10 Lessons I've Learned From 150,000 Brain Scans

Nearly 30 years after Amen Clinics first began our brain imaging work, we have built the world’s largest database of functional brain imaging scans related to behavior. Brain SPECT scans have taught myself and our patients so many important lessons.

Lesson #1: Current psychiatric diagnostic models are outdated because they don’t assess the brain.

Today, the typical way most people are diagnosed and treated for mental health issues is by going to a professional and telling him or her their symptoms. The doctor or therapist listens, examines them, looks for symptom clusters, and then diagnoses and treats them. Patients may say, “I’m depressed,” for example, and the doctor will look at them and then give them a diagnosis with the same name—depression. Treatment is typically an antidepressant medication.

Psychiatrists are the only medical specialists who virtually never look at the organ they treat. Cardiologists look, neurologists look, gastroenterologists look, orthopedists look. Psychiatrists guess. There is a better way.

Lesson #2: Psychiatric diagnoses are not single or simple disorders; they all have multiple types, and each requires its own treatment.

This was one of the earliest lessons SPECT taught us. Giving someone the diagnosis of depression is like giving him or her the diagnosis of chest pain. No doctor would do that because it doesn’t identify the cause of the pain or what to do for it. Consider this: What can cause chest pain? Heart attacks, heart arrhythmias, pneumonia, grief, anxiety, chest-wall trauma, gas, and ulcers, just to name a few. Likewise, what can cause depression? Loss, grief, low thyroid, brain infections, brain trauma, a brain that works too hard, or a brain that does not work hard enough. Do you think all of these will respond to the same treatment? Of course not.

We have described seven brain types associated with anxiety and depression, seven types of ADD, six types of addicts, five types of overeaters, and even three types associated with violence. No one treatment will work for everyone who is depressed, anxious, inattentive, addicted, overweight, or aggressive. They all have different brain types.

Lesson #3: Looking at the brain decreases stigma, increases compliance with treatment, and completely changes the discussion around mental health.

When psychiatrists don’t have hard biological data to help them make their diagnoses, many people do not take them seriously. Unfortunately, that leaves a huge emotional hole for patients, who often feel belittled or defective if they have to seek help for a “mental” illness.

Imaging completely changes the discussion around mental health. Quite frankly, few people really want to see a psychiatrist. No one wants to be labeled as defective, crazy, or abnormal, but everyone wants a better brain. What if mental health were really brain health? Scans have taught our patients that lesson over and over.

Lesson #4: If what you’re doing is not working, look at the brain.

Sudden changes in behavior are usually associated with brain trauma, toxins, infections, or a defined emotional trauma.

Lesson #5: Looking at the brain improves outcomes, and people get better faster.

The most important reason to look at the brain is to improve outcomes. That was my clinical experience when I first started scanning patients, but to find out what the data showed, we started a formal outcome study in 2011 on many of the patients we saw. To date we have six-month outcome results on more than 7,000 patients. The study made it crystal clear that in general, we see people with complex issues who have been unsuccessfully treated by multiple health care providers. On average, our patients have 4.2 diagnoses.

Lesson #6: Looking at the brain completely changes the discussion about good and evil.

A picture may be worth a thousand words, but a map is priceless. A map tells you where you are and gives you directions on how to get where you want to go. Without an accurate map you are lost, and that may cost you precious time in getting the help you need—or it may even cost your life. SPECT imaging is a map to help guide people to better brains and better lives.

Lesson #8: Looking at the brain provides hope.

Ever since we started our brain imaging work, the images provide hope that there is a better way, and there is hope for healing.

Lesson #9: Alzheimer’s and other forms of dementia start years, even decades, before people have any symptoms.

One of the most profound lessons from our brain imaging work is that Alzheimer’s disease and other forms of dementia can be seen on SPECT scans years before people have any symptoms. SPECT is a leading indicator of problems, meaning it shows evidence of the disease process years before people show signs of it. Anatomical studies, such as CT and MRI, are lagging indicators. They show problems later in the course of the illness, when interventions tend to be less effective.

Lesson #10: The most important lesson from 150,000 scans is that you can change your brain, and it will change your life.

This is the biggest and most exciting lesson our patients have learned from our work.

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