00:00 our brain doesn't really differentiate
00:05 nonwork suppose you have to work for 50
00:08 hours but the remaining time you're
00:09 scrolling on Twitter which you think is
00:11 rest you think is your personal time but
00:13 Twitter is full of say hate comments
00:14 even 2 hours of that is more harmful
00:18 than my friend Dr Sid Warrior a
00:22 practicing neurologist in Mumbai and
00:24 also very active in social media talking
00:26 about mental health issues in your
00:28 practice are you seeing teenage you know
00:30 like depression anxiety slightly more
00:33 yeah definitely stress is the common
00:36 factor stress can lead to stress eating
00:38 which can lead to obesity but stress can
00:40 also lead to anxiety and depression
00:42 somebody who has obesity because of
00:43 stress could also have a mental health
00:45 problem it's like this web of
00:47 interconnected things I'm going to ask a
00:50 controversial question if you pay
00:52 attention our brain keeps coming up with
00:54 excuses to not do something and that's
00:56 the limbic testing you I'm sitting with
00:58 you you have a drink in your hand I
01:00 don't have a drink in my hand my brain
01:01 is saying oh why am I not part of this
01:03 culture our brain plays these tricks on
01:06 us the day Big Boss stops being popular
01:08 is when human beings evolve why do you
01:11 say that the only reason big boss is
01:14 because I'm so excited me too because uh
01:18 I always wanted to be a neurologist oh
01:20 uh because the function that the brain
01:23 can do yeah I think gut can do as well
01:27 can but it is a masterpiece right gut is
01:31 brain is a masterpiece yeah right of the
01:33 bat I wanted to ask you that there has
01:35 been increasing mental health issues yes
01:38 uh in the last couple of uh years
01:40 especially after Co yeah and I have seen
01:42 your videos in the past and you said
01:44 whenever there's a mental health issue
01:47 it so I want you to rant about why
01:51 mental health issues are on the rise in
01:53 the last couple of years yeah ranting is
01:55 great I would recommend it to everyone
01:57 uh the ranting has got a bad name but
02:00 that's more because people who are being
02:02 ranted too don't know what to do with
02:04 this information but it's great for the
02:06 Ranter so I would definitely recommend
02:08 ranting um my so ranting can be done
02:11 without anybody else will it actually
02:12 can yes which is what journaling is
02:15 because the more you rant what you are
02:16 doing is you are giving emotions words
02:20 so you're giving so emotions are very
02:22 chaotic things it's like a cloud there's
02:25 no structure they're just feelings you
02:27 know but when you give them words they
02:29 suddenly start taking shape and the more
02:32 shape you give the more your brain has
02:34 control over them now so in a way
02:37 ranting is a way for your brain to get
02:39 get control over chaotic emotions so the
02:43 more you rant the calmer you will feel
02:46 so I would say rant it helps the reason
02:49 that mental health issues are rising
02:50 there are I I feel there are two reasons
02:52 one is greater awareness so a lot of
02:55 these mental health issues earlier would
02:57 not be diagnosed or they wouldn't be
02:59 called as has mental health problems but
03:01 now we know that it is an issue so the
03:03 awareness is increasing the diagnosis is
03:05 increasing but on the other hand our
03:07 lifestyles are also changing so now
03:10 there is more stress on our nervous
03:12 system there is more anxiety there is
03:14 more things that our nervous system has
03:16 to deal with so both of these things put
03:18 together is causing mental health
03:20 problems to rise to rise so in your
03:22 practice we seeing which age group you
03:24 know like 20 to 30 or like 40 to 50 um
03:27 so I'm actually seeing all AG groups but
03:30 the kind of problems that they come with
03:34 are different so kids would have more of
03:37 Developmental problems so there's
03:38 something genetic uh you know there's
03:41 some hormonal problems at that age
03:43 you're talking about less than 20 less
03:46 less than 10 yes so for example cerebral
03:48 paly or seizures so less than 10 years
03:51 old that is the issue the kid is not
03:53 able to walk the kid is not speaking
03:55 properly that kind of patience uh around
03:58 teenagers like so 18 to 30 most of them
04:01 will have some kind of um Spectrum
04:04 problem of mental health and physical
04:08 pain so I call this a emotional physical
04:12 pain Spectrum so that could be anxiety
04:16 sleep problems migraine back pain neck
04:19 pain all of this is on that spectrum of
04:22 the body and mind not able to deal with
04:24 the stresses of Life migraine can be a
04:29 yes so migraine is also part of that
04:31 pain spectrum and then once you've
04:33 crossed 4050 then you have problems of
04:37 age so now your brain is slowing down
04:40 you start having forgetfulness you're
04:43 not able to think so clearly and you can
04:45 have early onset Alzheimer's some of
04:48 them have Parkinson they're unable to
04:50 walk properly so that is the Spectrum
04:52 all this starts at 40 itself yes so 40
04:54 50 is when it can start but the symptoms
04:57 are very mild they usually get caught
05:00 much later thank you so much I just
05:06 doctor the YouTube I think I slowly
05:10 come okay I'll give you my clinic
05:14 address wow early on at 40 40 dementia
05:18 huh yes yes so some patients do come at
05:20 40 45 with early onset Alzheimers early
05:23 onset Alzheimer yes yes so Alzheimer's
05:25 is for the audience you know just a most
05:27 common cause of memory loss yes it is
05:29 the most common cause of dementia and
05:31 early onset Alzheimer's usually has a
05:33 genetic cause so their family history
05:35 will be strong so if anyone in your
05:37 family your grandfather grandmother has
05:41 started having memory loss at the age of
05:43 4050 then it's better to go to a
05:45 neurologist and get it checked out even
05:47 without any symptoms or no if you have
05:49 if you're having symptoms and how do we
05:51 usually the spouse or the close family
05:53 members will notice correct yes they are
05:55 the first ones to notice because
05:56 initially they will think oh you're just
05:58 being forget F correct right you forget
06:01 a birthday which is completely fine but
06:03 then you start forgetting more important
06:05 things you'll start forgetting what
06:06 you're supposed to do today you start
06:08 forgetting somebody's name you start
06:10 forgetting your own phone
06:12 number that is when they start thinking
06:14 oh this is not just work stress
06:17 something is actually wrong then they
06:18 will come to a neurologist no tell me an
06:20 interesting patient that you have seen
06:22 MH that which is a different
06:24 presentation at the age of 40 like small
06:26 small things that you picked up in your
06:28 practice so uh one interesting patient
06:30 was um it was a 55y old he used to be in
06:35 the Merchant Navy okay and then he left
06:38 Merchant Navy at the age of 40 and since
06:41 then he's been working as a businessman
06:42 in Bombay now at the age of 55 he
06:45 started having dementia and he had a a
06:48 slightly rare kind of dementia um
06:51 wherein he started forgetting about time
06:54 huh so he started getting confused about
06:57 what time it is and what year it is and
07:00 he started thinking that he was actually
07:05 1990 so his mind went back to the time
07:08 when he was still in the Merchant Navy
07:10 and he was only 55 he was 55 and he used
07:12 to think that now I'm 35 so he would
07:14 start behaving like that he would he
07:16 would get up and say that tomorrow I
07:18 have my ship is leaving and he would
07:20 pack his bags and he would say that I
07:23 go and what was uh causing the family
07:30 was that he would expect his wife to be
07:34 as involved with him physically as they
07:37 were back in the day and now they have
07:40 kids and the kids are grown up and one
07:42 of the kid is married and now his wife
07:45 has not been in that state of mind and
07:48 this man is thinking that I a
07:50 30-year-old and why is my wife not
07:52 finding me attractive so that was the
07:55 complaint that they came with wow so
07:58 brain problem s can there there are
08:01 maybe two three things that can go wrong
08:03 but there are 100 things that they can
08:05 come to you with with exactly right the
08:07 presentation might be very varied that
08:09 is what makes it both challenging
08:11 exciting as well exciting as well I mean
08:13 Alzheimer's dementia has been a while
08:15 since I have seen a neurological patient
08:17 but based on what I know is uh it's a
08:19 deposition of amloid it's a protein
08:21 deposit correct in the cells of the
08:23 brain yes tow proteins get deposited and
08:26 there are something called
08:27 neurofibrillary Tangles so that's when
08:29 those amids get caught up on top of each
08:32 other so it's literally like clutter
08:34 clutter in your brain correct like a
08:37 trash can like a trash can so over a
08:39 period of time that deposition becomes
08:41 too much so there's too much Katra and
08:44 now your brain stops working in that way
08:46 and you have seen patients with early 40
08:49 45 as well yes yes but of course it's
08:51 very important to check if is this
08:53 Alzheimer's or is this something else
08:55 sometimes there are other diseases like
08:57 prion diseases you know cruell jaob
09:00 disease that can also present early on
09:03 but then it's not Alzheimer's it is
09:04 something else let's say you know I'm
09:08 myself so let's say I'm 40 uh okay I
09:11 want to prevent Alzheimer's correct and
09:15 uh any steps that I can take absolutely
09:17 yes um so even if there's a genetic
09:21 background it is always you always have
09:24 to remember that genetic is just one
09:25 part of it you can never blame only
09:28 genetics because environment makes a
09:30 difference correct so for example I'll
09:33 use an example from your field doctor
09:35 there was use me as a patient no I
09:39 but uh I would use a example of someone
09:42 uh a friend of mine his father recently
09:45 passed away with uh liver cancer now his
09:50 I I asked them when when they were
09:51 diagnosed and it was a very brief
09:53 diagnosis so he was diagnosed and he
09:55 passed away within 3 4 weeks and he was
09:57 70 years old and when I asked their
10:00 history that father's father grandfather
10:05 and his two Elder Brothers all passed
10:08 away with liver cancer at the age of 60
10:11 to 64 so clearly there's a very strong
10:14 history hereditary history of liver
10:16 cancer but my friend's dad lived up to
10:19 70 and I asked him what kind of
10:22 Lifestyle he led and I've never heard of
10:24 a man living more of a disciplined life
10:27 so he never touched alcohol he he was no
10:29 smoking very clean habits wake up on
10:32 time sleep on time meditate every day
10:34 yoga he would spend every morning wake
10:37 up and write he would Journal he would
10:39 take long walks with his wife every
10:40 morning he would have a very close
10:42 family system so overall his body was
10:45 very healthy which is I believe what
10:47 made the difference and gave him an
10:48 extra 10 years so from 60 to 70 he was
10:52 able to live a good life because of his
10:54 lifestyle now suppose if he was also
10:56 drinking smoking if he had a bad
10:59 lifestyle I believe he would have had
11:01 these symptoms even earlier so genetics
11:04 is one reason but your lifestyle makes a
11:06 big difference you can compensate for
11:08 that compensate for that so Alzheimer's
11:10 at 50 and Alzheimer's at 70 is a big
11:13 difference because you get 20 more more
11:16 years of good life so that is why
11:18 lifestyle makes a difference yeah see
11:20 when you say lifestyle is main thing is
11:25 sleep sleep is the most important thing
11:27 because when we say kacha in the brain
11:30 the trash in the brain sleep is when
11:32 that trash gets taken out so there is
11:35 this drainage system called as the
11:38 glymphatic system in the brain that is
11:40 the sewage system seage system takes all
11:43 the trash out all the trash out it gets
11:45 activated in sleep M so no sleep the
11:49 trash gets accumulated so over a period
11:52 of time that is what causes most damage
11:55 and the second thing is stress uh
11:57 inflammation to be specific so anything
11:59 that increases inflammation in your body
12:02 increases the chances of Alzheimer's
12:03 alimer so the first part sleep is the
12:06 one thing yes that we do we doctors
12:08 don't get unfortunately yes no I want
12:11 think about all the night duties that we
12:13 did correct absolutely and all these uh
12:16 people especially in us I see um all
12:19 this big software companies correct yes
12:22 and the majority of their employees are
12:24 in India yes and their work hours is
12:27 8:00 a.m. to 5:00 p.m. a.m. correct
12:29 here's is 10: p.m. to 6:00 a.m.
