Speaker 2
That's why I'm in podcasting. I always wanted to be a writer and I could never find the discipline to actually do it. And when I discovered podcasting, now I'm spending 40 hours a week on it. So there you go.
Speaker 1
Wonderful. Wonderful. You find your bliss.
Speaker 2
Well, it would be bliss if I could actually get paid to do it.
Speaker 1
Well, that's right. That's right. To
Speaker 2
start out with, can you tell us just a little bit about your background and maybe how you got interested in the relationship of exercise in the brain?
Speaker 1
Yeah, I'm a psychiatrist. And when I was actually in medical school in 1974, but I had been working in psychiatry before that for a couple of years and saw the introduction of lithium and sort of wonder of the new antidepressants. That time they were the tricyclics in Mipramine and Dozipramine, Nalville, and that was just a marvelous change from where we had been before. And so there I am in medical school sitting and reading a paper about medical news, and they say this psychiatric hospital in Norway, I believe, was admitting patients with depression and offering them a choice, either one of the new great antidepressants or an exercise program. And that sort of stuck in my brain forever since. And then coming, I was at the University of Pittsburgh and then came back to Boston, which then was feet of the marathon craze with Bill Rogers and everyone was really all about running. And at the same time, Candice Pert had discovered the endorphin receptor in the early 70s, and so people were saying, oh, yeah, these marathoners who can run up heartbreak hill and push through the pain are really in this zone of nirvana zone, or they discovered they raised their endorphins in the periphery anyway. It actually doesn't cross the blood-brain barrier, but we do make endorphins when we're stressing our muscles also. But anyway, it took off and everyone was talking about the endorphin rush. And being in Boston, I saw a lot of marathoners and ex-marathoners who got hurt and couldn't run anymore. And a few of them that I saw got depressed, some treated with antidepressants because they couldn't run anymore and then one very successful person who I knew said you know when I had to stop running I got depressed and then after I got depressed I discovered I had ADD never had it before we're always in training always running and always focused. But since then, I'm a space shot. And so he was one of my very first patients that turned me on to ADD and adults back in 1982 or so. So it began to click with me in the 80s, in the 70s and 80s, really, Duke University and a lot of other places were starting to talk about how exercise was useful for collateral circulation in the heart and how to decrease problems with heart and heart disease and all that. At the same time, they started to notice that their patients not only were heart healthier, but they were less stressed, they're less angry, they're less depressed, they're less anxious. All the things that I was studying in psychiatry and we were thinking about from different perspectives, but medicine was certainly one of them, using medication. And so it just was something that sort of ran parallel. And every now and then a landmark study would seeming would come out about how exercise was as good as medicine was for anxiety or depression. And we've got front page news usually, and the New York Times are on Newsweek and then was promptly forgotten. But it always sort of stayed with me that this was really something in the background that we weren't paying enough attention to. So I began to really focus on this as I got deeper and deeper in working with people with attention deficit disorder and finding that a lot of them really self-treated their disorder by exercising some two or three times a day to help them stay focused. Then we began to see this across the board when parents would come in and say, yeah, when he was playing three sports and exercising every day, they didn't seem to have these problems or the one semester that they were involved in sports and really exercising a lot that their problems at home with their behavior or their grades at school would go up rather than down. Which one would think, oh, more time spent away from studies or whatever that their grades would suffer. But no, it just seemed to have the reverse effect. And so this began sort of our, my watch on what was happening in the world of science with exercise. And then a landmark, a landmark study came out in 1995 in a little article in Nature Journal written by Carl Kottman and his crew out at the University of California, Irvine, where he had started to look at the effect of exercise on the brain. person to really begin to look at what happened in the brain, what changed, and published an article talking about how the levels of BDNF, or brain-derived neurotrophic factor, went up when he had his exercising mice versus the control mice. It went up two or three times normal, which was linked up with sort of the just-known fact that exercise is one way to prevent the onset of cognitive decline and Alzheimer's disease. So this really opened the doors. Since then, there's an avalanche of neuroscience reports on exercise in the brain. I
Speaker 2
always cringe when I hear someone say that they're going to punish a kid by taking away playing sports, because that sounds like a very counterproductive solution for most kids. Right,
Speaker 1
