Drew Ramsey, MD is a board certified psychiatrist, psychotherapist, and author. His work focuses on evidence-based integrative psychiatry, Nutritional Psychiatry and male mental health. He founded the Brain Food Clinic, a digital mental health practice, and Spruce Mental Health in Jackson, Wyoming. Using the latest research along with decades of clinical experience, he hopes to help people improve their mental health and build resilient mental fitness.
He and his team have created three e-courses: Healing the Modern Brain, Eat To Beat Depression, and Nutritional Psychiatry for Clinicians; along with free downloads, the free nutritional psychiatry cooking class the Mental Fitness Kitchen, a weekly mental health update newsletter Friday Feels, and a mental health and mental fitness focused podcast.
His latest book, “Healing the Modern Brain: Nine Tenets To Build Mental Fitness and Revitalize Your Mind,” will be published by Harper Collins in March 2025. His previous books helped establish Nutritional Psychiatry and explore the connection between food and mental health: the international best-seller “Eat To Beat Depression and Anxiety” (HarperWave 2021) now translated into 9 languages; the award-winning cookbook “Eat Complete: The 21 Nutrients that Fuel Brain Power, Boost Weight Loss and Transform Your Health” (HarperWave 2016); the bestseller “50 Shades of Kale” (HarperWave 2013) and “The Happiness Diet: A Nutritional Prescription for a Sharp Brain, Balanced Mood and Lean, Energized Body” (Rodale 2011).
Dr. Ramsey is a mental health advocate/influencer, compelling keynote speaker and conducts workshops nationally. He co-hosts the Men’s Health Magazine series Friday Sessions with Gregory Scott Brown, MD, and has delivered three TEDx talks, a video series with Big Think, and the BBC documentary Food on the Brain. His work and writing have been featured by The Today Show, CBS Sunday Morning, The New York Times, The Wall Street Journal, The Atlantic, Lancet Psychiatry, TIME and NPR.
He served as an Assistant Clinical Professor of Psychiatry at Columbia University, Vagelos College of Physicians and Surgeon for twenty years where he taught and supervised Psychiatric Evaluation, Supportive Psychotherapy, Brief Dynamic Psychotherapy, Nutritional Psychiatry as well as helping the department’s media and social media initiatives. He is a Medical Advisor to Men’s Health Magazine, on the editorial board of Medscape Psychiatry, and the Scientific Advisory Board of the anti-stigma nonprofit Bring Change To Mind. He joined the board of Teton County Youth and Family Services in 2024.
Dr. Ramsey is a diplomate of the American Board of Psychiatry and Neurology and a Fellow of the American Psychiatric Association. He completed his specialty training in adult psychiatry at Columbia University and the New York State Psychiatric Institute, received an M.D. from Indiana University School of Medicine and is a Phi Beta Kappa graduate of Earlham College. He lives in Jackson, Wyoming, with his wife and children.
Learn more at DrewRamseyMD.com.
Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the “Inside Bipolar” podcast with Dr. Nicole Washington.
Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.
Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.
Gabe Howard: Hey, everybody, welcome to the podcast. I’m your host, Gabe Howard calling into the show today. We have Drew Ramsey, MD. Dr. Ramsey is a board certified psychiatrist, psychotherapist, and author. He is a medical advisor to Men’s Health magazine and on the scientific advisory board of the anti-stigma nonprofit Bring Change to Mind. His latest book, “Healing the Modern Brain: Nine Tenets to Build Mental Fitness and Revitalize Your Mind,” is out now. Dr. Ramsey, welcome to the podcast.
Drew Ramsey, MD: Gabe, it’s so great to be talking with you again, my friend. How are you doing?
Gabe Howard: Great. I am so glad that you’re back. Your your first appearance was wonderful. And I’ve got a little story I want to tell you in a minute, but I, I want to hit a little low hanging fruit. See, I’ve, I’ve heard of physical fitness, right? Everybody’s heard of physical fitness. We were forced to take it in high school. But. But mental fitness, it’s sort of handcuffing me a little bit. Can. Can you define mental fitness for our audience?
