Mayim Bialik's Breakdown - Substack Live Re-Air: What Lady Gaga’s Psychiatrist Thinks Is Making Us All Sick

Episode Date: August 15, 2026

This week we are re-releasing a Substack Live from our Breaker community! Mayim and Jonathan unpack their recent conversation with Dr. Paul Conti, psychiatrist and author of Trauma: The Invisible Epidemic, and the clinician who assessed Lady Gaga during her psychiatric crisis. His central argument: the lens through which you approach your own suffering may be the very thing keeping you stuck in it - and psychiatry needs to evolve to help you see that.Mayim breaks down one of Dr. Conti’s most profound suggestions — that if a diagnosis becomes your sole identity, the brain will actually reinforce it. Every time you return to a problem as the primary fact of your existence, you deepen the groove that rumination is creating in your brain. He’s offering a clinical framework for redirecting attention toward what is functioning, and why that reorientation affects real mental health improvement.More than half of the physical complaints that walk into a general practitioner’s office originate in the mind not as fabrication, but as the body’s honest response to unprocessed psychological overload. Mayim and Jonathan sit with what that actually means: your back pain, your gut issues, and your chronic fatigue may not be separate problems requiring separate specialists; they may be indications of a system under pressure that needs focused psychological care.They also explore:- Why internet self-diagnosis and social media labeling can be dangerous, and what the actual clinical criteria are for knowing when something needs professional attention versus when you’re just wired differently- The case that many mental health challenges are spiritual in nature, and what it means that our healthcare system lacks a framework for treating them that way- How chronic background stress erodes your capacity to handle normal life, and why you often can’t see it happening, because your baseline keeps shifting without your awareness- Practical takeaways from the recent episode with Dr. Stacy Sims, Exercise Physiologist and Nutrition Scientist, on women’s health, protein timing, and what actually happened when Jonathan snuck a bolus of protein into Mayim’s bedtime routineFollow us on Substack for Exclusive Bonus Content: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://bialikbreakdown.substack.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠BialikBreakdown.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube.com/mayimbialik⁠⁠⁠See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Hi, I'm I'm Bialik. And I'm Jonathan Cohen. And welcome to our breakdown. Today, we're so excited to share something very special that was previously only available on our substack page. This is a sneak peek into what it's like during the lives that we traditionally only do for our substack community members. This conversation covered the episode with Dr. Paul Conti.

Dr. Paul Conti is a psychiatrist and he's the author of What's Going Right. He's an expert in trauma. He's the clinician, the psychiatrist who was called in to assess Lady Gaga during her psychiatric crisis. This episode we did with Dr. Conti brought up so many topics that we couldn't wait to share with our substack audience, but we want to share it with you here now. Some of the topics we covered include what happens when a diagnosis becomes your soul identity and how your brain will actually reinforce it and potentially keep making you worse. We also cover his clinical framework for redirecting attention towards what is working and why that reorientation affects real mental health and physical health as well. One of the things that Dr. Conte talked about, which we explored in depth with our substack audience, is more than half of the physical complaints that people bring into a general practitioner's office actually originate in the mind. not as a fabrication, not as some psychosomatic symptom that we shouldn't pay attention to,

but it's the body's honest response to unprocessed psychological overload. And we go deep into figuring out how we can change that. We also cover the dangers of self-diagnosis over the internet, how social media labeling can actually lead you astray, and what actual clinical criteria there are for knowing when something needs professional attention. When Jonathan and I do lives over on Substack, the conversations are always fun, always playful. But in many cases like this one, we really get to do a deeper analysis of some of the things that often don't get fleshed out in the episode. It's a really special conversation.

If you want to join these lives and participate in the breaker community, you can do so over on Substack. Miami-Bialx Breakdown on Substack. And we do these lives every week, so please come over and be part of the community. We hope you enjoy this conversation and we will see you over on Substack. Mind Bialx Breakdown is supported by Helix Sleep. We can't tell you how excited we were to hear that Helix wanted to partner with us. I've had my Helix for over five years now, and it helps me sleep great. Jonathan loves his helix.

