The Food Medic - S4 E5 - The Female Brain

Episode Date: June 12, 2020

On this episode, Hazel chats to Dr Sarah Mc Kay, a neuroscientist and science communicator. Sarah has written a book titled demystifying the female brain (also called the women's brain book on the other side of the world) - The neuroscience of health, hormones and happiness.They discuss:*The main differences (if any) between male and female brains*Common gender stereotypes when it comes to the brain*How puberty and pregnancy alters the brain*PMS and mood*Why mental health conditions such as depression and anxiety are more common in women. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hello and a very big welcome back to the Food Medic podcast. For those of you who are new around here, I'm your host, Dr. Hazel Wallace. I'm a medical doctor working in the NHS in London and I'm a registered associate nutritionist, founder and author of The Food Medic. This season I'm keen to learn more about women's health and not just reproductive health but total body health and on this podcast I chat to Dr Sarah Mackay, a neuroscientist and science communicator who specializes in translating brain science research into simple actionable strategies for peak performance, creativity, health and well-being. Sarah has written a book titled Demystifying the Female Brain, also called The Women's Brain Book on the Other Side of the World,

which is how I stumbled upon her work in the first place. On this episode, we chat about the main differences, if any, between male and female brains and some common gender stereotypes when it comes to the brain. We talk about how puberty and pregnancy alters the brain, PMS and mood, and mental health conditions such as depression and anxiety, which are much more common in women. This podcast is kindly sponsored by the Marine Stewardship Council. Many of us are becoming more conscious of where we source our food from and it's not always easy to know if the food that we choose is sustainable and traceable. When shopping for sustainable fish I look out for the Marine Stewardship Council little blue label.

The MSC is a science-based non-profit organisation on a mission to end overfishing. It recognizes and rewards sustainable fishing so that future generations can enjoy the seafood that we love. You can find seafood with the MSC little blue label in most supermarkets in the UK. Head to MSC's website to find out more and make sure to check out episode eight of season two of the Food Medic podcast where I chat to Lucy Erickson, the former science communications manager for the MSc all about sustainable seafood. I think what would be lovely to start with is to just kind of get a background in terms of your kind of academic background and research and what got you interested in the brain specifically? Okay sure well I guess I was one of those kids who loved I loved school I loved learning I was very fortunate in that respect and I went off in my first year of university kind of doing that

medical sciences type going down that path and I was in a psychology lecture and I read a book by a neurologist called Oliver Sacks I don't know whether you're familiar with his work yeah and it's interesting you say that because my neurology lecture in my very first lecture at med school said read this book as well the man who must look white for a hat but like people who don't know about that Oliver Sacks is a neurologist and he just wrote these amazing he's a fantastic writer as well as a neurologist and wrote all these amazing case studies around the kind of the strange things that happen when people's brains malfunction and I read that and that was it that was it I was captivated by those stories

and I was thinking wow this whole idea of the biology of psychology is really interesting. And a friend of mine said, you know, there's a new degree course at another university down the road, Otago University in Dunedin in New Zealand. And they have just started a new degree course on neuroscience there. And I was like, oh, my God. And that was it. I was like, right. And so I moved towns moved universities and I was the one of the first to graduate in this cohort of neuroscientists and then I just fell in love and you know that was what 25 years ago so I was incredibly fortunate to head off

to Europe backpacking and you know I was going to find a job in a pub I found a job in a pub in Edinburgh actually not in London and while I was there I was casting to find a job in a pub. I found a job in a pub in Edinburgh, actually not in London. And while I was there, I was casting around for PhD opportunities. And I was incredibly fortunate to win a scholarship to Oxford to study a master's and a PhD in neuroscience there. And was looking then at this concept of neuroplasticity, except back then, kind of 98, 99, we didn't really use that term very often. But I was really interested in this nature-nurture question, what guides the development of the brain? How do the connections in the brain form? Is it biology? Is it experience? Is it a bit of both? It's a bit of both, as I found out after many arduous hours in the research lab. I met a gorgeous Irishman there, so that was

