Full Transcript Introduction to Nutritional Psychiatry 0:00 I think we need to understand that our body evolved with whole foods and solid nutrition over millennia, over eons, and that right now we're in this sort 0:15 of window of abomination in terms of just a food desert that we're feeding ourselves. 0:22 And it's no wonder that have an epidemic of mental health challenges in this country because our diet is so miserable. 0:35 What if mental wellness starts with nutrition? 0:38 Join us for insightful conversations with researchers and clinicians exploring the science of nutritional psychiatry and broad-spectrum micronutrient therapy. 0:47 Let's learn together. 0:55 Hello everyone, I'm Dr. 0:57 Z. 0:58 I have a doctorate in naturopathic medicine with a bachelor's of science in biochemistry. 1:03 Today we are helping bring you real science and real stories as the executive producer of NutriTalk podcast sponsored by Hardy Nutritionals. 1:13 We are joined today by Dr. 1:15 Scott Shannon, a founder of the Wellness Center in Fort Collins, Colorado, the major innovator in psychiatric care, someone who champions for systems-based 1:25 approaches to mental health creation. 1:27 Thanks, Celeste. 1:29 Happy to be with you and happy to share my experience over the last 40 years of working in integrative and holistic psychiatry. 1:38 We're so excited to have you today. 1:40 So Dr. 1:41 Scott, help the listeners have a little bit more context. 1:44 Where did you first hear about broad spectrum micronutrients? 1:49 Well, I think my background in sort of nutritional nutrition and maybe then nutritional psychiatry dates back to my medical school days with Dr Andrew 2:00 Weil at the University of Arizona. 2:02 He really emphasized diet and nutrition as sort foundational piece. 2:07 of creating health and that carried with me as I left medical school in the early 80s and began to explore other treatment options. 2:18 I think really began the see some of the first published research on broad-spectrum micronutrients in early 90s, and middle 90's. 2:28 And then sometime in later 90, I heard about this product being sold out of Canada to treat bipolar disorder. 2:38 And I was fascinated. 2:39 A friend of mine who was a psychiatrist at the time in Maine was using this project with good results. 2:46 I began to research it and that led me down the road to David Hardy.
Dr. Shannon's Path to Micronutrients 2:52 Things have been very different to me in psychiatry since then. 2:57 Can you help us understand what was that first encounter with David Hardy like? 3:02 I'm a child adolescent as well as an adult psychiatrist. 3:06 And I was working at a residential retreat center for severely abused children, aged three to 12. We wanted to develop some nutritional interventions. 3:18 So I reached out to True Hope at the Tallinn and began to dialogue with them about using these interventions. 3:26 That connected me with David Hardy and they were kind enough, he was kind to donate product to our residential retreat center, 3:36 our Residential Treatment Center for these children to give them free product. 3:41 And that was really sort of my introduction to his work and his generosity and wisdom. 3:48 I appreciate that. 3:49 So you were working with severely abused children and you'd heard about it from a psychiatrist in Maine who was getting good results. 3:58 Now, can you tell us a little bit more, who is David Hardy? 4:01 What's his background? 4:03 How did he come up with this kind of formula for mental health applications? 4:08 My understanding, the law is now pretty famous in the nutritional psychiatry world, but my understanding of this is that he was living in Southern Alberta 4:19 at the time working as an animal nutritionist, managing large herds of animals with nutritional support. 4:26 He had a neighbor, Tony Stefan, who was dealing with two or three children with severe bipolar disorder and a wife who had recently committed suicide. 4:36 from that erratic problem. 4:39 And after hearing Tony share all the failed medication trials that he'd been on, he looked at Tony and said, you don't need a medication adjustment. 4:48 You need nutritional adjustment, and that evolved into what was then EMPower Plus and then eventually onto Daily Essential Nutrients. 4:59 And I took a few iterations, but I know that over time they managed to find a formula that worked reliably and that has been at least the source of the 5:10 ongoing evolution of these products since then. 5:13 So somebody who is working in animal nutrition using something like, well, we can add micro and macro nutrients to animals and see a result. 