Zack Arnold

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The Science Behind Depression and Anxiety | with Dr. D and Dr. Michael Mark

About Episode

When discussing depression and anxiety, it’s not uncommon to hear people say things like, “Why don’t you just snap out of it!” or, “You just need to get some sleep and you’ll be fine.” But unfortunately for many people like myself, depression and anxiety come part and parcel with being blessed with creative talents. There is no simple way to “snap out of” depression or “sleep off” anxiety if you have the genetic predisposition towards both of these ailments or if your biochemistry has been altered due to external events or circumstances.

In this episode I have an in-depth conversation with not one but two experts on the topics of depression and anxiety, Dr. Edison de Mello and Dr. Michael Mark. We talk about the science and biology behind depression and anxiety which can hopefully help you understand why feeling depressed or anxious isn’t “all your fault.” More importantly, beyond simply understanding the neurobiology, we also discuss several treatment protocols that go well beyond simply “popping pills.”

Transcript

Zack Arnold: So we’re just going to go ahead and jump right in today. My guests, as I mentioned before, I have Dr. Edison de Mello and Dr. Michael Mark, both of whom have been guests on the podcast before. So hello, doctors.

Dr. Edison de Mello: Hello, Zack. Nice to be here again.

Dr. Michael Mark: Hi, Zack. Nice to hear your points.

Zack Arnold: So the idea behind today’s show is this is going to be a follow up to an episode I had a couple of weeks ago where I spoke with a couple of colleagues about the mental illness that seems to be rather rampant yet not talked about in the post-production industry, and we talked on a very informal level. It was just basically about our experiences with it, our experiences with other people dealing with it. But today, I want to really hit the scientific side of it because I’m not a doctor. The people that I was talking with are not doctors, but you guys are doctors. So rather than just me saying, “Well, I think it’s this and I think it’s that, I want to hear from the people that know what they’re talking about. So where I want to start is from the medical side. If Dr. de Mello, could you walk our audience through the basics of what’s happening with the brain and with the body, with hormones, with neurotransmitters, when we’re when we’re dealing with something like chronic depression, as opposed to just having a bad day.

Dr. Edison de Mello: Absolutely. So, as you know, Zack, the definition of mental illness is very broad, and so let’s start by defining what mental illness is. That is mental illness that you are born with, basically genetically predisposed, and there’s the mental illness that is actually acquired, and that’s the one that I will talk about. I will leave the other topic to Dr. Mark. My interest in medicine stems from looking at the whole person and basically meeting the person who has the condition before I meet the disease, and so what I see in your industry, in the movie industry in general, is that the number one cause of mental distress, or simply anxiety, or in some cases severe depression that can lead to hospitalization, is actually people who are unable to deal with the pressures of work, either because the work demand is too high for them. There’s something going on at home that is compounding the pressure at work. They don’t feel they are able to perform to their maximum maximum capacity, and so what we see is people just simply crack. Why do they crack? Anxiety is part of the human experience. I mean, when you get in your car and you drive from from point A to point B, you’re dealing with anxiety. Just being behind the wheel and you’re driving your car, but you’re also driving, you know, for the person next to you. You need to make sure that your attention span is really broad, and so that daily activity for most of us is in of itself, you know, anxiety-producing. Not to say, you know, having to go to work, they’re paying more bills, they’re having to do with relationship issues and a multitude of other things. When we allow those things to really add on without really expressing them or looking at the medical side of it, then like anything else that goes unresolved, it keeps mounting and getting bigger and bigger. So what we usually see in the medical practice is that people come in with what I refer to as circumstantial depression or circumstantial anxiety, and that is in addition to all the reasons that I gave you, they’re not sleeping, and because they’re not sleeping, they get hungry, and so because they get hungry in the middle of the night or in New York, in the case of people who are in the editing business, because they’re in the dark room all day long, so food become a becomes a comfort for people, and and so you eat that you know gives you immediate gratification. It’s usually processed food, sugar food, sugar-based foods, or anything that’s readily available for you, and then the cycle begins. That leads to the brain’s addiction to this so-called refined sugars or processed food. And then the more you stay awake, the more you’re anxious, the more your brain wants it. And then that particular food certainly doesn’t sit well with the gastrointestinal tracts, and so now you have increased hydrochloric acid in there, which means that you have to eat more to be able to diffuse the increase in acidity. And when you eat more, you gain weight, and when you gain weight, you feel horrible about yourself, and and it goes on and on until suddenly the patient, either him or herself, comes to the office, or a loved one, a loved one really makes it that calls for them. And what we do here is really put all these conditions aside and talk to the person, and and start with basic questions for. Are you, and what what’s your life dream? Are you living the life that you thought you would be living at this stage in your life? And if not, do you see a way out of this? And if so, what are the steps that you need to take to get there? So, in integrative medicine, the first one is to look at your laboratory results. Let’s look at your anything from your CBC to your liver enzymes to sometimes if people are having a lot of gastrointestinal issues, we do something called a breath test to see if they have any overgrowth of bacteria in the stomach in their gut. Then we can do a food sensitivity to see what foods they are maybe having difficulty processing, and from there we present to them with ways that they can really optimize this this you know so-called health markers. We also certainly look at the adrenals. Now, the adrenal system, the endocrine system, is to you what a hard drive is to your computer. If you have a hard drive that is completely overloaded, your computer, no matter how good of a computer it may be, won’t work properly because the hard drive is overly extended, is is overly spent. And so we do the same thing. We look at the endocrine system and we look at the cortisol levels, and we look at what happens, you know, when the patient is not sleeping. What kind of hormones he releases in in case of women with a 24-hour urine hormonal test to see what they are at, and then we start by looking at those two two pieces together. One, the metabolic aspect of the person’s condition at this particular state of their lives, what’s happening, how can we improve improve that, and then we also address things that you can do little by little to decrease the stress. The other day I saw one of your colleagues Zack, and the simple test of showing this particular person that his CO2 level, the carbon dioxide, was too high, and therefore he wasn’t able to take in a lot of oxygen. Gas exchange occurs when you breathe in oxygen to your fullest capacity, and then you breathe out as much CO2 as you can, but this person was not doing that, so stress was really becoming worse and worse for him. And when I said, “How long do you drive to work? and he said, “40-five minutes, and I said, “During that drive, can you spend five minutes every day taking deep breaths? You turn off your phone, turn off the radio. On that drive, just going for the next five minutes. I’m just gonna deep breathe as deeply as I can, and that was the first step for him. Second, to of course changing some of the sugar addictions that he had. So that’s just in in in a nutshell how we address those issues of stress and depression in the clinic, and when it’s needed, we do have an integrative psychiatrist that we refer to. Sometimes, you need to, you know, give the patient a little help, especially if the patient is so spent that no matter what we do, the container is so empty that we have to help him or her build it up, so we don’t shy away from pharmacology. But that’s not the first step for us. The first step is to make sure that we are seeing the person, seeing the whole person, and then if that’s necessary, we go to that step and we combine that certainly with some of the nutrients that the patient may need, some of the minerals and some of the amino acids, they are known to optimize hormonal metabolism.

