In this episode, host James Maskell sits down with Dr. Helen Lavretsky – integrative and geriatric psychiatrist, neuroscientist, and professor of psychiatry at UCLA, where she directs clinical research on integrated mental health and serves as research director for UCLA’s Integrative Medicine Collaborative.
Her path into the field began through Kundalini Yoga, sparking 20 years of studying mind-body practices with rigorous neuroscience. Despite initial pushback in academic psychiatry, her evidence ultimately gained widespread acceptance.
She details her clinical model: a partnership where patients choose self-regulation tools based on joy, avoiding rigid regimens. She also shares her landmark Kirtan Kriya research, showing that just 12 minutes of daily chanting meditation over 8 weeks rewired the brain, improved cognition, and reversed aging markers in dementia caregivers.
Discussing her new book, Living from the Soul: The Neuroscience of Spiritual Awakening, she addresses patients experiencing “spiritual emergence” – symptoms like insomnia and body pain often misdiagnosed as psychiatric illness. She links these rising rates to global instability and generational shifts in resilience.
They also explore brain health policy and the “Brain Capital” movement – from UCLA summits and UN testimonies to Texas’s $3 billion Brain Health Institute. Finally, they examine environmental risk factors, genetic predispositions like APOE4, and offer a candid critique of long-term SSRI use in older adults.
The episode closes on the future of precision medicine and data-driven Alzheimer’s care.
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About the Guest:
Dr. Helen Lavretsky is an integrative and geriatric psychiatrist, neuroscientist, and professor of psychiatry at UCLA. She directs clinical research programs on integrated mental health and serves as director of research for the UCLA Integrative Medicine Collaborative. She is a past president of the American Association for Geriatric Psychiatry and the author of several books, including her latest, Living from the Soul: The Neuroscience of Spiritual Awakening.
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About the Host:
James Maskell is a healthcare entrepreneur and founder of The Evolution of Medicine. For over 20 years, he has worked to scale functional medicine through community-driven models, group visits, and practitioner infrastructure. His work focuses on moving medicine upstream – toward prevention, lifestyle intervention, and systems-based care.
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Transcript:
Study that I did on dementia caregivers 20 years ago, the first one, Kirtan Kriya for stress, where we discovered that a 12-minute yogic meditation, chanting me- meditation for 12 minutes a day for eight weeks completely rewired the brain, improved mental health, resilience, cognition, which was unexpected, and also reversed aging.
I actually went to my yoga teachers then and I said, “Now I can prove that yogis don’t get old.” And they said, “No, they do.” So a warm welcome to the Evolution of Medicine podcast for the first time, Dr. Helen Lavretsky. Welcome, doctor. Thank you so much for having me here. I’m really excited to connect with you and to be able to bring your message, you know, to this platform.
Over the years, we’ve talked a lot about integrated mental health, we’ve talked about, you know, brain health, we’ve talked about Alzheimer’s and reversing cognitive decline, and you, you know, your career is unique in that you’ve straddled all of these different areas. So, you know, how does one take a journey and a path, uh, towards the journey that you’ve taken?
Well, with twists and turns at certain points, and being willing to go in this unknown path, unlikely path of development, which was Kundalini yoga for me when I, uh, turned 45. All of a sudden I took this, uh, turn and it’s paying off finally, you know, so it’s been a 20-year journey. Of discovery, self-discovery, and discovery for others, of, uh, mind-body practices’ value for brain health and the concept of resilience and brain health.
So I spent some time there studying that. Uh, and now it’s all kind of coming together, uh, in the same venue. And, uh, most importantly, the world is now responding, which was not the case 20 years ago. Yeah, absolutely. So take us back to those early days when you’re sort of making this awareness for yourself, but you’re also a professor at UCLA and, and I’d imagine quite a conservative specialty, right?
Very conservative. Interestingly, psychiatry, which should be more malleable because we’re, uh, paying attention to social factors, it’s biological and social, but not so, you know, especially in the, uh, ivory tower of academic medicine. Uh, so I did experience some pushback initially, uh, when I decided to study effects of yoga on brain and body.
