Dr. Mark Hyman: To Live Longer You Need...

Loneliness is as big a killer as anything else. Some have said it's equivalent to smoking two packs of cigarettes a day. There's a huge biology to it. Why aren't doctors prescribing to spend more time with friends? I do. We are what we eat, or so the adage goes. But it turns out that statement is actually medically true.

Dr. Mark Hyman is one of the leading voices in the field of functional medicine, which basically means that if we feed our bodies the nutrients it needs, not only does it help us prevent illness, but we can actually supercharge our immune systems to heal us when we get sick. So I wanted to talk to him about something we need in our lives as much as we need food. Friendship. World leaders ask Mark for health advice. He's the author of 15 books, many of them, New York Times bestsellers, and the host of the podcast, The Doctors Pharmacy.

So I really wanted to get his take. And it turns out if we give our friendships the same attention as we give our diets, it benefits our minds, our spirits, and our bodies. This is a bit of optimism. Mark, thanks so much for coming today. It was such a treat to sit down with you. There's so much I want to talk to you about. My big thing right now is I'm writing about friendship. Yeah. Sort of mildly obsessed with it. And so it's a good thing to be obsessed with. A good thing to be obsessed with.

So I want to go down the path of the connection between health and community and health and friendship. You made a comment that you can't be a good friend if you're not healthy. If you feel like shit, you know, you can't show up and be present and be engaged and be there. And yeah, just even be present to have a conversation. If you're foggy and fatigued and you feel like crap and you're dealing with all kinds of issues, it's hard to really be present. And that's what you need to do to be a friend. It's a paradox because you need mental health to be a good friend, but if you don't have friends, it's hard to have good mental health. We have such a crisis of mental illness in this country. And part of it's because of loneliness, isolation, disconnection,

social media, all the things that you're thinking about and actually writing about. Hopefully with your new book on friendship. Yeah. Yeah. But for my lens, when I look at people's mental health, I look at it through the lens of biology because we now understand that the brain is obviously connected to the body, which has not actually been part of medicine.

Isn't that a weird thing that that's a discovery that the brain is actually part of the body? The old joke in medicine is psychiatrists pay no attention to the brain and neurologists pay no attention to the mind. Right. But now psychiatrists are paying attention to the brain and they're finding that brain dysfunction, brain inflammation is actually driving much of mental illness.

Everything from depression to anxiety to OCD to bipolar to schizophrenia to autism, all these things are connected to brain dysfunction. And yes, it can be caused by an external stressor like a spouse dying or trauma or things that are external. But it also can be caused by nutritional deficiencies in your microbiome and environmental toxins and things that actually are treatable and measurable. There's a very famous trial in Australia called the Smiles trial.

I think I'm one of the only great news for studies. But it's not the Smiles. No, they said they had to get the acronym. But it was essentially they swapped out, you know, did a randomized controlled trial of giving people healthy whole foods and then versus processed food. And there was a huge improvement in mental health by eating whole foods on a depressed population.

They've done studies, for example, in juvenile detention centers with there's a lot of mental illness and these kids by swapping out the crap for healthy food had a 97% reduction in violence in 75% reduction in use of restraints, 100% reduction in suicide rates, which is the third leading cause of death in teenage boys. Profound, in presence of the same thing, you get prisoners healthy food compared to the crap, 56% reduction. And it's not like you're putting them on, like they eat the food you give them. It's not like they're going to the fridge and choosing.

No, so it's a great it's a great space for a controlled study because there's no choice involved. Right, it is. Yeah. And so it's like they have a mindset of health. No, they're just eating whatever they're given. And then they, you know, they've filed a crime dose down 56% in presence of you out of multivitamin goes down to 80%. And with function health, we're finding a huge amounts of nutritional efficiencies. I just had a friend who's a vegan and he was severely omega-3 deficient, very depressed. And he's piling on omega-3s and his mood's completely different.

And we know that omega-3s play a huge role in mood. We know that folate and B vitamins play a huge role. And we know that many people are deficient in these nutrients. And we can measure those biomarkers with testing that wasn't available before for people. Now it's accessible to anybody. Do you know what I think is really significant about this little insight, especially as we're relating it to friendship and having the mental capacity to be there for someone, to having the the strength of mind to be present for someone else as they're dealing with happiness or sadness or whatever they're dealing with just just being there to be a friend. So often when we talk about nutrition, we talk about eating right, we talk about you, we talk about so that you can be healthy,

so that you can live longer, so that you don't suffer from chronic disease. And most of us, let's be honest, it's the same reason we don't save money. You know, if it doesn't have an immediate impact, it's a slow-boiling frog. You know, nobody plans to get diabetes. It just kind of just shows up after years of being like, I'll deal with this tomorrow. In other words, we're crap at doing things for ourselves even though the data is overwhelming that if you just exercise, sleep and eat right, you'll be fine and healthier, but to think about eating well as an act of service that I choose to eat well, not for me, though I may get benefits from it, you know, as an unintended byproduct. I choose to eat well so that I can be a better friend to you. I choose to