22 years ago, and we're still together. I still think he's quite nice. And reached the end of my PhD studies and we moved to Sydney on just a bit of a whim because he's a sailor and we thought it might be nice to spend some time in the sun. And I did a couple of postdocs, kind of that post-PhD training in the neurosciences and academia, and saw that there was a real niche in terms of working in science communications explaining science to the general public but using my specialty of

neuroscience so what can we take from the neuroscience research lab and teach ideas about the brain so that's how come I ended up on your podcast amazing and I'm so glad to have you here so I mean on this side of the world your book is called demystifying the female brain yes and obviously when you read that title people are saying right well there's differences between a male and a female brain the title of the book is a bit of a that's a story I'm not going to get into. Let's just suffice to say, I wanted to call it In Her Head, The Intriguing Life of the Female Brain or something like that. But the book publishes like, sounds too much like, you know,

the girl on the train and, you know, the girl in the window, one of those kind of psychological thrillers and people might get confused and not realize it's science. So in Australia, it's called The Woman's Brain Book because in this part of the world, you say what's on the in Australia it's called the women's brain book because in this part of the world you say what's on the can is what's on the can and the publishers in the UK and Ireland came up with demystifying the female brain it's funny because when I used to say I was writing a book on the female brain people would go oh my god well can you tell me the difference between the male and the female brain? And that is the first question absolutely every bloke would say. So after a while, I got a

bit sick of that. And I started saying, I'm writing a book on women's brain health. And as soon as you say women's health, people ask very different questions, which is kind of interesting. But I got frustrated because I was like, I'm not writing a book about the difference between the male and the female brain at all. I want to write a book about I was writing a book about periods and the pill and pregnancy and menopause and all of these life things that happen to girls and women through the lens of neurobiology I wasn't going male brains are like this and female brains like that because quite frankly they're more similar than different. Yeah and I think a lot of people will be shocked to hear that because I think we kind of assign different attributes to men and women and assume that that's because of how we're made up and our

brain is made up and I know from kind of looking at the research that men typically have larger in terms of larger in weight brains than women and then there's this common the research that men typically have larger in terms of larger in weight brains than women and then there's this common belief then that men are therefore smarter but from my understanding is that's not the case as in the evidence just doesn't stand up to scrutiny when you look at it no well the reason yeah the reason they have larger brains is typically because their bodies are larger than women's brains so it's a bit like saying men have larger hands than women, therefore they're better at doing stuff with their hands. Like form doesn't follow function in that way when you look at biology.

And I think we get so hung up on saying, you know, is this part different? Can we peel open someone's skull and peer inside and see a woman has a pink brain and a man has a blue brain and therefore that explains every difference between us and really it's a little bit similar to any other sort of organ system that you look at in the body reproductive systems aside there are a great deal of similarities a cardiologist would say your hearts are pretty similar if you're operating on them but there will be some small differences and so I guess we need to be asking much more sophisticated nuanced questions like is there a difference that we're really interested in how different is that difference

because typically it's quite tiny sometimes tiny but important sometimes tiny and so unimportant so we can't look at women's brains and go well that means women are no good at planning and judgment and reason and they're far too emotional we could go well let's take a look at leadership for example women leaders in the current crisis appear to have done reasonably well we look at Jacinda Ardern prime minister of New Zealand where I'm from has done an absolute like she's you know smashed it out of the ballpark of leadership she has a female brain and she has a baby she was once pregnant she was pregnant as a prime minister and she had a baby brain then you know she's done a cracking job we could look at a very emotional politician like everyone's best friend Donald Trump and go well is he that way because

of his male brain makes him highly emotional impulsive can't make good judgments planning I mean very quickly falls down when you try to start applying you know these gender stereotypes that we love to use when we start trying to apply them to brain anatomy and physiology. And you just mentioned kind of gender stereotypes and you think when we come down to like discussing intelligence and emotion and things like that do you think these differences that we assume are there are largely due to potentially expectations we're putting on our children at a young age and potentially the opportunities we get as older women? I mean, we can look at differences in intelligence

like measures of IQ and typically any differences you see are really kind of non-existent and it really depends which study you look at. But when good studies are all pulled together together you don't find any difference in intelligence and there's more to life than IQ right emotions are emotions are interesting I'll put that aside for the time being but the question you kind of pose around children I think it's so fundamentally important to realize that babies are born male female with this brain that's ready to be kind of arrives in the world and if everyone remembers their kind of high school biology