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Let's talk about our minds and our bodies. Maim, tell us why focusing on what's wrong with you can actually keep you stuck. It sounds counterintuitive. A lot of people think, if I just figure out what's wrong, explain to us why that's actually an approach that can really be devastating and keep you in a cycle that you don't want to be in. Paul Conti's notion is there's actually a lot that goes right and you can start as small as you want. You know, think of all the things that have to go right, even for you in a debilitated state to wake up in the morning, right? Just think of all the systems that are working and all the biological things that go right, even if we don't feel like we're at our best.

What I really appreciated about Dr. Conti's explanation was he's not about toxic positivity. I'm like, everything's amazing. And that's kind of where I was more going with sort of like, what's the cellular environment? What's the energetic environment that you're creating? But Dr. Conti's notion, you know, is a little bit different. It is seeking not to focus on sort of, especially psychiatric challenges. as the foundation of your being, but as states which, like physiological states or biological states, if there are problems, we can tackle them as opposed to being given a diagnosis and then you

are manic depressive. You are depressed. You are a person who is anxious, right? As opposed to, I am experiencing this variety of symptoms or I am a person who has, you know, this sort of set of categorizations as opposed to I am this identity because it does. It can keep you locked. It can keep you kind of in a blocked state. Because I like to put you on the spot to explain extremely complicated things with no preparation. I'm going to push you even further. What happens in your brain when you are continually focusing on this is my problem? And it doesn't have to be a diagnosis. It could be I'm depressed or could be that my life doesn't have this. I don't have that house.

I don't have this job that I want yet. It doesn't, like, explain to us what is actually going on when there is a reinforcement of problem. The reinforcement, you know, has a sort of neuroanatomical substrate. When you think something over and over, when you feel something over and over, it does. It creates, you know, the kind of the metaphor is like it creates like a groove, like a groove in a record.

And that groove gets more and more emphasized, the more you think about it, perseverate, ruminate, obsess, those things. And then that group becomes harder to get out of. So if you think of it like, you know, you're in, you can even think of it like if you're, you know, digging a line like in the garden, right? And you're standing in it. And if you keep digging, it gets deeper and deeper. And if you keep stepping into that hole as it gets deeper and deeper and you keep digging out more, you will be deeper in that hole that is then literally harder to get out of it. When you dig that hole, you're creating a pattern by which you may apply that to other areas of your life. It's a pattern of thinking. Sure.

Yeah, depending on what kind of groove we're talking about, yeah, that's literally. And that's sort of the complexity of things like depression, of things like, you know, even obsessions and compulsions and rumination and things and that like kind of like cycling that we do. You know, I think what my therapist says, what we resist persists. It can be that, hey, I really, you know, don't like this. I don't like that. It may be isolated to what I don't like about my apartment. But I may take that same pattern and then apply it to my job because that's my pattern of thought. I'm used to, you know, literally going down that trail and applying that filter. So then maybe I'm in this relationship and I really dislike this one thing and I'm going to hyper focus on it instead of, pulling back and being like, I really don't like how the radiator rattles in my apartment, but I really like that it's in this great neighborhood. I really like that, you know, my bedroom has enough space for, you know, my bed to be there comfortably. Like, it's, it is finding those microappreciations.

Its gratitude is almost an oversimplification. It's how do we apply a lens of seeing even the small things that we appreciate. So that's one of the things that Paul Conte talks about when he says, what is going right? Let's play a game. What has gone right today, Maim? I needed a light installed. I've had the same electrician for 20 years. His name's Brian. And Brian showed up on time. He installed the light. It wasn't a problem. And he even had to install it on a very difficult wall. It wasn't a problem for Brian. That went right. I woke up this morning.

There was a fire in L.A., but just outside of L.A., so we're concerned for the people who were affected by that. But I was able to go outside. I was able to take the dogs to the park. What was novel and unique is that one of the dog owners at the park had little ball-shaped eggs that were squishy, and she had like a pack of them. I've never seen dogs be so excited.

