Precision Psychiatry & Holistic Mental Health With Dr. Mizyl Damayo

Lisa: Hi everyone, and welcome into Pushing the Limits. Today I have a wonderful psychiatrist for you from America who has kindly joined us, and I've got to know Dr Mizyl because I've been interviewing Dr Mark Gordon, and he just absolutely raves about this lady. So welcome to the show, Doctor, it's wonderful to have you. Thank you for coming on.

Dr Mizyl Damayo: Thank you, Lisa. I really, really appreciate it, because I have to be honest, I'm really a shy person. Mark kind of puts me out there sometimes and I'm just like, okay, I can't say no to the man. He's just been so great to me, just the things he's taught me. To be honest, I think he's taught me more than any other psychiatrist that I've learned from, even my attendings.

Lisa: But some of the stuff that he talks about is just mind-boggling. I'm still reeling from — I did a two-hour podcast with Dr Mark and it's actually in two parts that I've just published. People, please go and listen to that if you've got anything going on in your brain, and hormones and brain health. And so you've learned a lot from him?

Dr Mizyl Damayo: I've learned an awful lot from him.

Lisa: And he's just an amazing person doing incredible work in the world. And he's put us together and said, talk, you two. So here we are talking.

Dr Mizyl Damayo: Yeah, yeah. So I think your story is incredible, and kudos to you. Just to give a little background of who I am: I actually started out in dual training, internal medicine and psychiatry.

Lisa: Wow.

Dr Mizyl Damayo: And I thought I would love general medicine, but it was terrible. It didn't give me the allowance to really talk to my patients. I was disillusioned, because in training it was all about calculate this, calculate that, and I'm like, but they're right in front of me, can I please ask them how they're feeling?

Lisa: Exactly, exactly.

Dr Mizyl Damayo: So yeah, it was hard because I was thinking, oh, if I go to psychiatry, I'm not a real doctor. But because of that background, I was able to take what I've learned in general medicine and pathology and physiology, biochemistry, because I still love that. To be honest, I have a hard time just memorising things. It has to make sense to me.

Lisa: Yeah, it really does. It really should for all doctors. If you're being taught something and it's not making sense, that's probably — you need to understand things, not memorise things, not memorise protocols. You should understand the pathway, or you understand the process, or why. I think that's super critical. Critical thinking, really.

Dr Mizyl Damayo: Yeah. And unfortunately, I'm not saying that we didn't learn that in medicine, but I thought I was a great doctor as I know my DSM and I know my meds and what meds to give, what meds to give for side effects. And I guess it kind of segues into what I'm doing now, because I used to see, I don't know, 30, 40 patients a day.

Lisa: Wow.

Dr Mizyl Damayo: Working for corporate America.

Lisa: That's horrific. That's a lot.

Dr Mizyl Damayo: Doing that for about 10 years, I realised, what am I doing? My patients keep coming back, they're still not well, and I'm trying to find meds and then try this, and it works great for a while, and then they come back again, and I'm like, wait a minute, I think I need to take a step back and really look at my patient holistically. What are they eating? What relationships are they in? How are they sleeping? What drugs are they using? How much alcohol are they drinking? And to focus so much on pharmaceuticals that I didn't even have time to tell patients, you need to stop all that. Because here I am listening to them and saying, okay, here's your med, I'll see you in two, three weeks or a month.

Dr Mizyl Damayo: And so I figured, you know what, I started really doing a deep dive into things, and no one ever told me there is a 55% rate of failure for depression.

Lisa: Yeah, you don't hear that from the industry, because they want you to just keep doling out the meds.

Dr Mizyl Damayo: And even anxiety, it's 50%. And when you look at OCD — I don't know if you know much about that, it's really debilitating to people — and if you don't understand that OCD comes from trauma, and then here you are doling out these meds to think that that's going to treat that, you're not considering what really happened, what caused that OCD. Then you're not getting a full picture of what's happening with the patient. And unfortunately we don't have that luxury to sit there and really listen, because of our times we will just throw that at the therapist and say, you treat this. But then I need to appreciate why these treatments I'm giving my patient are not doing it, because maybe it's just more than just depression and more than just anxiety. Their background — I really want to know that now. I've learned to really listen to it, and I'm like, oh, I get it, this is why you haven't responded.

Dr Mizyl Damayo: And bipolar disorder is one of the hardest things to treat, and the most dangerous part of bipolar disorder is the depression. People love it when they're manic. That's why a lot of bipolar patients don't want to get their symptoms treated. But when they come off that high, that's the highest risk for suicide. So two-thirds don't respond to first-line treatment, so that's about 66%. I'm like, that's really something that we needed to address in mental health.

Dr Mizyl Damayo: And then sometimes what happens is, here we are, we're trying to figure out what treatment to give, but if we don't have a pathway to really figure out what's wrong with people, sometimes it makes them worse, and the episodes come more often, and it changes the brain to not really what it should be. Because what I have understood is that mental health disability is in young people — it's a leading cause of disability in young people worldwide. And by 2030, they say the mental health disorders are going to cost the world six trillion dollars.

Lisa: Wow.

Dr Mizyl Damayo: Yeah, and because we don't focus on the whole person, we don't correlate how their mental health affects their physical health. We are a whole person. Our brain affects how we feel, and it's in our heart, that's in our stomach, and so we have to consider all those things. And it really breaks my heart to hear doctors tell my patients before they came to me, it's all in your head. And I'm like, you know what, I don't want to believe that until I really do a deep dive into what's wrong with you.

