9 Tenets to Build Mental Fitness

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Transcript: 9 Tenets to Build Mental Fitness

Season 11, Episode 13  | September 9, 2025

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Welcome back to another episode of Life Time Talks. I’m David Freeman.
And I’m Jamie Martin.
In today’s topic, we’re going to be talking about Healing the Modern Brain — Nine Tenets to Build Mental Fitness. So studies have shown that over 50 million Americans live with mental health concerns. And that number only includes those who are willing to admit it.
As a result, many people are not receiving the help that is needed in this space. And as science and learnings continue to evolve, we now know that there are proactive steps we can take with our lifestyle to improve our mental health to combat these challenges placed on our modern brain. So Jamie, we got a special guest.
Yes, back with us for a second time is Dr. Drew Ramsey. He is a board-certified psychiatrist, author, and a leading voice in nutritional psychiatry and integrative mental health. He’s a fellow of the American Psychiatric Association and the founder of the Brain Food Clinic and Spruce Mental Health.
For 20 years, he has served as an assistant clinical professor of psychiatry at Columbia University, where he taught and supervised psychotherapy and nutritional psychiatry.
He has also authored five books, including the one we talked about last time on the podcast — Eat To Beat Depression and Anxiety, and his latest book, Healing the Modern Brain — Nine Tenets to Build Mental Fitness and Revitalize Your Mind is what we’re talking about today. Dr. Ramsey welcome back to the podcast. Thanks so much for being here again.
Oh, Jamie, David, everybody listening, it is awesome to be with you. A great way to start the day talking about mental health and mental fitness. So I’m thrilled to be back. Thrilled to be talking about how we can do more every day because I think we can all agree we need a little help with our mental health these days.
Absolutely, absolutely.
Yeah, so Doctor, last time — I want to say it’s been four years. We alluded to that prior to coming on, the behind the scenes. And last time, we were talking about building mental health through nutrition.
This time we’re excited to talk about mental fitness, how to build strength through that today. So I mean, before we jump into that, I know we can get right into it, but is there anything new with you you want to share with our listeners?
Well, I want to share with everybody. I’ve been working on my mental fitness. And I’m out in Jackson, Wyoming now, where I’ve moved with my family. And boy, living out in Wyoming, it’s wonderful. It’s beautiful. And it’s also a place that tests your mental fitness.
And as everybody knows, a move, a transition like that, you got to build new community. You’ve got to make connections. It also can test you. So that’s probably been the newest thing with me.
I’ve gone from being a farm boy out in Indiana, learning about nutritional psychiatry and spending time on my family farm, to being out in the mountains, understanding more about mental health and mental fitness.
I guess that’s a personal update, David, if that’s what you’re asking. Other than that, I turned 50, David. Is that what you’re alluding to there? David, I hit andropause. OK, I hit 50. I hit andropause. I’m going to start messing up right now, actually.
You noticed, man. You noticed. It’s beautiful because I don’t have a lot of gray. So sometimes people just — they don’t see it. But yeah, that’s the other thing that happened.
I would be saying, right now, you’re glowing right now. So I would not say anything about — anything’s pausing on you. You just keep going over there.
That’s what happens when you turn 50. If you do it right, you start to glow a little bit. You get a little content. It’s a really beautiful state. And then the other thing — I do have a little glow. It’s not just 50, I was just out with the American Psychiatric Association, all of my colleagues. It’s like shrink prom.
It’s like some of the — I mean, it’s the people who are the heart and soul of America’s mental health system. I’m beyond inspired. It’s hard to describe what it’s like to be with that many leaders, that many healers, and everybody who’s just thinking and taking care of our mental health, all the new research. So that’s the other thing, maybe, I’m a little jazzed up about.
Love that you’re on fire. I love it. I love it.
Well, to be together with those colleagues, I’m sure it’s great to be together, but also to be talking about what is happening in the state of mental health in the US and around the world.
There’s been an alarming rise in mental health issues among our population. And many people, while they may not be meeting the criteria for a diagnostics with a mental health condition, their well-being is impacted. We know that. We see a lot of people feeling that effects in their daily life.
So let’s get started by talking about the state of where we’re at as a population. And there’s some shocking statistics that you’ve shared on this. And we want to talk through that and just level set with where things are right now.
Yeah, everybody healing the modern brain did come from a very serious place that we’ve got to do more. And we all know that. And I wanted to sound an alarm that mental health challenges are coming for you. It’s not something that a few of us have or, oh, that family that’s got some challenges. No.
All of us have to be on the lookout. The most disabling illness in America is depression. Number two is probably anxiety or ADHD. And we know a lot more about these illnesses than ever before. And I would say we have to do more.
And so what I talk about in the book are both the statistics where I talk about teen depression went from about 8% when I became a baby psychiatrist way back, way back when, about 20 years ago. And now, it’s crept up, from about 10 years ago it was 14%. Now, 1 in 5, 20% of our adolescents are struggling with depression.
We also have some bummer statistics about some of our treatments like SSRI antidepressants are about 50% effective when it comes to teen depression. And so I’m a prescriber. I think medications are really helpful for, actually, a lot of people. But they’re very stigmatized.
A lot of people are unnecessarily frightened of them. And even if folks are interested in them, they don’t get everybody all the way better. And so we need to do more. And that’s where this book really comes from.
We could keep going down the list, but we look at substance use disorders. We have a country that is changing, very exciting. As I was writing this book, I saw people drinking less, turn into kombucha. I did that myself. Really amazing for your brain health.
We’ve seen, of course, the screens take over our lives. We just hosted — I’m part of a Teton Youth and Family Services, this wonderful nonprofit here in town. And we just hosted a youth mental health summit. And they did this amazing exercise.
They took all the teens into a room. And they had a facilitator. And they had all the adults in a room. They had this talk room to room with the facilitator. And it was very interesting what the teens were saying.
You all are asking and we hear you all asking how we’re doing. How’s your mental health? Are you OK? But it doesn’t really seem like you mean it. It doesn’t really seem like you’re listening. It seems like you’re distracted, too. You tell me to be careful on my phone, but it’s where I always find you.
