Complex Conditions

Unlike traditional psychiatry, which rarely looks at the brain, Amen Clinics uses brain imaging technology to identify brain patterns associated with multiple conditions.

What are Complex Conditions?

People with complex conditions struggle with a multitude of symptoms related to more than one disorder. For example, it is not uncommon for people to have a mental health condition, such as ADD/ADHD, as well as a substance use disorder, which is known as dual diagnosis or co-occurring disorders. People may also struggle with more than one mental illness, which is referred to as comorbidity or co-existing conditions. In others, symptoms may be associated with multiple mental health conditions, as well as one or more physical health problems (such as traumatic brain injury, hormonal issues, obesity, or infectious diseases), and/or substance abuse. Having complex conditions can seriously impact your day-to-day functioning in every aspect of your life—at work, at home, at school, and in your relationships—and lower your quality of life.

Who is at Risk?

About 1 in 5 Americans experience some form of mental illness each year, and approximately 45% of them meet the criteria for 2 or more disorders. At Amen Clinics, we have found that it is also very common for underlying biological conditions to overlap with mental health issues. In fact, a majority of the people who come to our clinics nationwide have complex cases with multiple contributing factors.

Why are Complex Conditions Difficult to Diagnose?

When there is a combination of issues involved, it is even more important to get a complete and accurate diagnosis so all of the contributing causes can be treated. In the traditional healthcare system, however, it can be very hard to get an accurate diagnosis. This is because conventional mental healthcare providers rarely look at the organ they treat and often do not assess the biological risk factors or the other psychological, social, and spiritual factors that can contribute to symptoms. (See below for more information on the BRIGHT MINDS risk factors that can steal your mind and contribute to complex conditions.)

A person may suffer from any combination of psychiatric conditions, but some of the more common ones include the following. (See below for more information.)

  • Anxiety
  • Bipolar Disorder
  • Dementia
  • Depression
  • Obsessive Compulsive Disorder
  • Post-Traumatic Stress Disorder
  • Schizophrenia

Why Choose Amen Clinics for Complex Conditions?

At Amen Clinics, a majority of the patients we see have complex conditions. Many have already seen multiple healthcare and mental health practitioners and tried several treatments without getting the desired relief from symptoms. We let them know that even if they’ve tried treatment without success, there is still hope. We use brain SPECT imaging as part of a comprehensive evaluation to diagnose and treat people struggling from complex conditions. We also perform lab work to help us identify any biological issues that could be causing your symptoms. In addition, we investigate the psychological, social, and spiritual factors that may be contributing to your issues.

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Brains With Complex Conditions Work Differently

Brain imaging shows that mental health disorders are not a character flaw or personal weakness. They are associated with biological changes in the brain.

Healthy Brain Scan

Complex Conditions Brain Scan

SPECT (single photon emission computed tomography) is a nuclear medicine study that evaluates blood flow and activity in the brain. Basically, it shows three things: healthy activity, too little activity, or too much activity. The healthy surface brain SPECT scan on the left shows full, even symmetrical activity. The scan on the right is from a patient who sought help for problems with concentration, focus, follow-through, and severe temper problems. The scan shows marked decreased activity, especially in the prefrontal cortex (a pattern often seen in people with ADD), as well as in the temporal lobes (associated with temper problems). Addressing both of these issues was key to finding the right treatment.

Ready to learn more? Speak to a care coordinator today!

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Common Comorbid Mental Health Conditions

A person may suffer from any combination of psychiatric conditions, but some of the more common ones involved in complex cases include:


Research shows that up to 30% of people with ADD/ADHD also suffer from depression. In addition, about half of all adults with the condition also struggle with anxiety, and half of all people with ADD/ADHD will develop a substance abuse problem if it remains untreated. Bipolar disorder and other conditions are also seen in people with this condition.


Generalized anxiety disorder is commonly seen with other psychiatric conditions, such as depression, bipolar disorder, and substance abuse. At Amen Clinics, we have found that anxiety and depression occur together 75% of the time. And people with anxiety are twice as likely to abuse drugs and alcohol compared with the general population.