Did they sweet? They squeak. I'm like, are they scented? Like, why are they... And they had so much fun. That was an unexpected little twist in the morning. Lightful. You know what? Also went right?

My New York Knicks won the basketball game last night in overtime. Watching Maim watch basketball is actually one of the joys of my life. It is so much fun that you never know what's going to happen. I accidentally referred to Patrick Ewing as the goat and you did not like that. I didn't mean it like that. Another thing from the Paul Conte episode that I'm going to tee you up on, he said more than half of physical health issues that come into a general practitioner's office originate in the mind. Think about that. Think about the times that you, any of us, have gone to the doctor in our life, right? In the years that we've been alive, statistically speaking, half of those. It's not that they weren't real. It's not that they didn't exist. It's not that there weren't. treatment's required or necessary, but that's a high percentage. And I mean, I would actually, based on

what we know from the other physicians we've spoken to, I wouldn't be surprised if it's higher, right? And all the things that we're like, oh, but this is really a thing, how many things have no environmental component, right? That's really the question. How many things that are wrong with your body have absolutely no component related to stress, related to ergonomics, right? The way you're holding your body and your workplace, right? How many of those things, right, have no influence of stress or how you manage it, right? Like in a perfect world, my stress wouldn't impact any part of me. I would never have my back go out.

You talked a little bit about overdiagnosis and why it's more dangerous than you think. Talk a little bit about especially the notion of internet diagnoses and our need for labels versus we're all on a version of a spectrum, you know, how do we identify what needs a label, what might be normal? And what is the criteria by which we should evaluate that things are, you know, going well for us? I have an idea. I'm going to follow up, but let me have you go first. Well, what Dr. Conti talked about, and you know, I think it's a lot of like, it can feel like a lot of lip service to be like, oh, everybody should have actually. to, you know, proper psychiatric care. Everyone should have access to proper therapy. Because

while that's true, how do you make that happen? Right. And I think for Paul Conti, like, he's a person who's in that world working as a psychiatrist and he acknowledges, which I think was very, you know, in some ways validating. He acknowledges that there's a problem. Like there's a problem in people's access to appropriate mental health care, whether that is psychiatry. whether it's psychotherapy, whether, like, whatever it is, there is a problem and there, you know, we went from just in our lifetimes people not talking at all about mental illness, right? I mean, not that just we didn't know the names, like you weren't supposed to report anything, right, that felt out of sorts. If you grew up with someone who's mentally ill, you kind of just dealt with

it or you didn't, right? But yeah, yeah, the notion that there's now a label for everything, you can hop on the internet and, you know, find a diagnosis. I mean, in many cases, it's very helpful for people. But I think it's something we also, you know, we definitely want to be careful about because sometimes we're just different and sometimes we're just on this sort of like spectrum of behavior and coping mechanisms and things like that. I think it's like, are we in conflict in our relationships?

You know, relationships don't just mean our, our life partner or a romantic partner, but like, can we navigate being in relation with other people at work, at home, with our parents as they age and we're, you know, navigating the complexity of, you know, did I get what I needed or didn't I? How am I with my kids, if I have kids, my coworkers, etc? Because so much of our life is about how we relate to other people. We are not islands.

We can work on ourselves. we can say this was done to me or not or I feel this particular way, but ultimately, and you and I, you know, I had an experience this morning where you pointed out that I was coming across in a way that I did not realize. It's like, are we learning about ourselves? Are we continuing to grow and understand ourselves? And are there things that are making that harder for us? Well, maybe that is a diagnosable act.

