In this episode, Dr. Sarah McKay dives into debunking common brain myths and explores what’s really holding you back from change. She also discusses willpower and how it isn’t the magic bullet for behavior change. This conversation is all about separating fact from fiction when it comes to understanding your brain and how it works.
Key Takeaways:
- [00:06:40] Neuromyths and neuroscience understanding.
- [00:09:31] Lizard brain myth debunked.
- [00:12:37] Constructed emotions vs. hardwired reactions.
- [00:16:24] Language and emotional understanding.
- [00:18:55] Change and brain plasticity.
- [00:24:41] Willpower and self-control dynamics.
- [00:30:36] Addiction vs. Habit Distinction
- [00:33:21] Aging versus dementia distinction.
- [00:38:24] Cognitive testing for memory concerns.
- [00:40:43] Alzheimer’s disease research trends.
- [00:44:47] Hearing loss as a risk factor.
- [00:49:24] Sleep’s impact on brain health.
- [00:51:20] Social connections and mental health.
Dr. Sarah McKay is a neuroscientist and science communicator, adept at making brain
science accessible for enhancing health, wellbeing and performance. She is the author of three books on brain health. The Women’s Brain Book: The Neuroscience of Health, Hormones, and Happiness, Baby Brain: The Surprising Neuroscience of How Pregnancy and Motherhood Sculpt Our Brains and Change Our Minds (for the Better), and Brain Health for Dummies
If you enjoyed this episode with Sarah McKay, check out these other episodes:
Understanding How the Brain Works with Lisa Feldman Barrett
Eating for Brain Health with Lisa Mosconi
How to Harness Brain Energy for Mental Health with Dr. Chris Palmer
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Episode Transcript:
Eric Zimmer 01:10
What if I told you that some of the most popular beliefs about your brain, like the idea that you only use 10% of it, are completely false, and worse, these myths might actually be holding you back from real change. Today, I sit down with neuroscientist Dr Sarah McKay to debunk the biggest neuro myths you probably still believe. We’ll also explore why willpower isn’t the magic bullet for behavior change, and what actually is and Sarah shares a deeply personal shift. She’s making it 50 that might just change how you think about your own life’s pace. If you’re ready to separate fact from fiction when it comes to your brain, and maybe even rethink how you’re living, stick around. I’m Eric Zimmer, and this is the one you feed.
Hi Sarah. Welcome to the show. Thank you for inviting me. I am happy to have you on I first came across your work, I think because my partner, Ginny, subscribes to your email list. Oh, that’s cool. The thing that sort of hooked me and that I wanted to talk about was that you often talk about neuro myths. And so we’ll be getting into neuro myths. We’ll be getting into your latest book, which is called Brain Health for dummies and all of that in a moment. But first, we’ll start like we always do with the parable of the wolves. And in the parable, there’s a grandparent who’s talking with their grandchild, and they say, in life, there are two wolves inside of us that are always at battle. One is a good wolf, which represents things like kindness and bravery and love, and the other is a bad wolf, which represents things like greed and hatred and fear. And the grandchild stops think about it for a second. They look up at their grandparent and they say, Well, which one wins? And the grandparent says, the one you feed. So I’d like to start off by asking you what that parable means to you in your life and in the work that you do.
Sarah McKay 03:05
Yeah, it means quite a lot right now, I was thinking about this last night because I’m one of those sort of seasons of life. Let’s say my mother loves to talk about seasons of life where I think that kind of the balance and moments and places and people kind of working against each other. So I turned 50 at the very beginning of the year last year, it was a huge year. I wrote a couple of books. We had a lot going on. I had lots of great, exciting, fun things happen, but we also had quite a lot of stress in our family. And I decided that this year, turning 50, I was going to take, like, a gap year, I think growing up. So meant to call it a sabbatical, which is, I don’t want to be at my desk. I don’t want to be writing. I don’t want to be don’t spend too much time thinking. To be honest, I’m going to do podcasts and speaking, but I want to travel and I want to connect. I’m trying to sort of shift a balance. I think my oldest son, it’s his final year of high school, and he’ll probably go away to university next year. And I left academia many years ago when I had my boys, because I wanted to be at home with them. And I feel like it’s a really nice book end of his schooling to kind of be here. I mean, to be honest, he probably won’t notice whether I’m here or not, but he will notice the food and the baking, just to kind of shift my focus and just sort of slow down and live a bit of a slower linear like, I like to say, less of a 360 life. So I feel sometimes I can be in a tug of war between striving and achieving and trying to do all of the things and parent with trust, not anxiety, try and give up control and be a mentor. So I feel like I’ve purposefully decided this year, it’s not the word slow down, but perhaps anchor myself a little bit more. You know, people have a word of the year. Last year I had this word equanimity, and I think I’m going to. Reuse it again this year, because I think that’s about kind of being grounded and balanced. And when life is kind of rushing around, I’m going to try and be a little bit more like linear, choosing where to place my focus, yeah, in a calm away this year. I think I need that my body needs that. I want to give that to my family again. So that’s what that parable kind of it’s about not fighting between different ideas. It’s just about setting some aside and leaning into some others.
