We have the wrong paradigm. We call these illnesses mental, when they are really brain. This is a mistake that perpetuates stigma. Plus, psychiatrists are the only medical doctors who virtually never look at the organ they treat. Think about it: If you have crushing chest pain, your doctor will scan your heart; but if you have crushing depression, no one will ever look at your brain. If you are sick to your stomach, your doctor will image your abdomen; but if you are sick with anxiety, no one will ever look at your brain, and so on. You have heard it said that a picture is worth a thousand words; but a map is worth a thousand images. Without a map you are lost. If you are lost in the wilderness without a map, you unnecessarily suffer and are at risk of dying. Likewise, many people are lost in the morass of psychiatric care, and without the proper diagnosis and treatment it costs many people their lives, and in 2019 this is simply unacceptable. The lack of neuroimaging led to a “brainless” psychiatry, which kept my profession steeped in outdated theories and perpetuated stigma for our patients. And we were dealing with the most complicated organ of all — the human brain! Our patients are every bit as sick as those with heart disease, osteoporosis, or cancer. Depression, bipolar disorder, addictions, and schizophrenia are all potentially lethal disorders, and even issues such as chronic stress, anxiety, and ADHD can affect all aspects of our lives.
I had the pleasure to interview Daniel G. Amen, M.D., who is a double board-certified psychiatrist, professor, and ten-time New York Times bestselling author. He is one of the world’s foremost experts on using brain-imaging tools to help optimize and treat his patients. His research was listed as one of the Top 100 Stories in Science for 2015 by Discover magazine. Dr. Amen has written and hosted twelve highly popular shows about the brain for public television and his work has been featured in The New York Times Magazine, the Washington Post, Men’s Health and on The Dr. Oz Show and Dr. Phil.
Thank you so much for joining us Dr. Amen! Can you tell us the “backstory” about what brought you to this specific career path?
In 1972 I became an infantry medic, where my love of medicine was born. But about a year into it I realized something very important about myself: I hated being shot at, and was retrained as an x-ray technician where my love of medical imaging was born. As our professors used to say, “How do you know unless you look?” In 1979, as a second year medical student, someone I dearly loved tried to kill herself, and I took her to see a wonderful psychiatrist. Over time I came to realize that if he helped her, which he did, it would not only help her, but it would also help her children and even her grandchildren as they would be shaped by someone who was happier and more stable. I fell in love with psychiatry because I realized it has the potential to change generations of people. Yet, I fell in love with the only medical specialty that virtually never looks at the organ it treats.
That all changed in April 1991, when I went to a lecture on brain SPECT (single photon emission computed tomography) imaging, which is a nuclear medicine study that looks at blood flow and activity in the brain. The doctor who gave the lecture said SPECT was a tool to give psychiatrists more information to help their patients. When I first started our brain imaging work, I was so excited because it added incredibly useful information to help my patients. Most physicians become doctors because they love helping people, and that was certainly true in my case. When people got better faster based on what I learned about them through our brain imaging work, I got hooked on doing more to get more people better faster.
When I began using SPECT I also scanned many people in my own family, including my 60-year-old mother, who had one of the healthiest SPECT scans I had seen. Her scan reflected her life. After scanning my mom, I scanned myself, and the results were not so good. I had played football in high school and gotten sick with meningitis as a young soldier, plus I had a lot of bad brain habits, such as not sleeping more than four hours a night, struggling with being overweight, eating junk food, and being chronically stressed at home and at work. Seeing my mom’s scan and then my own, I fell in love with my brain and vowed to make it better. I also developed what I call brain envy. I come from a very competitive family and was highly irritated that my 60-year-old mother had a better-looking brain than I did at 37. Much of my life after that moment has been about making my brain better and teaching others what I learned about how to do it. When my brain was rescanned 20 years later, it was much healthier. Now, close to 30 years after we started to look at the brain at Amen Clinics, we have built the world’s largest database of nearly 150,000 brain SPECT scans on patients from 120 countries.
According to Mental Health America’s report, over 44 million Americans have a mental health condition. Yet there’s still a stigma about mental illness. Can you share a few reasons you think this is so?
We have the wrong paradigm. We call these illnesses mental, when they are really brain. This is a mistake that perpetuates stigma. Plus, psychiatrists are the only medical doctors who virtually never look at the organ they treat. Think about it: If you have crushing chest pain, your doctor will scan your heart; but if you have crushing depression, no one will ever look at your brain. If you are sick to your stomach, your doctor will image your abdomen; but if you are sick with anxiety, no one will ever look at your brain, and so on.
You have heard it said that a picture is worth a thousand words; but a map is worth a thousand images. Without a map you are lost. If you are lost in the wilderness without a map, you unnecessarily suffer and are at risk of dying. Likewise, many people are lost in the morass of psychiatric care, and without the proper diagnosis and treatment it costs many people their lives, and in 2019 this is simply unacceptable.
The lack of neuroimaging led to a “brainless” psychiatry, which kept my profession steeped in outdated theories and perpetuated stigma for our patients. And we were dealing with the most complicated organ of all — the human brain! Our patients are every bit as sick as those with heart disease, osteoporosis, or cancer. Depression, bipolar disorder, addictions, and schizophrenia are all potentially lethal disorders, and even issues such as chronic stress, anxiety, and ADHD can affect all aspects of our lives.
