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The Melanie Avalon Podcast Episode #48 - Dr. Daniel Amen

The Washington Post called Dr. Daniel Amen the most popular psychiatrist in America and Discover Magazine listed his brain imaging research as the top neuroscience story for 2015. He is a double board-certified psychiatrist and 12-time NY Times bestselling author, with such blockbuster books as Change Your Brain, Change Your Life, Healing ADD, Memory Rescue, Change Your Brain, Change Your Grades, and The Daniel Plan, co-authored by Pastor Rick Warren and Dr. Mark Hyman. Dr. Amen is the founder of Amen Clinics, which has 8 locations across the United States. Amen Clinics has the world’s largest database of brain scans related to behavior, totaling more than 160,000 SPECT scans on patients from 121 countries. Dr. Amen’s research team has published more than 70 scientific articles. He is the lead researcher on the world’s largest brain imaging and rehabilitation study on professional football players. His research has not only demonstrated high levels of brain damage in players, but also the possibility of significant recovery for many with the principles that underlie his work. His team also published the world’s largest functional brain imaging study on how the brain ages with over 62,000 SPECT scans. Dr. Amen has also hosted 14 national public television shows about the brain, which have aired over 100,000 times across North America.


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www.amenclinics.com 
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SHOWNOTES

2:30 - GIVEAWAY:  IF Biohackers: Intermittent Fasting + Real Foods + Life: Join Melanie's Facebook Group For A Weekly Episode GIVEAWAY, And To Discuss And Learn About All Things Biohacking! All Conversations Welcome!

3:10 - FEALS: CBD oil which satisfies ALL of Melanie's stringent criteria - premium, full spectrum, organic, tested, pure CBD in MCT oil! Go To feals.com/melanieavalon To Become A Member And Get 50% Off Your First Order, With Free Shipping!

3:40 - DRY FARM WINES: Low Sugar, Low Alcohol, Toxin-Free, Mold- Free, Pesticide-Free , Hang-over Free Natural Wine! Use The Link DryFarmWines.com/melanieavalon To Get A Bottle For A Penny!

6:20 - What Is Mental Illness?

9:15 - Can You Be Born With Mental Health Issues? Where Does It Start?

12:00 - Epigenetics And Genetic Stress Transformation

The Melanie Avalon Podcast Episode #17 - David Sinclair

12:40 - The Long-term Implications Of COVID On Mental Health

14:30 - Long-term Stress Exposure, Trauma, And Brain Reserve

17:00 - Stacked Stressors

18:05 - The Role Of Grief And Self-Injury

18:45 - Mental Hygiene

The Melanie Avalon Podcast Episode #46 - Dr. Will Cole

20:20 - Labels And Depression: Seven Different Types Of Depression

22:40 - Justin Bieber's Take On Mental Illness  

27:10 - SUNLIGHTEN: Get $200 Off Any Sunlighten Cabin Model  Or $100 Off The Solo Unit (That Melanie Has!) AND $99 Shipping (Regularly $598) With The Code MelanieAvalon At MelanieAvalon.Com/Sunlighten. Forward Your Proof Of Purchase To Podcast@MelanieAvalon.com, To Receive A Signed Copy Of What When Wine!

Connie Zack: At Home Sauna For Ultimate Immunity, Detoxing Through Sweat, Infrared Vs. Traditional Saunas, Passive Calorie Burning, Optimizing Heat Therapy, Sunlighten For Sleep, Stress And More!​​​​

29:30 - The Role Of Shame In Mental Health Issues

30:00 - SPECT Brain Scans

33:10 - Brain Toxins (Mercury, Mold, Infections, etc.)

36:00 - Brain Blood Flow

36:50 - What Is Brain Health?

38:25 - Blood Flow, Caffeine, And Alcohol

40:00 - Pharmaceuticals Vs. Nutraceuticals

41:00 - The Science Of Nutraceuticals: Saffron

41:50 - The Problems With Antidepressants

42:20 - BEAUTYCOUNTER: Non-Toxic Beauty Products Tested For Heavy Metals, Which Support Skin Health And Look Amazing! Shop At Beautycounter.Com/MelanieAvalon For Something Magical! For Exclusive Offers And Discounts, And More On The Science Of Skincare, Get On Melanie's Private Beauty Counter Email List At MelanieAvalon.Com/CleanBeauty!

