The Blindboy Podcast - The Gut Brain Connection

Episode Date: April 1, 2025

I speak with professor Ted Dinan who is an expert on the relationship between food and mental health  Hosted on Acast. See acast.com/privacy for more information....

Transcript
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Starting point is 00:00:00 Shoo the croupy goose from the eunuchs jukebox you droopy kuseks. Welcome to the Blind By podcast. I am currently on an incredibly gruelling tour of Australia and New Zealand. I'm recording this right now in Auckland, or Tamaki Makaurau, as the indigenous Maori people would call it. The name literally means desirable location full of natural resources. I'm sure the Brits noticed that when they were colonizing it. However, I'm not recording this podcast in a particularly desirable location right now.
Starting point is 00:00:38 I'm in the fatal position. I'm in the fatal position in bed, covered by two quilts in complete darkness because my hotel room is tiled and the sound in my hotel room is atrocious. So the best way to get good sound on the road when I'm recording my podcast is underneath two quilts inside in a bed in the fetal position. And I know you're always saying to me, blind boy, you can miss a week. It's all right. You can take a week off if you're off on tour or whatever.
Starting point is 00:01:11 And I appreciate that. And thank you so much to the people who say that to me. But my personal role is, if I can fucking put a podcast out, if I can do it, if I can find a way to do it and get a podcast out every week, I do it, if I can find a way to do it and get a podcast out every week, I'm gonna do it. Simple as that. I'm gonna make it happen. A quality
Starting point is 00:01:30 podcast. I'm not gonna record a podcast on an airplane or in the car between gigs. I'm not gonna do that. But if I can maintain standards and put it out, I'm gonna have fun making that happen. I'm gonna do it very simply because of gratitude and humility. I genuinely love and adore making this podcast and every single day I remind myself how lucky I am that the thing that I love doing is also my job. So that gives me a wonderful feeling of gratitude and also also, I speak about failure a lot. And about maybe 10 years ago, maybe 11, I think it was 2015, before this
Starting point is 00:02:12 podcast or my books was in a musical act. And we'd booked a tour of Australia and New Zealand and so few tickets were sold we had to cancel the fucking tour. Which is, not only are you not making a living from your tour, but it's costing you money because you've paid for fucking flights and hotels and everything and you don't get it back. So that was 10 years ago, that was fucking devastating at the time. Booking a tour halfway across the world and then having to cancel it because you didn't sell enough tickets is... Anyone who's working in the music industry will tell you that'll send shivers down your spine. That's one of the worst things that can happen.
Starting point is 00:02:49 And it would have really devastated me at the time, but ten years later, here I am in fucking Auckland, underneath a dove, still gigging, the sky didn't fall down, and this tour sold out ages ago. So there's no such thing as fa- there's no such thing as failure on a long enough time scale, and every single failure is just a learning experience. And you know what I learned? Gratitude. Don't ever take anything for fucking granted. Focus on the work. And that's why, instead of taking the week off, even though it's difficult to record a podcast, I'm here under a duvet in a hotel in Auckland,
Starting point is 00:03:32 delivering a podcast and you're listening to it. So I'm aware that I can take a week off, and thank you for the people who remind me of that, but I'm choosing not to. I'm saying this too because if you're a long-term listener of this podcast, you'll know this is not the first. This is not the first crawled up in the fetal position underneath a duvet podcast. There's been a few. And every time I do those podcasts I get concerned messages from
Starting point is 00:03:56 people thinking I've gone mad. I haven't gone mad. It's just... Hold on, listen to this. Just... hold on, listen to this. Is this the podcast you want? Like this? In this room? Postman? Postman? Postman? You can't have a fucking podcast like this. No. You want this. You want this. This is what I want. This is the sound that I want.
Starting point is 00:04:23 Postman. Postman. Postman, postman, postman. Postman is a wonderful word for checking the quality of a microphone or the quality of a room, because what you get, you get a P, an S, and a T. Those hard consonants, they're like little darts. Sound, I mean sound, you can't fucking see sound, but it's vibrations of air that travel, you know, and different shapes, like a T or a P, they bounce, they bounce and create reflections or cause what's called plosives there on the microphone. And here under this duvet I could say postman as much as I would...postman, postman, postman
Starting point is 00:05:13 imagine. It's a fucking hotel now, imagine. Well one of the staff walks into the room and there's just a shape, a shape underneath the duvet on the bed just saying the word postman over and over. Very, very strange sexual fetish. Reminds me of that story. Now this could very well be a lie. This could be harsh shit or you could have heard a version of this story yourself. It was a story about one of the lad's older brother's friends, okay? So you couldn't confirm it, but the story was his name was Holly. That's what I remember I don't know why he was called Holly, but his name was Holly. This fellow was about 14 or 15 and It was the 90s so Pornography didn't really exist in Ireland in the 90s. It was actually illegal. Pornographic magazines,
Starting point is 00:06:08 films, you couldn't buy them. They were illegal. They existed, but they were smuggled in from Germany or England and sold under the counter in certain video shops. But they were illegal. And usually teenagers, if teenagers were to to see porn, it was someone's da. Someone's da had a VHS, had a video. So this fella, Holly, he had a friend who owned a porn video. He had a friend who owned a video of people having sex. So Holly would call to his friend's house
Starting point is 00:06:45 and they would watch it on a video player. And Holly was like, can I have a loan of the porn video? Can I have a loan of it? And then his friend was like, no, it's my Daz. This is my Daz and I'm after sneaking it. He doesn't even know we're watching this. He has it hidden, found it in his wardrobe. No, you can't have a loan of it. Now in those days with VHS, you couldn't like, you couldn't like copy a video onto another video. You needed to have a special video recorder that had a double deck. No one had that. But what you could do, and if you're old enough to remember this, you'll know, you could go to the headphone output on the video player, and if you also had a walkman, you could record just the audio.
Starting point is 00:07:29 You could record the sound of the video onto a tape. So Holly says, can I record the sound of your porn video? Can I just record this? You want to record the sound of the porn video? You want to hear people having sex? Yeah, it's the 90s, there's no internet. Yes, that's what I wanna do. I'm willing to record the sound of your porn video onto a cassette that I will listen to on my Walkman. So the buddy says, okay, work away. So he
Starting point is 00:07:58 did it with his Walkman and he recorded just the sound of a porn video, the sound of people having sex. So anyway, Holly, who was about 14, went home and went up and laid down on his bed with the door closed and he put his headphones on and closed his eyes and listened to the sound of people having sex while masturbating and then when he finished when he finished there was biscuits and tea beside him so his ma had walked in in the middle of his fucking while he was listening to people having sex on his headphones with his eyes closed and his dick old. His ma had walked in, and brought in, put tea and biscuits beside him, and then left quickly.
Starting point is 00:08:53 Now that might be bullshit. That might never have happened. You might have heard a version of that story yourself, where you're from, but that was... that was a horror story. When we were teenagers, that was a fucking horror story. That was terrifying. That left, that really left you frightened.
Starting point is 00:09:12 That left you scared. And I'm thinking of that now underneath this duvet, because what if the hotel manager just walks into the room, just walks in, and all they see is just a shape, and there's someone underneath the duvet just saying postman postman postman postman I'd nearly prefer if I was wanking you could explain that what are you doing underneath the duvet sir I'm recording a podcast what's it about?