Eric Zimmer 05:27
Yeah, that idea of being away from your desk is one that sounds good. I’ve been working on my first book, and it’s due to the publisher in a month. So, Oh, congratulations. Thank you. Thank you. So I spend a lot of time at my desk. Normally, you spend obviously, sitting down alone. Even, even more, yeah, and just lately, the last few days, I’ve just had this feeling like I get off. I’m like, I just need to go for a walk, you know, with no music, no audio books, no podcasts. I hate to say it, listeners. I don’t advise that. I think you should always have the one you feed on
Sarah McKay 06:08
to walk without a podcast. If you have a busy brain, I find it stops me thinking. As I say, I don’t like this. 360 my brain will just be going off in a million angles. So it’s
Eric Zimmer 06:18
I agree, and generally I felt like no stimulation for just even 30 minutes where it’s like there’s not something coming at me. So let’s move into talking first about neuro myths. What does that mean to you? And what are some of the most prevalent neuro myths out there? That’s interesting
Sarah McKay 06:40
because I haven’t thought, to be perfectly honest about neuro myths in quite some time. I feel like when I started, I sort of started the current phase of my career, which was very much about my background as a PhD neuroscientist, a research when I left academia and I was at home with my boys for a few years, and then I set up a practice, sort of teaching, talking, writing about neuroscience was probably at a point in time when I don’t know whether people, whether it’s gone backwards, people were as scientific literate as they are now, but then sometimes I wonder if that’s like, I say, changed again. Neuroscience wasn’t as popularized then as it is now, and I don’t think people had as clear understanding. And so there were lots of ideas people had about the brain that were reasonably whether they were widely shared or whether I just tuned into them, that as a neuroscientist, I’d never heard of, because when you’re in the neuroscience research world academia, you’re doing your thing, and you’re surrounded by other like minded people. And so then when I first stepped out, there were people saying things about the brain that I didn’t necessarily think were correct or I’d never heard of before. So I thought, I’m going to bust those myths. Let me show them and tell them. And so I started talking about some of these ideas, and honestly, it feels a little bit old fashioned for me now to talk about what some of them are, maybe these ideas around we have a right creative brain and a left analytical brain, and you’re either right brained or you’re left brained, or learning styles, either a kinesthetic or an auditory or a visual learner, we only use 10% of our brain. I think these are some of the more popular ideas that are out there about the brain, and initially I used to be I’m going to bust the myths, and I’m going to tell them. And I have learned a lot in the last sort of 17 years, I suppose, of doing what I do, that busting a myth isn’t a way of connecting with other people and educating them about neuroscience. No one wants to be told now what you think is wrong. In fact, that’ll make them dig their heels in, and that’s why I say when you say, what do neuro myths mean to me, this is what it means to me now. That’s not how I now approach their work that I do. It’s around taking ideas that are correct and are accurate and are based in the research, or at least our current understanding of where ideas about neuroscience are, and then sharing them in a way that will resonate with someone, that will land with someone. And then if they come to me and ask, Oh, what about this? Or what about that, then I might say, hey, let’s, let’s kind of take a look at what our latest understanding is. And often it will be kind of different. I suppose some ideas that have persisted over the years, and maybe not so much neuro myths, but might be just inaccurate ways of phrasing discussions about the brain. And perhaps the one that I still tend to rant on a little bit about would be the reptilian brain, or the lizard brain, and this, this gets thrown about as this kind of phrase, that we’ve all got this kind of lizard brain inside of us, kind of waiting to be scared, to freeze or to flee or to fight, where lizards don’t typically fight, and that kind of controls everything that could potentially go wrong. It controls our behavior. Here, and we don’t have a lizard brain, because we’re not lizards. We’re humans. Our brains are far more complex. We’re not born with this kind of fear hub inside us waiting for something to go wrong. So that is perhaps not a myth that I tell people is wrong, but I try and present different ideas instead, which I think are more contemporary ways of explaining how the brain works that I think are more useful and give people a bit more agency and a bit more to kind of move on with in a useful way,
Eric Zimmer 10:26
with the lizard brain. I mean, obviously I think that you’re right. We’re not lizards. Secondly, I think one of the things that you talk about in your book, and I think if you dig into neuroscience a little bit, you start to realize is that there’s a lot of connectivity among parts of the brain. So to think that one part of your brain is doing all of something is misleading. But is it safe to say that we have a part of our brain that is more I don’t even know if this would be safe to say limbically based, a part of our brain that is more reactionary, that is from older brain structures in creatures that we’ve evolved from and we’ve built on top of that, or is even that a misunderstanding? The brain
Sarah McKay 11:10
is complicated. It does a whole lot of things. This idea that we evolved from lizards, first of all, is inaccurate, because an evolutionary biologists will be able to tell you, we, you know, mammals didn’t evolve from lizards. If you kind of look at a kind of a an evolutionary tree, they branched off. We branched off. We kind of evolved along one kind of path, and they they evolved on the other. So this idea that we’ve retained some lizard part in us is inaccurate. On top of that, if we look at how the brain develops, this idea that there’s this kind of like layer by layer, kind of development of the brain, whereby these primitive, lizardy parts develop first and then the other parts grow on top, or develop on top. Again, that’s not necessarily how our brains develop, either. So the idea that they evolve and then develop in the same way has been set aside. The idea was really popularized many, many years ago, kind of back in the 1960s we’ve learned, let’s just say we’ve learned. We’ve learned a lot in the last five years, let