After two decades in medicine, I started questioning everything.

The Science of Metabolic Psychiatry: How Ketones Feed a Starving Brain | Dr. Matt Bernstein

What if some of the most severe mental illness is, in part, a brain energy problem? Dr. Ravi Kumar sits down with Dr. Matt Bernstein, a traditionally trained psychiatrist who now runs Accord, an immersive metabolic psychiatry program outside Boston, to unpack why brain regions like the hypothalamus, hippocampus, and amygdala can starve for fuel while glucose is plentiful everywhere else, and why ketones bypass that insulin gate entirely. They walk through the Stanford pilot in which every fully adherent patient with schizophrenia or bipolar disorder reached remission, a French inpatient series with effect sizes far beyond what antidepressants typically produce, and the clear limits of both, since neither had a control group. They also cover ketogenic ratios, why Bernstein keeps protein high, the three month commitment it takes to know if it is working, and why none of it works without sleep, sunlight, movement, and medical supervision.