In Episode #43, Dr. Jill interviews Dr. Robert Hedaya on NEW Frontiers in Treatment of Neuropsychiatric Disease: A Comprehensive Neuropsychiatric Practice Specializing in Advanced Treatment Methods & Life Changing Results. It features discussions on hyperbaric oxygen, qEEG, laser therapy, and more.
More Reading: Improve Your Health With Hope and Resilience
Dr. Jill Carnahan is Your Functional Medicine Expert® dually board certified in Family Medicine for ten years and in Integrative Holistic Medicine since 2015. She is the Medical Director of Flatiron Functional Medicine, a widely sought-after practice with a broad range of clinical services including functional medical protocols, nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness she brings a unique perspective to treating patients in the midst of complex and chronic illness. Her clinic specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and tailoring the intervention to specific needs.
Featured in Shape Magazine, Parade, Forbes, MindBodyGreen, First for Women, Townsend Newsletter, and The Huffington Post as well as seen on NBC News and Health segments with Joan Lunden, Dr. Jill is a media must-have. Her YouTube channel and podcast features live interviews with the healthcare world’s most respected names.
A popular inspirational speaker and prolific writer, she shares her knowledge of hope, health, and healing live on stage and through newsletters, articles, books, and social media posts! People relate to Dr. Jill’s science-backed opinions delivered with authenticity, love and humor. She is known for inspiring her audience to thrive even in the midst of difficulties.
Dr. Jill 00:12
All right. Hey everybody! Welcome back, [here on] Facebook Live. I know a lot of you are probably on break, so thanks for joining us. Some of you, like me, took last week off and are working this week. But I do have today, and I am so excited to be here with Dr. Hedaya. I will introduce him in just a minute.
Dr. Jill 00:29
But just some housekeeping items: If you've been on my page, this is recorded so you can come back and listen if you missed any pieces. It will also be on my YouTube channel, which is just under my name, Jill Carnahan. There are loads and loads of great interviews and free content there, so I would encourage you to go visit if you like this interview. Go see what else we have.
Dr. Jill 00:51
Today is going to be really, really exciting. You're just going to have to hang onto your brains because we're going to go deep into some of the technical aspects of neuropsychiatric illness and new frontiers in treatment. So just stay tuned. Dr. Bob Hedaya is an expert leader in this field, and I'm super excited. And I'm going to be learning along with you all as well. So thanks for joining us.
Dr. Jill 01:13
I'm going to introduce Dr. Robert Hedaya first here. He's been practicing at the cutting edge of psychiatry—clinical psychopharmacology and neuropsychiatry—since 1979. He [has] formally pioneered the use of functional medicine in these fields since 1996. And if I recall [correctly], Bob, I think you and I probably met through IFM somehow along the way. I know you were teaching, and I was as well. We were probably among the first to be certified.
Dr. Robert Hedaya 01:40
Dr. Jill 01:41
He's a clinical professor of psychiatry at Georgetown University Medical Center, where he's been awarded “Teacher of the Year” in psycho-neuro-immuno-endocrinology. Say that three times fast. [laughs] He's also the winner of the prestigious Vicennial Award at Georgetown and an educator and faculty member at the Institute for Functional Medicine. He is the author of three books—Understanding Biological Psychiatry, the Antidepressant Survival Guide, and Depression: Advancing the Treatment Paradigm—and the founder of Whole Psychiatry & Brain Recovery Center. He's an editor of one of my favorite journals, Advances in Mind-Body Medicine and Alternative Therapies in Health and Medicine. He's been featured all over. He's such a well-known teacher, beloved by all. I love having people like you, Dr. Hedaya, on the podcast.
Dr. Robert Hedaya 02:33
Dr. Jill 02:35
Bob, thank you. You bring this inquisitiveness and curiosity. And I come with the same thing, where we're just looking for new things and answers. And I think that's why, compared to all of our allopathic colleagues who are still in the conventional paradigm, we were trained in this. It's given us an incredibly strong foundation. But what we've done is we've asked more questions. We've been a little more curious, and we're kind of on the edge sometimes. But the edge is where progress is happening, where change is being made, and where you and I are seeing miracles. So thanks so much for joining us. I'm just delighted to have you here.
Dr. Robert Hedaya 03:11
Oh, it's great to be here, Jill. It's really a pleasure. Really a pleasure.
Dr. Jill 03:14
Thanks. I'd love to know: Why did you get into medicine? How did you first get connected to psychiatry? Tell me a little bit about your story and your journey here.
Dr. Robert Hedaya 03:23
That could take the whole hour, I'm telling you. [laughter] It was an accident. I was going to be a surgeon. I hated psychiatry, and my mentor actually said: “We got a kid on the fourth floor who has abdominal pain. We can't explain what it is. I'm going to teach you how to hypnotize him. Go hypnotize him.” I said, “I don't know how to hypnotize him.” So he hypnotized me, and he said, “Now go do it.” So I went up, and I hypnotized this little 10-year-old or something like that. I age-regressed him to 3 [years old]. Then I was like, “Oh my God, I don't know how to get him back.” So I improvised and brought him back, and his pain went away. And I was like: “Wow! I am blown away by the mind. I'm blown away. I will never ever be bored by this.” So I went to the dean of my medical school and I said, “Hey, I'm switching from surgery to psychiatry,” and he called up Georgetown. He said, “I got a guy here.” And I was in Georgetown, and that was it.
Dr. Jill 04:32
Did you always want to go into medicine? Did you have that heart from a young age?
Dr. Robert Hedaya 04:36
There was like a GPS signal in my brain. I didn't know why, but there was a GPS signal. It was medicine. That was it.
Dr. Jill 04:46
Oh, I love that. The same way, and I didn't even know because I was looking at acupuncture and chiropractic and all these alternatives. But there's this healer that's kind of inborn in us. Part of it was that curiosity we talked about because we love to seek answers and we love to help people find answers in the journey. And even in that experience with a 10-year-old boy, you took a totally unique route and probably helped him relate to come to some—
Dr. Robert Hedaya 05:13
He should only know what he did for me. He doesn't know.
Dr. Jill 05:19
Yes, maybe someday you'll meet him again. And then tell me more about the journey. So you got your residency and training in psychiatry. And then did you go right into conventional psychiatry? What happened after that?