12:32 graveyard ship it's a it's a very uh
12:34 it's a very serious problem dangerous
12:36 problem yes dangerous problem multiple
12:38 studies as you know that says that night
12:39 shift workers are increased risk of
12:40 obesity diabetes and hypertension yes
12:42 heart disease heart disease issue yes I
12:45 just want to know from a neurological
12:47 standpoint how long how much is too much
12:50 okay a young guy joins graduates in a
12:53 does all the good work uh passes in high
12:56 flying colors gets in Amazon yeah okay
12:59 online it's a wonderful thing to get in
13:01 Amazon it's not easy then they get a
13:03 handful of uh handsome amount of money
13:05 yeah and then uh they life is settled
13:07 that's what they think correct so they
13:09 start doing this night shift around 22
13:12 23 years of age and based on what I've
13:14 seen since the my YouTube channel is
13:16 that many people have been doing this
13:17 for the last 15 16 years yes so is there
13:20 a timeline that okay more than 5 years
13:22 if you do this the risk goes up or more
13:24 than 10 years what is your I know
13:25 there's no big research on that but your
13:27 thought process the the thing is that
13:29 our body can get used to anything so our
13:32 body has a reserve so till this point
13:35 there's not a lot of harm done because
13:37 our body can recover from it the problem
13:39 is that the pace of recovery slows down
13:43 so you can take more risks with your
13:46 body when you're 20 which you cannot
13:49 take at the age of 30 which would you
13:52 definitely should not take at the age of
13:53 40 and if you take it at 50 it can be
13:55 harmful it can kill you that same risk
13:59 right so going three sleepless nights at
14:01 the age of 18 versus at the age of 60
14:05 big difference so I have seen patients
14:07 of Parkinson and Alzheimer's who are
14:10 doing well they're taking medicines they
14:13 have one sleepless night say they're
14:15 traveling by train and they were not
14:17 able to sleep the next day they crash so
14:21 that is how powerful sleep is and the
14:22 amount of Reserve you have so I wouldn't
14:25 say that this is the time limit but if
14:28 you have to work hard at the age of 20
14:31 work hard so that after 25 you can start
14:33 slowing down and shift to a more
14:36 sustainable lifestyle so that's what I
14:38 tell students also a lot of students are
14:40 used to studying at night they call
14:44 owls fine I don't want to interfere with
14:47 your studies you study at night but
14:49 don't think that this is the lifestyle
14:51 that you should sustain for the rest of
14:52 your life so by the time you're closer
14:55 to 30 change that definition in your
14:57 head don't call yourself night owls
14:59 anymore switch because your body is
15:02 switching so it's okay to say that I
15:04 used to enjoy staying up but now I don't
15:08 and that is something that happens
15:09 naturally also but you should also try
15:11 to make that change and people say that
15:14 you know oh I have uh I'm being I'm
15:16 getting aged because I'm not able to
15:18 wake up at uh night yeah I'm not doing
15:20 night outs anymore which might be a good
15:22 thing it's a good thing listen to your
15:24 body it's a good thing it is telling you
15:27 and you know people feel social
15:28 pressured where you know they cannot
15:31 extend them night for a long time yeah
15:33 yeah correct but that's so silly um
15:36 because uh your body is trying to tell
15:38 you something it's absolutely okay to
15:40 grow up okay to grow up yeah you should
15:41 grow up gracefully not screaming and
15:44 protesting so you know as doctors yeah
15:47 correct and uh we don't have a choice uh
15:50 you know even at 30 we do the exact same
15:52 thing I have a strong feeling I think I
15:55 have a strong feeling where you we see a
15:58 lot of young young deaths among doctors
16:00 per se yeah correct and we are seeing a
16:03 young heart attacks in throughout India
16:05 yeah uh increased R compared to other
16:07 world part of parts of the world I have
16:09 a strong feeling that it is tied to
16:11 sleep absolutely in the medical
16:14 community it's there is a glorification
16:19 time that um you know the doctors are
16:23 available 24/7 um they will always be
16:25 there and I understand that of course as
16:29 the people responsible for the health of
16:32 the country you should be available but
16:35 uh we should also be aware that what
16:38 this is doing to you correct so there
16:40 should be a maybe a rotation system
16:43 where if you spend one week on Night
16:45 Calls then the remaining three weeks you
16:48 are able to sleep better because that
16:50 also makes a difference whereas if there
16:52 is a private practitioner who is
16:54 available every day 24/7 all throughout
16:59 the harm he's doing to himself or
17:01 herself is much more than what they know
17:04 and it will come back so it's it's
17:07 always better to take care of your own
17:08 health so that you can serve the public
17:10 longer rather than having to retire at
17:13 40 and and that retirement and 4 is not
17:15 going to happen that's not happening
17:17 that's just a pipe dream that's just a
17:19 pipe dream yeah it's not happening the
17:20 same thing with the engineering or any
17:22 other occupation as well where I think
17:25 that they should just be aware that the
17:27 abuse to the body is happening at some
17:30 level and then they should just revert
17:33 back a little bit Whenever there is a
17:35 chance correct it's the short burst
17:38 versus the marathon run concept because
17:41 what hustle culture says is you go all
17:44 in you work work work don't think about
17:46 anything else and then you get your goal
17:48 but then the goals keep shifting and you
17:50 keep having more and newer and newer
17:52 goals but if you are somebody who thinks
17:54 long-term saying that it's okay if I'm
17:56 not succeeding in two months but I want
17:58 to be successful in 20 years your whole
18:01 thought process changes now taking care
18:04 of your health taking care of your diet
18:06 mix more sense it becomes more important
18:09 that is the shift if you're only
18:11 concerned with shortterm gains then it
18:14 makes sense to have sleepless nights but
18:16 if you're planning for your long-term
18:19 future then taking care of your health
18:21 makes much more sense how about sleeping
18:24 in the afternoon they say they'll catch
18:26 up what is your thought process uh so
18:28 the problem is that people misunderstand
18:31 the concept of sleep debt you know this
18:33 is a famous term sleep debt that I've
18:35 slept for 3 hours then I'll sleep for 3
18:37 hours later but they don't understand
18:40 that what uninterrupted sleep does is
18:42 very different so it's not about just
18:45 giving back 200 rupees it's about having
18:49 that uninterrupted time so that your
18:51 brain can go up to that RM stage come
18:55 back to nrm and you need four such
18:57 Cycles of nrm followed by RM for a good
19:02 recovery of sleep I all these are stages
19:04 of sleep where you go to deep sleep yes
19:07 so ideally you should have around four
19:09 cycles and each Cycle takes
19:12 approximately 90 minutes so one stage as
19:16 you go from awake to sleep your brain
19:19 waves keep slowing down so you're going
19:21 deeper and deeper into rest so you first
19:24 go through a stage of nrm which is
19:26 nonrapid eye movement
19:29 and then you go through a stage of RM
19:30 which is rapid eye movement that's when
19:33 flutter and then you come back to nrm
19:36 and then you go back to RM this cycle is
19:39 what sleep is and you have to go through
19:42 four set Cycles minimum for a good sleep
19:45 so comes six hours 6 hours is minimum 8
19:49 hours is ideal ideal and then when you
19:51 are doing only 34 hours this cycle
19:53 you're not going through correct and
19:55 then when you're sleeping in the
19:56 afternoon again the same thing the cycle
19:58 is not not being completed correct and
19:59 people who will Who keep waking up also
20:02 will not complete the cycle
20:04 adequately so that is why it's very
20:07 important to see if do you wake up
20:09 multiple times at night so things like
20:11 obstructive sleep apnea for example one
20:13 of the most under diagnosed condition
20:16 disturbs your sleep and you won't even
20:18 know it you might not even know that
20:20 you're waking up and going back to sleep
20:22 so these things make a big difference
20:24 can you explain sleep apnea to the
20:26 audience of course yes I think it's
20:28 something that everyone should know
20:29 about traditionally it was associated
20:31 with obesity so obesity and a thick neck
20:35 means that when you sleeping your
20:37 trachea which is your wind pipe it gets
20:40 compressed and you're not able to
20:42 breathe properly but not enough that
20:44 you're choking but just enough that your
20:47 oxygen supply becomes less that's when
20:49 you traditionally snore so sleep apnea
20:54 snoring now throughout the night your
20:57 oxygen levels go down and your brain
21:00 activity suffers and over a period of
21:02 time if you keep having these apnea
21:05 episodes where you stop
21:07 breathing your body suffers in multiple
21:10 ways you get blood pressure you get
21:13 hypertension so your blood pressure goes
21:14 up you can have cardiac problems you can
21:17 have anxiety you can have morning
21:19 sleepiness because you haven't slept at
21:21 night and over a period of time the
21:23 chances of your heart attacks Strokes
21:26 all of these things go up it's very
21:29 important to check the only way you can
21:31 check is by doing a sleep study So
21:36 practice after my core test which is say
21:39 a nerve conduction an MRI sleep study is
21:42 the third most common test that I
21:44 prescrib very very important I actually
21:47 I did a sleep study yeah ah myself you
21:49 know why I found that out I have a mild
21:51 sleep apnea right uh the reason I found
21:53 that out was I felt extremely tired in
21:56 the morning even after 7 hours 8 hours
21:58 of quality sleep yeah and uh that is
22:00 what you thought was quality H correct
22:02 what I thought was quality sleep and I
22:04 was like you know I thought initially it
22:06 was night shift maybe it was too much
22:08 work then I realized okay even on
22:10 vacation uh this was happening so early
22:13 daytime sleepiness yes is one of the
22:16 most common symptom yes yes like like
22:19 you're feeling tired even after you have
22:21 sleep after you have slept so you go to
22:22 sleep at 11:00 you wake up at 7:00 you
22:25 think that you've slept well you're
22:26 having breakfast and you're asleep
22:28 you're in a meeting and you're sleepy if
22:30 it becomes worse sometimes you sleep
22:32 while driving which is very dangerous so
22:36 obstructive sleep apnea in its severe
22:38 form can be life-threatening in
22:40 itself and in its milder form can cause
22:43 other problems other problems yes I have
22:45 a feeling that you know um because of
22:47 the sleep deprivation all those things
22:48 the sleep apnea kicks in uh in terms of
22:51 you know most common condition yeah uh
22:53 that decreases the oxygen level in the
22:56 body mhm that strains the heart as you
22:58 said yeah and I I still believe that
23:00 that might be the initiating factor for
23:02 all the heart disease that we are seeing
23:04 because we don't give the respect to
23:08 sleep as much as it deserves as it
23:10 should I know absolutely and nowadays
23:13 things are changing people are
23:15 appreciative that sleep is important but
23:18 I don't think they understand how much
23:19 how much yeah and how in how many
23:22 different parts of our life sleep
23:24 affects so even memory loss there are a
23:27 lot of young people coming to me with
23:29 memory loss and it's very subjective
23:31 memory loss maybe on the tests they are
23:34 okay but subjectively they feel that I'm
23:37 not able to remember I'm not able to
23:39 focus I keep forgetting small small
23:41 things very likely that their sleep is
23:43 affected absolutely so for me if I sleep
23:46 properly you're saying that Alzheimer's
23:47 dementia will be gone down the chances
23:49 reduced so I'll get it eventually
23:51 huh you're very optimistic thank you so
23:58 so that's my 40 plus okay yeah so how
24:00 about this 20 to 30 yeah to be honest