And so there’s a lot of need that we have right now to get more conversation going to see things like schools getting rid of the screens and getting focus back on learning. We also learned, in the summit, these phones are also tools for a lot of us. And we’re doing more. So it’s not just getting rid of it.
So those are the kind of things, some of the headwinds that we’re facing. In my last book and also in this book, I talk about the nutrition is a great example.
And I started with nutrition. And I realized, boy, just like there are certain foods that are better for your mental health and there are certain foods that — it’s been 10 years now of data saying nutrition is one of the biggest drivers of mental health risk.
But there are these other things. I mean, how many people do you know when you say, how are you doing? They say, ooh, last night I slept so well. Let me tell you, I had this juicy dream I want to get into it. It’s 8, 9 hours. Oh, so rested, so much energy.
Or when you asked to schedule, they say, oh, I got a lot of time in my schedule for socializing. What works in yours? We’re all over busy. We’re underslept. There’s a real distractedness. And so I wanted this book to directly address that and to give people goals and aims, just like they do for their physical fitness.
David and I both know that we’re working on our core, so as we age, we can get those thirst traps — zaddy thirst traps on the Instagram. At least that’s what I’m working for.
What about the other part, probably the most important parts of our health? What about the aspects of our mental health that we need to work on? We can’t just — just like our core, just like our flexibility, we can’t just be lax.
And so that’s where mental fitness comes in. And these nine tenets, I think, we agree on. Nobody’s going to argue around sleep’s important. I don’t think we’re going to get a lot of argument around — I recommend and I’m, I think, known for this in the space.
I like having a lot of fun with people, and their food, and recommending whole real delicious foods, recipes, enthusiasm, farmers markets, CSA boxes, meat share.
I mean, there’s a lot of excitement that I have around your nutrition because I just learned over the last two decades, we are so blessed. There are so many amazing food resources.
I know we have a lot of hunger in our country, but we also have a lot of resources. We have incredible farmers, and small farmers, and family farms, regenerative farms. I mean, it’s really popping. So we need to remind people, just like with nutrition, you can hear my hopefulness, my excitement. You want to hear my pesto formula and recipe.
Send it over.
Yeah, you want to — let’s have dinner and feed your brain. Wow. That’s super fun and delicious. Just like with that, I hope these other tenets inspire people.
I guess, to turn to me from the grim statistics of yes, more people than ever, 50, 60 million Americans are struggling right now, this year. They woke up and they checked in with themselves. They use some of their tools, probably.
Some of my patients, after this call, I’m going to be checking in with. I am working with a number of people right now who are in tough spots. And so I think we need to remember that.
Before we get into the tenets, I also do just want to say I do have this new sound bite I’ve been breaking out, which I do also want us all to be really mindful of how we judge other people’s mental health treatments.
I’ve noticed that a lot where people have strong opinions about everything from the stimulants, medications like Adderall and Vyvanse, or antidepressants, or certain types of psychotherapy, real strong opinions.
And if you’re an expert in mental health, I guess that’s OK. But I don’t find there are a ton of experts who actually have that strong of opinions. They have very nuanced opinions.
And so we just want to be really cautious that everybody in America and everybody around the world feels the freedom to make the choices they need to make about their mental health and get the treatment that they need.
Otherwise, we live in a world of stigma where I’m not actually going to make the right choice based on the science. So sorry for that little PSA. I just think that we all need to loosen up a little bit in terms of our opinions.
Well, I mean, speaking of loosening up, I think when you define mental fitness, speaking from a male’s perspective, there’s so many times that it’s suppressed in a lot of ways because as a male, you don’t want to express certain emotions because it might come off, perception wise, as weakness.
So speaking from a male’s perspective, myself, a lot of the things that might be felt are not expressed because — I’m good, I’m OK, are certain terms that we usually say or phrases that we say.
So when you say mental fitness, as a definition, I know this could be broad here. But can you break that down and share with those who are listening, male and female. But I was speaking from a male’s perspective, how to get the reps in this realm, as far as mental fitness.
Yeah, that’s a great question, David. Let’s talk about the reps for men and for women. But I hope this appeals to men as is. And I hope you know I’ve been working very hard with Men’s Health Magazine, with my buddy Greg Scott Brown.
We’ve interviewed hundreds of men over the last few years about male mental health, mental fitness, what they do, how they got their first session in, what their reps look like.
And so I define mental fitness in this book. There is a few things. There is knowledge. I want to up level your knowledge. You’re not thinking about mental health according to the latest science, I’m sure of it.
You’re not thinking about sleep hygiene according to — I don’t know. You’re not trying to get your glymphatic system to get rid of all the waste up there. But as soon as you read this book and think about new modern sleep, that’s how you’re going to think about it. It motivates you a little differently to go to bed early.
It’s about identifying your patterns and building new habits. This is a big part of my book, big part of my work as a psychiatrist. As I sit with you, what we’re trying to understand and observe are the active choices that you’re making, and sometimes not making, and understanding those patterns.
And habits — when you get in a habit — I’m in the habit of not drinking alcohol. Ooh, boy. That’s nice. I was in the habit of drinking alcohol. I don’t know. It wasn’t awful. I had a lot of fun.
I see all those — my iPhoto album reminds me all the time. I show my wife. I was like, dang, this guy’s happy. That big grin. They’re holding the drink. And so I’m a little different now, but I’m in the habit of that. And I’m very grateful for it. It’s been very good for my health and for my relationships.
As people get older, they get in the habit, often, of getting up earlier and using that morning time really effectively. And so getting in some new, healthy, wonderful brain building habits.
And then people need some new skills I found. I learned in nutritional psychiatry — boy, I could talk about kale all day long. People needed some recipes. They needed some — they needed to learn the chiffonade.
You don’t know the chiffonade? Chiffonade is that little thin — you roll it up and then you thin slice it. There’s some things to learn. There’s a way — there’s some skills around, for example, how you organize and keep your bedroom prime for sleep.
There are skills that you need around — for example, I’m still working on that skill of thank you notes and writing them. We’ve gotten some written. I’m going to mail them. And mailing them — it’s really important for me. Actually, it’s one of my big goals this year for my mental fitness, so getting those new skills.
And all this culminates in a more enjoyable, more mentally sound life, meaning that if mental health challenges come your way — and I don’t mean to be a downer here, but I just — I treat everyone, all walks of life. It happens to everyone.
