The Mel Robbins Podcast - The Truth About ADHD in Adults: Harvard’s Dr. Chris Palmer Explains the Research

Episode Date: January 25, 2024

Have a hard time staying focused?Do you start projects and never finish them? Are you frustrated with your hyperactive brain?Your brain simply needs help, and today you’re going to learn exactly what to do about it, thanks to the expert advice of today’s guest Dr. Chris Palmer.Dr. Palmer is a psychiatrist who has practiced at Harvard’s McLean Hospital, the #1 psychiatric hospital in the nation, for almost 30 years. He is also the Founder and Director of the recently launched Metabolic & Mental Health Program at McLean Hospital. In this episode, you’ll also learn:What ADHD really is.The simple (and sneaky) signs of ADHD.What your doctor will be looking for to diagnose your ADHD.What ADHD meds actually do in the brain.How a person on the autism spectrum could improve their symptoms.What to look at before jumping to medication.How an elimination diet works and why you should try it.The specific types of exercise your brain needs to get you out of a funk.What you need to stop doing to make your brain healthier. To listen to Dr. Palmer's first appearance on The Mel Robbins Podcast, check out the episode right before this one, Reset Your Mental Health: The Diet & Nutrition Protocol from Renowned Harvard MDFor more resources, including links to Dr. Palmer's work, studies, and tips to implement everything you learn, click here for the podcast resources page.Listen to the episode about Mel’s deeply personal story of her own diagnosis of ADHD: 6 Surprising Signs of Adult ADHD Follow Mel:Watch the episodes on YouTube: https://bit.ly/45OWCNrInstagram: https://bit.ly/3QfG8bbThe Mel Robbins Podcast Instagram: https://bit.ly/49bg4GPLinkedIn: https://bit.ly/46Mh0QBTikTok: https://bit.ly/46Kpw2vSign up for Mel’s newsletter: https://bit.ly/46PVnPs   Disclaimer

Hey, it's your friend Mel, and welcome to the Mel Robbins Podcast. First of all, thanks for hanging out with me. And second, thank you for taking the time to choose to listen to something that could help you improve your life. I think that's pretty cool. And whether you're a long-time listener or you're brand new,

you are part of the Mel Robbins Podcast family. Welcome to the crew. We are positive, we are empowering, we are smart, and you are a really important part of this community. I'm Mel Robbins. I'm a New York Times best-selling author. I'm one of the world's leading experts on confidence and motivation, and I am on a mission.

I'm on a mission to inspire and empower you. I'm giving you tools, inspiration, and the expert resources that you need to create a better life. And one of the ways that I'm trying to tools, inspiration, and the expert resources that you need to create a better life. And one of the ways that I'm trying to empower and inspire you is to make sure you know you're not alone in some of the stuff that you're dealing with. And I share a lot about my life. I talk about my struggles.

I confess a lot of things to you. And one of the things that I've talked very openly about is the fact that I have ADHD. And I've shared not only my journey with ADHD, but I've also talked about the fact that like so many women that listen to this podcast, I wasn't diagnosed with ADHD until late in life. In fact, I was 47 years old when a doctor spoke the words, Mel, you have ADHD, you got dyslexia, and you have dysgraphia. And I was like, why didn't you tell me sooner? Well, my story resonated with so many of you because I found out as most adult women do during the process of our son Oakley,

who was in elementary school, he was getting assessed for learning disabilities. When we got his results back, I was like, oh my God, that sounds a lot like me. And from my experience, what I lived through was textbook. And it's this, that for most of my life, not knowing that I had dyslexia, dysgraphia, ADHD, I struggled with anxiety. I was extremely self-critical. I felt like something was wrong with me. Like I didn't understand why everybody else could like sit still and focus and remember things. I couldn't understand why it was so hard for me to be organized or on time

or be able to just direct my damn brain when I needed to get something done. You know what? Our son had the exact same struggles and it's one of the reasons why I'm so open about all the different things that I deal with and it's this. It's because when you're dealing with something that you either don't know is an issue or it's hidden from you like this was for me, you automatically personalize it. You literally can't help but go, there's something

wrong with me. I'm different, like I'm a loser. And here's what I want you to know. The only thing that's wrong is that you have no idea what's actually the real problem. And until you know what the real problem is, you can't address it. And that's why having a formal diagnosis, being told that I had ADHD and dyslexia

and all this other stuff, it was a game changer. Because when you understand what you're dealing with, I mean, I'm sure you've had this experience, you realize, oh my god, that's the issue. And then you realize, oh, I'm not the only one who feels this way. And then here's the most important part. You can take on the thing that is the real deal, like a project, instead of turning it into a personal attack. Honestly, that's a lot of my philosophy here on the Mel Robbins podcast. That's why I like to dig so deep into so many different topics, it's so that you and

I can both understand them, so that we can explain them to our family and to ourselves, and so that you realize that you're not alone. More importantly, there are always simple things that you can do. And there are simple actions that you can take that help you make your life better, no matter what you're dealing with. And it is certainly true when it comes to ADHD. And I know that you want information about this because it was about a year ago. That's like the last time I talked about this topic. I did an episode called The Six Surprising Signs of ADHD. Yep, I will link to it like we link to absolutely everything in the show notes. But when we

released that episode, it created an explosion. I mean, from podcast listeners around the world, our YouTube subscribers, everybody that saw the short stuff that we produced for social media, holy cow, so many questions. And they've been coming in for a year. I've been meaning to do something about ADHD, but we've just been covering all these other topics. But I kind of got my sign because I was on the Today Show a couple of weeks ago. And as I'm sitting in the chair,

the woman that was doing my hair, she leaned over and said in my ear, well, I heard that episode you did about ADHD and it made me go to the doctor. And it turns out, oh my gosh, I have ADHD too. Are you gonna keep talking about it? I mean, that was so helpful. Can you share more tips?