44:40 - SSRI Mechanism Of Action

46:15 - The Science Of Nutraceuticals: Ginger and Melatonin

47:00 - Post-SPECT Treatment 

49:30 - Micro-dosing Psychedelics

49:55 - Wine And The Brain

51:00 - CBD And The Brain

DRY FARM WINES: Low Sugar, Low Alcohol, Toxin-Free, Mold- Free, Pesticide-Free , Hang-over Free Natural Wine! Use The Link DryFarmWines.com/melanieavalon To Get A Bottle For A Penny!

53:00 - The Need For Social Connection

Brain Health Assessment Test 


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TRANSCRIPT

Melanie Avalon: Hi friends, welcome back to the show. I am here with a man who honestly needs no introduction, but I will introduce him anyway. He has been called by the Washington Post, “the most popular psychiatrist in America.” He's a 12-time New York Times best-selling author. He is well known for something we're going to talk about a lot in this episode, which is his work in brain imaging. Very, very fascinating. And he has a brand-new book out, The End of Mental Illness: How Neuroscience Is Transforming Psychiatry and Helping Prevent Or Reverse Mood and Anxiety Disorders, ADHD, Addictions, PTSD, Psychosis, Personality Disorders, and More.

Friends, listeners, you guys know I read a lot of books, but this book was a wonder. It was one of the most comprehensive, enlightening, no pun intended, overviews of the brain that I have ever had the pleasure of engaging with. I am here with Dr. Daniel Amen. Thank you so much for being here.

Dr. Daniel Amen: Well, what a joy to be with you. And thank you for helping me share my work.

Melanie Avalon: No, I am so grateful for the work that you're doing. For listeners who aren't familiar, you are really the pioneer in bringing to the public and making accessible brain SPECT imaging. And I'm so excited for my audience. I actually had the procedure done. We're going to talk about that in this episode. But basically, this is very evident in your book, The End of Mental Illness, but you put forth this idea, which is a bit of a paradigm shift. Well, I know there's a lot of approaches to, I have to use this word, “not lightly,” mental illness because you talk about how we should reframe what mental illness even is. But there's so many approaches to it and you really bring forth this paradigm where mental illness, if we call it that, is a real thing.

And you talked about how we should look at the brain as any other organ in the body and we should scan it, we should look at it, we should find what's wrong, and then we should create a comprehensive approach that addresses it. I thought that was how we could start this conversation. I know it's such a vague question, but how do you view mental illness and why do you think that we should reframe it as brain health and mental health issues?

Dr. Daniel Amen: I hate the term “mental illness.” I've actually always hated it. I have always, even when I was a young medical student and I decided to be a psychiatrist. It's just-- it's a bad term because if you call somebody mental, you're shaming them, and it's not accurate. These are brain health issues. When I started looking at the brain in the late 1980s, it just became even clearer to me that psychiatric problems are not mental illnesses. They're brain health issues. And what I've found is if I help you get your brain right, well, then your mind will follow.

Psychiatry has a marketing problem. Nobody really wants to see a psychiatrist. No one wants to be labeled as defective or abnormal, but everybody wants a better brain. So what if mental health was really brain health and how we're going to end mental illness is we're going to create a revolution in brain health. Most psychiatrists, they never look at your brain. They also don't talk to you about how to keep your brain healthy. Why you shouldn't drink is drinking decreases blood flow to the brain. So, if you prematurely age your brain, well, that's not going to be helpful to how you feel, how you act, how you think. So, just radically shifting the conversation and then the interventions. In our experience, we have the best outcomes in treatment-resistant patients in anybody I know that publishes their outcomes, and that’s sort of exciting.

Melanie Avalon: Yeah, that is absolutely incredible. Mental health issues, is it possible to be born in today's society with no “mental health issues?” Because you talk in your book about all the different factors that are involved. You have your Bright Minds, which are a lot of risk factors that can create these mental health issues. Is it even possible to have a mental health issue free brain? Where do you think it starts? Where do you fall in the nature versus nurture debate? I’m just wondering if it's possible to have a blank slate?

Dr. Daniel Amen: Yeah, it's a bad debate, because it's always both. Whenever I evaluate someone, I'm always thinking of them in four big circles. What's the biology? What's the physical functioning of your brain and your body? Because if your thyroid is not right, your brain is not going to be right. If your gut is not right, your brain is not right. So, really understanding the physiology of the brain and the body, which is why I think imaging is so important. And then, there's a psychological circle, so how you think and your development. Then, there's a social circle. So if you think of the biology as the hardware of your brain, psychology is the software. And then, the social circle are like the network connections, because who you hang out with matters. We're in the middle of this pandemic, which has increased everybody's baseline stress 50%. And then, the fourth circle is the spiritual circle, which is, why do you care? Why are you on the planet? What's your deepest sense of meaning and purpose? If I saw you as a patient, I would really want to know your brain and we got to look at your brain. But that's only a piece of who you are.

