Could Psychiatric Symptoms Be Hiding a Physical Illness? with Dr. Janet Settle (Ep 169)

In this eye-opening conversation, Dr. Linda Bluestein sits down with psychiatrist Dr. Janet Settle to unpack the medical mystery that is mast cell activation syndrome (MCAS) and why it may be hiding in plain sight as depression, anxiety, panic attacks, or even psychosis. Together, they explore how immune system dysregulation can masquerade as psychiatric illness, and why so many patients are misdiagnosed, medicated, and misunderstood. With deep expertise in trauma-informed psychiatry, Dr. Settle explains how MCAS and other overlooked conditions could be the real cause behind persistent mental health symptoms and what it takes to finally get the right diagnosis.


Takeaways:
Dr. Settle explains how MCAS can present as psychiatric symptoms like panic, depression, or brain fog—long before classic allergy symptoms appear.

The conversation explores how common psych meds can actually exacerbate MCAS-related symptoms in some patients, leading to confusing outcomes.

Learn how past trauma and immune dysregulation may work together to create a complex feedback loop—affecting mood, cognition, and inflammation.

Many patients are labeled with mental illness for years before MCAS or other immune-based conditions are considered. Dr. Settle shares why this misdiagnosis is so common.

Discover how identifying MCAS and understanding its psychiatric presentations can open the door to treatments that actually work—and a life patients didn’t think was possible.


References & Resources: Find all articles mentioned in this episode at bendybodiespodcast.com.


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Chapters:
00:00 Introduction to the Bendy Bodies Podcast
00:41 Meet Dr. Janet Settle: Integrative Psychiatrist
02:29 Dr. Settle's Journey into Holistic Medicine
05:38 Understanding Mast Cell Activation
09:21 Mast Cells and Mental Health
11:28 Histamine and Neurotransmitters
17:48 Neuroinflammation and the Gut-Brain Axis
24:15 Psychiatric Symptoms and Mast Cell Activation
30:56 Identifying Medical Causes of Psychiatric Symptoms
35:39 Understanding Root Canals and Hidden Infections
36:04 Exploring Cavitations and Their Impact on Health
37:45 Effective Treatments for Psychiatric Symptoms in MCAS
39:30 The Role of Fluvoxamine in Treating Obsessive Anxiety
44:02 Managing SSRI Withdrawal with Prozac
46:15 Ketamine for Depression and Pain Management
51:45 Challenges in Treating Mast Cell Activation Syndrome
58:10 Non-Pharmacologic Approaches for MCAS
01:01:14 Introducing Medical Intuitive Reading Practice
01:05:26 Final Thoughts and Resources