Dr Daniel Amen is an American psychiatrist and director of the Amen Clinics in North America. Amen's six clinics specialize in the use of brain imaging equipment (Single Photon Emission Computerised Tomography or SPECT) in diagnosing psychiatric disorders. He has also written ten books on his work that have hit the New York Times bestseller list.
Below is a 14 minute TED talk given by Dr Amen in 2013 entitled "The Most Important Lesson From 83,000 Brain Scans". He speaks candidly and openly about his own life journey along with his passion for psychiatry and mental health:
A SPECT scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3-D pictures. So while imaging tests such as X-rays can show what the structures inside your body look like, a SPECT scan produces images that show how your organs work. Thus a brain SPECT scan can show not only how blood flows to your brain, but also which areas are more active or less active.
However, Amen's methodology has been criticized by some psychiatrists and neuroscientists on ethical and safety grounds.
Since the original TED talk above Dr Amen and his team has gone on to have done over 100,000 brain scans using SPECT. His organisation has the world's largest database of brain scans related t0 behaviour on patients from at the last count 111 countries. He states that his work has been published in over 70 peer reviewed journals on subjects such as:.....
How SPECT changes clinical practice.
How the Amen Clinics Method improves patient outcomes
How SPECT can predict ADHD treatment response.
He is also the co-author of the Comprehensive Textbook of Psychiatry’s chapter on Functional Imaging in Clinical Practice.
He states that his clinics have treated among others, hundreds of doctors, nobel laureates, political figures, athletes, oscar winning actors, famous musicians and religious leaders. He has calculated by 2016 that over 5,000 medical and mental health professionals have referred patients, many of whom are their own family members. In addition 38% of referrals come from former patients or their family or friends.
So while being a controversial figure in some circles, there are important principles that emerge from Amen's talk and work that clearly strike a chord with many people.
As a psychiatrist I have, like most of my colleagues in the UK, not had experience of using SPECT scans routinely in my work. However, Amen's work does raise some important issues worth considering when it comes to mental health.
Here are six of these take away points:
- Your brain is involved in everything you do, including how you think, how you feel, how you act, and how well you get along with other people. When your brain works right, you work right; and when your brain is troubled, you are much more likely to have trouble in your life. (See Podcast #003 Stress, How To Make Stress Your Friend and Podcast #030 Do You Need More Sleep?)
- Amen makes the provocative point that psychiatrists are the only medical specialists that virtually never looks at the organ they treat. This is in direct contrast to virtually all other medical disciplines. Diagnoses today are made on the basis of symptom clusters - as they were for Abraham Lincoln in 1840. (See Lincoln: How Depression Moulded A Great Leader and Failure and Depression: The Other Side of Lincoln's Life).
- There is huge potential for the use of SPECT scanning in understanding conditions like anxiety, depression, ADHD, Alzheimer's disease and addictions not as single disorders, but as multiple types according to their scan images. This raises the potential of tailoring treatments to people with the same symptoms but radically different brains. At the moment it is almost impossible to predict the effect of a specific medication on a specific individual - rather like throwing darts in the dark.
- How Amen has come to the conclusion that mild traumatic brain injury can be a major cause of debilitating psychiatric illness in people's lives, as well as criminality, homelessness and drug and alcohol abuse.
- But perhaps the biggest insight of all is what is called the neuroplasticity of the brain. In other words no matter your age you are not stuck with the brain you have. There is this ability of your brain to reorganise itself both physically and functionally throughout your life due to your environment, behaviour, thinking and emotions. That is what SPECT scanning has allowed us to see in real time.
- The final conclusion Amen comes to is to raise the question, what if mental health is really about brain health? As we understand this from a physical, psychological, social and spiritual perspective then there is enormous potential for change, growth and development.
Have you come across such work before? I have to confess that Amen's work is relatively new to me. I am planning to explore and study it in more detail over the next few months. I would be very happy to hear from either colleagues or patients who have experience of the use of SPECT brain scanning for psychiatric disorders here in the UK or anywhere else around the world.
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