And so, people get well or sick in those four circles. All of them add to your health or your illness. There's a part of genetics that I'm pretty interested in called Epigenetics. That means you inherit what happened to your mom or what happened to your dad, both good and bad. You inherit some of their resilience, but you also inherit some of their vulnerabilities.

Melanie Avalon: Yeah, it's so fascinating. I particularly am really interested in the work of David Sinclair in genetics. I had him on the show a few times talking about the role of epigenetics and I've always wondered about-- it's fascinating, the idea of stress, for example, transferring through generations to the baby. And then, you're speaking about the social circle. One of the most fascinating things I learned in your book was you talked about how-- I don't remember when they did this experiment, but it was some experiment where they raise the babies with no touch or no language, and that they died, which is just really-- that was shocking to me. So, it really makes me wonder right now, especially with COVID and the quarantine situation, what are the long-term implications of this social isolation, for example? What are your thoughts on that?

Dr. Daniel Amen: Well, maybe even generational consequences of the pandemic. Remember when the pandemic happened-- for me, it was March 10th. The End of Mental Illness had just come out and I supposed to go to New York to be on the Mel Robbins Show, a nationally syndicated television show. And the producer called me and said, “Don't come. We're closing the studio.” And I wrote that night, “Mental hygiene is just as important as washing your hands.”

And then, I wrote down Pandemic Squared. This pandemic is going to cause another one, and the one it’s causing is a mental health pandemic, that we're actually running out of Zoloft, one of the good antidepressants. The incidence of anxiety, depression, suicide, posttraumatic stress disorder, grief, addictions are skyrocketing. And in nine months, we're going to have a whole bunch of more babies because people have more time. And we're going to have a lot more divorce because people are like, “If I'm going to be in a pandemic, I don't want to be in one with you.” [chuckles]

Thankfully, my wife and I are closer. But we have the rule in our house, that this is stressful, you get a tantrum a week and nobody will say anything to you. Now, more than once a week, then we have to talk about it, but it's stressful and the stress is changing the eggs in your ovaries, which means it's just not affecting you, it's going to affect your future babies and grandbabies.

Melanie Avalon: What have you seen with your patients and in your work when one is exposed to a chronic stress situation, for example, this quarantine situation? Is there is a certain timeline that's needed for it to create lasting effects in the person or is it more on an individual basis? I know, for example, you talk about in the book how with PTSD that the amount of brain reserve a person has can determine whether or not a trauma becomes posttraumatic. With this COVID situation, do you think some people, it's going to have more lasting effects than others and what might be the determining factor there?

Dr. Daniel Amen: It depends on the health of your brain going into the pandemic. A long time ago, I coined this term, “brain reserve.” It's the extra tissue you have to deal with whatever stress comes your way. It starts actually before you were born when your parents had you. Were they healthy? Because if they weren't, you don't have as much reserve. Then, what happened to you when you were inside your mother's womb, how healthy was she? Was she going through a great deal of stress? Or did she take her vitamins and have a reasonably healthy time? Your birth, the world is the most dangerous the day you're born. So, did you have the cord wrapped around your neck? Or somebody take forceps and drag you out?

And then, as you go through your childhood, how'd they feed you? Did you have falls? Did your parents let you play contact sports? All of that matters to the level of reserve you're bringing in to an accident or pandemic or divorce or job loss. I lost my dad a month ago. Not everyone who goes through a negative event has negative consequences. It depends. I often when I take a history for my patients, is I use the term “stocked stresses.” It's like, “Well, let's look at when you got depressed, how many stresses did you have leading up to that?”

So, I saw a new patient yesterday and she had surgery twice in January. Nobody knows general anesthesia can hit your brain in a negative way. She had surgery and then complications, and then the pandemic and lost a friend and lost another friend and lost another friend. Those things stock and then you end up with darkness. And people go, “Oh, it's depression! Take an SSRI.” And I'm like, “It's way more complicated than that.” But sort of understanding her and the four circles then helps me intervene properly with the right nutrients to help her biology, teaching her to kill the ANTs, automatic negative thoughts, that help her mind, make sure her connections are good, and getting back into a deep sense of purpose. All of those things help.