And so guess what? Today, we're sharing more. So if you've got questions, well, wait a minute. Could I have ADHD? How do I even know? What can I do about it? What does ADHD mean about my brain? What is neurodivergent?

How can I help my kids with ADHD? And is there a way to manage my symptoms without medication? Well, today you're getting those questions answered, not by me, but by Harvard's Dr. Chris Palmer. Dr. Palmer is a renowned psychiatrist at Harvard. He also appeared on the very last episode of the Mel Robbins podcast that we released. He has spent almost 30 years at the number one psychiatric hospital in the nation that is Harvard's teaching hospital. It's

here in Boston. It's called McLean. And based on his extensive clinical experience, he's on a mission to change the way mental health is discussed and treated. Now, I wanted Dr. Palmer to talk about ADHD because I find him to be so hopeful and I find him to have such an accessible way to approach really serious issues like we discussed in the last episode, but also they're relevant for any neurodivergent pattern and one of those patterns is ADHD.

Now, in the last episode, I'll link to it in the show notes. Don't worry, you don't need to listen to it right now. We're going to cover everything that you need to know in this episode, but you should go check it out. It is very powerful. In that episode, Dr. Palmer discussed his brain energy theory and his research that shows the connection between diet, brain function, and mental health.

He shared in that episode that improving your metabolic health, which just means changing your diet and making better lifestyle choices, has a really significant impact on the functioning of your brain and on your mental health. He calls this his brain energy theory. Well, this research has very important implications for understanding and learning how to thrive

with ADHD. And so Dr. Palmer is here today to tell you something that I want you to hear. There's nothing wrong with you. I'm going to say that again. There's nothing wrong with you. And when you're struggling, at least when I'm struggling, and when my family struggles, I notice that we internalize the struggle. So Dr. Palmer, he is here to say, you're not the problem.

There may just be an issue with your brain and how it metabolizes your food. And you know what? You want to hear the coolest part? Dr. Palmer says, we can fix this. Oh, I love that. Now, I want to ask you to please listen all the way to the end because Dr. Palmer outlines the specific protocol that he recommends to his patients here in Boston. And I'm going to underscore something, something that Dr. Palmer repeats.

If you feel inspired to make changes to your diet or your lifestyle, please always consult your doctor before doing so. And I want to ask you, whether you're listening for yourself or you're listening for somebody in your life that struggles with some issue like ADHD, this is information that could change somebody's life. Dr. Palmer is no joke. He has a waitlist that is several years long and he is here today for you and your loved ones. So please share this with anyone in your life who can benefit from this information.

All right, you ready? Let's jump into the conversation. As somebody who is diagnosed with ADHD and as kids who have ADHD, I am so excited to have the opportunity to learn from you, Dr. Palmer. And so why don't we start at just the basic level, what is ADHD? So ADHD is a condition that has to begin before age 12 and has to last at least six months. Right now, the diagnostic criteria require that symptoms must have begun before age 12.

It doesn't mean that anybody recognized them. It doesn't mean that anybody diagnosed them or treated them, but the symptoms fall into two main categories. One is inattention, and the other is hyperactivity or impulsivity. So it's kids who have trouble paying attention. They have trouble sitting still. They don't like to read books so much.

They have trouble focusing on hard, difficult tasks. Sometimes they have trouble even playing with other kids quietly. They're the ones running around fidgeting, knocking things down, climbing all over things. They can be the life of the party when there's a party, but when people are expecting peace and quiet, it's not a party anymore and they can be seen as hyperactive or disruptive. I read in my own research that the way that symptoms appear can be very different for boys and girls. Can you talk a little bit about that?

It can be. So traditionally, most people think of boys as having more of the hyperactive and impulsive symptoms. And so those are easier to recognize and diagnose because you see it, they're running around, they're getting into trouble, they're falling down, they're fidgeting, all of that stuff. It's obvious the teachers think of it as a problem because these are the kids that are talking in class, blurting out answers, not waiting their turn in line when it's time to go to the recess or time to switch classrooms. So they're often seen as discipline problems and so they often get recognized and then treated.

For the people who have primarily the inattentive type of ADHD, which tends to be more girls, but boys can have it as well, if they don't really have many of the symptoms of impulsivity or hyperactivity, they can be unrecognized and unnoticed. And they just have trouble focusing on tests. They have trouble paying attention when they read. They may not remember everything that they just read. They have to work harder. And if they don't work harder, unfortunately, they're

often just perceived as not being so bright. I am curious to understand from like a physical brain neurological standpoint. What's actually happening in your brain if you are developing ADHD? Like what is going on? So the easiest way to explain it is that with all mental illnesses or the mental health diagnoses- Would you call this a mental illness? It is in DSM-5 and it would be considered a mental illness or a mental disorder. Why do we have to call it an illness? Like I take personal

offense to that. Do they consider dyslexia a mental illness? Yes, it is a learning disorder. So it's a disorder. I like to call it difference. But okay, yes. And I know you're talking technically speaking and you don't think about it this way. And I don't think about it this way. How do you think about ADHD? So ADHD in many ways can be simply perceived

as neurodiversity. And many people think that in fact, it is not an illness or a disorder, that it is potentially a very highly adaptable trait in the right societies, in the right circumstances. And so people with ADHD don't want to roam and explore and innovate and create and protect and hunt and gather and all of these other things. So they're out energizer little bunnies running around doing all the work. They're the ones who have more confidence, who have energy, who have motivation, those traits are essential to

human survival. We need those people. But when you take somebody who has a good dose of those traits and puts them in a classroom and says, sit still and read for five hours and don't talk out a turn. I will lose my freaking mind. And don't move your body. See, I'm already reacting to the thing that you're telling me to do because it feels like a straight jacket.