organisms adapt to the environment in which they live in and a newborn baby human's brain is a bit like that it's like well what's this world i live in and every experience that happens sculpting changes that child's brain all the way through childhood, through your teenage years as well. Some really interesting work's been done, and I write about this in the book, looking at these ideas that men are often, they're more confident, they're more sure of themselves, and I have a 10-year-old and a 12-year-old boy,

and I see this super confidence that they just think that they are like the greatest things on the planet. And it just sort of starts at quite a young age and you think well is it innate or is it learned and this really interesting study was done looking at that idea of male confidence versus women being slightly less likely to lean in and be you know asked for the raise and all that kind of stuff so study was done looking at children who had just entered primary school elementary school so ages around five or six and they went in and said look kids we've got this game for you and this is a game that very smart children can play and all of the five and six year old all the boys said i'll play that and all the

girls said i'll play that and then they went a couple of years later in primary school and talked to seven and eight year olds. And they said, hey, kids, who wants to play the game for the really smart kids? And all the little boys went, yeah, yeah, me. And all the little girls went, some of them went, yeah. And some of them went, oh, no, the boys can play that. So there's no biological changes that happen between those first couple of years of primary school. there's no hormones that switch on that can explain that shift in gender expectations and that sets that sort of difference that the guys are the ones that'll go and do the stuff and the girls might not is carried all the way through and it's seen in lots of different cultures and societies and I guess one of the take-homes from this study is that the kids are picking this up

in a way I find that interesting because it's less devastating because we can do stuff about that we can do stuff about absolutely what we teach them the environments that we raise them in the gender expectations that we have of who they should be and what they can do with their lives if it was biological, that's a massive shame because we can't really do anything about that. If girls lack confidence by the time they're seven and it's their biology, well, you know, how are we ever going to get female doctors

and neuroscientists and prime ministers? Absolutely. And you made a really important point, you know, as children, there's no big hormonal shift going on. But then as we move into puberty, most of us can relate to that emotional turmoil of when you're going through those teenage years and just everything is like either amazing or it's the end of the world what changes occur to our brain during adolescence oh so many so many

and I think teenagers are given such a hard time and people who know a little bit about teenagers brains blame their brains but i think what's completely misunderstood about teenage boys and teenage girls is that they hit puberty and girls on average a year or two ahead of boys but boys boys eventually catch up um the the kind of that hormonal shift the reproductive hormones when they switch on kind of trigger this next phase of critical development in the brain and it's the parts of the brain that are involved in some very important very kind of human and growing up skills things like planning judgment and reasoning being able to solve complex problems being able to

see shades of gray really important skills like emotional regulation, skills around social cognition, being able to think and feel what other people are thinking and feeling and realising that's different from you. And what we see is it's a real critical period in development for learning these skills. The brain is going through an incredibly plastic period of time in which it's primed to learn these skills. So in a way, teenagers are at that point in time in which they're most easily able to learn the skills of emotional regulation, learn the skills of social cognition. And I think we do teenagers a disservice by saying that brains are half developed or they're not good at that skill yet.

We would never say if we had an 18 month old child learning language, developed or they're not good at that skill yet we would never say if we had an 18 month old child learning language well they're really crap at language they haven't learned it properly yet we understand how important it is to teach and model and engage with language with a child going through that critical period of brain development and that's what's happening in the teenage brain so we talk about learning the skills of emotional regulation that's what's happening in the teenage brain. So we talk about learning the skills of emotional regulation. That's when they're learning the skills of emotional regulation. They're not rubbish at it. Their brains are primed to learn and understand how to do that,

which is another great thing. So it's up to the adults around them to nurture them through that process. What the problem is is that when you turn into a teenager and all your reproductive hormones switch on the very first thing you do is divorce your parents and want to join the tribe of your friends which has got it there's a biological imperative for that and I see that with my 12 year old the last thing he wants to do is hang out with his mother unless he's hurt or hungry and that's quite

normal because they need to be engaging with different kind of social networks and their social brain is going through this period of development in which it needs to learn about you know who am I and who are the people I'm going to be engaging with and moving away from that kind of family group and I think lots of parents freak out about teenagers and without understanding that what they need right now is the right kind of environment in which to learn and grow. Yeah. And so this hormone switch, is that what we're attributing to these mood swings?

