Memory, Mood, and Focus: An Interview with Daniel G. Amen, MD

Memory, mood, and focus all depend on one thing—a healthy brain. That’s why brain health has been Dr. Daniel G. Amen’s passion and mission for more than 30 years. In this interview with Element Senior Writer Sarah Cook, ND, Dr. Amen shares his experiences in using brain imaging and brain typing to help patients optimize their mental and emotional health. 

SARAH COOK: You have developed the world’s largest brain-imaging database related to learning, emotions, and behavior. What’s the story behind this database?

Daniel G. Amen: I’m a psychiatrist by training. But it has always bothered me that psychiatry is the only medical specialty that never looks at the organ it treats. 

Before becoming a psychiatrist, I worked as an x-ray technician in infantry medicine in the army. Our instructors used to say, “How do you know unless you look?” So when I fell in love with psychiatry, I asked why we weren’t looking at the brain. I was told: “It’s not time; it’s not right; we can’t do it.” I thought it was insane that we were treating the brain without looking at it. 

When I was still in the army, we started looking at the brain with quantitative EEG (electroencephalogram). Then, in 1991, we started looking at the brain with a scan called SPECT (single-photon emission computed tomography). The SPECT scan looks at blood flow and activity in the brain. It tells us one of three things: There is either good brain activity, too little, or too much. 

When I started to look at the brain with SPECT scans, it rocked my world. For the first time in psychiatry, we could see the biology. I remember my first 10 cases vividly. I became hooked on imaging. 

I’ve become so passionate about brain imaging that we have now completed more than 160,000 scans on patients from around the world. Our youngest patient scan is of a 9-month-old, and our oldest patient scan is of a 105-year-old. We now have eight Amen Clinics across the U.S. that are using SPECT scans to look at the brain in everyday psychiatric practice. 

The lessons we’ve learned from this database of brain scans have been enormous. We have peer-reviewed studies of SPECT scans in patients with depression, anxiety, aggression, attention-deficit hyperactivity disorder, post-traumatic stress disorder, traumatic brain injury, dementia, marijuana use, and other brain-related conditions. 

In a study of National Football League (NFL) players, we saw high levels of brain damage, but also the possibility of recovery. I was recently talking with a former NFL player who said he didn’t want to know what his brain scan looks like because he thought there was nothing he could do about it. I told him that there is something he can do about it. 

The biggest and most exciting lesson we have learned from our more than 25 years of clinical experience and research on SPECT scans is that you are not stuck with the brain you have. You can make it better. 

We now see about 6,000 patient-visits per month at our clinics. We have seen patients from 121 different countries. They come to us because virtually no other psychiatrists around the world actually look at the organ they treat. 

COOK: You said we’re not stuck with the brain we have. What do you mean by that?

AMEN: When we look at SPECT scans of the brain, we see the damage done by things like concussions or marijuana use or emotional trauma, but we also see the scans improve as the brain heals.  

I have a book coming out next year titled The End of Mental Illness. The book is dedicated to my two nieces, who were raised amidst trauma. They were exposed to drugs, mental illness, and criminal behavior as children. I look at how we can end the cycle of mental illness with them. 

The new book will have more than 1,000 scientific references. It’s about a revolution in brain health. We have a modern epidemic of mental illnesses like anxiety, depression, addiction, attention problems, and suicide. My message is that the potential for healing is enormous.

COOK: Why do you think we have this epidemic? 

AMEN: In my upcoming book, I pose this scenario: If I were an evil ruler, how would I create mental illness in America?

Here are some of the answers. I would create companies that lie to people and say that vaping is a healthy alternative to smoking (e-cigarettes are the most commonly used form of tobacco by teens in America, and the trend is increasing). I would have children start school at 7 a.m. (teens who sleep less than six hours on school nights are three times as likely to attempt suicide). I’d pass out video games and online streaming devices (to steal kids’ attention so they have no time to play in the sun). 

These are just a few of the ways that we have created an epidemic of mental illness in America. It’s the result of the combined effects of lifestyle habits that damage the brain, a hostile media that pits people against each other, and social media that makes everybody else’s lives look better than our own.

COOK: Let’s get back to your passion for healing the brain. What are the best ways to support brain health? 

AMEN: There are three steps to brain health: Love your brain; avoid things that hurt it; and give it things that help it. That’s it.  

The first step is to love your brain, or to have what I call “brain envy.” When I first did a SPECT scan on my mother, she was 60 years old and had a stunningly beautiful brain. That was in contrast to my own brain, which had been damaged by playing football and having bad habits. I was envious of her brain. 

I decided that Freud had it wrong. He was about 3 feet too low. He talked about “penis envy,” but I’ve never seen it. That’s why I decided to hijack the term and instead talk about “brain envy.” 

The idea is that we need to care about and love our brains. Most people envy things they can see—like smooth skin or a tight stomach. Nobody seems to care about the brain because it’s out of sight. 

The second step is to avoid things that hurt the brain. Most elementary-school children can recognize what these things are from a list—for instance, hitting a soccer ball with your head, not sleeping, doing drugs, eating sugar, drinking alcohol, being overweight, and breathing polluted air. You just need to know the list. 