eat well so that I can be a better parent to my kids, so I'm less grumpy and less agitated. And to think of that, I think, as an act of service. Yeah, yeah, that's right. Well, illness starts with I. Wellness starts with we. Isn't that true? And so I think the correlation, and this is the thing that it drives me nuts when we think about things like innovation or health, is we make it a very I thing. You have to get healthy. You have to take a multivitamin. You have to exercise. You have to sleep. But we don't make it about a we. Right. And you know the data better than I do that when, you know, there's a group of people who are overweight and one of them decides to go on a diet, the disproportionately high

number of them will decide to go on a diet. Yeah, if there's a group of smokers and one of them says, I'm going to stop smoking and disproportionately high number. Yeah, getting healthy is a team sport. Getting healthy is a team sport. And and we are absolutely influenced by our friends. Yeah, you're always healthy as your five closest friends. So it raises, right? So it raises the question because clearly we're failing as a people, as a nation, doing all the things you recommend, because most of the things you recommend, at the high level, what you recommend is a lot of work, right? It can be or not. It's just what you set up for yourself. But at a functional level, a lot of the stuff that you recommend is not difficult, not expensive and pretty basic. Yeah,

it's kind of silly, but it is, right? And yet for not any more money, I mean, you can buy broccoli cheaper than you can buy McDonald's, you know, for not more money, a little bit of effort, but not complicated things. We can all live much healthier lives and yet we're not. And so it raises the question, you know, are we banging against our heads against the wall? We repeating the same behavior, expecting a different result that maybe the drum beat from the health establishment of change the way you eat, get more sleep, maybe work out, like we're all exhausted. We all know that it's not like it's not like you're, I think a lot of us know it, but there's a whole subset of our population that doesn't know what it means to eat well. Different problem. Yeah, different

completely agreed. It's shocking to me, but it's true. And it's because the food industry has been so good at manipulating the public to think that certain foods are healthy that are not. And they put health claims on labels of stuff that's the worst possible food. Well, natural, which means my basic rule is if it has a health claim on the label, it's bad for you, don't eat it.

You know, if it has a health claim on the label, it's trying to hide something. It's trying to hide something. Like fat, low sugar, sugar-free. What else is going on? It's like my favorite ones are new and improved for me. Like what was in the old one? So you were kind of going to the travel hole of, we know what to do. Why don't we do it? Why don't we do it? And I'm asking the question, maybe if we refocused our attention in a different place, let's call it friendship, with the rising rates of anxiety and depression and mental fitness challenges and inability to cope with stress. And then the worst case suicide, even the obsession with longevity, I'll go and I'll throw that one as well. Friendship is the ultimate biohack. Friendship literally fixes all of those

things. We know the data that people who have close relationships live longer. People with close relationships are happier and you look at Dan butiner's work and the blue zones. And so much attention is put to them, walking to the house and to the, and so much attention is put into what they're eating and how they're eating. But not enough attention is put into the fact that they're eating with their friends every single day. You're so right, Simon. I actually, I spent a lot of time in Tardinia and in Icaria or Akari, however you pronounce it. It was just stunning to see the level of community and connection. Even if, if someone, for example, like this woman, Julia was 100 to three months, like, you know, like I'm five and three quarters, I'm 103 months. I think when you're

very young and you're very old, every month, the quarter count. And now she didn't have kids, but she lived with her niece and nephew and they were in nursing homes. People just took care of each other. And it was really remarkable. And it was a guy, Carmine, who basically had this huge farm that he had his whole life in his family had. And he was 86 years old and he was raising animals and had fruit trees and gardens. And he, you know, he was feeding his whole community and family had meaning and purpose. And he would live with his kids and his wife had died. But it was all this incredible sense of connection and community. And it's so essential. And I learned this lesson when I went to Haiti after the earthquake. And I was the first medical team on the ground at the

main hospital, the general hospital in Port of Prince. And it was, it was a disaster. I mean, you can't imagine the scope. It was 300,000 people injured and 300,000 people dead. Wow. It was an unbelievable massacre that was a natural occurrence, but it was, it was horrible. And so we got there and there were people helping, everybody was helping. There was a sense of community and service and connection. And I got to meet Paul Farmer, who was a hero of mine. He was a doctor who went to Haiti and decided that even though the whole world had neglected this community of people who were suffering from TB and AIDS because they were poor, they didn't have sanitation, they didn't have clean water, they didn't have watches. They couldn't take the drugs. It's

complicated at that point to take the drug regimens for multi-resistant drug resistant TB or for AIDS. And he realized it wasn't a medical problem. It was a social problem. He called it structural violence, what are the social economic and political conditions that drive disease. And it wasn't that we needed better drugs or surgery. We knew how to solve it. But the entire public helped me to give it up on them. So he started to help by building a network of community health workers, neighbors helping neighbors, friends helping friends. And he called it a accompaniment. And it was French, but I'm not pronouncing French. So I'm going to skip that. A company model, a company model, yeah, like that. And he built this whole model and he scaled around the world. It was adapted

by the Clinton Foundation, the Gates Foundation to help. He did St. Peru, he did this in prisons in Russia, he did this everywhere where people were struggling in Marwanda, built hospitals. And it was an incredible model. And I realized that most of the diseases we have now in the West are non-infectious diseases. They're chronic illnesses, which are called non-comunic- What's the difference? Well, infectious diseases like malaria or measles or TB, right?

