AMEN CLINICS METHOD FOR BOOSTING YO U R M I N D, M O O D, A N D M E A N I N G
STOP FLYING
BLIND START FEELING
BETTER DANIEL G. AMEN, MD
STOP FLYING
BLIND START FEELING
BETTER AMEN CLINICS METHOD FOR BOOSTING YOUR MIND, MOOD, AND MEANING
DANIEL G. AMEN, M.D.
MEDICAL DISCLAIMER The information presented in this book is the result of years of practical experience and clinical research by the author. The information here, by necessity, is of a general nature and not a subsitute for an evaluation or treatment by a competent medical specialist. if you believe you are in need of medical interventions, please see a medical practitioner as soon as possible. The stories in this book are true. The names and circumstances of the stories have been changed to protect the anonymity of patients. Copyright Š 2015 by Daniel G. Amen, M.D. All rights reserved.
This book is dedicated to all the people and families who have trusted their care to Amen Clinics.
INTRODUCTION In this short book you will find the Amen Clinics Method for helping our patients who struggle with ADHD, anxiety, depression, addictions, and more. It was developed over the last 4 decades and has helped tens of thousands of people from all over the world, from 9 months old to over 100 years of age. We believe it represents a true paradigm shift in mental health care. The underlying message is that you are not stuck with the brain you have, you can make it better. But first, it is critical to look at the brain; At Amen Clinics we use a brain mapping study called SPECT (single photon emission computed tomography), which looks at blood flow and activity patterns. You’ve heard that an image is worth a thousand words. But a map is worth a thousand images. A map tells you where you are and how to get to where you want to go. Without this information in psychiatry, clinicians are literally flying blind, which can hurt the people they are trying to help. Our work with SPECT and brain mapping has completely changed the way we practice, and has deeply informed our method. My hope is that this little book will inspire you to care deeply about your brain.
1
MAVERICK
BEGINNINGS HOW IT BEGAN I am the middle sibling of seven children. Growing up, my father called me a maverick, which to him was NOT a good thing.
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1942...
“ How do you know unless you look?” In 1972 the Army called my number and I was trained as an infantry medic, where my love of medicine was born. After realizing I truly hated sleeping in the mud or the thought of being shot at, I was retrained as an x-ray technician, and developed a passion for medical imaging. As our professors used to say, “How do you know unless you look?”
1979... I fell in love with psychiatry because it has the potential to change generations of people.
In 1979 when I was a second year medical student, someone in my family became seriously suicidal and I took her to see a wonderful psychiatrist. I came to realize that if he helped her, which he did, it would not only save her life, but it could also help her children, and even her future grandchildren, as they would be shaped by someone who was happier and more stable. I fell in love with psychiatry because it has the potential to change generations of people.
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1991... Fast forward to 1991, when I attended my first lecture on brain SPECT imaging. SPECT shows blood flow and activity patterns in the brain. It looks at how your brain works. SPECT was presented as a tool that could give us more information to help our psychiatric patients. In that 4
lecture my two professional loves, medical imaging and psychiatry, came together and quite honestly revolutionized my life. Over the next 23 years my colleagues and I would build the world’s largest database of brain scans related to behavior on patients from over 111 countries.
WHAT CAN SPECT TELL US?
Full, even, symmetrical activity
HEALTHY SCANS
SPECT basically tells us three things about brain function: good activity, too little activity or too much activity. Here is a healthy set of SPECT scans. The image on the left shows full, even, symmetrical activity. The color is not important;
Areas of increased activity
it’s the shape that matters. In the image on the right, red indicates the areas of increased activity. In a healthy scan, the back part of the brain is typically the most active.
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WHAT CAN SPECT TELL US?
HEALTHY
STROKE VICTIM
Here is a healthy scan compared to someone who had 2 strokes. Can you see the holes of inactivity?
HEALTHY
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ALZHEIMER’S
This scan shows deterioration in the back half of the brain of an Alzheimer’s patient. Did you know that Alzheimer’s starts decades before you have any symptoms?
HEALTHY
TRAUMATIC BRAIN INJURY
Traumatic brain injury — your brain is very soft and your skull is very hard.
HEALTHY
DRUG ABUSE
The real reason not to use drugs is because they damage your brain.
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WHAT CAN SPECT TELL US?
HEALTHY
OCD
Obsessive compulsive disorder (OCD) typically has too much activity in the front part of the brain, which is why people have trouble turning off their thoughts.
HEALTHY 8
SEIZURE ACTIVITY
With epilepsy we often see focal areas of increased activity.
SPECT: MAKING A DIFFERENCE 1992...
In 1992 I attended an allday lecture at the American Psychiatric Association on brain SPECT imaging in psychiatry given by physicians at Creighton University. It was amazing and mirrored my own early experience. Yet, at the same conference, researchers complained loudly that clinical psychiatrists SHOULD NOT be using the scans; they were only for their research. Being a maverick and someone who had personal experience using scans, I knew that position was dead wrong! Without imaging, psychiatrists still made diagnoses like they did in 1840 when Abraham Lincoln was depressed‌ by talking to people and looking for symptom clusters. Imaging was showing us there was a better way.
