Psychiatrist Dr. Daniel Amen On All Things Brain Health, Dementia, Alzheimer’s & ADHD

This week, I am joined by Dr. Daniel Amen, a world-renowned psychiatrist and bestselling author, as we delve into the intricacies of brain health and cognitive decline. From discussing the challenges of managing family health issues to exploring the pivotal role of brain imaging technology in diagnosis and treatment, Dr. Amen provides invaluable insights into fostering mental resilience and well-being. We also examine the impact of lifestyle habits, childhood trauma, genetic and environmental factors on brain health, debunking misconceptions and misnomers in mental health along the way. Dr. Amen shares personal experiences and effective parenting strategies for promoting mental well-being in children, emphasizing the importance of setting boundaries in the digital age. Throughout our discussion, he underscores the significance of treating oneself with kindness and compassion, advocating for early intervention, and a proactive approach to brain health. This conversation offers practical advice and actionable steps to enhance brain health and well-being. Please enjoy! Show notes + MORE Watch on YouTube Newsletter Sign-Up  Today’s Sponsors: Inside Tracker: Save 25% OFF all Inside Tracker tests w/ code RICHROLL 👉insidetracker.com/richroll Waking Up: Get a FREE month, plus $30 OFF 👉 wakingup.com/RICHROLL On: Get 10% OFF apparel, shoes, & more 👉on.com/RICHROLL AG1: Get a FREE 1-year supply of Vitamin D3+K2 AND 5 free AG1 Travel Packs 👉drinkAG1.com/richroll Eight Sleep: Get $200 OFF the Pod 3 Cover 👉EightSleep.com/RICHROLL Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

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• 1:05Speaker 01

  The message in our society is wrong. You're not stuck with the brain you have. You can make it better, and I can prove it.

• 1:13Rich Roll?

  Meet Dr. Daniel Amen, a celebrity psychiatrist, a brain health expert, and a 12-time New York Times bestselling author.

• 1:21Speaker 01

  So if I'm right, and I am, you need brain envy. You need to love your brain. The mission is to end mental illness by creating a revolution in brain health.

• 1:35Rich Roll?

  Today, we discuss all things brain health, dementia, Alzheimer's, and ADHD, and debunk the few myths along the way.

• 1:42Speaker 01

  Come on, we need to get into the 21st century. Psychiatrists are the only medical doctors who virtually never look at the organ they treat. Think about that. If you want to keep your brain healthy, or rescue it, you have to prevent or treat the 11 major risk factors that steal your mind.

• 2:08Rich Roll?

  Well, Dr. Amen, it's a pleasure to meet you. Thank you for making your way on a very rainy day here in Los Angeles to spend time with me. I'm looking forward to discussing all things brain health, optimizing brain health, focus, memory, cognition, preventing things like cognitive decline, dementia, Alzheimer's. I'm interested in the mutability of the brain and brain health. And we're going to talk about your new book also, of course, Raising Mentally Strong Kids. I'm a parent of four kids. This is very interesting to me. But I think the two primary motivating things that made me most excited about sitting down with you today is first, a little over a year ago, I was diagnosed with ADHD, which came as quite a surprise. Many questions for you about this.

• 2:53Rich Roll?

  It was not something that I thought would be something I would be associated with. The second is that my mother is currently in the throes of dementia, obviously a quite devastating situation, as you know all too well. And so I want to learn as much as I can about how to help her, how to help my dad, as you also might imagine, is in a very challenging situation. And of course, to do everything I can to avoid a similar peril for myself. And as much as that might sound like I'm trying to make this about me, I'm actually not, maybe a little bit with the ADHD part, but when you consider the statistics on dementia and Alzheimer's, it really is about all of us, isn't it?

• 3:36Rich Roll?

  I kind of looked up some statistics about an hour ago, and it's quite devastating the extent to which these diseases of dementia are kind of taking over and growing at alarming rates. In 2023, 6.7 million Americans over 65 have Alzheimer's, which is like 1 in 9, 55 million around the globe. Two-thirds of these people are women, which is fascinating. And it's very much on the rise. I saw some statistics like by 2060, the CDC predicts a sevenfold increase, and globally from 55 million to 139 million by 2050.

• 4:17Rich Roll?

  So this is a problem that is going to leave very few people untouched.

• 4:23Speaker 01

  No question. I mean, if you're blessed to live to eighty-five, you have a one in two chance of being diagnosed with dementia.

• 4:32Rich Roll?

  One in two.

• 4:33Speaker 01

  One in two, which means it's either you or your partner, and that's horrifying. But what most people don't know is you can have an impact on that. And since two thousand and five, I wrote a book with my friend Rod Schenkel called Preventing Alzheimer's. And I updated it in two thousand and seventeen with Memory Rescue. And the big idea is if you want to keep your brain healthy, or rescue it, you have to prevent or treat the eleven major risk factors that steal your mind. And you talked about your mom having it.

• 5:16Speaker 01

  The mnemonic that we'll talk about is called bright minds. And the G in bright minds is genetics, but we don't think about it properly. Oh, well, I'm overweight because my family's overweight, or I have hypertension because it runs in my family, or I have diabetes because it runs in my family, or I have Alzheimer's disease, or I'm vulnerable to it, and there's nothing I can do about it. And that's a lie. Genes increase your vulnerability, and they teach you what you should be doing. So, for example, I have six children. Three of them are adopted. Two of my nieces, we adopted because their parents couldn't stop

• 5:58Speaker 01

  with drugs and alcohol, and it was a disaster for these kids. And I tell my nieces, if you never drink or do drugs, you're never going to have a problem. But if you do, it could be serious. You need to be on an alcohol-drug prevention program every day of your life. I have obesity and heart disease in my family. I'm going to be seventy this year. I'm not overweight, and I don't have heart disease because I'm on an obesity-heart-disease-prevention program every day of my life. So if you have it in your family, as soon as you know... You should be serious about preventing these 11 major risk factors.

• 6:43Rich Roll?

  I want to get into all those strategies, but let's talk a little bit about what's driving this, what is causing this. I mean, I would imagine a portion of the spike that we're seeing, this increase in incidence, is related to the fact that people are living long and baby boomers are aging up. But also, I suspect that lifestyle habits are contributing to this as well with the increase in type 2 diabetes, obesity, hypertension, and the like. So what's causing cognitive decline?

• 7:15Speaker 01

  Are seriously unhealthy lifestyle and undisciplined minds. Did you know depression doubles the risk of Alzheimer's in women and quadruples it in men?

• 7:30Rich Roll?

  What is the relationship between depression and dementia?

• 7:34Speaker 01

  So many people think if you're an older person and you get depressed, it's actually a precursor to dementia. They're both brain diseases or brain problems, if you will. And it's critical, and the M in Bright Minds, mental health stuff. So I am so excited about this because what I came to realize, I started looking at the brain in 1991, and we've looked at over 250,000 scans. But early on, I came to realize, you are not stuck with the brain

• 8:15Speaker 01

  you have. You can make it better, and I can prove it. And so if I look at your brain, and then you have a car accident, your brain's going to be worse. If I look at your brain, and then you go on a drug bender, your brain is going to be worse. If I look at your brain, and then all of a sudden you stop sleeping, or you go through a divorce, odds are your brain's going to change in a negative way. But I also did the big NFL study. When the NFL was sort of lying, they had a problem with traumatic brain injury in football. Eighty percent of my players got better. I could see the damage, but when they go on a brain healthy program, eighty percent, their brains looked better anywhere from two to six months later.

• 8:59Speaker 01

  That's exciting. I was a consultant on the movie Concussion, and I was sort of bummed because the movie's sort of a downer.

• 9:07Rich Roll?

  Is that the Will Smith one?

• 9:09Speaker 01

  The Will Smith one.

• 9:10Rich Roll?

  Yeah, I remember that.

• 9:11Speaker 01

  And it's like, where's the hope? And the message on football dementia, or CTE, chronic traumatic encephalopathy, the message in our society is wrong. It's like, oh, you have this. It's chronic, progressive, untreatable. And so, players don't come and get help because they feel hopeless. It's like, no, get help early, probably while you're still playing, so that you can begin to reverse the damage. It's the big, exciting lesson over the last thirty years in neuroscience. Neuroplasticity. You're not stuck with the brain you have. You can make it better. There's an area of the brain called the hippocampus, like, like seahorses.

• 9:56Speaker 01

  It's Greek for seahorse. It's shaped like a seahorse. Every day, you are making seven hundred new stem cells in the hippocampus, or I think of them as baby seahorses. Your behavior is going to grow them, or it's going to shrink them. And so, if you're vulnerable to dementia, that's the area that gets hit early in dementia. And you want to love those seahorses, nourish them, feed them, teach them, rather than get them drunk, or stoned, or shrivel them.

• 10:34Rich Roll?

  Your main protocol in evaluating people's brains is this imaging technology called SPECT, right? So can you describe what that is?

• 10:43Speaker 01

  So, can I tell the priest story? Just to put it in context. So, when I was eighteen, Vietnam was still going on, and the government had a draft. And I became an infantry medic where my love of medicine was born. But about a year into it, I didn't like being shot at. It just not for me. It's for some people, it's not for me. So I got retrained as an X-ray technician and developed a passion for medical imaging. As our professors used to say, how do you know unless you look? And then 1979, I'm a second-year medical student. I'd just get married and two months later, my wife tried to kill herself horrified.

• 11:23Speaker 01

  And I take her to see a wonderful psychiatrist and I come to realize if he helps her, it won't just help her. It'll help me. It'll help our children, our grandchildren, as they would be shaped by someone who's happier and more stable. So 45 years ago, I fell in love with psychiatry and I've loved it every day since. But I fell in love with the only medical specialty that never looks at the organ it treats. And I knew it was wrong and I knew it would change. I just had no idea it'd be part of it. 1991, I'm now a psychiatrist for about a decade. And I went to a lecture at my local hospital on brain spectroimaging, single photon emission computed tomography.

• 12:08Speaker 01

  It's a nuclear medicine study that looks at blood flow and activity. It looks at how your brain works. And it basically shows us three things: healthy activity, too little activity, or too much.

• 12:23Rich Roll?

  How is it doing that? What is the process by which that's revealing itself?

• 12:27Speaker 01

  So, again, it's a nuclear medicine study. So what we do is we take a radio pharmaceutical. So you take a radioisotope. We take, one we use is called Technetium. And Technetium has self-esteem problems. It doesn't like being who it is. And it changes shape. And when it changes shape, it produces a photon or a little packet of light that we can measure. So we combine Technetium.

• 12:55Speaker 01

  With HMPO, a medicine that's easily taken up by cells in the brain, combine them, inject them into your arm, and it's called a first pass extraction. So 70% of it is taken up in your brain in that first pass, or within about two minutes. And then, so, so hard is part of the procedure. Little tiny needle into a vein in your arm, inject the medicine, it lights up your brain, and then we can measure it, have you lay on a camera table. It's not claustrophobic, it's not like an MRI. People lay on the camera, the camera heads come around your head in about 15 minutes. And we get about 10 million counts,

• 13:40Speaker 01

  or 10 million times that little piece of light hits the crystals in the camera. And then we reconstruct it, and it looks like a brain. And we then can see in your brain which areas are most active, which areas are healthy, which areas are sleepy. Compare it to our massive database. And my eight-year-old grandson can look at a scan and go, "healthy or not." And it's so helpful to look. And off-camera, we talked about controversy. So I start looking at the brain. I'm like a little kid, so excited. And we never make a diagnosis from a scan.

