The patients arriving at Dr. Jeffrey DeSarbo’s Garden City office aren’t always in crisis. Sometimes they’re successful executives. Sometimes they’re Division 1 college students, prominent politicians, or corporate retirees. But increasingly, they share something in common: a sense of drift.
“The level of background chaos people feel has increased,” says DeSarbo, a neuropsychiatrist who founded ED-180 Treatment Programs in New York to help people live better lives. “News cycles move faster. Social media never stops. There’s political tension, economic uncertainty, and global instability. Even when your personal life is stable, the world doesn’t feel stable. It’s in a rapid state of change and division and people sometimes just want to stick their heads in the sand.”
For years, DeSarbo did what neuropsychiatrists typically do: reduce symptoms, stabilize mood disorders, treat anxiety. But stabilization alone began to feel insufficient and even futile. “Symptom reduction is critical,” he says. “But what are we stabilizing people for? What’s the plan after the crisis?”
When Coping Isn’t Enough
That question led DeSarbo and his son Lukas, a psychotherapist, to write The Neuroscience of a Bucket List: Getting the Most from Your Brain and Life. The book isn’t about skydiving or exotic travel. It’s about giving the brain something neuroscience shows it desperately needs: intentional forward motion.
“The brain is predictive,” DeSarbo explains. “It constantly asks: where are we going? If the answer is unclear, it often fills in the gap with threat.” Without structured goals and meaningful anticipation, the brain defaults to rumination and worry. People scroll, consume headlines, react to crises, and forget how to deliberately design their own trajectory. This all negatively impacts brain development.
Drawing on his background and expertise in neuroscience, DeSarbo began asking patients unusual questions during psychiatric sessions: What does your baseline internal state feel like? If fear wasn’t leading your decisions, what would you pursue? What small experience could you plan for next month? Many struggled to answer. Some hadn’t thought beyond survival in years.
“When people start talking about something they’re looking forward to, something with deep meaning and purpose, even some small goal or interest, their neurobiological physiology changes,” he says. “There’s anticipation. There’s imagination. There’s movement.”
The Biology and Anti-Aging Effects of Anticipation
The science supports his approach. Research shows that anticipation itself activates dopamine pathways, not just the reward of completing a goal, but the expectation of it. “That means planning something meaningful can lift mood before it even happens,” DeSarbo says. “Hope isn’t abstract. It has circuitry.” He adds that the approach he outlines in his books also has strong anti-aging effects crutial to protecting one’s brain from cognitive decline as we get older.
His structured approach to life enhancement encourages people to develop categories of goals: micro-goals achievable within weeks, relational goals centered on connection, contribution goals rooted in service, and experiential goals that stretch comfort zones. Neuro-designing a bucket list is more about focusing on finding novelty, intention, purpose, and gratitude, not just fancy trips and thrill seeking adventures.
Beyond Crisis Management
After appearing on over 350 radio and television programs discussing brain health, the importance of leading a balanced life, and of avoiding toxic coping mechanisms such as alcohol, illicit substances and behavioral additions such as social media, DeSarbo has noticed the message resonating across demographics. Corporate executives struggle with burnout from demands without direction. Younger generations experience overstimulation without purpose and hope for the future. Across age groups, people describe feeling busy but not fulfilled. Anxious, and they’re not sure why.
“External instability requires internal structure,” he says. “If you don’t design your life on purpose, the environment will design it for you. We used to stress that we need to keep balance in life. Now, it’s better looked at as we need to find proactive ways to counterbalance the chaos of today’s world.”
His neuroscience-based framework for purposeful living reframes the brain not as a victim of circumstance but as an adaptive system that can be guided through intentional pursuit. The inspiration came partly from personal experience: his father, who lived 17 years with kidney cancer on home dialysis, traveled the world in a wheelchair rather than waiting for “someday.”
“In a chaotic world, ‘someday’ becomes a dangerous word,” DeSarbo says. ” My father showed me through his actions to stop focusing on the excuses we make for ourselves, and instead focus on finding solutions yourself.”
Now, through speaking engagements and educational outreach, he’s working to shift psychiatry from crisis management to brain-based strategies for life design. In an era where external chaos shows no signs of subsiding, his message is simple: building something meaningful isn’t indulgent. It’s protective and it’s necessary