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SALLY AT REST
SALLY CONCENTRATING
SPECT: MAKING A DIFFERENCE In the first 50 cases I ordered SPECT scans, they made a dramatic positive difference for my patients. Here are some examples:
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Sally, 44, was admitted to the hospital for suicidal thoughts after a fight with her husband. As I got to know her, I thought she had ADD. She dropped out of college, despite having an IQ of 144, and she had a hyperactive son, which is
a frequent tip off that one of the parents has ADD. Plus, she was restless and pretty impulsive. When I talked to her about ADD she didn’t think it applied to her because she could concentrate if she was really interested. So I decided to scan Sally at rest, and again while she performed a concentration task. At rest Sally had a healthy looking brain, but when she tried to concentrate her brain really dropped in activity, especially in the front!
When I laid the pictures on the table in her hospital room and explained them to her she started to cry and said, “You mean it’s not my fault?” “Right,” I said, taking the glasses I wear to drive out of my pocket. “Having ADD is just like people who need glasses. People who wear glasses aren’t dumb, crazy or stupid. Our eye balls are shaped funny and we wear glasses to focus. Likewise, people who have ADD aren’t dumb, crazy or stupid. Their frontal lobes shut down when they’re supposed to turn on. They need help to turn them back on so they
Chris, 12, was hospitalized for the third time for violent outbursts, and his treatment of multiple medications and therapists had failed. At Amen Clinics, his scan showed low activity in his left temporal lobe, a part of the brain implicated in seizures and violence. On an anti-seizure medication, his aggressive outbursts stopped.
can focus. In fact, as you can see, the harder you try the worse it gets.” This helped Sally make sense of her life and she had a wonderful response to the treatment. She felt calmer, more focused, went back to school and finished her degree. The relationships with her husband and son were better and she no longer thought of herself as a failure, but as someone who needed help for a medical problem. The SPECT images made a radical change in her attitude toward herself and her treatment.
Chris’s scan showed low activity in his left temporal lobe 11
SPECT: MAKING A DIFFERENCE Matilda, 69, was diagnosed with Alzheimer’s disease, but she didn’t have the Alzheimer’s SPECT pattern. Her scan was more consistent with depression and her memory was restored on a medicine for depression.
MATILDA’S SCAN
KEN’S BEFORE SCAN
KEN’S SCAN ONE YEAR LATER
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Ken, 44, was abusing alcohol and cocaine, but was in denial about it. After seeing his “toxic” scan he completely stopped the abuse. A year later Ken and his brain scan were better.
Do you know that psychiatrists are the only medical specialists who rarely look at the organ they treat? Think about it. Cardiologists look, neurologists look, orthopedists look. In fact all other medical specialists look. Psychiatrists guess.
Pulmonologists look...
Cardiologists look...
Gastroenterologists look...
Obstetricians look...
Every other medical specialist looks... at Amen Clinics, we look too.
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Before imaging, I was throwing darts in the dark and had unintentionally hurt patients, which horrified me.
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LESSONS LEARNED FROM BRAIN SPECT IMAGING Early on, SPECT taught us many important lessons. The first one was that problems like ADD, anxiety, depression and addictions are NOT single or simple disorders in the brain; they all have multiple types. To the left are scans of two people with depression who have virtually the same symptoms, but radically different brains. One has low activity; the other high activity. Do you think they’ll respond to the same treatment? Of course not! Treatment needs to be tailored to individual brains, not a cluster of symptoms. And how would you ever know unless you actually looked?
Two patients with the same symptoms. Treatment needs to be tailored to individual brains.
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The current method by which almost all psychiatric patients are diagnosed is with symptom clusters according to a document called the DSM (Diagnostic and Statistical Manual V5).
If your symptoms cluster around depression you get a diagnosis called major depression and typically an antidepressant is prescribed. Or, if you have a cluster of anxiety symptoms, you are given an anxiety disorder diagnosis and typically prescribed anti-anxiety medication. If you have attention and impulse control problems, you receive an ADD or ADHD diagnosis and are prescribed stimulant medication. My favorite diagnosis to describe this phenomenon is if you explode intermittently you are given a diagnosis called intermittent explosive
disorder or I.E.D. and no one is quite sure what to do. Unfortunately, this symptom cluster based approach tells you nothing about what is going on in someone’s brain and psychiatric outcomes have not improved in over 50 years. We can do better, but we have to look at the brains of our patients and tailor the treatment to the symptom clusters together with what we see on scans. This is one of the big contributions Amen Clinics has been making to the field of psychiatry. Effective treatment needs to be tailored to individual brains, not a cluster of symptoms.
CURRENT WAY MOST ARE DIAGNOSED AND TREATED: SYMPTOM
DIAGNOSIS
“I AM DEPRESSED.”
“YOU ARE DEPRESSED.”
Anti-Depressants
“I AM ANXIOUS.”
“YOU ARE ANXIOUS.”
Anti-Anxiety Meds
“I AM UNFOCUSED.”
“YOU HAVE ADHD.”
“I EXPLODE INTERMITTENTLY.”
“YOU HAVE INTERMITTENT EXPLOSIVE DISORDER (IED).”