Can you tell our readers about how you are helping to de-stigmatize the focus on mental wellness?
Reimagining Mental Health as Brain Health Changes Everything
Early in my career I learned that very few people really want to see a psychiatrist. No one wants to be labeled as defective or abnormal, but once people learn about the importance of their brain, everyone wants a better one. What if we reimagined mental health as brain health? That is what the brain imaging work we are doing at Amen Clinics has taught us.
Reframing the discussion from mental health to brain health changes everything. People begin to see their problems as ‘medical’ and not ‘moral.’ It decreases shame and guilt and increases forgiveness and compassion from their families. Reframing the discussion to brain health is more accurate and elevates hope, increases the desire to get help, and increases compliance to make the necessary lifestyle changes. Once people understand that the brain controls everything they do and everything they are, they want a better brain so they can have a better life.
Was there a story behind why you decided to launch this initiative?
I believe that brain health and mental health is the center of overall health and success. When the brain is healthy, people are happier, physically healthier, wealthier, wiser, and they make better decisions, which helps them be more successful. When the brain is not healthy, for whatever reason, people are sadder, sicker, poorer, less wise, and their decisions are poorer, which diminishes their chances for success. At Amen Clinics, we use all the tools available to help make brain health happen. Achieving our mission will help to prevent and alleviate suffering and not only help individuals, but also generations of individuals. Our unique, well-researched process results in higher than average success rates utilizing the least toxic, most effective solutions that can help you feel better. I want you to know that you are NOT stuck with the brain you have — you can change it, and we can help you change your life today.
In your experience, what should a) individuals b) society, and c) the government do to better support people suffering from mental illness?
Individuals need to fall in love with their brains and care for them better. Brain is three simple things: 1) Brain Envy (you have to care about it); 2) avoid anything that hurts it (know the list); and 3) engage in regular brain healthy habits. We should use studies such as SPECT to screen the brain for people who are vulnerable to trouble and have Brain health education in schools, businesses and churches — anywhere people congregate.
In 2017, I was invited to the White House, to discuss with the Administration how we can better deal with prison reform, the opiate epidemic, and mental illness in America. My central recommendation was to create a national campaign that teaches brain health in schools, prisons, churches, recovery programs, and at work. This recommendation was based on three large-scale programs I helped to create. Here are details of these programs.
1. Brain Thrive by 25
Since 2005, Dr. Jesse Payne and I have created a high school and college course to teach students how to love and care for their brains, called Brain Thrive by 25 (www.brainthriveby25.com). It has been taught in all 50 states and 7 countries. Independent research has shown that it lowers drug, alcohol and tobacco use, lowers depression, and improves self-esteem. In the course we teach kids to love and care for their brains, including lessons on basic brain facts, the developing brain, gender differences, the impact of drugs and alcohol on the brain, nutrition, stress management, and how to throw a brain healthy party. It has been a popular course that has changed lives of those who take it.
2. The Daniel Plan
In 2010, I went to my own church and saw them serving donuts, bacon, hot dogs, and ice cream and was horrified that I was going there to get my soul fed yet these people were trying to kill my body. At that service I prayed that God would use me to change the culture of food at church. Two weeks later Pastor Rick Warren, the senior pastor at Saddleback Church, one of the largest churches in America with 20 campuses around the world, called me and said “I’m fat, my church is fat, will you help me.” Together with Rick and my friend Dr. Mark Hyman we created The Daniel Plan, based on the principles of the 4 Circles.
The first week 15,000 people signed up and over the first year they lost more than 250,000 pounds and reported better energy, focus, creativity, sleep and mood, plus reductions in stress, blood pressure, blood sugar, sexual dysfunction and many medications. Together, we went on to write a #1 New York Times and international bestselling book, The Daniel Plan: 40 Days to a Healthier Life. The Daniel Plan has been done in thousands of churches worldwide. Whenever I am on one of the Saddleback Campuses, I hear story after story of how people’s lives have been changed.
3. Creating BRIGHT MINDS at Work
We have planted brain health in corporations and sports teams, teaching management and employees about the 4 Circles and BRIGHT MINDS.
What are your 6 strategies you use to promote your own wellbeing and mental wellness? Can you please give a story or example for each?
- Brain envy — you have to care about it. This changed my life when I realized my brain was not healthy and I could make it better.
- Every day ask yourself, “Is what I am about to do good for my brain or bad for it.” This is the one tiny habit that can change your life.
- I start every day with the phrase, “Today is going to be a great day.” That way my brain will find what’s right, not just what is wrong.
- Take omega-3 fatty acids daily to help nurture my brain. Fish consumption lowers risk of depression.
- Target at least 7 hours of sleep at night. Soldiers who get 7 hours of sleep were 98% accurate on the range; 6 hours were only 50% accurate; 4 hours 15% accurate — they were dangerous.
- Floss your teeth daily and care for your gums — gum disease increases inflammation and damages your heart and brain