how we say that. I feel like I’m paddling on here. Like working with slide deck here.

Well, I’m happy to get into the data. I think it’s very informative. Another topic I wanna broach with you is stigma. Because there still is a lot of stigma in mental health, and I know you’re passionate about that. You’re part of an organization called “Bring Change to Mind” that the actress Glenn Close founded that focuses on stigma reduction. And I would love to hear more about why you’re passionate about that and what you’ve learned in playing a role in that organization.

Well, I’ve been practicing in an era where there’s been a lot of shift. When I first became a psychiatrist, it was, you know, it wasn’t cool. There weren’t Netflix shows about us and mental health professionals. So, you know, sort of hush hush. There’s there’s been a real shift and, bring change to mind as one of the organizations that’s been helping with that, of just keeping the conversation going and making sure that stigma, which is that if you would know one of your friends or family members had struggled with alcoholism or bipolar disorder or suicidal thoughts that you would think about them differently. And of course, as we learn things about our family members, we think about them a little differently, but you’d think about them as lesser. And, and that’s at the heart of stigma that when we’re struggling with illness or mental illness, that we’re lesser, we don’t have as much to contribute.

And that’s makes it horrible then to seek treatment. We see this as so true when it comes to treating depression in physicians and physicians make the top professional group when it comes to suicide completion in America. When we look at the suicides in America, we just lose a tremendous number of healthcare providers. And part of this is that as a physician or another healthcare provider doesn’t have to be a physician nurse practitioner, my colleagues who are nurse practitioners, nurses, right? If you’re struggling with something, mental illness or addiction and you go get help, right? Well, there are consequences. And so these are all elements of stigma and systemic stigma and how it prevents individuals from being upfront about our mental health saying, I’m struggling in these ways. I need this help. Like, right, right now, getting it and getting good quality care, and we don’t have a mental health system that delivers that.

I think we’re all responsible for building that, just to say it, you know, everyone listening. And, and I think hopefully individuals listening, you know, you’re, there are lots of places that are doing mental health a little differently and better. But that thank you for bringing that up. So that stigma. And the biggest and the hardest question for around stigma, Shay, is how you’re promoting it. I try to think about this all the time, just the things that I have biases about. It, it’s really one of the things I learned early in psychiatry in the emergency room is, you know, if you walk up to someone who’s psychotic and you’re treating them that they’re lesser than you are, you don’t treat it them with dignity and respect as a fellow human. Maybe hearing and seeing things that are different than you, but they have their own reality.

It’s just you’re not gonna be a good physician to that person. Mm-Hmm. , you’re not gonna really give them the care and, and that they deserve. So, right. Yeah. So, so we have to fight stigma kind of looking, so sitting with those feelings and, and then acting on them, you know, it’s awareness into action when it comes to mental health and mental health stigma. Bring change to mind. Glenn closest organization and, Pamela Harrington, the executive director, which did such a wonderful job creating a network of mental health clubs around America. We’re in 36 states. I think it’s something like 15,000 kids getting to talk about mental health. And, you know, I know it’s a very, in some ways controversial topic these days. But we know one thing is very clear when we don’t talk about mental health, when we don’t give neutral forums for kids to kind of open up and share and connect and have that peer-to-peer to support you know, tragedy ensues, you know, and so helping us all have the language to talk about ourselves.

Understand how to reach out and find resources. You know, one of the, one of the things that came out of the pandemic that was interesting is telemental health and telehealth, right? You have a wellness program, right, where you can connect with people all over the country who are struggling and, and grieving and in a challenging time. It’s like that we haven’t been able to do that before. So, you know, if you’re listening and this resonates with you and, and you’re struggling in some way please, please reach out to the many resources that are out there cuz it’s really the, I think people worry about finding the right spot, which, you know, I appreciate. I think the, the hardest part is realizing that the first step isn’t always the right one. And people put out like getting an evaluation for so long with that hope that like, it’s just that appointment, like that appointment’s just the first step.