Melanie Avalon: Yeah, it's like the tipping point feeling where all these things build up and then just that last one. I'm sorry, were you using that as an example? Or did you say your dad passed away a month ago?

Dr. Daniel Amen: My dad did pass away.

Melanie Avalon: I'm so sorry to hear that.

Dr. Daniel Amen: In the middle of COVID and Zoom funerals and all of that. But I've been helping people with grief for a long time. One of my patients who had lost her 12-year-old daughter to bone cancer, as she was getting well, she said, “I want you to tell people never to let grief be your excuse to hurt yourself.” And so through this time, supporting my mom, that's been really important to me. But then just engaging in the right mental hygiene, in the right discipline, has been so helpful. And I'm grateful for what I do because it helps. If you're helping someone else, and you’ve probably found this as well, is you're helping someone else always helps you.

Melanie Avalon: Yeah, it's so true. It's interesting. I've had my own health challenges which-- I never really had growing up-- I didn't identify as having stress or anxiety or anything like that. It really started with digestive issues and then a slew of other things, mercury toxicity, some chronic infections. But in any case, the point is dealing with all of that chronically has made me constantly search for tools - you were talking about gratitude - tools in my toolbox to constantly deal with uncertainty, deal with anxiety.

So, when the quarantine situation and COVID and all that happened, it was almost like-- because I'd been dealing with chronic anxiety and uncertainty and had these tools that I've been using, it wasn't that much of a change in a way. And I thought it was just me thinking this, but I was interviewing Dr. Will Cole who wrote The Inflammation Spectrum, and he works with a lot of autoimmune patients. He was saying that a lot of his patients are having that same experience. So, it's really nice to be having these tools for mental hygiene like you call it and be sharing them with others and keep using them. They're great.

One thing you just spoke to, labels when it comes to mental health conditions, one thing that really resonated with me and your book, for example, was when I think about something like anxiety or depression-- I was thinking about this the other day like depression, I think people will give it one word like, “Oh, it's depression.” You're talking about how prescriptions for Zoloft are going way up. But I would think about it and I'd be like, “I feel there's a lot of different types of depression,” because some people might exhibit the behavior of depression where they're withdrawn, not engaging with people, low energy, but they might still have a sense of hope. Whereas other people might-- it seems like there are a lot of different types. And then you said in your book that there are actually like seven different types of depression.

I was wondering what are your thoughts on these labels when it comes to mental health conditions? Do you think if we didn't have labels, if we didn't have the idea of depression, we didn't have the idea of anxiety, we didn't have all of these labels, do you think they maybe wouldn't exist? I know that's a really esoteric question, but what are your thoughts on that?

Dr. Daniel Amen: No, I think they'd still exist. Like you wouldn't say chest pain doesn't exist, because people experience it, but we also don't use it as a diagnostic category because it doesn't tell you what it is or what to do for it. And so, of course depression exists, but it's not really an illness. It's a cluster of symptoms that have many different causes like chest pain. And because we don't look at the brain, we assume it's one thing. For some reason, we think it's a serotonin deficiency, and it's not. I mean some people have a serotonin deficiency and giving them serotonin helps. Other people, it actually hurts them. And so our language is bad, our diagnostic categories are inadequate, and we just need to throw it out and start again. And that was the whole idea behind The End of Mental Illness. They're not mental, their brain, get your brain right and your mind will follow.

I'm in a new docuseries with Justin Bieber. And I've been Justin's doctor for a long time. He'd come and then he'd go, and he'd do what I ask and then he wouldn't. I mean he's a superstar, so he's entitled to listen or not to his doctor. But one day last spring, he came into my office and he said, “My brain is an organ just like my heart is an organ. If you told me I had heart problems, I'd do everything you say.  So now, I'm going to do everything you say.” And it was that epiphany of get my brain right and then my mind will follow, he's just done spectacularly well. And I could give him seven different psychiatric disorders, but how the heck is that helpful? What's helpful is, what are your strengths? Where are you suffering? And how can I improve each of those four circles?

And when you do that, people tend to get better. And you'd already said you suffered with infections and gut health, which both impact your brain. And so, getting those right is absolutely essential to getting your mind right, that your brain, the physical functioning, moment by moment of your brain creates your mind. It's not the other way around. And you really understand it when you look at people with serious brain issues.