These are the things that all were killing us a century ago. Now they're pretty much not except in certain parts of the world. But the disease we now have are what we call non-communicable diseases. But it's a fallacy because they are very communicable. They're not infectious, but they're contagious. And chronic diseases like heart disease, diabetes, cancer, an dementia, autoimmune diseases. These are diseases that are driven through our diet, toxins, but also through our social networks. And I realized that our social networks were more important than our genes. The social threads that connect us are more important than the genetic threads. And the data is really clear on this. Christakis work out of Harvard,

outlined this very clearly. He wrote a book called Connected About This. But he's published the research that showed you, for example, if your friends are overweight, you're 170 percent more likely to be overweight. Then if your families are overweight, we are 40 percent more likely to be overweight. Your social networks are driving your behaviors for good or bad. So I realized that yes, we have a society where the default is to do the wrong thing. And that we as a society aren't supporting each other to do the right thing. And I realized that community was medicine, just like food is medicine. And that love is medicine. And that's our anthropology, right?

We're tribal animals that grew up historically and tribes about 150 people. And that's how we lived. Yeah. We lived in these relatively small, we help each other communities, communes. Yeah. I mean, that's the history of humankind. We've only started farming 10 or 12,000 years ago. But for most of human history, we lived in these small groups where we couldn't have populations larger than about 150. Yeah. What's very interesting about the little statistic that you threw out, and the thought that I had, which is when our family is overweight, we're 40 percent more likely to be overweight. But when our friends are overweight, we're 170 times percent, I mean, we're likely to be overweight. And that's, you know, the immediate thing that popped into my head

was when you think about children, right? Children, all they want is their parents approval. Hey, mom, hey, dad, watch me, watch me, watch me, watch me, watch me, right? And they have no inhibitions in the outside world. They don't care what the world thinks about them at all. Just mom and dad. I'm going to dress like a princess. I'm going to dress like Spider-Man.

But I want mom and dad to watch me jump off the step. And I desperately want mom and dad's approval, right? And that's where all of the learning about what's appropriate, what's inappropriate comes from. Strickly from our parents, nothing else. Yeah. Until they reach about adolescence, and adolescence, we convert to only needing our parents approval to only needing our friends approval, frustrating for the parents, but very, very important for social animals, because what we're doing is a culture rating outside of our families beyond our families into the broader tribe. And that lasts for the rest of our lives. We don't actually go back to the family. It's all friends, which is why I have to believe, and I'm just sort of thinking about

this out loud now. I have to believe that's the reason so many of us go on Instagram and wish our parents happy birthday when our parents aren't on Instagram, right? It's for the social approval that I'm a good kid and showing you the pictures of my dad holding me when I was a baby, like scroll through those pictures and everybody likes that I'm a good son. And yet my dad's not on Instagram, right? And so I have to wonder if that same drive, that same weird need to want social approval for being a good son is the same. It comes from the same room. I mean, 100% if your friends are all drinking green juices and doing your job, then you're going to do the same thing. If all your friends, they're not a shit that I take because friends like you should do,

you know what I'm saying? Because you're in the industry, I'm going to say something that's potentially insulting to you. Please. That's what I like to do. I like to have, I like to talk to guests and then insult them. This is potentially insulting. Okay, we're friends. Everybody's sorry. So this is potentially insulting. So I need you to work this through me. Okay. Okay. It feels like I can't say that it is, but it feels like that the complete explosion in the supplement industry where nothing is evaluated by the FDA and every influencer now has a vitamin or a supplement or a powder or a drink with all kinds of nonsense claims, maybe they're good, maybe they're bad.

It feels like we're living in the dot com boom of supplements that, you know, in the dot com boom, you were like, I'm investing in this tech company because my neighbor told me I had to. Yeah. And now that's been replaced with I'm now taking these 87 pills per day. Yeah. Because one friend told me to take these for another friend and just like the dot com boom, you can't live in a bubble like that. It's going to have repercussions and it's going to be it's going to be unexpected and it's going to be pretty violent. Right. So riddle me this like, is it time for the FDA to get involved? Like I can no longer tell the difference between a claim on a product you're selling or a claim on something that some right. Like literally their only qualification is they have a

following on Instagram. Yeah. Isn't it is not a job that is being an influencer. Where was my course in college? Yeah. Influencer 101. We're living. We're living. I think we're living in a supplement boom. Yeah, it could be and it's going to and it's going to I don't know how it's suddenly, you know, kicks back. Yeah. But this can't this can't last forever. Yeah. I think that it's counted everything you're trying to do. Yeah. What I want people to do is do the right thing. It's what I've been my whole life trying to do is help people understand how to create health. And part of the new company I co-founded function health is really empowering people with their own health data to make choices that are personalized that aren't just random because