Starting point is 00:09:41 Wanking! I'm not lying I wouldn't be lying. So look, I'm not doing the entirety of this podcast in the fetal position underneath these doves, that's not gonna happen. But I do have, I have a guest, I have a wonderful guest this week, this is pre-recorded, the guest isn't climbing in under the duvet with me. Now this week I'm speaking with a psychiatrist, an incredibly established psychiatrist by the name of Professor Ted Dinan from UCC in Cork. Ted is a world renowned expert in the relationship
Starting point is 00:10:21 between the human gut and our mental health, the gut and the brain connection. He's an expert on how the food that we eat influences our mental health. I've had Ted on the podcast as a guest about five years ago, but I wanted to bring him back because the field he's in is it's a margin and it's utterly fascinating and it's an area where 15-20 years ago I don't think it was taken seriously this idea that food that we eat, our nutrition, can actually have an impact on our mental health. He co-authored a book about it called The Psychobiotic Revolution which is well worth
Starting point is 00:11:05 checking out. So I'm going to play this chat I had with Professor Ted Dinan. It was a live podcast down in Cork in the Opera House and the audio is beautiful. Dog bless. You're a psychiatrist, but your area is in the relationship between the food that we eat and our mental health? That's correct. When I came back to Cork, which is about 20 years ago now, most of my research up until then was pharmacology or drug related research. So when I came to UCC I kind of looked around the campus and thought well is
Starting point is 00:11:41 there anything that's kind of world class or approaching world class here? And there were a few things. And undoubtedly, food and microbiology in UCC are extremely strong. So I kind of, I suppose, mutated the research I was doing, which was brain-related research, to look at bacteria within the intestine and look at how we feed those bacteria, which clearly we do, and you know, so that's really how the research actually evolved. So you're right, nutrition and what we eat is very fundamental, but because it
Starting point is 00:12:20 directly affects the brain. I mean, clearly some food gets into the brain and some food ends up feeding the microbes in our intestine. And something what I find fascinating about the research is and the findings that you have is so I'd say nearly 30 years ago to say to somebody the food that you eat may impact your mental health or your mood this would have been considered like what we call holistic or you wouldn't it wouldn't sound very scientific absolutely and it'd be the type of thing that might be rubbish yeah yeah it would have been I mean when I was a medical student and I went to med school here in Cork when I was a medical student we
Starting point is 00:13:04 spoke about commensal bacteria in the intestine and that meant that there were bacteria in our intestine, they didn't do us any harm but they didn't do us any darn good either and we have about a kilo and a half so about three pounds of bacteria in our intestine which is a lot of, is a big volume of bacteria, it's about the same weight as the human brain. And you know, that those bacteria should all, I mean, there was never a time when humans were sterile. We've never been animals that didn't have bacteria on board. So we've evolved with those bacteria. And clearly, those bacteria do us a lot of good, as we can talk about in a moment, and we in turn of course feed them. I mean if we didn't eat those bacteria
Starting point is 00:13:53 wouldn't survive. You know I always find it quite intriguing, I'm a psychiatrist, a general adult psychiatrist, and I would occasionally see people who have anorexia nervosa for instance. It's a nasty condition to put it mildly, but it's interesting that in anorexia nervosa, when people, when the sufferer takes in a certain amount of nutrition, it might be a very small amount because obviously they're anorexic, but the actual bacteria result in the absorption of far more calories than any of us here would absorb. So we end up absorbing more calories than in fact than the normal person does, presumably because the bacteria I suppose in some sense realize that if they don't take in what calories are there, they'll
Starting point is 00:14:46 end up dying. I mean, if you know, I mean, and Rex intervals, it can be a it can be a lethal or a fatal condition in some conditions, you know. And what about like, the hard thing to understand is, is how you're even proving the stuff you're looking at. A simple question I'd have is, are we eating food today that you can tell isn't helping our moods or our mental health? I think there is no doubt about that. When you look at a Western diet, it
Starting point is 00:15:26 consists of a lot of processed food. I mean, if you go into a fast food joint, you know, you're going to get highly processed foods. And highly processed foods have a very negative impact on the gut microbiota, and they're not very nutritious. You know, if you consistently eat ultra-processed foods, the actual diversity of bacteria, as I said, is a kilo and a half of bacteria in your intestine, and they're very diverse. There are up to a thousand strain of different bacteria in your intestine, but the diversity of those bacteria shrinks enormously if you go on a diet of ultra processed foods. So it's like when you say biodiversity I'm thinking of like biodiversity so if we think of a forest yes if you throw a
Starting point is 00:16:20 factory into the middle of that forest, you lose biodiversity. Yeah. So that's what eaten fast, very processed foods. Absolutely. And we need a diversity of natural bacteria in our guts. We do. We do. You know, it's interesting that, you know, when a baby is initially born and if it was born per vaginum through the mum's birth canal, for the first two years of life it has very limited bacteria in the intestine. They're lactobacillus and bifidobacteria
Starting point is 00:16:50 so there's no there's no great diversity. Now obviously if the baby is born by caesarean section it's a different situation they end up with far more diversity than normal because they pick up bugs from the skin of the mum, the skin of the doctor, the skin of the nurse and so forth. So they end up with a very diverse microbiota. But when we're talking about healthy adults, as adults we want to retain as much diversity as possible. A loss of diversity is a forerunner to ill health. And that's particularly true in elderly people. I mean, elderly people, people, we all want to grow old and the older I get, the more I want to grow old
Starting point is 00:17:34 and age in a healthy way. But, you know, healthy aging is about maintaining diversity in the gut microbiota. There's wonderful data here from Cork actually, which was in nature, was on the front cover of nature a few years ago from Paul O'Toole's group, where he followed a large group of people in the community, some of whom ended up in nursing homes, some of whom didn't.
Starting point is 00:18:00 But before they became frail, there was a loss of diversity. The normal diversity that you see in healthy young adults was lost. And that preceded the onset of frailty. So people became frail after they lost the diversity in the microbiota. And if we're to look at a person who doesn't have this diversity of bacteria in their gut, right? What mental health issues does this person more at risk of? Right. That's an interesting question. Certainly stress related disorders are increased very dramatically. Now, there is increasing evidence emerging in neurology that maybe Parkinson's disease might be associated with disturbance of the
Starting point is 00:18:51 gut microbiota as well. But in healthy adults who lose diversity, the risk is that one develops stress-related disorders. Now, what do I mean by stress-related disorders? I mean the anxiety disorders, there were a few different anxiety disorders, and depression. We did a study, we published a paper a few years ago, where we took people who were attending my clinic at Cork University Hospital at the time, and they volunteered to give a sample of poo basically, faeces, and we looked at the diversity of the microbiota, the bacteria within their faeces, and we compared them to a group of healthy subjects. And what we essentially found was that the people who were depressed, now these would have been quite seriously depressed individuals, they had a definite decrease in diversity of microbes
Starting point is 00:19:46 within the intestine. And interestingly enough, you know, when you take the feces from somebody who's depressed, and if you transplant it into an animal, a rat, let's say, or a mouse, and that's very easy because rodents tend to be coprophagic. They will eat feces, you know, so it's not very difficult to transplant the microbiota. You don't have to do anything horrible to them. They'll do that naturally. But if you transplant the microbiota of the depressed patient into a rat and you have another group of rats in whom you transplant the microbiota from a normal healthy individual. The actual behavior of the animal who is the microbiota for the depressed patient radically changes.
Starting point is 00:20:35 They become more depressed like, they explore far less in their environment, their biochemistry alters, their immunology, I mean there's a lot written and spoken about even in the lay press now about immunology and how it can be disturbed in depression and other conditions. So in various ways their behaviour, immunology and biochemistry changes and that's when they've had the transplant from a depressed patient. An animal who has a transplant from a healthy subject, so who is a humanized microbiota but from a healthy subject, there is no change in behavior or any aspect of biochemistry. That's fucking unreal. What's coming up for me as
Starting point is 00:21:21 you say that too is I just couldn't like that's unbelievably fascinating and that for me there is that I? Love it when science Reminds me a bit of art and what I mean by that is the level of lateral thinking and absurdity Required to do that yes, and we're gonna get a rat Like let's be honest, but at the same time, yeah, like what's breaking my heart about it, right, is in America at the moment, you're seeing Trump in particular is removing funding for a lot of a lot of science is getting funding. Absolutely. And they're they would take a study like that.
Starting point is 00:22:05 They'd say, have you seen what they're doing in Cork? They're getting rats to eat shit. But they had, I think Trump used the example where they said that some scientists had taken several million, they were being funded several million to make mice transgender. And they used this as an example of, hey, isn't this mad? Look at these crazy scientists. Let's stop giving them money. But like what you've just described there, that's absurd.