24:04 I'm very concerned about them yeah and
24:07 uh I think this social media is not
24:09 helping okay and the second step is uh I
24:14 really want to talk to you about is I
24:15 know you have talked in the past as well
24:16 on the social media
24:20 addiction causing sleeplessness mental
24:24 issues and all those things one other
24:25 problem that all my patients tell me is
24:27 that you know they wake up in the middle
24:28 of the night yeah and then you know they
24:31 use the restroom and then they come back
24:33 and then finding it difficult to go back
24:34 to sleep yeah uh will that interfere
24:37 with anything at all um so waking up to
24:40 go to the washroom is absolutely okay um
24:42 of course if you're waking up too many
24:44 times so say more than twice in a night
24:48 you might have to get checked for other
24:50 things so if you're a middle-age or
24:53 older man you should get your prostate
24:56 checked out that's a different issue
24:58 because that can cause some what you
24:59 call nocturia which is increased
25:01 urination at night and that can disturb
25:04 your sleep which has a you know
25:06 waterfall effect you know so going down
25:09 because of the there might be nothing
25:10 wrong with your sleep per se but because
25:12 of a urine problem your sleep is
25:14 affected so that is one thing uh
25:17 reinitiation of sleep can be a problem
25:19 as your age goes up so you might sleep
25:23 but if somebody wakes you up then you
25:25 might have trouble going back to sleep
25:27 so that is an age issue you might have
25:29 to see a sleep specialist for that and
25:31 you might even need
25:32 medication the other reason why you have
25:35 trouble initiating sleep is because of
25:37 anxiety so if you're stressed out about
25:39 work if youve you know if you're
25:41 thinking about a lot of things you might
25:43 have trouble calming down so that is a
25:45 third thing people who consume
25:48 alcohol there is a inverse relationship
25:52 that you drink alcohol you can sleep but
25:53 if you are a chronic then you might have
25:56 trouble initiating sleep without alcohol
25:59 so again that you might need to go
26:02 through a de addiction program because
26:04 alcohol really messes up with your
26:06 nervous system but but even social
26:08 drinking can interfere with the your
26:09 sleep yes it depends on how often you do
26:11 it and once your brain gets used to a
26:14 certain chemical your brain cannot tell
26:17 if this chemical is coming from inside
26:18 or outside that is the issue so all
26:22 these drugs even alcohol or anything
26:24 else does not actually do anything from
26:27 outside they go into your brain and they
26:31 affect the chemicals that are already
26:33 there so for example alcohol affects
26:36 this chemical called Gaba now Gaba is an
26:39 inhibitory neurotransmitter it slows
26:41 your brain down so our brain is thinking
26:45 that for some reason my Gaba receptors
26:48 active and so I don't have to do
26:51 anything now because it's automatically
26:53 coming down and it gets used to this so
26:56 when you take away the alcohol now our
26:59 brain has kind of quote unquote
27:01 forgotten how to activate Gaba by itself
27:04 and so now it needs alcohol to come and
27:07 job it's like somebody who's always
27:10 known how to drive and then they hire a
27:12 driver and the driver has been driving
27:14 for 10 years and suddenly they are told
27:16 to drive for a minute they forget the
27:19 steering wheel where is the steering
27:21 wheel so somebody who's been drinking
27:23 alcohol a lot that is the way it is that
27:26 they forget how to how to go to sleep by
27:28 yourself um teach me here where you know
27:31 I've seen many of my us patients every
27:34 time I talk to them about you know not
27:36 eating late at night they say oh I don't
27:37 eat anything I just drink
27:40 wine you did you know this that every
27:43 American household dinner always has
27:45 wine always has wine and uh they think
27:49 that wine is relaxing them and I tell
27:51 them that you know wine is going to
27:52 disturb your circadian rhythm yeah if it
27:55 was you in America will you drink wine
27:59 there was that one study right that
28:01 showed that wine is good for your heart
28:03 yeah ratol I cannot think of another
28:07 study that has done more harm to the
28:10 world honestly that's um it is because
28:14 that study has been misinterpreted and
28:16 taken so much out of context that oh one
28:19 drink is okay one now there are two ways
28:21 to look at it our brain can get used to
28:24 anything and like I said at a younger
28:28 if you are giving it a particular amount
28:29 of stress it can get used to it and it
28:32 might not even do harm because if it
28:34 there is enough reserve it can get used
28:36 to it but the problem is that as you
28:39 keep growing older and you increase the
28:41 stress more it can do harm so similarly
28:46 with alcohol at a younger age if you're
28:48 drinking a little bit little bit little
28:49 bit little bit our brain gets used to it
28:51 and you can have a nor almost normal
28:54 life of course our liver problems are
28:56 different okay but over a period of time
29:00 that same amount can be can seem more
29:03 and more to the brain because our
29:04 brain's capacity is going
29:06 down so I would yes I know that people
29:11 go through a college phase they want to
29:13 experiment they want to drink so the
29:15 alcohol is just part of a larger
29:17 exploration right our brain is curious
29:20 it wants to experience new things and
29:22 anyone who says don't do this they
29:25 become part of the problem ah you want
29:27 to do more so I have realized that the
29:30 human behavior is such that don't say
29:33 absolutely no to anything you are just
29:37 on but after they have done with that
29:40 Curiosity phase then is the time to
29:42 teach them that okay now you're done
29:44 with this now understand that this is
29:46 the harm you've done to your brain and
29:48 do you want to keep doing this and it's
29:50 just like how they get exposed to
29:52 alcohol at the teenage years they should
29:54 get exposed to alcohol awareness at at
29:57 their 25 26 years of age and the earlier
30:00 they get exposed to this knowledge the
30:02 better so human beings are not meant to
30:06 alcohol by the age of 30 35 40 it should
30:09 definitely slow down and stop it can be
30:11 a part of that exploratory phase but
30:13 then they should stop absolutely and if
30:16 somebody goes through life without that
30:17 exploratory phase even better even
30:19 better yes but sometimes the problem is
30:21 the exploratory phase is very difficult
30:23 to cut down correct yeah uh that's the
30:26 that's the correct over there so the the
30:28 solution is to find healthier things to
30:31 explore like Sid Warrior Channel like
30:34 Channel I have to say Doc you're very
30:37 good at plugging things
30:39 in I must learn this from
30:41 you so you so you surround yourself with
30:44 good things and then you explore there
30:45 are lots of good things there are so
30:47 many things to explore in life but
30:49 whatever comes easily to us we will
30:51 explore those things first and the one
30:54 thing that alcohol companies have done
30:55 very well is marketing
30:58 they have made it so easily available
31:00 like for example uh rock climbing is a
31:02 great thing to explore but if I if in
31:05 living in Bombay if I want to go rock
31:07 climbing I can't think of a single place
31:09 nowhere where where do I go but alcohol
31:12 there's a shop in every corner you know
31:14 so healthier things are always more
31:17 difficult to come across whereas um
31:20 harmful things are so easy so easy
31:22 everywhere but you agree that even
31:24 social drinking interferes with your
31:26 sleep correct yes absolutely sleep yes
31:28 absolutely and uh so to start with our
31:31 life is like lot of stress as well to
31:33 start with and then you're adding this
31:35 we thinking that we drinking alcohol to
31:37 loosen us up yeah and then that disturbs
31:39 the sleep overnight and that adds the
31:42 stress in a wish cycle anyone who has
31:46 woken up saying never
31:51 again knows how much alcohol messes with
31:54 your sleep because you wake up feeling
31:57 completely messed up right you feel
32:00 horrible and that is your brain
32:02 recovering from what is essentially a
32:06 big big punch that it has taken to the
32:09 to itself so drinking alcohol or binge
32:12 drinking is like somebody punching your
32:15 brain it is reeling it is recovering
32:18 from it and slowly it is coming back to
32:21 reality now imagine getting punched
32:24 again and again every week of course
32:26 there will be some damage
32:27 right so that is the problem binge
32:29 drinking is of course extremely bad
32:32 social drinking is less bad but it's
32:34 also bad not drinking is best so
32:38 everything in a spectrum so if
32:40 somebody's binge drinking I would say
32:42 come back come down to social drinking
32:44 and when somebody's in Social drinking I
32:45 would say instead of three take one and
32:47 if you're at one then slow down stop
32:51 right so there are these small tricks
32:56 that one should use while weaning off
32:59 because while it is good to say that you
33:00 should be completely you know strong
33:02 willpower you should just quit with
33:04 people is difficult so many times it is
33:07 the social action that they crave I'm
33:11 sitting with you you have a drink in
33:12 your hand I don't have a drink in my
33:15 hand my brain is saying oh why am I not
33:17 part of this culture right they may not
33:20 even like the alcohol they want to be
33:22 part of it so to such people I would say
33:26 that instead of 60 ml you put 10 mL and
33:29 you fill the rest with water and ice you
33:31 will still enjoy the night as
33:35 much it's not about the alcohol many
33:38 times right that's why I say do
33:40 buttermilk yes absolutely but it has to
33:42 look also no that's the thing they don't
33:47 oh right they want to look like they're
33:50 drinking alcohol which is why you you've
33:53 seen those kids who have those little
33:54 candies that are shaped like cigarettes
33:57 oh oh correct correct correct right so
33:59 because they think they look at movies
34:00 they think oh this hero is so cool and
34:03 they pick up those candies that are
34:04 shaped like cigarettes and they put it
34:05 in their mouth and they think they're
34:06 cool our brain plays these tricks on us
34:09 so if somebody's trying to quit alcohol
34:12 just cut down the quantity and enjoy
34:15 your social Gathering you will have as
34:18 much fun with your body taking a lot
34:20 less damage which is what we want at the
34:23 end of the day right correct I think
34:25 this alcohol consumption has become a
34:27 part of the uh you know the productive
34:29 Community yes especially between 20 to
34:31 35 they work hard they relax they drink
34:34 alcohol at the same time they also very
34:37 productive that they are working you
34:39 know like 40 50 hours a week and uh we
34:42 having leaders in the field uh saying
34:44 that you should work even 70 hours a
34:46 week yeah correct yeah and uh when they
34:49 say that uh it's almost similar to like
34:52 what we are going through in our
34:53 training yeah so we used to do like 36
34:55 hour shifts and uh everything correct
34:57 and uh so I personally feel like I have
35:00 abused my body because of that and I
35:02 have had a health care and uh 5 years
35:04 ago okay uh which was my wakeup call oh
35:07 and when this person I mean when the um
35:11 thought process is that you know you
35:12 work more you become
35:14 productive what is the fine line that
35:16 they should do right you know what is
35:18 the brain damage that will happen or
35:20 they should be productive at this age
35:22 similar to how you said you know 20 to
35:23 30 and then 30 after slow down do you
35:25 have any thought process on that so
35:27 here's the thing our brain doesn't
35:29 really differentiate
35:32 between work and non
35:36 work okay it only knows between work and
35:40 rest we divide it saying that okay this
35:44 is work this is Hobby this is my
35:46 personal time this is something I'm
35:48 reading this is something for fun we
35:53 classifications for our brain it is
