The Chris Voss Show - The Chris Voss Show Podcast – Brain Inflamed: Uncovering the Hidden Causes of Anxiety, Depression, and Other Mood Disorders in Adolescents and Teens by Kenneth Bock MD

Episode Date: March 7, 2021

Brain Inflamed: Uncovering the Hidden Causes of Anxiety, Depression, and Other Mood Disorders in Adolescents and Teens by Kenneth Bock MD From renowned integrative physician Kenneth Bock, M.D., comes a groundbreaking approach to understanding adolescent and teen mental health disorders. Over the past decade, the number of 12- to 17-year-olds suffering from mental health disorders has more than doubled. While adolescents and teens are notorious for mood swings and rebellion, parents today are navigating new terrain as their children are increasingly at risk of struggling with a mental health issue. But the question remains: What is causing this epidemic of illness? In Brain Inflamed, acclaimed integrative doctor Dr. Kenneth Bock shares a revolutionary new view of adolescent and teen mental health—one that suggests many of the mental disorders most common among this population (including depression, anxiety, and OCD) may share the same underlying mechanism: systemic inflammation. In this groundbreaking work, Dr. Bock explains the essential role of the immune system and the microbiome in mental health, detailing the ways in which imbalances in these systems—such as autoimmune conditions, thyroid disorders, or leaky gut syndrome—can generate neurological inflammation. While most conventional doctors assume that teens’ psychological struggles can be resolved only with therapy and psychotropic drugs, Dr. Bock’s approach considers the whole-body health of his patients. In his integrative evaluations, he often uncovers triggers such as gluten sensitivity, adrenal dysfunction, Lyme disease, and post-strep infections—all of which create imbalances in the body that can generate psychological symptoms. Filled with incredible stories from Dr. Bock’s more than thirty years as a practicing physician, Brain Inflamed explains the biological underpinnings of many common mental health issues, and empowers the parents and family members of struggling teens with practical advice—and perhaps most importantly, hope for a brighter future.

You wanted the best. You've got the best podcast, the hottest podcast in the world. The Chris Voss Show, the preeminent podcast with guests so smart you may experience serious brain bleed. Get ready, get ready, strap yourself in. Keep your hands, arms and legs inside the vehicle at all times. Because you're about to go on a monster education roller coaster with your brain now here's your host chris voss hi folks this is voss here from the chris voss show.com the chris voss show.com hey we're coming here with another great podcast oh my gosh another podcast we certainly appreciate you guys tuning in you guys are going to learn so much today we're going to learn so much today.

We're going to be playing doctor today. Actually, we're not playing doctor. We have a doctor on this show for real, a real MD. He has the two letters behind his name. That, of course, makes him real. And the one thing you won't see behind my name is the word MD because I pass out when I see blood. I don't know why that's important to introducing him on the show,

but it sounded funny at the time in my head. Guys, go to YouTube.com, Forge says Chris Voss, and see the bell notification there. You click on it, and it's free for an unlimited time. You can get notifications of all the wonderful videos of the Chris Voss Show podcast, and, of course, the review products we do as well. Who wouldn't want to see that data?

And it's free for an unlimited time, so be sure to check that out. Go to goodreads.com. For instance, that's Chris Voss. You can see all the books we're reading, everything we're reviewing, and all that good stuff. You can see the multiple groups on Facebook, LinkedIn, and multiple accounts on Instagram as well. Today, we have a most amazing author, as I already gave away. He is a doctor, so we're going to be doing all the cerebral stuff, and speaking of cerebral, he actually works in that cortex of the body zone, I don't know what that means, that does not sound scientific at all, his name is Kenneth Bach, MD, and he has written an amazing new book that just barely came out, Brain Inflamed, uncovering the hidden causes of anxiety, depression, and other mood disorders in adolescents and teens. He is an internationally

recognized pioneer of integrative medicine and the best-selling author of several books, Healing the New Childhood Epidemics, The Road to Immunity, Natural Leaf for Your Child's Asthma, and the Germ Survival Guide. And he's also an in-demand national and international speaker. I laughed a little there thinking coronavirus. Over the course of his 35-year career, he has become known for the unique ability to identify and entangle the most complex multi-system multi symptom medical cases his world-renowned private practice bach integrative medicine is located in red hook new york in the beautiful hudson valley filled with powerful stories from dr books more than 30 years of experience brain inflamed it's going to shed some light on the possible

biological underpinnings of many psychiatric illnesses and empowers teens and their families with practical advice and, perhaps more important, hope for a brighter future. Hey, welcome to the show, Dr. Bach. How are you? I'm really good, Chris, and I'm happy to be there. Thank you so much. I'm happy to be here with you. Thank you.

Thank you. So give us your plugs so people here with you. Thank you. Thank you. So give us your plugs so people can find you on the interwebs and learn more about you. Bach Integrative, B-O-C-K Integrative with an I-V-E dot com. And it's Bach Integrative Medicine. And the phone number anybody needs to call up is 845-758-0001. And the website for the book is braininflamed.com. Braininflamed.com. Now, usually when I read the news, I experience brain inflamed.

