3 Simple Meditations to Calm Anxiety

Amen Clinics
April 14, 2025

No experience required—just three easy meditation techniques to calm anxiety and support your brain, naturally.

Do you have a difficult time turning off your fretful and anxious thoughts? Do you think anti-anxiety pills are the only way to calm your racing mind, nervousness, or panic attacks? Wrong!

Benzodiazepines, the anxiety medications often prescribed, are actually harmful to brain function, according to brain SPECT imaging studies at Amen Clinics.

Is there an alternative? Decades of research show that a simple meditation practice can help soothe stress and anxiety…without any negative side effects !

In fact, meditation enhances brain function. And you don’t need to spend years training to think like a monk, you can start enjoying the soothing benefits of meditation in mere moments.

In this blog, you’ll discover the science behind meditation for stress and anxiety, how medication rewires your brain, and three easy meditations you can start today. What are you waiting for?

Decades of research show that meditation is an effective alternative to anti-anxiety pills…without any negative side effects!

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THE SCIENCE ON MEDITATION FOR ANXIETY AND STRESS

Decades of scientific evidence show that meditation can help to calm anxiety and stress and enhance brain function in important ways that help you keep your chronic worrying and panic in check. Let’s look at just some of the most interesting findings.

As effective as medication: A fascinating 2023 study in JAMA Psychiatry found that mindfulness-based stress reduction (MBSR), a type of meditation training, was just as effective as escitalopram (a commonly prescribed anti-anxiety medication) for reducing anxiety symptoms. Over an eight-week period, both treatments led to similar improvements in anxiety levels.

Importantly, MBSR had far fewer side effects—only about 15% of participants experienced any, compared to nearly 79% of those taking medication. These findings suggest that MBSR can be a safe, well-tolerated, and effective alternative to medication for treating anxiety disorders.

Reduces emotional reactions: This study found that practicing a form of meditation called awareness-based compassion meditation (ABCM) can actually change how the brain reacts to negative emotions. Specifically, people who practiced ABCM showed less activity in the right amygdala—a part of the brain involved in fear and stress—when looking at upsetting images, even when they weren’t actively meditating.

The more compassion-based meditation someone practiced, the greater the calming effect on the brain. This suggests that meditation can help reduce emotional reactivity and anxiety, and that these brain benefits can carry over into everyday life.

Improves stress management: For an eight-week randomized controlled trial published in JAMA Internal Medicine, 93 people with generalized anxiety disorder either took part in MBSR or a stress education class. Both groups showed less anxiety by the end.

However, the MBSR group had significantly greater improvements in how they felt overall, responded to stressful situations, and how they talked to themselves during stress. In short, mindfulness meditation not only helped reduce anxiety symptoms, but also made people better at handling stress and thinking more positively.

Works quickly: Research on college students found that just five days of short meditation sessions using a method called integrative body-mind training significantly improved attention, mood, and stress levels. Compared to students who only did relaxation exercises, the meditation group had better focus, less anxiety and fatigue, lower stress hormones, and even improved immune response.
Improves heart function: It’s important to understand that cardiovascular problems and anxiety are often connected. In a presentation at the 2018 Experimental Biology annual meeting, researchers reported that just one 60-minute session of mindfulness meditation significantly lowered both anxiety levels and stress on the heart and blood vessels in adults with mild to moderate anxiety.

The calming effects lasted at least an hour after the session and could help protect vital organs like the brain and kidneys over time.

HOW MEDITATION REWIRES YOUR ANXIOUS BRAIN

Anxiety isn’t just a feeling—it’s a pattern of brain activity. Brain-imaging studies with SPECT scans at Amen Clinics show that anxiety is associated with overactivity in areas, such as the basal ganglia and amygdala. These are considered the brain’s anxiety and fear centers.

Meanwhile, the prefrontal cortex, responsible for logical thinking and impulse control, struggles to keep this response in check. This imbalance fuels persistent worry, fear, and even physical symptoms like a racing heart and shallow breathing.

Meditation offers a scientifically backed way to rebalance these brain regions. Regular practice strengthens the prefrontal cortex while calming the amygdala, making it easier to manage stress and respond thoughtfully rather than react impulsively.

Research shows that even short daily meditation sessions can create lasting changes in brain function, helping to reduce anxiety at its root.

NEUROBIOLOGICAL MECHANISMS IN MEDITATION

Meditation influences brain function through several key mechanisms:

Amygdala Deactivation: Regular meditation practice has been associated with reduced amygdala activity, decreasing the brain’s fear response and alleviating anxiety symptoms.
Prefrontal Cortex Engagement: Meditation strengthens the prefrontal cortex, enhancing executive functions such as attention and self-control, which are crucial for managing anxiety.
Neurotransmitter Regulation: Meditative practices can balance neurotransmitters like serotonin and dopamine, contributing to mood stabilization and reduced anxiety

MEDITATION TO CALM ANXIETY: 3 SIMPLE PRACTICES

Although there are several different types of meditation practices, many share the goals of increasing mental clarity and relaxation, while reducing self-judgment and fear-based thinking.

Contrary to some common misconceptions about meditation, you don’t have to sit cross-legged on the floor (but you can) and burn incense to reap its many positive benefits.

Here are three simple meditative practices you can use to help get your nervousness, fears, and runaway thinking under control:

Kirtan Kriya Meditation: This type of meditation takes only 12 minutes, but it is very powerful at instilling a sense of calm.

This meditation involves sitting comfortably and chanting the following simple sounds, “saa” “taa” “naa” “maa,” while repeating simple finger movements with your hands. Say the sound once as you touch the corresponding finger.

Here’s how it goes:

Touch thumbs to index fingers while chanting “saa.”
Touch thumbs to middle fingers while chanting “taa.”
Touch thumbs to ring fingers while chanting “naa.”
Touch thumbs to pinkie fingers while chanting “maa.”
Repeat the sounds for 2 minutes aloud.
Repeat the sounds for 2 minutes in a whisper.
Repeat the sounds for 4 minutes silently.
Repeat the sounds for 2 minutes in a whisper.
Repeat the sounds for 2 minutes aloud.

When you finish, sit quietly for 1-2 minutes. Try to hold onto your calmed mind and body throughout the day.

The Relaxation Response: This form of meditation was developed decades ago by Herbert Benson, MD, at Harvard Medical School. It’s one of the easiest ways to meditate and soothe your worried mind.

Here are the instructions:

Sit quietly in a comfortable position.
Close your eyes or softly focus on a spot on the wall if you aren’t comfortable with closed eyes.
Beginning at your feet and progressing up to your face, deeply relax all your muscles, keeping them relaxed as you move your awareness throughout your body. Relax your tongue too.
As you do this, breathe through your nose and become aware of your breathing. After each exhale, say the word “one” (or another relaxing word you choose) silently to yourself.
When distracting thoughts arise, don’t dwell on them, simply shift your attention back to your breathing and the word “one” (or whichever word you choose)
Try to do this for 10-20 minutes (but don’t set an alarm that will induce stress). Even if you can only do a few minutes at first, it will get easier with practice.
When you finish, sit quietly for several minutes, at first with your eyes closed (if they were) and open them when you are ready to. Stay seated for a few minutes after finishing.

As you do this meditation, don’t worry about whether you are successful in achieving a deep level of relaxation. Instead, maintain a passive attitude and permit relaxation to occur at its own pace. With practice, the relaxation response should come with little effort.

Diaphragmatic Breathing: Focusing on your breath for a few minutes is one of the simplest and quickest ways to give yourself a time-out and settle down your anxious mind. This is especially helpful if you aren’t in a place where you can do a regular meditation. You can even do this at your desk at work.

Breathing with your diaphragm (or belly) rather than your chest:

Inhale for 4 seconds.
Exhale for 8 seconds.
Repeat this pattern 10 times.

If you need to practice breathing with your diaphragm (instead of your chest) try this quick exercise:

Put one hand on your chest and one on your belly. Notice how you are breathing right now. If you’re breathing with your chest, do this:
Lie on your back and place a small book on your belly.
When you breathe in, make the book go up, and when you breathe out, make the book go down.
Once you get the hang of it, then do the diaphragmatic breathing described above.

The distress related to unchecked anxiety not only disrupts your mental health functioning, but it can lead to physical health problems too. However, by incorporating simple meditation practices such as these you can start to tame your anxious thoughts, manage your stress, and get back to doing the things you love.

MAKING MEDITATION A DAILY HABIT

The key to reaping these benefits is consistency. If you struggle to sit still for long periods, start with just five minutes a day. Use guided meditations, focus on deep breathing, or practice mindfulness while walking. Over time, these small efforts compound, leading to a healthier, less anxious brain.

By understanding how meditation positively alters your brain’s response to anxiety, you can approach your practice with greater motivation and clarity. This neurological perspective not only makes meditation more appealing but also deepens your commitment to this powerful tool for anxiety relief.

HOW BRAIN SCANS REVEAL THE ROOT CAUSE OF ANXIETY

Anxiety is often misunderstood as simply a reaction to stress or negative thoughts, but the reality is far more complex.

Brain imaging has shown that anxiety is not just an emotional state—it has a biological foundation that varies from person to person. Understanding this deeper level is essential for effective treatment.

DIFFERENT BRAIN PATTERNS IN ANXIETY

SPECT is a functional brain-imaging technology that measures blood flow and activity in the brain. A brain scan can uncover which specific areas of the brain are overactive or underactive, providing valuable insight into what’s fueling anxiety.

Here are a few common patterns, based on scientific research as well as over 250,000 SPECT scans performed at Amen Clinics:

Overactive Basal Ganglia – This structure is involved in setting the body’s anxiety level. When overactive, it can lead to excessive worry, tension, and nervousness, according to scientific findings.
Increased Activity in the Amygdala – The amygdala is the brain’s fear center. Hyperactivity in this area can result in heightened emotional reactivity and an exaggerated fight-or-flight response, according to a 2022 study.
Low Prefrontal Cortex Activity – Research shows that the prefrontal cortex is responsible for rational thinking and impulse control. If underactive, it may lead to poor emotional regulation and increased susceptibility to anxiety.
Anterior Cingulate Gyrus Overactivity – The Amen Clinics database shows that when this part of the brain is overactive, it can cause repetitive thoughts, making it difficult to let go of worries or anxieties.