exactly. I've been very involved in the education programs around the country these days. Since my book has come out talking about this, some schools have, instead of having time out, they have what they call time in. So a child who's really out of control and can't be in the classroom because they're too disruptive, instead of sending them to sit in the corner or down to the principal's office and just sit and be isolated, send them to either a stationary bike or another thing they use is a dance dance revolution the machine set up and they go in there for five minutes and burn off their energy that's what we used to say they burned off their energy but what they're actually doing is they're changing the neurochemistry in their brain because we know that when you exercise, you start releasing a lot of neurotransmitters and other neurofactors that are all useful to turn on the frontal cortex, which then inhibits lower function. Think of putting the brakes on the impulsive, runaway impulsive amygdala. You want
Speaker 2
to say a little bit specifically about the relationship, especially in kids, between physical fitness and academic performance? Oh,
Speaker 1
yeah. Just yesterday in USA Today, the CDC, they published an article about the CDC's new paper I haven't been able to get yet. It's online. 5,000 children looked at over the course of three years and found that the girls especially, the more exercise they did, the higher their marks went over the course of three years. The boys, it wasn't statistically robust enough to make it a legitimate finding, but then there may be other issues around that. But I think once we got into exercise and how it affects the elderly, and we know that it improves cognitive function to a great degree in the elderly and actually causes regrowth of the brain and makes up for more of our hippocampus to expand a bit as we're begin to exercise when we're sedentary to begin with. But we hadn't looked at kids because there wasn't any money in it. The educational research had been pretty lousy and it's hard to do a controlled study. So not real good science had been done until recently when you're now, people were turning to look at the effect of exercise on kids and their performance and finding that you do see this boost of effect on the executive function of the frontal cortex, especially an improvement in performance and an improvement especially in math, which is something that's really interesting. It sort of really ties into the real executive function of the frontal cortex.
Speaker 2
When you were in medical school, did you find time to exercise? Did you notice a difference in how you did when you did exercise and when you didn't?
Speaker 1
Well, I played some basketball, pickup basketball, but we're talking back in the 70s. I wasn't in Boston when the marathon craze hit. It was only when I came from my residency, and that's when I began to run like everybody in my class, I would imagine. And everybody was running back in 78 or so. But in medical school, I really didn't do much exercising. I was a jock all my life, but then I broke my arm and couldn't play tennis and yada yada. But I didn't. But boy, when I came and started running here and then I couldn't continue the running, so I started on the various machines early on and stayed on them ever since. But I'd absolutely noticed an effect for me in terms of energy and vigor, mood regulation, anxiety, all the things that we know that exercise helps. And we used to think, oh, like I said, burning off steam or, you know, burning off all that energy. Well, it's that, but also it's changing the chemistry in your brain. And that's what I write about in Spark, my new book. I'm
Speaker 2
going to ask you some questions about the chemistry in a few minutes because my listeners know a little bit about it because I've introduced them to some of the neurotransmitters, but I'm going to give you a chance to tell us about some that I had never heard about. But first, the other subject that I've talked a lot about in the last year, because it's just one that everyone finds intriguing and just exciting, is the whole issue of brain plasticity. Is there a connection between plasticity and exercise? Oh,
Speaker 1
huge. That's a softball question. Yeah,
Speaker 2
it was. It was. But, you know. Hey, that's great. No, no, no. That's
Speaker 1
great. It's what exercise does. It makes the brain, as far as we know, it's the ultimate way to improve plasticity in the brain for stuff available to most all of us, including people that have been looking to improve plasticity with medicines and whatnot. Exercise is a champ, I mean, undisputed, because it causes a rise in this plasticity throughout the brain. And plasticity, as you probably have talked about on many podcasts here, is really about the brain's malleability, its ability to change, which means its ability to wire one nerve cell to another, to expand the connection, to make it fatter and faster and better, and to really encode that information. That's what we really mean by brain plasticity. Then the sexy stuff comes with the stem cells that followed hard upon in the early part of the neuroscience and exercise interest. People were saying, hey, not only are we seeing the rats who we run learn quicker and better and faster, but boy, they had more of these nerve cells, new nerve cells in the hippocampus. Fred Gage and Von Prague did studies out in California, showing that exercise was the thing that seemed to increase the development of these stem cells into new nerve cells, even more so when they took away an enriched environment. They wanted to compare them and exercise even trumped that. But both together, of course, are the best. But that was a second astounding finding, really, in 98 or so when they found that. Want
Speaker 2
to talk a little bit about the neurotransmitters and other chemicals in the brain?
