Psychiatric Manifestations of MCAS with Dr. Janet Settle as part of the Mast Cell Matters series

In this episode of the Mast Cell Matters series, Dr. Janet Settle discusses the psychiatric manifestations of Mast Cell Activation Syndrome (MCAS). Dr. Settle, an integrative psychiatrist, emphasizes that many psychiatric symptoms such as anxiety, depression, bipolar disorder type II, and others can be linked to mast cell activation. She describes how these symptoms often present episodically, similar to physical symptoms in MCAS. Dr. Settle explains that mast cells at the blood-brain barrier and histamine-producing neurons play roles in these psychiatric symptoms, although research in this area is still developing. She is a proponent of both pharmacological treatments, such as SSRIs and benzodiazepines (which she notes also have an anti-inflammatory effect), and nonpharmacological treatments like limbic retraining programs to manage MCAS. Dr. Settle argues for a redefinition of certain psychiatric disorders like bipolar II as potentially being neuroinflammatory conditions related to MCAS, and highlights the stigma and clinical implications of such diagnoses. She advocates for a biopsychosocial approach and encourages patients to trust their bodies and explore MCAS management options when traditional psychiatric interventions are insufficient.