Zack Arnold: Right. Well, it’s bringing up the the psychological aspect of it. I just recorded a show and released it with Swati, who is actually that was my gateway to the Akasha Center, so everybody can learn all about Swati in that process. And I want to get to the neurochemical and the the electrical side of the brain stuff next. But one further question that I want to kind of bring up and debunk some myths is the C word, which is cortisol, which I know is a big aspect of all of this. And a lot of people think that cortisol is just bad. Period, and they don’t want any cortisol, and they don’t realize that cortisol is actually something you need to function properly. Like, for example, another one of my colleagues that was at your office recently, basically her cortisol is zero, and that’s where I started about 10 years ago with complete adrenal burnout, no sympathetic nervous system whatsoever. So, just talk very briefly in layman’s terms about how cortisol factors into our lives. Number one, how we need it, and number two, how having too much of it can be detrimental.

Dr. Edison de Mello: Yeah, absolutely. Cortisol, just like cholesterol, gets a bad rap up there in the world. Without cortisol, as you mentioned, you would not be able to get out of bed. The same way that without cholesterol you wouldn’t be able to produce any of your hormones, and so cortisol is highly necessary for everyday function. What happens with cortisol is what we call the the fight or flight response, and that is when you’re so anxious and you’re so spent and you’re so sleep deprived that your cortisol levels keeps going up and up and up to keep you functioning. It’s going up because it needs to keep you operating because you’re not sleeping, you’re not eating correctly or sufficient or nutritious food, you’re not having your emotional needs met. So what cortisol does is the very thing that happens if somebody sets fire and you have to get up and run out of your office because you are a danger? What cortisol does is when it perceives that you need help, stay up because you’re crashing. It it goes up and up and up until, of course, there is a almost a place of no return. The good point is, or the good, the good news is that there’s always, if there’s no significant chronic disease, there’s always a point where the patient can return to low to normal levels of cortisol. What we do then is look at the cortisol and try to help the body metabolize it differently. If the patient doesn’t have it because he or she has what we call adrenal insufficiency, not adrenal overload, but insufficiency in that there’s not enough, then we look at it and say, okay, what’s happening with the system, and how can we help this system optimize itself? Two reasons: one is that the patient is not producing cortisol. Period. That’s very unlikely in the spectrum of who we are as as as human beings. But it’s it’s possible. In most cases, what we see is cortisol is not being properly metabolized. It’s something right there in the excess that is being interrupted. And so, what we do, we go in there and we try to fix it, usually with amino acids that can really kind of redistribute the cortisol where it needs to go. Second to that, then a swats you may have addressed with you, Zack. Then we look at the mind and body connection. Most of these hormones, as Dr. Mark will later on explain is produced or released from any information that comes from the brain. They’re not metabolized in the brain; they’re released from that. The brain tells the organs to release it, and a great majority of those hormones are metabolized and optimize in your gastrointestinal tract, which is the second largest organ in your body? The first one being your skin, and so in your GI tract, you basically have receptors for most of the hormones that your body needs. So if the brain releases it, or any other organ releases, it goes to the gut to be optimizer to be metabolized. So, kind of a key and a lock. If I gave you a key and just handed you the key, and didn’t point to a lock, you wouldn’t know what to do with that key. But suddenly, even without language, verbal language, if I just give you a key and point to a lock, you know that that key is going to work in the lock. Well, that’s the connection, in simple terms, between the mind, the brain, and your gut.

Zack Arnold: Okay, so now we’ve talked a little bit about what’s happening in the body. Let’s move on to the brain. So, when somebody is dealing with chronic anxiety or depression, Doctor Mark, can you please walk me through what specifically is going on in the brain from both a neurochemical and electrical level.