And shortly after, I became very, uh, successful in developing new paradigms on how do you study the effects of yoga on brain and cognition and mind and mental health and resilience. It’s basically applying the best of neuroscience tools to the study of yoga. It’s no different than drugs, for instance, studying effects of drugs, and making it comparable, and in many cases, demonstrating that yoga practice surpasses standard treatments, uh, like drug or psychotherapy.
Yeah, that’s really interesting, and I’m sure once you’ve experienced it, it’s easy to talk about it. But ultimately, you know, for psychiatrists who haven’t experienced it, it probably sounds unlikely or otherwise. So what were some of the… Have, have there been some breakthrough moments where you feel like, uh, your colleagues really started to buy into it, or has that been more recent?
Uh, it did take some time, about five years of mostly acc- uh, accumulating, uh, scientific evidence, publishing papers, giving presentations, creating this evidence. So Also, I found myself in studying more than one modality. It wasn’t just yoga, it was also Tai Chi, and Qigong, and meditation, and art exposure, all of which had very similar kind of findings.
So I basically summarized the field. I wasn’t, you know, a crazy passionate follower of one thing, which is usually the case, and that’s why there is a mistrust. And, you know, in yoga community, people– when people come together who are practicing different part, uh, types of yoga, they start arguing very passionately, like to the war state between them whose yoga is better, you know?
And in my mind is, uh, the yoga, the best yoga is what you practice, you know? If you’re practicing it, then it’s gonna be valuable for you. If you’re not practicing, there’s no point of arguing about it. Yeah, I c- I could certainly see that. Well, look, that’s, you know, that’s a great foundation. I know you’ve written a number of books over time, and integrated mental health and so forth, but your latest book was the thing that really caught my attention, and I wanted to go a little bit deeper into that.
It’s called Living From The Soul: The Neuroscience of Spiritual Awakening. And, you know, ultimately, I would say if I come back to the reason why- Abe and I started the Evolution of Medicine 12 years ago was because we recognized that something very special occurs in the relationship between the patient and the practitioner, where there’s sort of like a potential for an awakening within, you know, both parties, but particularly the patient.
And, you know, ultimately I would love to get your views on this because it’s, you know, it’s unlikely, I guess, for a psychiatrist to, you know, go into these areas, and I’d love to get your thoughts on what is the neuroscience of spiritual awakening and why is it so relevant today? So I just wanna take a minute to talk about the incredible mission partners that we have here at the Evolution of Medicine that have made this possible.
So first and foremost, I wanna thank- Fullscript and Fullscript Journey. So Fullscript’s been an amazing partner for 10 years. We only pick partners that can help us achieve our vision and help you achieve your practice vision.
And Fullscript have been an incredible partner for a decade, but their new offering Journeys, this is why we called it The Evolution of Medicine Journeys, is allowing practitioners to combine the relationships that they have with the newest technology to sell direct-to-consumer lab testing, and use it as a funnel to bring into your practice, and it’s a game changer for the whole industry.
So go to goevomed.com/journeys, and you can get started on building the Journeys for your practice, an optimal way into your practice. We’re gonna have some conversations about it. This is a game changer. Next, Genova. Genova, um, have been fans of The Evolution of Medicine for a long time. We’re big fans of them, and they now have a lot more specialty testing.
They have a lot more tools, and it’s a key part of, uh, understanding the body ecologically. So go to goevomed.com/genova to find out more. Come on over here and I wanna show you about the other mission partners. You know, if you’ve been following us for a while, you know that these are organizations that we trust, that add a lot of value.
Freedom Practice Coaching. Um, I have been sup- supported by them since the beginning and, you know, so many of the issues that practitioners face in building a successful practice, scaling a successful practice, come down to having the right support with people who have been there and done that. Go to goevomed.com/fpc.
Um, BigBoost Marketing. Uh, Uli and his team are the best in the business when it comes to really understanding how to market your functional medicine practice. Go to goevomed.com/bigboost and see how they can help you. And then what you’re gonna be hearing a, a lot about is the formation of clinical networks.
And ultimately, TruNeura is our first effort at that, which is to build an integrated clinical network, combining independent practices from across the country into a network that can reverse cognitive decline. And if you go to goevomed.com/truneura, you can get a demo. You can see what it means to be part of an integrated clinical network.
