Dr. David Perlmutter on Why Our Brains Conspire Against Us (And How to Stop It)

Dr. David Perlmutter wants you to know how to improve your brain. But in his years practicing as a functional neurologist, he’s seen a disconnect between the information he tells patients and their ability to act on that information. Rather than blame the patient, he decided to investigate the neurological reasons for why it’s so difficult to make healthy, smart choices — and he found out that our modern lifestyles are actually conspiring against our brains and setting us up for failure. 

In his book Brain Wash he explains how this works and what you can do about it, and he shared his insights with WellBe. Read on to learn the ways that modern life leads to physical changes in our brain, how our devices impair us from making healthy choices, the integral relationship between sleep and the brain, and more.

*This is a short clip from our interview with Dr. David Perlmutter. Click here to watch the whole thing!*

You can also listen to an audio version of our interview with David Perlmutter on The WellBe Podcast.

Disconnection Syndrome (or Why We Can’t Follow Doctors’ Advice)

When a person doesn’t follow through on a doctor’s recommendations, it’s common for the healthcare provider to blame the patient. But according to Dr. Perlmutter, ignoring the advice of doctors is more the rule than the exception—patients fail to act on 50% to 80% of the information they receive from their doctor—and so clearly the issue is more systemic. Upon recognizing this, he took a step back and tried to understand the bigger picture. In doing so, he identified a phenomenon he called disconnection syndrome. 

To define disconnection syndrome, Dr. Perlmutter explains that there are two regions of the brain that control our thoughts and behavior: the prefrontal cortex and the amygdala. The amygdala is impulsive and seeks instant gratification (think eating a doughnut, sleeping in, watching another episode), while the prefrontal cortex is, as Dr. Perlmutter describes, “the adult in the room.” It’s the interplay between these two regions that allows us to make good decisions. 

Imagine it: you see a delicious-looking plate of donuts on the conference table at the morning meeting, and your amygdala lights up, giving you an urge to grab one. But then your prefrontal cortex, sensing the action in the amygdala, steps in and reminds you that you have some overnight oats packed in your bag, and that you’ll feel so much better if you eat that instead. You put the donut back.

The connection between the amygdala and prefrontal cortex is what keeps our behavior in check and allows us to make healthy choices (it also helps us make choices that save our lives in other ways, like not stepping too close to an edge or not hitting someone when we’re angry). But, as Dr. Perlmutter explains, there’s a problem: our modern lifestyles have broken that connection. 

Things like lack of sleep, an inflammatory diet, and constant digital input have an effect on the structure of the brain, and that effect includes disconnection syndrome, or a weakening of the connection between the prefrontal cortex and amygdala. “The world around us is actively hacking into us to rewire and restructure and refunctionalize our brains for a negative outcome,” he says. “A strong connection between the prefrontal cortex and the amygdala is really what separates those who actually accomplish lifestyle change and can make these things stick in their lives, and those who can’t.”

We all want to be in the former camp, obviously. Luckily, Dr. Perlmutter talked with us about how to improve your brain so that you can make healthy choices and accomplish big things going forward.

An 8-Point Plan for How to Improve Your Brain

Once Dr. Perlmutter understood that disconnection syndrome was behind people’s inability to make healthy, lasting changes, he needed to find a way to address the root issue. That meant coming up with a way to re-open the lines of communication between the amygdala and the prefrontal cortex, allowing “the adult in the room” to help guide our choices once again. 

What he found was that there are eight elements that are essential when you’re trying to figure out how to improve your brain and beat disconnection syndrome. They are:

1. Getting enough sleep. With the constant push to be productive, lack of sleep is almost encouraged in modern society. But if you don’t get enough restorative sleep, Dr. Perlmutter says, you’re going to be much more impulsive the next day (next time you sleep poorly, notice whether or not you crave sugar — chances are, you will!). 

2. A healthy diet. The predominant Western diet is high in red meat, sugar, refined carbs, and processed foods, all of which increase inflammation. Inflammation, in-turn, impairs brain function. Adopting an anti-inflammatory diet can give your brain the support it needs to function optimally. 

3. Regular exercise. Physical activity helps reduce levels of the stress hormone cortisol, which is important because cortisol can lead to more disconnection in the brain. Exercise also reduces inflammation

4. Using technology wisely. Mindless use of our phones or other devices trains our brain to be impulsive. Being mindful and intentional with the digital world helps put the prefrontal cortex back in charge. Think using your device for a purpose, like looking up directions, texting someone to tell them you’re running late, or seeing if it’s going to rain later, rather than mindlessly scrolling through social media, refreshing email, or opening every app on your phone!

5. Meditation. Dr. Perlmutter told us that meditation is extremely effective at lighting up the prefrontal cortex, and that this effect persists long after your meditation session ends. 

6. Investing in relationships. Reconnecting with the people close to you and making an effort to spend time engaged with other human beings can help beat disconnection syndrome. 