5:25 I wonder if that same premise follows through for humans. 5:30 Does David Hardy have a medical background or anything like that to your knowledge? 5:35 I think his background was in applied nutrition. 5:39 I believe he had a doctorate in biochemistry and nutrition, I'm not really positive about his backgrounds, but he certainly knew what he was talking about. 5:48 Well, I love that. 5:48 And as someone who has lived with a severe form of mental illness as diagnosed at 18, to think that you can ameliorate some of those more complex presentations 5:59 of behavior with broad spectrum micronutrient therapy is just a beautiful concept because for many of my peers, these medications come with some terrible 6:11 side effect profiles and may not work. 6:16 What has been your preferred approach in psychiatric applications? 6:21 When do you go to hearty nutritionals as an option for a family or an individual? 6:28 Well, I certainly think of them with any unstable mood disorder. 6:32 So whether it's bipolar disorder, cyclothymia, schizoaffective disorder. 6:38 Even some forms of recurrent psychosis and occasionally major depression. 6:45 So those are diagnostic categories that have been sort of very solid go-tos. 6:51 I think when there's ADHD with some behavioral challenges, unstable mood issues, I thing of it in those circumstances as well.
Using Micronutrients in Mood Disorders 7:02 I find that other treatments that we have such as lithium or some of the atypical antipsychotics or mood stabilizers are less effective and certainly have 7:15 a much higher side effect profile, which is why I've been so intrigued with this product for so long. 7:22 That's interesting, Dr. 7:23 Scott. 7:24 So you're willing to use this for unstable mood patterns, even schizoaffective features, bipolar or cyclothymia? 7:34 The way I look at this is that the more significant the unstable-mood disorder is, the most likely people find benefit with it. 7:45 Now, the challenge for me has always been when this is overlaying with psychiatric medications. 7:52 As a child psychiatrist, particularly working in an underserved area, I had the luxury, some would say luxury of getting to see kids who have not had any 8:04 prior intervention. 8:05 Thus, they have no psychiatric medication history. 8:09 So I'm often the first medical professional they encounter for this problem. 8:14 And what I found is that those folks who have not experienced psychiatric medication often tend to respond quickest and often most completely. 8:26 If people have been on psychiatric medications for a long time, it doesn't mean they won't respond, but it often means there's an extended period of adjustment 8:36 where you're often looking at cross tapers or sometimes we have prolonged withdrawal features coming off psychiatric medication. 8:45 and those represent another level of challenge. 8:48 And they're not insurmountable, but it just makes it more complex. 8:54 If I could see an eight or 10 or 15-year-old who's had no prior psychiatric medication history and presents with a very significant mood disorder, 9:05 often the response would be very, very positive and significant. 9:10 That's interesting. 9:11 So it sounds like in that residential treatment center where David Hardy donated product, you had a sort of blank slate, 9:18 children presenting with big behaviors. 9:21 If you introduced micronutrient therapy and there hadn't been prior medications, what was that typical response curve like? 9:29 Well, one thing I learned in那 setting. 9:32 is that kids that have very significant abuse histories, that a trauma history, they have PTSD, They tended to respond not as well. 9:44 And so it was really sort of inherent on me that I had to sort out those with a Trauma history from those without. 9:54 The ones that had minimal or no trauma would respond typically very well. 10:01 Often these kids were loaded with four and six different psychiatric medications, even at the age of six. 10:07 They've been in the state hospital for six weeks and come out with a lot of different medications. 10:14 So that presented some complexity. 10:18 One of the things that I learned is that as useful as these broad spectrum micronutrients were for unstable mood disorders or ADHD with behavioral sort 10:30 of overlay of impulsiveness, that they were less completely successful in dealing with significant trauma. 10:39 And this has been my experience that trauma creates a very different biochemical pattern in the body. 10:46 And it's important to us to recognize the differences in response. 10:51 That makes sense. 