Change Your Brain Every Day - CA Surgeon General Dr. Diana Ramos on Women's Health, EMDR & Postpartum Care

Episode Date: September 24, 2025

On this week's podcast episode, the Amens welcome CA Surgeon General Dr. Diana Ramos. As California’s Doctor, she is the leading spokesperson on the most pressing public health issues of the time within the State of California. With a steadfast commitment to addressing Adverse Childhood Experiences, mental health, and maternal mortality and morbidity, Dr. Ramos has been a driving force in shaping policies and programs that make a lasting impact. Her mission is simple: to advance the health and wellbeing of all Californians.

60% of the maternal deaths occur after the birth of the baby. Sadly, maternal deaths in California are three to four times higher with black moms than with white moms. In this day and age, why is that a thing? It's kind of crazy. It is crazy. And a lot of it has to do with the fact that women are waiting longer to have their first baby. Then oftentimes there are chronic medical conditions. And oftentimes, especially if you're under-resourced, you don't have the care.

you don't have the management of that medical condition, and that's why Prima is that piece. Dr. Diana Ramos is a distinguished public health leader. She is the spokesperson on the most pressing public health issues within California. She has been a driving force in shaping policies and programs that make a lasting impact. So the preconception medical assessment is a validated eight-question quiz for people to think about their health before they become pregnant. And when there was bad news that I would share, like the medication that you were taking is the reason for this birth defect.

Or had you maybe done something different for your diabetes, this would not be happening. And I would oftentimes hear patients say, I wish I would have known. I wish I would have known. Just simple education. That's it. And this is that simple call to action, just increase awareness. Every day you are making your brain better or you are making it better. worse. Stay with us to learn how you can change your brain for the better every day.

Are you struggling with anxiety, depression, obsessive thinking, past emotional trauma, ADHD, or brain fog, and don't know where to turn? Are your relationships a mess and you don't know why? Have you had a brain injury, concussion, or just don't feel the same after? or COVID? Is your memory worse than it was 10 years ago? Or do you have a parent or grandparent with dementia and want to work on prevention? Yes, prevention is possible, but the sooner you start, the better. For 35 years, we've been changing people's brains and their lives using brain inspect imaging and a personalized natural approach to brain and mental health care. And we have some of the best publish outcomes anywhere.

Go to amenclinics.com to learn more. And when you call us, mention Podcast 10 for a 10% discount. So I am so excited today. We have a very special guest on a topic that is very special to me. we have Dr. Diana E. Ramos, who is a distinguished public health leader dedicated to advancing the health and well-being of all communities. And as California's doctor, she is the leading spokesperson on the most pressing public health issues of the time within the state of California. So with a steadfast commitment to addressing adverse childhood experiences, mental health, and maternal mortality

and morbidity, Dr. Ramos has been a driving force in shaping policies and programs that make a lasting impact. Her mission is simple. To advance the health and well-being of all Californians. So before her historic appointment as California's first Latina Surgeon General, Dr. Ramos served as the assistant deputy director of chronic disease and prevention

at the California Department of Public Health. Her leadership has extended across local, state, and national platforms from serving as director for the reproductive health in Los Angeles County to holding key position. with the American College of Obstetricians and Gynecologists, the American Medical Association Foundation, Women's Preventive Service Initiative,

and the National Hispanic Medical Association. Over the past three decades, Dr. Ramos has provided compassionate, high-quality, reproductive care to thousands of Californians as an obstetrician gynecologist at Southern California Kaiser Permanente. So I am so excited about this. We are going to talk a lot about everything

you're doing. But of course, I have a passion about talking about ACE scores and how that affects mothers and children and the next generation. So welcome. Thank you so much to both of you for the honor to be here to speak with you in person. I love the work that you do. Well, thank you so much. So change your brain every day, the podcast, is very actionable that every day you're making your brain better or you're making it works. I would love for you to start on why you became a doctor. I became a doctor because I wanted to help people. I think that's the most common reason why many of us become doctors. But as I was continuing to grow and realize the role that I play in not only in my community, but in health care, realize that there are very few Hispanic

doctors in the field. In California, they're, and nationally only about 6% of physicians are Hispanic and 3% are female Hispanic. And so to be able to provide the care, the cultural care, understanding, the nuances, right, it is so critically important to establish rapport so that we can help our patients has really been a driving force. And we know when the data shows that when you can speak the language, when you understand the cultural, sometimes the barriers that exist in accessing care, you are going to get better patient outcomes and better patient satisfaction. So now, as my career has progressed, I am really thrilled to be not only a role model, because I hear it from many people that I have had the privilege of meeting throughout

