I recently came across a book titled Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health--and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More. The author: Christopher M Palmer, MD. Published by BenBella Books, November 2022. It is fair to say that I am typically very skeptical of books written by psychiatrists. It is not that I do not like psychiatrists or psychiatry, it is really an issue of the complexity of the topic and the habit of most elite psychiatrists to repeat much if not all of the so-called “accepted wisdom” of the Western psychiatric community. I requested a review copy from BenBella Books. They kindly – and promptly – sent me a copy.

I was astounded, pretty much. Palmer is very honest and very committed to writing an up to date reference for the general public as well as for psychiatrists and mental health professionals. Mr Palmer is obviously a wonderful person, very caring, totally and unreservedly devoted to his work – but also exasperated by his colleagues who mostly carry on doing what they are doing without questioning the whole enterprise.

Palmer is stating his thesis about as loudly as possible: that mental disorder or mental illness is mostly or even entirely a result of metabolic phenomena in the brain. The brain is energy, and food is converted into energy which the brain then uses. It is a crude summary to say this but he wants everyone with mental disorder to go on a “ketogenic diet”: that means pretty much only fat and protein, and only a little carbohydrate. He presents a lot of compelling evidence that this is therapeutic. I do not doubt that it is.

So I am super impressed. There is nothing to complain about, it is dense, not too wordy, and packed with important and relevant facts and it is also a clarion call for revolution. We need to look at mental health as an issue of metabolism. The argument is sensible to me, for sure. Sometimes it is a little abstruse but this is the brain we are talking about. Complexity is so immense, there are some 100 billion neurons in the human brain and perhaps 50 times more glial cells. Palmer does a good job telling you what we know about the human brain – and frankly that is not much. I do not hesitate saying that all mental health professionals must get a copy and study it. Anyone afflicted by mental health issues – of any kind – really ought to get themselves a copy. It will take a while to absorb his argument, but you will eventually get it.

I agree with Palmer that we are going to see a revolution in psychiatry. It is inevitable. Psychiatry is not a science, it is mostly just opinion, and most of this opinion is not really backed up by any data. Palmer is obviously also dismissive about psychopharmaceutical intervention. There is little evidence it restores healthy brain function. It is appalling to admit this but we are going to have to admit it.

So we are at the crossroads. Mental health disturbance is a growing problem. Some 50% of Americans are going to have some mental health issues in their lifetimes.

Palmer's treatise, as excellent as it is, did not satisfy me and in fact it provoked me to write up this article and present my own thesis as to what “mental illness” really is. I am going to define it. The title of this article indicates just what I am going to argue. Mental illness is not an illness at all. Yes it is distressing and even dangerous but I am going to argue – like I did with epilepsy – that “mental illness” is really only the sleep function breaking into the awake brain or what I call the cognitive or analytical brain function. You are conscious and you are thinking. You are willfully working and thinking – cognition.

If the brain does not get enough sleep, it will shut down its normal cognitive function to get some degree of sleep function. This is mental disorder or mental disease. It is not disease, in fact. Children do not suffer from severe depression and they do not generally become schizophrenic. They do have autism – mostly boys. Again, brain dysfunction is a function of sleep deficits, sleep deprivation. This happens in a mature or almost mature brain. The sleep function in the juvenile developing brain is augmented by the play function. The play function shuts down naturally as the brain enters the maturation period.

My wife asks me, “Crazy is the equivalent in the adult to play in a child?” Yes, to some degree it is, I replied. That was an amazing question and it revealed that she understood what I was trying to say.

Children are generally not cognitive, though it is fair to say that cognition makes fleeting appearances, then disappears. You do not reason with a child – even a teenager. Play is all they are capable of doing. That may seem an extreme statement but I believe it is generally true. Play is pretty much dominant in the juvenile developing mammal brain, including the human brain.

Crazy and irrational adults do resemble children. Yes there is considerable resemblance. Yet I do concede that play is a type of learning, there is some truth to this statement. Play is however only there to augment the sleep function – in the developing mammal brain.

We can conclude with these statements: removing sleep deficits will largely remove mental illness or mental disorder, it will restore cognition and strengthen cognition; removing schooling from a child's activity will pretty much mean the total absence of mental “illness” in adults; crazy is not a disorder, it is akin to sleep, the sleep function is breaking into the cognitive and analytical brain and causing havoc. No one likes what they see, it is not attractive and it is oftentimes bizarre.

So there are 4 independent brain functions: 1) sleep [unconsciousness] 2) cognition/analysis [consciousness] 3) play [augmenting sleep in juvenile brain] 4) irrational/“crazy” to varying degrees [sleep function breaks into consciousness].

Is this a cool theory or what?

I will at last conclude with two amazing and indeed bewildering statements of fact:

1) there appears to be two forms of energy in the mammal brain – chemical energy and electrical energy. After studying Palmer's treatise you will come to realize that chemical energy is not nearly as important and significant in the human mammal brain as electrical energy. He discusses epilepsy but of course he describes epilepsy as a disorder or disease which I believe is incorrect. We intervene in the brain with psychopharmaceuticals hoping to “restore balance” but there is really little evidence that this is an effective treatment for brain dysfunction. Actually I am arguing it is not dysfunction, it is the brain effecting its own attempt to restore proper function.

2) which brings me to the most amazing and indeed bewildering statement of fact: when I argue that “it is the brain effecting its own attempt to restore proper function” I really do mean that. The brain initiates its own activity, it is in charge, it decides what to do, how to configure itself, how to achieve cognition. This is sleep, this is electrical activity, this is what the mammal brain is all about.