The more you can have knowledge about it, the more you can have skills and tools, the more you can have a set of good habits. You whether that wave much more effectively. I think mental health problems are less frightening almost.
And so that’s how I think about mental fitness. And you get in those reps — I’m annoying. This whole three day a week, I was like, no, no, no. Your brain and your mental health, most important assets. This is every day.
Yeah.
And it’s even worse than that. It’s every day and I want you to like it. I want you to fill your life with activities that you, your brain, and your immediate group around you enjoy.
Yeah.
I think that’s probably one of the things when they asked me [INAUDIBLE] what’s different? What’s different is I’m in a community where it’s every day. Every day in this community, people are out. They’re active. And if you’re really in the know here, you’re twice a day.
You start your day out on a mountain bike. And then after work, you meet your friends and you hike up Snow King. I mean, it’s hard. It’s almost impossible to keep up.
But then you start — then you start trying. And then suddenly, you’re in that daily habit of really caring for yourself, prioritizing that, thinking about yourself — as a sometimes I tell my patients — it’s like, you got to think about yourself like a thoroughbred racehorse.
They don’t give the thoroughbred racehorse regular hay. They don’t give the thoroughbred racehorse regular stall. They get a lot of extra care because they do something extraordinary.
And I think you too, everybody listening, everybody’s got some extraordinary things in them. It’s not something the whole world maybe is going to hear about. For most of us, certainly not.
It might be something just a few people or only you know about, but I do believe all of us hold extraordinary things in us. And mental fitness, I hope, helps people tap into that and reach that a little bit more effectively.
Absolutely. I just think that’s really inspiring. This is the one body, the one life that we have. Let’s treat it as if it is that extraordinary thing that we have.
And we deserve that kind of care and treatment like we would want for anyone in our lives, but turn it around on ourselves. Look in that mirror and know we deserve that too. So I really love that perspective. Thank you.
We’ve talked a little bit about this already, but I want to jump to just the signs that somebody might be struggling with their mental fitness. I mean, in some ways, they can be super subtle. But what are ways that we might identify this?
And you already mentioned lifestyle habits that could be causing this — picking up our phones all the time and all those things. But what are some of the other things that can become a vicious cycle for us and just keep taking us in a downward spiral with mental fitness?
Yeah, for sure. Well, I think that you’re talking with the screen. I think if we unpack that into what I call digital stimulation, where you’re not making the choices about what gives you that little dopamine pleasure.
And you’re not actually in seeking anymore. You’re in receiving. And you’re in this mode of algorithmic receiving. And the algorithm is very good. If you’re a man, you’re going to get a mix of very active content. You’re going to get some testosterone influencers.
And gentlemen, I know that you know all the other things the algorithm feeds you. We don’t have to say it here on — we don’t have to say it here out loud.
But it’s a little terrifying when you go to check your phone and suddenly you’re getting dealt some images that you would not be looking at the dinner table or hanging out in your house usually.
So that’s a bigger challenge than just the screen. I think we make it the screen, but there’s a way that we’re missing something authentic and we’re missing something that it aggregates, that it builds over time.
Each time I see a patient, something is building — my skills, my knowledge base, what I’ve heard about, what I’ve witnessed. And so it’s very rich. Each time we pick up the phone, something doesn’t necessarily aggregate. We’re not after something. We’re not witnessing something intentional.
And so I think spending time away from the algorithm and building your own algorithm, like, how do you build happiness? Just like I did for nutrition. Seafood, greens, nuts, and beans. David, which one’s your favorite seafood? Jamie, what kind of fermented foods do you like?
And now, we’re planning a shopping list, some experiments, and dinner. And it’s very concrete. And so mental fitness — I want to take this — da — it was the algorithm just came — I said algorithm and Siri came on. That’s terrifying.
That’s how it goes.
No, it’s like you’re questioning me? I’m the overlord here. Sorry, you don’t like the algorithm, Ramsey? What was that? I was like —
I’m right for you.
Connection unstable. That’s terrifying. So in all seriousness, everybody, I believe these digital tools are here to stay. They’re going to help us. But as we go through the tenets and think about them, you’ll hear they’re very intentional ways I’m wanting to get you in with yourself, with your mind.
That’s what I’ve gotten to see with individuals if they’ve gotten hold of their mental health. And what I found interesting being a psychiatrist — I’ve been really blessed. This book is about my patients, and me, and our mental health journeys.
And the book is dedicated to my patients because these are really the lessons that I’ve learned from them. You learn very quickly as a psychiatrist to listen, obviously. But you get a notion of, really, needing to be humble and to be curious.
And in that, you hear a lot of things, things sometimes that maybe we don’t emphasize. We didn’t emphasize nutrition when we learned to be psychiatrists. But I think every psychiatrist knows, boy, if you eat better, you feel better. And there’s a certain healthy diet that we want our patients to eat.
There’s an emphasis on sleep, but we don’t really emphasize, how do you get people into amazing sleep hygiene? What does that look like? And so as we think through these tenets and think about, really, the way that we activate them in our lives.
Part of what we’re up against — again, there is a lot of stimulation, a lot of artificial light, and a lot of fetishization, I call it, where there’s this — we think about the — it’s a mix from, I would say, the news cycle, where we’re hooked on a constant need.
I was at a conference. They were talking about the 24-hour news cycle. That’s now a thing. That’s never been a thing before. So when you think about, again, what we’re up against, what our kids are up against, that there’s this notion of, you’re missing out if you aren’t always plugged in, always checking in.
And that’s very bad for us because we begin to look out here, out there. And we stop looking inside. And I’m not trying to make us all selfish creatures. I just think part of where humans are really struggling to connect, to manifest, to love one another, to transcend, all of the primitive feelings that we can have.
Part of that is that we’re way too distracted. And we’re not actually doing the work that we all need to do to build a healthy community, build a healthy society, and handle the struggles that are inherently human.
Well, I know everybody has heard it a few times now. And they’re curious to know the nine. So we’ve been dangling that carrot. Let’s go ahead and give them that nine course meal.
All right, as far as the core tenets for mental fitness. We’ll ping pong this back and forth. You just get ready in that hot seat over there. So let’s kick off with self-awareness. Break that down for us.