California, that wow, doctor, they say, doctor, I can actually see it. I can see you and I know that I can be it. So if you see it, you can be it. And that's been really an honor to be in this position as California Surgeon General. That's amazing. So when did you start to notice or become really interested in the effects of adverse childhood experiences with everyone, but especially with women's care. Yeah, so it started when I was in Los Angeles County as Director of Reproductive Health. Their LA County is very advanced, very innovative and we had Dr. Vincent Feletti speak to our one of our in one of our meetings there. Dr. Vincent Feletti is one of the key foundational researchers on

adverse childhood experiences and I heard him talk for the first time and say there is an direct increase correlation of women's health outcomes with adverse childhood experiences, from abortion to preterm birth to unintended pregnancies. And I remember going up to him and asking him, wait, Dr. Felady, is this really true? And he said, absolutely, happy to share the data with you. And that started me thinking. And as time has progressed, we now know the data has become much more powerful and more evident that there is a direct correlation of ACEs and our long-term health and is California surgeon general. It's codified in statute that one of the areas of focus, the adverse childhood experiences.

So I've really gone in knee-deep and learned as much as I possibly could about ACEs, still continuing my relationship conversations with Dr. Feletti, Dr. Brian Allman, who are the key researchers on ACEs, but now taking it to the next level. and taking it back to where it started, and that is in the adults, in women, in the reproductive age. So I oftentimes say it's really a two-for-one when you talk about aces in reproductive age. Women in pregnant moms, because if we can help a mom, then we can help not only her, but we can help the children, if she's pregnant, the baby, the whole family. It's a big ripple effect.

The whole community is positively impacted. Yeah, you're changing generations that way. That is it. That's why I find it so fascinating. So let's go back just a little bit for our audience. So Aces, as you said, adverse childhood experiences. So it started with an original study from Kaiser on 17,000 people. And they asked, they gave them a questionnaire.

From zero to 10, how many bad things happened to you? before you were 18, physical, emotional, sexual abuse, neglect, witnessing domestic violence, having a parent or someone in the household with a mental health problem with an addiction or jail. And people who score four or more have an increased risk of seven of the top 10 leading causes of death, and people have six or more died 20 years early.

but you don't have to. And I think that's the exciting thing is this is a vulnerable population. What are the interventions, especially from a state level, that we can do to mitigate this issue? Yes, so California was the first state in the country to make actionable opportunities available to everyone in California. The first one is the development of the Aces Aware. Aces Aware is through the California Department of Healthcare Services, and it is a training on adverse childhood experiences for health care providers. The reason why that's important is that if you go through the training and you get the certification,

it's a two-hour training, it's free, it's available, then you can then screen for adverse childhood experiences and be reimbursed for that care. So Medicaid will reimburse, Medi-Cal will reimburse $29 per screening. That is unique. Through the commitment for the California Children's Youth Behavioral Health Initiative, which is a $4.7 billion investment that was started five years ago, that investment is focusing on mental health, on the programs that are focusing on helping people who have high A score,

some more, for or more. And realizing that mental health is one of those key aces has been really, the realization is critical in the development of the programs that are available from apps that are helping parents, help their kids, helping teachers, help the kids, to apps that are available for young people from zero to 26, right? And the zero is for the parents to help their kids. But up to age 26, that's available for free. That can connect you with a provider in your community, whether that's in-person, virtual.

So all of these resources have been as a result of the realization that we need an upstream approach. We need to change the way that we've been thinking about mental health, about health in general. because, as you know, when you address ACEs before the age of 18, there is a 44% decrease in mental health disorders. They never even happen. So we know that medication, the best medication, will maybe have a 50% efficacy in terms of putting people into remission if they have depression. but to know that you can actually prevent 44% of those mental health disorders, this is an opportunity for California and everyone else to make a difference. And what's in the app or what's in the intervention that makes such a positive difference?

So the app is about a year out, and there are two. There is one for parents, right? And oftentimes as an OB-GYN, I would hand the baby after it was delivered to the new parents and I would look at them and smile and say, I wish I could give you a manual to tell you how to raise this child, right? We wish that could be, and there isn't. And so the app, it's called Soluna app. No, that one's actually Bright Life.

The Bright Life for Kids app is one for parents. And what you do is you put in the information on your child. So how old is your child? What are the issues that they're facing? And then you're given recommendations, immediate recommendations it uses a chatbot to help the parent. And then they will match you up with an advisor. The one for kids is Soluna.

