Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health—and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More

by Christopher M. Palmer

Metabolism is how our body creates and uses energy. And we can think of problems with metabolism as energy imbalances.

mitochondria in all their glory. Their function affects every cell in the human body. Their involvement in all aspects of cell function, neurotransmitters, hormones, inflammation, immune system function, regulation of gene expression, development, and the maintenance and health of cells results in widespread effects throughout the body and the brain. They are the drivers of cells and metabolism. They are the workforce of the human body.

In the 1980s, it was discovered that infusing lactate into the vein of a person with panic disorder would often precipitate an immediate panic attack.

the American Psychiatric Association published a “Resource Document on Neuroimaging” in 2018 in which they concluded: “There are currently no brain imaging biomarkers that are clinically useful for any diagnostic category in psychiatry.”2

They mutate often due to ROS and the lack of protection of mitochondrial DNA. Wallace argued that the brain is the organ that will be most affected by a problem with energy production by mitochondria. He argued that different parts of the brain might fail first—likely because they are more sensitive to energy deprivation than others. This makes sense, given that most machines do have “weakest links.” The brain is likely the same. So, a small amount of energy deprivation might result in ADHD or depression and a larger amount of energy deprivation might result in other disorders, such as schizophrenia.

Let’s put this all together using our car analogy. A car has many parts—a fuel tank, fuel that goes into the tank (gasoline), an engine, a battery for electrical energy, a steering system, and a braking system for stopping. Problems can occur in different parts, and different symptoms can result. In some cases, the car may sputter or move slower (underactive function) if it gets water in the gas tank or if a spark plug has gone bad. If the battery begins to fail, it might be that the lights dim, or the windshield wipers slow down, or the radio doesn’t work, or the car won’t start at all (all underactive functions). These are very different symptoms, but they’re all related to energy—and usually with just one cause. Now let’s make the car like a living cell. Suddenly it requires energy to work and energy to maintain itself. Without enough energy, the tires start to deflate, the wheels get wobbly, the doors develop rust and holes (maintenance problems). The engine and battery get old. Battery acid starts to leak all over the engine (ROS). The oil hasn’t been changed in a while, and engine parts are getting damaged. This lack of maintenance makes the engine even worse (a positive feedback cycle). At some point, this car will become a danger to the other cars and the flow of traffic on the highway. The brakes stop working (hyperexcitability due to impaired off switch). Eventually, it may cause a car crash and shut down the highway. The car can be towed to the junkyard for recy...

quick recap of the brain energy theory: Mental disorders are metabolic disorders of the brain. Although most people think of metabolism as burning calories, it’s much more than that. Metabolism affects the structure and function of all cells in the human body. Regulators of metabolism include many things, such as epigenetics, hormones, neurotransmitters, and inflammation. Mitochondria are the master regulators of metabolism, and they play a role in controlling the factors just listed. When mitochondria aren’t working properly, at least some of the cells in your body or brain won’t function properly.

Metabolism is the flow of traffic, and mitochondria are the drivers and workers inside the cars.

•Psychiatric medications have helped countless people with mental disorders. They will continue to play a role for many. •The brain energy theory offers new ways to understand how and why medications work. •It’s important to understand what impact your medications are having on your metabolism and mitochondria. •Medications that increase metabolism and improve mitochondrial function can improve symptoms of underactive cells, but they come with the risk of exacerbating symptoms related to overactive or hyperexcitable cells. •Medications that impair mitochondrial function should be used cautiously. Although it’s clear how and why these can reduce symptoms of hyperexcitable cells in the short run, it’s possible that they might interfere with your ability to heal and recover in the long run. In some cases, they might even be the cause of symptoms. Nonetheless, in dangerous and life-threatening situations, these medications can be lifesaving.

On the surface, it’s understandable how Jane ended up on so many medications. However, several of them are known to impair mitochondrial function. This means that they can help in the short run, but they come with the risk of making matters worse in the long run. That appears to be what happened to Jane. By the time I saw her, whatever caused her initial delirium had probably passed, and she was delirious because of the treatments she was receiving.

Thyroid hormone is also known to stimulate mitochondrial biogenesis, increasing the total number of mitochondria in cells.20 It also induces mitophagy—the mitochondrial repair process.21 As you know by now, these have powerful effects on human health.