10:51 It sounds like it kind of created a diagnostic opportunity for you to decide which of these people might be suffering from some malnutrition versus others 11:02 that are having complex trauma factor in. 11:05 You might. 11:05 Be willing to elaborate a little bit more. 11:09 For our listeners, how you would approach a case where there are already psychotropic medications involved? 11:17 Can broad-spectrum micronutrients like Hardee's Daily Essential Nutrient be added into a treatment protocol where medications are part of the equation? 11:27 Well, they certainly can be. 11:29 It's interesting, back in the day, in early days of doing this work, Citrus bioflavonoids were a big part of the formulation, 11:41 and those create cytochrome P450 issues, they create a variety of different issues. 11:47 And we had this whole complex dance of having to introduce the broad-spectrum micronutrients, reduce medications, then taper down and know when to make 11:59 the next change, looking at side-effect profiles and sedation. 12:04 It was fairly complicated. 12:06 It didn't take too long. 12:08 I think it may have been late in the 2000s that David recognized this and created a formulation, which I Think Hardee's now reflects in daily essential
Trauma, Medications, and Tapering 12:21 nutrients that minimizes the citrus bioflavonoids and really has reduced this cross intolerance with psychiatric medications. 12:33 And so I think it's become much simpler in the current era with these formulations that they can be often added to psychiatric medication. 12:44 One of the interesting things, and this has been a very powerful, interesting insight for me, is when someone is stable on psychiatric medicine, 12:54 and you add this formula to it, often what you see is a very pronounced side effect profile that comes into clear profile. 13:04 And I think that speaks to a lot of things and helps us understand what medications are doing in the brain. 13:13 And I think it also helps us understand when the brain is working efficiently, psychiatric medications can be used much more delicately and lightly if 13:25 needed at all. 13:27 And so one of the takeaways that I found working with people with bipolar disorder is we would often stabilize them over time, 13:37 get them off their psychiatric medications and get then quite stable. 13:42 And sometimes people needed just a little bit more. 13:45 What we found is that we could add a very small amount of something. 13:50 Often one of my favorites was Lamotrigine in very low doses. 13:56 That would be sufficient to get where they needed to be. 14:00 The doses would often be a fifth of what we would use in an active patient who was being managed with medications. 14:08 I appreciate that nuance very much. 14:12 Now, with my own journey, you guided my successful taper off of polypharmacy and onto nutrient stability. 14:19 And the motor gene was one of the last medications to lead my system. 14:23 We used it, we kept it in place for a long time while I reached that clinical dose of 12 capsules a day of daily essential nutrients. 14:33 Can I ask, who trained you on this sort of protracted taper journey that you'd led me down as a patient of yours at the Homeless Center? 14:43 Well, I mean, back in that day, it was trial and error. 14:46 It was often working with the representatives of either Hardy or True Hope and getting their input because they often had more experience than psychiatrists 14:58 did with these kinds of populations. 15:00 I, mean we, we maybe had a little better clinical sense, but they had sort of a better historical sense of how these interactions would go. 15:09 And so it's often just listening to your patient. 15:13 making small adjustments and giving it time. 15:17 I think one of the things, and maybe your own journey reflects this Celeste, is that because these psychiatric medications have significant effects on 15:31 neurotransmitter sensitivity, often those changes take weeks to months to sometimes years to rebalance that sometimes the last few steps can be a year 15:44 or two or three out from when you initiated the process. 15:48 So I think patience is one of the things that this work reinforced for me. 15:53 Always a struggle for because I'm not by nature a patient person, but these really helped to teach me that. 16:00 I appreciate that so much because something that I feel these psychotropics do is not only change the architecture and sensitization of the brain and nervous system, 16:12 but they're suppressing a lot of what might be underneath the symptoms for an individual. 16:16 And so I think with daily essential nutrients, the side effect is healing becomes possible. 16:24 And that is a journey. 