The Impact of COVID-19 on Psychiatric and Neurological Health with Dr. Decker Weiss

Dr. Weiss became the first Cardiologist as a “Naturopathic Physician”, completing a non-invasive cardiovascular hospital-based training program in the Columbia Hospital system, the Arizona Heart Institute, and the Arizona Heart Hospital. Dr. Weiss kept privileges at the Arizona Heart Hospital, while opening the breakthrough Scottsdale Heart Institute, where he helped thousands of patients reduce medication safely, eliminate the need for angioplasty and bypass surgery, and reverse heart disease and many arrhythmias naturally. The International Association of Health Care Practitioners and the International Association of Cardiologists named Dr. Weiss, a “Leading Physician in the World” in 2012; a distinction given to under 1000 physicians each year. Dr. Weiss shifted focus to inflammation, genetics, and the science of intractable conflict, as he joined Artis International as a Senior Fellow and Director of their Center for Health and Medicine. In this capacity he has lectured, practiced medicine, and performed research throughout the various conflict zones (war zones), including Iraq, Lebanon, Israel, and Haiti.

Transcript

Dr. Sutherland: My guest today is Dr. Decker Weiss. Dr. Weiss is a naturopathic physician and integrative cardiologist. His expertise in fact, covers multiple areas of human health, and today he will bring his clinical focus and wisdom to the topic of COVID-19 and psychiatric and neurological health. Thank you so much for being with us, Dr. Weiss.

Dr. Weiss:  It's an honor to be on.

Dr. Sutherland: Thank you. New research published in late January, 2021 has found that one in eight people who had COVID-19 or diagnosed with their first psychiatric or neurological illness, within six months of testing positive for the virus. The study also found that those figures rose to one in three, when patients with a previous history of psychiatric or neurological illnesses were included. So this strongly suggests two things. One, that survivors of COVID-19 appear to be at greater risk of developing a psychiatric condition as a consequence of the disease, and two, having a psychiatric disorder should be added to the list of risk factors for getting COVID-19. So, Dr. Weiss, I know you've worked with many COVID patients. What have you noticed about the mental health implications of COVID infection?

Dr. Weiss:  What I've noticed is what the study found and you know, Dr. Sutherland, sometimes these studies run two, three, five years after facts. When you look at disasters, nine 11, Oklahoma, will find data published four or five years, that sort of helps us. One of the advantages of COVID-19 is we're getting this data out faster. It's something where we finally, as medicine broke down a lot of those barriers to get things published and pre-published reads and all that. So at least we're getting that out there faster.

I think the other thing is that this isn't surprising. When any kind of holistic model looks at mental, emotional illness, we recognize it as an inflammatory disease, and it's a disease involving that hypothalamic pituitary axis, and chronic inflammation. So those folks that already have that, and then get a viral infection that really hammers that cytokine system and just irritates the heck out of it. This isn't a surprise. And when we're looking for solutions for this, popping a bunch of antidepressants is going to have some effect and some people absolutely need them, but it's not really going to get to where we need to, to recover, to truly, truly recover. And so those are my first thoughts on that.

Dr. Sutherland: Can you tell us something about the approach you have been using with post COVID patients who come to you with mental health issues as a consequence of the infection?

Dr. Weiss: Yeah. Dr. Sutherland, all of these long haulers, I've treated about close to 100. I have three in my office yesterday. We estimate just statistically about 35% of people who get COVID-19 have some form of long haul. And you brought a very important point in. We need to include mental health with it, because that has been left to the side. It's been things like shortness of breath, fatigue and things like that. But what really, we need to do is add in that mental health component.

And again, as a holistic practitioner, we look at that mental health issue as a chronic inflammatory issue. So for us, it's reflex. For areas of medicine that live in strong subspecialties and specialties, your psych and your endocrine and your that, they'll have a hard time blending that as they generally do. But for us, it's fairly easy.

For me, there's three potential causes or three pieces to this puzzle. One is the chronic inflammatory state in the brain and the CNS that has existed, maybe pre to this, or as a result of this. So let me break that into two things real quick. So one is you have people that they get brain inflammation, they gets CNS inflammation as a result of the virus, but you also have people that had depression before this, so they already had some of that, or they had a COVID-19 depression. There's a lot of folks out there that the shelter and place rules, the lack of flights, the lack of travel, loss of jobs, loss of opportunities, not getting into colleges and doing all of those things, university students not being on campus, that that COVID-19 induced that depression. And so I try and break that up for my patients. And sometimes that's hard. For patients dealing with depression, sometimes the pre COVID 19 is years and years away, where for us it's a short time away. So I need to break those into things.