Drew Ramsey, MD: Yes, for sure, Gabe. And that’s exactly why I wrote the book, is that even someone like yourself, a mental health advocate, someone like me, a psychiatrist, I found I had a physical fitness routine, whether I was keeping up to it or not. At least I had, you know, some goalposts. But for my mental fitness, my mental health, I didn’t find it was so clear, like so that’s really where mental fitness comes from. Is this idea that kind of just like we should be forced to take some physical fitness in high school, I think we should be forced to take some mental fitness because the game has changed. We know so much more about mental health, about diagnosis, about treatment, about tools. I mean, it’s just incredible. And so we shouldn’t really live in the world that we’re living in, where we’re still in this very stigmatized approach to mental health. It’s something you don’t want. You try and avoid it. Right. And if you don’t, then secretly you go see a mental health professional. We want something that’s much more proactive, protective, preventative. And that’s mental fitness.
Gabe Howard: I like the idea of mental fitness. And I have another question before we jump into the story that I swear is coming, but that you use the word “modern brain.” And there’s this. I don’t want to be a stickler, and I’m not a doctor. I’m not a scientist. But but have human brains really changed? I mean, if we did an autopsy on somebody 200 years ago and looked at their brain, would we be like an old fashioned brain or. I mean, when you say modern brain, can you unpack that a little bit?
Drew Ramsey, MD: Was the old saying goes, some things change, some things remain the same. And so some of the neuroanatomical structures of our brain our hippocampus, the hypothalamus, pituitary gland, the structure is the same. How the brain is connected, the connectivity, has probably shifted. And then what’s up there has shifted. You know, 45, 50 years ago, you didn’t have a brain that was full of plastic and microplastics. You do now you know, years ago, you didn’t have a brain that you know, was struggling to get enough, maybe omega three fats or magnesium, you know some brains, certainly in issues of you know not having enough food or food security, but for a well-nourished brain, you know, there’s nutrients that the majority of Americans aren’t getting enough of, like, key ones, like, think about folate, vitamin B9. Every single clinician mental health clinician in the world agrees. Vitamin B9, if you don’t have enough of it, causes clinical depression like 75% of Americans don’t meet the recommended daily allowance of vitamin B9. So I think there’s a mix of change in the biology of missing some molecules we’ve had in the way that our diets have changed, adding in some things, endocrine disruptors, plastics, plasticizers, microplastics and then adding in a new set of ideals and information. Right? There’s just a kind of bandwidth issue and a dopamine, let’s call it dopamine, depletion issue. Issues that a lot of constant stimulation that, you know, it’s a little new for our brain.
Gabe Howard: Dr. Ramsay, I think here is a good point for me to tell you that story that I alluded to earlier. Now, you were on the show a few years ago and everything that you said back then about food, exercise and mental health, it all checked out. All Healthline Media podcasts are medically reviewed. And I knew that everything that you were saying was true, but honestly, I didn’t care. I did hear you and I did believe you. And I, again, was 100% positive that you were right. And yet I still went right back to my pizza and diet soda and general couch potato-ness. And I didn’t give it another thought. Then about nine months ago, my my doctor, during a routine physical, he sat me down and looked me right in the eyes and he’s like, Gabe, I got to talk to you about your health, right? And I have this new pill that I want to prescribe you. It will improve your mental and physical health. It will help lower your cholesterol. It will lower your heart attack risk. It will lower your risk for diabetes and high blood pressure. And I was like, dude, I am all in. I think I literally said, hell yeah, give me that pill and I’ll take it. And he looked at me and he said, great, it’s a 20 minute daily walk. And I laughed because I thought he was joking, but he was completely serious. Look, long story short, I started walking. I did think it was complete B.S. at first, but it it stuck. He was right. Now I walk over four miles a day and yeah, I have made some better food choices along the way as well. But but look, I am far from perfect. I still drink way too much diet soda. I haven’t stopped eating sugar and fried foods or anything that extreme.