And the one for the zero to 26 year old starts out with a chat bot, knowing that oftentimes kids don't want to talk, or people typically don't want to talk to a health care provider, right? The first person that they will talk to or communicate with will be a friend. And oftentimes it is online and you're used to doing text messaging and being on chat rooms. Well, this is a safe, vet it quote unquote chat space. Do you find that there's any resistance as far as trust goes with people feeling like they're going to be watched or they're going to be, I just, I'm thinking of my own family history. Yes. And there's not a lot of trust. If you're putting your personal information into an app, are you going to get resistance from that with people? How do

you mitigate that? So how do you gain their trust? Those are great, great. points. And so just know that the apps were created with the voices from the community. So there were Hispanic, Asian, black, Native American, people from rural areas, people from, you know, everywhere. The voices of the community, the voices of California were used to develop these apps. And they were created with, with those, you know, specific points in mind. And so it is, when you go on, there's a disclaimer that qualifies, you know, this, what information is going to be shared, what information is not going to be shared. But the reality is, and this is something that we have been seeing, is the fact that young people today have no problem

putting their life out, right? On social media, that's just second nature, right? And this is something that is so important. So if you can do it in a way where people don't feel afraid, to share their vulnerable information, it has that potential to really be life-altering for them and for the next generation. It's just, I think that there's a lot of, I know if you're growing up in an environment like I grew up in, there's a lot of suspicion about authorities and such.

Well, when, so we ask everybody that comes. I have 11 clinics, and everybody takes the ace questionnaire. We also do a cognitive assessment. that lets you know, okay, how good are you at reading faces? And you read positive faces faster than negative faces. And what's your negativity versus positivity bias? The higher the A score, the faster you are at recognizing. That's survival.

Negativity. And you tend to be significantly more negative, which then increases your risk. your risk of depression. Well, and we don't want to give it up. That's another. Well, in fact, we developed a program to train people to recognize positive faces. And I thought it was the dumbest. When I gave it to Tana. I don't want to not recognize. I want to recognize the negative faces. I want to recognize the scary faces. I don't care about the people smiling at me. I want to know, you know, the guy behind me who's going to do something. And so we had this big discussion about it. I'm like, if you broke how I grow up, how I grew up, you don't want to let go of that

survival instinct. So retraining your nervous system is tricky and it takes time. But the most important thing I think you just brought up by sharing that is increasing awareness. Okay, that was something that helped me growing up. But now, now that you know more, now I can change and if there's a resource that can help you reframe the way that you think. interpret, change the filter. I think that's going to be much more healthy going forward, but you brought up a great point. You know, we need to increase awareness that this is happening so that we can then make the modifications that aren't needed. Well, I think at some point, and you, I'm sure you have taken this into account because sounds like you grew up similar to

how I did, you can honor that child that, you know, that survival instinct. You can honor that and still learn how to retrain your nervous system and still move forward and acknowledge that you're not in that same place now. But you don't have to just ignore or deny that that was real. That is what God is where we are right now, right? And that's the one thing

that oftentimes people want to completely forget it. And I oftentimes, for my personal experience and my personal life, I think, okay, had it not been for the fact that, you know, I had to go with my mom in the car to the Tupperware parties that she had to, one of her three jobs. And I saw her speak, you know, at the Tupperware parties. I wouldn't know all the freeways in L.A. I wouldn't know how to speak in public because my first role model was my mom seeing her speak. So yes, sometimes those experiences could be painful, but it's important to take those lessons out and then focus on that positive

and start to, a part of it is we learn how to ignore and eventually as a psychiatrist, I'm sure you're going to, you know, you've seen this many times people then it comes out in different ways. And so I think by first increasing the awareness. For TANNA, unlikely for you, it's post-traumatic growth. I was just thinking that. Absolutely. I was just thinking that. A lot of people don't understand that.

When you experience trauma, about 80% of people actually do okay with it. 10% of people develop post-traumatic stress disorder, but 10% of people also develop post-traumatic growth, where you take that and it fuels you to do good for yourself. and for other people, and you write about pain to purpose. And I'm really curious, you know, there, when I was growing up, there was absolutely no training on how to manage my mind. Now, between us, we have six children. There's still no training for children on how to manage their mind.

So if we're going to really address the mental health epidemic, is what can doctors in California do to help train children to manage their mind? We have a high school course called Brain Thrived by 25 where we teach kids. When my daughter, who's an interior designer, was learning quadratic equations in ninth grade, I'm like, she's never going to use quadratic equations. I'm like, and then I'm friends with Paul Simon, the singer. And he has a song I love called Kodochrome. It starts off with when I think back

and all the crap I learned in high school. It's a wonder I can think at all. And, you know, I wonder, as Surgeon General, is there anything you can do to get basic disciplining your mind, loving your brain training into our school system? Because that will help prevent.