• 14:25Speaker 01

  So that's really important. We make a diagnosis, like all doctors, with all of the information. Take detailed histories. If you came to see us, you'd fill out about an hour's worth of paperwork, talk to our historian for a couple of hours. I mean, we really get to know you. And then we would test your brain. We do a computerized neuropsych assessment, and we would scan your brain. And...

• 14:49Speaker 01

  When you put that puzzle together, it's so powerful. The first patient I ever scanned. So I went from the lecture on brain spect imaging, given by the head of the hospital where I worked, into Sandy's room. And I didn't met her, I just met her. She tried to kill herself the night before. And as I was talking to her, I'm thinking, she has adult ADD. Impulsive suicide attempt after a fight with her husband that she caused. IQ of 144, but never finished college. And I go, tell me how you studied. She said, well, I really never did unless it was the night before the test. I put on a pot of coffee, stay up all night, do the test. She had an eight-year-old son that had ADD.

• 15:31Speaker 01

  So in my mind, I'm feeling pretty confident about this. But when I broached the subject with her, she's like, oh, adults can't have ADD. And I'm thinking, I'm the doctor. She was resistant. I said, well, why don't we look at your brain? And I had been doing a study called quantitative EEG up to that point. So I knew I needed to do it twice. Once at rest, once while she did a concentration task. And then after I got the results, a couple of days later, I'm in her hospital room. She has a table. I put the scans on the table. She had a healthy brain at rest. And when she tried to concentrate, her frontal lobes and her cerebellum, which we'll talk about, dropped.

• 16:16Speaker 01

  It was so clear.

• 16:18Rich Roll?

  What does that tell you?

• 16:19Speaker 01

  The harder she tries, the worse it gets. It's a classic, is what I was predicting I would see. Because that's what I saw in quantitative EEG. And when I showed her the scans and explained them to her, she starts to cry. And she said, you mean, this is not my fault? And I'm like, you know, people have ADD, it's sort of like people who need glasses. They're not dumb, crazy, or stupid. You know, people wear glasses. I wear glasses to drive. We're not dumb, crazy, or stupid. Our eyeballs are shaped funny. And we wear glasses so we can focus. People have ADD aren't dumb, crazy, or stupid.

• 16:59Speaker 01

  Their frontal lobes and cerebellum often turn off when they should turn on. So medicine, or supplements, or other strategies we'll talk about, so you can focus. I could see with the image that her shame melted away. And her compliance went up. And she took the medicine. Her relationships were better. She ended up, she was underemployed, as many ADD people are. Finished college, got a better job and was in touch with her for about 10 years.

• 17:31Rich Roll?

  So this was sort of an inciting incident that allowed you to see the benefits of using this as a diagnostic tool, this imaging technology?

• 17:41Speaker 01

  Yes.

• 17:42Rich Roll?

  Yeah.

• 17:43Speaker 01

  I like it when my patients get better. So I went into psychiatry and it was totally personal for me. And I loved it, but I was already getting criticism from it. It's like, oh, we don't do this. It's not standard. It's not what we do. But 1992, all-day seminar at the American Psychiatric Association, brain spect imaging and child psychiatry, because I'm also a child psychiatrist. I'm so excited because I'm meeting colleagues who do it. And in 1993, I teach with that group. So I'm like all in on the technology.

• 18:25Speaker 01

  But it was 1993, lots of pushback from the American Psychiatric Association because it doesn't fit the current diagnostic paradigm.

• 18:37Rich Roll?

  Mm-hmm.

• 18:38Speaker 01

  It's like, stop giving people the diagnosis of depression. Depression's a symptom cluster. It shouldn't be a diagnosis. Sort of like, chest pain is a symptom. It's not a diagnosis, right? If you have chest pain, it doesn't tell you what's causing it and it doesn't tell you what to do for it, right?

• 19:00Rich Roll?

  Right. It's just indisha to look deeper and use other diagnostic tools to confirm.

• 19:05Speaker 01

  Right.

• 19:06Rich Roll?

  You know, what's happening. But that was 20 years ago. Is there a sense that the medical establishment has changed its tune? Because if you look at your Wikipedia page, it's like a, it's like a diatribe on, you know, the lack of scientific efficacy with respect to this imaging technology.

• 19:22Speaker 01

  Yeah, I don't know what to do about Wikipedia. 2016, January, I published 80 studies. People go, oh, he's never published his work. It's like, dude, do you read? Discover magazine listed our research as one of the top 100 stories in science for 2015. I was pretty excited about that. 2021, the Canadian Association of Nuclear Medicine.

• 19:46Speaker 01

  Wrote procedure guidelines on SPAC, basically as if I wrote them. And five of the 10 authors had been my students at some point. I've had 10,000 medical and mental health professionals referred to our 11 clinics.

• 20:02Rich Roll?

  And 250,000 scans that you reviewed.

• 20:06Speaker 01

  On people from 155 countries.

• 20:09Rich Roll?

  It's a massive dataset. What are some of the general trends that you see? Like, what can you extract from that giant dataset that speaks to brain health, the mutability of brain health, and the types of conditions that you see most consistently in the patients that end up in your clinics?

• 20:26Speaker 01

  Well, can I say with the controversy just a little bit longer? Because it really irritates me. The people who criticize me say, "Oh, he's only doing it for money. Oh, you can't see these things in the scans, even though they're not experts." But what's the alternative? I mean, I'd said it earlier. Psychiatrists are the only medical doctors who virtually never look at the organ they treat. Think about that.

• 20:55Rich Roll?

  And obviously, if you have a brain dysfunction, that's going to dictate a, you know, mental health outcome.

• 21:01Speaker 01

  Well, if we agree that your brain controls everything you do, right? How you think, how you feel, how you act, how you get along with other people. And when it works right, you tend to work right. And when it's troubled, you're more likely to have trouble in your life. If your brain, the moment-by-moment function of your brain, creates your mind, then why wouldn't you assess the organ that you're working on? And so, just a little more history, 1993, I start to get anxious because I have two big flaws.

• 21:42Speaker 01

  And I've worked on them a lot, but I like people to like me. And you can't change a medical specialty if you're anxious about what people think of you. And...

• 21:57Speaker 01

  I hate conflict. I'm a middle child. You and I both. I hate conflict and I like people to like me. And all that changed in 1995. So I spent from 1993 to 1995 just anxious because I knew I had to do this, right? There's not a choice. Once you look, you can't unlook. And 1995, I get a call late one night from my sister-in-law, Sheri, who told me my nine-year-old nephew, Andrew, had attacked a little girl on the baseball field for no particular reason. And I'm like, what? And she said, Danny, he's different. He's mean. He doesn't smile anymore.

• 22:39Speaker 01

  I went into his room today and found two pictures he had drawn. One of them, he was hanging from a tree. The other picture, he was shooting other children. So if you think about it, he's Columbine or Sandy Hook or Parkland, Florida, waiting to happen. And I'm like, I want to see him tomorrow. And they lived eight hours from me. So they brought him to me. I'm like, buddy, what's going on? And he's like, Uncle Danny, I'm just mad all the time. Like, is anybody hurting you? No. Is anybody teasing you? No. Is anybody touching you in places that shouldn't be touching you? No. And 999 child psychiatrists out of 1,000 would put him on medicine and therapy.

• 23:24Speaker 01

  And because of my experience, I already scanned 1,000 people at that point. I'm like, he's got a left temporal lobe problem. And so I'm like, I held his hand while he held his teddy bear and got scanned. And he was missing the function of his left temporal lobe. I'd never seen it. I've seen it 100 times since then. Turned out he had a cyst the size of a golf ball occupied the space of his left temporal lobe. And I told his pediatrician, I said, you find somebody to take it out because he wasn't in my neighborhood. And he talked to three neurologists, all of them said they wouldn't touch the cyst until he had real symptoms. At which point, I lost my mind and I start screaming at the pediatrician of a homicidal,

• 24:06Speaker 01

  suicidal child who attacks people for no reason. What do you mean, real symptoms? And he got anxious and he said, I think they mean like seizures or he loses consciousness. I'm like, serious? And in my head, I'm like, neurologists, neurologists, neurosurgeons, neurosurgeons will do stuff. So I called UCLA, talked to the head of the pediatric neurosurgery department, Jorge Lizarov, and he said, Dr. Amen, when these cysts are symptomatic, we drain them. He's obviously symptomatic. And after the surgery, I got two calls. One from my sister-in-law, who said the surgery went really well, and when Andrew woke up, he smiled at her.

• 24:46Speaker 01

  She said, Danny, he's not smiled for a year. Then I got a call from Dr. Lizarov, who said, oh my God, Dr. Amen, that cyst was so aggressive, that put so much pressure on Andrew's brain, that thinned the bone over his left temporal lobe, so his skull had been thinned. He said, if he would have been hit in the head with the basketball, would have killed him instantly. Either way, would have been dead in six months.

• 25:15Rich Roll?

  That's an amazing story. What's so interesting is the idea that our personalities are not static, that something amiss with the brain could completely change a person's outlook on life, how they show up in the world, the thoughts that they're entertaining. And with, in the case of that example, like a simple procedure, not a simple procedure, but a procedure could completely change that.

• 25:42Speaker 01

  Good or bad, right? It can go either way. But after Andrew, and you know, it's now 30 years later, 29 years later, Andrew's married, has two children, has his own business. I mean, he's normal. And it was that moment, I lost my anxiety and my need for you to like me. That's when the war began, to try to change.

• 26:12Speaker 01

  Psychiatry to become, it's like, come on, we need to get into the 21st century. And 1979, when I told my dad I wanted to be a psychiatrist, he asked me why I didn't want to be a real doctor.

• 26:23Rich Roll?

  Yeah, he wasn't happy about it.

• 26:24Speaker 01

  Why I wanted to be a nut doctor and hang out with nuts all day long. But that, he was just reflecting what society believes, that you're weak if you have a mental health problems, you're bad if you have behavioral problems. And the images clearly taught me free will is not zero or 100, that free will is gray. And I ended up testifying in some death penalty cases. So if I'm right, and I am, that means 40,000 psychiatrists and hundreds of thousands,

• 27:03Speaker 01

  family practice doctors, OB-GYN internists, that they're practicing witchcraft by making diagnoses based on symptom clusters with no biological data. Last year, 337 million prescriptions for antidepressants. That's insane. What's happening in our society is just tragic, and we need a different way. And the mission I have in my life, it's crazy, but the mission is to end mental illness by creating a revolution in brain health, which is why I'm so excited about brain health.

• 27:43Rich Roll?

  It's a bold statement. It's a great mission, I love it. I think ancillary to what you just shared is, there's a lot of misnomers when it comes to mental health, like language is important and the words that we associate with. Some of the things that people experience are perhaps not in the best interest of healing and welfare. Can you talk a little bit about that, like the idea of just talking about disease in general with respect to mental health?