You might not like that person, right? You might not want think that their idea or treatment plan is so good and so, you know, it’s time to, you know, find someone else. And so anyway, she thanks for that question about stigma. It’s, it’s one of those it’s a really deep and challenging issue. Blessing on that is that there’s an exciting organization in Indiana where I’m from the Erse Institute, which is looking, has this wonderful like, multidisciplinary team thinking about how stigma leads and things like stigma one com, how you can combat those, but also how to really within the medical system, save lives using that knowledge. It’s just so there’s a lot of movement and research in this world on stigma and, and, and yeah, just thanks, I’m glad we’re having this conversation. That’s one of the ways that we fighting.

That’s right. Absolutely. another area that I wanted to give you an opportunity to speak to a little bit, Drew, is is men’s health, because I know that you also are passionate about that and that you serve as a mental health advisor for Men’s Health Magazine as part of a series that’s called Friday Sessions. And so I wanna just get a little, you know, snapshot of what you feel are some of the most important takeaways in terms of men’s health specific to mental health and integrative psychiatry. So however you wanna tackle that. I know it’s a huge topic that could go on and on, but give you an introduction at least.

I like food, it seemed to me that I was working with a lot of men and there wasn’t a lot in literature about men and how they, for example, present with depression or men and, and how I think it’s 80% of completed suicides are by men. And so just from a kind of public health standpoint, how do we get more men into treatment? I see, you know, men are notoriously not engaged in mental health treatment. And, and then as a man in mental health with a lot of male colleagues in mental health and a lot of male patients, just is always, I dunno, it’s been of interest to me. I’ve learned a lot from my male patients over the years and I really enjoy working with men. And you know, there’s an idea. I remember the first time like men were crying in my office and I felt like I should like, collect their tears.

Like it was like unicorn tears or something. I’m gonna be like, man, it magic. And then you realize men are really like emotional sensitive creatures. And especially now the kind of changing notions and expectations of masculinity, whether we need to man up and be a man or whether something else is out there for us to be powerful in other ways. Boy, that’s, that’s all in debate for young men right now. And, and I would say for men in general right now. So male mental health is just of utmost importance. And we think also about the movements Friday sessions came out of a, I wrote to Rich Dormit, who’s the editor at Men’s Health and, and to, you know, I wanna do something because I think men are really gonna be struggling with mental health. And so Friday session started with the convert some Instagram lives.

And then my good friend Greg Scott Brown who’s a fellow psychiatrist joined me. And we’ve been interviewing, we have almost a hundred interviews completed with prominent men and women about this very question asking them about men’s mental health. I spoke to Maz Giron, the comedian, and he talked all about being an Iranian immigrant man in America who’s a comedian and talking about his mental health. And as he’s turning 50, I mean, it was so these conversations we hope serve as a bit of a library that if you know someone in your life, a man in your life that is struggling with his mental health, hopefully maybe we’ve interviewed somebody he likes and, and it can inspire folks that having the conversation is the first step and and, and a really important step, but male mental health yeah, just I think there’s a lot to it to help men.

You know, the primary issues that men struggle with, I think is untreated depression. Cause it looks a little bit more like irritability and stubbornness in men. Insecurity and untreated insecurity and really understanding the roots of that. I think there’s, there’s a real challenge for men right now about what power means and how to display it. And, and then substance use is the number one, you know, that, that we live in a country that just loves pouring big shots of alcohol down all of our men, and it turns them into raging assholes. And then we like kind of wonder why mental health isn’t the toilet. It’s like, oh, okay. It’s sort of it’sthe amount of drinking and binge drinking

Mm-Hmm.

Among men and young men is just really off, off the charts. It, I’ve been really touched recently, it feels like I get to beam into a lot of college dorms and see patients, which is really a, a you know, a wonderful, I think, privilege to sort of see what’s going on with young men today. And there, there’s a lot more talk of sobriety. There’s a lot more talk about emotional health. There it does feel like something is shifting in that kind of cliche notion of young, you know, what, what adolescent and, and kind of early twenties men are about does feel to me that it’s off, that it’s shifting.

