In this episode of The Evolution of Medicine podcast, host James Maskell speaks with Dr. Matthew Bernstein about the emerging field of metabolic psychiatry. They explore how addressing metabolic health – particularly through ketogenic diets – can treat and, in some cases, reverse serious mental health conditions that conventional psychiatric medications often fail to resolve.
Through personal stories, clinical insights, and a forward-looking discussion on research and policy, the episode challenges the long-standing “chemical imbalance” narrative and reframes mental illness as a systemic, energy-based disorder rooted in metabolic dysfunction.
James Maskell interviews Dr. Matthew Bernstein on metabolic psychiatry, ketogenic diets, and the future of mental health care, exploring how metabolic health can reverse depression, bipolar disorder, and psychosis on The Evolution of Medicine Podcast.
Dr. Matthew Bernstein is a psychiatrist and pioneer in metabolic psychiatry. After a family health crisis involving his sons’ diagnosis of PANS (Pediatric Acute Neuropsychiatric Syndrome), he shifted away from medication-centric psychiatry toward addressing root causes such as metabolic dysfunction, inflammation, and immune dysregulation. He is the founder of Accord, an immersive metabolic health program near Boston.
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Transcript:
There’s all these different mental health diagnoses, right? We’ve got depression, we’ve got bipolar, schizophrenia, OCD, ADHD. You know, all these are manifestations of the same problems in the brain. We’ve got insulin resistance, we’ve got mitochondrial dysfunction, we’ve got inflammation, oxidative stress, we don’t have enough BD. And so any intervention that’s going to help with all of those things can pretty much help with all these different manifestations.
Hello and welcome to the podcast. This week, we feature Dr Matt Bernstein. He is one of the leaders in the space of metabolic psychiatry. Now this is a growing movement where psychiatrists and other mental health professionals are learning to use ketogenic diets as adjunct to their work, and ultimately, we see that this is really taking off.
In this podcast, we talked about his own story of how he became passionate about functional medicine and also about metabolic psychiatry, how he sees the new food pyramid in that context, and the hopes of this becoming more of a standard of care, how patients are adapting to it, and how psychiatrists and other mental health professionals are adapting to it too, and also some of the connections between this and the world of cognitive decline. It was a really impactful half an hour.
Enjoy. So a warm welcome to the podcast for the first time. Dr Matt Bernstein, welcome, Doc, thanks for having me. Glad to be here. Really excited to have you on the evolution of medicine podcast, and we’ve been talking about brain for a little while, and this is actually the year of the brain 2026, and there’s so much happening in the space I’m very familiar with your work, and I just feel like we wanted to have a conversation about this emerging field of metabolic psychiatry, because I’ve started to see it everywhere.
I’m not sure if everyone else is like that, or maybe I’m just in the world, but it’s exciting to see it, you know, popping up, and I know you’ve been at the forefront of it. So, you know, for the last 12 years, as I’ve met doctors who get into functional medicine or do things differently. I know there’s, there’s typically a story of where you sort of had to go one way or the other, keep going the conventional way, or take a different path. And I know you have a story like that in your own life. I do. I do. Yeah, it happens to be my own family, my sons.
I have three boys, and two of them about nine years ago, had an abrupt onset when they were ages 12 and 14 of just massive neuroinflammation, to the point where they were having all kinds of mental health symptoms, but also cognitive symptoms. They couldn’t they couldn’t read. Literally. I mean, these were kids who are starting off, you know, straight A students and sports and music and friends, and, you know, they were really doing well, and almost overnight, they got to the point where they could not function at all.
And that, really, you know, was devastating. Blew our minds. Traditional mental health treatment did not help them at all. In fact, made them worse, which was hard for me to accept, because at the time, I was one of these medication psychiatrists who was prescribing a lot of medications. I had worked on an inpatient unit and work with people with serious mental illness, but it was treating them. No, I wouldn’t treat them myself, but we were taking them to really, really, you know, good people that we could access in our area. And they were confused.
They couldn’t figure out what was going on either eventually we sort of figured out that there’s something more going on here. This is not just some standard situation. Eventually got a diagnosis of pans, which is pediatric acute neuropsychiatric syndrome is sort of the inheritor of what used to be called pandas, which is really dealing with strep infections and autoimmune encephalitis from strep infections, in this case, it can be from other thing, other types of infections, other toxins, can cause this sort of massive neuroinflammation, which is what we were dealing with.