7. Spending time in nature. On average, Americans spend 87% of the time indoors, and 6% in their cars — yikes! That’s a combined 93% of our lives not outside, which is pretty depressing on its own, but Dr. Perlmutter finds it particularly problematic because nature reduces inflammation and cortisol and fosters less impulsivity. If you can’t get away to a national park or take a long walk outdoors, Dr. Perlmutter says that even just a plant in your home or a photograph of the natural environment can help. 

8. Practicing empathy. Today’s world is an extremely polarized, isolated one. Many people exhibit impulsive behavior by making mean and hateful comments on the internet (or just in their own minds). Exercising the impulse to hate those that you don’t know or understand further weakens the connection between the amygdala and the prefrontal cortex. By practicing empathy and showing compassion for the perspectives of other people, you can strengthen this connection.

All of these elements are essential when it comes to how to improve your brain and beat disconnection syndrome. However, if Dr. Perlmutter had to rank them, he says that getting enough sleep and using technology less and more intentionally are the two most important pieces. Let’s take a closer look at both of them. 

How to Improve Your Brain By Changing Your Digital Experience

The internet can provide a lot of value, but it feels like every day we’re learning more about the harm it can do as well. The effect it has on your brain is a prime example. 

Clickbait headlines, autoloading videos, constant pop-ups, push notifications, and suggested content that’s tailored for you — all of those things make you more distracted, more impulsive, and less able to access the part of your brain that thinks critically and keeps a long-term perspective. In other words, when you use technology mindlessly, it makes it nearly impossible for you to make good decisions. 

“The screen is a useful servant, but a dangerous master,” says Dr. Perlmutter, paraphrasing Nobel Laureate Christian Lange. “Let’s allow it to serve us, but let’s not be used by it, which is what is happening.”

To help people benefit from the convenience and power of our digital world without damaging their brains, Dr. Perlmutter came up with a helpful self-assessment called the Test of Time. It’s a simple acronym that you can go through whenever you find yourself on your computer, tablet, or phone to evaluate whether you’re using that technology in a helpful way (or whether the technology is using you)..

Time: Establish beforehand how long you’ll be on your device. “You know, it’s been said that when you have five minutes to spend on Instagram, it’s a great way to spend 35 minutes,” says Dr. Perlmutter (we can definitely relate — can you?). To combat this, just decide how much time you want to allot to the screen for a given task, whether it’s checking email or going on social media or finishing up some work. 

Intention: Make sure you have a clearly defined purpose when you go to your device. What is your goal? What do you hope to accomplish? If you can’t easily answer those questions, odds are high that you’re going to end up mindlessly scrolling.

Mindfulness: Speaking of mindlessly scrolling, let’s consider the opposite state, which is mindfulness. It’s important to consciously remain mindful when you use technology, which is hard given how hard that technology can try to distract us. Ask yourself whether you’re engaged and mindful of all of the things that are attempting to harvest your attention, because, as Dr. Perlmutter says, “there’s this great value in where your eyeballs go online — but it’s great value for others, not necessarily for you.”

Enrichment: Only allow digital experiences that are enriching to you. When you step away from the screen, do you feel better than you did before, or do you feel drained and like you just wasted time? Pay attention to this feeling, and adjust your use of technology accordingly.

“Technology is great, but it has to be reined in,” Dr. Perlmutter says. With the Test of Time, we have a simple tool for doing just that. We’re definitely going to try this — will you? 

Sleep and the Brain (and the Relationship Between Blue Light and Sleep)

One thing that our conversation with Dr. Perlmutter highlighted was just how important sleep is to brain function, and how few of us are getting the sleep we really need to function optimally.

Dr. Perlmutter told us that at least a third of American adults don’t get restorative sleep, and that the effects of this are significant — which is probably why it’s the most important step in his 8-step program to improve brain health.  

“If people really want to leverage one thing, I would say look at your sleep hygiene,” he says, comparing sleep to a “magic pill” for disconnection syndrome. Sleep hygiene refers to all the things you do during the day and in the time before bed that can either help or hurt your sleep quality. There are a lot of habits that could contribute to poor sleep — drinking caffeine too late in the day, exercising at the wrong time, eating heavy meals — but one of the major culprits is blue light. 

Many of us use our devices late in the evening, whether it’s scrolling on your phone, reading a book on a tablet, or finishing up some work on a laptop. But all of those devices emit blue light, and the relationship between blue light and sleep is powerful, since this kind of light inhibits melatonin. This matters for sleep, because melatonin is a hormone that regulates our sleep/wake cycles, and thus helps us fall and stay asleep. To avoid the effects of blue light, it’s important to stay away from your devices in the hours leading up to bed. 

Unfortunately, the relationship between sleep and the brain is so complex that even if you’re getting eight hours, you might still be experiencing issues in your brain function. That’s because the kind of sleep you’re getting matters just as much as the amount you’re getting. As Dr. Perlmutter explained to us, you need deep sleep to activate the glymphatic system and remove waste from your central nervous system, while you need REM sleep in order to process and contextualize your experiences and memory. REM sleep in particular is critical when it comes to reconnecting to the prefrontal cortex and offsetting disconnection syndrome. 