35:55 either work wherein it has to pay
35:58 attention and create stuff or it is
36:02 rest sympathetic and parasympathetic in
36:05 the autonomic nervous system language
36:09 states so if what you are doing actively
36:13 doing is something that you quote
36:17 enjoy is not really work okay so I would
36:22 say that you can work as much as you
36:25 want okay but if you are getting
36:30 it if you are not enjoying it if it is
36:33 not giving you pleasure if you are if
36:35 your body is fighting against it even 2
36:39 hours of that is more harmful than
36:42 spending 16 hours doing something you
36:45 like because ultimately what difference
36:49 brain if you are at home and you are
36:53 arguing with your wife okay technically
36:57 you're at home it's family time but
36:59 you're arguing all the time your work is
37:02 actually more is better for your brain
37:05 so it's not really about the 70-hour
37:08 work week it's about how stressed you
37:11 are while doing that activity because
37:12 for the brain it is just another
37:14 activity the brain does not care you
37:16 could get more stressed watching a bad
37:18 Netflix movie than having a good time at
37:21 work with your friends so if you're
37:23 getting along with your colleagues if
37:24 the work that you're doing is
37:25 stimulating if you're getting good
37:28 validation if you're enjoying your work
37:30 you it it identifies with you you feel
37:33 like this is what I want to do in life
37:35 you can work 100 hours a week it's fine
37:38 but the more your body is in sympathetic
37:40 that is in stressed Zone that is when
37:43 you suffer so the 70 hour work week is
37:46 very arbitrary it assumes that the
37:48 people don't enjoy work so for say Naran
37:52 morti 70 hour is nothing because it is
37:57 he will work all hours absolutely and it
37:59 is not going to harm him correct because
38:02 it is him he that's what he wants to do
38:03 with his energy and time the problem
38:06 happens when what you actually want to
38:07 do is something else and you're doing
38:09 this against your will that is when you
38:12 get stressed out that is the harmful
38:13 time yeah I'm going to ask a
38:16 controversial question okay okay okay I
38:18 think both of us can relate to this okay
38:20 not controversial just uh brainstorming
38:22 ideas okay so we are we all have a
38:25 full-time profession of doctors yeah
38:26 okay and we also do this YouTube thing
38:28 yes okay and you're also very active
38:30 yeah uh given an option between these
38:33 two which one you'll be in
38:39 parasympathetic let's have your hospital
38:41 not watch the podcast yeah no I actually
38:45 enjoy my time at the hospital I I
38:47 absolutely love it in fact I remember
38:50 thinking that when I enter my OPD and
38:53 that door shuts and I'm in my Consulting
38:56 room I feel so peaceful because I know
38:59 that for the next four hours five hours
39:01 I don't have to pay attention to
39:03 anything outside of this room I am
39:06 completely there and my entire world is
39:10 patient whoever calls me I can just say
39:13 I'm in the hospital it is actually very
39:16 peaceful because you're not conflicted
39:18 you don't have to be anywhere else you
39:20 know this is what you want to do when
39:21 they come with a problem and you are
39:23 able to help them is there any better
39:27 right and when they come back and say
39:28 that whatever medicine you gave whatever
39:30 advice you gave it helped them it is
39:32 constantly calming of course there are
39:35 stresses you know some patient who's
39:37 very serious some patient who's not
39:38 getting better those stresses are there
39:40 but that's what we went through
39:42 residency for so uh I spent three years
39:45 in Kem Hospital three years in lakau
39:48 Sanjay Gandhi Hospital uh and before
39:50 that in mbbs I was in JJ hospital I've
39:52 been through government setups I have
39:55 had all the stress that I could take and
39:57 now I know how to handle stress I know
39:59 how to handle this stress so I'm okay
40:03 YouTube is different because YouTube is
40:05 a whole new kind of stress so for me
40:08 YouTube stress is actually more
40:10 difficult to take because I'm not used
40:12 to it so I'm getting I'm getting used to
40:14 it now so for me YouTube is actually
40:16 more work more work because I'm trying
40:19 to figure out how to do it and I'm sure
40:21 everyone can relate to this there's some
40:23 things that they're very good at and
40:25 some things that they're learning
40:26 learning H like like me learning the
40:27 podcast yes and you're so good at it
40:31 already see the the consultation space
40:33 is the space I absolutely love right
40:35 because even when my wife says I say shh
40:37 I'm in the consultation room no one will
40:41 compl whereas if you say that I'm
40:43 shooting something what is it what is
40:46 this new hobby that I have be shooting
40:47 in the consultation space Oh see that's
40:50 a hack I should I should try that that's
40:54 clever so you absolutely right it on so
40:56 but I think uh every doctor should be in
40:59 YouTube the reason is that you know in
41:02 that consultation space you are just
41:03 helping that one particular patient yeah
41:06 in the YouTube space you're helping a
41:08 lot so many people you know look at all
41:09 the comments that you get Absolut where
41:12 you never know how many lives you are
41:14 touching uh based on all the good
41:15 information that you put in so for me I
41:18 think uh I'm in Paras simple State on
41:20 both maybe more on the YouTube side
41:22 sometimes amazing yes because I think
41:26 the the response that we get uh I always
41:29 have a feeling that you know it had a
41:30 larger purpose yeah uh this is also good
41:34 I mean Gastrology doing endoscopies and
41:36 everything finding colon cancers and all
41:37 those things that is a that is a
41:40 definite must have profession uh and
41:42 this is a larger so um what I'm
41:45 understanding is okay if you enjoy both
41:48 yeah so the stress is might be a little
41:52 bit less that's what you're saying yes
41:53 absolutely so if you are curious
41:57 ious I feel that curiosity is the game
42:01 changer whatever you do if you're
42:04 curious about what is the outcome of
42:07 this if I do this now suddenly your
42:11 anxiety goes down because anxiety is
42:14 wondering about the future with
42:17 fear and curiosity takes that fear away
42:22 exciting so same work same job same
42:26 outcome the way you look at it depends
42:28 on whether you're curious or not so if
42:30 you're curious your anxiety is low and
42:34 working then it's fine work 90 hours 100
42:37 hours it's fine as long as the remaining
42:39 time you are resting now the controversy
42:41 is I will flip that what Naran morti
42:44 said around you're saying you work for
42:46 70 hours suppose you have to work for 50
42:49 hours but the remaining time you're
42:50 scrolling on Twitter which you think is
42:53 rest you think is your personal time but
42:56 Twitter is full of say hate comments and
42:59 you are getting into arguments with
43:00 strangers you're talking about my
43:07 no then the ctis level goes up for
43:09 everybody including the producer
43:11 everyone is stressed everyone is
43:13 stressed nobody is uh technically you're
43:16 not working but more harm is done to
43:18 your sympathetic system in that time a
43:21 very good point so scrolling on
43:23 Instagram or Twitter you think is
43:25 resting but it's not it is actually more
43:28 work for your brain than doing your
43:31 actual work so you have to figure out
43:33 what is rest and what is work that's
43:36 that's very very important key ke that's
43:38 the key I think that's a fantastic segue
43:41 to the next topic that I was thinking
43:42 about you know social media per se yeah
43:45 you know we are talking about I myself I
43:47 have felt that you know this social
43:49 media algorithm is so addictive where um
43:53 what I you know initially when I start
43:55 about fasting so I signed up for this
43:57 channel okay um my uh Professor Sachin
44:01 Panda okay okay he's my professor he was
44:03 the one who taught me everything about
44:05 this time restive feeding so I signed up
44:07 for this YouTube channel then and then
44:08 everything about fasting came to me okay
44:11 and uh let's say a person has signed up
44:14 for a anti- fasting Channel okay yeah
44:18 and the algorithm is in such a way that
44:20 they will just feed the videos where say
44:22 fasting is bad yeah okay I think it is
44:25 just a m matter of chance and luck you
44:27 wear which bubble you land up in right
44:30 yeah and I'm very concerned about this
44:32 20 to 30 year old where they just trying
44:35 to explore the world and they just get
44:38 lobbied into this all scrolling uh thing
44:41 in your practice are you seeing teenage
44:43 you know like depression anxiety
44:45 slightly more yeah definitely so uh I've
44:50 been practicing for The Last 5 Years um
44:53 private private practice and before that
44:54 I was in government Hospital
44:57 so I won't um I won't say that I'm
45:00 seeing it more but I'm definitely I I
45:03 know that a lot of patients who come to
45:06 the neurology Op with things like back
45:09 pain and migraine seem to be having an
45:12 underlying psychological
45:15 stress now all psychiatric problems as
45:19 not all but the mood disorders like
45:22 depression and anxiety they lie on a
45:26 so everyone is somewhere on that
45:28 Spectrum okay because everyone feels sad
45:31 sometimes and everyone feels low mood
45:34 sometimes and everyone feels anxious
45:36 sometimes so you're all on that Spectrum
45:38 but if that anxiety increases to a point
45:41 that it stops you from working your
45:43 everyday jobs right or if your low mood
45:47 goes to an extent compromises your
45:49 quality of life compromis your quality
45:50 of reduces your functionality
45:52 functionality so if you're not
45:54 functional anymore you can if you're not
45:56 able to maintain a good relationship if
45:58 you're not able to take care of your own
45:59 health if you're not able to work that
46:01 is when it becomes pathological so
46:04 there's physiological anxiety and
46:06 there's pathological anxiety and I have
46:09 seen more and more people kind of going
46:12 from that physiological to that
46:14 pathological yes an example one of my
46:17 friend um you know he he he's a big
46:19 Vijay fan is a big of course and then
46:23 you know the other person is an Ajit fan
46:25 okay and uh there is a WhatsApp group in
46:30 okay okay so this guy keeps on taking up
46:32 V and this guy keeps on talking about
46:34 AIT and they are not stopping and all
46:36 the other people are just watching oh
46:37 wow good beautiful oh this guy is not
46:38 responding yet oh he's typing we let
46:42 wait right so uh the point I'm trying to
46:45 make here is that the uh the the stress
46:50 happening to a point that their kids are
46:54 crying okay okay and the wife is asking
46:57 him okay did you buy the grocery store
46:58 he said no no no I need to reply to this
47:01 right many of them are in that situation
47:03 more than what you think yeah more than
47:05 what you think that is called path
47:08 pathological because it is compromising
47:10 the quality of life yeah and it is
47:13 losing your functionality yes yes this
47:17 is so funny because I suddenly got this
47:20 scene of ancient Rome and the
47:23 Gladiators and I just realized that
47:25 Society does not change we are always so
47:28 Keen to watch other people
47:31 fight whether it is in a gladiator stage
47:33 with lions or it's on a WhatsApp group
47:36 no or or on big boss or on big boss
47:39 exactly the reason big boss is
47:40 successful is because Gladiators
47:46 Gladiators Gladiators would be fighting
47:48 with lions now they are like who stole
47:50 my toothbrush that is the Gladiators of
47:53 today no absolutely but I think um it
47:56 might sound like very silly right like
47:58 you know okay this is you're just
47:59 talking about actor right but that
48:03 particular concept is so important for
48:06 that person yeah where they not able to
48:09 overcome even if they are very highly
48:12 efficient oh yes see that is where the
48:15 problem is and we need to be aware of it
48:18 and then if that is the case the spouse
48:20 or any other family member should bring
