In this episode of Medicine Redefined, Dr. Altamash Raja and Dr. Darsh Shah sit down with psychiatrist Matt Bernstein, MD to question why mental health outcomes continue to worsen despite more medications and access to care.

Matt introduces metabolic psychiatry, a framework that looks beyond symptoms and diagnoses to the underlying biology of the brain — including metabolism, insulin resistance, and energy function. He explains why treating neurotransmitters alone often falls short, and how lifestyle-based interventions can lead to deeper, more lasting recovery.

They explore a new, human-centered approach to mental health that integrates nutrition, movement, circadian rhythm, and mind-body practices — challenging the way psychiatry is practiced today.

00:00 Introduction and Current State of Mental Health

01:20 The State of Psychiatry and Mental Health Outcomes

04:22 Understanding the DSM and Diagnostic Challenges

05:42 Introduction to Metabolic Psychiatry

06:31 Chemical Imbalance Theory vs. Metabolic Theory

17:27 The Role of Insulin Resistance in Mental Health

20:48 Assessing Metabolic Health in Psychiatry

25:37 Understanding Brain Energy and Mental Health

26:00 Insulin Resistance and Bipolar Depression

28:04 The Role of Fasting Insulin in Metabolic Health

28:43 Adverse Effects of Psychotropic Medications

30:20 Metabolic Health vs. Traditional Psychiatric Treatments

31:54 Innovative Approaches in Psychiatric Care

32:43 The Accord Program: A Comprehensive Metabolic Treatment

35:55 Challenges and Successes in Metabolic Interventions

46:10 Metabolic Dysfunction in Young Adults

50:04 Concluding Thoughts and Future Discussions

Resources & Studies Mentioned

Pillinger Study (Antidepressants): The effects of antidepressants on cardiometabolic and other physiological parameters (Pillinger et al., The Lancet 2025)
Perry Study (Insulin & Psychosis): Longitudinal Trends in Childhood Insulin Levels and Risks of Psychosis (Perry et al., JAMA Psychiatry 2021)
Book Mentioned: Brain Energy by Dr. Chris Palmer
Testing Tool: Keto-Mojo (Glucose & Ketone Meter)

Connect with Dr. Bernstein

Residential Program: Accord MH (accord.health)
Professional Bio: LinkedIn Profile
Clinical Group: Ellenhorn

Connect with Medicine Redefined

Website: medicineredefined.com
Instagram: @medredefined
Twitter/X: @medredefined
Newsletter: The Progress Note

Work with Dr. Raja

Refining Health & Performance: refininghealthrx.com
- Dr. Raja’s musculoskeletal and longevity practice (Telemedicine available in NJ, NY, PA, FL).

The 'P-word': Taking the No Provider Pledge

Patients at Risk

Variability and Online NP Programs

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