Dr. Michael Mark: Sure. First of all, we know that that major depression and we have mental illness affects 25% of the general population. And the area that I’m focusing on is involving the not just the external social stressors and of course Dr. Mello with the total body approach is is very important and necessary, and I kind of then veer off into the internal genetic vulnerability, so to speak, the neurophysiological basis for depression or anxiety. That’s where I kind of work on with our clinic, our expertise. So, basically, we have those particular brainwave patterns that we identify individuals with a biological predisposition for developing depression, as well as actually having it and having anxiety. And in depression, I’ll go there first. After we do a quantitative electroencephalogram, a QEG, a form of a neuroimage that we can actually see the electrical activity from 19 to 21 locations, and then put it into very specific software like Loretta, which stands for low-resolution electromagnetic tomography. We can see areas of the. Brain that are affected specifically not just not just through standard deviation which shows itself in colors, white being normal how we define that, and then we have standard deviations one two and three up and one two and three negative, kind of gives us an idea of the severity. But what happens in depression? A lot of times we see the left frontal area of the brain, which is typically associated with positive emotions and motivation, which is a desire to be involved with other people. The right frontal area of the brain is more associated with depression and fear, and it’s accompanied by motivation to withdraw from and avoid other people. So when there is more slow brainwave activity in the left frontal area, that part of the brain is more inactive, and the right is more dominant. Well, how is this important? Well, that person is probably predisposed to becoming depressed more easily, to withdraw from people, to be anxious, and this also could become maybe it could be because of the heredity, maybe the family history, or if obviously they had a concussion or mild head injury producing the slowing. So what we see is is that especially in depression, when we see the asymmetry or the dysregulation in those frontal areas, we are able to through analysis come up with a treatment plan that will improve that regulation and create stability out of instability in those networks related to the symptoms. Now, in anxiety, this is kind of interesting. So, I was seeing a an athlete about two months ago, and he had described all the symptoms: stress, anxiety, depression. And I asked him, you know, do you, you know, how often do you sleep? He said three hours a day, and then he said I haven’t had a good sleep in probably 10 years. And I’m, I listened to him, and I, and you know, just like we were just talking about the complete body treatment and what’s required, and blood tests and through analysis, the doctor so eloquently mentioned. I then said, you know, if we are able to reduce after we do a QEG the fast activity, the perseveration that’s going on, and you can actually rest, your memory will improve, your anxiety will lessen, and so we did that. And you know, when we see anxiety, we see a excessive activity in the brain that basically the brain is on 24/7 without any form of rest, and that individual we talk about. I want us to say one thing here just to clear to to make something clear about sort of the databases and what we’re working with in z-score neurofeedback, which is the Loretta software I’m talking about, we have real-time comparisons matching the population of healthy subjects, and we we simplify our protocol. And the important part is we can we have the ability to target modules and hubs that indicate dysregulation and instability in networks related to the symptoms of the patient. So it’s not we just do a QEG and we take a look at it and say, okay, we’re going to have to self-regulate. This is what we’re going to do. Everyone’s individual, right? Every every every basis is individual. So we target specific dysregulated anatomical structures, which can be in a deeper cortical location, so we have that ability with the new technology that is coming out all the time, where we take the symptoms that the patient describes, we do the map, we make sure that the areas that are part of those symptoms are treated actively, and we find that we have a very good track record in reducing those symptoms, so that the patient is you know has the ability to sleep and relax and you know participate in his life or her life the way they want to.

Zack Arnold: So basically, what I have heard from the two of you so far is that it is actually very possible to it’s very possible to quantify the idea of anxiety and depression, and the reason that I bring that up is because my understanding and maybe the science has just come further and society has come further. But when I was dealing with this like 10 years ago, the Western medical idea was well. There’s really no way to tell you if you’re depressed or not. But if we give you the pill and you feel better, well, then you were probably depressed and it worked, right? And it sounds like what you guys are very clearly telling me is there’s a very quantifiable scientific way to say whether or not somebody is dealing with chronic anxiety and depression. Is that correct?

Dr. Edison de Mello: From my end, yes, absolutely. That’s exactly what I said, and the the research is is enormous there when it comes to how, when you are stressed for all the reasons that I previously discussed, the end result is depression. The question is, is. This is a clinical depression that is secondary to a genetic factor that is going to require long-term pharmacological treatment, or even the patient being patient of Dr. Mark for longer period of times, or is it what I refer to as circumstantial depression, meaning there’s a circumstance that is causing the system to break down, that causes the system to crack. In that case, the pharmacological intervention sometimes is highly necessary. Dr. Mark’s work with neurofeedback is is highly necessary, as much as it is necessary, also to address the cause. What is why is this supposedly perfect system, in so many ways, beautiful system that does exactly what it needs to do to operate every day, from waking up to going to sleep, from walking to laying down, from standing to sitting, this system is an amazing system. Why is it cracking? And it’s no different than if you walk into your house and you look up and you say there’s water in your roof. You need to go and fix the the roof, but then you need to say, okay, so why did this happen? Is this you know significant, or is this is the cause of this leaking a cause in the system in the overall system? Meaning, I need to look at all the pipes. I need to look at air conditioning, or was it that it’s a pool of water that’s going to rain, and was something that it happened? I’m going to go in there, patch it up, and it’s not going to happen again. So it can be either, you know, it can be just a circumstantial evidence. Too much water on the roof can lead to you know mild leaking, or it can be just a sign of something bigger happening in the system. That’s what we look at. But you need to step back, to stand back. You, the person who owns the body, the person who feeds the body, the person who protects the body, the person who nurtures the body-in essence, your body is your child. Without you, this child, your body doesn’t live. So you need to take a step back and say, something is happening. The system is trying to tell me something. What is it? And when you cannot figure that out, that’s when experts like the Akasha Center or Dr. Mark’s clinic comes in and tries to help you identify your body’s language.

Zack Arnold: Well, and that perfectly led into my next question, which is if I’m somebody that’s working in the film industry and I’m a film editor and I’m in a dark room, how do I know the difference between well, I’m just really tired and it’s been a rough week and I just need to sleep a couple of nights, and knowing that you’re just not going to get out of the hole and you need help because that was I wish that I had had something like this to listen to 10 years ago or I had somebody like you to talk to, and eventually I found you. But I probably came to you a year too late. I dealt with this for maybe two years of just thinking this is just my life. I’m just miserable, and I’m just grumpy, and I’m exhausted all the time. And it’s just who I am as a person. It must be just genetically who I am. What’s the difference between I just need a good night’s sleep, and it’s time for me to see a professional.

Dr. Edison de Mello: And then I’m curious to also see what Dr. Murph thinks. But as easy as it sound, as simple as it sounds, the answer is to do that which you think you need to do to get out of the hole. When you take a multiple choice question and you don’t know the answer, more and more research points to the fact that go with that which you think is right, even if you don’t, if you’re not 100% sure. Just pick that answer, and you know, in a majority of of cases, that particular guess is the correct guess. If you are you the listener is out there thinking, wait, is this more of a long-term problem that I need to address, or is it that I just need a break? What happens if I were to take a two-day break and just get off the grid? If I were to turn off my cell phone, my computer as much as I can, and tell my you know significant other, my wife, my husband, whoever it is that that you’re in a relationship with, I need your support, and that he’s what I need. And if you do that, and you realize that well, that made a change, you know, that really led to a change, then it’s likely that your system just needs you to do more and more of that, take breaks, get off the grid, get more support, exercise. When you exercise, you reduce, you increase endorphins. That’s why people are addicted, can be addicted to exercise because it releases the feel-good hormone. So go out, exercise, drink a lot of water, find something that you love. Instead, riding a bike, walking on the beach, laying, you know, out in the sun, gardening, you know, or working on your in your car, whatever it is that can be really relaxing for you, that’s very different than your everyday life, and then sit back and say, okay, on a scale from one to 1010, being the best I’ve ever felt, and one being the worst I’ve ever felt, where was I before I took this break, and where am I now? And that will tell you whether or not you need to pursue further treatment.

