Low energy. Weight gain. Lethargy. Low mood. That is the symptom list for depression. It is also the symptom list for an underactive thyroid, and a blood test tells you which one you are looking at.

This episode is about the rule Rich Russell taught him: check the biology before you go to the psychology. Roger is a business psychologist, not a physician, and he is careful about that line throughout. What he is arguing is narrower and harder to dismiss. His own field is about a hundred years old. Physics has had a thousand. Chemistry has had seven or eight hundred. A discipline that young should be slower to hand out a label and quicker to rule out the body first.

What we cover:

• Why hypothyroidism produces the exact presentation clinicians call depression, and why a TSH panel comes before a diagnosis
• Chris Palmer, the research psychiatrist at Harvard whose book Brain Energy treats serious mental illness as a metabolic problem
• The Mad Hatter was real. Hatters treated felt with mercury, and a high proportion of them went mad
• Dale Bredesen on chronic inflammation, and why the plaques and tangles in Alzheimer's may be the brain's protective response rather than the disease
• Why some researchers have started calling Alzheimer's type 3 diabetes
• The gut and the brain: how what you feed the bacteria in your gut is communicated up the vagus nerve

Roger's line, and the reason this episode exists: "We have been around maybe a hundred years. Some humility would really be good."

Chapters
0:00 Cold open
1:35 Introduction
2:26 Rich Russell's rule: check the biology first
9:20 Psychology is an infant science
9:49 Hypothyroidism looks exactly like depression
18:04 Chris Palmer, Harvard, and Brain Energy
19:31 Mercury, and why the Mad Hatter was real
21:29 Dale Bredesen on inflammation and the brain
24:07 Insulin, and calling Alzheimer's type 3 diabetes

Second Thoughts, Episode 70. Part 1 of two, recorded 23 July 2026. Part 2 is Episode 71.

Dr. Roger Hall is a business psychologist and executive coach. He trains leaders to monitor and manage their thinking.

drrogerhall.com
compassconsultation.com

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