OK, self-awareness. You cannot manage what you can’t measure. You can’t begin to make changes in yourself if you don’t know what’s going on. People start down some path. I see this all the time.
They meet someone who has a solution. And they don’t take a step back and actually assess and evaluate what’s going on. Ranging from the symptoms you’re having, if you’re having a mental health thing, to your life stage. Are you in your 20s?
I love working with people in their 20s. It’s a little annoying now because I’m in my 50s. And I’m like, oh, it gets rich, baby. Just trust me. That’s not very helpful advice. But that’s a little how it feels. But problems are different when you’re worried about your finances or your profession when you’re 20 or when you’re 62.
And so being really aware. I find this a lot of times when people are getting advice. And, I don’t know, if you’re a pregnant woman, you should not be getting your advice from your friend who swaps between veganism and carnivorism about pregnancy nutrition.
You need to know, hey, you’re in a special state. This is a special stage of your life. You need real experts. And so self-awareness, huge part of the book. Huge part of everybody’s journey and something that we — it doesn’t stop.
I’m joking with David about andropause. I’ve got teens now. What I’m thinking about, what I’m struggling with, what my challenges are — very different than 5 years ago, 10 years ago. So that’s self-awareness, one of my favorites.
Oh, that’s so good. I mean, it’s just like — again, you just mentioned distraction right before that. Being willing to turn backwards and really reflect on where you are and the current circumstances that are going to change over time. So I love that. OK, the second tenet is — you’ve already alluded to this, is nutrition. Huge for you.
We’re going to do — I want to hear that [INAUDIBLE]. We’re going to go back. What do you guys do for your self-awareness? I said, it’s every day. just curious. You two are very mentally fit individuals. What’s on your self-awareness plate?
Yeah, I kick off my day — I usually have early morning days, whether it’s 4:00 or 5:00, getting up. And before getting out of the bed, it’s just that moment of gratitude of, wow, I just woke up, for one. So being grateful for that moment.
And then being asked to pretty much use me in the way so I can be the light to the world. So just grounding me as far just as being a servant leader and tapping into whatever that superpower will be for the day. So I just reflect as far as use me in the way that I need to be used to help impact and elevate lives around me.
Faith based intention is what I hear in that. And for people who have spirituality or people that’s been part of your past and you can tap into it, especially I love that first thing.
And it’s also you can hear by — if people hear “self-awareness,” oh, it’s going to make me selfish. Anybody, did David just sound selfish? I want to be of service. I want to be — please use me, make me of service the best — I mean, that’s a beautiful intention. Jamie, can you follow that? That’s tough to follow.
Oh, that is tough to follow. It’s really tough to follow. As he was saying that and I just was listening to you, mine is really at the opposite part of the day. I’m more of a night — I’m a night owl for myself.
And it’s taking those 20 to 30 minutes when I’m by myself at night to just reflect on my day. It’s a little bit of that gratitude practice in terms of, how did today go? Acknowledging just what was hard, what was good, and just being real about the circumstances that I’m currently facing.
Just being, OK, this is where we are. Now what? And being willing to sit with that and then know today’s a great day for what it was. It gave me a gift. And now tomorrow is another day. And so having that awareness and that reflection is something I’m working on. And also a little bit of meditation.
We have this event happening at Life Time right now, where we’re doing some meditation. I’m trying to do it even just for five minutes to just be quiet and let thoughts come and go and not judge myself for them. That’s where I’m at right now.
Yeah, it allows you to check in. And I think also it’s something I’ve learned treating a lot of wives over the years with problems husbands have, the husband-fix-it problem.
That’s the one where husbands hear about something, and before you even finish your sentence, they got a solution. They’re ready to fix this problem. And I think meditation and sitting with our thoughts, watching them, feeling them, not trying to do anything about them right away, again, allows us to have the self-awareness.
I love this way that you — everybody listening, you hear these two very classic bookends to the day. And I encourage everybody to try and engage in a little of both. And I love that way, Jamie, you’re framing things.
And also a big part of self-awareness is sitting with the reality. Our reality isn’t always unicorns and rainbows. It’s not human existence. Sometimes, those are amazing, but there’s a lot of other facets of our lives. And so I love those. Thanks for sharing your self-awareness practices.
I think the journaling is one that I also hear a lot of. Everybody groans and rolls their eyes. And then they get to it. And it’s really amazing what you write to yourself, not necessarily dear diary, just dear, David.
Yeah, it’s a good just a practice to just also know where you are in any given day.
Yeah.
All right, so self-awareness. I can see why that’s a favorite. Nutrition, yes.
Well, it’s a favorite because it’s so metaphysical. Who are you? Where am I? It’s also an act of self — it’s the first step in self-love. So many people are in service of others, especially women listening. So much service. Not that men aren’t in service.
But there’s a way that often people reflect that they are not caring for themselves. They’re almost blocked with caring for themselves with the same vigor, the same intensity, the same nuance, and the same listening attentiveness.
All right, well, let’s get into nutrition, everybody, because I wrote a whole book on this. Nutritional psychiatry is exploded. The American Psychiatric Association — you all won’t believe this.
I served up raw oysters on the half show once, which violated a lot of health codes in Toronto. I’m still actually working with some of the fallout from that.
But this year, they were really organized. And we had cooking classes and yoga every morning. Meditation. It was a lifestyle focused theme. They gave an award for lifestyle medicine from the psychiatrist to Dean Ornish, one of our real leaders, lifestyle medicine, focusing on things like nutrition, movement, sleep hygiene.
So it was really exciting to see that nutritional psychiatry has exploded. 10, 15 years ago when I talk about this at our annual meeting, I get teased a little bit. They call me Dr. Kale. It’s like, ha, ha, ha.
And now, it’s dozens and dozens of talks about how nutrition impacts mental health. So there’s been all this data about a Mediterranean diet for people with bipolar disorder and severe mental illness.
There’s this really interesting study that just came out of Stanford last year about a ketogenic diet. There are now 7, 8, 9 randomized trials for depression.
If anybody listening is struggling with depression and you’re not eating a Mediterranean diet or not eating this brain food diet, the data says that if you adopt a Mediterranean style diet, 30% to 36% of you will go into full remission from your depression.