Dr. Michael Mark: Thank you, doctor. What the doctor says is absolutely correct. What I advise our patients to do to get out of ruts, to get out of habits, to change it up, to go exercise, to do the things that that the doctor is talking about. Here’s here’s the issue with the with people in general, and this is just my opinion, professionally over the years, not only as a doctor but as a lawyer. People are stuck; they’re stuck in their own way of thinking. You’re saying you know you would ask well you know how do I know if this is a couple days or I need further treatment I need any treatment listen you know we have a society that’s based upon speed it’s you know we’re more divergent we’re we’re at five years old our parents are deciding what college we should go to and what extracurricular activities we should be participating in-it’s nonstop. So it is difficult, I think. Without, it’s difficult to step back. You’re in a position where your brain’s constantly going. It becomes imbalanced. Stress causes miscalibration, and now the person’s off, but they don’t really know they’re off until it becomes severe, because they always think, you know, I can handle it; it’s no problem. You know, you take the athlete; it is don’t worry about it. So I have a concussion; don’t worry about it. I mean, I as long as I can walk, I can play, and we have that attitude in in in every area. And also, I think you need to be able to when you step back, you have to have some you have to have some idea of who you are and how you function instead of being you know automaton and just doing the work and and being a provider and it’s really hard and and I think the doctor’s point is well taken and the reason why his expertise is so needed, is because I don’t think it’s that you know it’s very difficult to actually step back without listening to someone. You know, if someone says step back in your family, you might go yeah, sure, whatever, but you really don’t do it. And I think the whole point of neurofeedback really is recalibration, is to increase resilience to stressors, to improve self regulation. So maybe you have some basis to know what is quote good and better, and what makes you feel worse. I mean, I know Zack, you talked about you could feel a difference, and you know what you were like. So you have some comparison. It’s ability basically to rebalance one’s life, right? Empowering the person, and what we do with the neurofeedback and the new technologies, we treat these symptoms at the source. So we’re not while their subjective opinion is we listen to when we do traditional when we do the neurofeedbacks that we do, we we have an objective view of the symptoms and we have an objective game plan, taking into consideration their subjective opinions, but we we do this from an area of objectivity. And when they take a look at the brain map, they they now can var you know verify that oh you know I do need help because a lot of them think like they’re either making this up, they’re blaming everybody else, and they think there’s something you know really terrible that there’s something’s wrong with them as a person, and when they actually see the brain map, they can actually clarify and put together that their symptoms are real and that they do need help. You know, from from Dr. Mello and his expertise, as well as you know any type of brain balance that we provide.

Zack Arnold: Well, and I can speak to that a little bit because I know that for a long time, it it really is just this this vortex of a black hole where you just blame yourself and get angry with yourself. And I think that it was you, Doctor de Mello, that taught me this term, which is that depression is just anger turned inwards. And that was something that really hit me hard, and I realized that I was angry with myself for a long time because I didn’t have enough energy to get through the day, and I was always irritable, and I was always blaming myself for being lazy and whatever it was. And it’s just this thing that keeps going darker and darker and darker.

Dr. Edison de Mello: Right, right, Zack. I mean, it it is true that it’s very possible that in the majority of cases, or in a number of cases, depression is indeed anger turns turned inward, or the worsening of depression, even for those patients who have a predisposition to it. When you’re angry because you’re not doing what you need to do for yourself. Or you don’t you don’t look the way you want to look, or you’re not making the money you want to make, or that you need to make, or you’re not in the relationship that you wish you were in. When all those things happen, that it can lead to anger, and anger will lead to more depression. For those of us who work with in the field with both men and women, we see that all the time. Culturally, it’s much easier for us men to be angry than to be sad. And you know, daily I deal with that with my male patients when they come in, and they are very angry or they’re very irritated from things that may happen in the office, such as they have to wait for you know a little bit to see me to things that happen out there, and when I pose a question, you seem sad. What are you sad about? It makes them stop. They may not have the answer. They may not say, “Oh, I’m sad because blah blah, but it makes them stop, and you go sad. Like in a lot of cases, it’s like they are reacting as if they’ve heard the word for the very first time, as opposed to women. You know, women sometimes, and I’m really making a huge normalization here. So for those listeners there who are male and who are able to feel sad, then please forgive me if I misrepresent you. For women who are able to feel the anger instead of the sadness, I also ask for forgiveness. But what I see in a majority of cases is that it’s much easier for women to go to sadness and not necessary to anger, then that is for man to go to anger and unnecessary to sadness. So, and it’s all culturally, and so when you know those things from a psychological, metabolic, hormonal, adrenal standpoint, and you operate from that, let me pose the question. Then you can have a lot of answers that can help the pitch. In your case, Zack, you know, I’m sure you have shared some of your history with your listeners. You too act as if that question had never been posed to you. When I said to you, you know, what are you angry about? You know, you being somebody who you know take the bull by the horn, and and when you were asked to jump, you actually give somersault. You said, “Let me look at this, and you went to work. Sometimes people are not able to do that, and I couldn’t agree more with Dr. Marks that sometimes, even when we know the answer, oh, I’m actually sad here. Oh, I actually need a break from my routine. Having a professional walking through your options is extremely important. Be it neurofeedback, a counselor, be it meditation, be it all of the above. You know, sometimes as simple, simple again as it may sound, it takes a village, and sometimes it just takes a couple of people in your village to steer in the right direction. So, and sometimes listening, send back and saying, “What kind of reaction do I get when I feel what I’m feeling? So you’re feeling a certain way every day. You know, what kind of feedback am I getting from people that in of itself can be really eye opening for a lot of us.