Lisa: And this is — you're a holistic psychiatrist, you look at the whole person. And I loved it when I was reading about you, how you use things like genetics and personalised precision psychiatry, where you're looking at the person's genetic makeup, for example, and how does that actually predispose them and impact their life. And then things like transcranial magnetic stimulation, which we can get into, and some of the other modalities that you use in order to fix this whole person. Because we're not a head, we're not a heart, we're not a lung, we're not a cancer cell.

Lisa: When I'm working with people — like when you go to the oncologist, you're a cancer cell to them. They're not looking into your — and they don't have the time, they don't have the ability to do that, where they're looking at how did you get to be in this place. Is there a psychiatric component to it? Is there an environmental component? Is there a genetic component to it? It's just cancer cell, here's chemo, here's a surgery, here's radiation, here's the immune therapy. You're more than a cancer cell, you're a person with a whole lot of history. But it's complex, right? When you go down medicine and that approach, it is a layer upon layer and it's complicated, and it takes time. But it actually gets the job done much more efficiently rather than a Band-Aid approach, do you find?

Dr Mizyl Damayo: Exactly, yeah, exactly. Because I thought just knowing about genetic testing, that's where the solution is. But I found out later, just solely relying on a list of medicines I should give and I should avoid, I wasn't getting anywhere. So I actually started looking at things the other way. I look at, are you making enough serotonin, dopamine or epinephrine? What is your potential for brain healing? And how do you metabolise the dopamine?

Dr Mizyl Damayo: And once I really learned that and how it really affects people — because I'm sorry, nobody could answer that question. I had to beat my head trying to figure out, I was like, no, there is something to this. Why does it keep popping up in these tests? And then even then they can't even tell me. So I had to go different paths and really learn about even some of the metabolism. I learned from nutritionists, I learned from pharmacologists, because the general medicine doctor can't tell me these things, because they're so focused on whatever they have at hand. And in terms of really doing a deep dive into what does this mean, it doesn't happen. But I had to do it for me, because like I said, it has to make sense to me. I don't just listen to someone and do that. Because for me, I would feel better knowing I told my patient, this is the rationale why you have to do this.

Lisa: Yeah, yeah.

Dr Mizyl Damayo: So yeah, so that was only part of it. So then I started getting into the integrative world of — they called it integrative medicine for mental health. And Dr Daniel Amen — I mean, you know he's incredible and his brain is amazing. And then he taught me — I don't understand why it was such an epiphany to me — to say it's not about your mental health, it's about your brain health. And I'm like, bingo.

Lisa: Why are we not addressing this problem in my patients as a physical? Yeah, there's a physical reason. I was working with a young man at the moment and he's been diagnosed with depression and anxiety and been bedridden basically for the last couple of years, and exhausted, and a young man can't work. And they were just putting one pill after the other into him, and he was desperate, came to see me. We started hyperbaric oxygen and then we started to unravel the rest of the story and started to work with him on a number of levels and with a number of colleagues that are roped in as well, from neuro chiro, so the physical mechanical, to EEGs and neuro feedback, all of that sort of thing. And he's — it's a long, slow process. We're now six months in and he's probably 60, 70% better than he was, but still got a way to go, right? And he's throwing the bus at it and it costs a lot of money, but he'd been like that —

Lisa: — for years, and what they were all not seeing was the traumatic brain injuries, the repeated traumatic brain injuries from elite level sport. He'd landed on his head so many times snowboarding and surfing and mountain biking and all of this sort of stuff, where he'd had repeated brain injuries, and physical, like jaws out and things like this. So now we're getting somewhere, now we're actually working on those aspects, the hormonal aspects, all of these things that we have to address. And it's a long hard road, but it's one that's going to lead to success, that's going to lead to him being able to work again, and not the Band-Aid approach of here's another drug. And getting them off the drugs — some of the drugs, which we've done in collaboration with doctors, has been hell for him to get off the drugs. Some of the things like benzodiazepines and stuff, whoa, powerful.

Dr Mizyl Damayo: That's really hard to get off of. So what I like to do is I really want to do a deep dive in a patient. I look at their genetics, I look at where they are deficient in their vitamins and metabolism of the vitamins, I look at their inflammation markers, and then I look at the hormones. And then I'm not satisfied with just looking at their basic hormones, I want to know why these things are abnormal. And that's when Dr Mark Gordon came in and taught me, hey, we need to know why these things are low. Is it a brain injury, or is it just change in life and so forth? Because it totally changes the approach to how you treat the patient. If it's a brain injury, you've got to work on healing the brain, supplements to heal the brain.

Dr Mizyl Damayo: And then I started also looking into toxins, and I think Dr Gordon even mentioned it in his podcast with you, about glyphosate and heavy metals — that it itself can disrupt your neurotransmitters. And as he stated, it can decrease serotonin and dopamine or epinephrine, and then it increases your glutamate, which is excitatory. So maybe that's why a lot of these people with quote unquote PTSD, maybe there's something going on that's causing the imbalance. But then inflammation itself, psychological trauma itself, can also release the same kind of chemicals as if a brain injury would happen.

Dr Mizyl Damayo: This morning I was with a patient that I had no idea really was a brain injury. She came because she wanted to get TMS because it helped with her rapport. I said okay, but I told her, I'm not going to be just doing that on you, I need for you to humour me. Let's look at your genetics, let's look at your labs. And her labs were like — I'm surprised you're standing and talking to me. She absolutely had no brain hormones. And she absolutely had no sex hormones. And I'm like, have you had a brain injury? And that's why I really like to do this with my patients, to really find out, because some of them don't even think that they have a brain injury.