But this is a whole different thing that you're doing here, I'm sure. Give us an idea why you wrote this book. You've written four other books. This book, actually, it's interesting. It was a segue from my last book, Healing the New Childhood Epidemics, Autism, ADHD, Asthma, and Allergy. I call them the four A's. And I wrote that in 2007. And after that book came out, I had seen thousands of autistic kids over the course of the last 20 years. And I've had some pretty good success in helping improve them. And I got numbers of them now that are in college.

You wouldn't even know they were autistic. So a very gratifying road. But where this book came from that, and I still see lots of autistic kids, is that when parents would bring their kids, and if you have an autistic kid, and you're a parent, you will do whatever you can. And so I've had people coming from all over the country and all over the world, literally. And when they come, they also have other kids in their families and the other kids, they may not be autistic, but they may have mood disorders, anxiety, depression, OCD, mood dysregulation and things.

And so the parents saw what was happening with the autistic kids and said, hey, wow, maybe can you see what you can do for my other son or daughter, what have you? And I said, sure. And it turns out, I started seeing more and more and more of those kids. And so the numbers are quite large. And they also, in a lot of ways, is a similar approach. The key that made me write this book is recognizing that sometimes these kids present with psychological or we call neuropsychiatric symptoms, where they be anxiety, depression, obsessive compulsive disorder, panic attacks, that kind of stuff, insomnia, whatever it is. And it's not just a psychological or psychiatric illness. There is something biological or medical underlying it. And that's what I've become, like a medical detective. And sometimes a kid is just psychological. Listen, getting bullied at school or whatever, and a breakup, and you're a teenager, a breakup, the world is ending. But on the other hand, if it's attributed

to psych causes and some of the things that can underlie it, like brain inflammation is one of the keys, autoimmunity, tick-borne diseases like Lyme disease or Bartonella, and then all kinds of hormonal disturbances like thyroid or adrenal and metabolic and nutritional, all these things that a lot of ways manifest in inflammation, which is why it's called brain inflamed. But the point being is that when you find these things out and treat them, these kids can get better. And otherwise, their lives are relegated to psych meds and therapy, and you never get to the root causes. And so that's really what drove me. It really came from subtyping autistic kids. The way that I really helped improve and even recover autistic

kids is you subtype them. You figure out what's contributing to their autism, because that's just a broad term that is a descriptive term. It talks, you get good at that and move that to the siblings of these kids. And now, of course, I see many, many adolescents, teens and children, even. You don't have to, you can be a tween, you can be some kids, eight, nine, 10, even. And as we're seeing a lot more of this, the statistics for kids with mental health disorders are huge. It's really staggering

and quite frightening actually yeah even as a kid when in my teens i had adhd really bad i would go down and check the door like 20 times at night i'd have that madness where you're like that's actually not adhd i'm not going to make a diagnosis so it's not a diagnosis i'm just going to give you a sense of what that that's more like an ocd type thing yeah all right so i'm not i'm not good at separating the i'm gonna give you a little help with the letters there i'm a good guy with adh it's i i have too much of whatever it is to know the difference between the letter i don't know so you've written this book and and built a compilation of of of what your research has found and different ways to diagnose

it, would that be a good assessment? Yes. And this book is not written to, the book is really written for parents, mental health providers, and teachers, educators. That's who it's written for, so that they can, for the teachers, educators, and mental health providers, like maybe psychologists, social workers, so that they can recognize that maybe this kid has something more going on. And for the parents, it may give them paths to pursue. I'm not writing this so that they can make the diagnosis, but I'm talking about a lot of things that I might diagnose, but that may make them think, wow, maybe this could be happening in my child. And so I want them to either go to their healthcare practitioner, pediatrician, whoever they're seeing. And maybe after every chapter, there are clues and questions and they're actually templates. This is the thing I'm actually some way most proud of in the book. I spent a long time writing this book. I really put a lot into it.

And I was thinking a lot about it. And there's this whole thing I came up with. There's this whole thing called the autism spectrum, autism spectrum disorders. And that's quite a spectrum. You can have a kid who is totally withdrawn, doesn't speak, they're nonverbal and mute. You can have another kid who is just hyper

and agitated and screeching. And you may have somebody, a kid who's really aggressive. And so there's this whole, and then you may have a kid on the spectrum who's pretty high functioning, but really has trouble with social interactions and things. I came up with this thing that I've named the mood dysregulation spectrum for the other kids. So where they can fit on a spectrum, where it may just be, and there are some nice graphs in the book that kind of show this, where you may start with some moodiness or irritability

like a teenager might have. And some of it we even say is teenage-itis, the kids have it. And then as you progress to anxiety and depression and OCD and panic disorders, and then severe mood swings and aggression, and maybe even psychotic thoughts. It's a way of seeing where they fit on this spectrum and getting a sense of their picture. And actually on braininflamed.com, you can download a graph and

fill it in and then compare it to some of the templates I put together to maybe get a sense. Uh-huh. Maybe this could be going on in my kid. It's not to make a diagnosis. It's to give parents avenues and pathways to pursue because so many of them are pulling their hair out. They don't know what to do. And they've been told it's just anxiety.