• 28:10Speaker 01

  So of the 337 million prescriptions written for antidepressants, virtually no one was talked to about their diet. About their sleep habits, about if they turn on the news first thing in the morning. I love the idea of getting my patients excited about making their brains better. Rather than you have borderline personality disorder and you're probably not going to get better, but here are the things to do. Or you're bipolar, you're going to need to take this medication for the rest of your life. I'm in Justin Bieber's docu-series, Seasons, and he came to me diagnosed with bipolar disorder on lithium.

• 28:55Speaker 01

  I scanned him, that's not what he had. But can you imagine being 23 and people saying, you have a mental illness, you're always going to have this mental illness, you need to be on this medicine for the rest of your life? That's insane. With no biological data. Or, one of my favorite stories is Adriana, who I just dearly love. Normal 16-year-old, beautiful, goes to Yosemite. They think it's a magic moment when they're surrounded by six deer. 10 days later, she becomes aggressive, she starts to hallucinate, she's paranoid, she's hospitalized, given a diagnosis of schizophrenia.

• 29:39Speaker 01

  And after three hospitalizations, multiple medications, the family spent $100,000. Adriana's a shell. She comes to our clinic, sees one of our doctors, her brain's on fire. Why is her brain on fire? You know, we see inflammation. Turned out she had Lyme disease. On an antibiotic, within a year, she's normal. She graduated from Pepperdine, she's got a master's degree from the University of London. She's normal.

• 30:11Speaker 01

  I think infectious disease, and we can talk about COVID because it's part of it, is a major cause of psychiatric problems. And nobody knows about it because people aren't looking at the brain. And so you asked me, you know, what are sort of the big lessons I've learned? Mild traumatic brain injuries, a major cause of psychiatric illness. And nobody knows it because they don't look. One of my friends was mountain biking and had an accident. He fell, broke his helmet, didn't lose consciousness, never had an anxiety disorder, panic attack, depression, never in his whole life. He's in his 50s. All of a sudden, he's having panic attacks.

• 30:54Speaker 01

  Doctor put him on Prozac and Xanax, very common combination. And for the wrong brain, it's big trouble. He became suicidal. He saw me on TV and I came to see him. He had a dent in the left front side of his brain, his left frontal lobe, his left temporal lobe. I'm like, "Do you have a brain injury?" "No." "Are you sure?" What I found is you've got to ask people multiple times, "Do you ever have a brain injury?" When I see it on the scan, I'll generally find it. Did you ever fall out of a tree, off a fence, dive into a shallow pool? Car accident, cushion playing sports? He's like, "Oh, my God." Two weeks before I had my first panic attack, I had a mountain biking accident and I broke the helmet.

• 31:39Speaker 01

  I didn't think anything of it because I didn't lose consciousness. Consciousness is a brain stem phenomenon. So you can really do damage to your brain and not lose consciousness because you don't damage your brain stem. Yeah. Yeah. Phineas Gage, the famous case in neurosurgical history, was a railroad construction worker in 1848. And his job was in explosions. He'd explode out the rocks so they could lay the railroad tracks. And one day, there was an accident that happened. His three-foot tamping iron, he was tamping down the fuse and sand and gunpowder, and he dropped the rod.

• 32:23Speaker 01

  Caused a spark, then an explosion. It went through a missile underneath his left cheekbone, took out the left front side of his brain, landed 30 yards away. And he looked to his friend and said, "Did you see that?" And then he looked to another friend, "Did you see that?" He didn't lose consciousness, but obviously it damaged his brain, changed his personality. He was conscientious and a man of good character before that. And then he got fired because he couldn't stop swearing. And he didn't show up. And he had these crazy ideas. And was a stagecoach driver. And then moved to where all these people move, which is California.

• 33:15Rich Roll?

  In the case of somebody who suffered a CTE, some kind of brain injury, or in the case of someone like Justin Bieber, who's being diagnosed with bipolar disorder. I mean, not for nothing. Like, how about just the fact that he's so young and so famous and so wealthy? Like, how do you not have some kind of dysfunction being so young with a young brain, trying to navigate that type of world?

• 33:39Speaker 01

  Yeah, they almost killed that boy.

• 33:41Rich Roll?

  He was pretty out of control for a while, and he seems to be great now. That's all I know. I don't know him personally.

• 33:48Speaker 01

  And if you read his mom's book, I mean, it's public knowledge. He grew up with a lot of uncertainty and trauma and anxiety. Her parents didn't want her to have Justin. And she ended up going in Salvation Army Home for her wedmothers.

• 34:07Rich Roll?

  Oh, wow.

• 34:08Speaker 01

  There's a lot.

• 34:09Rich Roll?

  So there's some childhood trauma stuff there.

• 34:12Speaker 01

  Childhood trauma. And then you think early fame, which is one of the worst things for brain because you wear out your pleasure centers in the brain. All of that excitement and then unlimited money with very poor supervision in a brain that doesn't finish developing until 25. I mean, just see sort of.

• 34:37Rich Roll?

  Yeah, it's a recipe for some kind of dysfunction.

• 34:40Speaker 01

  And, you know, one of my other sort of patients I dearly love, Miley Cyrus, got the Grammy this year for Song of the Year.

• 34:49Speaker 01

  Makes me emotional because the song's really about love and loving yourself. But it was a shit show for a long time.

• 34:57Rich Roll?

  She's been on a journey, hasn't she?

• 34:59Speaker 01

  She's been on a journey. I'm just so proud of her because she's in charge of her life rather than fame's in charge, or drugs are in charge, or other people are in charge. I mean, you know, I work really hard with my patients for them to become good CEOs of their life, but you have to take care of the executive center in your life, which is your prefrontal cortex, largest in humans than any other animal by far. If you damage it with head trauma, drugs, alcohol, bad food, not sleeping, social media, it's not a good prescription.

• 35:38Rich Roll?

  What are some of the top line, most important lifestyle protocols or interventions that you recommend when your patients come through and you see something lighting up or not lighting up in these scans and realize that there's work that can be done to course correct?

• 35:56Speaker 01

  So it depends on your brain. I mean, you know, there are things everybody should do, like love your brain. And I horrified myself, I don't know, I guess about 10 years ago when I went, brain health is three things. Brain envy, gotta care about it. Nobody cares about their brain. Why? Because you can't see it.

• 36:15Rich Roll?

  We don't see it.

• 36:16Speaker 01

  You can see the wrinkles in your skin or the fat around your belly and you can do something when you're unhappy with it.

• 36:23Rich Roll?

  I also think we're just not taught to care for it.

• 36:25Speaker 01

  We're not.

• 36:26Rich Roll?

  It's not something that we think about. We know we should eat better and all the like, and we know we can learn things with our brain, but there isn't a broad sense that we can improve our brain health through certain lifestyle choices that we're making.

• 36:41Speaker 01

  Immediately, your brain's worse if you're drinking alcohol or if you're smoking pot. Immediately, your brain's worse if you...

• 36:51Speaker 01

  Don't prioritize sleep if you eat crappy food. You know, going back to these 11 major risk factors. But it's three things, brain envy. So when I started 1991, I scanned everybody I knew. I'm like so excited. And I scanned my mom. She was 60. She had a beautiful brain, which really reflected her life. She has seven children, 54 grandchildren, great grandchildren. She knows everybody, still 92. She knows everybody's name. She knows what's going on in their lives. And she's just someone that she brings people to her.

• 37:35Speaker 01

  I scanned myself a week later and it wasn't nearly as good as my 60 year old mother. And that just irritated me. But I played football in high school. I had meningitis twice as a young soldier, bad for the brain. And I had bad habits. You know, I never drank, I never smoked. But I wasn't sleeping. I thought I was special, like I could get by on four hours of sleep. And I'm not special. I'm stupid because sleep is critical. I was overweight. I was, I didn't care. I'm a double board certified psychiatrist, top neuroscience student in medical school, and I don't care about my own brain. I saw it and I cared. I have envy. I want my mom's brain. And so I always say Freud was wrong.

• 38:18Speaker 01

  Penis envy is not the cause of anybody's problem. You need brain envy. You need to love your brain. And that's where brain health starts. It's like, oh, I have this organ that creates me. Let me love it. And then avoid things that hurt it. Just got to know the list and do things that help it. And again, you just have to know the list. And if we do the bright minds, it says what to avoid and what to do.

• 38:46Rich Roll?

  Mm hmm. Yeah, those 11 sort of principles, right? That are built into that acronym.

• 38:51Speaker 01

  Yeah, they're everywhere in my head. Like B for examples for blood flow. Low blood flow is the number one brain imaging predictor of Alzheimer's disease. So if you have it in your family and I scan you, we're going to look. I mean, SPACT is a study that looks at blood flow and mitochondrial activity. Forty nine percent of the tracer is taken up in the mitochondria. So we're going to look at blood flow. And energy. And if it's low, we're gonna go, why? You know, head traumas, drugs, alcohol, caffeine, nicotine, not sleeping, having high blood pressure, being overweight.

• 39:36Speaker 01

  And we're gonna target the reasons why it's low. And then we're gonna do exercise, increases blood flow. I love exercise. Ginkgo is one of my favorite supplements because the best brains ever see have taken Ginkgo. Oregano, cayenne pepper, beets, increase blood flow. So know your risk factor and then know what to do. And the trick with exercise is coordination exercises. People who play rocket sports live longer than everybody else. This is a replicated study on like 90,000 people.

• 40:18Speaker 01

  Because what coordination does is it activates your cerebellum, little brain, 10% of the brain's volume in the back is half the brain's neurons. And if you activate that, it turns on the rest of your brain. So I'm a huge fan of table tennis and pickleball and tennis.

• 40:41Rich Roll?

  It's bad news for me. I'm very athletic, but when it comes to anything involving eye-hand coordination, I'm terrible at it, and so I've avoided it my whole life.

• 40:50Speaker 01

  But that's good news for you, if you can get over yourself.

• 40:52Rich Roll?

  Because there's more, more to be gained, right?

• 40:54Speaker 01

  Yeah, get a really good ping pong coach. And don't judge yourself. Just go and learn to be good. And don't have to beat people. If you spent a half an hour twice a week, it'll have a major impact on your ability to think. Because you gotta get your eyes, hands, and feet all working together while you think about the spin on the ball. I think of it as aerobic chess.

• 41:22Rich Roll?