Because I'm not the hugest fan of antidepressants. Do you see the new study on SSRI's increase your risk of dementia? Like, goodness. You know, another unintended consequence. And last year, there were 340 million prescriptions written in the United States for antidepressants. We have to teach them tools, skills, not just pills.

No, absolutely agree with you 100%. And it's been my pleasure and my honor to go up and down the states and to actually go to schools. I've been to Butte County, down to Imperial County, some of the most rural, some of the lowest-income resource schools, and Pasadena, everywhere throughout California, and see firsthand how the state is actually addressing mental help

and how wellness, not only mental wellness, but physical wellness, is truly an initiative in California. And that's all part of the children's youth behavioral health initiative that has been funding, has been funded, you know, from the governor's office. And it really truly is an investment in the future. The first partner, Jennifer Steeble Newsom, has been an amazing partner in also partnering with the mind-body connection in schools. And she really makes it a point to make it available.

that kids have the ability to go outdoors to have access to state parks to go to the library and check out a state park pass. Did you know that you can check out a state park pass? For free? I did not know that. For free, yes, that was one of her initiatives, that especially for low-resourced individuals

that perhaps don't want to spend the money on a state pass. Now you can go to the library and check it out. but it's critically important. So when I visited some of these schools, some of the things that I've realized is, wow, they actually have a room, a wellness room, where kids can speak with a mental health support person there, where there is a place if they just need to get out of the classroom,

they can go to the space and do whatever activity will help them mentally. there's also another program in, I think it was East L.A. They have a pass. So if there were bad things that happened overnight, right? Because oftentimes as a child, you're witnessing a lot. I mean, I remember as a kid, there were helicopters that would come around in our neighborhood, and you would be up at 2 o'clock in the morning. So there's a pass that our kids can receive so that the teacher knows,

okay, you know, let's give this child a little bit of slack today because they had a hard previous night. So there are lots of initiatives that are recognizing the importance of the mental health support for our kids. They have lessons for them. They have different group therapy. There is a big investment in peer-to-peer training for high school students and then helping the trajectory for education beyond. So, you know, having kids help themselves so they can help others really has been a great model that California has started. Yeah. I love that the discussion is starting, though, because, you know, when I was a kid or when you were a kid, we didn't talk about this stuff. We didn't really know. And so you

suffered silently with certain things, not even realizing what the origin was or why. You know, I had upper and lower GIs when I was four years old. Never occurred to me, even as an adult, that it might have something to do with what was happening in my home. In fact, that was something you brought to my attention, and I thought you were ridiculous. So it's good. The discussion is starting, right?

Absolutely. Yeah. I'm like, what happened it for? What did you say? My uncle was murdered, yeah, in a drug deal. And I remember the police in my house and my mother and my grandmother's screaming and it was just such a chaotic environment. Yeah, but it was a ridiculous question.

Yeah, I was a hard charging ICU nurse, and I'm like, it had nothing to do with that. It had everything to do with that. But as I really began to understand the impact that adverse childhood experiences have, explained my whole life, my GI issues, why I had cancer, why I, you know what I mean? It just so many things began to become clear,

and I became very passionate about this topic. So I love that we are having these discussions. Talk about the preconception medical assessment, which is an question tool to help individuals identify potential health concerns. Yeah, so the preconception medical assessment, we nicknamed it Prima on purpose. Prima in Spanish means cousin. And cousin is a positive term, you know, you want to share. year. You want to have a conversation with your cousin, with your prima. And in California, 48% of the birth are to Hispanic women. So the preconception medical assessment is a validated

eight question quiz that was created to provide an opportunity for people to think about their health before they become pregnant. So oftentimes when you want to have, when you're going to get married when you are looking for colleges, when you are getting your driver's license. What do we do? We prepare, right? We plan. We do research. But when it comes to pregnancy, very few people actually plan.

In California, about a third of births are unplanned nationwide. It's close to almost half. What do they say? Tequila should come with a warning label and make us pregnancy. Yes. Yes. Yes. And so Prima is meant to be.

in the community. It's meant to be, it's eight questions, single, one handout, and we now have a virtual app, a widget that can be placed anywhere. And it's eight questions that the person answers on their own, and then based upon the number of yeses, they are giving general information. It's meant to be very positive because we tested it with black, Hispanic, American Indian, white, multi-racial groups, and they kept on saying, we want this to be positive. So we really wanted to be positive, didn't want to scare people. So when you look at it, it's like, oh, okay, this is simple.