48:22 that person to a mental health therapist
48:25 yes absolutely in fact when the Facebook
48:27 algorithm was being made they realized
48:30 that messages or posts that got more
48:34 hate reactions did so much better and so
48:38 they started pushing those comments so
48:41 as you would scroll the number of posts
48:43 that would elicit the anger anger
48:46 reaction would be pushed up so they got
48:49 more likes they got more reactions more
48:52 comments and so it becomes a
48:53 self-fulfilling prophecy because that's
48:56 what you see more you're triggered more
48:58 you will type like that and you will
49:00 also find that oh my engagement is
49:01 increasing if I'm typing this so overall
49:04 it becomes a very hateful space and you
49:06 can't even blame the algorithm because
49:09 the algorithm just reflects who we are
49:11 we create the algorithm no I think the
49:13 algorithm is feeding on The Human
49:16 Behavior Uh and I think they are winning
49:20 yes and big boss is a great example the
49:23 day Big Boss stops being popular
49:26 is when human beings evolve why do you
49:28 say that because the only reason big
49:31 boss is popular is because our primary
49:33 Instinct of wanting to watch other
49:36 people fight and argue it is voyerism
49:41 right we are we are vois toally enjoying
49:43 violence that is our primary Instinct
49:47 the day we evolve out of that and we
49:49 think that this does not make any sense
49:52 that is the day we we realize that oh
49:55 there's so much more to our brain so you
49:58 know in your experience with teenage
50:00 patients you know many um parents have
50:03 come to me and then they said that hey
50:04 you know my son and daughter is always
50:06 on the phone or not talking to anybody
50:09 and yes I agreed that you know
50:11 technology is good and they have got
50:13 into the vious cycle what do you tell
50:14 them in your practice um so I realized
50:18 that it's now impossible to tell a
50:20 parent that don't allow your child it's
50:23 not possible it's not practical
50:25 especially because so many schools and
50:27 colleges have uh submissions online uh
50:31 they have apps that they have to use uh
50:34 they keep in touch with their teachers
50:35 and all through WhatsApp so now our
50:39 times have changed to the extent that
50:41 unless we change all of that and go back
50:44 to a non-mobile world it's not feasible
50:47 that's not going to happen it's not
50:48 going to happen so we should be
50:49 practical practical correct what is
50:51 important is that when we rely on the
50:54 screen for everything M education
50:58 entertainment love romance food
51:01 everything there is no need to look up
51:04 from the phone our entire world is on
51:07 the screen now right so where the parts
51:11 of our life that are unavoidable on the
51:13 screen fine but there are parts that are
51:16 avoidable so unless we make an active
51:18 effort to come out of the phone for that
51:21 it's not going to happen and kids learn
51:24 parents the amount amount of time that a
51:26 kid spends on the phone is a direct
51:27 reflection of the amount of time the
51:28 parents spend on the phone because the
51:30 kid is looking around and seeing that oh
51:32 this phone is always in your hand so the
51:34 kid's brain thinks that this is what the
51:39 like and the baby is thinking my hand is
51:42 empty now why why is there no phone in
51:45 my hand and clearly this phone is
51:48 important because the parent is always
51:49 looking at the phone so a kid can know
51:53 even a kid of one year-old can follow
51:56 the eyes of the parent and see what the
51:58 parent is looking at and if the parent
51:59 is looking at one thing a lot the kid
52:02 knows that this thing is important it
52:03 doesn't know why it's important but it
52:05 knows it's important and now the kid's
52:07 brain is thinking that whatever is
52:09 important I also want so the parents
52:12 wire the kid's behavior and then if they
52:15 complain that the kid is on the phone
52:16 all the time change your own behavior
52:18 first but that starts right from
52:20 childhood yeah right because the brain
52:22 from one year of age also it's yeah so I
52:24 have had people where me and my friend
52:26 were there the kid is telling the dad
52:30 you are on the phone all the time right
52:33 yeah and uh the dad is like Oh No 2
52:36 minutes 2 minutes you know yeah don't
52:38 come near me when I'm on the phone yeah
52:40 so this is what happened I'm talking to
52:41 a my friend okay and the kid is coming
52:44 towards him and then he says that when
52:46 Dad is on the phone I told you so many
52:49 times you should not come to me wow roll
52:54 huh and we were not talking about
52:59 either yeah maybe the new generation of
53:01 kids will know that this is a problem
53:03 maybe maybe because our generation I
53:05 think is already hooked already hooked
53:07 yeah there's no coming out so so
53:10 regarding the screen time do you tell
53:12 your uh Teenage patients like limiting
53:15 everything um yes so it's interesting
53:17 because once they have a problem say
53:21 migraine then they're much more willing
53:23 listen right because now they have a
53:26 reason to cut and then they are they are
53:29 more conscious of it and all until then
53:31 why will they believe you yes because
53:33 their life is going great so it's always
53:35 like that there's always some health
53:37 scare and if there's a health scare you
53:40 should take full advantage of that you
53:42 should not wait for a big one to make
53:45 changes even a small Health scare uh you
53:47 should make those changes with that so a
53:49 teenage a teenage girl comes to your
53:51 place okay let's say 18y old okay or
53:53 20-y old comes in with a migraine
53:54 headache yes okay it's a very common
53:56 complaint very common do you have screen
53:59 time as one of your treatments yes yes I
54:02 I asked them if they are on the phone a
54:04 lot invariably the parents start
54:07 ranting I've always told her not and the
54:10 kid is going oh no and so I tell her in
54:13 America parents are standing outside oh
54:16 yeah yeah if you're 18 plus you have to
54:18 ask the permission of the kid oh
54:20 interesting ah is is it okay with the
54:22 parents correct correct that's ideal so
54:26 practice the parents will come in first
54:29 and the kid will come in later and the
54:31 parents starts talking and I have to
54:33 tell the parents to shush let me ask her
54:37 then they are it's very difficult to
54:39 shush the parents because they think
54:41 that the kid doesn't know yeah yeah yeah
54:43 and the parent will keep talking so I
54:45 have sometimes I have to tell them that
54:46 it's okay let me talk to her and very
54:48 rarely if the kid is being very reserved
54:51 I can sense that she or he wants to say
54:53 some things and they don't want to talk
54:55 in front of the parent so I have to make
54:57 that call and I have to ask the parent
54:58 that can you step out for 2 minutes I
55:00 will talk to her this happens one
55:02 patient a day like out of 30 40 patients
55:05 one patient I have to do this where I
55:06 know I can see that they want to say
55:08 something but they're not comfortable
55:10 talking in front of the parents so I
55:12 have to make that call make that call
55:13 and then you talk about the screen time
55:14 with them screen time it's usually some
55:17 personal anxiety that they have some
55:19 personal stress that they have it could
55:21 be something like a relationship problem
55:23 also they are stressed about it and if
55:25 it's causing their migraine then it
55:27 becomes my problem so then I have to
55:29 kind of advise them about that as a
55:31 neurologist you are pretty much you know
55:33 you involve everything therapist you
55:35 have to know a little bit because you
55:36 end up doing it I think all doctors are
55:40 therapist to some level um but there are
55:42 still issues that doctors cannot handle
55:45 because of lack of time mainly and a
55:48 little bit of lack of awareness also
55:50 right so they may not understand the
55:51 full complexity of depression or anxiety
55:54 uh like why would a orthopedician or why
55:56 would a uh cardiologist understand the
55:59 full complexity of depression they have
56:01 not been trained in that so a lot of
56:04 doctors especially Old-Timers might find
56:06 it offensive that you know oh I can talk
56:08 to the patient but then it's a different
56:10 speciality so it's always better to work
56:14 together so I I have a therapist that I
56:17 refer to and I have found it helps a lot
56:20 so my patients improve after talking to
56:23 prescribed anti depress to a
56:26 teenager no not necessarily correct the
56:29 interesting thing is that a lot of
56:31 medication work differently at different
56:34 doses so say for example a drug like a
56:38 tricyclic anti-depressant at a higher
56:40 dose works as an anti-depressant but at
56:42 a much lower dose works as a painkiller
56:46 because it soothes the because the
56:48 essential yeah suits the nervous system
56:51 because at the chemical level uh it
56:53 works at that stage right it works at
56:55 the neurotransmitter level so I have
56:58 used tricyclic anti-depressants because
57:00 it works for migraine but at a much
57:02 lower dose so whereas a psychiatrist
57:05 might give it at a much higher dose for
57:06 depression and if somebody needs that
57:08 dose they will go to a psychiatrist I
57:10 will send them to a psychiatrist but if
57:12 they have migraine a very low a very low
57:15 dose of anti-depressant can work so it
57:17 depends on Patient to Patient what they
57:19 need um what I was trying to get at was
57:22 so just limiting screen time improving
57:24 Health lifestyle measures will that take
57:26 care of the migraine problem 90% yes it
57:30 time but if somebody's having headache
57:33 today I can't expect them to wait for
57:35 three months for the headache to go
57:37 because these things take time so many
57:40 patients require medicines for a couple
57:42 of weeks while yes but much shorter so
57:46 two three days uh so we have to tell
57:49 them that they have to be patient and
57:51 over 2 3 weeks the medicines will work
57:54 but you have to tell tell them that if
57:55 you don't want to be on medicine for a
57:56 long time lifestyle change is the only
57:58 way and most of them 90% of them will
58:02 have benefit with lifestyle life changes
58:04 but but one of the lifestyle changes to
58:05 limit the screen time but but it's very
58:08 difficult to limit the screen time
58:09 because you keep scrolling correct and
58:11 what is that mechanism you know I know
58:13 there is something called dopamin Hit
58:15 and everything can you explain to the
58:16 audience as well please so in simple
58:19 terms dopamine is an is a motivation
58:22 molecule okay people used to think it's
58:24 a happiness molecule it's not the
58:26 happiness it's not the happiness
58:27 molecule no dopamine does not itself
58:32 dopamine Rises when there is
58:34 anticipation of Happiness when you feel
58:37 that you are about to be happy that is
58:40 when dopamine is at its peak so for
58:42 example if I give you a gift okay and
58:45 that gift is a book and it's a good book
58:49 you take the book and you think oh I see
58:52 the book you have a chinu little
58:55 dopamine Spike so you're little happy I
58:58 gift trap the book with a nice ribbon
59:02 and with a word saying surprise
59:05 exclamation mark and I gift it to you
59:08 now your dopamine is this High because
59:12 your brain is thinking what can it be
59:13 what can it be what can it be and the
59:16 moment that you're un that you're
59:18 unwrapping the gift that is when
59:21 dopamine is at its peak as soon as
59:23 they've opened it and you see the book
59:26 your dopamine starts falling down
59:27 because now you know what it is you're
59:28 not unhappy but you're not as happy as
59:32 you were just before you opened it
59:34 that's why reels work because as soon as
59:36 you've opened one reel you've got that
59:39 dopamine Spike as you're watching The
59:41 Reel your dopamine is falling falling
59:42 falling falling now you need another
59:45 hit what can you do for the next hit
59:49 swipe so the amount of effort it needs
59:53 for that next dopamine hit has never
59:56 smaller right a smoker will need to take