Bipolar Disorder

Over half of all people with bipolar disorder (BD) also have an anxiety disorder. Studies show that BD is also seen with ADD/ADHD, eating disorders, other mood disorders, personality disorders, and substance abuse.


Memory problems and dementia, which includes Alzheimer’s disease, are often associated with other conditions, such as anxiety, depression, and substance abuse, according to research.


Among people who have been diagnosed with major depressive disorder, nearly 58% also had a substance abuse disorder, over 37% had experienced an anxiety disorder, and almost 32% had a personality disorder, according to research in JAMA. Substance abuse is about twice as common in depressed people as in people who don’t have this condition.

Obsessive Compulsive Disorder

OCD is frequently seen with depression, bipolar disorder, anxiety, and panic disorder. A review of the existing research shows that people with OCD are estimated to have a lifetime risk of experiencing depression (up to 80%) bipolar disorder (up to 35%), generalized anxiety disorder (30%), specific phobia (22%), social anxiety disorder (18%), panic disorder (12%), and schizophrenia (12%).

Post-Traumatic Stress Disorder (PTSD)

Approximately 80% of people with PTSD will experience a comorbid mental health condition in their lifetime, such as depression, anxiety, or substance abuse. Research shows that borderline personality disorder is also frequently seen in people with PTSD.


Scientific evidence shows that people suffering from schizophrenia also experience depression (50%), substance abuse (47%), PTSD (29%), obsessive compulsive disorder (23%), and panic disorder (15%).


“With A Better Brain Comes A Better Life”

– Daniel G. Amen, M.D.


Bright Minds Risk Factors That Contribute To Complex Conditions

We have identified 11 key risk factors that damage the brain, steal your mind, and can contribute to symptoms of mental illness. We use the mnemonic (memory device) BRIGHT MINDS to help you remember them.

  • B is for Blood Flow: Low blood flow on brain SPECT imaging has been seen with depression, suicide, bipolar disorder, schizophrenia, ADD/ADHD, traumatic brain injury, hoarding, murder, substance abuse, seizure activity, and more. Low blood flow is the #1 brain imaging predictor that a person will develop Alzheimer’s disease.
  • R is for Retirement/Aging: Advancing age is the single most important risk for memory loss and Alzheimer’s disease. In addition, many of the physical health issues associated with aging can contribute to psychiatric symptoms.
  • I is for Inflammation: Chronic inflammation is like a constant fire that harms your organs, damages your brain, and can affect your mind.
  • G is for Genetics: Some genes may predispose certain people to a vulnerability for mental or physical health problems.
  • H is for Head Trauma: Brain imaging studies show that even mild physical trauma can damage the brain and increase your risk of mental health issues.
  • T is for Toxins: Exposure to environmental toxins (such as toxic mold), as well as alcohol or drugs, has been linked to a host of physical and mental health problems.
  • M is for Mind-Storms: Abnormal electrical activity can change the activity of the brain and can be associated with temper outbursts, depression, suicidal thoughts, panic attacks, distractibility, and confusion.
  • I is for Infections/Immunity: Infections (such as Lyme disease) and autoimmune diseases are associated with a range of issues, including depression, anxiety, attentional problems, mania, psychosis, brain fog, and memory loss.
  • N is for Neurohormones: When hormone levels are out of whack, you can experience fatigue, memory problems, mood swings, anxiety, depression, and a host of other symptoms.
  • D is for Diabesity: The word “diabesity” combine diabetes and obesity, both of which decrease the size and function of your brain. Obesity has been linked to a greater risk of depression, bipolar disorder, panic disorder, agoraphobia (fear of going out), and addictions. High blood sugar is associated with a smaller hippocampus, which is involved with mood, learning, and memory.
  • S is for Sleep: Over time, sleep problems can lead to a higher risk of depression, ADD/ADHD, anxiety, panic attacks, brain fog, memory problems, and dementia.
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