And yeah, okay, I didn't realize that maybe if, you know, I may be needing more medical care, more labs, I may be needing specialty care. Okay, well, maybe I should go see somebody for my health, but it basically asked medical history question. So if you were born with a heart defect, if you've been hospitalized for a heart condition, because cardiovascular disease is the number one cause of pregnancy-associated deaths and really trying to identify those who are at risk, realizing that 80% of all maternal deaths are preventable, realizing that 85% of cardiovascular maternal deaths are preventable. So, you know, this is the opportunity for people to think about their health.

It's a conversation starter. And I can tell you, as an OBGYN, having seen and cared for many patients, when there was bad news that I would share, like, you know, the medication that you were taking actually is causing this, is the reason for this birth defect. Or had you maybe done something different for your diabetes, you know, this would not be happening. And I would oftentimes hear patients say, I wish I would have known. I wish I would have known. Simple education.

That's it. And this is that simple call to action, just increased awareness. And I will share that this was modeled after the Cosmo quizzes, the Cosmo magazine. You may not remember them at the grocery store. Right. So what would happen? I remember being there in the grocery line and, oh, what's the Cosmo Quiz this one? And just answering the questions, you know, is your best friend, really your best friend? Is the relationship going to work? Right. But you started to think about it. And this is exactly what that is. It's meant for people to start to think about their health. Right. Well,

preconception medicine is like a whole new great area of medicine. I don't know if it's new, but it's a newer area of medicine that is so interesting. And not everyone can afford to just go to a doctor for a year and have, you know, do it ideally in the ideal way. But if you have these ways, if they just change one or two things, just one or two things that they were not aware of before, it's going to have a huge impact. That's right. Yes, yes. And we say the, and so it's been validated. So we had a PI at Stanford, be our lead researcher. And it's been validated. And for understanding, it's been validated in English, Spanish. And the people who reviewed it, they said, wow, this is really helpful, easy to complete.

And I wish it would have had this when I became pregnant. Even I, as a medical professional, didn't know some of the basic stuff. Who are we going to, is this something you want OBGYNs and family doctors to give to? Is it a public service campaign? This is out in the public. So anyone, my vision would be to have this in the back of every bathroom stall at the supermarket in the clubs, right? Right. Because you, you're not thinking about pregnancy, but it's, you know, it could happen.

We want them to because when a baby is born, when a baby girl is born, she's born with all of the eggs she'll ever have. And throughout her life, her habits, her experiences are turning on or off certain genes, making illness more or less likely. I mean, when you really get teenage girls to understand this, this is your behavior is a big deal and how healthy you are, but on how healthy your children and even your grandchildren. But even people who are highly educated sometimes don't understand simple things. if it's not their field. Even just knowing if I had known when I was pregnant,

oh, being under a certain, you know, too much stress, you know, that one simple thing, I would have made changes. I would have done something different. Right. You know, I wouldn't have exposed that pregnancy to that much stress. So I think it's just such an important educational tool.

Just if they change one thing. Right. You know, if they change two things. Yes, yes. And we have general recommendations for everyone. So there's general recommendations for everyone. And then there's the realization like, okay, well, you scored four plus. You know, you may want to think about this.

And so. Yeah. And then give them a path. Absolutely. Healing takes a team. At Amen clinics, we have over 50 specialists from psychiatrists to integrative medicine doctors, nutritionists and therapists all working together to help you thrive. Visit amenclinics.com.

Talk about the strong start and beyond movement aiming to reduce maternal mortality in California. How big of a problem is that for us? So in California, we actually have the lowest maternal mortality rate in the country. And that's great. So when I announce that my vision is to reduce maternal mortality by 50% by December 20, 26th. Many people said, Diana, why are you doing this? We've cut the lowest. And my response was because we're losing one mom too many.

You know, any mom that you lose is one too many. But we've been successful in California because we have really focused in the hospital with the health care systems. And now is the opportunity to go beyond the hospitals. Again, looking at the fact is that 60% of the maternal deaths occur after the birth of a baby. Nobody knows that. Everybody thinks it's, oh, it's only during pregnancy, and I'm safe. I don't have to worry about my health.

