What if the key to understanding and treating mental illness isn’t in the brain itself, but in how the brain gets its energy? Could improving your metabolic health alleviate symptoms of mental illness?
Christopher M. Palmer’s book Brain Energy explores the connection between mental health and metabolism. He proposes that mental disorders stem from metabolic issues affecting brain function and offers insights into how lifestyle changes can boost metabolic efficiency and potentially improve mental health.
Continue reading for our Brain Energy book overview.
Brain Energy Book Overview
Brain Energy, a book by psychiatrist Christopher M. Palmer, proposes a theory that mental illnesses result from problems with your metabolism—the process that converts food into energy for your body. Palmer argues that when your brain doesn’t get enough energy, it doesn’t function properly and problems arise. But by making lifestyle changes that boost metabolic efficiency and ensure your brain gets the fuel it needs, you can lessen symptoms or even prevent mental disorders from developing in the first place.
Palmer has been involved in psychiatric research for over 23 years and helped pioneer the use of the ketogenic diet in psychiatry. He’s an assistant professor of psychiatry at Harvard Medical School and is the founder of the McLean Hospital’s Metabolic and Mental Health Program, which aims to research the role of metabolism in mental health and develop metabolic treatments. Brain Energy was published in 2022.
In this overview, we’ll explore Palmer’s ideas in three parts:
- In Part 1, we’ll discuss what mental illness is and why existing theories don’t sufficiently explain it.
- In Part 2, we’ll explore Palmer’s brain energy theory of mental illness and discuss how your mental health is linked to your metabolic health.
- In Part 3, we’ll discuss factors that affect your metabolism, ways you can improve your metabolic health, and Palmer’s tips for creating a custom treatment plan for improving your metabolic and mental health.
Part 1: Why We Need a New Theory of Mental Illness
Before we discuss the brain energy theory, let’s examine why we need a new theory for mental illness in the first place. Palmer explains that our current understanding of mental illness is far from complete: We’ve identified only risk factors—characteristics that put someone more at risk of developing a mental disorder—but we still don’t understand what causes mental illness. Without knowing the cause, we can only treat symptoms—not the illness itself.
What Is Mental Illness?
Palmer writes that mental illness develops when your brain functions abnormally for an extended period, leading to symptoms that disrupt daily life and cause suffering. There are three main ways your brain might function abnormally:
- Overactivity: when a brain function happens too often or too intensely
- Underactivity: when a brain function happens less often or less intensely than it should
- Absence of function: when your brain lacks a certain function due to developmental problems while the brain was forming or cell death caused by injury or certain diseases
Palmer contends that mental illnesses are complex and difficult to diagnose for two reasons: Mental illnesses have no clear causes, and they have varying symptoms and risk factors.
Reason #1: No Clear Causes
Palmer explains that the first reason mental illnesses are hard to understand is that mental illnesses don’t have obvious causes like physical illnesses do. For example, we know that a virus causes the flu, but we don’t know exactly what causes someone to have depression. Because mental illnesses lack obvious causes, they’re difficult to diagnose.
One reason is that no objective tests for mental disorders exist. We can measure signs of physical diseases, like bone mass for osteoporosis, but we lack clear indicators for mental disorders. Psychiatrists instead rely on a handbook called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose mental conditions, and they can only make assessments based on the symptoms their patients describe.
Reason #2: Varying Symptoms and Risk Factors
According to Palmer, a second reason mental illnesses are difficult to understand and diagnose is that mental illnesses don’t manifest in the same way for everyone. There aren’t standard symptoms or risk factors across all cases—in fact, symptoms can vary dramatically among people diagnosed with the same disorder. For example, not all people exposed to trauma develop post-traumatic stress disorder (PTSD), and people who do develop PTSD may experience a wide range of symptoms.
Another complicating factor in diagnosing mental illness, says Palmer, is that something can be considered normal in one context and a symptom of mental illness in another. In physical illnesses, things like low bone density and high blood pressure are universally recognized as signs of a problem. But with mental illnesses, many symptoms might be typical responses to everyday life events.
Take anxiety, for example. It’s normal to feel anxious before a test or public speaking. But when anxiety is consistent and triggered by everyday situations, it might be a sign of a mental disorder. This difference means doctors need to consider the context of symptoms in addition to the symptoms themselves to make a diagnosis.
Evidence for a Single Cause
Palmer contends that, despite manifesting in many different ways, all mental illnesses might stem from a single underlying disorder. He gives three reasons why the complexity of mental illnesses actually points to a common cause:
1. Shared features among disorders: Many mental illnesses, even though they’re listed as separate disorders in the DSM, share common symptoms, risk factors, and ways of treatment. For instance, some medicines work for both depression and anxiety. This hints that these illnesses may not be as different as we assume.
2. A rise in all kinds of mental disorders: Mental illness is a growing problem, with the World Health Organization (WHO) estimating in 2017 that nearly 800 million people were affected worldwide. But it’s not just one disorder that’s increasing—research shows an increase in different mental disorders like depression, ADHD, and schizophrenia. This increase across the board suggests a common underlying factor.