Starting point is 00:22:35 It's like, what are you doing there? What are you actually doing, Ted? Well, we're getting a rat to eat human shit. And that's what it is. And it's silly and crazy. But what you've discovered there is fascinating and probably life changing for humans in the future. Yeah. Well, I suppose the life changing aspect will be when we have technical
Starting point is 00:22:58 interventions that actually improve the management of mental health. And by that, I mean I mean you know I introduced a concept in the literature a few years ago called psychobiotics and psychobiotics are bacteria which when we ingest them in adequate amounts have a positive mental health benefit. Now we have worked on a number of different microbes and John Cryan and Harriet Chellicans and I and you know several others have worked on a number of different microbes, John Cryan and Harriet Chellicans and I, and several others have worked on a variety of different bacteria.
Starting point is 00:23:30 And most probiotic bacteria that you'll get in a health food store here in Cork or any town in Ireland really, most of them don't have any impact on mental health. But what we found was having, we identified a number of bacteria which clearly did have a positive benefit on mental health. There was one, it was a biflongum, I think it was strain 1714, but we began working with that a few years ago and we found that when people took it,
Starting point is 00:24:00 and we did, it was placebo controlled, so people didn't know whether they were taking this or they were taking a placebo they were less stressed and they reported themselves as less stressed. Now the stress hormone in humans as I probably most of you know is cortisol and when we're very stressed our cortisol levels are particularly high and the best time of day for distinguishing somebody who's very depressed, stressed from somebody who's not stressed is first thing in the morning when somebody wakes up. So one of the ways in which we've been looking at cortisol is just simply to take saliva from people and look at their cortisol levels and people who are stressed will have very high cortisol levels in their saliva. Now interestingly enough cortisol and saliva, the levels parallel those in the blood. So if they're up in the blood
Starting point is 00:24:51 they'll be up in the in the saliva. And what we showed was that people who reported themselves as less stressed on this particular psychobiotic, their cortisol levels were much lower. So they found themselves to be less stressed and their cortisol levels were much lower. So they found themselves to be less stressed and their cortisol levels were much lower. And interestingly enough, and I think this is quite intriguing, we did very sophisticated electrophysiological analysis of the brain and we found that ingesting these bacteria actually changed the EEG activity. So the electrical activity in the brain was altered following the administration of thisG activity. So the electrical activity in the brain was altered following the administration of this particular bacteria. So I think, you know, I'm a big
Starting point is 00:25:33 believer that for most of us, diet is the way to change bacteria. It isn't by taking capsules or supplements in any way. There are occasions where supplements are required, but I'm a big believer that diet is really the way forward. But having said that, we found that with this particular probiotic or psychobiotic, that there genuinely was an impact on stress. So I would like to see a situation evolve over the next few years, you know, most people who are depressed don't come to see psychiatrists like me. They might go to their GP, they might go to a psychologist, they might go to a counselor, you know, they don't end up seeing a psychiatrist, which is fine. So I see the tip of the
Starting point is 00:26:18 iceberg, so people who are very, very severely ill.. Now if you look at people who have milder forms of illness most of them don't want to take an antidepressant. Now I'm not adverse to antidepressants, I prescribe them and I think they can be very very useful but most people who have milder forms of depression don't want to take an antidepressant and I think over the next few years, and I would hope even within the next four or five years, you will see psychobiotic bacteria out there which are probiotic that can be taken that will be beneficial in people who are mildly depressed. In fact, there are studies out there at the moment, there are studies where they're called meta-analysis,
Starting point is 00:27:04 meta-analysis where you combine a whole load of studies and you draw conclusions not based on one study but on several studies and those meta-analysis do conclude that certain psychobiotics in fact have antidepressant effect. So I don't think that this is ever going to be a way for treating the very severe forms of depression that I might see at my clinic. But I do think that it will be the way forward with milder forms of depression in primary care or, you know, in a counseling or a psychotherapy session. That sounds incredible and phenomenal, right? But the thing that comes up for me when I hear you speaking about this is, and I look at society, what I
Starting point is 00:27:46 think of is issues around class and issues around poverty, right? So if you think of not so much in Ireland yet, right, but very much in America, if you're very poor in America, first off you're under a huge amount of stress, so your life is very stressful, but also cheap food tends to be processed. Getting your hands on fresh vegetables, fresh meat, whole foods is very, very expensive. So people who are experiencing the trauma and stress of poverty are also finding themselves in a situation where the food that they can afford happens to also be processed.
Starting point is 00:28:25 Like, how does that conversation start? Because obviously with this, the goal of this is that your research finds its way into government and into policy. And then if your research is saying, it's a good idea for the general population, for their mental health, to be eating whole foods, then you have to have a conversation of, well then everyone should be able to afford it in some way and we're drifting away from that. That's a very, very important point. You know, a few years ago I was part of a European consensus, we published a paper recommending an appropriate diet for people who suffer from depression or either currently depressed or suffer from depression.
Starting point is 00:29:07 And we made a number of recommendations and the recommendations essentially were that people who suffer from depression should eat a lot of fruit and vegetables, they should eat a lot of fermented food and nuts are certainly a good part of the diet and they should keep red meat particularly to a minimum. Now that is I think you know an optimal diet for somebody who's suffering or at risk of suffering from depression. The point you raise there is a very important point but you know I would ask you know, I would ask, you know, how much do carrots cost in cork? How much do turnips cost? How much does a cabbage cost if you go into the English market? Not an awful lot. You know, during the summer, mackerel can be very
Starting point is 00:29:57 plentiful. Mackerel, fish is a key component of a healthy diet. I know, you know, in my clinical practice, I have patients who come in to me and I say, do you eat fish? And they say, oh God, I wouldn't eat that, I hate the smell of it or whatever. So I appreciate that there are some people who don't like eating fish, but you don't have to eat expensive fish. You don't have to be eating oysters or flipping whatever. You know mackerel during the summer months is very cheap. So I think we have a big educational issue. You know, this isn't the money. I think money is important, I agree entirely. You know you can spend a lot of money on a very good diet but you can actually spend less money on a good diet than on a highly processed diet.
Starting point is 00:30:45 So information and education there is very important. Because the last time I was chatting to you, you were talking about how brilliant it is. Kimchi. Yes, yes, yes. Over the pandemic, I made fucking loads of kimchi. But kimchi is wonderful because it's just a fucking head of napa cabbage that you get in dons for like a euro and then the rest is salt and as much chilli as you
Starting point is 00:31:12 like and some garlic, but also just it's a very mindful thing to make. The process of making kimchi, keeping it in the jar. And then once you get the taste of it, it's a bit freaky because it's cabbage that's fizzy. So if you've never tasted kimchi, it'll freak you out. But you were saying like kimchi that you make yourself can actually be fantastic for. Oh, absolutely. I mean, there are kefir, kombucha. I mean, there are so many different types of fermented food out there. Like even my ma makes kefir. She's in her 80s. You know what I mean?
Starting point is 00:31:44 And she enjoys making it like kefir. Yeah, indeed. You know, I suppose certainly when I grew up in Cork, the only fermented food that was available at the time would be yogurt. But of course you go into any super value, you know, or any shop at all and you'll find kombucha, kefir, you know, kimchi, you know. So you get a wide variety of fermented foods. And fermented foods are very, very good because, you know, they're obviously, you can go into
Starting point is 00:32:12 a health food store and buy capsules with lactobacilli or bifida bacteria. But I believe I think the most appropriate way of taking anything is in a good diet. You know, there's a very interesting and I think it says a lot about about medicine. In 1905, Elie Metchnikoff who was a Russian zoologist won a Nobel Prize in medicine and he won a Nobel Prize. He traveled through Bulgaria and when he traveled through Bulgaria he noted that there were a lot of people who had reached a hundred years of age. Now back in 1905, you know, not too many
Starting point is 00:32:51 people would have reached a hundred, but he recognized the fact that the people who lived to very old age invariably were taking an enormous amount of fermented food in in their diet. So they were eating a lot of fermented food. He won the Nobel Prize in 1905 and it says a lot about medicine. For a hundred years his work was largely ignored and forgotten about. And that happens in medicine that something can be fashionable and Donald Trump or somebody comes along and castigates it and it disappears from vision. But certainly he found, and I think it is true, that eating fermented food and a variety of fermented food is exceedingly good.