Quite the contrary, if 60% of the deaths are occurring after pregnancy, and sadly, disproportionately, maternal deaths in California are three to four times higher with black moms than with white moms, American Indian moms also have a higher proportion of maternal deaths. So this is an opportunity for us, the strong start and beyond, to address maternal mortality. And I would be remiss if as an OBGYN, I would not take advantage of everything that I've been doing my career to address an area that really has been a passion of mine because I know, I know we can prevent maternal deaths and why not start? And one of the things that we're doing is looking at the data. And the opportunities are before pregnancy, and that's why we develop prima. But then

after delivery, so focusing on the cardiovascular disease, focusing on mental health, knowing that there's a lot of crossover is really a call to action. And we are here in California where innovation, collaboration is happening and really breaking down the silos and bringing us together to let a health plan know, there's this app available that they're working on reaching patients who are high risk and in a rural area. you know, this is just a wonderful opportunity to bring folks together and to work with the Department of Healthcare Services who has now reimagined what the care should be after delivery as well as the Department of Public Health. So lots of opportunities. Yeah, I remember, so I, granted,

I worked at a hospital that was known for high-risk pregnancies, but it was in San Bernardino at Loma Linda. And I remember when the stats came out, because I was a trauma, I worked on the level A trauma ICU unit, so I figured it was definitely one of the highest units in the hospital for deaths. Labor and delivery was higher. And I was shocked by that. But, you know, it was known for high risk. But I'm like, in this day and age, why, why is that a thing? Right? It's kind of crazy. Yes. It is crazy. And a lot of it has to do with the fact that one, and this is what's been published, that women are waiting longer to have their first baby. So we're getting older when we have our first baby. And then oftentimes there are chronic medical conditions with one and three

reproductive age women have a chronic medical condition. And it is just skyrocketing. Yes. And oftentimes, especially if you're under-resourced, you don't have the care. You don't have the management of that medical condition. And that's why Prima is that piece to increase the awareness and be the nudge conversation started to getting help. So let's talk about mental health and challenges among women, among all of us, but particularly women, are skyrocketing. You probably saw this study from the CDC, 57% of teenage girls report being persistently sad. 32% have thought of killing themselves, 24% have planned to kill themselves, and 13% have tried. These are statistics that, you know, I decided to be a psychiatrist 46 years ago.

I've never seen anything like that. What do you think is going on? And what can the state do to address this really frightening epidemic crisis? So I think there's a couple of things that are going on. One is that we now have more of an open. platform for people to communicate how they're feeling, right? So which is a good thing because now people are talking about it like we talked about it earlier, social media. So social media could be a plus and a minus. The plus you can express your feelings. You can hopefully somebody

is going to see and be able to reach out back to you and help you. The negative is that much of the social media is one of those negative pressures. You know, the, the, the, the, the fear of missing out, the fear that somebody else is better. And so, again, it could be a source. I love the fact that in California, we now have the regulation of limiting cell phone use during the school hours because we know that that peer pressure, especially among girls, is so intense. Do you see the new study? There's actually a new study out on children who got cell phones early have a higher risk of suicide. Yes. That you really, you know, if you want to give them a phone, give them a flip phone, but not before 14 or 15. Well, and certainly all the

girls in our house are, we're not, you know, immune to this. We've had struggles with all the girls in our house, either having anxiety or, you know, certain issues and having to really put limits on it. Absolutely. It is, unfortunately, it's endemic in our society. And, and the heart is, my heart breaks when I see a new mom with a baby and she's on the phone. Like, you know, You know, scrolling, and the baby's not getting attached. And the baby's like just looking up at her. And like I feel like going over and saying, please look at your baby, you know. But this is something that we have to, I think as a society start to change and then really build the new paradigm and the new expectations of what using the cell phone should be like.

Have you heard of the nanny contracts in Silicon Valley? No, I haven't. So many Silicon Valley executives. have contracts with their nannies that they cannot be on the phone, that their children cannot see any devices. And they're creating these addictive things, but they know this is not good for a developing brain. I love what Australia did.

Australia banned social media for kids under 16. I mean, I thought that was bold, but followed the neuroscience. What do you think the state can do to decrease this epidemic besides awareness? I mean, an awareness is huge. Yeah, no, I think we've already started, you know, passing the legislation that cell phone usage during the school time should not be happening. Also, the programs through the children's youth behavioral health initiatives, there are now programs also that provide on campus in school support. for mental health to be able to, now schools can treat and get reimbursed for the mental health care that they're providing to students through Medi-Cal, through their private insurance.