WHY BRAIN IMAGING MATTERS FOR ANXIETY TREATMENT

Traditional approaches to treating anxiety often take a one-size-fits-all approach, assuming all anxiety disorders are the same. However, the different brain patterns associated with anxiety suggest that what works for one person may not work for another.

Brain imaging can help tailor treatments by:

Identifying which medications or natural interventions may be more effective based on the specific brain pattern.
Guiding behavioral therapies to target the overactive or underactive regions of the brain.
Providing patients with a clearer understanding of their condition leads to a sense of validation and a more proactive approach to healing.

10 WAYS BRAIN IMAGING CAN HELP WITH ANXIETY

Seeing is believing.

For Marsha, seeing her SPECT brain scan convinced her that her condition wasn’t something that she should be able to control on her own. It made her realize that taking medication might be necessary on a temporary basis.

For many people who seek treatment at Amen Clinics, seeing their SPECT scans validates their feelings.

Brain scans show that anxiety is not just one thing.

Most people assume that people with anxiety experience the same signs and symptoms. This isn’t true.

The brain-imaging studies at Amen Clinics reveal that anxiety is not a single or simple disorder. In fact, there are seven different brain patterns associated with the condition, and each one requires a targeted treatment program.

The seven types of anxiety disorders are:

Type 1: Pure Anxiety

Type 2: Pure Depression

Type 3: Mixed Anxiety/Depression

Type 4: Over-focused Anxiety/Depression

Type 5: Temporal Lobe Anxiety/Depression

Type 6: Cyclic Anxiety/Depression

Type 7: Unfocused Anxiety/Depression

Brain imaging helps minimize feelings of guilt.

Many people with anxiety feel like their condition is a sign of weakness, a personal failure, or a lack of willpower. This can prevent you from seeking help, which compounds the problem.

When you realize that anxiety disorders aren’t your fault, it’s much easier to seek the help you need. You stop feeling ashamed and start feeling empowered to do something about it.

Brain scans give your loved ones better understanding and empathy.

Some family members may have a hard time understanding your struggles with anxiety or panic attacks. They may think you aren’t trying hard enough to get over it.

Seeing your brain scan can help them realize that your condition is biological in nature. This typically leads to family members being more encouraging and supportive in your healing journey.

Brain imaging can reveal unsuspected causes of anxiety.

Anxiety can be caused by many things, such as genetic vulnerabilities, neurochemical imbalances, hormonal issues, adverse childhood experiences, post-traumatic stress disorder (PTSD), head injuries, certain medications, and more.

Brain scans can offer clues about anxiety causes. This provides psychiatrists with valuable information that allows them to ask better questions to help get to the root causes of anxiety. By understanding underlying causes, mental health professionals are better equipped to develop more effective treatments for anxiety.

Seeing your brain can give you brain envy.

When people see their own brain scan compared with a healthy brain scan, it can prompt them to develop something the experts at Amen Clinics call “brain envy.” Wanting a better brain makes you more inclined to follow an anxiety treatment plan.

It also encourages you to make simple yet powerful lifestyle changes that optimize brain function. With better brain function comes better anxiety management.

Brain scans can reveal if anti-anxiety medications are harming your brain.

Brain imaging at Amen Clinics has shown that some anti-anxiety pills are damaging to overall brain function. For example, on SPECT scans, people taking benzodiazepines typically have reduced overall brain activity.

Research shows that decreased brain activity is associated with memory loss and an increased risk for Alzheimer’s disease. Finding treatments that don’t impair brain function is critical for better health.

Imaging tests can reveal other conditions.

Many people with anxiety disorders have a co-existing disorder. Common co-occurring disorders include ADHD, depression, eating disorders, substance use disorders, and chronic pain.

For example, among the tens of thousands of patients seen at Amen Clinics, anxiety and depression occur together 75% of the time.

SPECT scans offer important information that helps you see if you may have depression or other mental health conditions in addition to anxiety. Understanding if there are co-occurring disorders helps mental health professionals find solutions that address all underlying issues for better anxiety control.

Brain imaging takes the guesswork out of treatment.

When it comes to treatment in the field of psychiatry, health care providers basically throw darts in the dark at conditions. Brain imaging offers objective data for more targeted and effective solutions.

Treatment for anxiety disorders can include a wide range of interventions, including medications and nutritional supplements, different types of psychotherapy such as cognitive behavioral therapy (CBT), killing the ANTs, and more.

Looking at your own before-and-after SPECT scans offers an ideal opportunity to see how well your treatment is working. Seeing improvement in your brain function provides motivation to stick with your anxiety treatment program.

In addition, brain imaging lets your mental health professional know if treatment adjustments could enhance your progress.

SPECT brain scans offer a sense of hope.

Seeing the brain scans of other patients who have overcome anxiety and regained their life can be very powerful. Witnessing another person’s successful healing journey can give you hope that you can overcome anxiety.

CONNECTING BRAIN IMAGING TO HEALING

When viewed through the lens of brain imaging, it’s easier to understand why some anxiety treatments work while others fail. By identifying the exact brain mechanisms at play, you can pursue interventions that are truly effective rather than relying on trial and error.

Brain scans provide a window into what’s happening beneath the surface, offering hope and clarity to those struggling with chronic anxiety.

WHY YOU WORRY ABOUT WHAT OTHERS THINK OF YOU

There’s good reason why we are concerned about how other people view us. Social relationships are critical to our health, happiness, and overall well-being.

In fact, studies have found that close relationships are the most consistent predictor of happiness. For example, a decades-long study by Harvard University concluded that meaningful social connections have a more powerful influence on health and happiness than money or success.

Neuroimaging studies reveal that negative feedback leads to chemical responses in the brain. Other scientific findings indicate that fear of criticism is heightened in people who struggle with social anxiety.

Indeed, some people become overly concerned about what other people think of them. You may be one of them.

For example, are you one of those people who spends a lot of time fretting about what to wear at work or on Zoom calls? Do you replay every stupid thing you said in a meeting or a conversation and think of what you should have said instead?

On social media, do you only post the most flattering images of yourself or add filters to hide what you perceive as flaws so others will find you more attractive and likeable?

Constantly seeking validation from others or worrying what your friends, family, coworkers, and social media followers think of you can be exhausting.

It makes us more critical of ourselves, causes us to focus on our flaws (real or perceived), and zaps our self-confidence. Ultimately, it’s a recipe for unhappiness and leads to toxic perfectionism.

With social media, this issue has become inflated. And teens and young adults especially are more concerned than ever with what others think. Not getting enough “likes” or comments on a post can send people into a tailspin of negative thoughts that contribute to mental health conditions, including symptoms of anxiety and depression.

According to the latest statistics, more than one in five adolescents say they’ve experienced symptoms of depression or anxiety. Even more alarming is the fact that suicide rates among those ages 10-24 increased 62% from 2007 to 2021.

Some people are so concerned about how others view them they have what’s called rejection sensitive dysphoria. This condition, which is often associated with attention deficit hyperactivity disorder (ADHD), is characterized by having severe emotional reactions to the slightest critiques.

Being overly concerned about letting others down can be so detrimental that it holds you back and prevents you from taking chances in life.

HOW NEGATIVE THINKING INCREASES WORRYING ABOUT WHAT OTHERS THINK OF YOU

When you’re overly concerned with how other people perceive you, it can fill your mind with automatic negative thoughts, or ANTs. The same way an infestation of ants can ruin a picnic a barrage of ANTs can ruin your day.

At Amen Clinics, the brain heath experts have identified nine types of ANTs, including a type called Mind-Reading ANTs.

These negative thoughts make you believe you can know what others are thinking and feeling without them saying anything. When you have Mind-Reading ANTs you may think, “Everyone thinks I am stupid,” or “They are laughing at me.”

Even trained psychiatrists with 25 years of education can’t know what anyone else is thinking unless they ask. A glance in your direction doesn’t mean somebody is talking about you or mad at you. A negative look from someone else may mean nothing more than he or she is constipated! You just don’t know.

Trying to read people’s minds can fill you with more negativity and worries about what they are thinking. It’s a vicious cycle that keeps you mired in anxious thoughts.

CONQUER NEGATIVE THINKING WITH THE 18-40-60 RULE

It’s a shame the 18-40-60 rule isn’t taught in schools. Think how much happier and less stressed you might have been if you had known this earlier.

Fortunately, you don’t have to wait until your 60th birthday to put 18-40-60 rule into practice. You can implement it in your life at any age. When you keep this rule in mind, it helps you eliminate those pesky Mind-Reading ANTs.

Whenever the idea pops into your head that someone else thinks you aren’t good enough, pretty enough, smart enough, or funny enough, ask yourself if it’s true or just an ANT.

In addition, post the 18-40-60 rule somewhere you can see it every day—by your computer, in the Notes app on your phone, or on a little piece of paper in your handbag, backpack, or wallet.

The next time you start worrying about what other people are thinking about you, look at it and remind yourself that most people are thinking about themselves, not about you.

UNDERSTANDING TRAUMA AND ITS IMPACT ON THE BRAIN

Trauma takes various forms. An example of physical trauma, for example, is a concussion, a type of traumatic brain injury (TBI). TBI describes an injury to the head that disrupts healthy brain functioning. Those who have experienced head trauma, including a mild traumatic brain injury, or mTBI, can experience long-term cognitive, psychological, or behavioral issues.

Emotional trauma, on the other hand, occurs in response to distressing events. In many cases, the trauma is processed and does not create long-lasting effects. But in vulnerable populations, or as a result of ongoing trauma, post-traumatic stress disorder (PTSD) may occur. PTSD leads to persistent symptoms that can interfere with daily life and impact mental health.

Those with a high number of adverse childhood experiences (ACEs) comprise one population that is more vulnerable to emotional trauma. Children who have faced multiple hardships—such as abuse, neglect, or household issues like mental illness, suicidal behavior, and/or incarceration—can face lasting consequences in their later years.

The symptoms of trauma can be emotional, cognitive, and physical. Trauma affects multiple regions of the brain, including the amygdala, prefrontal cortex, and hippocampus.

Emotional trauma symptoms include anxiety, depression, PTSD, trouble sleeping, and hypervigilance, among other possible side effects. Meanwhile, TBIs can also raise the risk of depression, anxiety, and PTSD, as well as ADD/ADHD, psychosis, dementia, and suicide.

