In this in-depth conversation, Dr. Robert Hedaya joins Dr. Mark Hyman to explore the future of psychiatry through a functional medicine lens. They discuss root causes of mental health conditions, advanced brain mapping with QEEG, and innovative therapies designed to support the brain’s natural healing capacity.
Watch the full conversation here.
Dr. Robert Hedaya: A woman comes to me and she’s having panic attacks. She has B12 deficiency. I give her injection. With the first injection, her panic is gone. And I’m like, “Oh my god, what else am I missing?”
Intro: Today’s guest is Dr. Robert Hedaya, a true pioneer in functional psychiatry and has been doing this work for more than 46 years, helping people with some of the most complex and treatment resistant cases. Now psychiatrists are looking at the brain, doing imaging, doing something called QEEG, which is like a brain wave test that maps out things that we never saw before and that we’re now making sense of.
Dr. Mark Hyman: Talk about some of your more recent work around the whole adoption of this technology of improving neuropsychiatric treatment with QEEGs. What is it? Why do we use it?
Dr. Robert Hedaya: We can follow and detect the information flow patterns in the brain. So we can see this and study a person’s brain and then correlate with the symptoms. So when you’re seeing these patterns, it tells you which area of the brain is working, which is not working, what to target, how it correlates with symptoms, and so you can see almost diagnostically in a way you could never see before.
Dr. Mark Hyman: Yeah. Oh, it’s mindboggling. And you’re the only one doing this to my knowledge.
Dr. Robert Hedaya: Yeah.
Dr. Mark Hyman: So what do you think the most common things that are causing these problems of anxiety, depression, cognitive decline?
Dr. Robert Hedaya: I hate that question. If you said to me, what are four things that you could tell a person to do to help themselves, I would say diet. Be careful what comes into your mind. You need to really communicate with God or the universe or whatever you think this greater thing is. Some kind of exercise, whatever is appropriate for you is really critical, and I would say relationships are essential.
Dr. Mark Hyman: Bob, Dr. Hedaya, welcome to the podcast.
Dr. Robert Hedaya: Thanks for having me, Mark. It’s great, great, great to be here.
Dr. Mark Hyman: Holy cow. I don’t know where to start. We were the OG functional medicine neophytes learning functional medicine together at the first training session applying functional medicine in clinical practice in Gig Harbor, Washington in, what was it, 1998?
Dr. Robert Hedaya: ’98, yeah.
Dr. Mark Hyman: And we were one of the first cohorts to go through the program. There were more teachers than there were students in the class, and we became best friends there. It’s been almost 30 years that we’ve been doing this functional medicine stuff.
I want to say thank you to you for what you’ve done for functional medicine. You know, I’m the scientist, the clinician working in the trenches, learning and expanding and doing all this. And you’re out there.
Dr. Robert Hedaya: I’m just a big mouth.
Dr. Mark Hyman: Yeah, and you’re doing a great job, man. You’re spreading it to the world and it’s fabulous. This is really needed.
Dr. Robert Hedaya: I want to be the mind virus that infects everybody.
Dr. Mark Hyman: It’s amazing. Think back then — we were just joking before the podcast that people were laughing at us for what we were doing and making fun of us for talking about things like leaky gut and mitochondria and the microbiome. We didn’t even call it that then. We just called it “the gut.” And now it’s sort of mainstream.
Just last week, I got a call from the Chief Medical Officer of the Center for Medicare and Medicaid Innovation — CMMI — which is the innovation hub within Medicare that looks at new solutions to chronic disease. She called to tell me they were launching a $100 million effort with 30 different sites to study functional medicine and lifestyle medicine in the treatment and prevention of chronic disease.
In my lifetime, I never thought that would happen. On the website of Medicare it actually says the words “functional medicine.” I’m like, wow, we’ve come a long way.
And you’re a psychiatrist — also an everything-ist at this point, as you say.
Dr. Robert Hedaya: I’m an accidental internist.
Dr. Mark Hyman: Yeah. You can’t look at the body without looking at the brain. You can’t look at the brain without looking at the body. And you can’t look at the mind without looking at the brain, which is sadly what most psychiatry does.