TREATMENT
Stimulants Anger Management Meds
* There is a reason that most psychiatric medications have black box warnings. If you give them to the wrong person you can precipitate a disaster. 17
MILD TRAUMATIC BRAIN INJURIES The second lesson was that mild traumatic brain injuries are a major cause of psychiatric illness and ruin people’s lives. Few people know about it because only a handful of mental health professionals ever look at the brains of their patients. Here’s a SPECT scan of a 15-year-old boy who fell down a flight of stairs at the age of 3. Even though he was unconscious for only a few minutes and was given a diagnosis of mild traumatic brain injury, there was NOTHING mild about the enduring effect the injury had on his life. I met him after he had been kicked out of his third residential treatment program for violence. He needed a brain rehabilitation program,
not just more medication or behavior therapy. Research has shown us that undiagnosed brain injuries are a major cause of depression, panic attacks, drug and alcohol abuse, homelessness, ADHD and suicide.
The enduring effects of traumatic brain injuries.
Undiagnosed brain injuries are a major cause of depression, panic attacks, drug and alcohol abuse, homelessness, ADHD and suicide. 18
TOXIC EXPOSURE OR INFECTIOUS DISEASE Another important lesson was that unrecognized toxic exposure or infectious disease is a common cause of psychiatric symptoms. Adrianna was normal until the age of 16 when she went on a mountain vacation with her family. When they arrived at the cabin near Yosemite, they were surrounded by 6 deer. It was a beautiful moment. Ten days later, Adrianna became agitated and started having auditory hallucinations. Her family brought her to a psychiatrist who diagnosed her as psychotic and prescribed medications, which didn’t help. The next 3 months were a torturous road of different doctors, multiple medications and a cost of nearly $100,000. Adrianna had become a shadow of her former self. Adrianna’s parents brought her for a scan, which showed areas of unusually high activity. It caused our physician to look deeper at the potential
causes of her symptoms, such as an infection or toxicity. It turned out Adrianna had Lyme Disease, a bacterial infection often caused by deer ticks. Once she took antibiotics, Adrianna got her life back. 19
SOME PRESCRIPTION MEDS CAN BE TOXIC
Another critical lesson was that many psychiatric medications had the potential to be toxic for brain function. When I did my psychiatric training at the Walter Reed Army Medical Center, we were taught to use a class of anti-anxiety medication called benzodiazepines.
HEALTHY 20
When I ordered my first few scans for patients on these medications they looked like they were alcoholics, so I stopped using them. That’s when I really got serious about using natural ways to heal the brain, including hypnosis, meditation and nutritional supplements.
BENZODIAZEPINES
NOT LOOKING AT THE BRAIN HURTS PATIENTS AND FAMILIES ►►
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►►
►►
Symptom based diagnoses can be misleading. With many roads leading to psychiatric disorders, symptoms tell nothing of the underlying physiology. Physicians often make mistakes by calming underactive brains or stimulating overactive ones. One-size-fits-all treatments often fail. Each person is uniquely different and requires personalized targeted treatment.
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Marital problems are often mislabeled as psychological when they may be brain related. Marital therapists have no training in neuroscience and aren’t looking at the full picture. A huge opportunity is often missed to decrease stigma, increase treatment compliance and create the desire, known as brain envy, for healthy brains and lives.
There’s no understanding of illness subtypes. Most disorders have multiple subtypes. It’s important to find your subtype for the correct treatment. Physicians often miss traumatic brain injury, toxicity and infections which are frequently the primary cause of psychiatric symptoms. Physicians often miss the fact that some psychiatric medications are toxic.
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NOT LOOKING AT THE BRAIN HURTS OUR SOCIETY ►►
Organizations like the NFL/NHL remained in denial for decades about the long term effects of traumatic brain injury (TBI). Functional brain imaging tools changed everything.
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Military personnel with TBI are often left without appropriate help and hope. How do you know if a TBI was significant unless you actually look at brain function? Costly dementias are not diagnosed until late in the illness. Even though it starts in the brain decades before any symptoms appear, no prevention or early treatment can occur. Violent behavior is never truly rehabilitated because people are only judged morally, and not treated medically. This is like doing software programming on people who have hardware problems.
PUBLISHED OVER 60 PEERREVIEWED SCIENTIFIC ARTICLES As we continued our work with SPECT, the criticism from researchers GREW LOUDER… “Why doesn’t he publish his research?”, they cried. I asked if they knew how to read. Since 1993, my colleagues and I have continually published research, now numbering over 60 peer reviewed articles*, and I’ve presented at many medical conferences, including at the American Psychiatric Association, Biological Psychiatry, American Association of Neuropsychiatry, and the National Science Foundation.
* See references at the end.
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EVEN AS THE CRITICISM CONTINUED, SO DID THE LESSONS If you don’t admit you have a problem, you cannot do anything to solve it. The NFL formed its concussion committee in 1994, but over the next 20 years never sponsored a functional brain imaging study on players. Instead they studied rats. They actually put little helmets on the rodents and repeatedly hit them in the head with metal pellets. In 2009, Commissioner Goodell said to Congress, “The NFL didn’t know if playing football caused longterm brain damage. They
were still studying the issue.” The problem with the NFL position was that if you do not admit you have a problem, you cannot do anything to solve it. Many brain damaged NFL players were left without help or hope. From 2009 to 2012, Amen Clinics, together with the LA chapter of the NFL Retired Players Association, performed the first and largest functional brain imaging study on active and retired players. Brain SPECT helped to change everything.
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In our SPECT research published in the Journal of Neuropsychiatry, we demonstrated high levels of brain damage in players. That was not a surprise. Purple equals areas of low activity.
