Dr Daniel Amen on alcohol, brain health, and the hidden damage we do to ourselves
Psychiatrist Dr Daniel Amen discusses the findings from scanning 260,000 brains and what our habits — from alcohol to negative thinking — do to brain function.
Summary
Dr Daniel Amen, psychiatrist and brain health expert, discusses his findings from scanning 260,000 brains, including celebrities like Justin Bieber and Miley Cyrus. He argues that alcohol, marijuana, pornography, and simple carbohydrate diets all cause measurable brain damage — and that even moderate drinking creates structural changes in the brain. Amen presents evidence that depression can be treated as effectively with saffron, walking, and omega-3s as with SSRIs, and that negative thinking measurably decreases frontal lobe function. He advocates for a shift in psychiatry away from street drugs like psilocybin and ketamine and toward teaching people to love and care for their brains through lifestyle changes.
Key Takeaways
FULL TRANSCRIPT
The prevalence of brain-damaging habits
Dr Daniel Amen: There are in fact many roads to Alzheimer's disease. It's things like marijuana, alcohol, and football. And then a study found that people who had had a simple carbohydrate-based diet had a 400% increased risk of getting Alzheimer's.
I'm Dr Daniel Amen, a renowned psychiatrist and brain health expert who has scanned over 260,000 brains, including Justin Bieber, Miley Cyrus, and Kendall Jenner, to determine what we need to do for optimum brain health. In 2024 the word of the year was brain rot, because people are worried that their habits are shrinking their brain — food, gaming, social media, pornography.
Steven Bartlett: What about working? Is it bad for your brain? And is there anything non-obvious that we do to our children's brains?
Dr Daniel Amen: Yes, and this is so important, because this is one thing a lot of parents do without knowing the consequences for their children.
Steven Bartlett: What about negative thinking?
Dr Daniel Amen: We just did this huge study on this, and the science is really clear: it decreases activity in your prefrontal cortex, which impacts your motivation, focus, and mood. It is detrimental to your brain.
Steven Bartlett: So how can you kill the negative thoughts?
Dr Daniel Amen: There's a whole bunch of things. Saffron, head-to-head, has been shown to be equally effective as antidepressants. And then whenever you feel sad or mad or nervous, what I want you to do is — it's so simple.
Who is Dr Daniel Amen and why should we listen?
Steven Bartlett: Dr Daniel Amen, if someone's just clicked on this conversation now and they have no idea who you are — which is highly unlikely — can you tell me why listening to you and this conversation and the work that we're about to go through now is so important for everyone, even those who believe that right now they have no issues?
Dr Daniel Amen: Everybody has a brain. It controls everything they do — how they think, how they feel, how they act, how they get along with other people. Most people know it, but don't. Your brain is the organ of intelligence, character, and every decision you make. When it works right, you work right. When it doesn't, you have trouble. Most people have no idea that their bad decisions, their sadness, their anxiety, their insomnia, their poor relationships have to do with the physical functioning of their brain. So if they want to be happier, they need to think about loving and caring for their brain. Optimize your brain, you optimize your mind's ability.
Steven Bartlett: You mentioned scanning brains. Remind me again how many people's brains you've scanned now.
Dr Daniel Amen: It's now about 260,000.
Steven Bartlett: 260,000 people's brains. And you've scanned some famous brains.
Dr Daniel Amen: Yes. Actually, people from nine months old to 105, from 155 countries. It's public knowledge — I've been in Justin Bieber's docu-series Seasons. I scanned his brain. I've scanned Miley Cyrus's brain. Mel Gibson just went on Joe Rogan and talked about me scanning his brain. Muhammad Ali, Mike Tyson, Jake Paul.
Steven Bartlett: You also scanned my brain, and you actually taught me a lot from scanning my brain.
Dr Daniel Amen: Did you think about your brain after we talked?
Steven Bartlett: Of course I think about it all the time now. It's also interesting that in 2024, the year just gone, the word of the year was the word "brain rot." The subject of the brain hasn't been given the credit and attention it deserves really until recently, and much of your work has played into that. Why do you think — if you had to guess — why do you think Oxford University's word of the year was brain rot?
Dr Daniel Amen: Because people are worried that their habits are shrinking their brain, especially social media and digital addictions. I'm so hoping they'll go to brain health as more aspirational.
The impact of pornography on the brain
Steven Bartlett: We've talked about a lot of things on this show. One of the things that really stuck with me is how the content we consume can have a profound impact on our brains. We often think of the chemicals, the drugs, the alcohol, and all those things — which I want to talk about — but one such piece of content which I don't think we have talked about is the impact of pornography on the brain. Is there a link between brain health and pornography consumption?
Dr Daniel Amen: It's such an important question. The first thing that comes to my mind is exposing developing brains to pornography is so dangerous. Eight-, nine-, ten-year-old boys are being exposed to the internet where they can see all sorts of pornography when their brains aren't anywhere near the ability to discern what's good, what's not good, what's healthy, what's not healthy. It's deadening — I use that word purposefully — the nucleus accumbens, which is the area of your brain that produces and responds to dopamine.
Dopamine is the neurotransmitter that helps us with motivation, focus, happiness, and mood. When the nucleus accumbens gets hit repeatedly with pornographic images — dopamine, dopamine, dopamine — it begins to deaden that area, and then you need more and more to begin to feel anything at all. It's why fame is so hard on the brain. But pornography, especially in the young, is incredibly damaging to the brain.
Steven Bartlett: So is that applicable to all things that cause a really sharp burst of dopamine and stimulation — fame, pornography, potentially gaming or gambling, those kinds of things?
Dr Daniel Amen: Alcohol is obviously one of those things as well. Cocaine. Especially for a developing brain. If there's any message: protect your brain until you're 25, and then your brain will protect you. Until then, your prefrontal cortex — a third of your brain — is not fully developed. Which is sort of why God gave you parents. Supervise.
Steven Bartlett: But what if you get to 25 and you're listening to this now and you go, "Jesus, does this mean that I can do nothing about my brain?"
Dr Daniel Amen: Of course not. Let's just take the NFL work. Big damage, right? Let's stop lying about this. Football is a brain-damaging sport. Soccer as well is a brain-damaging sport. High levels of damage. Eighty percent of my NFL players got better when we put them on a rehabilitation program. So if you've been bad to your brain — non-stop gaming, lots of pornography, terrible food — and all of a sudden you go, "Oh, I can have a better brain," your brain can be better in as little as a couple of months, where you just feel better, think better, your mood is better. But it has to start with this concept — we've talked about brain envy. You have to want to have a better brain.
Why people seek out Dr Amen's help
Steven Bartlett: When people come to you, what is it they're typically motivated by? Do they come because they're curious about getting their brain scanned, or do they usually come with a symptom or some other ailment?
Dr Daniel Amen: Usually they come because they're in pain — they're anxious, they're depressed, their marriage is falling apart, their wife says "come or I'm going to divorce you." It's not an uncommon thing. Or they're struggling in school, they're not living up to their potential in one way or another.
About 10% of the people come and go, "I'm fine, but I want to see, and I want to be better. I don't want Alzheimer's." A lot of people come because they love a parent or grandparent that has Alzheimer's. They realize there's a genetic component to it, and they don't want to have that. But that's really someone who is forward-thinking. More people come because they're hurting.
The evidence that alcohol is bad for the brain
Steven Bartlett: What evidence have we got that alcohol is bad for the brain and bad for the rest of our body, especially in moderation?
Dr Daniel Amen: The US Surgeon General just came out wanting to put cancer warning labels on all alcohol. That's sort of big evidence. Three years ago the American Cancer Society came out against any alcohol, because drinking any alcohol increases your risk of seven different cancers. That's a big deal.
Then the evidence I have: my first clinic was outside the Napa Valley in Northern California, so alcohol is a big thing. As I was looking at scans, I'm like, "Your brain's older than you are." That alcohol is not a health food. It is detrimental to brain function.
And of course, I've been a psychiatrist now — I decided to be a psychiatrist 46 years ago — the number one problem I see is someone drinks and they make a bad decision. Someone drinks and they say something to their partner that they just shouldn't have said. Or they drink and they go to work. Or they drink and they drive. Or they drink and it just causes so much trouble.
In 1999 I did a show called The Truth About Drinking, and we took a young adult who had trouble with alcohol, got him sober, scanned him, and then on national television we got him drunk just like he got drunk, and it just crashed his frontal lobes. It's so clear that alcohol takes the brake off your brain. People use it to calm the brain down, but there's certain parts of your brain you really don't want to go offline — the part that says "don't say that, don't do that."
Steven Bartlett: Is that just when I've had one drink, and then when I sober up I'm back to normal? Or is this chronic?
Dr Daniel Amen: It depends. One drink will decrease in a mild way your decision-making. When it becomes chronic, your life begins to get out of control.
Steven Bartlett: If people drink in moderation, are they going to see long-term impacts to their brain? Is there such a thing as drinking just a little bit and being fine?
Dr Daniel Amen: There's always sort of a dose response. There was a study in Spain that looked at people who had mild, moderate, and severe drinking, and they compared them to people who didn't drink at all. Even the people who only drank a little had disruptions in the white matter of their brain.
Most people have heard about gray matter and white matter. Gray matter is nerve cell bodies. White matter is nerve cell tracks. If you think of gray matter as where the computation is happening in the brain, white matter is like the highways. Even a little bit of alcohol is creating potholes. It's disrupting the highways in the brain. If you're drinking a lot, you are prematurely aging your brain.