One of the things that you chat about in the book is how the different stages of puberty, as in what age someone goes through puberty and how they perceive themselves is a whole other kind of factor to consider yeah this was fascinating to me so there was this one fascinating study done looking at the onset of puberty and the development of kind of mental health problems so not necessarily mental health i guess the emotional turmoil of puberty because we'll especially girls remember what that's like when you first sort of

start developing and this exquisite self-consciousness that you develop and this is fascinating so if a little girl enters puberty before her friends so early but normal perhaps she develops breasts or gets a period at the same 10 normal but probably earlier than normal she's quite vulnerable to developing issues around anxiety and mood disorders in comparison to the girl who goes through puberty around the same time as her friendship group or the girl who goes through slightly later. Whereas the little boy who hits puberty much earlier than his friends, and one of my son's friends is that kid, they grow tall, they get hairy, their voice drops and they rise in social

stature they're musclier they're bigger they because they've become a man in their friendship group and they are protected against mental health issues versus that little guy who hit puberty when he was about 15 and everyone remembers that kid who was in their class who was a really little guy they're far more vulnerable so there you've got these four kids who've hit puberty their bodies and their brains are experiencing pubertal hormones for the very first time but their experience is is more so dependent on the social context in which those changes take place so it's not just hormones are not the loudest voice in the crowd they're pretty important but so is you know who am i who are my friends my body's changing what are other

people thinking about me and i think we need to really recognize that because especially when it comes to women's health we get very hung up on hormones and i'm not necessarily convinced they're always the loudest voice in the crowd we've just been told we've been told they are and that's a shame because we can't necessarily we can be biologically healthy and take care of our hormones but we can't necessarily do as much about them as we can about you know other things in people's lives like social support networks absolutely I think sometimes our hormones especially the fluctuations we experience as women is often kind of portrayed as this like disadvantage to the human race and it's like why we're not included in you know research and studies because we're too complex and one of the things I actually

wanted to touch on next is how when we're coming up to our period and we may experience an emotion and especially if it's negative we just automatically assume oh my gosh it's because my period's coming. Yeah this is fascinating so I was I thought well right so between puberty and menopause except if you're like on the pill or you're pregnant most women have a healthy natural hormonal cycle. And we understand that ovarian hormones, estrogen, progesterone, can make their way into the brain and can change how our brain cells and neurons respond and modulate them. And testosterone also can get into men's brains, except it gets converted into estrogen when it's there, which is how it has its effect, which I think is really quite entertaining. women have got these monthly fluctuations and they may be bigger or smaller and

different people and I thought well the first thing I looked at was do those fluctuations have any impact on cognition so thinking so these kind of higher order planning judgment emotional regulation skills and there was little evidence I mean there was a lot of work on this in this space but nothing showing that women couldn't think at any other time of the month than you know we can go to work every day of the month and perform quite adequately thanks very much but anyway emotions were a different kettle of fish and so I thought oh well this whole PMS we get cranky before our periods is a thing so I thought well I'll look at PMS first thing I did was look at what are the rates of PMS and so I'm a scientist

and so I go into PubMed which you doctors would be familiar with and I'm looking at meta-analysis of PMS because that pulls together all the different studies and there's power in numbers so I was like what's the rate of PMS symptoms in the world and the most recent meta-analysis had looked at that but to my surprise and to the surprise of the authors it varied hugely across the world with women putting their hand up or not saying I have symptoms of PMS so much so that in France and Switzerland it's around 10% jump over the border to Spain it's around 50% go over to the Middle East it's around 90% and I was like well how can this be the hormonal difference between Spanish woman and Swiss woman is not that different what is going on and there's a Kiwi women's health psychiatrist

Sarah Romans has also looked at this and so I looked at some of her work and rang her up and we chatted about this and she'd been really interested in this phenomenon around cultural and societal narratives of PMS and as a psychiatrist obviously she sees a sector of society where women have got serious mental health problems but she said she just didn't believe that this kind of I feel this way because of my reproductive status I feel this way because of my reproductive status, I feel this way because of my hormones was always the answer. So she designed this very clever study called the Mood and Daily Life Study. And so women were given an app and it popped up on a phone

and they were asked every day their mood and they were given a range of positive and negative moods to choose from. And interestingly, the same number of positive and neutral and negative moods, because a lot of studies give women like 12 negative emotions and one positive. So that kind of skews the data. So there was equal numbers of emotions to choose from. They also had to put down their physical health and their kind of social support that they were receiving.