  I have this thing, which I think might be fairly common, which is this idea that perhaps I'm past the point of no return. So let me explain. I was a competitive swimmer growing up. So between the ages of like 14 and 21, I was training, you know, four to five hours a day, waking up at 4:30 in the morning and walking around, overtrained like a zombie. So I wasn't getting good sleep. I never felt rested. I always felt fatigued during that period of time. Alcohol became quite the thing around age 18 and from 18 to 31,

• 42:04Rich Roll?

  a progression into alcoholism. And during that period of time, you know, maybe getting one good night of sleep while the rest of the nights were blackouts or recovering from blackouts. I get sober at 31, but from 31 to 40, I transfer a lot of that addictive energy into my lifestyle choices. So I was basically sedentary and subsisting on hot dogs, french fries, pizza, McDonald's, Jack in the Box, while not exercising. At around 40, I have a come to Jesus moment. I changed my lifestyle habits and, and many things about my life. And I'm a much healthier person now. I'm eat a plant-based diet. I'm

• 42:49Rich Roll?

  very fit and active. I'm engaged mentally through the process of doing this podcast and other things that I do. And my life is good, but I can't shake the sense that I have done so much damage over the course of my lifetime, that no matter how many good things I do now, that at some point, I'm not going to be able to overcome that damage. It's going to catch up to me. And so what's the point in doubling down and really investing in all of the things that you're saying? And I, I think on some level that might be common. People are thinking, well, I, I've treated myself terribly.

• 43:26Speaker 01

  I think it's very common.

• 43:27Rich Roll?

  That song has been sung. So

• 43:29Speaker 01

  But it's a lie.

• 43:30Rich Roll?

  You know, mutability is your whole thing. Like we can't, but is there a period at which, I mean, I would suspect it's more difficult than it is for others. But what would you tell someone like myself or someone who's of a similar mindset or a similar type past history?

• 43:48Speaker 01

  Well, one, we should look, right? How do you know unless you look? And so many people go, oh, no, I don't want to know.

• 43:55Rich Roll?

  Yeah, I'm scared. I'm a little, I'm a little scared.

• 43:57Speaker 01

  If you knew a train was going to hit you, wouldn't you at least try to get out of the way?

• 44:03Rich Roll?

  As long as there was a possibility to get out of the way.

• 44:05Speaker 01

  Of course.

• 44:06Rich Roll?

  If I couldn't get out of the way, just let it hit me and I'm none the wiser.

• 44:10Speaker 01

  So I do a show, actually, I want you to be on it, Scan My Brain, on YouTube and Instagram. And one of my favorite guys, Troy Gloss, 2002 World Series MVP, played third base for the Angels. Love him dearly, drinking way too much, four concussions, depressed, suicidal. I mean, he was in a dark place, didn't think there was any hope. And I got him to do my show. I don't know how that happened. His brain was awful, like awful. But he did what I asked him to do. And his wife, Anne, who I dearly love, she was a good partner.

• 44:52Speaker 01

  He stopped drinking, he ate better, exercised, took the supplements, lost 15 pounds in two months. And I'm like, let's look again, because I could just tell he was better. His brain's significantly better. In a two-month period? Two months. And then, I scanned him 16 months later. How old is he? Forty-seven now. And, you know, there were ups and downs, right? When you're an alcoholic, you just don't stop. I mean, some people do, but, you know, there was some bumps for us. But, you know, we're in the fight together. And 16 months later, his brain is so good.

• 45:33Speaker 01

  And I know, five years from now, if he continues on and he has brain envy, his brain's gonna be friggin' normal. You have a choice. But if you don't know, if you don't look, you don't know. And why would you ever be in that position? I want to know, which is why, you know, every couple of years, I'll get a whole-body scan. Because if trouble's coming, I want to get it early. I don't want to wait until late.

• 46:07Rich Roll?

  So many of the lifestyle illnesses that we're seeing now are tracked to chronic inflammation. So what are some of the things that we can do to ameliorate that? That have implications in terms of brain health?

• 46:21Speaker 01

  So in Bright Minds, the first eye is inflammation. And some surprising things, it's like 98% of us have low levels of omega-3 fatty acids. If you're not taking an omega-3 supplement or focused on eating low mercury, high omega-3 fish, that's a problem because low omega-3 increases inflammation. If you're not a bit obsessed with your gums and your teeth, if you have gum disease, you're more likely to have brain disease and heart disease. And like, I didn't really-

• 46:58Rich Roll?

  Just to drill down on that a little bit, it's always amazing to me that that doesn't get enough bandwidth in terms of our overall health. Because I know I've had periodontal disease and gum problems my whole life. And I was educated early about the implications of not treating that well because that tends to lead to arthrosclerotic issues. And brain health, obviously, it's a circulatory situation. It has to have implications in terms of brain health.

• 47:28Speaker 01

  Absolutely, because your brain is 2% of your body's weight, but uses 20% of the blood flow in your body. 20% of the oxygen in your body goes to your brain.

• 47:42Rich Roll?

  And if you have gum disease, infections in your gums, periodontal issues, abscesses and the like, how does that translate into circulatory issues? Like, what is happening?

• 47:55Speaker 01

  You have a higher risk of Alzheimer's disease. So it increases inflammation, which, you know, many people think is the mother of all illness. I don't know about that, but I don't want to have inflammation. And for a long time, I didn't really care about my own gums until study after study, gum disease, heart disease, gum disease, brain disease. Like, no, got to take care of them. So become a flossing fool.

• 48:25Rich Roll?

  In terms of blood work, what should people be paying attention to? I mean, you mentioned omega threes, but if someone's doing a blood panel and they get the results, what are some things that would jump out to you?

• 48:37Speaker 01

  So if we look at some of the important numbers for bright minds, like blood pressure would be for blood flow, retirement and aging, you don't want high iron levels. Iron accelerates aging. You don't want low iron because that'll make you not sleep and be anxious. And I tend to accumulate iron, so I go donate blood twice a year, and that seems to help. Good for other people, good for me. For inflammation, you want to know your C-reactive protein. For genetics, you probably should know your Apo E4 gene type. I'm a 2.3.

• 49:15Rich Roll?

  Is that the gene that's connected to dementia, the Chris Hemsworth situation?

• 49:21Speaker 01

  Yes, he's a double four.

• 49:22Rich Roll?

  Double allele or whatever? Yeah, yeah.

• 49:24Speaker 01

  Yeah, he's a E44, which means he has a tenfold risk. But a tenfold risk means about 25%. And so it just means be serious. And exercise, the kind of exercise you're doing, decreases the risk if you have one or two E4 genes. For head traumas, that's the number of head traumas you have. Toxins, how's your liver function? So liver function tests. Mental health, it's your ACE score. Adverse childhood experiences, zero to 10, how many do you have? My wife. Wrote a book called The Relentless Courage of a Scared Child. She's an eight out of 10.

• 50:07Speaker 01

  My nieces, who I adopted, are both nines. I mean, if you have four or more, it increases your risk of seven of the top 10 leading causes of death. If you have six or more, you died 20 years early. Now, my nieces and my wife aren't dying 20 years early because there are things you can do to extract the past trauma, which is super important. The second I is immunity and infections. So know your vitamin D level and get it above 40. People who are above 40 have half the risk of cancer of those who are under 20. And when I first tested mine, when I sort of figured this out 20 years ago,

• 50:52Speaker 01

  I was 17. I'm like, how am I 17? Because I exercise, but I exercise at night because I'm working during the day. And I realized I need more sun and I need to supplement to have a healthy level. Not too much, but a healthy level. And then N is neurohormones. Get them tested every year. We're living in a society where low testosterone levels are rampant in young males. And I've just never seen anything quite like it.

• 51:24Rich Roll?

  What is contributing to that?

• 51:26Speaker 01

  Head trauma and toxins.

• 51:29Rich Roll?

  Are more young males having head trauma than they used to be?

• 51:33Speaker 01

  Well, with football and soccer and skateboarding, maybe. The other thing is toxins on their body. The products you put on their body. So I have all my patients download the app Think Dirty and scan all of your personal products to see.

• 51:50Rich Roll?

  Is that an EWG thing?

• 51:52Speaker 01

  Like it. It's similar to it. So for example, I used to shave with Barbasol. 50 years. And on a scale of zero is live long, 10 is kill you early. It's a nine. And now I shave with something called Kiss My Face, which is a two.

• 52:08Rich Roll?

  It's insane, the extent to which. There are so many chemicals in our everyday products that we're unaware of. And the lack of regulation on this, I've had plenty of guests in the past come on to talk about it, Ken Cook from EWG. My friend Darren O'Leary wrote a book called Fatal Conveniences, and you read it, it's very solution oriented, but it's quite an eye opener to realize

• 52:32Speaker 01

  It's so disturbing.

• 52:33Rich Roll?

  the amount of toxicity in our personal care products and things that we sort of take for granted and assume are safe.

• 52:41Speaker 01

  And what happened during COVID? It's all of a sudden, these toxic hand sanitizers that have parabens and phthalates and fragrance that are just bad for you. People are lathering themselves, their children with this stuff, which is why I'm a fan of earth-friendly products, because they make these cleaning products that I have no interest in them, except I love them. You need to be thoughtful, you know, what you clean your clothes with, what deodorant you use, what sunscreen you use. Read the label. And it's like, oh, I can't understand it. Then you need to like, understand.

• 53:24Speaker 01

  Or get EWG or Think Dirty and just scan it. And it'll tell you, good for your brain and body, or bad for it. And people go, oh, but that's so expensive. I'm like, no, being sick is expensive. This is just about love. Why would you put something on your body or your child's body that is poison? Get your hormones checked, and then your hemoglobin A1C, obviously, and your BMI. They're very important numbers to know. 72% of Americans are overweight, 42% are obese. It's the biggest brain drain in the history of the world.

• 54:07Speaker 01

  I published three studies that say, as your weight goes up, The size and function of your brain goes down. And I learned that connection. 2009 Cyrus Raji from the University of Pittsburgh published MRI study that if you're overweight, you have 4% less volume in your brain and your brain looks eight years older than healthy people. If you're obese, you have 8% less volume in your brain and your brain looks 16 years older. And I have a normal database of scans, but we never, I mean, we ask them about weight, but we never use that as an exclusion criteria.

• 54:51Speaker 01

  Healthy weight versus overweight or obese significantly less blood flow. And then I did an NFL study, healthy weight NFL players versus overweight NFL players love frontal lobe function. And I'm like, oh, no. And can you talk about it without somebody being mad at you? So I've had lots of people mad at me, but it's just science, right? I'm just making the connection. If you are overweight, of these 11 risk factors, you have seven of them. Because it decreases blood flow, promotes aging, increases inflammation, changes healthy testosterone into unhealthy cancer promoting forms of estrogen and...

• 55:35Speaker 01

  You gotta get serious. Now, being underweight's bad for your brain, being overweight's bad for your brain.

• 55:43Rich Roll?

  You mentioned the importance of loving your brain. And I would imagine showing your patients these images, these scans, helps to create that connection because you see what's actually happening and perhaps that opens the door to loving your brain a little bit more. I think a lot about what the difference is between people who are able to... Absorb information and then make a change in their life versus people who absorb the same information and either choose not to or struggle to make that change or struggle to make that change last or sustain.

• 56:22Rich Roll?

  Because if you have low self-esteem, if you are somebody who is of a negative disposition or just see the world through the lens of lack as opposed to opportunity, those people, I would suspect, are more difficult cases in terms of trying to get them excited about the possibility. If you don't love yourself, it's pretty hard to invest in, get that person to invest in healthier lifestyle habits.

• 56:53Speaker 01

  It's absolutely true.

• 56:54Rich Roll?

  So there's a, it's a mental health thing as much as it is a rational, logical information thing.