Yeah, it is shifting. I think there’s more information too. I, I know I had read in one of Malcolm Gladwell’s more recent books, he talks about that link particularly with young men in college and high alcohol use, and then how it triggers a myopia literally like in the brain that then increases substantially the risk for sexual violence. And so, you know, it’s very interesting to think about like how substance use and abuse shifts the way we treat other humans, right? And the choices that we make and even the capacity, like the functionality of our brain, essentially. Like what we’re able to limit or control, whether we become myopic or we can see the broader picture, whether we’re able to step back from something or if we sort of, you know, impulsively do something damaging. And so, yeah, it’s interesting to see like the, the, as the kind of data in aggregate reveals some of the findings of like, what is happening to young men when they go off to college, if they’re you know, exposed to like high levels of alcohol, you know, use and it, it’s so endemic in our culture and it is having real I impact and it also has real impacts on young women that go off to college. Right? so it’s not that it’s just one gender, but it’s, yeah. It’s a very, very interesting topic, I think.

Well, thanks for asking about it, Shay. I appreciate it. I think there’s just, there’s so many great organizations out there thinking about it. There’s a psychologist has an organization Love Dad, which is the first that’s doing paternal assessments when there’s concerns postpartum that we really have done a much better job taking care of postpartum depression in moms. But, you know, dads go through lots of changes and not that it’s one or the other, but if we’re not sort of also checking in with dad, we’re missing an opportunity to have a great mental health intervention potentially. I’ve got a, a patient right now who has a baby that’s about five weeks old, and I was just so touch the first few sessions I sitting there holding this little, holding this baby and, and talking about all of these challenges and his, and it’s such a, a wonderful thing to be with a man in the midst of those transitions and talking about them and, and not, and you know, that’s really in some ways at the heart of this process that many men have been missing is being involved in a conversation that isn’t about advice from idealized gurus, but it really about the generation of a inner confidence and solidity clarity of an inner voice of you as a man.

Yeah. and so it’s yeah, it’s, it’s a, it’s a good conversation to keep going. Thanks for asking.

Yeah, that inner voice, I feel like to me that’s the epicenter of healing is that inner voice, right? Because really, ultimately no one else can tell you how to heal or what to do or, you know, we can get information and ideas, but ultimately all of that has to be processed and resourced like within, you know, to come to an a very personal understanding of you know, what do I need to heal? Cuz there are distinctions that are significant from one person to another. And so one of the questions, given that this is the “Conversations on Healing” podcast that I wanna ask you about is, you know, what experience in your own life would you say has taught you the most about what it means to heal?

Hmm. Well, I would probably say marriage has taught me the most about healing and sort of healing from trauma. That’s, that’s been my longest term relationship. And so I think that partnership and, you know, all those moments when someone’s with you and knows you and cares about you, that you see how your version of the truth you know, doesn’t hold up in a certain way. And, and it really causes, I think, a refinement of the ego. So I would say that certainly pops out as the, the top of of my list. I would say that, you know, the, the other thing that probably he healed me the most is the process of psychoanalysis, I would say. And I was trying to be more prepared for this question. You told me about this question. I don’t just have one psychoanalysis, right?

Cause I’m a strength and you gotta tune the instrument. And if that’s how I believe in that sacred practice. And so I’ve been in psychotherapy or psychoanalysis for most of my career, and it’s one of the privileges of being a psychiatrist in a mental health professional, right? Because there is the assumption to be good, you gotta go in, you gotta go into the deep end of the pool, get real comfortable there a lot. And so, yeah, I don’t think I’d be anywhere without my psychoanalyst, Ron. Thank you, Ron. This is like my highlight reel. Thank you.

That’s right.

And then I, yeah. And those are the two in terms of the healing. And then I moved, I, you know, how they say you can’t go home? Well, you know, they’re just things like, that’s, I’m a little contrarian I’ve realized, and I needed to go home for a number of reasons. And so for a, a period when our kids were young, we lived in rural Indiana with my parents, and I, still was practicing in New York, going back and forth. It was really, really intense time. But, you know, I would say in terms of healing going home and then, and then eventually leaving again as a, was a very informative and healing process for me. Mm-Hmm.

And as a follow up to that, Drew, how would you even define or describe what healing is? Like, what do you, what do you, what have you learned through your patients, through your life, you know, through all of it? In terms of what does it mean to heal? Like what is healing?