And the most important part of the study was women were not told. It was a study on PMS, which is mood and daily life and we're gathering all of this data and they crunched all of the numbers and it turned out that only about one or two in 20 women showed any clear variation of mood based on cycle day which is fascinating so lots and well, in Iran, 90% of women say, well, my mood varies depending on the day of my cycle. In France and Switzerland, only 10% do. When the women were not told it was about PMS, they were more like the French and Swiss women.

But when you repeat the study and you say, we're doing a study on PMS, we're really interested to know if you're going to get cranky before your period, women's expectations of their health status changed and therefore if they were maybe feeling slightly off they decided well I must be pretty cranky and angry today because my period's coming and they gave themselves a negative mood score. Fascinating how different moods change based on what women were primed to think that they should be feeling. The women who were not primed on, this is a study on PMS, they weren't told what it was about,

their mood was far more likely to vary based on physical health or whether they felt stressed. But most important of all was whether they were feeling they had social support that day, whether they were feeling loved and cared for. Yeah. um I was interested when you just said that mentioned that their kind of mood fluctuated more on social support but also physical health and I wonder in that study whether they also tracked the physical symptoms because obviously PMS is both a kind of a collection of physical and emotional symptoms and I think there's like over 150 symptoms that women report are related like like any anything like you know you can blame and that's and i guess that's the thing like if something is slightly off it must be my

hormones and this was looking at emotional outcomes so they did they and obviously lots of women you know get sore boobs or you get acne or whatever but this is specifically looking at around the emotional something do you get irritable and angry and is your mood affected by your period and mood was not affected when they weren't expecting it to be impacted however if they were primed to think it was going to be impacted it was far more likely to be and I guess that's what's important about that is mood is not something that's out of our control we're not on this like hormonal roller coaster we can't get off and I find that incredibly empowering now of course there were one or two women in every 20 who did show very clear fluctuations of mood based on hormones and that's you know there are many

women who are very sensitive but there are also women who are not but we've been told we are and if you're told that that's how you're going to be feeling well that's kind of a shame because you don't need to feel bad and again I think that's really empowering it's a bit like the puberty study that hormones are not always the loudest voice in the crowd yeah absolutely I agree I think it is quite empowering it's like our perception of mood and those feelings changes because we can stop blaming our biology for things that we're feeling when really it could be that you don't feel supported or that something else is going on in your life that's that needs to be addressed yeah and you know and sometimes it is I don't want to say it's never hormones I think sometimes I think you know obviously different

cultures and societies have different stories around this. So the stories that you're brought up with and the narratives that you have can play a big impact on health outcomes. Yeah. And off the back of that, how does synthetic hormones, i.e. in the form of the contraceptive pill, affect the brain because I know a lot of women report these things and there's been various studies linking depressive symptoms and use of the contraceptive pill how solid is that evidence? That's really interesting and we're quite lucky because we have these countries in Scandinavia who diligently track health records and so actually you know this kind of health crisis we're in right now is going to be a great source of data and so this idea that being on the oral contraceptive pill causes depression is pretty common and lots of women do report that I think also it's probably important to caveat it

by typically it's a cheap safe reliable form of contraception so often you start taking it because you're entering into a sexual relationship. So if you're being purely scientific, you're changing a couple of variables there in someone's life when you're looking at mood outcomes. But there are studies showing that there are some groups of women who do show changes in wellbeing. They feel less themselves, more emotional, less well

when they're on the pill. And I certainly, when I was in my very early 20s, on the pill and I certainly when I was in my very early 20s had this experience with one particular pill I was on I just felt a bit emotionally out of whack but I was also in a funny relationship left that relationship went off the pill met my current husband went on another pill and um and that pill didn't have any impact on my mood but then I was with a really nice guy. But that's very anecdotal. The studies that have been done in Scandinavia, there's one that was in Denmark and it looked at a million women who had been prescribed the pill and it could compare women who were on the pill,