59:59 out a cigarette put it in his mouth
01:00:02 light it wait for the wind to stop find
01:00:05 a corner then take a drag then he will
01:00:08 get that hit but here it
01:00:12 just that's it just one muscle has to
01:00:15 move and you've got the next hit so the
01:00:18 amount of effort it takes for a dopamine
01:00:20 hit has never been smaller that's why
01:00:22 scrolling is so and then scrolling takes
01:00:24 hours to together sometimes yeah and
01:00:26 what can we do to stop it
01:00:29 like any tips and tricks that you do I
01:00:32 mean I I have been into that situation
01:00:34 as well I tell patients not to do it but
01:00:36 sometimes you know while we are doing
01:00:37 this YouTube thing you know you look at
01:00:39 your videos yeah and then you your
01:00:41 videos come through oh what do Sid is
01:00:42 doing now yeah uh and what is Sid this
01:00:46 now yeah it's a it's a dangerous spiral
01:00:49 yes so even without your conscious
01:00:51 decision and subconsciously you keep
01:00:53 scrolling I think it's safe to say that
01:00:54 if you're scrolling so deep that you've
01:00:56 reached my mom's Instagram channel it's
01:00:58 definitely time to stop I would say
01:01:04 that because she doesn't even have a
01:01:10 account that is just Jing you know like
01:01:12 you know you keep on seeing the same
01:01:14 thing so your thing comes up and every
01:01:17 every doctor thing comes upct because
01:01:19 you know the algorithm feeds exactly and
01:01:21 sometimes I have been in the VIS cycle
01:01:23 as well yeah uh um maybe you know one
01:01:26 time I told my patient create a timer
01:01:28 yes uh I said okay you know your your
01:01:30 sleep time as you as you know right you
01:01:32 know we always say that you go to the
01:01:35 bed at the same time yeah you wake up at
01:01:37 the same time so that your circadian
01:01:38 rhythm is good and then when you wake up
01:01:41 go to bed let's say 11:00 p.m. and you
01:01:43 want to scroll preferably don't scroll
01:01:46 at all but if you scroll create a timer
01:01:49 for 15 minutes H so I generally what I
01:01:53 advise ideally is that um the last 15 20
01:01:56 minutes before your sleep should be
01:01:58 screen free right and it should not be
01:02:01 in bed now that is very difficult I
01:02:04 understand but that is ideal because
01:02:07 your bed should be a temple for sleep
01:02:10 and sex but mainly sleep because if you
01:02:14 associate that with screen then your
01:02:16 brain will keep turning towards that so
01:02:19 there is a transition time for a week
01:02:20 where you're uncomfortable but just put
01:02:22 the phone for charging on another table
01:02:26 another room and come to sleep and
01:02:28 you'll in a week's time you'll be fine
01:02:30 and you'll get much better sleep so the
01:02:32 last 15 minutes ideally should be in the
01:02:35 dark lights off and um no screens and no
01:02:40 stressful conversation in the last 30
01:02:42 minutes before going to bed I mean
01:02:43 that's ideal I mean but for married
01:02:47 couples you should buy a separate
01:02:51 house yeah married couples it's it can
01:02:53 be tricky because that's that's the time
01:02:55 that you know people get exactly time
01:02:57 for themselves that's what they think
01:02:58 exactly and all the arguments of the day
01:03:00 have kind of piled up for that moment
01:03:02 yes I tell my wife I respect your
01:03:04 decision of bringing this argument right
01:03:06 now I will answer tomorrow really you do
01:03:09 that you have separate
01:03:11 rooms no after that discussion I had a
01:03:17 room but but I think we underestimate
01:03:19 you know similar to that wake up morning
01:03:21 routine there's a sleeping routine as
01:03:23 well correct uh it has to be a sleeping
01:03:25 routine absolutely amazing so moving on
01:03:28 to the next segment of this podcast
01:03:30 where I have a strong feeling that you
01:03:33 know your stress sleep whatever you we
01:03:35 talked about so far is tied down to
01:03:38 obesity yeah and how I say that you know
01:03:41 your gut bacteria makes you crave for
01:03:44 what you need yeah I have a feeling that
01:03:46 your stress and lack of sleep also makes
01:03:51 yes what you want even more maybe that
01:03:54 the got bacteria and uh we are in a
01:03:57 obesity pandemic and we also in a mental
01:04:00 health yet to be a pandemic as well and
01:04:02 you know we are not that unfortunate to
01:04:05 have multiple diseases at the same time
01:04:08 right it has to be linked together yeah
01:04:10 it has to be linked together um in your
01:04:12 practice you think that the people who
01:04:14 are coming to your practice now compared
01:04:16 to before is obesity has been more
01:04:20 compared to before or it's almost be the
01:04:22 same that you're just diagnosing mental
01:04:23 health issues more obesity in the
01:04:25 younger population definitely is on the
01:04:28 high younger as age group uh so say less
01:04:31 than 30 less than 30 so around 20 24 25
01:04:35 um definitely more and more people
01:04:38 because I see very little above 50 year
01:04:43 obese most of them are their BMI is
01:04:46 reasonably okay but um many of them less
01:04:51 than 30 they are they are on the obese
01:04:54 side side and they come to you for what
01:04:57 um most commonly usually with some sort
01:04:59 of pain uh neck pain yes physical
01:05:03 symptoms because they are also people
01:05:05 who are leading kind of sedentary lives
01:05:07 they might be uh on their laptop all day
01:05:10 typing all the day so then they could
01:05:12 have a lot of neck pain they also have
01:05:14 carpel tunnel huh quite often because of
01:05:17 the typing um carp tunnel is explain
01:05:20 they in the so carple tunnel is pain on
01:05:23 your wrist and your hand hands because
01:05:25 of a nerve called median nerve which
01:05:27 gets compressed uh in the wrist and this
01:05:30 is associated with obesity because of uh
01:05:33 certain bad positioning of the wrist uh
01:05:36 that can happen and because of the fat
01:05:38 tissues uh uh accumulating there's lack
01:05:41 of movement of the nerve's a lack of mov
01:05:43 and that's why when your lean person
01:05:45 types in they might not get carel that
01:05:47 much compared to an obese patient yes uh
01:05:50 but of course there are lean people also
01:05:52 but um we see this Association a lot uh
01:05:56 so obese people do come in and there I
01:05:59 feel like there is a general increase in
01:06:02 that incidence of course nowhere close
01:06:05 to what it is in the west you know so I
01:06:08 was reading about this um obes obesity
01:06:11 being so common in the west where there
01:06:14 is a dichotomy where somebody's either
01:06:16 very fit or quite obese it's almost as
01:06:20 if there is no middle ground anymore in
01:06:22 the west especially in the US correct um
01:06:25 and I I would love to ask you about why
01:06:27 is that why is it
01:06:29 so spread out over there I think it is
01:06:31 environment if you go to San Francisco
01:06:34 downtown everybody will be running
01:06:36 around right sometimes without clothes
01:06:38 that is not a good
01:06:41 thing Freedom can mean different things
01:06:43 to different people maybe not that much
01:06:46 Freedom it's a it's a ISO for others
01:06:50 as uh but if let's say the same person
01:06:55 if you put them in Birmingham Alabama
01:06:57 which is a southernmost State uh in US
01:07:01 where obesity is pretty common okay
01:07:04 because they say that obesity runs in
01:07:07 their families that's not true because
01:07:09 nobody run in the
01:07:13 family so you know you know this like
01:07:15 said you know in neurology you say that
01:07:17 you are what you are surrounded by the
01:07:19 five people that you actually interact
01:07:21 with correct that is exactly true what
01:07:23 is happening in US exactly true if you
01:07:25 look at San Francisco and La Hollywood
01:07:29 uh main areas it's all everybody is like
01:07:32 running around working out and all the
01:07:35 gym memberships are like you know so
01:07:36 crazy expensive people do Pilates two
01:07:39 times a day yeah uh so if you go to
01:07:42 Alabama and they do yoga except they do
01:07:44 yoga TM because it is registered in the
01:07:48 now they do hot yoga Hot Yoga yeah then
01:07:53 they then only said hot means the
01:08:00 temperature so that's what the
01:08:01 environment is I think it's absolutely
01:08:04 in US answer your questions based on the
01:08:06 environment Environ and I can see that
01:08:09 that might be happening here as well if
01:08:11 you classify between urban and rural
01:08:13 areas yes I think so Urban cities are a
01:08:16 little bit obes yes that rate of obesity
01:08:18 is increasing more um because of again
01:08:21 like you said Lifestyle the work from
01:08:24 home culture you don't have to travel
01:08:26 much you can you don't have to there's
01:08:28 no social pressure to exercise you know
01:08:31 so unless you are part of that group
01:08:33 there's no in the traditional Indian
01:08:35 family there's no social pressure to
01:08:37 exercise um there's a social pressure to
01:08:39 perform well in academics exactly right
01:08:41 there's a lot of that there's social
01:08:43 pressure to get married and which is why
01:08:46 before marriage there's a lot of social
01:08:48 pressure to exercise because you want to
01:08:50 a find a partner and B look good in the
01:08:53 wedding photos after
01:08:55 marriage no more social pressure you can
01:08:58 let yourself go and there's no one who
01:09:00 will say anything the only goal is to
01:09:02 for me is to fit in the marriage
01:09:08 Rani correct absolutely absolutely so
01:09:12 are uh basically agreeing to the fact
01:09:14 that you know mental health and obesity
01:09:16 is pretty much uh Associated closely or
01:09:20 not no that's so those are two different
01:09:24 um so there are lifestyle choices that
01:09:28 can affect both so for example less
01:09:32 exercise has an impact on both obesity
01:09:35 less exercise leads to obesity but less
01:09:37 exercise can also mean there are less
01:09:39 endorphins there are less your brain
01:09:42 activity slows down which can be one of
01:09:44 the contributing factors to mental
01:09:46 health problem so we cannot say that
01:09:49 obesity leads to mental health but there
01:09:51 are common factors that lead to both
01:09:54 uh so for example stress can lead to
01:09:57 stress eating which can lead to obesity
01:10:00 but stress can also lead to anxiety and
01:10:02 depression so stress is the common
01:10:05 factor so that somebody who who has
01:10:07 obesity because of stress could also
01:10:09 have a mental health problem so there
01:10:11 are these it's like this web of
01:10:14 interconnected things and we still
01:10:17 cannot say that one thing leads to
01:10:19 another because I feel that is too
01:10:22 simplistic you know
01:10:24 uh it might be us trying to find a
01:10:26 simple answer that if you're obese then
01:10:28 you then you have a mental health issue
01:10:30 but it's not so straightforward there
01:10:32 are multiple other things that affect
01:10:34 each other which is also why people
01:10:36 don't get into it because it's too much
01:10:39 of cognitive load you know they don't
01:10:40 want to think so much um but definitely
01:10:44 there is a interconnection between
01:10:46 obesity stress migraine and mental
01:10:50 health problems like anxiety and
01:10:51 depression they are all connected Ed to
01:10:54 each other yes but when you exercise a
01:10:57 little bit more the risk goes down goes
01:10:59 down risk goes down yes absolutely and
01:11:01 when you are saying stress eating I
01:11:03 think this is the most common complaint
01:11:05 that people come to me when I say I know
01:11:08 that you will agree to the statement
01:11:09 that you know from a GI standpoint
01:11:10 Gastrology standpoint I tell my patient
01:11:13 is that don't expect me to prescribe
01:11:15 medications for weight loss no for GI
01:11:18 problems okay you do weight loss that is
01:11:21 the treatment hm uh 50% even I will say
01:11:25 100% sometimes that that plays a major
01:11:28 role in all your GI problems correct and
01:11:31 the first answer that they say is that
01:11:33 you know I'm very stressed out and
01:11:35 whenever I'm stressed out I reach for