If that was a medicine, it would be one of the most powerful medicines on the planet, what we call treatment resistant depression, which we’re trying to change that name, actually, because it makes it sound like patients are resisting.
And that’s not true at all. I’ve never seen anybody resist an effective treatment for depression. Instead, it’s people that we haven’t been able to help yet. And so nutrition is a big part of that.
Like I said, seafood greens, nuts and beans, and a little dark chocolate. And then I haven’t figured out my rhyme, but it’s rainbows and fermented foods. I’m not sure how to end it, but it’s something like that.
But those two foods — those are your food categories. And what that allows us to do is not be in the kale wars. We’re not fighting with the vegans or the carnivores like zombie apocalypse.
But actually, the eaters in the grocery store and thinking, OK, what have my seafood meal’s been because that’s where my omega 3 fats come from. OK, fermented foods, all this new science about the microbiome.
The way you access that science as an eater is by eating more plants, more diverse sets of plants, and more fermented foods. I’ve talked to all the microbiome experts and that’s the consistent advice.
They’re not like, oh, I’ve got the special probiotic. None of them. They’re all like, oh, do you know about kefir? So it’s a really, again, exciting time for nutrition in your brain health.
Some people, I think, feel it’s a lot of hype. And I think you have to be very mindful and find the right experts. But nutritional psychiatry, the science is real.
Last stat I’ll just throw. Your kid’s heading into college. What’s the top piece of advice you can give them to reduce their risk of There’s a study in Spain.
Alma Viega Sanchez is a researcher at University of Las Palmas. And she and her team followed 10,000 university students for 4 and 1/2 years, so all of college.
And what they noted is the people who are in the top half of the class — ate — most like grandma ate — ate that Mediterranean style diet. Some anchovies, more tapas, more real whole foods. Their risk of depression was 35% to 50% lower.
I mean, it’s just wow. That’s incredible data. So other studies have looked at all of these together and saying populations that eat more traditional, healthier diets have about a 18% to 20% decreased risk of depression.
So again, that’s what nutrition is. And it shows that mental fitness of, hey, if you’re struggling with mental health, this is something that can help you get better. Almost everybody agrees.
And if you don’t have a mental health problem, but you’re like my family. You got some stuff in the past generations. You’re on alert. You’re on lookout. You want to do something to help your mental health. It’s great preventatively. It’s great to really make sure your brain is fully nourished. So that’s nutrition.
Makes total sense.
And then taking the nutrition, obviously, great for the brain. And now, we’re also talking about how can you fuel through movement, which is our next tenet, so how nutrition can fuel movement and movement being another tenet. Why is that one’s so important?
Well, everybody knows moving your body is one of the best things. It feels amazing. Nobody finishes exercise and they’re like, that was awful. Even when it hurts, people were beaming. Always says, it’s so hard to feel amazing.
Even with that feeling, it’s tough for us to get out. I was just with Doug Noordsy who’s probably psychiatry’s leader nationally doing the research about how exercise impacts mental health.
And he has this amazing review paper with he and his colleagues. It’s a multimodal intervention. The data starts, inflammation, how it affects inflammation, how it affects things like muscle growth. How when you move your muscles, you excrete these things called myokines.
And myokines trigger brain growth. And so there’s just all this amazing data. How it affects your sleep. Everybody knows if you go out, you work hard, you exercise hard, you have a big physical day of labor, let’s say, you generally sleep really wonderfully.
And so there’s all these ways that movement benefits us. That said, 80% of new jobs are sedentary. That said, one of the side effects of white lotus is 8 hours, 10 hours, 16 hours on your butt, very stimulated and excited, not moving.
But that’s a lot of sitting on your butt. Binge watching. That means sitting still for hours and hours and hours. So how do we get moving. How do we get active. I think the good news is everybody’s heard about this.
I call it movement in the book. Everybody, I don’t call it exercise because I want you to go dancing. I just think if you’re going to pick something or if you’re not exercising, if you’re one of those people you keep buying running shoes and going out, stop. Just stop.
I don’t want you to do any of that. I want you to go dancing. Seriously, if you look at the meta-analysis, all the studies put together of movement, the one that seems most effective for depression is dancing.
Boy, it makes sense. You got music. You got a partner. You’re swinging, and grinding, and twerking. I don’t know what people are doing. They’re doing fun stuff. And we all know that.
When you get to be my age, and it’s like you mostly dance at weddings. And it’s a shame. You look at what I would say cultures that have a little bit of a healthier lifestyle. You look at what else is in that Mediterranean lifestyle besides the healthy food, they do a lot more dancing. They do a lot more singing. They do more going outside. So movement is what we’re after.
Yeah.
All right, so after movement, we get into sleep.
Sleep — I was going to say, what you talked a bit about already.
Talked a little bit about, [INAUDIBLE] just the glymphatic system is the thing I’m going to dangle out there. 2014, we didn’t even know about it. But everybody, what happens when you eat a lot of food? What happens when you burn fuel in your car? You make waste.
And so your brain is your most metabolically active organ, meaning it burns more fuel than any other organ. Neurons are burning more fuel, so they’re creating more waste. But I never really thought about that. Did you? Your brain has — I don’t know, it’s like brain sludge, I call it.
Only because we’ve reported on it a lot, that’s how I know about it.
OK, right. So the glymphatic system didn’t get discovered until 2014. They estimate 7 grams of brain sludge comes out of our brain. And so again, this is why sleep is so important. And so many people are struggling.
The numbers are horrible when you look at how many adults in America are struggling with insomnia in some way. And as a psychiatrist, I find, you ask people, how is it? And people say, it’s not the best man. I tried for six to eight hours.
And I just don’t think that’s good enough. It’s not a good enough assessment. Oh, what’s that mean, try? Tell me about it. What’s your bedroom like? What time do you eat dinner? What do you eat for dinner? When was your last caffeine?
Tell me about the light quality in your bedroom. How dark does it get? Do you monitor your sleep? I now have four, going on five years of sleep monitoring data, so I know exactly where my challenges are. I know when I have a good night of sleep.
A lot of people are monitoring their sleep now, so it’s a very exciting time for sleep. So we talk about sleep in the book, again, something I want you thinking about every night, not trying to catch up, really honoring just like you do movement and nutrition.