women who weren't, who ended up on antidepressants or being diagnosed with depression. So there's tons of data points there, so they could be be pretty clear and it turned out that there was quite a small increased risk for women being diagnosed with depression when they were on the pill but the absolute risk is quite small and it's interesting how these different studies are reported around the world so what you would need would be a hundred women taking the pill versus a hundred women not taking the So what you would need would be 100 women taking the pill versus 100 women not taking the pill. And you would have the woman on the pill, one extra one of them would be prescribed an antidepressant versus the woman not on the pill. So there is a tiny increased risk, but it doesn't mean the pill causes depression. It just means perhaps in some women there is a

vulnerability there to having, introducing a synthetic hormone that makes them more likely to be diagnosed with an antidepressant. But again, I think we need to be quite careful when we interpret this data because there's an increased risk, but it's quite tiny when you look at the numbers. So I think any woman who chooses to take any kind of medication like that needs to be working with a doctor or GP or women's health specialist who can kind of explain that to them and it's interesting because I am now in my mid-40s and so I'm in that kind of perimenopausal phase of life I don't quite know how I got here

it seems to have all come up quite suddenly but interesting I'll be back on the pill about a year and a half ago because I was getting night sweats and I was quite appalled by this whole fact that suddenly I was old enough to be getting hot flashes and and and I chose to kind of because when you go through menopause it's a little bit or perimenopause it's a little bit like puberty you have big kind of fluctuations of hormones and one of the knock-on effects of that is it affects your thermoregulation so you get much hotter much more easily it's like your thermostat's been narrowed and so I had some really long detailed discussions with my obstetrician gynecologist about that and I kind of had never had a bad experience on the pill I was on it for about 15 years before I had my kids and i said oh look i'll just go back on it and hot flashes have gone sleep has improved mood has improved my hair my hairdresser

has even said my hair has improved my skin has improved so and but i'm just an n of one right we need to be really careful when we look at research especially really large population studies and when we listen to people's stories like the personal story I've told you to be very careful that we don't extrapolate research and to me search or someone's particular story into yours make sure you're working with someone who knows what they're talking about and you can weigh up the risks and the benefits and work together to make the right kind of health care decision yeah and one of the things I found really interesting in the book is how the brain changes during pregnancy which is quite unique and so I'd love to chat to you a little bit about this and

whether this is the basis of baby brain or if that is just a complete and utter myth well when I um when I first um met my book agent and she was like, I can't, why don't you write a book? And I was like, I don't have any ideas. And we were throwing around ideas and she said, oh, what about baby brain? And I was like, well, I am from New Zealand. We don't do baby brain there.

And again, it's one of these cultural tales. Like I'd had my kids by the time we had this coffee, but I'd never come across this idea of baby brain until after I had my kids and I was still working as a scientist in the lab when I was pregnant and didn't even, had never heard of baby brain. However, it is a kind of a recognized phenomenon

amongst many pregnant women that you become a bit more forgetful or kind of dozy. And interestingly, there are lots of areas in women's health which are not very well studied, but cognition and kind of fuzziness, for want of a better word, baby brain during pregnancy is very, very well studied in the neurosciences. And by and large, in the research lab, we can't really find any differences between women who are pregnant or not pregnant, or in a comparison between a woman in a lab before pregnancy, during pregnancy and after pregnancy

in terms of things like memory and attention, which is different to how a lot of women find their experiences. So can we say it was hormones or is it you're just distracted, perhaps you're not sleeping well enough? There's a lot of questions around why does the research not support women's lived experience? It's an interesting interesting one but in terms of what actually happens to our brain a study came out from a research group in the Netherlands and it looked at a group of women that had MRI scans on these women's brains so it took a photo of the structure of their brain before they fell pregnant for the first time and then immediately after their first pregnancy and and all of the women the same change was seen

in the same region of their brain and it was quite striking this change and artificial intelligence program could then look at MRI scans of a woman and say whether that had a baby or not based on the structural change so it's quite significant and it's a really quite beautiful change that takes place in a region of the brain involved with empathy and involved with this and kind of the neuroscience as we would call it mentalizing which is that ability to put yourself in someone else's shoes or think about what someone else is thinking or feeling so it's almost like mother nature has this shortcut in our human brains to prepare us for motherhood and if we look at all the other female mammals of the animal kingdom running around having babies

there are structural changes that take place in their brains as well involved in the sort of skills of mothering their young and they don't read books on what to expect when they're inspecting and interestingly when you do cognitive studies on every other female mammal she actually becomes better at cognitive skills, better at maze finding, better at memory than other comparative females that haven't had babies. It's just us humans again we seem to like to think that hormones have some negative effect on our brain, which is kind of interesting. I don't think we're that special that we're different from the rest of the animal kingdom. So maybe the scientists are on to something.