And eventually we found our way to practitioners who could help them. But years into it, with very aggressive treatment for infections and toxins and helping their brain, you know, supportively. So it was a real education for me to realize that the way I was doing things you know, not only couldn’t help my kids, but was making them worse.
And I started thinking about all the other people that I treat where, you know, some version of this was going on, where we’re not doing a deep enough medical workup, we’re not figuring out the root cause, and we’re just, you know, giving them these strong medications that affect neurotransmitters but aren’t really dealing with the root cause of what was going on for them. Man, that’s such a it’s such a like, heartbreaking but also really common story in our world of like that.
Actually, it has to happen to your kids to see that. How did you find the juxtaposition of your medical training and your like, father’s intuition here? Yeah, it was tough. I think I credit my wife, who’s actually, she’s a psychologist, you know, not medically trained, but also deals with mental health. She was seeing it before me that, like, you know, this, what we were doing was not work. Working, and we need to really start thinking outside of the box. You know, she was thinking that way just a couple of months into it, where it took me a little longer to get there, but once I did, I mean, I was like, once you see it,
you can’t unsee, you know, these things, you know, you just now, you get it, and you realize, you know what, what we’re doing in the standard practice. Just we’re only at the tip of the iceberg here, I’m wondering if there’s a corollary here, because I was, you know, I’ve been interested in this brain work for more than a decade, but it really came home to me when my father got a cognitive decline that happened so rapidly, and the doctor, Dr Burke, who I consulted about it, said,
Look, if it happens that rapidly, it has to be an infection, or you should look for an infection. If it’s not an infection, obviously you should, you know, look for mold. And I’m wondering with your kids whether it’s the same kind of thing. If it happens that rapidly, is there any other mechanism that can do it outside of an infection or an acute toxic influence? It seems like it’s a likely corollary there, right? Yeah, of course, you know now, and now that we understand it, of course, you know, you can really see the acuity of onset, and that’s one of the diagnostic criteria of pandas actually, is abrupt onset, like, almost as if it happened overnight.
And sometimes that’s because there’s a recent infection, but also, like autoimmunity, like, kicks off, like a wildfire, you know, and it just takes off. Sometimes it’s more subtle, a little more subtle. And it doesn’t have to be exactly overnight, because it’s using the sort of the bucket analogy that a lot of people use. Eventually, sort of the bucket overflows with things in the body can’t handle it anymore, and then things start falling apart, just insult after insult after insult. Eventually it overflows.
Just wanted to take a moment to thank our mission partners for helping bring this podcast to you. As you know, we are in the business of building a network of clinics that can reverse cognitive decline, and our partners in that are organizations. You can find out more if you go to goevomed.com and look at the mission partners, but first and foremost, Truneura. If you go to truneura.com you can get a demo. This is the underlying software that will connect this network of clinics, and we have an incredible mastermind session, a lot of cool stuff coming out of that company.
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And then please also check out freedom practice coaching. Seth conga is going to be on the podcast very soon, built and scaled a very successful brain health practice and has been instrumental in helping practitioners with the non clinical aspects of running a practice doing this. These are our mission partners. These are people that I know well, these people are top of their sphere and really excited to bring you the rest of the podcast.
Enjoy Awesome. Well, that’s I mean, thanks for sharing that, and I appreciate you know that it’s obviously you know, you hope that your learning of it and your understanding is now impacting the lives positively of so many people because of this journey that you’ve been on. So tell us a little bit about the journey to end up being sort of a leader in the metabolic psychiatry space, and sort of the pathway from there and your learning journey.
Yeah, yeah. So, I mean, we were obviously learning all this functional medicine during this time our kids were getting those treatments every every time someone talked about a new diagnostic test or a new treatment, I was learning all about it. So we were getting really steeped in all of that. And around the same time, you know, when my kids were really not doing well, I heard the lecture from Chris Palmer at McLean, where I was working, or had worked, and I still would go back for these grand rounds lectures, and he was talking about reversing treatment resistant psychotic disorders with ketogenic diets.
And it blew my mind, because, I mean, at that point, my mind was already opened up to root causes. And, you know, thinking about what the root causes of things were, and just, you know, fixing metabolic health in the brain. Could take someone who had been, you know, psychotic for 50 years and was on the strongest antipsychotic medication that exists, Clozapine, and was still psychotic, and a few months on a ketogenic diet, all of that reversed and was not psychotic anymore.