That’s mentorship, that’s software, and that’s making it easier for you to get incredible outcomes in a disease state where there are no other options. So thanks to our mission partners.Let’s get back to the content
You know, the premise of the book is that it works for you. It’s very beneficial if you decide to know your soul, you know? Get to know your soul, and it stems– the name of the book comes from the meditation that I actually teach in my clinic. And to date, I’ve taught it to hundreds of people, starting with dementia caregivers in the first Kirtan Kriya study, and then progressing to just in clinic, people who are open to it, and the requirement prerequisite for that is being open to the existence of soul Not even believing, but be- being open to that.
And in my clinic, it’s about 95% of patients because they come for integrative medicine, integrative psychiatry, so that’s something they are seeking. Normally, in the US, about 85% of people, 80, 85, claim that they are either spiritual and/or religious, and so that’s a substantial… Uh, I mean, the likelihood of you getting patients who are spiritual and want you to know about it is very high.
It’s higher than in other developed countries. So except we never ask about it. So the approach of integrative medicine is where I find, uh, comfort, really. It, it resonates with me because it perceives a doctor-patient relationship as partnership in healing. And so– and, uh, it’s very much unlike Western medicine.
In fact, I stopped my geriatric psychiatry clinic years before, and only right before the pandemic I started integrative psychiatry clinic, which is the model I really enjoy practicing, where I am partnering, you know, soul to soul, heart to heart, basically. I’m just assisting v- uh, patients on their journey, on their soul evolution journey, and I have the tools.
I know the tools. I’m offering to teach the tools to the patient. It’s up to them to select them, but once they selected them to their liking, I typically go for joy. If the activities are joyous, the likelihood of them actually doing them is much higher than when I try to impose, which is how Western medicine does things, you know?
“You are to do this, that, and the other thing,” and guess what? Nobody’s doing it, you know? So if they’re enjoying it, if they generated the idea, if they selected… I ask for three to five tools in their toolbox. How to deal with stress, uh, how to improve your sleep, what to do for cognition and brain health.
Once they selected three to five tools, they have to practice them, and then when they come back for their appointment, they are reporting how well they’re doing and maybe they are practicing one tool and then they are expanding to the second tool. But it’s like this journey, you know, back and forth.
It’s partnership. Yeah. H- how do you deal with the juxtaposition, and maybe you don’t deal with it ’cause people search for you, but I think on one hand, you know, you have these kind of tools becoming much more popular amongst the general public, right? So there’s that sort of desire for people to go and search out new tools, the growth of meditation, you know, all the, uh, this area.
But on the other side, you have, you know, really, like, kind of what I said, the, the conservative specialty of, of psychiatry where it’s, you know, it’s not that outside of going to integrative medicine for mental health or reading your textbook or, you know, training with, you know, some of the leaders in this space, the majority of psychiatry is not really integrating these tools in any meaningful way as far as I see.
That’s very true. I just gave grand rounds to my own department, and they’re all, um, psyched. About the content, you know? Uh, it’s kind of unbelievable. I’ve been in the same department for almost 30 years, and I’m doing my work in that department. Nobody really is– knows exactly what I’m doing, which is, you know, works for me.
But in the end, they’re kind of surprised at the evidence I show they can’t argue with. It’s well-published. I’m the leader, a thought leader. I’m on these brain health commissions everywhere. It’s finally paying off. And what is exciting for me is that study that I did on dementia caregivers 20 years ago, the first one, Kirtan Kriya, for stress, where we discovered that a 12 minutes yogic meditation, chanting meditation for 12 minutes a day for eight weeks completely rewired the brain, improved mental health, resilience, cognition, which was unexpected, and also reversed the aging.
I actually went to my yoga teachers then, and I said, “Now I can prove that yogis don’t get old.” And they said, “No, they do.” You know, because they were in their 60s, and they had aches and pains. So, you know, but that’s to show that, you know, even in my own department, I’m no– I mean, at this point, they’re listening.
Uh, what did help to this promotion is pandemic and the mass disaster du jour. You know, we’re constantly bombarded by this cortisol-producing mass disasters that nobody can escape. N- there’s not a safe place Uh, place on the planet. So the two phenomena that I’m an expert in, uh, is aging, uh, aging of the population and, you know, unless we create caregiver robots, in 20, 30 years we’re gonna lose the number of caregivers because there are no children being born.