Yeah. And we discussed how there's no kind of major differences between the male and female brain or anything that's controlling the reproductive side of things but why then can we explain why women are more likely to suffer from depression and anxiety disorders and also things like alzheimer's disease maybe we'll look at them separately yeah i think you need to kind of look at them separately because one is a disease of aging and the other is really biopsychosocial or what i kind of call let's put the brain in the middle and think about what's impacting how we think feel and behave from our bottom-up biology from the outside in world and our top-down thoughts and feelings and certainly if we look at mental health disorders and there wasn't there is

an interesting statistic that's come out of New Zealand that from a longitudinal study of over a thousand people kind of looking at through the lifespan and I think only about 17, 1.7 percent of people reach midlife so reach their mid-40s without being diagnosed with some type of mental health problem whether it be anxiety, panic disorder, depression, whether it be the very serious things like schizophrenia or bipolar disorder or whether it be you know some type of childhood issue like ADHD. So it's pretty common to have some kind of problem. It's less common for it to be a long lasting serious condition, say something like schizophrenia. But anxiety and depression, they're kind of the most common ones. And lots of people have suffered from them at some point in time.

And I think if we were to look at something like depression often goes hand in hand with anxiety but if we look at what causes depression there's you know I always say depression comes in many many shades of blue and there's probably as many causes of depression as there are for shades of blue so we could look at our bottom-up biology you know are you getting enough sleep is your diet crap and you're never exercising? You know, there's some basic bottom-up biological changes you could make which might tweak your biology to improve your mood. You can take a look at what's happening in the outside world.

What are your social support networks like? One of the most fundamental indicators of health outcomes is social support. Are you lonely? Are you rejected? Are you grieving? All of these are real causes of someone perhaps feeling depressed you know are you not engaged with the work that you're in do you feel kind

of aimless and purposeless are you working night shifts you know your your night dark cycle is out of sync so there's outside in kind of factors and then we can look at top down factors which are kind of much more of a sort of a slippery ball to hold on to so what are your you know are you a worrier are you the kind of person that gets caught in a rumination cycle have you had adverse childhood experiences where some kind of traumas perhaps got in under your skin and an incredibly stressful event has triggered you to react in a certain way so when we look at all of the various causes and all of the different shades of blue outcomes of what may appear as simple as depression when we add gender in there as well biological sex or gender which is you know kind of different

then we kind of go well women have hormones which are one little voice in the crowd but you know we may be dealing with perhaps you've just had a baby you're not getting enough sleep you're not feeding yourself well you're not getting any exercise the baby's waking up all night you have no social support networks your mum's living in another country and you're worrying that you're world's most terrible mother and you didn't deserve this baby there's lots of bottom-up outside and factors going on there that a man would never have to deal with so once we start unpacking I think the biopsychosocial complexities of a lot of these mental health problems we can start to see where gender differences can emerge but what we do often

see is that men may not seek help or men may experience mood disorders and act or behave or think or feel in a way that they've learned different they may be aggressive they may just drink too much that they've learned is appropriate versus how a woman may learn is appropriate but of course we've all got different kind of pressures and expectations so it's quite complicated once you start trying to explain why a woman's slightly more likely to be diagnosed than men yeah it definitely is there's a lot of factors to consider yeah um i think it's reassuring that for women to know it's not just biologically programmed i don't think it is and i think in the, you know, talking about how do we end up here?