But, you know, like how are we actually basing what constant? well-being. I don't think it is I'm happy all the time, right? We should be able to have a normal fluctuation of emotion. It shouldn't be that, you know, if I feel a level of sadness, that I immediately need medication. Now, of course, if that's ongoing and persistent and impacting me in specific ways, but I actually think in this day and age, we need to recalibrate what it means to be okay or not and to have a resilience about ourselves and then start to evaluate. what is getting in the way of us achieving that new baseline. Yeah. And I think, you know, to answer your specific question of like, how does one tell

if it's just like, you know, a quirk or something that might need more, you know, investigation, even personal investigation, you know, the kind of clinical set of standards is like, you know, the frequency, the intensity, the severity, right? How often is it happening? How intense is it? What's your recovery like from it? You know, usually with things like obsessive compulsive disorder, you know, we look to like, what's the level of impairment, right? How much time of your day? And, you know, this is one of those diagnoses, which again, you know, everybody's like, I'm so OCD. You know, for a reason, there are clinical criteria for, you know, how many hours of a day do you spend, for example, washing your hands? How many hours of a day are

spent, you know, with obsessions and compulsions like locking the door and relocking the door and things like that? You know, double checking things does not give you an OCD diagnosis, checking things for an hour, you know, which is very real for some people with obsessive compulsive disorder, you know, that's a difference. And I'm not saying you can't get help or a diagnosis. That's not what I'm saying. My point is that the clinical criteria, right, tend to be how severe is it? And I think especially, especially in this age of, you know, kind of internet diagnosis and, you know, kind of social media, sort of giving everybody a box, you know, to put themselves in or several. Yeah, it can be very dangerous because it's not necessarily a full picture.

And, you know, it's a very elitist, you know, kind of thing to say, like, well, you have to go to, you know, psychiatrist for a proper diagnosis. I have many friends who are on Medicare, who cannot even access, you know, psychiatrists or they're few and far between. And, yeah, that's something I really hope will change. You know, I hope that, and, you know, this might be wishful thinking. But I do hope when I think of, like, young people, I think of my kids who are, you know, 17 and 20 and Jonathan, your son, who's 18, what kind of compassion can this next generation

bring when they go to college? You know, will there be kids who don't just want to, like, get through med school because they want to get through med school? But are there, you know, are there going to be kids and young people who say, I want to change the way we access mental health care? Someone also pointed out, I think her name was Nuri. You know, many mental health challenges are spiritual in nature, right? What does that mean that we don't have, you know, we don't have really access to treat things spiritually? Obviously, if you're in a spiritual community, if you're in a 12-step program, that's a program of spiritual recovery. Yeah, how many of the things that we, you know, also are dealing with are spiritual in nature. And what does a spiritual

solution, you know, look like? I want to circle back to spirituality as it relates to to our mental and physical health because there are so much increasing evidence on what that looks like. Why is why it's important how we're actually wired for a spiritual connection. And what does that actually mean? So prepare yourself because I'm going to circle back. But before we get there, the hidden roots of multiple symptoms that you did not know were connected. This is, I think, maybe one of the most interesting, follow-up points after the notion that 50% or more of issues that people go to to the doctor for may actually be originating in the mind. So the other thing that happens is that people are like,

well, this hurts and then that other thing hurts. And I'm going to go to two different doctors. One's going to be a gut doctor. One's going to be a pain doctor. Or one's going to be, I have a headache, but I also have gut issues. Or one of them is going to be, I have a back problem and then also my foot, but I'm not going to talk to the back doctor about my foot. I'm going to go to the foot doctor. And yet, what is actually going on, as Dr. Conte explains, is that these things are not only connected,

they could be coming from an original source. Great opportunity to give a shout out to Nicole Sacks. You know, you could have a variety of things happening in your body. And guess what? it could be one general system that is allowing a differential perception in sensation, in pain, and that dealing with, as Nicole talks about, you know, some of those really, really deep emotions that were not supposed to show, that often leads to a tremendous relief in symptoms from a variety of organ systems.

Like, it's unbelievable. A revolutionary program to release chronic pain and anxiety. If you have not already listened to our episode with her. Yes. We have it on this Substack channel. Go to the main page. Go back to it. Also, if you're just like, I cannot get enough,

it's on a practical spirituality page. That's my page. It's related but a different page than the MBB page. And guess what? There is another conversation with her that you can access. This was my long answer that led us through there. You know, anyone who's familiar with traditional Chinese medicine or, you know, many kind of other approaches from, you know, Eastern traditions, whether it's Ayurvedic or, you know, whichever. Yeah, there's the notion of like, oh, yeah, these are symptoms, but they're not actually telling us anything.