alone a lot, from the 1960s when it was originally proposed this idea of this kind of lizard brain, or the limbic brain. It was proposed by this chap, Paul McLean, and when he was first describing the different parts of the brain, he didn’t even label the limbic brain, the so called limbic regions of the brain, as the lizard brain. He in fact, labeled them as the mammalian brain. The lizard part, or the reptilian part of the brain, was even kind of more sitting below. There was more parts of the brain that are involved with things like kind of respiration and heart rate and sleep and awake, etc. So if his description is accurate, people aren’t using his description accurately today. Yeah. And I think what’s kind of funny, what I always encourage people to do is do a Google Image Search for lizard brain, or reptilian brain, and look to see the diagrams that people have drawn of this. And you could get an array of 20 of them. And I guarantee every single one of them will label a different part of the brain as lizard or reptilian. And the reason they can’t label it is because it doesn’t exist. It’s not kind of a thing. What we understand now, the current contemporary neuroscience perspective, and this may change, is that we don’t have these kind of hardwired neurobiological basic emotions that are widened from birth, whereby every human on the planet is going to respond in an identical way, in the same way that every lizard on the planet does, like Elizabeth Morocco in New York and in my backyard here in Sydney, are all going to behave the same way where humans don’t. Instead, we talk about this idea of constructed emotions, and some of this has been popularized by various neuroscientists, whereby like everything else in our brain, like a thought or a memory or an expectation or a belief and emotion is also constructed from kind of multiple inputs, or we could think about them as like ingredients. So some of these would be from our bottom up, kind of physiological body, the sensations we feel in our body. Some of us are more consciously aware of what happens in our body than others, the situation we’re in, the context we’re in, the people we’re with. I mean, and there’s a whole lot of data coming in these days from like your mobile phone, so war happening on the other side of the world is now happening 30 centimeters away from your face. And that gets combined with our memories and our personal experiences, the language we’ve learned to describe these kind of feelings, and so there’s this kind of conglomeration of or this kind of a mix or construction of all of these different components that create this kind of feeling that we would have, that we would give a particular word to. And we know that this is the case because people can. To learn to experience new emotions as they have different experiences as they’re going through life, we gain a much broader kind of emotional vocabulary, so to speak, as we get older, we see this from small children to teenagers to adults, in terms of the nuance and the kind of shades of gray that we learn to understand and feel and experience. And we also know from say therapy or cognitive behavioral therapy or other types of sort of learning or training that we can learn to respond in different ways to situations by understanding all of these different inputs. If we had a lizard brain that controlled our emotions, where would be like the lizard in Morocco, New York or Sydney, there would be no variation, and that’s not the case in a human Do
Eric Zimmer 15:45
you think the lizards are insulted by us constantly talking about them in this way?
Sarah McKay 15:50
I don’t really think that lizards, you know, have that many deeper thoughts. I do. I do spend a lot of time. I’ve got a little lizards. Let’s say I’m very familiar with lizards. Have a little lizards. Sort of happening in my house. There’s lizards inside the house. Australia is a wild place to live. There’s a lot of wildlife in and out. My dog just thinks that they’re all meant to live in here with him. Is it learned that they don’t belong? What I really try to teach and encourage people to do is to think about the words and the phrases they use to describe neuroscience and, or the brain and or their behavior, because it can be very limiting if we use certain phrases, it almost dials us in to think that that is the only option. So I don’t even like using the word stress, and that’s kind of, I suppose, related to these ideas of lizard brains where we say the word stress, it’s a useless word the English language, because it could mean the thing that’s happened out there now, whether it be a natural disaster or something that you’ve seen on your phone, or it could be something that you’ve imagined. It could be a threat, it could be a challenge. It could be an opportunity. One event could be all those three different things, depending on who you are, we’ve got various sort of physiological response systems which have deployed over different sort of time scales in response to those threats, challenges and opportunities. We’ve got sort of our stress response systems, but they’re not only responding when something is scary or a threat, they’re also responding. You know, your heart rate rises as as you stand up, so you don’t faint. That’s controlled by your sympathetic nervous system. Some people like to call that your fight and flight system. Your heart rate isn’t rising as you stand up because you were once chased by a saber toothed Tiger. It’s just how your body is responding and engaging, right? And then we’ve got the feeling that we use, so we’ve got the threat, challenge or opportunity, the response systems. And then we’ve got this word that we would use to describe, you know, our physiological response in the context. And again, we like to use the word stress. So what I try and do with all of the neuroscience education I do is to give people a very clear biological understanding of what is happening, and then some more sophisticated language to describe that, and that blows open opportunities for them to act in different ways instead of focusing in or we’ve got a lizard brain in this fight or flight,
Eric Zimmer 18:17
yep. So let’s change directions just a little bit, because I’d like to get a neuroscience perspective on a couple of different things. So one of the things that this show is about, and one of the things that I help people do in various different ways, is to make changes in their lives of different types. But change is difficult. This may be me using a broad term like change, which is like using a broad term like stress that doesn’t isn’t helpful enough, but from a neurological perspective, is there a reason that change is so difficult for us?