somebody said do this or do that. And so that's what I love about the testing. I had a, for example, a friend of the day showed me her results from function and she was low in zinc. She was low in iron. She was low in vitamin D. She was low in omega-3 fats. I'm like, oh, that's all you feel like crap. You know, you need to take these things. And here's what to choose. But most people don't have it. We have navigating this sort of morass of products that have, again, no regulations in terms of quality or efficacy. Now, because people are in protected in a sense that they don't know if the product they're taking has the exact ingredient it says. If the dose is what it says in the label, if there's any contaminants in it, if there's any fillers or products that kind of may be harmful

to you. So it's kind of a shit show. And so as a physician, I spend a lot of time investigating which companies are using pharmaceutical manufacturing practices, which do testing before and after their product. So they know that's a purity and potency is exactly right in it. They may throw the product out if it isn't. So there are good companies that are doing that. But it's like, I don't know. You can't unless you know what to ask. I did a thing a while ago, where there's a way to learn about. They took my blood and they evaluated all of everything in my blood from, I mean, you name it. All the minerals and everything I'm supposed to get and have. And then they made a personalized conscience, a personalized smoothie. Yeah. That replaced all my things and I'm

supposed to come back every six months. Yeah. And it was really interesting. And they introduced then I talked to a doctor who walks me through my results. Yeah. And then they gave me my smoothie and the only choice I get is what flavor. And and it sounded good until I was like, I don't even know if this is bullshit. Yeah. If they're just like, I don't know. That's a problem. If someone's if someone's selling you something off of something else, that can be a problem. They're not always a problem. But if you're saying, I took AG one for a few months and I mean, I do all these things.

I feel the same. I've done AG one. I've done claustrum. I've done, I mean, I've, you know, and again, all because somebody's like, you should try it. And there are people who I trust. That's why I did it. Yeah. And you know, they like, you take these things like it boosts your immune system. How do you measure that? Exactly. I got a cold. So does it work? It doesn't not work.

Well, you would have been worse if you, I mean, I don't know. And I, you know, I start, I get very cynical. Sometimes I'm all in and sometimes I'm very cynical. I'm in a very cynical mode. I hear that. I hear that. And I think it's fair and you're right to be cynical. And I think there's a lot of garbage out there and a lot of people pushing stuff and there's a lot of companies, for example, doing tests and then selling your products on the back end. I think there's a problem with that. Okay. Uh, for example, function health, we don't do that at all. We just say, okay, for example, you, you have these things that you found that you need to fix that are affecting your health and wellbeing. And here's how to make a decision. For example, we have a 30 page guide

on how to choose the right. And you don't take, we don't sell anything. And you don't take kickbacks from the products that you want. No, no, no, no kickbacks. No, we don't know. No, no, no, we're completely agnostic. We don't have any. Do whatever you want. You just need this. No, but not on doing it. But if you're going to, if you need something, here's how to choose the right product. Here's how to investigate the company. And here's the questions to ask. And here's what to look for. And here's how to make a good decision. So we teaching how to fish, not giving you a fish. I like that you're doing this. But I, I remember I'm in a cynical mode.

What else is new? Which is when there's, when there's a good business model, even if it's for the greater good, because money is fuel and that's totally fine, that means you'll have competition and other people will start doing similar things. And then we're back at square one, which is all of these companies are going to be funded by VC. And you and I know too well. Unfortunately, the way VC and PE works, which is they all are wonderful. They're all fantastic in the beginning. And they are so behind you in your vision at the beginning and just wait three to five to seven years. And all of a sudden, the pressures start to show up. And the growth, we want growth because that's our business model,

not your business model. And then all of a sudden, especially if you've given up control, controlling interests, you will have built up this beautiful brand. You get fired from your own company. I mean, the number of companies that have like the brand of Veda, Burtz Bees, Kashi, Amies, these were, well, they got bought by Kraft. You know, they're all great brands that built their brands based on natural ingredients. And we believed it because the founders were true. And then they sold to Kraft and L'Oreal and whoever buys these companies, they stripped the beautiful things out, put the shit in because they can increase margin. But we're none the wiser. We don't know, which is fired from beautiful companies. We don't know that these companies are owned by

large conglomerates that are driven by shareholder value. And then we end up suffering for these products that we were told were good and they were good until they weren't good. And we're back at square one. So I think we should just have friends. Well, let's get back to the conversation about friendship because I think that the fundamental thing is we should we should garden and farm with our friends and eat our own food. Oh, we can't live. You know, I mean, when you look when you look at the systems farming, that's right. I mean, I think community gardens are amazing.

I think they're great service for people. And I think that what we're finding is that loneliness is as big a killer as anything else. Some have said it's equivalent to smoking two packs of cigarettes a day. And how many, especially men, don't have someone who's a good friend. How many people don't have somebody to call when shit goes down? I go back to the work that I did some years ago when I was writing leaders eat last with alcoholics anonymous. If you want to overcome alcoholism as a 12 step program, most of us are familiar with the first step. You know, admit you have a problem.