You know, the birth c- rates are, uh, really down, and we just crossed past people over 65 are going like this, children under five are going like this. No caregivers. It’s either we live longer and well, you know, independently, and preserve our memory and brain health, or we create, and/or we create robot caregivers who are gonna take care of all of us.
Yeah, that’s interesting. You know, we, we’ve talked a lot in True Neuro Mastermind about this idea of, like, cognitive interdependence, right? We’re all interdependent on each other for caregiving and support, and actually, like, there’s a onus on all of us to maintain our own cognitive independence because without it, we sort of put a lot of pressure on friends, family, paid resources, and other rules.
And so, you know, I think that, uh, everyone is, is realizing that they don’t wanna put that pressure on each other and that, you know, it’s exciting to see that even though, you know, um, what we say, neurology and psychiatry has not really evolved, there’s a lot of good news in that people are sort of getting it, taking action, and the incidents, I believe, of, uh, cognitive decline on an individual level is falling.
It is true. There are a number of things that are responsible for that. One, the current aging… So, you know, we’re living in the very strange time of five generations, generational cohorts living together. Never happened. So we have the Second World War Silent Generation still alive, mostly dying off, then, uh, baby boomers, then X, uh, then millennials, then Zs, and Alphas living together.
They’re very different from each other. The most resilient cohort is actually Silent Generation, the Second World War. One, they are survivors, and two, they experienced a lot of upheaval, a lot of events in their lives, so they’re more resilient. Followed by– So every subsequent cohort is less resilient, and Gen Z is like resilience at a zero.
So something that I teach about that we have to teach our children how to be resilient, and mind-body therapies is one thing that we could teach early in childhood where they, uh, learn it as a skill, and it’s a lifelong skill of dealing with chronic stress and preparing them to deal with adversity, which is abundant on the planet right now.
So, and that’s a part of prevention, taking a lifelong- view of it. The second thing is that younger generations are much more proactive about their brain and mental health. So they want things done, they’re aware, they’re talking about it. It’s no longer as stigma- stigmatized as in, uh, older days. And although we blame social media for all sorts of damage, the information is abundant.
Like, you know, you could ask Dr. Google and get an answer to your question, how to deal with this problem. Sometimes it’s the wrong question, I mean, the wrong answer. But, you know, it’s up to the parents, for instance, for young children to be aware of this, but also consulting mental health professionals.
But it’s coming, you know, Dr. Google is here to stay, and AI therapists are being trained how to be less agreeable therapist, which is… You know, being an agreeable therapist is not useful. Um, so, you know, it’s coming here to stay. It’s not perfect right now, so it’s hard to anticipate. In the process, damage is being done, like for example, ChatGPT advises people to commit suicide.
You know, but it’s being perfected. In the end, it will be a combination of things. So the other factor is cardiovascular disease is treated more a-actively, cardiovascular risk factors. I’m actually working with the American Heart Association quite actively for several years, and, uh, they’re bored with the heart health.
They’re now… They want to own brain health. So they’re very gung-ho on brain health and how to deal with that. At the moment, we’re working on a commission of, uh, identifying the role of cardiologists in brain health, and that’s a more productive line of intervention, prevention at the cardiologist level.
Uh, the next level would be primary care physicians. Yeah. Well, that’s a big, big area. You know, I’ve been very interested in that because the vascular system is actually, you know, one of the drivers, and if you look at our doctors who, you know, who probably listen to this podcast, you know, they’re very familiar with like maybe the gut as the part of the vascular system.
But, you know, you’ve got the blood-brain barrier, you know, you’ve got the heart all made out of that same tissue. And so, you know, that any strategies that can, you know, help heal that part of the body can be very helpful for brain health, and that’s the whole body brain health that I think is, you know, the next generation.
So it makes a lot of sense for the American Heart Association to wanna be in on it, and I’m very excited to hear that. You know, when we first spoke, when I- when we connected, y- you felt like we were coming into a very special moment, and I’d love for you to share your thoughts on that because I, I agree.