Starting point is 00:33:34 Now, if one doesn't like fermented food, maybe taking capsules is a reasonable alternative. But I do genuinely believe that there is no alternative to eating good food. Now, it's a bit like, you know, I've mentioned fish. Personally I like eating fish. I enjoy fish. Some people don't. And you know, polyunsaturated fatty acids are the fatty acids that we get from fish. And there's a lot of omega-3 in particular in fish. Now you can buy polyunsaturated fatty acids in capsules and any in boots or wherever.
Starting point is 00:34:12 If one doesn't eat fish, I think it is reasonable to take in polyunsaturated fatty acids in a capsule because we don't make polyunsaturated fatty acids ourselves. I mean, you know, most things in our diet we might be able to replicate by taking in some other food or we may manufacture it ourselves but we do not manufacture polyunsaturated fatty acids so I would recommend that if somebody doesn't eat fish, doesn't like fish, that taking in polyunsaturated fatty acids is probably important. Somebody is vegan and don't want to eat anything that comes from animals.
Starting point is 00:34:49 There are sources of polyunsaturated fatty acids that are vegan appropriate, so they don't come from fish. And so I would suggest, and you can get those in boots, you can get them in various pharmacies. Flaxseed. Yeah, exactly. Flaxseed would be a good example. And of course, you know, you mentioned mental health and supplements a while ago. And of course, most people here will have heard of serotonin because, you know, various, I suppose, Eli Lilly and drug companies have rendered it popular by introducing drugs that impact on the serotonin system. And serotonin is manufactured from tryptophan. So tryptophan is an amino acid.
Starting point is 00:35:30 That's a tarpehiness. And a lot from Turkey. But we showed about 10 or 12 years ago that in fact, it used to be said, and it still is said in a lot of medical textbooks, that all the tryptophan comes from diet. And Turkey is a very rich source of tryptophan, but we actually showed that in fact microbes can produce tryptophan as well and that particularly bifidobacteria actually manufacture tryptophan. So there's two sources of tryptophan. There's tryptophan from the diet and there's tryptophan from the bacteria in our intestine and tryptophan crosses the blood-brain barrier, gets into the brain and it's the building block of serotonin. Now I sometimes regard it as simplistic but psychiatrists are often, you know, sometimes
Starting point is 00:36:23 can talk in my opinion in rather simplistic ways. I don't believe that depression is just simply a disorder of serotonin. I think that that's a gross oversimplification. But I do believe that serotonin does play a role in mood and undoubtedly tryptophan, which is the building block of serotonin, we need enough of it crossing the blood-brain barrier in order to keep the serotonin levels normal because without adequate serotonin you undoubtedly see a lowering of mood, you have problems with sleep, sleep undoubtedly becomes dysregulated and appetite can become dysregulated as well. Before we go for a break, something...
Starting point is 00:37:05 So you also, you worked in pharmacology, you got a PhD in pharmacology. And when I listen to you sometimes, I feel like the things that you're saying are actually quite threatening to the pharmaceutical industry because you're saying... you're not... what you're saying can't be turned into a pill. Well it can be, but you're saying actually just go and eat better food. You're not saying we're going to get this and put it in a pill. Do you ever find pushback from pharmaceutical industry or anything? No, well my attitude is that the people who would come to see me who are very severely depressed, undoubtedly they need pharmacological and or psychological intervention. So I think what I'm saying
Starting point is 00:37:49 really is more applicable to milder forms of depression. I mean, you know, cognitive behaviour therapy is a very useful form of psychological intervention. Antidepressants also have a role in treating depression. But I do think that it's, you know, when you look at milder forms of depression, the two key items as far as I'm concerned are good diet and exercise. And I think that in general, people do not exercise enough. I mean, I always give people advice that they should exercise and I have 23 or 24 year olds come into my clinic and they come in the following maybe two or three weeks later and they say, I've been exercising.
Starting point is 00:38:30 I've been walking two or three miles a day. Now, for somebody at 23 or 24 years, two or three miles a day walking is a joke. I mean, you know, it needs to be vigorous exercise. And I think ultimately optimally, it should be a combination of aerobic and anaerobic exercise. By that I mean, you know, by aerobic exercise, I mean, I've always loved running, you know, I still run, I enjoy it, I get a lot of pleasure from it, I've been doing it since I was a kid. But anaerobic exercise would be lifting weights or sprinting or whatever, you know, because
Starting point is 00:39:06 they're, they're, they're, you run out of oxygen pretty quickly when you're doing those sort of things. But there's no doubt about it that when it comes to mental health, apart from diet, which is clearly very important, exercise is absolutely fundamental. And not just in relation to depression, although, you know, if you run five or six miles or, you know, whatever, your mood lifts. Yeah, definitely. You know, like, I mean, Jesus, we all noticed that over the pandemic. Like if anyone here was exercising regularly, I was exercising,
Starting point is 00:39:41 like running and going to the gym was the cornerstone of my mental health. And then when the pandemic hit, couldn't go to the gym anymore. Yeah. Then because I couldn't go to the gym, I started running more, but it was like my muscles wasted away and then I ended up injured and couldn't run at all. Yeah. And that's when my mental health difficulty started over the pandemic. And one thing I would like to ask to ask you before we have a break is
Starting point is 00:40:06 when my, okay if I'm experiencing anxiety and I'm depressed, I want to eat shaped processed food, right? But when I'm exercising frequently, going to the gym, feeling good, I don't crave processed food, I crave food that's homemade, that's that's whole. What's going on there? Why do I want shit when I'm depressed and good food? That's an interesting question. I mean I'm fascinated by muscle and the proteins they produce. I mean the proteins that are produced by muscle are called myokines and when we exercise obviously we produce a lot of myokines. One of the myokines is actually brain derived neurotrophic factor so it's actually very important from a brain perspective but the other myokines are very important as well. And they have a big influence on our gut. They have a big
Starting point is 00:41:05 influence on the microbes within our intestine. So I don't, I can't give a very specific answer to your question, but I do believe that generating myokines by vigorous aerobic exercise does tend to lead us towards good food choices and poor food choices when we exercise badly or when we don't exercise at all. Or when you've got the fear from a hangover. Jesus Christ. But seriously, you know, when you get the fear from a hangover and depressed and anxiety, it's like I battered sausages only, please.
Starting point is 00:41:41 Nothing else. You know what I mean? That is true. I won't disagree, but... We're going to take a break so you can have a little pint and a piss and we'll be back out in about 15 minutes, all right? Welcome back to the Dove.
Starting point is 00:41:55 I'm underneath the Dove, welcome back. Let's, I hope you're enjoying the chat there with Professor Ted Dinan. Let's have a little Ocarina pause before we get back into the rest of the chat, alright? I did bring the ocarina with me to the other side of the world. Of course I did. I'm going to play it underneath the bed covers. That was my bass ocarina. For any new listeners it might be that people could just tune into the fucking
Starting point is 00:42:45 podcast because they want to hear about the relationship between the brain and the gut and now all of a sudden, now all of a sudden I'm talking from underneath the duvet and playing an ocarina. There's a reason for that. It's that you didn't get startled by any advertisements. I don't like startling people with advertisements. They can be very loud and abrasive, so I play an ocarina to warn people. And that's a dog-friendly ocarina. It's a base ocarina, so it won't excite the ears of any nearby dogs who might be listening to this podcast. Support for this podcast comes from you, the listener, via the Patreon page, patreon.com the blind by podcast. If this podcast brings you mirth merriment escapism
Starting point is 00:43:28 Entertainment whatever the fuck has you listening to this podcast, please consider supporting it directly where listener funded I adore making this podcast I'm incredibly grateful that this podcast is my job But it is my job and the reason that this is my full-time job is because of direct funding from listeners via the patreon page This is how I pay my bills So I rent out my office Everything all I'm looking for is the price of a pint or a cup of coffee once a month That's it and for that you get four podcasts a month
Starting point is 00:44:00 But you know what if you can't afford, if you don't have the money, whatever, that's no problem at all. Listen for free. You can listen for free because the person who is paying is paying for you to listen for free. So everybody gets the exact same podcast. I get to earn a living. Patreon.com forward slash the blind by bad guest Ideally sign up on on a desktop or the web browser on your phone Don't sign up as a new patron right using the patreon app on the iPhone Because Apple are greedy greedy bastards, and they take 30% okay, just a few a few upcoming gigs I mean I Think I'm gonna have a quiet-ish summer. Well, no, there's a big huge fucking, a big tour.