It should feel like a straight jacket because your brain, in fact, may be hardwired to be one of those explorers, hunters, gatherers, innovators. Your brain is ready to go out and create and save the tribe. So we can talk all day long about the fact that there are so many benefits and gifts to having something that is neurodivergent and the way that your mind works, whether it's dyslexia that makes you more innovative or creative or whatever, we could go down that road. What I really want to understand before we talk about your recommendations and the exciting new treatments that are available that you should be considering is what is actually happening in the functioning of your brain when you

are somebody that has ADHD or this inability to focus? The easiest way to explain it is that there are going to be some brain regions that are overactive and some brain regions that are underactive. So brain regions that help people focus and concentrate are likely going to be underactive, meaning that if we compare them to the brains of people who are able to sit still and learn for five hours, people with ADHD have differences. It's the frontal lobes and striatum, which is involved somewhat in emotion regulation and other tasks. Those seem to be the networks most affected, but the reality is there is no universal brain scan for any mental health,

neurodivergent condition. So there's no brain scan that we can do to say whether you have ADHD or don't have ADHD. So it can be highly variable, highly different. So some people might be able to focus on some things. Some people might have hyperactivity, others may not. Depending on who you are and where you live and what society you live in and what people expect of you in that society, those traits might be welcome and admired and respected or those traits might be vilified and thought of as insubordination or misbehavior? Well, that was exactly the experience that we had with our son.

And I know for you listening, you may have had that experience yourself or know somebody that was the problem kid or always acting out or interrupting or couldn't focus. And it turned out to be this issue around attention as a Harvard psychiatrist. When somebody comes into your office and you're meeting with a patient and it's very clear that they have indicators that ADHD is something that they may be struggling with. What is the realm of options that you have at your disposal to help somebody function at a better level or a happier level when they are neurodivergent in this way? So most people would get a full diagnostic interview and workup and so we're going to

look for any other comorbid disorders like depression, anxiety, other things. Why would those be comorbid? So those are very commonly comorbid actually. Why? It turns out that if you have any DSM-5 diagnostic label, you're more likely to have more than one. About 50% of Americans who have one have more than one. And for people who actually seek treatment, on average,

people have about three to four different diagnostic labels. So it means that if you got ADHD, there's a very high likelihood you might also have dyslexia like you mentioned, or you might also have an anxiety disorder or depression or bipolar disorder or conduct disorder, but all the way to even more serious neurological conditions like autism spectrum disorder or seizures. Wow. So Dr. Palmer, for the last 30 years, has been researching the connection between food, sleep,

exercise, and lifestyle choices and how it impacts your metabolism. And the medical community and mental health community is extraordinarily excited about the fact that you can improve your brain functioning and improve mental wellness by changing your diet, by increasing exercise and prioritizing sleep and getting yourself off of substances that are ruining your health. And so I guess I want to go backwards because one of the other things that you said in our first conversation was that a root cause of all

mental illness and brain misfiring issues is metabolism issues, metabolic issues that anything mental, everybody, we think from the neck up, Dr. Palmer's like, uh-uh, go from the neck down and let's talk about what you're eating and how you're sleeping and whether or not you're exercising because that should be part of the treatment. So when you said that ADHD tends to show up before 12, is it showing up because of metabolic reasons?

It almost certainly is. And then- What does that mean? Because as a busy mom, I was diagnosed late in life like most women. And I was diagnosed as a result of having my son go through the testing process because he was labeled a problem kid in fourth grade. Turns out he couldn't read. Turns out he was highly ADHD.

That made me go, oh, wait a minute. This sounds exactly like me. Then I went through testing and got a formal diagnosis, but I didn't know anything about ADHD. And so, talk to the busy mom or dad or concerned aunt or uncle or teacher or caregiver who's like, wait, did he just say metabolic issues like food and exercise and sleep can be a root cause of ADHD. Yes. There's no question that they play a profound role in our brain function, and that includes

our ability to sit still, our ability to pay attention, our ability to learn and concentrate. I don't want anyone to come away from this conversation thinking that if everybody just follows a healthy diet, we will eradicate all ADHD or we will eradicate all other mental health conditions because that's not what I'm saying. But what I am saying is that if you look at the root cause, we know this from decades of doing brain scans on people. What are those brain scans measuring? They're measuring brain metabolism.

When we see brain regions that are underactive or overactive, we mean that they are underactive and overactive in terms of brain metabolism. What does that mean, brain metabolism? So brain metabolism is basically blood flow to brain regions that bring food and oxygen so that the cells can create energy or not. And so if you're, the simplest way to think about it is if there are brain cells that are not getting enough food and oxygen, they are not going to have enough

energy and they are more likely to malfunction or not function optimally. So if I can attempt to translate this, you're basically saying that with an ADHD diagnosis, which means that there are parts of my brain, or perhaps your brain is your listening, that are, quote, under-functioning. I've heard it described as like the conductor in your brain that directs your focus and quiets other inputs so that you can pay attention. If my conductor with an ADHD brain is under functioning to put it in your language, the metabolism in my brain is not getting the energy that is required to that part of my brain for the conductor to work.