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Here is a healthy SPECT scan compared to one of our players who was a 16 year NFL veteran:
HEALTHY
16 YEAR NFL GUARD
What really excited us was that while on the Amen Clinics Method, 80% of our players showed significant levels of improvement, especially in the areas of blood flow, mood and memory.
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80% of the players showed improvement
THE SAME PLAYER A YEAR LATER, MUCH BETTER. 27
INEFFECTIVE TREATMENT IS VERY EXPENSIVE Some people complain about the cost of an evaluation with SPECT scans, but they often forget to compare the cost to ineffective treatment, which can be VERY expensive. Because of the wrong diagnosis or treatment plan, people spend thousands of dollars on the wrong medications, hospital stays, residential treatment programs, and divorce or criminal attorneys. Also, school failure, job failure and underachievement are very expensive. Seen in this light, our evaluations and treatment plans are usually very cost effective, as they are targeted to your brain.
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►► ►► ►►
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Effective treatment can help you feel better quickly.
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►►
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Underachievement, demoralization — not living up to your potential is costly and decreases tax revenue! School failure — failed college attempts are costly! Job failure — multiple job changes, absenteeism, and being fired is expensive! Relationship problems — divorce is very expensive! Legal problems — lawyers are expensive! Failed therapy attempts. Multiple failed medication trials with side effects cost a lot. Residential treatment can cost about $100,000 a year. 28-day drug treatment can run from $20,000 to $80,000 a month. Psychiatric hospital stays can exceed $2,000 a day.
$$$
LEGAL
JOB
PROBLEMS
FAILURE
HOSPITAL STAYS $2,000/DAY
D THER LE
TS MP
Y ATTE AP
MULTIPLE MEDICATION TRIALS
DIVORCE RELATIONSHIPS UBLED TRO
PSYCHIATRIC
tion raliza o m de
FAILURE IN
SCHOOL
FAI 29
CHANGING PEOPLE’S BRAINS AND LIVES BETTER BRAIN, BETTER LIFE. After nearly 100,000 brain SPECT scans over the past 3 decades, the most important lesson we’ve learned is that we can literally change people’s brains and their lives. You are not stuck with the brain you have — we can help you make it better.
ADD TEENAGER BEFORE 30
Here is the scan of an ADD teenager who had been cutting herself, failing in school and fighting with her parents. On treatment, the low activity in her brain became much better and she went from Ds and Fs to As and Bs and was more emotionally stable.
AFTER TREATMENT
Here is Nancy’s scan who was diagnosed with dementia. The doctor told her husband that he should find a home for her because in a year she would not know his name. After 10 weeks on an intensive brain rehabilitation program, Nancy’s brain was better, her memory was improved and 5 years later she still knows her husband’s name.
NANCY BEFORE TREATMENT
AFTER 10 WEEKS 31
CHANGING PEOPLE’S BRAINS AND LIVES ANDREW’S STORY. My favorite story is of Andrew, a 9-year-old boy, who attacked a little girl on the baseball field for no particular reason and was drawing pictures of himself hanging from a tree, and shooting other children. Andrew was Columbine, Aurora and Sandy Hook waiting to happen. Most psychiatrists would have medicated him, as they did with Eric Harris and the other shooters before their shocking crimes, however our imaging work taught us to first look at his brain to better target what he needed.
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Large cyst was evident in the left temporal lobe, an area often implicated in violence.
His SPECT scan showed a cyst the size of a golf ball occupying the space of his left temporal lobe, an area often implicated in violence. No amount of therapy or medication would have helped Andrew. When the cyst was removed, his behavior went COMPLETELY back to normal and he was once again the sweet loving boy he always wanted to be.
Now, 18 years later, Andrew, who is my nephew, is employed, owns his own home and is a happy, loving human being. Because someone looked at his brain, he has been a better son, and will be a better husband, father and grandfather.
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THE AMEN CLINICS METHOD A true paradigm shift in Brain Health
The Amen Clinics Method represents a true paradigm shift in optimizing and healing the brain. We believe it is critical to look at your brain within the context of your life. ►► Looking
at specific biological, psychological, social, and spiritual influences
►► Neuropsychological
testing
►► Brain
SPECT imaging at rest and during concentration
►► Lab
tests (when necessary)
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The Amen Clinics Method gives our physicians a deep understanding to target treatment specifically tailored to your brain and situation. In studying our outcomes on more than 2,000 patients, the Amen Clinics Method has proven very successful for many and we have some of the best outcome results anywhere, even for people who have been labeled as complicated or treatment resistant.
CURRENT PSYCHIATRY NEEDS IMPROVEMENT... “I feel depressed.”
“You suffer from depression. Here is an antidepressant.”
... WITH A NEW APPROACH “I feel depressed.”
AMEN CLINICS METHOD
“We need more information”
THE PROBLEM
We need to do better Today, psychiatry is practiced by many physicians the same way it was 60 years ago: A doctor assesses your symptoms, forms a diagnosis based on those reported symptoms, and then prescribes a medication at a dosage that may or may not work. From there, it’s a matter of watching to
see if he or she got it right. Many times patients will get multiple diagnoses and prescriptions before they find relief — if at all. Treatment success rates have not improved in decades, even though technology and science have progressed dramatically. 35
AMEN CLINICS METHOD STAGE 1:
Assess Detailed Personal History At Amen Clinics, we see the condition of every patient as a result of four primary factors, or circles, all of which can have a meaningful impact on mental health: your biology, psychology, social life, and spiritual life. We have designed our intake process to look at each of these circles. This allows us to truly understand you.