01:11:37 the chips I reach for the thing yeah and
01:11:39 what is this connection between stress
01:11:41 and emotional eating yeah is that
01:11:43 dopamin is more or that is they are
01:11:47 satisfying that with the food cravings
01:11:50 eat eating is a parasympathetic action
01:11:54 so you eat and you feel rested okay so
01:11:59 stress is a sympathetic activity which
01:12:02 is against parasympathetic so whenever
01:12:04 you're sympathetic you are alert you are
01:12:07 active you want to do things but when
01:12:10 you're too sympathetic that is when
01:12:11 you're too stressed out your body
01:12:13 desperately wants you to come back
01:12:16 parasympathetic yes it is a kind of Auto
01:12:19 regulation now there are many ways to
01:12:22 convert sympathetic into Paras
01:12:23 sympathetic you can sleep you can sit
01:12:27 with your friends and look in laugh you
01:12:30 can just close your eyes and do some
01:12:32 deep breathing You Can chant you can
01:12:35 meditate you can go for a walk all of
01:12:38 these things are parasympathetic
01:12:40 activities but you can also
01:12:43 eat now amongst all these things eating
01:12:48 is probably the easiest because it is
01:12:50 right in front of you you don't even
01:12:54 for everything else you have to put in
01:12:55 some effort but there's a bag of chips
01:13:00 out now would I rather go down for a
01:13:03 walk which takes physical effort or can
01:13:06 I just open this bag of chips and eat
01:13:08 something and as soon as I eat it my
01:13:10 body goes into parasympathetic so I feel
01:13:12 better now I can go back to work so now
01:13:16 there is a connection between working
01:13:18 and relaxing by eating which is what
01:13:21 stress eating means it is like a
01:13:24 emergency parasympathetic booster right
01:13:27 so it's like firefighting where there is
01:13:30 fire and there is you break the glass
01:13:32 and you take out the fire extinguisher
01:13:33 and you put it except here the fire
01:13:37 extinguisher is a bag of
01:13:38 chips so the problem is that we become
01:13:41 so used to putting out fire by eating
01:13:43 the bag of chips that we don't realize
01:13:45 that you should not have so much fire in
01:13:47 the first place it's why the chips
01:13:48 packet is red in
01:13:50 color exactly which is also why
01:13:53 McDonald's is red all the burger because
01:13:56 we associate red with hunger food you
01:14:00 know it's it's bright you chase it Chase
01:14:02 it um so having that connection is one
01:14:06 of the problems with obesity wow
01:14:08 whenever you're stressed you'll eat so
01:14:10 one tip that I tell all my patient is
01:14:12 that okay you know take all the junk
01:14:14 Foods out of your closet you can eat
01:14:17 when you go out to start with that's
01:14:20 what I say so take you know in uh many
01:14:23 of my South Indian patients ask for M
01:14:25 yes of course okay and uh they say I
01:14:27 love M I said you know yes you can have
01:14:28 M if you're going to a friend's place or
01:14:31 a get together or a potl or something I
01:14:34 don't want especially when I when I do
01:14:36 this fasting method talking to them I
01:14:37 say that the first step that you should
01:14:39 do was go and eat all the mura at your
01:14:44 now I can see why they love you for the
01:14:49 visit and then from next time no Mur at
01:14:52 all I'm not saying don't eat it M go and
01:14:54 eat whenever you are outside so I think
01:14:56 now so then when they stressed out they
01:14:58 don't have anything to eat and then they
01:15:01 forced to unsubscribe from my channel
01:15:04 there's no other way no other solution
01:15:07 that they can think of so my personal
01:15:09 demon is the is what we call Shari which
01:15:12 is um those banana chips that are made
01:15:15 with banana Jagger Jag have you seen
01:15:18 those you you make it with Jag I love
01:15:24 so the my problem is that I I have a
01:15:27 magic trick where one second they are
01:15:29 there and the next second they've
01:15:31 gone and my mom is always amazed that oh
01:15:34 this full bag of jaggery chips where did
01:15:36 it go like Tada my friend s has a
01:15:40 different magic trick you close your
01:15:41 eyes there's a second packet that
01:15:44 comes this is the this is the main issue
01:15:47 so the way the advice that I give is
01:15:51 that you can eat whatever you want okay
01:15:54 but you have to earn it ah so
01:15:57 evolutionarily you can only eat
01:15:59 something that you have worked for okay
01:16:02 so if you're a monkey and you want you
01:16:04 have to eat a fruit you have to climb a
01:16:05 tree right if you're a tiger you have to
01:16:08 eat a deer you have to hunt it you have
01:16:10 to kill it then only you will eat it
01:16:11 correct so whatever you worked for you
01:16:15 eat so eat whatever you
01:16:19 want if you're making it if you are uh
01:16:22 if you're cooking it cooking it huh huh
01:16:24 if you have made it so you buy the raw
01:16:27 materials you cook it you make it you
01:16:29 eat it no problem the problem is that
01:16:32 you have not earned that packet of chips
01:16:35 right you have not grown the potatoes
01:16:37 you've not even bought the potatoes
01:16:38 you've not cut them you've not fried
01:16:40 them you've not put the Masala on them
01:16:42 nothing so our B but our brain doesn't
01:16:45 know that so when our brain eats such a
01:16:48 high calorie food our brain thinks that
01:16:51 such a high calorie food means means you
01:16:53 have earned this high calorie food so it
01:16:56 gives you a lot of
01:16:57 dopamine because high calorie food is
01:17:00 very hard to come in the
01:17:03 jungle but here just opening a packet of
01:17:05 chips and eating it our brain gives you
01:17:08 so much dopamine that you've not
01:17:10 deserved right so no packet
01:17:14 Foods eat whatever you want but no
01:17:17 packet Foods according to me out of all
01:17:21 the diets this is probably the best one
01:17:24 you cook and you eat whatever you want
01:17:28 your body will get used to it right over
01:17:30 a period of time the body will get used
01:17:32 to it especially if something that
01:17:33 you've grown up with but nobody's grown
01:17:36 up with chips it's a very new phenomenon
01:17:39 evolutionarily we are not used to such
01:17:41 high density processed process high fat
01:17:44 yeah so I would my take on diet would be
01:17:49 that everything cooked is fine but at
01:17:51 the time of stress eating stressful
01:17:53 eating alternative methods
01:17:56 is um okay so let's say I I have let's
01:18:00 say my patient okay and I've said
01:18:01 there's no snacks at all and they
01:18:03 stressed they want to bring the you know
01:18:05 lyic uh system to the prefrontal contct
01:18:07 thing yes okay so when they do that what
01:18:10 do they what else they can do uh I have
01:18:13 read something about this vagal nerve
01:18:14 stimulation all those things uh that Val
01:18:17 Salva Manu and all those things help uh
01:18:19 so Val Salva doesn't help so much but
01:18:21 deep breathing helps
01:18:23 so when you stretch the diaphragm in
01:18:27 under your lungs when you expand your
01:18:29 lungs with air your diaphragm gets
01:18:31 stretched the diaphragm will activate
01:18:34 the vagus nerve and it'll activate the
01:18:36 parasympathetic nervous system so if you
01:18:40 take a deep breath and you count from 1
01:18:42 to five and you exhale slowly and you
01:18:46 keep doing this five times your body
01:18:48 will automatically shift from
01:18:49 sympathetic to parasympathetic so this
01:18:52 is probably the the simplest way so when
01:18:54 they say that if you're angry you should
01:18:56 count to 10 and take a deep breath it is
01:18:59 just this you're angry you're in
01:19:01 sympathetic overdrive you take a deep
01:19:03 breath and you count to 10 you're coming
01:19:05 back into parasympathetic so coming back
01:19:07 to parasympathetic means in your brain
01:19:09 you're going from lyic to prefrontal now
01:19:12 you are calmer you have more control you
01:19:14 will not say stupid things that you will
01:19:16 regret later so this is the simplest way
01:19:19 wow yeah you know I while you are saying
01:19:22 this I pictur see in a patient in front
01:19:23 of me uh I was getting a consent for the
01:19:26 procedure for Endoscopy and then he got
01:19:28 a phone call and then he took the phone
01:19:30 call and then all of a sudden he was
01:19:31 talking to me and then uh he was talking
01:19:33 on the phone and then he kept like this
01:19:38 said yeah right and then I said who are
01:19:41 I talking to see my
01:19:43 wife no you have been like Bing my wife
01:19:46 I think I have to go back to
01:19:48 home like you said my Hospital does not
01:19:51 see the podcast I hope your wife does
01:19:55 but actually it's the other way around
01:19:56 my wife does that when I talk to
01:20:00 her so and then I was shocked that's the
01:20:03 first time that I've seen somebody
01:20:05 actually seeing that in front of me yeah
01:20:07 and he he was like 65 years old and he
01:20:09 said Dr pal you need to do this yeah uh
01:20:13 take this tip and then you know take a
01:20:15 deep breath and then exhale to 5 Seconds
01:20:18 wow so what chanting does is uh just
01:20:22 take this concept and add another layer
01:20:26 which is vibrating your vocal cords so
01:20:29 your vocal cords are also controlled by
01:20:31 a branch of the vus nerve recurrent
01:20:34 lenal nerve so that Branch also
01:20:37 activates the vocal cords so when you
01:20:40 are chanting basically what it means is
01:20:44 that your uh vocal cords are vibrating
01:20:47 now that in itself can be an activator
01:20:50 of the vus nerve so it increases the V
01:20:52 Al tone these are all very transient
01:20:55 spikes okay it's not going to be a
01:20:56 massive difference but in that moment
01:20:59 that's all you need so whenever people
01:21:02 are chanting om for example like like oh
01:21:06 like deep down deep down so that word m
01:21:11 people I think uh attribute a lot of
01:21:13 spiritual significance to that word
01:21:15 itself but it is actually a
01:21:17 syllable and the focus is not on the
01:21:20 word but it is on the sound coming from
01:21:22 your throat so when the sound is leaving
01:21:25 your throat it's oh and then eventually
01:21:29 when you put your lips together it
01:21:33 M that's all it is so the focus is on
01:21:36 the vibrating vocal cord so that your
01:21:39 body shifts into parasympathetic and you
01:21:42 calm that's the important thing wow yeah
01:21:46 wow really good you feel something when
01:21:49 this wow wow super so so all this we
01:21:53 talking about that stress emotional
01:21:54 eating thing and these are the tips and
01:21:56 tricks that we can cut down to cut down
01:21:58 to cut down correct um the other end of
01:22:00 the spectrum is where people are obese
01:22:05 yeah okay by the uh weighing scale body
01:22:08 mass index and fat percentage and
01:22:10 everything um and there is one school of
01:22:13 thought where they say that love your
01:22:15 body correct and when you say love your
01:22:19 body there is a fine line where you need
01:22:22 to to be a little bit aware that this
01:22:25 kind of an this end of the spectrum
01:22:27 where your body mass index is slightly
01:22:28 high uh it's okay to love the body at
01:22:31 the same time there's some health
01:22:32 consequences associated with that as
01:22:33 well right and I get this uh uh concept
01:22:36 all the time with my audience is that
01:22:38 hey what is about body positivity right
01:22:40 you know you need to love your body so
01:22:42 it is this is what I am and my body mass
01:22:44 index is 35 so what it is what I am so
01:22:48 what I'm still trying to wrap my head
01:22:50 around in terms of how do I convince
01:22:51 that patient that you know body M3 is
01:22:53 okay yeah as long as it is not causing
01:22:55 any health problems and I'm saying that
01:22:57 it is at increased risk of all the
01:22:59 things that we're talking about yeah
01:23:01 from a neurological standpoint what is
01:23:03 that body positivity about is that
01:23:05 something like a confidence that they
01:23:07 get so in my mind I try to look at it as
01:23:13 scientifically as possible which is that
01:23:16 your ultimate risk is because of