16:26 Talk about consciousness research, talk about the need for bringing in these other integrative options down the road. 16:32 Because when a person starts to have command of their nervous system and their brain and body is well fed, a lot becomes possible that was never potentially 16:45 available to these individuals. 16:47 And I really appreciate so much that you have this sort of paradigm and belief in. 16:52 healing and the body's capacity for healing, and that you're willing to support that journey and work for me. 17:00 How do you manage expectations for patients that might be looking at a longer road to healing? 17:05 Because perhaps they've been sick for a long time, they have been in the standard model of care for Well, I think it depends a little bit on their background. 17:14 It's a great question. 17:15 I'd think if they've been struggling with psychiatric medication for years or decades, we're going to take it from the approach. 17:22 The prior approach has not been fully successful for you. 17:26 We're gonna take a different approach and it may take time. 17:29 And I really what I encourage is, let's not judge the results day to day or even week to week. 17:37 Let's call it month to month. 17:39 And let's look at how you're doing with these changes month to month and we'll monitor them. 17:45 And it's my hope that your health will continue to improve over many, many months and many many years. 17:53 I think that's one of the endpoints that I see in integrative and holistic medicine, even naturopathic medicine Dr. 18:00 Z. 18:02 is that we take a longer timeframe. 18:04 And when we look at results, we really want to know, is this really supporting the patient's positive outcome and healing over a path of many years? 18:16 And I think one of the travesties of modern psychiatry is we often judge results and set up trials that are four to six to eight weeks long. 18:27 And in that timeframe, we don't really get to understand the body's true homeostatic response to things.
Nutrition, Diet, and Brain Health 18:34 We don' get a chance to understanding people's long-term health outcomes. 18:39 So I think as we move from a mechanistic narrow frame on mental health to a systems-oriented healing and viable frame, then we have to start looking years out. 18:51 We have say, is this person better off five years down the road because of what you've done or not? 18:58 And six weeks doesn't cut it for me as a decision point in making these choices. 19:07 So you're playing the long game and you are helping your patients understand that this is about not a six week to eight week window, 19:16 not even month to month, but where were you five years ago? 19:22 Where are you today? 19:25 My job shifts from being an expert manipulator of interventions to a coach of support. 19:32 You know, you even have to have some ministerial zeal and helping people to keep their faith, so to speak, because people get discouraged. 19:44 And one of the big downsides of mental illness, and you can probably speak to this, Celeste, is how demoralized people can get when they're so frustrated 19:55 and they can't find their potential and their health. 20:00 You're given a sort of license to give up on your life when you're labeled with a heavy hitting diagnosis in many cases and so you are not really taught 20:09 to harness self-efficacy or what self respect should be or quality of life might even mean for you. 20:16 It is a very dehumanizing experience to go through the conventional model of psychiatric care and I'm just grateful that In the early 2000s, 20:26 my mom found you and then by the time postpartum health challenges had really nearly cost me my life. 20:33 Your team have expanded and you started doing more functional diagnostic testing at the homeless center and it completely changed the playing field, 20:42 the game for me and my daughter. 20:45 Let's talk a little bit about that if we can about like, what does the brain and body need to truly thrive? 20:51 In your book, Parenting the Whole Child, you give a beautiful depiction of a case where this teenager is presenting with even hallucinations and severe 21:01 mood swings. 21:02 And part of her treatment you recommended she cut back her caffeine, she increased her protein intake, increased your omega-3 fatty acids. 21:12 You know, that sounds a lot like a standard American diet, the average teenager who's living on monster energy drinks and whatever they can buy at the 21:22 gas station. 21:23 So how can we help create understanding about the fact that the brain is a metabolically demanding organ? 