• 57:00Speaker 01

  No question. And there are many people who had early childhood trauma, for example, who developed real rage about what happened, but then guilt about the rage because I still have to be with these people, they still house me and feed me. And so it goes unconscious. They start attacking themselves. And I'm bad. It's hard for me, if I believe at my core I'm bad, to do the right things out of love because you don't love yourself.

• 57:42Speaker 01

  And that is a brain problem because trauma gets stuck in your brain, but it's also a psychological problem. I think of all my patients in four big circles. It's what's the biology, which is brain health. Why we got to look at your brain and those important numbers we talked about.

• 58:02Speaker 01

  How's your psychological health? Right? It's your mind. What's the quality of your thoughts? The level of the trauma you have? What's the chatter in your head? There's also a social circle. What's going on in your life now with your kids? With your spouse? With work? And there's a spiritual circle. So why the heck do you care? You know, what is your deepest sense of meaning and purpose? And so in my mind, when I evaluate my patients, all four circles, all the time. I want to have an exercise called the one-page miracle. I want you to know, what do you want? Relationships, work, money? Physical, emotional, spiritual? What do you want? Let's define it.

• 58:46Speaker 01

  So you can look at it on a regular basis. Are you noticing what you like about the other people in your life more than what you don't? And whenever you feel sad, mad, nervous, or out of control, write down what you're thinking. And I have this great process, thinking in honest, accurate ways. So I'm not a huge fan of positive thinking. I'm a fan of accurate thinking with a positive spin. And that'd be worth chatting about. And that'll get your brain healthy. So if I give you these strategies and you don't do it, I want to bond with you so you come back and trust me. And then I want to work on, you know, perhaps the past trauma. I love a therapy called EMDR,

• 59:29Speaker 01

  Specific Psychological Treatment for Trauma. Stands for Eye Movement Desensitization and Reprocessing. And I love another one called ISTDP, Intensive Short-Term Dynamic Therapy. And the foundation of that therapy is people really struggling. They like, won't do the things they could do to be healthy. It's attachment problems.

• 59:56Speaker 01

  That led to rage and then guilt about the rage and self-attack. It's like they're living that I did something wrong. Even though everybody's done things wrong and, you know, most people forgive themselves. They're living with this self-attack. And that takes sometimes intense therapy, but it doesn't have to be long. That's why they call it intensive, short-term dynamic psychotherapy.

• 1:00:23Rich Roll?

  And you've had success with that, great success with that?

• 1:00:25Speaker 01

  Yes.

• 1:00:26Rich Roll?

  Yeah, it's so interesting. I mean, because you can show that person as not as many scans as you want, but until you untie that knot and get to the root of what's driving that, you know, disposition that's preventing them from making changes, it's not going to matter.

• 1:00:40Speaker 01

  I've never seen anything as powerful as showing somebody their brain, like with addiction. When I first started ordering scans, I was the director of a dual diagnosis unit, so a psychiatric hospital unit that takes care of substance abusers. Their brains were so bad. And I was like, here's a healthy brain, here's your brain. Your brain controls everything you do. Which brain do you want? I mean, I think anybody with an addiction should get their brain scanned. And I came up with, I wrote a book with David Smith called Unchain Your Brain: Breaking the Addictions That Steal Your Life. And like giving everybody Prozac's insane, right? There are many different ways to get depressed.

• 1:01:22Speaker 01

  Give everybody a 12-step program's a bit insane because they're impulsive addicts, they're compulsive addicts, they're impulsive compulsive addicts, they're sad addicts, they're head trauma addicts. It's like, no, the type you had, and if somebody diagnosed you with ADD, which we will talk about, well, that's our impulsive addicts group. It's like, you want to do the right things, but you just don't have enough of a break to stop. And that Could go with low frontal lobe activity. Are compulsive addicts. They just get the same thought in their head over and over again. And sometimes clinically, it's hard to tell the difference. Because they go, I'm impulsive. But what they really mean is they're compulsive.

• 1:02:07Speaker 01

  They get a thought. The impulsive person gets a thought and does it without thinking. The compulsive person gets the thought over and over again and has to do it. And so, one is a dopamine intervention. The other is a serotonin intervention. And how would you know unless you really looked?

• 1:02:26Rich Roll?

  Interesting.

• 1:02:39Rich Roll?

  A little over a year ago, I did a week-long, intensive therapeutic process that was intended to be trauma-oriented, childhood trauma-oriented. And it was incredible. And over the course of that week, I spent time with a wide variety of psychiatrists. And at the end of that week, there was a consensus among all of these psychiatrists that I had ADHD. As I said at the beginning, that was news to me. Because I had always thought of this as a condition associated with hyperactivity. I was not a hyperactive kid. I didn't feel like I had any of the symptomology that, at least in my mind, was associated with that condition.

• 1:03:25Rich Roll?

  But through the process of being diagnosed and kind of working through it, I've developed a whole new perspective on this. And I realized the extent to which I developed coping strategies to deal with this that allowed me to kind of overcome that predisposition. I would have never known. I just didn't think that I was, you know, that person.

• 1:03:47Speaker 01

  Swimming will treat it.

• 1:03:49Rich Roll?

  Yeah, that's how I did it. I would just exhaust myself through exercise and then I could calm down and sit. So I didn't have that experience of not being able to focus because the exercise gave me a different baseline.

• 1:04:01Speaker 01

  So can I talk about the five hallmark symptoms of ADD and you tell me which ones you have? I mean, there are more. The diagnostic criteria includes 18, but I think of one, it's short attention span, but not for everything. It's short attention span for regular routine, everyday things, schoolwork, homework, paperwork, chores. For things that are new, novel, highly stimulating, or frightening, people with ADD can pay attention just fine because they have their own intrinsic dopamine. Love is a drug, especially new love is a dopamine

• 1:04:42Speaker 01

  drug. So if you love your teacher, you're gonna want to please them and so you do fine in that class. But your attention span is erratic and that's what fools people because they're like, no, I'm interested. I heard President George W. Bush say this and he said, no, I did well in the classes I was interested in. And I'm like, not another ADD president, right? We just came off of Bill Clinton who clearly had impulse control issues. So, does that resonate with you?

• 1:05:16Rich Roll?

  Sure. The things that I'm interested in, I can be completely obsessed by. The things I'm not interested in are more challenging. But to me, that just, isn't that everybody? And I think in reflecting on that, like, I've made some pretty big life decisions about career in the past where I was choosing a career path that, that really wasn't what I should have been doing. And I have a huge capacity for persevering and determination. And I could force myself to, you know, do the work that I wasn't interested in, but it becomes... Very exhausting. And I was a lawyer for a long time, and I have many memories of being

• 1:05:58Rich Roll?

  in the law firm and trying to force myself to write these briefs and motions and do discovery and all the stuff that you do as a litigator, and looking around and realizing that my colleagues seemed much more interested in this than me. And I just thought, everybody was suffering through this in the same way that I was, rather than the truth, which was, I was this round peg trying to jam myself into a square hole.

• 1:06:23Speaker 01

  Yeah, that you didn't love it. And if you have ADD, one of the things I tell all my ADD patients is find something you love that you can make money out. Right? I mean, too often people go, oh, find things you love that you're then dependent on other people. That's a prescription for misery. The second symptom is distractibility. You see too much. You feel too much. You sense too much. It's like the world comes at you quickly. And so you want to sit down and read a book, but then you get distracted by the email, or by your phone, or because you're hungry, or something.

• 1:07:04Rich Roll?

  But also, isn't that everybody?

• 1:07:05Speaker 01

  No. My best friend in medical school had ADD, and I loved him dearly. He graduated top of our class. I was second. He was first. But he was my partner, so I was proud of him. And just so distracted. And it was funny to sort of watch it.

• 1:07:24Rich Roll?

  I don't feel like I'm a distracted person, but I do feel like I need to be doing one thing at a time. And as long as I just have this one thing that I'm doing, like, I'm okay, I can focus, I can, even when I don't feel like, like doing it, I can kind of overcome that, override it and do it. Where I get into trouble is when I wake up, and now my life is very full. There's lots of things happening, and I start to think about all the things that I have to do, and it becomes very overwhelming very quickly. And I get stressed and anxious, and that gets translated into just being an aggravated person and, you know, being unpleasant to be around. But it's left to my own devices. If I can just, I like to go all in on one thing, disappear, complete it, and then I'm open for the next thing.

• 1:08:10Speaker 01

  The third one is organization. It's hard for people who have ADD, Organization for Time and Space. Now, I think there are seven different types of ADD.

• 1:08:21Rich Roll?

  I was gonna say, what's the difference between ADD, ADHD? What are we talking about?

• 1:08:26Speaker 01

  Well, I think there are seven types. That's what I learned from imaging. But ADD, Attention Deficit Disorder, was a name given to this thing. It used to be called Minimal Brain Dysfunction before then by the American Psychiatric Association with DSM III, Diagnostic and Statistical Manual, 1980. That's what I trained on. 1987, for god knows what reason, they changed the name to ADHD. So it used to be ADD with hyperactivity, or ADD without hyperactivity. And they changed the name to ADHD to sort of lump everybody together. The problem is, half the people who have this disorder are never hyperactive.

• 1:09:10Speaker 01

  And so it was very confusing. And then 1994, they changed the name again to AD/HD, highlighting half the people who have this are never hyperactive. So, you know, the names are not scientific. Let's just be super clear about this. There's no biology to this. A group of psychiatrists get together and they vote based on what they think the best evidence is. And often, it's sort of silly. Like, we lost Asperger's this time. Everybody now, whether you're Elon Musk and high-functioning autistic, gets the same diagnosis as someone who's in a developmental center that can never live independently.

• 1:09:55Speaker 01

  I mean, it's just bizarre. When I first started imaging, I'm like, oh, it's not one thing based on imaging. And if we look at your brain, I'll be able to tell you. So, type 1 is classic ADHD. Short attention span, distractibility, disorganized.

• 1:10:16Speaker 01

  For time and space, we didn't talk much about that one. But your room, your desk, your bookbag, trouble with organization.

• 1:10:25Rich Roll?

  I'm not that guy. If anything, I'm OCD.

• 1:10:29Speaker 01

  So you might be type 3, we'll get to that. People with ADD tend to be late or just right on time. Because they actually don't start getting ready to go until, oh my god, I'm late.

• 1:10:40Rich Roll?

  That's not me either.

• 1:10:41Speaker 01

  Okay.

• 1:10:42Rich Roll?

  I'm generally timely. This is why, like, I want to go and get a break. I'm not convinced that I have this.

• 1:10:48Speaker 01

  So one, sort of, two, not that much.

• 1:10:50Rich Roll?

  Uh huh.

• 1:10:51Speaker 01

  The not being able to multitask is very male brain thing. As opposed to an ADD thing. Disorganization. Four is procrastination. You put things off, put things off, put things off.

• 1:11:03Rich Roll?

  I do that.

• 1:11:04Speaker 01

  Until you're mad, or somebody else is mad at you. And then five is impulse control. You say things you probably shouldn't say. Or do things probably shouldn't do. And it's like the break in your brain is vulnerable. And I think those are the five things. And if you have three out of five, you probably do have it. And it sounds like for you, somebody should look at your brain.

