Anxiety & Depression


Anxiety and depression are extremely common public health problems that are at epidemic levels in the United States—according to the National Institutes of Health, they affect 38 million Americans each year. Additionally, twice that number (75 million) will suffer from an anxiety or depressive illness during some point in their lives. The loss to our society from these illnesses is staggering: individual pain, family strife, school and relationship failure, lost work productivity, and death. People actively seek out a cure for anxiety and depression, and are put on prescription medications that can harm them in other ways.
Our work and the research of many others have demonstrated that anxiety and depression are brain illnesses, not the result of weakness or flawed personalities. 

Common symptoms of depression and anxiety are:

  • Anxiousness
  • Fearfulness
  • Tension
  • Irritability 
  • Headaches and stomach aches
  • Panic attacks
  • Negativity
  • Obsession
  • Sadness
  • Low energy
  • Mood swings
  • Irregular sleep and appetite habits
  • Feelings of hopelessness, helplessness and worthlessness
  • Suicidal thoughts

Untreated anxiety and/or depression affect nearly every aspect of a person's life and has been associated with:

  • Failure to reach potential at school or work
  • Family conflict
  • Withdrawal from social activities
  • Lack of interest in things the person used to be enthusiastic about
  • Disturbing thoughts
  • Drug abuse
  • Legal and criminal problems
  • Low self-esteem
  • Chronic stress
  • Suicide
Typically, doctors prescribe anti-anxiety medications, such as Xanax, or antidepressant medications, such as Prozac or Lexapro, to treat anxiety and depression. While these medications are helpful for many people, they also make symptoms much worse for other people. The side effects of these medications can be extreme, and include hallucinations, violent outbursts, volatile tempers, psychosis, and suicidal behavior.

How Amen Clinics Can Help

The specialists at Amen Clinics understand how debilitating anxiety and depression can be, and treat people suffering from these illnesses with utmost respect. We treat each patient as an individual, and take a full personal history before beginning SPECT imaging or recommending any treatment program. 

SPECT Imaging

SPECT imaging (which stands for single-photon emission computerized tomography) is a special kind of photograph we take of the brain to help us better understand how it works and what is going on inside of it. SPECT can specifically help people with anxiety and depression by:
  • Helping evaluate whether or not the person has anxiety, depression, or a combination of both
  • Helping determine the type of anxiety or depression to inform treatment decisions 
  • Helping determine if treatment is working correctly 
  • Helping determine if there could be co-occurring conditions that need treatment 
  • Reducing emotional pain and stigma by demonstrating that symptoms and behaviors are not imaginary
  • Increasing treatment compliance by showing pictures of results
  • Helping people gain a better understanding of the illness through visuals
Learn more about SPECT
Visit our Science page to learn more about how SPECT works. 

Dr. Amen’s Discovery: Types of Anxiety and Depression

It became obvious to Dr. Amen during his studies of SPECT imaging in the early 1990’s that there were groups of patterns in the brain activity of people with anxiety and depression. Over time, and with careful research, he was able to identify the following types of anxiety and depression below, and to observe how each type responded to different treatment programs. 
“Knowing your anxiety or depression type is essential to getting the right treatment for yourself.” — Dr. Amen

Type 1: Pure Anxiety


Sufferers of this type feel stirred up, anxious, or nervous. They often feel uncomfortable in their own skin. They report feeling as though they "could climb the walls" or that they are "crawling out of their skin." They are plagued by feelings of panic, fear and self-doubt, and suffer the physical feelings of anxiety as well, such as muscle tension, nail biting, headaches, abdominal pain, heart palpitations, shortness of breath, and sore muscles. It’s as if they have an overload of tension and emotion. The symptoms may be a consistently disruptive presence or may come in unexpected waves. Irrational fears or phobias may also be a burden. People with "pure anxiety" tend to avoid anything that makes them anxious or uncomfortable, such as places or people that might trigger panic attacks or interpersonal conflict. People with this type tend to predict the worst and look to the future with fear. They may be excessively shy or startle easily, or they may freeze in emotionally charged situations. 