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ASSESS THE 4 CIRCLES OF BRAIN HEALTH BIOLOGICAL
We want to know about your genetics, overall health, diet, exercise, and any history of brain injury or exposure to toxins.
PSYCHOLOGICAL We’ll explore your thinking patterns and ask if you had any significant developmental events or emotional traumas in the past.
SOCIAL We’ll ask what your relationships with friends and family are like, if you have a lot of stressors and if you spend time with others or feel isolated.
SPIRITUAL We want to know why you care, what’s important to you and what gives you a sense of meaning and purpose in life.
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STAGE 2: Evaluate Brain Activity, Function & Chemistry
SPECT images tell us three important things: ►► Areas
of the brain that work well
►► Areas
of the brain that don’t work hard enough
►► Areas
of the brain that work too hard
SPECT images provide extremely valuable insight: They connect the dots between your brain function, behaviors and symptoms, which helps our doctors create an individualized treatment plan that is effectively targeted to meet your needs.
REST 38
How can we know what is going on with your brain unless we look?
CONCENTRATION
NEUROPSYCHOLOGICAL TESTING We use 2 neuropsychological tests to give us additional details about how your brain is working. The Conners Continuous Performance Test-II helps to assess focus, response speed and impulse control.
KNOW YOUR IMPORTANT NUMBERS Your biological state plays a powerful role in your mental health. For instance, if your hormones are out of balance, your mood and mental clarity will be out of balance too —and no amount of antidepressants or stimulants are going to help. If deemed appropriate, we will order a set of diagnostic lab tests to measure your basic health numbers, and depending on the circumstances, we may also order genetic markers or more extensive testing.
WebNeuro measures domains of function in thinking, feeling, emotion, and self-regulation; including tests for mood, anxiety, attention, and memory.
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STAGE 3: Targeted and Personalized Care Plan
At the Amen Clinics, we understand that no two people are alike, and treatment is not one-size-fitsall, especially in psychiatry. With a complete picture of your biological, psychological, social and spiritual health, together with SPECT imaging, neuropsychological tests and labs (when appropriate), our doctors will provide you with a personalized, targeted treatment plan geared toward your symptoms and your brain. Based on your needs and desires, your plan may include a combination of different treatments such as: ►► Key
lifestyle changes
►► Dietary
interventions
►► Nutritional
supplements
►► Medication ►► Targeted ►► Exercise
psychotherapy
(brain & physical)… and more
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High Published Success Rates
Least Toxic, Most Effective Solutions Did you know that some psychiatric medications are actually toxic for brain function? As we formulate individual treatment plans, our doctors follow a simple guiding precept: Find solutions that will treat the condition most effectively while imposing the least possible toxicity. We offer many natural therapies and robust support for patients as they make brain-healthy life changes. Where medication is indicated and appropriate, Amen Clinics’ doctors are able to prescribe them.
During the last 23 years, we have performed nearly 100,000 brain SPECT scans on patients from 111 countries and have seen how carefully made diagnoses and targeted personalized treatment can literally and dramatically change people’s lives. Recently, our experience was clinically confirmed in a major study involving more than 500 patients from the Amen Clinics: ►► After
6 months of treatment, 77% of these patients were better across all measures.
►► 85%
reported having a better quality of life.
►► And
the results were even higher when the patients carefully followed their treatment plan!
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BRAIN ACTIVITY
STEP 4: Boosted Brain Reserve and Happier Life
Symptoms Start Brain Reserve Trouble Zone
AGE & HABITS Your Amen Clinics evaluation and treatment plan will empower you with the tools you need to optimize your brain function. You will learn how to love and care for your brain through healthy lifestyle strategies, including physical and mental exercise, a brain healthy diet, eliminating toxins, improving sleep,
and supplementation or medication (if necessary). This combination of treatment methods will help you boost your brain’s reserve; giving you greater resilience in times of stress, improving your overall functioning and leading you to a more balanced, productive and happier life.
BETTER BRAIN = HAPPIER LIFE!!! 42
DEVELOP BRAIN ENVY 3 simple principles will boost your brain health.
1. CARE You need to care about your brain health.
“
“
“Brain Envy” is the strong desire to have a better brain. It means wanting to protect, nourish and focus on your brain’s health. Falling in love with your brain is the first step to becoming healthier, smarter and happier.
My last scan, at age 52, looks healthier and younger than my first scan, even though brains typically become less active with age. Why? Seeing other people’s scans, I developed ‘brain envy’ and wanted mine to be better.
— Actual Amen Clinics Patient 43
2. AVOID Avoid anything that hurts your brain. ►►
Brain injuries
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Drugs & alcohol
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Obesity
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Lack of activity
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Insomnia/apnea
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Poor diet
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Nicotine/caffeine
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Low omega 3s
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Environmental toxins
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Low hormones
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Emotional trauma
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Chronic stress
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Unhealthy peer group
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Poor decisions
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Not knowing your own brain’s vulnerability
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Diabetes
►►
High blood pressure
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3. ENGAGE Engage in regular brain healthy habits. ►►
Great decisions
►►
Physical health
►►
Mental workouts
►►
Healthy weight
►►
Physical activity
►►
Healthy blood sugar
►►
Brain healthy diet
►►
Positive peer group
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7-8 hours of sleep
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Clean environment
Counteract negative thoughts
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upplements, such as S multiple vitamins, omega 3s, Vitamin D and brain nutrients
►►
Stress management
►►
nowing the health of K your brain
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AMEN CLINICS METHOD HELPS... ... to see the underlying physiology in individual patients.