Lisa: No, a lot of people don't know, because it could have happened when you were eight years old and you've forgotten it, or you think it's so far past that it no longer is relevant. And that's so not true. Brain injuries just don't heal on their own accord. We sort of rewire and we're able to cope a lot of the time, but the actual injury is still there and it's still causing damage, and you're still having an inflammatory response, or your hormones are still offline and so on. And most people don't equate that thing that happened three years ago with the thing they're dealing with now. And that's problematic, because they go, but I went to the doctor when I had the brain injury, and I went to the ED and they did a CT and they told me I was fine, there's no bleeding. That does not show what's going on in the brain. That just shows if you need a surgery right now because you're dying. Yes, it'll pick that level of damage up, but it won't pick up the rest of it, the torn axons, the inflammatory biochemical cascades that are happening in the weeks after.

Lisa: That's another pet peeve of mine, when I see contact sports, rugby players and stuff, and they do head injury assessments on the side of the paddock and then they go, oh no, you're fine, you just got knocked out on the paddock, but no, no, you're fine, or you had a big knock, we'll put you back out again, because your eyes are okay and you've still got strength in your arms. That's not an assessment, I'm sorry. It's happening in the weeks after, and when you get another injury on top of that injury, that's exponential then. And those young guys are in for trouble later on in life, and ladies. So the head injury piece is huge.

Dr Mizyl Damayo: Yeah, it's amazing, because I do deal with treatment-resistant cases. It's kind of sad that people come to me when they're out of options, and I'm like, okay. They come in a desperate state. I said, okay, well, we're not going to just do standard treatment. I'm not even going to do anything until I really know what I'm working with. And then once I get the patient and I see everything and listen to their story, I'm like, listen, this is why you have not responded to treatment. Your genetics didn't help, then you had trauma, physical trauma, psychological trauma, you've had a head injury, you were in an accident, you were in the military, you have toxins, you have inflammation, then it whacked your hormones. So this is the kind of thing that I have to explain to my patients.

Dr Mizyl Damayo: But what's great about how I practise is because it does take away the stigma of mental illness, takes away the shame. It's right here, this is why you've been [suffering for] decades.

Lisa: Yeah, it's a physical thing.

Dr Mizyl Damayo: This is why you felt like crap, nothing works, things made you worse, and so we're going to unwind this. And it's still hard sometimes for patients to grasp it. They come to me because, well, I hear you're good. And I was like, well, this is why I'm good. Okay, but if you don't, then you can just go down the street and find the magic pill that you think you're going to find. Unfortunately that's a myth.

Lisa: Oh yeah, I hear you, because I'm a bit in the same boat. I'm not a psychiatrist obviously, but I get cases that are desperate and then they end up at my doorstep, and then it's like, you've got a hell of a mess to unravel. I'd love to be working more with the ones just starting out on their journey and then putting them in the right direction — it'd be a lot easier. And I can tell pretty quickly if I've got someone who's just looking for the magic bullet, and I stop it right there, because I know that if that's the approach, then we're not going to get anywhere and I'm going to waste their time and effort and my limited brain power on the case.

Lisa: If they are there to work and they know that it's going to take a process and it's going to take a long time and it's going to take a lot of effort and a lot of pills and lifestyle changes and exercise and all of the aspects that go into it, taking out all the environmental toxins as best they can, and all of these aspects that we can work on, and they're in for the long haul, then we can get somewhere. There is no magic bullet. There is no, you come to me once and — I get a lot of people go, oh, you fixed your mum, amazing, amazing, can you do it for my dad? It's like, that's massive. She's had 24/7 care for nine years. Are you in for the long haul? And she was an extreme case and she's a miracle, but that's what it takes, right? Day in, day out, day in, day out, grinding it out with someone of that severity. But even with lesser cases, it's still going to take you forever, and it's still going to take changes.

Lisa: I love working with athletes because athletes tend to have a mentality of work, of grinding it out. They understand that biology, to change it takes time. They understand training, they understand getting up every day when you don't feel like it and doing the thing that you have to do. So it's a lot easier to work with people who have been athletes in some way, shape or form, I find.

Dr Mizyl Damayo: Yeah, and military. I love working with my veterans because they really appreciate how I help them. It's not just, here's a pill. Nine times out of ten, maybe 100%, basically, I've had all brain injuries, and that's how they wind up at my doorstep, because their psychiatrist in the VA is like, I don't know what to do with you, so you're going to have to go out to the community psychiatrist. And the VA is kind of funny. They were really helpful in the beginning to try to help these guys better, but now sometimes there's roadblocks that's happening right now.

Lisa: Yeah, I hear that all around, actually.

Dr Mizyl Damayo: And I have to tell them, you just have to fight for your right. I had one patient that called the White House.

Lisa: Go straight to the top, got what he needed. Exactly.

Dr Mizyl Damayo: Yeah, I have to just tell these guys, you just have to advocate for yourself, and then we can work on making sure that we can continue to treat you. So the thing about what I do is that sometimes, yeah, some patients just look for that magic bullet, and I had to take a step back and I tell them, listen, how long have you been suffering with this? Decades. And I'm like, well, can you give me a year or two to try to help you? Because we're going to do something different here. Okay? We are going to look at you as a whole person, not just listen to your symptoms and I think this is the medicine that's good for you.

Dr Mizyl Damayo: And don't get me wrong, because when you define integrative psychiatry, it really is a combination of conventional and novel treatment. You do what you can to get the patient better.