What heavy alcohol use does to the brain
Steven Bartlett: You've scanned a lot of people who are alcoholics.
Dr Daniel Amen: Lots.
Steven Bartlett: Can you explain to me exactly what a brain looks like when the person has been drinking heavily for a long period of time?
Dr Daniel Amen: We do a study called SPECT. SPECT looks at blood flow and activity. It looks at how the brain works. The SPECT tracer — 49% of it is taken up by the mitochondria in the brain, so we're also looking at energy metabolism.
What we see with alcoholic brains is something we call scalloping — this global decrease in activity. A healthy brain: full, even, symmetrical activity. It sort of looks big, fat, and round. With alcohol or other drugs, you see the brain begin to shrivel, and it gets this wavy appearance. The real reason not to drink is it damages your brain.
Steven Bartlett: If you drink, then you have a smaller brain than you would have otherwise?
Dr Daniel Amen: Correct.
Steven Bartlett: That's pretty scary. Why does brain size matter? When people say "it's going to shrink your brain," why does that matter?
Dr Daniel Amen: The only organ where size really does matter is your brain, because you don't want to lose brain tissue. There is a part of your brain called the hippocampus, which is on the inside of your temporal lobes, right here. It's really important. It makes new stem cells every day — about 700 — and if you're drinking, it's not allowing those new stem cells to take hold, to take root. You want to strengthen them so they will continue to support mood, memory, spatial orientation, spatial processing.
Those are the symptoms you're inadvertently naming — symptoms of someone who has damaged their hippocampus: poor memory, probably poor spatial awareness, brain fog, mood issues, and judgment and impulse control. But it impacts the brain globally. The cerebellum — they're not going to process as quickly. Their decisions are not going to be as good.
The ethical case for optimizing your brain
Steven Bartlett: I worked with my friend BJ Fogg, who wrote a wonderful book called Tiny Habits. He's the director of Stanford's Persuasive Technology Lab, which is on how people change. I met him at a conference like 18 months after we worked together, and he said, "I just want to thank you." I'm like, "Why?" He said, "I wake up 100% every day." I'm like, "Why?" "I stopped drinking." Because people around me enough, they either drink more, I suspect, or they stop. And isn't that what you want? You wake up 100% every day. Why would you ever do anything that damages stem cell production in your brain?
Steven Bartlett: One might argue that it's serving me in the short term.
Dr Daniel Amen: Of course. But there are lots of things that... Let's say you're married, but you're at a conference and you see this really cute person, and you're like, "Oh, well, in the short run that could be awesome." In the long run, you lose half your net worth and visit your children on the weekends. That's not a good thing. In the short run, you feel more relaxed with alcohol. You feel more relaxed. In the long run, it increases your risk of Alzheimer's disease. That's not a good tradeoff.
A study on alcohol and brain cell development
Steven Bartlett: On your blog you published a study from 2009 — a study on monkeys that showed a decline in new brain cell development. In that study there was a 58% decline in new brain cells and a 63% reduction in the survival rate of new cells from alcohol use.
Dr Daniel Amen: They had monkeys drinking alcohol. They have monkeys doing all sorts of things they shouldn't be doing.
Steven Bartlett: Which is effectively like premature brain aging, right? And it's worse if you do it before your brain is finished developing. If you think of fraternities and sororities, I'm not a fan of sending children away to college. You have all these underdeveloped brains — or not fully developed brains — and you put them all together without appropriate adult supervision, and a lot of bad things happen at fraternity parties and sorority parties.
Steven Bartlett: They're drinking less though now, no?
Dr Daniel Amen: They're still drinking. Now they're adding mushroom parties to it — alcohol and psilocybin and marijuana, because everybody thinks marijuana is innocuous, which is a lie.
Why marijuana is not innocuous
Steven Bartlett: Is it? Marijuana? It's a lie?
Dr Daniel Amen: I was actually really upset. President Biden, during the time he was running for president — 2019 — he's on the debate stage with a lot of other people, and they asked him if he would federally legalize marijuana. He said, "I don't think the science is decided, and no, I don't think I would." Cory Booker, the senator from New Jersey, shamed Biden on national television. He said, "Man, are you high?"
I'm watching this going, "The science is actually really clear. Marijuana is bad for the brain." I published a study on a thousand marijuana users: every area of their brain is lower in activity. Just today a study came out in the Journal of the American Medical Association on 21,000 marijuana users. It decreased activity in the hippocampus, which affected their memory centers. If you're a teenager and you use marijuana, in your 20s you have a higher incidence of anxiety, depression, and suicide. This is not innocuous.
We've been advertised this load of crap — "Oh, it's just good medicine." For some people it is helpful. But let's not say it's innocuous, because that's a lie. So many states have legalized marijuana for recreational use, including here in California, and the mental health crisis is not better. If anything, it's dramatically worse.
The issue of legalization versus education
Steven Bartlett: There's two issues here, isn't there? There's the impact cannabis has on the brain, and then there's the whole issue of legalization.
Dr Daniel Amen: Please don't put people who use marijuana in jail. That's just a bad use of money. That's not smart. But the problem becomes we're not educating kids on the potential damage to brain development, which nobody really argues about. Nobody reputable I know of is going, "Yeah, give it to teenagers and let them smoke all they want." No, it's just dumb.
I think the answer: I have a high school course called Brain Thrive by 25. We actually studied it in 16 schools. Decreases drug, alcohol, and tobacco use. Decreases depression. Improves self-esteem. We teach kids to love and care for their brain. You got your brain scan, and now you love your brain more. You want it to be better. That's the answer. It's not scanning everybody, it's educating everybody.
Your brain controls everything you do. When it works right, you work right. When it doesn't, you don't. So let's love it, and let's learn together how to optimize it.
The return of street drugs as psychiatric treatments
Dr Daniel Amen: But the big innovation for 2025 in psychiatry: marijuana, psilocybin, and ketamine. The street drugs of the '60s are coming back. I feel like I'm living in this insane world where we're not talking about you should eat better and exercise and learn not to believe every stupid thing you think, and meditation could calm your mind probably more effectively than alcohol or marijuana. It's not hard to learn.
Steven Bartlett: What's wrong with psilocybin and magic mushrooms?
Dr Daniel Amen: Everybody's so excited about microdosing — "It's a treatment for depression." I think I've seen this story before. In the early '80s, benzos — Xanax, Klonopin, Ativan — they were "Mommy's Little Helper." "This will really help your anxiety." The problem is they make your brain look older than you are, and they're addictive as hell.
Then there was "alcohol is a health food," "marijuana is innocuous," "pain is the fifth vital sign," which led to the opiate epidemic. Now we're into mushrooms. Psilocybin-associated psychosis has gone up 300% in the last couple of years. Not for everybody, but for some vulnerable people — and we don't know who they are — it can flip them into a psychotic episode. We need to be careful. We need to be thoughtful.
The clinical trial landscape for psilocybin
Steven Bartlett: Psilocybin hasn't yet been legalized in the US, has it?
Dr Daniel Amen: In Oregon.
Steven Bartlett: In Oregon. Is it being delivered yet?
Dr Daniel Amen: Just now. There was a two-year waiting period, and they were training people to do psilocybin-assisted psychotherapy. But there isn't a psilocybin compound that's been approved yet by the FDA. There's still stage three clinical trials.
Steven Bartlett: I was quite involved in that world as an investor once upon a time. I understand the rigor to get these compounds clinically approved. In the early clinical trials, there's groups of like 20 people. As they're progressing to stage three, they need bigger sample sizes to make sure these compounds are safe.
From what I've seen, a lot of people are trying to get it approved in a clinical setting for cases of treatment-resistant depression. In the studies I've read, you see some people have adverse responses. Some people get worse. If you take someone who's treatment-resistant depressed and potentially suicidal and give them a strong compound like psilocybin, some people can get worse. But for the ones that get better, it's pretty remarkable.
I remember the first study I read — I think coming out of Imperial College London — said something like 30% of people that did one dose of psilocybin went into clinical remission after 12 weeks. After one dose. There's really nothing else I can think of that can deliver that kind of response in that period of time.
Dr Daniel Amen: Ketamine. Ketamine. MDMA has — ketamine can do it, but then ketamine can also be addictive and can be problematic.
Why brain imaging should precede treatment
Dr Daniel Amen: Why wouldn't we scan them first and then try to figure out why you're depressed? Because if you think about it, depression is like chest pain. Nobody gets a diagnosis of chest pain. It doesn't tell you what's causing it, and it doesn't tell you what to do for it. All sorts of things can cause chest pain — heart attack, heart arrhythmia, heart infection, gas, an ulcer, grief. All of those can cause chest pain.
Well, there's a whole bunch of things that can cause depression: loss, negative thinking, low thyroid, having a head injury, being exposed to mold or mercury, Lyme disease. If you don't look, if you just give everybody an SSRI — that's ludicrous. That's assuming everybody with depression has the same problem. It's like giving everybody with chest pain nitroglycerin. Stupid. You would never give everybody who has chest pain one treatment. You'd go, "I have to target the treatment to the cause."
For example, I was on The Kardashians. It's public that I saw Kendall. I saw her for post-COVID anxiety. Her brain was on fire from COVID. A lot of people don't understand that COVID and other infections can cause inflammation in the brain. That's not a psilocybin thing. That's an anti-inflammatory cocktail to help post-COVID anxiety or post-COVID depression. If you don't look, you don't know. You end up flying blind.