And then the second thing is that there's a continuation of the immune system, despite the lack of virus where a lot of those immune activities in the T-cell system especially, are altered and continuing to be dysfunctional after the COVID exposure. So you have this pre COVID depression, no matter what it is. And then the COVID hits and the inflammation is ramped up. And then the third thing, and we just found this out recently, is we do find active COVID in the brain. Now this is scary. And so that means that we have ongoing infection in long haulers potentially in the brain. And we're going to have to do whatever we can to get in past that blood-brain barrier to knock down the replication of that virus.

And when you think about viral etiologies in the central nervous system sitting around, you look at things like MS and other things that eventually go on to cause autoimmune diseases as well. So you have those three factors that are into all of it, and all of it needs to be knocked down.

One interesting note, Dr. Sutherland is with these patients, these psycho- neuroimmunology patients, where they have chronic inflammation, depression and anxiety, things like that, we need to go back to our botanical roots a little bit. Herbs that influence the HPA axis also tend to have antiviral effects. Now, we don't know if it gets COVID-19. Most of these have never been studied that way, but they are very much recognized as having antiviral activity. Herbs like rhodiola and green tea, schisandra, ashwagandha which you're seeing quite a bit of. Herbs like St. John's wort, which is commonly known in our world is antiviral.

And so with those herbs, it's not so far off to help these people. Nature saw that chronic inflammatory state leading to these mental, emotional illnesses long before we did. So if we have a little humility and when we go to our roots here, we have some real treatment opportunities for these folks.

Dr. Sutherland: A lot of the botanicals that you've mentioned are adaptogenic in nature, which is perfect in a situation when there are so many variables, it's difficult to tease out cause and effect, and which factors are more significant. Can the virus directly or indirectly damage the integrity of the blood-brain barrier?

Dr. Weiss: We think so. Anything that'll add a chronic inflammatory state in the brain can absolutely cause problems in that blood-brain barrier. There was a great, great naturopathic physician named Konrad Kail, who was also a PA, one of my teachers. And Konrad used to talk about barrier functions, skin, eyes, lungs, blood-brain barrier, gut-brain, all of that stuff. And he talked about the commonalities in all of it. And it was a very old naturopathic lesson and holistic lesson that we used to do. All of these areas, gut and brain, they're all semipermeable membranes. And when they get irritated, inflamed, damaged...

And by the way, Lyme disease too, we cannot forget, a lot of times these patients are coming in for long haul symptoms and we're finding it's Lyme. So clinicians out there, don't forget to check for Lyme. But you get some of these long haulers out there that are coming in and we're looking for where the problem is with mental, emotional stuff, it really could be in the brain. And it could be that that blood-brain barrier, after being irritated becomes leaky or inflamed. You have leaky gut, we all know that one. Leaky lung, which tends to cause asthma and things like that. And we can have a leaky, more permeable blood-brain barrier result of inflammation.

One of the great botanicals for that as curcumin. And when I think of one botanical that stands out amongst all of these, it would be a curcumin. And I like the tumerones, the curcumins, the whole tumeric. I like the whole bunch involved in helping get that brain to recover.

Dr. Sutherland: As you mentioned, increasing evidence is actually suggesting that the composition of the gut microbiome may be the strongest predictor of COVID-19, and that many of the pre-existing conditions, including old age, that appeared to make people more vulnerable to becoming seriously ill with COVID, they're all linked to a loss of microbial diversity. Is diet, nutrition the elephant in the room when it comes to severe COVID morbidity and mortality?

Dr. Weiss: Yeah. It's the elephant, the lion, the bear, everything, because when you see people go into long haul syndromes, and when it's sticking around and we, again need to look at mental illness, just like every other long haul symptom, you're going to have to fix gut-brain barrier. And that gut and that brain talk all the time. Two thirds of our immune system is in our gut. This is an immune chronic inflammatory issue. And the nice thing is that we're better than ever, better than ever at getting that gut microbiome reset. We have wonderful diets now. I like hydrochloric acid and berberine with meals to get that pH nice and acidic in the stomach. And then you get alkaline and you've got all sorts of products that help bring back that barrier, and then probiotics. So we can get there quickly.

I think where patients get a little disappointed is gut stuff and nutrition stuff, it's not sexy. It's not a magic herb from the Himalayas. Or it's not this new drug, or it's an old drug that comes out, and it's not breakthrough or whatever. It's the grunt work of recovery. You know, Dr. Sutherland, there's just sometimes work. You’ve just got to work, and you’ve got to say, "I'm not going to be sick anymore. I'm willing to change my diet, as long as it makes sense and has good science behind it." And these folks with long haul syndromes, I don't believe anybody who goes into long haul had a healthy gut before it happened, I just don't.

If we look at that pre COVID depression that you were talking about, where is serotonin made? The far majority of serotonin is made in the gut, not in the brain. And so to me, here we go. And we can get so into technicality, and we need to, specific RNA sequences and all that. But the body still works in very specific patterns. And the gut barrier and the brain barrier talk and communicate through G-protein systems. We can't directly access brain stuff, but we can get to it through the gut. You use some adaptogens, you fix gut, you do some things to bring out replication, load them with curcumin, everybody gets better. I don't know if they recover, but everybody gets better in my opinion.