So the support is there where the kids are, because oftentimes, as you know, kids spend more time at school than they do at home. And so getting the care to them where they need is a critically important piece. Have you heard of EMDR? I don't think so. It's a wonderful treatment for trauma. It stands for eye movement, desensitization, and reprocessing. And I published a study on police officers who are involved in shootings. And they had the trauma pattern in the brain. And after an average of eight sessions, it had calmed down. One of the initiatives working on a national trauma force, so people who are trained in EMDR, so if there is a fire, if there's a flood, if there's an earthquake, there's hurricane, that we have people trained to work with this, just, it's such an elegant

model. When we met, and I found out her ACE scores, my first gift to her was 10, sessions of EMDR. I was like, that's why I wasn't going to date a shrink. It was the best thing I ever did. I ended up continuing on with it because it was just so helpful. I think it's probably one of the most important things I've ever done as a mom, as a wife, because I made a promise to myself, I didn't want to pass those things on to my child, unknowingly doing that I was actually doing that very thing until I actually went back and

addressed the trauma and let it go. Like, it loses the trigger. What are the most pressing chronic health conditions affected women? I mean, we know we have this chronic disease epidemic in the United States. I think cardiovascular disease is a sleeping giant. Oftentimes, people think of heart disease as a male medical issue. It really is equal, sadly. It kills men and women equally number one cause of death.

and then in pregnancy. So when a woman goes to the emergency room and presents with, you know, shortness of breath or neck tightness, they're not dismissed. And oftentimes they are as, oh, you're just anxious. You're just, you know, you're, what's going on at home? It's your anxiety. And then they give them Xanax, which increases their risk

of dementia and addiction. it's like right but let's listen to the patient what would you do if it was a male patient okay let's get an EKG let's like you know send the blood work and look let's make sure that it's not heart disease or you're not having an MI so it's really I think heart disease is the most pressing issue we need to reframe how we think about it and what do you think are the most important things women can do before they get pregnant? I think they should take care of themselves first, right? The preconception.

That's it. The preconception, answer the prima quiz, but more importantly, try to be the healthiest, not only physically, emotionally, and mentally, so that there is more of you, a healthier you to give when you have that baby. My grandmother would always say, Miha, what you're feeling is what the baby's feeling. And I would say, what do you mean, grandma? She says, yeah. And this was from somebody that had a third grade education.

She was so right. So take care of yourself first so that then there's more and a better you to take care of others. That's so important because when you're sad, there's a certain mix of chemicals. that the baby feels when you're mad when you're stressed when you're anxious when you're happy when you're grateful they all have their own sort of soup of chemicals and that means the baby is being bathed and even after birth you're modeling that yes yes no exactly and i think we need to highlight that even more is try to be in a more positive state more positive, emotionally, mentally when you're pregnant because of the fact that you really

are, like you said. I love that analogy, the soup. So there are so many things that we can do from a medical perspective. We can, you know, make suggestions. Some of them people will do. Some of them they won't. And some of them they can't afford or they're just not going to have those resources. What would you say have, what have you seen that are simple things that families can do, whether it is having dinner together, whether it is reading to your baby every day, whether it is, whatever it is, 15 minutes of time you spend that's uninterrupted, what are some simple things that anyone can do? Thank you for that question, Tanna. You're right on, and you're describing those positive childhood experiences. I don't think we've talked enough

about that. The positive childhood experiences are the, actually, the data has shown when you do having dinner together, have a trusted adult in the family that the child can talk to, feeling like the kids belong in, have a group of friends that in high school, feeling like they're safe in school, all of these things are positive experiences that can mitigate the adverse childhood experiences. And I think it's important for us to remember. And the data shows that if you have at least one trusted adult, outside of your parents, that a child can talk to, that a child can go to, be, feel like they're

really truly listened to, that can mitigate some of the negative effect of ACEs. So even if they're exposed to those negative experiences when they have that one person or you do some of those simple things, it can actually balance out those negative? Yes, it can. Yes. And so I look, when I found out about the positive childhood experience, I thought about my life. Oh, yes. I thought as part of the CDC publications, and I thought about, well, what happened in my life? And some of the one person that truly stood out in my life was my aunt, who lived across the way from us in another apartment. And I was a latchkey kid. I would come home, and she would see when I would come home, and she would call me, right, the old-fashioned phone. And she would say, meha, come on over. I just made some cookies. and I would come over, sit down with her, and she would look at me in the eye and say, how is your day? So that, she was one of the critically important, positive people in my life.

And I realized, and I thought, wow, okay, it was my Tia. She was one of the key people in my life. It was the fact that I could talk to my cousin, that was a true, more of a friend, more of a sister than a family member. So it's having those people, those experiences that make a big difference. So things, tangible things that we can do is one for ourselves. I love it. You know, things that we can do to start out with yourself.