Drew Ramsey, MD: Okay, I haven’t either, so I’m glad that, I bet most people listening haven’t entirely cut out. Some of you have. Congrats!
Gabe Howard: Yeah, yeah, yeah.
Drew Ramsey, MD: Most of us, they pop in.
Gabe Howard: But I’ve significantly reduced it. My wife and I started adding vegetables with every meal, you know, real easy. You know, there’s a lot of, like, steam-in bags. You just throw it in the microwave for five minutes and then, you know, put half of it in a bowl and give the other half to your wife if you’re kind, you know. Same with like, green beans and things like that, just little things like that. And I started drinking water. I didn’t give up diet soda. I don’t want anybody to hear. Oh, but I reduced my intake of diet soda by half. And I replaced it with water. And all of these were very reasonable things that I made over a few months, and gangbusters. Like, I, I don’t want to call it magic, but I’m telling you, it is.
Drew Ramsey, MD: Let’s call it science. Let’s call it science.
Gabe Howard: I mean, it is science. It’s it’s sad that it’s this simple.
Drew Ramsey, MD: But, Gabe, but I wanted to start here. You started telling me this story. I wanted to start right here because you’re sharing something which is really important for everyone listening and important in terms of how I thought about and wrote Healing the Modern Brain, I kept seeing these moments in my clinical practice like this, where someone came in and somehow, after all of the recommendations, you know, to exercise, you know, to eat vegetables, you know, to drink water, you’re an educated person. Something shifted. You heard about it in a way where you’re like, wow, I was really excited about that, and I’m going to put in effort. Now you’re doing three times the dose. You were recommended
Drew Ramsey, MD: 20 minutes a day. You’re doing an hour. That’s how good of a medicine this is. And I think people need to hear more about this, because the conversation of mental health so often is really about treatment resistance, stigma, medications efficacy. And these are all important conversations. But I think what’s been really missing is our ability to build up more mental fitness through small actions in our daily life. And so you’re really talking about some of these core tenets of mental fitness, where again, not a huge change. More vegetables, not no sugar, more vegetables. And that’s a perfect example of really high yield intervention. Chicken. That’s delicious that you and I, you know, we’re kind of blessed to live in a food environment, that there are a lot of vegetables around if you want to eat them.
Gabe Howard: And hey, I’ll give a little bit of pushback. You know, delicious might be too strong of a word, but certainly not bad. Right? And I
Drew Ramsey, MD: Oh, no, Gabe, that’s just right there.
Gabe Howard: I know, I know.
Drew Ramsey, MD: That’s, you know, you know, that’s right in your nutrition goal. I mean, maybe it’s true, but like, I’ve just not met a person where we can’t figure out. That’s probably my favorite thing about nutritional psychiatry, where we can’t figure out some ways to help you think about plants and maybe making plants delicious a little differently.
Gabe Howard: You know, we talk a lot in mental health about meeting people where they are, meet people where they are, meet people where they are. But I.
Drew Ramsey, MD: Uh-huh, yeah.
Gabe Howard: Think that in practice we don’t do that. There’s, there’s there’s just a lot of stigma and challenges and barriers to care. I think people go in with this mindset that often doesn’t get challenged in a way that they can, they can understand. And I thought I was above this. Like, I want to be clear, this is this. I’ve been I’ve been hosting this podcast for ten years. I have interviewed people like Dr. Ramsey, the director of the National Institute of Mental Health. You know, people appointed by presidents to lead the mental health revolution. Executive directors of national charities. I thought I was immune to this because I am super advocate, but I carried in my own beliefs and biases.
Drew Ramsey, MD: I don’t understand because. Because you’re knowledgeable and your mental health advocate, it meant that like somehow like the self-care and that like kind of I don’t know, like just the taking good care of the human frame, some of the basics. It didn’t apply to you as much or like, you didn’t have to focus on it as much.