SPECT BRAIN IMAGING AND TRAUMA

The brain imaging diagnostic tool called SPECT (single photon emission computed tomography) can help accurately identify any underlying brain issues that may be contributing to mental health symptoms. Therefore, SPECT scans help determine how trauma is affecting the brain. Other types of brain imaging, such as MRIs, can reveal the brain’s anatomy but do not indicate how well it functions.

And because SPECT is a functional brain imaging tool that evaluates brain activity and blood flow patterns, it helps differentiate between TBI and PTSD, which can have many of the same symptoms. In fact, one study found that brain SPECT imaging was able to differentiate a PTSD group from a TBI group with 89% accuracy.

Can trauma change brain function? SPECT scans indicate that it can. Amen Clinics clinicians have found a diamond pattern in the brain of those with emotional trauma. This pattern reflects increased activity in the anterior cingulate gyrus, basal ganglia/amygdala, and thalamus. Similarly, those with PTSD show overactivity in the deep limbic area, basal ganglia, and anterior cingulate gyrus.

Because SPECT shows which areas of the brain are working too hard, not working hard enough, and working well, this type of brain scan is especially important to help guide treatment strategies. A 2012 study found that adding SPECT scans to a standard mental health evaluation changed psychiatrists’ recommended diagnosis and/or treatment eight times out of 10.

This study also highlighted how SPECT can reveal previously undetected trauma. More than one in five cases showed an undiagnosed brain injury, while another one in five cases indicated unexpected toxicity. In 60% of cases, consulting SPECT scans led to a change in the medications or supplements recommended by medical experts.

A BRAIN-BASED APPROACH TO HEALING TRAUMA

In instances of trauma, the entire body is affected. Facing an acute stressor activates the sympathetic nervous system, creating a chain reaction that leads to the stress response known as fight or flight. As a result, the hormones cortisol and adrenaline flow through the body.

Frequent or long-term stressors can lead to this stress response getting stuck in place. Chronic stress may then create a variety of physical, psychological, cognitive, and behavioral symptoms. It can even weaken the body’s immune response.

In other words, chronic trauma dysregulates the brain-body connection. That’s one reason why it’s so important to address both the brain and body when healing trauma. Amen Clinics advocates a “whole body” approach to recovery, looking at the entire person to treat problems at the root causes—rather than prescribing a medication designed to merely mask symptoms in the short term.

Evaluating the entire person is important when dealing with trauma, which can contribute to or aggravate multiple mental health conditions, including:

PTSD and complex PTSD
Depression
Anxiety
Addictions and other trauma-related coping mechanisms

A brain-based approach to healing trauma also allows for personalized treatment plans. Because each person is unique, and each mental health condition is never a single or straightforward issue, a helpful treatment for one individual may be ineffective or even harmful to another.

Others may experience mental health issues that do not respond to traditional treatments like antidepressants. Using brain imaging to identify trauma-related dysfunction helps create personalized treatment plans that target the exact areas of the brain in need of help.

The individual can then take the proper steps to rebuild their brain health—because brain health is mental health. Since there are many natural ways to heal trauma in the brain, medications are never considered the first or only strategy for recovery. Tactics like dietary changes, exercise, meditation, and supplements can make a major impact without any damaging side effects.

THERAPEUTIC INTERVENTIONS FOR TRAUMA

Many victims of trauma will experience mental health improvements through lifestyle interventions. But there are numerous additional evidence-based therapies available to tackle PTSD brain recovery and other trauma-related symptoms or conditions. These include:

Eye movement desensitization and reprocessing (EMDR). This interactive psychotherapeutic technique uses bilateral hemispheric brain stimulation. During a session, the individual processes traumatic memories in a healthy way and is able to reduce or eliminate the strong emotions they evoke.
Cognitive behavioral therapy (CBT). In this form of psychotherapy, clients learn to identify and then replace their negative or harmful patterns of thinking and behaving. Patients learn more helpful ways of thinking and acting, as well as better coping skills to handle challenging situations in the future.
Neurofeedback. This treatment helps people retrain their brain. Those with stress, anxiety, and behavioral issues can learn healthier forms of self-control, emotional self-regulation, responses, and behavior. Thanks to its neuroplasticity, the brain learns a more efficient way of functioning and, with practice, reinforces new pathways for better mental health.
Hyperbaric oxygen therapy (HBOT). This innovative, noninvasive treatment involves breathing 100% pure oxygen in a pressurized chamber. The client’s lungs take in up to three times more oxygen than usual, which is transported by the bloodstream to damaged tissues. This process facilitates improvements in mental health conditions, TBIs, and cognitive or memory problems.
Mindfulness and meditation. A study at Harvard showed that eight weeks of mindfulness-based training not only led to enhanced psychological well-being and reduced mental health symptoms. Participants also demonstrated “changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.”

In addition, numerous lifestyle choices will support trauma healing. For example, adopting a brain-healthy diet fuels the entire body with proper nutrition. We know that the Standard American Diet (SAD) deteriorates brain function. But consuming vegetables, fruits, lean proteins, and healthy fats (including omega-3s, which improve brain blood flow) contributes to better mental health.

Sleep is another key factor in the process of recovering from emotional trauma. Unfortunately, there is an association between exposure to traumatic events and reduced sleep quality. As one study notes, sleep problems often accompany PTSD and “may interfere with recovery from elevated post-traumatic stress levels.”

Finally, physical activity helps the brain recover from trauma—both physical and emotional. Exercise has been shown to reduce symptoms of anxiety and depression as well as feelings of stress and anger. Studies have noted numerous positive brain changes, increased neuroplasticity, and better moods as a result of exercise. It also releases feel-good endorphins and promotes better sleep.

TRAUMA AND RELATIONSHIPS

Implementing brain-based trauma treatment using the above tactics is not only important for the individual suffering from the effects of emotional trauma. We know that childhood trauma impacts adult relationships in a multitude of ways. Therefore, many lives can be affected by just one person’s unaddressed trauma.

For example, the brain changes associated with trauma can lead to:

Trouble forming secure attachments in relationships
Issues with trust and interpersonal communication
Behavioral issues
Poor emotional regulation
Problems with learning
Difficulties in social interactions
Aggression
Risky behaviors

These issues may then contribute to larger effects over a lifetime, such as chronic physical health conditions, unemployment, and poor performance at school and work. Ultimately, those who do not receive help are unable to fulfill their true potential

And, as the effects of trauma are being treated, rebuilding relationships is instrumental for healing. Healthy relationships have been called the single most important factor in long-term health and longevity.

Connecting with others—support groups, therapists, mental health organizations, family, and friends—can transform both physical and mental health outcomes. Conversely, a lack of quality relationships can be detrimental to health over the long term.

SUCCESS STORIES IN USING A BRAIN-BASED APPROACH

Clearly, trauma and mental health (which is inextricably linked with brain health) go hand in hand. That means using a brain-based approach is the most effective way to treat trauma, as seen in numerous success stories at Amen Clinics.

Seeing before-and-after SPECT scans of these clients verifies the progress they’re making—and highlights when and what different interventions may be needed. By examining issues like trauma as brain health issues, individuals shed stigma and shame. Meanwhile, their loved ones can better understand their behavior and avoid moral judgments.

However, when it comes to healing, early intervention is crucial. Addressing trauma sooner rather than later can help prevent further symptoms and chronic mental health conditions. Those with PTSD, for example, often experience co-occurring mental health issues, including:

Anxiety disorders
Chronic stress
Insomnia
Addictions
Anger problems
Panic attacks
Bipolar disorder
Major depressive disorder
Psychotic disorders
Obsessive-compulsive disorder
Traumatic brain injury
Cognitive problems
Memory loss

If you or a loved one are dealing with long-term effects of emotional or physical trauma, it’s never too soon (or too late) to address this disruption in brain function. Seek help and resources immediately, choosing those that are rooted in healing the brain.

HEALING EMOTIONAL TRAUMA FOR OPTIMAL MENTAL HEALTH

Without optimal brain functioning, an individual can lose out on important facets of what life has to offer. The impacts of trauma can affect everything from personal relationships to overall sense of well-being. Before emotional or physical trauma further impacts your health, life quality, and longevity, turn your attention to your brain.

With a combination of accurate diagnosis and a targeted treatment plan that addresses the brain and the entire body, you can get started on the road to recovery. Remember that the traumas of your past never need to dictate your future.

10 SIGNS OF MENTAL HEALTH TREATMENT FAILURE

1. Your symptoms aren’t improving.

One of the clearest signs that your mental health treatment isn’t working is the lack of improvement in your symptoms. Whether you’re managing clinical depression, anxiety disorders, post-traumatic stress disorder (PTSD), or another condition, effective treatment should lead to measurable progress over time.

According to statistics from the National Library of Medicine, up to 50% of people with depression do not respond to their initial treatment plan. If you feel like you’re running in place, it’s time to discuss alternative options with your provider.

2. You feel worse over time.

It’s not uncommon to experience emotional discomfort when diving into tough topics during therapy, but constantly feeling worse without relief could signal a deeper problem. A 2023 study found that treatment-resistant mental health issues often worsen without appropriate adjustments.

So, if your symptoms are intensifying, it’s crucial to reevaluate your approach with your mental health professional.

3. You lack a sense of connection with your therapist.

Clear and comfortable communication provides therapeutic rapport that plays a significant role in a successful mental health treatment plan. If you don’t feel heard, understood, or respected by your therapist, it can hinder your progress.

Research from Frontiers in Psychiatry Journal shows that a strong therapist-client alliance can be a powerful predictor of therapeutic success, impacting nearly 8% of success in therapy. If this connection is missing, consider seeking a different provider to ensure you’re giving yourself the best chance for treatment.

4. Your treatment plan feels generic.

A cookie-cutter approach to mental health treatment often fails to address the specific needs of an individual. For example, stimulant medication for ADHD may be highly effective for one person, but could make another person’s symptoms worse.

Personalized treatment plans often allow space for better outcomes. If your current plan doesn’t feel tailored to you, discuss customized options with your provider.

5. Side effects from medication outweigh benefits.

While medication can be a lifeline for many, the wrong prescription or dosage can lead to side effects that worsen your quality of life. According to a 2023 report by the JAMA Network Research Journal, about 25% of people experience adverse effects from antidepressants that cause them to discontinue treatment within the first month and 68% within three months.