We’re in this extraordinary moment of revolution. You’re 73, I’m 66. We’re kind of old now — but getting younger.
Dr. Robert Hedaya: Getting younger.
Dr. Mark Hyman: We’ve seen the trajectory of science emerging over the last decades. Now there’s metabolic psychiatry, psychedelic psychiatry, ketamine-assisted therapy — all these things we talk about on the podcast. You’ve had a front-row seat to what’s happening in mental health through the lens of functional medicine.
Your book way back when — before we even used the term functional medicine — was already laying out biological psychiatry.
Dr. Robert Hedaya: I didn’t know it, but I had discovered functional medicine in 1987 — maybe even before. During my internship there was a woman who had low potassium, and I decided to give her bananas instead of potassium pills. They were not happy with me.
Dr. Mark Hyman: Food is medicine.
Dr. Robert Hedaya: Yeah.
Dr. Mark Hyman: And you basically have seen the development of this field and how so much of our ideas and concepts around mental health are just wrong. And that in order to treat people, you need to think about treating the whole system. And that there are ways to fix the brain that change your mind.
Dr. Robert Hedaya: Mhm. And that’s not something that is really done in psychiatry. You have therapy, you have psychiatric drugs — they suppress symptoms — but they don’t really deal with the root cause. And you know, as functional medicine doctors, we are root cause specialists. That’s what we do. We dig and dig and dig until we find the thing or the things that are off, and then we try to correct them.
And we also then try to do things with modalities that we’re going to talk about, which help map out where the dysfunction or imbalances are, and then how to correct them by supporting the body’s own endogenous healing system — the built-in repair system that we have — which is available, we just don’t know how to activate it.
Dr. Mark Hyman: What’s really tragic is that there’s so many people suffering with mental health issues and they’re not able to access the care. They don’t know that this is even an option for them. They don’t understand that there’s a way out of their suffering that has nothing to do with talking to a therapist — not that that’s bad — or taking psychiatric drugs, which generally don’t work, cause side effects, or just suppress symptoms without really doing the trick.
Maybe you can walk us through the original insights you had around how to think differently. As you mentioned before, I wrote a book called The UltraMind Solution in 2009, which was a good decade after we first met. I was seeing all these people and treating their bodies and their mental symptoms would get better — their ADD or their dementia or their depression or anxiety or whatever was going on, or bipolar or schizophrenia. I’m like, well, what’s going on here? And I realized, oh, the body is connected to the brain. I think we missed that lecture, right?
Dr. Robert Hedaya: Well, they didn’t give that lecture actually. It’s true. In psychiatry we don’t really think about what happens below the neck, but that’s where all the action is typically, and it’s systemic.
Dr. Mark Hyman: So can you walk us through the origin story of how you began to understand this? What were some of the original cases you had, and what have you learned over the last 30 years? Give us sort of a bird’s-eye view of the life and mind of Hedaya.
Dr. Robert Hedaya: Okay. A quick thing that happened in medical school is I took six months off of medical school to study medicine on my own. I had the two years under my belt and I said, you know, I’m memorizing stuff — let me get this right. So I took six months off and I was studying about 10 hours a day. I laid out a whole program and stuck to it, and I actually came to understand the body and basic physiological principles. I wasn’t just memorizing.
Fast forward — I go in thinking I’m going to be a surgeon. I have a great mentor who teaches me hypnosis in 10 minutes. I’m blown away by the results, so I switch to child psychiatry. I go to Georgetown, then to NIH where they were doing cutting-edge research. Then I go into practice doing psychopharmacology and cognitive behavioral therapy, which at the time was cutting-edge therapy, which I learned from one of the top doctors in the country.
So a woman comes to me — we’ll call her Joanne — she’s 50 years old and she’s having panic attacks. I’m like, well this is a piece of cake. I’ll do some cognitive behavioral therapy. That didn’t work. So I give her imipramine or Xanax. At the time they were telling us to use 8 milligrams of Xanax. Eight milligrams — it’s like a horse’s dose.
My working hypothesis was she’s 50, she has an unhappy marriage, her only child is going off to college. She’s having separation anxiety because she wants to leave her husband. Panic is basically separation anxiety where you think you’re going to die. The locus coeruleus gets activated and you feel mortal threat.