Awesome.
Nice. Big one for me. Connection for us all. I would hope.
All of us can.
[INAUDIBLE] connection.
Yeah, I want to hear about that. It’s a big one. What are you feeling?
Well, we were talking about superpowers, as far as — if one thing that’s been a constant in the health and fitness industry as coaches. And I was, like, my constant has always been connection, human connection.
And you heard it in the self-awareness, as far as just use me in a way, and then to make or create the biggest impact to those that come in contact with.
So connection has always been huge for me, just because I know that whatever a person may be going through, if I have that opportunity as far as within that hour to create positive change for them to be contagious, to take that to whoever else that they come in contact with beyond the four walls. So that’s why connection is huge for me.
Oh, I love that, David. I think about that a lot. Sometimes sitting here you realize you’re helping someone who’s leading a family, someone who’s leading a company, or someone who’s going to work.
They’re not leading. They’re just there. And the more positive energy they can take, the more health they can take into that situation, the better it is for everybody. And that always can be a challenge. So I love that.
Connection is something that — I like what you’re illustrating, that connection is in some ways one of the scoreboards and that we can see the results, see results of the efforts.
We can see where we’ve done a good job reaching out and being both influenced by. I know you’re quite inspired by these folks you’re helping and also, have helped too.
So connection is one of those things I look at as a psychiatrist. And in the book, there are a lot of journaling prompts in the book, not a lot but a few chapters of journaling prompts and some exercises because I really wanted to create something actionable.
There’s so many self-help books there. It’s got mantras and ideas. And I wanted to give you things to do. We have mental health awareness every month — every year rather in May. And I love mental health awareness month.
But I always remind people that awareness without action doesn’t get us there. And we need actions. And so connection, how do you take connection on that?
Well, again, the first step, again, is that awareness assessment. And so we talk about your web of connection, thinking through inner circle. And there’s a wonderful interview, Mental Health brought in some real luminaries. We talked to Jeremy Butler the NBA star.
And we’re all waxing on. He was like a male mental health thing about vulnerability and how to be vulnerable. And he was — it’s Jimmy Butler, sorry. Don’t be vulnerable to everybody. You need to be very selective.
And it inspired this chapter, where encouraging people to really think about who is around you and what roles do they play and to acknowledge not everyone is for everything.
You have mentors and people in your life who help you with something very specific. There might be other things about them that you might not even respect or look up to but there are certain things that they’re there for you. It’s a reason that they’re in your path.
And so understanding your connections, thinking about institutions is a big one. I think especially right now is that’s really — I’m a good example of someone who’s just — institutions have taken very good care of me over the years.
I’ve been blessed with scholarships — Indiana University Medical School and the Hoosiers of Indiana and their tax dollars helped pay for my end of my high school at an amazing academy that Hoosiers created, the Indiana Academy.
I’ve gotten help at Earlham College. As I’m getting older, it’s one of those things that’s more and more clear to me. The institutions that helped shaped me and formed me.
Everybody listening has that, whether it’s educators, whether it’s your pastor at your church growing up, whether it’s that hometown that you moved away from but you haven’t been back to but some really powerful things, some and powerful people were back there.
So making sure to keep making those connections and also playing it forward — as you get to be a little older, making sure to mentor people, have people that you can help and take pleasure in their accomplishments.
So again, these are all aspects of our connections that if we’re a little more intentional about, you realize — I had this realizing, oh, it’s 15 years ago. I hadn’t refreshed or added on some new mentors. I went around and asked. I looked and started making some new relationships. Boy, wow, really people who’ve helped propel my career to the next level.
Same thing I’ve noticed recently with friends. I noticed my wife Wives are, like, wow. They always stuff like book club. Have you noticed this? My wife just had book club last night.
It’s all these friends, and all that eating, and talking about a book they all read. When do guys do, like, a book club or get together like that? And I was — I’ve heard myself actually reflect on that three or four times. Like, ha, ha, ha.
And then I decided today that I’m going to call four or five guys today or text them or something and be like, hey, our wives are getting together. And I think we should.
Do the same.
And I guess putting out dates is a thing that we’re — I’m bad at. I don’t know what — I’m ever going to [INAUDIBLE] I don’t know what I’m nervous about. It’s just like I’m ashamed. I’m not really that indoctrinated into that behavior somehow.
And again, connection challenge. That’s on me. I’ll send that text today or I won’t. I’ll work to get that group together or I won’t. And so again, just for everybody listening, I hope this is resonating with you of if you’re feeling isolated or alone, one is not true. That’s just not true.
I felt very much that way in the depths of some bad moments. And boy, it’s just not true in any way for me. And so it’s amazing. You asked about earlier about the mental health crisis. What I find amazing is how our minds can deceive us.
So I work a lot with patients that a commitment to a treatment plan means not doing what you feel, doing what you know. And sometimes there are two different things, especially of really bad depression or really bad anxiety.
What you feel is — and if you follow that, you’re going to be avoidant. You’re going to have a panic attack. You’re going to be isolated. So again, connection is a huge thing, huge thing for our mental health.
Nothing really protects your mental health like your personal relationships. It’s the first person you’re going to go to when you’re struggling. The first person you’re going to tell. So you really want to make sure you’re creating relationships that have the quality that, again, it’s not just for you. This protects your friends, your loved ones.
Because when you’re that person that people come to — I’m really lucky I get to be that person a lot when people have mental health problems. To me, that gives me the signal that I’m doing it right. People are trusting me with the deepest stuff. And to me, that signals that I can do the same thing.
Yeah, it’s safe to do that.
Huge one.
Grounding, I’m really curious about this one. Tell us what this means. It’s tenet number six.
Your tenet number six — tenet number six is a trick, Jamie. Tenet number six, engagement. So tenet number six is engagement.
Did I miss some?
Seven is grounded.
Oh, we got to swap them.
There are little sequences that you can — people ask, is it an intentional sequencing? And you can do grounding and engagement either way. Let’s just quickly start.
Engagement is just — it’s a very simple tenet as what it sounds like. It’s about building something called your cognitive reserve. It’s about reclaiming your mind from the algorithm.