If you have questions or feel your medication isn’t improving your mental health and creating additional challenges, it’s essential to work with your doctor to find a better solution.

6. You’re not learning new coping strategies.

Effective mental health treatment should equip you with tools and strategies to manage stress, triggers, and symptoms. If you’re not gaining actionable coping skills, you might not be receiving the full benefit of therapy.

You can feel more empowered to support your own brain health alongside your choice of therapy by incorporating practical strategies that have been proven to work like:

Practicing gratitude journaling to shift focus toward positive daily experiences
Having a creative outlet like painting, music, or crafting to better express yourself emotionally
Spending time in nature to reduce stress, improve mood, and get your body moving
Practicing mindfulness meditation to increase self-awareness which calms the mind and restores control over your emotional health
Using aromatherapy with calming scents like lavender or eucalyptus to promote relaxation

If your sessions lack this focus, it’s worth discussing with your therapist and your doctor.

7. You’re avoiding therapy sessions or assignments.

If you find yourself dreading therapy sessions or avoiding assigned homework, it could be a sign that your current approach isn’t resonating with you. A 2019 article by the American Psychological Association found that client engagement is a critical predictor of success and continued attendance in mental health treatment.

If your treatment feels like a chore, consider exploring alternative therapies that align better with your needs.

8. Your goals are unclear or unmet.

A clear roadmap is vital for effective mental health treatment. Goal setting has been shown to help young people with anxiety or depression by improving communication, building trust, and making their care feel more manageable.

If you haven’t set specific goals with your provider or feel like you’re not making progress toward them, it’s a red flag. Measurable progress is a key indicator of treatment success. If your sessions feel aimless, request a structured plan with clear milestones.

9. You’re only addressing surface-level issues.

Some therapy models focus on immediate symptom relief without digging into the underlying causes. While short-term relief is important, ignoring the root cause can lead to recurring problems and disengagement when things don’t work out.

Comprehensive mental health treatment should address both immediate symptoms and long-term factors like trauma or lifestyle. If your sessions lack depth, it may be time to switch approaches.

10. You’re relying solely on one form of treatment.

Mental health treatment often works best when it’s multifaceted. For instance, combining therapy with lifestyle changes, medication, or brain-healthy habits can amplify results.

Decades of research and clinical practice at Amen Clinics underscores the value of integrating brain health practices like proper nutrition, exercise, and mindfulness into treatment plans. If your current approach feels one-dimensional, consider supplementing it with additional strategies.

WHAT TO DO IF YOUR MENTAL HEALTH TREATMENT ISN’T WORKING

If any of the above signs resonate with you, it’s time to act. Here’s how you can advocate for better mental health therapy outcomes starting now:

Communicate openly with your provider: Share your concerns in detail and ask for adjustments to your treatment plan.
Seek a second opinion: Consulting another mental health professional can offer fresh insight and alternative approaches to find new ways to heal your brain.
Build brain-healthy habits: Learn about how your brain and body work together to help or hinder your progress. Take steps to tailor your lifestyle to support brain function and mental clarity, including a nutrient-rich diet, regular exercise, and mindfulness practices.
Consider innovative therapies: If traditional talk therapy isn’t working, explore options like EMDR therapy, neurofeedback, or group coaching.
Explore personalized care: The brain SPECT imaging and integrative approaches at Amen Clinics help address root causes of mental health issues, so you can get a targeted treatment plan for your individual needs.

Identifying when your mental health treatment isn’t working can feel discouraging, but think of it as an opportunity for growth and positive change. By recognizing the signs and taking proactive steps, you can find a treatment plan that truly supports your overall wellness. Mental health is a journey, not a destination—and the right support can make all the difference.

WHAT IS LONG COVID?

Long COVID – also known as post-COVID condition – is a syndrome that occurs in individuals with a history of likely or confirmed SARS CoV-2 infection, usually about three months from the onset of COVID-19.

Long COVID comes with an array of symptoms that last for at least two months and cannot be explained by an alternative diagnosis to be considered long COVID. The most common symptoms may include any of the following:

Fatigue
Malaise
Brain fog
Memory issues
Heart palpitations
Blood clots
Persistent cough
Chest pain
Loss of lung function
Muscle pain and joint aches
Headache
Hair loss
Loss of smell
Altered taste
Sexual dysfunction
Sleep disturbances
Gastrointestinal issues
Anxiety
Depression

These symptoms often have an impact on everyday functioning. Symptoms may appear for the first time following initial recovery from an acute COVID-19 episode, or they can persist from the time of the initial illness. Additionally, they may vary or relapse over time.

One of the most recent scientific surveys of nearly 30,000 participants revealed that about 8% of U.S. adults reported having ever had long COVID. Just under 4% of U.S. adults reported currently having the condition or currently having activity-limiting long COVID.

Of course, the SARS CoV-2 infection is the original initiator of long COVID, but more research is needed to fully understand what transpires at the cellular and molecular levels that brings about long COVID health complications and symptomology.

WHAT DRIVES LONG COVID?

Scientists see long COVID more as an umbrella term because it appears there are likely multiple mechanisms that lead to its development and these conditions are not mutually exclusive—and may even coexist.

According to 2023 research, the leading theories about what drives long COVID include damage/alteration to the immune system, the persistence of residual COVID viral components that lead to chronic inflammation, endothelial (lining of blood vessels) dysfunction or activation, reactivation of pre-existing chronic infections, microflora imbalances in the gut, and unrepaired tissue damage.

Here’s a closer look at a few of them.

Viral Persistence

Viral persistence is characterized by ongoing shedding of SARS-CoV-2 after the acute infection has run its course. These persistent infections from long COVID shedding may fly under the radar, but their subclinical viral presence is thought to continuously aggravate the immune system – which, in turn, may trigger chronic inflammation.

Indeed, persistent COVID viral RNA was found in the feces of a group of individuals months after clearing the initial infection, according to one study reported by researchers at the Yale School of Medicine. These individuals also reported experiencing residual GI symptoms months after being diagnosed with COVID.

If long COVID develops due to subclinical levels of the virus persisting in the body, that would make the condition similar to other infection-associated chronic conditions (also called post-acute infection syndrome) such as CFS, Lyme disease, EBV, or herpes zoster (shingles) that develop after the acute infection has passed.

COVID and Dormant Infections

Because COVID can cause immune system dysfunction, scientists sought to explore an important question: Can COVID reactivate infections? After all, a compromised long COVID immune response could leave an opportunity for previously dormant viral or bacterial infections to re-emerge—especially the IACC’s just mentioned.

There’s a likely connection between COVID and immune system reactivation, evidence suggests. EBV, which causes mononucleosis and other illnesses, appears to be reactivated in some long COVID patients. Indeed, research shows that an increase of EBV antibody levels are present in some individuals with continuing long COVID symptoms.

Additionally, research has found many overlaps between long COVID symptomatology with clinical presentation of chronic fatigue syndrome. Twenty-five out of 29 known chronic fatigue symptoms were noted in one COVID study. However, it is still not exactly clear how COVID impacts chronic illnesses.

Autoimmunity

SARS-CoV-2 infection may trigger autoimmune disease. Some patients with long COVID have elevated levels of autoantibodies (malfunctioning immune cells), which are thought to play a role in autoimmune disorders such as rheumatoid arthritis, lupus, or Sjögren’s syndrome, Yale Medicine reports.

Antibodies help to protect against foreign invaders, such as bacteria and viruses. However, autoantibodies can attack the body’s own cells, leading to inflammation and tissue injury.

In some patients with long COVID, antinuclear autoantibodies have been observed up to one year after acute infection. They can target parts of cell nuclei, which may promote inflammation and damage organ systems.

For instance, in the inner lining of blood vessels (the endothelium), these antinuclear autoantibodies can create a hyper-inflammatory state or alterations to blood cells that can lead to inappropriate clotting.

Inflammation

Inflammation, or recruiting white blood cells and the release of cytokines that initiate tissue swelling and injury, may also underlie some types of long COVID. The acute phase of COVID infection alters tissue function and unleashes a chronic inflammatory state in cells, specifically cells in the brain that are longer-lived. Inflammation is one of the major chronic illness triggers after COVID.

All of the theories noted above may possibly contribute to the sustained inflammation seen in long COVID cases.

WHAT IS LYME DISEASE?

Lyme disease is a bacterial infection that develops after a person is bit by a tick carrying the infection-causing bacterium, Borrelia burgdorferi. In rare cases, Lyme can develop from another tick-carrying bacterium called Borrelia mayonii.

While cases of Lyme have been reported in all 50 sates in the U.S., the vast majority of Lyme disease is found in the Northeast, mid-Atlantic, and upper-Midwest.

LYME DISEASE SYMPTOMS

When Lyme disease infection first occurs, the most common symptom is an erythema migrans rash. It appears like a red circle with a bullseye on the skin. Research has found about 70-80% of cases have this rash, which appears at the site of the tick bite.

Over time, other symptoms of Lyme disease may appear. However, some people may not notice any symptoms initially. The CDC notes that any of the following early symptoms of Lyme disease typically appear three to 30 days after the tick bite:

EM rash
Headache
Fatigue
Fever
Chills
Muscle and joint aches
Swollen lymph nodes

Days or even months after the tick bit, these later symptoms may appear:

EM rashes that appear on other areas of the body
Severe headaches and neck stiffness
Arthritis (particularly in large joints like the knees)
Pain that comes and goes in the tendons, joints, muscles, and bones
Facial paralysis or severe weakness of facial muscles
Heart palpitations or an irregular heartbeat
Bouts of dizziness or shortness of breath
Shooting pain, tingling, or numbness in the feet and or hands
Nerve pain
Brain and spinal cord inflammation
Sometimes if an individual receives treatment right away, before the condition develops, they may not experience these later symptoms of Lyme disease.

Lyme disease may also trigger symptoms related to mental health conditions, such as:

Brain fog
Anxiety
Depression
OCD
Memory loss

And similar to long COVID, some Lyme patients continue to have ongoing symptoms, which can be severe and debilitating. The CDC calls this phenomenon post-treatment Lyme disease syndrome (PTLD), also known as chronic Lyme disease.

Many researchers and clinicians believe that the persistence of bacteria is the cause of these lingering symptoms. The antigen that triggers the inflammatory responses in chronic Lyme symptoms is found on the outer layer of the bacterial cell wall.

