Change Your Brain Every Day - How To Effectively Treat Depression

Episode Date: April 9, 2018

Dr. Daniel Amen and colleagues recently published a study on patient outcomes and Depression in the Journal of Alzheimer’s. In this episode, he and Tana share some of the study’s findings, including some easy ways to help treat depression, and how certain treatments can backfire if you don’t know your depression type.

Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel Amen. And I'm Tana Amen. Here we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions. The Brain Warriors Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using brain spec imaging to better target treatment and natural ways to heal the brain. For more information, visit amenclinics.com.

The Brain Warriors Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit brainmdhealth.com. Welcome to the Brain Warriors Way podcast. And stay tuned for a special code for a discount to Amen Clinics for a full evaluation, as well as any of our supplements at brainmdhealth.com. Welcome back. I want to talk about something fun today. So I got an email notification on my phone and when I opened it up, guess what was there? I have no idea. You're supposed to be able to read my mind.

Wish I could. No, I don't think i want to so it was amen clinics was in is actually in a study in the journal of alzheimer's disease oh we're in the news yeah so many things so talk about the study um so our research department has just been on fire and one of the things we do here at Amen Clinics is we actually do a formal outcome study on everybody we see. And we call them at six weeks, 12 weeks, six months. And it's like, well, how are you doing? And we have, as far as I know, one of the highest success rates of any mental health organization for complex psychiatric problems. So on average, people who come to see us have 4.2 diagnoses. They have failed 3.3 providers and five medications.

And at the end of six months, if we treat them, 84% are better. That's huge. But not everybody. And so for this study, we looked at people who had depression and it's like, okay, who gets better and who doesn't? So what's the difference? And can we predict it on scans? Because if we can predict who's going to have more trouble getting better,

then we can wrap them more closely with services. And actually, what we did in the paper, it replicated work from other centers showing if you have a healthier looking brain, you are much more likely to get better than if you have low activity in your brain, especially in the front part of your brain and in your temporal lobes. So frontal temporal decreases. So let me get this right. So you're more likely to get better if certain parts of your brain are not low in activity, but doesn't that mean if you actually find out, you actually look and you know which parts are low, you can specifically treat those areas to increase the activity? Almost always. Okay. But you have to know. Almost always. And that's what's so exciting. So what I learned a long time ago here at Amen Clinics, that people who have

depression, it's not one thing in the brain. If you go to 999 psychiatrists out of a thousand, if you go to virtually a thousand family doctors out of000 or 1,000 OBGYNs or internists, they're going to make a diagnosis of depression based on talking to you. Right. Think of how insane that is. Right. Right. If you have belly pain, someone's going to look at your belly.

If you have chest pain, someone's going to look at your lungs. Someone's going to look at your belly. If you have chest pain, someone's going to look at your lungs. Someone's going to look at your heart. But if you have mental pain, nobody is going to look at your brain. Well, and language is subjective. So based on your experiences and where you come from, and I mean, that's a very subjective way to come up with a diagnosis, it seems like. Well, and I actually had a heated discussion with Nora Bolkow, who's the director of the National Institute of Drug Abuse. Right.

And she's an imager. And I'm like, why aren't you recommending people image more addicts? And she goes, oh, the brain has language. The brain will tell you what's the matter, which I'm like, seriously? The brain will never tell you that it's underactive. It'll never tell you that it's overactive.

It'll never tell you that it's been traumatized. And it won't go, hey, look, I have Lyme disease. Right? I mean, it's insanity. What's going on? That just reminded me of our cat. I don't know why that reminded me of our cat, but that reminded me of our cat.

Really? The cat? Yeah, no, because our poor kitty, he's amazing just reminded me of our cat. I don't know why that reminded me of our cat, but that reminded me of our cat. Really? The cat? Yeah. No, because our poor kitty, he's amazing. We have this adorable cat, and for the last few weeks he's been acting crazy. I mean, like seriously crazy. He attacks you whenever you walk by him.

He reaches out, grabs onto you with both paws, bites you, and he starts demanding your food off of your plate. Like, he's been acting crazy. Yeah, but you know what he's saying is I'm in pain. Please help me. Right. So he's trying to tell you something, but he can't tell you what's actually wrong with him. We had to go get him tested.

Right. And for whatever insane reason, people who have mental health problems, Nobody has been looking at their brain. And that's what we are trying to do here at Amen Clinics. I mean, we do this day in, day out. We've done 140,000 scans on people from 120 countries. And what the imaging tells us with depression, and that's the study we just published, is there are certain people likely to get better. They have busy brains. They have healthier brains.