So how do you know if you’re getting the restorative sleep you need for your brain to function optimally? Dr. Perlmutter shared a few suggestions:

  • Try a wearable device that gives you data on your sleep quality. He uses the Oura Ring, but there are several other smartwatches and wearables that have a similar function. These types of devices can clue you into sleep issues you might not know about, like sleep apnea or periodic leg movements. 
  • Go to a doctor’s office and get a polysomnogram, which records your brain waves, oxygen level, heart rate, breathing, and eye and leg movements while you sleep. 
  • If you have a partner, ask them if they’ve observed anything notable while you sleep. Do you snore? Stop breathing? Kick the sheets? That’s all good information to have, because it can alert you to things that may be pulling you out of important stages of sleep. 

Once you have a sense of your sleep quality, you can begin making changes to try to improve it and track your progress. “Who knows what it may be,” says Dr. Perlmutter, “but being able to have that feedback is really great, because you can have a single variable, make a change, and then see what it’s like the next night.” For him, he found that even checking his email after dinner was impacting his sleep quality (see the power of blue light and sleep??), but everyone’s particular sleep sensitivities will be different. Ultimately, the most important thing when it comes to sleep and the brain is to prioritize restorative sleep and make lifestyle changes that support it. 

The WellBe Takeaway on Dr. Perlmutter’s Advice for Your Brain

Dr. Perlmutter’s research makes it clear that our modern lifestyles are damaging to our brains, which then leads to damage in other parts of our health. It made sense (but was surprising!) to learn that our fast-paced, stressful, “always on” modern lifestyle has had a physical impact on our brains, mostly for the worse. The good news is that there are things you can do to combat this reality and become a calmer, more empathetic, more clear-headed version of yourself. 

Here’s cheat sheet of takeaways from our interview with Dr. Perlmutter:

  • Our behaviors are driven by two regions of the brain: the amygdala and the prefrontal cortex. The amygdala is impulsive and rewards immediate gratification, while the prefrontal cortex acts as the “adult in the room.” The connection between the two is crucial to our ability to make good decisions.
  • Our modern lifestyles, especially our relationship to technology and devices, have severed the connection between these two brain regions, leading to “disconnection syndrome.” Because of this, our amygdala rules our behavior, leading to impulsive and unhealthy choices.
  • Dr. Perlmutter’s advice for how to improve your brain and beat disconnection syndrome includes 8 parts: 1) Eating a healthy diet; 2) Exercising; 3) Using technology judiciously; 4) Meditating; 5) Getting enough quality sleep; 6) Exercising empathy; 7) Spending time in nature; 8) Investing in relationships.
  • The two most important parts of that eight-point plan are getting quality sleep and using technology more intentionally (and less).
  • When it comes to using our devices, we should use the acronym “TIME” to make sure we’re using it wisely. TIME stands for: Time, Intention, Mindfulness, Enrichment
  • When it comes to sleep and the brain, it’s important to not only get enough sleep, but also get the right kind of sleep. You can use a wearable, get a sleep scan, or talk to your partner to get data on your sleep, and then adjust your sleep hygiene to improve it.

In the end, it’s important to not get overwhelmed by these eight steps, or to give up because you’re having trouble with one of them. As Dr Perlmutter says, “it doesn’t matter where you jump on the carousel. It might be by paying attention to your sleep, changing your diet, getting out into nature — whatever it takes to get you a little bit better in terms of your decision making, that will be feed-forward and translate into better decision making across the board.”

Watch our full interview with Dr. Perlmutter to learn the role CBD plays in brain function, how being more empathetic relates to your neurological health, why he goes to conferences that have nothing to do with his speciality, the specific gratitude practice he does every morning and why, and much more.

You can also listen to an audio version of our interview with David Perlmutter on The WellBe Podcast.

Which of Dr. Perlmutter’s 8 steps to improving your brain do you find the most challenging? Why? Tell us in the comments below — I bet we can help each other come up with some good strategies for overcoming obstacles!


  1. Arnsten, Amy et al. “This is your brain in meltdown.” Scientific American vol. 306,4 (2012): 48-53. doi:10.1038/scientificamerican0412-48
  2. Gupta, Rupa et al. “The amygdala and decision-making.” Neuropsychologia vol. 49,4 (2011): 760-6. doi:10.1016/j.neuropsychologia.2010.09.029
  3. Domenach, P. et al. “Executive control and decision-making in the prefrontal cortex.” Current Opinion in Behavioral Sciences vol 1 https://doi.org/10.1016/j.cobeha.2014.10.007

The information contained in this article comes from our interview with Dr. David Perlmutter, MD, FACN, ABIHM, and board-certified Neurologist. His qualifications and training include graduating from the University of Miami School of Medicine. He serves on the Board of Directors and is a Fellow of the American College of Nutrition. He is an author, researcher, and lecturer, and serves as a member of the Editorial Board for the Journal of Alzheimer’s Disease. You can learn more about him here

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