Dr. Michael Mark: When you know doctors is talking about stepping back and listening, you know a lot of patients come to us and and you know there there’s like they tell you a couple things that that you’re not sleeping well, little irritable, and they really don’t say much, either they don’t remember it, or they don’t want to share it, or it’s not that important. They don’t think it’s relevant, and I’m going, boy. You know, he’s mentioning a couple of these symptoms, and she’s mentioning some symptoms. I know there’s something else going on here, but you don’t like put them up to it. You just let them just relax. You do the brain map, and now you just kind of you know for yourself. So you’re able to see which neurons are firing and which areas are not. When the big thing is is brain behaviors become habits, right? So as long as they’re habits, they become bad habits. You know, we we have to afford them the ability to build new ones, ones that are more efficient, optimal functioning for their brain, for their for their attitude, for their family. It’s exactly what Doctor says. He’s he’s you know very clear that it takes a lot to step back and take a look and see what’s wrong because no one wants to be vulnerable. No one wants to say you know I need some help. I mean we just take a look at our society. You know just recently. I mean you know there’s a lot of issues that successful people are not successful-they keep within themselves. They’re too embarrassed to share. We go into professional football. You can see what’s happened over the years with traumatic brain injury, and these are powerful people, strong people, and they don’t want to say a word. They just keep it in where they-they pain so great and they end their life. So clearly. You know the symptoms often are side effects of another primary issue or diagnosis, and it does take the ability for for professionals to be able to step in and and give some hope in an area where a lot of people feel they don’t have any.

Zack Arnold: Now, Doctor de Mello, I know that I basically caught you in between sessions of saving people’s lives, and you’re a super busy guy, so I’m gonna let you go as soon as I can. I just have one further question that I think would be really, really helpful for my audience. We’re gonna have to go into generalizations here because I know everybody is different. But if I come into a regular doctor and say I feel like I’m depressed and anxious, it’s gonna be a 15 minute appointment, and they’re gonna say, “Okay, well I think you’re depressed, so here’s Lexapro, or here is Prozac, or whatever it is, and let’s see if it helps you feel better. And I know that you do the pharmacology side of it, but give me a broader overview of we would do this, or we would do this, or do that, because there are so many different like neurotransmitter support things that you offer, and fish oil, and vitamin D, and like give me an idea of just a quick, comprehensive approach, and then we’ll take it over to the brain side for somebody that comes in and wants to know how to fix this.

Dr. Edison de Mello: Sure, Zack. So the first thing that we do, like I said in the beginning of this this interview, Zack, is we we meet the patients as the medical director of the clinic. That is my music to my ears when I hear my colleagues saying, “I met the patient, you know, as a supervising attending physician. This is what I love to teach the residents. It’s not whether or not they’ve learned a lot about you know why the patient’s kidney is failing. I can get that information in the internet, but whether or not they can tell me a lot about the patient who happens to have the kidney failure, because that is going to tell me a lot. You know, who is the person’s support system? Is this patient happy? What is one thing that this patient could do for herself or himself right now to get better? And sometimes the answer will surprise you when you spend the time to meet the patient, so that’s the first step of the questions. Let’s meet the patient. We spend an average of an hour to an hour and a half for the first meeting, and the subsequent meetings are never less than half an hour. For the most time, they are anywhere from half an hour to to an hour for follow up. So that gives us time to remember who the patient is, to know about the patient’s milestones events in their lives, so what we do, we first look at that, and then we go to the metabolic function of the body, both the metabolic as well as the immune system. So we do what we call an akasha anal panel, where we look at everything from how your immune system is operating into your metabolic function, all your organs are operating through what kind of enzymes they need to to operate at at its optimal level, and whether or not those enzymes are increased or decreased. If they increase, it means that you’re overworked, or the enzyme, the the organs overwork. If they are decreased, it may mean that it’s luggage. So we look at that. We look at your endocrine system, which is a part of the body that produces the organ in the body that produces all the hormones that you need to operate. So we look at your thyroid. We look at your testosterone in the case of a male, and even in the case of female, because testosterone also drives a lot of the energy needed for the female body, so we do that also. We look at the hormonal panel. If the patient is having gas intestinal issues, we we may order a food sensitivity panel. You know that if you have a food allergy because you eat the food, you and you get sick or you you feel get a rash. But most of us have what’s called food sensitivity. You don’t know that your body is is spending a lot of energy to to metabolize a particular food. So we try to find that out through a blood test. We also look at, in case of circumstantial depression or case of in depression, we want to look at the neuro hormones. The body also produces hormones, neurohormones such as epinephrine, dopamine, serotonin. You know all the hormones that they self-date in a lot of those pharmacological treatments. Those are hormones. They are naturally occurring in the body. So we want to know: Is it that you’re producing the hormones, these hormones, and they’re not being properly metabolized, or is it that you’re not producing them at all? What is the problem? So we look at that as well, and because one of the mantras here at Akasha is “less is more, we want to make sure that we’re going to give you the supplements that you need, not the supplements that your neighbor who loves you or your family who adores you even more suggested, but the supplement that your body is actually telling us it needs. So we do vitamin D levels, we do B12 levels, and in some cases we also do an assay of amino acids and minerals that to make sure that you you fall within the percentage necessary. And once we do that, then we bring you back everybody who comes in first. Of course, we’re going to look at nutrition, and we’re going to say, “Tell us about what you’re eating. Can you try this, or can you give, can you take a break from this particular foods to see if you feel better? And so we do all that. We do this intervention, but when the labs come back, that’s when we go and we develop a very personal treatment plan, and sometimes that will be for three months, six months, or even a year, where we say, “Okay, for the first 90 days, this is what we want you to do. Your body’s telling us that these hormones, or that these enzymes, or that these amino acids are out of range, and this is what we think you need to do. Can you do it? And the patient says, “No, I cannot do it. Then we say, “Okay, within this range that I’m giving you, within those steps, tell me which ones you can do it. So we work with the patient where the patient is. If you are in the editing business. I cannot tell an editor to follow the body’s normal circadian rhythm, which is you should be in bed every night before 11 o’clock. It doesn’t fit the lifestyle that you need to have in order to pay your mortgage. So I can’t do that. But what I can do is say, okay. So when you work, when you go to sleep at 2o’clock in the morning, what do you do before bedtime? How do you shut the brain off? And so we go into what’s called sleep hygiene, and then we say, and what is the first thing that you do in the morning when you wake up? If it is, oh, I cannot wait to go to that pot of coffee, then it’s like, okay, you can go to the pot of coffee, but let’s find out why. Is it because it’s a habit, right? This is how you grew up. You like the smell. Is it because you need that energy to operate? If that’s so, let’s find out what is it that you need in the morning, in addition to or instead of the cup of coffee to give you the energy. So, and then it becomes sort of like putting a puzzle together. The puzzle is your life the puzzle? Zack Arnold, your children, your wife, your work, your mortgage, your parents. This is the puzzle. How can we help you balance it all? That’s that’s a cautious word.