Light exposure on your skin increases a molecule called urocanic acid (UCA) in the bloodstream. UCA travels to the brain where it stimulates neurons that make glutamate. This has a direct impact on learning and memory.13 So, light exposure can help you think better.

Three of the best-known vitamin deficiencies that can result in mental and neurological symptoms include thiamine, folate, and vitamin B12.

Trans fatty acids (TFAs) are man-made, processed fats that were originally marketed as a healthier alternative to saturated fats. We were told that “healthy vegetable shortening” was far better than lard. For years, TFAs were ubiquitous in the US food supply. Tragically, it turns out that they are in fact toxic to human health, and they have now been banned in the US.

High levels of adherence to the Mediterranean diet, which includes lots of fruits, vegetables, whole grains, and olive oil, has been associated with lower rates of depression and cognitive impairment.

I shared with you that people who adhere to the Mediterranean diet (MD) are less likely to develop depression. But for people who are already depressed, can adopting this diet improve symptoms? It appears that it can, at least for some people.

There is also evidence that fasting, intermittent fasting (IF), and fasting-mimicking diets may play a role in treating mental disorders. They all result in the production of ketone bodies, which are made when fat is being used as an energy source. Fat gets turned into ketones. And, interestingly, this process occurs exclusively in mitochondria, yet another role for these magnificent organelles. Ketones are an alternate source of energy to cells. They also serve as important metabolic signaling molecules, resulting in epigenetic changes. Ketones can be a rescue energy source to insulin-resistant brain cells. While glucose might have trouble getting into these cells, ketones can get inside pretty easily. Fasting also results in autophagy, as I’ve described. There are several versions of IF. Some restrict eating to eight to twelve hours per day. Others allow one meal a day. And others restrict nighttime eating. We have evidence that IF improves mood and cognition, and protects neurons from damage in animal models of epilepsy and Alzheimer’s disease.

Another review article outlines many of the ways that IF is thought to promote brain health, including reducing oxidative stress and inflammation, improving mitophagy and mitochondrial biogenesis, increasing brain-derived neurotropic factor (BDNF), improving neuroplasticity, and promoting cellular stress resistance.33 These are powerful healing interventions not currently available in a pill.

The ketogenic diet is now the best-studied dietary intervention for its effects on the brain. Neurologists, neuroscientists, and pharmaceutical companies have been studying this diet for decades trying to better understand its anticonvulsant effects. It provides an alternate fuel source, which can be a lifeline to insulin-resistant brain cells. It also changes neurotransmitter levels, regulates calcium channels, decreases inflammation, improves the gut microbiome, increases overall metabolic rate, reduces insulin resistance itself, and most importantly, induces both mitophagy and mitochondrial biogenesis.

any type of exercise was better than no exercise, but that the largest benefits were seen for team sports, cycling, and aerobic and gym activities. The optimal “dose” was forty-five minutes, three to five times per week.

The first thing to highlight was that the study with 1.2 million people was a correlational study. As you know by now, correlation doesn’t equal causation. It’s possible that people who exercise already have good mental and metabolic health, and that allows them to exercise. This would be reverse causation.

As a rule of thumb, exercise can do one of two things: It can help people maintain their current abilities, or it can improve their abilities. This translates into maintaining your current metabolic status or improving it. Taking a leisurely walk around the block helps people maintain their current metabolic status. This is useful. It’s certainly better than losing strength or ability. However, to improve metabolic capacity, people need to push themselves. They must work toward getting faster, stronger, more flexible, doing more reps, or achieving some other metric of increased capacity.

This concept of “use it or lose it” applies to more than just muscles. It also applies to the brain.

Sarah’s story highlights the power of exercise as a metabolic treatment, but also the psychological and social aspects of finding meaning and purpose in life, stress-reduction practices, having a social support network, and not letting the expectations of others rule us. We are all different, and want—and need—different things. Sarah found her own way to metabolic and mental health.

When a flower doesn’t bloom, you fix the environment in which it grows, not the flower. -Alexander den Heijer

“Fixing” a mental illness requires identifying the problems and addressing them. The “environment” in this case is writ large. It includes all factors that affect metabolism and mitochondria, such as diet, exercise, stress, light, sleep, hormones, inflammation, relationships, love, and meaning and purpose in life, to name just a few.