Could taper off of that medication and never got psychotic again for the next 10 years of her life. When I heard that story, I was absolutely blown away. I think I always joke that I think I was the only one in the audience that actually believed what he was saying. I think the rest of the audience sort of said, Oh, that’s a nice story. And just sort of walked on, oh. Um, you know, there’s like, that’s impossible. It’s a nice story, but it’s impossible.
But I was ready to hear it, and so that really, you know, lit the fire for me at the time, was we were so deep in taking care of our kids, I was not able to sort of bring this into my medical practice right away, but I sort of filed it away. As soon as my kids started getting better, I realized, like, Okay, this is a really powerful tool for mental health and brain health that I need to start figuring out how to bring to all the people in my practice and spread the word about how powerful it is.
So what’s been your journey thus far? Like, how long has it been? What have you did? How did you bring it in? How did you start? How do you deal with the like other practitioners that you work with, and they’re probably, they don’t have the same, you know, push, that’s right. Find it, right? Yeah, absolutely. So. So at first, I just started talking to outpatients of mine that I’d worked with for years, this is about five years ago, and started trying to convince them to start, let’s look at, you know, doing this dietary change.
Can we? Can we think about starting to make some ketones, which, you know, in mental health, it’s really, there’s a lot of things that are powerful, but that’s really one of the most powerful things that you can do. And so I started convincing people, one by one, you know, yes. And at first, when I started talking about it, they looked at me like, Are you the same doctor? You’re the same guy, like, I’ve known you for years. Why are you talking about, you know, nutrition?
And it took a while sometimes to convince people, but and when I would convince them, and they would start doing it, first, we would start with just, you know, low glycemic index eating, and then maybe do a little fasting, add a little MCT oil, and people were invariably come back to me and say, what was that? My brain turned on, you know, that’s incredible. So, you know, started having success with people in that realm. Brought it to the company where I was working, which is called Ellen Horn.
We’re a Psychosocial Rehabilitation program where we take people with, you know, complex conditions and try to get them back into the community. So I started doing it in that setting. But it’s a company, and it’s a program that’s not designed around metabolic health. It’s not designed around functional medicine. So it’s, you know, it would be an add on. And for some people, it wasn’t enough. It wasn’t immersive enough to really make these behavioral changes.
You know, it’s not, it’s not easy for anyone to do this who’s got a brain condition. We’re, you know, we’re focusing on their brain for a reason, and their brain isn’t functioning optimally, so making all these behavioral changes is often very hard, but eventually I decided we should open up a separate, freestanding program that’s just about metabolic psychiatry. So about a year and a half ago, we opened up Accord, A, C, C, O, R, D, which is a little program that we have outside of Boston, where people come from locally, but also from all over the country.
We’ve had people come from all over the world to get this immersive metabolic psychiatry program where we’re doing the ketogenic diet with a dietitian and a chef, exercise with a personal trainer, Mind Body practice mindfulness and circadian rhythm work at the same time, and so all that at once, and we can really get some traction with almost anyone, no matter how long they’ve had their mental health condition, no matter how severe it is, we’re able to really get some traction if they’re willing to come and do it. Amazing.
Yeah, I love that. I guess you’re going through this process now where you’re seeing these kind of outcomes. You’ve had this push from the universe, to get into it, and you’re doing it now, how does, how does it look when you now reflect on the medicine that you used to practice? Yeah, and I still do a little bit, I haven’t like completely shed the trappings of some of the other ways that I used to practice, but, and some of that is just person dependent.
You know, some people are just not interested in figuring out the root cause, or working out the root cause, they’ve accommodated to this illness or condition and the medications that they’re taking, and they’re just like, you know, I don’t want to rock the boat and so, you know, I’m not going to kick people out, you know, if that’s the case. But, yeah, I mean, it’s just a whole different it’s a paradigm. I mean, really, what we were doing in the previous paradigm is we’re fiddling with neurotransmitters and,
you know, sometimes getting a little bit of a benefit in terms of symptoms, but often with a lot of side effects, terrible side effects, and not really getting at the root cause. So the condition is still there. It’s still kind of, you know, churning and grinding away at people’s brain health and mental health, and you know, eventually, you know it. You know it doesn’t really, it doesn’t things don’t get better, like you can get a little bit better.