In my book, it’s not this one, but in Change Your Brain, Change Your Life and Feel Better Fast, I talked about my passion story, which is about Andrew, my nephew. I started SPECT in 1991 and I got no end of grief from my colleagues, calling me all sorts of bad names, because I'm a psychiatrist and psychiatrists don't look at the brain. But I'm not big on authority. If you talk to my parents, they would say I was a pain in the neck when I was a teenager, because I'd always go, “Why?” “How do you know?” “Well, that's dumb.” [chuckles]

And so, I started imaging and then I got all this criticism and I fought back, but I was pretty anxious about the whole thing for the first four years. And then one day, I got a call from my sister-in-law, Sherry, who told me my nine-year-old nephew Andrew, who was also my godson, attacked a little girl on the baseball field for no particular reason, like out of the blue, and I'm horrified. I'm like, “What else is going on with him?” And she said, “Danny, he's different. He's mean. He doesn't smile anymore. I went into his room today and found two pictures he had drawn. One of them, he was hanging from a tree in a suicide attempt. The other one, he was shooting other children.” And I'm horrified. In retrospect, he was Columbine or Aurora or Sandy Hook waiting to happen. But I'd already scanned hundreds of people and I'm like, “He's got a temporal lobe problem,” because when you damage one or both of your temporal lobes, you can get these dark, evil, awful thoughts.

And so, the next day they came from Southern California to Northern California, where I was living at the time. And I'm like, “Buddy, what's going on?” And he said, “Uncle Danny, I don't know. I'm mad all the time.” I'm like, “Is anybody hurting you?” He said, “No.” “Is anybody teasing you?” “No.” “Is anybody touching you in places they shouldn't be touching you?” “No.” And when I scanned him, we found he had a cyst the size of a golf ball occupying the space of his left temporal lobe. And when we took it out, his behavior completely went back to normal. It was at that moment, I lost my anxiety. I just didn't care anymore if you didn't like me. If you don't look, you don't know. Stop lying. Let's change our mental health as practice because it's brain health. It's not mental health.

Melanie Avalon: I love this so much. Yeah, the amount of shame that surrounds mental health diagnostics and labels is just, it's insane. Any other illness or thing, malady suffered by the body, it's expected that you take some sort of medicine or do some sort of route to fix it. And there's not—I mean there might be with some lifestyle-type things, some sense of responsibility, but it seems like with mental health conditions, that there is just this shame surrounding it. So, I love that you are literally opening our eyes to what might be going on.

To that point, these brain scans, how do they actually work? I got one done, listeners. You take a radioactive isotope. Isotope, does it that have to do with energy and blood flow in the brain? How can we see where the issues might be?

Dr. Daniel Amen: SPECT is a nuclear medicine study. They've been doing nuclear medicine procedures for 50 years or longer. It looks at blood flow and activity, looks at how your brain works. What we do is, we take a very small dose of a radioisotope, we use one called technetium, actually discovered by Madame Curie, and combine it with a substance that’s easily taken up by cells in the brain. Ceretec is the medicine we use. So, we make Ceretec and then we inject it. The reason we do that and they're like, “Oh my God, radioisotope.” Yes, it's about the same radiation as a CAT scan that is done millions of times every year in the United States. So, standard medical procedure. You don't do it for fun, although I have to-- full disclosure, when I met my wife two and a half weeks later, I scanned her because I wanted to know if I really wanted--

Melanie Avalon: [chuckles] Make sure you're compatible. [chuckles]

Dr. Daniel Amen: Yeah. And then if you date any of my children, I have four children, you get scanned. If I think you're going to stick around-- One of them, she went through a guy every month. So, I'm like, “You got to stick. But once Kyle stuck, you got to get scanned.” It's not to weed people in or out. It's just if your brain’s not right, you have to be willing to do the right thing—

Melanie Avalon: Address it.

Dr. Daniel Amen: To fix it. Yeah. Anyways, so we inject the medicine. It goes and locks in your brain in about two minutes. And then, you lay on a table and the camera takes a picture of where the medicine went. Because it's a nuclear procedure-- SPECT actually stands for single-photon emission-computed tomography, which basically means we're getting this 3D look at your brain and the photons act like little pieces of light, where we can track where they went in your brain and we get about 10 million counts-- so, your scan is made up of 10 million counts or 10 million times the photons hit the crystals in the camera. And then, we process it and get this beautiful 3D look at your brain and it basically tells us three things.