A supervisor shared with me a great quote by an old analyst, I think it was Hans Leo who said I’m gonna paraphrase it cause he did. But something was the process of turning ghosts into ancestors, which I thought was I’ve been, I’ve been chewing on for my own practice healing. I, I think one is a stigma, free treatment of symptoms. Mm-Hmm. , when people get real hung up on diagnosis, and I get really hung up on function. Are you loving? Are you laughing? Are you working? Are you sleeping? Are you focused? Are you intentional? Right. Or are you, you know, not, and if not, what’s in the way? And, and, and so I think that that is a, in terms of mental health, that’s a big step. I see people miss. I see a lot of folks with chronic bad depressions who’ve never had a Zoloft trial or a St.John’s ward trial, or a psychotherapy trial. I see a lot of people with the results of chronic trauma, and whether that’s trauma that we think about as trauma, violent trauma or whether it’s the trauma of neglect the trauma of racism, the trauma of emotional discord with family. And, and so I would say that that in terms of, I think of healing as how I approach healing is and remind myself that I create and I hope our clinicians create a safe framework to do something people haven’t done before, and discover something inside themselves that they haven’t discovered before to use the past. And we talk about often letting go. And there’s no way to let go of our past. I’m never gonna let go of my development. It’s gonna be with me forever.

But how can we, how can we really transcend the challenges of our past? And I think as you were saying, how do we listen to that? How do we listen to that voice? Right? At the end of the day, it really only matters to you the way that you live your life, what you value who you spend your time with. You know, this is your journey. And, and so I think healing for many people is coming to terms with that. And so there’s that beginning. Often when I meet people, which is around symptoms, you know, we mostly treat depression, anxiety, end up treating a fair amount of like alcohol use disorder. But but the, the longer process, I think for people is around creating a confidence and a set of skills and a resolution.

You know, often there needs to be a resolution of and an understanding of what’s happened to us. And, and therapy creates a narrative for that. I’m mainly a therapist, I think so mm-hmm. . And then I have to tell you she, I think part of the mystique of it and the, the magic of it, I guess, and, and the faith of, of being a therapist is that, you know, I don’t, I don’t exactly know, you know, I see it happen. I see it happens in a 45 minute arc. I see the, I see something get created and my patients see it too. And we feel it together. But it’s, you know, it’s such private moments with individuals that it, it’s you know, sometimes, you know, almost like when people are talking about how, like psychedelic trips, like you can’t really write about it. Like, you know, transcends words. And like, you know, I, I think that way often about that movement is all about tapping into the things that therapists, psychotherapists, meditators, dreamers, dream interpreters, musicians, artists have, have been tapping into mm-hmm. . And that’s one way to do it. Right. But we, we, we also have the capacity to do that with ourselves all the time. Mm-Hmm.

Yeah. And kinda as we bring our conversation to a closed door, I wanna ask you about sort of the, the model for your practice currently, like how you’re seeing we could be modeling the future, sort of, of integrative mental health, what that can look like. You mentioned psychedelics, obviously there’s a lot of kind of, you know, new exploration research and understanding around the use of psychedelics, some benefits in the literature for depression and complex trauma and alcohol use disorder in particular. And so like, that’s an emerging area. I know you’ve designed your practice as an integrative practice. It might be interesting for our listeners to hear like, what could the next wave or the next level of mental health that includes an understanding of nutrition and what we eat and, you know, other integrative strategies or approaches. Like what do you, what do you see as where we’re going? Like what are some of the optimal approaches for practices that are being developed?

That’s a great question. I’ve gotta say spirit creatures for the last question. I don’t mean to be silly. It’s just that when I think about things that have healed me, a number of animal companions in my life, yeah. Mostly dogs for me, but also a couple of horses been like in like incredibly powerful, especially recently just worked through some things that I don’t think I’d ever be able to work through without this giant horse that I love. So just to say that, that, thank you for asking me this really big question, and I think there’s all, there’s so much new information coming out that I would say that a, the, the integrative clinic that we hope to be in, we have a, a new clinical space opening in Jackson, Wyoming to try and responsibly answer the questions that are coming out about responsible psychedelic medicine.

And, and how do we also then continue and hold up and honor with traditions that we know have taken care of patients for decades. And, and so that, and, and, and how do we honor both of these? One of the things I loved about training in at Columbia Psychiatry and still being on the faculty there, it’s one of the, one of the few places, sort of back then, but in general, where you’ve got some of the best sort of brain meds. Gene people like the hard science of mental health and medications, and the genetics of mental illness in the same room with the psychoanalyst. And they love each other and they respect each other. And, and so doing both of those things well is what a new clinic will have to do. I would say that there are gonna be a few things that get added on.