Again, you can map out your connection web, but if you don’t engage with that information — you can go and get a degree in whatever. But if you don’t engage with that information — we can have connections in a relationship, but if we sit down at that date or at that book club and I’m not engaged — I’m on my phone. I’m distracted. I’m upset. Whoa whoa, whoa about whatever, my renovation project. I need to talk about it one more time.
I hate it when I leave things like that. I hate it when I just blabber mouth about whatever. And I wasn’t engaged. I wasn’t really — that sense of being present. So engagement, again, is a request that people really use your mind as a laser like tool, something that can focus and can be engaged.
And I know so many people are struggling with that. We have this — everybody’s thinking about ADHD. And I just spent half a day in an adult ADHD course. I mean, about 4.1% of the adult population has ADHD.
I also think as we up the distraction, we up noise, we up light pollution, we increase the number of connections we have, and the apps we’re checking, and all this stuff, everybody can feel some of the symptoms of ADHD. Misplacing things, losing things, cognitive fog, not completing tasks. So again, engagement is my request to fight against that.
Then Jamie, then we get into grounding. And grounding is really about some of my personal journey and some of what the data says. And it’s about being in nature. You can see this office of mine. There’s plants in every room that I’m in. I always have plants.
If you see my Instagram — I hope you’ll check out my Instagram. My most recent reel is a reel of all of me and all of my psychiatry colleagues from around the world. And it probably — to me, I posted it.
And I think it’s maybe the most meaningful post around connection I’ve ever put up, where I just — I don’t know. I’ve been feeling in a isolated spot. And then I get to smacked in the face with, boy, just how wonderful profession I have, how many wonderful colleagues I have.
But to get back to grounding, you’ll see a lot of nature because I like getting out. I grew up on a farm. And then I moved. I spent most of my career in New York City.
And boy, Central Park and those woods in Central Park and the Inwood Hills Forest, which is huge urban forest and the very northern tip of Manhattan. It just became these lifelines for me, these places to go.
Oh, I just feel my whole nervous system settle down. And at first it’s just it’s because I’m a redneck. I’m from the country. I was, like, of course. But then I realized, no, there’s a lot of science behind this. Yeah, it’s not just that I grew up out in the farm. I mean, that certainly has something to do with it.
People can experience this really easily. Take off your shoes and walk in the grass. Take some deep breaths, really feel that. I love going to places where you get overwhelmed with the nature like a greenhouse.
When I was in medical school at Indiana University, we did our first two years in Bloomington, Indiana. And the medical school back then was right next to this big arboretum. Sometimes you’d walk into the lobby into med school and smell it. It’s ozone, and warm, humid air.
And I remember in the middle — it was one horrible test. We had a 15 minute break. I just followed that smell. I was falling asleep. I was not doing so well. And I walked through the arboretum. And I just — oh, I just came alive. It was like extra oxygen.
I don’t know. It just really lit me up. And part of it was just being there, seeing all the different plants, being very inspired by all the nature and then getting back to my bio chem test.
And so again, nature is all around us. You don’t have to move out to the middle of Wyoming. That’s where my journey has led me. Just because I’ve had a lot of nature and there’s something for me right now.
You get out into the mountains here — Jackson, Wyoming is right on the edge of the wilderness, Yellowstone Bridger-Teton National Forest.
And so if you start walking out of town, it can get pretty dangerous. There’s not anything for hundreds of miles in every direction. And so there’s a power of the nature here that I’ve never experienced before or in this raw of a form.
You go out with your kids for a walk in nature and suddenly you’re standing next to one of the scarier animals out here, the moose, which get very terrified and stomp people, or you bump into a grizzly, or you bump into — so there’s something about the big nature that I found really compelling but I guess what I want everyone to hear.
And I think we all appreciate, whether it’s when you lay down on the beach or whether you dive into the water on that cool lake this summer, or whether when you — that snow for me is — the snow comes down here, I just grin so big. There’s so many different types of snow here in the mountains.
It’s like being a student of something. I don’t know what I’m studying, but boy, it’s just the most beautiful thing. And so really, again, spending time with that awareness of what lights you up in nature.
Somebody recently asked me about nature and pets. Pets for me throughout this book — the reason I invoke my Instagram. So I got a lot of pets on there. Gussy my Shih Tzu who — I bumped into one of my residents. And she told this story about when we used to smuggle my dog into her supervision.
When we were sitting there and my little Shih Tzu was sitting on her lap. And we’re talking about her patient. We hear like, boom, boom, boom. And security’s says, we’re looking for a dog. So they’re holding this little dog. She’s like a doctor treating her. I just got this big. She’s terrified. Yeah, that’s us. We got the dog in here.
Oh, that’s funny.
Anyway everybody, I hope it helps you enjoy and think about nature and the natural things in your life. Is it your backyard? If you’re in the city, if it’s a little herb garden in your windowsill. I mean, just whatever you can do to engage with plants, engage with nature, get outside. I highly, highly advise it and great for your mental health.
Actually, good data. There’s seven trials of forest bathing. And two of them are virtual. So even if you’re feeling off — if you’re on a plane and you watch a nature documentary versus a violent film, the data suggests that it’ll help your mental health a little bit.
And so being in nature, but also virtual experiences of nature, all of those have been shown to help with clinical depression. And then grounding runs right into this eighth tenet of unburdening.
And unburdening is something I’ve witnessed as a psychiatrist. A lot of people come to me. And they take a while. People take about six months, I find, four to six months to really actually settle in, and get to know me, and let me get to know them.
And there’s a lot that happens to people that they never talk about. Everybody listening, I think, has had some type of trauma. And I don’t mean to belittle trauma. I know a lot of people rate trauma, like big T and little T.
I sit with a lot of people who have very complex trauma, parents who were very successful and didn’t really see them or interact with them in a certain way, but certainly love them or people who have really creepy relatives that nobody knows did some really awful things, or people who just had an awful boss when they were in their 20s, combined with the bad depression.
And those two things totally derailed their life. But it’s really embarrassing because the boss wasn’t that awful. So unburdening is really asking us all to transcend. And I don’t think that’s an easy thing to do, but to be intentional about transcending our trauma and our pasts.
I’ve heard this expressed a lot of wonderful ways by people deeper in the trauma world than me, but one I like a lot is turning our ghosts into ancestors and not to be haunted by our pasts in the same way.
