The Long Game 131: Mental Illness & Metabolic Disease, Marriage Is a Team Sport, “Better note-taking” Misses the Point

👫 Do Women Really Find 80% of Men Unattractive?, Rewire Yourself to Enjoy Hard Work, The Psychopharmacology Of The FTX Crash, Removing Plastics, and Much More!

Mehdi Yacoubi

Nov 21

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Hi there, it’s Mehdi Yacoubi, co-founder at Vital, and this is The Long Game Newsletter. To receive it in your inbox each week, subscribe here:

In this episode, we explore:

Mental illness & metabolic disease
Marriage is a team sport
Better note-taking misses the point
Rewire yourself to enjoy hard work

Let’s dive in!

🥑 Health

🧠 The Cellular Link Between Mental Illness and Metabolic Disease

I’ve seen a good number of people excited for the launch of Brain Energy, a book explaining the link between mental illness and metabolic disease:

Brain Energy explains this new understanding of mental illness in detail, from symptoms and risk factors to what is happening in brain cells. Palmer also sheds light on the new treatment pathways this theory opens up—which apply to all mental disorders, including anxiety, depression, ADHD, alcoholism, eating disorders, bipolar disorder, autism, and even schizophrenia. Brain Energy pairs cutting-edge science with practical advice and strategies to help people reclaim their mental health.

This is a good introductory article to understand the ideas of the book.

“This is not a book about weight loss or the ketogenic diet,” he says. Rather, it’s an exploration of the underlying cellular and metabolic mechanisms that could explain how the ketogenic diet was able to help a person like Tom find relief from his psychiatric symptoms. This exploration has helped Palmer develop what he calls a novel theory for mental illness
“The overall theme of the book is that mental disorders are metabolic disorders of the brain,” he says. “When you take an overarching view of metabolism and ask basic questions like what is a metabolic abnormality at a cellular level, you are led to mitochondria, and once you do a deep dive into the science of mitochondria, you can connect the dots to what causes mental illness.”

If you’ve been reading The Long Game for a little while, you’ll understand why I’m particularly excited to read this book (I’ve repeatedly written about the Mind-Body connection, mind-body syndromes, chronic back pain, etc… TL;DR, read Dr. Sarno.)

This is accepted science in the field of metabolic disease, but it has garnered less attention in the field of psychiatry despite a solid foundation of evidence. “We have literature dating back to the 1940s showing that metabolic and mitochondrial abnormalities are present in the brains and bodies of people with mental illness,” he says. “The studies have been done and the data is there. The mind and body are connected, and the metabolic theory of mental illness can explain this connection down to the cellular level.”
On the role of mitochondria in mental illness, Palmer says he supports a theory that others before him have proposed: that energy shortfalls caused by mitochondrial dysfunction can cause the brain to “fail” in predictable ways, and that psychiatric symptoms or disorders are the result of these failures.

Chris Palmer, MD @ChrisPalmerMD

#BrainEnergy challenges the status quo in #mentalhealth. I didn't write it to be disrespectful to clinicians or researchers. In general, they are kind and compassionate people. I wrote this on behalf of the millions of people who deserve better solutions and better lives.

🌱 Wellness

💒 Marriage Is a Team Sport

I loved this article by Arthur Brooks on marriage.

Few people, I imagine, enter into a romantic union seeing it explicitly as a competition. “I’m going to kick his butt” doesn’t make for a great wedding vow. However, this is effectively what happens when each partner prioritizes “I” over “we,” creating a clash between two identities, according to scholars writing in the journal Self and Identity. In contrast, couples who see themselves as part of a unique couple identity—where neither partner’s individual identity is dominant—tend to be better at coping with conflict. This makes sense: Good teams see internal strife as a problem to solve together, because if unresolved, it lowers the whole team’s morale and performance.

If your relationship is a little too competitive and not collaborative enough, there are a few practical steps to consider.

More we, less me.
Put your money on your team.
Treat your fights like exercise.

Pair with: This Is How Your Marriage Ends: A Hopeful Approach to Saving Relationships (must read!)