I feel like community is sort of preparing for something spectacular. But it was something about the way that you described it or the way that you understand it that I would love for you to share with our audience. Right. So, you know, uh, for the past 20 years, I’ve personally experienced the growth of interest in public, in general public, in yoga practitioners, in spiritual communities.
Initially, it was like 50 people M- max 100 people, 200 people. Now it’s several thousands at a time on conference calls, at the conferences. Really, the pandemic spurred that interest in breathing practices, self-regulation, because, you know, we just don’t have enough practitioners of, at any level to take care of this many people who are aging and need, have needs.
Um, so you know, people are, are now understanding this and looking for tools of self-regulation to learn. And breath– in my view, breathing practices is like the simplest, less controversial, least controversial tool to adhere to, and also has visible effects. Once you get to coherent breaths of three-second inhale, three-second hold, three-second exhale, three-second hold, or longer exhale, 4-7-8 breath, very popular, 4-4-6-2 with longer exhale, activating vagal nerve and vagal system, parasympathetic nervous system with blood pressure and heart rate dropping, inflammation lessening, and you feel like you’re creating the space not being reactive or in fear, then you know, that’s a more comfortable place to deal with adversity and, and disasters.
I’ll give you an example. I was teaching a breathing, six-hour breathing workshop on January, uh, 8th of 2025, which was LA Fires day, like this apocalyptic picture, and sirens are everywhere, clouds of, you know, fumes and, uh, you know, red sun and all the apocalyptic picture. People are running, evacuation, evacuation.
We’re breathing for six hours. I can’t leave because I’m teaching the workshop. So I’m completely stone cold in the end, very calm. I come home, and we have to evacuate. My husband is running around not doing anything, and I just put together a couple of suitcase, and we left, you know? But also at this workshop, which was international, we were calmly reporting about what the LA fires are doing.
You know, it’s not being involved. It was like a removed view from above at what’s going on, but also being able to stay calm, collected, centered, and being able to make rational decisions. Yeah. That’s really interesting. So do you think there’s– like, how would you describe the time that we’re coming in to the practitioners on the front line that are educated in community, that are, you know, supporting people and taking new healthy behaviors, whether it be specifically for mental health or, you know, more broadly for, you know, building function or complex chronic illness?
Is there something that practitioners need to know about the time that we’re about to arrive into? Yes Yes. So that’s why I wrote the book, exactly for this time, for people who are awakening to this bigger awareness of why they’re on the planet, who they really are, and who they really are is their authentic soul stripped of the outside influences from their families, schools, government, whoever, outside of themselves, not knowing where to go for the truth because media is really confusing the, the flow of information, and resorting to their own wisdom.
For that, they have to go within and look out without, you know, living in a bubble. So a lot of people have physical manifestation of awakening, and sometimes it’s very unpleasant. They have, they… And I’m describing my own experiences and my patients, where it’s physically very demanding, not something that we’ve ever dealt with, and people are confused.
Typically go to doctors. Doctors have no clue. They diagnose it with neurological, psychiatric illness. People are labeled, and they are thrown in the hospital. They are given medications, and it’s actually a spiritual emergence or awakening, spiritual awakening that has this profound manifestation. So the book is for, to raise the awareness of those who are awakening and teaching how to take care of the symptoms, but also to, to teach the tools of how to, to move beyond and how to create their own reality from their authentic self.
That’s what the book is about. But also warning- Be the- Yeah. Yeah, what would be the top symptoms that you might, that you might see in patients that are in the middle of a spiritual awakening? Oh my God. No, I actually give a lecture. There’s a whole chapter on it. So I’ve seen pe- so once I became known like this weird, uh, psychiatrist who knows subtle energies, I got referred neurological patients and psychiatric patients with, uh, really severe debilitating symptoms of frank psychosis or mania, inability to sleep.
My own symptoms were not sleeping for six months. One– maybe one hour of very superficial sleep. And that was disabling, and I didn’t know how to deal with that. And it’s very common, really being over-energized. Popularity of yoga practices can lead to that because, you know, kundalini rising or kundalini syndrome, overactive chi is something that is a known phenomena in bodies who are overdoing it, not properly doing it, and not…
don’t know when to stop and how to deal with this. So it’s quite prominent. It can present as an anxiety, psychosis, mania, depression, spiritual crisis of a sort. In the end, suicide because people are so in- unable to deal with the symptoms. I’ve seen patients with, uh, frank, like what looks like a paralysis or severe pain throughout the body, brain shots, like electric shots through the brain, through the body.