I find that something that so many of my patients and I’ve also struggled with. Why can I not let go of this? Why am I still haunted by this thing so long ago? I’ve done everything. I’ve talked about it. I’ve tried all the treatments. I’ve done the weekend retreat. Why am I still plagued by these things?
And so I don’t think unburdening is easy. And I don’t mean in a simple book chapter about mental fitness to in any way belittle someone’s trauma, but I do get to sit with people as they transcend their trauma, my whole career.
And it’s one of the most wonderful things to witness because bad things that happen in our past, we can’t go back to our past and change that. We can only change — we can only really have control over right now, today, this moment.
And when you have a lot of trauma — and I’ve both gotten to sit with a lot of trauma, but also personally experienced a lot of it. I entered this world through trauma. Right before I was born, this big storm took hold in Northern Indiana.
And my mom heard a train coming. And she went down to the basement with this litter of puppies. And she heart it get louder and louder. And the whole house got torn up. She looked right up into the eye of the tornado.
She was holding on to this washing machine, she says. Yeah, she says she felt the spirit of her grandmother like a dome over her. And the washing machine went up. And it was just her and the puppies sitting down there in the basement.
And so that’s been with me my whole life, been with my family. I don’t want that to be the dominant narrative. I want to be able — how do I put this? I like sitting and watching a thunderstorm. I think that it didn’t get me yet.
So we all have things. And unburdening is asking people to think around the idea of what it takes for them to take some steps working through that. I talk about ACEs, adverse childhood experiences, is a way that we can think about what you saw, what you experienced, and how that affects our mental health.
The statistics — if you look at the original — it’s called the ACE study, where they sent out a survey to people asking them about trauma. I mean, it was like off the charts.
And then the last tenet is purpose. And purpose is a very short chapter reminding you that you have a sense of purpose, encouraging you not to fall down the path that we hear everybody, oh, kid, find your passion.
Don’t ask teens and 20-year-olds what their passions are. People shouldn’t spend their life in porn. It’s like, come on. It’s a teenage boy. It’s like, come on.
Yeah, that’s not it.
Passions burn hot. What we’re looking for — what we’re hoping for is something that you find — is a process that you find purposeful, that you find your hands naturally do, that lights you up, that you keep thinking about, that you come back to, that connects you with other people. So those are the nine tenets of mental fitness.
Wow, pretty amazing collection of tips and things. And I’m assuming putting these into practice as you’re working with people. It’s like, where do you — somebody’s like, where do I start? Is there a place to start or is it what’s calling you? How do you start to, as you’re working with people, put some of these into action, as you talked about?
Well, everybody who’s been listening this long knows because something in these nine tenets sticks out to you. I do believe that there’s a sequence, the intentional sequence that manifested in me as I wrote these out.
And we actually all said it was so clear, self-awareness goes first. And so I like starting with the self-awareness because, again, share with yourself. Share with us, but mostly with yourself. Where are you right now? What is the top thing?
And when I see patients, a lot of times it’s like, oh, I don’t have a plan. I make sure at the end of the day — right then I say, OK, I guarantee you at the end of this, we’re going to have a plan. It might just be for the next day or for the next week.
But usually when I see people, it’s like, OK, this is what we see going on. And it’s going to be the next three to six months. And so I like starting with the self-awareness.
But again, if something stuck out to you — you haven’t eaten lentils in a while or I said pesto and your mom had an amazing pesto recipe you haven’t made for a while.
I really want you to pay attention to that. The thing that lights you up captivates you is the way into your mental fitness. And also, I like to remind people, you’re already doing so much.
Part of this is an accounting to acknowledge all of the things you are doing to move your body, that you are doing to get the nutrient dense food, and to sleep well, and to connect with people, and to honor that. It’s huge for your mental health and it’s huge for your community.
Awesome, awesome. So we had a lot that we just went through. And for our listeners, we want to make sure, is there anything else that you want to leave them with that we might have not covered?
I want to ask everybody to follow me on Instagram. I’m Drew Ramsey, MD. And I hope mostly that — most important thing for me, everybody listening, I’d love you to check out the book, review the book, check out my website. Drew Ramsey, MD, all that stuff, of course.
But really, seriously, the most important thing for me from this conversation is that you do something for your mental fitness. I insist on it. It’s the price of admission.
I really don’t want to be in your life, in your ear, you thinking about hearing this conversation unless it leads to something for you. Very actionable and tangible. So that’s what I’d like to leave everybody with.
David and Jamie, you too. I hope you do it. I hope you post it and tag me if you have to, but that’s fine. It can just be you. And it’s great to be back with you.
I really appreciate you supporting me, supporting mental health, all that you do to educate and talk about mental health and help folks like me get our message out there. It’s just awesome to have a little connection with you and see you all again. And I really appreciate it. Thank you so much.
Well, we appreciate you. And I don’t know — do you want to — David has his one last surprise question for you he wants to make sure to get to, so.
Yeah, you gave us a little mic drop moment when you put it on us, as far as our self-awareness practice. What’s your self-awareness practice?
Well, I think I have two that drive me. One is the psychotherapist. I’m always every day, every session thinking about, how I’m reacting, what I’m feeling, what I’m thinking, how focused I am, what the various aspects of my mind are informing me in that moment.
And so that to me is, I don’t know, maybe 40,000 hours in. That to me, has been my professional practice, and pleasure, and skill to try and be more and more self-aware.
Recently, I found journaling, especially as the book was coming out. I was dealing with a lot of — just a lot of big feelings of vulnerability, putting stuff out there. I just found having this little private spot for me.
I almost felt like I got addicted to it. I’d go up in the middle of the night. And I’d write two pages. And I’d be like, I’m going to have a third page. And it was great. And so those are big.
And then I find music is really big for me. I really like strumming an instrument or singing in the car with my kids. Those things just help me just settle down and feel a little bit more self-aware, and more gracious, a little more gratitude. Thanks so much for that question.
Thank you for your time. It’s been amazing to see you again. We appreciate you. And we will be sure to tag you in all the things going forward.
All of them.
We’ll be in touch.
Thanks so much. Have a great day. And everybody, thanks so much for listening. I really appreciate you both. I’ll see you all soon.
Appreciate you.

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