Good activity, areas with good activity and you have many areas with too little activity, and you have a couple, and areas where it's too much. For yours, your emotional brain was pretty busy, but it looked like there was some toxicity in your brain. It's a little bumpier than we would want it to be for your age. And the little holes, you don't have holes in your brain, but that just means lower blood flow. And that could go with heavy metal toxicity, it could go with Lyme disease. But when I first started to see this pattern, I'm like, “So why has she been poisoned?” It could be drugs or alcohol, and that's why I'm not a fan of drugs or alcohol for brain health. But a lot of times, it happened for my patients that weren't drinking or weren't smoking pot and I'm like, “Oh, it could be mold exposure. It could be Lyme or other infections.” I'm sort of excited to see what COVID does to brain. And working up and treating toxins and infections has just been so helpful for many of my patients.

Melanie Avalon: Yeah. For listeners, the show notes for today's episode will be at melanieavalon.com/brainscan. I'll actually put there the picture of my brain scan so you can see the type of imaging that you can get from this technology. When I was emailing your assistants, I emailed them and I said I thought that it would probably show scalloping and decrease perfusion on surface SPECT due to a history of mercury toxicity, carbon monoxide, and black mold poisoning. Is that something that you see evidence of in this picture?

Dr. Daniel Amen: Tell me about the carbon monoxide.

Melanie Avalon: I was living in an apartment-- really, I started feeling unwell after I graduated from USC and I moved into an apartment that when I moved out of two years later, I realized that every time I was using the oven at night, it was releasing carbon monoxide poisoning. I finally had the gas company come when I was moving out, and they're like, “Oh, this should not have been on, like ever.” And there was also black mold everywhere. I realized when I moved my bed that there was black mold underneath it. And then, I since then got mercury toxicity, my blood levels were over 30, which is not good. So, this brain has been through a lot. I also dropped a lava lamp on my head. [laughs]

Dr. Daniel Amen: I saw that, which was crazy and all of those things stock. So, when I talked about stocked stresses, that's exactly what I meant.

Melanie Avalon: Yeah. I have a really quick specific question. For listeners, who are looking at the show notes, the lower right image of the brain where it does look like there's a hole, is that what you were referring to? Is that an actual hole?

Dr. Daniel Amen: It's low blood flow. You don't have any holes in your brain. Yeah, we're looking at function, not structure. And what the hole indicates is decreased blood flow in that area. You actually have a beautiful brain. The outside of your brain is beautiful. There is not anything you cannot do because of your brain. But it's not as healthy as it could be, and the scalloping, the bumpiness, yes, you see it in the bottom right image the best and those holes indicate, for your age, that's not a good thing. So, we need to fix it, and that's the exciting piece.

Brain health is basically three things. Brain envy, you got to care about it. Avoid anything that hurts it. It's already been assaulted. To have a discussion with a psychiatrist and you're talking about black mold, most psychiatrists would roll their eyes because they have no idea what that means. Carbon monoxide, they’d go, “Right,” and mercury. Most psychiatrists never ask about these things. If you tell them, they diminish you as if you're histrionic. When those things are real, they're additive and they're important to heal.

Melanie Avalon: Actually, to that point, I remember I was auditioning different therapists. I met with one therapist and I was talking about some symptoms that I would have, like physical symptoms of things--especially you talk in your book about all the different factors - hormones, mold, toxicity, all these things. I was talking about physical symptoms I was experiencing and he was like, “Well, you know that actually all lines up with anxiety, so maybe it's just anxiety.” And I was like, “This is not the correct approach to take here.” Anxiety for me is not the root cause. I want to figure out what is the-- in the symptom cluster, what is it speaking to? So, yeah, it's nice to find people that do take the whole approach.

You were speaking about blood flow. You do talk in the book about how the number one strategy for optimizing a healthy brain and mind is supporting blood flow. So, for listeners, just so they can have some really practical takeaways, what are some of the best ways to do that? I find it really fascinating that caffeine and alcohol, do they both reduce blood flow, even though one’s a depressant and one’s a stimulant, you think they would have opposite effects, but how does that pan out?

Dr. Daniel Amen: Alcohol is a depressant, so it is going to decrease blood flow. Caffeine is a vasoconstrictor, so that means it constricts blood flow, and you don't want that. Because if it constricts blood flow, it's prematurely aging the brain. So, avoid things that hurt it, do things that help it. Do you want to avoid anything that damages blood flow? Caffeine, alcohol, nicotine, not exercising, hypertension, and any form of vascular or heart disease. And so, the guys that are listening, erectile dysfunction is a vascular problem. So, if you have blood flow problems anywhere, it likely means they're everywhere. So, the things that increase blood flow - exercise, ginkgo, certain foods like beets, oregano, cayenne pepper, rosemary. And so, you want to avoid the things that hurt it and do things that help it.

