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Largest functional brain imaging study to date identifies specific brain differences between women and men, according to a new report in the Journal of Alzheimer’s Disease. In the largest functional brain imaging study to date, the Amen Clinics (Newport Beach, CA) compared 46,034 brain SPECT imaging studies provided by nine clinics, quantifying differences between the brains of men and women. The study is published in the Journal of Alzheimer’s Disease. Lead author psychiatrist Daniel G. Amen, MD, Medical Director, Amen Clinics, Inc., commented, “This is a very important study to help understand gender-based brain differences. The quantifiable differences we identified between men and women are important for understanding gender-based risk for brain disorders such as Alzheimer’s disease. Using functional neuroimaging tools, such as SPECT, is essential to developing precision medicine brain treatments in the future.” The brains of women in the study were significantly more active in many more areas of the brain than men, especially in the prefrontal cortex, involved with focus and impulse control, and the limbic or emotional areas of the brain, involved with mood and anxiety. The visual and coordination centers of the brain were more active in men. Single photon emission computed tomography, or SPECT, can measure blood perfusion in the brain. Images acquired from subjects at rest or while performing various cognitive tasks will show different blood flow in specific brain regions. Subjects included 119 healthy volunteers and 26,683 patients with a variety of psychiatric conditions such as brain trauma, bipolar disorders, mood disorders, schizophrenia/psychotic disorders, and ADHD. A total of 128 brain regions were analyzed for subjects at baseline and while performing a concentration task. Understanding these differences is important because brain disorders affect men and women differently. Women have significantly higher rates of Alzheimer’s disease, depression, which is itself is a risk factor for Alzheimer’s disease, and anxiety disorders, while men have higher rates of attention deficit hyperactivity disorder (ADHD), conduct-related problems, and incarceration (by 1,400%). The study findings of increased prefrontal cortex blood flow in women compared to men may explain why women tend to exhibit greater strengths in the areas of empathy, intuition, collaboration, self-control, and appropriate concern. The study also found increased blood flow in limbic areas of the brains of women, which may also partially explain why women are more vulnerable to anxiety, depression, insomnia, and eating disorders. women-more-active-brains Caption: Side view of the brain summarizing blood flow results from tens of thousands of study subjects show increased blood flow in women compared to men, highlighted in the red colored areas of the brain: the cingulate gyrus and precuneus. Men in this image have higher blood flow in blue colored areas – the cerebellum. To see if brain SPECT imaging may be right for you, call us today at 888-288-9834 or visit our website to contact us. Bipolar Spectrum Disorder (BSD), previously known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. These shifts are more severe than the normal ups and downs that are experienced by everyone. According to the Center for Disease Control (CDC), BSD affects nearly 4 percent of Americans in any given year and seems to have been increasing over the last few decades. Additionally, BSD is more common in women than men, with a ratio of approximately 3:2. There is no one cause of BSD, although research indicates it does run in families. There are, in fact, at least four distinct types of BSD: bipolar I disorder, bipolar II disorder, cyclothymic disorder, and bipolar disorder not otherwise specified. The distinction between the types is related to the severity of the symptoms – some people suffer with mild mood swings while others have trouble staying out of hospitals or jails. Some of the core symptoms often associated with BSD includes periods of: Left untreated, BSD can get worse over time and the symptoms can result in damaged relationships, poor job or school performance, and even suicide. In fact, people with BSD are 15 times more likely to attempt suicide than the general population and more people with BSD (39%) end up being hospitalized than any other mental illness. But BSD can be treated, and people with this illness can lead full and productive lives. However, misdiagnosis and improper treatment is very common. BSD is often mistaken for (exclusive) depression and/or ADD/ADHD because some of the symptoms are very similar. The distinction between BSD and other disorders is critical, however, because treating them with the wrong medication can make them much worse. This makes it very important to “look” at the brain with SPECT imaging. If we don’t look, how do we know exactly what we’re treating? During the filming of my television special, On the Psychiatrist’s Couch, I took time to answer questions from the audience. Watch this short video to see how I answer a question regarding BSD. https://youtu.be/WwZTG-jCp68?list=PL9um_lw5zvlcnWF_TkOdepKmUsPMlIeF1 Here are just a few of the valuable things you will learn: Although BSD is usually quite responsive to treatment, people with bipolar disorder typically have poor compliance with their treatment regimen. The problem is that when people with BSD improve, many feel so normal they do not believe they ever had a problem to begin with. It is difficult for people to accept that they have to keep taking supplements or medication when they think they no longer have a problem. Unfortunately, prematurely stopping treatment actually increases the chances of relapsing. Through the use of brain imaging studies, I have been able to decrease the relapse rate of my patients by visually demonstrating the biological nature of their disorders and the need to treat them as such – a great asset in encouraging patients to cooperate in their own healing. In addition to that, SPECT imaging studies have helped me persuade patients to stop blaming themselves for their symptoms. Imaging changes everything. At Amen Clinics, we can help you and your loved ones overcome the stigma and suffering associated with disorders like bipolar disorder. If you are ready to change your brain and change your life, give us a call today at 888-288-9834 or visit our website to schedule an appointment.   Lyme disease is a bacterial infection caused by the bite of an infected black-legged tick, also known as a deer tick. Lyme and its numerous co-infections can mimic or cause virtually any medical, neurological, or psychiatric condition. Known as the “great imitator,” Lyme has been vastly under-diagnosed in the United States due to inadequate testing methods and a general lack of acknowledgment by the medical community. A nasty relative of the sexually-transmitted disease, syphilis, Lyme causes a multitude of disorders, yet is much harder to cure.