That's what I've been fighting with my colleagues for the last 33 years: How do you know unless you look? What other medical specialist never looks at the organ they treat?
The US leads the world in antidepressant prescriptions
Steven Bartlett: There's this graph I saw the other day circulating around the internet which shows globally which countries distribute the most antidepressant pills — SSRIs. The United States leads the way by a long margin. It's almost ten times more antidepressant pills per person are handed out in the United States than other parts of the world. I wondered why. Why does the USA hand out antidepressant pills like water?
Dr Daniel Amen: It's such an interesting graph. Here in America, we want the fast answer: "I don't feel well, fix me." Do you know 85% of psychiatric drugs in America are prescribed by non-psychiatric physicians in seven-minute office visits that do standard of care 12% of the time?
Steven Bartlett: What does that mean?
Dr Daniel Amen: They do what most doctors would consider good medicine 12% of the time. You go to your family doctor or your nurse practitioner and you go, "I'm sad, I'm anxious, I'm not sleeping." We hear this all the time at my clinics — I have 11 clinics around the United States: "I went to my doctor and he gave me a prescription for Lexapro, Xanax, and Ambien."
It just blows my mind that they would put you on something that changes your brain to need them in order for you to feel normal. People don't understand — I am not opposed to medication. I use it when I think I need to. But let's be clear: they do not heal or fix anything. What they do is they suppress symptoms. But then once they've suppressed the symptoms, they've changed your brain so you need them in order to feel okay. I don't like that.
Natural alternatives to antidepressants
Dr Daniel Amen: What can I do naturally? Head-to-head against antidepressants, saffron has been shown to be equally effective. The spice saffron. Head-to-head against antidepressants, walking like you're late — 45 minutes, four times a week — equally effective. Head-to-head against antidepressants, taking omega-3 fatty acids — equally effective in a study from Australia. Head-to-head against antidepressants, learning how to not believe every stupid thing you think has been shown to be equally effective.
So why not, if you're depressed and you can't get scanned, start walking, take omega-3 fatty acids and saffron, and learn how to kill the ANTs? ANTs stand for Automatic Negative Thoughts — the thoughts that come into your mind automatically and ruin your day. We grow up — I don't know if the same thing is in England — there's no training on how to manage your mind.
I was 28 years old in my psychiatric residency when one of my professors said, "You have to teach your patients not to believe every stupid thing they think." I'm 28, and I'm in my residency — which means I finished college, I finished medical school — and I believe every stupid thing I think. No one had ever taught me how to manage my own thoughts.
The evidence on saffron for depression
Steven Bartlett: I can't believe that thing you just said about saffron. I was reading about it here. It says research indicates that saffron may be as effective as SSRIs in treating mild and moderate depression. A meta-analysis of eight studies found no difference between saffron and SSRIs in reducing depressive symptoms. But in fact, the side effect profile is probably better for saffron.
Dr Daniel Amen: I got interested in saffron about 25 years ago because I saw a study. There are now 25 randomized controlled trials showing that saffron is as effective as SSRIs and other antidepressants. But the thing that caught my interest — and this may speak more about me — is they didn't decrease sexual function. In fact, they enhanced it.
I've been a psychiatrist a long time. SSRIs, for the right brain, they work. But they make it harder to have an orgasm. They decrease your libido. I don't like that. If you're depressed, you're already separated from your partner. If you're depressed and you can't have an orgasm or you're not interested, that's damaging not only to you but to your partner.
Saffron can enhance sexual function. I thought, "Okay, I'm paying attention." I have collected every study ever published on saffron and brain and mental health. There's actually five studies showing it enhances memory. It was as good as Aricept in people — Aricept, a medicine we use in Alzheimer's disease.
It helps memory, it helps mood, it helps sexual function. Mood, memory, and sex? I'm going to take it. Why wouldn't we start with that and exercise and learning to manage your mind, rather than start with Lexapro or even psilocybin or ketamine?
Trauma and the brain
Steven Bartlett: One of the things when people are talking about psychedelics that they're trying to treat is trauma — early childhood trauma. Is that something that you can see? If you looked at my brain, could you see trauma on my brain?
Dr Daniel Amen: Yes. I've written about a diamond pattern. I published in Discover Magazine in 2016 a study on 21,000 people showing we could separate post-traumatic stress disorder from traumatic brain injury with high levels of accuracy. Then we repeated this study on soldiers and showed the same thing. This year I just published the world's largest study on childhood trauma.
Steven Bartlett: Do you know the ACE score?
Dr Daniel Amen: Yes. A measure of childhood trauma. Adverse Childhood Experiences. It's on a scale of zero to ten. How many bad things happened to you as a child: physical, emotional, sexual abuse, neglect, being raised with a parent that has a mental illness, that's incarcerated, addiction, watching your mother be abused — domestic violence. Zero to ten.
I'm a one. My wife's an eight. We adopted our two nieces who are both nines. I'm very interested in childhood trauma. If you have four or more, you have an increased risk of seven of the top ten leading causes of death. If you have six or more — my wife's an eight, my nieces are nines — you die 20 years earlier than the general population.
In our study, what we showed: the more ACEs you had, the more activation of your limbic structures, especially a very interesting area called the anterior cingulate gyrus. I think of this as the brain's gear shifter. Lets you go from thought to thought, move from idea to idea, be flexible, go with the flow. When this is overactive, people worry, they hold on to things. It's like the trauma is always in front of them.
I often do a timeline. I ask people, "Do you see your life going from left to right or from front to back?" I see the past behind me. My wife sees the past in front of her. That's often what you see with trauma. Their brain becomes overactive in their emotional brain, which makes them at higher risk for pain syndromes, higher risk for anxiety, higher risk for depression, higher risk for insomnia. They're sort of always looking for bad things to happen.
What to do at home for trauma
Steven Bartlett: Is there anything someone can do at home? Not everybody can afford to go to a therapist. It's hard to get access to these kinds of treatments. If I have some kind of trapped trauma or traumatic experience, PTSD that I've been through, and I don't have any money at all, what would you recommend for me?
Dr Daniel Amen: The first thing I want everyone to do is love their brain. The healthier your brain — before we started, we talked about this idea: it's the brain you bring into trauma that often determines how you deal with it. To get well, you have to get your brain healthy.
That means getting off the alcohol, exercise, eat well, certain simple supplements.
Steven Bartlett: What supplements?
Dr Daniel Amen: Multiple vitamin for basic nutrition. Know your vitamin D level and optimize it. Most people need to supplement vitamin D. If you have darker skin, you need five times the level of sun as someone from northern Europe to get a healthy vitamin D level. You should know your vitamin D level and optimize it. I always say you can't change what you don't measure. Vitamin D is a very important number to know.
Multiple vitamin, vitamin D, omega-3 fatty acid. I did a study: 50 consecutive patients at Amen Clinics who were not taking vitamin D. We measured their omega-3 index. Forty-nine were suboptimal. I think most people would benefit from an omega-3 fatty acid supplement.
Then it sort of depends. If you have issues with your mood, saffron would be great. If you tend to be anxious, don't go for the benzo. Theanine, ashwagandha, magnesium, GABA, diaphragmatic breathing, hypnosis — so many things to help anxiety before you ever go to something that's addictive, that makes your brain look older than you are, that increases your risk of dementia.
Negativity bias and the brain
Steven Bartlett: One of the really interesting things you mentioned which I had never heard of or thought of before is the impact of negative thinking on your brain.
Dr Daniel Amen: We just published this huge study on negativity bias, and it's not good for your frontal lobes. I love doing positivity bias training. I train all of my patients: start every day — "Today is going to be a great day."
Somebody asked me today if I believe in manifestation. I think you have to tell your brain what you want, and then your brain will figure out how to get it. If you go, "Today is going to be a great day," your brain starts looking like, "Why is today going to be a great day?" When you go to bed at night, "What went well today?" That's so helpful to just start programming your brain to look for what's right, not just for what's wrong.
Virtually every depressed patient I see has a high negativity bias. Training them to be more positive — not irrationally positive, because you need some anxiety. People who have low levels of anxiety die early from accidents and preventable illnesses.
I have an older brother who I love, but he's one of the "don't worry, be happy" people. I sort of always wanted to be like him because I'm much more serious, much more driven. I'm like, "No, I wanted to be like him," until I read the research. There's a study from Stanford. They started in 1921 and they looked at 1,548 ten-year-old children. They were looking for what goes with success, health, and longevity.
What they found was shocking: the "don't worry, be happy" people died the earliest from accidents and preventable illnesses. The people who live the longest — the one theme was they were conscientious. If they said they were going to show up, they showed up reliably, consistently. They lived longer than everyone else. It shows they had good frontal function.
Steven Bartlett: Could that be also linked to discipline? Those people are more likely to be disciplined with other areas of their life — habits, eating, gym.
Dr Daniel Amen: Yes. Which means they had better frontal lobe function. So why would we ever take these guys' frontal lobes offline? Love your frontal lobes. This is why, when you have children, don't let them hit soccer balls with their forehead. It's just not a smart thing to do.
How to become a more disciplined and motivated person
Steven Bartlett: I think that's probably a big thing people are thinking about this time of year. We're recording now in January 2025. Everybody's thinking about New Year, new me — New Year's resolution, becoming a new person. Habits, motivation, discipline — these are like the trifecta of what I see people talking about the most at this time of year. With everything you understand about the brain, how do I become a more disciplined, motivated person who has better habits?