It's just depression. It's just this. And they say, you know what? He's not or she, they're not responding to the medicines. They're not getting something else is going on. That was why I wrote the book to try to give them some, something to, to, to pursue perhaps. That's pretty cool. Most times in medicine and different things, we don't, we don't really find out what the core problems are. We just kind of try and treat them and make them go away. Like for years with my depression depression i just treated it with alcohol and that didn't seem to work very well but that is but that's the

that's the truth it might help for a few minutes but then you're worse so drinking alcohol is not one of the that's not they'll probably make inflammation worse as far as i my experience i didn't i was mostly doing scientific studies of high consumption of vodka to see the inflammation on the body and the brain that's what i was doing i'm still working on that book and that what do you guys what do you guys call it in the medical sciences industry my my thesis or whatever on your research yeah there you go on my research i'm not sure it's going to be pure research because most people don't want to drink that much so you have 30 years experience doing this

i researching i saw some videos and some other stuff that you were doing talking about lyme disease and of course i've had some friends that have gotten lyme disease they didn't know it and they went through just batteries and years of pain and horror and and tests And then one day, you know, somebody finally goes, you must have Lyme disease because we've exhausted everything else. And so this is really interesting to me, the findings that you have in your book and what goes into it. The Lyme disease is actually a good point. I live up in the beautiful Hudson Valley.

My office is in Red Hook, is in Dutchess County. It's very, very endemic for Lyme disease and other tick-borne diseases. It's not just Lyme now, it's co-infections. There's all these other things that are in the tick and get transmitted to us. I've had many kids come in and they have these symptoms. If they started suddenly, let's say their parents were on a trip to Cape Cod or they're in the Hamptons, and then maybe that was in July or August, and then September, they start getting these symptoms. They don't want to go to school. They have anxiety. They have separation anxiety. They need to be around, and it turns out, and sometimes they may have fatigue or headaches or

joint aches. That's more of a clue. Obviously, that's more of a clue for Lyme, and if they have the rash, the bullseye rash, that's a huge clue, obviously. That's, you say, it's pathognomonic, but in the point i wanted to make in the book and there are some really very compelling stories that we have so many patients and so i told a lot of patients a lot of stories that i think parents could relate to but the point being is that in these kids sometimes the only symptoms are psychiatric they don't have the fatigue they don't have the joint aches. They don't have headaches, that kind of stuff. They may never have the skin rash. They may never know they

had a tick bite. Half of the people don't ever know they had a tick bite or the rash. And you get the clues when either they live in Westchester or they live in these endemic areas in the Northeast. They're soccer players, so they're out in the woods a lot. They go hiking. And also if they've had a trip to really endemic areas like Cape Cod, Martha's Vineyard, the Hamptons, it just makes you think, wow. And it happened maybe after a trip and a hiking trip or a camping trip. You just have to think of these things. And the problem is that there is some more sophisticated testing we can do to

confirm the clinical suspicion. And the problem is a lot of doctors will just get a very simple test. And if it's negative, they say you don't have Lyme. And in fact, I've had doctors say to people, I don't know what you have, but I know you don't have Lyme disease. I call it the no Lyme diagnosis. And that's a problem because you could say, maybe I don't think you have Lyme disease. It's okay.

Doctors make mistakes. But when you tell somebody they don't have it, and in fact, it turns out they do, it's a bummer because you put them, you set them back and they haven't, they don't pursue it. They think, oh, I haven't told, I don't have Lyme. So I end up making that diagnosis

when it's appropriate, when it's real. And you treat it. It's amazing. You treat it with antibiotics. And I use nutrients and herbals as well, but I certainly use antibiotics and you protect the gut, you protect the liver. That's part of what we do in integrative medicine. You got to make sure you protect the gut and these kids get better. And it's really gratifying because these kids have been sick sometimes a long time. Yeah. It's quite a hellish disease. That's why I never go in the woods and never go near deer.

So there's that. So you mentioned autism, and sometimes autism can be people on the spectrum. Do you find that some of the different techniques you're using is, I don't know if you can completely solve all autism, but it lessens the different experiences people are having with it? Yeah, so it's,'s first of all anybody who says they can recover every autistic kid is is not telling you the truth because you can't i i probably have as much success as as many because i i've been doing this a lot of thousands of kids and the key is subtyping them so you got to figure out are they a gut brain kid a lot of it relates

to the gut we hear a lot of the biome now in the gut. Oh, yeah. These kids have a lot of inflammation in the gut. And what happens is, and then this is related to the other kids that I talk sometimes about house-clearing stools. It can be that. Wow. Abdominal bloating like they're six months pregnant or pain. And really, gas can be really malodorous as well. A lot of them have a lot of brain and gut inflammation. And there's this whole thing called the gut-immune brain axis that's very, very important in so many of the chronic illnesses, even in adults, but obviously I'm talking about in here, in the kids. And if you don't address that,

and you're only giving them psych meds, because if the gut is inflamed, then you get inflammation and our gut is made so that the junctions between the cells that line the gut are very tight. And 70% to 75% of our immune system lies under this one layer of epithelium in the gut. And you say, well, why the heck is three-quarters of our immune system in the gut? It's because just think of what the typical American shoves in their mouth every day. Think about it. It could be a scary story. You've been over at my house, haven't you? Yeah.