People with Lyme disease have been misdiagnosed.

Some of these people have been misdiagnosed with a variety of neurological, psychiatric and medical conditions, including: Along with physiological symptoms like unexplained fevers, swollen glands, sore throat, headache, and joint pain or swelling, Lyme disease can cause the following common neuropsychological issues:

70% of those afflicted with Lyme disease report changes in their thinking, such as memory loss and reduced mental sharpness.

The fortunate ones are able to catch Lyme within the first few weeks when the appropriate antibiotics have a much better chance of working. Unfortunately, Lyme disease is often missed and the infection is allowed to take hold, disrupting the immune system and causing a cascade of inflammatory responses. A tick bite is the best way to know whether you are at risk – however, one study showed that only 17% of those surveyed even recalled being bitten! Therefore, prevention is critical. Here are a few tips:
  1. Avoid walking through brush and high grass. When hiking in the woods, camping, gardening or mowing the lawn, wear long, light-colored clothing and tuck pant legs into tight-fitting socks. Remove clothes before coming back indoors, and wash and dry them separately.
  2. Shower as soon as possible after being outdoors, using a washcloth or loofah, and check your body carefully, especially in skin folds, for attached ticks. Remove ticks carefully with tweezers (without crushing) them by pulling gently and steadily near the mouth; then apply an antiseptic to the site

Lyme Disease Cases are Often Overlooked.

Thirty thousand cases of Lyme disease are reported by the Centers for Disease Control and Prevention each year. But because Lyme is often overlooked or misdiagnosed, the International Lyme and Associated Diseases Society estimates that the actual number of tick-borne illness cases each year is ten times that! If you have any concerns about Lyme disease it is important to be evaluated right away, especially by a physician who is knowledgeable about this evasive but serious disease. Amen Clinics has several doctors with extensive experience diagnosing and treating Lyme disease, particularly the neuropsychological symptoms that Lyme disease can cause. The first step in any healing process is an accurate diagnosis. Call the Amen Clinics at 888-288-9834 to learn more about our Lyme literate physicians, or click here to ask a question and have someone contact you. We are experiencing an absolute epidemic of Lyme disease in the United States. Making things even worse is that many physicians don’t understand or deny that Lyme is so serious. It’s a tragedy. Lyme disease was so-named because it was “discovered” in Lyme, Connecticut. It is most common in New England, up and down the east coast, and the Midwest. But other individuals with Lyme have lived in Texas, South America, Europe, and Asia. When we speak of Lyme disease, we mean not only Borrelia, the name of the Lyme organism itself, but many co-infections that infected individuals also have. These co-infections include Babesia, Bartonella, Brucella, Chlamydia, Ehrlichia, Mycoplasma, Rocky Mountain Spotted Fever, Tularemia, and a variety of viruses. Lyme is contracted by being bitten from a tiny deer tick, a tick so small that you can barely see it. Some individuals who are bitten by the deer tick may find the tick on their body or see a “bulls-eye” rash, but most people don’t find the tick and don’t have a rash. Infections with Borrelia and its co-infections brethren typically have a gradual onset, often with a flu-like illness. People can have unexplained fevers or hot and cold spells. Memory, planning, reading, brain processing, and judgment may be impaired. In severe cases it can literally become impossible to string together words to make a sentence. Fatigue and exhaustion are common. Sleep problems—often severe—are almost invariably present. Headaches are common. Infected people are often moody and irritable. Individuals may have gastrointestinal disturbances. Sensitivity to sounds is increased, so that people can feel assaulted by the world around them. Light sensitivity is common. Bell’s palsy can occur—a mild or not so mild—one-sided facial drooping. In fact, Bell’s palsy is always due to Lyme disease until proven otherwise. Infected individuals can have erratic blood pressure changes or life-threatening changes in heart electrical rhythms. Our experience, and that of others who are very familiar with Lyme, is that chronic fatigue syndrome and fibromyalgia are often caused by Lyme and co-infections. The reality is that infection with Lyme and its co-infections can cause or contribute to virtually any medical, neurological, or psychiatric problems. We’ve seen Lyme mimic ADD, anxiety disorders, depression and bipolar disorder, OCD, and schizophrenia. Sometimes, but not all of the time, when we treat the underlying infections, we see all of these “psychiatric” problems melt away. Lyme is also likely involved with ALC (Lou Gehrig’s disease), multiple sclerosis, autism, and various forms of dementia, including Alzheimer’s disease.

