Anxiety / Depression

Anxiety and depression are not the result of character flaws or personal weakness; they are the result of biological problems in the brain that can be balanced. The Amen Clinics Method represents a true paradigm shift in the treatment of anxiety and depression. Rather than simply mask your symptoms, we will help you learn about, heal and optimize the organ of personality and emotion… your brain.

One Size Does Not Fit All

It is critical to treat anxiety and depression within the context of your life. We will:

  • Take the time to explore your specific biological, psychological, social and spiritual influences
  • Perform neuropsychological tests to measure various aspects of your brain function
  • Perform two brain SPECT scans: one at rest and one during concentration
  • Order lab tests to rule out nutritional deficiencies, hormone imbalances, toxicity, etc.—if deemed necessary

“The unfortunate reality is that current medications help too few people to get better and very few people to get well.” —Thomas Insel, Director of the National Institute for Mental Health

The 7 Types of Anxiety and Depression

Having seen tens of thousands of patients at the Amen Clinics, we know that anxiety and depression are not simple disorders.

  • Anxiety and depression occur together 75% of the time.
  • There are many forms of anxiety and depression. We’ve identified 7 different types, or patterns, within the brain.
  • There are a number of effective treatments that are specific to each type. Identifying your type guides us to create a more precise, targeted treatment plan that simply works better, while reducing the likelihood of negative side-effects.

Type 1: Pure Anxiety

Pure Anxiety often results from too much activity in the basal ganglia, setting one’s “idle speed” on overdrive. People with pure anxiety often feel a great deal of tension and nervousness, and are overwhelmed by feelings of panic, fear and self-doubt; they tend to predict the worst and look to the future with fear. Their symptoms may be a consistently disruptive problem or may come in unpredictable waves.

Common symptoms of Pure Anxiety include:

  • Frequent feelings of nervousness or anxiety
  • Panic attacks
  • Avoidance of people or places, due to a fear of having panic or anxiety attacks
  • Symptoms of heightened muscle tension (headaches, sore muscles, hand tremor)
  • Periods of heart pounding, nausea or dizziness
  • Tendency to predict the worst
  • Multiple persistent fears or phobias (such as dying or doing something crazy)
  • Conflict avoidance
  • Excessive fear of being judged or scrutinized by others
  • Being easily startled or tendency to freeze in anxiety provoking or intense situations
  • Shyness, timidity and getting easily embarrassed
  • Biting fingernails or picking skin

Type 2: Pure Depression

Pure Depression often results from excessive activity in the deep limbic system—the brain’s emotional center. People with this type struggle with depressive symptoms that range from chronic mild sadness (dysthymia) to crippling major depression, where it’s difficult to even get out of bed.

Common symptoms of Pure Depression include:

  • Persistent sad or negative mood
  • Loss of interest in usually pleasurable activities
  • Restlessness, irritability or excessive crying
  • Feelings of guilt, worthlessness, helplessness, hopelessness or pessimism
  • Sleeping too much or too little, or early morning awakening
  • Decreased appetite and/or weight loss or overeating and weight gain
  • Decreased energy, fatigue or feeling “slowed down”
  • Thoughts of death or suicide, or suicide attempts
  • Difficulty concentrating, remembering or making decisions
  • Persistent physical symptoms that don’t respond to treatment, such as headaches, digestive problems or chronic pain
  • Chronic low self-esteem
  • Persistent feeling of being dissatisfied or bored

Type 3: Mixed Anxiety/Depression

Mixed Anxiety/Depression involves a combination of both Pure Anxiety symptoms and Pure Depression symptoms (listed above). This type shows excessive activity in the brain’s basal ganglia and the deep limbic system. One type may predominate at any point in time, but both symptom clusters are present on a regular basis.

Type 4: Over-Focused Anxiety/Depression

Over-Focused Anxiety/Depression involves excessive activity in the brain’s anterior cingulate gyrus, basal ganglia and/or the deep limbic system. People with this type have trouble shifting attention and often get locked into negative thoughts or behaviors.

When “difficulty shifting” is combined with excessive basal ganglia activity, people get stuck on anxious thoughts. When combined with excessive deep limbic activity, people get stuck on negative and depressing thoughts. Many people get stuck on both anxiety-provoking and depressive thoughts at the same time. This can look like:

  • Obsessive-compulsive disorder (stuck on negative thoughts or actions)
  • Phobias (stuck on a fear)
  • Eating disorders (stuck on negative eating behavior)
  • Posttraumatic stress disorder (stuck on a past traumatic event)

Over-focused Anxiety/Depression tends to occur more frequently in children or grandchildren of alcoholics.

Common symptoms of Overfocused Anxiety/Depression include 4 symptoms from Pure Anxiety and/or Pure Depression (listed above), plus at least 4 of the following:

  • Excessive or senseless worrying
  • Upset when things are out of place or things don’t go the way you planned
  • Tendency to be oppositional or argumentative
  • Tendency to have repetitive negative or anxious thoughts
  • Tendency toward compulsive or addictive behaviors
  • Intense dislike for change
  • Tendency to hold grudges
  • Difficulty seeing options in situations
  • Tendency to hold onto own opinion and not listen to others
  • Needing to have things done a certain way or you become upset
  • Others complain you worry too much
  • Tendency to say “no” without first thinking about the question

Type 5: Temporal Lobe Anxiety/ Depression

Temporal Lobe Anxiety/Depression is related to too little or too much activity in the temporal lobes, in addition to overactivity in the basal ganglia and/or deep limbic system. The temporal lobes are very important to memory, moods and emotions.