Is that what you're basically saying? That is correct. So what are stimulants doing? So if somebody, because you go in for ADHD and typically you get prescribed Adderall or Concerta or some other kind of stimulant or you're told to drink a cup of coffee, I remember that being one of the first things. They said, well, just give them caffeine in the morning. What are those pills doing? So stimulants are increasing a neurotransmitter called dopamine.

And that dopamine is actually increasing brain metabolism in those conductor regions of your brain. So when you take a stimulant, you're taking these underactive brain regions or these conductor brain regions and you're giving them a boost. You are stimulating them, which means stimulating their metabolism, which means giving them more energy so that they work more robustly. So the drugs that are prescribed for ADHD are just increasing my brain metabolism? Absolutely.

But most people don't think of it that way. I don't think about it that way. They think about it as correcting a chemical imbalance. That's exactly what I thought it was. I want people to think about it differently. I want people to think about it as correcting a brain metabolism problem. The reason is not because I am against stimulants. It's

not because I'm against effective therapies and treatments. If somebody is taking a stimulant and it is working well for them, by all means, keep doing it. I am all about improving human health, human happiness, human productivity. I am all for it. However, if you understand that this is a metabolic intervention, it gives us additional strategies and options because there are other ways to improve brain metabolism other than stimulant medications. And not everybody does well with stimulants. Some people have bad side effects.

Some people can kind of crash and burn toward the end of the day in terms of mood or energy level. For some, that's not a problem, but for others, it's a major problem. And they seriously are crashing every night. For some people, stimulants disrupt their sleep. Even when they only take them in the morning, the kids aren't sleeping well. And now that's wreaking all sorts of havoc. And if you don't sleep well, guess what? That's going to further disrupt your brain metabolism. And now-

And plus a lot of them impact your appetite. Yes. And so, if you're not actually fueling your body, that also impacts your brain metabolism and the metabolism in your body. If you're watching this on YouTube, you can see my reaction, which is basically my jaw is kind of hanging open because I'm in real time thinking about so many things. Like, as a mom, I'm thinking back to the fact that our son, Oakley, was a profoundly picky eater.

And if I am being honest with you, Dr. Palmer, I fed that kid chicken nuggets three meals a day because it was the only thing that I could get into that kid's mouth. He hated the texture of peanut butter. I tried to sneak crap into the smoothies. And so now I'm sitting here going, oh God, I gave my kid ADHD because I fed him processed crap.

And he was not a sports kid and he played a lot of video games and I did this to him. And then I tried to medicate him, and they told us you had to have three or four different types of medication, and I watched him turn into the Hulk when they put him on Vyvance,

and then I watched him drop off the Adderall cliff at the end of the day, and I saw our 12-year-old literally, like I'm gonna start crying when I think about this, like I literally saw like the light going out in him. And I, thankfully, he's like, I'm not taking this. I'm just not taking this because the only thing that was being offered to us him to have him sit still. And it was awful. And you're here to say there's something else you can do. What else can you do?

There are so many things we can do. And I mean, hearing your story and your son's story, it's heartbreaking because I know there are hundreds of thousands of other people, if not millions of other people, just like that. There are so many parents who are being told, you must medicate your child in order to keep them in school. He is a problem. I said that to him too. I was like, you have to take this. Like this is not, it's not an option for you. The heartbreaking thing is that kids internalize the message that they are a problem. They're not getting the message that there is a problem with your brain metabolism, honey. And this is something we can address.

It's not your fault. Your brain metabolism isn't working right. And the evidence for that is your inability to sit still and pay attention and do all these other things. And we can fix this. Oh, don't you just love hearing a doctor say, we can fix this? And there's a way in which he speaks that I believe him. And let's just take a minute and underline how incredible and ballsy it is for Harvard's Dr. Palmer to say, we can fix ADHD.

There's just a little issue in your brain and how it's metabolizing stuff. And as soon as he said that, you know what I did? I was like, I'm in and I bet you're into. Well, here's what you got to do. We got to take a quick break to hear a word from our sponsors because our amazing sponsors helped me bring this life-changing information to you at zero cost. But when we come back, you're going to hear how Dr. Palmer says, you can improve ADHD with a diet and he's going to give you the protocol he recommends for anyone struggling with ADHD.

So don't you dare go anywhere. I'm gonna be waiting for you after a short break. ["Darkness"] Welcome back, I'm Mel Robbins. I'm so thrilled you're taking the time to listen to this interview that we did here in our Boston studios with Harvard's Dr. Chris Palmer. Now, before the break, Dr. Palmer just shared his belief that the root cause of ADHD is a metabolic issue. And honestly,

his argument is making a lot of sense to me. And as I think about my life with ADHD and my kids who have ADHD. I'm really grabbing onto this. And I loved it when he said, you can fix this. So let's get back into the interview where I'm now starting to connect the dots on just how empowering this is. What's so liberating about this as I'm processing what you're saying is that you're right. When you get handed a diagnosis, you think, oh, this just is how it is. I am just somebody that will have anxiety for the rest of my life. I'm somebody that will struggle with ADHD.

Oh, I'm dyslexic. It just is what it is. And you're saying that while that may be true right now, the dyslexia, the ADHD, any of these neurodivergent diagnoses that you tend to then have somebody throw medication at you, you're here to say that, I completely lost my train of thought because I'm getting so emotional about this, but you're basically here to tell us that it's not is what it is.