Sarah McKay 18:55
Yeah. I mean, as a neuroscientist, bat that back and ask you to define change in a little bit more of a clear way. So if I was to reframe that question and think about change would be, you’re in place a, and you want to get to place B. Now that might be, you’re wanting to learn something new. So maybe you’re, you know, you’re 15 years old, and you’re the real example. You’re in high school, and you’re studying Shakespeare, and you’ve got to learn some quotes, but you know an essay that you’ve got to write in class coming up, that’s change. That’s you’ve got to read Shakespeare, which you find a struggle and really difficult. And then you’ll get to the point where you’ve learned those and you can understand and write about that. So that’s change. Learning something new is change having, perhaps a mood that you know you’ve got low mood, and you’ve been struggling with that for some time, and you want to have more upbeat mood. So perhaps you’ve been diagnosed with depression or anxiety, perhaps you’ve just got the blues, yeah, and you want to not be like that anymore. That’s that’s also changed. So we’ve got different. Types of scenarios, or perhaps you’re trying to learn a new skill. Like, you know, I’m in a musical theater group. I’m very untalented at singing and dancing, but I do like knocking about in the back row with the other mums and the ensemble. We’ve got to learn a new dance for the show coming up, and it’s like we first get taught it. And again, that’s change. I have to change something to be able to get from point A to point B, and if you are, you know, five years old or 10 years old, and it’s a context relevant type of learning that you’re doing or change that you’re trying to make it is a whole lot easier than it is when you’re 50 years old. Anything is easier to learn when you’re young versus old. And one of the principles around that is based on the degree of plasticity in which your brain kind of has, or the degree to which it changes by experience. And we know that there are certain times through life, particularly during infancy, childhood, adolescence, and then, interestingly, some context relevant plasticity takes place in pregnancy for women, where the brain is incredibly kind of receptive and can be shaped very, very easily by the experiences it has. And in fact, it often fundamentally requires those experiences to guide its development appropriately. And we might call these sensitive periods of development. And by and large, these kind of phases of life open, and then they close because you want to grow up and learn and adapt to the environment in the context in which you’re in and be changed and molded and shaped for it, and then an adulthood function within that. And so what we see is that the capacity for plasticity dialing down some types of different brain networks that are responsible for different types of behaviors we might perform will retain plasticity longer than others. So your hearing centers in your brain are very, very plastic when you’re very, very young in infancy, and then they kind of close down. So it’s much harder to learn languages later in life than it is earlier in life. And if you’re born profoundly deaf and you never hear spoken language, it’s going to be very, very hard for those brain centers to ever hear spoken language later in life, if there’s not an intervention straight away. However, we can still learn to solve a maths problem. We can still learn to play a new musical instrument. You can still learn new dance moves in your 50s. You know, 40s, 50s, 60s and 70s. It’s just whole lot harder than it was then. So again, it’s going to very much depend on what is this change that you are wanting to make, and what is the process by which you’re going to go through that change, if it’s learning a new motor skill, if it’s changing a thought process. Often, those are kind of two different things, because learning something new is often easier than trying to unlearn something old. Because typically say you have this thought that you’re always having, perhaps you’re berating yourself for being a useless mother. I used to do that. Now I think I’m a brilliant mother, but back in the day, when my boys were young, I used to think I was terrible. I was completely fine. I was just going through early toddlerhood years. It was very hard to unlearn that to stop that thought process. In fact, I had to figure out what triggered that thought process, and this is what we would do if we were talking about habit change. What is triggering or causing that particular thought, and what can I think or do instead, when I encounter that trigger, instead of trying to unwind a thought, I had to learn a new thought in its place. Yeah, so it’s very important, when we’re talking about change, to say, Am I just trying to learn something new? Do I need the skill development that someone could teach me. Am I having to learn something new? I really don’t want to like learning Shakespeare quotes. And so the problem isn’t the teaching and the skill development. The problem is like the kind of the motivation and the grit and the kind of emotional regulation required to perform the task even, and the absence of wanting to or is there some particular habit or learned skill that you don’t want to do anymore, so you need to kind of unpack the trigger for that and learn a new process in its place. And those are three different kind of brain networks and processes that would be involved for change
Eric Zimmer 24:41
in psychology studies, there is discussions about the idea of willpower or self control and in general, the behavior change lens on this is that you want to rely on these things as little as possible, right? You want to set up your environment. You want to. Get all the support that you can get, et cetera, et cetera. But neurologically, do we know where this idea of willpower or self control comes from, which I guess I’m just gonna define it as I’m in a moment where I need to make a choice, and I’ve got the two wolves going, right? And one wolf is the one that I’ve decided I want to follow, and the other is the other Wolf. Do we know what’s happening neurologically when somebody is sort of in a moment of wrestling with these questions and then making the right choice? Is it solely an executive function? Do we know
Sarah McKay 25:38
it probably depends how sophisticated your self awareness and executive functions are, and whether you’re able to kind of stand back and look at those choices from a distance and then consciously choose which one or the other to choose, or whether you know perhaps you’re very emotionally dysregulated and you know you’ll be driven to the right or the wrong decision, you’re listening to your emotions instead of being able to thoughtfully engage in that task. What I always try to explain to people is pretty much that one of the main things that the brain does is it draws from our past experiences and predicts what we should do next. So whether that be, you know, the construction of emotion, last time I was in this situation and my body was feeling this way, surrounded by these people, then this is what I felt. So I’ll feel that again. Or the last time I was in this situation, I made choice A, and that felt really good, so I’m going to do choice A again. Or last time I was in this situation, I chose B, and it did not work. I was very disappointed, or it was really scary or I really didn’t enjoy it, so I’m going to do a instead of B. So all your brain is doing is kind of gathering a lot of information as it goes along through life, and stores that information so that when you’re in that situation next, you can make that decision about what to do. And a lot of the time we will be making decisions based on did that feel really good last time, or did that not feel so great last time? And part of that learning process, the signaling process, for that, one component of that there’s a whole lot going on, is what we would call, like, kind of our dopamine system. People think that dopamine is released just when something feels great, but actually it’s a learning cue. It’s been constantly kind of dribbled out this kind of, like really sort of slow rate. And the reason the brain often sort of has these kind of baseline rates. It’s not going from zero to on it’s got a baseline rate that means it can dial up the release and it can dial down the release. So you’ve got far more kind of, you know, scope there for dopamine to act as a teaching signal. So if something was really horrible. Last time you did it, dopamine dropped off. If it was really good last time, dopamine went up. And that’s a teaching signal that didn’t work, that did work. And so the next time you encounter that in advance of you making the decision to act, you’ll be going, Oh, that felt really great, or that didn’t feel really great, and that’ll be part of the desire to do it again, or the kind of, oh gosh, the feeling of not wanting to do it again. Often the problem lies therein when last time you think you didn’t really enjoy it, but it’s kind of the smart choice, and then you’re trying to override that feeling of aversion or disappointment, or, you know, just, I don’t want to do that, but that’s the thing that you’ve got to do, and that’s really tough, yeah, and that’s all around dopamine acting as a teaching signal so our brain can predict what to do next.