Dr. Robert Hedaya 05:30
I went into conventional psychiatry. I would say that I have a high tolerance for not knowing. A high tolerance for uncertainty. A high tolerance for anxiety. You're sitting in front of somebody, and you don't know what the answer is. You have to tolerate the anxiety of not knowing. That's tough. There were certain markers along the path of my career—a woman who had panic disorder was untreatable until I figured out that she had a B12 deficiency, and then her panic went away, and then my own chronic fatigue syndrome—that got me into functional medicine. And then I was treating my patients. I was a psychopharmacologist, and I was using a lot of medications in cognitive behavioral therapy, which was cutting-edge at the time. Then, when I got into functional medicine, I was blown away by the efficacy in my treatment-resistant patients.
Dr. Robert Hedaya 06:31
Particularly after my second book, which was a best-seller, we had a flood of patients. I was treating everybody. They were all motivated through functional medicine. They're all getting better. Then I thought: “Everyone's getting better. I must be lying to myself.” So I did a retrospective analysis of the patients. It was 23 patients over a period of about 18 months with treatment-resistant depression, and they all got better. These were severe depressions with no medication changes except for one patient. That was pretty astounding. So really, I switched. I still do some psychopharmacology. It's a useful tool, but it's way, way overused.
Dr. Robert Hedaya 07:12
I've been doing functional medicine pretty much since the late '90s. Then, about two and a half years or so ago, I just really went on a learning quest and started to read about lasers. I didn't know anything about lasers at the time. People were doing some work with lasers. I was blown away. I said, “This could really help people.” So I started studying lasers, and then I bought a laser. And then, somewhere along the line, I said, “Well, I've got to know where to apply the laser.” So I investigated qEEGs and basically developed the method through which I use qEEG-guided laser treatment of the brain. We layer that on functional medicine, along with hyperbaric oxygen, neurofeedback, and some other medications that I wasn't using before for traumatic brain injury when needed. I like to avoid that. So I've really come to a big change. It's a long way from where I started, but it's a big change. And now I can help a lot of people that I couldn't help.
Dr. Jill 08:35
I love that. And if you're listening, we are going to dive into qEEG. If you don't know what that is, we're going to dive into HBOT, which you probably don't know what that is yet. And we're going to dive into lasers. And I want to hear Dr. Hedaya tell us all about each of these things. He's actually going to share a few cases. So stay tuned. Before we do, our common interest was functional medicine, and both through our own journeys and illnesses, we kind of found that. And when did you first come across functional medicine? Do you mind telling just a little bit of your story about the fatigue and then how you got into functional medicine?
Dr. Robert Hedaya 09:05
I didn't know it was functional medicine. Jeff Bland was calling it, I think, metabolic medicine before. Then I wrote my first book, and I had a chapter in which I had an acronym, THINKMED, which was tumors and inflammation, etcetera—all the functional medicine nodes. Jeff Bland saw it. So he contacted me, and he interviewed me. Then I finished my book. I was exhausted after my book, and a nutritionist friend said, “I think you're on the edge of chronic fatigue.” So I tested my natural killer cells. My NK cell activity was low, and I became very alarmed. And I was like, “Wow, I've got to change my behaviors.” I changed my diet, started exercising and supporting my adrenals, etcetera. I recovered very quickly. Then I started to learn functional medicine or metabolic medicine more formally, which was overwhelming because the amount of information was crazy. And then, by, I think it was 1999, I went to, I think that it might have been the second AFMCP—
Dr. Jill 10:18
I knew you were on the cutting edge. You were, like, the very first cohort.
Dr. Robert Hedaya 10:22
It was like 30 people. It was unbelievable. It was truly a gift. Truly a gift. What Jeff Bland has done is just phenomenal. Just phenomenal.
Dr. Jill 10:34
It really is. And I remember the same journey for me. When I heard functional medicine, “What is it?” It's kind of like what my heart has always wanted to do all along, but I didn't know there was a name for it. And for those of you listening, if you know me—of course, hopefully, you know what functional medicine is—basically, we're looking for the root cause of disease. And we're not throwing aside our medical training. We're both allopathic physicians and trained in the best medicine in our system right now for trauma and these kinds of things.
Dr. Jill 11:00
But I always say it's like our toolbox was just small enough to have medication, surgeries, interventions, and psychopharmacology. Now our toolbox is much, much bigger. And some of the things you're going to talk about today are even more tools. Before we started recording, we were talking about how even supplements, nutrition, and lifestyle are core functional medicine concepts. But now we have lasers. I have red light therapy here. I have PEMF behind me. And then even dealing with childhood trauma and limbic system activation, it goes so much broader than even just functional medicines. So our toolbox just keeps getting bigger.
Dr. Robert Hedaya 11:39
It really does. And it has to, because illness is becoming, in a certain sense, more complex. In a certain sense, we're really learning that most chronic illnesses have their origins in one or two processes. Like insulin resistance, it affects the whole body.
Dr. Jill 11:56
Yes! When I remember really diving into teaching LPS endotoxemia—which is, for those of you listening, when the bacterial coating of the gut crosses over into the immune system—this is probably the underlying factor in the majority of heart disease, obesity, diabetes, mental illness, depression, anxiety, insomnia, bipolar, etc., and back to the gut. Some of the founders of functional medicine said, “Start with the gut.” Well, they were right, because a lot of our psychiatric illnesses start with the gut. And of course, there's a lot more, but—
Dr. Robert Hedaya 12:24
What I'm going to show you today is mind-boggling. My mind has been turned inside out by what I'm going to show you. I tell my wife: “Honey, my mind is blown. I cannot believe that I have practiced with psychiatric patients all this time, and what I have been missing blows my mind. Blows my mind.”
Dr. Jill 12:48
Oh, I am so excited to dive in. I also just want to say to those listening, if you don't know Dr. Hedaya, what I love [is that] he's humble. He is the most kind and generous kind of person you'd ever want to meet. But he is brilliant. You guys are in the presence of genius, and I just have such great respect for you. I really mean that, Bob. You've been an inspiration to me, and I just feel honored to be your colleague and be in these circles. Well, let's kind of dive in. First of all, tell us what your practice is and the kinds of patients that you see. Then let's define some of these things that you're using, and then we can dive into the cases of how you're using them.