A year into treatment I’m dancing Saturday night at a bar mitzvah and my pager goes off. I find a phone booth — back in the day — and call. “Hey Joanne, what’s going on?” “I’m having a panic attack.” I talk her down, but I’m like, what is going on here? This is a year — she should be better.
Monday morning I go in early to look at her chart. I had one lab — a CBC. Psychiatrists doing blood tests? That was heresy back then. The size of her red blood cells — the MCV — was 101. The range was 80 to 100. I ignored it for two reasons. One, I was taught to treat train wrecks. A little out of range? Don’t bother. Second, I didn’t know what it meant.
So I went to the National Library of Medicine, looked it up, and it said it could be a B12 deficiency. I ran the test — she had a B12 deficiency. I gave her an injection. With the first injection, her panic was gone.
And I’m like, “Oh my God, what else am I missing?” Because people are just in the system, going around this revolving door — this doctor, that doctor, this med, that med. That’s when I realized I must be missing a lot of stuff.
Dr. Robert Hedaya: My mother-in-law used to say, when the doctor says “it’s all in your head,” it means either you’re crazy or the doctor’s missing something. And I’d say nine times out of ten, it’s the doctor missing something.
This is simplistic, but you have the software — how you think about things — and then you have the hardware. How’s the brain functioning? Does it have nutrients? Is inflammation low? Is the circuitry working properly?
You’ve got to have good hardware to deal with the software. If the hardware is broken, you’re not going to get far. You’ll be in therapy for 100 years and not get anywhere. It’s a lot easier to get enlightened if you’re not mercury-poisoned or B12-deficient, your thyroid’s working, and your gut microbiome is healthy.
Dr. Mark Hyman: That’s an amazing story. It’s not that everybody with panic attacks has a B12 deficiency. That’s the problem in medicine. We go, oh, you have panic attacks — B12. No. Psychiatry categories are based on symptoms, not cause.
Dr. Robert Hedaya: The DSM is good for insurance companies. It’s good at categorizing symptoms, but it doesn’t tell you anything about the cause.
Dr. Mark Hyman: So you kind of had that insight and saw this, and then you really began to expand your model.
Dr. Robert Hedaya: Right. Now don’t get me wrong — allopathic medicine is great for certain things. I don’t want to throw that out. But I saw really horrible care with my mother-in-law and my father at major hospitals in New York City. They misdiagnosed and lost my mother-in-law. She had myxedema — severe hypothyroidism — and they wouldn’t treat it because of the reference range. They didn’t look at her clinically. The reference range went up to 10. She was 11. They didn’t want to treat it, even though clinically she was profoundly hypothyroid. Really it should be under three and a half, maybe even lower if you have psychiatric issues or certain genetics.
So you’re forced to learn because there’s nobody out there to help your patients. I’d send people to endocrinologists and get nothing back. So I had to learn myself. You’re the accidental internist; I’m the accidental psychiatrist. It all comes around to the same stuff because the body is one interconnected system.
Dr. Mark Hyman: There’s this whole field now of metabolic psychiatry using ketogenic diets and nutrition more aggressively. What do you think about that?
Dr. Robert Hedaya: I think it’s great. But it depends on the patient. It has to be personalized. One thing people should understand is there are fads in psychiatry, just like in medicine. There’s a book called Mad in America that traces the history of psychiatry. A couple hundred years ago, they thought mental illness was demons — so exorcisms. Then they put people in giant centrifuges and spun them around. They said it worked. Hospitals bought machines that could spin 12 people at a time. After 30 years, the science didn’t hold up, so that disappeared. Then insulin coma therapy. Then the psychopharmacology revolution in the 1950s.
I’m not saying meds are bad — I wouldn’t want to practice without them — but they’re overused. Functional medicine isn’t a fad. We’re identifying real root causes of the chronic disease epidemic, and that’s going to permeate the system. It may take 10, 20, 30 years, but it will.
Diseases change over time. In training, thyroid problems were rare. Now one in five women has Hashimoto’s. Now we have long COVID. Things evolve, and medicine has to evolve with them.