Uh, very uncomfortable feelings. Yeah. Well, it’s– I’m sure, obviously, if you’re seeing patients like that every day, I’m sure you’re seeing it regularly. I- is there something about this moment in time that is conducive to the mass spiritual awakening? Yeah. We’re– Basically, what’s going on on the planet, solar activity, Earth’s activity, uh, the resonance of the Earth is shooting up, and our bodies are really of the Earth.
Five elements in the body that are, you know, Eastern healing practices. They balance, you know, five elements, same five elements in the Earth. And whatever is going on the Earth, in the Earth, like earthquakes, which, you know, we just witnessed humongous 7.2, 7.4 around the world, Japan, Latin America, everywhere, and volcanic eruptions also quite a bit, and fires and floods in the United States.
All of this unsettles and prepares us to explode, basically. It’s a very explosive energy, and because our bodies are of the same nature, they are responsive to this explosive energy and might explode in that fashion. But also you’re– we’re pressed by this en- energetic flow and, you know, photonic belt we’re going through and all of this other phenomena, but also rise in the questioning of the formal government and, uh, mainstream medicine ever since pandemic, you know.
That drove people to search for s- other sources, alternative sources of information, and that also leads to a great awareness questioning. Some of, some of it is true, some of it is false, but just, you know, the overall trend is to trust mainstream anything. Yeah. Well, that’s, yeah. Well, it’s interesting timing.
Well, look, I wanted to pivot a little bit into something that I actually heard about, you know, through you, um, on LinkedIn. It was the first time I came across it. I wrote some blogs on it. You know, as someone who came to this work through economics and really seeing sort of like the, uh, the fiscal cliff that we were gonna fall off if we kept on going in the same direction, you know, you were the person that connected me to this new brain health, the, the sort of Brain Health for Economic Resilience Commission, and ultimately, that was on the front page of “Nature,” uh, really looking at brains as infrastructure.
And I’d love for you to jump into that because the connection between brain health and mental health is fascinating, and I certainly feel that some of the work that’s being done in our community right now is at the forefront of actually really understanding how we keep brains healthy. And some, some of that might affect dementia and cognitive decline, some of that will affect mental health, and some of it will affect, you know, all kinds of other conditions.
But, um, I’d love to get your, uh, your, your perspective on this project and how you see it rolling out, and where you see the value is for our community to understand it better. Right. So this is something I’ve been working on all 20 years, and, uh, people who worked with me in my lab now are leading some of the other directions.
I’m partnering with other organizations. I’m a past president, recently past president of, uh, American Association for Geriatric Psychiatry, so I’ve been at this leadership position where I was able to navigate this in that direction. But it’s also, you know, other organizations, uh, like American Academy of Neurology, AARP, uh, American Heart Association, Us Against Alzheimer’s, are coming together.
What we are introducing– I just held UCLA summit on brain health that brought together really all sorts of specialists across specialties, economists as well, and policymakers in the same room. Never happens. Also, stakeholders like patients and caregivers all together, and that’s what we are trying to do, and it’s getting the traction finally.
There are actually, uh, psychiatry and neurology never talk to each other, but we’ll take care of this really small space over here- You know, we’re sharing disorders that have similar genetics, similar predispositions, similar risk factors, and it’s across lifespan. So what we came away with from the Brain Health Summit, where Dan Geschwind, who’s like a luminary in neurodevelopment and neurodegenerative condition, said that neurodegeneration is a neurodevelopmental disorder.
You can’t separate it. So we’re trying to unsilo all the specialties to own the entire brain, neuropsychiatry, psychoneurology, whatever, neurosurgery is enhanced, and pinpoint exposome exposure factors that are risk factors for all of this. And interestingly, of course, and not surprisingly, it’s one brain, one life.
You can’t really divide it in child psychiatry or geriatric psychiatry. It’s the result of child psychiatry that is geriatric psychiatry, you know? So we’re coming to this understanding, and to my excitement, everybody’s getting on this train, that is brain health across lifespan, starting from conception on.