Melanie Avalon: Actually, speaking to that, nutraceuticals like ginkgo and stuff like that, what is your approach to pharmaceuticals versus nutraceuticals? Are some conditions more suited to starting with pharmaceuticals and that are some conditions more appropriate to start with nutraceuticals? And by nutraceuticals, I mean “natural supplements,” ginkgo, curcumin, things like that compared to, say, an SSRI.

Dr. Daniel Amen: I tend to start with natural treatments. It's the bias I have, unless someone has schizophrenia or bipolar disorder, or they're so depressed, they're thinking they might kill themselves. Other than that, I pretty much start with natural supplements, because I found them to be very effective and I'm very good at using them. In The End of Mental Illness, there's a whole chapter called Mind Medicines versus Nutraceuticals. There are critics because they haven't read the science. A lot of critics go, “There's no science.” Well, in that one chapter, there's 286 scientific references.

For example, I'm a huge fan of saffron, and there are 21 randomized controlled trials showing that saffron is an effective treatment for depression, as effective as Prozac, Zoloft, Effexor, imipramine, and so on. So, I'm really excited about using supplements to balance your brain. Because once you start an antidepressant like Zoloft, it’s just they’re hard as heck to stop. So, why would I start something that's going to change your brain to need it in order for you to feel normal?

Now, if I do the natural things and they don't work, well then, I’ll absolutely use the medications because I don't want you suffering. But we're so quick to go for the pills, because it's easy. And then, we're not doing the nutrition and the skills, which is a little bit hard. It's not really hard, it's hard being sick. It's just a different way of looking at it.

Melanie Avalon: Yeah, some follow-up questions to that, especially with the SSRIs. What are your current thoughts on the mechanism of action behind the SSRIs? I know now there's like pretty much a whole reevaluation of are they even affecting serotonin levels? What are your thoughts on that?

Dr. Daniel Amen: Well, the theory is they block the reuptake of serotonin, which means there's more around to work, but it's more complicated than that. What I see is they decrease brain function. So, you're starting with decreased brain function-- so, if you had a really busy brain, then, oh, they'd be really good because they'd sort of calm-- quiet it down. My wife has a book coming out in January called The Relentless Courage of a Scared Child. And she talks about getting cancer when she's 25 and getting very depressed where she felt passively suicidal. And the doctor put her on Prozac, which completely disinhibited her. And she said, “I wasn't so depressed, but I didn't really feel anything. And I started making really bad decisions.” And when I looked at her brain, that's the worst medication for her because she already had sleepy frontal lobes and it dropped them further, which is likely to disinhibit someone which is in fact what it did for her.

Melanie Avalon: Wow, you really need to get your brain scanned before you go on, before you decide what route to take. Speaking to about the natural supplements and people say that there's not science, for example, you were talking in your book about, I did see that you mentioned saffron a lot, I hadn't really researched saffron much. But you mentioned in the sleep section about how ginger had melatonin and so, I started researching ginger. There were so many trials on ginger and the direct mechanism of action for how-- I don't want to say it functions like a drug, but how it's changing genetic potential and what it's actually doing on the receptor level. And I just think there's a disservice on our world that these natural compounds aren't taken with the credibility that I think that they can quite often serve.

For a person who is struggling with some sort of mental health issue that they would like to get to the root of, they can go to your clinics and get the scan. What would it look like if they get the scan afterwards, like the treatment protocol? Is it addressing the different lifestyle factors? What does that look like?

Dr. Daniel Amen: So, it's actually we go through those four circles. There's gonna be biological things we want you to do. One of my patients, “You need to stop drinking, because it's a problem.” That's when his marriage has the most problems, when he's drinking. We have to avoid things that hurt the biology of the brain. Bad diet. So, diet, supplements, medicine if needed, exercise. Psychologically, we'll teach you how to kill the ANTs, the automatic negative thoughts. How to get your thinking, not positive, I'm not a fan of positive thinking. I'm a fan of accurate thinking. And socially, if we need to work on your relationships, we'll certainly do that. And then, we talk about meaning and purpose for the spiritual circle.