Zack Arnold: Well, I would say that your your work has done wonders for me, and I know that it’s doing the same for other people that I’m sending your way. And on that note, I know that you have another life to save, so I’m going to let you go, and I’ll I’ll continue with Dr. Mark. But I wanted to thank you again for for being on the show with me and doing this, and we’ll definitely have you back again soon.

Dr. Edison de Mello: Love to be back, and Dr. Mark, thanks for sharing this time with me. I’ve heard a lot from Zack about you, and I look forward to to meeting you in person very soon. So maybe we should come up with a time to to get off the grid. The two of us forget and have a cup of tea.

Dr. Michael Mark: That sounds great. I’ve heard a lot about you and your fine work at the center, as well as your personal way you care about people. So I look forward to seeing you as well.

Dr. Edison de Mello: Same here, Zack. As always, it’s a pleasure.

Zack Arnold: Okay, thank you, sir. Appreciate it. Bye bye. Okay, bye bye. So now, Doctor Mark, what I want to do is kind of talk about the same thing, but from the neurological side, because Doctor de Mello just talked about ways that they can go ahead and approach. You know, and obviously this is very generalized, and every single patient is going to be different. But I just want to kind of eliminate the intimidation factor because people are so used to the idea of I’m depressed, I need a pill that solves the problem, and even integrative medicine can be intimidating. So once somebody has seen an integrative medical doctor like Dr. de Mello at his clinic, and they’ve been given a nutrition protocol or maybe pharmacology, how do you specifically fit into that equation?

Dr. Michael Mark: That’s a good question, Zack. At NeuroEdge, when Dr. de Mello was talking about blood panels, and that’s basically you know he starts off with a thorough interview analysis, and then all the blood work that’s necessary to make a proper diagnosis. We do it the same way, but we’ll do it. Let’s call ours brain test levels. So we’ll we’ll do a complete interview, and that might take us about 45 minutes. We’ll send out the interview in advance, so we don’t have to technically use the time to go over that. But we we review that a little bit with the patient, kind of know where they’re coming from, and then we do a quantitative electroencephalograph. So we do a very simple test. It’s by the time that it’s put on and off, it’s 20 minutes. It’s a brain map. A little cap goes on your head with 21 sensors, and we can see all the electrical activity going on in the brain. We do that with eyes open and eyes closed, and then we do an analysis into software. We put that into specialized software. It’s four or five types of software they put into to actually take the raw data and then be able to have a clear picture of what is going on in the brain, what networks are functioning, which networks are stuck, which networks are not are dysfunctional, and then to come up with a specific treatment plan to optimize brain. Function. When I talked about brain test levels, we take a look at the available power in the brain from the connections, the usage of power, the connectivity, how how sharp is the connection, how fast or slow, the quality goes along with that, and the strength and the networks available. And what we typically find is that the default network? When our brain is doing whatever it’s doing, then it’s going into a relaxed state, whatever that state is for each individual. If that state is too fast, we’re getting anxiety. If it’s too slow, we’re getting depression. And I’m not trying to simplify it in layman’s terms, that make it sound easy, but in fact, once we we target the network in the brain, and I’m calling it right now the default network because that’s on 24/7. Once we target that, the treatments are fairly straightforward. They’re about 30-35 minutes each, and there’s there’s nothing involved other than playing a game, and your brain is a joystick. We can train up to with Loretta neurofeedback. We can train up to three to 400 different areas of the brain, and as little as maybe 40 or 50. It’s it’s a fairly simple process, and the results are amazing.

Zack Arnold: Now you brought up a really interesting term that it took me a little while to figure out, but you have a great analogy for it, and that’s the default network. And you had mentioned that to me a few times, and I’m like, “What the heck is a default network? But then you explain the concept of how a car idles. So just kind of talk about that analogy to help the audience understand what a default network

Dr. Michael Mark: Is okay. So, what typically happens if you’re driving a stick shift for the very first time, and you’re on an uphill slope, and there’s a car in front and a car in back, you have your foot slightly on the gas, slightly on the stick, and slightly on the brake, so you don’t either stall or back into the car behind you. And so what happens is your brain. If you translate that into your brain function, that means that you’re constantly revving. It might be slow, but you’re not able to shut it off for any period of time and recoup the necessary neurons and oxygen that’s necessary to function properly. So the default network is the networks that that we’re talking about are the networks of the brain. They’ve been really more specialized in the past couple years. We use a part of our software is is NeuroGuide provided by Dr. Thatcher in Florida, and he came up with the different types of networks and treatments for networks. But basically, the default network is the authentic you. The rest is excess noise, distractions that detract from your optimal self. That is on 24/7. So when we target the default network at its core, we then can see what is producing depression in the frontal areas, or anxiety in the central to parietal area. Also, we can see temperament, memory, irritability, frustration, focus-all that’s related. While we talk about anxiety, depression as these broad areas. The other symptoms are pretty important too. And if you don’t sleep, for example, then you can’t focus. You can’t have any. Your memory is decreased. You’re more irritable. Everything goes hand in hand with the ability to have the brain function as optimal as possible. We believe at NeuroEdge that the brain-it’s what’s running, obviously with help. That’s what’s running the body. That’s the hard drive. If that is dysfunctional, or if that gets injured in any way, then symptoms generate. And I wanted to say one thing: we were talking about, you know, for a person to know when they should come for assistance or help or advice, disorders-the old version of disorders-the only thing that defines them as disorders is that it affects other people. You know, if it affects you, a lot of people go, you know what? I’m not. You know, that’s just who I am. But when it starts affecting your family and friends and coworkers, then quote, it’s a disorder. And this was taught to us years ago, so I think that the ability to know what the authentic you is, how the brain’s functioning, is very important in regulating the way you a see the world and also function in the world.