Yeah. Okay, let's say I'm depressed or I'm lonely. Let's let's admit that's the problem, right? But it's the 12 step that people don't talk about. Right. And alcoholics anonymous knows exactly. Alcoholics anonymous knows that you can master 11 steps and not the 12th and you also come to the disease. And it's the exactly to help another alcoholic service. And so I think the people who are the most lonely are the ones who have to go first. Because the way to solve your problem is to help your friend who's suffering from the same problem. If you're an alcoholic, you help another alcoholic. If you're lonely, help a friend who's lonely. And I think that the the therapeutic benefits of helping someone who's struggling with the same thing that you're struggling with,

rather than worrying about yourself goes right back to the gym. You know, there's a huge biology to it. Dude, I don't know if you know, but there's a whole field of sociogenomics, which is how our social interactions affect our gene expression. Say more. So if you're in a conflictual relationship with someone, your inflammatory genes are turned on. Literally, that's just your emotions are inflamed, but your biology turns on the inflammation. Just fight or flight, kind of stuff. Not fight or flight. Just if you're like in a shitty relationship or if you're fighting with someone or you have a conflict, you turn on inflammatory genes that then increase expression of cytokines that cause inflammation and that cause disease and all

chronic disease from depression, heart disease to diabetes to obesity, Alzheimer's are all inflammatory diseases. Conversely, if you have a connected loving relationship with somebody, it turns on anti-inflammatory genes. And inflammation is the core of like everything. Yeah. And maybe it's studies with an entrainment, you know, where you have where if you sit with someone and you have an authentic connection that you can put EEG and EKGs on, basically brainwaves and heartwaves, you can see the heartbeat of someone you're having a deep connected relationship with in your brainwaves. It's wild. So it's not just a feel good thing on an emotional level. It's a physiological response that happens of being in connection. If you take animals and put them in

cages and separate animals and feed them exactly the same thing and have everything else the same, the one that's isolated versus the ones that are connected will triple and die and get sick. Right. And so humans are the same way and we've gotten we've gotten in a situation where friendship and connection is sort of like okay. So why are doctors why aren't doctors prescribing to spend more time with friends? I do. Like like doctor. I'm suffering from X, Y and Z. Yeah.

Okay. I'd like you to try and get an extra hour of sleep. Go to bed a little earlier. I'd like you to stop eating before you know eat no don't eat past eight o'clock at night. And I want you to spend at least three hours a week with with a friend. How come that's not enough? It should be. It should be. It should be. I mean, I I prescribe it. In fact, based on this work that I did in Haiti, I I met a pastor after Rick Warren who wrote the Purpose Driven Life and had a church with 30,000 members. And I met him. He came to my office and we started talking and I said, Hey, you know, Rick, tell me about your church because I don't really I'm a Jewish doctor from New York. I don't know much about evangelical Christian church. Like yeah, we got 30,000 people like wow. It's a lot of

mega church. He's like, yeah, we got 5,000 groups that mean every week small groups in the church to help each other live better lives. I'm like, Oh, this isn't a mega church. This is thousands of mini churches. Yeah. And I had that the light bulb moment. I'm like, well, I just come back from Haiti. I said, why don't we put a healthy living program into the groups and see what happens? Yeah.

He said, great idea because I was baptizing my church last week. And after about the 800th person, I'm like, man, we're a fat church. And I'm fat. And we got to do something about it. And so we put a program together through the small groups where people were just helping each other. There was no doctor, nutritionist, health coach. Nobody. There was just a curriculum. We had a big rally. So a big event where we talked about and Rick talked about the biblical rationale for why God wants us to be healthy. I gave it a bunch of speeches and talked about how, you know, God lives in you.

Why are you feeding him crap and things like that? I mean, you know, Jesus came to dinner. What was you feeding him? You know, big Mac fries in a Coke. And they got it. And Jesus came to dinner. What would you feed him? Exactly. So they got it. I think, you know, if you feel like crap, how you going to serve God? How are you going to serve each other? You've got to take care of your body.

And so they got it. And they did this together in community. It was jogging for Jesus. And they all these incredible, it was incredible. And they lost together a quarter million pounds in the first year. And they did it together. And then I took that same model. And I applied it to Cleveland Clinic where we created small groups where people helped each other. We did research on us and published it. We were three times better health outcomes on validated metrics of health outcomes compared to one-on-one visits for the same condition with the same doctors. So the doctors at our clinic could see them in one-on-one or support them in a group. The group was three times as good as seeing the doctor one-on-one in terms of health. But why aren't these things then being

implemented across the medical field? You're trying. Why aren't we going to the doctor with our friends to dealing with similar issues? Why aren't we like everything's so siloed? It is essential. I mean, I think the models of support, whether it's coaching, whether it's one-on-one, coaching or support, whether it's group models, they have to be the thing that it's going to change.

Because we get healthy together or we get sick together. What did Benjamin Prangle say? We was all hang together or surely we'll all hang separately. I mean, and I think that's kind of where we're at in society. One of the problems we have in our society is community things, you know, bullying leagues don't exist anymore. Church attendance is down. And church attendance and faith are not the same thing. You know, you can have faith and not go to church and you can go to church and not have faith. That's right. The church would rather that they're overlapping. But the idea of doing things in commune, in community, this is why I love things like Comic-Con or Burning Man or whatever you're, you know, then you've never been to Burning Man. I have been to

Burning Man. You have? Yeah. Oh. Sturgis. The motorcycle thing. How is angels? Like all of these things, doing things in community with people who have common interests. And one of the questions I'm getting since I've started talking about friendship, it's amazing how many people are coming up to me who are of all ages, of all income levels, who are saying to me, I don't know how to make friends. I struggle to make friends. Because we're afraid to be authentic. I mean, that's the hard part, right? Is you ever struggled to make friends? One, I was a kid. I didn't have any. I was a weird kid.