In fact, Dan, Dan Geschwind made a, an argument, he’s a geneticist really and knows neurodevelopment really well, that some of the risks are preconception. You know, like rare genetic mutation that determine size of the brain structures, that determine neurodevelopmental or neurodege-degenerative disorders.
And to me as a yoga teacher, which I am, a certified yoga teacher, that’s also very exciting because what was illuminating for me was that practice of conscious conception. Couple comes together and intends to have this high level soul, and they do meditations to invite that high vibrational soul. And then, uh, mom and me and mom, uh, uh, the entire pregnancy yoga and mom and me zero to two years of age, two to five and five to 15, is all this conscious development where it’s teaching of the tools how to become a conscious creator of your life Uh, so, um, I got the idea from the yoga actually, but it’s now being bought into.
So how do you implement it? It would require complete, uh, uh, restructuring of how we practice medicine. The other thing is, like you said, uh, and I came to it, uh, in, in the ’90s, that the governments will run out of money, uh, bef- uh, before everybody ages, you know? That there’s not enough money or resources to take care of this aging population that is a tsunami that is here, you know?
Uh, with chronic disease and dementia burden and caregiving and whatever else is involved. So it’s best to prevent anything than trying to treat, uh, an aged brain at the age of 80. Absolutely. You mentioned the exposome. What are some of the exposome, key exposome ingredients that you believe are the most critical to tackle for these range of brain illnesses?
Well, you know, any kind of adversity in utero and early age is a part of modifiable, uh, variables, risk factors for dementia that if addressed early could be alleviated, you know, could be treated. So then exposure to drugs and toxicities, and their climate-based toxicity is off the charts. Like after LA fires, uh, concentration of heavy metals in the ground is like exceeding in Los Angeles and also in the air.
Air pollution is another factor for dementia that is also affecting neurodevelopmental, uh, disorders across. So we’re finally able to agree with, uh, neuro- neurodevelopmental. This is a point of agreement that we share all these exposure factors that could– we could start focusing on trying to prevent the results, you know, the gene expression changes over time.
The other thing, the example I usually give, and that would be a conscious attention to your risk factors cultivated in families who are raising children with existing risk factors. For instance, if we know that the family carries Alzheimer’s risk genes like APOE4, which is also cardiovascular and cholesterol risk, you would not send a son or a daughter with this APOE4, for which you co- you have to test them early, to play football, for instance, because a combination of APOE4 carrier and head trauma is detrimental.
First of all, outcomes of head trauma are worse, but also combination would lead to later development of dementia. Yeah. Actually, I just saw a statistic today saying they had looked at the brains of historical football players and saw like 97%, maybe with the, uh, you know, with the, the structure of CTE. So I totally get that.
I grew up playing rugby, which is not quite as bad because you don’t have a, the same sort of head-to-head collision, but certainly in the UK there’s been a lot of conversations about motor neuron disease and that kind of thing. I guess the one thing that I would love to ask is, are you seeing any interest or openness to talk about The iatrogenic side of brain injury, or is that still the third rail of psychiatry?
Uh, tell me more. Well, just, you know, what are the long-term outcomes from children being on psychotropic medication? Well, you know, this is not well-studied, but I’m a geriatric psychiatrist. I don’t know if anybody’s studying risks of exposure in children, but I have an example about that. When SSRIs ca- came to life, where was it?
1980s, I, I would say. It took about 15 to 20 years for the field, and, uh, not all of the field, but part of the field that was paying attention, to recognize that, uh, uh, long-term exposure to SSRIs decrea- in, in older people where you could track it very easily, decreases, uh, dopamine production. It down, down regulates dopamine production and results in extrapyramidal side effects like, uh, tardive dyskinesia or Parkinson’s disease or apathy, syndrome of apathy, when people are just not…
don’t care, and that is because of this long-term effect of SSRIs. And so I started noticing it when practicing in, uh, the nursing homes. When people were agitated, I would put them on SSRI, and they become basically not respond. Very apathetic, not involved, not engaged. And that’s a common, you know, you could observe it.