Lisa: Yeah, absolutely, both sides of the equation.

Dr Mizyl Damayo: Yeah, totally. And integrative psychiatry, it's also defined as using science to know how to treat the patient. So it's like, we're not coming at this from off the top of my head here, people. I can honestly say that I've had some really, really amazing people who took me under their wing, including Mark Gordon, who really taught me all about a new theory when it comes to mental illness. When I met him, I thought he was just going to teach me how to do hormones. All right, let's do it. And then he's like, wait a minute. I'm like, what? We're going to work on inflammation. I'm like —

Dr Mizyl Damayo: What's that? But I mean, because going directly to hormone treatment with my patients but not without considering inflammation, I was not getting the results I needed to see. In fact, some of them were having adverse reactions. So I had to take a step back and say, okay, I've got to figure out what are my inflammation markers. So I run that too. So a lot of my patients, if they come to me thinking they're just going to get hormones, I say, I'm not doing anything on you for the next 90 days. We are going to clean you out, because if I give you hormones now, you're going to be in a worse state.

Lisa: Yeah.

Dr Mizyl Damayo: So we have to consider that, and then sometimes if it's that bad of inflammation, I will say, humour me, humour me, and please do my tox panel. And then it's amazing what I find. I have people who are 100% filled with glyphosate and they've been diagnosed with quasi-MS. And it's like, it's not that, it's glyphosate that killed their nervous system.

Lisa: Wow. And it takes time. Is there anything we can do for glyphosate? How do you get glyphosate out?

Dr Mizyl Damayo: I have somebody that actually kind of forced me under her wing because I was sending her my patients. She's like, you're killing me, I need to teach you this. And I'm like, I don't know if I can do this. But yeah, environmental toxins really do a lot of damage to someone's mental health. It throws their neurotransmitters off, it increases their glutamate, which is excitatory, and so they're like going like this and then nothing is balancing it out. So we have to work on removing the toxin. So I do have protocols for that. Depending on how bad it is, I give more dosages than others. I use sometimes, especially with heavy metal toxicity and glyphosate, there's an ingredient called zeolite. And people say that it doesn't work, but I think it's because they're just not using high dosages of it. And I've seen it work in my patients. They go from 100 of glyphosate down to 50% in months.

Lisa: With a zeolite, do you have to keep it away from the other supplements and minerals and things? Does it take the minerals out like some of the other binders do, like bentonite clay or things like that? Or is it not too bad in the way it gets rid of stuff?

Dr Mizyl Damayo: No, it's not that. It really does work on just getting rid of the bad things. But then I also use another kind of detox which really works hard at targeting the toxins, what's not supposed to be there, as well as decreasing the inflammation. Because the toxins are there, that's another layer in itself. When you are exposed to things 24/7, you're full of it, your inflammation does not stop. So what happens to that? It goes to the brain and then it starts to build antibodies to the hypothalamus and the pituitary gland, so you're going to have hormonal deficiencies.

Dr Mizyl Damayo: So brain injury can happen in lots of ways. Say there was a patient today, his wife was like, he does not have a brain injury. I go, then why am I seeing this in your blood work? And I go, well, there's different ways, and this is what I learned from the movie called Explosions. It doesn't have to be trauma like an impact. It can happen in surgery. And then the wife told me he had back surgery and he had a dural bleed. The CSF fluid was coming out already and then he had the worst headache in his life. I'm like, well, there you go. What is in the brain? It's in a skull full of jagged edges. So it's just doing that, scraping against, with no fluid. And there you go, brain injury.

Lisa: Yeah, there's so many ways for us to get brain injuries. I don't think any of us by the time we're in our 40s, 50s have not got a brain injury of one shape or form or another, because it's environmental, it's toxins, it's your surgeries, it's your anaesthetics, as well as your impact traumas, as well as whiplash, where you don't need to be knocked out either — that's another myth that people think — or it's even bad foods that you're allergic to, leaky gut, which causes inflammation in the body, which goes to the brain, and so on and so forth. So there's so many ways for us to get brain injuries of various types, and there's lots of things that we need to do.

Lisa: So one of the areas that I haven't focused on yet in my clinic is working out the toxins, the mycotoxins, the moulds, that type of thing. I've just not got there yet, really. So are there any other sorts of things that we can use? Or do you use chelation therapy or modified citrus pectin or anything like that, besides the zeolite, to help people detox toxicants out of their body?

Dr Mizyl Damayo: Yeah, that's also another thing. I was seeing toxins in my patients, mycotoxins, and I'm like, oh gosh, this is totally a different world for me. Another thing to learn.

Lisa: I know.

Dr Mizyl Damayo: And I'm like, oh boy. So I just kept researching and researching, and there is this one doctor, I think he's from Michael labs, and he's brilliant. I just started watching him and I was like, oh my gosh, some of the stuff I've been telling my patients to take wasn't even the right thing. So sometimes you have to avoid even glutathione with certain moulds. But yeah, the usual thing where my normal cocktail is like vitamin C, a probiotic, and D and omegas, B complex. What he recommends is even higher dosages of these things.

Lisa: Wow. Who's that doctor, can I ask who that is? I'll look him up.

Dr Mizyl Damayo: Gosh, what is his name? I'll get it for you.

Lisa: Yeah, email me.

Dr Mizyl Damayo: Yeah, he's on Michael labs. Gosh, I don't know why it's escaping me. But I've learned so much from him, and he's another one like Dr Gordon, where he's not doing this to make a ton of money. He just wants people to know the right way to treat mycotoxins. And it really was interesting, because I give people a thousand milligrams of vitamin C and he's like, they need to take it three times a day.