How do you make a Lyme diagnosis?

Well, blood tests are fallible, so currently a diagnosis of Lyme is a clinical one. This is so important that it bears repeating: Lyme is a clinical diagnosis, made by a clinician with extensive experience with these infections. Individuals suspected of having Lyme should consult a “Lyme Literate Medical Doctor” (“LLMD”), typically a clinician who is a member of the leading organization for Lyme called ILADS (International Lyme and Associated Diseases Society, www.ilads.org). A diagnosis of Lyme and co-infections is made by an LLMD who takes a detailed clinical history, does a thorough physical exam, and orders appropriate laboratory testing. Laboratory testing for Lyme leaves much to be desired. Commonly-done testing by Quest or LabCorp, using the standard “Western Blot” testing, often gives a result that is a false-negative. That means that, if you get a negative result, you don’t know if you can trust it. Therefore, we commonly use specialty labs to try to diagnose Lyme such as IGeneX labs (www.igenex.com). IGeneX focuses solely on Lyme and co-infections, so they’ve become very good at detecting these illnesses. Even IGeneX testing is not perfect, but it typically is much better than most other labs. What many don’t understand, and why Lyme testing with most labs is often worse than useless—because it can be misleading—is that CDC (the United States Centers for Disease Control) criteria for Lyme are based on surveillance criteria, not criteria for actual clinical diagnosis. This is a complicated, complex, politically-charged issue. Suffice it to say that even many doctors don’t understand that the so-called CDC criteria, upon which most testing (but not IGeneX and other specialty labs) is based, are not useful for making an actual clinical diagnosis in a patient, because of their high false negative rate. This has confused many doctors, who are not aware of the nuances of this diagnostic issue, resulting in many infected patients being told that they do not have Lyme when they actually do. It’s a real disaster, one of the most confusing and contentious issues we’ve seen in my many years, resulting in missed diagnoses and misdiagnosis. Often, struggling individuals end up being told that they have a psychiatric disorder because their physicians cannot figure out what is wrong. To make things even worse, physicians who are active in diagnosis and treating tick-borne infections like Lyme are being targeted by insurance companies and medical boards. Some have been forced out of medical practice and driven into bankruptcy. Their personal and professional lives have been ruined.