Dr Daniel Amen: One: you take care of your brain. Two: you know when relapse happens. Relapse happens when you don't sleep. When you've gone too long without eating, when blood sugar levels go low. Relapse happens — you start making bad decisions — if you're a female, when you're in the last week of your cycle, because blood flow to your frontal lobe drops for many women.
I have five sisters and five daughters. I completely believe in PMS. I've scanned people best time of their cycle, worst time — it's like they're two different people. They have multiple personality disorder, because their brain is just so different. Obviously not with all women, but for certain ones it's a big issue.
If the ANTs are taken over — the automatic negative thoughts, which also tend to go up if you haven't slept, if you've gone too long without eating, if you're at that time of your cycle, or you're under chronic stress, or you're drinking or using other drugs — you might suppress them, but then they come back and they attack you. Then you have to suppress them again. This is how addiction starts.
Steven Bartlett: Is it fair to say that if you're trying to change who you are and you're trying to establish a new habit or crack motivation, then the goal shouldn't be necessarily to get a six-pack? It should probably be something further upstream, like sleep well, or better frontal lobes?
Dr Daniel Amen: How do I get better frontal lobes? It's three strategies: frontal lobe envy — brain envy. Got to care about it. Avoid things that hurt. Damaging my frontal lobes. Do things that strengthen my frontal lobes. We talked about two of these points earlier — alcohol in the context of sleep. I heard on your podcast: after two drinks, your REM sleep drops to roughly an hour. After four drinks, your REM sleep drops to 30 minutes. After six drinks, your REM sleep drops to less than two minutes.
Obviously these aren't specific numbers because everybody's brain is different, but it just goes to show the relative drop in REM sleep — which is your restorative sleep — based on alcohol consumption. If I drink, I'm not going to sleep well. I'm not going to get restorative sleep. I wake up the next day, I'm going to struggle more with motivation and keeping any habit that I have, ending anxiety.
Then you're going to be more ANTs, and then you're going to drink more to shut up the ANTs, and then when they come back they come back stronger.
Steven Bartlett: And by ANTs, you mean the automatic negative thoughts.
Dr Daniel Amen: The chatter that hurts you. We talked about how to kill them. Whenever you feel sad or mad or nervous or out of control, what I want you to do is just write it down, and then ask yourself a series of questions. I have this cute diagram of the different types of ANTs.
I always ask my patients, "Which are your ANTs? Are they All or Nothing ANTs? Are you thinking words like always, never, everyone, every time? Are they Less Than ANTs, given to us by social media, where we compare ourselves to others in a negative way? Guilt-beating ANTs, mind-reading ANTs, fortune-telling ANTs, blame ANTs?" Identify the type.
Steven Bartlett: Do you have an example of a bad thought that just sort of runs around your head?
Dr Daniel Amen: Oh gosh. I think I live in a permanent state of assuming I'm going to get bad news. It doesn't haunt me. I think I'm generally quite a calm person and quite focused and peaceful in my brain. But I think because I've run companies for the last ten years or longer, you're always just about to get bad news. I think that can be playing on the radio in the background somewhere. Like, I'm going to open an email and it's going to be bad news. There's so many opportunities for bad news in my world.
The five-question process for killing ANTs
Dr Daniel Amen: I think you write it down: "This is going to be bad." Then my friend Byron Katie has this process that I've refined a bit. That's a fortune-telling ANT. "This is going to be bad news," or "I always get bad news" — fortune-telling and all or nothing.
The first question is: is it true?
The second question: is it absolutely true, with 100% certainty? If one is no, two is automatically no.
The third question: how does that thought make me feel?
Steven Bartlett: On edge.
Dr Daniel Amen: On edge. How does the thought make me act?
Steven Bartlett: Removed. What's that word? Is it apathetic? Reticent.
Dr Daniel Amen: The third part of that: what's the outcome of believing "it's always going to be bad news"?
Steven Bartlett: I mean, there's no good outcome really. Suffering.
Dr Daniel Amen: Suffering. The fourth question: how would you feel if you didn't have that thought?
Steven Bartlett: Free.
Dr Daniel Amen: How would you act?
Steven Bartlett: Happier. More present.
Dr Daniel Amen: And the outcome of not having that thought?
Steven Bartlett: Better relationships, because you're more present.
Dr Daniel Amen: The fifth question is my favorite. Just take the thought and turn it to the opposite, and then ask yourself, is that true? "It's going to be good news," or "it's going to be innocuous news." Then go, "Yeah, 99 times out of 100, that's true."
I would, because I'm also a CEO, go, "Well, how many of these things can't I handle?" Virtually none of them. I can handle all of them. So I'll be okay. Then I meditate on the opposite of the thought that's bothering me. I take these thoughts captive.
Steven Bartlett: I like that.
Dr Daniel Amen: People who are depressed are infested with negativity. But you can train that. If your brain is healthy, it's easier to do. But imagine: there's no second-grade class in the world where teachers teach children not to believe every stupid thing they think.
I was watching one of the confirmation hearings today, and the senators were filled with ANTs. They were distorting things. They were angry. They were making things more negative than they needed to be. We model bad thinking.
The news does it purposefully because they know if they piss you off, if they scare you, you're going to tune in so they can sell you more copper underwear. We're in a society that breeds these ANT attacks. You have to be careful.
People who watch the news in the morning are 27% less happy in the afternoon. You have to guard what goes in. Every day, you're programming happiness or sadness.
Happiness as a moral obligation
Dr Daniel Amen: Dennis Prager has this great five-minute video called "Why Be Happy?" I love it so much I wrote a book called You, Happier. I start with his idea that happiness is a moral obligation.
I grew up not too far from here. I went to Catholic school. My mom was very serious about being Catholic. Growing up, the idea that happiness is a moral obligation was nowhere in my childhood. I had a good childhood.
Why is it a moral obligation? Because of how you impact other people. If you were raised by an unhappy parent or married to an unhappy spouse or raising an unhappy child, and you ask those people, "Is happiness an ethical issue?" they would all say yes.
Is it wrong to program your mind to look for what's right? It's hard for some people. It's just a pattern. It's like getting biceps. It's hard, but it's not right. It's just repeatedly doing the same thing that gives you the desire you want.
Steven Bartlett: Have you seen someone shift from being a stereotypically negative person, down and out, negative, depressed, to the opposite?
Dr Daniel Amen: Yes. Truly the opposite. A lot. But you've got to do the process. You've got to do the work.
When you love yourself, you do the work. I come from a family of fat people, but I'm not. Why? Because I know it's a risk for me. Every day of my life, I'm on an obesity prevention plan. I wish I didn't have to be. I wish I could just eat anything I want and it would be okay. But it's not the reality of my life.
Elizabeth Smart: post-traumatic growth
Steven Bartlett: For people that don't know who Elizabeth Smart is, who is she, and what did you learn from scanning her brain?
Dr Daniel Amen: Elizabeth is someone who made international news many years ago. She was kidnapped when she was a teenager and virtually raped every day for nine months. Then she was found. She was actually very smart, and she manipulated her kidnappers to bring her back to Utah, Salt Lake City, where they'd kidnapped her from. She was found by the police.
One would think she would have severe lasting post-traumatic stress disorder. I was very interested to scan her and be helpful to her. She in fact did not have post-traumatic stress disorder. She had post-traumatic growth. She took her trauma and made something special out of it. She actually runs an organization for women who have been abused.
I just remember sitting there, and her brain was actually quite healthy. I think she helped me more than I helped her. I was so fascinated by how she could take something that's truly horrifying and come out of it and be quite okay.
Steven Bartlett: She's in her 30s now?
Dr Daniel Amen: She's in her 30s. She's married. She has children. She's running an organization. She speaks around the country.
Steven Bartlett: When people hear that, they might begin to question how they think about trauma, because we think of trauma as a very deterministic thing. If that happens to you, I can predict that you're going to be depressed, not social, not functioning, probably not going to have functional good relationships. That's the kind of thing we think when we hear about such a horrific event. We see it as deterministic of who you then become. But she's proving that that's not the case.
Dr Daniel Amen: In fact, of people who go through something really terrible, about 10% of people will develop PTSD, and about 10% of people will develop post-traumatic growth. Most people sort of land in the middle.
I wrote an article in 1982 when I was a resident at Walter Reed called "Post-Vietnam Stress Disorder: A Metaphor for Current and Past Life Events." It was when I was a resident. I got the idea: it's the brain you bring into Vietnam that often determines the brain that comes out of Vietnam. If you grew up in an alcoholic home or you grew up with a lot of stress, you are much more likely to become a heroin addict and much more likely to come home and struggle. Obviously not always, but we should —
There's a concept since I started imaging that I just dearly love so much, called brain reserve. Brain reserve is the extra tissue you have to deal with whatever stress comes your way. Brain reserve actually starts before you were conceived. You get your brain wrapped around that a little bit. It's the idea of epigenetics: if your parents grew up in trauma and abuse, it changed their genes to make you more vulnerable.
Your genetic history matters. The health of your mom while she's carrying you — your brain starts to develop three weeks after she gets pregnant. About day 21. Her stress level, her infectious disease burden, her nutrition, her sleep — all of these things matter.
One of my patients' wife is pregnant. I'm like, "You need to be nice to her. You need to lower her stress, because this has generational consequences."