Zack Arnold: Well, the interesting thing that you say when you talk about the default network and idling, and you’d said that anxiety is when the brain is going too quickly, and depression is when it’s moving too slowly. I was actually dealing with both, and the the way that I had kind of created the analogy in my own head, and I had explained it to this way to Dr. de Mello years ago before I had even heard this analogy. I told him that I feel like I’m sitting in a car. And I have my foot totally on the gas where I’m pushing it as hard as I can, but I also have the parking brake up, and I have my foot on the brake as well. So I’m putting as much energy possible into sitting still and doing nothing. So does that make sense? Is that is that kind of a good way of explaining where you can be if you’re dealing with both anxiety and depression?

Dr. Michael Mark: Yes, Zack, and I believe that when you said doing nothing, you mean being stuck. Is that correct?

Zack Arnold: Yeah, like I literally, I would be sitting on the couch, completely motionless, just breathing. But the internal feeling was that I had both feet as hard as I could be pressing on the gas and the brake, meaning that I was expending tremendous amounts of energy just existing, right? Because my brain was moving both too fast and too slow at the same time, and it was just constantly at odds with each other. I couldn’t relax, I couldn’t sleep, I couldn’t enjoy myself. I was just-it was like a machine was turning inside me 24/7 Yet I wasn’t capable of moving or turning that energy into kinetic energy.

Dr. Michael Mark: Right, and what makes sense, and you hit it right on the head, is again simplistically that our brain is a combination of fast and slow frequencies, all in different proportions, in different hertz, in different speeds. So when the networks that are producing these frequencies are off, you hit it right on the head. Pardon the pun. But the issue is to have functional areas, the ones that should be slow. Again, what’s too slow? There’s there could be slow activity that’s on the high average or the low average. There’s fast activity when those are at odds with each other, besides depression and anxiety, which you mentioned, that’s when we have difficulty in focus, concentration, and attention. That’s when we have difficulty in staying asleep and falling asleep. That’s when we have difficulty in irritability and frustration. And so, what what we’re talking about is the distractibility. How do we get ourselves to optimize our brain to function the best way possible, and when you were giving your description, your spinning wheels going nowhere, digging deeper. Those are all favored lines, but there’s the same thing: is that it’s not easy and not taught in our society to ask for help. We’re taught to be strong people, especially in the men. For men, you don’t ask questions. You just kind of burrow through. Doesn’t matter as long as you’re vertical, you’re fine. You know, and and it’s also tough for successful women to actually say, you know, there’s issues. I need to take time off and deal with that. Or it’s a difficult area. So it takes someone that can know that there’s options out there, and that they can kind of see what those options are. Not be forced into it, not assume something, but just check it out and know that there is at NeuroEdge there is assistance and there is the ability to learn about themselves at their rate. No one’s pushing them. No one’s forcing them to do something that they wouldn’t want to do, and it comes out where they’re very thankful, just just like Dr. de Mello and what he does. It’s rare that you have doctors that care about people in a manner where it’s not a pill and it’s not a quick diagnosis in 20 minutes and you’re out the door. Where it’s actually, I have to know who you are and what your life is about before I open my mouth to give you any advice. And basically, it’s it’s on on both of our sides. It’s a very holistic and a very healthy ability to to help people. Does that make sense?

Zack Arnold: That absolutely makes sense. Yes. The last thing that I want to get into before we go, which is something relatively new that you’ve had me dabbling in recently, and that’s biofeedback and heart math. So, can you talk to me a little bit about the the program I’m using right now, which is called EM Wave Pro? What it is and why it’s helping me get so much better sleep and be more relaxed. What is it? What’s going on?

Dr. Michael Mark: It’s pretty amazing, right? So the bottom line is that when we do a form of biofeedback or neurofeedback, biofeedback, we’re looking at the physiology of our body. We’re having someone show us what our body actually looks like, and we make the changes in physiology, heart rate, respiration, and in neurofeedback, right? It’s it’s the ability to see our brain how it’s functioning, how it’s how it’s structured, and how we can make changes on our own. So the way heart math works, and it’s not it’s it’s heart rate variability, which is they realize over the years that how one breathes and what your cycle is per minute can actually slow down your sympathetic nervous system, so you’re able to not be in a fight or flight on a regular basis, or not being anxious. And what they found out is that if you find out. Your optimal breath rate, and most for most people, it’s between six and seven breaths per minute. Not yogis who do one breath per minute, which is fairly difficult. And we always focus on the exhale. So if we’re doing eight breaths per minute, we’re doing three seconds in. I mean, five seconds out. We’re kind of getting our exhale is always longer than our inhale, and what that ends up doing is, is that this slows our body in layman’s terms, right? It slows our body down. It lessens our ability to react too quickly, so we can actually listen to a Thanksgiving dinner and not get upset, or we actually can be in a line and not get upset. Our breathing is always. I’m glad you discussed it because we always use most of the time we use heart rate variability prior to doing any neurofeedback, because if the individual has a tough time breathing, and it’s a shallow breath and it’s basically a very learned poor breathing style, that doesn’t help. That makes it more difficult. So we spend a little bit of time training the patient how to breathe. Listen, we breathe normal as babies, dogs and cats. You can see how they breathe. You can see singers how they breathe abdominally through their diaphragm. And when there’s shallow breaths, we don’t recover. We don’t have the ability to be at a place that’s beneficial for us, and so the heart math lets us breathe better. Through breathing better, we can slow ourselves down. The anxiety doesn’t increase. The sleep patterns improve. Focus improves, and it’s a really simple procedure. And again, that’s only that takes us 10 minutes a day, and that makes life a lot easier. So if we look at all feedback training, basically you look in a mirror where you can see your facial expressions, your reactions, self regulations. That’s what feedback is about. Feedback is knowing yourself, and there’s nobody watching you, so it’s just you learning how to improve yourself and self regulate.