Gabe Howard: I just thought that I’d be okay. I we
Drew Ramsey, MD: Oh, I appreciate that.
Gabe Howard: Always find reasons, right? We
Drew Ramsey, MD: (Laughter)
Gabe Howard: Always find reasons to believe that we’re different from everybody else. Let’s take, for example, the the not needing exercise. Well, I was like, you know, look, I’m not I’m not I’m not morbidly obese. I’m not having trouble moving. I am not every time I go get my yearly physical, all of my labs are perfect, my EKGs are perfect, my cholesterol is perfect. I do not have high blood pressure. You know, every time I go in, the doctor is like, oh, you’re a bastion of health. And then in my mind, it’s working. I need to change nothing. But this is sort of stupid, right? It’s like ripping the roof off your house, like tearing off all of the shingles. And then two months go by and nothing bad happens, and you’re like, look, it’s working. Shingles were a scam, and I never needed them. The problem is, is that all of the builders around you are like, it hasn’t rained. It’s not winter. You’re setting yourself up for a future problem and you’re not even aware of it Now, the chances are it’s going to rain soon and then the damage is going to be catastrophic. So it’s sort of a bad analogy with health. It’s it’s slower. Yeah. It turns out that, you know, eating garbage and not paying attention to diet and exercise didn’t bother 30 year old Gabe. It didn’t bother 40 year old Gabe. But I guarantee if I didn’t change my behavior, it was going to really catastrophically bother 60 year old Gabe and then the die would be cast. I mean, how many 60 year olds do you know who suddenly get healthy? It’s the older you get, the more set in your ways you get. I, I had trouble changing my ways at 47. I can only imagine if I went another 13 years with these beliefs.
Gabe Howard: And we’re back with Dr. Drew Ramsey discussing mental fitness.
Drew Ramsey, MD: Well, I think it would be harder to turn the ship around. I see folks turn the ship around all the time. I’ve had a patient who’s been very ill for the past year. She’s in her 70s, and it’s been very challenging. She had a bone fracture and then needed some eye surgery. So I saw her this week and she’s always inspires me because she’s really spunky and she’s back in the gym. She’s like crushing it and just like, strong, vibrant. 70. 75. 76 year old. So I see people in a lot of stories in the book come from the inspiration I’ve found over the years from my patients, that I’ve tried to help people with their mental health and try to keep my own mental health on track. It’s it’s been really delightful for me professionally to be in this milieu where I get to see so many people who are making good choices or interesting choices, or even surprising choices. Things you’d never expect on their path to feeling better. Some of what you’re talking about, having an epiphany of saying I hadn’t really considered it could feel so much better. I could feel energized, more vibrant.
Drew Ramsey, MD: So self-awareness, knowing the hand to how to play the cards were dealt starts with what are the cards you’ve been dealt? What is your situation socioeconomically, biologically, psychologically? What’s your character like? What kind of are the patterns of your relationships. So we start with self-awareness, and then we go into some of the classics of lifestyle medicine. Of course, thinking about nutrition, right. We can’t build better mental health without having solid nourishment to our brain. And we know a lot of people are getting that wrong. 70%, 80%, 70% of all, of all calories are processed, ultra processed foods. Now in America, that’s just been going up 70, 80, 90% of Americans, depending on where you look at your data, aren’t eating the daily recommended allowance of vegetables. Look at school lunch in America. It’s like the future brains of America, and we’re not even willing to spend like a buck a day a meal on them. I mean, it’s like.
Gabe Howard: A lot of lot of fried foods, a lot of processed foods, a lot, a lot, a lot, a lot of sugared foods. As I’m really surprised at the amount of, of like snack cakes that are involved. I, it’s.
Drew Ramsey, MD: Yeah, and cheap, cheap food,
Drew Ramsey, MD: Right? The idea that, like, efficiency. If we’re after efficiency, the notion that we are putting you know, minimal quality ingredients into our really most important asset. The future of humanity rests in the next generation of brains. That’s not efficient. That is very costly.