And there are people who are going to struggle getting better. It doesn't mean they won't get better. What it means is we have to be more cautious with them. We have to do more stimulating things with them. You know, nine times out of 10, if somebody goes to a psychiatrist or a family practice doctor's office, they're going to end up on an SSRI. Right. So those are serotonin reuptake inhibitor drugs.

Like Prozac. Like Prozac, Lexapro, Zoloft, Pfexor, Celexa, Luvox. And they calm down activity in the brain. Right. But what if you start with low activity in the brain and then someone calms it down? actually disinhibit them and make them act out on the sad or mad or even sexual feelings that they have. And they can end up killing themselves or killing someone else or hating themselves for their behavior that just got unleashed because their low frontal lobes got lower still. I talked about my experience when I was depressed after having thyroid cancer in a previous episode about how that happened and why I didn't trust sort of the psychiatric community

because they wouldn't listen. So, you know, their response was, well, you just need to take more medicine. And it was the wrong medicine. And did the doctor ever ask you if you had a head injury? Did the doctor ever ask you if you had a head injury? No, they didn't even get into my thyroid conditions. And this is a psychiatrist. Right.

At a major university. Right. Yeah, it's insanity. We can do better. So let's give you some tips. If you've had depression and you're not getting better, right? You went to your family doctor

and he puts you on Zoloft or Prozac or Lexapro. Well, what can you do? What our study indicates is, well, if you're not getting better, you may in fact have low activity rather than high activity. And to stimulate your brain, exercise can really help. Fish oil that's higher in a substance called EPA rather than DHA, more stimulating to the brain. It's actually not only been shown to be helpful

for depression, but also for ADD, which is low activity in the brain. Stimulating antidepressants like Welbutrin. So Welbutrin is one of my favorite ones, especially for this pattern. Sometimes stimulants can help. If you have low activity in your brain, often it's secondary to a brain injury. And so sometimes things like hyperbaric oxygen

can really be helpful. But the idea is there are so many things that you can do if you struggle with depression. And another thing for resistant depression, I was just thinking about it, thinking about you, is thyroid medicine. Even if your thyroid is normal in resistant depression, they have found that thyroid medication can actually be helpful. In one study, 30% of people with resistant depression, when they took thyroid hormone, actually got better. That's fascinating. There are some unusual medications.

They're called MAOI inhibitors, like Nardil or Parnate. They tend to be more stimulating. Right. And sometimes they're just miraculous. I've had that happen. And for resistant depression, some doctors, even those of us here at Amen Clinics, are using ketamine infusion because it sort of restarts or jumpstarts your brain. So we talk about this a lot and sometimes I think it almost sounds like, I don't know,

it sounds like a cliche or like we're just overusing it. We just like mention it in passing. But one thing that has been, I mean, obviously exercise for me is like, it's just a medicine. It's for sure medicine for my brain. But when I started meditating, it just changed everything. When I meditate regularly, it doesn't have to be for a long time. It can be for five minutes a day. It can be sometimes it's 20 minutes a day. It just depends on my time schedule, but I can't explain it. At first, it was difficult. It was challenging. And then after a few days, maybe even two weeks, maybe a few days is wrong. Because at first it feels like, okay, I'm learning how to do something new.

But pretty soon I started to notice this just calmness and this like peace and this feeling of happiness. Just I would look forward to that time. And it's just so helpful. Well, and meditation has actually been found. It fooled us. You know, most people think, oh, I'm meditating, I'm calming my brain. Well, you're calming your emotional brain. It feels like that.

But what you're actually doing is you're activating your frontal lobes. Right, and I don't know why, it's just this feeling of happiness and peace comes over you. So it's very interesting. So to review, if you have depression and it's not getting better, there's a whole bunch of things you should do. And if you have failed two or three

serotonin drugs, you want to be thinking, okay, maybe I don't need to calm my brain. Maybe I need to stimulate it. A good book of mine to read is Change Your Brain, Change Your Life, where I go through different brain systems, what they do, what happens when things go wrong, and how to fix it. That would be a great place to start. We'll tell you about what are your important numbers to check, especially thyroid, but also estrogen, progesterone. Yeah, testosterone. Testosterone in men, DHEA.

In some studies, DHEA has actually been found to be helpful for a person's mood. For sure. There are so many things that you can do. Don't give up. Stay with us. Use the code podcast10 to get a 10% discount on a full evaluation at amenclinics.com or on our supplements at brainmdhealth.com. Thank you for listening to the Brain Warriors Way podcast. Go to iTunes and leave a review and you'll automatically be entered into a drawing to get a free signed copy of the Brain Warriors Way and the Brain Warriors Way cookbook we give away every month. Thank you.