Dr. Robert Hedaya 13:23
I really see [people] from [ages] 10 to 90. The primary issue for me is that functional medicine is complex and demanding. It's not easy. It's not “swallow a pill and get better.” It's lifestyle change, it's supplements, it's exercise, and it's organization of this. You need support, and you need to find the resources for the testing. I'm very data-driven. So I like to know what I'm doing. I don't like to guess, etcetera. So one of the things is, does the person have support? Can they pull this thing off or not? And that's very important. But for me, what I see is that it's such a broad range because it's psychiatric. I see people with early cognitive decline, vascular dementia, and Parkinson's disease. There are certain things I won't touch because I know I can't help. ALS, for example—I can't do anything for that. And then the psychiatric problems, from A to Z, really. Along with that, as everybody really knows, come all the comorbidities like diabetes and hypertension. So I'm kind of an internist.
Dr. Robert Hedaya 14:36
And now with COVID, I'm very involved with COVID. I've been working very intensively with the ICU doctors at Cornell and Mount Sinai, which is quite a headache because they are so locked in. These are very bright people. They're very bright people. They're encyclopedic in their knowledge, but they don't think. Most of them don't think. I kind of joke that if they were on Apollo 13, it would not have come back.
Dr. Jill 15:05
No, you're right. There's something unique that connects us in functional medicine, and it's the curiosity and the willingness—you said it best—to go to that place of uncertainty. And I always say that number one is asking the question, ‘Why?'
Dr. Robert Hedaya 15:19
Right. You have to just follow the evidence. Follow the data; that's all you have to do. Look for the truth. That's what you have to do.
Dr. Jill 15:29
I mean, I'm a very analytical, left-brain kind of person. I had an engineering background. But as I've grown into my career and what I do, I really tap into the right-brain intuitive side because I feel like we can process millions of points of data in a split second with our subconscious versus linear thinking. And it actually totally expands our ability to get new and creative answers to difficult problems. Don't you agree?
Dr. Robert Hedaya 15:54
Yes, so what I find is that as I'm getting deeper into all of this stuff, my right brain is falling behind. [laughter] It's not good. It's not good.
Dr. Jill 16:07
Well, this is great. So we've got a foundation of what you treat. And again, we're going to go to cases in a bit. But tell us a little about some of these new modalities because some of these terms [such as] qEEG, HBOT, lasers—what are they?
Dr. Robert Hedaya 16:20
Okay, great; qEEG is quantitative EEG. The EEG, for people who don't know, is basically where you put a cap on. You can do 139 measurements, but we use a 19-channel, which is what's used clinically in most cases. Some people use less. And you're measuring the electricity at the surface of the brain in the different areas—the frontal, temporal, occipital, and parietal areas of the brain. You're measuring them and comparing them with standard measurements, [such as] age, sex, etc. Then you see which areas of the brain are overactive and which are underactive. There are amazing mathematical calculations that have been done so that you can actually use the surface data to accurately predict what is happening with deeper structures in the brain and also with neuronal networks in the brain.
Dr. Robert Hedaya 17:17
So you can actually say, “Oh, this nerve track is under-functioning.” It's under-communicating or over-communicating. They're both bad. They're both non-functional. So with the qEEG, you can actually know what's going on inside the brain better than an MRI. Now, it is not for looking for tumors. This is different. This is a functional test. But you can actually see how the brain is functioning at a very remarkably detailed level. I think the resolution is 21 cubic millimeters, or 21 voxels, which is pretty good. It's not great; it could be better. But it's on par with MRI and PET, actually.
Dr. Jill 17:58
So, a couple of questions. And, again, I'm just coming as an ignorant because I don't know the details here. First of all, some of us in mold, Lyme, and these kinds of chronic infections and toxic things are doing NeuroQuants, which are volume metrics, for people listening, of the regions of the brain. For example, the hippocampus is blown up spherically, and they give a volume that is age-matched. They say, “Is this shrunken”—atrophied or hypertrophied—”or inflamed? I have a feeling that that does not correlate completely. We really don't know how it correlates. But what are your thoughts on NeuroQuant compared to this [in terms of] accuracy, and if there's even value in NeuroQuant?—because I don't know what to make of it yet.
Dr. Robert Hedaya 18:40
It's a great question. In not a lot of patients, but in two patients, I have been able to have a NeuroQuant and compare it to the qEEG, and it actually correlates.
Dr. Jill 18:50
Interesting. That's what I was thinking, because I'm guessing it's hypofunctioning in some of the atrophied areas. And it could be with inflammation, I'm assuming, like frontal lobe inflammation or—
Dr. Robert Hedaya 19:01
If you're atrophied, for example, then what you're going to see is decreased function. And if you're hypertrophied, you'll see decreased or altered function. But the difference will perhaps be that you might see something that's called hypercoherence or hypocoherence—over coherence or under coherence—meaning, are the neurons communicating? Think of it as waves in the ocean. You have waves in the ocean, and you want to accelerate a wave. Then the next wave has to come at just the right time, and then it'll accelerate it. If one neuron wants to talk to another neuron in a different part of the brain, it has to send its signal at just the right time, and it has to arrive at just the right time in order to accentuate or cancel whatever the intended effect is—the wave at the other point. So if the waves are out of sync, then you have reduced communication either because of excessive wave activity or underactivity. What I have found is that the areas that are disturbed on the neuroquant seem to correlate with the areas that are disturbed on the qEEG.
Dr. Jill 20:15
Okay. That's good. I have seen some changes with treatment on the NeuroQuants, which is exciting to see. We say that the hippocampus won't change, but I've actually seen it go from 40% to 60% to 80%.
Dr. Robert Hedaya 20:28
Well, if we have a chance, I'm going to show you a woman's hippocampal change.
Dr. Jill 20:35
Oh, good. I can't wait! So one other thing on the qEEGs, and again, just for myself and everybody listening, can you describe a little bit about the different waves and what they mean, like beta, delta, and gamma?
Dr. Robert Hedaya 20:45
Sure, sure, sure. We divide the waves into categories. We give them silly names. When we talk about the frequency of the neurons and how they fire, when they fire one time per second, we say it's 1 Hz, because Hertz is the guy who discovered the frequency. So 1 Hz are neurons that fire one time per second, and 2 Hz are neurons that fire two times per second. And we measure them. They can go up to hundreds of Hz in the brain. But we right now only have the capacity, and at least in my clinical awareness of measuring, maybe up to 40 Hz.