3. Individuals often suffer from more than one mental disorder: Research shows that if you have one mental disorder, you’re more likely to get another. Palmer writes that about half of the people with one mental disorder have one or more additional disorders, a situation known as comorbidity, which hints at a relationship between different mental disorders.
4. A connection between mental disorders and metabolic diseases. Palmer points out that people with mental illnesses often have metabolic issues, which include conditions like obesity, diabetes, and heart disease. This suggests that mental health disorders and metabolic diseases are also linked.
Part 2: The Brain Energy Theory
We’ve talked about how diagnosing mental illnesses is complicated and how there appears to be a common cause that links all mental illnesses and metabolic diseases. Now, let’s explore Palmer’s theory for what that cause is.
According to Palmer’s brain energy theory, mental disorders are caused by metabolic issues. Metabolism is the process that converts food into energy, keeping your cells healthy and allowing your body to grow, maintain itself, and get rid of waste. If your metabolism malfunctions, the energy in your body gets disrupted, and depending on where this malfunction occurs, you might experience a range of mental and physical symptoms. Palmer notes that your brain consumes about 20% of the energy your body produces, which makes it highly reactive to imbalances in the amount of energy it receives.
Palmer explains that metabolic issues occur when your mitochondria don’t function properly. Mitochondria are the parts of your cells that turn food and oxygen into energy. They also influence gene expression (how genes are turned on or off), produce and regulate neurotransmitters and hormones, and manage your immune and stress responses. Thus, your overall well-being and functioning depends on the health of your mitochondria.
Mitochondria that don’t function properly can lead to various issues: decreased cell maintenance as your brain struggles to get the energy required for upkeep, overactive or underactive cells, developmental issues, and even cell death. These consequences dramatically affect brain health and can manifest as various mental illnesses. For example, if cells in mood-regulating brain areas like the limbic system become underactive due to mitochondrial dysfunction, it could lead to symptoms of depression.
Part 3: Ways to Improve Your Metabolic Health
Let’s explore how you can improve your metabolic health and, in turn, your mental health. First, we’ll explore some of the factors that affect metabolism and put you at risk for mental disorders. Then, we’ll outline Palmer’s suggested treatments. Finally, we’ll discuss Palmer’s advice for implementing these treatments.
Factors That Affect Metabolic Health
Palmer writes that all factors that increase the risk of mental illnesses also affect your metabolism and the functioning of your mitochondria. He identifies some of these factors.
Genetics: Research shows that many genes associated with mental illnesses are responsible for your metabolic functioning. Although you can’t change your genes, you can alter how they are expressed. Your DNA contains instructions for how your body functions, and it has chemical tags that can be added or removed. These tags tell your body whether to turn certain genes on or off, for instance.
Chemical and hormonal balance: Palmer says that your lifestyle also affects the balance of neurotransmitters and hormones in your body, which in turn has an effect on your metabolic health. For example, mitochondria help produce essential neurotransmitters like dopamine and serotonin, which affect things like mood and addiction. Similarly, mitochondria play a role in producing hormones like cortisol and insulin, which help regulate your stress response and blood sugar, respectively.
Inflammation: Inflammation is the body’s natural response to injury or infection. While short-term inflammation is helpful because it promotes healing, prolonged or chronic inflammation can be harmful because it constantly uses up the body’s metabolic resources, leaving less energy for normal cellular functions. Lifestyle factors like poor diet, stress, and bad sleep can lead to chronic inflammation, which can both cause and result from mitochondrial dysfunction.
Treatments to Improve Your Metabolic Health
Palmer asserts that, to improve your metabolic health, you must replace unhealthy lifestyle habits that harm your mitochondria with healthier ones. By addressing issues related to metabolism through lifestyle changes, such as a better diet, regular exercise, ample sleep, and stress management, we can reduce these risk factors and treat mental disorders more effectively. Let’s look at these lifestyle changes in more detail.
Treatment #1: Improve Your Diet
Palmer writes that eating a nutritious diet can improve your metabolic and mental health. He explains that dietary quality has declined over the last 50 years: On the whole, we’re eating more low-fiber, high-sugar junk food. A lack of nutritious foods in your diet can lead to mental and neurological disorders because your mitochondria need enough nutrients to function well. Additionally, many of these foods can lead to addictive eating habits, which in turn may result in obesity and insulin resistance, further affecting your metabolism.
To improve your diet, Palmer suggests you:
1. Correct nutritional deficiencies. Eat a diet rich in whole foods and high-fiber foods like fruits and vegetables. Consider consulting a professional to identify deficiencies in essential vitamins, minerals, and other nutrients in your diet.
2. Avoid inflammatory substances. Palmer says certain foods like junk food and trans fatty acids (TFAs) contain toxic substances that cause inflammation, which impedes your metabolic functioning. Some people may also need to avoid common allergens like gluten or dairy that can trigger immune reactions. Additionally, heavy use of drugs and alcohol can also harm your metabolic health.