It's not a permanent life. It's not a permanent condition. ADHD can be helped. We can help people heal and recover. There are some neurodevelopmental conditions that are permanent and that are likely not quote unquote changeable. So people who lack social skills, they don't take a pill and all of a sudden have great social skills. And then when the pill wears off, their social skills go away again. They permanently have a difference in their social skills. That is likely not going to change even if we change their brain

metabolism. Are you referring to somebody who might be on the autism spectrum? Yes. So what will happen though if you improve a person who has been diagnosed on the autism spectrum and has difficulty making social connection or reading social cues? What will happen though if you improve their metabolism? So people who are on the spectrum almost always have comorbid DSM diagnostic labels. About 50% will have ADHD. Many of them will have seizures. 60% will have depression and anxiety symptoms. Most of them have OCD symptoms because they're embedded

into the diagnostic criteria for autism. A study just came out two weeks ago. 10% will go on to develop schizophrenia. Wow. People with autism have essentially higher rates of all of the mental health conditions. And so although we may not be able to change their social skills, if we improve their brain metabolism, we can improve many of those other symptoms.

We can reduce their ADHD symptoms. We can improve their capacity to learn. We can improve their mood and energy, reduce their anxiety, make them feel better, think better, be more positive, have more energy. It can make profound differences in their lives. If we intervene early enough before social skill development is complete. And what age is that? The earlier the better.

So social skills start developing from birth. If we know that there are problems, the sooner we can intervene with brain metabolism strategies, we might be able to reduce symptoms or improve symptoms or modify the course of illness. But after childhood, people have either learned social skills or they haven't, or they've learned different social skills. It's not that it's all or nothing,

but there are differences. And those differences are gonna be difficult, if not impossible to change, and we shouldn't expect to change them. I would imagine if you achieve a reduction of feelings of depression or bouts of anxiety, that though makes somebody feel remarkably better, even if they're not connecting socially with people. You know what I'm saying?

No doubt about it. And let me be clear, there are many people who are autistic, who have tremendous strengths and invaluable traits to the human species. Some of our most notable geniuses, billionaire businessmen and others are supposedly on the spectrum. And we as a society would not be thriving in the ways that we are if we didn't have Albert Einstein, if we didn't have other current ones, I won't name names, but other current ones who have self-disclosed that they have received that label when they were young. Because sometimes it comes with benefits. It doesn't always, though.

There are people who are on the spectrum who have to live in group homes, who are on the spectrum, who have to live in group homes, who are unable to care for themselves, who are having seizures, who have profound cognitive impairment, who are injuring themselves repetitively. And I believe that using metabolic treatment strategies, we can help those people. We can help those people live better lives, maybe live more independently, function at a higher level. I'm intrigued by the fact that you said that ADHD is not a condition that you're stuck with forever

because I have believed that it is. And I have brought that into marriage counseling multiple times, like I'm sorry, honey, I'm just gonna leave my Kleenexes on the counter and my vanity in the bathroom is always going to look like somebody shot all of my makeup out of a cannon right on top of the sink. Like I am forgetful. I thought there was no hope, but you're saying there is.

So how does improving my brain metabolism help with either inattention or hyperactivity? It helps with both. So improving brain metabolism is about helping those brain regions that are underactive become more active. At the same time, if there are brain regions that are overactive, it helps them normalize their activity so that they aren't hyper-excitable or overactive. At the end of the day, in a very practical, concrete way, to someone like you, I would first ask the question, do you really want to change? No.

Do you really want to change? No. I don't know. Well, I mean, I don't know. I don't know what it would feel like to be me if I didn't like have ADHD as part of my identity. And maybe what I'm realizing as I'm talking to you in this confessional, Dr. Palmer, is that I use it as an excuse to not have to pay attention,

to not have to pay attention, to not have to slow down, to be responsible for the fact that I am a little bit chaotic, both internally in my thoughts and externally. And if I'm being honest, I know that if I work out, for example, and it's one of those workouts where somebody's yelling at you and you're really going for it, and you get that kind of chemical rush that Dr. John Rady, probably one of your colleagues calls MiracleGrow for the brain, that I have the same experience of being able to hyper-focus for about an hour and a half after I exercise as if I had taken Adderall. Which is perfect.

So... But I don't want to have to exercise like that every morning, but it's easier to take an Adderall. No. Well, and again... I'm just being biased. So both of those are strategies to address brain metabolism. So you're using effective strategies, a stimulant, and exercise.

Both of those are directly influencing your brain metabolism. You are noticing some benefit. I want to come back to the bigger question that I asked you. Do you want to change? Because at the end of the day... I want to stop feeling frustrated. And I think when I was younger and certainly watching our son struggle, you do feel like there's something wrong with you. I see a direct connection between the undiagnosed ADHD and the inability for me to either pay attention in class or focus when I needed to focus.

And the fact that mentally I just felt like there was something wrong with me and anxiety started to develop, and that became the overriding thing that I felt and that people could see. And so I was medicated for anxiety for 25 years until I got this diagnosis around ADHD. And I'm like, wait a minute,

maybe it wasn't anxiety as the core issue after all. Maybe it was this inability to focus and what you're actually offering is a deeper epiphany that maybe it's not actually ADHD. Maybe it's my brain metabolizes differently than other people. And when I pay attention to that in myself or in our son, because he doesn't take medication, he has not taken medication since he was 13, he changed his diet, he's more active. It's as if his entire brain changed. That's a perfect example of what I'm here to say. It's as if his entire brain changed.