The third step is to give the brain things that help it, like new learning opportunities, exercise, nutrient-dense foods, omega-3 fatty acids, and vitamin D. 

To help people remember the things that hurt and help the brain, we created the mnemonic BRIGHT MINDS. This mnemonic is explained in Protocols that Work on page 20. 

COOK: You mention omega-3 fatty acids and vitamin D. As a psychiatrist, why do you use nutritional supplements with your patients?

AMEN: One of the promises that we make as physicians is to “first do no harm.” When we started doing brain scans, I saw that some of the medications we were using to treat mental illnesses were actually harming the brain. 

I have never seen supplements harm the brain. Supplements have a very low risk of side effects, we get excellent compliance from patients, and they work. 

There’s an extensive body of research to show that supplements like vitamin D, ginkgo, saffron, phosphatidylserine, and others support the brain. That’s why we now have the BrainMD line of supplements formulated to support brain health. Using supplements fits within the mindset to use the least toxic interventions with the greatest efficacy. I still use medications on a case-by-case basis, but drugs are not ideal for all patients. 

COOK: What supplements support overall brain health, including memory, mood, or focus?

AMEN: More than 90 percent of people don’t eat five servings of fruits and vegetables per day. We did a study that showed 97 percent of our patients were deficient in omega-3 fatty acids. And nearly 40 percent of Americans are deficient in vitamin D. That’s why I think almost everyone needs to take a multivitamin, fish oil, and vitamin D. Beyond that, supplementation needs to be individualized. 

From our research, we have come up with 16 different brain types. Each type benefits from different lifestyle habits and different dietary supplements.

For example, if you have attention problems, you might be a type 2. You need to make sure you’re sleeping and exercising well. We might suggest green tea, rhodiola, ashwagandha, and ginseng. 

If you’re a worrier, you might be a type 5. You could benefit from supporting serotonin and mood with saffron.   

COOK: Tell us more about the 16 brain types. 

AMEN: I learned long ago that no two people with the same psychiatric condition are exactly the same. Based on our tens of thousands of brain scans, we began to correlate certain brain patterns with mental or emotional characteristics. 

We came up with five primary brain types: Type 1 is balanced, 2 is low-focus or spontaneous, 3 is persistent, 4 is sad, and 5 is anxious. The remaining 11 types are combinations of two or more of these five primary types. For example, a person can be spontaneous and persistent, low-focus and sad, or sad and anxious.

These brain types are determined by a questionnaire about the mind and emotions. They’re not as reliable as seeing the SPECT brain scan, but they’re the next best thing. 

We also created a free online tool so that people can determine their brain type when they don’t have access to the imaging. It can be found at brainhealthassessment.com.     

COOK: Are there any simple habits you recommend to optimize brain health? 

AMEN: Start every day by saying: “Today is going to be a great day.” That programs your mind to seek out why it’s going to be a great day. Then when you go to bed at night, think about what went well. That will set your dreams up to be more positive. 

When people ask what the smallest thing they can do to make the biggest difference is, I tell them to follow this tiny little habit: Before you do anything, ask yourself, “Is this good for my brain or bad for my brain?” 

I try to get people to ask themselves that question four or five times a day. If they can answer with honesty and love, they will make better decisions. 

COOK: What’s a common pitfall that practitioners face when working with brain health?

AMEN: The biggest problem I see is that practitioners will assume that one size fits all. It never does. Some people do well with Ritalin and others don’t. Some people do well with saffron and others don’t. 

Two of the tools that we use at the Amen Clinics to understand each unique patient are the SPECT scans to look at the brain and the brain-health assessment to categorize their emotional characteristics. 

Practitioners who want to do brain-health assessments for their patients can use our online tool. And if they want to order SPECT scans to evaluate brain health, there are a couple of options. 

Although SPECT scans are available at every hospital, using them for mental health is not standard. That will be met with resistance. It’s better to send the patient to one of the Amen Clinics or to a CereScan clinic. We have eight locations across the U.S., and CereScan has 16. 

We also offer a training program for practitioners to learn the methods and strategies we use at the Amen Clinics. It’s a brain-health certification course that offers 50 units of continuing medical education (CME) credit. 

COOK: What do you think is the future of brain health?

AMEN: In The Structure of Scientific Revolutions, Thomas Kuhn explained that revolutions in science start when people who are unhappy about something come up with a new method. That’s what we did when we started using SPECT scans for mental-health brain imaging. 

The next phase is that everyone hates the idea and rejects it. After that, as a new generation grows up, they begin to accept it. We are currently in these last two phases. I still face rejection, but more and more people are starting to accept it. 

I believe we are on the verge of a revolution in brain health. I was invited to the White House to talk about the opioid epidemic, prison reform, and mental health. I was asked: “What’s your big idea?” I said that we need to teach brain health everywhere that people gather—churches, schools, neighborhoods … everywhere. 

That can create a revolution. That is the future. That is how we are going to end mental illness. n 

SELECTED REFERENCES

Amen DG, et al. J Alzheimer’s Dis 53, no. 1 (2016): 237–41.

Parva NR, et al. Cureus 10, no. 6 (2018).

Weaver MD, et al. JAMA Pediatr 172, no. 12 (2018): 1187–89.