• 1:11:29Rich Roll?

  Right. And what would you see?

• 1:11:31Speaker 01

  Was it the interrupting at the conference you went to? Or at the treatment you went to? Where all the psychiatrists, you have ADD?

• 1:11:40Rich Roll?

  The interrupting? What do you mean?

• 1:11:42Speaker 01

  Like, were you interrupting people in conversations? Or?

• 1:11:45Rich Roll?

  No, I don't think so.

• 1:11:46Speaker 01

  I mean, why were they saying that?

• 1:11:48Rich Roll?

  Am I interrupting you now? Is that why you're saying that? I get accused of that on the podcast, interrupting people too much. If I was interrupting, they didn't tell me that I was. And if I was doing it, I was probably not consciously aware of doing it.

• 1:12:04Speaker 01

  So why did they want to drug you? What did they see that they went, you have ADHD?

• 1:12:11Rich Roll?

  Probably related to addiction issues, perhaps? I don't know. Or coping mechanisms that I've developed to focus. Or the way in which I can use excessive exercise to calm myself down. I'm not sure.

• 1:12:29Speaker 01

  Well, we'll look at it.

• 1:12:29Rich Roll?

  Mm hmm.

• 1:12:30Speaker 01

  And it's like, how do we know unless we look? Right. It's like

• 1:12:34Rich Roll?

  Right.

• 1:12:34Speaker 01

  one of the themes I've lived by.

• 1:12:35Rich Roll?

  And what would you see in a brain scan of a brain with ADHD versus a healthy brain?

• 1:12:42Speaker 01

  So often, healthy at rest and drops with concentration, especially in your prefrontal cortex, front third of your brain, an area called the basal ganglia where dopamine works and your cerebellum. So, healthy at rest, drops when you concentrate. We need to fix that. And you can fix it with exercise. You can fix it with certain stimulating supplements. And sometimes medication can be incredibly helpful. But the problem is, what I saw, because I'm a child psychiatrist and an adult psychiatrist, but about half the patients we have at Aiman clinics have ADD of one form or another.

• 1:13:26Speaker 01

  And what I found, there's classic, short attention span, distractibility, hyperactivity, impulse control issues. There's inattentive ADD, never really hyperactive or terribly impulsive, but trouble performing, trouble with focus. I have a child with both of those types. Type three is overfocused ADD. The problem is not that you can't pay attention, it's you can't shift your attention. You end up to get stuck on things. And because you're organized, that tends to be the one exception is type three.

• 1:14:07Speaker 01

  But these people also tend to be argumentative, oppositional. If things don't go their way, they get upset and they can hold on to grudges. And their addiction of choice tends to be things that calm their brain down, whether it's alcohol or marijuana. Type four is limbic ADD. Their emotional brain works too hard and they tend to see the world through dark glasses. They have the eight hallmark ADD traits plus sort of mild depression. Type five is temporal lobe ADD, often from a head injury. One or both of their temporal lobes hurt. So mood instability, irritability, temper stuff. Six

• 1:14:53Speaker 01

  Famous for. It's made it to movies. It's called The Ring of Fire, where the brain is not low in activity. It's high in activity. It's working way too hard, often due to inflammation. And type seven is anxious ADD. And it's their level of anxiety that gets them places on time, but they have to work so much harder than their colleagues.

• 1:15:16Rich Roll?

  And all of these are rooted in genetics?

• 1:15:20Speaker 01

  Some is rooted in trauma, but ADD is very genetic. Right? It's so genetic that if I see an ADHD child and I don't see it at all in their mom's side or their dad's side, I'm looking at the kid to see if he looks like their parents. I mean, it's literally that genetic.

• 1:15:40Rich Roll?

  Really? Interesting. Yeah, I don't know if I could identify it in my, in my family tree. I mean, I'm not qualified to.

• 1:15:48Speaker 01

  But it can also be caused by a concussion. And so, you know, if you come to see me, one of the things we're going to ask you five or six, seven, 10 times, have you ever had a brain injury? Have you ever fallen out of a tree, off a fence, dove into a shallow pool? Have you ever had a concussion playing sports, a car accident?

• 1:16:09Rich Roll?

  I look forward to getting my brain scanned. It'll be super interesting. You'll have me, right? We can do this?

• 1:16:15Speaker 01

  I'm so excited.

• 1:16:16Rich Roll?

  Yeah, good. Let's talk about raising mentally strong kids. I apologize, you just handed me this book. I haven't read it yet. So perhaps you can kind of give us the thesis, like, why did you write this book? And what is it that you're trying to say here?

• 1:16:30Speaker 01

  So children are at the worst in recorded history as far as mental health problems. The levels of anxiety, depression, ADHD, self-harming behaviors is out of control. Brand new study. 54% of teenage girls report being persistently sad. 32% have thought of killing themselves. 24% have planned to kill themselves. And 13% have tried to kill themselves. Schools are overwhelmed by the incidence of kids on medication and the kids suffering

• 1:17:15Speaker 01

  with panic attacks and other mental health problems.

• 1:17:20Speaker 01

  It's awful what's happening. And what I learned really early in my career is the most effective intervention to raise mentally healthy kids is parenting strategies. And the first one, obviously, if you want mentally healthy children, you have to be mentally strong yourself. I talk about how important that is. And then there's this system that I've become attached to that I just think is so effective. And I wrote the book with my friend, Dr. Charles Faye, who's the president of the Love and Logic Institute. And that program's actually very important to me personally

• 1:18:05Speaker 01

  because when we brought that into our home, it just became so much happier. And so in the book, we mixed neuroscience and the program I've been using for years with Love and Logic. So we combine these two programs to really do what we think of as the latest innovations in parenting.

• 1:18:32Rich Roll?

  Every parent wants mentally strong kids. We want our kids to be confident, kind, responsible, all of these things. And obviously, kids intuit how you're behaving. That's much more important than what's coming out of your mouth. If your behavior doesn't match what you're saying, they're paying attention to the behavior much more than the words. But where are even the best intentions going wrong? I mean, the statistics that you quoted are devastating. There's a lot of things contributing to that, of course. But where is it where we think we're doing the right thing and perhaps we're misguided?

• 1:19:12Speaker 01

  We're rescuing children way too much. We're solving their problems because of our low self-esteem. And I'm guilty of this, I think, for the first three. And I love all of my children. And if you don't feel really great about yourself, you get self-esteem by doing for your children when they could do for themselves. And then what you do is you create incompetent people. So when a child comes to you and says, "I'm bored." Too often, parents then scramble to get them the latest video game, or take them someplace, rather than just give them the problem back. "Oh, I wonder what you're gonna do about that."

• 1:19:58Speaker 01

  And then be loving enough to not fix it. So, my wife and Chloe, our 20-year-old, when she was six, seven, they'd have these monster homework battles. And I'm a child psychiatrist, and I look at Tana and go, "You've done second grade. Get out of this fight." She wouldn't listen to me. So, but three of her friends recommended Parenting with Love and Logic, and that's the foundational principle. Let kids solve their own problems. I mean, be a good coach, be a resource, don't solve it. And so, when Tana really understood it, she announced to Chloe,

• 1:20:42Speaker 01

  "Sweetheart, I've done second grade. I'm never, ever, again, gonna ask you to do your homework. It's on you. And if you don't do it, you'll just have to be okay with the consequences." And Chloe had a fit and said, "I never said I was gonna do my homework. I'm just not gonna do it now." Stormed off, came back 20 minutes later. She's now a junior at Chapman. No one's ever asked her to do her homework again. And she had a 4.2 out of high school. She's responsible. She's competent and can solve her own problems. We go wrong when we steal their self-esteem by solving their problems. So, for example, Chloe knew it.

• 1:21:25Speaker 01

  If she forgot her homework, nobody's bringing it to her. If she forgot her sweater on a cold day, nobody's bringing it to her. If she forgot her lunch... It takes 24 hours to starve. Nobody's bringing it to her. And she only forgot those things like twice. And now she doesn't forget anything.

• 1:21:46Rich Roll?

  You learn the lesson. Yeah, you become self-directed. You develop that self-efficacy that will serve you later in life. Self-esteem comes from performing estimable acts on behalf of yourself. And if you're always rushing in to solve the problem or rescue, you're depriving your child of the opportunity to learn those things.

• 1:22:07Speaker 01

  Right.

• 1:22:08Rich Roll?

  It's a short-term gain, long-term pain situation.

• 1:22:11Speaker 01

  Right.

• 1:22:12Rich Roll?

  And I think a lot of time-crunched parents are like, "Okay, let me just solve the problem because I just, you know, I have other things to do and I can fix this," rather than allow the child to scramble and mess up and figure it out on their own because sometimes that's not convenient.

• 1:22:27Speaker 01

  Right. And it's also not goal-directed. So principle number one is know what you want. What kind of parent do you want to be? And what kind of child do you want to raise? Ask yourself that question. Ask the other parent that question. What kind of parents do we want to be? And what kind of child do we want to raise? Because then your behavior stems from whatever mission statement you create. And then the second thing is attachment. It's bonding. And that requires two things. Time, actual, physical time. And listening. Parents talk way too much. And we have all this great knowledge and all these great experiences.

• 1:23:11Speaker 01

  We just want to pour it into their little heads. And they tune us out. If you do active listening with them, they'll be so close to you. But if you tell them how to think and you interrupt them, it's very bad for the relationship, for the attachment. And then I have an exercise in the book that's just gold. I mean, it works. It's worked every time, I think. Parents who actually do it the way I ask is 20 minutes a day with the kid. Do something with them they want to do. And during that time, no commands, no questions, no direction. And when I first figured it out, and then I just saw it work and it worked and it worked.

• 1:23:57Speaker 01

  My literary agent at the time, Carl, he called me up and he said, "I'm having trouble with my two-year-old." So he had a child later in life and Laura was two and she's like, "She never wants anything to do with me." And I'm like, "You're ignoring her." He's like, "What do you mean?" I'm like, "Do this." And I told him special time, 20 minutes a day, do something with her that she wants to do, which means basically sit on the floor and play with her blocks. And no questions, no commands, no directions. And he's like, "That won't work." He tended to be oppositional. And I'm like, "Oh, great. You're representing idiot." I said, "You need to do this. I'm gonna call you in three weeks. Get the party started."

• 1:24:41Speaker 01

  And three weeks later, I called him up and I'm like, "Hey, Carl, it's Daniel. Daniel, she won't leave me alone. All she wants to do is be with me. I walk in the door, she grabs my leg. She wants her time." Right. Because isn't that what we all wanted? I mean, unless our parent was awful, we all wanted their attention. And, you know, I'm one of seven, so, you know, my mother had to be judicious about how she did it. But because my dad was never home, we didn't have a relationship. And 1972, turned 18, he told me if I voted for McGovern, the country would go to hell.

• 1:25:25Speaker 01

  And because we didn't have a relationship, I voted for McGovern and the country went to hell, but it had nothing to do with McGovern. It was because of Nixon and Watergate. And I like having influence with my kids, but there's no influence without connection.

• 1:25:41Rich Roll?

