In this episode of Field Notes, Dr. Rob Downey sits down with integrative psychiatric provider Dr. Josh Waddell to unpack mental health through a functional medicine lens—moving beyond symptom labels and "chemical imbalance" shortcuts to ask what's actually driving anxiety, depression, and emotional instability in the first place.

Dr. Waddell lays out a clear roadmap for understanding mental illness as a progression—from real-world triggers to cellular/mitochondrial disruption to downstream neurotransmitter changes—then introduces his practical "Four Pillars" framework (Body, Mind, Spirit, Environment) to help people pinpoint where their system is wobbling and what to address first.

The conversation is equal parts compassionate and actionable, emphasizing that mental health struggles are not a character flaw, that healing is often about restoring stability in the right pillar(s), and that the best plan is the one that meets you where you are—sometimes including medication as a bridge so deeper root-cause work can actually stick.

Learn more about Dr. Josh Waddell here: http://www.arukahwell.co

5 Key Takeaways

Mental health symptoms often follow a progression: triggers → mitochondrial/cellular dysfunction → neurotransmitter changes, so "root cause" usually sits upstream of brain chemicals.

The Four Pillars (Body, Mind, Spirit, Environment) offer a simple way to identify what's most off—and why progress can stall when you're only focusing on one area.

You can't out-supplement a toxic context: chronic stress, unhealthy relationships, burnout jobs, or constant distressing media exposure can keep the nervous system stuck.

A timeline exercise (mapping life events, illnesses, stressors, and turning points) can reveal the earliest catalyst and clarify where to start.

Supplements can help, but basics matter: food-first, third-party testing, avoid vague proprietary blends, and match herbs/supports to your symptom pattern—not trends.

In this episode of Field Notes, Dr. Rob Downey sits down with Dr. Jen Mann to talk about one of the most frustrating (and common) experiences in modern health care: the "mystery illness" — the symptoms that don't fit neatly into a diagnosis, and the exhaustion that comes from chasing answers. Instead of defaulting to more tests, more protocols, or another "perfect stack," Dr. Jen invites a different starting point: your body already has information — and learning to listen is part of the medicine.

Together, they explore how healing can be both science and art… and how true recovery often begins when we shift from "fixing what's broken" to cultivating more aliveness. Along the way, Dr. Rob shares how many patients get stuck in the pressure to "figure it out," and why the relief sometimes comes not from finally getting a label — but from rebuilding trust in your own internal guidance, regulating your nervous system, and finding support that makes the journey feel human again.

Learn more about Dr. Jen here: http://novawellnessmed.com

Key Takeaways

• Healing is both science and art. Tests and protocols can help, but they're most powerful when paired with presence, self-compassion, and deeper listening.
• Mystery illness can be a doorway, not a life sentence. Reframing symptoms as signals (instead of personal failures) reduces suffering and opens curiosity and growth. You are the primary agent in your healing.
• Doctors, supplements, AI, and tools can support you — but your relationship with your body is the foundation.
• Rigid wellness routines can become another form of stress. Hustle culture can sneak into "health" and keep the nervous system stuck in fight-or-flight. Regulation + connection accelerate recovery.
• Nervous system practices (done in ways you enjoy) and healing in community/partnership can fast-track progress and reduce overwhelm.

In this powerful episode of Field Notes—hosted by Nurse Practitioner Heather Moon—we're joined by Mary Ellen Doty, NP, a pioneer in wilderness medicine and founder of Wilderness Medical Staffing.

Mary Ellen shares gripping stories from serving as the sole medical provider in some of the most remote and unforgiving environments on earth, including Bush Alaska, where medicine is practiced not by protocol alone—but with presence, creativity, and deep respect for the human story.

Learn more about Mary Ellen here: https://maryellendoty.com/ Her journey reveals a stark contrast between relationship-centered care in extreme settings and the burnout-driven pace of modern corporate medicine, offering timely lessons on resilience, meaning, and what it truly takes to heal both patients and practitioners.

Drawing from decades of experience and her upcoming book Medicine at 50 Below, this conversation is a moving reminder that when medicine slows down, humanity shows up—and everyone benefits.

Key Takeaways:

True healing requires presence and time, not rushed, transactional care

Burnout in healthcare is driven more by loss of meaning than lack of money

Rotational and boundary-based work models can restore balance for clinicians

Harsh environments reveal the importance of community, adaptability, and systems thinking

Practicing medicine with purpose benefits patients, providers, and entire communities

This episode is a powerful reminder that the future of medicine isn't about doing more—it's about caring deeper.

If you've ever felt burned out, disillusioned, or called to a more human way of healing, this conversation will stay with you.