Lisa: I totally agree with that. Totally agree.

Dr Mizyl Damayo: Yeah, super high dosages. Even magnesium — I'm used to only like 400 twice a day, because I'm in the mental health range, I'm like, this is what you do. And he's like, a thousand milligrams twice a day. And I'm like, wow. And I will send you that, because I wrote notes and I thought that was really fascinating to hear, because it's important for me. How many of my patients have struggled with their mental health and really it was toxins? Unfortunately, I couldn't even find anybody I could collaborate with locally, and so I said, I need to learn this stuff.

Lisa: You need to learn.

Dr Mizyl Damayo: Yeah, I'm not in a big city. I'm in a little town, Punta Gorda, Florida. We have kind of a tri-county, we have outreaches to several cities out here, but we're in a place where it's traditional medicine. Nothing against it, we do need it, but I'm just saying, if anybody does anything like this — I can't even think of any off the top of my head.

Lisa: We've got the same problem here. I live in a little town. We've got a couple of good doctors in town and that's about it. And so you end up having to learn all of these things, which takes constant learning and research, and then there's always something you haven't got to yet. But this is the wonder of the world now, learning — you can learn from the best professors and the best doctors and the best scientists now online, and you can get that information. I couldn't learn from Dr Gordon 10 years ago, because he was in America, or I couldn't learn from you. But now we can. And that's putting the power back in the people's hands if they're motivated to learn.

Lisa: And this is the other thing I find with my clients too: it's very much a co-learning experience. I don't ever come at it from, oh, I've got all the answers for you. It's just like, I've got some answers for you, I may need to go and work out some more answers for you. I know how to research, I know who to reach out to, I know things that you may not know. But it's really important for me for my clients to actually engage in the process with me and to bring things to me. I learn so much from my clients because they bring — have you heard of so-and-so? And I'm like, going, list this long of people that I haven't got to. But they're challenging me all the time and bringing me information that is of value to me and then to the next person. And so we have this collaborative approach, rather than the gods in whites, and they know everything and you know nothing because you're an idiot and didn't go to medical school. That's not true. We've gone beyond that.

Lisa: And I hate anybody who's arrogant, to be honest. I hate it. I think we need to all come at this from a humble place of, we know bugger all and we're just scratching the surface. This is the best information we have at the time and we do what we can with the information that we have. And as the science develops, we've got to develop with it. So I'm not scared of changing my opinion or viewpoint on something and sometimes realising, well, that probably wasn't the best thing to do, because that is medicine and that is science. It is evolving and you have to evolve with that. I mean, back in the 50s they used to think smoking was good, right? The doctors, 20,000 doctors smoke Camel cigarettes. That should be a warning to us that they don't always get it right.

Dr Mizyl Damayo: Yeah, yeah. You just have to be an individual thinker, unfortunately, even in my field. This is my thing, Lisa. I don't know how I came to be this way, but I really do want to change the way we approach psychiatry, because it's time. I've got colleagues that say genetic testing is a joke, and then they change my patient's regimen and I'm like, wait a minute, you're going to make them go backwards now. And how we do things in terms of supplements and all — I do tell my patients three to six months, you're going to have to just be patient, because what you've done with taking all these meds, you've thrown off your chemistry and your receptors way

Dr Mizyl Damayo: ...off. And then when I found out, really, you didn't need those things, you just needed certain supplements to support that. But then working backwards with some of these patients is really difficult, because they'd say, "No, I've got to have my Adderall, Doc." And I'm trying to tell them that's not good for your genetics, but they've gotten so used to it, and their brain and their wiring, their physiology and biochemistry, has also learned to acclimate to it. So their body, their brain, is having a hard time.

Dr Mizyl Damayo: What I love — I don't talk about it too much — is I love getting treatment-naive patients, especially kids. I do see children, but they come in through a special kind of referral, because I don't just take anybody who's calling. I'm not into medicating kids if I don't have to. The parents that come to me now, they're like, "The teacher says they're going to throw them out of class if I don't do something about this." And so I said, okay, let's look at what's going on with him. And then I find out a couple of things with their genetics, put them on all-natural supplements, and even just 30 days later they're like, "He's the best kid in the class now, sitting." But it didn't change the personality — because I think that's why parents don't want to put their kids on these things, because it kind of zonks them out, and they're falling asleep in class or not eating.

Dr Mizyl Damayo: So it's time that we have another modality to treat mental health issues without having to resort to these strong drugs. I even have a pre-med student, and I really appreciate her, because she's never been on meds, but she's worried about going into medical school and not being able to focus and concentrate. So we found out what her genetics were, fixed a couple of things, and like 30 days later, here she is showing up with me going, "I feel good. I'm able to focus, and I can deal with stress." And part of the treatment is holistic: okay, you can't eat this, you have to eat that, you have to do this kind of exercise. And she was doing all of that. I'm like, oh gosh, finally somebody listens to me. Now they're doing amazing, and they don't have to be on meds.

Lisa: I know, I know. And sometimes people just want the easy way out. They don't want to stop eating their pies and their crap McDonald's and whatever. And it's just like, you're not ever going to fix the person if they — I mean, you don't have to be a saint and never have anything, but if you're eating on a daily basis, crap in, crap out. The membranes in your brain, the fat tissue, the wrong type of fats, the communication between the neurons, the synapses, they're not going to be working properly. And then when you go off those bad inflammatory foods, the trans fats, the deep-fried, all of that sort of stuff, it's going to take a long time to unravel, because that fat stays in the body for two years plus.

