PDF Summary:Brain Energy, by Christopher M. Palmer

What if the key to understanding and treating mental illness isn’t in the brain itself, but in how the brain gets its energy? In Brain Energy, psychiatrist Christopher M. Palmer argues that mental illnesses result from problems with your metabolism—the process that converts food into energy for your body. He writes that when your brain doesn’t get enough energy, it doesn’t function properly and problems arise. But by making lifestyle changes that boost your metabolic efficiency, you can lessen symptoms or even prevent mental disorders from developing in the first place.

In this guide, we’ll explore Palmer’s brain energy theory and how mental health is linked to metabolic health. We'll also discuss factors affecting metabolism, ways to improve metabolic well-being, and tips for creating a personalized treatment plan. Throughout, we’ll compare Palmer’s ideas to other experts’ views and provide additional advice for improving your metabolism.

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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.

Mitochondrial Dysfunction vs. Mitochondrial Disease

Mitochondrial dysfunction isn’t the same as mitochondrial disease. The type of dysfunction Palmer talks about is technically called secondary mitochondrial dysfunction. This happens when mitochondria fail to work effectively because of another health problem, not because of a genetic issue. Many common diseases can cause this, including Alzheimer’s, diabetes, multiple sclerosis, and cancer.

In contrast, mitochondrial diseases are genetic disorders you inherit from your parents that directly affect the mitochondria. These diseases, which include conditions like MELAS syndrome, Leigh syndrome, and Kearns-Sayre syndrome, are caused by mutations in the genes that provide instructions for making mitochondria. So while primary mitochondrial diseases and secondary mitochondrial dysfunction both impair energy production in your cells, they have different causes.

Part 3: Ways to Improve Your Metabolic Health

Now that we’ve discussed the brain energy theory and how your metabolic health is linked to mental illnesses, 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.

(Shortform note: Gene editing technology offers potential cures for genetic diseases, including some mental illnesses. However, many people worry about unintended consequences and where to draw ethical lines with tools, like CRISPR, that allow scientists to make precise changes to DNA. Some argue that altering genes could prevent suffering, while others worry it may change a person's identity or devalue certain groups. Altering genes linked to depression or anxiety could change a person's identity beyond the epigenetic ways that Palmer discusses. Also, trying to “fix” conditions such as deafness or autism implies that these conditions are problems that need to be solved instead of respecting that they’re parts of human diversity.)

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.

(Shortform note: When your hormones and neurotransmitters are in balance, your body is in a state called homeostasis. Your nervous and endocrine systems work together to maintain this balanced state. Your nervous system uses neurotransmitters like dopamine and serotonin for quick, short-term signals, while your endocrine system releases hormones like cortisol, insulin, and estrogen for slower, longer-lasting effects. When these systems are in balance, you're better able to handle stress, maintain stable moods, and regulate bodily functions like digestion and sleep.)

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.

(Shortform note: The symptoms of acute and chronic inflammation can be quite different. With acute inflammation from an injury, you’ll usually notice redness, pain, swelling, and heat in the affected area. The symptoms are localized and can limit your ability to use that body part normally. In contrast, the symptoms of chronic inflammation tend to be more generalized and subtle. You might experience symptoms like fatigue, insomnia, joint pain, skin rashes, and digestive problems. Chronic inflammation can also impact your mood, leading to anxiety or depression.)

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.

(Shortform note: In In Defense of Food, Michael Pollan elaborates on the decline in dietary quality in recent history. He explains that the industrialization of food production has led to a focus on quantity and shelf-life over nutritional value. For example, the vitamin and mineral content of fruits and vegetables has dropped by 15-38% since the 1940s. At the same time, highly refined grains and added sugars (which provide little nutritional value) now make up over 50% of the typical diet. This means you now need to eat more food to get the same nutritional value people used to get from smaller portions.)

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.

(Shortform note: Vitamin D, potassium, calcium, and dietary fiber are some of the most common nutritional deficiencies, since many people in the US don’t get enough of these nutrients from the foods they eat. These nutrients are important for your health, from building strong bones to maintaining healthy blood pressure and digestion. To get more of these nutrients, eat a variety of nutrient-dense foods from different food groups. Some top sources include dairy products and leafy greens for calcium, fruits and vegetables for potassium and fiber, and fish or dairy products for vitamin D.)

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.

(Shortform note: Environmental toxins may be another hidden source of inflammation and metabolic problems. In Estrogeneration, Anthony Jay explains how common chemicals in certain foods, plastics, pesticides, and personal care products mimic estrogen (a hormone that plays a role in regulating metabolism). These chemicals can disrupt your hormonal balance and can cause a variety of health problems, including obesity, depression, cancer, and infertility.)

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.

(Shortform note: In I Contain Multitudes, Ed Yong echoes Palmer’s suggestion to avoid antibiotics, but he disagrees on the benefits of taking probiotics like those found in pills and yogurt products. Yong argues that commercially sold probiotics are largely ineffective for two reasons: First, most studies on probiotics were done in labs or on animals, so it’s unclear if the results apply to humans; the studies that did involve people tended to be small and likely biased. Second, Yong points out that the amount of probiotics in supplements or yogurt is tiny compared to the trillions of microbes already living in your gut. So, any supplements you consume probably won’t make much difference.)

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.

Choose a Diet That Works for You

Although Palmer’s diet and fasting recommendations may be good options for maintaining a healthy metabolism, you should experiment to find the right diet for your body’s needs. Many experts argue that no diet that suits everyone:

In Outlive, Peter Attia argues that there is no best “universal” diet because everyone metabolizes food differently. However, he does offer some broad guidelines that can benefit most people. In general, people who eat a diet heavy in processed, sugary foods, consume too many calories, and don’t get enough nutrients. For this reason, Attia suggests you focus less on finding a specific diet and instead try to eat more protein, fewer carbohydrates, and a moderate amount of healthy fats. He only suggests fasting if you have metabolic dysfunction, however, because fasting makes it hard to eat enough protein and causes you to lose muscle.