Dr. Robert Hedaya 21:26
So the 1 to 4 Hz, one to four times per second, are the delta. And the deltas are kind of like unconscious processes. When you go into deep sleep, that's delta sleep; that's 1 to 4 Hz. Your neurons that are firing primarily are the ones that are firing one to four times. It's slower. It's only one to four times. Now, when we get to 5 to 9 Hz, it is called theta. And theta is really where you have a lot of the emotional regulation, so 5 to 9 Hz. And that's where you find seizure activity, for example, typically at 6 and 7 hertz. And then, when you get to 10 or 11 Hz, we call that alpha. That's the frequency at which you're aware of your internal environment, you're aware of the external environment, and you're very relaxed. Meditators have a lot of alpha.
Dr. Robert Hedaya 22:22
And then, when we go above alpha, we go from 12 to 30; let's just say, that's beta, which is subdivided. But beta is firing, let's say 12 to 30 times per second. That's a lot faster. Now, if you just think about it, if you're trying to solve problems in your environment, you've got to be really, really quick. You're going to be doing a lot of beta. If you're anxious, you're going to be doing a lot of beta. So that's kind of a broad assessment of these things.
Dr. Jill 22:51
Oh, this is super helpful for the listeners. And then the other thing I was going to ask—a little sidetrack here—you've heard me talk about Vielight. It's kind of old-school now. There are so many other things out there. I still like it, and I have the alpha Vielight. So it's at that hertz. And for me, it helps me to focus and probably come down from my beta. For people listening, this is a red light that actually has a prong that goes up your nose, so it hits through here. And you can probably describe better what that does, Bob. And then it sits on the head and actually through the skull. What do you think about red light? Any thoughts on that?
Dr. Robert Hedaya 23:29
The studies done by Henderson show that with a high-intensity laser, say 10 or 15 watts, only 2.4% to 2.9% of the light actually penetrates the skull, the meninges, etc—without the hair. Forget the hair; you've got to shave. So you're getting a very little amount of light. And when you're using something, say a quarter of a watt, not 10 or 15 watts. I wonder if it's penetrating the skull. There are studies that show that there's efficacy, although I think a lot of them are done by the company. But they still show efficacy. So I wonder, and people wonder, if it's related to the remote effects of the light, say on the blood or something like that. Now, when you talk about the light in the nose, there's still a lot of tissue that it has to go through. So I don't have an answer. I'm not ready to say, “No, it's not valid.” I can't say that I just can't understand it.
Dr. Jill 24:35
I totally understand. Now, what you're doing with lasers, though, is on another level. It's a similar idea, but way more powerful. So tell us a little about lasers.
Dr. Robert Hedaya 24:43
It's not only more powerful… it's just incredible.
Dr. Jill 24:48
So tell us about the lasers, because I want to hear about that.
Dr. Robert Hedaya 24:51
All right, I can't contain myself.
Dr. Jill 24:53
I know! Me neither!
Dr. Robert Hedaya 24:55
I have to just show you. I'm going to show you one slide here. I'm going to share my screen here. Let's see.
Dr. Jill 25:04
I think you should be able to do that.
Dr. Robert Hedaya 25:06
Here we go. I'm going to share my screen now, okay? So this here… Wrong one. Hang on. I'm sorry. Here it is. That should be it. There we go. Okay, so let me tell you about this guy. So let me actually orient everybody first. Anything that's gray is normal. Basically, you can see this guy's brain is completely normal, except he has a problem here and here. What we see over here is another way of looking at connectivity in the brain. So this is the right side of the brain. This is the left side of the brain. This is showing us that this part of the frontal cortex is over-signaling and very inefficient to this part of the… probably the parietal temporal, probably the parietal area. So this is where this guy was. Now, let me tell you about this guy. This is a guy who anybody would probably say is a paranoid schizophrenic. A 24-year-old guy. Oh boy. Oh boy. Oh boy. Anyway, this guy—
Dr. Jill 26:37
And, Bob, real quick, are we looking at qEEG data? Or forgive me, what kind of imaging is this?
Dr. Robert Hedaya 26:4
This is qEEG data. So if you look at this here, this is the superior occipital fasciculus. And this is the superior longitudinal fasciculus. This is the vertical occipital fasciculus here. Basically, this guy, his whole life, was seeing people as if they were—let me just expand this more here—looking at him in a demeaning manner. So he had a social phobia. Now, what happened here is that when I looked up this tract here, it turns out that this tract modulates the emotional valence of faces and is also involved in reading. This is also involved in facial recognition.
Dr. Jill 27:41
Is that one of the superior lateral inferior sulcus or one of those guys? Or am I totally off, Bob?
Dr. Robert Hedaya 27:46
Well, this isn't a sulcus. This is a connection. This is a connection between probably area 17 or 18 back here, Brodmann area 17 or 18, and a part of the temporal lobe, which is emotional regulation. So the emotional and visual areas are talking to each other, but they're not talking well. This here is under-connected. They're not communicating to each other. This one here is the frontal. This is kind of where you do your thinking, and this is also communicating poorly because it's overcommunicating. It's the equivalent of me yelling in your ear really loud. You wouldn't know what I was saying, [but] you'd know I was talking. And this is the equivalent of me whispering. You may know I'm saying something, but you don't know what I'm saying. So they're both very inefficient. This is, again, layered on a functional medicine program. For example, he was very gluten intolerant—extremely gluten intolerant. So we got him off gluten, got him off sugar, got him off dairy, and put the laser right here and right here. And four treatments later, the problem is gone.
Dr. Jill 29:02
Dr. Robert Hedaya 29:04
Now, here's the amazing thing. The amazing thing is that he starts reporting that these visual distortions are disintegrating. He starts to notice for the first time in his life that what he's seeing actually doesn't fit with the facts. Like, the person is talking nicely, but the face looks demeaning. Now he's beginning to make that connection. It doesn't actually fit. And by a month after the treatment, his visual distortions had melted away and were gone. So his social phobia, his anxiety, and his paranoia are gone. Now, I said to him: “You know what? You're like a colorblind person. If you were colorblind, I would not have you decorate my house. And the way it's been for your entire life is that you can't really read faces. You've been misreading faces. Of course you're having social anxiety!” There's more complexity, obviously, in this case. So that's the specificity that I'm talking about. Now, this is mind-boggling.