Gabe Howard: It sounds dire and I want to build on that a little bit. I think we as a society are more and more disconnected from one another. You know, the modern brain seems to suffer from being lonely, even though we are literally surrounded by people. What can we do about that?
Drew Ramsey, MD: Connection, thinking about, in some ways, what we do with this idea and knowledge that we have an isolation epidemic on our hands in America. Loneliness epidemic. What do you do about that on a Friday night? As a clinician, that’s kind of my question. And that’s why it’s very important to think about your connections, not just friends and going out on a Friday night. That’s important. But in some of what I do in clinical practice is just think about the web of connection that people have. It’s not just your friends. It’s of course, family, colleagues, their institutions, their mentors. There are people who inspire you. There are people that feel you because you’re angry at them. There’s all kinds of different types of connections in this world, and really important for us to be explicit about that and build those from connection. We move to engagement, which is something that I’ve seen really take over people, which is all of us, you know, find a lot of stimulation in scrolling through our phones. And it’s a lot of pleasure and interest and dopamine and not a lot of effort. And in that, over time erodes our ability to engage in more goal directed behavior that give us pleasure. But the pleasure is like, you know, it’s out there a little bit longer. It’s the pleasure of getting to the top of a mountain. It’s maybe a good analogy, or it’s the pleasure of getting good at playing the ukulele. It’s a little bit of maybe a different scale than we’ve been on in engagement asks us to really reclaim a mindfulness and a thoughtfulness around what we’re spending our time doing.
Gabe Howard: I wanted to ask Dr. Ramsey because I recalled from reading your book, you discussing unburdening ourselves, and I have to confess, I was a little confused as to what you meant.
Drew Ramsey, MD: Unburdening is the notion that all of us have a set of things to work through, and some of those are traumas, violent traumas, traumas of betrayal. Some of those are traumas in our development being cared for in a certain way, types of neglect, not being known, not fitting in, being bullied. There are some really challenging moments and challenging experiences. So unburdening is asking people as much as you can in a chapter in a book to recognize that and recognize that’s often part of what’s going on. I mean, I’m mostly a psychotherapist, Gabe. I really like long form relational psychodynamic psychotherapy, sitting with patients weekly and kind of seeing the patterns of, of our lives and our development and how those play out. And so that’s really, I think, at the core of this tenet of just seeing that as people struggle, as they sit with a skilled clinician in a therapeutic setting, which I think is actually a little hard to find these days. You see that underneath what’s being said is something else. And once that thing starts getting talked about Something begins to move and a different type of healing starts to happen. So unburdening is asking people to to honor their past. One of my favorite quotes in the trauma world, and I heard it from Tanmeet Sethi, my friend who wrote “Joy is My Justice,” but she had this idea of turning ghosts into ancestors. And I really like that. Not not being haunted any longer.
Gabe Howard: The name of your book is “Healing the Modern Brain: Nine Tenants to Build Mental Fitness and Revitalize Your Mind.” Now, we’ve been discussing a few of your tenants and we don’t have time to get to all nine. But I wanted to ask you, Dr. Ramsey, which tenant is your favorite? Or maybe more pointedly, which tenant would you recommend someone start with?