3. Improve gut health. Palmer writes that probiotics may help boost your gut health, but research isn’t conclusive. Avoid antibiotics and foods that contain antibiotics, as these disrupt your gut microbiome.
4. Consider diets and fasting. Palmer cites research suggesting that the Mediterranean diet, which focuses on whole grains, vegetables, fruits, and healthy fats, improves mitochondrial functioning. The ketogenic diet (a high-fat, low-carb eating plan) and intermittent fasting (which involves cycling between periods of eating and fasting) can also improve metabolism and brain functioning.
Treatment #2: Exercise Regularly
Palmer writes that based on studies, another way to improve your metabolic health is to exercise regularly. To get the most metabolic benefit from exercise, aim to challenge yourself physically rather than just doing leisurely activities. Palmer argues that pushing your body helps improve the health of your mitochondria, so instead of a slow-paced bike ride, consider alternating between bursts of intense cycling and rest, for instance.
However, Palmer notes that if you already have health conditions or metabolic dysfunction, you might not experience the full positive effects of exercise. For example, insulin resistance can limit or even negate the benefits of exercise. However, Palmer still suggests exercise as a way to either improve or at least maintain your metabolic health.
Treatment #3: Get Good Sleep
In addition to improving your diet and exercise, Palmer writes that getting enough quality sleep is crucial for maintaining a healthy metabolism. During sleep, your body undergoes various processes to rest and heal itself. Thus, when you deprive yourself of quality sleep, you disrupt these processes and, consequently, the maintenance and growth of your mitochondria.
Palmer writes that you can improve your sleep by fixing your circadian rhythm. Your circadian rhythm is your body’s internal sleep-wake clock—it determines when you feel awake and when you feel sleepy. To fix your circadian rhythm and get better sleep, get natural light during the day and limit light exposure at night. Every morning, regulate your circadian rhythm by exposing yourself to direct sunlight for about 30 minutes. At night, help your body prepare for sleep by staying away from lights, such as technology screens.
Treatment #4: Develop a Sense of Purpose
Palmer suggests you manage stress better by cultivating a sense of purpose to improve your mental and metabolic health. This sense of purpose can come from various sources, such as spiritual beliefs, personal goals, or community involvement.
Chronic stress takes a toll on your brain’s ability to function properly, affecting cognitive processes like focus, learning, and memory. This is because stress consumes a significant amount of your brain’s energy resources, meaning it has less energy available for other critical tasks like cellular maintenance. Over time, this lack of proper maintenance can lead to more serious issues with your brain’s health and functionality.
Palmer explains that people who have a clear understanding of their life’s meaning tend to manage stress more effectively. Also, when you have a strong sense of purpose, you’re more likely to make healthier lifestyle choices. Thus, make it a priority to reflect on what gives your life meaning, and pursue activities aligned with that purpose. For instance, if you find meaning in creative expression, regularly engaging in art or music could help reduce stress and improve your mental state.
Treatment #5: Evaluate Your Medications
Palmer recommends you learn about how your medications affect your metabolism, especially how they affect your hormones and neurotransmitters. Commonly prescribed medications like some antidepressants, anti-anxiety medications, antipsychotics, and hormonal treatments can have varying effects on mitochondrial function. For example, some antidepressants might boost serotonin levels, which could potentially improve mitochondrial function in some people. Conversely, some antipsychotic drugs designed to calm hyperexcitable symptoms can also suppress mitochondrial function as a side effect.
While Palmer encourages you to be proactive in understanding your medications, he advises against making any changes without professional guidance. Abruptly stopping or changing medications can have serious consequences for your health. So, if you have concerns about how your medications might be affecting your metabolism or energy levels, discuss these issues with your doctor to explore potential alternatives or adjustments.
How to Get Started on Treating Your Metabolism
To start treating your metabolic issues, Palmer suggests you try one metabolic treatment at a time for at least three months so your body has time to adapt. For example, you could start by adjusting your diet, focusing on whole foods and reducing processed items.
If after three months you notice even slight improvements, Palmer recommends sticking with that intervention. But, if you don’t see any benefits, it’s OK to move on and experiment with a different approach, such as improving your sleep routine. If you’re seeing partial improvement to your metabolic health with one treatment, consider adding another to the mix, as this could help address symptoms more comprehensively.
Palmer notes that, when you first begin treating underlying metabolic problems, it can disrupt your body’s metabolic balance. While this transition may feel uncomfortable initially, it’s a necessary part of the healing process. Your body needs time to adapt and establish a new baseline. As you continue with the interventions, Palmer suggests slowly increasing the intensity or dosage to support your body’s ongoing adaptation. This gradual increase allows your body to continuously adapt without being overwhelmed, enhancing the effectiveness of the treatment over time.
For those dealing with serious mental health conditions, Palmer recommends considering inpatient or residential treatment programs that provide more intensive, round-the-clock support. These settings can offer intensive, structured support for those who need more comprehensive care than outpatient treatments can provide. Work with a mental health professional to determine if a higher level of care is appropriate.