I'm visualizing. You've been over over at my house, haven't you? I'm visualizing. You've been over on Taco Bell night, haven't you? So meanwhile, so imagine this stuff comes into the gut, right? It's called the lumen. It's the center, you know, where this, and so this immune system, all these cells have to figure out in a nanosecond, is this friend? Is this foe? Is this just benign?

We just let it go. And this is like happening, like boom, boom, boom. And this epithelium keeps out a lot of the bad stuff. But let's say it gets leaky and more stuff in that should come in. It gets this whole, kicks up the immune system. You get all these inflammatory mediators because that's what happens when you kick up the immune system. It gets into the circulation. It goes to this thing we call the blood-brain barrier, which is what separates the outside of us from the brain. And you can imagine that that's very important too. It's this dynamic cellular interface of, again, one cell's capillary is tiny, but that's what keeps the stuff out of the brain. That gets leaky because the inflammatory

medias that come out of the gut make that leaky and all this inflammation gets into the brain. Now we know that inflammation and stress, all the stress that these kids are going through now, and you add on to the social media, the performance and the constantly having to be on and having the pandemic related isolation and loneliness, all this stuff. It turns out the stress manifests in systemic inflammation. Stress actually causes us to be inflamed. And then that translates to brain inflammation and brain inflammation can actually translate to symptoms like anxiety and depression. So it's not just psychological. It may look psychological, but there's really inflammation and we need to quiet that

inflammation. That's one of the big points I make in the book. Same thing with autism, autism, the brains of autistic kids, most of them are inflamed. I can't say every one of them, but many of them are inflamed. And so what I try to figure out in the subtyping of autistic kids, do they have allergies? Do they have hyperimmunity? Do they have autoimmunity? Do they have infections? Some of them have these tick-borne infections. They have viruses that are just lingering covertly and contributing to these symptoms.

Do they have yeast in their guts that contribute to this bloating and all this stuff? Yeah. So sometimes- I have a lot of yeast in my gut, evidently. I can't see your gut, but it's sounding like- It's a pretty big gut. Well, the alcohol feeds the yeast. Yeah. Anyway, the point being, of course, is that if you can figure out the subtype, and I look at nutrients, I look at metabolism, and I look at a lot of subtleties. But the reality is, if you address the subtleties and the details, and I spend an hour and a half with new patients, I ask a lot, we have very detailed questionnaires. And then I get these labs that give me information, so I can target my treatments. And I'll tell you, it doesn't happen right away. But I would say that the vast majority of my autistic kids improve.

They don't overcover. But more and more, like I say, I have kids that are doing great in college. You would never know that they're autistic. The friends they make in school now would never know that they had autism when they were younger. And that, of course, you got to think is just an amazingly gratifying feeling. Amazing. That's pretty darn amazing. But it makes sense from everything I've studied about the human body. I dealt with inflammation when I got older with my liver and kidneys were like, we're not doing

your drinking thing anymore. And we're leaving. And then recreational marijuana became legal in Vegas. And I started taking that instead of drinking. And it was amazing how much like it would work for me. And then years ago, I lost some weight becoming vegan. And I learned how important diet is and some of the crap that like you mentioned, we just throw into our bodies. We're just like dumping grounds. Yeah, throw that in. Yeah. Yeah. A whole can of Mountain Dew. Throw that in there. That sounds healthy healthy i'm sure that i'm sure our caveman ancestors were drinking that crap back in the day there is something that we that we have used in in in my field called the caveman diet exactly oh what do you think it's meat and

vegetables baby yeah yeah who knew just the i i remember going on a diet dietary um weight loss thing and i started you know reading labels and seeing what was in all the frozen crap. I was eating the Stouffer's frozen foods and all that stuff. And I was just like, yeah, I don't think this is really natural anymore. But so does diet, I would imagine, from what we talked about is one of the elements.

And then you mentioned there's sometimes different little issues with the body you're going to get fixed up. The diet's a biggie. I think when I look at how I deal with these kids, you always look, because I have stories like there's one in the book of a kid who basically I diagnosed a corn allergy. Corn, corn's in everything. Processed corn's in everything. And that was causing difficulty with attention and also mood dysregulation.

It took corn out of the diet. And like I say, corn is harder to get away from than even wheat. And we think wheat's in all the bread products and everything. But they did it. Parents were very determined. They were very strict. And there were some very significant improvements. So the point being is that, and even like somebody says,

this is whole wheat. It's good. It's whole wheat. A lot of these kids have problems with gluten. And so even though it's quote whole wheat, it's still a problem for them. So a lot of them, I made gluten and casein, which is in dairy. So gluten and dairy are inflammatory to many people. And so if we take them off that, not everyone improves. But in our statistic, if you put them on a gluten-free, dairy-free diet, I would say probably 60% may improve. That's a very high. Wow. That's pretty huge. I'm lactose intolerant.