Pieces of these bacterial cell walls can linger in the body—undetected in the neurons or spinal cord, even post infection. This may contribute to the prolonged inflammation that leads to chronic illness.

According to a recent 2024 study in the Journal of Infectious Diseases, prevalence of PTLD varies from 0% to 48%, depending on how chronic Lyme disease is measured and defined. Some advocacy groups settle on a prevalence rate of 30%.

LONG COVID AND LYME DISEASE

COVID symptoms and Lyme disease share similar symptoms, but that’s not all. In a 2022 study, researchers found that chronic Lyme and COVID-19 are linked as having a history of Lyme disease correlated to increased risk of severe COVID-19.

In fact, long COVID and Lyme disease have so many overlapping similar features, research has been conducted to find biomarkers that differentiate between the two conditions.

Unfortunately, without clear biomarkers, the lack of differences between them impedes scientific research, according to some experts. A potential participant in a trial might be sick from long COVID, Lyme, or another infection-associated chronic condition.

At Amen Clinics, brain SPECT imaging and lab work play important roles in helping determine the underlying root cause of symptoms.

At this point, there are currently no FDA-approved treatments for chronic Lyme, or full-scale clinical therapy trials, which is very common among chronic conditions. But there’s hope that with the prevalence of long COVID, new research will reveal therapies that may help treat all of these similar chronic conditions, such as COVID, Lyme, EBV, CFS, and the herpes zoster.

MANAGING POST-COVID LYME SYMPTOMS

Until an effective treatment is found, post-COVID Lyme symptoms can be managed through lifestyle changes. (Of course, an acute Lyme infection requires antibiotics.) Here’s what you can do for chronic Lyme and long COVID symptoms:

Support from a qualified mental health professional, good sleep hygiene, consuming a brain healthy diet and avoiding alcohol, excess sugar, and refined carbohydrates can all help to support a healthy mood and keep inflammation levels down.
Additionally, practicing deep breathing or mindfulness practice like yoga, tai chi, or meditation can help keep anxiety levels down, and inflammatory cortisol levels in check.
Acupuncture, gentle massage, heat, stretching and toning exercises, and water therapy are all good for managing pain.

WHAT IS REJECTION SENSITIVE DYSPHORIA?

Rejection sensitive dysphoria is a form of emotional dysregulation. Although it is not classified as a mental disorder, it can be highly disruptive in daily life.

People with rejection sensitive dysphoria experience an overwhelming emotional response to real or perceived rejection, criticism, judgment, or being left out. They may lash out in anger, dwell on negative thoughts, feel hopeless, think they’re a failure, or feel their self-esteem plummet.

Their moods may drop so rapidly and dramatically, it can feel like major depression and can lead to suicidal thoughts and behavior.

As a result of these intensely distressing feelings, people with RSD tend to avoid social situations, become perfectionists, develop an extreme fear of failure, and adopt people-pleasing attitudes.

Because the symptoms and consequences associated with rejection sensitivity are similar to those seen in many other mental health conditions, it is often overlooked or misdiagnosed.

WHO’S AT RISK FOR REJECTION SENSITIVE DYSPHORIA?

RSD is real, and it can affect anyone, but it is more commonly seen in people who have one or more of the following three mental health conditions:

Anxiety:
People with anxiety are generally more sensitive to criticism, and they tend to be people pleasers. Prior to the pandemic, over one-third of Americans struggled with anxiety. Those numbers have since increased.

According to the American Psychiatric Association’s 2024 mental health poll, 43% of Americans reported feeling more anxious than the year before. Some of the top anxiety-inducing issues reported in 2024 were the economy, the presidential elections, and gun violence.

ADD/ADHD:
Research has found a strong connection between people with attention-deficit hyperactivity disorder (ADHD)—also known as attention-deficit disorder (ADD)—and RSD. In fact, it is estimated that almost all ADHD sufferers also experience hypersensitivity to rejection.

ADHD is a brain-based disorder that is associated with an array of behavioral and emotional symptoms, including short attention span, distractibility, poor impulse control, irritability, being easily stressed, and a sense of insecurity. Having ADD tends to amplify emotions, including those related to rejection.

Autism:
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication problems, abnormal social skills, and learning and behavioral issues. People with ASD often have trouble understanding social cues and difficulty recognizing and expressing emotions.

Combined with heightened sensory reactions, this adds up to extreme hypersensitivity to criticism. Emerging research suggests that people with autism may experience greater rejection-induced social pain, which can then lead to psychological distress.

Other research has found that people who are highly sensitive to rejection are at increased risk of depression, borderline personality disorder, and body dysmorphic disorder.

REJECTION SENSITIVE DYSPHORIA IN THE BRAIN

According to brain-imaging research in Social Neuroscience, people with higher levels of rejection sensitivity experience activation in specific regions of the brain when looking at faces displaying disapproval.

At Amen Clinics, which has built the world’s largest database of functional brain scans related to behavior, people who are hypersensitive to rejection tend to have overactivity in certain regions of the brain. Single photon emission computed tomography (SPECT) scans performed at Amen Clinics show that these areas include:

Basal ganglia (the brain’s anxiety center)
Anterior cingulate gyrus (the brain’s gear shifter)

Too much activity in the basal ganglia is associated with heightened anxiety. When there is hyperactivity in the ACG, it is linked to getting stuck on negative thoughts and worries, like “I’m going to say the wrong thing, and everybody will laugh at me.”

**DO YOU HAVE REJECTION SENSITIVE DYSPHORIA?**

How can you tell if you have RSD? Only a professional who performs a comprehensive examination including functional brain imaging and lab tests to help identify possible root causes for your symptoms can give an accurate diagnosis.

However, if you recognize yourself in the following traits, it’s worth investigating RSD further with an integrative neuropsychiatrist.

Overwhelming emotional reactions to any form of rejection
Extremely sensitive to the mere possibility of rejection, fear of failure
Perfectionism, or setting higher standards for yourself than for others
Quickly feeling intense shame and guilt when your actions don’t live up to your expectations
Lashing out with anger or rage in response to criticism, judgment, or exclusion
Social withdrawal as a way to avoid rejection
Approval-seeking behavior
Low self-esteem, or needing validation from others
Overreact or misinterpret facial expressions

5 HELPFUL TIPS IF YOU’RE HYPERSENSITIVE TO REJECTION

If you’re struggling with rejection sensitivity, here are 5 strategies that can help.

Don’t believe every stupid thought you have.
If you get stuck on thoughts—such as, “I messed up and gave the wrong statistic during my work presentation, now everybody thinks I’m stupid”–you can stop the loop by challenging your thoughts.

Learn to kill the ANTs (automatic negative thoughts) that make you feel rejected. Ask yourself if your thoughts are really true and talk back to them. This is especially true if you have suicidal thoughts. Many people have thoughts of taking their own life, but they don’t act on them.

One study found that over half of all college students had suicidal thoughts during their lifetime. Suicide is a permanent solution to a temporary feeling. And if you hurt yourself, you’re teaching your kids that this is how grown-ups solve problems.

Learn the 18-40-60 rule.
If you’re overly sensitive, remember this. When you’re 18, you think everybody is judging you, and you care deeply about what they think of you. When you reach 40, you no longer care what anybody thinks about you. Once you hit 60, you realize nobody has been thinking about you at all because most people only think about themselves.
Accept that teenage children will reject you.
You may feel hurt when your teen pushes you away, but this is a normal part of life. During adolescence, teens have the psychological tasks of creating their own identity separate from their parents and developing independence. Accepting this fact of life can help you cope with the rejection.
Stay connected.
Isolation and loneliness are not good for people with RSD. Rather than retreating from people, find ways to stay connected.
Take care of your brain.
Fueling your brain with healthy foods, healthy behaviors, and healthy thinking patterns can help you handle criticism in a healthier way.

WHAT IS ADHD?

ADHD, or ADD, is a neuropsychiatric disorder that is characterized by problems with focus, impulse control, and hyperactivity (in some cases). Commonly diagnosed in childhood, ADD/ADHD may persist throughout adulthood.

Some people may have signs and symptoms of ADHD but go undiagnosed as children. These individuals may struggle with symptoms for years or even decades before finally getting diagnosed with adult ADHD.

WHAT IS ANXIOUS ADD/ADHD?

Among patients at Amen Clinics, anxious ADD/ADHD is becoming more prevalent. Unlike the other types of the condition, people with this type typically don’t seek excitement and conflict.

In fact, it’s more common for these individuals to avoid situations that cause stress or conflict.

People who have anxious ADD/ADHD often latch onto the worst possible outcome and fixate on it. Those with this ADD/ADHD type frequently freeze in situations that trigger anxiety, such as taking a test or giving a big presentation.

How does anxious ADD/ADHD differ from anxiety disorders? In general, anxiety disorders tend to fluctuate over time, while anxious ADHD symptoms typically remain constant.

WHAT ARE THE CORE ADHD SYMPTOMS?

Core symptoms of ADHD that are seen in all 7 types of the condition include:

Problems paying attention
Being easily distracted
Being disorganized
Procrastinating
Being forgetful
Having trouble with follow-through
Being impulsive

People may have some or all of these symptoms, which can range from mild to severe.

ANXIOUS ADD/ADHD SYMPTOMS

In addition to the common symptoms listed above, the signs and symptoms of anxious ADHD include:

Frequently anxious or nervous
Tense and stressed out
Predicts the worst
Conflict avoidant
Fear of being judged
Tendency to clam up in social situations
Physical stress symptoms such as headaches
Dislikes or gets excessively nervous speaking in public

As with the core symptoms, these can vary in terms of severity.

ANXIOUS ADD/ADHD IN THE BRAIN

At rest and concentration there’s increased activity in the basal ganglia. With concentration, there is decreased activity in the prefrontal cortex and cerebellum.

As with most of the 7 ADD/ADHD types, this type is associated with abnormal brain function. During concentration, blood flow to the brain decreases, which lowers the ability to focus or pay attention.

On SPECT scans of people with anxious ADD/ADHD, blood flow decreases are seen in the prefrontal cortex and the cerebellum. Reduced blood flow in these areas is associated with difficulties with planning, focus, organization, impulse control, empathy, and judgment.