Eric Zimmer 28:32
Well, you’ve got the other example also, which I think addiction is the extreme version of 100% you know, I’ve heard addiction framed as a learning disorder. I’m a recovering person. When I heard that, it made a certain sense to me, because in the beginning it was all good. It’s obvious to me why I did it and why I kept doing it, because it felt freaking great, and I loved it, and it made my life. That’s kind
Sarah McKay 28:55
of the unspoken, yeah. Thing about especially, they say drugs of addiction or it feels really good, that’s why you keep doing it.
Eric Zimmer 29:03
But over time, the adverse effects start to really add up, and it almost seems as if the brain is not getting the new learning information on a deep enough level, right? It almost just seems like that reward learning loop somehow has just been broken, yeah, but I think we can say this even on a much lesser level. Let’s say people who have a mild issue with eating more than they want to in the evening and when they do it now, what they end up with is shame and remorse, which seems that if reward learning was driving the whole show, your brain would be like, Oh, the last three times I did that, maybe it felt good for a minute, but I just then felt terrible for an hour. And yet, yeah, we continue, particularly
Sarah McKay 29:53
when we’re talking about drugs of addiction, but they have a psychoactive component, part of the. Problem there is they’re acting on the exact same neural pathways and synapses as that reward learning process. So that kind of makes it twice as hard because they’ve interfered with that process others. You know, it’s more like the act of doing them, the psychological processes acted on those pathways. So I don’t know enough about addiction and neuroscience to know how much we can sort of differentiate and tweak between those two, but I suppose one of the definitions, and there’s many definitions of addiction, is that you are compelled to keep on doing this behavior or activity despite the negative consequences, even if you’re not getting the high or the pleasure from it anymore. And that’s the difference between what we would call a habit or an automated behavior and an addiction. Because a habit, you can always intervene, you can consciously intervene. Whereas an addiction, you’re often compelled. Even if you don’t want to do it, you still appear to be compelled to do it despite the negative consequences. And that makes that very, very hard. And I mean, that’s why we have these, you know, support programs of people with problems, because, again, these circumstances change is so incredibly difficult,
Eric Zimmer 31:11
yep, and so a habit has aspects of that nature to it, though, right? I’m basically probing it an unanswered and probably unanswerable question, right, which is, where does something verge from being a bad habit into an addiction? And I don’t think we have to answer that, but there is something happening even with a bad habit. You sort of feel it right? You might technically yes, you can intervene, but I like to think of as like the habit energy, which is just the pushing forward. Yeah. It feels so strong,
Sarah McKay 31:46
yeah. And often, I mean, if it was a, as I like to call them, a true habit from a neuroscience perspective, which was very, very similar to an automated behavior. Riding a bike, for example, as some motor process that is learned, you have to be very conscious and aware about it, engage a lot of cortical networks to learn that process, and then eventually your brain goes right? I know how to do that. I’m going to store that down in the striatum, where I will just roll that motor program out when someone gets on a bike you don’t, you know, roll the motor program out when you’re not on a bike. So there’s a specific trigger or contextual situation in which that behavior is performed, and it doesn’t require, typically, motivation. You know, you don’t really need to think about how to do it. It’s a little bit like the analogy of brushing your teeth. I like to say, well, it’s a light brushing your teeth, but actually, it’s not just going and brushing your teeth. It’s that the way that you move your hand around your mouth, move the brush around your mouth. You probably do that the same every time, but you never really think about that. So again, that’s a stored behavior. But you can get on a bike and go, Well, I’m just going to not pedal. I’m going to stand here and not do that. So you can intervene consciously. Got it? Yeah, the addiction would be not being able to stop yourself from doing that despite not wanting to so that’s how we would differentiate a habit from an addiction. Addictions that compulsion despite the negative consequence.