🧠 Better Thinking

📒 “Better note-taking” misses the point; what matters is “better thinking”

I had my #productivity™️ phase, but I’m happy it’s over!

Lots of people write about solutions to the problem that Note-writing practices are generally ineffective. The vast majority of that writing fixates on a myopic, “lifehacking”-type frame, focused on answering questions like: “how should I organize my notes?”, “what kind of journal should I use?”, “how can I make it easy to capture snippets of things I read?”, etc.
Answers to these questions are unsatisfying because the questions are focused on the wrong thing. The goal is not to take notes—the goal is to think effectively. Better questions are “what practices can help me reliably develop insights over time?”, “how can I shepherd my attention effectively?” etc. This is the frame in which Evergreen note-writing as fundamental unit of knowledge work makes sense: Evergreen note-writing helps insight accumulate.
In terms of technology, what matters is not “computer-support note-taking” but “computer supported thinking.”
It’s easy to focus on “note-taking” because it’s a visible component of an invisible practice: if you see someone insightful writing in their notebook, you might imagine that if you get the right notebook and organize it well, you’ll be insightful too. And of course, taking notes is tangible. It’s relatively easy, and it feels like doing something, even if it’s useless (Note-writing practices provide weak feedback). So it’s an attractive nuisance.
People who write extensively about note-writing rarely have a serious context of use.

⚡️ Startup Stuff

🧠 Rewire Yourself to Enjoy Hard Work

I found this tweet very well-written because it shares a common sentiment in the startup world in an original way: “rewire yourself to enjoy.”

We know it’s possible to rewire your brain, so why not apply this in this specific context?

I had a similar experience as the one Alexandr describes in French prep school, where working very hard and long hours for years taught me how to do it and learn to enjoy it. Since then, I’ve learned a few things, but the core idea stays the same.

Alexandr Wang @alexandr_wang

Life hack: rewire yourself to enjoy grinding. MIT did this for me & most classmates. The school embrace the grind because there is no other way. The harder you work early in your career, the faster you’ll compound. The payoff later in life can be astronomical (>10x).

📚 What I Read

🧹 Against the Odds: An Autobiography

An exceptional autobiography of James Dyson.

What I've learned from running is that the time to push hard is when you're hurting like crazy and you want to give up. Success is often just around the corner.

Pair with: #200 Against The Odds: An Autobiography of James Dyson and A History of Great Inventions

📤 The Email Caste's Last Stand

Many “unicorn” tech startups began with a few engineers and a product they wanted to sell, but over the past decade-plus, they have accrued a bloated bureaucracy of “equity”-minded h.r. activists, ESG-savvy consultants, affinity-group mavens, climate-change specialists, and many other email-caste hangers-on. Now that times are turning bad, tech companies can no longer afford to sustain a massive “court” of professional-class nobility, paying sinecures to sons and daughters of the good and the great who don’t know how to code or crunch numbers, but know how to write emails, hold useless meetings, and talk about diversity and inclusion.

Antonio García Martínez (agm.eth) @antoniogm

What Elon is doing is a revolt by entrepreneurial capital against the professional-managerial class regime that otherwise everywhere dominates (including and especially large tech companies), and that same PMC (which includes the media) is treating it as an act of lèse-majesté.

💒 Wife Economics and the Domestication of Man (Part I)

Not long ago I had my own Fermi moment. I looked at the world around me and asked: Where are all the polygamists?
Consider almost any past empire or civilisation — Mongol, native American, Chinese, Indian, African, old European — and you will find powerful men with many wives. It’s all over the Hebrew Bible. 90% (!) of hunter gather societies around the world practice some degree of polygamy. Yet we look around today and… zilch?
I guess you might say our culture has gone down a different route, developed different norms. Slavery too used to be ubiquitous, and is now universally condemned as evil. (Slavery is a salient analogy, and I consider it in more detail in this series). But polygamy has been so thoroughly vanquished it’s not even considered evil, it’s simply not there.