There Is Hope

Let us say that help is available for Lyme and other tick-borne infections and there is reason for hope. Infected people can get better. There are courageous clinicians who are willing to diagnose and treat these patients the right way. But you must take matters into your own hands. Research your condition. Seek out clinicians who have experience. Ask questions and then ask more questions. You need to have a doctor who will spend time with you. The initial visit with a LLMD typically lasts about three hours. Is your doctor spending three hours with you? Probably not. Find one who will, and you’ll likely get better. Never give up hope! The first step in any healing process is an accurate diagnosis. If you or someone you know may be experiencing symptoms of Lyme disease, call us today at (888) 288-9834 or visit our website to schedule a visit and find out more about how we can help. Dr. Joseph A. Annibali graduated magna cum laude from the University of Pennsylvania, where he was a Senatorial Scholar, and from which he received an Honors award for studies in Biological Chemistry. Dr. Annibali is the Chief Psychiatrist at Amen Clinics Washington DC.  Author of Reclaim Your Brain—How to Calm Your Thoughts, Heal Your Mind, and Bring Your Life Back Under Control. Joey, age 9, struggled with hyperactivity, restlessness, impulse control problems, inattention, and distractibility. His pediatrician had suggested trying a couple of different medications but Joey’s mother was interested in trying alternative treatments first. She had heard about our work with neurofeedback and wanted an alternative to medication. Joey did neurofeedback twice a week and we quickly began seeing significant changes, including less hyperactivity and longer ability to focus. After he stopped the neurofeedback he continued to do well in school and at home.

WHAT IS NEUROFEEDBACK?

Neurofeedback is a specialized treatment that uses advanced computer technology for balancing and optimizing your brain. It is a fun, interactive and engaging treatment that helps you strengthen and retrain your brain to a healthier, more focused state. Using real-time displays of brain activity, you can learn how to self-regulate your brain function. Monica, age 17, came to the clinic for problems with anxiety, worrying, temper outbursts, poor school performance, and oppositional behavior. She had been in psychotherapy for two years, which seemed to help her temper problems but not her oppositional behavior or school performance. Additionally, she had tried two different medications but she did not like the side effects. When she learned about neurofeedback she liked the idea of learning how to control her own brain. We did neurofeedback twice a week and within the first month she noticed less worrying. By the end of 6 months she felt more focused, less anxious, and overall more cooperative, which her family validated. Research has demonstrated the effectiveness of neurofeedback to improve many conditions including:

WHAT ARE THE BENEFITS OF NEUROFEEDBACK?

Patients report enhanced memory and focus, decreased impulsivity and anxiety, better mental clarity, more restful sleep, improved mood, and a host of other benefits after using neurofeedback without side effects! In fact, the American Academy of Pediatrics named neurofeedback a “Level 1: ‘Best Support’ intervention for ADD/ADHD, on par with medication.” The effects and benefits of training last long after the training itself has stopped. Because the brain has actually learned (or relearned) a more efficient way of performing, it will continue in this way as new pathways in the brain are created, thus making lasting change the path of least effort.

WHAT TO EXPECT?

With neurofeedback, YOU become an active part of your brain’s healing.  You will play a video game using just your brain—it’s fun! Here’s how it works: electrodes are placed on your head to measure electrical activity in your brain (this is painless, non-invasive, and safe for people of all ages). Then, you will play some games that require concentration. At the same time, you will be able to view your brain activity on a computer monitor. A clinician will show you how to interpret the activity: which patterns mean your brain is engaged and which patterns mean your brain is less engaged. You CAN change your brain and change your life. Amen Clinics can help. To learn more about neurofeedback strategies or to schedule an appointment, contact the Amen Clinics Care Center today at 888-288-9834.

Who You Spend Time With Impacts Your Mood

When you are with positive, supportive, and loving people, you feel happier and more content, and you live longer. This is not only intuitively true but research has demonstrated it again and again. For example, in a study at Case Western Reserve in Cleveland, Ohio, 10,000 men were asked, “Does your wife show you her love?” The detailed health histories of the men followed over ten years who answered yes showed fewer ulcers, less chest pain, and longer lives than those who answered no. When you spend time with negative or hostile people, you tend to feel tense, anxious, upset, sick, and less intellectually on the ball. Being around people who make you feel stress causes your body to secrete an excessive amount of adrenaline, which makes you feel anxious and tense and puts you on your guard. Increases in the stress hormone cortisol can disrupt neurons in the hippocampus, one of the main memory centers in the brain. Through the years people have told us that living with a person who suffered from schizophrenia, bipolar disorder, depression, panic disorder, Attention Deficit Disorder, or borderline personality disorder has had a negative impact on their physical and emotional health. The chronic stress for family members associated with these illnesses when they are untreated or under-treated can be devastating. Mothers of untreated ADD children, for example, have a higher incidence of depression themselves and often complain that they are physically sick more often and cognitively less sharp than before they had the child. In our experience, a hallmark of unhappy people is that they have a tendency to surround themselves with negative people – with people who do not believe in them or their abilities, people who put them down, discourage them from their goals, and treat them as though they will never amount to anything. Surrounded by these types of people, you eventually get a clear message that you are no good.