Then when you're born, how did the birth go? As a child, what was your nutrition like? What were your stress levels like? Did you play football? Did you fall off the swing? All of those things are either building your brain reserve or stealing your brain reserve.
When you get kidnapped, or let's just take two soldiers at war — they're in the same tank, they go over an IED, the tank is blown up — one walks away unharmed, the other one's permanently disabled. Why? It's their brain reserve. The brain they brought into the explosion often determines how they are.
I argue we should always be building reserve. I turned 70 this year. I know 50% of people 85 and older have Alzheimer's disease — one in two. Horrifying statistics. Between now and 15 years from now, what are the things I can do to build my reserve so the gravity of age has less impact on me? Your brain is going to shrink with aging, regardless.
Although I have a whole group of superbrains — people that are 80, 90, 105 — stunningly beautiful brains. But they're people that had stunningly beautiful brain reserve habits. They didn't smoke. They weren't drinkers. They ate well. They were not overweight.
The 11 risk factors for Alzheimer's disease
Steven Bartlett: On this subject of Alzheimer's: it's increasing globally. The Alzheimer's Association predicts by 2050 there's going to be 150 or 160 million people globally that have Alzheimer's disease. There's still a lot of question marks around what causes it, what increases its probability, etc. But what do you think the cause of Alzheimer's is?
Dr Daniel Amen: I think there are many causes of it. The going wisdom until recently was excessive beta-amyloid plaque formation caused Alzheimer's. There's a lot of questions around that theory.
I have a mnemonic I like called BRIGHT MINDS. If you want to keep your brain healthy or rescue it, you have to prevent or treat the 11 major risk factors. I think there are in fact many roads to Alzheimer's disease.
People go, "What's the difference between Alzheimer's and dementia?" Dementia is the umbrella category — you start losing your faculties. Alzheimer's is one of the types. But the more you get into it, you realize it's a pretty mixed bag.
BRIGHT MINDS: B is blood flow. R is retirement and aging. I is inflammation. G is genetics. H is head trauma. T is toxins. M is mental health — if a woman is depressed, it doubles her risk of Alzheimer's disease. If a man is depressed, it quadruples his risk of Alzheimer's.
Then the sleeper in all of these is I: immunity and infections. Many of us think it's one of the major causes of Alzheimer's disease. In fact, there's a new study out on COVID: people who had COVID had a significantly increased risk of getting Alzheimer's disease.
Then N is neurohormones. We have this epidemic of low testosterone in young males now. D is diabesity — you either have high blood sugar and/or you're overweight. If you have that one risk factor, now all of a sudden you have 10 of the 11 risk factors.
Because if you have diabetes, if you're overweight, or you have high blood sugar, it lowers blood flow to your brain. It prematurely ages your brain. It increases inflammation. Fat cells produce something called adipokines, which are inflammatory molecules. It changes your genetics. Fat stores toxins. You're more likely to be depressed. It damages your immunity. It takes healthy testosterone, turns it into unhealthy cancer-promoting forms of estrogen, and impairs your sleep.
Then people go, "Oh, but you're fat-shaming." It's like, no. I published a study on 33,000 people: as your weight goes up, the size and function of the brain goes down. Somebody's got to say the truth. The truth is, being at an unhealthy weight is unhealthy for your brain and body.
Alzheimer's as type 3 diabetes
Steven Bartlett: I was reading some studies earlier. When I spoke to an insulin resistance expert, one of the things they said to me was that they now almost describe Alzheimer's as type 3 diabetes. When they look at brains that are insulin resistant, the person — between 40 and 80% of the time, depending on which studies you look at — has insulin resistance. They've had elevated blood sugar levels which have caused an insulin resistance, or something else. It could be stress that causes insulin resistance, or many other things.
It's interesting to think of that one thing — high blood sugar levels, insulin resistance — can have such a profound impact on the brain. If I've ever heard a case for being a bit more careful about sugar and other things that will spike my blood sugar levels chronically, I think that's probably it.
Dr Daniel Amen: You don't like sugar as much as you like your brain and my life.
There's a study from the Mayo Clinic where they looked at people who had primarily a fat-based diet — fish, healthy oils, avocados, nuts, and seeds. They had 42% less risk of getting Alzheimer's disease. Then they looked at people who had primarily a protein-based diet — think of a caveman diet — 21% less risk of getting Alzheimer's disease. Then they looked at people that had a standard American diet — simple carbohydrate-based diet: bread, pasta, potatoes, rice, fruit juice, sugar — a 400% increased risk of getting Alzheimer's disease.
It's the sugar and the foods that quickly turn to sugar. Having high blood sugar makes your blood vessels brittle and more likely to break, which means it takes longer for things to heal, and you're more likely to have a stroke. Having a stroke increases your risk of Alzheimer's threefold.
Steven Bartlett: Are you a fan of the keto diet?
Dr Daniel Amen: For some people. I find that it doesn't have enough plants in it, which means it's probably not going to be awesome for your microbiome. I'm more a fan of a paleo diet that has healthy fat, healthy protein, and lots of plants.
Hope and grief
Steven Bartlett: We've covered so much. The one thing we started talking about briefly before we started recording was the subject of hope and grief. I've never heard someone talk about the impact that grief has on the brain when we lose someone, when we're going through prolonged pain because of a loss.
Dr Daniel Amen: I know more about this than I want. It activates the limbic or emotional circuits in the brain. When you lose someone important to you, or even a pet — I had Larry, a white shepherd, so beautiful and so sweet. He got cancer. When he died, he still lives in my head.
I lost someone important to me about 20 years ago. For like a year, I was just not okay. I scanned myself, and my emotional brain was so busy. When you have someone, they actually become ingrained in every fun place in your brain. They get stored in multiple places in your brain. When they're not there anymore, your brain still looks for them.
Figuring out ways to sort of calm down your emotional brain can be so helpful.
Steven Bartlett: What part of the brain is that? Is that the amygdala?
Dr Daniel Amen: No, it's more the insular cortex and the thalamus. That's what we found with depression. I published a study with scientists from USC and LA Children's Hospital on depression. What we found: those were the structures that were dramatically overactive compared to people who were not depressed.
Steven Bartlett: In grief, the prefrontal cortex — that's the more rational part of the brain — that's probably going to be quieter, right?
Dr Daniel Amen: It's the prefrontal cortex you bring into the loss that often determines how you deal with it. If you're drinking and taking the prefrontal cortex offline, it can't manage it.
One thing people don't understand is the fibers from the prefrontal cortex to the rest of the brain are inhibitory, which means they calm things down. If this isn't working right, the emotional part can sort of override it and it becomes problematic. Protecting this is so important to managing so much of your life. It's really the most human, thoughtful part of us.
Hope and the insular cortex
Dr Daniel Amen: What we found within hope was the insular cortex was low. It's really interesting to us. Hope is "tomorrow can be better, and I have a part in it." When you're hopeless, you don't believe you have agency to make tomorrow better.
Often there are hope training courses that can be good. With all of my patients, I do this exercise called the one-page miracle. I referred to it earlier. Write down what do you want: relationships, work, money, physical, emotional, spiritual health. Write it down.
We talked earlier about we're recording this in January. I have all my patients do it when I first see them, and then every January for sure. You just ask yourself: does my behavior get me what I want? But it starts with, what do you want? You have to write it down.
With my wife, I'm very clear: I want a kind, caring, loving, supportive, passionate relationship. Always want that. Don't always feel like that. I've got these rude thoughts that show up or conflicting ideas that'll just show up in my head. I'm like, "Oh no, don't say that. Don't do that." Because it doesn't fit.
It's been the best relationship of my life, because both of us have the same goals, and we're pretty good at matching our behavior to the goal. As a CEO, what do you do with companies? You have a business plan. You have regular meetings and key performance indicators to go, "How are we doing?" If we're not doing great, we change. But it always starts with plan.
Most individuals never have a plan, so they're kind of just being dragged around by whatever. Now, in social media, it's very dangerous because you might want what the Kardashians have. Wait a minute: relationships, work, money, physical, emotional, spiritual health.
Then, if I had tattoos — I don't yet; my wife got one that freaked me out — it's my daughter's birthday. But the tattoo would be: does it fit? Know what you want. Ask yourself every day: my behavior, does it get me what I want?
Some people go, "Well, isn't that selfish?" Absolutely not. Because if I'm good, I'm good for everyone around me. Your goal could be to be a great father. It absolutely should be. A great father. To be a loving husband — kind, caring, loving, supportive, passionate.
Oh, by the way, when people do our program, their erections are better. Just saying. Because blood flow is better when brain health is better. Your brain uses 20% of the blood flow in your body. If you're working to have a healthy brain, everything works better.
Steven Bartlett: Why did that come to mind when I asked about your goals?
Dr Daniel Amen: Because I went "passionate," and I'm like, okay, you have to be clear. Or even think about work. What's the goal with work? It's to do meaningful work. It's to make a difference.
How to raise healthy brains in children
Steven Bartlett: I'm not a father yet, but I hope to be. I've got three little nieces and one nephew. My brother's a year older than me, and he's had three kids already. I've got some catching up to do. As I'm progressing towards this season of life, one of the things I think about, having met you, is how to raise healthy brains. What parenting style is going to make sure that my kids have very healthy brains?
There's so much conversation about parenting stuff. Some people say just let them do whatever they want to do. Some people say be an authoritarian and put rules in place. I'm wondering, from the perspective of someone who scanned 260,000 brains, how do you raise a perfect brain?