I just was in my head, read a lot of books. It was a little weird. And, you know, kind of a nerd. I was living in Toronto in the 70s. It was a spiritual wasteland. And, in fact, I actually my first real friend I met on the top of a mountain in the Canadian Rockies. We were backpacking. And it was a week out in the middle of nowhere by myself. And he was a week out. And we crossed over on Badger Pass in Banff National Park. And we just had this kind of moment of connection.

And we both found out we're going to be at Cornell. In the fall, he was in the figure college. I was a Cornell. We got back and we got together. And, you know, we didn't know if we're going to be friends or not. But we became like brothers. And he's my best friend. Yeah, we 40, 46 years later. Wow. Yeah, 46 years later, we do mountain bike trips all over. We're very close. And, you know, we help each other. And when one's down, the other picks one up and I'm down. He picks me up. When he's down, I pick him up. And we've had this really sustained deep, authentic intimate relationship for 45 years. That's amazing. And we love each other. We hug each other. We cry together. And we laugh together. And, you know, it was a place where where I could say and be

and do anything. And it was it was a remarkable experience for me to actually feel seen and loved. It was like the first person who loved me who didn't actually have to love me like my parents. Here's something I discovered about close friendships, right? Which is we always talk about close friends as the person you would call when you're in need, when you need help, the person you can cry with, the person when you're in pain. Yeah. And I actually think that's true. That's a level of close friendship that you can call that person in a time of struggle or need. But I think there's even a closer level of friendship, which is when you can call somebody when something amazing.

Yeah. And they're not jealous. And there's no jealousy. And you can call them. And what you're doing is bragging. But not really, you just need to tell someone about this amazing thing that you accomplished or that was given to you or that you won or that you know, whatever it is. And if you would told anybody else, they'd be like, they'd think you were bragging. But to that friend, they have unbridled joy with you and for you. And what I've learned is the number of people I would call with good news is actually smaller than the number of people I would call with bad news.

That's interesting. Well, you can call me with good news. Oh, thank you. Oh, sorry. But do you know what I mean? Yeah. Well, it is. It's important to take an inventory of your life and your friends. And if you don't have good friends, it's really important to cultivate them, to invest in them, to find them. And there's ways to do that. I mean, there's ways to put yourself in environments and situations. And I don't think you probably saw the articles in New York Times about men and friendships. And it was just it was just so heartbreaking. And when COVID happened, you know, we're all isolated. We're all alone. And September 2020, my wife and I split up. I just had back surgery. I was alone. It was COVID. And what did I do? I sent an email to my closest

men friends, six other men who I've done, men's work with, does men's retreats with, done medicine journeys with. And I said, Hey, guys, like, can we start a little zoom once a week for an hour, maybe? And they're like, how about we do two hours? Everybody, you know, and we've been going for it's plus four years now. And it's remarkable to have this container. And what's been interesting to watch is that even though these are all my close friends for 40 years, 30 years, that the depth of our friendship has gotten more profound, the more vulnerable we've gotten, the more we open our hearts, the more we share our fears, the more we share our successes, the more we share whatever is going on in our life doesn't matter. There's always something with

one of us. And to me, it's like an anchor. Another friend of mine is struggling with one of her friends. And she asked herself, if I was in a marriage or just a romantic relationship, a long-term romantic relationship and the relationship was struggling, we wouldn't just break up. We would get help. We would seek therapy, couples counseling. And so she went to her friend and said, this is tension has been going over too long. We're going to go to therapy together.

This is therapy. Yeah. And again, why do we instinctively understand that if a marriage or a relationship is struggling, that we expect people to at least try, to at least try the couples therapy before you call the whole thing quits. And yet we don't do that with friendships. When we have tension with friendships, we're quicker to end the friendship or sit in weird tension or avoid the person than to go to the therapy with the person to try and work through the struggles.

We may still end up breaking up. Yeah. But let's at least put in the effort to rescue this friendship that we claim we care about. Yeah. I love the idea of friendship counseling. And it speaks at the same point about not just co-living in a sense of just doing things together. Existing together. Yeah. Going to movies together and having fun together. Yeah.

Going back together. Yeah, just superficial dinner. And by the way, I will stress that I don't believe all friendships need to be at this level. Like it is perfectly fine to have friends. At least a couple. You need to at least a handful. Some have more, some have fewer. You need, but having friends where they're not deep bonds of vulnerability, you just have fun together. Totally fine. Yeah.

Adventure partners or activity partners. Totally fine. And I think that's one of the problems we have in our country. If not the world, I don't know about other languages. I only know about English. But like one of the problems I think is language. So for example, if you have stage for a liver cancer or you have a mild melanoma, the problem is both of those things are called cancer. But they are clearly not the same thing. But we use the same word.