And older people, when you prescribe it to older people, it’s easier to detect side effects. ’cause they’re more visible. I don’t know if anybody– if child psychiatry is conscious enough to study itself, you know? Yeah. Well, I know there’s a, there’s a area of the reproductive psychiatry, which is extremely niche and, you know, we’ve had a lot of content over the years on that sort of– those sort of ideas.
But, uh, I do think that that is, uh, something that should be looked at more because ultimately you can see that the long-term use of drugs that are designed for short-term use has unknown effects that are probably not, you know, not good for function and physiology. But I’m glad that there’s still some areas that we can work into.
Doctor, I just wanted to share, you know, ultimately, I feel like I’ve had kind of a good pulse on the integrative psychiatry world for the last 12 years, and I’d never come across your work. And then now that I have come across it, I guess I just wanna say that it is heartwarming and very validating to see that someone who I haven’t come across in my work is doing such exceptional work.
Not only putting the word out there to, um, individuals through the books and, and those efforts, but like infecting the UCLA department with these ideas, uh, you know, Department of Psychiatry and, and having more of an impact at the brain level, at the economic level, at the individual level, at the community level.
And so I just wanted to share, you know, my, my thoughts and appreciation for, you know, being on the front lines for all these years and to making a real change, you know, in the period of your lifetime. I really do feel that we’re coming into an era where massive transformation is really possible, and that there’s like hunger and interest in it.
And, uh, I wanna just, yeah, share my appreciation for being there at the front end and doing the work and having an impact. Yes, I’m overjoyed. In fact, when I gave my grand rounds just on Tuesday, I said, you know, it’s a rare case when someone, a scientist, lives long enough, and I mean, it, it’s just 20 years of my life, but the timing was right.
You know, when I caught this upsurge, you know, and it was in the beginning of it, and now I’m seeing the productivity. The next event we’re hosting, by the way, is all the big employers in the state of California are coming to discuss it, and that’s a big opportunity, and everybody’s interested because of this AI issue pushing the workforce, and also aging of the workforce.
And the conversation is about participating in brain economy as a, as a company, as a industry, but also protecting the workforce, and that’s where we get the interest from the governments of the world. There are s- uh, entire countries and also some states in the United States, uh, like the State of Texas just passed a bill, and it’s now law, recognizing brain health, establishing BrainHealth Institute of Texas, State of Texas, and throwing $3 billion, uh, to establish that.
Yeah. Um, also State of Ph-Philadelphia is interested. California is getting online. But this, the entire s- uh, countries of Spain, France, and Switzerland, and some others are getting involved in producing regulat- government regulations for protection of workforce. I’m giving a testimony twice to the UN Commission on Human Rights about brain health as human right in older adults.
So there’s are different aspects that bring this brain health as a common language and tent where we could meet and negotiate the terms, you know? And new- Yeah … strategies. Absolutely. Yeah, that sounds, sounds right on time. Well, that’s the next phase. I mean, ultimately, in order to get to everyone, you need to, you know, be in all these areas, right?
You need to understand the pediatric side because that’s setting the foundation for the rest of life. There’s opportunities in the employer, you know, opportunity to create a spiritual awakening, so much so that people wouldn’t need to be on, you know, lecanemab in their older years, right? That they would be able to live, uh, you know, with healthy brains throughout their life.
Yeah, this is very validating. I had an intuitive moment. So, you know, I, I had never been the guy who had my own illness that drove me towards integrated medicine. I just, y- I came to it from an economic point of view, and also just sort of an intuitive point of view. But when my father had a cognitive decline that was really from an, a very clear, obvious exposome, like in this case, you know, mold, I just realized that, you know, that I just had an intuitive moment that this is you know, really where the future is, and, and you are living at that cross section.
I’m really grateful to meet you, to connect with you, and to hopefully, you know, introduce more people to your book and your work. Thanks so much for being part of The Evolution of Medicine podcast. Thank you so much for having me. Well, this is The Evolution of Medicine podcast. I’m your host, James Maskell.
We’ve been with Helen Lavretsky. She’s an integrative and geriatric psychiatrist, neuroscientist, professor of psychiatry at UCLA, and, uh, we’ll be sharing a little bit more about her in the show notes, how you can get involved with the work, and some of the things that we’ve spoken about today. Thanks so much for tuning in, and we’ll see you next time.
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