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OVERACTIVE
UNDERACTIVE
TOXIC
TRAUMATIC
... to see all psychiatric illnesses have multiple types.
UNDERACTIVE
OVERACTIVE
TEMPORAL LOBE
ANT. CINGULATE
Multiple Types of Depression 47
AMEN CLINICS METHOD HELPS... ... to see traumatic brain injuries, toxins, and infections.
TRAUMA
CHRONIC LYME
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CHEMO BRAIN
... to prevent mistakes, such as stimulating an overactive brain, calming one that is underactive, missing toxicity, or not finding a space occupying lesion. This 17-year-old violent boy, failed 6 psychiatrists, 6 medications and 18 months of residential and drug treatment costing over $130,000. No one looked at his brain and his neurological exam was NORMAL! His brain was wildly abnormal!
MRI
SPECT
Scans showed a large left frontal and temporal lobe cyst.
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AMEN CLINICS METHOD HELPS... ... to offer hope for alcohol and drug addictions. ►► Breaks ►► “Brain ►► Help
denial
Envy” increases compliance
understand co-morbidity
►► Follow
treatment
►► Education
and prevention
BEFORE
50
AFTER TREATMENT
... lead to more effective ways of treating the brain by seeing before and after scans. MMA Fighter SPECT scans before treatment and 2.5 hours after a group of brain-directed supplements.
BEFORE
2.5 HOURS AFTER
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AMEN CLINICS METHOD WE HAVE NOTHING ELSE IN PSYCHIATRY THAT IS THIS POWERFUL OR IMMEDIATE. ►► SPECT
scans help to decrease stigma
►► Patients
and families see the problem as medical not moral
►► Dramatically
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decreases shame, guilt, self-loathing and anger
►► Increases
forgiveness and compassion
►► Increases
brain envy and compliance with treatment
SPECT CHANGED THE DIAGNOSIS OR TREATMENT PLAN 79% OF THE TIME.
79%
►► Research
demonstrates that SPECT changes clinical management 79% of the time.
Improved outcomes. ►► 500 ►► On
consecutive patients
average our patients have 4.2 diagnoses
►► Failed ►► 77%
3.3 prior providers and 6 medications
significantly improved across all measures
►► Quality
of Life Inventory significantly increased in 85%
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GET HELP NOW Would you like better: ►► Energy? ►► Focus?
►► Memory? ►► Mood? ►► Inner
peace? ►► Self-control? ►► Overall physical health? We are here to help you and your loved ones have the best brain function possible.
Have you (or a loved one): ►► Seen
several doctors and taken numerous medications but still haven’t found relief for your symptoms?
►► Been
disappointed with mental health treatment because it was ineffective for you?
►► Tried
many things to feel healthier and happier, have better focus and increased energy, but can’t seem to get all the way there?
►► Felt
like you’re looking through a foggy lens and wished your brain worked better?
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Do you want: ►► To
see how your brain functions to help prevent trouble in the future?
►► Take
advantage of the latest technology to enhance your healing and optimization?
When you change someone’s brain, you not only improve his or her life, you have the potential to change generations to come.
►► Optimal
mental performance?
If you answered YES to any of these questions, we are here for you. Over decades of work, we have seen that you can literally change your brain and change your life. Our passion is to help you do just that.
Amen Clinics has helped tens of thousands of people over the last three decades and we would love to help you! Call (888) 516-4946. to speak with a Patient Care Specialist for more information about the Amen Clinics Method, or visit us at www.amenclinics.com.
CALL NOW! 888-516-4946 55
DANIEL G. AMEN, M.D. Named the web’s #1 most influential mental health expert and advocate, Daniel G. Amen, MD is a physician, double board certified psychiatrist, and nine-time New York Times bestselling author. He is the founder of the Amen Clinics, which has a database of nearly 100,000 brain SPECT scans on patients from 111 countries. Dr. Amen has dedicated his career to changing the lives of his patients and everyday people through helping them improve brain health.
“ Dr. Amen is one of the most gifted minds in medicine.” — Mehmet Oz, MD
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SELECTED PEER-REVIEWED SCIENTIFIC REFERENCES Willeumier K, Taylor DV, Amen, DG. Neurobiological correlates of introversionextraversion with activation-state brain SPECT imaging (submitted for publication).
Amen DG, Trujillo M, Keator D, Taylor DV, Willeumier K: rCBF gender differences in a sample of 46,034 SPECT scans (submitted for publication).
Harcourt S, Amen DG, Willeumier K, Golden, C. Regional cerebral blood flow in schizophrenia while in attention task. Presented at the American Psychological Association
Amen DG, Jourdain M, Taylor DV, Pigott HE, Willeumier K (2013) Multi-site, six month outcome study of complex psychiatric patients evaluated with addition of brain SPECT imaging. Advances in Mind-Body Medicine, 27(2): 4-14.