The authors of Life Force add that many of your dietary needs depend on your ancestry. They explain that different groups of people evolved to eat certain foods based on what was available in their environment. This affected their microbiome and as a result, some people’s bodies are better at processing certain foods than others. The authors suggest getting your gut microbiome tested to find out which foods are best for your health.

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.

(Shortform note: In Outlive, Attia offers a similar perspective on exercise and metabolic health. He recommends "Zone 2" aerobic exercise, which is light to moderate in intensity. This type of exercise, according to Attia, helps produce more high-quality mitochondria in your cells, improving their ability to burn fat and glucose. Attia suggests at least three hours of Zone 2 exercise per week for the average person.)

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.

(Shortform note: The inability to exercise (and reap the benefits of exercise) due to health issues like metabolic dysfunction is known as exercise intolerance. It occurs when problems with the heart, lungs, or muscles reduce the body’s ability to take in oxygen, distribute it via the bloodstream, or use it efficiently in the muscles during physical activity. Exercise intolerance is common, affecting around half of the over six million Americans with heart failure for example. The best treatment is usually a personalized exercise training program, with the intensity tailored to your condition.)

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.

(Shortform note: In Sleep Smarter, Shawn Stevenson explains that your brain’s waste removal system, called the glymphatic system, is 10 times more active when you’re asleep than when you’re awake. During sleep, your brain cells shrink by about 60%, making this cleaning process more efficient. If you don’t get enough quality sleep, your brain can’t properly remove these waste products, toxins, and dead cells. Over time, this buildup can lead to major health problems, including Alzheimer’s disease.)

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.

(Shortform note: The discovery of the circadian rhythm dates back to the 18th century. A French scientist noticed that mimosa plants opened and closed their leaves at regular times, even when kept in constant darkness. This suggested that plants had an internal clock. Later research identified the specific genes controlling the circadian clock. So while light is the main cue, circadian rhythms are an intrinsic part of your biology.)

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.

Other Ways to Combat Chronic Stress

In Mind Over Medicine, Lissa Rankin elaborates on Palmer’s discussion of chronic stress, explaining that stress causes your body to go into “fight-or-flight’ mode. While this response can help you survive life-threatening situations, chronic stress keeps your body in a constant state of emergency. Over time, this doesn’t just affect your brain, but it also damages your blood vessels, causes plaque build-up, increases heart attack risk, weakens your immune system, and leads to muscle stiffness and structural problems.

Rankin says that positive beliefs and relaxation activate your “rest and repair” response, allowing your body to focus on important maintenance tasks like digestion, cell repair, and boosting your immune system to fight disease. In addition to developing a sense of purpose, as Palmer suggests, consider some of Rankin’s suggestions for managing stress:

1. Accept negative emotions. Rankin explains that it’s normal and inevitable to experience feelings like sadness, anger, and fear at times. By acknowledging these feelings rather than suppressing them, you can process them more effectively and let them pass. This helps prevent these emotions from spiraling into chronic stress.

2. Meditate. Regular meditation can lower blood pressure, boost immunity, and activate areas of your brain associated with creativity, happiness, and empathy. At the same time, it calms the amygdala, the part of the brain that triggers the stress response.

3. Develop your spirituality. Rankin suggests you acknowledge the sacred in everyday life, trust in a higher power to guide your healing journey, and follow a spiritual path true to your values. She notes that being a part of a spiritual community is linked to better mental health and longevity. Reflecting on what gives your life meaning, as Palmer advises, can be a good starting point for developing your spirituality.

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.

(Shortform note: In the short term, antidepressants can reduce appetite and cause weight loss by increasing serotonin levels as Palmer suggests. However, long-term use can cause a decrease in the number of your body’s serotonin receptors, which increases cravings for carbohydrate-rich foods and can lead to weight gain. Moreover, in addition to causing weight gain, antipsychotics can also lead to other health issues like high blood sugar, high cholesterol, and high blood pressure.)

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.

(Shortform note: The emerging field of pharmacogenomics studies how your DNA affects your response to medications. Your genes can influence how your body processes medications in several ways. For instance, your DNA determines the types and numbers of receptors in your cells, which can affect how well a drug works for you. It also impacts how quickly your body breaks down drugs, which can influence the dosage you need. In some cases, your genetic makeup might mean a particular drug won't work for you at all. Understanding your genetic profile could help your doctor choose medications that are more likely to work well for you and less likely to cause harmful metabolic side effects.)

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.

(Shortform note: As you embark on your metabolic treatment process, consider ways to monitor your progress, such as by keeping a symptoms journal to monitor your metabolic health over the three-month periods—track any changes in how you feel day-to-day, and record details like your diet, sleep, exercise, mood, and any symptoms you experience. Another way is to use wearable technologies, an emerging way to track health biomarkers like blood sugar or cortisol levels. Studies show that 46% of people who track health indicators say it has changed their overall approach to maintaining their health. Many report that health tracking has led them to ask their doctor new questions, seek second opinions, and make different treatment decisions.)

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.

(Shortform note: There are resources that can help you find inpatient or residential treatment facilities. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a Treatment Locator that can help you find facilities based on factors like insurance, cost, and type of treatment. Other resources include the American Residential Treatment Association’s facility locator and FindTreatment.gov, which let you search for treatment centers by location and filter results based on your specific needs.)