Dr. Jill 30:21
It is! I'm just literally jaw-dropped going, “This is spectacular!” It reminds me of years and years ago, the man who mistook his wife for a hat. Was he a neurologist, I believe, that—
Dr. Robert Hedaya 30:33
Now… Now, you're going to love this. Now, you're going to love this. It turns out that when he was young, he started having seizures. It turns out he started having seizures when he was 2. So his mother figured out that dairy, gluten, and sugar were a problem, so she got rid of those. The seizures went away, but his behavior became very difficult. His mom was going through a tough time, and she was aggressive with him. She's a sweetheart of a woman, so it's not like she's an abuser or anything, but she was irritable and temperamental, etc. And he became very frightened because he's a harm-avoidant kind of guy. He's just kind of built that way. So he had trauma. Now he's going through trauma therapy. We're dissolving that basic, fundamental anxiety that he's been living with his whole life. So there are lots of layers to this kind of thing. It's not just “point the laser”. It's not just functional medicine. It's also the trauma.
Dr. Jill 31:38
Bob, I love this. And for those of you listening, gluten—we always think of it as gut-affecting and causing celiac. But Bob and I know we see at least 50% of neurological complications from gluten. So it's funny because many people just [have] ataxia or, even like you said, psychosis or other behaviors or psychiatric illnesses purely with no gut symptoms at all.
Dr. Robert Hedaya 32:03
Right. So this is the idea. And this takes me back to my training, when at 12 o'clock the doctors were saying, “Well, the explanation of mental illness is cognitive problems.” At one o'clock, it's molecules. At two o'clock, it's the mother—Freud—and at three o'clock, it's the family system. And I used to go: “What? Who knows what is going on?” And the answer is: All of it's going on. The answer is: It depends on the lens that you use. What level is your lens [at]? How broad is your lens? How narrow is your lens? So in the whole psychiatry approach, we try to use many different lenses to identify the problem. So that's one example.
Dr. Jill 32:49
Wow! That is mind-blowing. I'd love to hear some more. I know you've got some cases. If you want to jump in and share a few, this is [inaudible].
Dr. Robert Hedaya 32:54
Let me show you another one here. This is patient zero. After I got my qEEG set up, my laser, and everything else, and I knew how to use these things and everything, this woman came to me actually six months before [that] with mild cognitive impairment and a temporal lobe seizure, which you didn't even know she's been having all her life. [She] also [had] prosopagnosia, so she couldn't recognize faces for the last seven years. She was post-menopausal. There's a whole history. She was, at one point, a drinker. She was exposed to some toxins, etcetera.
Dr. Robert Hedaya 33:49
We did the whole thing, and she was feeling so much better. But then I did a QEEG, and she was much better, but she was not well. So this on the left is her qEEG. Now we have a lot more information. What we see here—all this red area—means that these cortical areas on the surface of the brain are overactive. What causes the brain to be overactive? It's a lack of energy because the brain uses most of its energy to stop firing. You need energy to inhibit the action potential, and then you withdraw that when you need to send out the signal. But basically, most of the energy is spent stabilizing the brain. The brain is spending most of its energy inhibiting firing. So in this case, what you're looking at, even though it's red, is a brain that's firing wildly and out of control. And the area that's worst here in this woman, who's about 57, I think, is the hippocampus. Her hippocampus is very unstable.
Dr. Robert Hedaya 35:07
If you look down here… Let me enlarge this here. I can't enlarge it. But the hippocampus here is 2.8 standard deviations from the norm, so that's pretty abnormal. She was having cognitive problems. What you see here is her thalamus in red. That's also overactive. And you can see here that the connectivity is disturbed, etcetera. Now, this on the right is after, I think it was 17 treatments; this is still at 6 Hz. These are the neuron populations that are firing six times per second. And here is six times per second. You can see a vast improvement in the surface. It's not normalized yet, but it did normalize.
Dr. Robert Hedaya 35:59
And you can see that her hippocampus here—these crosshairs are on the hippocampus—is now 1.4 standard deviations from the norm. She's actually considered normal, and her memory did improve. Actually, her seizures went away. And here's the mind-boggler: After her first laser treatment at T3 on the left side of her brain, her ability to recognize faces came back completely.
Dr. Robert Hedaya 36:33
So basically, the neurons that are involved in facial recognition—there are a bunch of tracks, but some of them go through the temporal lobe—were alive, but kind of asleep. So with the focused laser treatment, we basically delivered ATP, or energy, to those neurons. This woman had her treatment, came back into my office 10 minutes later to schedule the next appointment, and said: “Oh my God, I remember the face of the person that I worked with this morning and his wife. She had a mole on her face.” And she went through the whole thing. Then we did a Cambridge Facial Recognition Test, and she was normal on the test. And it's remained normal. That's why I like using the qEEG to focus—
Dr. Jill 37:39
I am just blown away! I have a few practical questions. How long have you had the qEEG equipment in that? Has it been years or decades? Or how long have you been doing that?
Dr. Robert Hedaya 37:50
No, no, no. It's been about two and a half years, I would say.
Dr. Jill 37:54
And then the lasers—did that come after the qEEG?
Dr. Robert Hedaya 37:57
No, I didn't use the laser until I had the qEEG. I got the qEEG setup, which was not an easy task because the field is kind of arcane. First of all, I'm an Apple guy, and it's all on PC. That alone is horrible.
Dr. Jill 38:15
I know. Me too. I wouldn't know what to do.
Dr. Robert Hedaya 38:18
It's horrible. That alone is a trauma. So I got the qEEG set up. It's very difficult. And then I got the laser set up, and then I had to read the qEEG. I had to hire somebody to read it because it takes [inaudible]—
Dr. Jill 38:38
This is highly technical. That's what I'm saying: We're not trained in medical school at this level of neuropsychiatry.