Lisa: I had Dr Michael Lewis on the podcast last week. Do you know Dr Lewis? He is Mr Fish Oil. He does high doses of fish oil — high, high doses of fish oil, especially with traumatic brain injuries and stuff. Because if we're doing just the normal, up to three grams a day type of level, which is sort of the FDA generally recognised as safe level, he said it's going to take us years to get the omega-6 to omega-3 ratio back into balance. And omega-6s are not bad, but we have way too many of them in our diet, in our life. They preserve our food better than an omega-3, so it's in all of our processed foods, and so we're getting this 25 to one ratio when it should be like a one to one or a two to one ratio with omega-3s. So he goes high doses, bathes the brain in fish oils. I'm doing his protocols at the moment with myself and my mum, to see what happens. And I'm already on things like plasmalogens — if you've come across plasmalogens. I'm a big fan of plasmalogens. I've got to put that on your radar.

Dr Mizyl Damayo: No, I haven't heard of that, but okay. Once I really got into the integrative psychiatry world — just even learning about not decreasing somebody's cholesterol, to me that was eye-opening. I'm like, what do you mean I shouldn't bring down somebody's cholesterol? Because this is what I was taught in medicine, bring their cholesterol down.

Lisa: Yeah, destroy their brain.

Dr Mizyl Damayo: And I was like, oh, okay. So when I see somebody — because I run my labs and I do look at people's cholesterol — one of the reasons why I do it is, it's not so much I'm looking for high cholesterol, I'm looking for low. Because if your cholesterol is below 200 — I've seen somebody in one of my cases where the cholesterol was 100, and I was like, whoa, buddy, that's why you're not responding to treatment. So I have to give them high dosages, anywhere between one to 3,000 milligrams of fish oil, and they're better. And it's like, stop that statin.

Lisa: The statins can do a lot of benefits —

Dr Mizyl Damayo: Two benefits.

Lisa: You need cholesterol to protect your brain cells, because it's the lipid layer around the cells, as well as you don't want to cause hormonal deficiencies.

Dr Mizyl Damayo: Yeah, hormones.

Lisa: You don't get hormones if you don't have cholesterol at all. Where does it come from? It comes from cholesterol to pregnenolone and all the benefits of hormones.

Dr Mizyl Damayo: However, I'm sorry, it's like people will claim that they're hormone experts, and I'm like, I'm not listening to you unless you've done Dr Gordon's protocol, because there's so much harm that can happen with hormone replacement when you're not thinking about it from the top.

Lisa: Yep, it's very complicated. It's very, very complicated.

Dr Mizyl Damayo: Yeah. And I've seen some of these cases where I'm looking at the hormone replacement and going, this is not good for you, because you killed off your own physiology. There are so many mental health benefits when it comes to the pre-hormones, like pregnenolone and progesterone. Progesterone increases GABA in the brain. So naturally, as females age, they're not supposed to have that much, because that's only for quote-unquote pregnancy, but we have now found out there are mental health benefits — it increases GABA. And what is GABA? Anti-anxiety. What is the amount of women that come to me in their 40s and 50s looking for Xanax? Right? And back then I didn't know anything, and I'd go, "Yeah, it's your hormones, but what do you want me to do about it?" But now I have the ability to say, I can do this, and I can do this in a safe way. I don't have to shut off your own hormone production.

Dr Mizyl Damayo: And people get intrigued when I tell them a lot of my males don't even have testosterone shots. We're using their own physiology — medication, supplements to support normal hormone balance and production — that way we're not doing harm, we're just doing good.

Lisa: Yep, and using clomiphene and things like that that aren't going to — and it's complicated. I hope that I can do Dr Mark Gordon's course at some point, as I haven't done the course yet, but I've got a colleague, Dr Harris, who's gone through the course, and she sort of takes over my clients at that point, and another lady here who's also done Dr Gordon's course. But I want to do it myself, because it is really, really complicated.

Lisa: I'm on bioidentical hormone replacement therapy, and I think in the past it's been wrong — wrong levels. And then the other thing, you've got to keep checking, because what was right for you maybe a year ago is maybe not right for you now, because your hormones have changed, and you can downregulate your receptors. I had a change of brand of testosterone recently — I've been taking small amounts of testosterone, but the new brand was much more powerful and the dosing was wrong on the packet. So I ended up like 5x-ing my testosterone levels and then wondering why, man, I've got a few muscles coming out and a couple of hairs that I don't want, and I'm really angry.

Dr Mizyl Damayo: Oh, you don't even want to know some of those levels of testosterone in females who are on some crazy dosages. They come to me and I tell them, you need to just don't do that anymore. And a month later, "Yeah, I'm not so crazy."

Lisa: Yeah, I mean, you need some, right? You need a little bit of testosterone, because then you can train, and your muscles, you maintain your muscles and your get-up-and-go and your vigour and your bone density and all of that. Out in the social world you're stronger, you're not so emotionally labile — all those sorts of positives. But you've got the other side: you don't want to downregulate your own LH and FSH, which, in that case, because of the brand change, wiped out my own LH and FSH, which is not good.