Right. I have a skin cancer. Right. Exactly. I was like, you're fine. You know, what did Larry David say? It's the good cancer. And I think we do that. Well, I think we have very few taxonomies. We have very few words for friends. And so I've started using best friend friend. Yeah, that's pretty much it.

And even then best friend is sometimes a little overused. Yeah. When somebody says, hey, aren't you friends with them? I go, I'm friendly with them. Where somebody says, aren't you close with them? I'm like, no, they're in acquaintance. Or they were a work friend. Yeah. You know, and so I've actually started to use the language for my own clarity and for other people's clarity. Then not everybody I know is my friend that I'm going to like.

Can't have an infinite number. I can't have an infinite number. It takes, it takes time. It takes time. And investment is a real thing. This is a central part of happiness, of joy, of longevity, of health. By the way, go back to that longevity thing. You're in that space. And you know more of them, but I know some of the folks who are sort of like the longevity folks. Yeah.

And I find a lot of them every unhappy people. Yeah. Enjoy. Where's the joy? These guys, mostly men who are obsessed with longevity. And they're taking all of the measurements. And they're taking all the vitamins and supplements. And they're doing all the exercises. And they're doing all the things and everything scheduled and highlighted.

And I find them not very happy people. No, you know, find the joy. Find where and like where like maybe you work out a little less. Don't worry about if you miss the supplement and maybe just hang with friends. I bet. I mean, the data will prove it out. Like we have to wait a bunch of years because the longevity obsessives. The only way we'll know if it works or not is when they die.

Yeah. And if they will be happy and healthy and old age. Yeah. Because nobody wants to live a long time and be decrepit. No. You know, and so we have. That's why like I, well, my friends are in their thirties and forties now because like, you know, a lot of my older friends have just sort of checked out. But, but we have to, we have to redo this podcast in 40 years and see if all the longevity obsessives are still around or if they're dead.

I'm going to do a Vegas bedding pool here, which is I would bet that the people who are healthy-ish, like they don't, they're not unhealthy, but they're not obsessively healthy, right? Like yes, they get enough sleep. Yes, they eat mostly well. You know, like good. They do the basics. They do the basics. They're not unhealthy is the way I would define them.

But they're spent a ton of time with friends. And they have a fantastic sense of humor. And they love to laugh. I will bet money that those people will live longer than all of the folks who are measuring and I agree and powdering and I mean, it's, it's evolutionary. I mean, I don't know if you know, E. Wilson wrote about called the social conquest of the earth about from ants to humans, how we have to work together to survive. Yeah.

And in fact, altruism is a built-in phenomenon and that it activates the same neural circuits as heroin or cocaine or sugar in terms of the nucleus accumbens and the pleasure. And I remember this. It sounds kind of weird to say, but when I was in Haiti and I was sleeping four hours a night and I was working, helping people all day, you were barely eating anything, probably dehydrated in the hot sun, I felt like the sense of happiness and joy like I never felt.

And it was weird because I was in the middle of this disaster where people with limbs amputated and dead people everywhere. But something was happening in me where I was in service of others. I wasn't thinking about myself. And it's sort of why do I do? I mean, I'm happiest when I'm serving others. There's a book called Survival of the Friendliest. That's good. And it makes, it makes an argument that we've completely misunderstood Darwin that the idea of survival of the fittest, we have always attributed to brute strength. Yeah. And so if you can overpower someone, you're more likely to survive. And they make an argument for social animals and mammals that that's actually completely incorrect. That what he meant by fittest was most fit to create

community and take care of each other. And survival of the fittest is actually nothing to do with brute strength. But it's actually to do with the ones who were better at taking care of each other. So as you start to think about this book assignment and I can't wait to read it even though you haven't written it yet. That's a good sign. I should put it up on Amazon, drive those presales before I get out of it. I get a pre-order cover to come title to come yet untitled book.

And you know, as I think about it, I don't, I don't, I can't think of a lot of books on friendship. Well, this is, this is the reason that my friend Will and I decide, my friend Will Gadarin, I decided to write this because it seems to make sense that you should write a book about friendship with a friend. Yeah. Writing a book about friendship by yourself doesn't make sense.

So Will and I decided to write together. And we came to the realization that there's an entire industry to help us be better leaders. An entire industry to help us be better parents. An entire industry to help us, you know, thrive in our relationships, how to eat better, how to exercise better, how to live longer. And yet, you've written all those books. And yet precious little, yet precious little on how to be a friend. That's right. And when you look at all the challenges, as we said in the world of depression and anxiety, and all of the, all these epidemics that doctors and, and well-intended folks are talking about, no one is talking about friendship as the antidote. Yeah. And I think that friendship is the ultimate bio hack. I think if you can master