Dr Daniel Amen: One: you get rid of the idea that you're going to raise a perfect brain, because there's a little OCD in there.
The first thing you do is you have goals for yourself. What kind of parent do you want to be? What kind of child do you want to raise? For me, I want to be present, kind, and effective. For my kids, I want them to be mentally strong and resilient, and I want them to feel good about themselves.
Then you bond with them. You want to be a good dad? Bonding requires two things: time — actual physical time — and listening.
I have an exercise I love so much called special time. Twenty minutes a day, do something with your child that your child wants to do. During that time, no commands, no questions, no directions. Just time to bond. The most important thing to children is time with their parents. People are busy. Doesn't have to be a lot. But if you do that 20 minutes a day, it's money in the relational bank.
My first literary agent, I think he was 42 when he had his first child. He's like, "My daughter — she's two — Laura never wants to be with me. I come home, she completely ignores me. She just wants her mother. She wants nothing to do with me."
"That's because she's a girl, right?"
"Absolutely not, Carl. You're ignoring her."
"What do you mean I'm ignoring her?"
I said, "You're ignoring her. Do this." I told him about special time.
He's like, "That won't work."
I'm like, "Negativity bias. Great, you represent an idiot." You represent me. You're telling me it won't work. I said, "Do this. It works. I'm going to call you in three weeks."
I wrote it in my appointment book. We had appointment books then. Three weeks later, I called him.
"Carl, it's Daniel."
"Daniel, she won't leave me alone. All she wants to do is be with me. As soon as I get home, she grabs my leg and wants her time."
I'm like, "I told you it works."
It works. Time — actual physical time. Then shut up. Listen. This is so important. Parents are awful at listening. You've heard of active listening?
So active listening is so simple. Child says something. Before you give your two cents, just repeat it back and sort of listen to the feelings behind the words.
"I want to have blue hair."
I know what my dad would have said: "I want to have blue hair? No way in hell. As long as you live in my house, you cannot have blue hair."
But what does that do? It just shuts down the conversation or starts a fight.
"Oh, you want to have blue hair." Then just be quiet. Then the child might say, "Everyone's doing that."
My dad would say, "I don't care what anyone else is doing. As long as you live in this house, you're not going to have blue hair. If they're going to jump off a cliff, are you going to go with them?"
Not helpful.
"Sounds like you want to be like the other kids." Then he might say, "Sometimes I feel like I don't fit in."
Which is really the conversation you want to have. My mother would have said, "Of course you fit in. You're a good boy. You're a good-looking boy."
That's not helpful either. It's just helpful to listen. If you have time and you have listening, you bond. Then the kids tend to pick your values because they're bonded. Then when they make a mistake, don't rescue them.
Today, parents do way too much for their children, and they steal their self-esteem. I often say, if you do too much for your kids, you build your self-esteem by stealing theirs. You're going to be tempted because you're going to have such love for them. You don't want them to hurt. That's a mistake, because character is built through struggle. Character and self-esteem are built by feeling competent — you can solve problems.
When a child says, "I'm bored," rather than, "Well, we could do this, or we could do that, or we could do this," go, "I wonder what you're going to do about it."
Steven Bartlett: In terms of their diet and lifestyle, am I right in thinking it's pretty obvious here? Sugar, chemicals, toxins — these kinds of things are really bad for the child's brain. Is there anything non-obvious that we do to our children's brains?
Dr Daniel Amen: I think the most important thing is you model. The message. What you do. There's a reason that all the sugar-poison cereals are on the bottom two rows, because that's where children can see them. They're like, "Mommy, I want this."
I always want you to remember this rule, and I want you to consider sharing it with your children: if you have a tantrum to get your way, the answer is no. It's always going to be no.
Steven Bartlett: Go for it.
Dr Daniel Amen: I'm dead serious. We teach people how to treat us by what we tolerate. We train children to be bad by what we pay attention to. I think that's always been a very effective rule for me. If you have a fit, the answer is no. It's always going to be no. I'm not going to be fazed if you do.
Steven Bartlett: What if they do it in a store?
Dr Daniel Amen: Do you want long-term pain or short-term pain? Short-term pain is not giving into the tantrum. There'd probably be a consequence when you come home for acting like that.
Steven Bartlett: Are you saying to ignore the tantrum?
Dr Daniel Amen: I'm not giving in. Have fun with it. I am not giving in. "We're at a friend's house and you have a fit? Well, one, there's going to be a consequence when you come home. I don't know what it is, but I'm going to think about it."
It's such a great line — in my book Raising Mentally Strong Kids, we have lots of great lines for parents. "I don't know what the consequence is, but I'm going to think about it," just to increase their anxiety about it, because we want them thinking about their behavior. In life, there's consequences to bad behavior. We want them to think about what that might be.
Steven Bartlett: Might that stray into neglect when they express their emotions, though? For example, if my kid is in a supermarket and screaming and crying, "Daddy, give me this," and I just always ignore them, are they going to be raised to be like neglected children or something?
Dr Daniel Amen: If you do it in the context of special time and active listening, and I think rules are important — tell the truth, put away things that you take out, we treat each other with respect, do what I ask the first time. It's one of my favorite rules. It prevents the kids from going on and on about being oppositional.
There's no way they're going to feel like you're not listening and you're ignoring them. But if they're acting inappropriately, you want: one, not give into it, and two, have a significant conversation and consequence.
ADHD: real and treatable
Steven Bartlett: One of the big themes that I wanted to ask you about — it's the last thing I really wanted to focus on today — is there's been such a huge rise in the conversation around neurodivergence, which we talked about in part last time. You looked at my brain. We did some tests and such. You spoke to some of my colleagues and people that know me. I think they did some surveys about me as well. You concluded that I had ADHD.
So many people are being diagnosed with ADHD. When we look at some of the numbers around the increase in diagnosis, it's quite alarming. I wonder why that is. Are people being born with more ADHD? Or is it an increase in the diagnosis? Is there a pop culture element to it, where it's become quite popular to say that you have ADHD if you like forget your keys or something? What is it in your view?
Dr Daniel Amen: ADHD is real. There's a significant genetic component to it. But we're also living in a society that promotes its expression. The more sugary cereals with red dye number 40 — increases hyperactivity. The more gadgets you give them so they can't pay attention. The less they're outside in the sun. The more they're playing video games. All of those things increase the expression of ADHD.
Again, something I know more about than I want to. I have a book called Healing ADD. I write about my own personal experience being married to someone who has ADHD and having several of my kids who have it. It's real. Left untreated, there are all sorts of consequences.
People always ask, "If you think of medicine like Ritalin or Adderall, what are the side effects?" It has side effects. Sometimes it can increase tics. Sometimes it'll cause sleep problems. Sometimes you'll lose some weight or decrease your appetite. But they don't ask me the other question, and I always want to make sure they do: what are the side effects of not treating ADHD?
They are things like school failure, incarceration, bankruptcy, divorce. It's serious.
For someone like you who's really driven and very bright, for you the consequences — this is going to sound crazy, but it's underachievement, or it takes more for you to be at your best than if you had it treated.
I have an example of a 14-year-old who was literally failing in school and conflict-driven with everyone around him, so people didn't really want to be near him. I diagnosed him, started with natural things. They help, but not enough. Put him on Concerta, a form of methylphenidate or Ritalin. He went from failing to all A's and B's. He got into the high school he wanted to get into, which was very competitive. He's easy to be around. That's a win, because it's going to change the trajectory of his life.
Dr Amen's daughter and ADHD
Steven Bartlett: I remember you talking last time about your daughter. We have the clip. We can just insert it here.
[Clip plays of Dr Amen describing scanning his daughter's brain and discovering her ADHD, which transformed her academic performance from struggling to straight A's.]
Dr Daniel Amen: It was really powerful, and something that I then spoke to lots of my friends about.
Why ADHD presents so differently in different people
Steven Bartlett: One of the things I've always struggled with with ADHD in terms of my understanding is some people that I know that have ADHD — they're so remarkably different to me, and they're so remarkably different from each other. I think about one of my friends that has it — very different in terms of productivity, symptomology — versus someone like me who, for example, in my case, I'm very focused. I think I can be very focused. Not always, but when I'm into something, I can focus on it for a long period of time.
In fact, people don't know this, but it's worth me saying: my last book, I went to Bali for, I think it was either 11 or 14 days, and I came out of the jungle with the book. I went into the jungle with basically 33 sentences. I knew what the chapter titles were. I came out of the jungle and handed my publisher Penguin the manuscript after that period in the jungle, which basically meant that for those 11 or 14 days — I can't remember the exact number — I sat there for about ten hours a day and wrote the whole book.
I was obviously getting distracted once in a while, but I wrote the whole book in about 14 days. Decent book.
Dr Daniel Amen: I'm so jealous.
Steven Bartlett: But for me, it's an example of when I think of ADHD, I think of like attention deficit. And again, I don't know much about ADHD, so I'm very naive. I represent most of the population probably in that regard. But I don't think I have an attention deficit necessarily.
Dr Daniel Amen: Well, for things that are new, novel, highly interesting, stimulating, or frightening, people with ADD can pay attention just fine. That's why a lot of people who have it — though I don't have it — if I love my history teacher, I'm focused. But then when I go to geometry, I can't do it at all.
Steven Bartlett: That's the story of me in school.