Dr. Robert Hedaya 38:42
No, no, no. I still always, in every case, consult with somebody who's an expert. There are people who've been doing this for 20 to 30 years. They know what they're doing. But what I will say that they don't do, that I am doing, is analyze the pathways, like the guy where I talked about the frontal occipital fasciculus. I spent six hours going over his qEEG, correlating the symptoms in the tracks with what they do. And I identified these tracks.
Dr. Jill 39:15
Unbelievable. And you're right, this is mind-blowing. You're one of the few people who's really doing this, Bob. Is that correct? I don't know of anyone else.
Dr. Robert Hedaya 39:26
There are people doing laser on the brain—high-intensity laser. There's nobody that I know who is doing a qEEG-guided laser. I'm trying to get a setup where I can train clinicians and get more data so we can publish more data, of course. The lasers are very, very expensive. The qEEG equipment is expensive, etcetera. So I'm trying to figure out how to make that happen.
Dr. Jill 39:56
Exactly. Well, I'm going to be sure to share this as much as I can to get the word out. And at the end, we'll make sure [to include] where people can find you, if there's a clinician who's interested, or how we can support you because I want to support the work that you're doing. I think this is absolutely critical to the future.
Dr. Robert Hedaya 40:09
Let me blow your mind one more time.
Dr. Jill 40:12
Yes. I love this so keep going.
Dr. Robert Hedaya 40:17
Okay, let me share my screen here and show you this one here. So for people who don't know qEEGs, this is the raw data that we start with. It's a lot of squiggly lines, etcetera.
Dr. Jill 40:27
So in the images you were showing us, is that the analysis of the raw data put into images and places?
Dr. Robert Hedaya 40:34
Yes. It's a refined analysis. I mean, you could do a lot of analysis of this qEEG record, really. And you could see, for example, right here… Well, not exactly here. Somewhere in this record is a theta phase reversal, which is indicative of pre-seizure activity, etcetera. There's a lot you can learn from the raw wave, but it's actually more refined. This analysis here is more refined. The reason I want to show you this is because now, with this, I can actually move things around. I'll show you what's going on. So just to orient everybody, here it is like you're looking down at the person's head, slicing the top of the head off, and this is what you're looking at.
Dr. Robert Hedaya 41:18
Here, it looks as if you sliced the middle of the head. And here is a frontal slice, so the eyes of the person would be looking at you coming out of your computer. Here, what we have is a model of the person's head. And here in the blue [areas] are a bunch of nerve tracks that are under-communicating. For example, if we look here, we see the frontal lobes are not communicating. And we can look here at the particular tracks. Let me move this thing here. This should be the anterior commissure here. No, maybe not. Let's see. There's the corpus callosum. So that's the anterior corpus callosum. Do you see it coming and going? So I can say where the underfunction is happening. Now, this person obviously has a bunch of areas that are under-functioning.
Dr. Robert Hedaya 42:21
So the story with this guy, just to give you a little background: This is a guy who came to me twice. Once I treated him with functional medicine, helped him a little bit, and diagnosed Lyme disease, he went to a Lyme clinic where he had IV antibiotics. His temper and rage went down. But when he came back to me, his derealization was quite high—his depersonalization, [which affected him] 70% of the time, [made him feel] separate from his body. [He had] severe depression and difficulty falling asleep. Every time he'd fall asleep, he'd get alerted and activated. He had to sleep in his parents' home, in their bedroom. He was that anxious. So this is the first qEEG that we did. And here we're looking at the neurons that are firing one time per second. I'm just going to scroll up here, and you'll see.
Dr. Jill 43:16
So the delta, right?
Dr. Robert Hedaya 43:17
This is the delta. One, two, three, four. Now we get to four, and things start to change. We're at the top of the delta. We get to five. Now things are getting worse. Now we're in low theta. But what you see here as we go up here is that it's really getting pretty bad. If we go down here, what you see is another of those mind-bending things. Let me just scroll up to 9 for a second and see if it shows it better. No, he's better at 9. So with this guy here at 7, you see that the worst area that's picked up by the crosshairs is Heschel's gyrus. This is in the medial temporal area, the parahippocampal areas. And the parahippocampal areas are the first areas, and the thalamus, which is right here… Right here is the thalamus. So I'll bring the crosshairs here to the thalamus.
Dr. Robert Hedaya 44:23
These are the parahippocampal areas in here. The parahippocampal areas are the first areas to take a hit when you're hypoxic. So I went back after this analysis and asked his mother, “Did he ever have hypoxia?” And sure enough, she says she had a horrible 24-hour labor, and he was hypoxic. Wow. So what does this mean? You see that his thalamus gets worse as we go up here. It turns red. You see his thalamus here. Basically, he can't integrate his internal experience and the external experience—his whole life. He can't predict what's going to happen in his world because the thalamus is an integrating station from the internal to the external. And the thalamus sends fibers out to layer four of the cortex, and that's in the delta area and the theta area.
Dr. Robert Hedaya 45:29
So this guy can't function in the world. So he's having trouble getting through, and he starts using drugs. But he's growing up in a middle-class family, a professional family with good people, and he wants to have a life. But there's no way he's going to make a life for himself because he can't function because he can't integrate. So what do you get? You get depression. You get anxiety. You use drugs. You get dissociated, etc.
Dr. Robert Hedaya 46:01
So, long story short, basically, we did functional medicine. In his functional medicine analysis, his iron was running high. He tended to hemochromatosis, so we treated that. He had pyroluria. So we treated his zinc, his copper, his B6—he had some thyroid issues from really chronic stress—and [his] vitamin D [levels] [and] that kind of thing. And basically, then we gave him hyperbaric oxygen because that will work on these problems, and we did neurofeedback.
Dr. Robert Hedaya 46:37
In six months, he's got a job, and he's working full time. And we still have work to do, but he's not depressed. His depersonalization and dissociation are markedly reduced. He can sleep. Now, he couldn't sleep because, when you're going to sleep, your brain is winding down. It's going from beta/alpha to theta to delta; you're asleep. Well, every time he gets into theta, his brain is going wild.
Dr. Jill 47:04
Yes, it's like: Woo, party time!
Dr. Robert Hedaya 47:07
Yes, party time. He can't sleep. So that's the story on this guy.