Eric Zimmer 33:09
Let’s talk a little bit about some of the things in your brain health for dummies book, and the things that you talk about in that book are cognitive diseases, Alzheimer’s, dementia being some of the most common ones. I think there’s a section that’s called knowing what’s normal aging versus dementia. So talk to me about this, because those of us like you and me who’ve hit 50, right? We have to start to wonder about this stuff a little bit like, Okay, what’s normal here, and what’s this? What’s early mild cognitive impairment, and my dad died of Alzheimer’s. Jenny’s mom died of Alzheimer’s. So we’re on the lookout to a certain degree. So how do we know what is normal aging and what is a problem? Yeah, we
Sarah McKay 34:02
do get to a certain point in life when you have those sort of, like, tip of the tongue moments, or you used to be really, really quick and sharp. And I’m like, that, I used to be like, really, really quick and sharp, and now I’ve got like, quick, sharp teenage sons. And it drives me crazy, because I think I’m kind of a bit Dopey and slight. And I’m like, Excuse me, I’m very well qualified. I may be your mother, but that doesn’t mean I’m not capable. So we do get to these points in life when, when these things happen, or they can happen throughout life, it just may depend what we want to attribute them to. And to use the example of teenage boys who are very sharp and quick they I reckon at least two or three days a week. Now, still, they’ll come to me because they can’t find their school tie, or they can’t find their shoes, or one of them left their PE bag at school. Now, if I was doing that much forgetting of my personal belongings, I would be probably at the GP asking. For some kind of cognitive test, but we’re not assuming that there’s anything wrong with them. What’s probably going on there is attention. And when we think about memory, and we think about what we remember, a big part of the information that we take in and what we filter out is around attention, and that’s one of our most kind of precious resources, or we can kind of learn how to control that we’re kind of halfway there. So sometimes, when we are forgetting things, that we’re leaving things in places, it’s really just coming down to, what are we choosing to pay attention to, and what are we not we know through pregnancy and early motherhood, lots of women, many, many women, four out of five women will say, Oh, I’m really I forgetful. I can’t remember everything, like my brain’s not working the way it used to. And part of that is around attention, and just still trying to do it all, as well as trying to look after a whole new human so again, a lot of that is around attention, but other times in life, it may not be, you know, just that there’s a lot going on and we’re trying to remember things. You may genuinely feel that there is some kind of cognitive impairment with your brain, or you might just be noticing that things are sort of starting to slow down or change. And as we go through life, we know that one thing that does change is kind of the processing speed at which we’re kind of able to sort of sort through all of the information that we have with our brain and retrieve it. You know, part of that is not that the information is not there and it’s inaccessible. We might just be a bit slower at retrieving it. However, at the same time, we’ve learned, we’ve gained a whole lot of experience and a whole lot of wisdom. So, you know, we’ve also got this kind of treasure trove of content and information and learning that the young, Swift thinkers don’t necessarily have at hand. Forgetting where you’ve left things is probably an attention issue, and it’s pretty common and normal. Forgetting how to drive a car or getting lost when you’re driving that’s when we need to sort of start checking things out. So then you would head off to your general practitioner or your family doctor, or wherever you are in the world. I tried to write this book so everyone in the world could read it, because there’s different healthcare systems in different places, so people are going to have access to different resources. But essentially, then you would go and you might say to you, I would go down to my local GP, and I’d say, ruzica, I’m forgetting things. And then she would just look at me, because she’s this very tall Eastern European lady, and she’d be like, tell me a little bit more. I mean, she would be slightly skeptical knowing me. But then there’s various types of cognitive testing that can be done that would act as a good screening tool to help her decide we need to send Sarah off to say, a memory clinic to get this looked at in much more detail. Or we can reassure Sarah that this is completely normal, and there’s standard tests that are used in a lot of places in the world where, say, a perfect score might be 30 and test all different aspects of your memory and your reasoning and your being able to name objects and remember numbers, there’s a lot of kind of quick type executive skills that are tested in these and say, a perfect score is 30, if you got below sort of 2425 then that might be kind of cause for concern. And perhaps we’ll go away and do a bit more of an investigation to see are these cognitive symptoms the sign of something to be concerned about, something neurological. If you get above that, it might just be you need to kind of look at, you know, what’s your sleep like? What’s your mood like? Are you doing enough exercise, all the kind of typical health and well being things just to kind of get you back on track? Because it might not be neurological, it might be just lack of well being.
Eric Zimmer 38:38
So if you draw a clock and it looks like a Salvador Dali picture. That’s a good sign that maybe things are going wrong. Yeah.