I think we’ll have a better sense of biomarkers already. We, we think a little bit more around inflammatory biomarkers with patients. Not a lot. We’re not a lab heavy clinic in any way. I think the integrative model is multidisciplinary. I love that I’m getting to teach a cooking class with a chef and health coach Emily Burner. And what I love even more is when patients come and they wanna see me for food, and I say, you know, I’m gonna tell you lentils and pesto, all right, edge, wild salmon, but meet with Emily. It;S a more efficient process and a higher quality in info information. And so whether it’s some of our, our therapists like Samantha El Creef who just has brought so much to our practice or whether it’s thinking about some of psychedelic medicine or integrative and functional medicine and, and some of our clinicians like Donme Setti or, or Sarjehu I think this multidisciplinary team is something that we’ll see in the best centers cuz there are a lot of different things you need to be able to do Well I think there’s gonna, then there’s the question mark, there’s the question mark of where concierge medicine and the advanced kind of echelon of the wellness world is not based in current evidence, but being utilized and, and it’s just a question mark of whether some of these things are, are sort of shams or whether they’re useful.

I also am like a stubborn farm boy. It’s like, show it to me. Show me. You can’t get to good human health and happiness without the tools we have now. Cuz most people that, that we meet encounter there, there’s a lot of things that already exist that we haven’t been utilized that said, there are lots of people really suffering. And I’m excited about the next era. Whether that’s the next era of medications where we understand some of what the psychedelic, you know, some people don’t wanna do a psychedelic trip for eight hours. That’s like the last thing they wanna do, but they’d like to harness the biology behind that. So I think we’re gonna enter an era where there’s a little bit more of a menu. And I think, I hope part of our integrative approach, and I’m, I’m still working on this with our team, but there, there’s more of a partnership, you know, and there’s more of an honor of patient autonomy and selection.

If there’s equal evidence for a lot of different things, what happens if you get to choose the sequence a little bit more? So I, we’ll, we’ll, we’ll we’ll see. I, I think that that, you know, the challenge hasn’t been that we don’t have awesome integrative mental health centers. I don’t think, I think the challenge has been stigma that a lot of people don’t have access to mental health in a way that’s palatable to them or ex or accessible to them. We talked about men, we talked about stigma today. There’s lots of groups who just can’t access care. It’s hard to find a therapist that sounds or looks like them or they feel is gonna get them. So yeah. As much as I love thinking about the future, I also, you know, always like to note that the problem doesn’t exist. Cause we don’t, the problem, the mental health crisis in America doesn’t exist because we don’t have good evidence-based treatments and solutions for mental health concerns. It exists cuz most people don’t have access to them. And we don’t have a culture that allows people to really freely engage in pursuing mental health and mental fitness. And it’s excited to be to you in 2023 as that is shifting. Hmm.

It is. Yeah. We’re in a time of tremendous change. So it’ll be very interesting, you know, a few years from now what this all looks like because I don’t think it will look the same.

Fermented foods, I didn’t say an integrated mental health center will also have a fermentation lab in it.

We’ll have a fermentation lab on site. That’s part of the design. That’s the build.

That would, that would be a kombucha on tap. That’s how we’re building that kombucha tap.

Yeah, that’s the, I put that in the contract. It was like, I don’t come unless there’s kombucha on tap.

Yeah. I know, it’s like the musicians who have their stipulations. You have a stipulation of kombucha tap. It’s just how it’s been.

I’ve been drinking live bacteria this whole time. Good.

Love the conversation everyone. Thank you so much for listening. Please check out the books or let us know if our team can be of help. And I wish everybody the best and Shay, I wish you all the best in your, in your personal mental health journey. And I will see you on down the road.

All right. Thank you Drew. I very much appreciate your time. It was lovely to have you on the show.

Thanks!

Conclusion (01:06:22): We hope you enjoyed this episode of The Conversations on Healing podcast. If you haven’t yet, please go to Apple Podcast, Spotify, or your preferred podcast platform and subscribe, rate, and review. This podcast, it helps so you won’t miss an episode. See you next time.