But I like to say I’ve never really seen someone completely and fully recover from a medication, a psychiatric medication intervention. I mean, we can definitely get people improved, but like to fully recover. We just don’t see that that often from us. You know, major depression or bipolar or schizophrenia, schizoaffective disorder, we can, we can get to a truce with the illness, but then they’ve never really regained their full level of functioning. And that’s what I do see with this meta.
Ulrich intervention, people get back to full level of functioning. They get their whole level of cognitive and creative energies back. And it’s just amazing to see when that happens. Yeah, that’s that’s healing, right? Yeah, that’s right. Amazing. So, you know, we connected, or we’ve been in the same room at the same time, I guess, at the integrative medicine for Mental Health Conference, which, you know, having a comeback, and super grateful to Kirkland for leading that charge.
And I’ve had the chance to go in person the last two years, and just, you know, seen the energy there. And I guess I just love to get your thoughts on, you know, one of the things that I see happening there is, obviously, there’s a, there’s a focus on these topics. And you’ve had, you’ve you’ve presented there. So bringing metabolic psychiatry in, but also, I really think it’s the one place where other areas of mental health and brain health are being brought into one place.
So they’ve had, last year, Dr Bredesen, Dr Sanderson, you know, cat tubes, all speaking there as well as, you know, psychedelic stuff. And it just seems that there’s a, there’s a melting pot of brain health that has a lot of different strands to it, but it seems like all of these things are one and the same in a certain way. Yeah, that’s right. I mean, yeah. And some people have different emphasis, you know, and you might emphasize Hormonal Health, or, you know, getting rid of toxins might be the emphasis. Or, you know, treating infections might be the emphasis.
All of it can be important, and all of it can be helpful. Sometimes it’s really important to edit, though, and I talked to Kirkland about this when I was on her podcast. You know, it worries me, because I was, I was on, I was consumer of functional medicine for many years before I got into the practice of doing things a different way. And I can tell you that as a consumer parent of kids who are really ill, you know, you’re desperate, someone’s coming at you and saying, we need to do all these things we need to do,
you know, we need to do testing for toxins and infections and hormones and, you know, nutrients, and you know you’re it can feel like too much for the consumer, and it’s very important for functional medicine practitioner, I think, to edit down to some extent, their protocol to what can this person handle at This time, what’s the most powerful thing, what’s the most likely thing to make an enormous difference for this person?
I think sometimes we get into this sort of shotgun approach, where it’s sort of like we’re going to look at every possible aspect of this in every possible way and try to treat it all at the same time. And that does worry me sometimes. Yeah, I used to feel exactly like that, until I was immersed in this world of cognitive decline and in that particular condition, you know, I’ve been, my mind has been revitalized about this topic, because I agree with you.
I mean, I literally wrote a book on doing medical, you know, group visits and sort of taking taking it down to be as easy as possible, so that it could become the standard of care and use the power of the peer to peer dynamic like I love all of that, and I think that the vast majority of the population needs functional medicine, light right, doing healthy things in community and so forth. So I’m, I’m all in on that. But in this cognitive decline world, the thing that’s interesting is they have this phrase they use called time.
Is brain where, literally, like the clock is ticking in a way that you know, with a 14 year old with pandas, it’s not because you got your whole life in front of you. And yes, you want to work it out as quickly as possible. And yes, there are probably some issues that are happening to the brain that will be harder to resolve if it continues for a longer period of time. In in that work, it’s actually reimagining, like, getting clinicians to realize, like, if it’s mold and you miss that for six months, you might not be able to get it back, because the brain is is falling off.
So I think it’s, I think it has to be nuanced, but I agree with you, in general, I think the vast majority of the population needs something that looks a lot more like just healthy living, you know, but right, with a little bit of a push start. But, you know, certainly, when you get into these, like niche conditions and niche areas, I think there’s, there’s more along the way, it seems to me, you know, I wrote this article after I went to two years ago when I listened to yourself and Chris Palmer and others talk about, sort of what the root causes of mental health were.
They were talking about metabolic psychiatry, talking about hormones, talking about toxins and so forth. You know that ultimately cognitive decline and mental health issues have a lot of the same root causes. And ultimately what you’re in the business of then is trying to work out, how does, how do those root causes express in different people? And for some people that could go down the route of mental illness, and some people that could go down the route of their brain just not working and not being able to remember things, memory and processing speed, does that?