So if you give me dairy, you better leave for a day. Watch out. There's going to be fireworks and explosions. In your evaluations, you uncover triggers such as post-strep infections, which is pretty interesting, Lyme disease, gluten sensitivity, like we just talked, adrenal dysfunction. Do you find that – I heard one time that the reason we have more people that they have issues with peanut butter, wheat, and milk is because we don't grow up on farms anymore,

so we don't build up those immunes or something. You're talking about the microbiome that so in the gut i was talking about the gut and where i was going to go and there's a whole chapter in this new book on the microbiome called gut feelings it's because the gut is so related to how we feel and it's now this is something in my field we've been into for i've been practicing now 37 years and i've been into it ever since i started but but now it's really caught hold and in conventional medicine the microbiome is huge and and what it is is you want to have a diversified balanced microflora but the problem the problem is that a lot of kids get antibiotics right from

the get-go and just think so i ask the ask the question always, how is your child delivered? And think about C-sections. We have probably around a 33% rate of C-sections. It's very high in this country. Many other countries are having, we think we're advanced. What's supposed to happen is that the infant, the neonate, is supposed to go down the vaginal canal, get in contact with all that good vaginal flora and be born. And that starts to

repopulate in them. But if you're a C-section, you don't get that experience. You don't get that luxury of going through the vaginal canal. You get delivered right into it. And what is the first bacteria? You see the bacteria on somebody's skin maybe, or in the OR rather than the mother's healthy vaginal flora. And what happens early on sets the tone for what happens later in adolescence. Holy crap. Yeah, no, no. So I have this thing. We have an infant probiotic that I would recommend every kid who's delivered by C-section. And I think probably every child should probably be on it, but it's certainly every kid that's delivered by C-section should take it. It's a probiotic and a prebiotic. It's the prebiotic in breast milk that helps the good bacteria, because that's what you're saying. Yes. If you don't have that, what you're talking about, there was once an article I read that was great. It was called Eat Dirt. That was the article's name, because that's living on a farm. What are you doing? You're exposed to cow manure. And it sounds gross, but the point is you're getting all those microbes. And now we're growing up in a sterile society. And if we were, if from birth, our mother had group B strep

in the vagina, so she got antibiotics right away. So you got exposed to antibiotics. If you, if you had any kind of issues, they put you in the NICU and you get, they rule out sepsis, you get three days of IV antibiotics, all that stuff right away throws your flora off. And if you don't get it replenished early on, you're at a disadvantage. Because those microbes have to, they basically become instructors for your immune system. Wow. Oh, yeah. It's amazing. That makes logical sense, actually.

It really does. This is common. Yeah. Yeah. I didn't think about that. Sometimes people ask you, what kind of medicine do you do? And hopefully I say I do very good medicine, but we call it integrative medicine because I use all the skills I learned as a very well-trained physician.

I went to the University of Rochester. I even got my MD with honor and I got some very good conservative medical training. But I also, in addition to medicines, I use dietary modifications. I use nutrients and herbs. I do allergy testing, and we have sublingual, sometimes drops. We take people away from things they're allergic to. We look for all the things that may, under the surface, contribute to it. And like you say, the microbiome is huge, is very, very big, Chris. That's amazing. That makes logical sense. We're really these complex things and yeah,

coming right from birth, because I've always wondered about people. I was, I didn't, my mom didn't have a C-section, so I guess I need to go thank her for my flora. Thanks mom for giving me bacteria. That'll be my car doer for christmas it'll be like on the inside hopefully i'll have some good bacteria the good bacteria thanks for giving me good bacteria mom she'll be like what the hell is going on with you like seriously why did i give birth to you but just what she does already so we're we're already across that bridge what haven't we talked about in your book that you'd like to tell our audience about? One of the things when we think of stress, right?

And so there's one case we call adrenals. And in my field, we think of the adrenals. But unfortunately, in medicine, we don't think about the adrenals that much. It's interesting. And we're taught about a condition called Addison's disease, frank adrenal deficiencies, where the adrenals don't work at all. And that's very infrequent. You don't see that.

But we see a lot of stressed adrenals. The adrenals are these little glands that sit atop the kidneys. And they produce either epinephrine and norepinephrine. These are the neurotransmitters of the fight or flight reaction. In other words, like, wow, you've got to get ready. In the old days of the caveman, had to get ready to either fight or flee. And so you need these kind of neurochemicals and things to help you do that. The other part of the adrenal produces cortisol. You've heard of cortisone. Well, cortisol is something natural.