Common SPECT findings: 

  • Increased activity in the basal ganglia seen while the person is at rest and while the person is concentrating 

Type 2: Pure Depression


This type of depression is associated with primary depressive symptoms that range from chronic mild sadness (also known as “dysthymia”) to the devastating illness of major depression. The hallmark symptoms of Pure Depression include:
  • Persistent sad or negative mood
  • Loss of interest in usually pleasurable activities
  • Periods of crying
  • Frequent feelings of guilt, helplessness, hopelessness, or worthlessness
  • Changes in sleep and appetite patterns and habits
  • Low energy levels
  • Low self-esteem
  • Suicidal thoughts or attempts 

Common SPECT findings:

  • Noticeable increased activity in the deep limbic area while the person is at rest and while the person is concentrating
  • Decreased prefrontal cortex activity at rest that improves with concentration
  • Deactivation of the prefrontal cortex at rest and improvement with concentration (less common). 

Type 3: Mixed Anxiety and Depression


Sufferers of this type have a combination of both pure anxiety symptoms and pure depressive symptoms.

Common SPECT findings:

  • Excessive activity in the brain's basal ganglia and 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 and Depression


These people have trouble shifting attention and tend to get locked into negative thoughts or behaviors. When this is combined with excessive basal ganglia activity, people get stuck on anxious thoughts. When it is combined with excessive deep limbic activity, people get stuck on negative, depressing thoughts.
Many people get “stuck” on both anxiety-provoking and depressive thoughts: obsessive-compulsive disorder (stuck on negative thoughts or actions); phobias (stuck on a fear); eating disorders (stuck on negative eating behavior); and Post-Traumatic Stress Disorder (PTSD, stuck on a past traumatic event) fit into this type. This type is also associated with people who worry, tend to hold grudges, and have oppositional or argumentative behavior. This type of anxiety and depression tends to occur more frequently in children or grandchildren of alcoholics.

Common SPECT findings:

  • Increased anterior cingulate gyrus activity
  • Increased basal ganglia and/or deep limbic activity at rest and while the person is concentrating

Type 5. Temporal Lobe Anxiety and Depression


These people struggle with temper outbursts, memory problems, mood instability, visual or auditory illusions, and dark, frightening, or “evil” thoughts. People with this type of disorder tend to misinterpret comments as negative when they are not, have trouble reading social situations, and appear to have mild paranoia. They may also have episodes of panic or fear for no specific reason, experience frequent periods of déjà vu, and become zealous about religious or philosophical beliefs. People with this type of disorder may also exhibit aggressive behaviors toward others or themselves, learning or reading problems, and irritability. There may be a family history of these problems, or they can be triggered by a brain injury.

Common SPECT findings:

  • Increased or decreased activity in one or both temporal lobes
  • Increased basal ganglia and/or deep limbic activity at rest and while the person is concentrating

Type 6: Cyclic Anxiety and Depression


This type is primarily characterized by emotional episodes which the person has little or no control over. Cyclical disorders, such as bipolar disorder, cyclothymia, and premenstrual tension syndrome as well as panic attacks are part of this category because they are episodic and unpredictable. The hallmark of Type 6 is its cyclical nature.

Common SPECT findings:

Not surprisingly, SPECT scan findings vary significantly with the phase of the illness or point in the patient's cycle. 

Type 7: “Lights Are Low” Anxiety and Depression


People with this type of disorder have trouble with executive functions: attention span, forethought, impulse control, organization, motivation, and planning, for example. When the prefrontal cortex is underactive, people complain of being inattentive, distracted, bored, off task, and impulsive. It is important to note that people with this type of disorder may also have been exposed to brain toxins, brain infection, extreme fatigue, or other brain trauma.

Common SPECT findings:

  • Decreased activity in the prefrontal cortex at rest and while the person is concentrating
  • Increased basal ganglia and/or deep limbic activity
  • Overall decreased activity (less common)

Recommendations for all types of anxiety and depression

At Amen Clinics, we want to help you learn more about your brain and how to feel better. Call us today at 1-888-564-2700 or tell us more to schedule an appointment. 
*Please note that not all treatment recommendations are the same, and that treatment recommendations are given on a case-by-case basis with knowledge of the type of anxiety or depression a person has and following complete assessments by trained professionals. Some supplements work best when used together; others should not always be used in combination. Please schedule a visit to learn what will work best for you. 

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