friendship, a lot of those other things correct themselves. It's true. It's true. People listening, I, I imagine our thinking, oh, this is great. I feel this. I know this how important. And I feel the disconnection. Yeah. But I don't know how to make friends. I don't know how to start. I don't know how to take their friends. I have to make them better or find new friends. I don't know how to make friendship, the medicine that I need in my life. Yeah. So I think starting with common interests, sign up for a ceramics class and go by yourself. Or if you're too nervous to go by yourself, go with a friend, but talk to the person you're sitting next to. Because the great thing about doing a thing with common interests is the icebreaker is really, really easy. You just have

to say, is this your first time here? Have you done this before? And it pretty much starts the conversation. You don't have to form a deep, meaningful relationship out of it. But I think starting to do hobby things. And I think having hobbies, and we've seen the decline in hobbies, even, you know, and doing hobbies with people. That's why I said, yeah, that's why I said, go play chess, you know, in a park, you know, that's why I've said, I think things like Comic-Con and things like that are spectacular. Because when you find a group of people who, when people laugh at your hobby, and you find a group of people who we've all been laughed at, but now we're the, we're the norm here, it's incredibly easy to make friends. I've been to Comic-Con many, many times.

And, you know, it's, it's Nirvana. What is Comic-Con? You don't know what Comic-Con is? No, vaguely, it's, it's, uh, well, it's changed over the years, but basically it's a comic book convention. That's what I thought it was. That's the history, but it's part of it. But these days, comic books are only a part of it. It's also science fiction and hero movies, you know, Marvel stories and Star Wars and, you know, DC and all of that. And it's all that nerdy kind of pop culturey stuff. People will dress up as their favorite cartoon character or superhero or, you know, some obscure character and some of them are super creative and some, and it's, and, you know, some people are there for the content of the convention and some people there just to walk around

and costume and have fun. And what's so wonderful about it is it's an incredibly polite group of people. So if you are in a great costume where you see someone who's in a great costume and you want to have a picture with them or they want to picture with you, everybody asks, everyone goes, can I have a picture with you, please? Hey, you may have a picture with you, please. And so, there's a lot of interaction. You can go up to somebody and say, I love your costume and they will be friendly back. There's not a lot of cynicism. I met one of my ex-girlfriends there. I literally went up to her and said, you look amazing, can I have a picture with you? And she goes, absolutely, we took a picture together because I just loved her costume. I don't remember how the

conversation started, but we ended up talking a little bit for just a few minutes. I don't know how we got to it, but we ended up trading phone numbers. And then we ended up having sort of a really great relationship. And the best part about that is I still have the photograph, not from our first date, I had the photograph from the moment we met, which doesn't happen in relationships.

You don't say, nice to meet you, let's take a selfie just in case. But I have the photograph of the time that we, the minute we met. And I think when you go to places where people like the things you like, it's going to increase the odds. And it's not the increasing odds that you'll find a deep meaningful relationships, but it makes it easier to break the ice. Just get started. To get started.

So what's your goal with your book? What's the set of aim you're targeting? You know, I'm somebody who has had very few long-term relationships in my life, and the world criticizes me for that. I'm seen as unhealthy or I've been judged as having commitment issues. I mean, love relationships are just friendships. Love relationships.

You know, I've never been married. I don't have a 10-year romantic relationship, but I haven't had it. And even some of the women I've dated, they're like, what's wrong with you? You mean either? I mean, there was four or five. What's wrong with you is what I hear a lot. And I have a friend who was in a 16-year relationship, an unhealthy relationship. For 16 years, she freely admits that she should have stayed in that relationship for one year. And yet society looks at her and says she got it right and I got it wrong, which is twisted. And if you look at the quality of my friendships, like I have a lot of really, really good friends, and I am fulfilled in almost every aspect of my life, but just not necessarily all from one person. And look, I like relationships,

and I love being in a relationship, and I love being a partner to someone. And you know, people say, why haven't you been married? And like, is it obvious? I haven't met the right person yet. That's such a stupid question. But I found comfort in recognizing that by fostering friendship, I don't have to feel guilty or bad or explain myself why haven't had a marriage or a 10-year romantic relationship. And friendships out last relationship. And friendships out last and friendships are there to help you through relationships. And if you don't have good friendships, you'll struggle in your relationships because you have to have somebody to ask advice or event to. You can't always go to one person. It will work. And so I think we don't give enough credit to friendship.

We don't give enough credit to friendship and we don't give credit to people who are good at friendship. We give credit to people who stay in relationships, even if those relationships are unhealthy. And I think we just need to reevaluate how we're managing relationship in general in our lives. I want to be a part of the friendship movement. I love that. I mean, that's, it's it's even that one of the chapters of our book around how to get healthy is friends with five Fs.

Exactly. Amen. Mark, I so appreciate you coming in to get a physician's perspective, especially the work that you do because your work is so different than traditional medicine where we treat illness where your work is really about staying healthy and living healthy and you never get ill or your body will know how to fix itself. That friendship is a core part of staying healthy and helping the body fix itself and prevent itself from getting ill. Tell it to your friendship.

And on that, my friend, thank you so much for having this conversation with me. This is the great, so good, so great. It's produced and edited by Lindsay Garbenius, David Ja and Devon Johnson. Our Executive Producers are Henrietta Conrad and Greg Rudershot.

Dr. Mark Hyman: To Live Longer You Need...

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