Speaker 1
Sure. There's the whole bunch that exercise pumps up, partly because of the activity of the nerve cells that are going on when all the nerve cells seem to be activated when we're exercising and some more than others, but all of them are at play. And so what you get is a lot more of those chemicals that myself as a psychiatrist is trying to influence with all of our medicines, dopamine, serotonin, norepinephrine, GABA. All of these are, for that moment, increased, some lasting for varying lengths of time. And so you see after a bout of exercise, people having better focus, which comes from the dopamine and norepinephrine, feeling more vigorous, the same too. Also less impulsive, less fidgety, mood improves. They're more confident, even more motivated. All of that is a lot of different things, but certainly our friend that we came to know and love with the Prozac revolution, serotonin is increased immediately and then more so over time as we bring in more building block for it. If you're really exercising, you boost your serotonin levels. As somewhat of a psychopharmacologist in my distant past, we always were targeting and worrying about those particular neurotransmitters. And most, if not all of our drugs, affect those neurotransmitters in some way. And so here's a holistic way of what I say a lot of exercises like taking a little bit of Ritalin and a little bit of Prozac in just the right area of the brain in a very holistic, non-side manner so that you get then more contained and focused individual.
Speaker 2
I think I discovered this intuitively when I was a teenager. And like you mentioned, a lot of your patients discovered this on their own too, didn't they? But now we have the science to show why it works.
Speaker 1
Exactly. Exactly. And then we, you know, just to pick back up on that, our mood is improved too with these neurotransmitters. And as I say, we used to think, oh, it's the big rush of endorphins. Well, it's pretty hard to get your brain to release that much endorphins. We do when we're exercising a little bit, but it's only those people who really can go for 45 minutes flat out that I think get this endorphin rush where they really are in the wrong state and they don't feel any pain and they end up injuring themselves usually because they're not listening to their joints as they're stressing them. Another newer neurotransmitter on the map is the cannabinoids or the marijuana factors that we have both in our body and released like endorphins in our body and in our brain. And these marijuana factors, which are still hard for me to pronounce their real names, really also help improve the mood, decrease pain sensation peripherally and centrally. So they combined with the soup that you're making during and the following exercise has a very nice effect on the reward and pleasure and satiation centers, as well as turning on the frontal cortex, which allows us to cognate better and adapt better to the world. What
Speaker 2
about something else you introduced in your book, which was the neurotropins?
Speaker 1
Yes. Now, that's the big new news, I think, that really got people excited, which Dr. Cotman sort of really showed in 1995, that exercise increased these neurotropic factors, which is a bunch of them, but the queen of them is one called DDNF, or brain-derived neurotropic factor, which I called, and I think probably he called at one point, the miracle growth for the brain, because it's literally fertilizer for the brain. It helps everything about growth in the brain to happen. It fosters growth and development. So we're talking here of nerve cells that are buffed up by it. Also, it makes fertile ground for the development of our stem cells into healthy, involved nerve cells, which they can turn into even in us humans, which was a huge debate following the discovery. These neurotropins are brain growth factors that really have a wide range of effects and help our plasticity really maintain itself and get better. And what's really fascinating in the last four or five years in my field in psychiatry, we're looking at depression a little bit differently than when we were even five years ago when we were talking about changing the serotonin and dopamine norepinephrine levels. But now we're thinking more along the lines of what we're really doing. That's sort of part one. Part two is that we're increasing with antidepressant action. We're increasing the level of these neurotropins, especially BDNF. This goes along with us now looking at the brain as losing its neuroplasticity a lot if we're in that chronically stressed state of depression. Our antidepressants as well exercise, cause this whole scenario to get reversed.