21:32 Yeah, I think we need to understand that our body evolved with whole foods and solid nutrition over millennia, over eons. 21:44 And that right now we're in this sort of window of abomination in terms of just a food desert that we are feeding ourselves. 21:56 It's no wonder that have an epidemic of mental health challenges in because our diet is so miserable. 22:04 And I think the current exploding research on nutritional psychiatry shows that in countries that have a Mediterranean diet or a Whole Foods diet, 22:15 or traditional diet whatever term we want to label it, they have much lower rates of mental distress. 22:23 The more processed and ultra-processed foods that people consume, the greater their risk. 22:30 And I think it's not because we don't have enough psychiatric medication in this country. 22:37 Our children get the most psychiatric medications in the world in United States, and they have the worst rates of mental health in world. 22:48 So these things are not addressing the real problem. 22:52 And we just really need to realize that Whole Foods is the fastest path to whole health and wholeness. 23:01 It's such a paradigm shift for many because when they see or read how this person's suffering from a hallucination and a remedy might be fish oils, 23:10 protein, and micronutrients. 23:13 Sometimes that's a disconnect, right? 23:16 So I really appreciate that you've done a lot to educate and champion nutritional psychiatry, even so much as you break down what inositol does and how 23:26 important that is for the signals in our cells and the neurotransmission can't work effectively without these building blocks. 23:34 So would you say perhaps that supplying supplementation, understanding that most of us are consuming heavily processed diets, 23:43 Would you think that there's a repertoire of supplementation people should take as a preventative measure? 23:51 Well, yes. 23:54 I'm a little bit low to prescribe any sort of thing as routine or a protocol. 24:01 And I also think the understanding that we have supplements to back up nutritional deficiencies creates a bit of a counterproductive cycle where people 24:13 give themselves an excuse. 24:15 Well, I'm going to take supplements so I can eat half crap and half good food. 24:21 So I am not opposed to routine supplementation. 24:26 But I think we need to caution that approach in that the wisdom needs to fall to diet primarily, and that needs be our go-to.
Case Study and Systems-Based Care 24:37 And then if that's insufficient, then we can begin to look to other interventions. 24:43 Sometimes we have to be willing to evaluate. 24:47 If people are having some struggles, let's look to a biochemical or functional evaluation to see if there are problems or challenges. 24:57 And sometimes they're not readily apparent and it's likely that most people can do better than they are doing currently. 25:05 But I think diet and supplementation are good solutions, but not one over the other completely. 25:14 That's a very judicious approach, and I appreciate that. 25:17 You know, the work of Dr. 25:18 Rutledge and Dr Kaplan illustrates that in the RCT study of the ADHD children, those who were consuming vegetables and fruits responded much better. 25:30 So the vegetables, fruits provide a nice bioavailable form of cofactors to help boost what the supplements can do because you're right. 25:41 supplementation shouldn't be an excuse for a poor diet. 25:45 So do you feel like people who are doing, you kind of alluded to this, but people get on this micronutrient approach, are they sort of graduating out of 25:55 your practice and going on to recover? 25:57 Or what does that look like for person to sort-of buy into this They're not cheap vitamins necessarily, and sometimes it is a nuanced journey if they have 26:07 to taper. 26:09 What would be sort of the reason someone might want to give this a shot? 26:15 Well, one good reason is so they don't have pay to see me anymore. 26:19 I would tell people that once you find health and once find the recipe for your health, then you're in charge. 26:28 You can make those decisions and you can operate independently and autonomously with good freedom. 26:33 That's really what everybody wants. 26:37 Sometimes you do need professional help and support and guidance, but I think my goal in all treatment is to make people not dependent on me. 26:49 And that's sort of an operating principle in North Star that I've always had is that if the treatment is moving in the direction where they have more freedom 26:59 and have less need and dependence on my care, then we're going in right direction. 