And that's just give yourself at least, like you said, 15 minutes to have a good start to the day. You know, whether it is taking a walk, whether it is praying, meditating, just stopping. and starting your day positively, just saying, thank you, I'm awake, you know, being grateful. There's going to be more of you, again, to give to others and modeling that. So when it comes time for the family, you mentioned it. Having dinner together is one of those simple things that we can all do that is a simple way to have conversations and to meet together and, again, just spend time together without the phone,

shut the TV off and just even if it's 10, 15 minutes. Yes, they are, but you set the rules. So I love the term positive childhood experiences, and I'd love to see more about even when kids grow up in these negative environments, even when they're coming from poverty, I'd love to see more about the impact of just some of those positive childhood experiences. against the Aces. Like, that would be so interesting. But wouldn't it be interesting, which is something we can do quickly, is give someone

the ACE questionnaire, but then develop a positive childhood experience questionnaire and see if that, in fact, doesn't mitigate some of the consequences. So the data is available and the questionnaire does exist. And so looking at California, data. In California, the group with the highest A score are the Native American then followed by the black population. The group with the highest positive childhood experience is the Native American group. Isn't that wild? Yes. And so, you know, the... And does it mitigate? Well, so let's stop to think about it. So when I saw the data, I realized, wow, how is this? So we know

that when you look at all of the chronic diseases, the medical outcomes, it's worse with the native population. So I had to think about it. And I thought, wow, what would happen if they didn't have all of those positive experience, if they didn't have the positive childhood experiences, their data would be so much worse. The group with the lowest positive childhood experiences in California are Hispanics. And so when I saw that, I thought, why? And I had a chance to listen to some of our focus groups that have been conducted as part of the Children's Youth Behavioral Health Initiative.

And it was very eye-opening and things that we take for granted. And some of it had to do with the names that parents loved ones used for the kids, right? They will call their sons Gordo, or Gorda, Ofea. And they mean it as a little loving term, but it doesn't. Correct, which means fat or ugly, but it's like in a loving term, but it is a word that has a definition. So, you know, you grow up with those words. You grew up with that subconscious. My nieces are their father's side of the family, they're first generation Americans.

So that side of the family is Hispanic. And they talk a lot about the names they were called. And I'm like, why is that a bad name? It doesn't sound like a bad name to me, but in the context of how it was used, in their minds, it was bad. Basically, I don't even remember the word, but it basically meant they were too white to be, you probably know what I'm talking about. They were not, yes. But in the context of their family, that was not a good thing. And it was, they were outcast.

And so it was so interesting to hear that. I'm like, and we're such a blended state. It's like, why does that matter? Whenever I go elsewhere, I miss California because. we just have so many colors. Yeah. Yeah. But there's really a thing where if you're half white and half Hispanic or half black

and half Hispanic where you don't feel like you belong anywhere. And I always try to get my patience to go, you have so many places you belong. Right. Right. Yes. That ultimately it's how you interpret the behavior. Right. So what else is exciting that you're working on?

The other exciting thing is that we are going to be launching, releasing our brief on adverse childhood experiences and the reproductive health. I love that era. And so it's going to be, we're going to be releasing an animated video that just gives a brief snippet of, why is this important? And we're going to be releasing the brief that is a call to action of what we need to do. not only in California but beyond, but what California already is providing,

and how by helping somebody that's pregnant, helping them before pregnancy, you really are impacting and improving the mom's health, the baby's health, the family's health, the community. It's a big ripple effect in the positive direction when you help a reproductive age. I love that.

Well, thank you so much for being with us. We enjoyed this. so much. My pleasure. Thank you so much. I'm grateful for the work you're doing. Having me. I really enjoyed this. Thank you. Great. You're listening. The Change Your Brain Every Day podcast. Where can people learn more about what you're doing and perhaps take the questionnaire we talked about? Yes. So they can go to the California Office of Surgeon General website and they can get information on everything that we've talked about.

You're in a war for the health of your brain. Everywhere you go, someone's trying to shove bad food down your throat that will kill you early or give you an addictive gadget, put terrible news in your head making you anxious. Hi, I'm Dr. Daniel Aman, founder of Aiman Clinics and Aiman University. My wife, Tanna and I created the Brain Warriors Way course

It's 26 hours of content where we walk you through specifically in detail how to have a better brain and a better life. From the food you eat to the thoughts you think to the strategies that you can engage in every day. If you want to survive and thrive, you have to become a brain warrior. Thanks again for being with us. Leave us a comment, question, or review, subscribe, share it with friend.