Starting point is 00:44:49 But in Ireland on the 18th of May, I'm up in Caven. Wonderful, beautiful Caven. I can't wait. The Caven Arts Festival. I think I gigged that last year or the year before. Beautiful, wonderful, Cavern. There's, that's a very small gig. It's a tiny little gig that I wanna do
Starting point is 00:45:11 because Cavern is beautiful and I wanna have a day trip up to Cavern and do a little gig at an arts festival. So there's very little tickets for that. Come along to it, the Cavern Arts Festival, the 18th of May. And then I embark on my big giant tour of Scotland and England which is starting in June. I'm in Bristol, Cornwall, Sheffield, Manchester, Edinburgh, Glasgow, York, London, Norwich, East Sussex and Bexhill. I'm doing a big tour for the wonderful Kraken Tans
Starting point is 00:45:48 in the middle of summer. I'm really looking forward to it. There's very little tickets left for that tour. So come along, please. Come out, ye Kraken Tans. It's gonna be great, Krak. And also, any of those places that I listed out, if you have suggestions for guests
Starting point is 00:46:06 or people who'd like me to speak to at these podcasts, just give me a shout on Instagram. Blind by Ball Club on Instagram. Back to the chat with Ted Dinan. It's toasty underneath these. It's fucking hot outside. And I'm underneath this duvet. Back to Cork in the past.
Starting point is 00:46:21 We were chatting backstage about... When you're mentioning fermented food right now, I was drinking a beer and I'm like well beer is fermented, does that count? Well I think it does, I mean you know beer, I wasn't drinking them I quickly had but anyway, the beer and wine are natural products. I mean, I do see distillation as producing something which is highly processed. I mean, you know, one can make an argument for Irish whiskey or whatever, but it is a processing business. I mean, when you look at beer and wine, they occurred naturally.
Starting point is 00:47:08 They weren't something that we suddenly evolved with. So they are natural products of yeast fermentation. I'm going to go on a small bit of a tangent now, right? But on that subject of distillation, something I'm fascinated about with your work is I I love mythology and I love folklore, right? Because I think that mythology and folklore were things that human beings had before we had writing and before we had science. Yeah. So you can find a lot of knowledge in in our stories. And even you're mentioning there about distillation.
Starting point is 00:47:48 Distillation is something to be cautious about, and distillation also isn't natural. And you can see evidence in that, in Irish folklore around distillation. Like I was speaking to you backstage about, just on the subject of mental health, the changelings. We had changelings in Irish folklore. And you know about just on the subject of mental health, the changelings. We had changelings in Irish folklore and you know about changelings, do you?
Starting point is 00:48:10 So changelings were... It wasn't just Irish folklore, you had it in a lot of European folklore too, but a changeling is the fairies will come and they will harm someone that you love and they will replace the person that you love with a changeling and this was often used as an explanation for very very sad things that we didn't understand. So one thing was there was huge infant mortality. Infant mortality was massive 200 years ago and if a person went to their baby and the baby wasn't alive anymore, their way of rationalizing it wasn't my baby has died, this is a
Starting point is 00:48:53 changeling. What is before me is a changeling. This is a like a little doll that the fairies have put here and they've taken my baby and that baby is away with the fairies. And it was also used as an explanation for people who might have been mentally ill. You know, if your brother or sister experienced psychotic symptoms or even dementia, they would say that's not your brother, that's not your sister, that's not your father, that's a changeling. The fairies have come and they have taken the person that you love and they're away with the fairies But what's been left behind is a changeling and these were the stories that people told themselves to to explain grief something they didn't understand
Starting point is 00:49:33 But with pochene makers, right? very fascinating thing occurred with it within the folklore of pochene makers and how I find this shit out is makers and how I find this shit out is there's a beautiful website called Ducas.ie and what Ducas is is it's our collection of national national collection of folklore. In the 1930s the government went to all of the children in Ireland, all the school kids and the government wanted to create what's called the schools collection. They went to all the kids in Ireland in the 30s and said go up to the mountains's called the Schools Collection. They went to all the kids in Ireland in the thirties and said, go up to the mountains, go and find some old people in your community,
Starting point is 00:50:11 get them to tell you their stories and write it down. And this is the Schools Collection. And when you go to Dukas.ie, there's 700,000 documents. You can type in any word and you will read a story that a kid wrote down and they might have been talking to their great-grandparent or whatever these old stories. And when I type in Puccine I find out about the folklore of Puccine makers and Puccine makers believed that they were susceptible to the fairies to the point that if a a poutine maker had a little kid, a little boy, boys
Starting point is 00:50:47 in particular, they would dress the boy as a girl until that boy was about six or seven years of age because they wanted to confuse the fairies. But the poutine makers believed that this process of getting fermented beer and then running it through a still was so unnatural and so strange and this end result of this spirit was so strange that they must be stealing it from the fairies, that this is somehow wrong. So they believe that when they were doing this that what they do is you start fucking brewing Puccine now or you start distilling Puccine, you're stealing magic from the other world and the fairies are going to come and get you and what they're going to do is they're going to come for
Starting point is 00:51:26 your boy child. They're going to make it into a changeling. So dress the boy as a girl to confuse the fairies. But also they weren't writing recipes down. They weren't writing down the process of distillation. So they had the stories about how to do it. And the first bit of Puchin that comes out from the still is known as the fairies' leavings and they take it and they throw it over the shoulder for the fairies but that first bit that comes out, I don't know the name of it, it's whatever type of alcohol it is, it's the one that can blind you. Methanol.
Starting point is 00:51:58 So methanol is the first one that comes out. These poutine makers didn't know what the fuck methanol was but they knew that this is. So you give that one to the fairies. And what you have there is indigenous folk knowledge confirming what you're saying there. This is not natural. This thing that's being done. And the interesting thing about just about the history of distillation, the Irish were the first to make whiskey. We were the first ones to make what we would call whiskey, right? And how we figured out how to make whiskey was around the time 56th century Patrick comes over, right? And what Patrick does is he doesn't just introduce Christianity, he introduces the
Starting point is 00:52:42 new technology of writing, okay, to Ireland in the 5th century. And what the Irish monks were doing in the 5th century, Britain was collapsing, Europe was collapsing because the Roman Empire was collapsing, and Irish monks were preserving Latin. They were preserving the Latin language and through trade Irish monks were getting their hands on any piece of Latin script or Greek script that they could get their hands on and translating it into the illuminated manuscripts that we know. But what they also came across was the people who invented the process of distillation were the Arabs, okay? And the Greeks translated the Arab distillation process. But when the
Starting point is 00:53:26 Arabs were distilling, they weren't making alcohol, they were making perfumes. They were getting flowers and making essential oils. But then Irish monks were the ones to go, what would happen if we did that with beer? That's how whiskey came about. That's why whiskey comes from Ireland. It was just drunk Irish monks because beer was being made in monasteries, you know, this natural beer. And some monk just said, those Arabs there that were making perfume, let's chance that with beer. And then we end up with whiskey.
Starting point is 00:53:56 Yeah, yeah. And I think, you know, one of the points you've made there is, you know, the very essence of being human is to want explanation. And in recent times, I mean, obviously, science has provided some explanation. There's still loads of issues that we don't have scientific explanations for. But of course, you know, when you look back, people had different explanations, you know, you're back to polytheistic times
Starting point is 00:54:25 when people believed in multiple gods. I mean look back at ancient Rome and they had numerous gods and they explained things based on the activity of the gods, you know, and obviously in recent times we've had monotheistic religions like Catholicism or Christianity, Judaism, Islam and so forth. And they do provide as religions, they provide a certain explanation for things. Science, I suppose, has only been around for relatively short period of time and it does provide a certain explanation. You know, it's interesting. When you look back
Starting point is 00:55:06 at ancient Rome, one of the most famous physicians in ancient Rome was Galen. And Galen, he was actually Spanish but he was regarded as a Roman, and he put together the first group of pharmacology compounds of drugs that were used for treating a variety of illnesses. And that pharmacopoeia actually lasted for 1500 years. And after 1500 years it was largely replaced. But it really does demonstrate that advances in science, we all like to think there are going to be major advances in science and a cure for cancer around the corner and a
Starting point is 00:55:44 cure for this and that but in fact science moves very very slowly and the progress that's made over a lifetime is actually very limited. I mean we like to think that there are major advances being made at the moment and there are some advances being made and undoubtedly things like artificial intelligence will help move the process forward because if you have, let's say, a receptor that you think blocking it might be useful in treating a cancer, you can now look at a library of thousands of molecules and come up with one or two molecules that block that receptor and you can do that in maybe 10 or 15 minutes whereas before it might
Starting point is 00:56:25 take months of manually going through the various compounds. So I think, you know, science does move, it moves rather slowly, it moves erratically, in other words there are, you get paradigm shifts where you get a shift in a paradigm and then things remain static for a very long period of time. But I do think to get back to the point really of what you were saying is that there are, there is the fundamental issue that humans like predictability and humans like to be able to explain things. Even if the explanation we might regard as inadequate or inappropriate.