27:05 I've always appreciated that. 27:06 I feel like I was blessed with privilege to access your care and we were able to front and load this nutritional psychiatry. 27:15 And the fact is that enabled me to change my entire socioeconomic status. 27:21 So I'm looking out at a very different picture than I once was when I involuntary held. 27:28 When you're a ward of the state and somebody else is deciding if you fit to join polite society, the earning potential is rather capped. 27:37 So for me, this was a priceless investment. 27:42 And I hope for others, they can see that, yes, there's a high capsule count. 27:46 It is a behavior change in order to see the results like I had. 27:51 it was commitment on both parties' part, but one that I'm super grateful that did and that had your guiding hand in. 28:01 Are there any other things you would like for our listeners to know? 28:06 Let's see. 28:07 Well, you know, I think there's so many options. 28:10 And I, think when people embrace this understanding that they can get better and they then it opens up so many different avenues of care. 28:21 You know what, I've practiced acupuncture for 35 years and have really endorsed a strongly nutritional orientation to mental health. 28:32 There are so other treatment options for people. 28:36 And I think part of my efforts now are to help people understand a systems approach to mental health. 28:45 It is so different from a narrow reductionistic model that includes, really, when you go to see a psychiatrist these days, 28:53 your choices are between this medication and that medication. 28:57 And that is just such an overly narrow view of what healing is and what humanity is. 29:03 that I think we need to broaden our view and expand. 29:07 And it's not as though mechanistic interventions and neuropharmacological tools are wrong. 29:14 but I think they have to be understood in context, and we have understand the options that come before or after in the middle of all of those choices. 29:26 And that's my biggest challenge to modern psychiatry is we need to expand our palette. 29:32 We need see choices like hearty, like daily essential nutrients, but other things as well. 29:37 You know, we did some early research at our clinic on CBD, hemp-based CBD in mental health. 29:44 And we found enormous benefit to anxiety. 29:48 We tested it on sleep and the results were not as robust, but we published about its benefit anxiety and even trauma. 29:57 And, you know, it's just one of those tools that's out there. 29:59 I think it is quite safe and it represents good options for people who maybe want to avoid benzodiazepines or SSRIs. 30:09 So there are good option out their and I Finding someone who can steward your healthcare with an open mind and a big heart is really some of the most important 30:22 things to search for in a provider. 30:25 Thank you for imparting that. 30:27 And here's to having big-hearted, open-minded providers taking bottom-up, top-down, and systems-based approaches. 30:36 I also have a question for you, Dr. 30:39 Scott. 30:40 Yes. 30:41 Something that I'm excited to be asking our guest is, what is a case study or a that you had that like really stands out in your mind where this person, 30:52 you know, with their side effects or whatever they were going through and then being put on a treatment protocol and their regression and the remission, 31:00 how did that just, if you could give us one of the many that Well, an interesting one, as I remember, and this is probably from 20 some years ago, 31:12 I was working at a children's hospital in Denver, part of the CU medical school, leading a nutritional psychiatry rotation. 31:26 I had a child psychiatrists fellow rotating with me. 31:29 And we had a young man come in who was very regressed, had lot of bipolar-like features and was having enormous rage outbursts and difficulty managing 31:44 his behavior. 31:45 And the psychiatrist that I was working with, who is in the middle of his fellowship at the time, still young, probably around the age of 30, You know, 31:55 he said, well, I don't see how you can do anything else other than put this person on a mode stabilizer in a typical anti-psychotic. 32:03 And I said well. 32:05 watch this. 32:06 And so what I did was I presented to the patient's parents, I think you have two choices, roughly, let's say at least two that we can talk about right now. 32:18 One is conventional load stabilizers, Depakote or Lithium, and the other is atypicals antipsychotics, which would have been Resperidone or I don't even 32:31 know if Alanzapine was out then, but let say Alazapines. 32:34 Or we can try a nutritional intervention with a broad-spectrum micronutrient. 