From Chemical Imbalance to Metabolic Breakthrough: A New Path for Mental Health

Many psychiatric labels—like bipolar disorder and schizophrenia—can
obscure underlying biology, and symptom checklists often fail to
explain or heal what’s really going on. Emerging evidence reframes
mental illness as a problem of brain energy, mitochondria, and
inflammation—shaped by insulin signaling, circadian rhythm
disruption, the gut–brain axis, toxins, infections, and nutrient
status. Metabolic interventions such as ketogenic nutrition,
already established for epilepsy, show promise for rebalancing
neurotransmitters, lowering neuroinflammation, and improving
overall brain function. With depression now a leading cause of
disability, shifting from “manage the symptoms” to “fix the
biology” could dramatically improve outcomes where standard drugs
fall short. In this episode, Dr. Christopher Palmer, Dr. Todd
LePine, Dr. Iain Campbell and I explore how rethinking mental
illness as a metabolic and inflammatory disorder of the
brain—rather than just a chemical imbalance—could transform the
treatment and prevention of conditions like depression, bipolar
disorder, and schizophrenia. Dr. Chris Palmer is a psychiatrist and
researcher working at the interface of metabolism and mental
health. He is the Director of the Department of Postgraduate and
Continuing Education at McLean Hospital and an Assistant Professor
of Psychiatry at Harvard Medical School. For over 25 years, he has
held leadership roles in psychiatric education, conducted research,
and worked with people who have treatment-resistant mental
illnesses. He has been pioneering the use of the medical ketogenic
diet in the treatment of psychiatric disorders - conducting
research in this area, treating patients, writing, and speaking
around the world on this topic. More broadly, he is interested in
the roles of metabolism and metabolic interventions on brain
health. Dr. Todd LePine graduated from Dartmouth Medical School and
is Board Certified in Internal Medicine, specializing in
Integrative Functional Medicine. He is an Institute for Functional
Medicine Certified Practitioner. Prior to joining The UltraWellness
Center, he worked as a physician at Canyon Ranch in Lenox, MA, for
10 years. Dr. LePine’s focus at The UltraWellness Center is to help
his patients achieve optimal health and vitality by restoring the
natural balance to both the mind and the body. His areas of
interest include optimal aging, bio-detoxification, functional
gastrointestinal health, systemic inflammation, autoimmune
disorders, and the neurobiology of mood and cognitive
disorders.  Dr. lain Campbell is the first academic research
fellow to specialise in Metabolic Psychiatry as the Baszucki
Research Fellow in Metabolic Psychiatry at the University of
Edinburgh. He has a PhD in Global Health from the University of
Edinburgh and is a principal investigator on a pilot trial of a
ketogenic diet for bipolar disorder. He is a workstream lead and
co-investigator on the first publicly funded research hub for
Metabolic Psychiatry, the UKRI Medical Research Council Hub for
Metabolic Psychiatry at the University of Edinburgh. His research
in metabolic psychiatry has been published in Nature press journals
Molecular Psychiatry and Translational Psychiatry and presented at
Mayo Clinic Grand Rounds and The Royal College of Psychiatrists
International Congress.  This episode is brought to you by
BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN to
save 15%. Full-length episodes can be found here:A Harvard
Psychiatrist Rethinks Mental Health As A Metabolic Disease Is Brain
Inflammation The Cause of Depression, Dementia, ADD, And Autism? A
Functional Medicine Approach To Neuroinflammation Is Bipolar
Disorder Really a Diet Problem?