That's a perfect example of what I'm here to say. So at the end of the day, you are going to be hard pressed to convince me that your ADHD has ruined or impaired your life. You are a ridiculously successful woman who has a full life with a family, a career impact. And I would never want you to think that your ADHD has stood in the way. Your ADHD symptoms may be the reason you have achieved as much as you have. And so, although the teachers may have said, this is bad, stop behaving this way, smarten up, read faster, what's wrong with you, why didn't you comprehend that book the way we everybody else did?

Why can't you sit still? Why are you always trying to show off? Why are you always looking for attention? Now, those very traits may actually be what are fueling your success. And I would really hate to see you medicate away your success so that you can become a mediocre human being. Dr. Palmer. We don't want that. Wow.

So, well, I'm on the other side of it. So, let's also, like, put into context, I'm now 55. That's also put into context. I'm now 55, and I have been utilizing medication. What's interesting is I only take it in environments where I think I need it. I didn't take medication this morning because I knew that we would be doing this interview. Being in an environment with lights on and microphones, I feel so focused because my adrenaline is going, that the metabolism is probably different than if I'm just trying to get stuff done around the house. And so I want to go back though to somebody who feels like their inability to pay attention,

or their inability to be still is causing anxiety. It is creating a ruckus in their life because having practiced for 30 years, you have seen plenty of people where ADHD is not fueling their success because it's out of control. So based on the brain energy theory and 30 years as a Harvard psychiatrist, what are the new research-supported breakthroughs in terms of what you would tell somebody listening to implement immediately if they or somebody that they love is in the category of really kind of struggling with a brain that is not metabolizing correctly and it's showing up as ADHD. So if the symptoms are clearly interfering with ability to function.

And what does that look like? If it's a child, let's say, not doing well in school at all, getting very poor grades, getting into trouble all the time, has trouble keeping friends even because friends feel like he's too wild, he's out of control, he doesn't sit still, he's always getting into trouble, I want to stay away from him. So this kid feels dumb, feels like he's a troublemaker because all the teachers are telling him that. Or weirdo. Or weirdo and all the kids, all the other kids are even agreeing. And certainly if the

parents and the family feel the same way, like you're just a troublemaker, why can't you sit still? Why don't you do what you're told? Then I would say, okay, things aren't going well for this kid. So we have all of the basic treatment options still on the table, psychotherapy, behavioral interventions, cognitive behavioral therapy, all those things, and stimulants and a couple of other medications, those are all on the table. And those may all play a role. But again, they may or may not work. For some people,

they can make the condition even worse because now they're interfering with your sleep or they're making kids like a different person, a monster. And so if that's the case, but I would argue even before you get to medications, let's do a common sense assessment of some basic lifestyle factors. Is anyone else thinking at this point in the conversation? Why the heck didn't I hear this a decade ago? I mean, that's what I was thinking.

And I'm sure you wish you have heard this information earlier too, but let me tell you something, you're hearing it now. So you can be empowered by the information. So let's hear a quick word from our sponsors. They bring this to you at zero cost. And when we come back, we're going to jump back into the conversation where Dr. Palmer will break this down step by step so you can apply this to your life when we return. Welcome back.

I'm Mal. I'm so glad you're here with me. We're talking to Harvard's Dr. Chris Palmer. And right before the break, Dr. Palmer was outlining the fact that there are all different types of options when you're dealing with a neurodivergent condition like ADHD. And one of the things that he said, before you jump to medication, consider his metabolic theory and use diet and lifestyle changes as a way to improve neurodivergent symptoms

that people feel from conditions like ADHD. Now, I was all in in that moment and I wanted him to break down, okay, well, great, happy to try that, glad I know about this, but where do we start? Like, how do we get going on this? So let's jump right back into the conversation and listen to Dr. Palmer break down exactly what he means when he says improving your diet and lifestyle choices.

Let's do a common sense assessment of some basic lifestyle factors. Is the person eating mostly processed foods? Is the person getting adequate nutrition? So that means adequate vitamins, minerals, other nutrients, adequate protein. Is that happening? Yes or no? Like you said, there can be lots of reasons. Picky eater, upset stomach, all... I get it. I can hear all those questions, but if those things are not happening, if person is

not getting adequate, healthy nutrition, that needs to be on the table as one possible intervention of something that we might want to look at to address. I think it's even more important than that because I have never been in a psychiatrist, psychologist, neuropsych evaluation, therapist's office where the first thing that somebody asks is, well, what are you eating and how much exercise are you getting? There's typically a question about screen time at the end and to kind of limit it, but not from a metabolic standpoint. The conversation is always like, how do you feel? What are you thinking about?

What do you want to talk about today? And you're talking about physical changes in your lifestyle that have a direct research back impact on your brain's metabolism, which impacts ADHD and anything that's neurodivergent. Yes. That what we're eating is affecting the way your brain functions, which may in fact be playing a role in what you're thinking, how pessimistic or how optimistic you are, whether you have crippling depression or anxiety, or whether you have

mild depression or anxiety, or whether you have mild concentration problems or not, or whether you're happy and healthy, and that we need comprehensive human healthcare. We need to look at the whole person, and we need to understand that what they're putting into their mouth and whether they're sleeping at night and whether they're on screens, what they're doing affects their brain too. This makes so much sense because we know it in the opposite, right? Like if I come home from a stressful week of work

and I make a B line for like one of those burgers, you know, that you need both hands to hold. And as you squeeze it in on the brioche bun, it starts dripping grease down your arms. I'm like, and I'm eating the fries. And then I slug it down with a beer. What do I feel like after that? I feel like a human job of the hut. I just want to slither down into my chair. I am low energy,

lay in there. And the thing that I put in my mouth absolutely changes the energy in my body and the way that my brain is functioning. And so, from a common sense standpoint, this makes perfect sense. So, depends on the person and different people are going to do better with different diets. I just want to say that up front. I also want to be respectful of people's dietary preferences and choices. So, if you want to be vegan or vegetarian or omnibore or whatever, you can do that. However, there are some common themes. So if you have a child with very severe kind of neurodiversity that's really interfering with life, if maybe they have ADHD and they're a little bit on the spectrum and they've got some learning disorder issues

and other things. One thing to consider would be an elimination diet. There are lots of different types. But elimination diets are basically looking for food sensitivities. So is this person in front of us, is their brain function being impacted by the gut-brain connection? That's really the question we're asking.