🤴 Inventing the Crypto King

One of the most striking things about the collapse of crypto exchange FTX, once counted among the world’s largest, is the extent to which it caught the supposed watchdogs of the tech industry by surprise. How could Sam Bankman-Fried, the brainiac financial visionary, crowned earlier this year the “crypto emperor” by The New York Times, have steered his armada of crypto firms into the rocks so recklessly? With allegations of an enormous, brazen fraud lingering, the first place to look is at the central role of the media in this fiasco. Through an almost endless churn of fawning coverage, the news media turned an inexperienced—and, it seems, ethically deranged—trader into the second coming of Warren Buffett.

🍭 Brain Food

💊 The Psychopharmacology Of The FTX Crash

I find the growing reliance of many people on amphetamines to get their job done concerning. This was a fascinating read explaining what was happening at FTX on that front.

Andrew D. Huberman, Ph.D. @hubermanlab

I just learned from a colleague and it was confirmed by every student I asked, that 25% of students age 16-32 take Adderall 1-7X/week (not prescribed). And 5-10% do the same w/Modafinil or Armodafanil; 30-35% of students are on amphetamine. This is serious. Safer options exist

7: So Was This All Because Of Weird Drugs?
I don’t really want to have an opinion on this, because I assume at some point one of their lawyers will hit on the defense “it was all because of weird drugs”, and I don’t want to seem like I’m shilling for one side or the other in a legal case.
I think you could make an argument that dopaminergic drugs shift various complicated risk curves in the brain. But a lot of Wall Street is on stimulants of one sort or another, and most of them don’t act like FTX did. Emsam is a little stranger than the usual Wall Street stimulants, and combining it with other stimulants might amplify the effects. But I still would think in terms of “how much are we moving the risk curves, and is it really that much further than a lot of other things do all the time?” rather than “does this switch you into uncontrollable pathological gambling mode?”
If I were one of the psychiatrists who will one day buy second houses from the money they make as expert witnesses on this case (DON’T EVEN THINK ABOUT ASKING ME TO DO THIS), I would focus on what doses were involved. Adderall 10 mg will help treat ADHD and give you a nice motivational boost. Adderall 200 mg will cause paranoia and sometimes hallucinations. There are similar considerations for modafinil and Emsam. All of these drugs are compatible with “probably didn’t matter” or “probably the main cause of everything” depending on what doses we’re talking about.
(and of course there could be other drugs I don’t know about)
The other free advice I would give these witnesses is to think about sleep. The most common way stimulants cause psychosis (this is my personal opinion, I haven’t checked if the literature agrees with me) isn’t by some kind of direct dopaminergic agonism. It’s by making it feel possible to operate on two hours of sleep a night. This is not actually possible and will land you into some kind of very exotic and maladaptive mental state. Someone who takes lots of stimulants during the day and then manages to sleep fine at night might do better than someone who takes the same amount of stimulants in order to work 130 hour weeks.

Mehdi Yacoubi @Mehdiyac

Choose your stimulants wisely.

Pair with: America’s Adderall shortage

🎥 What I’m Watching

👫 Do Women Really Find 80% of Men Unattractive?

Interesting video. As a reminder: only 14% of men are above 6 feet in the US (and 10% worldwide.)

Pair with: The real cost of modern dating

🔨 Training Hard is Natty Cope

This is a good reminder that, as a natural lifter, you must train very hard to get optimal results. Don’t listen to people telling you otherwise.

Mehdi Yacoubi @Mehdiyac

🔧 The Tool of the Week

🚫 Removing Plastics

I’ve grown more and more concerned about microplastic recently, especially after reading Countdown, and I had in mind to try to remove all plastic from my day-to-day life (as much as possible.)

I was reminded of this with these tweets about plastic in salt and in your pan.

Pair with: 10 ways to reduce your exposure to endocrine disruptors.

🪐 Quote I’m Pondering

I'm convinced that about half of what separates the successful entrepreneurs from the non-successful ones is pure perseverance.

— Steve Jobs

👋 EndNote

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Until next week,