Does that seem sort of ring true for you and your experience? Absolutely. Yeah. I mean, I. Think in many ways, you know all the different and there’s all these different mental health diagnoses, right? We’ve got depression, we’ve got bipolar, schizophrenia, OCD, ADHD, you know, all these are manifestations of the same problems in the brain. We’ve got insulin resistance, we’ve got mitochondrial dysfunction, we’ve got inflammation, oxidative stress, we don’t have enough bdn.
So any intervention that’s going to help with all of those things can pretty much help with all these different manifestations. And again, in an older person, the manifestation is going to be cognitive decline most prominently, but sometimes it could be, you know, really severe depression with cognitive decline, or movement disorders with cognitive decline. You know, Parkinson’s so but ultimately, these things that we know fix brain health are good for all of it.
And I will just put a plug in that. You know, the most powerful thing for brain health is ketogenic diet, in my view. I mean, after looking at all of these things and seeing what they can really do in the real world. Sometimes we need to add on to the ketogenic diet. But to me, that is, you know, if someone has a significant brain issue, brain health issue, that is the number one most important thing that needs to happen first, and it will fix a lot of the other problems.
Because, you know, when the glial cells are over activated, they’re going to get benefits from ketones as well, right when the neurons are not firing, you know, and manifesting as depression, you know, that’s going to get help from ketogenic diet. But also, your liver is going to do better. Your immune system is going to do better. Your whole detoxification system is going to do better. Every cell does better on ketones in some ways, in like, the hierarchy of like, where we’re going to put the most important intervention.
I really put that one talk number one. Well, it’s interesting you say that because I know, like you said, Dr Chris Palmer and others have been quite close in with the new administration, and we’re doing this interview, you know, two weeks after the new reverse food pyramid comes out, right? And obviously we’re sitting at a point where there’s obviously, you know, you have functional medicine that’s very individualized.
You have public health that’s kind of for everyone. But if I just take what you just said, which is that, you know, the ketogenic diet is the best thing for brain health, it might start to give a little bit more of a push to why the new pyramid was shaped the way that it is, because a lot of the things at the top of the pyramid now are things that could keep your brain in ketosis. That’s right, yeah. I mean, if you just stay on the top of the period, and don’t ever get to that point at the bottom with the new guidelines, you’re going to be in ketosis.
And in fact, you know, very low carbohydrate diets are mentioned in the guidelines as if you have a chronic health condition as an important option. So that was a really big thing that they added in, which I applaud them for, because we didn’t have it in the guidelines ever before, as an option for people. And so there’s a recognition that, you know, if you’ve, if you’ve got a chronic health condition of any kind.
Most likely, you know, helping your metabolism with a very low carbohydrate diet is going to make an enormous positive difference.
And now we know that that’s actually 90% of adults in studies have some type of significant metabolic health condition. We’re not talking about, you know, 10 or 20% here. We’re talking about 90% of people, adults in our country, and probably more, like about 50% of children, and we need to catch the kids. So one of the most important things about those guidelines is the fact that now schools are going to have to do better for breakfast and lunch for kids, because essentially no amount of added sugar is okay anymore, and the schools have to follow the dietary guidelines.
So it’s going to take them a little while, but I’m just thinking about how many boxes of, you know, frosted flakes are now not going to be served, how many muffins and donuts and juice boxes are not going to be served? And it really makes me feel good. Yeah, right. Well, I guess I’d just love to give you, and I give you an opportunity to share where you where you see, the year of metabolic psychiatry, or the, you know, the future trajectory on, you know, sort of how far it’s made it into medicine thus far.
And what you think the trajectory is, and what you think the, sort of, the, the what will, what will drive the trajectory? Yeah, well, I think we’re in for a big year for this, this hypothesis and this way of doing things. Because, you know, a few years ago, a lot of research studies were funded in this space, metabolic psychiatry, ketogenic diets for serious mental illness.
And a number of them are randomized, controlled trials, and some of them have completed, and some of them are going to be published in 2026 with my colleagues, other psychiatrists, anyone in academic medicine, if I’m talking about this, you know, one of the main things the complaints I will get back from them is, yeah, that data looks really impressive, but it’s not the gold standard of the type.
Research design that we are used to in academic medicine, which is a randomized controlled trial. So now we are going to see the results of randomized controlled trials for ketogenic diets. And I think we’re going to we’re going to get some more traction with some more clinicians because of that, and more interest. And in general, I think the public is already really interested in this. You know, whenever I talk, people come up to me and are fascinated by it.