Starting point is 00:57:08 I think as humans we do like to have explanations. And a story if we can. Exactly, exactly. Just another one that you love as a psychiatrist. Have you ever heard of Gláine Géilt down in Kerry? I've heard the name, yeah. It means Valley of Madness. And it's so there's this near the Shleve Mish mountains down in Kerry, right? There's a
Starting point is 00:57:32 holy well down here and we call it a holy well. But before it was a Christian well, it was definitely a pagan well. And in the mythology of this particular well in this area of Kerry, it's associated with madness. Like there's one story about mad King Sweeney and this story could be thousands of years old and it's about a king called King Sweeney. He kept hearing bells in his ears and then he convinced himself that he was a bird. And this man, this particular king, sounds like someone who was experiencing quite severe psychosis, you know, and it's there in the stories. And at the end of this story, the only place where he could find peace
Starting point is 00:58:13 was by this sacred well in Glan na Géalt, the Valley of Madness. And for years and years in Irish folklore, people who were experiencing severe depression, psychosis, would travel to this valley and they'd eat watercress and they'd drink from the well. And this is there in the folklore. And then a few years ago, a team of scientists went down and tested the well. And you know what they found? Lithium. Isn't that fucking amazing? No, a lot of these holy wells in Ireland have a high level of lithium. And this is true across Europe in general.
Starting point is 00:58:49 And there are papers, there was a paper in the Lancet there a few years ago showing that people who were living around these wells, who were drinking water with high levels of lithium, had far less mental illness in general than the populations that were living far away. And we still use lithium for treating manic depression or bipolar illness as it's now called. I think it's an underused treatment. I'm not saying it's for everyone but I think for some people it really can be miraculous
Starting point is 00:59:21 in its impact. I mean I've seen people who've had bad manic depressive illness and have went on it and lithium and have been well for 30 years and remain well, you know, over a very extended period of time. I'll tell you a story of someone who came in to see me a few years ago and this particular gentleman had had a diagnosis of bipolar illness and he'd been on lithium for about 30 years and he had been perfectly well for the 30 years and the GP said to him look go and see Dine and maybe he might recommend that you come off the lithium
Starting point is 01:00:00 so I thought look 30 years he's going to be fairly okay if I take him off the lithium so I suggested he'd come off the lithium very So I thought, look, 30 years, he's going to be fairly OK if I take him off the lithium. So I suggested he'd come off the lithium very slowly over the next week or two. He comes off the lithium over two weeks. I went on a Monday morning, he's admitted on the Sunday night, having went bananas really over the weekend, having stopped the lithium. So lithium is really, it can be a very, very useful element. I mean, it's an element, it's not a drug in the traditional sense of the word. And its use has died out a lot, a lot of younger doctors and particularly if I lecture in America, I find that American psychiatrists are very loathe to prescribe lithium nowadays, but I think there is a need for it and some people benefit enormously, but the point you
Starting point is 01:00:51 raise about these holy wells and the fact that they have high levels of lithium I think is intriguing to say the least that people are ingesting levels of lithium that are not too toxic, not too high, because that's one of the problems with lithium is a very high level can be quite toxic. But obviously these holy wells have a level of lithium that seems to be protective against the emergence of particularly mood disorders. And before we had the science, it's just you've got stories about people with different types of madness or irrationality and that's attached to these certain wells. So we're holding the knowledge. We might not know what it means, but the knowledge is there for a reason.
Starting point is 01:01:31 And another thing I'd love to ask you about is, like, are there any, like, if I think of the Hindu religion and certain parts of Buddhism, There's a thing called the AOVA diet, I believe it's called. Yes. So Hare Krishnas. If you go to any Hare Krishna restaurant, Govinda's is one, they're very specific about the type of foods, when you should eat them, eating very mindfully, not to wolf the food down. Yes. There's no garlic present for some reason. They have this, no, seriously, that there's no garlic or onions.
Starting point is 01:02:07 They have another thing called asafoetida. I'm not sure what it is, but it tastes like garlic. But you have these like the Ayurvedic diet is I think it could be five thousand years old. Right. Yeah. You have these people practicing the religion and this strict diet works for them. Similarly, you have in Christianity right now is Lent. You had people fasting. Ramadan, people fasting. These things are working for people for a long, long time.
Starting point is 01:02:36 Do you ever look at that and think maybe some of the research that you're doing now is just confirming through science what some people understood just in a different way. Oh I think that may very well be the case. I have no doubt, I mean the most widely studied diet is the Mediterranean diet and there's lots of good evidence that from a mental health perspective it's excellent. But of course as you rightly point out there are many other diets that haven't really been studied to any significant extent. I mean I regard the large intestine as a bit like a big fermenter. It's fermenting the food we take in and it's producing
Starting point is 01:03:15 hundreds of molecules, if not thousands of molecules, that can travel to our brain and to other organs in the body as well. Now you know I'm sure most of you have heard of neurotransmitters you know they're the way in which one neuron in the brain communicates with another neuron and there are neurotransmitters like serotonin and dopamine and noradrenaline and so forth and all of the common neurotransmitters can be produced by microbes within the gut, all of them. Now, I'm not suggesting that they go to the brain directly, because even if they could get to the brain, they wouldn't cross the blood-brain barrier anyway.
Starting point is 01:03:55 But what they do is they can influence the brain in a variety of ways. Because you might, I mean, I suppose the question is, if what I'm saying is true and if it's not a whole lot of BS, the question really is how do microbes within the gut actually talk to the brain? I mean how do they actually get about talking to the brain? And they do that in a variety of ways. The microbes can produce molecules that travel to the brain, like short chain fatty acids
Starting point is 01:04:26 or we spoke about tryptophan earlier on, they can produce tryptophan and that can travel to the brain. Of course there's that long meandering nerve that connects the brain and the gut which is the vagus nerve and a lot of impulses from microbes go through the vagus nerve. We showed a few years ago that if you caught the vagus nerve that microbes couldn't, certain microbes couldn't communicate with the brain. They needed this vagus nerve or they didn't function. Now it's interesting that, I mean I remember and most of you are far too young to remember this, but I remember when I was a medical student one
Starting point is 01:05:01 of the things they frequently did when people had peptic ulcer disease is they would cut the vagus nerve. That was every general surgeon had in his toolkit the technique of cutting the vagus nerve and they would snip the vagus nerve and it would certainly improve people's peptic ulcers. It probably had other effects as well but it certainly did improve people's ulcers. So the vagus nerve is another route of communication. So there are many ways in which these microbes from the gut do talk to the brain and they do talk to the brain in a variety of ways. And just around the vagus nerve there, because that's another one that I hear it mentioned
Starting point is 01:05:41 a lot and sometimes when I hear it brought up it's treated as not pseudoscience but something which isn't generally accepted yet. Like one thing I'm thinking of is, have you heard the Polly Vega theory? Yes, yeah. Like can you tell us about, do you know anything about that? Well you know the Vegas nerve is, has a bi-directional role in man. What do I mean by that? I mean that it sends signals up to the brain and it sends signals from the brain down to the gut as well.
Starting point is 01:06:11 So 95% of them go up, about 5% of them actually come down in the opposite direction. Now, a lot of people believe that if you can control your Vegas nerve, you can control anxiety. And there are a variety of techniques for some of them. Most of them are breathing techniques. Yeah.