More and more research is telling us, yes, there is a very strong bi-directional relationship between the gut and the brain. So the brain impacts the gut, the gut impacts the brain, and that means if you're eating food like gluten and you're allergic to it, It's inflaming your gut and that is traveling up to the brain. That message at least is getting up to the brain and influencing your brain function. And that might result in ADHD or other neurodivergent symptoms.

I just wanna be clear that I'm tracking. You're basically saying that if you have a child with ADHD, or even if you are an adult that suspects that this could be you, simply trying an elimination diet that by removing certain food groups and seeing how you respond from a metabolism standpoint, you could see a dramatic reduction in mental health symptoms or focus symptoms because your thesis and all your research is that anything that your body is processing, it is either going to be good energy or it could really interfere with the energy that your brain needs. And when that happens, you start to have these symptoms of being neurodivergent.

Is that what you're saying? Yes. So if you are allergic to gluten and you're eating gluten, it could cause ADHD symptoms. It could cause anxiety. It could cause you to feel depressed. And simply figuring that out could actually alleviate those symptoms. 100%. That's insane.

There are thousands and thousands and thousands of people like that. You know what I love about you and your research? Because I'm just really getting this now that we are in part two of this series is that we've been thinking about food in the wrong way. Like when I think about friends that have allergies, you think about allergy because you swell or you itch or your neck swells, you're actually saying that same crap is happening in your brain. Of course it is. And that's causing you to be anxious. And so think about sensitivity to food and the way that your body can't really metabolize it as affecting absolutely

everything, but especially that thing between your ears that is the conductor for your entire life, that it is swelling because of it, it is misfiring because of it. And so starting with an elimination diet would be revelatory in terms of what you might discover about how you feel. Yes. And it's, for most people, it's a big ask. An elimination diet is not easy, depending on how many things you're going to eliminate, what you're going to do.

But for most people, they can figure it out within about two weeks. So if you eliminate a wide range of foods over two weeks, And there are some classic ones, gluten. Some people are sensitive to dairy. Other people might be sensitive to soy, sugar. Some people can be sensitive to artificial dyes and sweeteners and other things. So if you go with a whole 30 kind of diet or something else, it's gonna eliminate

a lot of those types of foods. And you give it two weeks. If you notice dramatic improvement in your brain function, now you've got a little bit of a project on your hands and now you have to figure out what exactly am I sensitive to? Cause you're probably not sensitive to all of it. And you wanna come up with the least restrictive, most fun,

easy diet to do. So you want to really try to see, can I zero in? Can I add some of these foods back? And as you're adding those foods back, you're really paying attention to the brain symptoms to see, am I getting worse? Are things coming back? And if symptoms are coming back when you add back gluten,

then you know, OK, gluten was it. And maybe I would do better with a gluten-free diet. If you don't want to do an elimination diet or if an elimination diet doesn't necessarily tell you what you want to know or doesn't give you the symptoms, higher protein, lower carbohydrate, sticking primarily with whole real foods more than you normally do. What I'm hearing is I'm hearing chicken cutlets, not chicken nuggets for all you moms and dads

out there. Yeah, absolutely. A lot of people will notice significant benefit. And I would give that probably at least a month, give it a month, see if it makes a difference. If it doesn't make a difference, don't keep doing it. I'm not asking people to make sacrifices with no clear return on investment. Well, what's interesting about when this episode is releasing

is we're going to be in the middle of dry January. And you may be listening to this at an entirely different time a year, but you will have had experiences in your life where you go without drinking for a period of time or you go without gluten for a period of time. But if you're listening to this and you're in the middle of dry January and you're having that experience, you're like, oh my God, I removed alcohol and I sleep better. And I'm more focused.

And I have more energy. And maybe this is a really good thing for me to just continue doing this. This is exactly what you're saying, that your metabolism is 100% driven by what you eat, what you drink, whether or not you exercise, whether or not you are on screens or getting connection and what your sleep is like. And when you improve those things, your metabolism improves. And what you're also saying is, so does your ADHD. Yes. So does dyslexia. So does a bazillion

other things in your life. Yes. Is there a form of exercise that's better than another in terms of your metabolism? So the two best strategies are to increase muscle. Yep. The more muscle we have, the more metabolically healthy we will be. Now, I know sometimes women bulk at that and they think I'm encouraging them to look like Arnold Schwarzenegger. I am not. I'm just saying just a little bit of healthy muscle tone can go a long way.

And can I be honest about some, if you already are not exercising enough, you are likely not going to exercise enough to bulk up and have the neck of a weightlifter. So like if you can just get your butt to the gym three days a week, like Dr. Gabrielle Lyons was on our show and start doing some resistance training, you're gonna win. You are. And to quote one of my male friends speaking to women who are afraid that they're gonna get too big, he said, do you know how hard men have to work

to try to get just even a little bit of extra muscle? Do you know how much time and energy we put into that? Trust me, you are not gonna just bulk up out of nowhere by accident. So it's just not going to happen. The other type of exercise I would highly recommend is called zone 2 cardio. So it's basically a lower intensity cardio that you can do for maybe a half an hour to an hour. I think I've heard David Goggins talking about this.

