Nothing Exists in Isolation: What a Think Tank Taught Me About Environment and Mental Health

I just got back from the Nova Institute for Health annual meeting, and I’m still sorting through my notes. When I joined Nova as invited faculty, I wrote about why their mission lines up with mine: the idea that health lives at the intersection of people, places, and planet. This year was my second year sitting in the room for the think tank itself, and it felt less like a conference and more like a long dinner conversation with people who don’t usually share a table. Neuroscientists, rheumatologists, geographers, journalists, folks building AI tools. Nobody was selling a protocol.

I’m not going to summarize every talk. Instead, I want to share what stuck, and why it matters for how we think about environment and mental health, and the systems that shape both.

The acorn problem

One line from the AI panel became my lens for the whole meeting: an acorn only becomes an oak tree in the right context. The same acorn in a parking lot is… just an acorn.

That’s the whole game in nutritional psychiatry. We keep looking for the magic nutrient, the right supplement stack, the perfect protocol, as if the acorn could do it alone. But nothing exists in isolation. A person’s biology unfolds inside a family, a neighborhood, a food environment, and an economy. If we only treat the acorn, we shouldn’t be surprised when it doesn’t grow.

The brain is a prediction machine (and so is the food industry)

Dr. AZA Allsop is a psychiatrist, neuroscientist, and working musician, a combination I wish we saw more of. His talk was about music and the brain, and the core idea was prediction error: the brain cares about patterns, and it responds when a pattern bends in an unexpected way. He described the angular gyrus as a hub where social processing and music processing overlap, and shared work showing that people with dementia can retrieve memories through music. Live music, in particular, seems to reach people in a way that a recording doesn’t.

Two things hit me here.

First, prediction error is the language of reward learning. It’s the same machinery we talk about in addiction neuroscience. And ultra-processed foods are engineered for reliable reward: same crunch, same salt-sugar-fat hit, every single time. A brain built to learn from patterns is going to learn this one fast.

Second, the live-versus-recorded idea stayed with me. Something about being in the room, with other humans, changes what the brain does. I can’t help thinking about food the same way. A meal cooked and shared is a different event than the same calories eaten alone in front of a screen. Are we measuring the wrong thing when we only count the nutrients?

Self, non-self, and the inflamed mind

Dr. Ralph Snyderman asked a deceptively simple question: why are you really, REALLY here? He also offered a definition of the immune system I keep coming back to: its job is protecting self from non-self. That was the backbone of his case for whole health care that sees the whole person rather than a list of diagnoses.

Dr. Christina Lanata, a physician from Peru who works in autoimmunity and lupus, picked up the thread from a different angle. Lupus is, in a sense, what happens when the line between self and non-self gets blurry. What struck me was that she considers her patients’ state of consciousness as part of the clinical picture. She drew on Andean concepts like kawsay (living energy, or good living) and ayni (sacred reciprocity), and described the limpia, a cleansing retreat, as part of the healing context.

This is where my clinical brain lit up. A meaningful subset of people with depression show an inflammatory phenotype: elevated markers like hs-CRP and IL-6, often a weaker response to standard antidepressants, and frequently a history of early adversity. For these folks, depression isn’t only a serotonin story. It’s an immune story too. That’s why I pursued my functional medicine certification, and why at FxMed Mental Health we use lab testing to ask whether inflammation, gut health, or nutrient status is part of the picture before assuming another medication is the answer.

But ayni is the piece I didn’t expect to take home. Reciprocity. Our dominant food system runs on extraction: from soil, from workers, from our attention. What would it look like to eat in a way that gives something back? I don’t have a tidy answer. I just think it’s a better question than “what’s the healthiest diet?”

Counting what goes right

Dr. Christina Bethell at Johns Hopkins developed the Positive Childhood Experiences (PCEs) scale, and if you work in mental health, you should know it. Most of us were trained to count adverse childhood experiences (ACEs). Bethell’s work asks the flip side: Could you talk to your family about your feelings? Did you have at least two non-parent adults who genuinely cared about you? Did you feel like you belonged at school? In her 2019 study, adults with the most positive experiences had about 72% lower odds of depression or poor mental health, even after accounting for adversity.