Dr. Jill 47:15
Bob, you told me this is interesting, but literally, I could spend three hours here with you. We're going to have to come back, for sure. So a couple of questions I'm thinking [about] because I deal a lot with chronic environmental toxicity, just environmental chemicals and especially mold, and then, of course, Lyme and tick-borne infections. But what I'm hearing is that there's probably ancestral prebirth events, there's birth events, there's trauma, and then there's things like food, diet, and lifestyle. And then there is…
Dr. Robert Hedaya 47:45
Dr. Jill 47:46
Yes. We didn't even talk about concussions. But this is really what we talked about at the beginning before we got on: Functional medicine is just this much of what we do. And then adding these things on is so profound because there's no supplement that could do what you just showed us the laser could do. There's nothing like that. And it's profound because you're changing, and it's pretty instantaneous, right? You're getting a very quick result.
Dr. Robert Hedaya 48:07
We get quick results. The one guy I showed you before was four times. But the woman who had the MCI and the temporal lobe [inaudible] had, I think, 25 treatments. If someone has early dementia, for example, you might need ongoing treatments. I treated a guy with early vascular dementia, and he did everything I asked. One day, I texted him just to check in on him. And he said, “Oh, my memory is my new superpower.” I was like, “He must be having a good day, that's all.” But I took CNS vital signs on him, and he was not kidding. He scored in the 95th percentile.
Dr. Jill 48:51
Dr. Robert Hedaya 48:55
Maybe he'll need ongoing treatment—certainly an ongoing lifestyle change for his vascular system, etc.
Dr. Jill 49:01
Do you see any particular patterns that differentiate mold or Lyme? Or are they just all similar things that are dysfunctioning in different ways?
Dr. Robert Hedaya 49:10
No, no, there are definite patterns. In the mold situation, for example, you'll see a similar picture to what I just showed you: Broadened diffuse instability in the cortical areas. A broadened diffuse, really. It won't be localized because it's systemic. And as you know, you can do everything, but you're not going to get someone better if they're in a moldy environment. That's not happening.
Dr. Jill 49:39
I don't know the terms but like toxic encephalopathy—is that a good term?
Dr. Robert Hedaya 49:43
Yes. I think that's a very good term. You have to have the functional medicine. You have to have that. You need a lot of modalities. The neurofeedback in this guy that I just showed you was critical. It was very helpful.
Dr. Jill 50:01
What about infections? Are they more localized, say Bartonella versus Lyme? Or are they more—
Dr. Robert Hedaya 50:06
Yes, they're more localized. So here's another quick and interesting case for you. This is a 24-year-old sweetheart, sweetheart of a girl—an African American girl—who wants to own her own professional firm. She kept straight A's and [was] doing great, and then boom, she ends up in a psychiatric hospital five times. So she was treated for Lyme, not by me. This was all done before me. She was treated for Lyme and relapsed. She was treated for Lyme and relapsed. Hospitalization again. The treatments don't stick. So we did the qEEG. And we see this red pattern localized in the left frontotemporal area, the site of the infection, which is probably because she had a traumatic brain injury there when she was younger. She has seizures, which weren't picked up, but we picked them up.
Dr. Robert Hedaya 51:06
So we're treating the seizures with clonazepam and trying to get her on a ketogenic diet so we can get rid of the clonazepam. So her seizures are gone. She's doing better. And we're treating her gut because she has SIBO. She's got a lot of SNPs in her NR3C1 and FKBP5, so she has adrenal problems transmitting the cortisol signal to the nucleus. Most of those genes are variants. And she—of course, consistent with that—has a history of being unable to fight infections and getting sick easily. So I have to treat the gut, then I have to treat the adrenals. And then, when I've got the adrenals treated, I'm going to treat her with a couple of antibiotics that will go inside the brain. And then we're going to do—if we need to—neurofeedback or laser whatever. So I think what they're calling schizophrenia is not schizophrenia. It's an infectious cause, causing seizures and cognitive instability.
Dr. Jill 52:17
Absolutely. I see that all the time. One thing you mentioned that I think is true, and I want to see if you agree: Say you have a car accident with a neck injury, a low back issue, or a brain trauma. I always see that Lyme and coinfections tend to go to the areas where you've had a previous injury, and I'm assuming in the brain, it could be the same thing. Say you've had a concussion from a sports injury. You might have more activity from that infection in that injured area. Is that correct?
Dr. Robert Hedaya 52:40
That's right—100%. Yes, 100%.
Dr. Jill 52:44
Interesting, wow. And would you always see asymmetric kinds of findings more with trauma versus [something] like this global effect of toxins?
Dr. Robert Hedaya 52:53
So yes, with trauma or brain injury, for example, you'll see a localized or a coup-contrecoup pattern. So you might see something in the right frontal, left occipital kind of thing. So this qEEG is something every psychiatrist should learn to do.
Dr. Jill 53:15
Oh, I could not agree more! And we need you to train. I want to talk just briefly about hyperbaric. And let's see, there was something else. This is so fascinating. Talk just a little about when you would use hyperbaric. What have you seen it useful for? How would you know that's a good idea to use?
Dr. Robert Hedaya 53:32
Yes, so hyperbaric oxygen, I'm going to say in general for brain problems—generally speaking—is really good. It's obviously really helpful for traumatic brain injuries. It's really helpful, strangely enough, with PTSD. There's a group in Israel—you've probably heard of them—that's using hyperbaric oxygen to treat PTSD. And what happens is that when you go into the chamber, you have your sessions, you come out, you start having memories, and you process your memories.
Dr. Jill 54:08
You kind of have to have someone there to help facilitate a little bit.
Dr. Robert Hedaya 54:10
You have to have somebody. It may not happen immediately, but in the days after, because the brain is functioning better. Obviously, in a vascular situation… I've used it for Alzheimer's disease. I'm using it on someone who has Lewy body dementia. But I'm not saying I'm having success because she's not out of the mold. We can't get her into ketosis. Her inflammatory markers are still high. We did laser, and I'm seeing the connectivity improving, probably by about 30%. But it's not translating to clinical improvement because there are other factors: You have to be out of the mold… But the hyperbaric seems to be helpful in those situations.
Dr. Jill 55:07
I'm curious; Richard Horowitz had mentioned that with the Babesia, that would be the one caution. And I'm wondering if you've seen if there are any other contraindications to hyperbaric.
Dr. Robert Hedaya 55:21
I haven't used it on anyone with Babesia. I don't know if it's a contraindication. Maybe it is.