What’s unique about brain activity in these individuals is that there is also increased activity in an area called the basal ganglia. This uptick in brain activity is seen at rest and during concentration.

In the images below, red and white represent the highest levels of activity, while blue indicates average activity. In the anxious ADD/ADHD SPECT scan, there is overactivity in the basal ganglia.

ANXIOUS ADD/ADHD TREATMENT

Stimulant medications aren’t the only way to treat ADD/ADHD. There are also many natural ways to help ADD/ADHD. Science-backed strategies include:

Learn to relax.

The main treatment goal for this type is to promote relaxation. There are a variety of relaxation methods, including: meditating, diaphragmatic breathing and listening to calming music. Find relaxation techniques that work for you and use it whenever you feel stressed.

Take nutraceuticals for calming support.

Nutritional supplements such as GABA, L-theanine, and magnesium can produce a sense of calm and relaxation. Multivitamin/mineral supplements and omega-3 fatty acids can improve focus and mental energy.

Try a new menu.

Your diet is another aspect that can help you control the anxious symptoms associated with this ADD type. Individuals with anxious ADD/ADHD should eat a lower-carbohydrate, higher-protein diet. Cutting out artificial sweeteners and MSG can also support healthy dopamine and GABA levels.

Laugh it off.

Laughing reduces stress and increases the release of endorphins in the brain. Laughter truly is the best medicine and can work wonders in relieving anxiety.

Talk it out.

People with this type tend to avoid conflict, but it’s an absolute must to let friends and family know when you’re emotionally overwhelmed. If necessary, seek help from a mental health professional.

Learn to say no.

Having this type may increase the likelihood of saying yes to every request you get without thinking about the ramifications. You may agree to participate in projects to avoid seeming disagreeable, but it can end up making you feel overloaded. Learning how to say no is a skill you need to develop. Whenever someone asks you to do something, make it a habit to say, “Let me think about it.” This will give you time to decide if it’s something that is worth your time and effort.

Seek targeted treatment.

Having anxious ADD/ADHD requires personalized solutions. For example, taking stimulant medications alone may improve focus and attention, but it can also exacerbate symptoms of anxiousness. To find the most effective treatment plan for your needs, it’s important to know two things:

To identify your type of ADHD, consider getting a brain SPECT scan. The blood flow and activity patterns in the brain can be very helpful in determining your type. Without looking at the brain, psychiatrists and other physicians can only guess if you have ADD/ADHD and which type you might have.

Want more information? Download Amen Clinics’ free Getting to Know the 7 ADD Types eBook.

It Starts With You

In addressing a child’s mental health needs, parents sometimes discover long overlooked mental health conditions in themselves. This frequently happens in cases of ADD/ADHD and ASD. Sometimes adults have lived their lives with ADD/ADHD or ASD without diagnosis or treatment. The best way to teach your child about mental health is to take care of your own!

Get Started

Amen Clinics

REFERENCES

Villatro AP, et al. Parental Recognition of Preadolescent Mental Health Problems: Does Stigma Matter? Soc Sci Med. 2018 Sep 22;216:88–96.

National Alliance of Mental Illness website

https://www.nami.org/your-journey/kids-teens-and-young-adults/kids/#:~:text=Mental%20health%20conditions%20are%20very,before%20the%20age%20of%2024.

Accessed January 24, 2025

U.S. Centers for Disease Control and Prevention website

https://www.cdc.gov/children-mental-health/data-research/index.html#:~:text=Childhood%20mental%20health%20conditions%20affect,mental%20or%20behavioral%20health%20condition.

Accessed January 24, 2025

U.S. Centers for Disease Control and Prevention website

NCHS Data Brief, No. 499, March 2024

https://www.cdc.gov/nchs/data/databriefs/db499.pdf

Accessed January 24, 2025

U.S. Centers for Disease Control and Prevention website

https://www.cdc.gov/adhd/data/index.html#:~:text=Other%20concerns%20and%20conditions%20with%20ADHD&text=According%20to%20a%20national%202022,children%20with%20ADHD%20had%20anxiety.

Accessed January 24, 2025

Koppelman J. Children with Mental Disorders: Making Sense of Their Needs and the Systems That Help Them [Internet]. Washington (DC): National Health Policy Forum; 2004 Jun 4. (Issue Brief, No. 799.)

2022 National Healthcare Quality and Disparities Report [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2022 Oct. CHILD AND ADOLESCENT MENTAL HEALTH.

Jensen P, et al. Overlooked and Underserved: “Action Signs” for Identifying Children With Unmet Mental Health Needs. Pediatrics. 2011 Nov;128(5):970–979.

Mental Health and Post-Concussion Syndrome: Katie’s Story

Facebook-f X-twitter Youtube TL;DRKatie Jolly struggled with mental health challenges for most of her life, often feeling ashamed and without clear answers.Her breakthrough came after

How Zach Healed His Brain from Alcohol and Drug Addiction

Facebook-f X-twitter Youtube TL;DR: Zach Skow’s life was once defined by early alcohol and drug addiction, leading to liver failure and a fight for survival. Through

Amen Clinics
January 13, 2025

Antidepressants come with a laundry list of side effects, including sexual dysfunction, insomnia, headaches, and nausea. The good news is, there are many effective alternatives

America is an unhappy nation, with depression rates escalating to records levels. Many depressed people turn to pharmaceuticals for what they think is an easy solution to their feelings of emptiness, sadness, and hopelessness.

That’s why rates of antidepressant prescriptions are on the rise. According to a 2024 study in JAMA Network Open, the number of antidepressant prescriptions jumped 21% from 2019 to 2022. And a greater percentage of these scripts were written via telehealth, skyrocketing from only 1.5% in 2019 to over 31% in 2022.

The problem with this is that antidepressants come with a laundry list of side effects, including sexual dysfunction, insomnia, headaches, and nausea. They also carry a black box warning, meaning they pose the most serious and dangerous potential side effects, such as suicidal thoughts. In addition, once you start taking certain types of antidepressants, it can be very hard to stop.

The good news is, there are many effective alternatives to antidepressants to consider. In this blog, you’ll learn more about clinical depression, antidepressant medications, and 11 proven strategies to try before turning to medication.

Antidepressants come with a laundry list of side effects, including sexual dysfunction, insomnia, headaches, and nausea. The good news is, there are many effective alternatives to antidepressants to consider.

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UNDERSTANDING MAJOR DEPRESSIVE DISORDER

Major Depressive Disorder (MDD) is a serious mental health condition that affects millions of people worldwide. Characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities that once brought joy, MDD can significantly impair daily life.

This condition can stem from a complex interplay of genetic, environmental, and psychological factors, often triggered by stressful life events, trauma, or underlying medical conditions.

Common depression symptoms include:

Persistent feelings of sadness, emptiness, or hopelessness
Loss of interest in activities that once brought pleasure
Changes in appetite or sleep patterns
Fatigue or loss of energy
Difficulty concentrating or making decisions
Feelings of worthlessness or guilt
Recurrent thoughts of death or suicidal ideation

Diagnosing clinical depression involves a comprehensive evaluation by a mental health professional, which includes a physical exam, medical history, and psychological assessment.

Treatment typically involves a combination of medication, therapy, and lifestyle changes, tailored to the individual’s needs. Understanding MDD is the first step towards effective depression treatment and improving overall mental health.

TYPES OF ANTIDEPRESSANT MEDICATIONS

There are several types of prescription antidepressants, which are believed to work by altering brain chemistry. Some of the most commonly prescribed antidepressants include:

Selective serotonin reuptake inhibitors (SSRIs) increase serotonin availability in the brain and are one of the most commonly prescribed types of antidepressants
Serotonin-norepinephrine reuptake inhibitors (SNRIs) increase the availability of serotonin as well as norepinephrine in the brain.
Norepinephrine-dopamine reuptake inhibitors (NDRIs) increase the availability of both norepinephrine and dopamine in the brain.
Atypical antidepressants, such as bupropion (Wellbutrin), aren’t as easily categorized as the ones mentioned above.

BETTER WAYS TO BOOST MOODS

Beyond traditional treatments, several alternative therapies have shown promise in managing depression symptoms. These therapies can be particularly beneficial for those seeking holistic approaches to mental health.

1. Attack your BRIGHT MINDS risk factors.

At Amen Clinics, the world’s leader in brain health and mental wellness, the specialists typically assess each patient’s biological risk factors. These are known as the 11 BRIGHT MINDS risk factors that steal your mind and can increase mental illness, including depression and anxiety. BRIGHT MINDS stands for:

B is for Blood flow

R is for Retirement/Aging

I is for Inflammation

G is for Genetics

H is for Head Trauma

T is for Toxins

M is for Mental Health

I is for Immunity and Infections

N is for Neurohormones

D is for Diabesity

S is for Sleep

To learn more about how to prevent, treat, or minimize your risk factors to help soothe depression and other mental health issues, watch this video. You’ll discover how the BRIGHT MINDS risk factors impact depression and other mental health symptoms, and what you can do about them.

2. Check for and correct low thyroid function.

Hypothyroidism is a very common cause of depression. Be aware that most traditional medical professionals only check for “normal” levels of thyroid, but some people may have normal test results but have symptoms. It’s better to test for “optimal” levels.

3. Eliminate the ANTs (automatic negative thoughts) to reduce depression symptoms.

Whenever you have a thought, your brain releases chemicals. Whenever you have an angry, hopeless, helpless, or worthless thought, your brain releases chemicals that make you feel bad. On the flip side, hopeful, helpful, loving, happy thoughts release chemicals that make you feel good.

If you focus on what you hate about your life, you’ll hate it. Focus on what you love about your life, and you will love your life.

To kill the ANTs, learn to question your negative thoughts. Whenever you have a thought that makes you feel sad, ask yourself if it is true. Chances are, it isn’t.

This simple technique is similar to mindfulness-based cognitive therapy (MBCT). Combining mindfulness techniques with cognitive-behavioral therapy, MBCT helps individuals manage negative thoughts and behaviors, promoting a more balanced mental state.

4. Try Eye Movement Desensitization and Reprocessing (EMDR) therapy.

This innovative therapy uses eye movements or other forms of stimulation to process and integrate traumatic memories, reducing symptoms of post-traumatic stress disorder (PTSD) and depression.