Starting point is 01:06:34 They're, you know, might involve deep breathing. Hylotropic. Indeed. So, so you control the vagus nerve and you control anxiety. Now I remember a few years ago we published a paper and we did so with some neurosurgeons in Bowman Hospital in Dublin where they implanted a stimulator in the vagus nerve in people who were very severely depressed. Now these were not people who were anxious, they were really very severely depressed and they'd been treated with all sorts of drugs and psychotherapy and none of the treatments worked. But these
Starting point is 01:07:10 stimulators implanted in the vagus nerve and the impact on some of these patients was quite dramatic. So there's no doubt about it that you can improve mental health or depression by stimulating the vagus nerve. My problem really is that a lot of this current social media suggests simple ways of stimulating the vagus nerve and I'm not sure that half of these ways, manner or techniques actually work. I do believe that stimulating the vagus nerve would be good if we had a reliable way of doing it. But I'm not sure that, you know, I do believe that deep breathing is useful, Henk. I mean, if you're stressed, it's a good thing to do. But really stimulating the vagus nerve,
Starting point is 01:07:56 I'm not sure that we have the technology or the techniques that right now for doing that. Just around the, let's just say the stomach and the experience of emotions, right? Yes. If, if I, if I have anxiety, I feel it in my tummy. Yes. If I have panic attacks over a long enough period of time, I don't want to eat anymore and I'm getting indigestion and I'm noticing anxiety as a tummy type of thing. Similarly, oh God, if you get really sad, upsetting news again, it's not the heart.
Starting point is 01:08:33 It's just somewhere there around the tummy. And there's something about the understanding of my stomach and how I experience the physicality of emotions. Is that in any way related to what you're doing? And what's going on there? I think that, you know, when one gets a lot of adrenaline in the bloodstream, and that is a key component of panic attacks, I mean, panic attacks are horrible.
Starting point is 01:08:57 You know, I always take the view that, you know, if somebody comes to see me with a panic attack, and maybe they're having four panic attacks a day or whatever, I don't really think it's particularly reasonable to say, oh well you were four when you saw me last time, bring it down to two. I mean you really want to hit this thing on the head because it's a horrible event and the more panic attacks you have the more likely to have panic attacks in the future. That's the worst crack.
Starting point is 01:09:26 Yeah, but it is true. Or for me, when I was getting them, I'd be like, oh, I got a panic attacks in a supermarket. Better not go to supermarkets anymore until I can't leave my room. Absolutely. Well, agoraphobia, which is what you're describing, I mean, occurs. I've seen people with all sorts of agoraphobia over the years, but panic attacks lead to that and it's a horrible, horrible condition.
Starting point is 01:09:51 You know, what you do see in panic attacks is you see a large or a big volume of adrenaline coming from the adrenal glands being pumped into the bloodstream and then of course it causes the palpitations and it causes the sensations in the stomach and so forth. Probably vagal nerve over activation is probably involved as well. It's too simplistic to just put it down to one hormone, but it is a horrible condition. There's no question about it. So when I first started getting panic attacks, I was about 19. The worst part was I didn't know what they were. Right. That was for me was yes.
Starting point is 01:10:32 To be honest with you, as soon as the first person I went to see was a psychiatrist, because I believed that I didn't know what the fuck they were. It's just like, oh, yesterday I thought I was in the process of dying. Do you know what I mean? I was like I was dying yesterday for no reason. I was I was in the process of actually I'm going to die. And that's what it felt like 10 out of 10 anxiety. And even when I just went to the to the psychiatrist and he said, oh, there's a name for that and that's called the panic attack.
Starting point is 01:11:01 And lots of people get them like that alone was 50 percent of my anxiety is gone. But then the other thing was and it was a beautiful thing because I was I was I was only 19 and this psychiatrist said to me, I could I could give you these pills here, these I think there was annex, I could give you them if you want. But for the crack instead, get this book. And the book, all it was was simple breathing meditation. It was called the calm technique.
Starting point is 01:11:29 And he said the medications here, if you want it, but try this first and come back to me in maybe six weeks. Right. And I just got this book and all it was was a very, very simple mindfulness breathing meditation where I'm counting my breaths. And I did that in the morning and in the evening. And I became mindful of my breathing and diaphragmatic breathing. Throughout my day, I was breathing from my stomach. And then after about two weeks, like I didn't even need to go back to the psychiatrist.
Starting point is 01:12:03 Yeah. Yeah. Like what happened there? Because that's I really I've been agoraphobic. I couldn't leave my house. It was really, really bad. And what started me was breathing initially. And then after the breathing, then I was able to do CBT. Yeah, because I wasn't in fight or flight all the time. I was in a position to start looking at my own thoughts, looking at my beliefs around my anxiety, but I needed to get the anxiety down first and breathing did it. I didn't need medication.
Starting point is 01:12:31 What's happening in my body and brain? Well, you know, what you described there reminds me of a patient I saw a few years ago when I was in London and he was a PhD student in Imperial College, he was doing maths and he was a very bright guy, he was from Nigeria originally and he came to see me and he described that when he was five years old he was walking across the schoolyard in Lagos and he had what clearly was a panic attack as he walked across the schoolyard and he from then on, he was the only person in the world suffering from this disorder. He didn't, he had never heard a panic disorder and he was somebody who couldn't walk across an open space. So he could never go to the
Starting point is 01:13:20 seaside or go, he was living near Victoria Park. He couldn't walk across Victoria Park because he would get a panic attack in the park. And sometimes he would be late coming to my clinic because he knew every alleyway and laneway between where he was living and my clinic. And he couldn't walk across a wide street because he would get a panic attack. But the bizarre thing was that here was somebody who was a smart, intelligent person but from the age of five until when he came to see me I think it was about 25 or 26, he literally thought he was the only person in the world suffering from these panic attacks. He had never heard the term before. So we know that centrally there's a nucleus in the brain called the nucleus locus coeruleus and it's
Starting point is 01:14:06 a noradrenergic nucleus. It's in the pons which is kind of, I suppose, roughly speaking between both one's ears and that seems to have played a pivotal role. Now I have no doubt that the breathing techniques that you used were able to regulate that particular neuronal network. That neuronal network does control the periphery as well. I mentioned the fact that you get high levels of adrenaline when you have a panic attack, but in fact the central regulator of that adrenaline system is this noradrenergic nucleus locus rullius in the pons in the brain. So one can learn, one can take a drug as you mentioned, Alprazolam or Xanax can do that,
Starting point is 01:14:54 but of course it's short-lived and it wears off. But in your case you were able to use a breathing technique to bring this particular nucleus under control, because what it was doing really was just simply firing sporadically in a chaotic manner and resulting in overt panic attacks. And have you anything to say about mushrooms? Like not even, I don't even mean magic ones, but again we're just seeing over the past 10 years in particular this attention being put towards mycelium mushrooms fungus as being something that we've overlooked. Yeah, I mean there's been a lot, I'm no expert on the subject that's for sure,
Starting point is 01:15:39 but there has been a lot written about the nutritional value of mushrooms and various mushrooms have various nutritional components. And I, you know, it's interesting, you know, we've spoken about bacteria in the intestine, but of course, you have fungi in the intestine as well, you know, there are a variety of fungi in the human intestine. They're not as plentiful as, let's say, bacteria. But I do think that from a nutritional perspective, rather I don't know precisely what they do to gut microbes or anything else, I do believe that that that mushrooms are a very good source of nutrients. No question about it. And if the teacher came to you tomorrow and said recommend a diet for
Starting point is 01:16:28 the whole country right and I'm gonna make sure this happens. If I was to say what would be the best diet I think that on the basis of science right now you would have to say the Mediterranean diet is the best diet you know and if you look at let's say people who are centenarians who reach a hundred Now a lot has been written about centenarians in Japan in Okinawa because there were a lot of centenarians in Okinawa but the Spanish have a big increase in centenarians in recent years and of course
Starting point is 01:17:02 There are people who tend to first of all eat a Mediterranean diet and they tend to be very active into old age. They tend to walk up steps and you know a lot of villages I suppose in Spain tend to be rather hilly particularly down in Andalusia and they'll walk up and down in their 90s or even when they reach a hundred. So I would, I think, you know, if I was talking to the Taoiseach, I would say education is absolutely essential. The diet would undoubtedly be a Mediterranean type diet and I would advocate exercise. Exercise should be for everyone. And something like I love fucking exercising, what I always say to people, for myself, right. I exercise for the process of exercising.