Are you surrounded by people who believe in you and give you positive messages?

Do you spend time with people who encourage you to feel good about yourself? Or do you spend time with people who are constantly putting you down and down playing your ideas? Who are the five people you spend the most time with? Are they positive or negative? The reasons people surround themselves with negativity are easy to understand. People who grow up in negative environments often grow up to be negative. It is what they are used to and, in a strange sort of way, it is what they are comfortable with, what their brain knows. A Choctaw medicine man once told us, “People do not seek happiness, they seek familiarity.” If an insecure parent continually belittles his child to make himself feel better, the child grows up believing that he is no good and that he is not worthy of being around people who make him feel good. When the trauma of divorce of death happens in a family, a young child often erroneously believes he is at fault and carries around tremendous guilt for a long time. Some children who witnessed parents struggle through a difficult marriage get the message programmed in their brains that relationships are inherently problematic, and they, too, get caught in incompatible relationships. Adults, as well as children, can be beaten down after years of living through a difficult marriage or being in an abusive job situation. Many people will stay in a job they hate, for example, because their boss leads them to believe that no one else would hire them and that they are lucky to have the job. Just as in an abusive marriage, in an abusive job situation, employees have their self-esteem beaten down to the point that they no longer believe they can go beyond their abusive environment.

Past relationships have a real impact on present ones.

If your past relationships were filled with negativity, chances are your present and future relationships will be the same unless you make a conscious effort to overcome the past. If you are experiencing depression caused by your past or present relationships, you are not alone. Depression CAN be treated and Amen Clinics CAN help. Call us today at 888-288-9834 or visit our website to schedule an appointment. One of our key approaches to treatment of mood and behavior disorders is brain SPECT imaging, a type of brain scan that shows brain function. For decades now we have used SPECT as a tool to see how a patient’s brain function factors into their psychiatric condition. Even though we have seen the power of brain imaging, it remains uncommon for most psychiatric doctors to get images of their patients’ brains.

The Search for Psychiatric Biomarkers

If you had chest pain, a cardiologist would consider your symptoms, do sophisticated imaging of your heart, plus an EKG and blood tests. He or she would be looking for certain biomarkers before forming a diagnosis. Biomarkers are objectively measured indicators of a biological state, something that would give a higher certainty of insight into the physiological reality beyond the symptoms that the patient is experiencing. For instance, a biomarker for a heart attack is an elevated level of the protein complex troponin. At Amen Clinics, when we do a scan of a patient’s brain, we are looking for biomarkers like elevated or decreased blood flow in certain areas of the brain. With the recent storm of criticism surrounding the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) produced by the American Psychiatric Association and the NIH announcement that they would not be funding new studies based on the DSM approach to diagnosis, we predict that we will be seeing a lot more research into the merits of brain imaging for the diagnosis and treatment of psychiatric disorders.

Risks are Revealed

Our own database of scans looked at the activity in the right insular cortex in over 8,750 patients. This is what we found. Increased blood flow in the right insular was positively associated with: • Bipolar disorder • Anxiety disorders, including generalized anxiety disorder • Obsessive compulsive disorders • Substance abuse disorders • ADHD Low insular activity was more highly correlated with: • Depression • Dementia People with Bipolar disorder also have increased right insular activity. Using right insular hyperactivity as a biomarker for an SSRI medication when someone may have an underlying Bipolar disorder may actually flip him or her into a manic episode. In other words, it can make a patient much worse. In addition, prior studies have shown that SSRIs can help Generalized Anxiety Disorders and some forms of OCD, but SSRIs usually make people with ADHD worse and they often don’t care that they are worse, because they have less anxiety.

Symptoms, Biomarkers and the Whole Person

We are coming to grips with the fact that the old approach of diagnosing and treating psychiatric disorders using symptoms alone is ineffective, and in many cases actually makes things worse. Likewise, using brain imaging by itself can’t always tell the entire story. To understand and treat psychiatric conditions effectively, we need to listen to our patients, evaluate their brains and develop targeted treatment plans.

Let Us Help You Today

Our experienced staff will help you learn more about your brain. If you’re ready to take control over your future, call us today at 888-288-9834 or visit our website to schedule an appointment.