5. Exercise for better mental health.

In a head-to-head study against Zoloft, exercise was equally effective in treating depression at 12 weeks. At 10 months, exercise was more effective than antidepressant medication.

To get the antidepressant benefits of exercise, walk like you’re late for 45 minutes 4-5 times a week. In addition, do weight training twice a week as it can increase testosterone, which improves mood, memory, and motivation. Do some kind of coordination exercise, such as table tennis, to work your cerebellum, which activates the rest of your brain.

6. Take saunas.

Getting a good sweat from taking saunas has been shown to help reduce symptoms associated with depression.

7. Eat right to feel right.

Your diet has a major impact on your moods. Increase your consumption of foods that boost moods and decrease your intake of foods that contribute to depressive symptoms.

For example, eat high-quality protein, complex carbohydrates, and lots of colorful vegetables. A 2016 study showed a linear correlation between the number of fruits and veggies in your diet and your level of happiness. The more fruits and veggies (up to eight servings per day), the happier you will be.

On the flip side, eliminate processed foods, fried foods, and high-glycemic foods. To determine if specific foods are contributing to your depression, try an elimination diet.

Eliminate sugar; gluten; dairy; corn; soy; artificial dyes, preservatives, and sweeteners; and other potentially allergenic foods from your diet for three weeks. Then add each one back one at a time (except for sugar, which you should eliminate for good) and take note of any reactions to them, which would indicate that you should permanently eliminate that food.

Some people say they can’t afford to eat well, but how much is your depression costing you? A study from the Harvard School of Public Health found that eating well can cost just an extra $1.50 a day. That’s less than the cost of one session with most psychiatrists.

8. Try Mindfulness-Based Stress Reduction (MBSR).

Combining mindfulness techniques with stress reduction strategies, MBSR helps individuals manage stress and anxiety, contributing to improved mental health.

MBSR may include yoga and meditation. These mind-body practices incorporate physical postures, breathing techniques, and meditation to reduce stress and anxiety, fostering relaxation and mental clarity.

9. Consider acupuncture.

A 2022 systematic review of 22 trials involving 2,391 participants found that acupuncture has clinical benefits and is a safe alternative for managing depression. Rooted in traditional Chinese medicine, acupuncture involves inserting thin needles into specific points on the body to stimulate healing and relaxation, potentially alleviating depression symptoms.

10. Consider emerging alternatives to antidepressant medications.

Transcranial magnetic stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to stimulate nerve cells in the brain, showing effectiveness in treating depression, particularly for those who haven’t responded to other treatments.

11. Check nutrient levels and use nutritional supplements.

You can’t change what you don’t measure. Having abnormal levels of these certain vitamins and nutrients has been linked to symptoms of depression. For example, having low levels of omega-3 fatty acids, folate, vitamin B12, vitamin D, and homocysteine have been associated with depressive symptoms.

Approximately 93% of the population has sub-optimal levels of omega-3 fatty acids. The Omega-3 Index is a blood test that measures your omega-3 level. Try to get it above 8% by using 1,000mg-3,000mg of omega-3 fish oil. EPA has been found effective for depression, so be sure to choose a high-quality fish oil that is rich in EPA to help treat depression.

To boost methylfolate, vitamin B12 and vitamin D levels, take a high-quality supplement.

Work with a nutritionally informed physician, such as a functional medicine physician (also known as an integrative medicine physician), to check and optimize your nutrient levels.

Other natural supplements have A-level or B-level scientific evidence for mood and can be used to treat severe depression. What does that mean? A-level means there is robust research conducted with more than 2 placebo-controlled, double-blind clinical trials. B-level means there are multiple studies where at least 2 are placebo-controlled, double-blind studies. Among these well-studied supplements for mood are:

Saffron: There are more than 20 studies showing saffron is more effective than placebo and equal to the antidepressants Prozac, Zoloft, Effexor, and imipramine for depression.
Curcumin: Studies have found that curcumin—not as turmeric root but as Longvida, which is much more efficiently absorbed—helps with depression.
Zinc: A review of the existing studies suggests potential benefits of zinc supplementation—as citrate or glycinate—either as a stand-alone therapy or as an adjunct to antidepressants for depression.

Exploring these alternative therapies for depression can provide additional tools for managing depression and enhancing overall mental health.

Take Caution with Psychedelics as an Alternative to Antidepressant Medications

In recent years, psychedelics have emerged as alternatives to antidepressants and have gained attention. Although some believe they offer new hope for individuals struggling with treatment-resistant depression, they come with potentially dangerous side effects and may harm the brain in the long-term.

Ketamine: Known for its rapid antidepressant effects, ketamine has shown some benefits for individuals with treatment-resistant depression. However, it may produce serious side effects. Several research studies have concluded that ketamine may be addictive and can lead to cognitive deficits.
Psilocybin: This psychedelic compound has demonstrated antidepressant effects in clinical trials, but adverse side effects include anxiety, paranoia, and psychosis. Tune in to the Change Your Brain Every Day podcast with Dr. Daniel Amen and his wife Tana Amen for a deep dive into the hope, the hype, and the risks of psilocybin.

Before resorting to these antidepressant alternatives, it’s important to understand the pros and cons of psychedelics for depression.

Managing Depression Symptoms

Effectively managing depression symptoms can often involve alternatives to antidepressants, such as therapy, lifestyle changes, and natural remedies, which offer holistic paths to recovery. Here are some strategies to help manage depressive symptoms and improve mental health:

Establishing a Daily Routine: Creating a structured daily routine can provide a sense of stability and control, helping to alleviate feelings of chaos and uncertainty.
Practicing Self-Care: Engaging in self-care activities such as regular exercise, meditation, and spending time in nature can significantly improve mood and reduce stress.
Building a Support Network: Surrounding yourself with supportive friends, family, and mental health professionals can provide emotional support and reduce feelings of isolation.
Engaging in Pleasurable Activities: Participating in activities that bring joy and satisfaction can help counteract depressive symptoms and enhance overall well-being.
Getting Enough Sleep: Prioritizing good sleep hygiene is crucial, as sleep deprivation can exacerbate depression symptoms. Aim for a consistent sleep schedule and create a restful sleep environment.

By incorporating these strategies into daily life, individuals can better manage their depression symptoms and work towards improved mental health and well-being.

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REFERENCES

Chiappelli, Joshua et al. “Depression, stress and regional cerebral blood flow.” Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism vol. 43,5 (2023): 791-800. doi:10.1177/0271678X221148979

Nagappan A, Miller A, Jain S, Oakes AH. Stimulant, Antidepressant, and Opioid Telehealth Prescription Trends Between 2019 and 2022. JAMA Netw Open. 2024;7(9):e2433334. doi:10.1001/jamanetworkopen.2024.33334

Miller, Andrew H, and Charles L Raison. “The role of inflammation in depression: from evolutionary imperative to modern treatment target.” Nature reviews. Immunology vol. 16,1 (2016): 22-34. doi:10.1038/nri.2015.5

Warner, R.M., Frye, K., Morrell, J.S. et al. Fruit and Vegetable Intake Predicts Positive Affect. J Happiness Stud 18, 809–826 (2017). https://doi.org/10.1007/s10902-016-9749-6

Yang X, Chen X, Fu Y, Luo Q, Du L, Qiu H, Qiu T, Zhang L, Meng H. Comparative efficacy and safety of Crocus sativus L. for treating mild to moderate major depressive disorder in adults: a meta-analysis of randomized controlled trials. Neuropsychiatr Dis Treat. 2018 May 21;14:1297-1305. doi: 10.2147/NDT.S157550. PMID: 29849461; PMCID: PMC5967372.

Lopresti AL, Drummond PD. Efficacy of curcumin, and a saffron/curcumin combination for the treatment of major depression: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2017 Jan 1;207:188-196. doi: 10.1016/j.jad.2016.09.047. Epub 2016 Oct 1. PMID: 27723543.

Lai J, Moxey A, Nowak G, Vashum K, Bailey K, McEvoy M. The efficacy of zinc supplementation in depression: systematic review of randomised controlled trials. J Affect Disord. 2012 Jan;136(1-2):e31-e39. doi: 10.1016/j.jad.2011.06.022. Epub 2011 Jul 27. PMID: 21798601.

Chen, Binglei et al. “Efficacy and safety of acupuncture for depression: A systematic review and meta-analysis.” Research in nursing & health vol. 46,1 (2023): 48-67. doi:10.1002/nur.22284

Strong, C E, and Mohamed Kabbaj. “On the safety of repeated ketamine infusions for the treatment of depression: Effects of sex and developmental periods.” Neurobiology of stress vol. 9 166-175. 21 Sep. 2018, doi:10.1016/j.ynstr.2018.09.001

National Center for Complementary and Integrative Health. Psilocybin for Mental Health and Addiction: What You Need To Know. https://www.nccih.nih.gov/health/psilocybin-for-mental-health-and-addiction-what-you-need-to-know

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Amen Clinics
January 6, 2025

One of Amen Clinics’ seven types of anxiety and depression, this type involves a mix of both anxiety symptoms and depression symptoms.

Traditional psychiatry continues to diagnose and treat people with anxiety and depression in a cookie-cutter fashion.

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Did you know that mixed anxiety and depressive disorder, where anxiety and depressive symptoms occur together, is not only common but also challenging to diagnose effectively? These conditions are common in our society, yet they aren’t the same for everyone.

Traditional psychiatry often uses a cookie-cutter approach to diagnosing and treating mixed anxiety and depressive disorder, leading to many treatment failures and unnecessary suffering. For example, physicians may throw medicated-tipped darts in the dark, guessing which antidepressants or anti-anxiety pills—or both—might work.

Traditional psychiatry continues to diagnose and treat people with anxiety and depression in a cookie-cutter fashion. Share on X

However, only one-third of people with depression respond fully to treatment with antidepressants, according to a randomized controlled trial. And anti-anxiety pills, known as benzodiazepines, may be helpful in the short term, but they can lead to long-term problems, including reduced brain activity, addiction, and memory loss.

When they don’t work, it contributes to unnecessary frustration, added expenses, and a sense of personal failure. Many treatment failures in mixed anxiety and depressive disorder stem from conventional psychiatry’s lack of focus on brain imaging, which is crucial to understanding the unique brain patterns associated with this condition.