We all need it. And a lot of people hear about it, like now with COVID. When people get COVID, what do they give them? They give them dexamethasone or prednisone as steroids, very strong steroids to suppress the inflammation and the immune response. But I'm talking about the adrenals producing small amounts of natural cortisol, hydrocortisone, that you need for a healthy immune system, let's say, that you need for a healthy metabolism. And if you're low on it, you may be fatigued. You may feel anxious. But before you get low, a lot of people are

actually high. We call it hypercortisolism. When you're stressed, the adrenals produce the cortisol in reaction to stress. That's what you do. You need it to meet. Let's say you're walking across the street and a car comes at you. You need the adrenals to respond, to pour out epinephrine, norepinephrine, and cortisol to have you react, to get out of the way of that car. That's what happens. And shut down the GI tract, shut down other things so that you can get all that fuel to your muscles, let's say, to get out of the way. And that's great for the acute response. But what happens if that's happening every day, many times a day? Think about it. Think about where people live. Think about being caught in rush hour traffic in New

York City or Chicago or any other city. I don't want to, but I grew up in New York City or Chicago or any other city. I grew up in New York City. I know what it's like, at least what it used to be like. If that's happening all the time, you're pouring out this cortisol. You have too much cortisol, and too much cortisol suppresses the immune system. Rather than the small amounts that your adrenal makes naturally physiologically to enhance the immune response to keep you healthy. Too much of it suppresses it and makes you more vulnerable to things. And it can cause you to be anxious. It's that thing when you can't sleep in it. Maybe if you wake up at night and your mind's racing, you get all these thoughts. I mean, I know many people have that.

That's probably hypercortisol. That's probably too much cortisol. Really? Yeah. Yes, that's right. So that can contribute to anxiety and stuff, huh? Yeah. So that can contribute to anxiety. And basically what you want to do is have the normal amount of cortisol. You want to have, it's the highest amount in the morning and it gets lower as you, so it's the highest amount in the morning gets lower as you go through the day. And by the time you go to bed, you want to have low cortisol because you want to just go to sleep. You don't need the cortisol, but people who are sometimes depressed or people are really anxious, people have insomnia, wake up, you may have high cortisol. And so we have

various ways to quiet that various nutrients, various herbs that can quiet that cortisol and also stress management management doing things like meditation yoga or what have you sometimes have to see a therapist whatever to manage that stress because that stress is not only psychological stress that stress has physiological correlates and that's the key that's the thing i want people to understand that we really we have to deal with the physical, not only the psychological. Psychology, I'm listening, all my autistic patients, they get ABA, they get OT, occupational therapy, speech therapy, physical therapy, all these kids that I have that are not in the autism spectrum, but they may be in the mood dysregulation spectrum. They may need to be on an SSRI. They

need to see a therapist, maybe cognitive behavioral therapy. But if that's all they're doing and we're not looking at the other things, like we're not treating the adrenals or we're not looking at thyroid. Do they have a problem with their thyroid? They have inflammation of the thyroid. Yeah. So many of these people. And if they have tick-borne disease like Lyme disease,

many of them may have inflammation of their thyroid. We call it Hashimoto's. And if you don't testborne disease like Lyme disease, many of them may have inflammation of their thyroid. We call it Hashimoto's. And if you don't test it, you don't see it. So the key is to be aware of these things and to do the right testing so that I can make the proper diagnoses and then remediate it. And that's the points I want to make to people is that there are many things to think about. And I don't want him to think that every psych problem is all these things because the reality is sometimes a panic attack is a panic attack. And the kid had something really terrible happen and you have a panic attack, but that doesn't, that doesn't mean that many times,

there may be something else going on. We don't want them to. That's pretty interesting. I had a girlfriend who had cushing's disease which was cancer on the thyroid is for that cushing's is the adrenal adrenal gland yeah and i remember reading up on it and everything it did and the regulation of our body's steroidal system or steroid system i was just i was just blown away i'm like wow i had no idea this was going on inside me. These are master glands. So you have, these are glands, you have your master gland, it all starts in the brain. You have these brains, but then at the base of the brain is the hypothalamus and the pituitary. Those are the real master glands that control all the other things. They secrete their types of hormones that go to

the thyroid and the adrenal and the adrenal and thyroid, they're very much involved in metabolism. And every cell in your body needs proper metabolism. So that's why the symptoms can be so varied. That's the thing. It's not just so simple at one symptom. And for me, it's just a matter of getting the clues, the adrenals, let's say. One of the clues is something called low blood sugar. I don't know if you've ever heard of low blood sugar or hypoglycemia. You see those commercials, the Snickers commercials, where somebody gets hangry, you know what I'm saying? And we have, if you ask the questions, the parent says, yeah, I don't feed my kid frequently enough. They're a monster, they're a bear. And so what happens is in the morning, sometimes they're really, really worse because they haven't eaten all night and they need to get something in there, not sugar, hopefully something more healthy, not sugar. That's the problem.

I'm not sorry, Snickers, but I'm not talking about Snickers. This show brought to you by. So anyway, so that's and so I have a story in the book about this guy. He hikes the Adirondacks, the Appalachian Trail, and he had lots of anxiety. It turns out he ended up in headaches when he first came to me. He had Lyme disease, and we had to treat that. Wow. But then as you uncover the layers, as you peel the layers, as you treat something like the Lyme disease, then you get down to other things where it turns out his blood sugar, I remember, was like 44.

It should be, it's supposed to be greater than 60 at the very least or 70. This was 44, very low. And he talked about when he would be doing this hiking, he would go for days. He'd be camping and he'd do all this hiking and he would bring, he wouldn't really have, he'd bring all these bars. That's what they do when you're hiking. And so his blood sugar would go crazy up and down and he would get anxious. He'd have anxiety and panic disorders and things. But it turns out when we figured it out and he realized that he had the low blood sugar, he then knew how to deal with it. And we gave him obviously some supplements for the adrenals and things.