Starting point is 01:17:47 So if I go to the gym, I'm not really going to the gym to look a certain way. Yeah, I love being at the gym. Now, also something I've learned because I told you backstage I'm autistic. And the thing with me and my autism is. I actually love being around people. What I don't like is having to do loads and loads of small talk with lots of people. Yeah. And the gym for me as an artistic person is actually fantastic because I'm
Starting point is 01:18:14 in this space where I'm surrounded by people. And if you try and talk to someone, it's actually rude. So I have to be by myself surrounded by people, headphones headphones on all the time and small talk is shunned. So that's why I go to the gym. But I go to the gym and I run not for results, but for the love and process. I run because I love running. Yeah. You know, I don't try and I want to do 11K.
Starting point is 01:18:41 You can if you want, if you want to do that. But for me, it's just I'm doing this because I love doing it. It's the process and this makes me feel a certain way. And that's why I do it. And if I don't have it in my life, I feel like fucking shit. And when I feel like shit, I make the wrong food choices and it just all spirals. And then eventually, then after that,
Starting point is 01:19:01 I'm of the way that I speak to myself internally is quite negative. So I can see holistically, like even they're mentioning the capacity to cook. When I was in college, the first thing that gave me a real proper panic attack was actually witnessing my friend making a stew. I swear to fuck. Because I went to first year in college and I went to my buddy's apartment and he was like 18, 19 as well and he was making a fucking full Irish stew and I got this mad panic attack and I had no idea and only after a bit of psychotherapy did I come to realize
Starting point is 01:19:38 that the stew represented adult autonomy. I was terrified of being an adult and standing on my own two feet. Yeah. And I didn't know. Not only did I not know how to make a stew, the idea of going into a supermarket, buying carrots and buying meat, just it might as well have been trying to get a mortgage. You know what I mean? And I,
Starting point is 01:20:00 I conquered my anxiety through learning to cook. Like my therapist said to me, here's a little going to Duns and pick out carrots and pick out meat and mindfully pick these things out and then go home and make a stew. And I did. Yeah. And it basically through the change in behavior, it showed me, oh, your anxiety is actually a lot of bullshit. It's a belief that you had. I believe that I was incapable. I believe that I was incapable. I believe that I couldn't.
Starting point is 01:20:28 But now I've shown myself that I can. So I then wanted to learn how to cook everything. Yeah. So I fell in love with the with cooking and I cook because I love the process of cooking, I love doing it, you know what I mean? Yes. And my attitude towards my mental health, it's always holistic. It has to be exercise, diet, and then how I speak to myself, and meditation and mindfulness.
Starting point is 01:20:53 Yeah. Well, I think you've put your finger on all the key ingredients really to be in a good place. It keeps me away then from needing to knock on the door of someone like you. Yeah. You know what I mean? I don't. I still have a seek. I'll get a little bit of anxiety, a little bit of depression, but I would consider them. This is healthy. This is a response to the stress that arises in my life. But I don't think I end up mentally unwell anymore.
Starting point is 01:21:19 You know, you see, I think a lot of people, if they're suffering from undue anxiety because of problems at work or whatever, they may decide to go down a good road and to go to the gym regularly or go running and to eat more appropriately. But as soon as the stress is off and they're back to normal again, they kind of revert back to their old ways and they stop exercising. I always think that I enjoy running, you know, whether it is 10 miles or a half marathon or whatever. But I always think that, you know,
Starting point is 01:21:53 it's easy to get into the habit of doing things and it's easier to fall out of the habit as well, really, isn't it? You know. But the vibe I'm getting as well, Ted, is that a lot of what you're saying is it's a proactive thing rather than a reactive thing. It's a good idea that people should just be doing these things anyway to proactively. Absolutely. I think so. You know, one doesn't need to develop mental health to start exercising or to start going on a good diet.
Starting point is 01:22:19 I think, you know, and a good diet and exercise is not just for mental health. It's for one's overall well-being. You know, there's no doubt whether you're talking about cardiovascular health or the health of your intestine or any other organ in your body, exercise and a proper diet is good for all organs in the body, not just the brain. And it is 20 minutes past 10. You people have homes to go to. Professor Ted Dinan, thank you so much. I appreciate it.
Starting point is 01:22:49 Yes. All right. What a magnificent chat there with Professor Ted Dinan. If you want to get his book, The Psychobiotic Revolution, please do. A biggie farewell. I'm gonna have to record next week's podcast. I'll be recording it in Melbourne, I believe. So, let's see what happens with that.
Starting point is 01:23:13 I might do a little walk and talk. Sometimes I like to do a walking tour podcast. So, I'm gonna have that in, in the back of my head, actually people of Melbourne are Narm, as it is known by the indigenous Wurundjeri people from Narm and again I believe Narm means a rich and abundant area of natural resources. I'm gonna be chatting with Tyson Yunkaporta when I'm in Melbourne and I'm looking forward to that. He's an Aboriginal scholar and
Starting point is 01:23:41 critic that loads of people have asked me to speak to, so I'm looking forward to chatting to him. But anyway, listen, if next week I might do a walk and talk podcast around our own Melbourne, our own Narm, so if you have any interest in local history or an area that you think I might like to walk around and tell the history of this area or just investigate and make a podcast out of it, give me a shout on Instagram, Blind by Ball Club, and tell me some interesting local stories. And Jesus, I could fucking hell. I've definitely told you this one before, but I remember I gigged in Melbourne, I'd say it was 2011, long time ago. And anytime I go anywhere on tour tour as a result of the autism I'm just
Starting point is 01:24:27 continually on Wikipedia all the time trying to learn about everywhere where I am and I remember I was staying in Queen Street in Melbourne in a hotel I remember whipping out my laptop looking at the maps and going oh I wonder I wonder what happened here I wonder what happened here, I wonder what happened, I wonder what the name Queen Street means. So I start going on Wikipedia trying to figure out the exact location where I am, and I'm at the location of a thing called the Queen Street Massacre. It was a horrendous mass shooting that occurred in 1987, Queen Street in Melbourne, on, in a post office, I believe. But I remember, like 11 years ago,
Starting point is 01:25:09 I was there Googling it, and as I'm reading about it, I realize, not only am I on the building where the massacre occurred, but I'm on the floor where it occurred. And my bed was where people were hiding during the shooting, before the hotel was a hotel and when it was where people were hiding during the shooting before the hotel was a hotel and when it was a post office. That was a very strange experience.
Starting point is 01:25:31 That was a strange experience. I always remember that from Melbourne. I believe it's where the term going postal came from. It came from that particular mass shooting in Melbourne in 1987. Australia has a dark enough history with mass shootings, quite similar to America. But when mass shootings occurred in Australia, Australia tightened its gun laws. And what happened? There was less mass shootings, something that America could definitely learn from whenever they say that it's not guns it's people well in Australia I'm sure that was people but
Starting point is 01:26:09 taking the guns away definitely helped alright dog bless I'll catch you next week where I'm gonna be in Melbourne I don't know what's gonna happen having a clue having a clue what happened in Melbourne once as well. I was walking around the hipster area I can't this again is about Ten years ago, maybe 15 years ago I was walking around the hipster area in Melbourne, and it was really really hot pure sunny And then I'm just walking on the road and that band the XX remember them they were just there skateboarding in all black. Big heavy coats all black. Fucking roasting. I was wearing shorts and sandals, gagging to
Starting point is 01:26:53 take my top off and go bare chest and there's the fucking XX. Dressed like like the cure. Anyway I'm looking forward to Narm. Alright? In the meantime, wink at a cocoa burr, genuflect to a wallaby, and show some respect to the echidna. Dog bless. Continental Quilt Kisses. Don't wanna get, don't, get... Imagine that! That's when you don't want the fucking hotel manager walking in. What the fuck are you doing under that duvet, sir? Blowing kisses. Blowing kisses to a million people. Mind your own business.... you You You.. Thank you.

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