So many people come up to me and say, look, I’ve got a kid with diagnosed with bipolar disorder. I’ve got a kid with schizoaffective disorder. How do we get them to do this? And the challenge, though, is that often that the parents are all into it, the individual, the kid is skeptical and not sure they want to make all those behavioral changes. So we need to turn this into something that, you know, everyone feels excited about, even the people who are going to have to do, you know the changes.
You know those individuals, the ones who do it, are, in the end, you know, incredibly happy that they did. I’ve now have dozens and dozens of people who lives are completely turned around from from doing this intervention. And you know, I’m hoping that it’s going to be a really big year for more people embracing this. When you’re out on the floor and you’re talking to patients who have a range of mental health issues, what is the what would be your best guess as to the percentage of people who are interested in doing participatory medicine, like something where they have to do something different, as opposed to just, just keep giving me the pill stop.
Unfortunately, I don’t know the exact percentage, but I definitely think right now, like that level of motivation and participation is the minority right now, and part of that is that we’ve all bought this idea that there’s something broken in those people’s brains, and those people themselves have unfortunately been fed that idea, and they believe it, that what’s the point? It’s just a diet. My brain is broken from some chemical, chemical imbalance, and it’s not going to be significantly altered by just changing what I eat. You know, come on.
And unfortunately, I think, unfortunately, that narrative has so permeated our culture, and that’s really what needs to change. It’s like, you know, people need to understand that that narrative was never true, and it was, you know, all reverse engineering from these medications work on neurotransmitter so it must be a neurotransmitter imbalance that’s causing the original problem, but no one ever had any strong, compelling evidence that it was a neurotransmitter imbalance in the first place.
But that, unfortunately, is what our culture has bought as the reason and the cause, and until we can reverse that narrative, unfortunately, people are sitting there saying, it’s just a diet, Doc, you know, what are you saying? And as much as I say, You don’t understand, I’ve gotten people off all these medications, they’re back living their lives. And they sort of say, Yeah, but it’s hard and and I understand, I mean, people are beaten down from their experience, from their condition.
It’s been a tough road for people, and they don’t necessarily have that spark and energy back, especially when they’re on all these medications. So it is challenging. I do understand how challenging it is for people. Well, let’s talk a little bit about that, because I know that one of the most challenging things is actually dealing with the tapering off the medication, or, you know, trying to get off the medication, the medication in itself, is a barrier to getting to a sense of health.
What are some tips that you would give to clinicians who have patients who want to get off their medication and looking for best ways to think through that journey? Yeah, this is going to be a bigger and bigger topic. People realize they’re on these medications and they say, Well, I’m not sure I really want to be on these medications long term, but they’ve already now been on them for a few years or longer. And all of these medications have withdrawal syndrome.
So that’s number one. People think about withdrawal syndromes from antidepressants, SSRIs or SNRIs, and that certainly they have withdrawal syndromes. But so do all and benzodiazepines, of course, have withdrawal syndromes, but so do antipsychotic medications, so do mood stabilizing medications. And so we have to be skillful at reducing medications only when that person is ready, and only taking that next step to reduce when they’re ready, and doing small increments.
You know, I think you know, what we’ve learned over the years is that you can’t just drop by 25% and expect everything to go, okay, that’s probably too big of a drop. You know, you’re going to induce withdrawal syndrome, and then we misinterpret the withdrawal syndrome as a recurrence of their original illness, which is another big disservice that my field does to people all the time. You know, okay, you went off your medication and you got manic again or psychotic again.
Look, that’s your illness coming roaring back, right? But it’s not necessarily the case. They’re in withdrawal from the medication. So we need to support the whole person. We need to support their metabolic health. We need to support the terrain of their being when we’re. Drawing from medication. Again, the ketogenic diet, I think, is the most powerful intervention where we can do that. If you think about what a what does a neuron need to do when we’re withdrawing medication, it needs to do a lot of changes.
It needs to change the receptor density for that neurotransmitter, and it has a lot of metabolic work to do. And what’s the best way to support that neuron is with a ketogenic diet. But also, of course, with, you know, aligned circadian rhythms and sleep and mindfulness and Mind Body practices and exercise, all these things support the metabolic terrain, the mitochondrial health of those neurons. And they need all the support and help they can get when you’re doing a withdrawal program.