The brain SPECT imaging work at Amen Clinics, which has the world’s largest database of functional brain scans related to behavior (over 250,000 scans from 155 countries), has identified seven brain patterns associated with anxiety and depression. Each type needs its own treatment protocol.

This blog series will explore each type, including the common symptoms, brain SPECT findings, and effective interventions.

WHAT IS MIXED ANXIETY AND DEPRESSIVE DISORDER?

Mixed anxiety and depressive disorder is a mental health condition characterized by the simultaneous presence of both Pure Anxiety and Pure Depression, significantly affecting daily functioning and quality of life.

Unlike major depressive disorder (MDD) or generalized anxiety disorder (GAD), mixed anxiety/depression involves a blend of mood and anxiety symptoms. This condition, also known as mixed anxiety-depressive disorder (MADD), can involve persistent feelings of sadness, hopelessness, and nervousness, along with panic attacks, changes in appetite, sleep patterns, and energy levels.

Mixed anxiety/depression is a common mental health issue that can affect individuals of any age, gender, or background.

According to the World Health Organization (WHO), this condition is a significant public health concern, affecting millions of people worldwide. The dual nature of mixed anxiety/depression means that individuals may experience a fluctuating dominance of either anxiety or depressive symptoms, making it a complex and often challenging condition to manage.

Based on the patient population at Amen Clinics, anxiety and depression co-occur 75% of the time. It’s also common for these people to self-medicate with toxic substances, such as alcohol or marijuana, that calm the brain.

COMMON SYMPTOMS OF MIXED ANXIETY DEPRESSIVE DISORDER

Individuals with mixed anxiety and depressive disorder experience a blend of anxiety and depression symptoms, which may vary in intensity but are persistently present. One type may predominate at any point in time, but both symptom clusters are present regularly.

Anxiety symptoms include:

Frequent feelings of nervousness or anxiety
Panic attacks
Avoidance of people or places due to a fear of having anxiety or panic attacks
Symptoms of heightened muscle tension (headaches, sore muscles, hand tremors)
Periods of heart-pounding, nausea, or dizziness
A 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 having a tendency to freeze in anxiety-provoking or intense situations
Shyness, timidity, and getting easily embarrassed
Biting fingernails or picking skin

Depression symptoms include:

Persistent sad or “empty” mood
Loss of interest or pleasure in activities that are usually fun, including sex
Restlessness, irritability, or excessive crying
Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
Sleeping too much or too little, early-morning awakening
Loss of appetite and/or weight loss, or overeating and weight gain
Decreased energy fatigue, feeling “slowed down”
Thoughts of death or suicide, or suicide attempts
Difficulty concentrating, remembering, or making decisions
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Persistent negativity or chronic low self-esteem
Persistent feelings of dissatisfaction or boredom

CAUSES AND RISK FACTORS

The causes of mixed anxiety and depressive disorder are not fully understood but are believed to involve a mix of genetic, environmental, and psychological factors, including traumatic life events, chronic stress, and personality traits.

Several risk factors can increase the likelihood of developing this condition, including:

Family History of Mental Health Disorders: A family history of anxiety disorders, depressive disorders, or other mental health conditions can increase the risk.
Traumatic Life Events: Experiences such as abuse, neglect, or significant loss can trigger mixed anxiety/depression.
Chronic Stress: Prolonged exposure to stressful situations, whether personal or professional, can contribute to the development of this condition.
Substance Abuse: The use of drugs or alcohol can exacerbate symptoms and increase the risk of mixed anxiety/depression.
Medical Conditions: Certain medical issues, such as thyroid disorders or chronic pain, can be linked to mixed anxiety/depression.
Personality Traits: Traits like perfectionism, low self-esteem, or a tendency towards negative thinking can make individuals more susceptible.
Head Injuries: Published research, as well as the brain-imaging work at Amen Clinics indicates that mild traumatic brain injuries significantly increase the risk of developing depression and anxiety.

Significant life changes, such as the loss of a loved one, job changes, or moving to a new home, can also act as triggers for mixed anxiety/depression. Understanding these risk factors can help in identifying and managing the condition more effectively.

TYPE 3: MIXED ANXIETY/DEPRESSION IN THE BRAIN

Brain-imaging studies using SPECT (single photon emission computed tomography) scans at Amen Clinics have shown that individuals with mixed anxiety and depressive disorder often exhibit excessive activity in the basal ganglia and deep limbic system, highlighting the need for tailored treatment approaches.

Anxiety disorders, characterized by excessive fear and hyperawareness of potential threats, often coexist with depression, complicating diagnosis and treatment. On SPECT scans, this type shows excessive activity in two areas of the brain—the basal ganglia and the deep limbic system.

Basal ganglia: This set of large structures toward the center of the brain surrounds the limbic system. They are involved with integrating feelings, thoughts, and movement, along with helping to shift and smooth motor behavior.
Research suggests the basal ganglia are involved in forming habits. At Amen Clinics, we’ve noticed they are also involved with setting the body’s anxiety level.
In addition, the basal ganglia help to modulate motivation and are involved with feelings of pleasure and ecstasy (which is why drugs like cocaine and methamphetamines work in this part of the brain).
Deep limbic system: Considered the brain’s emotional center, this system is one of the most interesting and critical parts of being human. It is power-packed with functions, all of which are crucial for human behavior and survival.
The limbic system typically includes the thalamus (involved in relaying information), amygdala (fear center), hippocampus (memory center), hypothalamus (emotional center), and olfactory cortex (sense of smell).

DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS

Historically, depressive and anxiety disorders were understood and classified within the psychiatric community as manifestations of a single affective spectrum disorder. However, they were later defined as separate entities in the DSM-III (Diagnostic and Statistical Manual of Mental Disorders), which significantly influenced treatment and diagnostic guidelines.

The complexity and evolving definitions of anxiety and depressive disorders in clinical settings highlight the significant burden these conditions impose on patients and the healthcare system, necessitating comprehensive diagnostic criteria.

A comprehensive evaluation by a mental health professional is essential for an accurate diagnosis. It’s important to choose a mental health care provider who understands that mental health is really brain health. A complete diagnostic process should involve:

Clinical Interview: A detailed interview to assess the individual’s symptoms, medical history, and mental health history.
Neuropsychological Assessments: Tools such as questionnaires or rating scales to evaluate the severity of anxiety and depression symptoms.
Lab Work (if needed): When necessary, blood work can help rule out any underlying medical conditions that might be contributing to the symptoms.
Functional Brain Imaging: Scanning the brain with SPECT offers valuable biological data that helps mental health professionals more accurately diagnose and treat co-existing anxiety and depression.

Differential diagnosis is crucial to distinguish mixed anxiety/depression from other mental health conditions with similar symptoms, such as:

Major Depressive Disorder (MDD)
Generalized Anxiety Disorder
Bipolar Disorder
Post-Traumatic Stress Disorder (PTSD)
Substance Use Disorder

A mental health professional will work closely with the individual to develop a personalized treatment plan that addresses their specific symptoms and needs. Treatment for mixed anxiety/depression often includes a combination of interventions to achieve the best outcomes.

MIXED ANXIETY AND DEPRESSION TREATMENT OPTIONS

Mixed anxiety and depressive disorder involve a blend of symptoms that require a comprehensive treatment plan. This type is best treated with a brain-body approach that can include personalized nutraceuticals, lifestyle changes, helpful forms of psychotherapy, and targeted medications (when necessary).

Cognitive behavioral therapy (CBT) has proven to be a particularly effective treatment for mixed anxiety and depressive disorder, addressing negative thought patterns that exacerbate both anxiety and depressive symptoms.

In terms of medication, a growing body of research, including a fascinating study in Psychiatry Research, shows that SPECT neuroimaging can predict who will respond to certain antidepressants, such as SSRIs (selective serotonin reuptake inhibitors). Knowing which patients are more likely to respond well to certain medications and which aren’t improves outcomes.

In terms of natural solutions, try a combination of therapies for anxiety and depression, such as regular exercise, a healthy diet, meditation, and journaling. For treatment to be effective, any toxic substances, such as mood-altering drugs or alcohol, must be stopped.

With a comprehensive, targeted approach tailored to your brain and individual needs, you are much more likely to overcome the root causes of mixed anxiety/depression rather than just masking the symptoms.

DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS

Clinical Interview: A detailed interview to assess the individual’s symptoms, medical history, and mental health history.
Neuropsychological Assessments: Tools such as questionnaires or rating scales to evaluate the severity of anxiety and depression symptoms.
Lab Work (if needed): When necessary, blood work can help rule out any underlying medical conditions that might be contributing to the symptoms.
Functional Brain Imaging: Scanning the brain with SPECT offers valuable biological data that helps mental health professionals more accurately diagnose and treat co-existing anxiety and depression.

Differential diagnosis is crucial to distinguish mixed anxiety/depression from other mental health conditions with similar symptoms, such as:

Major Depressive Disorder (MDD)
Generalized Anxiety Disorder
Bipolar Disorder
Post-Traumatic Stress Disorder (PTSD)
Substance Use Disorder

MIXED ANXIETY AND DEPRESSION TREATMENT OPTIONS

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REFERENCES

REFERENCES

Wiles N, et al. Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial. Health Technol Assess. 2014 May;18(31):1-167, vii-viii. doi: 10.3310/hta18310. PMID: 24824481; PMCID: PMC4781198.

Yin, H., Knowlton, B. The role of the basal ganglia in habit formation. Nat Rev Neurosci 7, 464–476 (2006). https://doi.org/10.1038/nrn1919

Al-Kader, Dania A et al. “Depression and Anxiety in Patients With a History of Traumatic Brain Injury: A Case-Control Study.” Cureus vol. 14,8 e27971. 13 Aug. 2022, doi:10.7759/cureus.27971

Brockmann, Holger et al. “The value of HMPAO SPECT in predicting treatment response to citalopram in patients with major depression.” Psychiatry research vol. 173,2 (2009): 107-12. doi:10.1016/j.pscychresns.2008.10.006

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Facebook-f X-twitter Youtube TL;DRKatie Jolly struggled with mental health challenges for most of her life, often feeling ashamed and without clear answers.Her breakthrough came after

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Facebook-f X-twitter Youtube TL;DR: Zach Skow’s life was once defined by early alcohol and drug addiction, leading to liver failure and a fight for survival. Through

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**DO YOU HAVE REJECTION SENSITIVE DYSPHORIA?**