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?