Sarah McKay 38:44
So there’s lots of different kinds of tests in there, like here, copy this, or remember this, you know, we’ll name 10 animals, you know, be able to kind of perform those and and I guarantee that a teenager will be able to do that quite quickly. Someone in their 50s will be doing that slower. You probably get there. But you might not be quick, quick, quick, quick. But then, as I talk about in the book, there are lots of different types of mental abilities. And if I was going to go and have brain surgery because, you know, say, I had a benign tumor that I needed removed, for example, I would much rather have a 55 year old skilled surgeon who maybe sometimes was a bit slow at remembering names, versus the 22 year old trainee who’s super, super, super quick. Because obviously there’s a skill set involved there. So there’s, there’s a whole lot of different ways to think about mental capacity as we age. And there’s this lovely idea whereby, you know, perhaps we do need to be kind of quick and fast, and we’re building, and we’re kind of creating, and we’re kind of as we’re younger, we’re needing all of the quick fire, and then as those skills kind of lessen as we get older, that’s okay, because we need to be kind of still, and we need to be slow, and we need to be. They’d gather the information and mull over it and impart wisdom. So maybe becoming like, if you’re a female, a matriarch, isn’t about having that quick fire memory and remembering every single little item. It’s about the kind of the slower imparting of wisdom in a more thoughtful way
Eric Zimmer 40:22
you Is there much happening in the neuroscience world that you’re aware of that seems exciting on this dementia front, there’s
Sarah McKay 40:43
things that are happening and then the things that I’m excited about. So I think that people are desperate to try and find, like, a cure. If you’ve been diagnosed with Alzheimer’s disease or frontier temporal dementia, or one of the dementia is like, what kind of medicine can we give that person and make them better straight away. And there’s lots of different people working on that problem, and it’s incredibly complex. Because, you know, I think it’s pretty safe to say that Alzheimer’s disease is a disease of unhealthy brain degeneration, typically seen as you’re older, but it’s kind of an accumulation of years, if not decades, of, you know, unhealthy brain aging, and so it’s not like if you’ve broken a leg, where you can kind of fix it. So it’s a very complicated problem in there. What I’m more interested in, which I think is more kind of population data science, I think, is taking a look like a really big like, kind of zooming out from the whole globe, looking at rates of dementia around the world, and looking at different kind of cohorts of ages of people going through because we’ve got a lot of throwaway statistics about dementia, like, two out of three cases of dementia are women. Why is it women? Is it something to do with female biology? Let’s look at menopause, and that must be the answer give women. HRT, we’ve solved Alzheimer’s disease. No one’s kind of going back to that original statistic and trying to interpret and understand that. And it’s interesting if you look at the difference between prevalence, which is the number of people with a diagnosed disorder at any kind of moment in time versus incidence, which is kind of always the rate in which you’re adding new cases in. We’ve also got, it’s like a pool of water. You’ve got incidence as the inflow, but you’ve also got people dying as they’re flowing out the bottom. And if we look at healthy, wealthy countries around the world, sometimes the US is included in that. Sometimes it’s not Australia, and you know, say the Nordic countries and some European countries, let’s just say to be more safe, we’re actually seeing the incidence of Alzheimer’s disease and other dementias declining slightly. We’re seeing more prevalence, because this is less outflow, because people are living longer, but actually the inflows slowing a bit. So we’re starting to see that incidence coming down, and that gives us some clues to the cause. And we know partly the incidence is coming down because we’re getting much better at treating some of the diseases that predispose people to Alzheimer’s, like heart disease and metabolic disorders, diabetes, etc. So that’s slowing the incidence down in the healthy, wealthy countries, but we’re not seeing that in parts of the world that are less wealthy and more unhealthy, where there’s much lower socio economic support, where people are poorer but want a better language. So that’s interesting, because I think if we take that perspective, it gives us clues into where we could be intervening as well. Yeah, the two out of three cases of dementia. We need to have a look at Alzheimer’s disease, and again, prevalence versus incidence. And what we see in terms of Alzheimer’s disease, that males and females. When we’re looking at women in their sort of 60s, 70s and 80s, we’re looking at people in their 60s, 70s and 80s. There’s more females in there because they’re living longer. But are the incidence rates, the kind of the rates of inflow the same? It would be very easy to think, oh, it’s the rate of inflow of females is much greater. But actually, you don’t see a greater rate of inflow until you’re looking at people in their 90s. The men just kind of die off soon as they’re coming out of the pool. So the overall prevalence is higher. And so we’ve got to start to be a little bit more sophisticated with thinking about the stats, instead of assuming the statistic that you heard is correct and then trying to look at the causes. From there, I’m interested in taking this bigger picture perspective, because we must do that, or else we will jump to trying to solve a problem that may not necessarily be the right problem to solve midlife the greatest risk factor, which no one talks about because it’s very unsexy and it doesn’t make for good social media content is hearing loss. So untreated hearing loss, and then later in life, untreated vision loss, and no one wants to talk about them because they’re very, very boring and very unsexy. But what does that mean if. You can’t hear and you can’t see, your brain is not like interacting with the world. It’s not receiving input from the world. It’s almost shutting off one of the signals coming up from your body. It’s completely shutting off those senses to the world. And that’s how we kind of take in and make meaning of the world and navigate our way around and use our brain for what it evolved to do. So there’s lots of kind of points in which we can intervene. And I think unless we take this big picture perspective, that’s what I’m interested in, we’re going to be intervening in the wrong places. That
Eric Zimmer 45:31
makes a lot of sense. I mean, honestly, a lot of the things that you do to be more preventative of Alzheimer’s all fall into the not very sexy category. I mean, it’s the basic stuff, like eat, better exercise, get better sleep, yeah,
Sarah McKay 45:49