01:23:20 inflammation okay so you are increased
01:23:23 risk of heart attacks your increased
01:23:24 risk of stroke inflammation is like a
01:23:26 burning volcano inside the body burning
01:23:28 in the body burning in the body right so
01:23:30 that burning is basically your body
01:23:33 creating inflammatory cells because it
01:23:35 thinks that it is under attack now
01:23:38 obesity is a pro-inflammatory state so
01:23:42 the more obese you are the more
01:23:44 inflammation is there in your body which
01:23:47 is what causes the risk of heart attacks
01:23:55 self-image when you look at yourself in
01:23:57 the mirror and you hate yourself is also
01:24:01 a pro-inflammatory
01:24:02 state so when you look at yourself and
01:24:05 you hate yourself what happens is that
01:24:07 there is a part of the brain called
01:24:10 insula insula is responsible for
01:24:14 how you perceive your own body to be
01:24:18 okay now if what you if you have a
01:24:21 self-image of someone who is thin and
01:24:25 you see a mirror that shows you as a fat
01:24:27 person there is a
01:24:29 conflict and your brain rejects this
01:24:32 image okay so there's a conflict in the
01:24:35 brain and that causes
01:24:37 stress and that causes anxiety which
01:24:41 inflammation okay and that is also a
01:24:44 problem so if there is somebody who is
01:24:47 looking at the mirror and seeing a fat
01:24:49 person and they know that they are a fat
01:24:51 person so there's no conflict anymore
01:24:54 then at least that stress is gone they
01:24:57 are at peace with the body they're at
01:24:58 peace with their body so that
01:25:01 inflammation is gone great otherwise you
01:25:04 are adding inflammation on top of
01:25:06 inflammation so that's double the
01:25:07 problem so if somebody is fat and
01:25:10 they're stressed or they're feeling
01:25:12 guilty about being fat to the point that
01:25:14 their body is rejecting itself then they
01:25:17 are at twice the
01:25:18 risk so starting me I would definitely
01:25:23 peace it's okay it's okay right like if
01:25:26 you are 100 kgs we can't shift you to
01:25:29 ideal body weight in a day it'll take
01:25:32 what a year that one year let's avoid
01:25:36 additional damage through negative self
01:25:38 talk so positive body image very
01:25:41 important okay be at peace with yourself
01:25:45 but that doesn't mean that people don't
01:25:47 change right so uh a 50 kg person can
01:25:52 become become an 80 kg person that can
01:25:54 also create body image issue but 100 kg
01:25:56 person can become a 70 kg person
01:25:58 whatever is your ideal body weight you
01:26:00 should try to become that so body
01:26:03 positivity means I am who I am but
01:26:06 wanting to lose weight means this is not
01:26:08 who I want to be later so this
01:26:11 distinction has to be made so the
01:26:14 problem happens when people say I want
01:26:18 now then there is a
01:26:21 problem so the language has to be very
01:26:23 clear I am obese that's okay but in 2025
01:26:29 I don't want to be obese so I'm at peace
01:26:32 now but I want to be peaceful later but
01:26:34 I want to be a peaceful thinner person
01:26:37 but let me ask you this way where they
01:26:39 don't want to be thin at all okay and
01:26:42 they just want to be where they were
01:26:44 yeah and we as doctors we know that
01:26:46 there's an increased risk of all these
01:26:48 Health complications what is your way to
01:26:50 tell them that you know I think you must
01:26:53 at least consider decreasing the BMI
01:26:55 because there's an increase risk of all
01:26:56 this what is your uh uh way to explain
01:27:00 to them in a very yeah so I believe that
01:27:02 the role of the doctor is to provide
01:27:05 knowledge facts facts and uh that fact
01:27:09 should be given in as empathetic a way
01:27:12 as possible so that the patient does not
01:27:14 feel attacked it sometimes it's very
01:27:17 difficult for the patient to remember
01:27:18 that the doctor is on their side right
01:27:21 nobody's attached them is the ultimately
01:27:24 what everyone wants is for them to be
01:27:26 healthy yes so this message has to get
01:27:29 across very clearly but at the end of
01:27:32 the day uh every patient has
01:27:35 autonomy decision making decision making
01:27:38 so if somebody is an alcoholic right you
01:27:41 tell them that you should stop drinking
01:27:43 they don't stop drinking they don't stop
01:27:44 drinking but then when they come to you
01:27:46 with an alcohol related problem you will
01:27:49 not say I told you so you should go that
01:27:52 so that is the doctor's ego coming in
01:27:54 the way the doctor's job is not I Told
01:27:56 You So doctor's job is to treade the
01:27:58 patient in whatever condition they come
01:28:01 in and then give them advice about how
01:28:03 to live a better life but if they don't
01:28:06 the doctor doesn't have to take it
01:28:08 personally that I have failed as a
01:28:10 doctor it's not like that every patient
01:28:12 has their own Journey right so I feel
01:28:15 that a lot of times the person who's
01:28:17 trying to help their own ego comes in
01:28:19 the way it's fine you give them all all
01:28:22 the information so that they should
01:28:23 never feel that I wasn't told but then
01:28:25 at the end of the day the decision is
01:28:27 theirs yeah it's a huge thing in US yeah
01:28:30 I can huge thing in us and I always say
01:28:33 you know I have a template and then I
01:28:36 say oh increase body mass index increase
01:28:37 risk of diabetes hypertension stroke
01:28:39 colon cancer and all those things no you
01:28:41 can choose yeah correct but they if when
01:28:44 they feel attacked then they're less
01:28:46 likely to uh listen correct corre you
01:28:48 know so I always say that um you know
01:28:51 when I promote this uh fasting method um
01:28:54 I start very slowly I said you know I
01:28:56 don't say that oh you know you are going
01:28:57 to lose weight in one year and I say
01:29:00 that you know right now you have this
01:29:03 liver enzyme elevation yeah okay for
01:29:06 this liver enzyme elevation to come back
01:29:08 to normal you need to do this yeah
01:29:10 similar to how you said that you know
01:29:11 when there's a problem with migraine
01:29:13 it's very easy correct same thing the
01:29:15 Teck that I use yeah for some some hook
01:29:18 that they can use yeah the issue is that
01:29:22 before they start on a weight loss
01:29:24 journey I believe that there are certain
01:29:26 mental uh states of mind that they have
01:29:29 to work on for example
01:29:32 resilience how to handle stress should
01:29:35 be something that they fig learn before
01:29:38 they embark on their weight loss Journey
01:29:41 because you need a lot of resilience to
01:29:43 go through it and invariably people the
01:29:46 reason people want people don't want to
01:29:48 do it is because they are afraid nothing
01:29:51 else people are just afraid of what will
01:29:53 happen if they start try and they fail
01:29:56 so then they would rather not try at all
01:29:58 and say I'm happy with this so it is a
01:30:01 kind of defense mechanism so it's
01:30:03 completely understandable U it's like uh
01:30:07 if a if a if you tell a child that you
01:30:09 have to study to get good marks and the
01:30:10 child feels that they can't then they
01:30:13 will say I will I don't want to study
01:30:15 then they you know they'll they'll try
01:30:17 and do something else so uh that empathy
01:30:21 has to be very cor individualized yeah
01:30:24 because I've realized that putting
01:30:26 yourself or if the patient feels like
01:30:28 you against them correct then that is
01:30:30 nothing is going to happen nothing will
01:30:31 happen nothing will happen then neither
01:30:32 the patient will benefit nor will you
01:30:33 benefit and then you keep seeing the
01:30:35 patient repeatedly correct that's what
01:30:37 happening so in in for example that
01:30:39 brings to the next segue where you know
01:30:41 I promote this um sunrise to sunset
01:30:45 method of uh eating uh that's what we
01:30:48 did some research in uh my uh lab not my
01:30:51 lab in my Professor lab uh and then we
01:30:53 found out that okay you know if you
01:30:54 respect your circadian rhythm all the
01:30:56 hormones what you talked about you know
01:30:57 the Melatonin cortisol everything works
01:30:59 at night yeah uh growth hormone comes
01:31:01 and repairs all the hormones at night
01:31:03 all the damage that happens at night and
01:31:05 then you know when you wake up in the
01:31:06 morning uh with good 7 hours of quality
01:31:08 sleep and then a minimum of 12 hours of
01:31:09 fasting um that's what our nature
01:31:12 demands um so uh when I say that people
01:31:17 understand and then I to say them hey
01:31:19 this is a method that work for me it's
01:31:20 not for everybody you try out and then
01:31:22 say so they try it out for like a month
01:31:24 or two and then they absolutely love it
01:31:26 okay okay because they start seeing
01:31:28 changes but the problem is in terms of
01:31:33 consistency okay and then what is
01:31:35 happening is you know yes I I know that
01:31:38 this is good for me right uh but I'm so
01:31:41 busy that I'm not able to prioritize
01:31:44 this okay and then I say that okay know
01:31:46 do this on a daily basis it become a
01:31:48 habit and all things I want to ask from
01:31:50 a neurologist in terms of what is this
01:31:52 habit forming Loop and how long does it
01:31:56 take for a person to buite the bullet
01:31:58 and do this uh and then it becomes a
01:32:01 habit and not with a willpo yeah so I'm
01:32:06 glad that we earlier spoke about lyic
01:32:08 system and prefrontal cortex because
01:32:11 that is the framework to understand
01:32:12 habit also so a habit is an action that
01:32:15 initially starts from the lyic system uh
01:32:18 initially starts from the prefrontal
01:32:20 cortex so for the audience prefontal
01:32:22 Contex is the uh is the more evolved
01:32:25 recent part of the brain it is right
01:32:26 behind the forehead and um it matures
01:32:30 throughout the life but it reach reaches
01:32:33 adult maturity by 25 whereas the lyic
01:32:36 system is behind it's under your brain
01:32:39 it is an old part of the brain and that
01:32:41 is what is responsible for your emotions
01:32:43 Instinct uh love anger jealousy all of
01:32:47 those things come from the lyic system
01:32:48 the opposite of the spectrum yeah to
01:32:50 correct but they both need need each
01:32:51 other each other and they're always in
01:32:53 conflict or mostly they're in
01:32:56 Conflict which is interesting because um
01:32:59 going a little deeper into Neuroscience
01:33:00 there is a part called as the anterior
01:33:02 singulate cortex singulate cortex looks
01:33:05 like my anatomy class yeah so the
01:33:07 anterior singulate cortex is literally
01:33:10 like the meeting room between pre
01:33:12 prefrontal cortex and lyic so whenever
01:33:14 there is a conflict the anterior single
01:33:17 cortex lights up on MRI say it again
01:33:20 whenever there's a conflict whenever
01:33:22 there's a conflict between emotion and
01:33:26 huh anterior single cortex is what
01:33:28 lights up so this I it's called the ACC
01:33:33 the ACC is responsible for all conflict
01:33:36 resolution and it is always working so I
01:33:39 always think that the most overworked
01:33:41 part of our brains is the ACC ACC
01:33:43 because we are always arguing between PR
01:33:45 prefrontal and lyic wow and the
01:33:48 prefrontal is the area where you
01:33:50 initiate the trying to theit it is
01:33:52 logical it plans in the future all of
01:33:55 that so A limpic cannot plan to the
01:33:57 Future that's the problem I see so the
01:34:00 reason habits are so difficult is
01:34:02 because the limic can only plan for uh
01:34:04 one or two minutes 10 minutes that's it
01:34:07 so it might seem that oh I should go to
01:34:10 the gym but the effect of the gym will
01:34:12 come after 6 months our limic system
01:34:16 does not care after 6 months a limic
01:34:18 system says AB what now so limic is like
01:34:22 start two delivery yes two day delivery
01:34:25 immediate drone delivery drone delivery
01:34:27 so given the option between eating a
01:34:29 cake which will feel good now versus
01:34:33 going to the gym which will feel good