Dr Daniel Amen: It should be. Love is a drug. If you love something, you can do it. But the problem is most of life you don't love. You end up with this really sort of erratic attention disorder. They tend to gravitate toward things.
I hear this story a lot, unfortunately: they experiment in college, and they take a little bit of methamphetamine, and it helps them. They're more focused. But then they don't know how to manage it, and they end up taking more and more, and they end up getting addicted, and it steals their soul.
Love and the brain
Steven Bartlett: Can you see love on the brain?
Dr Daniel Amen: Helen Fisher, who's a neuroscientist in New Jersey, has actually studied love. New love shows up as increased activity in the dopamine centers of the brain, and it makes you just a bit obsessive.
I think of new love as dopamine, but lasting love more like opiates. New love, when you break up, is sort of like getting off cocaine. Hard, but not that bad. Lasting love, if it goes away — we talked about grief earlier — it's like ripping your skin off. It's really hard. Sort of like getting off of heroin.
Steven Bartlett: Do people come to you that are heartbroken a lot?
Dr Daniel Amen: What do they say? I can't stop thinking... their brain gets into anxiety, sadness. That person just lives in every fun place in their brain, and they can't get over it. It can be quite messy for them.
The one question Dr Amen wants everyone to ask
Steven Bartlett: What is the change that you would like to see in the world?
Dr Daniel Amen: I'm actually working on it. I want everybody to just ask this one question. We mentioned my work with BJ Fogg on how people change. He talks about tiny habits: what's the smallest thing I can do that will make the biggest difference?
If I could impact the world, it would be through one question: whatever I'm doing right now, is it good for my brain or bad for it? I want to teach people to love their brains and to just make better decisions for the health of their brain, because then everything follows that.
Good for my brain or bad for it? I'm 15. I have a developing brain. My brain is myelinating itself, which means it's wrapping all my nerves, all my brain cells, with a white fatty substance called myelin. My frontal lobes are not done until I'm 25. Oh, I'm going to love my brain, so I'm not pouring crap in my body with what I eat or what I drink, because it's bad for my brain.
When I'm 60 and I'm stressed because my football team's not winning, I'm not going for extra beer, because I love my brain. I'm going to get to a healthy weight because I love my brain. That's the change. That's why I think God put me on the earth.
Trends: good or bad for the brain?
Steven Bartlett: I was just thinking about it as you were speaking then about the one simple thing that I can do to help my brain and to love my brain. When you think about behaviors and habits that are popular and trendy at the moment, are there any that stand out to you as being particularly good for the brain or particularly bad for the brain? I had a couple come to mind that I wanted to throw at you.
One of them that's exploding in the UK at the moment is paddle, which is kind of — I think you call it pickleball here. Good for my brain, bad for my brain?
Dr Daniel Amen: Good for your brain. Really good. You know what? When you scanned my brain, you told me, "For the next six months, Steve, I need you to take some omega-3, do this, do this, and I'd like you to play more racket sports." I built a paddle court in my garden, so I have a paddle court in Cape Town. I love playing it now. When I play it all the time, I say, "Dr Amen said it's good for my brain."
It's exploding across Europe really, but really across much of the world now. Paddle.
Dr Daniel Amen: And here in the US too. It's so good for your brain because it's working your cerebellum. I told you that because yours was sleepy. As you activate this, and you do that with coordination exercises, it then activates your frontal lobes.
Steven Bartlett: Does that mean that people that are uncoordinated have a cerebellum issue?
Dr Daniel Amen: Yes.
Steven Bartlett: Oh really?
Dr Daniel Amen: And the more you do it, the better coordination you develop. That's why coordination exercises for kids — we talked about kids — you want to do that with them early. Play sports, but not sports where they're going to get a head injury. We have to be smarter than we are.
When I was young, my mother — who's now 93 — was the ping-pong champion in the neighborhood. She was really good. She never let us beat her until we could. But she was always encouraging.
Steven Bartlett: I was looking then as you were speaking about different trends at the moment that are either good or bad for the brain. One big trend at the moment is neuroplasticity training. Lots of people are doing games and using other things. There's apps you can get that are neuroplasticity training apps. Does any of that stuff work?
Dr Daniel Amen: Some of it works. If you're doing memorization games, do them while you're on the bike. Not in the street, but if you're on a stationary bike and you're doing those games, it's been found that exercise increases blood flow to the hippocampus, meaning you're more likely to remember it, and you're strengthening your brain in the process.
Exercise with new learning: stunning. If I want to learn something, I should do it while walking or moving?
In motion. If you're listening to a language app, for example, do it while you're walking.
Steven Bartlett: Mindfulness and meditation. Good or bad for the brain?
Dr Daniel Amen: Great. I published three studies on a Kundalini Yoga form of meditation called Kirtan Kriya. It's a 12-minute meditation. I always say it's the perfect ADD meditation, because it's only 12 minutes.
For 12 minutes you do this: "Sa ta na ma." It's two minutes out loud, two minutes whispering, four minutes silently to yourself, two minutes whispering, two minutes out loud. You're done. Sa ta na ma. Birth, life, death, rebirth. Birth, life, death, rebirth.
But the one we studied is sa ta na ma. If they look it up: Kirtan Kriya. Activates your cerebellum. Activates your frontal lobes. Calms down your emotional brain. People who did that for 12 minutes for eight weeks, their resting frontal lobe function was stronger. So simple.
Steven Bartlett: What the hell is going on there?
Dr Daniel Amen: I think it's the focused attention, plus you're doing a coordination meditation.
Steven Bartlett: Cold therapy, cold exposure therapy, ice baths — those kinds of things. Good or bad for the brain?
Dr Daniel Amen: I think you have to be careful with it, because it can trigger atrial fibrillation. I think taking a cold shower is probably good for your brain, because it's going to short-term increase dopamine and sort of give you a jolt.
Steven Bartlett: Loving your job?
Dr Daniel Amen: Absolutely great for your brain if you're learning new things. People who are in a job that does not require new learning have a higher incidence of Alzheimer's disease. If you're stagnant in your work, you have a higher risk of Alzheimer's.
If I just read brain scans all day, I know how to do it. I'm not learning anything new. So I do that, but I also am writing about something I don't know about, or I'm learning something new.
Steven Bartlett: What if you're working with — I'm sorry, I love the job, but I'm working with — bad for your brain?
Dr Daniel Amen: Chronic stress increases cortisol. I think everybody should sort of know their baseline cortisol level. Cortisol shrinks the hippocampus and puts fat on your belly. That's two very bad things for your brain.
Steven Bartlett: Breathwork? That's a big trend.
Dr Daniel Amen: Excellent. You want to break a panic attack? The 15-second breath: four seconds in, hold it for a second and a half, eight seconds out, hold it for a second and a half. You just do that four or five times, your whole nervous system will calm down.
The research shows: take twice as long to breathe out as you breathe in. That's why four seconds in, eight seconds out. Shifts your nervous system.
Steven Bartlett: Doesn't it? It increases something called vagal tone.
Steven Bartlett: Some bad things then. Social media usage. Chronic social media usage. Good for the brain, bad for the brain?
Dr Daniel Amen: Because you're constantly comparing yourself to people who aren't real.
Steven Bartlett: What about workaholism and hustle culture?
Dr Daniel Amen: I love my work. Am I addicted to it? I don't know. But I love it. When they say people are workaholics and it's bad for the brain, it's they're working with, or doing something they don't like, or doing it for the money but without other purpose.
Steven Bartlett: Microplastics? That's a big trend.
Dr Daniel Amen: Awful for the brain. One of the major causes of hormone disruption and cancer and other environmental — thank you for not giving me a plastic water bottle.
Steven Bartlett: Yeah. Imagine if we did that when we spend a lot of time these days talking about the microplastics and other environmental toxins that I think people are becoming more aware of now, which is good.
Noise pollution?
Dr Daniel Amen: Bad for the brain. If it hurts your hearing, hearing loss is actually one of the risk factors for Alzheimer's.
Steven Bartlett: Why is that?
Dr Daniel Amen: Because you're not getting input. If you're not getting appropriate input, your brain starts to atrophy. If you don't hear what other people are saying and you have a lot of ANTs, you have a high negativity bias — you can actually begin to get a bit paranoid and fill in the empty spaces with negativity.
I just bought some new Apple AirPods. When I connected them to my phone, it said, "You want to do a hearing test?" So I did the hearing test. Then I asked my girlfriend, "You should do this hearing test as well," because I needed something to compare it to. I was a little bit shocked. It said I hadn't lost any hearing yet, but my hearing was significantly not as good as hers. I remember thinking, "Gosh." But I didn't have any idea that it was linked to Alzheimer's at all.
Now I've turned down the volume for the first time in my life. Your hearing declines regardless really of what you do with age anyway. But as you said earlier, starting from a better baseline when you're talking about the brain reserves is really the game, I think, with aging.
Artificial intelligence and the brain
Steven Bartlett: My last question is a bit uncorrelated, but the world is heading towards a world that's driven by artificial intelligence. It's all the rage at the moment. If you log on to the internet, people are talking about they're going to lose their jobs, all of these new tools that allow us to optimize our lives in a variety of different ways.
When you think about the world of AI that we're heading into, there's so many ways that I imagine it's going to make your job easier as someone who's doing scans of brains and so on. But do you think artificial intelligence is going to be good or bad for our brain?