But just knowing that he knew he had to eat every couple of hours. And rather than just have these bars that were high in sugar, he'd have nuts or other types of food, maybe cheese or something. You can keep it cold, but certainly nuts, celery or whatever. And those kinds of things, they actually seem simple and they are. But if you don't think about them they're not so simple and that's why i call this medicine some way we call it integrated medicine but sometimes i'll say it's common sense medicine you ask the right questions you get these

answers and you do common sense solutions yeah it sounds it sounds it sounds intelligent because we do have to balance our bodies and some of our bodies are a little bit different and maybe our experiences now you're writing the book that mostly this is for younger people and babies and stuff like that is can adults be fixed like the way you've been fixing younger people or are we just screwed because we're just so first of all i i see in i've been i i i'm board certified in family medicine so i've seen my whole whole career from very young to even when I first started way back in the 80s. I even was doing more of what we in those days called a holistic family practice. So I'd even be in the delivery when there's a C-section.

I'd get the baby. I'd see the kids in the hospital. I haven't done that kind of medicine because I'm really much more focused on the real complex cases now. And that's really what I do. But the point being is I've taken care of adults my whole career. And yes, when I wrote the other book called Healing the Childhood Epidemics, the four A's, I had somebody after a lecture say, Dr. Park, why didn't you call it the five A's? Why didn't you include Alzheimer's? And I said, the truth is that book was 460. I said, it's too big. I couldn't put

anything else in. But the reality is that autism in a lot of ways is the childhood equivalent of Alzheimer's. Very, very similar underlying biological issues. We call it oxidative stress, too many of these free radicals that are harming the cells, toxicants, all kinds of toxicants, and chronic inflammation. Same thing that we're talking about with the kids with the mood disorders. So yes, this is really true for adults and they need the same kind.

Adults have adults who have bad mood swings or anxiety, depression. Also with the other symptoms, they may also have Lyme and thyroid. So this book, although I really wrote it, I mean, if you, when you write books, you have, you pick out certain populations that you really want to focus on. But the truth is the, all the things I talk about, the immune system, the microbiome, and every chapter is really applicable to adults, except maybe the post-strep. That's the thing you would just ask, the post-STREP. We're a kid. Now, that's a fascinating chapter. It's been called PANDAS, sounds weird, PANDAS,

Pediatric Autoimmune Neuropsychiatric Disorder Associated with STREP, or PANS, P-A-N-S, Pediatric Acute Neuropsychiatric Syndrome. I call it a TABI, I-T-A-B-I, which is Infection Triggered Autoimmune brain inflammation. And this is more, this would not be adults. This is where a kid encounters an infection, like a strep infection, typical like sore throat. But because of their genetics and because of what's going on in their body, the immune system attacks the strep, which is good. But unfortunately, there's a very tiny piece of that strep, we call it an epitope, that looks exactly like a very tiny piece of the brain

called the basal ganglia. It's in the base of the brain, this very tiny part of the brain that's responsible for movements and also mood. And so when the immune system mistakenly attacks that part of the brain called the basal ganglia, you get inflammation, you get autoimmunity, and you get tick disorders where they might start blinking or moving their head. And you get OCD, where I have kids, I'm talking about severe OCD, like you were talking about, you had to check the door 20 times. That really is OCD, but I have kids with such severe OCD, they won't leave their room. I've had kids literally not leaving their room. And I'm talking about really severe. One kid going to the bathroom is really, really bad. Not going to school for years. Not being with their friends at all, maybe not interacting because

they have rituals. They have so many rituals. To come down from their bedroom to the kitchen, they may not be till two in the afternoon because they have to go through all these OCD rituals. Wow. It can be very severe and it can happen like that. That's what's amazing with some of these disorders. These are the clues. And that's what I mean. So let's say it manifests with severe OCD and anxiety, and they have tics, but it's really severe OCD and anxiety. And their doctor treats it as OCD and anxiety, and doesn't really look for the clues that this happened overnight. I have kids where they are A plusplus students, significantly really accomplished athletes, lots of friends, great family, get along with their siblings.

They wake up one morning, they are like an alien. Honest to God, Chris. And that is triggered by an infection. The immune system gets activated. But rather than just fighting the infection, it's not only strep. It could be another bacteria, my only strep, it could be another bacteria, mycoplasma, it could be Lyme, it could be a virus, a sinus infection, but it's pretty crazy. But the thing is, if you recognize it and you figure out what causes it, which is

what we try to do, and you treat it, and we have some, it can give an antibiotic or an antiviral, but we also have these immune treatments, like something called IVIG. It's the most intensive thing I do. It's a two-day IV for the kids that quiets the inflammation in their brain and quiets the autoimmunity and really helps these kids turn around. So I've had these kids, I'm serious. I have kids come in in a wheelchair because they basically can't walk because, yeah, it's affected their neurologic system. And when you make the right diagnosis, and in this case, I'm thinking of two of the cases were tick-borne and brain inflammation. You quiet the brain inflammation, you treat the infection, and it's pretty remarkable, actually. And it's something that

the reason, one of the things that really propelled me to write the book is for people to understand this, because if they're seeing a therapist who doesn't recognize this, or a doctor that doesn't either recognize it, or crazily enough, doesn't believe it, there are some doctors who don't believe it exists, that the kid won't get diagnosed. And then they're just, they'll just be bad, and they get worse and worse. And the longer your brain is inflamed, unfortunately, the more chance of it having what we call neurodegeneration and like Alzheimer's and Parkinson's are neurodegenerative diseases. So you want to get it while it's inflamed so you can quiet the inflammation. You don't want it to get burnt out.