32:40 And if that fails, we could always go to the other, the medications. 32:45 If the medication fails we do the reverse, but it sometimes complicates things. 32:51 What would be your preference to begin first? 32:54 And the parents said, oh, yeah, let's try the nutritional thing first, of course. 32:59 And one teaching point for the fellow was when given choice, parents will often respond to non-pharmacological options just because Nobody really wants 33:11 to use psychiatric medications in a five or eight year old child. 33:14 I mean, by extension, you would think no one would want to do that in the 30 or 50 year-old adult, but with children, the decision point seems more stark 33:25 and parents have more of a, I think a custodial harm reduction mindset. 33:31 And so they said, yeah, let's try the nutritional supplements. 33:36 So we tried them and this child's behavior improved dramatically within I think it was within a month. 33:45 It was, I thinks, by the next visit. 33:47 We saw them a months later. 33:49 And this was a real eye-opener. 33:51 The psychiatrist then wanted to come and work with me at our clinic for a number of years. 33:57 This was really an impression driving point. 34:02 And, you know, so I think there's a couple takeaways there is that number one, we need to give people really truly informed choice. 34:11 And if we're only presenting the difference between risperidone and glanzapine or lithium carbonate and Depakote, have we really given them really, 34:22 truly-informed consent? 34:25 I would say probably not. 34:27 And the other is that, you know, if people respond to a less risky intervention, we can always escalate up to riskier, more challenging interventions. 34:39 For example, atypical antipsychotics require periodic blood tests to make sure that you're not developing hyperlipidemia or hyperglycemia. 34:50 And, it's a whole getaway from the whole question of weight gain induced type two diabetes. 34:58 I think the other takeaway here is we shouldn't be able to tier our choices based on risk inherent. 35:07 And so there are a few takeaways in that case example for me, but was there a couple of them? 35:15 So I hope that helps to answer your question. 35:18 Yeah, it really helps to like just ground everything into the practical and the impact, especially when families may be watching this and they're going 35:31 through it. 35:32 I found that when people share like this happened for me, then people viewing or hearing the story can be like, wow, that could be me too. 35:40 And it just takes that one story, you know, to create that sequence of impact. 35:45 So thank you so much for that. 35:48 I appreciate that. 35:55 Big behaviors treated by simple and safe first-line therapy and educating about all possible options that might work to quiet the nervous system down. 36:07 Yeah, and I speak of these interventions, both the medication and the broad spectrum micronutrients as hardware. 36:16 And I think we also have to realize that sometimes people need software help too. 36:20 And that can be psychotherapy, behavioral change, you know, and then we layer on lifestyle medicine. 36:26 So there's psychiatry has many levels. 36:30 Part of the challenge is you have master many different levels of care. 36:35 And you inspire engagement, right? 36:37 When sometimes my peers are so used to handing over their outcomes to that practitioner who's their psychiatrist and they're not engaged. 36:46 They're just like, I got to take my meds. 36:47 I gotta fill my prescription and this is what I do. 36:50 You have to get them motivated to be active participants in cultivating recovery. 36:59 Before we go, Dr. 37:00 Z, do you have any final remarks? 37:06 I just want to acknowledge how grounding your presence has been. 37:10 And just bringing me back again to my own roots to remembering least invasive approaches first and just hearing all of this like philosophy and through 37:22 your wisdom and experiences like just so good. 37:26 It feels so on my soul right now. 37:28 So I wanted to say thank you for that and for sharing that for other people to experience too. 37:34 Thank you. 37:35 Oh, you're welcome. 37:36 Dr. 37:36 Z and it's interesting is that I think I've always felt more at home at naturopathic conferences than I have in psychiatric conferences. 37:44 I completely understand that. 37:47 Yeah, I'm happy to have been part of your podcast and the dialogue that you are trying to share with people. 37:52 This is important work and I really support what you do. 37:57 Thank you, thank you so much and see you next episode.
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