This matters to me personally. I’ve written about how my ACE score is zero, yet I carried generational trauma. Counting only what went wrong misses a lot of the story, in both directions. In my practice, I’m increasingly curious about what went right: the grandmother who cooked, the coach who noticed, the family table that held people together even when other things didn’t. Those aren’t just nice memories… they may be part of the biology of resilience.

Trading connection for convenience

Journalist Juhie Bhatia talked about third places: coffee shops, libraries, barbershops. The places that aren’t home and aren’t work, where community actually happens. Her summary line was that we’re trading connection for convenience.

I underlined that twice, because it’s basically the business model of ultra-processed food. Convenience is the product. The cost shows up later, and unevenly. The same forces that hollowed out third places (car-centric design, rising rents, apps that deliver everything to your door) also reshaped how we eat. That is what I mean by the commercial determinants of health. Individual choices are real, but people make them inside environments designed for profit.

Environment and mental health: where you live gets under your skin

Yvette Cabrera, an investigative journalist and Nova Media Fellow, presented her reporting on lead contamination in Santa Ana, especially the Logan barrio in the 92701 zip code. UC Irvine research has confirmed the spatial patterns: contamination clusters in specific neighborhoods, and those neighborhoods are largely Latino and working class. Lead exposure has been linked to ADHD, and her reporting asks what that means for Latino kids growing up on that soil.

This one is close to home, an hour down the 405 from my office. When a kid in 92701 gets an ADHD diagnosis, the conversation in the clinic usually turns to stimulants. It rarely turns to the backyard soil. There’s a nutrition angle here too (iron and calcium deficiencies increase lead absorption, so food insecurity and lead exposure compound each other), but let’s be honest: a family can’t eat their way out of a contaminated neighborhood. This is a structural problem, and it deserves a structural response.

Dandelions, patterns, and how change actually spreads

Kate Morgan, a journalist and host of Nova’s podcast, made an unexpected case for the dandelion. We spend a fortune spraying it off our lawns, yet it has a long history as a medicinal plant with anti-inflammatory properties (most of the data is still preclinical, so I take that with a grain of salt). She emphasized how adaptive it is: it adjusts in real time and keeps coming back. Resilient by design. Some of what we treat as a weed might be medicine we haven’t learned to see.

Dr. Hannah Gosnell, a geographer at Oregon State who studies regenerative agriculture and transformative change, gave me the idea that reframed how I think about impact. Change doesn’t have to scale up. It can scale through pattern. One farm, one clinic, one family table that does things differently can ripple outward because others recognize the pattern and make it their own. She also pointed out that stories maintain the status quo as much as they bring about change.

That one landed hard, because nutrition is a field at war over stories. The diet culture story says your body is a problem to fix. The anti-diet story can slide into the idea that any food boundary is harm. Both hold some truth, and both, told rigidly, can keep people stuck. My work on ultra-processed foods and eating disorders lives in the uncomfortable middle, and Gosnell gave me better language for why that middle matters: it isn’t a compromise; it’s a different pattern.

So why am I really here?

Back to Snyderman’s question. The AI panel named a feeling a lot of us share right now: vertigo as the graph goes vertical. Technology is accelerating, and it’s tempting to believe the next app or algorithm will finally deliver personalized nutrition. Maybe some of it will. But a few days at Nova reminded me that the most powerful variables are still the slow ones: relationships, place, reciprocity, the context the acorn lands in.

Nutrition is still mostly missing from mental health care. Insurance barely covers it, and psychiatry remains dominated by a pharmaceutical model that treats the brain as if it were separate from the gut, the immune system, the neighborhood, and the dinner table. I think that’s changing, slowly, one pattern at a time.

So here’s my answer, at least for now: I’m here to help build the context. What would change in your own health if you treated your environment as part of your treatment plan?