So it's like basically like an Alzheimer is basically there's inflammation there as well, but there's also neurodegeneration. So you want to get it as early as you can. The early we get it, and that's partly why I'm really trying to educate people is partly why I'm doing a lot of this, these shows and I do lectures. And the book, thankfully, is, I think, going to reach a lot of people. So hopefully they can jump on it sooner than later. There you go. There you go. So as we go out, any last thoughts?

And give us your plugs so people can look you up on the interwebs and order up the book. So last thoughts would be that I just want to leave people with this whole notion that basically that if your kid has psych symptoms, that I want you to be aware that there may be biological and medical underpinnings. And the most common is brain inflammation. And there are ways to even look at that and make diagnoses and treat. And there are other causes other than stress

that just cause inflammation that that one needs to realize and there are questions and clues that are at the end of every chapter in the book that can help people get a sense of wow could this be going on in my kid could it be thyroid could it be adrenals could it be a heavy metal like mercury or leg could my kid be nutritionally deficient or insufficient those kind of could there be a metabolic metal like mercury or lead? Could my kid be nutritionally deficient or insufficient? Those kinds of, could there be a metabolic need? And without getting into the complications, because it can get complicated. The point being is just to be aware that sometimes in kids, in adolescents and teens, that the psychological manifestations are just that.

They're manifestations of something boiling underneath. And we got to try to figure that out. That's what, and maybe not. It may be, sometimes I'll get the history and these kids really going through things. And I realized that I say, you know what? It's, I think something's going on in school. I think the kid may be getting bullied.

I think you need to get an educational psych evaluation. We need to look at that. And sure enough, that sometimes happens. So I'm not saying it's all this. Don't get me wrong. But I'm saying if you miss it, you relegate kids to a life of psych meds and therapy. And if you get it, if it can be figured out, you can change the trajectory of the kid's life and the family's life. Because trust me, this is not something that just affects the kids.

When these kids are severely affected, it's not only the parents, it's the siblings, it's the grandparents, it's the cousins, it's close friends. It really affects many lives. And so that's why for me, healing the kids is healing the families. And we have to remember the other kids in the family that may not be as bad, may also be getting short shrift because so much attention is going to this other kid. So I like to always be very aware of what's happening in the other family members. So that's how I want to leave people understanding that. And so the sites they can go to, the book site is called Brain Inflamed, B-R-A-I-N, Inflamed, I-N-F-L-A-M-E-D.com, all one word. And there you can actually see some information and also look at, you can see some of the graphs that I put together, templates of what the mood dysregulation may be in certain of these

illnesses and disorders I talk about. And also there's a blank one that you can download totally for free. And you can in some way fill out your own kids. Try to see how it may compare to some of the templates. It's not, these are just templates. They're not only one way, but, and maybe give you some avenues to pursue for your child. And then in terms of my practice, if anybody needs information, if anybody really has some issues they think that maybe we can help them with, I work with a terrific nurse practitioner,

Jennifer Petkos, and it's Bach Integrative, B-O-C-K-I-N-T-E-G-R-A-T-I-V-E.com, bachintegrative.com. And it's called Bach Integrative Medicine. And the phone number is 845-758-0001. And Teresa Ortiz, as we call her, has been with me 35 years. My staff has been with me many 20, 20 plus years, 25 years, 35 years. So they it's, I'm very lucky that way. And they really, they know how to handle and how to really help. Cause I couldn't do without my staff. They're going to be smiling. Oh, my staff is going to be smiling. There you go. Give the staff plug. We appreciate you being on the show with us and sharing your wonderful

knowledge today. Thank you very much for spending the time. My pleasure, Chris. I really, wonderful knowledge today. Thank you very much for spending the time. My pleasure, Chris. I really, really appreciate it. Thank you so much. Thank you. And to my audience, check it out. Brain Inflamed. I sound like I'm doing a movie or something.

Brain Inflamed, uncovering the hidden causes of anxiety, depression, and other mood disorders in adolescents and teens. Check it out. Order it up. Go to your local bookstore. Order it from Amazon, wherever the case may be. Check out Dr. Bach's websites and everything else. I really love our discussion we've had here today. To see the video version of this, go to youtube.com forward slash Chris Voss. Go to goodreads.com forward slash Chris Voss. Our numerous groups

on Facebook, LinkedIn, and Instagram as well. Thanks for tuning in. Be sure to wear your mask, stay safe, and we'll see you next time.