  There's different kinds of attachment also. I think that's very wise and it's also very straightforward and doable, like... Invest your time in your children, be interested in what they're interested in. When they tell you something, don't lecture them or tell them why they're wrong. Just say, "Tell me more," and be on their level where they don't feel judged or like you're going to, you know, basically explain something to them, right? I think that's great advice. On the opposite end of the spectrum from someone like your father is the very enmeshed parent. That's a different kind of attachment disorder where they're overly invested

• 1:26:23Rich Roll?

  in their child's well-being and the child becomes a vehicle for their own self-esteem.

• 1:26:30Speaker 01

  Right.

• 1:26:30Rich Roll?

  So they're projecting all of this emotional baggage on their child. And the child then is shouldering this responsibility to make their parent feel okay. And whether that projection is ambition, or their own insecurities, or their own dreams that were never realized, the child, on an unconscious level, is subsuming all of that and that, you know, becomes problematic.

• 1:26:56Speaker 01

  No question. I like to think of good parents like good coaches. And I've been blessed to work with some amazing coaches. And good coaches notice what you do right, and they teach. Bad coaches notice what you do wrong and focus on it. And in the book, there's a whole section on why I collect penguins. So I have like 2,000 penguins. It's a little weird.

• 1:27:31Rich Roll?

  Not real live penguins?

• 1:27:32Speaker 01

  No. Penguin pens, cups, dolls, tie. I have a penguin weather rain, a penguin vacuum. It's bizarre. But my oldest child, Anton, who I adopted, he was hard for me. He was argumentative, oppositional, thinks things go his way, got upset. And I talked to my supervisor and she said...

• 1:27:57Speaker 01

  You need more one-on-one time with him. And I took him to a place called Sea Life Park, which is in Hawaii. It's on Oahu, sort of like Sea World. They had sea animal shows and we had a great day. Whale show, sea lion show, dolphin show. And at the end of the day, I took him to the Fat Freddie show. He was a humbled penguin, chubby, but he's amazing. He climbed like a 20-foot diving board, went to the end, would bounce and jump in the water, bowled with his nose, countered with his flippers, jumped through a fire. And at the end of the show, the trainer asked him to go get something. He went and got it and he brought it right back.

• 1:28:38Speaker 01

  And time stood still for me because in my head, I'm like, damn, I asked my kid to get something and he wants to have a discussion for like 20 minutes and then he doesn't want to do it. And I knew my son was smarter than the penguin and I realized I was the problem. And so I went up to the trainer afterwards and I'm like, how'd you get Freddie to do all these really cool things? And she said, unlike parents, whenever Freddie does anything like what I want him to do, I notice him. I give him a hug and I give him a fish. And the light went on in my head that when my son did like things I really liked, I wasn't paying attention.

• 1:29:21Speaker 01

  But when he didn't, I gave him a lot of attention because I didn't want to raise bad kids. And I collect penguins as a way to remind myself, every day I'm shaping the people around me by what I pay attention to.

• 1:29:36Rich Roll?

  That's interesting. Yeah, so it's like this totem to bring you back to that place. That's cool. You mentioned the peril that so many teenage girls are experiencing currently. When a young person reaches a certain age, it's natural for them to differentiate. And sometimes, if not often, the communication suffers with the parent as a result because the kid is no longer interested in hanging out with the parent as much. They got their own thing. They want to shut the door to their bedroom and do their thing and not be bothered. So with this rise in mental health issues that young people are experiencing,

• 1:30:18Rich Roll?

  what is the counsel to the parent who is in the middle of that situation where it's more challenging to connect and communicate with their young teen because that person, you know, they're not in the same place as when the kid was an adolescent, but also knowing there are all these threats out there and, you know, the risks are much higher in terms of the mental health conditions that we're seeing now.

• 1:30:43Speaker 01

  So there's so many things we talk about in the book. Attachment protects and you need to supervise your kids until their brain develops. I mean, you really need to understand normal development. Your prefrontal cortex, so the front third of your brain, largest in humans and any other animal by far, is not fully myelinated until you're about 25. And so we think of 18-year-olds as adults. It's ridiculous from a neuroscience standpoint. And the insurance industry actually knew this way before neuroscientists knew it. When do your insurance rates change?

• 1:31:28Speaker 01

  When you're 25. They go down significantly because you make better decisions because you have more myelinated frontal lobes. And myelization is really important. So when you're born, there's not much of it going on in your brain. About two months, the back of your brain becomes myelinated and you see better, which is why when you smile at a newborn, they don't smile back. But when they're about eight weeks old, you smile at them, they totally begin to connect with you. So myelization, think of a copper wire or a neuron, a brain cell.

• 1:32:07Speaker 01

  Myelination is it gets wrapped with a white fatty substance, sort of like insulation on a copper wire. And that neuron works 10 to 100 times faster. And so your prefrontal cortex, the most human thoughtful part of you is not fully myelinated till you're about 25. And so it's undergoing wild development from 14 to 25, yet that's when many parents abdicate their role. And they're like sending kids off even though they're really not mature enough to go hang out with a bunch of other unmylinated brains

• 1:32:50Speaker 01

  that join sororities and fraternities and all sorts of bad things happen to kids then. I think we need to have supervision in a way, not that's intrusive, but it's like, I'm watching. I want to know where you are. I want to know when you're coming home. And kids hate it. But you know what? They hate it more if you don't do it because that means you don't care.

• 1:33:16Rich Roll?

  What's the counsel for the parent who's struggling to bridge that communication gap with the teenager who's like, leave me alone. I don't want to talk to you. Or how was your day? Fine. You know, the sort of navel gazing, you know, that kind of occurs around that age.

• 1:33:32Speaker 01

  Yeah, I think just try to be in their space as much as you can and be a good listener. There's always two words to default to, firm and kind. If you really understand the research, we talk about this in Raising Mentally Strong Kids. It's parents who are firm and loving do way better than parents who are loving and permissive. So permissiveness raises the most unhealthy children. Whether you're loving and permissive or hostile and permissive, permissiveness is not good. It's good to have boundaries and rules. And kids should have chores.

• 1:34:15Speaker 01

  And the problem is, and I would love for people to write down this statement, I only do nice things for people who treat me with respect. And too often, children will be very disrespectful and then the parents will go out of their way to give them things because of their own guilt. I do nice things for people who treat me with respect. And I'm always nudging to have that time. And even if they reject you, just keep coming back. But don't bend over and do all these nice things for people who are rude to you. That's not good.

• 1:34:52Rich Roll?

  What is your counsel around devices? Clearly, some portion, probably a large portion of the depression, the suicidal ideation, et cetera, that's on the rise, particularly with teenage girls, is a result of, on some level, social media, the comparison that takes place, the 24/7 access to what your peer group is doing at all times, the bullying and criticism that occurs there. Parents, I think, are often confounded and confused about how to kind of manage that.

• 1:35:28Speaker 01

  Like. The selfish absorption. I mean, what social media leads to is a toxic level of it's about me. And my counsel is delay it as long as you can. I mean, like, I would hold out as long as you could and then supervise it. And if you're paying for it, it's like, you know, you can have this, make sure there are parental security things on it, because having eight-year-old boys exposed to pornography is a very bad thing for the developing brain. Talk about wearing out your pleasure centers.

• 1:36:07Speaker 01

  So you need parental devices, delay it, and then if they have it, it's like, you only can keep this if I have access to it. So I think it's really important to have supervision. You have to be their frontal lobes until theirs develop, because there's dangerous things out on the web. You get it as long as it's not a problem. Like those kids who play video games, it'll have a fit when you tell them to stop. The video game needs to go away. I mean, like, needs to go away because you're the parent. That's your role. I've sent way too many children to video game addiction programs.

• 1:36:52Speaker 01

  I don't like that. And they're like, oh, but his friends are doing it. Oh, it's like, you can do it as long as it's not creating a problem. And I think you should limit it because the vices in social media and video games, they dump dopamine. They were purposefully created to addict you. They use the same principles that Las Vegas uses to win money in gambling, which is intermittent reinforcement. I'm not going to reinforce you all the time. We're going to do it every so often. And it dumps dopamine. So what does that mean? So you have two pleasure centers in your brain. They're called the nucleus accumbens, part of the basal ganglia.

• 1:37:34Speaker 01

  And when you get excited about something, it produces a little bit of dopamine, pushes on the pleasure center. But the more you push on it, the harder you push on it. Think about these violent video games. Pretty soon, the nucleus accumbens becomes numb, and you need more and more to get the same effect. So you had an addiction, right? You struggled with an addiction. Toward the end of the addiction, you were not getting the out of fact that you did in the beginning, right? Because your pleasure centers had been worn out, were wearing them out earlier than ever before.

• 1:38:15Speaker 01

  And I think that's one of the big reasons for the escalating incidence of depression.

• 1:38:22Rich Roll?

  Well, the social media sites are similarly designed.

• 1:38:26Speaker 01

  Similarly designed.

• 1:38:27Rich Roll?

  They're scientifically devised to addict in the same way that a slot machine or a video game. Is designed and

• 1:38:37Speaker 01

  Mindshare. That's what they want.

• 1:38:38Rich Roll?

  That becomes tricky when you have a 16 year old or an 18 year old and part of being a member of their cohort or their tribe is being conversant on these platforms and being in communication on these devices. So it's not as easy as saying, I'm taking your phone away, because that's the same as saying you're being kicked out of your community.

• 1:39:03Speaker 01

  Yeah, but you have to be careful. I mean, you have to be willing to do that in order to show love, which is supervision.

• 1:39:14Rich Roll?

  If a parent is seeing their child sink into a depressive state, what is the advice that you would give?

• 1:39:22Speaker 01

  Well, the first thing is do not put them on an antidepressant. That's not the first thing to do. Now, maybe the seventh or eighth thing to do, but the first thing is to sort of evaluate their lifestyle. Too often, children are taking their devices to bed and they're not sleeping. And so I think it's a really good family habit for everybody, including the parents, to put their devices away. Or for you to take your kids. I had one patient recently that got a new phone, had an iPad and was up till 2 o'clock, 3 o'clock, 4 o'clock. And he wasn't doing well in school.

• 1:40:05Speaker 01

  It's like, yeah, sleep deprived people don't do well in school. So supervising technology, I think, is critical. I teach a high school course called Brain Thrive by 25. We've done it for 15 years. It's been like on seven different countries, all 50 states. We teach kids to love and care for their brains. And what I've found is the going idea about teenagers is parents have lost influence and their friends are more important and they won't listen is wrong. If you are bonded to them, they listen. You have to explain it to them and give them reasons why.

• 1:40:50Speaker 01

  These companies use neuroscientists to addict your brains and steal your mind. These vaping companies, they are making money off of your early death. So you have to educate them and get them angry at what I call the evil ruler. Right? If I was an evil ruler and I wanted to create mental illness, what would I do? I'd create vaping devices and go, this is a healthy form of smoking. Or I'd make them think marijuana is innocuous, because clearly it isn't.