Dr. Mark Hyman: One thing that’s really interesting about your work is that you’ve evolved into using modalities that typically haven’t been used in psychiatry. Neurologists pay attention to the brain but not the mind. Psychiatrists pay attention to the mind but not the brain. Now you’re using brain imaging and something called QEEG.
So let’s talk about that. What is a quantitative EEG? How does it work? Why do we use it?
Dr. Robert Hedaya: A quantitative EEG — QEEG — involves putting a cap on a patient’s head and measuring electrical output at 19 points. The data goes into a computer and is analyzed using AI. It’s standardized against age- and sex-matched controls using NIH databases.
We collect data over 15–20 minutes with eyes open and closed. It’s painless and non-invasive. We even send equipment to patients’ homes. What we get back is essentially a wiring map of the brain. We can see the brain’s networks, surface areas, and information flow patterns.
For example, in dissociation you might see disrupted information flow between the frontal and parietal lobes on one side of the brain. We correlate these patterns with symptoms. We also do structural imaging like NeuroQuant MRI, which measures the size of different brain regions. Then we combine structure, function, and symptoms to understand what’s going on.
If someone’s worry network is overactive, or their salience network isn’t filtering what’s important, we can see that. It’s diagnostic in a way we never had before.
Dr. Mark Hyman: That’s mind-boggling. So what patterns do you see in conditions like depression or schizophrenia?
Dr. Robert Hedaya: In depression, the frontal lobes often aren’t communicating well with each other. We can target that with light therapy to specific regions. I had a patient with schizophrenia who didn’t know he was paranoid. On his QEEG I saw a tract from the frontal lobe to the visual cortex that wasn’t functioning properly. That tract helps interpret facial expressions.
I treated that area with laser therapy. After a few treatments, he said, “I’m reading faster, and people’s faces don’t look distorted anymore.” His paranoia was based on misreading faces.
Dr. Mark Hyman: What causes these brain wave abnormalities?
Dr. Robert Hedaya: Many things. Head injuries — even ones you don’t remember. Toxins. Infections — certain infections target specific brain regions. Mycoplasma can affect the basal ganglia. Treat the infection and the QEEG changes over months.
We know about PANDAS — strep infections leading to OCD via basal ganglia involvement. These tools let us see into the brain in ways we never could before. We might see six networks out of balance, but we ask the patient which symptoms bother them most and start there. Reducing stress and improving function helps them cope with life.
Dr. Mark Hyman: You also use modalities like neurofeedback, hyperbaric oxygen, and laser therapy. Tell us about the “hammock moment” when this came together.
Dr. Robert Hedaya: I had retired in 2014. My family had booked a trip we couldn’t cancel, so I went. One day I lay in a hammock for six hours reading a book about brain healing. It described Russian researchers using lasers delivered through veins to treat the brain. I was amazed — it increased ATP production and helped cellular repair.
Then I thought, “How would I know where to aim the laser?” The next chapter was about QEEGs. That was the moment. I studied QEEGs and laser therapy for three years and started using them clinically in 2017.
A laser is just focused light. We can control wavelength, pulse frequency, and many other parameters. With QEEG guidance, we know where to apply it.
Dr. Mark Hyman: This ties into mitochondrial function, right?
Dr. Robert Hedaya: Exactly. The photons from the laser reach the mitochondria — the cell’s energy producers. They displace nitric oxide and allow ATP production to increase. More ATP means the brain has energy for repair. Nitric oxide also improves blood flow. Over time, we see reductions in misfolded proteins like alpha-synuclein and tau.
Dr. Mark Hyman: How long are treatments?
Dr. Robert Hedaya: Usually 10–25 minutes per session. Some conditions respond in a few sessions; others require ongoing treatment, like a brain gym.
Dr. Robert Hedaya: The first patient I ever treated with the laser had early dementia and some memory problems. I didn’t even know she had facial blindness — prosopagnosia. After the first treatment, she said, “Oh my God, I can remember the face of the woman I worked with this morning.” She had built an entire system around not recognizing faces — taking photos of clients, their homes, everything — because she couldn’t rely on memory. Five minutes after treatment, she could suddenly recall faces.
I eventually realized that some brain cells are in a liminal state — not fully dead, not fully alive. When you provide energy, they “wake up.” I published that case as the first documented cure of acquired prosopagnosia.