Drew Ramsey, MD: Well, I start them with self-awareness because I find it. It’s the catalyst for so many people. When you get into a stance where we avoid externalization. I talk about this in the book. We’re really kind of, again, blaming others fixating on the, the, the kind of actions of others and instead get into more of a sense of self-actualization. Right. We’re like our life is a lot of it is in our hands what we eat often not for everybody, but for a lot of people. Those are choices that you get to make when you go to bed. That’s a choice you get to make. So I ask people to start with self-awareness. So if it feels overwhelming, you know, I hope to get you into your journal for a few minutes this morning or tomorrow morning. Gabe. Kind of like it feels overwhelming. You know so much about self-care. Like, you really think these nine things, I bet you stack them all the time. Where you’re going on a walk. I bet you’re listening to interesting things. I bet you’re contemplating stuff like your relationships. So you’re working the tenet of connection or your engagement. You know, thinking through something you’re out in nature probably when you’re walking. So that’s two tenets right there. So I hear what you mean. If it’s like every day, like, what’s my ten minutes that I did on tenant seven? Sure, that can feel overwhelming. But when our life is being lived according to a rhythm of mental fitness, these are baked in. You wake up in the morning and you’re engaged in mental fitness. Why? Because there’s there’s a way to start your day that sets it up for success.
Drew Ramsey, MD: For some people, that’s exercise. For people like me, that’s coffee and journaling. For other folks, maybe that’s sleeping in a little bit because they’ve got to get that extra sleep. But but there’s a way for you to engage in many of these stacked mental fitness activities, I think together, and that’s how I think the hope is, you know, not that in any way that it’s overwhelming, but it creates a naturalistic framework that protects our mental health. Right. Because we haven’t sort of put the dire warning on it yet. But the book didn’t just come from like happy, patient stories of everybody getting better because we start moving our bodies and eating more lentils and thinking about our purpose. The book comes from a simple place, and I’m a little terrified, as everybody else should be, that the mental health epidemic is consuming our country.
Drew Ramsey, MD: That that the rates of mental health disorders continue to increase, right? We still have a horrifically high overdose and suicide rate in our country. When you just see, let’s just take one like teen depression when I finished residency, 2004 talking like 88. 1% of the population. Ten years later, it’s 14% of our teens. Today it’s 20% of our teens, 1 in 5. T here’s a lot of concern about what’s happening. And I think we shouldn’t pretend like it’s such a mystery. You know, we’ve changed how we eat. We’ve created a sedentary lifestyle for a lot of people. There’s a lot of harmful stuff coming through the phone, and a lot of ways that phone has disrupted our engagement. There’s not as much nature as there should be in people’s lives. And I don’t mean to say that this explains all mental health problems, but I am saying in my clinical experience working in a lot of different settings, these tenants do tend to help people who are having any type of mental health problem.
Gabe Howard: Dr. Ramsey, I on that note, thank you. Thank you so much for being here. Your book, “Healing the Modern Brain: Nine Tenets to Build Mental Fitness and Revitalize Your Mind” is, of course, out now and I’m sure is available wherever books are sold. But do you have a website where folks can find you and maybe get the book directly?
Drew Ramsey, MD: Yeah. For sure, Gabe. Everyone can check out the resources on DrewRamseyMD.com. We also have an e-course, Healing the Modern Brain. We’ve got some free downloads. I’m very active on Instagram. I’m @drewramseymd there. And most important to me, everybody, whether you order the book or check it out, I hope you do, but I really hope that you’ll share this conversation with someone who needs a little inspiration. And I hope our conversation today helps you. One of these tenets maybe leaps out. I hope you do something about it today. That’s what would really matter for me.
Gabe Howard: I think that’s beautiful. Dr. Ramsey, once again, thank you so much for being here.
Drew Ramsey, MD: Gabe, thanks for hosting me. Thanks for all you do for mental health, I love you keeping the conversation going and real and thanks for having me back on. I look forward to seeing you in the future, man.
Gabe Howard: Oh, you’re very welcome.
Gabe Howard: Oh, you are very welcome. All right everybody. My name is Gabe Howard, and I’m an award winning public speaker who could be available for your next event. I also wrote the book “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon, but you can get a signed copy with free show swag. Or learn more about me over at gabehoward.com. Wherever you downloaded this episode, please follow or subscribe to the show. It is absolutely free and you don’t want to miss a thing. And hey, can you do me a favor? Recommend the show to everyone you know. Sharing the show with the people you know is how we’re going to grow. I will see everybody next time on Inside Mental Health.
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