all of those things, yeah. And most health and well being advice is boring. It’s, you know, I like to call them the tech bros. I call them ice bath boys. They like to dial it on that top 1% and like tweak that is because they think that’s going to matter, but the vast majority of the population isn’t doing the 99% so the top 1% isn’t going to make any difference. They just popularize it. Yes, you know, we need to get all all of those basics right, and some of those basics are beyond the control of an individual, air pollution, education in childhood, you know, a lot of those. Or head injury. I mean, you can, like, try and prevent getting a concussion, but, like, you might just get knocked over by your dog and hit your head, you know, you know, we’ve got lots of contributing factors, either that are risk factors, individual risk factors, but the individual can’t necessarily do things about and then that overall metabolic health, heart health, metabolic health that we talk about, which is the diet and the exercise and keeping, you know, your blood pressure under control and your cholesterol down, and all of the boring things most people aren’t doing, and a lot of people just don’t have the education or the capacity or the kind of resources to be able to manage that Well, and particularly in parts of the world, you know, the low and middle income countries, is even harder to do that, and that’s where we’re seeing the cases of dementia rising. Yeah. I
Eric Zimmer 47:09
mean, I do think you make a really good point in the book, and you just made it there, which is that there’s a bunch of risk factors. There are some that are modifiable. And then even within the modifiable ones, right? There are some that are going to be easier given your geographic, socio economic type status,
Sarah McKay 47:32
yeah, health is this enormous kind of social factor embedded in it that people don’t realize. I live in the northern beaches of Sydney, one of the healthiest, wealthiest kind of you know, places to live in, Australia, if not the planet. And it’s very easy to be healthy when you are resourced and when everyone around you is fit and healthy. If I lived in a completely different part of the world, I’d be surrounded by a completely different social and resource environment, which would make it that much harder, and it perhaps wouldn’t occur to me, because everyone I know wouldn’t be behaving in a certain way. So I think we need to be very, very careful, and I know that there’s a bit of a shift without like trying to police language. It’s not about that, but if we’re talking about lifestyle choices, there’s a bit of shame in there, and it’s not always taking into account why people make a lifestyle choice, it may not just because they lack will power. It’s usually very, very complicated,
Eric Zimmer 48:27
yep, yep, which is why changing behavior can be so very challenging, because there are so many different factors. What are a couple of other things besides the things we just talked about around diet, exercise, sleep, that are risk factors that are modifiable. Let me even broaden it out a little bit, because I think that what we’re talking about is a healthy brain here at any age, right? And so we may choose to engage with these things more, because we’re like, oh, I don’t want to get Alzheimer’s. We may just choose to engage with them because we just want to have a healthier brain overall. What are a couple other strategies people could kind of walk out of here that they should be thinking about if they want a healthier brain? Yeah,
Sarah McKay 49:13
I think if I had to kind of choose a couple, and I would like to try and choose those which are most important, one would be sleep. Lots of people have problems with getting a good night’s sleep, and there’s lots of resources out there now to teach us about sleep hygiene and how to kind of manage sleep. And again, that’s kind of a bit boring, but it’s super important, because that’s sort of the foundation on which everything else can be built. If you miss one night’s sleep, you feel not great, weeks, months. And it increases, you know, mortality, yeah, and it increases poor brain health, and then lots of those kind of first signs and symptoms people might start to query about, is my brain working? May be around an adequate sleep, or you’re sleeping, but it’s not good, deep, healthy sleep. So if you can, you know, do all of the things. And to get your sleep sorted, that would be great. But again, don’t need to belabor that point. Yeah, the thing that I think perhaps always, always shows up in all of the research search I do and the teaching I do, is around it’s another s, it’s that social, you know, the sort of the social relationships and people that we have around us, and they can be the source of the greatest kind of, you know, neurological architecture and support that we need for a healthy brain, but they can also perhaps be one of the greatest sources of stress and stress, yeah, and I think if we look at the phases of life we go through when there’s probably these inflection points whereby our brains are most vulnerable, say, to develop mental health problems or later in life, neurological, you know, problems or diseases of unhealthy brain aging. So we look at puberty and adolescence, young people a bit more vulnerable to mental health disorders. But a large component of that is this, the social brain is going through this massive phase of reorganization from, you know, the focus towards family, towards friends, and the greatest vulnerabilities, there are kids who are lonely or socially isolated, or perhaps are being bullied or picked on. It’s the social component there that the greatest risk or the greatest kind of benefit, we see, that all throughout life, that the social architecture that we have around us is one of the strongest, and in some studies, it comes up almost top, is the strongest kind of protection for good health. The Biggest Brain reorganization that we’re seeing taking place is in the social networks of the brain. Because we’re, you know, we’re tribe animals, it’s fundamental to our health and well being to have good, strong, healthy social connections, you know, like, go out and make lots of friends. Sounds like a little bit of a trite piece of advice, but you might think about this, I actively chose to do this after I wrote my first book, because I spent, like, a year sitting down in my office alone with my dog, writing, and I got to the end of the year, and I had this book, but I felt terrible because I’ve been doing all of the opposite things that I should be doing to feel healthy. So I needed to get up, out in the world, move, connect, communicate, interact with other people, then you’re kind of using your brain for what it evolved to do. Didn’t evolve to sort of sit in a little room all alone, staring at a screen. Yeah, it evolved to be moving and navigating around the world with other people by your side.
Eric Zimmer 52:27
Excellent. Well, I think that is a great place for us to wrap up, Sarah, thank you so much for joining me on the show. It’s been a real pleasure to talk with you. You’re very welcome. Thank you so much for listening to the show. If you found this conversation helpful, inspiring or thought provoking, I’d love for you to share it with a friend. Sharing from one person to another is the lifeblood of what we do. We don’t have a big budget, and I’m certainly not a celebrity, but we have something even better, and that’s you just hit the share button on your podcast app or send a quick text with the episode link to someone who might enjoy it. Your support means the world, and together, we can spread wisdom one episode at a time. Thank you for being part of the one you feed community you.
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