Dr. Mark Hyman: How often do people need laser therapy?
Dr. Robert Hedaya: It depends. Some issues resolve in a few treatments. Chronic conditions may need ongoing sessions. For example, an 80-year-old with Parkinson’s had visual tract issues. Three treatments corrected that symptom. For Parkinson’s itself, we might start twice a week and taper to maintenance.
Think of it like the brain gym. You feed the brain nutrients, then exercise it.
Dr. Mark Hyman: Let’s talk about hyperbaric oxygen therapy.
Dr. Robert Hedaya: HBOT is like a general tonic for the body. You increase oxygen delivery, improve blood flow, stimulate stem cells, increase nerve growth factors, and enhance mitochondrial function. It’s not targeted like laser, but it supports systemic repair. We avoid it in certain infections like Babesia, which thrive on oxygen.
We have chambers in our office. Some patients move nearby for weeks or months of treatment. Others install chambers at home.
Dr. Mark Hyman: Neurofeedback is different from older systems where you had to consciously control a video game, right?
Dr. Robert Hedaya: Yes. In our approach, the brain gets rewarded automatically. The patient watches a movie. When the brain produces the desired wave pattern, the movie plays normally. When it doesn’t, the screen dims or sound drops. The brain learns subconsciously. After six or seven sessions, it “gets it.”
Dr. Mark Hyman: Are you reaching conditions you couldn’t treat before?
Dr. Robert Hedaya: Absolutely. Schizophrenia, schizoaffective disorder, Parkinson’s, treatment-resistant depression, early Alzheimer’s. For bipolar disorder, we must stabilize patients first because laser can increase activity and trigger mania. Bipolar II often responds to lifestyle and root-cause work before brain therapies.
I had a man depressed since age 12. Laser therapy brought relief he hadn’t felt in decades.
Dr. Mark Hyman: You also described a dental infection case.
Dr. Robert Hedaya: Yes. A woman with severe psychiatric symptoms refused dental treatment but had chronic oral infection. I put her on antibiotics to control it. Her psychiatric stability improved dramatically. Chronic infections increase glutamate and inflammation in the brain.
Genetic studies of psychiatric illness show strong links to immune system and hormone pathways — not just neurotransmitters.
Dr. Mark Hyman: What are the most common drivers today of anxiety, depression, and cognitive decline?
Dr. Robert Hedaya: I still hate that question because every case is different. But broadly: food, mindset, hormones, infections, sleep, and social breakdown. Social media is not community.
If I had to give four basics:
- Diet — what you eat matters profoundly.
- Mental input — be careful what you consume mentally. News, media, relationships — it’s all information that shapes your brain.
- Spiritual connection — some relationship with something greater than yourself.
- Exercise — appropriate physical activity.
- Relationships & community — true human connection is medicine.
Dr. Mark Hyman: You once studied 23 treatment-resistant depression patients and saw 100% recovery.
Dr. Robert Hedaya: After my book came out, we screened patients with severe depression who had support and resources to follow a functional medicine program. I hired a statistician to review outcomes because I couldn’t believe what I was seeing. Within months, depression scores dropped from severe into remission. Diabetes, hypertension — other conditions improved too. Treat the system and everything improves.
Dr. Mark Hyman: Prevention and treatment are really the same thing.
Dr. Robert Hedaya: Exactly. If you create health, disease disappears as a side effect. When parents improve health, kids learn by watching. This is generational change.
Dr. Mark Hyman: How are psychiatrists responding?
Dr. Robert Hedaya: Slowly. Many lack bandwidth, curiosity, or comfort with uncertainty. We have to follow the truth, not a model. If something better comes along, we adopt it.
Dr. Mark Hyman: Bob, thank you for decades of pioneering work. Where can people find you?
Dr. Robert Hedaya: At WholePsychiatry.com. We offer educational consults where we collaborate with a patient’s doctor. The goal is to help patients and train physicians in this model.
Dr. Mark Hyman: I’m getting my QEEG done.
Dr. Robert Hedaya: I do mine regularly. My doctor says my brain looks like a 55-year-old.
Dr. Mark Hyman: Amazing. Thanks for being here.