Common symptoms of Temporal Lobe Anxiety/Depression include 4 symptoms from Pure Anxiety and/or Pure Depression (listed above), plus at least 4 of the following:

  • Short fuse or periods of extreme irritability
  • Periods of rage with little provocation
  • Often misinterpreting comments as negative when they are not
  • Periods of spaciness or confusion
  • Periods of panic and/or fear for no specific reason
  • Visual or auditory changes, such as seeing shadows or hearing muffled sounds
  • Frequent periods of déjà vu
  • Sensitivity or mild paranoia
  • Headaches or abdominal pain of uncertain origin
  • History of head injury
  • Family history of violence or explosiveness
  • Dark thoughts that may involve suicidal or homicidal thoughts
  • Periods of forgetfulness or memory problems

Type 6: Cyclic Anxiety/Depression

Cyclic Anxiety/Depression is associated with extremely high activity in the brain’s basal ganglia and/or deep limbic system. These areas of excessive activity act like “emotional seizures” as the emotional centers hijack the brain for periods of time. Those with Type 6 Anxiety/Depression often have little or no control over these intense emotional episodes.

Cyclical disorders, such as bipolar disorder, cyclothymia, premenstrual tension syndrome and panic attacks are part of this category, because they are episodic and unpredictable. A cyclical pattern is the hallmark of this type. Like other types, Cyclic Anxiety/Depression is a spectrum disorder, which means that it can range from mild to severe.

Common symptoms of Cyclic Anxiety/Depression include 4 symptoms from Pure Anxiety and/or Pure Depression (listed above) plus periods of time with at least 4 of the following:

  • Abnormally elevated, depressed or anxious mood
  • Decreased need for sleep, feeling energetic on dramatically less sleep than usual
  • Grandiose notions, ideas or plans
  • Increased talking or pressured speech
  • Racing thoughts
  • Markedly increased energy
  • Poor judgment leading to risk taking behavior (departure from usual behavior)
  • Inappropriate social behavior
  • Irritability or aggression
  • Delusional or psychotic thinking

Type 7: Unfocused Anxiety/Depression

Unfocused Anxiety/Depression is associated with low activity in the prefrontal cortex (PFC) in addition to high activity in the basal ganglia and/or deep limbic system. The PFC is the brain’s CEO and helps with the executive functions such as attention, focus, impulse control, judgment, organization, planning and motivation. When the PFC is underactive, people often have problems with these executive functions.

Distinguishing Unfocused Anxiety/Depression from ADD can be difficult because of the similarity in symptoms; however, ADD—in its classic form—starts in childhood and can be seen consistently throughout a person’s life. Unfocused Anxiety/Depression may not arise until later in life, and may be misdiagnosed as Adult ADD.

Symptoms of Unfocused Anxiety/Depression include at least 4 items from the Pure Anxiety and/or Pure Depression symptoms (listed above), plus at least 4 of the following:

  • Trouble staying focused
  • Spaciness or feeling in a fog
  • Overwhelmed by the tasks of daily living
  • Feeling tired, sluggish or slow moving
  • Procrastination, failure to finish things
  • Chronic boredom
  • Distractibility
  • Forgetfulness
  • Difficulty expressing feelings
  • Lack of empathy for others

Of note: A variant of Unfocused Anxiety/Depression is caused by overall reduced blood flow and activity in the cortex along with too much activity in the basal ganglia and/or deep limbic system. This pattern may be related to a number of factors, such as physical illness, drug or alcohol abuse, hypoxia (lack of oxygen), infections (i.e. Lyme disease), traumatic brain injury or exposure to toxic substances (i.e. environmental or occupational toxins).

Symptoms of this variant include those listed for Unfocused Anxiety/Depression in addition to frequent feelings of sickness, mental dullness, “brain fog” or cognitive impairment.


Knowing your particular type of Anxiety/Depression is very important.

Even though the 7 types have some symptoms in common, each type also has its own set of symptoms and specific treatments.

One size does not fit all: What works for one person with Anxiety/Depression may not work for another—or could even make the symptoms worse!

The Amen Clinics Method—developed through 26 years of clinical practice—uses a detailed clinical history, SPECT imaging to understand brain function, neuropsychological testing and laboratory studies to target treatment specifically to your brain using the least toxic, most effective means.

85% of patients treated with the Amen Clinics Method experience improved quality of life after just 6 months of treatment!

Gerard was at his wits end. He had tried everything and more to resolve his depression and anxiety symptoms, without success. After a full evaluation at Amen Clinics, he was able to move beyond desperation and grasping, and into a newfound sense of hope for his brain—and his life.

“I got help here. You can get help too. I felt hopeless, and now I feel like there’s a light at the end of the tunnel and I’m going to regain my sanity. I’m going to be the person I was two years ago.” –Gerard