• 1:41:30Speaker 01

  Or I'd give them a device that's clearly addictive and has all sorts of side effects. And go, well, have fun with this and other people your age are doing it, so it's probably okay. When you educate them, like my 20 year old, she knows the time a day that she's on her social media sites and she limits it. And now she's doing this thing is, how much sleep can I get? Right? And she finds I do better with nine and a half hours than I do with eight hours. I was like, well, how smart is that, that she's tracking it, right? So she uses devices, an Oura ring, to track it. And it's because she understands it.

• 1:42:13Speaker 01

  So rather than do this, don't do that, that's not helpful. It's relationship and then this is your brain. How can you take care of your brain? And that's what we do with Brain Thrive by 25.

• 1:42:28Rich Roll?

  It's very clever, creating this narrative where they're sort of an evil overlord, you know, kind of connect emotionally, you know, with healthy habits. Because, you know, young people, and I would put myself in this category when I was young. I mean, there is a sense of invincibility, like I can just do whatever I want. And you can, you can get away with things when you're young. So it's harder to do that math, especially when the brain isn't as developed. Like I want to eat what I want to eat and I want to like, you know, satisfy my urges when they crop up and it doesn't matter if my parents tell me otherwise, like I'm still going to do it. And there's a process of like learning for themselves, like, well, over time, it's like, well, this isn't working anymore.

• 1:43:10Rich Roll?

  Sometimes that takes longer than, you know, for certain habits than other habits. But I think that idea of like connecting with them on a story level where it's like, oh, I understand, like it's we're in a competition and there's a battle against these people that want to keep me down is a really interesting, cool way.

• 1:43:30Speaker 01

  Actually, Florida used that strategy. They'd spent hundreds of millions of dollars on campaigns to help kids stop smoking and none of it worked until they used that strategy. Let me tell you how the tobacco companies making money off of making you sick and getting them angry. So activating the rage, I thought was brilliant. And when I wrote my book, The End of Mental Illness, I'm like, here are 62 evil ruler strategies. And you can just see like Girl Scouts selling Girl Scout cookies. I mean, the big evil ruler strategy,

• 1:44:10Speaker 01

  there was one girl in San Diego who set up outside a pot dispensary and sold like 300 boxes in three hours. More people had to come.

• 1:44:21Rich Roll?

  She's like a marketing genius.

• 1:44:23Speaker 01

  But, you know, giving these very unhealthy, sugar laden things that increases the risk of diabetes.

• 1:44:29Rich Roll?

  Right. But selling it to people who are high and have the munchies too is like not a bad idea.

• 1:44:34Speaker 01

  Brilliant.

• 1:44:35Rich Roll?

  From an entrepreneurship perspective. We got to kind of wind this down, but maybe you can leave us with a few more thoughts on not just the importance of caring for our brains, but a few more practices to think about that we could incorporate into our lives.

• 1:44:52Speaker 01

  So I worked with BJ Fogg for six months.

• 1:44:54Rich Roll?

  Sure, I know BJ.

• 1:44:55Speaker 01

  Tiny Habits. So he and I worked together and here are some of the tiny habits for brain health. Start every day with, today is going to be a great day. Push your brain to look for what's right rather than what's wrong. As you go through the day, this is our big mother tiny habit. Go, is this good for your brain or bad for it? So I used to do that with Chloe. We played a game, we called it Chloe's Game. I'm like, blueberries, good for your brain or bad for it? Two thumbs up. Avocados, two thumbs up. God's butter. Hitting a soccer ball with your head, oh, no. Two thumbs down. Your brain is soft, your skull is hard.

• 1:45:40Speaker 01

  Play the game with them. Whatever they're going to do, good for your brain or bad for it? I mean, ask yourself, is this good for my brain or bad for it? You just have to know the science. My favorite tiny habit, it's actually not so tiny, but it's so good. When you go to bed at night, I say a prayer and then I go, well, went well today. And it's not like just writing down three things you're grateful for. I go hour by hour, looking for what I liked about the day. What made me happy? Even the tiniest things, like we have this health challenge at home with my mother-in-law. It's public knowledge.

• 1:46:22Speaker 01

  And just walking up the stairs, I grabbed my wife's hand. And that made the highlight reel, because it was just this really tender moment in a hard time. If you do that, the research shows your level of happiness will increase in just three weeks. And when you go to pick something to eat or to drink, ask yourself, do I love it? And does it love me back? You're in a relationship with food and with the things you consume. Do I, it's like, oh, but I love wine, but does it love you back? We didn't talk about alcohol, but it doesn't love you back, right?

• 1:47:04Speaker 01

  It damages the microbiome in your mouth and in your gut. It'd be a bad thing.

• 1:47:10Rich Roll?

  Beautiful. I love that practice. It's similar to a gratitude practice, but the paying attention to the little things that happen every day. And those little things then becoming the big things that drive happiness.

• 1:47:23Speaker 01

  I did that the night my dad died three and a half years ago. One of the worst days of my life.

• 1:47:31Speaker 01

  And I'm like, really? We're gonna do this tonight? But this is a very important point. Your brain is lazy. What you do, what you teach it to do, is what it's just gonna do automatically. So because I've done that for a decade, even on an awful day, I found these three moments that were just so tender and beautiful that it put me to sleep. And it didn't mean I didn't grieve. I still do. But it means I'm managing my mind rather than letting it manage itself.

• 1:48:07Rich Roll?

  Do you think that a fundamentally negative or pessimistic person can transform themselves into an optimist?

• 1:48:15Speaker 01

  I don't know about an optimist, but they certainly can transform themselves to be more of a realist. Which is why I love Byron Katie's work. I don't know if you ever had her on.

• 1:48:25Rich Roll?

  No, I haven't, but I'm familiar with her work.

• 1:48:27Speaker 01

  She's awesome. And it's about what's true. And too many people have the negative side of what's true and completely ignore the positive side of what's true. Like, my wife never listens to me. I've had that thought. Write it down. And then go, is that true? Is it absolutely true? How does that thought make me feel awful? How would I be without the thought? I'd be just fine. Then take the original thought and turn it to the opposite. She does listen to me. And in fact, she does. Not all the time. But if I'm focused on what's wrong, I'm gonna feel wrong. If I'm focused on what's right,

• 1:49:11Speaker 01

  I'm gonna be so much happier. This thing got like 12 million views on Instagram. I have the rule of 12. Which is, if I'm gonna do something important, film a public television special, write a book, go on a trip, shit happens. Stuff is gonna go wrong. Just own it. I don't get mad till the 13th thing has gone wrong. Because a mentally strong person can roll with things. Not roll over, but they can roll with whatever comes your way. Not roll over because they don't want people taking advantage of you. But learning that mental flexibility, and that comes with practice.

• 1:49:56Rich Roll?

  Part of it is not self identifying with your thoughts and understanding that just because you're thinking something doesn't mean it has to be part and parcel of your identity, nor that you need to act on it.

• 1:50:07Speaker 01

  One of the strategies I love is give your mind a name. I named my mind after my pet raccoon when I was 16. I literally had a pet raccoon. Loved her, she loved me. But she was a troublemaker. She like ate all the fish out of my sister's aquarium, TP'd my mom's bathroom, leave raccoon poo in my shoes.

• 1:50:27Rich Roll?

  Raccoon in the house, claws and all, and rabies and all that kind of stuff?

• 1:50:32Speaker 01

  I loved her, but she was a troublemaker. That's my mind.

• 1:50:37Rich Roll?

  But that's what raccoons, that's what they do.

• 1:50:40Speaker 01

  They have 200 different sounds. I mean, it's just like my mind. And now, when my mind is bothering me, I'm like, I should put you in the cage. Or what I do now, because initially I would like just metaphorically put my mind in the cage and ignore her. And now what I do is I flip her me over, because I used to do that and tickle her. And raccoons, they have 200 different sounds. And I'm like, oh, I bet I can get you to purr, just so I can separate from my mind and be in control. It's not the thoughts you have that make you suffer, it's the thoughts you attach to.

• 1:51:22Rich Roll?

  Right. It's the attachment and the attachment to expectations and outcomes. But if you can uncouple that, it allows more space to respond rather than to react and to be in a more neutral frame of mind about whatever's happening.

• 1:51:38Speaker 01

  And I have to treat me. Like I would want other people to treat me. So many of my patients, when I first see them, if they treated their friends the way they treated themselves, they would have no friends. They're so mean. But sort of like a good coach. Am I noticing what's right? And am I learning? I treat, it's public knowledge, Alicia Newman, who I dearly love. She's a Canadian pole vaulter. She's going to be in her second Olympics. Last year, she was the world indoor champion. And she's so hard on herself when we first met. And we've come to, we win or we learn. We win or we learn.

• 1:52:21Speaker 01

  And that's what I want all my patients to do. You have a good day, you win. If not, we learn.

• 1:52:29Rich Roll?

  I think that's a good place to land the plane for today. Thank you for coming and sharing with me today. I appreciate it. And I look forward to visiting your clinic and having my brain looked at.

• 1:52:42Speaker 01

  And we'll see. ADD or not.

• 1:52:44Rich Roll?

  Who knows? Who knows what it is? I am a little scared, though.

• 1:52:48Speaker 01

  No, don't be scared. So many people go, oh, I'm scared. And I'm like, whatever we see is good news. Because you have what you have. And if it's awesome, because you've done so many awesome things, we celebrate. And if it's not, we rehabilitate. And now is the time. How old are you?

• 1:53:12Rich Roll?

  57.

• 1:53:13Speaker 01

  Yeah. Now is the time to get the party started. It's not when you're 77 and you're dropping names and forgetting appointments and people are trying to take your keys from you. The most loving thing you can do for your children is to work on having a healthy brain.

• 1:53:35Rich Roll?

  Cheers to that. Thank you.

• 1:53:37Speaker 01

  You're welcome. Peace.

• 1:53:49Rich Roll?

  That's it for today. Thank you for listening. I truly hope you enjoyed the conversation. To learn more about today's guest, including links and resources related to everything discussed today, visit the episode page at richroll.com where you can find the entire podcast archive, as well as podcast merch, my books, Finding Ultra, Voicing Change, and The Plant Power Way, as well as the Plant Power Meal Planner at meals.richroll.com. If you'd like to support the podcast, the easiest and most impactful thing you can do is to subscribe to the show on Apple Podcasts, on Spotify, and on YouTube, and leave a review and/or comment. Supporting

• 1:54:34Rich Roll?

  the sponsors who support the show is also important and appreciated. And sharing the show or your favorite episode with friends or on social media is, of course, awesome and very helpful. And finally, for podcast updates, special offers on books, the Meal Planner, and other subjects, please subscribe to our newsletter, which you can find on the footer of any page at richroll.com. Today's show was produced and engineered by Jason Camiolo with additional audio engineering by Kale Curtis. The video edition of the podcast was created by Blake Curtis with assistance by our creative director, Dan Drake. Portraits by Davy Greenberg. Graphic and social media assets courtesy of Daniel

• 1:55:16Rich Roll?

  Salis. Thank you Georgia Whaley for copywriting and website management. And of course, our theme music was created by Tyler Pyatt, Tractor Pyatt, and Harry Mathis. Appreciate the love, love the support. See you back here soon. Peace. Plants.