Zack Arnold: Well, it’s funny that you bring up the bit that you did a couple of minutes ago about how kids breathe and how pets breathe, because my son has actually gotten really interested in the heart math too. Because there’s nothing invasive; you literally are just putting a tiny sensor on your earlobe and using light. It’s just measuring your pulse and measuring the heart rate variability and the the distance between your heartbeats, and he’s like, “Oh, Daddy, I want to try that, right? And I’m like, “Well, how am I going to get a four year old to do heart math? I’m like, “I’m going to have to explain, you know, he needs to relax and he needs to breathe deep. And I’m like, “This is going to be a nightmare, right? I put the sensor on him, and he starts sitting there, and he starts knocking it out of the park, and I’m watching. I mean, he’s belly breathing, right? And for those that don’t understand belly breathing, most people, when somebody asks them to take a deep breath, they’ll breathe in. Their chest will get really big. Their shoulders go up, but their stomach doesn’t go out. And to properly breathe, and this is something you learn a lot in martial arts and in yoga, is that you actually want to breathe with your belly because that’s using the diaphragm more and bringing more oxygen into your system, and I didn’t tell him a thing, and he was belly breathing because he’s a kid, and that’s just the default state of the human being is to breathe that way and not to breathe shallow the way that we do. So that was really an eye-opening experience for me.

Dr. Michael Mark: That makes a lot of sense. I know, and you’re right. They haven’t been taught how to breathe poorly.

Zack Arnold: Yeah, which is what we’ve all been taught just through society. Not consciously, it’s not like we take a poor breathing class one on one in college, but just from from constantly being bombarded with stress and distractions and pressure, we just learn how to suppress that ability to breathe properly. And I don’t think that there’s any more important skill to learn on the planet than learning learning how to properly breathe, and that’s actually one of the things that we focus on for an entire week in our challenge groups. Everybody thinks, oh well, it’s fitness, and we’re going to be you know going on these diets and eating all this crazy food and doing P90X. It’s like, well, not really. There’s a lot more to it. I spend a whole week on nothing but breathing, and people are like, wait a second, we’re just talking about breathing. I’m like, yeah, let’s see how you feel at the end of the week once you try it. And people are like, wow, I didn’t realize what a difference just learning how to breathe can really make.

Dr. Michael Mark: Well, two little tricks that you could probably use in your class. One is is when a person is lying down, they put a book on his or her belly, and as they breathe in and out, the book goes up and down. If the book doesn’t go up and down, they’re breathing in through their chest. The second one, which is easy as well, is that when we breathe, we always we lift our shoulders up. When we lift our shoulders up, we never typically bring it down all the way. So, so what ends up happening is is there’s something called just noticeable difference, which is the tension that amounts in the trapezius areas in the back of our neck that goes up into our skull and causes a tremendous amount of stress over eight 910 hours a day, where then we have a better chance of getting neck. Pain, shoulder pain, and also tension headaches. So there’s a lot of things that are beneficial, a lot of good things that are beneficial from proper breathing. The good thing is it’s free. You know that you buy the system, but after you buy the system, it’s self-taught, and there’s games to play, and there’s music to listen to, and you can do it standing in line at the bank. If you’re upset, you can do three little breaths called a mini relaxation. You’re not upset anymore. There’s all these little tricks, but when someone has anxiety and severe anxiety, typically they hear from their friends. You know, you need to go to the doctor, get some medication, take this, take that, and before they, no one will recommend. I mean, very few people recommend breathing because the pay the person will say, “What are you talking about? Breathing’s not going to make that big of a difference. I breathe anyhow, right? And so I think that the heart rate variability. And you know, the other day when you were not feeling, you know, right on, you were at your best, and you and later on the day you said you did it and you felt like a new person. I mean, that how long did that take you? 10 minutes? 15 minutes?

Zack Arnold: Yeah, I just did 115-minute session. I was basically just with everything that’s been going on lately with developing the fitness and post program and with my Go Far documentary, and I’m going to be starting a new show. It all just kind of converged in the the course of a couple of days, where everybody needed something, and the only time I really feel stressed is when I feel like I’m letting other people down, or they’re waiting for me. If I have days and days of work to do, but it’s on my own schedule and it’s my own priorities, I don’t really get stressed. But when I’m letting other people down, that puts a lot of pressure on me and stresses me out. And everything converged at once, and I just started to slowly feel like I was slipping back down into the hole a little bit, just a tiny bit, and I said, you know what? I’m just going to turn everything off, and I’m going to sit in front of my laptop, which I just you know set a little little bit further away than I normally would. I hook up the sensor. I did 15 minutes of the heart math, and within an hour, I was like, oh my god, I feel like I just took 10 pills. I really did. It was it was literally like the effect, and this would be a bad analogy. But if you were to drink five Red Bulls, right, you’re gonna feel that. There is no question that that is gonna have a profound physiological effect, and your body’s gonna know that you drank five Red Bulls. I had the same type of reaction, just in a completely natural way, without putting anything in my body. And later on that day, I was like, “Hey, I’m back to myself, and I’m not anxious, and I’m focused, and I’m ready to go. And it was 15 minutes without doing anything except the heart math and breathing.

Dr. Michael Mark: Right, and and I think from a, you know, we had an expanded version, similar version of that overseas, dealing with relaxation after practice from football players, that we had them bring their heart rate down to their own particular area of comfort within 20 minutes after practice, and by getting their breathing down and getting them to relax, we reduced injuries by an astounding 70-five to 80% So it doesn’t just work for Anxiety; it reduces lactic acid, it creates focus and concentration in a relaxed manner. It allows the brain to re-energize itself, and since we spend 30% of all our calories on the on our brain function, you know when do we ever take care of it? We really don’t. We always look for some external factors to justify our feelings when all along it’s our internal way of living and how our brain is functioning that’s causing what the issues are, good or bad.

Zack Arnold: Well, if anybody listening is interested in what the heck we’re actually talking about, there’s a link in the show notes. It is a piece of technology called the HeartMath EMWave Pro, and there are also other versions. If it is something that you’re interested in getting, you can contact us directly, and we can help you out, or you can just get it directly from the HeartMath site as well. But I am very hopeful that after this conversation, if there’s anybody out there that is dealing with anxiety or depression, or knows somebody that is, they understand there are a lot of other treatment options out there, other than just popping the pill for the rest of their life. So I hope that this was helpful, and I just wanted to thank you, Dr. Mark, for being on the show once again. This has been tremendously insightful for me as well. So thank you very much.

Dr. Michael Mark: Thank you, Zack, for for having us and for including NeuroEdge in your site.

Zack Arnold

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The Science Behind Depression and Anxiety | with Dr. D and Dr. Michael Mark

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