Silverman DH, Willeumier K, Torosyan N, Mallam S, Raji C, Dahlbom M, Amen, DG. Regional cerebral blood flow patterns during performance of an attention-focused cognitive task in patients resistant and responsive to antidepressant therapy. Accepted by the Society of Nuclear Medicine Meeting 2014. Amen DG, Mallam S, Torosyan N, Silverman DH, Raji C, Dahlbom M, Willeumier K. Regional cerebral blood flow (rCBF) patterns distinguishing bipolar mood and attention deficit hyperactivity disorders (submitted for publication). Raji C, Amen DG, Torosyan N, Willeumier K, Mallam S, Dahlbom, M, Silverman, DH. Altered regional cerebral blood flow patterns in NFL offensive linemen and defensive backs. Accepted by the Society of Nuclear Medicine Meeting 2014. Newberg AB, Serruya M, Gepte A, Intenzo C, Lewis T, Amen DG, Russell D, Wintering N (2014) Clinical comparison of 99mTc exametazime and 123I ioflupane SPECT in patients with chronic mild traumatic brain injury. PLoS One, 9(3): e91088. Raji C, Tarzwell R, Pavel D, Schneider H, Uszler J, Thornton J, van Lierop M, Cohen P, Amen DG, Henderson TA (2014) Clinical utility of SPECT in the diagnosis and treatment of traumatic brain injury: A systematic review. PLoS One, 9(3): e91088. Amen DG, Taylor DV, Ojala K, Willeumier K (2013) Effects of a brain-directed nutrient system on rCBF and neuropsychological testing: A randomized, double blind, placebo controlled, cross-over trial. Advances in Mind-Body Medicine, 27(2): 18-27.
Amen DG (2013) It’s time to stop flying blind: How not looking at the brain leads to missed diagnoses, failed treatments, and dangerous behaviors. Alternative Therapies, 19(2). Amen DG and Burnett L (2012) Daniel Amen, MD: The impact of brain imaging on psychiatry and treatment for improving brain health and function. Alternative Therapies, 18(2): 52-58. Amen D, Highum D, Licata R, Annibali J, Somner L, Pigott HE, Taylor DV, Trujillo M, Newberg A, Henderson TA, Willeumier K (2012) Specific ways brain SPECT imaging enhances clinical psychiatric practice. Journal of Psychoactive Drugs, 44(2): 96106. Amen DG, Willeumier K, Johnson R (2012) The clinical utility of brain SPECT imaging in process addictions. Journal of Psychoactive Drugs, 44(1): 18-26. Willeumier K, Taylor D, Amen D (2012) Elevated body mass in National Football League players linked to cognitive impairment and decreased prefrontal cortex and temporal pole activity. Transl Psychiatry, 2(1): e68. Harch PG, Andrews SR, Fogarty EF, Amen D, Pezzullo JC, Lucarini J, Aubrey C, Taylor DV, Staab PK, Van Meter KW (2012) A Phase I study of low pressure hyperbaric oxygen therapy for blast-induced postconcussion syndrome and posttraumatic stress disorder. J Neurotrauma, 29(1): 168-185.
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SELECTED PEER-REVIEWED SCIENTIFIC REFERENCES Harch P, Andrews SR, Fogarty E, Amen DG, Lucarini J, Van Meter KW (2012) Response to Letter to the Editor by Wortzel and Colleagues. J Neurotrauma, 29(14): 2425-2430. Amen DG, Willeumier K (2011) Brain SPE CT imaging: A powerful, evidence-based tool for transforming clinical psychiatric practice. Minerva Psichiatrica, 52(3): 109-23. Willeumier K, Taylor D, Amen D (2011) Decreased cerebral blood flow in the limbic and prefrontal cortex using SPECT imaging in a cohort of completed suicides. Translational Psychiatry, 1(8): e28. Amen DG, Trujillo M, Newberg A, Willeumier K, Tarzwell R, Wu JC, Chaitin B (2011) Brain SPECT imaging in complex psychiatric cases: An evidence-based, underutilized tool. Open Journal of Neuroimaging, 5: 40-48. Willeumier K, Taylor D, Amen D (2011) Elevated BMI is associated with decreased blood flow in the prefrontal cortex using SPECT imaging in healthy adults. Nature Obesity, 19(5): 1095-7. Amen DG, Wu JC, Taylor D, Willeumier K (2011) Reversing brain damage in former NFL players: Implications for TBI and substance abuse rehabilitation. Journal of Psychoactive Drugs, 43(1): 1-5. Amen DG, Newberg A, Thatcher R, Jin Y, Wu J, Keator D, Willeumier K (2011) Impact of playing American professional football on long term brain function. Journal of Neuropsychiatry and Clinical Neurosciences, 23(1): 98-106. Newberg AB, Wintering N, Waldman MR, Amen D, Khalsa DS, Alavi A (2010) Cerebral blood flow differences between long-term meditators and non-meditators. Conscious Cogn, 19(4): 899-905. Amen D (2010) Brain SPECT imaging in clinical practice. Am J Psychiatry, 167(9): 1125.