Dr. Sutherland: It's really frightening what you're saying, and I've heard this statistic before that about a third of people who get COVID infection will have post COVID syndrome. I struggle to use the term silver lining in this pandemic, but it is an opportunity to begin to look at health in a holistic way, because as you've implied, the body doesn't have the same attitude of compartmentalization toward itself -- body consciousness is not like that -- that science or medicine has.

You mentioned psychoneuroimmunology, which is a field very close to my heart. I have to tell you though, a big disappointment for me many years ago, when I found out about PNI was when I was standing in a university library, and I saw a journal of psychoneuroimmunology right next to a journal of psycho- neuroendocrinology. They say fragmentation leads to greater fragmentation, but this was an attempt at being holistic that it was irresistible to fragment. 

Dr. Weiss: Yes, psychoneuroimmunology is very important. It's a very, very big term. I think you could almost look at it in different ways, if you're coming as a psychologist or psychiatrist, if you're coming at it from a neurologist, or if you're coming from it as a person like myself that's an anti inflammologist. I just like to get rid of inflammation and control it and manage and clear it. That’s very funny because psychoneuroimmunology is a chance for our patients to not be compartmentalized, for us to say, "The infection is making your depression worse." It is. And we all know it, inflammation breeds inflammation on top of it, but they're not hearing that out there. They're not hearing that, "Wow. I was a little down and I always battled some mood stuff, but I can't get out of my funk since then."

There's one thing that I don't want to miss here. Let's not miss thyroid. So one of the things clinically I see is, and I have a 30 year old male who came in post COVID syndrome and his thyroid took a hit. And I'm seeing a lot of thyroid problems with post COVID as well. And I've been very aggressive at doing things like the Wilson's temperature work and stuff like that, because if they're coming in and they're 96 and 95 degrees under the tongue in their temperatures, how do I expect they're going to burn the rest of the virus out? And so I don't want to miss that. It's one of the clinical pearls that I kindly offer you. It’s very, very relevant. In my post COVID protocol, everybody takes temperatures and everybody gets thyroid panels, and I've been shocked about how high it is.

It gives us so many clinical opportunities. The HPA axis and using thyroid supports and things like that. And then if they need it, we can put them on thyroid, but it's very tough to get over anything if your thyroid is really taking a hit. So that's just a little clinical piece I wanted to add in. 

Dr. Sutherland: I really appreciate that point because I think the term psycho- neuroimmunology, to a lot of people, they stop listening after psycho, and they-

Dr. Weiss:  I did first time. That's funny.

Dr. Sutherland: And it's easy to forget that all approaches really have to be grounded in the body. Not to ignore psychological effects, but the body is central to all of the so-called separations of the systems that medicine has. They all converge on the body functioning as a holistic whole. Having any reminder that you have to address fundamental things, like does this person have enough energy to mount the healing response, or is all of their energy simply going into keeping them basically metabolically alive?

Dr. Weiss: Yeah. from thyroid to mitochondria, some people are going to get hit and that thyroid's just not going to recover right. Other people, you support the thyroid, you support mitochondria, and you need to be looking at things like PQQ and ubiquinol for these long haulers too, which I'm using on occasion as well. Sometimes I'll pair that with thyroid, but we get hit. We get down and we're struggling to get back. And we're trying to figure out as holistic practitioners, how do we restore them? Do we have to replace some hormones to get them to restore? Do we have to just support them? And it's very, very unique.

And one of the things that I think we're saying that we just haven't said it out loud is, COVID's exposing our country as being very vulnerable. We weren't healthy going into this. Overweight, too much sugar, too much stress. It's not a surprise that a third or more, it's a little bit more is what I've been reading, about 35% can't recover. Think about if everybody, all of a sudden got chickenpox. There's no COVID, but everybody got chickenpox, what percentage of us would have gone into chronic shingles? Probably just as much. We wouldn't have been able to actually beat this thing down. I heard a number the other day that also just sent a shiver in my spine, that the cost of post COVID syndrome, they think might be higher than type two diabetes.

Dr. Sutherland: Wow.

Dr. Weiss:   And the head of Miller Hospital, I'm on a committee with HHS and Global Solutions, and he was saying, "No, we're estimating this to be the most expensive part of healthcare going on and on for the next 20, 25 years." And that's assuming that we knock this thing down and get it under control. And again, I think as holistic practitioners that frustrates us. We know we can get people back most of the time after COVID-19. Patients have to be patient. It is a variety of different mechanisms. We're not good at it yet, but we're getting better every day.