This is like the light jog where you can hold a conversation. I mean, I would not be able to do that for a city block, but that's kind of what a zone two is, right? That you're kind of elevated heart rate, but you're not. Yes, not out of breath. You can still have a conversation.

Hiking would be an example of that for me. It could be hiking, it could be cycling, Yes, not out of breath. You can still have a conversation hiking I'll be an example of that for me. It could be hiking. It could be cycling. It can be swimming There are lots of options many options for zone 2 cardio but both of those will improve metabolic health mitochondrial health and then health. And then reducing substance use. So if you are on substances that are impairing your metabolism, please cut down or stop. So that includes things like alcohol. It includes marijuana. I'm sorry to rain on everyone's parade. Everybody loves marijuana these days. It's legal. It is not good for your brain health. It's not good for your metabolic health. If somebody's on psychiatric medications even

that are causing weight gain, those might be working against you over the long run. So trying to think of strategies to slowly but surely get off those substances, smoking, vaping, absolutely not good for you. What final thing do you wanna say, Dr. Palmer, to somebody who's listening? And this is all a little overwhelming, but also there's some hope here. The great news is that most people can see dramatic improvement with those basic simple steps that you just outlined.

And so the overwhelming majority of your listeners, if they do that, they're going to notice dramatic improvements. Not everyone will, because there are some people who have more complex conditions, infection leading to chronic inflammation that may need a different treatment strategy or a more sophisticated treatment strategy. What I'm here to say to those people is please don't give up. That if you learn this science, if you understand the general framework and the general principles. I am convinced we can help the overwhelming majority of people heal and recover from neurodivergence kind of conditions from what we call mental illness, the DSM-5 mental disorders that most of those things are in fact treatable and that we can help people heal and recover and live

better lives. So, if a woman comes to me and she's got obesity and type 2 diabetes and some symptoms of heart disease and she's got polycystic ovary syndrome and she's got fatty liver disease. It sounds like she's about to die. Sounds like she's about to die. It sounds like she's about to die. Because that sounds like a lot. But one comprehensive lifestyle strategy of diet, exercise, good sleep, stress reduction, get rid of toxic substances, like if she's a smoker. If we do all of those things, guess what?

It's going to address all of them at the same time. I don't need different pills for each of those conditions. I don't need different treatments for each of those conditions. And guess what else? Tell me. If she also has depression and ADHD at the same time that she's got all of those things. If I help her effectively implement lifestyle strategies that help her begin to improve her metabolic health,

I can almost guarantee you she's gonna say, wow, I feel so much better. My brain is functioning better. I'm more positive and everybody's going to dismiss it. They're going to dismiss it and say, well, she just feels better because she's losing a little weight and it's psychological. And what I'm going to say is no, it is not psychological, it is biological. Her biology is changing. We are improving her metabolism and that is improving her brain function and it is not trivial. We should not dismiss it. We should not think that these

are light woo woo interventions. These are serious interventions for serious health conditions that jeopardize people's lives. And they also impact people's brain function, which impacts whether people are happy and healthy and thriving. Dr. Palmer, you're the best. Where were you 30 years ago when I needed you? No, I'm just kidding. You're here now, and we are grateful that you're here now.

Thank you, Mel, for having me. Oh, I just love Dr. Palmer. grateful that you're here now. Thank you, Mel, for having me. Oh, I just love Dr. Palmer. I love how positive he is. I kind of feel more focused. I feel like I know what to do. I really appreciate being somebody that's often distracted that the information is very simple. So thank you, thank you, thank you, Dr. Palmer, for taking the time and thank you. Thank you for taking the time and thank you. Thank you for taking the time to listen to something that could truly change your life or the life of somebody that you love. On that note, share this.

This is coming to you at zero cost. Please be generous and share this episode on social media. Share it with absolutely anyone who you think can benefit from it. I'm going to tell you some. I don't know about you, but when I try to tell my kids or my family and my husband to take this advice, and I just heard this thing, they don't listen to me. I know they may surprise you, but my family doesn't listen to me just like your family doesn't listen to you. That'll tell you some. When I share an episode like this and they hear it straight from somebody like Dr. Palmer, it makes a real difference,

especially when it comes to those lifestyle changes that people can be really resistant to making. And so thank you, thank you, thank you for using this as a resource to help somebody else that you love change. And one more thing, in case no one else tells you this today, let me be the one to say, I love you and I believe in you and I believe in your ability to create a better life. And you know what else I believe? I believe that absolutely everything

that Dr. Palmer just explained to you can help you do it. Alrighty, I'll talk to you in a few days. ["Dance of the Sugar Plum Fairy"] Audio rolling. And action. Literally just weeks ago. Hold on, let me go back up to that. Great. Right there.

Okay. Then they have in their entire life. Hold on, that did not belong there, right? But where is that sentence? Like I wrote it. That's the end of it? That was the end? Oh my God, what did I just say?

There's something about this stand that just feels like more authoritative. We did? Are you sure? Oh my God. Okay, I don't know what's going on. Okay, sorry. Oh no, thank you so much. Oh my God. Oh, no. Thank you so much. Oh, and one more thing.

And no, this is not a blooper. This is the legal language. You know what the lawyer's right and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend. I am not a licensed therapist and this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist or other qualified professional. Got it? Good. I'll see you in the next episode. Stitcher.