So, you end up, here's what's going on in these four circles, here is how to get well, and then we work it. In The End of Mental Illness, most of the book is actually, do you want to keep your brain healthy or rescue it if it's headed to the dark place? We have to prevent or treat the 11 major risk factors that steal your mind. For you, we have low blood flow on the scan and we also have evidence of toxins and infections and gut health issues. So, in that Bright Minds mnemonic, we'd go through each one and go, “Okay, what are your vulnerabilities and how are we going to get this part of you better?”

Melanie Avalon: I do wonder what my scan would have looked like if I had done it when I was at the height of the mercury toxicity and all of that stuff. Since then, I did a lot of actually pharmaceutical chelation which was taxing on my body but I got my mercury down. I do sauna every single night, I have an infrared sauna. I do intermittent fasting every single day. My favorite thing in the world is cold therapy. I want to move to Alaska for that. So, always trying to just tackle all of the things. Really random curveball question, what are your thoughts on psychedelics-- microdosing psychedelics?

Dr. Daniel Amen: I think that's insane. I'm really not happy about—so, the big trends in psychiatry, marijuana and CBD for everyone, and psychedelics.

Melanie Avalon: What are your thoughts on CBD?

Dr. Daniel Amen: I think it's the Wild West. Did you see the American Cancer Society came out this week and said you shouldn't drink at all?

Melanie Avalon: No, really?

Dr. Daniel Amen: Yeah, because it's a risk factor for cancer. But for years, people have been saying alcohol is a health food, and it's complete crap. I see it on the scans. It's like, “No, it's not a health food.” We're going down that same road with marijuana is innocuous. Vice President Biden got shamed by Senator Cory Booker during a debate when Biden said, “I don't think the science is clear.” And Booker said, “Are you high?” And the science is clearly not clear, it increases your risk of psychosis 450% if you smoke marijuana as an adolescent. It increases the risk of anxiety, depression, and suicide in your 20s if you smoked as a teen. So yeah, I'm not a fan.

And CBD has been unleashed on to the world with virtually no study. I'm pretty irritated about that. And now, the big movement is on microdosing psychedelics. And I'm like, “Are you really going to do that before you take saffron?” Or, “Before you exercise or before you change your diet?” It's sexy, we get well by doing these things. I've just seen too much hurt from the use of these things that it's not first on the list. Maybe it's 20th on the list. It's certainly not first.

Melanie Avalon: Yeah, my thoughts in the matter just because my audience will be like, “Why didn't you say anything?” So, I am a fan of wine, but only like Dry Farm Wines, for example, so wine that's tested to be low sugar, pesticide free, low mold, no additives. Literally, like the way wine was before conventional life. I think the majority of wines today is very toxic. And then CBD, I think it can be very therapeutic for a lot of people but the fact that there's just no regulation and now it's just everywhere, I'm like, “This is just so terrible.” So, you need to definitely do your vetting.

I want to be really respectful of your time. This has been so incredible, so amazing. I will just refer listeners to your book. It has everything you could ever want to know. The last question I actually ask every single guest on this podcast and it's just because I really think mindset is so important for overall well-being and that is, what is something that you're grateful for?

Dr. Daniel Amen: Today, I'm grateful for you and you allowing me to share the message I have with your audience. I'm grateful during the pandemic, my family got closer to each other rather than further apart.

Melanie Avalon: I love that. That's so beautiful. Yeah, actually, one thing I wanted to bring up really quick in your book was something that really stuck with me. I'm paraphrasing, but you said something about the fastest way to get healthy was to spend time with healthy people or with people living the type of lifestyle of health that you want. I do think that is a huge issue right now for people with the whole situation, so I think it's wonderful that we can still find ways to connect with each other and maybe come out stronger on the other side of this, is find what's important to us and connect with that. Thank you so much. This has been so wonderful. Is there any links that you'd like to share with our audience?

Dr. Daniel Amen: Well, people can get The End of Mental Illness anywhere great books are sold, Barnes & Noble, Amazon. If they want to learn more about the clinics and our work, they can go to amenclinics.com. Amen, like the last word in a prayer, clinics.com. And if they want to know, it's like, “I can’t afford to go get a scan or I'm not where one of the clinics,” we have a test online, brainhealthassessment.com. They'll find out which of the 16 brain types they have and what supplements might help them.

Melanie Avalon: Fantastic. Thank you so much. That is such a wonderful resource. I will put links to all of that in the show notes. The show notes will be at melanieavalon.com/brainscan. Thank you, Dr. Amen, this has been so wonderful.

Dr. Daniel Amen: Thanks, Melanie. Take care.

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