Dr. Jill 55:29
I don't either; I'm just wondering.
Dr. Robert Hedaya 55:30
Yes, I'm not sure. The contraindications are: Pneumothorax, for example. You wouldn't want to use it if someone's had a pneumothorax in the last year, [or] if they're having sinus infections and can't clear their nose. Some people who have Lyme, for example, will go into the hyperbaric [chamber], and they will feel worse. They'll have a Herxheimer reaction for several sessions. So maybe go slow with that. And obviously, if there's brain mass or something like that, that's not a great idea.
Dr. Jill 55:58
And typically, with hyperbaric, what number of sessions? Or what would they be looking at to actually get a clinical outcome?
Dr. Robert Hedaya 56:03
It depends on the situation. We like to use the hyperbaric with the neurofeedback. If you're a young person, you do 40 HBOTs, or hyperbaric oxygen therapies, with neurofeedback. That's beautiful. It seems to accelerate the progress. If you're someone with a dementia or early dementia, you're going to need probably 100 or 120 treatments, and you might need to use them ongoing, three times a week, or four times a week. Older people obviously need more; younger people need less. I do it myself three times a week because it does good things. It makes stem cells. It does a lot of good things. It's a good anti-inflammatory, etc.
Dr. Jill 56:47
Oh, this is so exciting. And then I've had a lot of questions on the feed about: Is this permanent? I'm assuming, like you mentioned, that some of these dementias and things that are progressive are going to need some ongoing maintenance and treatments. They're not going to just get better. But I'm assuming some of your 20-somethings actually start to see a reversal, and it may be fairly permanent. Would you say?
Dr. Robert Hedaya 57:04
Yes, yes, yes. I just finished treating a woman who's 30 with severe depression. Most people would call her “borderline personality [disorder].” Not anymore. She's done everything I've asked. She did, I think, 16 laser treatments and neurofeedback, and she's doing well. Now she's working through her trauma because she has PTSD from bullying, etc. And then you have to redevelop your personality because your conception of who you are and your character need work at that point, right?
Dr. Jill 57:44
Yes, because we identify with these things. I've done a lot of personal work in the last several years, especially the last year, and I realized, “Wow, I'm actually not that same person.” But your mind still thinks of yourself that way.
Dr. Robert Hedaya 57:55
Right, right, right. So that's very important work. So yes, she's not going to need more laser treatments, I don't think.
Dr. Jill 58:07
Wow. Well, Bob, you're right, it is mind-blowing! I am so delighted. This has been one of my favorite interviews, and I hope we can do more. Where can people find you? I want to make sure to mention your books. I'll put links to your books and website. Tell us a little bit about: Where else can they find more information about you?
Dr. Robert Hedaya 58:25
Well, you could go to our website. It's WholePsychiatry.com. Like Whole Foods, Whole Pyschiatry. And I came up with it before they did. But it's easy to remember it that way. WholePsychiatry.com. There's a contact form. There's a lot of resources on the page. And I've done radio shows, back when there was such a thing as radio shows. There's video, and there's a lot of information. You have to dig a little bit, but there are a lot of videos, etc. And people can contact me if they'd like.
Dr. Jill 59:00
Perfect. And again, practitioners will be listening to this as well. So if you're a practitioner and you hear this and you want to get in contact for training or information or to fund Bob, I'm sure he would be happy to take some investments and funding, because I love this. If I had extra funds, I would—
Dr. Robert Hedaya 59:16
You know what my dream is, Jill? My dream… It's my dream. My dream is to have a small hospital where we can take these patients who are either really ill or with mild cognitive impairment and can't pull this off outside the hospital very well, bring them into the hospital in a wonderful environment, do the functional medicine, train them, teach them, exercise them, teach the family, do the neurofeedback, do the laser, the PMF, whatever it is you have to do. And then, after a few months—two or three months—they go out into the world, and they're much, much, much better. That's my dream. I'm putting it out.
Dr. Jill 59:55
I love it, Bob! And I'm going to just plant a little seed here publicly. I've been in Switzerland [for] two years [in a row]—I didn't go this year—to a Swiss fountain clinic that was amazing, to get away. And while I was there last year, I had this real download, kind of a spiritual inspiration of where someday I want to head. It's exactly what you're describing—a place for people to come where the food is taken care of for them; they sleep and stay there. They're taken care of, and they've got all the therapies and all the access. They have functional medicine. They have qEEGs. They have HBOT. They have all of this stuff, and people like you and me are trying to really help nurture [them].
Dr. Robert Hedaya 1:00:30
Oh, that'd be awesome, Jill!
Dr. Jill 1:00:31
So let's just put that intention out, because I really believe it'll happen.
Dr. Robert Hedaya 1:00:36
Yes, I'm working on it. I'm working on it. I have to tell you one last thing. I have a patient, a friend of the family, so I'm working with the physicians at Mount Sinai. I do know that they're giving her TPN—she's unconscious—128 grams of sugar a day, and they're expecting her to recover. Now they, of course, have to put her on insulin. So the insanity… The insanity in the hospitals—they're killing you with one hand and helping you with the other. So that's my dream; I want a hospital—
Dr. Robert Hedaya 1:01:13
Me too. Let's stay in touch. I'm just manifesting that the right investors and people who see the value will come and help us out, Bob, because we have the passion and the dream. I think it'll all happen at the right time. But I believe. I saw a vision as I was walking up a Swiss mountain, and I just literally wept because I thought: “Who am I to be involved in this? I'm just a little peon.” But I know that I believe in big dreams, and sometimes I see them happen. And so, let's put it out there.
Dr. Robert Hedaya 1:01:41
Let's put it out there. I'm with you. I'm with you.
Dr. Jill 1:01:43
Awesome. Awesome. What a great time! Thank you for your time today. Thank you for inspiring us.
Dr. Robert Hedaya 1:01:49
Thanks for having me. I really appreciate it, Jill. First of all, I appreciate all your great work. I just love your teaching, your lecturing, and how you're moving the field forward. It's just fabulous, fabulous, fabulous! Keep it up. And I really appreciate the opportunity to put this out there because it's important.
Dr. Jill 1:02:09
It really is. And we will do it again.
Dr. Robert Hedaya 1:02:13
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