How are we going to get out? And again, I guess I always would say, well, let's approach it from the bottom up, from the outside in and the top down. And that's three kind of rocks there to, you know, there's a lot of bottom up and a lot of outside and a lot of top down factors that you can work on. And all these threads need to kind of be entwined together to help you kind of move through that process. And that's why I think we need to be very careful as well

when we're ascribing saying the only answer is an antidepressant or an antidepressant is never the answer. The only answer is this particular type of therapy or that you should do CBT or you should only do mindfulness or you should really just be jumping in an ice bucket bath and holding your breath or whatever the you know latest kind of trend is because there's probably a multi-pronged approach required but that's you know science is always really boring like that we always kind of never have a magical solution do we no we never do and it is always a combination of factors and in most cases

and that's kind of one of the questions I wanted to finish on sort of based on what you discussed initially and that your PhD was looking at whether it was nature and nurture and you kind of came to the conclusion that it's a little bit of both. So for people listening, what determines healthy brain development kind of throughout the lifespan and how can we kind of take control as much as possible and nurture a healthy brain for life? Yeah, look, I think, you know, a little bit of everything. And I also, you know, there's nothing new under the sun.

There's so many things that those of us were lucky enough to have mums who told us these things that we grew up with about getting enough sleep and eating your vegetables and but if I had to write a prescription for someone I mean I very much went into writing this book as a neuroscientist thinking this is going to be a book about biology you know how hormones change our brain because it's a book about women's health and so I kind of was not quite naive going into that and what I learned and every point in the lifespan every researcher I spoke to every kind of health expert I would say you know what you know what would be your kind of prescription or what do you think is the most important for primary school children or for nurturing children through puberty or helping support teenagers or middle-aged menopausal women

who's coping with homeschooling and every single person said oh it's other people and I think a social prescription is perhaps one of the maybe up until 2020 one of the least well considered aspects of health and suddenly we've all been told we can't see other people right now this social distancing kind of world that we're living in and everyone hates it and everyone's struggling it's so hard and it feels so unnatural and it's so against all of our instincts what do you do when you're under stress our biology is designed that when we're under stress our stress hormones go up so do all those hormones like oxytocin that are there to nudge us into connecting with other people and I think that was the biggest lesson I got was that it's the people the people the people that are the loudest

voice in the crowd when it comes to you know the biggest changes we can make around people's health and I reckon that there's going to be a lot of interesting lessons coming out of this world we're living in right now, but I think people suddenly it's been thrown into reality. Like, wow, it is other people are really important to us. And when we can't be with each other, it's incredibly painful. Absolutely. I think that perhaps for me that's the message that I would like people

to take out of my book. And that's what the biggest surprise was when I was writing my book I thought I was writing this book about individual humans and it was a book about we it's a book about people and how important we all are to sculpting and shaping our brains and everything else that our brains do it's a interesting conclusion I think a lot of people will also be surprised to find out that's kind of the main lesson but it's also quite nice and like you said at the moment we're going to a really weird time it's almost like a huge human experiment in terms of what we're going to see and I'm quite scared to find out what will happen in a couple of months time but it's also nice to

see how people are learning to connect in other ways that is not physical but social. Yeah, and what's the thing you always say to kids, you know, there's a disaster or, you know, we had all the bushfires here in Australia earlier this year. You just keep saying to kids, who are the people, who are the helpers, who are the people who are helping when it's really scary and stressful? Look for the people who are doing the good work. And I think we tell our kids

that we need to remember that ourselves too. Yeah. Well, it's been an absolute joy speaking to you. I feel like this is going to be an incredible episode to listen back. And I will listen back because you did mention some really great studies there

and it was really interesting. But I'm sure people will want to find out more from you and more of the stuff that you're talking about. So where shall we signpost people to? So my website's drsarahmackay.com. And if people go to drsarahmackay.com forward slash toolkit, they can download an applied brain science guide, which is, you know, teaches them how to take care of their brain and their mind health from the bottom up the outside and on the top down cool well thank you for joining us and um

we can't wait to see more from you and hopefully more books in the future but i bet that's a bit like childbirth still at the moment pain is still there in my mind yeah we'll see okay guys thank you so much for tuning into today's episode don't forget to subscribe and leave us a review and a five-star rating if you love the content that we're putting out you can hear more from me over on social at the food medic instagram twitter and facebook and on my website thefoodmedic.co.uk. If you're interested in grabbing a copy of my books you can grab both online on Amazon. See you again next time.