One of the fundamental problems with the Western medical system is the siloing of all the different parts to specialists. we want specialists, but we want to understand how the systems are working together as a whole, because my digestion works in relation to my entire body. It doesn't work in a vacuum in and of itself. So when we talk about, you know, these interconnected systems, what we're talking about is like the overall stress of the system and how is our mental state, our perception, influencing the overall stress of the entire system. Often a stressor is not a stressor. an objective reality of what happened to us based on a panel of experts rating that from a stressor of zero to 10. A stressor where there is some sort of violence or impact can be 10,

but some people can go through the exact same thing. One person recovers, goes on with their life, doesn't impact them. And the other person has issue upon issue that seem unrelated for years and even decades to come. So what constitutes something, severe for one person. It's not always an objective thing. It's a subjective thing. And so there's another component here which says how recurring thoughts may shape your entire life. It's not just the thinking. It's the perceiving, right? And this goes back to what is going right. If I am trained to constantly look for everything that's going wrong. That adds a level of stress on my body and on my mind that overall impacts the entire system.

So I may be like, oh, I have these horrible stomach aches. It may be that I'm just like so negative, so fearful, constantly looking for the things that go wrong, that I'm in a state of protection, a very underlying in what we're calling chronic persistent stress, that over time is impacting my ability to have resources to rest, digest, and having the body go through its natural healing process. So many of us are this frog in the boiling water,

especially as we're subjected to more and more digital material, more and more news, which has an incentive structure to incite anger, incite rage, because that is the most addictive quality for the algorithms that reward the algorithms and get our attention. Like, this morning, I'll give you an example. I like to listen to news in the morning, some short podcast just to get the head.

headlines. I turned on the daily show and it had a subject that I could feel myself getting so annoyed at. I was like the injustice, the way that this is going to have a ripple effect and downstream consequences that I know are going to be negative. And I listen to about three minutes and I'm like, you know what? I don't feel great. I feel myself getting agitated. There are some days that I can have more tolerance to sort of allow a media, you know, to listen to media without sort of of riding the roller coaster of it and I can, you know, pull back from it. But I felt myself so annoyed that I had to turn it off. We don't realize that we're being impacted all the time, right? We don't know what our baseline is because it's constantly rising and especially if we have stress

in our lives that we perceive as unchangeable, right? I'm just going through a rough time at work right now. well, I don't want to get a new job because that's too hard. And, you know, my boss I'm really in conflict with. And I'm having this, you know, my relationship is a little bit on the rocks. And, oh, actually, and you have one more thing than all of a sudden, the normal bandwidth that we have to deal with our everyday life stressors just continues to erode and a road. And we don't need a yoga class necessarily.

We need a way to sort of reestablish a higher baseline on a regular basis. In that state, we can also, you know, begin to experience. these random pains, these random discomforts, and we may not even be realizing it. Let's go back to something from Stacey Sims. She explained creatine in a way that I very much appreciated. Oh, yeah, that was great. She also explained why it's different for women. I liked all her, like, it's not the same for everyone, because I feel like a lot of women

are told, like, you can be a professional athlete at 50. No, I can't. Professional athletes can be professional athletes at 50, not me. She also said 30 plants a week you should be eating. I was talking with my younger one, and he was like, that's ridiculous. And I was like, the fact that you just had like carrots, cucumber and celery, like with your lunch, like, that's three, right? It's not that high. It's not like you have to eat a...

You just need 27 more and you're there. I made asparagus that week. I was like, we're going to eat a different thing. Well, we also get into the habit of eating the same things over and over. Thank you, everyone. check out the Stacey Sims episode if you have not seen it. Thank you everyone for being here and be safe out there.

It's Miami Alex Breakdown. She's going to break it down for you. She's got a neuroscience PhD or two. One fiction. And now she's going to break down. It's a breakdown. She's going to break it down. Mymbialics breakdown is supported by Elastique where science meets style in wearable wellness.

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