Dr Daniel Amen: I think in the short run it's going to be bad, because your brain is going to do less, and that's bad for the brain. I think it's fascinating to watch what's going to happen. Ultimately, in the words of my friend Byron Katie, "Argue with reality, welcome to hell." We need to figure out how to use it to enhance our lives, rather than to steal brain development.
So much of technology — you haven't talked about this — has stolen brain development. When video games came into my house, it was actually 1987. I remember my son was 11. He was a straight-A student, and then he wasn't. Then we started fighting about it. "You can play for a half an hour." I took it out of the house because I saw it as an agent of thrilling his brain to death, deadening the dopamine structures.
I've watched this whole group of kids grow up with very cool video games that are, I think, damaging their brain. Unleashing technology without any neuroscience study on the impact of brain development: it's a bad idea.
Steven Bartlett: Our brains getting bigger or smaller? Does anybody know?
Dr Daniel Amen: I don't know. Wondering if tech...
Steven Bartlett: Interesting question.
Dr Daniel Amen: If you ask Chat GPT...
Steven Bartlett: Oh gosh.
Dr Daniel Amen: It thinks for you. This is the thing, although one caution with Chat GPT: it sucks if you ask it for medical advice. It often will make mistakes. There are other sites I like better that I trust more.
Steven Bartlett: Social connections. Obviously another point on that, because there's now articles where men are getting into relationships with an AI character of a woman they like.
Dr Daniel Amen: Social connection is so good for the brain. I wonder if artificial social connection is probably not great for the brain, because your brain doesn't have to work as hard. With an artificial, especially one you created, your brain doesn't have to do as much. When you're with another real person, your brain has to do a lot more calculations to make that work than with someone you can just trash anymore.
Steven Bartlett: You'd program it for dopamine, wouldn't you, if you're making a friend or partner yourself?
The most important thing we haven't talked about: purpose
Steven Bartlett: What's the most important thing we haven't talked about that we should have talked about, Dr Amen?
Dr Daniel Amen: I think purpose. What is purpose? Connection to a higher power.
When I assess patients, I think of them in four big circles. What's the biology? We talked a lot about the brain. What's the psychology? We talked about development a little bit and trauma and ANTs. What's the social circle? What's going on in your life now, and who you're connected with? We talked about love.
But we didn't really talk about the spiritual circle, which is: what's the point? Why am I here? Am I here because of random chance, because of an explosion that happened billions of years ago? Or do I believe in creative design, where I'm really created for a purpose, which is to make the world a better place?
I find people who live without purpose have a higher incidence of depression, have a higher incidence of loneliness, have a higher incidence of dementia. I encourage all of my patients to seek and live with purpose.
It's one of the reasons the one-page miracle is so important to me. What do I want: relationships, work, money, physical, emotional, spiritual health, which is really the "why" question?
A lot of my colleagues go, "Well, how can you believe in God if you're a scientist?" I'm like, "Do you know anything about physics?" The second law of physics is entropy: things go from order to disorder. I'm like, "I think there's an order to this, and that I'm here talking to you, and there's a purpose behind it that's greater than me."
Studies on religious belief and the brain
Steven Bartlett: Studies suggest that religious belief can be associated with differences in brain structure and function. While there is no single "religious brain," certain patterns have been observed in neuroscience research. The prefrontal cortex, involved in decision-making, morality, and self-regulation, tends to be more active in religious individuals. And their right temporal lobe tends to be bigger.
Dr Daniel Amen: There's another study with that. If there is a God, and we communicate with God, there's got to be a neuroscience mechanism for that.
Michael Persinger is a researcher out of Laurentian University in Canada. He would put helmets on people and give them low-voltage electrical activity. Whenever he would stimulate the right temporal lobe, people would get a "sensed presence." They would actually feel the presence of God in the room.
I just think that's so interesting. Does that mean that the brain makes up God, or that the brain has pathways to experience God? I think it's an interesting question.
I actually did a study on prayer. We have a foundation called the Change Your Brain Foundation. We raise money for research, education, service. I did a prayer study of conversational prayer — I pray for you — and speaking in tongues, which is channeling the Holy Spirit in Christian tradition.
It was so interesting. There's actually been other studies. Andrew Newberg, who studied channelers in Brazil — they would channel the dead — the idea is if you're going to channel an outside spirit, you have to turn down the noise in your brain so that you can hear the other frequencies. That was our hypothesis.
Sixty percent of our subjects dropped their brain activity when they were speaking in tongues. One completely activated the dopamine centers. I'm looking at him like, "I bet you do this a lot."
Steven Bartlett: Prayer can change the brain. We talked about meditation changing the brain. Dr Newberg again studied Tibetan monks while they meditated and Franciscan nuns while they prayed, and they found very similar changes: strengthens the prefrontal cortex, reduces stress and anxiety, increases dopamine, changes brain connectivity, thickens the cortex, promotes neuroplasticity.
If you pray... now, what if you're not religious? Because I don't think I believe in any particular God, but I would like some of these benefits. So I guess I could achieve them by meditation and those kinds of things. I could still pray. I've got no issue with praying. I just don't know what I'd be praying to. Praying to the universe, I guess.
Dr Daniel Amen: Spirituality is another big trend. I wonder if that's good for the brain. If any — I guess it depends on is it a healthy tradition or is it an unhealthy tradition. I've seen both. I've seen some religions being very rigid and shaming. I've seen others be more open and seeking.
How scanning brains has impacted Dr Amen's belief in God
Steven Bartlett: You've scanned 260,000 brains roughly. How has that, if at all, changed your belief in a God?
Dr Daniel Amen: I believed in God since I can remember. There's not been one thing in my life that's caused me to not believe. I always thought, going back to the second law of physics, that if it's random chance, it just doesn't make sense that randomly we would get a brain cell that has DNA and a mitochondria. It's statistically impossible.
We are so beautifully made. I just don't get the whole thing.
The LA fires and the impact of disaster on the brain
Dr Daniel Amen: One thing we haven't talked about is the LA fires and the impact of disaster on the brain. I grew up in Los Angeles. I'm just horrified by what happened. We talked — my foundation is actually going to give away a hundred evaluations for firefighters.
I almost feel bad. I did the big NFL study. It was really cool. It was a lot of fun for me. But NFL players aren't heroes. They're entertainers. Firefighters are heroes. First responders are heroes. What I've seen with firefighters — this makes me so sad — because they have damaged brains, often because of the toxins that they're exposed to, the emotional trauma that goes with that job, and the head trauma that also goes with it — things falling on them.
They have a higher suicide rate than the general population. Significantly higher. I think it's like 25% higher. Shouldn't we be teaching them about brain health and go, "Hey, look, this is a brain-damaging job, but we need you to do it. All the way along, let's see and repair your brain. Let's make sure your reserve is something special, rather than we had a really bad day at work, let's go get drunk together"?
Let's elevate brain health to the people who save us. We're not doing a good job of caring for them. I think I have part of the answer. I just wish I could do more.
Steven Bartlett: Incredibly kind of you to offer to scan a hundred firefighter brains.
Dr Daniel Amen: Yeah. Hopefully as our foundation — you know, can raise money — we can do thousands of them.
Steven Bartlett: How does one go about supporting your foundation? Where do we go to support it?
Dr Daniel Amen: changyourbrain.org. Change Your Brain dot org.
Closing question: advice for couples who want to start a family
Steven Bartlett: We have a closing tradition, as you know, where the last guest leaves a question for the next. The question left for you is: what advice would you give a couple who want to start a family?
Dr Daniel Amen: I love that question so much. If you want to start a family, you have to get your bodies ready. She was born with all the eggs she'll ever have. You want to give them time — a year or more of good nutrition.
Steven Bartlett: The child?
Dr Daniel Amen: No, no. The mom. So my partner — I'm someone that wants to start a family. You want to go: what I'm eating, what I'm thinking, the stress I'm under is going to impact the next generation. What are the right brain and body habits that we both can do to get our bodies in the best shape?
Is this good for my brain and body, or is it bad for it? Really focus on good. A lot of people who are drinking — they actually stop drinking when they find out they're pregnant. Remember, the brain develops at day 21. You may not even know you're pregnant at day 21. Just let that roll around your head a little bit.
I love this question: I can start to get my brain and my ovaries and my sperm ready to connect, to be healthy. I think that's the advice I would give them.
Final thanks
Steven Bartlett: Dr Daniel Amen, thank you so much once again for your time, and thank you for the wisdom and value you've given to my audience over the years. As I was saying before we started filming, I get stopped all the time, everywhere I go, people telling me about you.
I told you I was stopped yesterday — well, I was having a spa treatment. I won't say what it is because people will roast me. But I was having a first-of-its-kind-for-me spa treatment, and the lady turned to me 20 minutes in and was like, "By the way, thank you so much for having Dr Daniel Amen on, because he helped me understand my ADHD," etc., etc.
I see that absolute love and admiration for you in the comment section every time, where people recount stories from decades ago where their kid came to see you and how you've transformed their life. I actually think the top comment on our last episode was someone who — I think they came to see you 15 years ago, and they said that you changed their son's life. That is just over and over and over and over again in the comments.
So the life you've lived is such an important one, and it's added so much value and hope, and it's turned on the lights for so many people in so many ways. So on behalf of all those people and on behalf of the tens of millions of people who've tuned into our conversations, thank you so much.
Dr Daniel Amen: Well, Steven, thank you. The last time I was on, we got calls from all over the world. Obviously you're doing amazing, purposeful work.
Steven Bartlett: Thank you.
Dr Daniel Amen: Isn't this cool?