Lisa: And then there are other things like Mucuna pruriens. I took that for a couple of weeks to try to support the growth hormone, because we can't get growth hormone — we can't get Dr Mark Gordon's Sermorelin or Genotropin down here. So I was trying and experimenting with Mucuna pruriens. That made me so like, rage. I don't know what effect that — but that's a dopamine thing, right? Now, if I look at my genetics, I've got a dopamine deficiency, so the DRD2 gene, I don't have many trees in the forest, so to speak, for the receptors. I've got a lack of receptors for dopamine, so that means that I'm always sort of chasing dopamine, and it makes me very mission-orientated, very driven. But when I took the Mucuna — and maybe it was this or something else, I don't know — but it made me very like, yelling at mum, going, was that me?

Dr Mizyl Damayo: Yeah, yeah. In addition to that, the patients that go through the programme and they're doing very well, of course their friends are like, "What are you taking?" And I have to tell them, please don't tell them, because what may be good for you may not be good for them.

Lisa: Yeah, the genetic space.

Dr Mizyl Damayo: The genetics. Like twins, male and female, but they were both born from the same womb — I'm looking at their genetics and I'm looking at their lives, like, man, you guys are just so opposite.

Lisa: Yeah, you see it in the personalities too.

Dr Mizyl Damayo: I always get surprised, but I shouldn't. That's why, when just listening to people, I get an idea of where they are, where their genetics fall, but I get surprised sometimes. So that's why I don't start throwing things at people right away. I just want to —

let me know what I'm working with. Because when you're talking the dopamine gene, there's the COMT, the enzyme.

Lisa: Yep, the COMT one.

Dr Mizyl Damayo: Yep. No one could answer that question for me, I had to do my own research, because I couldn't even figure this out. But you have to know whether you're normal, you're high, or you're low, because the treatment is total opposite. One way is high protein diet, the other way is low protein diet. And one is you have to do relaxation, yoga, Pilates, and then the other one is like, go run a marathon. So we have to know these things, because here I was thinking I was integrative, and telling everybody to go exercise and this and that, and then, wait a minute, I was telling them something wrong. That's why I went into precision, because it's like, what's good for you and what to avoid. So it's very, very important that people get the precise treatment, otherwise they're just going to give up, like nothing works.

Dr Mizyl Damayo: And before I realised all this — I'm sure you've heard about the MTHFR gene — so I was throwing out L-methylfolate to everybody, but then I didn't realise the correlation with that and the COMT gene. I said, you need to just take that back, because I didn't know that back then, when I first started in genetics. So I was throwing L-methylfolate at people, and half of them were calling me going, that made me anxious. And I looked at them like, why? That should have worked for you. And then I started researching more, because, like what you said, we are not just the heart, we are not even the genetics — you have to look at how they correlate with each other.

Lisa: Yeah, this is the hype. Like, you're not just single genes, but how does that gene work with that gene, with that gene? And that's when it gets very, very confusing.

Dr Mizyl Damayo: Yeah. So there's times where I see people with MTHFR and low COMT, so sometimes I wouldn't even give them L-methylfolate. I have to give them something like 5-HTP, because you want to avoid that dopamine route, you want them to make more serotonin to counteract some of that dopamine that they cannot metabolise. But then the other way around, people who are MTHFR and they are high COMT — this is the reason why you may see people who have problems with addiction, because not only can they not make this stuff, but their brain is metabolising that dopamine so quickly. And so they're wasting that dopamine.

Dr Mizyl Damayo: I'm also certified in addiction medicine, so we're always taught, don't judge, don't judge. And I'm like, yeah, of course, I want to hear the story. So I don't even ask them anymore why you like to do this. I always ask, how do you feel when you use drugs, or whatever you want to do — watch pornography, or game, whatever the case?

Lisa: Yep, yeah.

Dr Mizyl Damayo: Then it gives me an idea, like, maybe they need more support with dopamine. So I always call people with MTHFR deficiency and high COMT — I call that the double whammy gene. So I'm looking at, man, you are dopamine deprived. No wonder you're out there jumping off buildings and putting stuff in your nose.

Lisa: But then it kind of validates them as a person.

Dr Mizyl Damayo: Absolutely.

Lisa: Yeah, because there's a reason why you're that way, because you can beat yourself up about why you're that way. I've got addictive tendencies, and I think it's that DRD2 gene and the ADRA2B gene. I'm medium COMT, so I should be okay there, and I don't have the MTHFR, but I've got a couple of others. And it is complicated. It's really complicated as a clinician. I don't pretend to know half of what I need to know still, but you've got some tools there that you can work with, and you could keep learning for the next 20 years, I think, and still be a baby in the space. But yeah, some major ones like that, when you inform the patient...

Dr Mizyl Damayo: It's not always about genes. It's about inflammation and trauma and hormones and toxins. So that way, once I put that out for the patient, they get overwhelmed thinking about, oh my gosh, this is all that's wrong with me. And I say, well, think about how you've struggled with your mental health for decades trying to find the right medicine. Because this is the thing: psych meds don't address inflammation, and psych meds don't treat hormones. If those two things are really what's causing your mental health issues, then you're going about it the wrong way thinking a psych med is going to do it.

Dr Mizyl Damayo: I'm not against psychiatric medicines, but let's figure out what's wrong first, and let's see if we can get away with not having to give that to you. And sometimes there's cases where, okay, I've done everything I could with natural, and whatever I need to do to support their brain, but it's still not working, or they're still having a lot of issues — then reach for that psych med. But then perhaps that medicine is going to work the way it's supposed to work, because you got the brain healthy, you got the brain prepared, you got the brain filled with the right things, then that medicine is actually going to do something.