But what I do find is that it’s much easier to withdraw people from medications when they’re on a ketogenic diet. Awesome. Yeah, yeah. So that’s a you got to get the diet right, and then you got to work with a skilled professional who knows how to do that. What do you what do you think of the chances of the skilled professional team growing quickly? Like is this? Is this something that you see, that other psychiatrists are hungry for, becoming hungrier for? I’m hopeful, especially in the younger generation.
But you know, occasionally, you know, even people my age can can change. So, you know, it’s just a little harder. You know, the older we get, the more sort of, like, entrenched we get in our beliefs and our way of doing things, and it’s harder to make big changes. I think for me, it was a lot easier to make these big changes in how I practice, because I’m made sure to treat myself first and make sure I was metabolically healthy, you know, 20 years younger than I did five years ago, when I first started doing all of those things, ketogenic diet, exercise. You know, it’s just amazing how much, you know, it’s I’ve become more capable, energetic and flexible because of all of that.
And so, you know, I think there are some individuals who can do that. You know, I had a strong motivation because of what happened to my kids, but I’m really hopeful about the younger generation. When, when I, when I go give talks, you know, always the young people come up to me and say, this is exciting. I’m really into this, you know, I want to, I want to learn more about this. And so I’m really hopeful that we’re going to, over time, you know, convince a whole bunch of other psychiatric clinicians that this is an approach that they want to be a part of awesome.
And then, you know, for yourself, growing this in Alan horn and growing accord. What’s your goals for the year of the brain? 2026, I’m hoping, if everything the stars align, that we can expand a chord to a different location, have another location for a chord, maybe also a slightly different model, where we would work with people less intensively, because right now, accord is this very immersive, intensive program for people who want to make all the changes all at once, and people come for a month or two or three, whereas my the next phase or iteration of it, maybe we’ll do something fewer hours per week people who want to make the change In a little bit of a slower way awesome, yeah?
Well, I Yeah, I’d love to keep keep tabs on that. I think there are some exciting projects that are popping up to try and create the perfect environment to get the you know, to get data to show what’s possible. That’s right. It’s about finding ways to scale that out with minimum inputs, you know, to a much broader population. And I guess very end of that, you can see the new food guidelines. And on the other end of that, you can see intensive work you’re doing with patients.
And somewhere in the middle, hopefully, there’s a new standard of care for for creating health as a primary way of of treating people. Thank you so much for your leadership and for having the courage to go and practice in a new direction. I know it makes easier for every next doctor to follow the path. It’s something we’ve seen in functional medicine, where it’s, you know, for years, sort of just grinding out, getting the foundation, and then it starts to take off.
Because I think it becomes aspirational for for clinicians to practice in this new way, rather than, rather than weird, and something that people want to do, not enforce into just because their kids got sick. That’s right, that’s right, yeah. I mean, ultimately, yes. I mean a little bit of this should be sprinkled in every single medical practice around the country, right? And doctors, unfortunately, like, they fall into this paradigm of, you know, just finding, like,
what’s that one perturbation or pathological problem that we can reverse and everything will get better, instead of focusing on, how do we actually build the person up from a foundation, fix the whole terrain, and ultimately, all the little stuff actually can reverse itself. You know, the body is wise and can can heal, but we have to give it the tools and the foundation to be able to do so and take away the barriers. Yeah, agree. Awesome. Well, thanks so much for being a part of the evolution of medicine podcast. We will have a.
The details in the show notes for the work of Dr Matt Bernstein. Doc, thanks so much for leading the charge and being here on the evolution of medicine podcast. Thanks for having me. It’s fun conversation. Appreciate it. All right, this has been the evolution of medicine podcast. We meet with Dr Matt Bernstein. He’s a leader in the field of metabolic psychiatry. We’ll put all the details in the show notes on how you can find out more about his work.
Thanks so much for tuning in, and we’ll see you next time. So that was the podcast. What an epic session. And just a reminder that coming up in April, we will have version two of our reversing Alzheimer’s Summit, and we’re gonna have updates on some of the new studies from Dr Bredesen and be charting a path forward for the reversal of Alzheimer’s and cognitive decline. Thank you so much for tuning in to the evolution of medicine podcast. We’ll be back again next week, and thanks so much for tuning in and we’ll see you next time.
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