Things like rosmarinic acid. Rosmarinic acid is one of the things that's really helping my long haulers. And it has to do with that T-cell system that it gets just so taxed in COVID. T-cell systems are related to all your inflammatory cycles, depression, you find it everywhere. But rosmarinic acid, it's one of those adaptogens. I look at rosmarinic acid as being like the T-cell system adaptogens. Is that fair?

Dr. Sutherland: I think that's a great way of describing it. 

Dr. Weiss:  It's really, really interesting. Cordyceps, Rehmannia, some of these other T-cell system stuff, but as we're digging, we're going to get better. Look how much better we are at Lyme than we were even five years ago. People with holistic practitioners who have very, very terrible Lyme conditions can have a life. It's not the easiest life, but they can have it. And we're continuing to make progress more and more to their quality of life getting better and better. I mean, my Lyme patients used to be laying in bed. Now they're taking vacations and they're taking extra naps and they take their supplements. But look how far we came with Lyme. There's no magic drug that did that. That was practitioners communicating with each other and improving on therapies over and over, getting those hormones set, neurotransmitters set, and so on. But I think COVID will be something like that.

Dr. Sutherland: It's been more than 100 years since the worldwide influenza pandemic, which itself led to a marked increased rate of neurological and psychological sequelae. So even aside from the potentially tremendous mental health consequences of lockdown, economic insecurity and so on, it's terrifying to think we might be headed toward a public health crisis based on the psychiatric and neurological impact of COVID, as well as everything else.

Dr. Weiss: Yeah. And it's the vulnerability. When I listed all of our vulnerabilities, diabetes, hypertension, obesity, all that, I didn't talk about that we already had a mental health crisis in our country. We have problems with income disparity that's feeding that and racial disparities that's feeding that, and so on. We had serious problems. Why would it get better? So it's funny. Here I am treating COVID and I didn't even put that mental health aspect in immediately. So good work, Dr. Sutherland. It will be burnt in forever now.

Dr. Sutherland: That's interesting. What's happening in our country is a holistic crisis. And so it's going to take a holistic approach to heal it, not a piecemeal approach, which will just create a kind of equal and opposite set of problems.

Dr. Weiss:  Yeah, I would agree. And for those listening, doctors, patients, everybody out there who are going through some of the long haul stuff, stick with us. If you're battling depression and anxiety and things like that after COVID, and let's say it was there before a little bit, stick with us holistic practitioners. We're going to get better and better at helping you. In the last 10 years, the use of amino acids to restore neurotransmitters without pharmaceuticals, it's blown up, it's helped thousands and hundreds of thousands of people around the world. We will help you. I promise you. You have a chronic inflammatory condition that we can get things that it will respond to. You might have to be patient with us because we're all new at COVID, but we're going to help you. I promise.

Dr. Sutherland: Thank you for those inspiring words, Dr. Weiss. I remember one of the criticisms that used to and probably still gets leveled at so-called complementary and alternative medicine, natural medicine, is that we can give people false hope, but there's also the problem with conventional medicine of giving people false despair. So I really appreciate your words.

Dr. Weiss:  False despair. If I could bring you in to talk to my heart patients, because my heart patients have been given so much false despair. Heart patients sometimes they get to me, they feel like they're machines and not people, we have to rely on mechanical means to fix them. And I try and remind them of that. But false despair, it's a real term. 

Dr. Sutherland: Yes. Yes.

Dr. Weiss:  Did you trademark that, Dr. Sutherland?

Dr. Sutherland: I'm about to. Dr. Weiss, it's been so inspiring as usual to talk with you. Before we end, is there anything else you'd like to say?

Dr. Weiss: To the practitioners out there listening, I would say we're tired. We're overworked. We are going through all these things. Try and remember each patient's going through their own journey. That's when I looked at my schedule yesterday and I had 14 patients and three of them were serious post COVID patients. I was exhausted going in, but I had to remember each patient's going through this.

And I would say to the folks out there that are battling long haul COVID, that this is a recoverable condition. If doctors are dismissing you, because that's what's going on now, doctors are saying, "Oh, you just are under stress. You're fine. Or you're this or that," because what does medicine do when they don't have an answer? Quite often it dismisses. So if you feel dismissed or you're not being heard, get to a holistic practitioner and we are going to have to energize up for each patient, but we will hear you. And we will look at the individual imprint that this COVID-19 has had on you, not what everybody goes through, so there's everybody gets this treatment, but individually, some people it's anxieties, other people it's depression, other people it's fatigue. We will look at you individually and find out what that darn virus did to you and help you restore your health. And so that's my last thoughts.

Dr. Sutherland: That's fantastic. And as I've taken to saying to people: “From your mouth to God's iPhone.” May it be so!

Dr. Weiss: Another phrase you should trademark. You're just a machine here.

Dr. Sutherland: It's my new career. Thank you so much, Dr. Weiss.

Dr. Weiss:  My pleasure.