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Khalsa DS, Amen D, Hanks C, Money N, Newberg A (2009) Cerebral blood flow changes during chanting meditation. Nucl Med Commun, 30(12): 956-61. Amen DG, Prunella JR, Fallon JH, Amen B, Hanks C (2009) A comparative analysis of completed suicide using high resolution brain SPECT imaging. The Journal of Neuropsychiatry and Clinical Neurosciences, 21: 430–439. Boersma N, Wiersma J, Hanks C, Huijsmans M, van Isselt H, Amen D (2008) Cerebral blood flow in TBI patients: SPM analysis of HMPAO-SPECT. Presented at the World Congress Brain Injury in Lisbon, Portugal April 2008 Amen DG, Hanks C, Prunella, J (2008) Predicting positive and negative treatment responses to stimulants with brain SPECT imaging. Journal of Psychoactive Drugs, 40(2): 131-8. Amen DG, Hanks C, Prunella, J (2008) Preliminary evidence differentiating ADHD from healthy controls using brain SPECT imaging in older patients. Journal of Psychoactive Drugs, 40(2): 139-46. Shankle WR, Hara J, Bjornsen L, Gade GF, Leport PC, Ali MB, Kim J, Raimo M, Reyes L, Amen D, Rudy L, O’Heany T (2008) Omentum transposition surgery for patients with Alzheimer’s disease: a case series. Neurol Res, 30(3): 313-25. Amen DG, Hanks C, Prunella, JR, Green, A (2007) An analysis of regional cerebral blood flow in impulsive murderers using single photon emission computed tomography. J Neuropsychiatry Clin Neurosci, 19(3): 304-9. Amen DG (2006) Brain imaging in clinical practice: Pro/con: pro position. Clinical Psychiatry News, September. Lansing K, Amen DG, Hanks C, Rudy L (2005) High resolution brain SPECT imaging and EMDR in police officers with PTSD. J Neuropsychiatry Clin Neurosci, 17(4): 526-32.
Amen DG, Wu JC, Carmichael B (2003) The clinical use of brain SPECT imaging in neuropsychiatry. Alasbimn Journal, 5(19). Amen DG (2001) Why don’t psychiatrists look at the brain: the case for the greater use of SPECT imaging in neuropsychiatry. Neuropsychiatry Reviews, 2(1): 19-21. Amen DG (2001) Brain SPECT imaging in the assessment and treatment of aggressive behavior: A putative “Reward Deficiency Syndrome (RDS)” behavioral subtype. Abstract of presentation at the First Conference on “Reward Deficiency Syndrome:” Genetic Antecedents and Clinical Pathways, San Francisco, November 12-13, 2000, in Molecular Psychiatry, Vol. 6 Supp. 1: S7. Amen DG (2001) Attention, doctors. Newsweek, Feb 26; 137(9): 72-3. French AP, Amen DG (1999) Criminal recidivism as a neurobehavioral syndrome. J Am Acad Child Adolesc Psychiatry, 38(9): 1070-1. Amen DG (1999) Regional cerebral blood flow in alcohol induced violence: A case study. Journal of Psychoactive Drugs, 31: 4. Amen DG (1998) Brain SPECT imaging in psychiatry. Primary Psychiatry, 5(8): 83-90. Amen DG (1998) Attention deficit disorder: A guide for primary care physicians. Primary Psychiatry, 5(7): 76-85. Amen DG, Waugh M (1998) High resolution brain SPECT imaging in marijuana smokers with AD/HD. Journal of Psychoactive Drugs, 30(2): 1-13.
Amen DG, Carmichael B (1997) Oppositional children similar to OCD on SPECT: Implications for treatment. Journal of Neurotherapy, 2(2): 1-6. Amen DG, Waugh ME (1997) Three years on clomipramine: Before and after brain SPECT study. Ann Clin Psychiatry, 9(2): 113-116. Amen DG, Carmichael B (1997) High resolution brain SPECT imaging in ADHD. Ann Clin Psychiatry, 9(2): 81-86. Amen DG (1997) Criminal recidivism as a neurobehavioral syndrome. J Am Acad Child Adolesc Psychiatry, California State University Stanislaus, December issue, 23-29. Amen DG (1997) Windows into the ADD mind: Essential knowledge base for educators. School of Education Journal, California State University Stanislaus, December issue, 23-29. Amen DG (1996) High resolution brain SPECT imaging in psychiatry provides real help for patients. Diagnostic Imaging, 85-88. Amen DG (1996) Brain SPECT imaging in psychiatric practice. Advance for Radiological Professionals, 9(16): 12-13. Amen DG, Stubblefield M, Carmichael B, Thisted R (1996) Brain SPECT findings and aggressiveness. Ann Clin Psychiatry, 8(3): 129-137. Amen DG, Paldi F, Thisted RA (1993) Brain SPECT imaging and ADHD. J. Am. Acad. Child Adolesc Psychiatry (Letter), 32(5): 1079-1080.
Amen DG, Yantis S, Trudeau J, Stubblefield MS, Halverstadt JS (1997) Visualizing the firestorms in the brain: An inside look at the clinical and physiological connections between drugs and violence using brain SPECT imaging. Journal of Psychoactive Drugs, 29(4): 307-319.
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STOP FLYING BLIND START FEELING BETTER Call now for a free consultation 888-516-4946
Contact one of our clinics today and see how much better life can be. Amen Clinics Orange County 3150 Bristol Street, Suite 400 Costa Mesa, CA 92626
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Visit us today: www.amenclinics.com