Lisa: It's a little bit like — I've got a hyperbaric oxygen therapy clinic and I'm a huge fan of hyperbaric, because it was Mum's cornerstone of her recovery. But when I first started, it was like, yeah, get them in the hyperbaric and off you go, and do a block of treatments, and you need repeated treatments, and all of that's correct, right? But now I've been learning from Dr Scott Sherr, like, you need to prepare the person to have an optimal response in the hyperbaric. So that is looking at, how is your nutrient status, how are your hormones, how are your lifestyle factors, all of these things, so that you optimise their time in the tank. And it costs money, so you want to have the best things on board. If we're dealing with a brain injury, that might be ketones, and it might be fish oils, and it might be plasmalogens, and it might be whatever the case is. But they've got that on board with them, not just doing the hyperbaric on its own. It's a, let's prepare your body for the treatment.

Dr Mizyl Damayo: Yeah. So you talked to Scott? That's my buddy.

Lisa: Oh really? He's amazing. I love him.

Dr Mizyl Damayo: He's just super brain, super brain. He roped me into one of his podcasts too, and he was excited, because I'm like, I'm your first, right? And he goes, yes, you are — you're my second.

Lisa: Well, man, I'm in good company then. I think Dr Scott is just absolutely amazing. He's been on two, three times on my show. I've learned so much.

Dr Mizyl Damayo: Yeah, I would love to do the HOMe HOPe course with Dr Ted, but just too many things to do right now.

Lisa: I think Dr Scott is the world's best on the hyperbaric and so many other things. The GABA-ergic pathways — I've learned so much from him on GABA and methylene blue. He's taught me a lot.

Dr Mizyl Damayo: But to give credit to our programme, he is the one who created our protocol.

Lisa: Wow.

Dr Mizyl Damayo: So we don't have that machine at our office, because it's too big for us, and the cost.

Lisa: Oh yeah.

Dr Mizyl Damayo: But if we're doing all these modalities and still maybe they're not getting what they need to get, but now they're ready for HBOT because their inflammation is down, their hormones are right, their deficiencies are fixed, and then they're ready for HBOT. So that's what he taught me — like, hey, you can't just put somebody...

Lisa: We had the same teacher. Throw some in the tank, like, yeah, I know how to do this. And then he says, take a step back.

Dr Mizyl Damayo: Same thing with Scott — take a step back, okay, we need to do these things first. And yes, he created a protocol. I said, I need for you to create a mental health protocol. So we have HBOT for dementia, ADHD, and all those different diagnoses that come in for patients. So we have that protocol, we have that recipe, so we can just give it to them and say, take this to wherever you want. If you can afford the HBOT, more power to you.

Lisa: Yeah, absolutely. I think that's a super good approach, to prepare everything for it. Dr Mizyl, you've been absolutely wonderful today. I'll have to go and get Mum her coffee before she goes to sleep on the exercise. But I just want to say you're amazing. You're the first psychiatrist that I've had on, I think, and you're the first holistic psychiatrist, definitely, that takes this holistic, integrated approach. And I think it's wonderful that people can get access to people like you that can really put all the pieces of the puzzle together, take away the blame and the guilt, and look at the physical stuff of it, and fix the actual imbalances, the actual nutrients, the hormones, the stuff we've been talking about. And then use different tools like the magnetic stim, which we didn't even get into — the transcranial magnetic stimulation — all of these modalities that you can use to actually get long-term healing, and to understand that it's a process. I think that's what I've taken away from today: it's a multi-pronged approach, it's looking at you as a whole person, and it's using all of these tools to get you better. And it's going to take a while, and that's just a beautiful truth, I think. So thank you so much for sharing.

Dr Mizyl Damayo: Thank you.

Lisa: And is there any — if people want to work with you, can they do that remotely? Obviously I've got a lot of listeners in New Zealand, Australia. Do you work online at all?

Dr Mizyl Damayo: Yes, we do have telemedicine, and if you are in the state of Florida, we can treat you by telemedicine. But the way that we've done our programme through the Brain Well Program, we can look at your genetics, we can look at your labs, we can look at your hormones, and we can come up with a 20, 30 page treatment plan. And that's not like practising medicine per se, this is just, here are my opinions, this is what I would recommend, and you can take that to your doctor. And if I recommend that you need prescriptions — some people do need like shots of testosterone right away — they can just take that and they can work with their doctor. Then I always tell them, don't hesitate for their doctor to contact me if they're kind of confused, because it is a lot. So we do not limit ourselves to just being here in Florida.

Lisa: It's awesome.

Dr Mizyl Damayo: We have a lot of work to do in the state of Florida too.

Lisa: Yeah, yeah, you do. But that's absolutely wonderful. And your website — where can people find you, or are you on social media?

Dr Mizyl Damayo: It's paradisebehavioral.com. Paradise Behavioral.

Lisa: And we'll put that in the show notes. Paradise Behavioral.

Dr Mizyl Damayo: Yeah, and then go to the website. They can put their name in there if they want to be a patient at the Brain Well Program, or if they're in the state of Florida and they just want to be a patient at the office. I have nurse practitioners that also will just do standardised medicine, and then I get to deal with the really difficult cases, which I love. It's actually fun.

Lisa: It takes the drone out of, like, here's another script.

Dr Mizyl Damayo: Yeah, yeah, using my brain.

Lisa: I love it. You're absolutely wonderful, Dr Mizyl. Thank you so much, and we look forward to maybe having you on again. So thank you.

Dr Mizyl Damayo: Yes, yes, we will.

Lisa: Okay, thank you so much. Bye-bye.